The Role of Sound in Adult and Developmental Auditory Cortical Plasticity

Novel sound exposure drives dynamic changes in auditory lateralization that are associated with perceptual learning in zebra finches

Songbirds provide a model for adult plasticity in the auditory cortex as a function of recent experience due to parallels with human auditory processing. As for speech processing in humans, activity in songbirds' higher auditory cortex (caudomedial nidopallium, NCM) is lateralized for complex vocalization sounds. However, in Zebra finches exposed to a novel heterospecific (canary) acoustic environment for 4-9 days, the typical pattern of right-lateralization is reversed. We now report that, in birds passively exposed to a novel heterospecific environment for extended periods (up to 21 days), the right-lateralized pattern of epidural auditory potentials first reverses transiently then returns to the typical pattern. Using acute, bilateral multi-unit electrophysiology, we confirm that this dynamic pattern occurs in NCM. Furthermore, extended exposure enhances discrimination for heterospecific stimuli. We conclude that lateralization is functionally labile and, when engaged by novel sensory experience, contributes to discrimination of novel stimuli that may be ethologically relevant. Future studies seek to determine whether, (1) the dynamicity of lateralized processes engaged by novel sensory experiences recurs with every novel challenge in the same organism; (2) the dynamic pattern extends to other cortical, thalamic or midbrain structures; and (3) the phenomenon generalizes across sensory modalities.

The neuroanatomical hallmarks of chronic tinnitus in comorbidity with pure-tone hearing loss

Tinnitus is one of the main hearing impairments often associated with pure-tone hearing loss, and typically manifested in the perception of phantom sounds. Nevertheless, tinnitus has traditionally been studied in isolation without necessarily considering auditory ghosting and hearing loss as part of the same syndrome. Hence, in the present neuroanatomical study, we attempted to pave the way toward a better understanding of the tinnitus syndrome, and compared two groups of almost perfectly matched individuals with (TIHL) and without (NTHL) pure-tone tinnitus, but both characterized by pure-tone hearing loss. The two groups were homogenized in terms of sample size, age, gender, handedness, education, and hearing loss. Furthermore, since the assessment of pure-tone hearing thresholds alone is not sufficient to describe the full spectrum of hearing abilities, the two groups were also harmonized for supra-threshold hearing estimates which were collected using temporal compression, frequency selectivity und speech-in-noise tasks. Regions-of-interest (ROI) analyses based on key brain structures identified in previous neuroimaging studies showed that the TIHL group exhibited increased cortical volume (CV) and surface area (CSA) of the right supramarginal gyrus and posterior planum temporale (PT) as well as CSA of the left middle-anterior part of the superior temporal sulcus (STS). The TIHL group also demonstrated larger volumes of the left amygdala and of the left head and body of the hippocampus. Notably, vertex-wise multiple linear regression analyses additionally brought to light that CSA of a specific cluster, which was located in the left middle-anterior part of the STS and overlapped with the one found to be significant in the between-group analyses, was positively associated with tinnitus distress level. Furthermore, distress also positively correlated with CSA of gray matter vertices in the right dorsal prefrontal cortex and the right posterior STS, whereas tinnitus duration was positively associated with CSA and CV of the right angular gyrus (AG) and posterior part of the STS. These results provide new insights into the critical gray matter architecture of the tinnitus syndrome matrix responsible for the emergence, maintenance and distress of auditory phantom sensations.

Cognitive decline in acoustic neuroma patients: An investigation based on resting-state functional magnetic resonance imaging and voxel-based morphometry

OBJECTIVE

Acoustic neuroma (AN) is a clinically common benign tumor. There are few neuropsychological investigations for AN, especially cognitive neuropsychology. Herein, the study probed into cognitive function changes in AN patients and expounded possible mechanisms through structural and functional magnetic resonance imaging (fMRI).

MATERIALS AND METHODS

Neuropsychological tests were performed between 64 patients with AN and 67 healthy controls. Then, using resting-state fMRI, the possible mechanisms of cognitive decline in AN patients were further explored by calculating the amplitude of low-frequency fluctuations (ALFF) and regional homogeneity (ReHo). Furthermore, using high-resolution T1-weighted images, voxel-based morphometry (VBM) was adopted to investigate the changes in gray matter volume (GMV) and white matter volume (WMV) in AN patients.

RESULTS

AN patients had worse cognitive performance than those in the healthy controls. Relative to the healthy individuals, the mALFF value was increased in the right caudate nucleus of the patients with left-sided AN (LAN) and the right rectus region of the patients with right-sided AN (RAN). The mReHo values of the bilateral superior frontal gyrus and middle frontal gyrus were decreased in LAN patients. Compared with healthy subjects, the GMV values were elevated in the left fusiform gyrus, parahippocampal gyrus, calcarine gyrus, and cuneus in LAN patients as well as in the right fusiform gyrus and parahippocampal gyrus in RAN patients. Meanwhile, the WMV values showed elevations in the bilateral putamen, left rectal gyrus, and thalamus in LAN patients.

CONCLUSION

Cognitive dysfunction occurs in AN patients. Cognitive decline in AN patients activates functional activity in some brain regions, thereby compensating for cognition decline. Additionally, the ReHo values were reduced in the frontal lobe in LAN patients, and the connectivity was decreased, affecting the functional differentiation and integration of the brain, which may be associated with the decline in cognitive function. Lateralized brain reorganization induced by unilateral hearing loss was presented in AN patients. LAN caused a more significant interference effect on the brain while RAN patients showed more stable cerebral cortices. Altogether, responding to cognition decline in AN patients, structural reorganization occurs, and compensative increases in cognitive-related brain regions, which compensates for cognitive impairment.

Hearing more to hear less: a scoping review of hearing aids for tinnitus relief

OBJECTIVE

As tinnitus is often associated with hearing loss, hearing aids have been proposed for tinnitus relief in literature for more than 70 years. There is a need for recent literature to be reviewed and guide decision making in tinnitus management. This scoping review aims to provide an update of the available evidence on hearing aids for tinnitus, focussing on the effect of sound amplification or combination devices (i.e. amplification and sound generation within one device).

DESIGN

Research studies were included if they investigated hearing aids or combination devices for tinnitus and were published after 2011.

STUDY SAMPLE

A total of 28 primary research studies were selected.

RESULTS

Positive results of hearing aids in tinnitus patients were shown in 68% of the studies, whereas 14% demonstrated no change in tinnitus distress. However, the quality of the evidence across studies was variable.

CONCLUSIONS

Scientific support for hearing aids and combination devices for tinnitus relief was found. The standalone effect of sound amplification and the added value of sound generators and adjustment of sound processing strategies needs further investigation. Stronger methodology in future studies is needed to reach consensus on how to optimise hearing solutions in a multidisciplinary approach.

Short-Term Pediatric Acclimatization to Adaptive Hearing Aid Technology

Purpose This exploratory study assessed the perceptual, cognitive, and academic learning effects of an adaptive, integrated, directionality, and noise reduction hearing aid program in pediatric users. Method Fifteen pediatric hearing aid users (6-12 years old) received new bilateral, individually fitted Oticon Opn hearing aids programmed with OpenSound Navigator (OSN) processing. Word recognition in noise, sentence repetition in quiet, nonword repetition, vocabulary learning, selective attention, executive function, memory, and reading and mathematical abilities were measured within 1 week of the initial hearing aid fitting and 2 months post fit. Caregivers completed questionnaires assessing their child's listening and communication abilities prior to study enrollment and after 2 months of using the study hearing aids. Results Caregiver reporting indicated significant improvements in speech and sound perception, spatial sound awareness, and the ability to participate in conversations. However, there was no positive change in performance in any of the measured skills. Mathematical scores significantly declined after 2 months. Conclusions OSN provided a perceived improvement in functional benefit, compared to their previous hearing aids, as reported by caregivers. However, there was no positive change in listening skills, cognition, and academic success after 2 months of using OSN. Findings may have been impacted by reporter bias, limited sample size, and a relatively short trial period. This study took place during the summer when participants were out of school, which may have influenced the decline in mathematical scores. The results support further exploration with age- and audiogram-matched controls, larger sample sizes, and longer test-retest intervals that correspond to the academic school year.

Sequential Bilateral Cochlear Implantation With Prolonged Time Intervals

Purpose The aim of the study was to assess whether sequential cochlear implantation (CI) with a prolonged interimplant interval (M = 15.2 years) between the first and second CIs benefited speech recognition and health-related quality of life. Method This prospective study included 14 prelingually deafened participants who received their second CI after a prolonged interimplant interval (M = 15.2 years). Additionally, speech recognition ability over a 12-month period of bilateral implant use was investigated. The results of the speech recognition test in both quiet and noisy conditions were statistically analyzed for each CI alone and both CIs together. Nijmegen Cochlear Implant Questionnaire scores were also collected at activation and at 12 months after activation. Results Improvements in speech recognition ability were observed following the use of the first implant alone and with the use of both implants together; however, progress was much slower with the use of the second implant alone, following its introduction. Furthermore, a significant difference in the trajectory of speech recognition ability was observed between the first and the second implanted ear. According to Nijmegen Cochlear Implant Questionnaire scores, all participants benefitted from bilateral CI after 12 months. Conclusions Prolonged interimplant intervals resulted in asymmetrical speech recognition abilities. A significant improvement in the speech recognition scores was observed with the first implanted ear, and much slower progress was observed with the second implanted ear. However, the "poorer" second implanted ear could provide a considerable beneficial effect on the improved speech recognition and health-related quality of life with the bilateral CI. Supplemental Material https://doi.org/10.23641/asha.12861152.

Cochlear synaptopathy: new findings in animal and human research

In animal models, prolonged exposure (2 h) to high-level noise causes an irreparable damage to the synapses between the inner hair cells and auditory nerve fibers within the cochlea. Nevertheless, this injury does not necessarily alter the hearing threshold. Similar findings have been observed as part of typical aging in animals. This type of cochlear synaptopathy, popularly called "hidden hearing loss," has been a significant issue in neuroscience research and clinical audiology scientists. The results obtained in different investigations are inconclusive in their diagnosis and suggest new strategies for both prognosis and treatment of cochlear synaptopathy. Here we review the major physiological findings regarding cochlear synaptopathy in animals and humans and discuss mathematical models. We also analyze the potential impact of these results on clinical practice and therapeutic options.

Predicting Sequential Cochlear Implantation Performance: A Systematic Review

This systematic review of the literature reveals which pre-operative factors affect sequential cochlear implantation outcomes in adults. The findings can help health care prof-essionals provide evidence-based advice on the expected benefits from a second cochlear implant (CI). We searched PubMed, EMBASE, and the Cochrane database from November 1977 to August 26, 2017, using the terms "sequential cochlear implantation"; the most frequently cited predictors for unilateral cochlear implantation performance and other potential predictors for sequential implantation outcome; and "speech perception," "localization" as well as synonyms of all of the above. Ten studies were included. The effects of age, duration of hearing loss, time between implantations, preoperative hearing, etiology of hearing loss, hearing aid use and duration of follow-up on sequential cochlear implantation performance were studied. The literature has shown that duration of deafness, age at onset of deafness, etiology of hearing loss, and preoperative speech perception score are (inversely) related to unilateral cochlear implantation outcome in adults. One would expect that these factors would also affect sequential bilateral implantation outcome. However, the best available evidence to date shows that advanced age, a long duration of deafness, or a long interval between implantations should not be considered negative factors when considering sequential bilateral cochlear implantation.

Cortical and thalamic connectivity to the second auditory cortex of the cat is resilient to the onset of deafness

It has been well established that following sensory loss, cortical areas that would normally be involved in perceiving stimuli in the absent modality are recruited to subserve the remaining senses. Despite this compensatory functional reorganization, there is little evidence to date for any substantial change in the patterns of anatomical connectivity between sensory cortices. However, while many auditory areas are contracted in the deaf, the second auditory cortex (A2) of the cat undergoes a volumetric expansion following hearing loss, suggesting this cortical area may demonstrate a region-specific pattern of structural reorganization. To address this hypothesis, and to complement existing literature on connectivity within auditory cortex, we injected a retrograde neuronal tracer across the breadth and cortical thickness of A2 to provide the first comprehensive quantification of projections from cortical and thalamic auditory and non-auditory regions to the second auditory cortex, and to determine how these patterns are affected by the onset of deafness. Neural projections arising from auditory, visual, somatomotor, and limbic cortices, as well as thalamic nuclei, were compared across normal hearing, early-deaf, and late-deaf animals. The results demonstrate that, despite previously identified changes in A2 volume, the pattern of projections into this cortical region are unaffected by the onset of hearing loss. These results fail to support the idea that crossmodal plasticity reflects changes in the pattern of projections between cortical regions and provides evidence that the pattern of connectivity that supports normal hearing is retained in the deaf brain.

Longitudinal Changes in Electrically Evoked Auditory Event-Related Potentials in Children With Auditory Brainstem Implants: Preliminary Results Recorded Over 3 Years

OBJECTIVES

This preliminary study aimed (1) to assess longitudinal changes in electrically evoked auditory event-related potentials (eERPs) in children with auditory brainstem implants (ABIs) and (2) to explore whether these changes could be accounted for by maturation in the central auditory system of these patients.

DESIGN

Study participants included 5 children (S1 to S5) with an ABI in the affected ear. The stimulus was a train of electrical pulses delivered to individual ABI electrodes via a research interface. For each subject, the eERP was repeatedly measured in multiple test sessions scheduled over up to 41 months after initial device activation. Longitudinal changes in eERPs recorded for each ABI electrode were evaluated using intraclass correlation tests for each subject.

RESULTS

eERPs recorded in S1 showed notable morphological changes for five ABI electrodes over 41 months. In parallel, signs or symptoms of nonauditory stimulation elicited by these electrodes were observed or reported at 41 months. eERPs could not be observed in S2 after 9 months of ABI use but were recorded at 12 months after initial stimulation. Repeatable eERPs were recorded in S3 in the first 9 months. However, these responses were either absent or showed remarkable morphological changes at 30 months. Longitudinal changes in eERP waveform morphology recorded in S4 and S5 were also observed.

CONCLUSIONS

eERP responses in children with ABIs could change over a long period of time. Maturation of the central auditory system could not fully account for these observed changes. Children with ABIs need to be closely monitored for potential changes in auditory perception and unfavorable nonauditory sensations. Neuroimaging correlates are needed to better understand the emergence of nonauditory stimulation over time in these children.

The Enigma of Poor Performance by Adults With Cochlear Implants

OBJECTIVE

Considerable unexplained variability and large individual differences exist in speech recognition outcomes for postlingually deaf adults who use cochlear implants (CIs), and a sizeable fraction of CI users can be considered "poor performers." This article summarizes our current knowledge of poor CI performance, and provides suggestions to clinicians managing these patients.

METHOD

Studies are reviewed pertaining to speech recognition variability in adults with hearing loss. Findings are augmented by recent studies in our laboratories examining outcomes in postlingually deaf adults with CIs.

RESULTS

In addition to conventional clinical predictors of CI performance (e.g., amount of residual hearing, duration of deafness), factors pertaining to both "bottom-up" auditory sensitivity to the spectro-temporal details of speech, and "top-down" linguistic knowledge and neurocognitive functions contribute to CI outcomes.

CONCLUSIONS

The broad array of factors that contribute to speech recognition performance in adult CI users suggests the potential both for novel diagnostic assessment batteries to explain poor performance, and also new rehabilitation strategies for patients who exhibit poor outcomes. Moreover, this broad array of factors determining outcome performance suggests the need to treat individual CI patients using a personalized rehabilitation approach.

Two Ears Are Not Always Better than One: Mandatory Vowel Fusion Across Spectrally Mismatched Ears in Hearing-Impaired Listeners

Hearing loss and auditory prostheses can alter auditory processing by inducing large pitch mismatches and broad pitch fusion between the two ears. Similar to integration of incongruent inputs in other sensory modalities, the mismatched, fused pitches are often averaged across ears for simple stimuli. Here, we measured parallel effects on complex stimulus integration using a new technique based on vowel classification in five bilateral hearing aid users and eight bimodal cochlear implant users. Continua between five pairs of synthetic vowels were created by varying the first formant spectral peak while keeping the second formant constant. Comparison of binaural and monaural vowel classification functions for each vowel pair continuum enabled visualization of the following frequency-dependent integration trends: (1) similar monaural and binaural functions, (2) ear dominance, (3) binaural averaging, and (4) binaural interference. Hearing aid users showed all trends, while bimodal cochlear implant users showed mostly ear dominance or interference. Interaural pitch mismatches, frequency ranges of binaural pitch fusion, and the relative weightings of pitch averaging across ears were also measured using tone and/or electrode stimulation. The presence of both large interaural pitch mismatches and broad pitch fusion was not sufficient to predict vowel integration trends such as binaural averaging or interference. The way that pitch averaging was weighted between ears also appears to be important for determining binaural vowel integration trends. Abnormally broad spectral fusion and the associated phoneme fusion across mismatched ears may underlie binaural speech perception interference observed in hearing aid and cochlear implant users.

Acoustically evoked auditory change complex in children with auditory neuropathy spectrum disorder: a potential objective tool for identifying cochlear implant candidates

OBJECTIVES

The overall aim of the study was to evaluate the feasibility of using electrophysiological measures of the auditory change complex (ACC) to identify candidates for cochlear implantation in children with auditory neuropathy spectrum disorder (ANSD). To achieve this overall aim, this study (1) assessed the feasibility of measuring the ACC evoked by temporal gaps in a group of children with ANSD across a wide age range and (2) investigated the association between gap detection thresholds (GDTs) measured by the ACC recordings and open-set speech-perception performance in these subjects.

DESIGN

Nineteen children with bilateral ANSD ranging in age between 1.9 and 14.9 years (mean: 7.8 years) participated in this study. Electrophysiological recordings of the auditory event-related potential (ERP), including the onset ERP response and the ACC, were completed in all subjects and open-set speech perception was evaluated for a subgroup of 16 subjects. For the ERP recordings, the stimulus was a Gaussian noise presented through ER-3A insert earphones to the test ear. Two stimulation conditions were used. In the "control condition," the stimulus was an 800-msec Gaussian noise. In the "gapped condition," the stimuli were two noise segments, each being 400 msec in duration, separated by one of five gaps (i.e., 5, 10, 20, 50, or 100 msec). The interstimulation interval was 1200 msec. The aided open-set speech perception ability was assessed using the Phonetically Balanced Kindergarten (PBK) word lists presented at 60 dB SPL using recorded testing material in a sound booth. For speech perception tests, subjects wore their hearing aids at the settings recommended by their clinical audiologists. For a subgroup of five subjects, psychophysical GDTs for the Gaussian noise were also assessed using a three-interval, three-alternative forced-choice procedure.

RESULTS

Responses evoked by the onset of the Gaussian noise (i.e., onset responses) were recorded in all stimulation conditions from all subjects tested in this study. The presence/absence, peak latency and amplitude, and response width of the onset response did not correlate with aided PBK word scores. The objective GDTs measured with the ACC recordings from 17 subjects ranged from 10 to 100 msec. The ACC was not recorded from two subjects for any gap durations tested in this study. There was a robust negative correlation between objective GDTs and aided PBK word scores. In general, subjects with prolonged objective GDTs showed low-aided PBK word scores. GDTs measured using electrophysiological recordings of the ACC correlated well with those measured using psychophysical procedures in four of five subjects who were evaluated using both procedures.

CONCLUSIONS

The clinical application of the onset response in predicting open-set speech-perception ability is relatively limited in children with ANSD. The ACC recordings can be used to objectively evaluate temporal resolution abilities in children with ANSD having no severe comorbidities, and who are older than 1.9 years. The ACC can potentially be used as an objective tool to identify poor performers among children with ANSD using properly fit amplification, and who are thus, cochlear implant candidates.

The neuronal porosome complex in health and disease

Cup-shaped secretory portals at the cell plasma membrane called porosomes mediate the precision release of intravesicular material from cells. Membrane-bound secretory vesicles transiently dock and fuse at the base of porosomes facing the cytosol to expel pressurized intravesicular contents from the cell during secretion. The structure, isolation, composition, and functional reconstitution of the neuronal porosome complex have greatly progressed, providing a molecular understanding of its function in health and disease. Neuronal porosomes are 15 nm cup-shaped lipoprotein structures composed of nearly 40 proteins, compared to the 120 nm nuclear pore complex composed of >500 protein molecules. Membrane proteins compose the porosome complex, making it practically impossible to solve its atomic structure. However, atomic force microscopy and small-angle X-ray solution scattering studies have provided three-dimensional structural details of the native neuronal porosome at sub-nanometer resolution, providing insights into the molecular mechanism of its function. The participation of several porosome proteins previously implicated in neurotransmission and neurological disorders, further attest to the crosstalk between porosome proteins and their coordinated involvement in release of neurotransmitter at the synapse.

[Cochlear implants and tinnitus]

The cochlear implant became a very successful method of hearing rehabilitation for patients with profound sensorineural hearing loss. The benefits of the CI extend beyond the medical success and positively influence social and psychosocial areas, reflected by an improved HRQoL. Furthermore, variety of studies demonstrated that the tinnitus severity improves in 46-95 % of cases following the cochlear implantation. However, the parameters investigated in such studies are not always standardized or addressed by validated questionnaires, which explains the high outcome variation between the studies. The relationships between HRQoL and tinnitus distress before and after cochlear implantation have not been well studied. Nevertheless, it is believed that the improvement in HRQoL following CI affects particularly tinnitus.However, an existing tinnitus can also worsen or occur for the first time after the surgery. Since neither tinnitus frequency nor tinnitus loudness correlate with the tinnitus-induced distress, the measurement of HRQoL, distress factors, stress reactions and psychiatric comorbidities appears to be the meaningful assessment of positive or negative effects of CI on tinnitus.Initial studies demonstrated that also patients with unilateral hearing loss may benefit from CI supply, as shown by an improvement in HRQoL and reduction of tinnitus-induced distress. For those patients, who despite CI implantation experience severe tinnitus, there is an option of tinnitus-specific CI-fitting and tinnitus-specific therapy with psychosomatic and psychological approaches, and- in addition- a treatment of possible mental comorbidities.

The effectiveness of neuro-music therapy according to the Heidelberg model compared to a single session of educational counseling as treatment for tinnitus: a controlled trial

OBJECTIVES

Tinnitus is a very common symptom, yet the quest for an effective treatment is challenging. Results from several clinical trials support the notion that neuro-music therapy is an effective means to reduce tinnitus distress with short duration and long lasting effect. However, until now, the effectiveness has not been tested in a controlled trial against an active comparator.

METHODS

The trial was designed as two-center, parallel intervention group controlled study with two intervention groups: Counseling (50minute individualized personal instruction) or neuro-music therapy (counseling plus eight 50-minute sessions of individualized music therapy). Data of n=290 patients suffering from chronic tinnitus were analyzed. Outcome measure was the change in Tinnitus Questionnaire Total Scores (TQ) from baseline (admission) to end of treatment.

RESULTS

Both treatment groups achieved a statistically relevant reduction in TQ scores, though 66% of patients in the music therapy group attained a clinically meaningful improvement compared to 33% in the counseling group. A binary logistic regression revealed two variables significantly influencing therapy outcome: initial tinnitus score and type of therapy with an OR for the music therapy compared to the counseling of 4.34 (CI 2.33-8.09).

CONCLUSIONS

Counseling is an appropriate treatment option with well above chance of improvement. The neuro-music therapy outperformed the counseling. This treatment targets the tinnitus sound itself, is short in duration, intrinsically motivating and easy to operate and thus presents a possible complement to the therapeutic spectrum in chronic tinnitus. The trial was registered at the ClinicalTrials.gov registry (ID: NCT01845155).

Cochlear injury and adaptive plasticity of the auditory cortex

Growing evidence suggests that cochlear stressors as noise exposure and aging can induce homeostatic/maladaptive changes in the central auditory system from the brainstem to the cortex. Studies centered on such changes have revealed several mechanisms that operate in the context of sensory disruption after insult (noise trauma, drug-, or age-related injury). The oxidative stress is central to current theories of induced sensory-neural hearing loss and aging, and interventions to attenuate the hearing loss are based on antioxidant agent. The present review addresses the recent literature on the alterations in hair cells and spiral ganglion neurons due to noise-induced oxidative stress in the cochlea, as well on the impact of cochlear damage on the auditory cortex neurons. The emerging image emphasizes that noise-induced deafferentation and upward spread of cochlear damage is associated with the altered dendritic architecture of auditory pyramidal neurons. The cortical modifications may be reversed by treatment with antioxidants counteracting the cochlear redox imbalance. These findings open new therapeutic approaches to treat the functional consequences of the cortical reorganization following cochlear damage.

Benefit from non-linear frequency compression hearing aids in a clinical setting: the effects of duration of experience and severity of high-frequency hearing loss

OBJECTIVES

To determine whether non-linear frequency compression (NLFC) is effective for hearing-impaired adults in a clinical setting. To determine whether benefit from NLFC is related to duration of NLFC experience or severity of high-frequency hearing loss.

DESIGN

Participants were fitted with Phonak frequency compression hearing aids as part of their standard clinical care, using the manufacturer's default fitting settings. Participants had been using NLFC for between 1 and 121 weeks at the time of testing. Speech recognition thresholds in noise and consonant recognition in quiet were measured with and without NLFC enabled.

STUDY SAMPLE

Forty-six experienced adult hearing-aid users.

RESULTS

Consonant recognition in quiet, but not speech recognition in noise was significantly better with NLFC enabled. There was no significant correlation between duration of frequency compression experience and benefit. Benefit for consonant recognition was negatively correlated with mean audiometric thresholds from 2-6 kHz.

CONCLUSIONS

NLFC was beneficial for consonant recognition but not speech recognition in noise. There was no evidence to support the idea that a long period of acclimatization is necessary to gain full benefit. The relation between benefit and high-frequency thresholds might be explained by the poor audibility of compressed information for some listeners with severe loss.

White noise and neuronal porosome complex: transmission electron microscopic study

In the present electron microscopic study the effect of continuous white noise on the morphology of synapses and neuronal porosome complex (the neurotransmitter-release or secretory machinery) in two subcortical auditory brain regions - colliculus inferior and medial geniculate body in cat, were investigated. Several morphological alterations in some synapses were detected in both subcortical areas. These alterations mainly indicate to the decrease of functional activity of synapses. Rarely important pathological modifications in pre- and post-synaptic regions were detected. In addition to descriptive studies, the morphometric analysis of porosome diameter and depth was performed in colliculus inferior and medial geniculate body. The results revealed that while white noise has no effect on the porosome diameter and depth in colliculus inferior, it provokes significant alterations in the morphology of porosome complex in medial geniculate body. In particular, the significant increase of porosome depth in this nucleus may reflect the alteration in neurotransmission.

Altered regional and circuit resting-state activity associated with unilateral hearing loss

The deprivation of sensory input after hearing damage results in functional reorganization of the brain including cross-modal plasticity in the sensory cortex and changes in cognitive processing. However, it remains unclear whether partial deprivation from unilateral auditory loss (UHL) would similarly affect the neural circuitry of cognitive processes in addition to the functional organization of sensory cortex. Here, we used resting-state functional magnetic resonance imaging to investigate intrinsic activity in 34 participants with UHL from acoustic neuroma in comparison with 22 matched normal controls. In sensory regions, we found decreased regional homogeneity (ReHo) in the bilateral calcarine cortices in UHL. However, there was an increase of ReHo in the right anterior insular cortex (rAI), the key node of cognitive control network (CCN) and multimodal sensory integration, as well as in the left parahippocampal cortex (lPHC), a key node in the default mode network (DMN). Moreover, seed-based resting-state functional connectivity analysis showed an enhanced relationship between rAI and several key regions of the DMN. Meanwhile, lPHC showed more negative relationship with components in the CCN and greater positive relationship in the DMN. Such reorganizations of functional connectivity within the DMN and between the DMN and CCN were confirmed by a graph theory analysis. These results suggest that unilateral sensory input damage not only alters the activity of the sensory areas but also reshapes the regional and circuit functional organization of the cognitive control network.

Adaptation of the communicative brain to post-lingual deafness. Evidence from functional imaging

Not having access to one sense profoundly modifies our interactions with the environment, in turn producing changes in brain organization. Deafness and its rehabilitation by cochlear implantation offer a unique model of brain adaptation during sensory deprivation and recovery. Functional imaging allows the study of brain plasticity as a function of the times of deafness and implantation. Even long after the end of the sensitive period for auditory brain physiological maturation, some plasticity may be observed. In this way the mature brain that becomes deaf after language acquisition can adapt to its modified sensory inputs. Oral communication difficulties induced by post-lingual deafness shape cortical reorganization of brain networks already specialized for processing oral language. Left hemisphere language specialization tends to be more preserved than functions of the right hemisphere. We hypothesize that the right hemisphere offers cognitive resources re-purposed to palliate difficulties in left hemisphere speech processing due to sensory and auditory memory degradation. If cochlear implantation is considered, this reorganization during deafness may influence speech understanding outcomes positively or negatively. Understanding brain plasticity during post-lingual deafness should thus inform the development of cognitive rehabilitation, which promotes positive reorganization of the brain networks that process oral language before surgery. This article is part of a Special Issue entitled Human Auditory Neuroimaging.

On the similarities and differences of non-traumatic sound exposure during the critical period and in adulthood

There is an almost dogmatic view of the different effects of moderate-level sound stimulation in neonatal vs. adult animals. It is often stated that exposure in neonates results in an expansion of the cortical area that responds to the frequencies present in the sound, being either pure tones or frequency modulated sounds. In contrast, recent findings on stimulating adult animals for a sufficiently long time with similar sounds show a contraction of the cortical region responding to those sounds. In this review I will suggest that most neonatal animal results have been wrongly interpreted (albeit generally not by the original authors) and that the changes caused in the critical period (CP) and in adulthood are very similar. Thus, the mechanisms leading to the cortical map changes appear to be similar in the CP and in adulthood. Despite this similarity, the changes induced in the CP are occurring faster and are generally permanent (unless extensive training paradigms to revert the changes are involved), whereas in adults the induction is slower and a slow recovery (months) to pre-exposure conditions takes place.

Plasticity in the developing auditory cortex: evidence from children with sensorineural hearing loss and auditory neuropathy spectrum disorder

The developing auditory cortex is highly plastic. As such, the cortex is both primed to mature normally and at risk for reorganizing abnormally, depending upon numerous factors that determine central maturation. From a clinical perspective, at least two major components of development can be manipulated: (1) input to the cortex and (2) the timing of cortical input. Children with sensorineural hearing loss (SNHL) and auditory neuropathy spectrum disorder (ANSD) have provided a model of early deprivation of sensory input to the cortex and demonstrated the resulting plasticity and development that can occur upon introduction of stimulation. In this article, we review several fundamental principles of cortical development and plasticity and discuss the clinical applications in children with SNHL and ANSD who receive intervention with hearing aids and/or cochlear implants.

Auditory map reorganization and pitch discrimination in adult rats chronically exposed to low-level ambient noise

Behavioral adaption to a changing environment is critical for an animal's survival. How well the brain can modify its functional properties based on experience essentially defines the limits of behavioral adaptation. In adult animals the extent to which experience shapes brain function has not been fully explored. Moreover, the perceptual consequences of experience-induced changes in the brains of adults remain unknown. Here we show that the tonotopic map in the primary auditory cortex of adult rats living with low-level ambient noise underwent a dramatic reorganization. Behaviorally, chronic noise-exposure impaired fine, but not coarse pitch discrimination. When tested in a noisy environment, the noise-exposed rats performed as well as in a quiet environment whereas the control rats performed poorly. This suggests that noise-exposed animals had adapted to living in a noisy environment. Behavioral pattern analyses revealed that stress or distraction engendered by the noisy background could not account for the poor performance of the control rats in a noisy environment. A reorganized auditory map may therefore have served as the neural substrate for the consistent performance of the noise-exposed rats in a noisy environment.

Effects of degree and configuration of hearing loss on the contribution of high- and low-frequency speech information to bilateral speech understanding

OBJECTIVES

The purpose of this study was to examine the effects of degree and configuration of hearing loss on the use of, and benefit from, information in amplified high- and low-frequency speech presented in background noise.

DESIGN

Sixty-two adults with a wide range of high- and low-frequency sensorineural hearing loss (5 to 115+ dB HL) participated in the study. To examine the contribution of speech information in different frequency regions, speech understanding in noise was assessed in multiple low- and high-pass filter conditions, as well as a band-pass (713 to 3534 Hz) and wideband (143 to 8976 Hz) condition. To increase audibility over a wide frequency range, speech and noise were amplified based on each individual's hearing loss. A stepwise multiple linear regression approach was used to examine the contribution of several factors to (1) absolute performance in each filter condition and (2) the change in performance with the addition of amplified high- and low-frequency speech components.

RESULTS

Results from the regression analysis showed that degree of hearing loss was the strongest predictor of absolute performance for low- and high-pass filtered speech materials. In addition, configuration of hearing loss affected both absolute performance for severely low-pass filtered speech and benefit from extending high-frequency (3534 to 8976 Hz) bandwidth. Specifically, individuals with steeply sloping high-frequency losses made better use of low-pass filtered speech information than individuals with similar low-frequency thresholds but less high-frequency loss. In contrast, given similar high-frequency thresholds, individuals with flat hearing losses received more benefit from extending high-frequency bandwidth than individuals with more sloping losses.

CONCLUSIONS

Consistent with previous work, benefit from speech information in a given frequency region generally decreases as degree of hearing loss in that frequency region increases. However, given a similar degree of loss, the configuration of hearing loss also affects the ability to use speech information in different frequency regions. Except for individuals with steeply sloping high-frequency losses, providing high-frequency amplification (3534 to 8976 Hz) had either a beneficial effect on, or did not significantly degrade, speech understanding. These findings highlight the importance of extended high-frequency amplification for listeners with a wide range of high-frequency hearing losses, when seeking to maximize intelligibility.

Cortical plasticity in 4-month-old infants: specific effects of experience with musical timbres

Animal models suggest that the brain is particularly neuroplastic early in development, but previous studies have not systematically controlled the auditory environment in human infants and observed the effects on auditory cortical representations. We exposed 4-month-old infants to melodies in either guitar or marimba timbre (infants were randomly assigned to exposure group) for a total of ~160 min over the course of a week, after which we measured electroencephalogram (EEG) responses to guitar and marimba tones at pitches not previously heard during the exposure phase. A frontally negative response with a topography consistent with generation in auditory areas, peaking around 450 ms, was significantly larger for guitar than marimba tones in the guitar-exposed group but significantly larger for marimba than guitar tones in the marimba-exposed group. This indicates that experience with tones in a particular timbre affects representations for that timbre, and that this effect generalizes to tones not previously experienced during exposure. Furthermore, mismatch responses to occasional small 3% changes in pitch were larger for tones in guitar than marimba timbre only for infants exposed to guitar tones. Together these results indicate that a relatively small amount of passive exposure to a particular timbre in infancy enhances representations of that timbre and leads to more precise pitch processing for that timbre.

Listening to tailor-made notched music reduces tinnitus loudness and tinnitus-related auditory cortex activity

Maladaptive auditory cortex reorganization may contribute to the generation and maintenance of tinnitus. Because cortical organization can be modified by behavioral training, we attempted to reduce tinnitus loudness by exposing chronic tinnitus patients to self-chosen, enjoyable music, which was modified ("notched") to contain no energy in the frequency range surrounding the individual tinnitus frequency. After 12 months of regular listening, the target patient group (n = 8) showed significantly reduced subjective tinnitus loudness and concomitantly exhibited reduced evoked activity in auditory cortex areas corresponding to the tinnitus frequency compared to patients who had received an analogous placebo notched music treatment (n = 8). These findings indicate that tinnitus loudness can be significantly diminished by an enjoyable, low-cost, custom-tailored notched music treatment, potentially via reversing maladaptive auditory cortex reorganization.

Development of auditory phase-locked activity for music sounds

The auditory cortex undergoes functional and anatomical development that reflects specialization for learned sounds. In humans, auditory maturation is evident in transient auditory-evoked potentials (AEPs) elicited by speech or music. However, neural oscillations at specific frequencies are also known to play an important role in perceptual processing. We hypothesized that, if oscillatory activity in different frequency bands reflects different aspects of sound processing, the development of phase-locking to stimulus attributes at these frequencies may have different trajectories. We examined the development of phase-locking of oscillatory responses to music sounds and to pure tones matched to the fundamental frequency of the music sounds. Phase-locking for theta (4-8 Hz), alpha (8-14 Hz), lower-to-mid beta (14-25 Hz), and upper-beta and gamma (25-70 Hz) bands strengthened with age. Phase-locking in the upper-beta and gamma range matured later than in lower frequencies and was stronger for music sounds than for pure tones, likely reflecting the maturation of neural networks that code spectral complexity. Phase-locking for theta, alpha, and lower-to-mid beta was sensitive to temporal onset (rise time) sound characteristics. The data were also consistent with phase-locked oscillatory effects of acoustic (spectrotemporal) complexity and timbre familiarity. Future studies are called for to evaluate developmental trajectories for oscillatory activity, using stimuli selected to address hypotheses related to familiarity and spectral and temporal encoding suggested by the current findings.

Tonotopic reorganization of developing auditory brainstem circuits

A fundamental organizing principle of auditory brain circuits is tonotopy, the orderly representation of the sound frequency to which neurons are most sensitive. Tonotopy arises from the coding of frequency along the cochlea and the topographic organization of auditory pathways. The mechanisms that underlie the establishment of tonotopy are poorly understood. In auditory brainstem pathways, topographic precision is present at very early stages in development, which may suggest that synaptic reorganization contributes little to the construction of precise tonotopic maps. Accumulating evidence from several brainstem nuclei, however, is now changing this view by demonstrating that developing auditory brainstem circuits undergo a marked degree of refinement on both a subcellular and circuit level.