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Schmidt FH, Hocke T, Zhang L, Großmann W, Mlynski R. Tone Decay Reconsidered: Preliminary Results of a Prospective Study in Hearing-Aid Users with Moderate to Severe Hearing Loss. J Clin Med 2024; 13:500. [PMID: 38256634 PMCID: PMC10816404 DOI: 10.3390/jcm13020500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 01/08/2024] [Accepted: 01/12/2024] [Indexed: 01/24/2024] Open
Abstract
Among hearing aid (HA) users, there is a considerable variability in word recognition scores (WRSs). This variability is most pronounced among individuals with moderately severe to severe hearing loss. The variability cannot be adequately explained by factors such as pure-tone audiogram, audiogram type or age. This prospective study was designed to investigate the relationship between tone decay (TD) and WRS in a group of HA users with corresponding pure-tone hearing loss. The study population included 22 patients with hearing loss between 50 and 80 dB HL. Aided WRS, unaided WRS and TD were assessed for both ears. TD was found to be frequency-dependent. TD and WRS were correlated, with up to R = -0.66. The TD test was revealed to be a feasible method for explaining variability in WRS among HA users with hearing loss below 80 dB. This may contribute to improved differential diagnostics. The TD test may thus offer a better understanding of the limitations of HA use in the context of cochlear implant candidacy assessment for HA users.
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Affiliation(s)
- Florian Herrmann Schmidt
- Department of Otorhinolaryngology, Head and Neck Surgery, ‘Otto Körner’, Rostock University Medical Center, Doberaner Strasse 137-139, 18057 Rostock, Germany; (L.Z.); (W.G.); (R.M.)
| | - Thomas Hocke
- Cochlear Deutschland GmbH & Co. KG, Karl-Wiechert-Allee 76, 30625 Hannover, Germany;
| | - Lichun Zhang
- Department of Otorhinolaryngology, Head and Neck Surgery, ‘Otto Körner’, Rostock University Medical Center, Doberaner Strasse 137-139, 18057 Rostock, Germany; (L.Z.); (W.G.); (R.M.)
| | - Wilma Großmann
- Department of Otorhinolaryngology, Head and Neck Surgery, ‘Otto Körner’, Rostock University Medical Center, Doberaner Strasse 137-139, 18057 Rostock, Germany; (L.Z.); (W.G.); (R.M.)
| | - Robert Mlynski
- Department of Otorhinolaryngology, Head and Neck Surgery, ‘Otto Körner’, Rostock University Medical Center, Doberaner Strasse 137-139, 18057 Rostock, Germany; (L.Z.); (W.G.); (R.M.)
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Ford CL, Riggs WJ, Quigley T, Keifer OP, Whitton JP, Valayannopoulos V. The natural history, clinical outcomes, and genotype-phenotype relationship of otoferlin-related hearing loss: a systematic, quantitative literature review. Hum Genet 2023; 142:1429-1449. [PMID: 37679651 PMCID: PMC10511631 DOI: 10.1007/s00439-023-02595-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 08/09/2023] [Indexed: 09/09/2023]
Abstract
Congenital hearing loss affects one in 500 newborns. Sequence variations in OTOF, which encodes the calcium-binding protein otoferlin, are responsible for 1-8% of congenital, nonsyndromic hearing loss and are the leading cause of auditory neuropathy spectrum disorders. The natural history of otoferlin-related hearing loss, the relationship between OTOF genotype and hearing loss phenotype, and the outcomes of clinical practices in patients with this genetic disorder are incompletely understood because most analyses have reported on small numbers of cases with homogeneous OTOF genotypes. Here, we present the first systematic, quantitative literature review of otoferlin-related hearing loss, which analyzes patient-specific data from 422 individuals across 61 publications. While most patients display a typical phenotype of severe-to-profound hearing loss with prelingual onset, 10-15% of patients display atypical phenotypes, including mild-to-moderate, progressive, and temperature-sensitive hearing loss. Patients' phenotypic presentations appear to depend on their specific genotypes. For example, non-truncating variants located in and immediately downstream of the C2E calcium-binding domain are more likely to produce atypical phenotypes. Additionally, the prevalence of certain sequence variants and their associated phenotypes varies between populations due to evolutionary founder effects. Our analyses also suggest otoacoustic emissions are less common in older patients and those with two truncating OTOF variants. Critically, our review has implications for the application and limitations of clinical practices, including newborn hearing screenings, hearing aid trials, cochlear implants, and upcoming gene therapy clinical trials. We conclude by discussing the limitations of available research and recommendations for future studies on this genetic cause of hearing loss.
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Rance G, Carew P, Winata L, Sale P, Delatycki M, Sly D. Auditory neuropathy in mice and humans with Friedreich ataxia. Ann Clin Transl Neurol 2023; 10:953-963. [PMID: 37060174 PMCID: PMC10270266 DOI: 10.1002/acn3.51777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 02/20/2023] [Accepted: 03/08/2023] [Indexed: 04/16/2023] Open
Abstract
OBJECTIVE Recent studies have found that human Friedreich ataxia patients have dysfunction of transmission in the auditory neural pathways. Here, we characterize hearing deficits in a mouse model of Friedreich ataxia and compare these to a clinical population. METHODS Sixteen mice with a C57BL/6 background were evaluated. Eight were YG8Pook/J animals (Friedreich ataxia phenotype) and eight wild-type mice served as controls. Auditory function was assessed between ages 6 and 12 months using otoacoustic emissions and auditory steady-state responses. At study end, motor deficit was assessed using Rotorod testing and inner ear tissue was examined. Thirty-seven individuals with Friedreich ataxia underwent auditory steady-state evoked potential assessment and response amplitudes were compared with functional hearing ability (speech perception-in-noise) and disease status was measured by the Friedreich Ataxia Rating Scale. RESULTS The YG8Pook/J mice showed anatomic and functional abnormality. While otoacoustic emission responses from the cochlear hair cells were mildly affected, auditory steady-state responses showed exaggerated amplitude reductions as the animals aged with Friedreich ataxia mice showing a 50-60% decrease compared to controls who showed only a 20-25% reduction (F(2,94) = 17.90, p < 0.00). Furthermore, the YG8Pook/J mice had fewer surviving spiral ganglion neurons, indicating greater degeneration of the auditory nerve. Neuronal density was 20-25% lower depending on cochlear region (F(1, 30) = 45.02, p < 0.001). In human participants, auditory steady-state response amplitudes were correlated with both Consonant-Nucleus-Consonant word scores and Friedreich Ataxia Rating Scale score. INTERPRETATION This study found degenerative changes in auditory structure and function in YG8Pook/J mice, indicating that auditory measures in these animals may provide a model for testing Friedreich ataxia treatments. In addition, auditory steady-state response findings in a clinical population suggested that these scalp-recorded potentials may serve as an objective biomarker for disease progress in affected individuals.
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Affiliation(s)
- Gary Rance
- Department of Audiology and Speech PathologyThe University of MelbourneMelbourneVictoriaAustralia
| | - Peter Carew
- Department of Audiology and Speech PathologyThe University of MelbourneMelbourneVictoriaAustralia
| | - Leon Winata
- Department of OtolaryngologyUniversity of MelbourneMelbourneVictoriaAustralia
| | - Phillip Sale
- Department of OtolaryngologyUniversity of MelbourneMelbourneVictoriaAustralia
| | - Martin Delatycki
- Victorian Clinical Genetics Services, Bruce Lefroy Centre for Genetic Health Research, Murdoch Children's Research InstituteMelbourneVictoriaAustralia
| | - David Sly
- Department of OtolaryngologyUniversity of MelbourneMelbourneVictoriaAustralia
- Ear Science Institute AustraliaPerthWestern AustraliaAustralia
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Forli F, Capobianco S, Berrettini S, Bruschini L, Romano S, Fogli A, Bertini V, Lazzerini F. Temperature-Sensitive Auditory Neuropathy: Report of a Novel Variant of OTOF Gene and Review of Current Literature. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:medicina59020352. [PMID: 36837553 PMCID: PMC9962730 DOI: 10.3390/medicina59020352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 02/08/2023] [Accepted: 02/10/2023] [Indexed: 02/16/2023]
Abstract
Background and objectives: Otoferlin is a multi-C2 domain protein implicated in neurotransmitter-containing vesicle release and replenishment of the cochlear inner hair cell (IHC) synapses. Mutations in the OTOF gene have been associated with two different clinical phenotypes: a prelingual severe-to-profound sensorineural hearing loss (ANSD-DFNB9); and the peculiar temperature-sensitive auditory neuropathy (TS-ANSD), characterized by a baseline mild-to-moderate hearing threshold that worsens to severe-to-profound when the body temperature rises that returns to a baseline a few hours after the temperature has fallen again. The latter clinical phenotype has been described only with a few OTOF variants with an autosomal recessive biallelic pattern of inheritance. Case report: A 7-year-old boy presented a picture compatible with TS-ANSD exacerbated by febrile states or physical exercise with mild-to-moderate hearing loss at low and medium frequencies and a decrease in speech discrimination that worsened with an unfavorable speech-to-noise ratio. Otoacoustic emissions (OAEs) were present whereas auditory brainstem responses (ABRs) evoked by a click or tone-burst were generally absent. No inner ear malformations were described from the CT scan or MRI. Next-generation sequencing (NGS) of the known deafness genes and multi-phasic bioinformatic analyses of the data detected in OTOF a c.2521G>A missense variant and the deletion of 7.4 Kb, which was confirmed by array-comparative genomic hybridization (array-CGH). The proband's parents, who were asymptomatic, were tested by Sanger sequencing and the father presented the c.2521G>A missense variant. Conclusions: The picture presented by the patient was compatible with OTOF-induced TS-ANSD. OTOF has been generally associated with an autosomal recessive biallelic pattern of inheritance; in this clinical report, two pathogenic variants never previously associated with TS-ANSD were described.
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Affiliation(s)
- Francesca Forli
- ENT, Audiology and Phoniatrics Unit, University of Pisa, 56124 Pisa, Italy
- Correspondence: ; Tel.: +39-050-997381
| | - Silvia Capobianco
- ENT, Audiology and Phoniatrics Unit, University of Pisa, 56124 Pisa, Italy
| | - Stefano Berrettini
- ENT, Audiology and Phoniatrics Unit, University of Pisa, 56124 Pisa, Italy
- Division of ENT Diseases, Karolinska Institutet, 171 77 Stockholm, Sweden
| | - Luca Bruschini
- ENT, Audiology and Phoniatrics Unit, University of Pisa, 56124 Pisa, Italy
| | - Silvia Romano
- Department of Medical and Oncological Area, Section of Medical Genetics, Azienda Ospedaliero Universitaria Pisana, 56124 Pisa, Italy
| | - Antonella Fogli
- Department of Laboratory Medicine, Section of Molecular Genetics, Azienda Ospedaliero Universitaria Pisana, 56124 Pisa, Italy
| | - Veronica Bertini
- Department of Laboratory Medicine, Section of Cytogenetics, Azienda Ospedaliero Universitaria Pisana, 56124 Pisa, Italy
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Saidia AR, Ruel J, Bahloul A, Chaix B, Venail F, Wang J. Current Advances in Gene Therapies of Genetic Auditory Neuropathy Spectrum Disorder. J Clin Med 2023; 12:jcm12030738. [PMID: 36769387 PMCID: PMC9918155 DOI: 10.3390/jcm12030738] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 01/11/2023] [Accepted: 01/13/2023] [Indexed: 01/18/2023] Open
Abstract
Auditory neuropathy spectrum disorder (ANSD) refers to a range of hearing impairments characterized by an impaired transmission of sound from the cochlea to the brain. This defect can be due to a lesion or defect in the inner hair cell (IHC), IHC ribbon synapse (e.g., pre-synaptic release of glutamate), postsynaptic terminals of the spiral ganglion neurons, or demyelination and axonal loss within the auditory nerve. To date, the only clinical treatment options for ANSD are hearing aids and cochlear implantation. However, despite the advances in hearing-aid and cochlear-implant technologies, the quality of perceived sound still cannot match that of the normal ear. Recent advanced genetic diagnostics and clinical audiology made it possible to identify the precise site of a lesion and to characterize the specific disease mechanisms of ANSD, thus bringing renewed hope to the treatment or prevention of auditory neurodegeneration. Moreover, genetic routes involving the replacement or corrective editing of mutant sequences or defected genes to repair damaged cells for the future restoration of hearing in deaf people are showing promise. In this review, we provide an update on recent discoveries in the molecular pathophysiology of genetic lesions, auditory synaptopathy and neuropathy, and gene-therapy research towards hearing restoration in rodent models and in clinical trials.
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Affiliation(s)
- Anissa Rym Saidia
- Institute for Neurosciences of Montpellier (INM), University Montpellier, INSERM, 34295 Montpellier, France
| | - Jérôme Ruel
- Institute for Neurosciences of Montpellier (INM), University Montpellier, INSERM, 34295 Montpellier, France
- Cognitive Neuroscience Laboratory, Aix-Marseille University, CNRS, UMR 7291, 13331 Marseille, France
| | - Amel Bahloul
- Institute for Neurosciences of Montpellier (INM), University Montpellier, INSERM, 34295 Montpellier, France
| | - Benjamin Chaix
- Department of ENT and Head and Neck Surgery, University Hospital of Montpellier, 34295 Montpellier, France
| | - Frédéric Venail
- Institute for Neurosciences of Montpellier (INM), University Montpellier, INSERM, 34295 Montpellier, France
- Department of ENT and Head and Neck Surgery, University Hospital of Montpellier, 34295 Montpellier, France
| | - Jing Wang
- Institute for Neurosciences of Montpellier (INM), University Montpellier, INSERM, 34295 Montpellier, France
- Department of ENT and Head and Neck Surgery, University Hospital of Montpellier, 34295 Montpellier, France
- Correspondence: ; Tel.: +33-499-63-60-48
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Parker A, Skoe E, Tecoulesco L, Naigles L. A Home-Based Approach to Auditory Brainstem Response Measurement: Proof-of-Concept and Practical Guidelines. Semin Hear 2022; 43:177-196. [PMID: 36313050 PMCID: PMC9605808 DOI: 10.1055/s-0042-1756163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023] Open
Abstract
Broad-scale neuroscientific investigations of diverse human populations are difficult to implement. This is because the primary neuroimaging methods (magnetic resonance imaging, electroencephalography [EEG]) historically have not been portable, and participants may be unable or unwilling to travel to test sites. Miniaturization of EEG technologies has now opened the door to neuroscientific fieldwork, allowing for easier access to under-represented populations. Recent efforts to conduct auditory neuroscience outside a laboratory setting are reviewed and then an in-home technique for recording auditory brainstem responses (ABRs) and frequency-following responses (FFRs) in a home setting is introduced. As a proof of concept, we have conducted two in-home electrophysiological studies: one in 27 children aged 6 to 16 years (13 with autism spectrum disorder) and another in 12 young adults aged 18 to 27 years, using portable electrophysiological equipment to record ABRs and FFRs to click and speech stimuli, spanning rural and urban and multiple homes and testers. We validate our fieldwork approach by presenting waveforms and data on latencies and signal-to-noise ratio. Our findings demonstrate the feasibility and utility of home-based ABR/FFR techniques, paving the course for larger fieldwork investigations of populations that are difficult to test or recruit. We conclude this tutorial with practical tips and guidelines for recording ABRs and FFRs in the field and discuss possible clinical and research applications of this approach.
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Affiliation(s)
- Ashley Parker
- Department of Speech, Language, and Hearing Sciences, University of Connecticut, Storrs, Connecticut
- Connecticut Institute for Brain and Cognitive Sciences, University of Connecticut, Storrs, Connecticut
- Department of Communication Sciences and Disorders, University of Pittsburgh, Pittsburgh, Pennsylvania.
| | - Erika Skoe
- Department of Speech, Language, and Hearing Sciences, University of Connecticut, Storrs, Connecticut
- Connecticut Institute for Brain and Cognitive Sciences, University of Connecticut, Storrs, Connecticut
- Cognitive Sciences Program, University of Connecticut, Storrs, Connecticut
| | - Lee Tecoulesco
- Cognitive Sciences Program, University of Connecticut, Storrs, Connecticut
- Department of Psychological Sciences, University of Connecticut, Storrs, Connecticut
| | - Letitia Naigles
- Connecticut Institute for Brain and Cognitive Sciences, University of Connecticut, Storrs, Connecticut
- Cognitive Sciences Program, University of Connecticut, Storrs, Connecticut
- Department of Psychological Sciences, University of Connecticut, Storrs, Connecticut
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Çildir B, Tokgoz-Yilmaz S, Türkyilmaz MD. Cochlear synaptopathy causes loudness perception impairment without hearing loss. Noise Health 2022; 24:49-60. [PMID: 35900390 PMCID: PMC9703821 DOI: 10.4103/nah.nah_67_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
PURPOSE In this study, the development of a quantitative measurement method to predict long-term auditory adaptation through the stimuli that have been modulated according to different short-term modulation types was aimed to form a psychoacoustic test battery. It might be used in the evaluation process of individuals with hidden hearing loss. METHODS The individuals participating in our study were separated into two groups: high-risk group (n = 39) and low-risk group (n = 30) according to the noise-exposure score. To all participants, auditory brainstem response (ABR), dichotically digit test, Turkish matrix sentence test, otoacoustic emissions test, amplitude modulation detection test, and loudness adaptation test were applied. Stimuli, used in loudness adaptation tests, were provided in three different experiment pairs (experiment 1-2, experiment 3-4, and experiment 5-6). RESULTS The amplitude of wave I of ABR increased as the intensity level increased in the low-risk group, whereas the amplitude reduced as the intensity level increased in the high-risk group (P < 0.05). When different carrier frequency stimuli were used in amplitude modulation detection test, we found that loudness adaptation was highest at 1 kHz carrier frequency with background noise (P < 0.05). CONCLUSION We observed that individuals assumed having hidden hearing loss had high adaptation scores. It was thought that this result might be related to auditory nerve fibers with low spontaneous rate and thus distortion in temporal coding skills might lead to abnormal loudness adaptation, especially with contralateral noise.
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Affiliation(s)
- Bünyamin Çildir
- Audiology Department Health Sciences Faculty, Hacettepe University, Ankara, Turkey
,Address for correspondence: Bunyamin Çildir, Language and Speech Therapy Department Health Sciences Faculty, Ankara Yildirim Beyazit Üniversity, Ankara, Turkey.
E-mail: ,
| | - Suna Tokgoz-Yilmaz
- Audiology Department Health Sciences Faculty, Ankara University, Ankara, Turkey
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Almishaal AA, Saleh S, Alferaih H, Alhelo O. Prevalence, risk factors, and audiological characteristics of auditory neuropathy. Int J Audiol 2021; 61:1018-1026. [PMID: 34928752 DOI: 10.1080/14992027.2021.2014074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE The objective of this study was to determine the prevalence, risk factors, and audiological characteristics of auditory neuropathy spectrum disorder (ANSD) in the pediatric population. DESIGN A retrospective review of medical charts was conducted for children visiting two hospitals in Saudi Arabia. STUDY SAMPLE Medical records of 1025 patients with sensorineural hearing loss (SNHL) were reviewed. We analyzed the databases for results of audiological examinations, risk factors, and outcomes of intervention including hearing aid (HA) and cochlear implantation (CI). RESULTS Out of 1025 children with SNHL, 101 patients (9.85%) were identified to have ANSD. Audiological characteristics of the ANSD group revealed a severe-to-profound degree of hearing loss, all showed type A tympanogram and absent reflexes, absent auditory brainstem response (ABR) findings with present cochlear microphonic while otoacoustic emissions were absent in 54.5% of patients. The most prevalent risk factors for ANSD in this group were family history of hearing loss, consanguinity, hyperbilirubinemia, and low birth weight. Pure tone and speech detection thresholds improved significantly with CI compared to HA use in this sample of patients with ANSD. CONCLUSION This study shows that ANSD is not extremely rare among Saudi children with severe to profound hearing loss, with a prevalence of 9.85%.
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Affiliation(s)
- Ali A Almishaal
- College of Applied Medical Sciences, University of Hail, Hail, Saudi Arabia
| | - Shaza Saleh
- King Abdullah Ear Specialist Center, King Saud University Medical City, Riyadh, Saudi Arabia
| | - Hala Alferaih
- Ear, Nose, and Throat Department, Audiology Clinic, King Fahad General Hospital, Jeddah, Saudi Arabia
| | - Osamah Alhelo
- College of Applied Medical Sciences, University of Hail, Hail, Saudi Arabia
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Rance G, Zanin J, Maier A, Chisari D, Haebich KM, North KN, Dabscheck G, Seal ML, Delatycki MB, Payne JM. Auditory Dysfunction Among Individuals With Neurofibromatosis Type 1. JAMA Netw Open 2021; 4:e2136842. [PMID: 34870681 PMCID: PMC8649832 DOI: 10.1001/jamanetworkopen.2021.36842] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
IMPORTANCE Neurofibromatosis type 1 (NF1) affects hearing through disruption of central auditory processing. The mechanisms, functional severity, and management implications are unclear. OBJECTIVE To investigate auditory neural dysfunction and its perceptual consequences in individuals with NF1. DESIGN, SETTING, AND PARTICIPANTS This case-control study included children and adults with NF1 and control participants matched on age, sex, and hearing level. Patients were recruited through specialist neurofibromatosis and neurogenetic outpatient clinics between April and September 2019. An evaluation of auditory neural activity, monaural/binaural processing, and functional hearing was conducted. Diffusion-weighted magnetic resonance imaging (MRI) data were collected from a subset of participants (10 children with NF1 and 10 matched control participants) and evaluated using a fixel-based analysis of apparent fiber density. MAIN OUTCOMES AND MEASURES Type and severity of auditory dysfunction evaluated via laboratory testing and questionnaire data. RESULTS A total of 44 participants (18 [41%] female individuals) with NF1 with a mean (SD) age of 16.9 (10.7) years and 44 control participants (18 [41%] female individuals) with a mean (SD) age of 17.2 (10.2) years were included in the study. Overall, 11 participants (25%) with NF1 presented with evidence of auditory neural dysfunction, including absent, delayed, or low amplitude electrophysiological responses from the auditory nerve and/or brainstem, compared with 1 participant (2%) in the control group (odds ratio [OR], 13.03; 95% CI, 1.59-106.95). Furthermore, 14 participants (32%) with NF1 showed clinically abnormal speech perception in background noise compared with 1 participant (2%) in the control group (OR, 20.07; 95% CI, 2.50-160.89). Analysis of diffusion-weighted MRI data of participants with NF1 showed significantly lower apparent fiber density within the ascending auditory brainstem pathways. The regions identified corresponded to the neural dysfunction measured using electrophysiological assessment. CONCLUSIONS AND RELEVANCE The findings of this case-control study could represent new neurobiological and clinical features of NF1. Auditory dysfunction severe enough to impede developmental progress in children and restrict communication in older participants is a common neurobiological feature of the disorder.
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Affiliation(s)
- Gary Rance
- Department of Audiology and Speech Pathology, The University of Melbourne, Carlton, Victoria, Australia
| | - Julien Zanin
- Department of Audiology and Speech Pathology, The University of Melbourne, Carlton, Victoria, Australia
| | - Alice Maier
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
| | - Donella Chisari
- Department of Audiology and Speech Pathology, The University of Melbourne, Carlton, Victoria, Australia
| | - Kristina M. Haebich
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, Victoria, Australia
| | - Kathryn N. North
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, Victoria, Australia
| | - Gabriel Dabscheck
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
- The Royal Children’s Hospital, Parkville, Victoria, Melbourne
| | - Marc L. Seal
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, Victoria, Australia
| | - Martin B. Delatycki
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, Victoria, Australia
- Victorian Clinical Genetics Services, The Royal Children’s Hospital, Parkville, Victoria, Australia
| | - Jonathan M. Payne
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, Victoria, Australia
- The Royal Children’s Hospital, Parkville, Victoria, Melbourne
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Sound level context modulates neural activity in the human brainstem. Sci Rep 2021; 11:22581. [PMID: 34799632 PMCID: PMC8605015 DOI: 10.1038/s41598-021-02055-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Accepted: 10/27/2021] [Indexed: 11/08/2022] Open
Abstract
Optimal perception requires adaptation to sounds in the environment. Adaptation involves representing the acoustic stimulation history in neural response patterns, for example, by altering response magnitude or latency as sound-level context changes. Neurons in the auditory brainstem of rodents are sensitive to acoustic stimulation history and sound-level context (often referred to as sensitivity to stimulus statistics), but the degree to which the human brainstem exhibits such neural adaptation is unclear. In six electroencephalography experiments with over 125 participants, we demonstrate that the response latency of the human brainstem is sensitive to the history of acoustic stimulation over a few tens of milliseconds. We further show that human brainstem responses adapt to sound-level context in, at least, the last 44 ms, but that neural sensitivity to sound-level context decreases when the time window over which acoustic stimuli need to be integrated becomes wider. Our study thus provides evidence of adaptation to sound-level context in the human brainstem and of the timescale over which sound-level information affects neural responses to sound. The research delivers an important link to studies on neural adaptation in non-human animals.
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Zhu YM, Li Q, Gao X, Li YF, Liu YL, Dai P, Li XP. Familial Temperature-Sensitive Auditory Neuropathy: Distinctive Clinical Courses Caused by Variants of the OTOF Gene. Front Cell Dev Biol 2021; 9:732930. [PMID: 34692690 PMCID: PMC8529165 DOI: 10.3389/fcell.2021.732930] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 08/31/2021] [Indexed: 11/13/2022] Open
Abstract
Objective: To investigate the clinical course and genetic etiology of familial temperature-sensitive auditory neuropathy (TSAN), which is a very rare subtype of auditory neuropathy (AN) that involves an elevation of hearing thresholds due to an increase in the core body temperature, and to evaluate the genotype-phenotype correlations in a family with TSAN. Methods: Six members of a non-consanguineous Chinese family, including four siblings complaining of communication difficulties when febrile, were enrolled in this study. The clinical and audiological profiles of the four siblings were fully evaluated during both febrile and afebrile episodes, and the genetic etiology of hearing loss (HL) was explored using next-generation sequencing (NGS) technology. Their parents, who had no complaints of fluctuating HL due to body temperature variation, were enrolled for the genetics portion only. Results: Audiological tests during the patients' febrile episodes met the classical diagnostic criteria for AN, including mild HL, poor speech discrimination, preserved cochlear microphonics (CMs), and absent auditory brainstem responses (ABRs). Importantly, unlike the pattern observed in previously reported cases of TSAN, the ABRs and electrocochleography (ECochG) signals of our patients improved to normal during afebrile periods. Genetic analysis identified a compound heterozygous variant of the OTOF gene (which encodes the otoferlin protein), including one previously reported pathogenic variant, c.5098G > C (p.Glu1700Gln), and one novel variant, c.4882C > A (p.Pro1628Thr). Neither of the identified variants affected the C2 domains related to the main function of otoferlin. Both variants faithfully cosegregated with TSAN within the pedigree, suggesting that OTOF is the causative gene of the autosomal recessive trait segregation in this family. Conclusion: The presence of CMs with absent (or markedly abnormal) ABRs is a reliable criterion for diagnosing AN. The severity of the phenotype caused by dysfunctional neurotransmitter release in TSAN may reflect variants that alter the C2 domains of otoferlin. The observations from this study enrich the current understanding of the phenotype and genotype of TSAN and may lay a foundation for further research on its pathogenesis.
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Affiliation(s)
- Yi-Ming Zhu
- Department of Otolaryngology-Head and Neck Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, China
- Department of Otolaryngology-Head and Neck Surgery, Lanzhou University Second Hospital, Lanzhou, China
| | - Qi Li
- Department of Otolaryngology-Head and Neck Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Xue Gao
- Department of Otolaryngology, PLA Rocket Force Characteristic Medical Center, Beijing, China
| | - Yan-Fei Li
- Department of Otolaryngology-Head and Neck Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - You-Li Liu
- Department of Otolaryngology-Head and Neck Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Pu Dai
- Department of Otolaryngology-Head and Neck Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, China
- Department of Otolaryngology-Head and Neck Surgery, Chinese PLA General Hospital, Beijing, China
| | - Xiang-Ping Li
- Department of Otolaryngology-Head and Neck Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, China
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Vona B, Rad A, Reisinger E. The Many Faces of DFNB9: Relating OTOF Variants to Hearing Impairment. Genes (Basel) 2020; 11:genes11121411. [PMID: 33256196 PMCID: PMC7768390 DOI: 10.3390/genes11121411] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 11/23/2020] [Accepted: 11/25/2020] [Indexed: 01/05/2023] Open
Abstract
The OTOF gene encodes otoferlin, a critical protein at the synapse of auditory sensory cells, the inner hair cells (IHCs). In the absence of otoferlin, signal transmission of IHCs fails due to impaired release of synaptic vesicles at the IHC synapse. Biallelic pathogenic and likely pathogenic variants in OTOF predominantly cause autosomal recessive profound prelingual deafness, DFNB9. Due to the isolated defect of synaptic transmission and initially preserved otoacoustic emissions (OAEs), the clinical characteristics have been termed "auditory synaptopathy". We review the broad phenotypic spectrum reported in patients with variants in OTOF that includes milder hearing loss, as well as progressive and temperature-sensitive hearing loss. We highlight several challenges that must be addressed for rapid clinical and genetic diagnosis. Importantly, we call for changes in newborn hearing screening protocols, since OAE tests fail to diagnose deafness in this case. Continued research appears to be needed to complete otoferlin isoform expression characterization to enhance genetic diagnostics. This timely review is meant to sensitize the field to clinical characteristics of DFNB9 and current limitations in preparation for clinical trials for OTOF gene therapies that are projected to start in 2021.
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Apeksha K, Kumar AU. Effect of Quiet and Noise on P300 Response in Individuals with Auditory Neuropathy Spectrum Disorder. Int Arch Otorhinolaryngol 2020; 24:e462-e471. [PMID: 33101512 PMCID: PMC7575403 DOI: 10.1055/s-0039-3402441] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Accepted: 11/04/2019] [Indexed: 10/31/2022] Open
Abstract
Introduction Auditory neuropathy spectrum disorder (ANSD) is a clinical condition in which individuals have normal cochlear responses and abnormal neural responses. There is a lack of evidence in the literature regarding the neural discrimination skill in individuals with ANSD, especially when the signal is presented in the presence of noise. Objectives The present study was performed with the aim to investigate auditory discrimination skill, in quiet and in the presence of noise, in individuals with ANSD and to compare the findings with normal-hearing individuals. Methods A total of 30 individuals with normal hearing sensitivity and 30 individuals with ANSD in the age range of 15 to 55 years old, with the mean age of 27.86 years old, were the participants. P300 response was recorded from both groups using syllable pairs /ba/-/da/ in oddball paradigm and the syllable /da/ in repetitive paradigm in quiet and at +10 dB signal-to-noise ratio (SNR). Results There was significant prolongation in latency and reaction time, and reduction in amplitude of P300 response and sensitivity in both groups with the addition of noise. The topographic pattern analysis showed activation of the central-parietal-occipital region of the brain in individuals with ANSD, whereas activation of the central-parietal region was observed in individuals with normal hearing. The activation was more diffused in individuals with ANSD compared with that of individuals with normal hearing. Conclusion The individuals with ANSD showed a significantly more adverse effect of noise on the neural discrimination skill than the normal counterpart.
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Affiliation(s)
- Kumari Apeksha
- Department of Speech and Hearing, JSS Institute of Speech & Hearing, Mysuru, India
| | - Ajith U. Kumar
- Department of Audiology, All India Institute of Speech & Hearing, Mysuru, India
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14
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Reisinger E. Dual-AAV delivery of large gene sequences to the inner ear. Hear Res 2020; 394:107857. [DOI: 10.1016/j.heares.2019.107857] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Accepted: 11/22/2019] [Indexed: 01/06/2023]
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High Frequency of AIFM1 Variants and Phenotype Progression of Auditory Neuropathy in a Chinese Population. Neural Plast 2020; 2020:5625768. [PMID: 32684920 PMCID: PMC7350177 DOI: 10.1155/2020/5625768] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Revised: 05/14/2020] [Accepted: 06/02/2020] [Indexed: 12/12/2022] Open
Abstract
To decipher the genotype-phenotype correlation of auditory neuropathy (AN) caused by AIFM1 variations, as well as the phenotype progression of these patients, exploring the potential molecular pathogenic mechanism of AN. A total of 36 families of individuals with AN (50 cases) with AIFM1 variations were recruited and identified by Sanger sequencing or next-generation sequencing; the participants included 30 patients from 16 reported families and 20 new cases. We found that AIFM1-positive cases accounted for 18.6% of late-onset AN cases. Of the 50 AN patients with AIFM1 variants, 45 were male and 5 were female. The hotspot variation of this gene was p.Leu344Phe, accounting for 36.1%. A total of 19 AIFM1 variants were reported in this study, including 7 novel ones. A follow-up study was performed on 30 previously reported AIFM1-positive subjects, 16 follow-up cases (53.3%) were included in this study, and follow-up periods were recorded from 1 to 23 years with average 9.75 ± 9.89 years. There was no hearing threshold increase during the short-term follow-up period (1-10 years), but the low-frequency and high-frequency hearing thresholds showed a significant increase with the prolongation of follow-up time. The speech discrimination score progressed gradually and significantly along with the course of the disease and showed a more serious decline, which was disproportionately worse than the pure tone threshold. In addition to the X-linked recessive inheritance pattern, the X-linked dominant inheritance pattern is also observed in AIFM1-related AN and affects females. In conclusion, we confirmed that AIFM1 is the primary related gene among late-onset AN cases, and the most common recurrent variant is p.Leu344Phe. Except for the X-linked recessive inheritance pattern, the X-linked dominant inheritance pattern is another probability of AIFM1-related AN, with females affected. Phenotypical features of AIFM1-related AN suggested that auditory dyssynchrony progressively worsened over time.
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Abstract
OBJECTIVES This study tested the hypothesis that undetected peripheral hearing impairment occurs in children with idiopathic listening difficulties (LiDs), as reported by caregivers using the Evaluation of Children"s Listening and Processing Skills (ECLiPS) validated questionnaire, compared with children with typically developed (TD) listening abilities. DESIGN Children with LiD aged 6-14 years old (n = 60, mean age = 9.9 yr) and 54 typical age matched children were recruited from audiology clinical records and from IRB-approved advertisements at hospital locations and in the local and regional areas. Both groups completed standard and extended high-frequency (EHF) pure-tone audiometry, wideband absorbance tympanometry and middle ear muscle reflexes, distortion product and chirp transient evoked otoacoustic emissions. Univariate and multivariate mixed models and multiple regression analysis were used to examine group differences and continuous performance, as well as the influence of demographic factors and pressure equalization (PE) tube history. RESULTS There were no significant group differences between the LiD and TD groups for any of the auditory measures tested. However, analyses across all children showed that EHF hearing thresholds, wideband tympanometry, contralateral middle ear muscle reflexes, distortion product, and transient-evoked otoacoustic emissions were related to a history of PE tube surgery. The physiologic measures were also associated with EHF hearing loss, secondary to PE tube history. CONCLUSIONS Overall, the results of this study in a sample of children with validated LiD compared with a TD group matched for age and sex showed no significant differences in peripheral function using highly sensitive auditory measures. Histories of PE tube surgery were significantly related to EHF hearing and to a range of physiologic measures in the combined sample.
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Auditory Neuropathy Spectrum Disorders: From Diagnosis to Treatment: Literature Review and Case Reports. J Clin Med 2020; 9:jcm9041074. [PMID: 32290039 PMCID: PMC7230308 DOI: 10.3390/jcm9041074] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 03/21/2020] [Accepted: 04/01/2020] [Indexed: 12/21/2022] Open
Abstract
Auditory neuropathy spectrum disorder (ANSD) refers to a range of hearing impairments characterized by deteriorated speech perception, despite relatively preserved pure-tone detection thresholds. Affected individuals usually present with abnormal auditory brainstem responses (ABRs), but normal otoacoustic emissions (OAEs). These electrophysiological characteristics have led to the hypothesis that ANSD may be caused by various dysfunctions at the cochlear inner hair cell (IHC) and spiral ganglion neuron (SGN) levels, while the activity of outer hair cells (OHCs) is preserved, resulting in discrepancies between pure-tone and speech comprehension thresholds. The exact prevalence of ANSD remains unknown; clinical findings show a large variability among subjects with hearing impairment ranging from mild to profound hearing loss. A wide range of prenatal and postnatal etiologies have been proposed. The study of genetics and of the implicated sites of lesion correlated with clinical findings have also led to a better understanding of the molecular mechanisms underlying the various forms of ANSD, and may guide clinicians in better screening, assessment and treatment of ANSD patients. Besides OAEs and ABRs, audiological assessment includes stapedial reflex measurements, supraliminal psychoacoustic tests, electrocochleography (ECochG), auditory steady-state responses (ASSRs) and cortical auditory evoked potentials (CAEPs). Hearing aids are indicated in the treatment of ANSD with mild to moderate hearing loss, whereas cochlear implantation is the first choice of treatment in case of profound hearing loss, especially in case of IHC presynaptic disorders, or in case of poor auditory outcomes with conventional hearing aids.
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Moser T, Grabner CP, Schmitz F. Sensory Processing at Ribbon Synapses in the Retina and the Cochlea. Physiol Rev 2020; 100:103-144. [DOI: 10.1152/physrev.00026.2018] [Citation(s) in RCA: 80] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
In recent years, sensory neuroscientists have made major efforts to dissect the structure and function of ribbon synapses which process sensory information in the eye and ear. This review aims to summarize our current understanding of two key aspects of ribbon synapses: 1) their mechanisms of exocytosis and endocytosis and 2) their molecular anatomy and physiology. Our comparison of ribbon synapses in the cochlea and the retina reveals convergent signaling mechanisms, as well as divergent strategies in different sensory systems.
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Affiliation(s)
- Tobias Moser
- Institute for Auditory Neuroscience and InnerEarLab, University Medical Center Göttingen, Göttingen, Germany; Auditory Neuroscience Group, Max Planck Institute for Experimental Medicine, Göttingen, Germany; Synaptic Nanophysiology Group, Max-Planck-Institute for Biophysical Chemistry, Göttingen, Germany; and Institute for Anatomy and Cell Biology, Department of Neuroanatomy, Medical School, Saarland University, Homburg, Germany
| | - Chad P. Grabner
- Institute for Auditory Neuroscience and InnerEarLab, University Medical Center Göttingen, Göttingen, Germany; Auditory Neuroscience Group, Max Planck Institute for Experimental Medicine, Göttingen, Germany; Synaptic Nanophysiology Group, Max-Planck-Institute for Biophysical Chemistry, Göttingen, Germany; and Institute for Anatomy and Cell Biology, Department of Neuroanatomy, Medical School, Saarland University, Homburg, Germany
| | - Frank Schmitz
- Institute for Auditory Neuroscience and InnerEarLab, University Medical Center Göttingen, Göttingen, Germany; Auditory Neuroscience Group, Max Planck Institute for Experimental Medicine, Göttingen, Germany; Synaptic Nanophysiology Group, Max-Planck-Institute for Biophysical Chemistry, Göttingen, Germany; and Institute for Anatomy and Cell Biology, Department of Neuroanatomy, Medical School, Saarland University, Homburg, Germany
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Al-Moyed H, Cepeda AP, Jung S, Moser T, Kügler S, Reisinger E. A dual-AAV approach restores fast exocytosis and partially rescues auditory function in deaf otoferlin knock-out mice. EMBO Mol Med 2019; 11:emmm.201809396. [PMID: 30509897 PMCID: PMC6328916 DOI: 10.15252/emmm.201809396] [Citation(s) in RCA: 112] [Impact Index Per Article: 22.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Normal hearing and synaptic transmission at afferent auditory inner hair cell (IHC) synapses require otoferlin. Deafness DFNB9, caused by mutations in the OTOF gene encoding otoferlin, might be treated by transferring wild‐type otoferlin cDNA into IHCs, which is difficult due to the large size of this transgene. In this study, we generated two adeno‐associated viruses (AAVs), each containing half of the otoferlin cDNA. Co‐injecting these dual‐AAV2/6 half‐vectors into the cochleae of 6‐ to 7‐day‐old otoferlin knock‐out (Otof−/−) mice led to the expression of full‐length otoferlin in up to 50% of IHCs. In the cochlea, otoferlin was selectively expressed in auditory hair cells. Dual‐AAV transduction of Otof−/−IHCs fully restored fast exocytosis, while otoferlin‐dependent vesicle replenishment reached 35–50% of wild‐type levels. The loss of 40% of synaptic ribbons in these IHCs could not be prevented, indicating a role of otoferlin in early synapse maturation. Acoustic clicks evoked auditory brainstem responses with thresholds of 40–60 dB. Therefore, we propose that gene delivery mediated by dual‐AAV vectors might be suitable to treat deafness forms caused by mutations in large genes such as OTOF.
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Affiliation(s)
- Hanan Al-Moyed
- Molecular Biology of Cochlear Neurotransmission Group, Department of Otorhinolaryngology, University Medical Center Göttingen, and Collaborative Research Center 889, University of Göttingen, Göttingen, Germany.,Göttingen Graduate School for Neurosciences, Biophysics, and Molecular Biosciences, University of Göttingen, Göttingen, Germany
| | - Andreia P Cepeda
- Molecular Biology of Cochlear Neurotransmission Group, Department of Otorhinolaryngology, University Medical Center Göttingen, and Collaborative Research Center 889, University of Göttingen, Göttingen, Germany.,Göttingen Graduate School for Neurosciences, Biophysics, and Molecular Biosciences, University of Göttingen, Göttingen, Germany
| | - SangYong Jung
- Institute for Auditory Neurosciences and InnerEarLab, University Medical Center Göttingen, Göttingen, Germany.,Synaptic Nanophysiology Group, Max Planck Institute for Biophysical Chemistry, Göttingen, Germany
| | - Tobias Moser
- Göttingen Graduate School for Neurosciences, Biophysics, and Molecular Biosciences, University of Göttingen, Göttingen, Germany.,Institute for Auditory Neurosciences and InnerEarLab, University Medical Center Göttingen, Göttingen, Germany.,Synaptic Nanophysiology Group, Max Planck Institute for Biophysical Chemistry, Göttingen, Germany
| | - Sebastian Kügler
- Center Nanoscale Microscopy and Physiology of the Brain (CNMPB), Department of Neurology, University Medical Center Göttingen, Göttingen, Germany
| | - Ellen Reisinger
- Molecular Biology of Cochlear Neurotransmission Group, Department of Otorhinolaryngology, University Medical Center Göttingen, and Collaborative Research Center 889, University of Göttingen, Göttingen, Germany
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Shearer AE, Hansen MR. Auditory synaptopathy, auditory neuropathy, and cochlear implantation. Laryngoscope Investig Otolaryngol 2019; 4:429-440. [PMID: 31453354 PMCID: PMC6703118 DOI: 10.1002/lio2.288] [Citation(s) in RCA: 59] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Revised: 05/17/2019] [Accepted: 06/13/2019] [Indexed: 02/03/2023] Open
Abstract
Cochlear implantation has become the standard-of-care for adults and children with severe to profound hearing loss. There is growing evidence that qualitative as well as quantitative deficits in the auditory nerve may affect cochlear implant (CI) outcomes. Auditory neuropathy spectrum disorder (ANSD) is characterized by dysfunctional transmission of sound from the cochlea to the brain due to defective synaptic function or neural conduction. In this review, we examine the precise mechanisms of genetic lesions causing ANSD and the effect of these lesions on CI outcomes. Reviewed data show that individuals with lesions that primarily affect the cochlear sensory system and the synapse, which are bypassed by the CI, have optimal CI outcomes. Individuals with lesions that affect the auditory nerve show poor performance with CIs, likely because neural transmission of the electrical signal from the CI is affected. We put forth a nuanced molecular classification of ANSD that has implications for preoperative counseling for patients with this disorder prior to cochlear implantation. We propose that description of ANSD patients should be based on the molecular site of lesion typically derived from genetic evaluation (synaptopathy vs. neuropathy) as this has implications for expected CI outcomes. Improvements in our understanding of genetic site of lesions and their effects on CI function should lead to better CI outcomes, not just for individuals with auditory neuropathy, but all individuals with hearing loss.
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Affiliation(s)
- Aiden Eliot Shearer
- Department of Otolaryngology-Head and Neck Surgery University of Iowa Carver College of Medicine Iowa City Iowa U.S.A
| | - Marlan R Hansen
- Department of Otolaryngology-Head and Neck Surgery University of Iowa Carver College of Medicine Iowa City Iowa U.S.A.,Department of Neurosurgery University of Iowa Carver College of Medicine Iowa City Iowa U.S.A
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Santarelli R, La Morgia C, Valentino ML, Barboni P, Monteleone A, Scimemi P, Carelli V. Hearing Dysfunction in a Large Family Affected by Dominant Optic Atrophy (OPA8-Related DOA): A Human Model of Hidden Auditory Neuropathy. Front Neurosci 2019; 13:501. [PMID: 31191217 PMCID: PMC6546873 DOI: 10.3389/fnins.2019.00501] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Accepted: 04/30/2019] [Indexed: 11/13/2022] Open
Abstract
Hidden auditory neuropathy is characterized by reduced performances in challenging auditory tasks with the preservation of hearing thresholds, resulting from diffuse loss of cochlear inner hair cell (IHC) synapses following primary degeneration of unmyelinated terminals of auditory fibers. We report the audiological and electrophysiological findings collected from 10 members (4 males, 6 females) of a large Italian family affected by dominant optic atrophy, associated with the OPA8 locus, who complained of difficulties in understanding speech in the presence of noise. The patients were pooled into two groups, one consisting of 4 young adults (19-50 years) with normal hearing thresholds, and the other made up of 6 patients of an older age (55-72 years) showing mild hearing loss. Speech perception scores were normal in the first group and decreased in the second. Otoacoustic emissions (OAEs) and cochlear microphonics (CMs) recordings were consistent with preservation of outer hair cell (OHC) function in all patients, whereas auditory brainstem responses (ABRs) showed attenuated amplitudes in the first group and severe abnormalities in the second. Middle ear acoustic reflexes had delayed peak latencies in all patients in comparison with normally hearing individuals. Transtympanic electrocochleography (ECochG) recordings in response to 0.1 ms clicks at intensities from 120 to 60 dB peak equivalent SPL showed a reduction in amplitude of both summating potential (SP) and compound action potential (CAP) together with delayed CAP peak latencies and prolonged CAP duration in all patients in comparison with a control group of 20 normally hearing individuals. These findings indicate that underlying the hearing impairment in OPA8 patients is hidden AN resulting from diffuse loss of IHCs synapses. At an early stage the functional alterations only consist of abnormalities of ABR and ECochG potentials with increased latencies of acoustic reflexes, whereas reduction in speech perception scores become apparent with progression of the disease. Central mechanisms increasing the cortical gain are likely to compensate for the reduction of cochlear input.
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Affiliation(s)
- Rosamaria Santarelli
- Department of Neurosciences, University of Padova, Padua, Italy.,Audiology Service, Santi Giovanni e Paolo Hospital, Venice, Italy.,Audiology and Phoniatrics Service, Treviso Regional Hospital, Treviso, Italy
| | - Chiara La Morgia
- Dipartimento di Scienze Biomediche e Neuromotorie, Università di Bologna, Bologna, Italy.,IRCCS Istituto delle Scienze Neurologiche di Bologna, UOC Clinica Neurologica di Bologna, Bologna, Italy
| | - Maria Lucia Valentino
- Dipartimento di Scienze Biomediche e Neuromotorie, Università di Bologna, Bologna, Italy.,IRCCS Istituto delle Scienze Neurologiche di Bologna, UOC Clinica Neurologica di Bologna, Bologna, Italy
| | | | - Anna Monteleone
- Audiology and Phoniatrics Service, Treviso Regional Hospital, Treviso, Italy
| | - Pietro Scimemi
- Department of Neurosciences, University of Padova, Padua, Italy.,Audiology Service, Santi Giovanni e Paolo Hospital, Venice, Italy.,Audiology and Phoniatrics Service, Treviso Regional Hospital, Treviso, Italy
| | - Valerio Carelli
- Dipartimento di Scienze Biomediche e Neuromotorie, Università di Bologna, Bologna, Italy.,IRCCS Istituto delle Scienze Neurologiche di Bologna, UOC Clinica Neurologica di Bologna, Bologna, Italy
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Liu W, Wang X, Wang M, Wang H. Protection of Spiral Ganglion Neurons and Prevention of Auditory Neuropathy. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2019; 1130:93-107. [DOI: 10.1007/978-981-13-6123-4_6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/28/2023]
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23
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Ridley CL, Kopun JG, Neely ST, Gorga MP, Rasetshwane DM. Using Thresholds in Noise to Identify Hidden Hearing Loss in Humans. Ear Hear 2019; 39:829-844. [PMID: 29337760 PMCID: PMC6046280 DOI: 10.1097/aud.0000000000000543] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Recent animal studies suggest that noise-induced synaptopathy may underlie a phenomenon that has been labeled hidden hearing loss (HHL). Noise exposure preferentially damages low spontaneous-rate auditory nerve fibers, which are involved in the processing of moderate- to high-level sounds and are more resistant to masking by background noise. Therefore, the effect of synaptopathy may be more evident in suprathreshold measures of auditory function, especially in the presence of background noise. The purpose of this study was to develop a statistical model for estimating HHL in humans using thresholds in noise as the outcome variable and measures that reflect the integrity of sites along the auditory pathway as explanatory variables. Our working hypothesis is that HHL is evident in the portion of the variance observed in thresholds in noise that is not dependent on thresholds in quiet, because this residual variance retains statistical dependence on other measures of suprathreshold function. DESIGN Study participants included 13 adults with normal hearing (≤15 dB HL) and 20 adults with normal hearing at 1 kHz and sensorineural hearing loss at 4 kHz (>15 dB HL). Thresholds in noise were measured, and the residual of the correlation between thresholds in noise and thresholds in quiet, which we refer to as thresholds-in-noise residual, was used as the outcome measure for the model. Explanatory measures were as follows: (1) auditory brainstem response (ABR) waves I and V amplitudes; (2) electrocochleographic action potential and summating potential amplitudes; (3) distortion product otoacoustic emissions level; and (4) categorical loudness scaling. All measurements were made at two frequencies (1 and 4 kHz). ABR and electrocochleographic measurements were made at 80 and 100 dB peak equivalent sound pressure level, while wider ranges of levels were tested during distortion product otoacoustic emission and categorical loudness scaling measurements. A model relating the thresholds-in-noise residual and the explanatory measures was created using multiple linear regression analysis. RESULTS Predictions of thresholds-in-noise residual using the model accounted for 61% (p < 0.01) and 48% (p < 0.01) of the variance in the measured thresholds-in-noise residual at 1 and 4 kHz, respectively. CONCLUSIONS Measures of thresholds in noise, the summating potential to action potential ratio, and ABR waves I and V amplitudes may be useful for the prediction of HHL in humans. With further development, our approach of quantifying HHL by the variance that remains in suprathreshold measures of auditory function after removing the variance due to thresholds in quiet, together with our statistical modeling, may provide a quantifiable and verifiable estimate of HHL in humans with normal hearing and with hearing loss. The current results are consistent with the view that inner hair cell and auditory nerve pathology may underlie suprathreshold auditory performance.
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Affiliation(s)
- Courtney L. Ridley
- Center for Hearing Research, Boys Town National Research Hospital, 555 North 30 St, Omaha, Nebraska 68131, USA
- Department of Speech, Language, and Hearing Sciences, University of Florida, 1225 Center Drive, Gainesville, FL 32610, USA
| | - Judy G. Kopun
- Center for Hearing Research, Boys Town National Research Hospital, 555 North 30 St, Omaha, Nebraska 68131, USA
| | - Stephen T. Neely
- Center for Hearing Research, Boys Town National Research Hospital, 555 North 30 St, Omaha, Nebraska 68131, USA
| | - Michael P. Gorga
- Center for Hearing Research, Boys Town National Research Hospital, 555 North 30 St, Omaha, Nebraska 68131, USA
| | - Daniel M. Rasetshwane
- Center for Hearing Research, Boys Town National Research Hospital, 555 North 30 St, Omaha, Nebraska 68131, USA
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Abstract
OBJECTIVES Auditory steady state responses (ASSRs) are used in clinical practice for objective hearing assessments. The response is called steady state because it is assumed to be stable over time, and because it is evoked by a stimulus with a certain periodicity, which will lead to discrete frequency components that are stable in amplitude and phase over time. However, the stimuli commonly used to evoke ASSRs are also known to be able to induce loudness adaptation behaviorally. Researchers and clinicians using ASSRs assume that the response remains stable over time. This study investigates (1) the stability of ASSR amplitudes over time, within one recording, and (2) whether loudness adaptation can be reflected in ASSRs. DESIGN ASSRs were measured from 14 normal-hearing participants. The ASSRs were evoked by the stimuli that caused the most loudness adaptation in a previous behavioral study, that is, mixed-modulated sinusoids with carrier frequencies of either 500 or 2000 Hz, a modulation frequency of 40 Hz, and a low sensation level of 30 dB SL. For each carrier frequency and participant, 40 repetitions of 92 sec recordings were made. Two types of analyses were used to investigate the ASSR amplitudes over time: with the more traditionally used Fast Fourier Transform and with a novel Kalman filtering approach. Robust correlations between the ASSR amplitudes and behavioral loudness adaptation ratings were also calculated. RESULTS Overall, ASSR amplitudes were stable. Over all individual recordings, the median change of the amplitudes over time was -0.0001 μV/s. Based on group analysis, a significant but very weak decrease in amplitude over time was found, with the decrease in amplitude over time around -0.0002 μV/s. Correlation coefficients between ASSR amplitudes and behavioral loudness adaptation ratings were significant but low to moderate, with r = 0.27 and r = 0.39 for the 500 and 2000 Hz carrier frequency, respectively. CONCLUSIONS The decrease in amplitude of ASSRs over time (92 sec) is small. Consequently, it is safe to use ASSRs in clinical practice, and additional correction factors for objective hearing assessments are not needed. Because only small decreases in amplitudes were found, loudness adaptation is probably not reflected by the ASSRs.
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Geissler DB, Weiler E, Ehret G. Adaptation and spectral enhancement at auditory temporal perceptual boundaries - Measurements via temporal precision of auditory brainstem responses. PLoS One 2018; 13:e0208935. [PMID: 30571726 PMCID: PMC6301773 DOI: 10.1371/journal.pone.0208935] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2018] [Accepted: 11/26/2018] [Indexed: 12/21/2022] Open
Abstract
In human and animal auditory perception the perceived quality of sound streams changes depending on the duration of inter-sound intervals (ISIs). Here, we studied whether adaptation and the precision of temporal coding in the auditory periphery reproduce general perceptual boundaries in the time domain near 20, 100, and 400 ms ISIs, the physiological origin of which are unknown. In four experiments, we recorded auditory brainstem responses with five wave peaks (P1 –P5) in response to acoustic models of communication calls of house mice, who perceived these calls with the mentioned boundaries. The newly introduced measure of average standard deviations of wave latencies of individual animals indicate the waves’ temporal precision (latency jitter) mostly in the range of 30–100 μs, very similar to latency jitter of single neurons. Adaptation effects of response latencies and latency jitter were measured for ISIs of 10–1000 ms. Adaptation decreased with increasing ISI duration following exponential or linear (on a logarithmic scale) functions in the range of up to about 200 ms ISIs. Adaptation effects were specific for each processing level in the auditory system. The perceptual boundaries near 20–30 and 100 ms ISIs were reflected in significant adaptation of latencies together with increases of latency jitter at P2-P5 for ISIs < ~30 ms and at P5 for ISIs < ~100 ms, respectively. Adaptation effects occurred when frequencies in a sound stream were within the same critical band. Ongoing low-frequency components/formants in a sound enhanced (decrease of latencies) coding of high-frequency components/formants when the frequencies concerned different critical bands. The results are discussed in the context of coding multi-harmonic sounds and stop-consonants-vowel pairs in the auditory brainstem. Furthermore, latency data at P1 (cochlea level) offer a reasonable value for the base-to-apex cochlear travel time in the mouse (0.342 ms) that has not been determined experimentally.
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Affiliation(s)
| | - Elke Weiler
- Institute of Neurobiology, University of Ulm, Ulm, Germany
| | - Günter Ehret
- Institute of Neurobiology, University of Ulm, Ulm, Germany
- * E-mail:
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26
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Giraudet F, Charles P, Mom T, Boespflug-Tanguy O, Dürr A, Deltenre P, Avan P. Rapid exhaustion of auditory neural conduction in a prototypical mitochondrial disease, Friedreich ataxia. Clin Neurophysiol 2018; 129:1121-1129. [PMID: 29625343 DOI: 10.1016/j.clinph.2018.03.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Revised: 02/07/2018] [Accepted: 03/13/2018] [Indexed: 11/26/2022]
Abstract
OBJECTIVES In patients with Friedreich ataxia (FRDA), mitochondrial failure leads to impaired cellular energetics. Since many FRDA patients have impaired hearing in noise, we investigated the objective consequences on standard auditory brainstem-evoked responses (ABRs). METHODS In 37 FRDA patients, among whom 34 with abnormal standard ABRs, hearing sensitivity, speech-in-noise intelligibility and otoacoustic emissions were controlled. ABR recordings were split into four consecutive segments of the total time frame used for data collection, thus allowing the dynamics of ABR averaging to be observed. RESULTS Most ears showed features of an auditory neuropathy spectrum disorder with flattened ABRs and impaired speech-in-noise intelligibility contrasting with near-normal hearing sensitivity and normal preneural responses. Yet split-ABRs revealed short-lived wave patterns in 26 out of 68 ears with flattened standard ABRs (38%). While averaging went on, the pattern of waves shifted so that interwave latencies increased by 35% on average. CONCLUSIONS In FRDA, the assumption of stationarity used for extracting standard ABRs is invalid. The preservation of early split-ABRs indicates no short-term dyssynchrony of action potentials. A large decrease in conduction velocity along auditory neurons occurs within seconds, attributed to fast energetic failure. SIGNIFICANCE This model of metabolic sensory neuropathy warns against exposure of metabolically-impaired patients to sustained auditory stimulation.
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Affiliation(s)
- Fabrice Giraudet
- Laboratory of Neurosensory Biophysics, UMR INSERM 1107, University Clermont Auvergne, Clermont-Ferrand, France
| | - Perrine Charles
- APHP Department of Genetics, Groupe Hospitalier Pitié-Salpêtrière, Paris, France
| | - Thierry Mom
- Laboratory of Neurosensory Biophysics, UMR INSERM 1107, University Clermont Auvergne, Clermont-Ferrand, France
| | - Odile Boespflug-Tanguy
- Assistance Publique des Hopitaux de Paris (APHP), Reference Center for Rare Diseases "Leukodystrophies," Child Neurology and Metabolic Disorders Department, Robert Debré University Hospital, Paris, France; Inserm, Paris Diderot University, UMR 1141, DHU PROTECT, Sorbonne Paris-Cite, Robert Debré University Hospital, Paris, France
| | - Alexandra Dürr
- APHP Department of Genetics, Groupe Hospitalier Pitié-Salpêtrière, Paris, France; ICM, Institut du Cerveau et de la Moelle, INSERM U1127, CNRS UMR7225, Sorbonne Universités - UPMC Université Paris VI UMR-S1127, Paris, France
| | - Paul Deltenre
- CHU Brugmann, Université Libre de Bruxelles, Belgium
| | - Paul Avan
- Laboratory of Neurosensory Biophysics, UMR INSERM 1107, University Clermont Auvergne, Clermont-Ferrand, France; Centre Jean Perrin, Clermont-Ferrand, France.
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27
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Ismail EI, Morgan AE, Farag RE. Assessment of auditory functions in chronic hepatitis C patients treated by sofosbuvir. J Otol 2018; 13:10-15. [PMID: 29937860 PMCID: PMC6002635 DOI: 10.1016/j.joto.2017.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2017] [Revised: 11/01/2017] [Accepted: 11/02/2017] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE Evaluating the auditory function in patients with chronic hepatitis C treated with sofosbuvir and ribavirin. METHODS This study involved 80 patients with chronic hepatitis C who agreed to receive sofosbuvir and ribavirin. All participants were subjected to baseline otological and audiological assessment just before treatment. The audiological assessment included standard pure tone audiometry, extended high-frequency audiometry, immitancemetry and otoacoustic emissions (OAEs) (transient and distortion product). According to baseline hearing threshold measurements, the study population was divided into 2 groups. Group 1 included 42 patients with normal hearing sensitivity (250-8000 Hz), and Group 2 included 38 patients with sensorineural hearing loss. After 24 weeks of therapy, otological and audiological assessments were repeated and compared between the two groups and before and after therapy. RESULTS Post-treatment hearing threshold evaluation showed no significant difference from pretreatment evaluation at all tested frequencies. There was no statistically significant difference between pre and post-treatment otoacoustic emissions results. CONCLUSION Therapy with sofosbuvir and ribavirin in chronic hepatitis C has no noticeable effects on cochlear functions.
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Affiliation(s)
| | | | - Raghda Elsayed Farag
- Department of Tropical Medicine, Faculty of Medicine, Mansoura University, Egypt
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Skoe E, Brody L, Theodore RM. Reading ability reflects individual differences in auditory brainstem function, even into adulthood. BRAIN AND LANGUAGE 2017; 164:25-31. [PMID: 27694016 DOI: 10.1016/j.bandl.2016.09.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2016] [Revised: 08/22/2016] [Accepted: 09/03/2016] [Indexed: 06/06/2023]
Abstract
Research with developmental populations suggests that the maturational state of auditory brainstem encoding is linked to reading ability. Specifically, children with poor reading skills resemble biologically younger children with respect to their auditory brainstem responses (ABRs) to speech stimulation. Because ABR development continues into adolescence, it is possible that the link between ABRs and reading ability changes or resolves as the brainstem matures. To examine these possibilities, ABRs were recorded at varying presentation rates in adults with diverse, yet unimpaired reading levels. We found that reading ability in adulthood related to ABR Wave V latency, with more juvenile response morphology linked to less proficient reading ability, as has been observed for children. These data add to the evidence indicating that auditory brainstem responses serve as an index of the sound-based skills that underlie reading, even into adulthood.
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Affiliation(s)
- Erika Skoe
- Department of Speech, Language, and Hearing Sciences, University of Connecticut, 850 Bolton Road, Unit 1085, Storrs, CT 06269, United States; Connecticut Institute for the Brain and Cognitive Sciences, University of Connecticut, 337 Mansfield Road, Unit 1272, Storrs, CT 06269, United States.
| | - Lisa Brody
- Department of Speech, Language, and Hearing Sciences, University of Connecticut, 850 Bolton Road, Unit 1085, Storrs, CT 06269, United States.
| | - Rachel M Theodore
- Department of Speech, Language, and Hearing Sciences, University of Connecticut, 850 Bolton Road, Unit 1085, Storrs, CT 06269, United States; Connecticut Institute for the Brain and Cognitive Sciences, University of Connecticut, 337 Mansfield Road, Unit 1272, Storrs, CT 06269, United States.
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30
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Strenzke N, Chakrabarti R, Al-Moyed H, Müller A, Hoch G, Pangrsic T, Yamanbaeva G, Lenz C, Pan KT, Auge E, Geiss-Friedlander R, Urlaub H, Brose N, Wichmann C, Reisinger E. Hair cell synaptic dysfunction, auditory fatigue and thermal sensitivity in otoferlin Ile515Thr mutants. EMBO J 2016; 35:2519-2535. [PMID: 27729456 DOI: 10.15252/embj.201694564] [Citation(s) in RCA: 59] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2016] [Revised: 08/24/2016] [Accepted: 09/13/2016] [Indexed: 11/09/2022] Open
Abstract
The multi-C2 domain protein otoferlin is required for hearing and mutated in human deafness. Some OTOF mutations cause a mild elevation of auditory thresholds but strong impairment of speech perception. At elevated body temperature, hearing is lost. Mice homozygous for one of these mutations, OtofI515T/I515T, exhibit a moderate hearing impairment involving enhanced adaptation to continuous or repetitive sound stimulation. In OtofI515T/I515T inner hair cells (IHCs), otoferlin levels are diminished by 65%, and synaptic vesicles are enlarged. Exocytosis during prolonged stimulation is strongly reduced. This indicates that otoferlin is critical for the reformation of properly sized and fusion-competent synaptic vesicles. Moreover, we found sustained exocytosis and sound encoding to scale with the amount of otoferlin at the plasma membrane. We identified a 20 amino acid motif including an RXR motif, presumably present in human but not in mouse otoferlin, which reduces the plasma membrane abundance of Ile515Thr-otoferlin. Together, this likely explains the auditory synaptopathy at normal temperature and the temperature-sensitive deafness in humans carrying the Ile515Thr mutation.
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Affiliation(s)
- Nicola Strenzke
- Auditory Systems Physiology Group, Department for Otolaryngology and InnerEarLab, University Medical Center Göttingen, Göttingen, Germany .,Collaborative Research Center 889 "Cellular Mechanisms of Sensory Processing", Göttingen, Germany
| | - Rituparna Chakrabarti
- Collaborative Research Center 889 "Cellular Mechanisms of Sensory Processing", Göttingen, Germany.,Molecular Architecture of Synapses Group, Institute for Auditory Neuroscience and InnerEarLab, University Medical Center Göttingen and Max Planck Institute of Experimental Medicine, Göttingen, Germany.,Göttingen Graduate School for Neurosciences, Biophysics, and Molecular Biosciences, Göttingen, Germany
| | - Hanan Al-Moyed
- Göttingen Graduate School for Neurosciences, Biophysics, and Molecular Biosciences, Göttingen, Germany.,Molecular Biology of Cochlear Neurotransmission Group, Department for Otolaryngology and InnerEarLab, University Medical Center Göttingen, Göttingen, Germany
| | - Alexandra Müller
- Collaborative Research Center 889 "Cellular Mechanisms of Sensory Processing", Göttingen, Germany.,Göttingen Graduate School for Neurosciences, Biophysics, and Molecular Biosciences, Göttingen, Germany.,Molecular Biology of Cochlear Neurotransmission Group, Department for Otolaryngology and InnerEarLab, University Medical Center Göttingen, Göttingen, Germany
| | - Gerhard Hoch
- Institute for Auditory Neuroscience and InnerEarLab, University Medical Center Göttingen and German Primate Center, Göttingen, Germany
| | - Tina Pangrsic
- Collaborative Research Center 889 "Cellular Mechanisms of Sensory Processing", Göttingen, Germany.,Synaptic Physiology of Mammalian Vestibular Hair Cells Group, Institute for Auditory Neuroscience and InnerEarLab, University Medical Center Göttingen and Max Planck Institute of Experimental Medicine, Göttingen, Germany
| | - Gulnara Yamanbaeva
- Auditory Systems Physiology Group, Department for Otolaryngology and InnerEarLab, University Medical Center Göttingen, Göttingen, Germany.,Collaborative Research Center 889 "Cellular Mechanisms of Sensory Processing", Göttingen, Germany.,Göttingen Graduate School for Neurosciences, Biophysics, and Molecular Biosciences, Göttingen, Germany
| | - Christof Lenz
- Bioanalytical Mass Spectrometry Group, Max Planck Institute for Biophysical Chemistry, Göttingen, Germany.,Bioanalytics, Institute of Clinical Chemistry, University Medical Center Göttingen, Göttingen, Germany
| | - Kuan-Ting Pan
- Bioanalytical Mass Spectrometry Group, Max Planck Institute for Biophysical Chemistry, Göttingen, Germany
| | - Elisabeth Auge
- Auditory Systems Physiology Group, Department for Otolaryngology and InnerEarLab, University Medical Center Göttingen, Göttingen, Germany
| | - Ruth Geiss-Friedlander
- Department of Molecular Biology, University Medical Center Göttingen, Göttingen, Germany
| | - Henning Urlaub
- Collaborative Research Center 889 "Cellular Mechanisms of Sensory Processing", Göttingen, Germany.,Bioanalytical Mass Spectrometry Group, Max Planck Institute for Biophysical Chemistry, Göttingen, Germany.,Bioanalytics, Institute of Clinical Chemistry, University Medical Center Göttingen, Göttingen, Germany
| | - Nils Brose
- Collaborative Research Center 889 "Cellular Mechanisms of Sensory Processing", Göttingen, Germany.,Department of Molecular Neurobiology, Max Planck Institute of Experimental Medicine, Göttingen, Germany
| | - Carolin Wichmann
- Collaborative Research Center 889 "Cellular Mechanisms of Sensory Processing", Göttingen, Germany .,Molecular Architecture of Synapses Group, Institute for Auditory Neuroscience and InnerEarLab, University Medical Center Göttingen and Max Planck Institute of Experimental Medicine, Göttingen, Germany
| | - Ellen Reisinger
- Collaborative Research Center 889 "Cellular Mechanisms of Sensory Processing", Göttingen, Germany .,Molecular Biology of Cochlear Neurotransmission Group, Department for Otolaryngology and InnerEarLab, University Medical Center Göttingen, Göttingen, Germany.,Department of Molecular Neurobiology, Max Planck Institute of Experimental Medicine, Göttingen, Germany
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Abstract
Sensorineural hearing impairment is the most common form of hearing loss, and encompasses pathologies of the cochlea and the auditory nerve. Hearing impairment caused by abnormal neural encoding of sound stimuli despite preservation of sensory transduction and amplification by outer hair cells is known as 'auditory neuropathy'. This term was originally coined for a specific type of hearing impairment affecting speech comprehension beyond changes in audibility: patients with this condition report that they "can hear but cannot understand". This type of hearing impairment can be caused by damage to the sensory inner hair cells (IHCs), IHC ribbon synapses or spiral ganglion neurons. Human genetic and physiological studies, as well as research on animal models, have recently shown that disrupted IHC ribbon synapse function--resulting from genetic alterations that affect presynaptic glutamate loading of synaptic vesicles, Ca(2+) influx, or synaptic vesicle exocytosis--leads to hearing impairment termed 'auditory synaptopathy'. Moreover, animal studies have demonstrated that sound overexposure causes excitotoxic loss of IHC ribbon synapses. This mechanism probably contributes to hearing disorders caused by noise exposure or age-related hearing loss. This Review provides an update on recently elucidated sensory, synaptic and neural mechanisms of hearing impairment, their corresponding clinical findings, and discusses current rehabilitation strategies as well as future therapies.
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Affiliation(s)
- Tobias Moser
- Institute for Auditory Neuroscience and InnerEarLab, University Medical Center Göttingen, 37099 Göttingen, Germany
| | - Arnold Starr
- Center for Hearing Research, University of California, Irvine, California 92697, USA
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Selective Inner Hair Cell Dysfunction in Chinchillas Impairs Hearing-in-Noise in the Absence of Outer Hair Cell Loss. J Assoc Res Otolaryngol 2015; 17:89-101. [PMID: 26691159 DOI: 10.1007/s10162-015-0550-8] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2015] [Accepted: 12/07/2015] [Indexed: 10/22/2022] Open
Abstract
Poorer hearing in the presence of background noise is a significant problem for the hearing impaired. Ototoxic drugs, ageing, and noise exposure can damage the sensory hair cells of the inner ear that are essential for normal hearing sensitivity. The relationship between outer hair cell (OHC) loss and progressively poorer hearing sensitivity in quiet or in competing background noise is supported by a number of human and animal studies. In contrast, the effect of moderate inner hair cell (IHC) loss or dysfunction shows almost no impact on behavioral measures of hearing sensitivity in quiet, when OHCs remain intact, but the relationship between selective IHC loss and hearing in noise remains relatively unknown. Here, a moderately high dose of carboplatin (75 mg/kg) that produced IHC loss in chinchillas ranging from 40 to 80 % had little effect on thresholds in quiet. However, when tested in the presence of competing broadband (BBN) or narrowband noise (NBN), thresholds increased significantly. IHC loss >60 % increased signal-to-noise ratios (SNRs) for tones (500-11,300 Hz) in competing BBN by 5-10 dB and broadened the masking function under NBN. These data suggest that IHC loss or dysfunction may play a significant role in listening in noise independent of OHC integrity and that these deficits may be present even when thresholds in quiet are within normal limits.
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Rance G, Starr A. Pathophysiological mechanisms and functional hearing consequences of auditory neuropathy. Brain 2015; 138:3141-58. [PMID: 26463676 DOI: 10.1093/brain/awv270] [Citation(s) in RCA: 104] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2015] [Accepted: 08/05/2015] [Indexed: 01/19/2023] Open
Abstract
The effects of inner ear abnormality on audibility have been explored since the early 20th century when sound detection measures were first used to define and quantify 'hearing loss'. The development in the 1970s of objective measures of cochlear hair cell function (cochlear microphonics, otoacoustic emissions, summating potentials) and auditory nerve/brainstem activity (auditory brainstem responses) have made it possible to distinguish both synaptic and auditory nerve disorders from sensory receptor loss. This distinction is critically important when considering aetiology and management. In this review we address the clinical and pathophysiological features of auditory neuropathy that distinguish site(s) of dysfunction. We describe the diagnostic criteria for: (i) presynaptic disorders affecting inner hair cells and ribbon synapses; (ii) postsynaptic disorders affecting unmyelinated auditory nerve dendrites; (iii) postsynaptic disorders affecting auditory ganglion cells and their myelinated axons and dendrites; and (iv) central neural pathway disorders affecting the auditory brainstem. We review data and principles to identify treatment options for affected patients and explore their benefits as a function of site of lesion.
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Affiliation(s)
- Gary Rance
- 1 Department of Audiology and Speech Pathology, The University of Melbourne, 550 Swanston Street, Parkville 3010 Australia
| | - Arnold Starr
- 2 Department of Neurology, The University of California (Irvine), 200 S. Manchester Ave., Suite 206, Orange, CA 92868-4280, USA
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Santarelli R, del Castillo I, Cama E, Scimemi P, Starr A. Audibility, speech perception and processing of temporal cues in ribbon synaptic disorders due to OTOF mutations. Hear Res 2015; 330:200-12. [PMID: 26188103 DOI: 10.1016/j.heares.2015.07.007] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2014] [Revised: 06/21/2015] [Accepted: 07/12/2015] [Indexed: 11/26/2022]
Abstract
Mutations in the OTOF gene encoding otoferlin result in a disrupted function of the ribbon synapses with impairment of the multivesicular glutamate release. Most affected subjects present with congenital hearing loss and abnormal auditory brainstem potentials associated with preserved cochlear hair cell activities (otoacoustic emissions, cochlear microphonics [CMs]). Transtympanic electrocochleography (ECochG) has recently been proposed for defining the details of potentials arising in both the cochlea and auditory nerve in this disorder, and with a view to shedding light on the pathophysiological mechanisms underlying auditory dysfunction. We review the audiological and electrophysiological findings in children with congenital profound deafness carrying two mutant alleles of the OTOF gene. We show that cochlear microphonic (CM) amplitude and summating potential (SP) amplitude and latency are normal, consistently with a preserved outer and inner hair cell function. In the majority of OTOF children, the SP component is followed by a markedly prolonged low-amplitude negative potential replacing the compound action potential (CAP) recorded in normally-hearing children. This potential is identified at intensities as low as 90 dB below the behavioral threshold. In some ears, a synchronized CAP is superimposed on the prolonged responses at high intensity. Stimulation at high rates reduces the amplitude and duration of the prolonged potentials, consistently with their neural generation. In some children, however, the ECochG response only consists of the SP, with no prolonged potential. Cochlear implants restore hearing sensitivity, speech perception and neural CAP by electrically stimulating the auditory nerve fibers. These findings indicate that an impaired multivesicular glutamate release in OTOF-related disorders leads to abnormal auditory nerve fiber activation and a consequent impairment of spike generation. The magnitude of these effects seems to vary, ranging from no auditory nerve fiber activation to an abnormal generation of EPSPs that occasionally trigger a synchronized electrical activity, resulting in high-threshold CAPs.
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Affiliation(s)
- Rosamaria Santarelli
- Department of Neurosciences, University of Padova, Via Giustiniani 2, 35128 Padova, Italy; Audiology and Phoniatrics Service, Treviso Regional Hospital, Piazza Ospedale 1, 31100 Treviso, Italy.
| | - Ignacio del Castillo
- Servicio de Genética, Hospital Universitario Ramón y Cajal, IRYCIS, 28034 Madrid, Spain; Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), 28034 Madrid, Spain
| | - Elona Cama
- Department of Neurosciences, University of Padova, Via Giustiniani 2, 35128 Padova, Italy; Audiology and Phoniatrics Service, Treviso Regional Hospital, Piazza Ospedale 1, 31100 Treviso, Italy
| | - Pietro Scimemi
- Department of Neurosciences, University of Padova, Via Giustiniani 2, 35128 Padova, Italy; Audiology and Phoniatrics Service, Treviso Regional Hospital, Piazza Ospedale 1, 31100 Treviso, Italy
| | - Arnold Starr
- Department of Neurology, University of California, Irvine, CA 92697, USA
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Wynne DP, George SE, Zeng FG. Amplitude modulation reduces loudness adaptation to high-frequency tones. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2015; 138:279-283. [PMID: 26233027 PMCID: PMC4506306 DOI: 10.1121/1.4922707] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2014] [Revised: 06/03/2015] [Accepted: 06/08/2015] [Indexed: 06/04/2023]
Abstract
Long-term loudness perception of a sound has been presumed to depend on the spatial distribution of activated auditory nerve fibers as well as their temporal firing pattern. The relative contributions of those two factors were investigated by measuring loudness adaptation to sinusoidally amplitude-modulated 12-kHz tones. The tones had a total duration of 180 s and were either unmodulated or 100%-modulated at one of three frequencies (4, 20, or 100 Hz), and additionally varied in modulation depth from 0% to 100% at the 4-Hz frequency only. Every 30 s, normal-hearing subjects estimated the loudness of one of the stimuli played at 15 dB above threshold in random order. Without any amplitude modulation, the loudness of the unmodulated tone after 180 s was only 20% of the loudness at the onset of the stimulus. Amplitude modulation systematically reduced the amount of loudness adaptation, with the 100%-modulated stimuli, regardless of modulation frequency, maintaining on average 55%-80% of the loudness at onset after 180 s. Because the present low-frequency amplitude modulation produced minimal changes in long-term spectral cues affecting the spatial distribution of excitation produced by a 12-kHz pure tone, the present result indicates that neural synchronization is critical to maintaining loudness perception over time.
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Affiliation(s)
- Dwight P Wynne
- Center for Hearing Research, University of California, Irvine, 110 Medical Science E, Irvine, California 92697, USA
| | - Sahara E George
- Center for Hearing Research, University of California, Irvine, 110 Medical Science E, Irvine, California 92697, USA
| | - Fan-Gang Zeng
- Center for Hearing Research, University of California, Irvine, 110 Medical Science E, Irvine, California 92697, USA
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36
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Abstract
Neural disorders of the auditory nerve are associated with particular disorders of auditory perceptions dependent on processing of acoustic temporal cues. These include: (1) speech perception; (2) localizing a sound's origin in space; and (3) identifying sounds in background noise. Auditory neuropathy (AN) is a consequence of: (1) presynaptic disorders affecting inner hair cell ribbon synapses; (2) postsynaptic disorders of auditory nerve dendrites; and (3) postsynaptic disorders of auditory nerve axons. The etiologies of these disorders are diverse, similar to other cranial or peripheral neuropathies. The pathologies cause attenuated and dyssynchronous auditory nerve discharges. Therapies and management of patients with AN are reviewed.
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Affiliation(s)
- Arnold Starr
- Departments of Neurology and Neurobiology, University of California, Irvine, CA, USA.
| | - Gary Rance
- School of Audiology, University of Melbourne, Melbourne, Australia
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37
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Moore DR. Sources of pathology underlying listening disorders in children. Int J Psychophysiol 2014; 95:125-34. [PMID: 25086259 DOI: 10.1016/j.ijpsycho.2014.07.006] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2013] [Revised: 07/08/2014] [Accepted: 07/11/2014] [Indexed: 11/18/2022]
Abstract
Some children referred to audiology and developmental disability services have listening difficulties, despite normal audiograms. These children may be tested for 'auditory processing disorder' (APD), a controversial construct suggesting that neural dysfunction in the central auditory system leads to impaired auditory perception. An important question, not currently tested in clinical evaluation, is whether listening difficulties result from problems with bottom-up auditory sensory processing or top-down modulating cognition. Perceptual variability and poor performance on standardized tests suggest that listening difficulties are primarily cognitive in origin. However, evidence for impaired olivocochlear function and temporal processing deficits may implicate peripheral or central auditory dysfunction in some cases. Wide-spread, top-down modulation of auditory cortical, brainstem and ear function suggests that afferent and efferent control systems may not be simple to segregate. During normal maturation, hearing appears to develop in proportion to the complexity of both stimuli and tasks. But some younger individuals have mature hearing, highlighting individual differences that suggest APD may be due to a generalized developmental delay. Recent studies have investigated specific hypotheses showing, for example, that spatial hearing and executive function are compromised in some children with listening difficulties. Using speech stimuli (e.g. consonant-vowel syllables) to examine auditory brainstem responses, and psychophysiological relations between dichotic hearing and cortical physiology, various effects of auditory experience and development point the way to promising approaches for further studies of APD. Newer technology, from genetic sequencing to MRI, may have the sensitivity to test whether and how frequently APD is associated with impaired processing in the auditory system.
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Affiliation(s)
- David R Moore
- Communication Sciences Research Center, Cincinnati Children's Hospital Medical Center, S1.300, 240 Albert Sabin Way, Cincinnati, OH 45229, USA; Department of Otolaryngology, College of Medicine, University of Cincinnati, Cincinnati, OH, USA; School of Psychological Sciences, University of Manchester, Manchester, UK.
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Santarelli R, del Castillo I, Starr A. Auditory neuropathies and electrocochleography. HEARING BALANCE AND COMMUNICATION 2013. [DOI: 10.3109/21695717.2013.815446] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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