Concurrent measures of contralateral suppression of transient-evoked otoacoustic emissions and of auditory steady-state responses

Effects of contralateral noise on envelope-following responses, auditory-nerve compound action potentials, and otoacoustic emissions measured simultaneously

This study assessed whether the effects of contralateral acoustic stimulation (CAS) are consistent with eliciting the medial olivocochlear (MOC) reflex for measurements sensitive to outer hair cell (otoacoustic emissions, OAEs), auditory-nerve (AN; compound action potential, CAP), and brainstem/cortical (envelope-following response, EFR) function. The effects of CAS were evaluated for simultaneous measurement of OAEs, CAPs, and EFRs in participants with normal hearing. Clicks were presented at 40 or 98 Hz in three ipsilateral noise conditions (no noise, 45 dB SPL, and 55 dB SPL). For the no noise condition, CAS suppressed or enhanced EFR amplitudes for 40- and 98-Hz clicks, respectively, while CAS had no significant effect on CAP amplitudes. A follow-up experiment using slower rates (4.4-22.2 Hz) assessed whether this insignificant CAS effect on CAPs was from ipsilateral MOC stimulation or AN adaptation; however, CAS effects remained insignificant despite favorable signal-to-noise ratios. CAS-related enhancements of EFR and CAP amplitudes in ipsilateral noise were not observed, contrary to the anti-masking effect of the MOC reflex. EFR and OAE suppression from CAS were not significantly correlated. Thus, the effects of CAS on EFRs may not be solely mediated by the MOC reflex and may be partially mediated by higher auditory centers.

Auditory brainstem mechanisms likely compensate for self-imposed peripheral inhibition

Feedback networks in the brain regulate downstream auditory function as peripheral as the cochlea. However, the upstream neural consequences of this peripheral regulation are less understood. For instance, the medial olivocochlear reflex (MOCR) in the brainstem causes putative attenuation of responses generated in the cochlea and cortex, but those generated in the brainstem are perplexingly unaffected. Based on known neural circuitry, we hypothesized that the inhibition of peripheral input is compensated for by positive feedback in the brainstem over time. We predicted that the inhibition could be captured at the brainstem with shorter (1.5 s) than previously employed long duration (240 s) stimuli where this inhibition is likely compensated for. Results from 16 normal-hearing human listeners support our hypothesis in that when the MOCR is activated, there is a robust reduction of responses generated at the periphery, brainstem, and cortex for short-duration stimuli. Such inhibition at the brainstem, however, diminishes for long-duration stimuli suggesting some compensatory mechanisms at play. Our findings provide a novel non-invasive window into potential gain compensation mechanisms in the brainstem that may have implications for auditory disorders such as tinnitus. Our methodology will be useful in the evaluation of efferent function in individuals with hearing loss.

Shortened neural conduction time in young adults with tinnitus as revealed by chirp-evoked auditory brainstem response

Tinnitus is generally considered to be caused by neuroplastic changes in the central nervous system, triggered by a loss of input from the damaged peripheral system; however, conflicting results on auditory brainstem responses (ABRs) to clicks have been reported previously in humans with tinnitus. This study aimed to compare the effect of tinnitus on ABRs to chirps with those to clicks in normal-hearing young adults with tinnitus. The results showed that the tinnitus group had no significantly poorer hearing thresholds (0.25-16 kHz), click-evoked otoacoustic emissions (1-16 kHz), and speech perception in noise (SPIN) than the control group. Although chirps evoked significantly larger wave I and V amplitudes than clicks, people with tinnitus had no significantly smaller wave I amplitudes for either stimulus. Nevertheless, adults with tinnitus exhibited significantly smaller interpeak interval (IPI) between waves I and V for chirps (IPI-chirp) but not for clicks. In addition, the IPI-chirp correlated significantly with the SPIN for individuals with tinnitus when the signal-to-noise ratio was low. The present results suggest that the chirp-evoked ABR may be a valuable clinical tool for objectively assessing the SPIN in individuals with tinnitus. Further studies should be conducted to investigate possible etiologies of tinnitus.

Computational modeling of the human compound action potential

The auditory nerve (AN) compound action potential (CAP) is an important tool for assessing auditory disorders and monitoring the health of the auditory periphery during surgical procedures. The CAP has been mathematically conceptualized as the convolution of a unit response (UR) waveform with the firing rate of a population of AN fibers. Here, an approach for predicting experimentally recorded CAPs in humans is proposed, which involves the use of human-based computational models to simulate AN activity. CAPs elicited by clicks, chirps, and amplitude-modulated carriers were simulated and compared with empirically recorded CAPs from human subjects. In addition, narrowband CAPs derived from noise-masked clicks and tone bursts were simulated. Many morphological, temporal, and spectral aspects of human CAPs were captured by the simulations for all stimuli tested. These findings support the use of model simulations of the human CAP to refine existing human-based models of the auditory periphery, aid in the design and analysis of auditory experiments, and predict the effects of hearing loss, synaptopathy, and other auditory disorders on the human CAP.

Brainstem auditory physiology in children with listening difficulties. Hear Res 2023;429:108705. [PMID: 36709582 PMCID: PMC10152893 DOI: 10.1016/j.heares.2023.108705]

Children who have listening difficulties (LiD) despite having normal audiometry are often diagnosed as having an auditory processing disorder. A lack of evidence regarding involvement of specific auditory mechanisms has limited development of effective treatments for these children. Here, we examined electrophysiologic evidence for brainstem pathway mechanisms in children with and without defined LiD. We undertook a prospective controlled study of 132 children aged 6-14 years with normal pure tone audiometry, grouped into LiD (n = 63) or Typically Developing (TD; n = 69) based on scores on the Evaluation of Children's Listening and Processing Skills (ECLiPS), a validated caregiver report. The groups were matched on age at test, sex, race, and ethnicity. Neither group had diagnoses of major neurologic disorder, intellectual disability, or brain injuries. Both groups received a test battery including a measure of receptive speech perception against distractor speech, Listening in Spatialized Noise - Sentences (LiSN-S), along with multiple neurophysiologic measures that tap afferent and efferent auditory subcortical pathways. Group analysis showed that participants with LiD performed significantly poorer on all subtests of the LiSN-S. The LiD group had significantly greater wideband middle ear muscle reflex (MEMR) growth functions in the left ear, and shorter Wave III and Wave V latencies in auditory brainstem responses (ABR). Across individual participants, shorter latency ABR Wave V correlated significantly with poorer parent report of LiD (ECLiPS composite). Greater MEMR growth functions also correlated with poorer ECLiPS scores and reduced LiSN-S talker advantage. The LiD and TD groups had equivalent summating potentials, compound action potentials, envelope-following responses, and binaurally activated medial olivocochlear reflexes. In conclusion, there was no evidence for auditory synaptopathy for LiD. Evidence for brainstem differences in the LiD group was interpreted as increased central gain, with shorter ABR Wave III and V latencies and steeper MEMR growth curves. These differences were related to poorer parent report and speech perception in competing speech ability.

The role of medial olivocochlear activity in contralateral suppression of auditory steady-state responses

OBJECTIVE

The auditory steady-state response (ASSR) amplitudes fall in the presence of contralateral noise. However, whether and to what extent medial olivocochlear (MOC) activity involves in contralateral suppression of ASSR remain unclear. Therefore, we assess the role of MOC activity in contralateral suppression of ASSR.

METHODS

Mice were treated with strychnine to completely eliminate MOC activity and then measured ASSR amplitudes in the presence of contralateral noise.

RESULTS

The contralateral noise reduces ASSR amplitudes at some stimulus intensity. After treating with the strychnine to eliminate MOC activity, ASSR amplitudes recovered again.

CONCLUSIONS

MOC activity participated in contralateral suppression of ASSR.

Contralateral noise effects on otoacoustic emissions and electrophysiologic responses in normal-hearing adults

Contralateral noise inhibits the amplitudes of cochlear and neural responses. These measures may hold potential diagnostic utility. The medial olivocochlear (MOC) reflex underlies the inhibition of cochlear responses but the extent to which it contributes to inhibition of neural responses remains unclear. Mertes and Leek [J. Acoust. Soc. Am. 140, 2027-2038 (2016)] recently examined contralateral inhibition of cochlear responses [transient-evoked otoacoustic emissions (TEOAEs)] and neural responses [auditory steady-state responses (ASSRs)] in humans and found that the two measures were not correlated, but potential confounds of older age and hearing loss were present. The current study controlled for these confounds by examining a group of young, normal-hearing adults. Additionally, measurements of the auditory brainstem response (ABR) were obtained. Responses were elicited using clicks with and without contralateral broadband noise. Changes in TEOAE and ASSR magnitude as well as ABR wave V latency were examined. Results indicated that contralateral inhibition of ASSRs was significantly larger than that of TEOAEs and that the two measures were uncorrelated. Additionally, there was no significant change in wave V latency. Results suggest that further work is needed to understand the mechanism underlying contralateral inhibition of the ASSR.

A Time-Course-Based Estimation of the Human Medial Olivocochlear Reflex Function Using Clicks

The auditory efferent system, especially the medial olivocochlear reflex (MOCR), is implicated in both typical auditory processing and in auditory disorders in animal models. Despite the significant strides in both basic and translational research on the MOCR, its clinical applicability remains under-utilized in humans due to the lack of a recommended clinical method. Conventional tests employ broadband noise in one ear while monitoring change in otoacoustic emissions (OAEs) in the other ear to index efferent activity. These methods, (1) can only assay the contralateral MOCR pathway and (2) are unable to extract the kinetics of the reflexes. We have developed a method that re-purposes the same OAE-evoking click-train to also concurrently elicit bilateral MOCR activity. Data from click-train presentations at 80 dB peSPL at 62.5 Hz in 13 young normal-hearing adults demonstrate the feasibility of our method. Mean MOCR magnitude (1.7 dB) and activation time-constant (0.2 s) are consistent with prior MOCR reports. The data also suggest several advantages of this method including, (1) the ability to monitor MEMR, (2) obtain both magnitude and kinetics (time constants) of the MOCR, (3) visual and statistical confirmation of MOCR activation.

The role of the medial olivocochlear reflex in psychophysical masking and intensity resolution in humans: a review

This review addresses the putative role of the medial olivocochlear (MOC) reflex in psychophysical masking and intensity resolution in humans. A framework for interpreting psychophysical results in terms of the expected influence of the MOC reflex is introduced. This framework is used to review the effects of a precursor or contralateral acoustic stimulation on 1) simultaneous masking of brief tones, 2) behavioral estimates of cochlear gain and frequency resolution in forward masking, 3) the buildup and decay of forward masking, and 4) measures of intensity resolution. Support, or lack thereof, for a role of the MOC reflex in psychophysical perception is discussed in terms of studies on estimates of MOC strength from otoacoustic emissions and the effects of resection of the olivocochlear bundle in patients with vestibular neurectomy. Novel, innovative approaches are needed to resolve the dissatisfying conclusion that current results are unable to definitively confirm or refute the role of the MOC reflex in masking and intensity resolution.

Correlation and Reliability of Behavioral and Otoacoustic-Emission Estimates of Contralateral Medial Olivocochlear Reflex Strength in Humans

The roles of the medial olivocochlear reflex (MOCR) in human hearing have been widely investigated but remain controversial. We reason that this may be because the effects of MOCR activation on cochlear mechanical responses can be assessed only indirectly in healthy humans, and the different methods used to assess those effects possibly yield different and/or unreliable estimates. One aim of this study was to investigate the correlation between three methods often employed to assess the strength of MOCR activation by contralateral acoustic stimulation (CAS). We measured tone detection thresholds (N = 28), click-evoked otoacoustic emission (CEOAE) input/output (I/O) curves (N = 18), and distortion-product otoacoustic emission (DPOAE) I/O curves (N = 18) for various test frequencies in the presence and the absence of CAS (broadband noise of 60 dB SPL). As expected, CAS worsened tone detection thresholds, suppressed CEOAEs and DPOAEs, and horizontally shifted CEOAE and DPOAE I/O curves to higher levels. However, the CAS effect on tone detection thresholds was not correlated with the horizontal shift of CEOAE or DPOAE I/O curves, and the CAS-induced CEOAE suppression was not correlated with DPOAE suppression. Only the horizontal shifts of CEOAE and DPOAE I/O functions were correlated with each other at 1.5, 2, and 3 kHz. A second aim was to investigate which of the methods is more reliable. The test–retest variability of the CAS effect was high overall but smallest for tone detection thresholds and CEOAEs, suggesting that their use should be prioritized over the use of DPOAEs. Many factors not related with the MOCR, including the limited parametric space studied, the low resolution of the I/O curves, and the reduced numbers of observations due to data exclusion likely contributed to the weak correlations and the large test–retest variability noted. These findings can help us understand the inconsistencies among past studies and improve our understanding of the functional significance of the MOCR.

Cochlear Dysfunction Is a Frequent Feature of Facioscapulohumeral Muscular Dystrophy Type 1 (FSHD1)

INTRODUCTION

Facioscapulohumeral muscular dystrophy type 1 (FSHD) represents one of the most common forms of muscular hereditary diseases and it is characterized by a great clinical variability with the typical muscular symptoms and other clinical features, including hearing impairment. However, etiopathogenetic mechanisms of auditory dysfunction are still not completely understood and it has been suggested that it could be assigned to a cochlear alteration that is present even in those subjects with a normal pure tonal audiometry (PTA) examination.

METHODS

We found out the cochlear function in 26 patients with molecular diagnosis of FSHD1 and in healthy controls. All patients underwent complete neurological and audiological examinations, including FSHD clinical score, pure-tone audiometry (PTA), and otoacoustic emissions (OAEs), in particular transient evoked otoacoustic emissions (TEOAEs) and distortion product evoked otoacoustic emissions (DPOAEs).

RESULTS

All FSHD1 patients showed significantly reduced DPOAEs and TEOAEs, bilaterally and at all frequencies, even when considering only subjects with a normal PTA or a mild muscular involvement (FSHD score ≤ 2). No correlation between OAEs and FSHD clinical score was found.

DISCUSSION

Cochlear echoes represent a sensitive tool in detecting subclinical cochlear dysfunction in FSHD1 even in subjects with normal hearing and/or subtle muscle involvement. Our study is focused on the importance of evaluating the cochlear alteration through OAEs and, in particular, by performing TEOAEs and DPOAEs sequentially, to evaluate more frequent specificities of cochlear dysfunction with a wider spectrum of analysis.

Evaluating the Function of the Medial Olivocochlear Bundle in Patients With Bilateral Tinnitus

Purpose No study has investigated the effects of contralateral noise (CN) on speech-in-noise perception (SINP) in listeners with tinnitus. The mechanisms underlying the involvement of medial olivocochlear (MOC) reflex with SINP remain to be elucidated. This study aimed to investigate the MOC function in patients with bilateral tinnitus by measuring distortion product otoacoustic emission and SINP. Method Eighteen patients with bilateral tinnitus (one male and 17 females; age: M ± SD = 45.61 ± 10.18 years) and 19 listeners without tinnitus (six males and 13 females; age: M ± SD = 34.11 ± 8.35 years) were recruited for the study. Each subject underwent distortion product otoacoustic emission measurement and the SINP test for both ears. The effects of CN on these two measurements were compared between tinnitus ears (TEs) and no-tinnitus ears (NTEs). Results The presence of CN significantly reduced distortion product (DP) amplitudes and improved SINP for TEs, and the amounts of DP suppression and SINP improvement were similar to those in NTEs. Improvement of SINP was positively correlated with DP suppression at 6185 Hz for NTEs and at 1640 Hz for TEs. Conclusions The results of this study suggest that the amounts of DP suppression and SINP improvement were similar between listeners with and without tinnitus. For both ear groups, the MOC reflex was involved with SINP at specific frequencies. Any clinical test outcomes with regard to the MOC bundle in patients with tinnitus should be interpreted with caution until further studies are conducted.

Olivocochlear Efferent Activity Is Associated With the Slope of the Psychometric Function of Speech Recognition in Noise

OBJECTIVES

The medial olivocochlear (MOC) efferent system can modify cochlear function to improve sound detection in noise, but its role in speech perception in noise is unclear. The purpose of this study was to determine the association between MOC efferent activity and performance on two speech-in-noise tasks at two signal-to-noise ratios (SNRs). It was hypothesized that efferent activity would be more strongly correlated with performance at the more challenging SNR, relative to performance at the less challenging SNR.

DESIGN

Sixteen adults aged 35 to 73 years participated. Subjects had pure-tone averages ≤25 dB HL and normal middle ear function. High-frequency pure-tone averages were computed across 3000 to 8000 Hz and ranged from 6.3 to 48.8 dB HL. Efferent activity was assessed using contralateral suppression of transient-evoked otoacoustic emissions (TEOAEs) measured in right ears, and MOC activation was achieved by presenting broadband noise to left ears. Contralateral suppression was expressed as the decibel change in TEOAE magnitude obtained with versus without the presence of the broadband noise. TEOAE responses were also examined for middle ear muscle reflex activation and synchronous spontaneous otoacoustic emissions (SSOAEs). Speech-in-noise perception was assessed using the closed-set coordinate response measure word recognition task and the open-set Institute of Electrical and Electronics Engineers sentence task. Speech and noise were presented to right ears at two SNRs. Performance on each task was scored as percent correct. Associations between contralateral suppression and speech-in-noise performance were quantified using partial rank correlational analyses, controlling for the variables age and high-frequency pure-tone average.

RESULTS

One subject was excluded due to probable middle ear muscle reflex activation. Subjects showed a wide range of contralateral suppression values, consistent with previous reports. Three subjects with SSOAEs had similar contralateral suppression results as subjects without SSOAEs. The magnitude of contralateral suppression was not significantly correlated with speech-in-noise performance on either task at a single SNR (p > 0.05), contrary to hypothesis. However, contralateral suppression was significantly correlated with the slope of the psychometric function, computed as the difference between performance levels at the two SNRs divided by 3 (decibel difference between the 2 SNRs) for the coordinate response measure task (partial rs = 0.59; p = 0.04) and for the Institute of Electrical and Electronics Engineers task (partial rs = 0.60; p = 0.03).

CONCLUSIONS

In a group of primarily older adults with normal hearing or mild hearing loss, olivocochlear efferent activity assessed using contralateral suppression of TEOAEs was not associated with speech-in-noise performance at a single SNR. However, auditory efferent activity appears to be associated with the slope of the psychometric function for both a word and sentence recognition task in noise. Results suggest that individuals with stronger MOC efferent activity tend to be more responsive to changes in SNR, where small increases in SNR result in better speech-in-noise performance relative to individuals with weaker MOC efferent activity. Additionally, the results suggest that the slope of the psychometric function may be a more useful metric than performance at a single SNR when examining the relationship between speech recognition in noise and MOC efferent activity.

Human medial efferent activity elicited by dynamic versus static contralateral noises

The medial olivocochlear reflex (MOCR) modifies cochlear amplifier function to improve encoding of signals in static noise, but conflicting results have been reported regarding how the MOCR responds to dynamic, temporally-complex noises. The current study utilized three MOCR elicitors with identical spectral content but different temporal properties: broadband noise, amplitude-modulated noise, and speech envelope-modulated noise. MOCR activity was assessed using contralateral inhibition of transient-evoked otoacoustic emissions in 27 normal-hearing young adults. Elicitors were presented contralaterally at two intensities of 50 and 60 dB SPL. Magnitude and growth of contralateral inhibition with increasing elicitor intensity were compared across the three elicitor types. Results revealed that contralateral inhibition was significantly larger at the elicitor intensity of 60 dB SPL than at 50 dB SPL, but there were no significant differences in the magnitude and growth of inhibition across the three elicitors, contrary to hypothesis. These results suggest that the MOCR responds similarly to both static and dynamic noise.

Efferent modulation of pre-neural and neural distortion products

Distortion product otoacoustic emissions (DPOAEs) and distortion product frequency following responses (DPFFRs) are respectively pre-neural and neural measurements associated with cochlear nonlinearity. Because cochlear nonlinearity is putatively linked to outer hair cell electromotility, DPOAEs and DPFFRs may provide complementary measurements of the human medial olivocochlear (MOC) reflex, which directly modulates outer hair cell function. In this study, we first quantified MOC reflex-induced DPOAE inhibition at spectral fine structure peaks in 22 young human adults with normal hearing. The f1 and f2 tone pairs producing the largest DPOAE fine structure peak for each subject were then used to evoke DPFFRs with and without MOC reflex activation to provide a related neural measure of efferent inhibition. We observed significant positive relationships between DPOAE fine structure peak inhibition and inhibition of DPFFR components representing neural phase locking to f2 and 2f1-f2, but not f1. These findings may support previous observations that the MOC reflex inhibits DPOAE sources differentially. That these effects are maintained and represented in the auditory brainstem suggests that the MOC reflex may exert a potent influence on subsequent subcortical neural representation of sound.