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Skoe E, Powell S. Hypoactivation of the central auditory system in listeners who are hypertolerant of background noise. J Neurophysiol 2024; 132:1074-1084. [PMID: 39081211 PMCID: PMC11427039 DOI: 10.1152/jn.00297.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 07/26/2024] [Accepted: 07/29/2024] [Indexed: 09/19/2024] Open
Abstract
Listeners exhibit varying levels of tolerance for background noise during speech communication. It has been proposed that low tolerance of background noise may be the consequence of abnormally amplified gain in the central auditory system (CAS). Here, using a dataset of young adults with normal hearing thresholds, we asked whether central gain mechanisms might also explain cases of hypertolerance of background noise, as well as cases of reduced, but not abnormal, tolerance. We used the auditory brainstem response to derive a measure of CAS gain (wave V/wave I ratio) to compare listeners' background noise tolerance while listening to speech, grouping them into three categories: hyper, high, and medium tolerance. We found that hypertolerant listeners had reduced CAS gain compared to those with high tolerance. This effect was driven by wave V not wave I. In addition, the medium tolerant listeners trended toward having reduced wave I and reduced wave V amplitudes and generally higher levels of exposure to loud sound, suggestive of the early stages of noise-compromised peripheral function without an apparent compensatory increase in central gain. Our results provide physiological evidence that 1) reduced CAS gain may account for hypertolerance of background noise but that 2) increased CAS gain is not a prerequisite for medium tolerance of background noise.NEW & NOTEWORTHY Our findings strengthen the proposed mechanistic connection between background noise tolerance and auditory physiology by suggesting a link between hypertolerance and reduced central auditory gain, measured by the auditory brainstem response.
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Affiliation(s)
- Erika Skoe
- Department of Speech, Language, and Hearing Sciences, University of Connecticut, Storrs, Connecticut, United States
- Institute for the Brain and Cognitive Sciences, University of Connecticut, Storrs, Connecticut, United States
| | - Sarah Powell
- Department of Speech, Language, and Hearing Sciences, University of Connecticut, Storrs, Connecticut, United States
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, Tennessee, United States
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Cherri D, Formby C, Secor CA, Eddins DA. Counseling Protocol for a Transitional Intervention for Debilitating Hyperacusis. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2024; 67:1886-1902. [PMID: 38718266 PMCID: PMC11192559 DOI: 10.1044/2023_jslhr-23-00353] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Revised: 10/31/2023] [Accepted: 12/18/2023] [Indexed: 06/07/2024]
Abstract
INTRODUCTION This clinical focus article describes a structured counseling protocol for use with protected sound management and therapeutic sound in a transitional intervention for debilitating hyperacusis. The counseling protocol and its associated visual aids are crafted as a teaching tool to educate affected individuals about hyperacusis and encourage their acceptance of a transitional intervention. DESCRIPTION OF COUNSELING COMPONENTS The counseling protocol includes five components. First, the patient's audiometric results are reviewed with the patient, and the transitional intervention is introduced. An overview of peripheral auditory structures and central neural pathways and the concept of central gain are covered in the second and third components. Maladaptive hyper-gain processes within the auditory neural pathways, which underlie the hyperacusis condition, and associated connections with nonauditory processes responsible for negative reactions to hyperacusis are covered in the fourth component. Detrimental effects from misused hearing protection devices (HPDs) and the necessity to wean the patient from overuse of HPDs are also discussed. In the fifth component, the importance of therapeutic sound is introduced as a tool to downregulate hyper-gain activity within the auditory pathways; its implementation in uncontrolled and controlled sound environments is described. It is explained that, over the course of the transitional intervention, recalibration of the hyper-gain processes will be ongoing, leading to restoration of normal homeostasis within the auditory pathways. In turn, associated activation of reactive nonauditory processes, which contribute to hyperacusis-related distress, will be reduced or eliminated. As recalibration progresses, there will be less need for protected sound management and sound therapy. Sound tolerance will improve, hyperacusis will subside, and daily activities in typical healthy sound environments will again become routine. RESULTS AND CONCLUSION The combination of counseling with protected sound management and therapeutic sound is highlighted in companion reports, including a summary of the outcomes of a successful trial of the transitional intervention.
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Affiliation(s)
- Dana Cherri
- Auditory & Speech Sciences Laboratory, University of South Florida, Tampa
| | - Craig Formby
- Auditory & Speech Sciences Laboratory, University of South Florida, Tampa
- The University of Alabama, Tuscaloosa
| | - Carrie A. Secor
- Auditory & Speech Sciences Laboratory, University of South Florida, Tampa
| | - David A. Eddins
- Auditory & Speech Sciences Laboratory, University of South Florida, Tampa
- University of Central Florida, Orlando
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Hutchison P, Maeda H, Formby C, Small BJ, Eddins DA, Eddins AC. Acoustic deprivation modulates central gain in human auditory brainstem and cortex. Hear Res 2023; 428:108683. [PMID: 36599259 PMCID: PMC9872081 DOI: 10.1016/j.heares.2022.108683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 12/16/2022] [Accepted: 12/26/2022] [Indexed: 12/28/2022]
Abstract
Beyond reduced audibility, there is convincing evidence that the auditory system adapts according to the principles of homeostatic plasticity in response to a hearing loss. Such compensatory changes include modulation of central auditory gain mechanisms. Earplugging is a common experimental method that has been used to introduce a temporary, reversible hearing loss that induces changes consistent with central gain modulation. In the present study, young, normal-hearing adult participants wore a unilateral earplug for two weeks, during which we measured changes in the acoustic reflex threshold (ART), loudness perception, and cortically-evoked (40 Hz) auditory steady-state response (ASSR) to assess potential modulation in central gain with reduced peripheral input. The ART decreased on average by 8 to 10 dB during the treatment period, with modest increases in loudness perception after one week but not after two weeks of earplug use. Significant changes in both the magnitude and hemispheric laterality of source-localized cortical ASSR measures revealed asymmetrical changes in stimulus-driven cortical activity over time. The ART results following unilateral earplugging are consistent with the literature and suggest that homeostatic plasticity is evident in the brainstem. The novel findings from the cortical ASSR in the present study indicates that reduced peripheral input induces adaptive homeostatic plasticity reflected as both an increase in central gain in the auditory brainstem and reduced cortical activity ipsilateral to the deprived ear. Both the ART and the novel use of the 40-Hz ASSR provide sensitive measures of central gain modulation in the brainstem and cortex of young, normal hearing listeners, and thus may be useful in future studies with other clinical populations.
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Affiliation(s)
- Peter Hutchison
- Department of Communication Sciences and Disorders, University of South Florida, 4202 E. Fowler Ave., PCD 1017, Tampa, FL 33620, USA
| | - Hannah Maeda
- Department of Communication Sciences and Disorders, University of South Florida, 4202 E. Fowler Ave., PCD 1017, Tampa, FL 33620, USA
| | - Craig Formby
- Department of Communication Sciences and Disorders, University of South Florida, 4202 E. Fowler Ave., PCD 1017, Tampa, FL 33620, USA
| | - Brent J Small
- School of Aging Studies, University of South Florida, 4202 E. Fowler Ave., PCD 1017, Tampa, FL 33620, USA
| | - David A Eddins
- Department of Communication Sciences and Disorders, University of South Florida, 4202 E. Fowler Ave., PCD 1017, Tampa, FL 33620, USA; Department of Chemical and Biomedical Engineering, University of South Florida, 4202 E. Fowler Ave., PCD 1017, Tampa, FL 33620, USA
| | - Ann Clock Eddins
- Department of Communication Sciences and Disorders, University of South Florida, 4202 E. Fowler Ave., PCD 1017, Tampa, FL 33620, USA; School of Communication Sciences and Disorders, University of Central Florida, 4364 Scorpius Street, Orlando, FL 32816, USA.
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Henry JA. Sound Therapy to Reduce Auditory Gain for Hyperacusis and Tinnitus. Am J Audiol 2022; 31:1067-1077. [DOI: 10.1044/2022_aja-22-00127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Purpose:
Hyperacusis is the most common of the different types of sound tolerance conditions. It has been defined as physical discomfort or pain when any sound reaches a certain level of loudness that would be comfortable for most people. Because hyperacusis and tinnitus occur together so often, it has been theorized that they have a common neural mechanism. A leading contender for that mechanism is enhancement of auditory gain. The purpose of this tutorial is to review the evidence that sound/acoustic therapy can reduce auditory gain and, thereby, can increase loudness tolerance for people with hyperacusis and/or suppress the percept of tinnitus.
Method:
The scientific literature was informally reviewed to identify and elucidate relationships between tinnitus, hyperacusis, sound therapy, and auditory gain.
Results:
Evidence exists, both in animal and human studies, that enhanced auditory gain is associated with hyperacusis and tinnitus. Further evidence supports the theory that certain forms of sound therapy can reduce neural hyperactivity, thereby reducing auditory gain. The evidence for sound therapy reducing auditory gain is stronger for hyperacusis than it is for tinnitus.
Conclusions:
Based on results from numerous studies, sound therapy clearly has application as a method of desensitization for hyperacusis. Enhanced auditory gain might be responsible for tinnitus, but other mechanisms have been theorized. A review of the relevant literature leads to the conclusion that some form(s) of sound therapy has the potential to suppress or eliminate tinnitus on a long-term basis. Systematic research is needed to evaluate this premise.
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Affiliation(s)
- James A. Henry
- VA RR&D National Center for Rehabilitative Auditory Research, VA Portland Health Care System, OR
- Department of Otolaryngology - Head and Neck Surgery, Oregon Health & Science University, Portland
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Hyperacusis: Loudness Intolerance, Fear, Annoyance and Pain. Hear Res 2022; 426:108648. [DOI: 10.1016/j.heares.2022.108648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 11/02/2022] [Accepted: 11/07/2022] [Indexed: 11/10/2022]
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Graterón E, Scaglione T, Airen S, Goncalves S, Ceballos SA, Baguley D, Chiossone JA. Transient decrease in sound tolerance levels following hearing deprivation in normal-hearing subjects. J Otol 2022; 17:232-238. [PMID: 36249923 PMCID: PMC9547106 DOI: 10.1016/j.joto.2022.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 08/30/2022] [Accepted: 09/04/2022] [Indexed: 11/19/2022] Open
Affiliation(s)
- Eleazar Graterón
- Fundación Venezolana de Otología, Clinical Research Group, Venezuela
| | - Tricia Scaglione
- University of Miami, Department of Otolaryngology, USA
- Corresponding author. 8100 SW 10th Ave, Crossroads Business Park Bldg 3, Floor 3, Plantation, FL, 33322, USA.
| | - Shriya Airen
- University of Miami, Department of Otolaryngology, USA
| | | | - Sinay A. Ceballos
- Fundación Venezolana de Otología, Clinical Research Group, Venezuela
| | | | - Juan A. Chiossone
- Fundación Venezolana de Otología, Clinical Research Group, Venezuela
- University of Miami, Department of Otolaryngology, USA
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Jahn KN. Clinical and investigational tools for monitoring noise-induced hyperacusis. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2022; 152:553. [PMID: 35931527 PMCID: PMC9448410 DOI: 10.1121/10.0012684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
Hyperacusis is a recognized perceptual consequence of acoustic overexposure that can lead to debilitating psychosocial effects. Despite the profound impact of hyperacusis on quality of life, clinicians and researchers lack objective biomarkers and standardized protocols for its assessment. Outcomes of conventional audiologic tests are highly variable in the hyperacusis population and do not adequately capture the multifaceted nature of the condition on an individual level. This presents challenges for the differential diagnosis of hyperacusis, its clinical surveillance, and evaluation of new treatment options. Multiple behavioral and objective assays are emerging as contenders for inclusion in hyperacusis assessment protocols but most still await rigorous validation. There remains a pressing need to develop tools to quantify common nonauditory symptoms, including annoyance, fear, and pain. This review describes the current literature on clinical and investigational tools that have been used to diagnose and monitor hyperacusis, as well as those that hold promise for inclusion in future trials.
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Affiliation(s)
- Kelly N Jahn
- Department of Speech, Language, and Hearing, School of Behavioral and Brain Sciences, University of Texas at Dallas, Richardson, Texas 75080, USA
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Alshabory HF, Gabr TA, Kotait MA. Distortion Product Otoacoustic Emissions (DPOAEs) In Tinnitus Patients. Int Arch Otorhinolaryngol 2022; 26:e046-e057. [PMID: 35096158 PMCID: PMC8789488 DOI: 10.1055/s-0040-1722248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Accepted: 11/08/2020] [Indexed: 11/17/2022] Open
Abstract
Introduction Tinnitus is the perception of sound in the absence of external sound stimulation. There is a general agreement that it is a direct consequence of irreversible and permanent cochlear damage. Objectives The present work is designed to study the distortion product otoacoustic emissions (DPOAEs) in tinnitus patients with normal hearing in comparison with normal hearing control and to study any possible correlation between DPOAEs recording and patients' complaints. Methods The present study included 80 subjects divided into 2 groups: Control group: consisted of 30 normal-hearing adults not complaining of tinnitus and Study group: consisted of 50 normal-hearing adults complaining of tinnitus. The methodology includes full audiological history, otoscopic examination, basic audiological evaluation, DPOAEs including both DP-gram and DPOAEs input/output functions. Results Basic audiological evaluation showed within normal hearing sensitivity in both groups, however, with significant higher hearing thresholds in tinnitus patients at all frequency ranges. The Tinnitus Handicap Inventory Questionnaire showed mean scores of 35.2 ± 16.9 in the study group. The DP-gram showed higher amplitudes in the control group when compared with tinnitus patients. The DPOAEs input-output functions at different frequencies (1, 2, 4 and 6kHz) also showed higher amplitudes at all frequencies and different input levels. The slope of the I/O function tends to be steeper in tinnitus cases. Conclusion Patients with tinnitus might have neural dysfunction at either the level of the cochlea, as shown in reduced DPOAE levels, and changes in the normal DP-I/O function recorded in the present work.
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Affiliation(s)
- Hend F. Alshabory
- Audiovestibular Medicine Unit, Otolaryngology Department, Faculty of Medicine, Kafrelsheikh University, Kafrelsheikh, Egypt
| | - Takwa A. Gabr
- Audiovestibular Medicine Unit, Otolaryngology Department, Faculty of Medicine, Kafrelsheikh University, Kafrelsheikh, Egypt
| | - Mona A. Kotait
- Audiovestibular Medicine Unit, Otolaryngology Department, Faculty of Medicine, Tanta University, Tanta, Egypt
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9
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Hyperacusis and stapes surgery: An observation in fifty patients after stapedotomy. J Otol 2020; 16:18-21. [PMID: 33505445 PMCID: PMC7814076 DOI: 10.1016/j.joto.2020.07.001] [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: 04/09/2020] [Revised: 07/05/2020] [Accepted: 07/05/2020] [Indexed: 12/05/2022] Open
Abstract
Objective To assess hyperacusis after stapedotomy and its possible influencing factors. Study design Prospective, interventional, and longitudinal study. Setting A tertiary referral center. Patients Fifty consecutive patients (35 females, mean age = 46.8 years). Intervention All patients underwent stapedotomy. The validated Portuguese version of the “Hyperacusis Questionnaire” (HQ) was administered before and two weeks and one month after surgery. Results No hyperacusis was reported by any patient before surgery. At two weeks after surgery, all patients experienced hyperacusis, with a mean HQ at 16.88 ± 6.54 (range 4–25). One month after surgery, hyperacusis had already resolved in most patients. Gender, preoperative presentation or surgeon had no influence on HQ scores (p > 0.05). Patients with previous contralateral stapedotomy showed lower HQ scores (p = 0.001). Audiological parameters improvement measured at one month after surgery (PTA, SRT and contralateral SRT) were associated with HQ higher scores. Conclusion This study confirms that hyperacusis is a common complaint after stapedotomy that usually resolves in one month after surgery. The HQ highest scores were registered among patients with the highest audiological gain after surgery. This suggests that hyperacusis may be a positive prognostic factor for audiological success after stapedotomy.
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Preserving Inhibition during Developmental Hearing Loss Rescues Auditory Learning and Perception. J Neurosci 2019; 39:8347-8361. [PMID: 31451577 DOI: 10.1523/jneurosci.0749-19.2019] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Revised: 08/16/2019] [Accepted: 08/19/2019] [Indexed: 12/15/2022] Open
Abstract
Transient periods of childhood hearing loss can induce deficits in aural communication that persist long after auditory thresholds have returned to normal, reflecting long-lasting impairments to the auditory CNS. Here, we asked whether these behavioral deficits could be reversed by treating one of the central impairments: reduction of inhibitory strength. Male and female gerbils received bilateral earplugs to induce a mild, reversible hearing loss during the critical period of auditory cortex development. After earplug removal and the return of normal auditory thresholds, we trained and tested animals on an amplitude modulation detection task. Transient developmental hearing loss induced both learning and perceptual deficits, which were entirely corrected by treatment with a selective GABA reuptake inhibitor (SGRI). To explore the mechanistic basis for these behavioral findings, we recorded the amplitudes of GABAA and GABAB receptor-mediated IPSPs in auditory cortical and thalamic brain slices. In hearing loss-reared animals, cortical IPSP amplitudes were significantly reduced within a few days of hearing loss onset, and this reduction persisted into adulthood. SGRI treatment during the critical period prevented the hearing loss-induced reduction of IPSP amplitudes; but when administered after the critical period, it only restored GABAB receptor-mediated IPSP amplitudes. These effects were driven, in part, by the ability of SGRI to upregulate α1 subunit-dependent GABAA responses. Similarly, SGRI prevented the hearing loss-induced reduction of GABAA and GABAB IPSPs in the ventral nucleus of the medial geniculate body. Thus, by maintaining, or subsequently rescuing, GABAergic transmission in the central auditory thalamocortical pathway, some perceptual and cognitive deficits induced by developmental hearing loss can be prevented.SIGNIFICANCE STATEMENT Even a temporary period of childhood hearing loss can induce communication deficits that persist long after auditory thresholds return to normal. These deficits may arise from long-lasting central impairments, including the loss of synaptic inhibition. Here, we asked whether hearing loss-induced behavioral deficits could be reversed by reinstating normal inhibitory strength. Gerbils reared with transient hearing loss displayed both learning and perceptual deficits. However, when animals were treated with a selective GABA reuptake inhibitor during or after hearing loss, behavioral deficits were entirely corrected. This behavioral recovery was correlated with the return of normal thalamic and cortical inhibitory function. Thus, some perceptual and cognitive deficits induced by developmental hearing loss were prevented with a treatment that rescues a central synaptic property.
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Brotherton H, Turtle C, Plack CJ, Munro KJ, Schaette R. Earplug-induced changes in acoustic reflex thresholds suggest that increased subcortical neural gain may be necessary but not sufficient for the occurrence of tinnitus. Neuroscience 2019; 407:192-199. [DOI: 10.1016/j.neuroscience.2019.03.017] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2018] [Revised: 03/06/2019] [Accepted: 03/07/2019] [Indexed: 12/14/2022]
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12
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Pienkowski M. Rationale and Efficacy of Sound Therapies for Tinnitus and Hyperacusis. Neuroscience 2019; 407:120-134. [DOI: 10.1016/j.neuroscience.2018.09.012] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Revised: 09/05/2018] [Accepted: 09/07/2018] [Indexed: 12/20/2022]
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13
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Parry LV, Maslin MR, Schaette R, Moore DR, Munro KJ. Increased auditory cortex neural response amplitude in adults with chronic unilateral conductive hearing impairment. Hear Res 2019; 372:10-16. [DOI: 10.1016/j.heares.2018.01.016] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Revised: 01/18/2018] [Accepted: 01/30/2018] [Indexed: 10/18/2022]
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Gault R, Mcginnity TM, Coleman S. A Computational Model of Thalamocortical Dysrhythmia in People With Tinnitus. IEEE Trans Neural Syst Rehabil Eng 2018; 26:1845-1857. [PMID: 30106678 DOI: 10.1109/tnsre.2018.2863740] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Tinnitus is a problem that affects a diverse range of people. One common trait amongst people with tinnitus is the presence of hearing loss, which is apparent in over 90% of the cohort. It is postulated that the remainder of people with tinnitus have hidden hearing loss in the form of cochlear synaptopathy. The loss of hearing sensation is thought to cause a reduction in the bottom-up excitatory signals of the auditory pathway leading to a change in the frequency of thalamocortical oscillations known as thalamocortical dysrhythmia (TCD). The downward shift in oscillatory behavior, characteristic of TCD, has been recorded experimentally but the underlying mechanisms responsible for TCD in tinnitus subjects cannot be directly observed. This paper investigates these underlying mechanisms by creating a biologically faithful model of the auditory periphery and thalamocortical network, called the central auditory processing (CAP) model. The proposed model replicates tinnitus related activity in the presence of hearing loss and hidden hearing loss in the form of cochlear synaptopathy. The results of this paper show that, both the bottom-up and top-down changes are required in the auditory system for tinnitus related hyperactivity to coexist with TCD, contrary to the theoretical model for TCD. The CAP model provides a novel modeling approach to account for tinnitus related activity with and without hearing loss. Moreover, the results provide additional clarity to the understanding of TCD and tinnitus and provide direction for future approaches to treating tinnitus.
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Myne S, Kennedy V. Hyperacusis in children: A clinical profile. Int J Pediatr Otorhinolaryngol 2018; 107:80-85. [PMID: 29501317 DOI: 10.1016/j.ijporl.2018.01.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2017] [Revised: 01/10/2018] [Accepted: 01/10/2018] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Hyperacusis is commonly seen in clinical paediatric practice and can be distressing for the children and their families. This paper looks at the clinical profile of children seen for hyperacusis in a paediatric audiology service and reviews the possible underlying mechanisms. METHODS Retrospective study of case notes of 61 children with troublesome hyperacusis seen in the paediatric audiology service, looking at their clinical presentation and presence of other medical conditions. RESULTS Hyperacusis was the main presenting complaint in more than half of the cases (n = 31, 51%). The commonest age at presentation with this problem was 3-4 years (n = 33, 54%). Hearing was normal in the majority of these children (n = 41, 67%). An active middle ear problem was observed in nearly half (n = 29, 48%) of all the children, of which glue ear (otitis media with effusion, OME) was the commonest. Presence of a neurodevelopmental condition was found in almost half (n = 28, 46%) of these patients of which autistic spectrum disorder was the commonest (8/61, 13%). In nearly one-fourth of the children (23%), presence of both middle ear problems and neurodevelopmental was noted. Tinnitus was an accompanying symptom reported in 11% of all the patients. CONCLUSION Hyperacusis may commonly present at a very young age. Awareness of different clinical presentations, presence of other medical conditions and possible underlying pathomechanisms in children with hyperacusis can be helpful for clinicians in informing prognosis, counselling and in individualising management plan.
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Affiliation(s)
- Shibani Myne
- Paediatric Audiology Department, Bolton NHS Foundation Trust, Bolton, UK
| | - Veronica Kennedy
- Paediatric Audiology Department, Bolton NHS Foundation Trust, Bolton, UK.
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16
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Tortorella F, Pavaci S, Fioretti AB, Masedu F, Lauriello M, Eibenstein A. The short hyperacusis questionnaire: A tool for the identification and measurement of hyperacusis in the Italian tinnitus population. Audiol Res 2017; 7:182. [PMID: 29071058 PMCID: PMC5641829 DOI: 10.4081/audiores.2017.182] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2017] [Revised: 07/10/2017] [Accepted: 08/10/2017] [Indexed: 12/28/2022] Open
Affiliation(s)
- Federica Tortorella
- Department of Applied Clinical Sciences and Biotechnology, L'Aquila University, L'Aquila
| | - Silva Pavaci
- Department of Applied Clinical Sciences and Biotechnology, L'Aquila University, L'Aquila
| | | | - Francesco Masedu
- Department of Applied Clinical Sciences and Biotechnology, L'Aquila University, L'Aquila
| | - Maria Lauriello
- Department of Applied Clinical Sciences and Biotechnology, L'Aquila University, L'Aquila
| | - Alberto Eibenstein
- Department of Applied Clinical Sciences and Biotechnology, L'Aquila University, L'Aquila.,Tinnitus Center, European Hospital, Rome, Italy
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17
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Sheppard AM, Chen GD, Manohar S, Ding D, Hu BH, Sun W, Zhao J, Salvi R. Prolonged low-level noise-induced plasticity in the peripheral and central auditory system of rats. Neuroscience 2017; 359:159-171. [PMID: 28711622 DOI: 10.1016/j.neuroscience.2017.07.005] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2017] [Revised: 06/28/2017] [Accepted: 07/04/2017] [Indexed: 02/06/2023]
Abstract
Prolonged low-level noise exposure alters loudness perception in humans, presumably by decreasing the gain of the central auditory system. Here we test the central gain hypothesis by measuring the acute and chronic physiologic changes at the level of the cochlea and inferior colliculus (IC) after a 75-dB SPL, 10-20-kHz noise exposure for 5weeks. The compound action potential (CAP) and summating potential (SP) were used to assess the functional status of the cochlea and 16 channel electrodes were used to measure the local field potentials (LFP) and multi-unit spike discharge rates (SDR) from the IC immediately after and one-week post-exposure. Measurements obtained immediately post-exposure demonstrated a significant reduction in supra-threshold CAP amplitudes. In contrast to the periphery, sound-evoked activity in the IC was enhanced in a frequency-dependent manner consistent with models of enhanced central gain. Surprisingly, one-week post-exposure supra-threshold responses from the cochlea had not only recovered, but were significantly larger than normal, and thresholds were significantly better than controls. Moreover, sound-evoked hyperactivity in the IC was sustained within the noise exposure frequency band but suppressed at higher frequencies. When response amplitudes representing the neural output of the cochlea and IC activity at one-week post exposure were compared with control animal responses, a central attenuation phenomenon becomes evident, which may play a key role in understanding why low-level noise can sometimes ameliorate tinnitus and hyperacusis percepts.
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Affiliation(s)
- Adam M Sheppard
- Center for Hearing and Deafness, State University of New York at Buffalo, 137 Cary Hall, 3435 Main Street, Buffalo, NY 14214, USA.
| | - Guang-Di Chen
- Center for Hearing and Deafness, State University of New York at Buffalo, 137 Cary Hall, 3435 Main Street, Buffalo, NY 14214, USA
| | - Senthilvelan Manohar
- Center for Hearing and Deafness, State University of New York at Buffalo, 137 Cary Hall, 3435 Main Street, Buffalo, NY 14214, USA
| | - Dalian Ding
- Center for Hearing and Deafness, State University of New York at Buffalo, 137 Cary Hall, 3435 Main Street, Buffalo, NY 14214, USA
| | - Bo-Hua Hu
- Center for Hearing and Deafness, State University of New York at Buffalo, 137 Cary Hall, 3435 Main Street, Buffalo, NY 14214, USA
| | - Wei Sun
- Center for Hearing and Deafness, State University of New York at Buffalo, 137 Cary Hall, 3435 Main Street, Buffalo, NY 14214, USA
| | - Jiwei Zhao
- Department of Biostatistics, School of Public Health and Health Professions, State University of New York at Buffalo, Buffalo, NY 14214, USA
| | - Richard Salvi
- Center for Hearing and Deafness, State University of New York at Buffalo, 137 Cary Hall, 3435 Main Street, Buffalo, NY 14214, USA
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Aazh H, Moore BCJ. Factors related to uncomfortable loudness levels for patients seen in a tinnitus and hyperacusis clinic. Int J Audiol 2017. [PMID: 28622055 DOI: 10.1080/14992027.2017.1335888] [Citation(s) in RCA: 58] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
OBJECTIVES The aims were as follows: (1) to explore patterns of uncomfortable loudness levels (ULLs) across frequency and their associated factors for patients with tinnitus and hyperacusis, and (2) to re-evaluate the criteria for diagnosing hyperacusis based on ULLs and scores for the Hyperacusis Questionnaire (HQ). DESIGN This was a retrospective cross-sectional study. STUDY SAMPLE 573 consecutive patients for whom ULLs had been measured were included. RESULTS A good correspondence between the diagnosis of hyperacusis based on the across-frequency average ULL for the ear with the lowest ULLs (ULLmin) and hyperacusis handicap based on HQ scores was obtained with cut-off values of ULLmin ≤77 dB HL and HQ score ≥ 22. A regression model showed significant relationships between ULLmin and the score on the HQ and age. The mean HQ score for patients with a large interaural asymmetry in ULLs was significantly higher than for the remainder. Hyperacusis handicap was associated with strong across-frequency variations in ULLs. CONCLUSIONS Appropriate cut-off values for diagnosing hyperacusis are ULLmin ≤77 dB HL and HQ score ≥22. Large interaural asymmetry and large across-frequency variations in ULLs are associated with higher HQ scores.
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Affiliation(s)
- Hashir Aazh
- a Audiology Department , Royal Surrey County Hospital NHS Foundation Trust , Guildford , UK and
| | - Brian C J Moore
- b Department of Experimental Psychology , University of Cambridge , Cambridge , UK
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Alkharabsheh A, Xiong F, Xiong B, Manohar S, Chen G, Salvi R, Sun W. Early age noise exposure increases loudness perception - A novel animal model of hyperacusis. Hear Res 2017; 347:11-17. [DOI: 10.1016/j.heares.2016.06.018] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2016] [Revised: 06/04/2016] [Accepted: 06/15/2016] [Indexed: 11/26/2022]
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Sherlock LP, Formby C. Considerations in the Development of a Sound Tolerance Interview and Questionnaire Instrument. Semin Hear 2017; 38:53-70. [PMID: 28286364 DOI: 10.1055/s-0037-1598065] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Most clinicians approach the objective fitting of hearing aids with three goals in mind: audibility, comfort, and tolerance. When these three amplification goals have been met, the hearing aid user is more likely to adapt to and perceive benefit from hearing aid use. However, problems related to the loudness of sounds and reduced sound tolerance, which may or may not be reported by the aided user, can adversely impact adaptation to amplification and the individual's quality of life. Although there are several standardized questionnaires available to evaluate hearing aid benefit and satisfaction, there is no standardized questionnaire or interview tool for evaluating reduced sound tolerance and the related impact on hearing aid use. We describe a 36-item tool, the Sound Tolerance Questionnaire (STQ), consisting of six sections, including experience with hearing aids, sound sensitivity/intolerance, medical and noise exposure histories, coexisting tinnitus problems, and a final question to differentiate the primary and secondary problems related to sound intolerance, tinnitus, and hearing loss. In its current format as a research tool, the STQ was sensitive in pinpointing vague sound tolerance complaints not reported by the study participants in eligibility screening by Formby et al. A refined version of the STQ, the Sound Tolerance Interview and Questionnaire Instrument (STIQI), structured as a two-part tool, is presented in the appendix for prospective clinical use. The STIQI has potential utility to delineate factors contributing to loudness complaints and/or reduced sound tolerance in individuals considering hearing aid use, as well as those who have been unsuccessful hearing aid users secondary to loudness complaints or sound intolerance. The STIQI, when validated and refined, also may hold promise for predicting hearing aid benefit and/or assessing treatment-related change over time of hearing aid use or interventions designed to remediate problems of loudness and/or sound intolerance among hearing aid candidates or users.
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Affiliation(s)
- LaGuinn P Sherlock
- Army Hearing Division, United States Army Public Health Center, Aberdeen Proving Ground, Aberdeen, Maryland; National Military Audiology and Speech Pathology Center, Walter Reed National Military Medical Center, Bethesda, Maryland
| | - Craig Formby
- Department of Communicative Disorders, University of Alabama, Tuscaloosa, Alabama
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Abstract
A structured counseling protocol is described that, when combined with low-level broadband sound therapy from bilateral sound generators, offers audiologists a new tool for facilitating the expansion of the auditory dynamic range (DR) for loudness. The protocol and its content are specifically designed to address and treat problems that impact hearing-impaired persons who, due to their reduced DRs, may be limited in the use and benefit of amplified sound from hearing aids. The reduced DRs may result from elevated audiometric thresholds and/or reduced sound tolerance as documented by lower-than-normal loudness discomfort levels (LDLs). Accordingly, the counseling protocol is appropriate for challenging and difficult-to-fit persons with sensorineural hearing losses who experience loudness recruitment or hyperacusis. Positive treatment outcomes for individuals with the former and latter conditions are highlighted in this issue by incremental shifts (improvements) in LDL and/or categorical loudness judgments, associated reduced complaints of sound intolerance, and functional improvements in daily communication, speech understanding, and quality of life leading to improved hearing aid benefit, satisfaction, and aided sound quality, posttreatment.
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Affiliation(s)
- Susan L Gold
- Retired; formerly affiliated with the University of Maryland Tinnitus and Hyperacusis Center, Baltimore, Maryland
| | - Craig Formby
- Department of Communicative Disorders, University of Alabama, Tuscaloosa, Alabama
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Korczak PA, Sherlock LP, Hawley ML, Formby C. Relations among Auditory Brainstem and Middle Latency Response Measures, Categorical Loudness Judgments, and Their Associated Physical Intensities. Semin Hear 2017; 38:94-114. [PMID: 28286366 DOI: 10.1055/s-0037-1598067] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
This study characterizes changes in response properties of toneburst-evoked auditory brainstem responses (ABRs) and/or middle latency responses (MLRs) as a function of perceived loudness and physical intensity of these stimuli and delineates the range of levels corresponding to categorical loudness judgments for these stimuli. ABRs/MLRs were recorded simultaneously to 500- and 2,000-Hz tonebursts in 10 normal-hearing adults at levels corresponding to each listener's loudness judgments for four categories on Contour Test of Loudness. Group mean ABR wave V and MLR wave Pa latency values increased significantly as loudness judgments decreased. Group mean amplitude values for ABR wave V-V' and MLR wave Na-Pa increased as the listeners' categorical judgments increased. Listeners assigned a broad range (30 to 40 dB) of stimulus intensities when judging loudness of these stimuli within a specific loudness category. This was true for all four loudness categories and both frequencies. Thus, it appears that tone-evoked ABR/MLR response measures reflect, in part, the listener's perception of loudness. Response latencies are a more sensitive indicator of listener's loudness percept than corresponding response amplitudes. An appreciable range of signal levels was judged to be categorically equivalent across listeners. Thus, limiting how loudness judgments can be applied to prescriptive hearing aid fittings in individuals who cannot provide accurate loudness judgments.
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Affiliation(s)
- Peggy A Korczak
- Department of Audiology, Speech Language Pathology and Deaf Studies, Towson University, Towson, Maryland
| | - LaGuinn P Sherlock
- Army Hearing Division, United States Public Health Center, Aberdeen Proving Ground, Aberdeen, Maryland; National Military Audiology and Speech Pathology Center, Walter Reed National Military Medical Center, Bethesda, Maryland
| | - Monica L Hawley
- Department of Otolaryngology, University of Iowa, Iowa City, Iowa
| | - Craig Formby
- Department of Communicative Disorders, University of Alabama, Tuscaloosa, Alabama
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Brotherton H, Plack CJ, Schaette R, Munro KJ. Using acoustic reflex threshold, auditory brainstem response and loudness judgments to investigate changes in neural gain following acute unilateral deprivation in normal hearing adults. Hear Res 2017; 345:88-95. [DOI: 10.1016/j.heares.2017.01.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2016] [Revised: 01/10/2017] [Accepted: 01/11/2017] [Indexed: 11/28/2022]
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Plonek M, Nicpoń J, Kubiak K, Wrzosek M. A comparison of the brainstem auditory evoked response in healthy ears of unilaterally deaf dogs and bilaterally hearing dogs. Vet Res Commun 2017; 41:23-31. [PMID: 27896671 PMCID: PMC5306067 DOI: 10.1007/s11259-016-9668-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2016] [Accepted: 11/09/2016] [Indexed: 10/31/2022]
Abstract
AIMS Auditory plasticity in response to unilateral deafness has been reported in various animal species. Subcortical changes occurring in unilaterally deaf young dogs using the brainstem auditory evoked response have not been evaluated yet. The aim of this study was to assess the brainstem auditory evoked response findings in dogs with unilateral hearing loss, and compare them with recordings obtained from healthy dogs. METHODS Brainstem auditory evoked responses (amplitudes and latencies of waves I, II, III, V, the V/I wave amplitude ratio, wave I-V, I-III and III-V interpeak intervals) were studied retrospectively in forty-six privately owned dogs, which were either unilaterally deaf or had bilateral hearing. The data obtained from the hearing ears in unilaterally deaf dogs were compared to values obtained from their healthy littermates. RESULTS Statistically significant differences in the amplitude of wave III and the V/I wave amplitude ratio at 75 dB nHL were found between the group of unilaterally deaf puppies and the control group. The recordings of dogs with single-sided deafness were compared, and the results showed no statistically significant differences in the latencies and amplitudes of the waves between left- (AL) and right-sided (AR) deafness. CONCLUSIONS The recordings of the brainstem auditory evoked response in canines with unilateral inborn deafness in this study varied compared to recordings from healthy dogs. Future studies looking into electrophysiological assessment of hearing in conjunction with imaging modalities to determine subcortical auditory plasticity and auditory lateralization in unilaterally deaf dogs are warranted.
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Affiliation(s)
- M. Plonek
- Department of Internal Diseases with Clinic for Horses, Dogs and Cats, The Faculty of Veterinary Medicine, Wroclaw University of Environmental and Life Sciences, pl. Grunwaldzki 47, 50-366 Wrocław, Poland
| | - J. Nicpoń
- Department of Internal Diseases with Clinic for Horses, Dogs and Cats, The Faculty of Veterinary Medicine, Wroclaw University of Environmental and Life Sciences, pl. Grunwaldzki 47, 50-366 Wrocław, Poland
- Centre for Experimental Diagnostics and Biomedical Innovations, Grunwaldzki sq. 47, 50-366 Wroclaw, Poland
| | - K. Kubiak
- Department of Internal Diseases with Clinic for Horses, Dogs and Cats, The Faculty of Veterinary Medicine, Wroclaw University of Environmental and Life Sciences, pl. Grunwaldzki 47, 50-366 Wrocław, Poland
| | - M. Wrzosek
- Department of Internal Diseases with Clinic for Horses, Dogs and Cats, The Faculty of Veterinary Medicine, Wroclaw University of Environmental and Life Sciences, pl. Grunwaldzki 47, 50-366 Wrocław, Poland
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García-Hernández S, Abe M, Sakimura K, Rubio ME. Impaired auditory processing and altered structure of the endbulb of Held synapse in mice lacking the GluA3 subunit of AMPA receptors. Hear Res 2016; 344:284-294. [PMID: 28011083 DOI: 10.1016/j.heares.2016.12.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2016] [Revised: 10/28/2016] [Accepted: 12/12/2016] [Indexed: 02/07/2023]
Abstract
AMPA glutamate receptor complexes with fast kinetics conferred by subunits like GluA3 and GluA4 are essential for temporal precision of synaptic transmission. The specific role of GluA3 in auditory processing and experience related changes in the auditory brainstem remain unknown. We investigated the role of the GluA3 in auditory processing by using wild type (WT) and GluA3 knockout (GluA3-KO) mice. We recorded auditory brainstem responses (ABR) to assess auditory function and used electron microscopy to evaluate the ultrastructure of the auditory nerve synapse on bushy cells (AN-BC synapse). Since labeling for GluA3 subunit increases on auditory nerve synapses within the cochlear nucleus in response to transient sound reduction, we investigated the role of GluA3 in experience-dependent changes in auditory processing. We induced transient sound reduction by plugging one ear and evaluated ABR threshold and peak amplitude recovery for up to 60 days after ear plug removal in WT and GluA3-KO mice. We found that the deletion of GluA3 leads to impaired auditory signaling that is reflected in decreased ABR peak amplitudes, an increased latency of peak 2, early onset hearing loss and reduced numbers and sizes of postsynaptic densities (PSDs) of AN-BC synapses. Additionally, the lack of GluA3 hampers ABR threshold recovery after transient ear plugging. We conclude that GluA3 is required for normal auditory signaling, normal ultrastructure of AN-BC synapses in the cochlear nucleus and normal experience-dependent changes in auditory processing after transient sound reduction.
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Affiliation(s)
- Sofía García-Hernández
- Department of Otolaryngology, University of Pittsburgh, School of Medicine, Pittsburgh, PA, USA
| | - Manabu Abe
- Niigata University Brain Research Institute, Japan
| | | | - María E Rubio
- Department of Otolaryngology, University of Pittsburgh, School of Medicine, Pittsburgh, PA, USA; Department of Neurobiology, University of Pittsburgh, School of Medicine, Pittsburgh, PA, USA; Center for the Neural Basis of Cognition, University of Pittsburgh, School of Medicine, Pittsburgh, PA, USA.
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Brotherton H, Plack CJ, Schaette R, Munro KJ. No change in the acoustic reflex threshold and auditory brainstem response following short-term acoustic stimulation in normal hearing adults. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2016; 140:2725. [PMID: 27794325 DOI: 10.1121/1.4964733] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Unilateral auditory deprivation or stimulation can induce changes in loudness and modify the sound level required to elicit the acoustic reflex. This has been explained in terms of a change in neural response, or gain, for a given sound level. However, it is unclear if these changes are driven by the asymmetry in auditory input or if they will also occur following bilateral changes in auditory input. The present study used a cross-over trial of unilateral and bilateral amplification to investigate changes in the acoustic reflex thresholds (ARTs) and the auditory brainstem response (ABR) in normal hearing listeners. Each treatment lasted 7 days and there was a 7-day washout period between the treatments. There was no significant change in the ART or ABR with either treatment. This null finding may have occurred because the amplification was insufficient to induce experience-related changes to the ABR and ART. Based on the null findings from the present study, and evidence of a change in ART in previous unilateral hearing aid use in normal hearing listeners, the threshold to trigger adaptive changes appears to be around 5 days of amplification with real ear insertion gain greater than 13-17 dB.
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Affiliation(s)
- Hannah Brotherton
- Manchester Centre for Audiology and Deafness, University of Manchester, Manchester Academic Health Science Centre, Manchester M13 9PL, United Kingdom
| | - Christopher J Plack
- Manchester Centre for Audiology and Deafness, University of Manchester, Manchester Academic Health Science Centre, Manchester M13 9PL, United Kingdom
| | - Roland Schaette
- Ear Institute, University College London, London WC1X 8EE, United Kingdom
| | - Kevin J Munro
- Manchester Centre for Audiology and Deafness, University of Manchester, Manchester Academic Health Science Centre, Manchester M13 9PL, United Kingdom
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Clarkson C, Antunes FM, Rubio ME. Conductive Hearing Loss Has Long-Lasting Structural and Molecular Effects on Presynaptic and Postsynaptic Structures of Auditory Nerve Synapses in the Cochlear Nucleus. J Neurosci 2016; 36:10214-27. [PMID: 27683915 PMCID: PMC5039262 DOI: 10.1523/jneurosci.0226-16.2016] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2016] [Revised: 08/03/2016] [Accepted: 08/12/2016] [Indexed: 11/21/2022] Open
Abstract
UNLABELLED Sound deprivation by conductive hearing loss increases hearing thresholds, but little is known about the response of the auditory brainstem during and after conductive hearing loss. Here, we show in young adult rats that 10 d of monaural conductive hearing loss (i.e., earplugging) leads to hearing deficits that persist after sound levels are restored. Hearing thresholds in response to clicks and frequencies higher than 8 kHz remain increased after a 10 d recovery period. Neural output from the cochlear nucleus measured at 10 dB above threshold is reduced and followed by an overcompensation at the level of the lateral lemniscus. We assessed whether structural and molecular substrates at auditory nerve (endbulb of Held) synapses in the cochlear nucleus could explain these long-lasting changes in hearing processing. During earplugging, vGluT1 expression in the presynaptic terminal decreased and synaptic vesicles were smaller. Together, there was an increase in postsynaptic density (PSD) thickness and an upregulation of GluA3 AMPA receptor subunits on bushy cells. After earplug removal and a 10 d recovery period, the density of synaptic vesicles increased, vesicles were also larger, and the PSD of endbulb synapses was larger and thicker. The upregulation of the GluA3 AMPAR subunit observed during earplugging was maintained after the recovery period. This suggests that GluA3 plays a role in plasticity in the cochlear nucleus. Our study demonstrates that sound deprivation has long-lasting alterations on structural and molecular presynaptic and postsynaptic components at the level of the first auditory nerve synapse in the auditory brainstem. SIGNIFICANCE STATEMENT Despite being the second most prevalent form of hearing loss, conductive hearing loss and its effects on central synapses have received relatively little attention. Here, we show that 10 d of monaural conductive hearing loss leads to an increase in hearing thresholds, to an increased central gain upstream of the cochlear nucleus at the level of the lateral lemniscus, and to long-lasting presynaptic and postsynaptic structural and molecular effects at the endbulb of the Held synapse. Knowledge of the structural and molecular changes associated with decreased sensory experience, along with their potential reversibility, is important for the treatment of hearing deficits, such as hyperacusis and chronic otitis media with effusion, which is prevalent in young children with language acquisition or educational disabilities.
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Affiliation(s)
| | | | - Maria E Rubio
- Departments of Otolaryngology and Neurobiology and Center for the Neural Basis of Cognition, University of Pittsburgh, Pittsburgh, Pennsylvania 15261
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Brotherton H, Plack CJ, Schaette R, Munro KJ. Time course and frequency specificity of sub-cortical plasticity in adults following acute unilateral deprivation. Hear Res 2016; 341:210-219. [PMID: 27620512 DOI: 10.1016/j.heares.2016.09.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2016] [Revised: 09/06/2016] [Accepted: 09/08/2016] [Indexed: 10/21/2022]
Abstract
Auditory deprivation and stimulation can change the threshold of the acoustic reflex, but the mechanisms underlying these changes remain largely unknown. In order to elucidate the mechanism, we sought to characterize the time-course as well as the frequency specificity of changes in acoustic reflex thresholds (ARTs). In addition, we compared ipsilateral and contralateral measurements because the pattern of findings may shed light on the anatomical location of the change in neural gain. Twenty-four normal-hearing adults wore an earplug continuously in one ear for six days. We measured ipsilateral and contralateral ARTs in both ears on six occasions (baseline, after 2, 4 and 6 days of earplug use, and 4 and 24 h after earplug removal), using pure tones at 0.5, 1, 2 and 4 kHz and a broadband noise stimulus, and an experimenter-blinded design. We found that ipsi- as well as contralateral ARTs were obtained at a lower sound pressure level after earplug use, but only when the reflex was elicited by stimulating the treatment ear. Changes in contralateral ARTs were not the same as changes in ipsilateral ARTs when the stimulus was presented to the control ear. Changes in ARTs were present after 2 days of earplug use, and reached statistical significance after 4 days, when the ipsilateral and contralateral ARTs were measured in the treatment ear. The greatest changes in ARTs occurred at 2 and 4 kHz, the frequencies most attenuated by the earplug. After removal of the earplug, ARTs started to return to baseline relatively quickly, and were not significantly different from baseline by 4-24 h. There was a trend for the recovery to occur quicker than the onset. The changes in ARTs are consistent with a frequency-specific gain control mechanism operating around the level of the ventral cochlear nucleus in the treatment ear, on a time scale of hours to days. These findings, specifically the time course of change, could be applicable to other sensory systems, which have also shown evidence of a neural gain control mechanism.
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Affiliation(s)
- Hannah Brotherton
- Manchester Centre for Audiology and Deafness, University of Manchester, Manchester Academic Health Science Centre, Manchester, M13 9PL, United Kingdom.
| | - Christopher J Plack
- Manchester Centre for Audiology and Deafness, University of Manchester, Manchester Academic Health Science Centre, Manchester, M13 9PL, United Kingdom; Department of Psychology, Lancaster University, Lancaster, LA1 4YF, United Kingdom.
| | - Roland Schaette
- Ear Institute, University College London, London, WC1X 8EE, United Kingdom.
| | - Kevin J Munro
- Manchester Centre for Audiology and Deafness, University of Manchester, Manchester Academic Health Science Centre, Manchester, M13 9PL, United Kingdom; Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, M13 9WK, United Kingdom.
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Formby C, Hawley ML, Sherlock LP, Gold S, Payne J, Brooks R, Parton JM, Juneau R, Desporte EJ, Siegle GR. A Sound Therapy-Based Intervention to Expand the Auditory Dynamic Range for Loudness among Persons with Sensorineural Hearing Losses: A Randomized Placebo-Controlled Clinical Trial. Semin Hear 2016; 36:77-110. [PMID: 27516711 DOI: 10.1055/s-0035-1546958] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
The primary aim of this research was to evaluate the validity, efficacy, and generalization of principles underlying a sound therapy-based treatment for promoting expansion of the auditory dynamic range (DR) for loudness. The basic sound therapy principles, originally devised for treatment of hyperacusis among patients with tinnitus, were evaluated in this study in a target sample of unsuccessfully fit and/or problematic prospective hearing aid users with diminished DRs (owing to their elevated audiometric thresholds and reduced sound tolerance). Secondary aims included: (1) delineation of the treatment contributions from the counseling and sound therapy components to the full-treatment protocol and, in turn, the isolated treatment effects from each of these individual components to intervention success; and (2) characterization of the respective dynamics for full, partial, and control treatments. Thirty-six participants with bilateral sensorineural hearing losses and reduced DRs, which affected their actual or perceived ability to use hearing aids, were enrolled in and completed a placebo-controlled (for sound therapy) randomized clinical trial. The 2 × 2 factorial trial design was implemented with or without various assignments of counseling and sound therapy. Specifically, participants were assigned randomly to one of four treatment groups (nine participants per group), including: (1) group 1-full treatment achieved with scripted counseling plus sound therapy implemented with binaural sound generators; (2) group 2-partial treatment achieved with counseling and placebo sound generators (PSGs); (3) group 3-partial treatment achieved with binaural sound generators alone; and (4) group 4-a neutral control treatment implemented with the PSGs alone. Repeated measurements of categorical loudness judgments served as the primary outcome measure. The full-treatment categorical-loudness judgments for group 1, measured at treatment termination, were significantly greater than the corresponding pretreatment judgments measured at baseline at 500, 2,000, and 4,000 Hz. Moreover, increases in their "uncomfortably loud" judgments (∼12 dB over the range from 500 to 4,000 Hz) were superior to those measured for either of the partial-treatment groups 2 and 3 or for control group 4. Efficacy, assessed by treatment-related criterion increases ≥ 10 dB for judgments of uncomfortable loudness, was superior for full treatment (82% efficacy) compared with that for either of the partial treatments (25% and 40% for counseling combined with the placebo sound therapy and sound therapy alone, respectively) or for the control treatment (50%). The majority of the group 1 participants achieved their criterion improvements within 3 months of beginning treatment. The treatment effect from sound therapy was much greater than that for counseling, which was statistically indistinguishable in most of our analyses from the control treatment. The basic principles underlying the full-treatment protocol are valid and have general applicability for expanding the DR among individuals with sensorineural hearing losses, who may often report aided loudness problems. The positive full-treatment effects were superior to those achieved for either counseling or sound therapy in virtual or actual isolation, respectively; however, the delivery of both components in the full-treatment approach was essential for an optimum treatment outcome.
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Affiliation(s)
- Craig Formby
- Department of Communicative Disorders, University of Alabama, Tuscaloosa, Alabama
| | - Monica L Hawley
- Department of Otolaryngology, University of Iowa, Iowa City, Iowa
| | | | - Susan Gold
- Retired; previously affiliated with University of Maryland Tinnitus & Hyperacusis Center, Baltimore, Maryland
| | - JoAnne Payne
- Department of Communicative Disorders, University of Alabama, Tuscaloosa, Alabama
| | - Rebecca Brooks
- Department of Communicative Disorders, University of Alabama, Tuscaloosa, Alabama
| | - Jason M Parton
- Department of Communicative Disorders, University of Alabama, Tuscaloosa, Alabama
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Lehmann A, Skoe E. Robust Encoding in the Human Auditory Brainstem: Use It or Lose It? Front Neurosci 2015; 9:451. [PMID: 26648840 PMCID: PMC4664693 DOI: 10.3389/fnins.2015.00451] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2015] [Accepted: 11/13/2015] [Indexed: 11/29/2022] Open
Affiliation(s)
- Alexandre Lehmann
- Department of Otolaryngology Head and Neck Surgery, McGill University Montreal, QC, Canada ; International Laboratory for Brain, Music and Sound Research, Center for Research on Brain, Language and Music Montreal, QC, Canada
| | - Erika Skoe
- Department of Speech, Language, and Hearing Sciences, Cognitive Science Program Affiliate, University of Connecticut Storrs, CT, USA
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Diehl PU, Schaette R. Abnormal Auditory Gain in Hyperacusis: Investigation with a Computational Model. Front Neurol 2015; 6:157. [PMID: 26236277 PMCID: PMC4502361 DOI: 10.3389/fneur.2015.00157] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2015] [Accepted: 06/24/2015] [Indexed: 12/27/2022] Open
Abstract
Hyperacusis is a frequent auditory disorder that is characterized by abnormal loudness perception where sounds of relatively normal volume are perceived as too loud or even painfully loud. As hyperacusis patients show decreased loudness discomfort levels (LDLs) and steeper loudness growth functions, it has been hypothesized that hyperacusis might be caused by an increase in neuronal response gain in the auditory system. Moreover, since about 85% of hyperacusis patients also experience tinnitus, the conditions might be caused by a common mechanism. However, the mechanisms that give rise to hyperacusis have remained unclear. Here, we have used a computational model of the auditory system to investigate candidate mechanisms for hyperacusis. Assuming that perceived loudness is proportional to the summed activity of all auditory nerve (AN) fibers, the model was tuned to reproduce normal loudness perception. We then evaluated a variety of potential hyperacusis gain mechanisms by determining their effects on model equal-loudness contours and comparing the results to the LDLs of hyperacusis patients with normal hearing thresholds. Hyperacusis was best accounted for by an increase in non-linear gain in the central auditory system. Good fits to the average patient LDLs were obtained for a general increase in gain that affected all frequency channels to the same degree, and also for a frequency-specific gain increase in the high-frequency range. Moreover, the gain needed to be applied after subtraction of spontaneous activity of the AN, which is in contrast to current theories of tinnitus generation based on amplification of spontaneous activity. Hyperacusis and tinnitus might therefore be caused by different changes in neuronal processing in the central auditory system.
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Affiliation(s)
- Peter U. Diehl
- Bernstein Center for Computational Neuroscience, Berlin, Germany
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Pienkowski M, Tyler RS, Roncancio ER, Jun HJ, Brozoski T, Dauman N, Coelho CB, Andersson G, Keiner AJ, Cacace AT, Martin N, Moore BCJ. A review of hyperacusis and future directions: part II. Measurement, mechanisms, and treatment. Am J Audiol 2014; 23:420-36. [PMID: 25478787 DOI: 10.1044/2014_aja-13-0037] [Citation(s) in RCA: 73] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2013] [Accepted: 02/21/2014] [Indexed: 12/24/2022] Open
Abstract
PURPOSE Hyperacusis can be extremely debilitating, and at present, there is no cure. In this detailed review of the field, we consolidate present knowledge in the hope of facilitating future research. METHOD We review and reference the literature on hyperacusis and related areas. This is the 2nd of a 2-part review. RESULTS Hyperacusis encompasses a wide range of reactions to sounds, which can be grouped into the categories of excessive loudness, annoyance, fear, and pain. Reasonable approaches to assessing the different forms of hyperacusis are emerging, including brain-imaging studies. Researchers are only beginning to understand the many mechanisms at play, and valid animal models are still evolving. There are many counseling and sound-therapy approaches that some patients find helpful, but well-controlled studies are needed to measure their long-term efficacy and to test new approaches. CONCLUSIONS Hyperacusis can make life difficult in this increasingly noisy world, forcing sufferers to dramatically alter their work and social habits. We believe this is an opportune time to explore approaches to better understand and treat hyperacusis.
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Affiliation(s)
| | | | | | | | - Tom Brozoski
- Southern Illinois University School of Medicine, Springfield
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Gay JD, Voytenko SV, Galazyuk AV, Rosen MJ. Developmental hearing loss impairs signal detection in noise: putative central mechanisms. Front Syst Neurosci 2014; 8:162. [PMID: 25249949 PMCID: PMC4158805 DOI: 10.3389/fnsys.2014.00162] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2014] [Accepted: 08/21/2014] [Indexed: 12/22/2022] Open
Abstract
Listeners with hearing loss have difficulty processing sounds in noisy environments. This is most noticeable for speech perception, but is reflected in a basic auditory processing task: detecting a tonal signal in a noise background, i.e., simultaneous masking. It is unresolved whether the mechanisms underlying simultaneous masking arise from the auditory periphery or from the central auditory system. Poor detection in listeners with sensorineural hearing loss (SNHL) is attributed to cochlear hair cell damage. However, hearing loss alters neural processing in the central auditory system. Additionally, both psychophysical and neurophysiological data from normally hearing and impaired listeners suggest that there are additional contributions to simultaneous masking that arise centrally. With SNHL, it is difficult to separate peripheral from central contributions to signal detection deficits. We have thus excluded peripheral contributions by using an animal model of early conductive hearing loss (CHL) that provides auditory deprivation but does not induce cochlear damage. When tested as adults, animals raised with CHL had increased thresholds for detecting tones in simultaneous noise. Furthermore, intracellular in vivo recordings in control animals revealed a cortical correlate of simultaneous masking: local cortical processing reduced tone-evoked responses in the presence of noise. This raises the possibility that altered cortical responses which occur with early CHL can influence even simple signal detection in noise.
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Affiliation(s)
- Jennifer D. Gay
- Department of Anatomy and Neurobiology, Northeast Ohio Medical UniversityRootstown, OH, USA
- Biomedical Sciences Program, Kent State UniversityKent, OH, USA
| | - Sergiy V. Voytenko
- Department of Anatomy and Neurobiology, Northeast Ohio Medical UniversityRootstown, OH, USA
| | - Alexander V. Galazyuk
- Department of Anatomy and Neurobiology, Northeast Ohio Medical UniversityRootstown, OH, USA
| | - Merri J. Rosen
- Department of Anatomy and Neurobiology, Northeast Ohio Medical UniversityRootstown, OH, USA
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Abstract
Dramatic results from recent animal experiments show that noise exposure can cause a selective loss of high-threshold auditory nerve fibers without affecting absolute sensitivity permanently. This cochlear neuropathy has been described as hidden hearing loss, as it is not thought to be detectable using standard measures of audiometric threshold. It is possible that hidden hearing loss is a common condition in humans and may underlie some of the perceptual deficits experienced by people with clinically normal hearing. There is some evidence that a history of noise exposure is associated with difficulties in speech discrimination and temporal processing, even in the absence of any audiometric loss. There is also evidence that the tinnitus experienced by listeners with clinically normal hearing is associated with cochlear neuropathy, as measured using Wave I of the auditory brainstem response. To date, however, there has been no direct link made between noise exposure, cochlear neuropathy, and perceptual difficulties. Animal experiments also reveal that the aging process itself, in the absence of significant noise exposure, is associated with loss of auditory nerve fibers. Evidence from human temporal bone studies and auditory brainstem response measures suggests that this form of hidden loss is common in humans and may have perceptual consequences, in particular, regarding the coding of the temporal aspects of sounds. Hidden hearing loss is potentially a major health issue, and investigations are ongoing to identify the causes and consequences of this troubling condition.
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Fournier P, Schönwiesner M, Hébert S. Loudness modulation after transient and permanent hearing loss: implications for tinnitus and hyperacusis. Neuroscience 2014; 283:64-77. [PMID: 25135356 DOI: 10.1016/j.neuroscience.2014.08.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2014] [Revised: 08/06/2014] [Accepted: 08/07/2014] [Indexed: 11/19/2022]
Abstract
Loudness is the primary perceptual correlate of sound intensity. The relationship between sound intensity and loudness is not fixed, and can be modified by short-term sound deprivation or stimulation. Deprivation increases sound sensitivity, whereas stimulation decreases it. We review the effects of short-term auditory deprivation and stimulation on the auditory central nervous system of humans and animals, and we extend the discussion to permanent auditory deprivation (hearing loss) and auditory pathologies of loudness perception. Although there is sufficient evidence to conclude that loudness can be modulated in normal hearing listeners by temporary sound deprivation and stimulation, evidence is scanter for the hearing-impaired listeners. In addition, cortical effects of sound deprivation and stimulation in humans, which may correlate with loudness coding, are still largely unknown and should be the target of future research.
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Affiliation(s)
- P Fournier
- School of Speech Pathology and Audiology, Université de Montréal, Montréal, Québec, Canada; International Laboratory for Research on Brain, Music, and Sound (BRAMS), Université de Montréal, Montréal, Québec, Canada; Centre de recherche de l'Institut Universitaire de Gériatrie de Montréal (CRIUGM), Montréal, Québec, Canada
| | - M Schönwiesner
- International Laboratory for Research on Brain, Music, and Sound (BRAMS), Université de Montréal, Montréal, Québec, Canada; Department of Psychology, Université de Montréal, Montréal, Québec, Canada
| | - S Hébert
- School of Speech Pathology and Audiology, Université de Montréal, Montréal, Québec, Canada; International Laboratory for Research on Brain, Music, and Sound (BRAMS), Université de Montréal, Montréal, Québec, Canada; Centre de recherche de l'Institut Universitaire de Gériatrie de Montréal (CRIUGM), Montréal, Québec, Canada.
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36
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Abstract
Manipulations of the sensory environment typically induce greater changes to the developing nervous system than they do in adulthood. The relevance of these neural changes can be evaluated by examining the age-dependent effects of sensory experience on quantitative measures of perception. Here, we measured frequency modulation (FM) detection thresholds in adult gerbils and investigated whether diminished auditory experience during development or in adulthood influenced perceptual performance. Bilateral conductive hearing loss (CHL) of ≈30 dB was induced either at postnatal day 10 or after sexual maturation. All animals were then trained as adults to detect a 5 Hz FM embedded in a continuous 4 kHz tone. FM detection thresholds were defined as the minimum deviation from the carrier frequency that the animal could reliably detect. Normal-hearing animals displayed FM thresholds of 25 Hz. Inducing CHL, either in juvenile or adult animals, led to a deficit in FM detection. However, this deficit was greater for juvenile onset hearing loss (89 Hz) relative to adult onset hearing loss (64 Hz). The effects could not be attributed to sensation level, nor were they correlated with proxies for attention. The thresholds displayed by CHL animals were correlated with shallower psychometric function slopes, suggesting that hearing loss was associated with greater variance of the decision variable, consistent with increased internal noise. The results show that decreased auditory experience has a greater impact on perceptual skills when initiated at an early age and raises the possibility that altered development of CNS synapses may play a causative role.
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Munro KJ, Turtle C, Schaette R. Plasticity and modified loudness following short-term unilateral deprivation: evidence of multiple gain mechanisms within the auditory system. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2014; 135:315-22. [PMID: 24437771 DOI: 10.1121/1.4835715] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
Auditory deprivation and stimulation can change the threshold of the acoustic middle ear reflex as well as loudness in adult listeners. However, it has remained unclear whether changes in these measures are due to the same mechanism. In this study, deprivation was achieved using a monaural earplug that was worn by listeners for 7 days. Acoustic reflex thresholds (ARTs) and categorical loudness ratings were measured using a blinded design in which the experimenter was unaware of which ear had been plugged. Immediately after terminating unilateral deprivation, ARTs were obtained at a lower sound pressure level in the ear that had been fitted with an earplug and at a higher sound pressure level in the control ear. In contrast, categorical judgments of loudness changed in the same direction in both ears with a given stimulus level reported as louder after unilateral deprivation. The relationship between changes to the ART and loudness judgments was not statistically significant. For both the ARTs and the categorical loudness judgments, most of the changes had disappeared within 24 h after earplug removal. The changes in ARTs, as a consequence of unilateral sound deprivation, are consistent with a gain control mechanism; however, the lack of relationship with the categorical loudness judgments, and the different pattern of findings for each measure, suggests the possibility of multiple gain mechanisms.
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Affiliation(s)
- Kevin J Munro
- School of Psychological Sciences, University of Manchester, Manchester M13 9PL, United Kingdom
| | - Charlotte Turtle
- School of Psychological Sciences, University of Manchester, Manchester M13 9PL, United Kingdom
| | - Roland Schaette
- Ear Institute, University College London, London WC1X 8EE, United Kingdom
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38
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Anderson S, White-Schwoch T, Choi HJ, Kraus N. Training changes processing of speech cues in older adults with hearing loss. Front Syst Neurosci 2013; 7:97. [PMID: 24348347 PMCID: PMC3842592 DOI: 10.3389/fnsys.2013.00097] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2013] [Accepted: 11/11/2013] [Indexed: 01/29/2023] Open
Abstract
Aging results in a loss of sensory function, and the effects of hearing impairment can be especially devastating due to reduced communication ability. Older adults with hearing loss report that speech, especially in noisy backgrounds, is uncomfortably loud yet unclear. Hearing loss results in an unbalanced neural representation of speech: the slowly-varying envelope is enhanced, dominating representation in the auditory pathway and perceptual salience at the cost of the rapidly-varying fine structure. We hypothesized that older adults with hearing loss can be trained to compensate for these changes in central auditory processing through directed attention to behaviorally-relevant speech sounds. To that end, we evaluated the effects of auditory-cognitive training in older adults (ages 55-79) with normal hearing and hearing loss. After training, the auditory training group with hearing loss experienced a reduction in the neural representation of the speech envelope presented in noise, approaching levels observed in normal hearing older adults. No changes were noted in the control group. Importantly, changes in speech processing were accompanied by improvements in speech perception. Thus, central processing deficits associated with hearing loss may be partially remediated with training, resulting in real-life benefits for everyday communication.
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Affiliation(s)
- Samira Anderson
- Auditory Neuroscience Laboratory, Department of Communication Sciences and Disorders, Northwestern University Evanston, IL, USA ; Department of Communication Sciences, Northwestern University Evanston, IL, USA
| | - Travis White-Schwoch
- Auditory Neuroscience Laboratory, Department of Communication Sciences and Disorders, Northwestern University Evanston, IL, USA ; Department of Communication Sciences, Northwestern University Evanston, IL, USA
| | - Hee Jae Choi
- Auditory Neuroscience Laboratory, Department of Communication Sciences and Disorders, Northwestern University Evanston, IL, USA ; Department of Communication Sciences, Northwestern University Evanston, IL, USA
| | - Nina Kraus
- Auditory Neuroscience Laboratory, Department of Communication Sciences and Disorders, Northwestern University Evanston, IL, USA ; Department of Communication Sciences, Northwestern University Evanston, IL, USA ; Institute for Neuroscience, Northwestern University Evanston, IL, USA ; Department of Neurobiology and Physiology, Northwestern University Evanston, IL, USA ; Department of Otolaryngology, Northwestern University Evanston, IL, USA
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Anderson S, Parbery-Clark A, White-Schwoch T, Drehobl S, Kraus N. Effects of hearing loss on the subcortical representation of speech cues. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2013; 133:3030-8. [PMID: 23654406 PMCID: PMC3663860 DOI: 10.1121/1.4799804] [Citation(s) in RCA: 90] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
Individuals with sensorineural hearing loss often report frustration with speech being loud but not clear, especially in background noise. Despite advanced digital technology, hearing aid users may resort to removing their hearing aids in noisy environments due to the perception of excessive loudness. In an animal model, sensorineural hearing loss results in greater auditory nerve coding of the stimulus envelope, leading to a relative deficit of stimulus fine structure. Based on the hypothesis that brainstem encoding of the temporal envelope is greater in humans with sensorineural hearing loss, speech-evoked brainstem responses were recorded in normal hearing and hearing impaired age-matched groups of older adults. In the hearing impaired group, there was a disruption in the balance of envelope-to-fine structure representation compared to that of the normal hearing group. This imbalance may underlie the difficulty experienced by individuals with sensorineural hearing loss when trying to understand speech in background noise. This finding advances the understanding of the effects of sensorineural hearing loss on central auditory processing of speech in humans. Moreover, this finding has clinical potential for developing new amplification or implantation technologies, and in developing new training regimens to address this relative deficit of fine structure representation.
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Affiliation(s)
- Samira Anderson
- Northwestern University, Auditory Neuroscience Laboratory, Communication Sciences, 2240 North Campus Drive, Evanston, Illinois 60208, USA
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40
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Anderson S, Kraus N. Auditory Training: Evidence for Neural Plasticity in Older Adults. ACTA ACUST UNITED AC 2013; 17:37-57. [PMID: 25485037 DOI: 10.1044/hhd17.1.37] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Improvements in digital amplification, cochlear implants, and other innovations have extended the potential for improving hearing function; yet, there remains a need for further hearing improvement in challenging listening situations, such as when trying to understand speech in noise or when listening to music. Here, we review evidence from animal and human models of plasticity in the brain's ability to process speech and other meaningful stimuli. We considered studies targeting populations of younger through older adults, emphasizing studies that have employed randomized controlled designs and have made connections between neural and behavioral changes. Overall results indicate that the brain remains malleable through older adulthood, provided that treatment algorithms have been modified to allow for changes in learning with age. Improvements in speech-in-noise perception and cognition function accompany neural changes in auditory processing. The training-related improvements noted across studies support the need to consider auditory training strategies in the management of individuals who express concerns about hearing in difficult listening situations. Given evidence from studies engaging the brain's reward centers, future research should consider how these centers can be naturally activated during training.
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Affiliation(s)
- Samira Anderson
- Auditory Neuroscience Laboratory, Department of Communication Sciences, Northwestern University, Evanston, IL
| | - Nina Kraus
- Auditory Neuroscience Laboratory, Department of Communication Sciences, Neurobiology and Physiology, Otolaryngology, Institute for Neuroscience, Northwestern University, Evanston, IL
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41
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Investigation of cortical and subcortical plasticity following short-term unilateral auditory deprivation in normal hearing adults. Neuroreport 2013; 24:287-91. [DOI: 10.1097/wnr.0b013e32835f66ea] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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42
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Maslin MRD, Munro KJ, El-Deredy W. Evidence for multiple mechanisms of cortical plasticity: a study of humans with late-onset profound unilateral deafness. Clin Neurophysiol 2013; 124:1414-21. [PMID: 23529154 DOI: 10.1016/j.clinph.2012.12.052] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2012] [Revised: 12/04/2012] [Accepted: 12/08/2012] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To investigate 1: plasticity due to partial unilateral deafness of slow onset and 2: the time course of plasticity following abrupt, profound unilateral deafness in adult humans using cortical auditory evoked potentials. METHODS Baseline data were measured from six participants with partial unilateral deafness due to an acoustic neuroma and compared with data from six controls. Further measurements were made in the unilaterally deaf group at 1-, 3- and 6-months post surgery for acoustic neuroma removal and consequent profound unilateral deafness. Data were recorded from 30 channels in response to pure tones presented to the intact ear. RESULTS Baseline data revealed statistically higher amplitudes in unilaterally deaf participants but with normal hemispheric asymmetry. Longitudinal data revealed further increases in P1 amplitudes by 1-month post-surgery, and in N1 and P2 amplitudes by 6-months post-surgery, with statistically different scalp field topographies indicating reduced hemispheric asymmetries. CONCLUSION Different patterns of plasticity occur following partial and profound unilateral deafness. Plasticity occurs both relatively rapidly and more gradually over at least 6-months post-surgery. SIGNIFICANCE The different patterns of change over time are consistent with multiple physiological mechanisms of plasticity. Unravelling these mechanisms and their time course in humans may be relevant in understanding and, ultimately, influencing plasticity for therapeutic gain.
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Affiliation(s)
- Michael R D Maslin
- School of Psychological Sciences, University of Manchester, Oxford Road, Manchester M13 9PL, United Kingdom.
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43
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Abstract
The Tinnitus Retraining Therapy Trial (TRTT) is a National Institutes of Health-sponsored, multi-centered, placebo-controlled, randomized trial evaluating the efficacy of tinnitus retraining therapy (TRT) and its component parts, directive counseling and sound therapy, as treatments for subjective debilitating tinnitus in the military. The TRTT will enroll 228 individuals at an allocation ratio of 1:1:1 to: (1) directive counseling and sound therapy using conventional sound generators; (2) directive counseling and placebo sound generators; or (3) standard of care as administered in the military. Study centers include a Study Chair's Office, a Data Coordinating Center, and six Military Clinical Centers with treatment and data collection standardized across all clinics. The primary outcome is change in Tinnitus Questionnaire (TQ) score assessed longitudinally at 3, 6, 12, and 18-month follow-up visits. Secondary outcomes include: Change in TQ sub-scales, Tinnitus Handicap Inventory, Tinnitus Functional Index, and TRT interview visual analog scale; audiometric and psychoacoustic measures; and change in quality of life. The TRTT will evaluate TRT efficacy by comparing TRT (directive counseling and conventional sound generators) with standard of care; directive counseling by comparing directive counseling plus placebo sound generators versus standard of care; and sound therapy by comparing conventional versus placebo sound generators. We hypothesize that full TRT will be more efficacious than standard of care, directive counseling and placebo sound generators more efficacious than standard of care, and conventional more efficacious than placebo sound generators in habituating the tinnitus awareness, annoyance, and impact on the study participant's life.
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Affiliation(s)
- Craig Formby
- Department of Communicative Disorders, The University of Alabama, Box 870242, Tuscaloosa, AL 35487, USA.
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44
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Hébert S, Fournier P, Noreña A. The auditory sensitivity is increased in tinnitus ears. J Neurosci 2013; 33:2356-64. [PMID: 23392665 PMCID: PMC6619157 DOI: 10.1523/jneurosci.3461-12.2013] [Citation(s) in RCA: 111] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2012] [Revised: 11/26/2012] [Accepted: 11/29/2012] [Indexed: 12/23/2022] Open
Abstract
Increased auditory sensitivity, also called hyperacusis, is a pervasive complaint of people with tinnitus. The high prevalence of hyperacusis in tinnitus subjects suggests that both symptoms have a common origin. It has been suggested that they may result from a maladjusted increase of central gain attributable to sensory deafferentation. More specifically, tinnitus and hyperacusis could result from an increase of spontaneous and stimulus-induced activity, respectively. One prediction of this hypothesis is that auditory sensitivity should be increased in tinnitus compared with non-tinnitus subjects. The purpose of this study was to test this prediction by examining the loudness functions in tinnitus ears (n = 124) compared with non-tinnitus human ears (n = 106). Because tinnitus is often accompanied by hearing loss and that hearing loss makes it difficult to disentangle hypersensitivity (hyperacusis) to loudness recruitment, tinnitus and non-tinnitus ears were carefully matched for hearing loss. Our results show that auditory sensitivity is enhanced in tinnitus subjects compared with non-tinnitus subjects, including subjects with normal audiograms. We interpreted these findings as compatible with a maladaptive central gain in tinnitus.
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Affiliation(s)
- Sylvie Hébert
- School of Speech Pathology and Audiology, Faculty of Medicine, Université de Montréal, Montreal, Quebec H3C 3J7, Canada.
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45
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Munro KJ, Merrett JF. Brainstem plasticity and modified loudness following short-term use of hearing aids. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2013; 133:343-349. [PMID: 23297907 DOI: 10.1121/1.4770234] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Previous research has shown that the threshold of the middle ear acoustic reflex is modified in adult listeners following 1 week of continuous monaural sensory deprivation [Munro and Blount, J. Acoust. Soc. Am. 126, 568-571 (2009)]. The results of the present study provide evidence of plasticity in the brainstem of adult listeners following monaural auditory stimulation. Acoustic reflexes were obtained at a higher sound pressure level in the ear that had been fitted with a low-gain hearing aid for 5 days. These changes are in the opposite direction to those reported after sensory deprivation and are consistent with a gain control mechanism mediated by a process within the brainstem. Stimuli were reported as less loud after hearing aid use but the relationship with changes to the acoustic reflex threshold was not statistically significant.
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Affiliation(s)
- Kevin J Munro
- School of Psychological Sciences, University of Manchester, Manchester M13 9PL, United Kingdom.
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46
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Schaette R, Turtle C, Munro KJ. Reversible induction of phantom auditory sensations through simulated unilateral hearing loss. PLoS One 2012; 7:e35238. [PMID: 22675466 PMCID: PMC3366980 DOI: 10.1371/journal.pone.0035238] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2011] [Accepted: 03/14/2012] [Indexed: 11/24/2022] Open
Abstract
Tinnitus, a phantom auditory sensation, is associated with hearing loss in most cases, but it is unclear if hearing loss causes tinnitus. Phantom auditory sensations can be induced in normal hearing listeners when they experience severe auditory deprivation such as confinement in an anechoic chamber, which can be regarded as somewhat analogous to a profound bilateral hearing loss. As this condition is relatively uncommon among tinnitus patients, induction of phantom sounds by a lesser degree of auditory deprivation could advance our understanding of the mechanisms of tinnitus. In this study, we therefore investigated the reporting of phantom sounds after continuous use of an earplug. 18 healthy volunteers with normal hearing wore a silicone earplug continuously in one ear for 7 days. The attenuation provided by the earplugs simulated a mild high-frequency hearing loss, mean attenuation increased from <10 dB at 0.25 kHz to >30 dB at 3 and 4 kHz. 14 out of 18 participants reported phantom sounds during earplug use. 11 participants presented with stable phantom sounds on day 7 and underwent tinnitus spectrum characterization with the earplug still in place. The spectra showed that the phantom sounds were perceived predominantly as high-pitched, corresponding to the frequency range most affected by the earplug. In all cases, the auditory phantom disappeared when the earplug was removed, indicating a causal relation between auditory deprivation and phantom sounds. This relation matches the predictions of our computational model of tinnitus development, which proposes a possible mechanism by which a stabilization of neuronal activity through homeostatic plasticity in the central auditory system could lead to the development of a neuronal correlate of tinnitus when auditory nerve activity is reduced due to the earplug.
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Affiliation(s)
- Roland Schaette
- Ear Institute, University College London, London, United Kingdom.
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47
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Noreña AJ. Stimulating the Auditory System to Treat Tinnitus: From Alleviating the Symptoms to Addressing the Causes. SPRINGER HANDBOOK OF AUDITORY RESEARCH 2012. [DOI: 10.1007/978-1-4614-3728-4_10] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
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48
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Aazh H, Moore BCJ, Prasher D. Providing support to school children with hyperacusis. ACTA ACUST UNITED AC 2011. [DOI: 10.12968/bjsn.2011.6.4.174] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Hashir Aazh
- Audiologist and tinnitus specialist, Audiology Department, Royal Surrey County Hospital NHS Foundation Trust
| | - Brian CJ Moore
- Professor of Auditory Perception, Department of Experimental Psychology, University of Cambridge
| | - Deepak Prasher
- Professor of Audiology and head of the department, Audiology Department, Royal Surrey County Hospital NHS Foundation Trust
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49
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Noreña AJ. An integrative model of tinnitus based on a central gain controlling neural sensitivity. Neurosci Biobehav Rev 2011; 35:1089-109. [PMID: 21094182 DOI: 10.1016/j.neubiorev.2010.11.003] [Citation(s) in RCA: 285] [Impact Index Per Article: 21.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2010] [Revised: 10/20/2010] [Accepted: 11/12/2010] [Indexed: 02/03/2023]
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50
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Slagter HA, Davidson RJ, Lutz A. Mental training as a tool in the neuroscientific study of brain and cognitive plasticity. Front Hum Neurosci 2011; 5:17. [PMID: 21347275 PMCID: PMC3039118 DOI: 10.3389/fnhum.2011.00017] [Citation(s) in RCA: 147] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2010] [Accepted: 01/26/2011] [Indexed: 11/13/2022] Open
Abstract
Although the adult brain was once seen as a rather static organ, it is now clear that the organization of brain circuitry is constantly changing as a function of experience or learning. Yet, research also shows that learning is often specific to the trained stimuli and task, and does not improve performance on novel tasks, even very similar ones. This perspective examines the idea that systematic mental training, as cultivated by meditation, can induce learning that is not stimulus or task specific, but process specific. Many meditation practices are explicitly designed to enhance specific, well-defined core cognitive processes. We will argue that this focus on enhancing core cognitive processes, as well as several general characteristics of meditation regimens, may specifically foster process-specific learning. To this end, we first define meditation and discuss key findings from recent neuroimaging studies of meditation. We then identify several characteristics of specific meditation training regimes that may determine process-specific learning. These characteristics include ongoing variability in stimulus input, the meta-cognitive nature of the processes trained, task difficulty, the focus on maintaining an optimal level of arousal, and the duration of training. Lastly, we discuss the methodological challenges that researchers face when attempting to control or characterize the multiple factors that may underlie meditation training effects.
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Affiliation(s)
- Heleen A Slagter
- Brain and Cognition Unit, Department of Psychology, University of Amsterdam Amsterdam, Netherlands
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