Afferent projection patterns in the auditory brainstem in normal and congenitally deaf white cats

Microstructural Changes in the Brainstem Auditory Pathway in Children With Hearing Loss

OBJECTIVE

To assess the utility of diffusion tensor imaging of the auditory pathway in children with sensorineural hearing loss (SNHL).

STUDY DESIGN

Retrospective cohort study.

SETTING

A single academic tertiary children's hospital.

PATIENTS

Sixteen pediatric patients with bilateral SNHL of at least moderate severity in the poorer ear (eight male; mean age, 5.3 ± 4.9 yrs). Controls consisted of age- and sex-matched children with normal hearing who were imaged for nonotologic, non-neurologic medical concerns and found to have normal magnetic resonance imaging (MRI).

INTERVENTIONS

Three Tesla MRI scanners were used for diffusion tensor imaging.

MAIN OUTCOME MEASURES

Quantitative diffusion tensor metrics were extracted from the superior olivary nucleus (SON), inferior colliculus (IC), and ipsilateral fiber tracts between the SON and IC delineated by tractography.

RESULTS

We identified differences in fractional anisotropy of the SON between the SNHL cohort and controls (0.377 ± 0.056 vs. 0.422 ± 0.052; p = 0.009), but not in the IC. There were no differences in the mean diffusivity (MD) values in the IC and SON. Among younger children (≤5 yrs), MD was decreased in the SNHL cohort compared with controls in the IC (0.918 ± 0.051 vs. 1.120 ± 0.142; p < 0.001). However, among older children (>5 yrs), there were no differences in MD (1.124 ± 0.198 vs. 0.997 ± 0.103; p = 0.119). There were no differences in MD or fractional anisotropy in the white matter fibers of the IC-SON tract.

CONCLUSIONS

Our results suggest abnormal neural tracts along the central auditory pathway among children with SNHL. Longitudinal studies should assess the prognostic value of these MRI-based findings for assessing long-term outcomes and determining intervention efficacy.

Changes in Speech-Related Brain Activity During Adaptation to Electro-Acoustic Hearing

Objectives: Hearing improves significantly with bimodal provision, i.e., a cochlear implant (CI) at one ear and a hearing aid (HA) at the other, but performance shows a high degree of variability resulting in substantial uncertainty about the performance that can be expected by the individual CI user. The objective of this study was to explore how auditory event-related potentials (AERPs) of bimodal listeners in response to spoken words approximate the electrophysiological response of normal hearing (NH) listeners. Study Design: Explorative prospective analysis during the first 6 months of bimodal listening using a within-subject repeated measures design. Setting: Academic tertiary care center. Participants: Twenty-seven adult participants with bilateral sensorineural hearing loss who received a HiRes 90K CI and continued use of a HA at the non-implanted ear. Age-matched NH listeners served as controls. Intervention: Cochlear implantation. Main Outcome Measures: Obligatory auditory evoked potentials N1 and P2, and the event-related N2 potential in response to monosyllabic words and their reversed sound traces before, as well as 3 and 6 months post-implantation. The task required word/non-word classification. Stimuli were presented within speech-modulated noise. Loudness of word/non-word signals was adjusted individually to achieve the same intelligibility across groups and assessments. Results: Intelligibility improved significantly with bimodal hearing, and the N1-P2 response approximated the morphology seen in NH with enhanced and earlier responses to the words compared to their reversals. For bimodal listeners, a prominent negative deflection was present between 370 and 570 ms post stimulus onset (N2), irrespective of stimulus type. This was absent for NH controls; hence, this response did not approximate the NH response during the study interval. N2 source localization evidenced extended activation of general cognitive areas in frontal and prefrontal brain areas in the CI group. Conclusions: Prolonged and spatially extended processing in bimodal CI users suggests employment of additional auditory-cognitive mechanisms during speech processing. This does not reduce within 6 months of bimodal experience and may be a correlate of the enhanced listening effort described by CI listeners.

Neuronal Development of Hearing and Language: Cochlear Implants and Critical Periods

The modern cochlear implant (CI) is the most successful neural prosthesis developed to date. CIs provide hearing to the profoundly hearing impaired and allow the acquisition of spoken language in children born deaf. Results from studies enabled by the CI have provided new insights into ( a) minimal representations at the periphery for speech reception, ( b) brain mechanisms for decoding speech presented in quiet and in acoustically adverse conditions, ( c) the developmental neuroscience of language and hearing, and ( d) the mechanisms and time courses of intramodal and cross-modal plasticity. Additionally, the results have underscored the interconnectedness of brain functions and the importance of top-down processes in perception and learning. The findings are described in this review with emphasis on the developing brain and the acquisition of hearing and spoken language.

Hearing disorders in cats

Practical relevance: Auditory function is a sense that is central to life for cats - being important in situational awareness of potential predators, pursuit of prey, and for communication with conspecifics, humans and other species. Deafness in cats is most frequently the result of a genetic disorder, strongly associated with white fur and blue eyes, but may also result from acquired causes such as advancing age, ototoxic drugs, infection, environmental noise and physical trauma. Deafness can be sensorineural, where there is loss of cochlear hair cells, or conductive, where sound is muffled on its way to the inner ear. Clinical challenges: Establishing whether a cat is deaf can be difficult as behavioral testing of hearing is subjective and does not reliably detect unilateral deafness. Brainstem auditory evoked response testing is an objective measure but is limited in its availability. Currently, sensorineural deafness is irreversible because no treatments are available to restore lost hair cells. Conductive hearing loss can usually be treated, although full hearing recovery following otitis media may take weeks as the body clears the middle ear of debris. Evidence base: The author draws on the published literature and his extensive research on clinical aspects and molecular genetics of deafness, principally in companion animals, to review types and forms of deafness in cats. He also discusses current diagnostic approaches and provides brief advice for managing cats with hearing loss.

Monaural Congenital Deafness Affects Aural Dominance and Degrades Binaural Processing

Cortical development extensively depends on sensory experience. Effects of congenital monaural and binaural deafness on cortical aural dominance and representation of binaural cues were investigated in the present study. We used an animal model that precisely mimics the clinical scenario of unilateral cochlear implantation in an individual with single-sided congenital deafness. Multiunit responses in cortical field A1 to cochlear implant stimulation were studied in normal-hearing cats, bilaterally congenitally deaf cats (CDCs), and unilaterally deaf cats (uCDCs). Binaural deafness reduced cortical responsiveness and decreased response thresholds and dynamic range. In contrast to CDCs, in uCDCs, cortical responsiveness was not reduced, but hemispheric-specific reorganization of aural dominance and binaural interactions were observed. Deafness led to a substantial drop in binaural facilitation in CDCs and uCDCs, demonstrating the inevitable role of experience for a binaural benefit. Sensitivity to interaural time differences was more reduced in uCDCs than in CDCs, particularly at the hemisphere ipsilateral to the hearing ear. Compared with binaural deafness, unilateral hearing prevented nonspecific reduction in cortical responsiveness, but extensively reorganized aural dominance and binaural responses. The deaf ear remained coupled with the cortex in uCDCs, demonstrating a significant difference to deprivation amblyopia in the visual system.

How does visual language affect crossmodal plasticity and cochlear implant success?

Cochlear implants (CI) are the most successful intervention for ameliorating hearing loss in severely or profoundly deaf children. Despite this, educational performance in children with CI continues to lag behind their hearing peers. From animal models and human neuroimaging studies it has been proposed the integrative functions of auditory cortex are compromised by crossmodal plasticity. This has been argued to result partly from the use of a visual language. Here we argue that 'cochlear implant sensitive periods' comprise both auditory and language sensitive periods, and thus cannot be fully described with animal models. Despite prevailing assumptions, there is no evidence to link the use of a visual language to poorer CI outcome. Crossmodal reorganisation of auditory cortex occurs regardless of compensatory strategies, such as sign language, used by the deaf person. In contrast, language deprivation during early sensitive periods has been repeatedly linked to poor language outcomes. Language sensitive periods have largely been ignored when considering variation in CI outcome, leading to ill-founded recommendations concerning visual language in CI habilitation.

Functional and structural changes throughout the auditory system following congenital and early-onset deafness: implications for hearing restoration

The absence of auditory input, particularly during development, causes widespread changes in the structure and function of the auditory system, extending from peripheral structures into auditory cortex. In humans, the consequences of these changes are far-reaching and often include detriments to language acquisition, and associated psychosocial issues. Much of what is currently known about the nature of deafness-related changes to auditory structures comes from studies of congenitally deaf or early-deafened animal models. Fortunately, the mammalian auditory system shows a high degree of preservation among species, allowing for generalization from these models to the human auditory system. This review begins with a comparison of common methods used to obtain deaf animal models, highlighting the specific advantages and anatomical consequences of each. Some consideration is also given to the effectiveness of methods used to measure hearing loss during and following deafening procedures. The structural and functional consequences of congenital and early-onset deafness have been examined across a variety of mammals. This review attempts to summarize these changes, which often involve alteration of hair cells and supporting cells in the cochleae, and anatomical and physiological changes that extend through subcortical structures and into cortex. The nature of these changes is discussed, and the impacts to neural processing are addressed. Finally, long-term changes in cortical structures are discussed, with a focus on the presence or absence of cross-modal plasticity. In addition to being of interest to our understanding of multisensory processing, these changes also have important implications for the use of assistive devices such as cochlear implants.

Development of brainstem-evoked responses in congenital auditory deprivation

To compare the development of the auditory system in hearing and completely acoustically deprived animals, naive congenitally deaf white cats (CDCs) and hearing controls (HCs) were investigated at different developmental stages from birth till adulthood. The CDCs had no hearing experience before the acute experiment. In both groups of animals, responses to cochlear implant stimulation were acutely assessed. Electrically evoked auditory brainstem responses (E-ABRs) were recorded with monopolar stimulation at different current levels. CDCs demonstrated extensive development of E-ABRs, from first signs of responses at postnatal (p.n.) day 3 through appearance of all waves of brainstem response at day 8 p.n. to mature responses around day 90 p.n.. Wave I of E-ABRs could not be distinguished from the artifact in majority of CDCs, whereas in HCs, it was clearly separated from the stimulus artifact. Waves II, III, and IV demonstrated higher thresholds in CDCs, whereas this difference was not found for wave V. Amplitudes of wave III were significantly higher in HCs, whereas wave V amplitudes were significantly higher in CDCs. No differences in latencies were observed between the animal groups. These data demonstrate significant postnatal subcortical development in absence of hearing, and also divergent effects of deafness on early waves II–IV and wave V of the E-ABR.

Developmental neuroplasticity after cochlear implantation

Cortical development is dependent on stimulus-driven learning. The absence of sensory input from birth, as occurs in congenital deafness, affects normal growth and connectivity needed to form a functional sensory system, resulting in deficits in oral language learning. Cochlear implants bypass cochlear damage by directly stimulating the auditory nerve and brain, making it possible to avoid many of the deleterious effects of sensory deprivation. Congenitally deaf animals and children who receive implants provide a platform to examine the characteristics of cortical plasticity in the auditory system. In this review, we discuss the existence of time limits for, and mechanistic constraints on, sensitive periods for cochlear implantation and describe the effects of multimodal and cognitive reorganization that result from long-term auditory deprivation.

Synaptic morphology and the influence of auditory experience

The auditory experience is crucial for the normal development and maturation of brain structure and the maintenance of the auditory pathways. The specific aims of this review are (i) to provide a brief background of the synaptic morphology of the endbulb of Held in hearing and deaf animals; (ii) to argue the importance of this large synaptic ending in linking neural activity along ascending pathways to environmental acoustic events; (iii) to describe how the re-introduction of electrical activity changes this synapse; and (iv) to examine how changes at the endbulb synapse initiate trans-synaptic changes in ascending auditory projections to the superior olivary complex, the inferior complex, and the auditory cortex.

Use it or lose it? Lessons learned from the developing brains of children who are deaf and use cochlear implants to hear

In the present paper, we review what is currently known about the effects of deafness on the developing human auditory system and ask: Without use, does the immature auditory system lose the ability to normally function and mature? Any change to the structure or function of the auditory pathways resulting from a lack of activity will have important implications for future use through an auditory prosthesis such as a cochlear implant. Data to date show that deafness in children arrests and disrupts normal auditory development. Multiple changes to the auditory pathways occur during the period of deafness with the extent and type of change being dependent upon the age and stage of auditory development at onset of deafness, the cause or type of deafness, and the length of time the immature auditory pathways are left without significant input. Structural changes to the auditory nerve, brainstem, and cortex have been described in animal models of deafness as well in humans who are deaf. Functional changes in deaf auditory pathways have been evaluated by using a cochlear implant to stimulate the auditory nerve with electrical pulses. Studies of electrically evoked activity in the immature deaf auditory system have demonstrated that auditory brainstem development is arrested and that thalamo-cortical areas are vulnerable to being taken over by other competitive inputs (cross-modal plasticity). Indeed, enhanced peripheral sight and detection of visual movement in congenitally deaf cats and adults have been linked to activity in specific areas of what would normally be auditory cortex. Cochlear implants can stimulate developmental plasticity in the auditory brainstem even after many years of deafness in childhood but changes in the auditory cortex are limited, at least in part, by the degree of reorganization which occurred during the period of deafness. Consequently, we must identify hearing loss rapidly (i.e., at birth for congenital deficits) and provide cochlear implants to appropriate candidates as soon as possible. Doing so has facilitated auditory development in the thalamo-cortex and allowed children who are deaf to perceive and use spoken language.

[Early hearing experience and sensitive developmental periods]

This article reviews the studies on functional deficits in the auditory cortex of congenitally deaf animals. It compares their results with psychophysical and imaging data obtained from prelingually deaf humans. The studies demonstrate that the development of the auditory cortex is affected by the absence of hearing experience. In humans, the restoration of hearing after congenital deafness shows a sensitive period of 4 years, whereas even within this sensitive period cortical plasticity is already decreasing with increasing age. The reasons for the sensitive period are developmental changes of synaptic plasticity, developmentally modified synaptogenesis and synaptic pruning as well as changes in connectivity of the auditory cortex. Absence of top-down interactions from higher order auditory areas is another cardinal reason for the sensitive period. All these mechanisms contribute to the decreasing capacity for cortical plasticity during postnatal development. From the developmental and neurophysiological point of view, an early identification of hearing loss is an important prerequisite for effective therapy.

Connections and synaptic function in the posteroventral cochlear nucleus of deaf jerker mice

Mutations in the gene that encodes espins can cause deafness and vestibular disorders; mice that are homozygous for the autosomal recessive jerker mutation in the espin gene never hear. Extracellular injections of biocytin into the anteroventral cochlear nucleus (AVCN) revealed that although the cochlear nuclei are smaller in je/je mice, the topography in its innervation resembles that in wild-type mice. Auditory nerve fibers innervate narrow, topographically organized, "isofrequency" bands in deaf animals over the ages examined, P18-P70. The projection of tuberculoventral cells was topographic in je/je as in wild-type mice. Terminals of auditory nerve fibers in the multipolar cell area included both large and small endings, whereas in the octopus cell area they were exclusively small boutons in je/je as in wild-type mice, but end bulbs near the nerve root of je/je animals were smaller than in hearing animals. In whole-cell recordings from targets of auditory nerve fibers, octopus and T stellate cells, miniature excitatory postsynaptic currents (mEPSCs) had similar shapes as in +/+, indicating that the properties of AMPA receptors were not affected by the mutation. In je/je animals the frequency of spontaneous mEPSCs was elevated, and synaptic depression in responses to trains of shocks delivered at between 100 and 333 Hz was greater than in wild-type mice, indicating that the probability of neurotransmitter release was increased. The frequency of spontaneous mEPSCs and extent of synaptic depression were greater in octopus than in T stellate cells, in both wild-type and in je/je mice.

Cochlear implants: cortical plasticity in congenital deprivation

Congenital auditory deprivation (deafness) leads to a dysfunctional intrinsic cortical microcircuitry. This chapter reviews these deficits with a particular emphasis on layer-specific activity within the primary auditory cortex. Evidence for a delay in activation of supragranular layers and reduction in activity in infragranular layers is discussed. Such deficits indicate the incompetence of the primary auditory cortex to not only properly process thalamic input and generate output within the infragranular layers, but also incorporate top-down modulations from higher order auditory cortex into the processing within primary auditory cortex. Such deficits are the consequence of a misguided postnatal development. Maturation of primary auditory cortex in deaf animals shows evidence of a developmental delay and further alterations in gross synaptic currents, spread of activation, and morphology of local field potentials recorded at the cortical surface. Additionally, degenerative changes can be observed. When hearing is initiated early in life (e.g., by chronic cochlear-implant stimulation), many of these deficits are counterbalanced. However, plasticity of the auditory cortex decreases with increasing age, so that a sensitive period for plastic adaptation can be demonstrated within the second to sixth months of life in the deaf cat. Potential molecular mechanisms of the existence of sensitive period are discussed. Data from animal research may be compared to electroencephalographic data obtained from cochlear-implanted congenitally deaf children. After cochlear implantation in humans, three phases of plastic adaptation can be observed: a fast one, taking place within the first few weeks after implantation, showing no sensitive period; a slower one, taking place within the first months after implantation (a sensitive period up to 4 years of age); and possibly a third, and the longest one, related to increasing activation of higher order cortical areas.

Distribution of Fos-like immunoreactivity in the auditory pathway evoked by bipolar electrical brainstem stimulation

OBJECTIVE

The auditory brainstem implant (ABI) represents a new modality for the treatment of patients deafened as a result of complete excision of a bilateral VIIIth nerve tumor. However, little work has been done on the effect of the ABI on the mammalian auditory pathway. The aim of this study was to demonstrate the effect of the ABI using Fos-like immunoreactivity.

MATERIAL AND METHODS

A bipolar electrode was implanted in the dorsal cochlear nucleus of bilaterally deafened Sprague-Dawley rats, and electrical stimulation was presented at an intensity four times that of threshold.

RESULTS

Fos-like immunoreactivity was induced in the neurons of various auditory brainstem nuclei and observed in the low-to-middle frequency area. In the ipsilateral dorsal cochlear nucleus, ipsilateral posterior ventral cochlear nucleus and bilateral inferior colliculus, Fos-like immunoreactive neurons were observed as a distinct banding pattern.

CONCLUSIONS

This study showed that Fos-like immunoreactivity was observed in the restricted area of the primary brainstem auditory pathway with the appropriate tonotopicity. These results indicate that the ABI can provide auditory information suitable for speech recognition.

Postnatal Cortical Development in Congenital Auditory Deprivation

The study investigates early postnatal development of local field potentials (LFPs) in the primary auditory cortex of hearing and congenitally deaf cats. In hearing cats, LFPs elicited by electrical intracochlear stimulation demonstrated developmental changes in mid-latency range, including reductions in peak and onset latencies of individual waves and a maturation of their shape and latencies during the first 2 months of life. In long latency range (>80 ms), the P(1)/N(1) response appeared after the fourth week of life and further increased in amplitude and decreased in latency, reaching mature shapes between the fourth and sixth months after birth (p.n.). Cortical activated areas became increasingly smaller during the first 3 months of life, reaching mature values at the fourth month p.n. The layer-specific pattern of synaptic activity matured 4 months p.n. In congenitally deaf cats, the developmental pattern was different. The lowest cortical LFP thresholds were significantly smaller than in hearing controls, demonstrating a "hypersensitivity" to sensory inputs. The development of N(b) waves was delayed and altered and the long latency responses became smaller than in controls at the second and third months. The activated areas remained smaller than in controls until the third month, then they increased rapidly and exceeded the activated areas of age-matched controls. From the fourth month on, the activated areas decreased again and smaller synaptic currents were found in deaf cats than in controls. The presented data demonstrate that functional development of the auditory cortex critically depends on auditory experience.

Activity-dependent developmental plasticity of the auditory brain stem in children who use cochlear implants

OBJECTIVES

1) To determine if a period of early auditory deprivation influences neural activity patterns as revealed by human auditory brain stem potentials evoked by electrical stimulation from a cochlear implant. 2) To examine the potential for plasticity in the human auditory brain stem. Specifically, we asked if electrically evoked auditory potentials from the auditory nerve and brain stem in children show evidence of development as a result of implant use. 3) To assess whether a sensitive or critical period exists in auditory brain stem development. Specifically, is there an age of implantation after which there are no longer developmental changes in auditory brain stem activity as revealed by electrically evoked potentials?

DESIGN

The electrically evoked compound potential of the auditory nerve (ECAP) and the electrically evoked auditory brain stem response (EABR) were recorded repeatedly during the first year of implant use in each of 50 children. The children all had pre- or peri-lingual onset of severe to profound sensorineural hearing loss and received their implants at ages ranging from 12 mo to 17 yr. All children received Nucleus cochlear implant devices. All children were in therapy and in school programs that emphasized listening and required the children to wear their implants consistently.

RESULTS

Initial stimulation from the cochlear implant evoked clear responses from the auditory nerve and auditory brain stem in most children. There was no correlation between minimum latency, maximum amplitude, or slope of amplitude growth of initial responses with age at implantation for ECAP eN1, EABR eIII and eV components (p > 0.05). During the first year of implant use, minimum latency of these waves significantly decreased (p < 0.01, p < 0.0001, p < 0.0001, respectively). Neural conduction time, measured using the interwave latency of ECAP eN1-EABR eIII for lower brain stem and EABR eIII-eV for upper brain stem, decreased during the period of 6 to 12 mo of cochlear implant use (p < 0.01 (lower), p < 0.0001(upper)). The ECAP wave eN1 and the EABR wave eV showed significant increases in amplitude during time of implant use (p < 0.05 and p < 0.01, respectively). There were no correlations between the rate of interwave latency decrease and the rate of amplitude increases and the age at which children underwent implantation (p < 0.05).

CONCLUSIONS

Activity in the auditory pathways to the level of the midbrain can be evoked by acute stimulation from a cochlear implant. EABR measures are not influenced by any period of auditory deprivation. Auditory development proceeds once the implant is activated and involves improvements in neural conduction velocity and neural synchrony. Underlying mechanisms likely include improvements in synaptic efficacy and possibly increased myelination. The developmental plasticity that we have shown in the human auditory brain stem does not appear from EABR data to be limited by a critical period during childhood.

A morphometric analysis of auditory brain regions in congenitally deaf adults

We investigated whether variation in auditory experience in humans during development alters the macroscopic neuroanatomy of primary or auditory association cortices. Volumetric analyses were based on MRI data from 25 congenitally deaf subjects and 25 hearing subjects, all right-handed. The groups were matched for gender and age. Gray and white matter volumes were determined for the temporal lobe, superior temporal gyrus, Heschl's gyrus (HG), and the planum temporale. Deaf and hearing subjects did not differ in the total volume or the gray matter volume of HG, which suggests that auditory deafferentation does not lead to cell loss within primary auditory cortex in humans. However, deaf subjects had significantly larger gray matter-white matter ratios than hearing subjects in HG, with deaf subjects exhibiting significantly less white matter in both left and right HG. Deaf subjects also had higher gray matter-white matter ratios in the rest of the superior temporal gyrus, but this pattern was not observed for the temporal lobe as a whole. These findings suggest that auditory deprivation from birth results in less myelination and/or fewer fibers projecting to and from auditory cortices. Finally, the volumes of planum temporale and HG were significantly larger in the left hemisphere for both groups, suggesting that leftward asymmetries within "auditory" cortices do not arise from experience with auditory processing.

Temporal and spatial coding of periodicity information in the inferior colliculus of awake chinchilla (Chinchilla laniger)

Amplitude modulation responses and onset latencies of multi-unit recordings and evoked potentials were investigated in the central nucleus of inferior colliculus (ICC) in the awake chinchilla. Nine hundred and one recording sites with best frequencies between 60 and 30 kHz showed either phasic (18%), tonic (25%), or phasic-tonic (57%) responses. Of 554 sites tested for responses to modulation frequencies 73% were responsive and 57% showed clear preference for a narrow range of modulation frequencies. Well defined bandpass characteristics were found for 32% of rate modulation transfer functions (rate-MTFs) and 36% of synchronization MTFs (sync-MTFs). The highest best modulation frequency (BMF) of a bandpass rate-MTF was 600 Hz. Neurons with phasic responses to best-frequency tones showed strong phase coupling to modulation frequencies and were dominated by bandpass rate-MTFs and sync-MTFs. Most neurons with tonic responses showed bandpass tuning only for sync-MTFs. Both BMFs and onset latencies changed systematically across frequency-band laminae of the ICC. Low BMFs and long latencies were located medially and high BMFs and short latencies laterally. Latency distributions obtained with evoked potentials to clicks showed a similar gradient to the multi-unit data. These findings are in line with previous findings in different animals including humans and support the hypothesis that temporal processing results in a topographic arrangement orthogonal to the spectral processing axis, thus forming a second neural axis of the auditory system.

Electrode discrimination by early-deafened subjects using the cochlear limited multiple-electrode cochlear implant

OBJECTIVE

The aims of this study were to determine whether electrode discrimination by early-deafened subjects using the Cochlear Limited prosthesis varied at different locations on the electrode array, was influenced by the effects of auditory deprivation and experience with electric stimulation, and was related to speech perception.

DESIGN

Difference limens for electrode discrimination were measured in 16 early-deafened subjects at three positions on the array: electrodes 18 (apical), 14 (mid), and 8 (basal). Electrodes were stimulated using random variations in current level to minimize the influence of loudness cues. Assessed were correlations between the difference limens, subject variables related to auditory deprivation (age at onset of deafness, duration of deafness, and age at implantation) and auditory experience (duration of implant use and the total time period of auditory experience), and speech perception scores from two closed-set and two open-set tests.

RESULTS

The average difference limens across the three positions were less than two electrodes for 75% of subjects, with average limens between 2 and 6.5 electrodes for the remaining 25% of subjects. Significant differences across the three positions were found for 69% of subjects. The average limens and those at the basal position positively correlated with variables related to auditory deprivation, with larger limens for subjects implanted at a later age and with a longer duration of deafness. The average limens and those at the apical position negatively correlated with closed-set speech perception scores, with lower scores for subjects with larger limens, but not with open-set scores. Speech scores also negatively correlated with variables related to auditory deprivation.

CONCLUSIONS

These findings showed that early-deafened subjects were generally successful in electrode discrimination although performance varied across the array for over half the subjects. Discrimination performance was influenced by the effects of auditory deprivation, and both electrode discrimination and variables related to auditory deprivation influenced closed-set speech perception.

Congenital auditory deprivation reduces synaptic activity within the auditory cortex in a layer-specific manner

The present study investigates the functional deficits of naive auditory cortices in adult congenitally deaf cats. For this purpose, their auditory system was stimulated electrically using cochlear implants. Synaptic currents in cortical layers were revealed using current source density analyses. They were compared with synaptic currents found in electrically stimulated hearing cats. The naive auditory cortex showed significant deficits in synaptic activity in infragranular cortical layers. Furthermore, there was also a deficit of synaptic activities at longer latencies (>30 ms). The 'cortical column' was not activated in the well-defined sequence found in normal hearing cats. These results demonstrate functional deficits as a consequence of congenital auditory deprivation. Similar deficits are likely in congenitally deaf children.

Pitch estimation by early-deafened subjects using a multiple-electrode cochlear implant

Numerical estimates of pitch for stimulation of electrodes along the 22-electrode array of the Cochlear Limited cochlear implant were obtained from 18 subjects who became deaf very early in life. Examined were the relationships between subject differences in pitch estimation, subject variables related to auditory deprivation and experience, and speech-perception scores for closed-set monosyllabic words and open-set Bamford-Kowal-Bench (BKB) sentences. Reliability in the estimation procedure was examined by comparing subject performance in pitch estimation with that for loudness estimation for current levels between hearing threshold and comfortable listening level. For 56% of subjects, a tonotopic order of pitch percepts for electrodes on the array was found. A deviant but reliable order of pitch percepts was found for 22% of subjects, and essentially no pitch order was found for the remaining 22% of subjects. Subject differences in pitch estimation were significantly related to the duration of auditory deprivation prior to implantation, with the poorest performance for subjects who had a longer duration of deafness and a later age at implantation. Subjects with no tonotopic order of pitch percepts had the lowest scores for the BKB sentence test, but there were no differences across subjects for monosyllabic words. Performance in pitch estimation for electrodes did not appear to be related to performance in the estimation procedure, as all subjects were successful in loudness estimation for current level.

Recruitment of the auditory cortex in congenitally deaf cats by long-term cochlear electrostimulation

In congenitally deaf cats, the central auditory system is deprived of acoustic input because of degeneration of the organ of Corti before the onset of hearing. Primary auditory afferents survive and can be stimulated electrically. By means of an intracochlear implant and an accompanying sound processor, congenitally deaf kittens were exposed to sounds and conditioned to respond to tones. After months of exposure to meaningful stimuli, the cortical activity in chronically implanted cats produced field potentials of higher amplitudes, expanded in area, developed long latency responses indicative of intracortical information processing, and showed more synaptic efficacy than in naïve, unstimulated deaf cats. The activity established by auditory experience resembles activity in hearing animals.

A model for prelingual deafness, the congenitally deaf white cat--population statistics and degenerative changes

Cochlear implantation in congenitally deaf children leads to electrical stimulation of an entirely naive central auditory system. In this case, processes of central auditory maturation are induced by the electric stimuli. For the study of these processes the deaf white cat (DWC) appears to be an appropriate model. However, a knowledge of the basic data of these animals is necessary before such a model may be used. This paper presents these data and is one of a series of publications concerning congenital deafness in children and cochlear implantation. In our strain 72% of the animals are totally deaf as judged by the absence of any brain stem evoked potentials at click intensities up to 120 dB SPL peak equivalent. Primarily, there is a degeneration of the entire organ of Corti during the first postnatal weeks. An absence of acoustically evoked brain stem responses in the early postnatal weeks shows that DWCs probably never have any hearing experience. Months after the degeneration of the organ of Corti, the spiral ganglion starts to degenerate from the midportion of the cochlea. However, even in adult cats (2 years), a sufficient number of functionally intact auditory afferents remain, which are suitable for electrical cochlear stimulation.

Response of the primary auditory cortex to electrical stimulation of the auditory nerve in the congenitally deaf white cat

Neural activity plays an important role in the development and maintenance of sensory pathways. However, while there is considerable experience using cochlear implants in both congenitally deaf adults and children, little is known of the effects of a hearing loss on the development of the auditory cortex. In the present study, cortical evoked potentials, field potentials, and multi- and single-unit activity evoked by electrical stimulation of the auditory nerve were used to study the functional organisation of the auditory cortex in the adult congenitally deaf white cat. The absence of click-evoked auditory brainstem responses during the first weeks of life demonstrated that these animals had no auditory experience. Under barbiturate anaesthesia, cortical potentials could be recorded from the contralateral auditory cortex in response to bipolar electrical stimulation of the cochlea in spite of total auditory deprivation. Threshold, morphology and latency of the evoked potentials varied with the location of the recording electrode, with response latency varying from 10 to 20 ms. There was evidence of threshold shifts with site of the cochlear stimulation in accordance with the known cochleotopic organisation of AI. Thresholds also varied with the configuration of the stimulating electrodes in accordance with changes previously observed in normal hearing animals. Single-unit recordings exhibited properties similar to the evoked potentials. Increasing stimulus intensity resulted in an increase in spike rate and a decrease in latency to a minimum of approximately 8 ms, consistent with latencies recorded in AI of previously normal animals (Raggio and Schreiner, 1994). Single-unit thresholds also varied with the configuration of the stimulating electrodes. Strongly driven responses were followed by a suppression of spontaneous activity. Even at saturation intensities the degree of synchronisation was less than observed when recording from auditory brainstem nuclei. Taken together, in these auditory deprived animals basic response properties of the auditory cortex of the congenitally deaf white cat appear similar to those reported in normal hearing animals in response to electrical stimulation of the auditory nerve. In addition, it seems that the auditory cortex retains at least some rudimentary level of cochleotopic organisation.