Case studies in neuroscience: subcortical origins of the frequency-following response

Myogenic artifacts masquerade as neuroplasticity in the auditory frequency-following response

The frequency-following response (FFR) is an evoked potential that provides a neural index of complex sound encoding in the brain. FFRs have been widely used to characterize speech and music processing, experience-dependent neuroplasticity (e.g., learning and musicianship), and biomarkers for hearing and language-based disorders that distort receptive communication abilities. It is widely assumed that FFRs stem from a mixture of phase-locked neurogenic activity from the brainstem and cortical structures along the hearing neuraxis. In this study, we challenge this prevailing view by demonstrating that upwards of ~50% of the FFR can originate from an unexpected myogenic source: contamination from the postauricular muscle (PAM) vestigial startle reflex. We measured PAM, transient auditory brainstem responses (ABRs), and sustained frequency-following response (FFR) potentials reflecting myogenic (PAM) and neurogenic (ABR/FFR) responses in young, normal-hearing listeners with varying degrees of musical training. We first establish that PAM artifact is present in all ears, varies with electrode proximity to the muscle, and can be experimentally manipulated by directing listeners' eye gaze toward the ear of sound stimulation. We then show this muscular noise easily confounds auditory FFRs, spuriously amplifying responses 3-4-fold with tandem PAM contraction and even explaining putative FFR enhancements observed in highly skilled musicians. Our findings expose a new and unrecognized myogenic source to the FFR that drives its large inter-subject variability and cast doubt on whether changes in the response typically attributed to neuroplasticity/pathology are solely of brain origin.

Myogenic artifacts masquerade as neuroplasticity in the auditory frequency-following response (FFR)

The frequency-following response (FFR) is an evoked potential that provides a "neural fingerprint" of complex sound encoding in the brain. FFRs have been widely used to characterize speech and music processing, experience-dependent neuroplasticity (e.g., learning, musicianship), and biomarkers for hearing and language-based disorders that distort receptive communication abilities. It is widely assumed FFRs stem from a mixture of phase-locked neurogenic activity from brainstem and cortical structures along the hearing neuraxis. Here, we challenge this prevailing view by demonstrating upwards of ~50% of the FFR can originate from a non-neural source: contamination from the postauricular muscle (PAM) vestigial startle reflex. We first establish PAM artifact is present in all ears, varies with electrode proximity to the muscle, and can be experimentally manipulated by directing listeners' eye gaze toward the ear of sound stimulation. We then show this muscular noise easily confounds auditory FFRs, spuriously amplifying responses by 3-4x fold with tandem PAM contraction and even explaining putative FFR enhancements observed in highly skilled musicians. Our findings expose a new and unrecognized myogenic source to the FFR that drives its large inter-subject variability and cast doubt on whether changes in the response typically attributed to neuroplasticity/pathology are solely of brain origin.

Frequency-Following Responses in Sensorineural Hearing Loss: A Systematic Review

PURPOSE

This systematic review aims to assess the impact of sensorineural hearing loss (SNHL) on various frequency-following response (FFR) parameters.

METHODS

Following PRISMA guidelines, a systematic review was conducted using PubMed, Web of Science, and Scopus databases up to January 2023. Studies evaluating FFRs in patients with SNHL and normal hearing controls were included.

RESULTS

Sixteen case-control studies were included, revealing variability in acquisition parameters. In the time domain, patients with SNHL exhibited prolonged latencies. The specific waves that were prolonged differed across studies. There was no consensus regarding wave amplitude in the time domain. In the frequency domain, focusing on studies that elicited FFRs with stimuli of 170 ms or longer, participants with SNHL displayed a significantly smaller fundamental frequency (F0). Results regarding changes in the temporal fine structure (TFS) were inconsistent.

CONCLUSION

Patients with SNHL may require more time for processing (speech) stimuli, reflected in prolonged latencies. However, the exact timing of this delay remains unclear. Additionally, when presenting longer stimuli (≥ 170 ms), patients with SNHL show difficulties tracking the F0 of (speech) stimuli. No definite conclusions could be drawn on changes in wave amplitude in the time domain and the TFS in the frequency domain. Patient characteristics, acquisition parameters, and FFR outcome parameters differed greatly across studies. Future studies should be performed in larger and carefully matched subject groups, using longer stimuli presented at the same intensity in dB HL for both groups, or at a carefully determined maximum comfortable loudness level.

Time-locked auditory cortical responses in the high-gamma band: A window into primary auditory cortex

Primary auditory cortex is a critical stage in the human auditory pathway, a gateway between subcortical and higher-level cortical areas. Receiving the output of all subcortical processing, it sends its output on to higher-level cortex. Non-invasive physiological recordings of primary auditory cortex using electroencephalography (EEG) and magnetoencephalography (MEG), however, may not have sufficient specificity to separate responses generated in primary auditory cortex from those generated in underlying subcortical areas or neighboring cortical areas. This limitation is important for investigations of effects of top-down processing (e.g., selective-attention-based) on primary auditory cortex: higher-level areas are known to be strongly influenced by top-down processes, but subcortical areas are often assumed to perform strictly bottom-up processing. Fortunately, recent advances have made it easier to isolate the neural activity of primary auditory cortex from other areas. In this perspective, we focus on time-locked responses to stimulus features in the high gamma band (70-150 Hz) and with early cortical latency (∼40 ms), intermediate between subcortical and higher-level areas. We review recent findings from physiological studies employing either repeated simple sounds or continuous speech, obtaining either a frequency following response (FFR) or temporal response function (TRF). The potential roles of top-down processing are underscored, and comparisons with invasive intracranial EEG (iEEG) and animal model recordings are made. We argue that MEG studies employing continuous speech stimuli may offer particular benefits, in that only a few minutes of speech generates robust high gamma responses from bilateral primary auditory cortex, and without measurable interference from subcortical or higher-level areas.

Methodological considerations when measuring and analyzing auditory steady-state responses with multi-channel EEG

The auditory steady-state response (ASSR) has been traditionally recorded with few electrodes and is often measured as the voltage difference between mastoid and vertex electrodes (vertical montage). As high-density EEG recording systems have gained popularity, multi-channel analysis methods have been developed to integrate the ASSR signal across channels. The phases of ASSR across electrodes can be affected by factors including the stimulus modulation rate and re-referencing strategy, which will in turn affect the estimated ASSR strength. To explore the relationship between the classical vertical-montage ASSR and whole-scalp ASSR, we applied these two techniques to the same data to estimate the strength of ASSRs evoked by tones with sinusoidal amplitude modulation rates of around 40, 100, and 200 Hz. The whole-scalp methods evaluated in our study, with either linked-mastoid or common-average reference, included ones that assume equal phase across all channels, as well as ones that allow for different phase relationships. The performance of simple averaging was compared to that of more complex methods involving principal component analysis. Overall, the root-mean-square of the phase locking values (PLVs) across all channels provided the most efficient method to detect ASSR across the range of modulation rates tested here.

Brainstem speech encoding is dynamically shaped online by fluctuations in cortical α state

Experimental evidence in animals demonstrates cortical neurons innervate subcortex bilaterally to tune brainstem auditory coding. Yet, the role of the descending (corticofugal) auditory system in modulating earlier sound processing in humans during speech perception remains unclear. Here, we measured EEG activity as listeners performed speech identification tasks in different noise backgrounds designed to tax perceptual and attentional processing. We hypothesized brainstem speech coding might be tied to attention and arousal states (indexed by cortical α power) that actively modulate the interplay of brainstem-cortical signal processing. When speech-evoked brainstem frequency-following responses (FFRs) were categorized according to cortical α states, we found low α FFRs in noise were weaker, correlated positively with behavioral response times, and were more "decodable" via neural classifiers. Our data provide new evidence for online corticofugal interplay in humans and establish that brainstem sensory representations are continuously yoked to (i.e., modulated by) the ebb and flow of cortical states to dynamically update perceptual processing.

Athleticism and sex impact neural processing of sound

Biology and experience both influence the auditory brain. Sex is one biological factor with pervasive effects on auditory processing. Females process sounds faster and more robustly than males. These differences are linked to hormone differences between the sexes. Athleticism is an experiential factor known to reduce ongoing neural noise, but whether it influences how sounds are processed by the brain is unknown. Furthermore, it is unknown whether sports participation influences auditory processing differently in males and females, given the well-documented sex differences in auditory processing seen in the general population. We hypothesized that athleticism enhances auditory processing and that these enhancements are greater in females. To test these hypotheses, we measured auditory processing in collegiate Division I male and female student-athletes and their non-athlete peers (total n = 1012) using the frequency-following response (FFR). The FFR is a neurophysiological response to sound that reflects the processing of discrete sound features. We measured across-trial consistency of the response in addition to fundamental frequency (F0) and harmonic encoding. We found that athletes had enhanced encoding of the harmonics, which was greatest in the female athletes, and that athletes had more consistent responses than non-athletes. In contrast, F0 encoding was reduced in athletes. The harmonic-encoding advantage in female athletes aligns with previous work linking harmonic encoding strength to female hormone levels and studies showing estrogen as mediating athlete sex differences in other sensory domains. Lastly, persistent deficits in auditory processing from previous concussive and repetitive subconcussive head trauma may underlie the reduced F0 encoding in athletes, as poor F0 encoding is a hallmark of concussion injury.

Brainstem evoked auditory potentials in tinnitus: A best-evidence synthesis and meta-analysis

Introduction

Accumulating evidence suggests a role of the brainstem in tinnitus generation and modulation. Several studies in chronic tinnitus patients have reported latency and amplitude changes of the different peaks of the auditory brainstem response, possibly reflecting neural changes or altered activity. The aim of the systematic review was to assess if alterations within the brainstem of chronic tinnitus patients are reflected in short- and middle-latency auditory evoked potentials (AEPs).

Methods

A systematic review was performed and reported according to the PRISMA guidelines. Studies evaluating short- and middle-latency AEPs in tinnitus patients and controls were included. Two independent reviewers conducted the study selection, data extraction, and risk of bias assessment. Meta-analysis was performed using a multivariate meta-analytic model.

Results

Twenty-seven cross-sectional studies were included. Multivariate meta-analysis revealed that in tinnitus patients with normal hearing, significantly longer latencies of auditory brainstem response (ABR) waves I (SMD = 0.66 ms, p < 0.001), III (SMD = 0.43 ms, p < 0.001), and V (SMD = 0.47 ms, p < 0.01) are present. The results regarding possible changes in middle-latency responses (MLRs) and frequency-following responses (FFRs) were inconclusive.

Discussion

The discovered changes in short-latency AEPs reflect alterations at brainstem level in tinnitus patients. More specifically, the prolonged ABR latencies could possibly be explained by high frequency sensorineural hearing loss, or other modulating factors such as cochlear synaptopathy or somatosensory tinnitus generators. The question whether middle-latency AEP changes, representing subcortical level of the auditory pathway, are present in tinnitus still remains unanswered. Future studies should identify and correctly deal with confounding factors, such as age, gender and the presence of somatosensory tinnitus components.

Systematic review registration

https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021243687, PROSPERO [CRD42021243687].

Objective Detection of the Speech Frequency Following Response (sFFR): A Comparison of Two Methods

Speech frequency following responses (sFFRs) are increasingly used in translational auditory research. Statistically-based automated sFFR detection could aid response identification and provide a basis for stopping rules when recording responses in clinical and/or research applications. In this brief report, sFFRs were measured from 18 normal hearing adult listeners in quiet and speech-shaped noise. Two statistically-based automated response detection methods, the F-test and Hotelling’s T² (HT²) test, were compared based on detection accuracy and test time. Similar detection accuracy across statistical tests and conditions was observed, although the HT² test time was less variable. These findings suggest that automated sFFR detection is robust for responses recorded in quiet and speech-shaped noise using either the F-test or HT² test. Future studies evaluating test performance with different stimuli and maskers are warranted to determine if the interchangeability of test performance extends to these conditions.

Listening in the Moment: How Bilingualism Interacts With Task Demands to Shape Active Listening

While there is evidence for bilingual enhancements of inhibitory control and auditory processing, two processes that are fundamental to daily communication, it is not known how bilinguals utilize these cognitive and sensory enhancements during real-world listening. To test our hypothesis that bilinguals engage their enhanced cognitive and sensory processing in real-world listening situations, bilinguals and monolinguals performed a selective attention task involving competing talkers, a common demand of everyday listening, and then later passively listened to the same competing sentences. During the active and passive listening periods, evoked responses to the competing talkers were collected to understand how online auditory processing facilitates active listening and if this processing differs between bilinguals and monolinguals. Additionally, participants were tested on a separate measure of inhibitory control to see if inhibitory control abilities related with performance on the selective attention task. We found that although monolinguals and bilinguals performed similarly on the selective attention task, the groups differed in the neural and cognitive processes engaged to perform this task, compared to when they were passively listening to the talkers. Specifically, during active listening monolinguals had enhanced cortical phase consistency while bilinguals demonstrated enhanced subcortical phase consistency in the response to the pitch contours of the sentences, particularly during passive listening. Moreover, bilinguals’ performance on the inhibitory control test related with performance on the selective attention test, a relationship that was not seen for monolinguals. These results are consistent with the hypothesis that bilinguals utilize inhibitory control and enhanced subcortical auditory processing in everyday listening situations to engage with sound in ways that are different than monolinguals.

Sex differences in auditory processing vary across estrous cycle

In humans, females process a sound's harmonics more robustly than males. As estrogen regulates auditory plasticity in a sex-specific manner in seasonally breeding animals, estrogen signaling is one hypothesized mechanism for this difference in humans. To investigate whether sex differences in harmonic encoding vary similarly across the reproductive cycle of mammals, we recorded frequency-following responses (FFRs) to a complex sound in male and female rats. Female FFRs were collected during both low and high levels of circulating estrogen during the estrous cycle. Overall, female rodents had larger harmonic encoding than male rodents, and greater harmonic strength was seen during periods of greater estrogen production in the females. These results argue that hormonal differences, specifically estrogen, underlie sex differences in harmonic encoding in rodents and suggest that a similar mechanism may underlie differences seen in humans.

Frequency-Following Response and Auditory Behavior in Children with Prenatal Exposure to the Zika Virus

Introduction Prenatal exposure to the Zika virus can impair neurodevelopment and cause auditory damage.

Objective To analyze the frequency-following response (FFR) and the auditory behavior (with the LittlEars ® questionnaire) of children with and without prenatal exposure to Zika virus infection.

Methods A total of 30 children participated in the present study, divided into 3 groups: 10 children with microcephaly and prenatal exposure to the Zika virus; 10 normocephalic children with prenatal exposure to the Zika virus; and 10 children with no evidence of prenatal exposure to the virus. The FFR test was performed with the /da/ syllable. The LittlEars ® questionnaire was used with parents/guardians.

Results For the FFR measurements, there was no difference between the groups. The children with exposure to the Zika virus presented a final score in the questionnaire below what is expected from children with normal hearing. A significant difference was observed for the final, semantic, and expressive scores between the group with microcephaly and the other groups. A strong negative correlation was seen between the LittlEars ® questionnaire final score and the FFR measurements for the group with microcephaly when compared with the other groups.

Conclusion Children exposed to the Zika virus, with and without microcephaly, presented FFR patterns similar to what was seen in children with no evidence of virus exposure. However, they showed signs of immature auditory behavior, suggesting auditory development delay.

Multiple Cases of Auditory Neuropathy Illuminate the Importance of Subcortical Neural Synchrony for Speech-in-noise Recognition and the Frequency-following Response

OBJECTIVES

The role of subcortical synchrony in speech-in-noise (SIN) recognition and the frequency-following response (FFR) was examined in multiple listeners with auditory neuropathy. Although an absent FFR has been documented in one listener with idiopathic neuropathy who has severe difficulty recognizing SIN, several etiologies cause the neuropathy phenotype. Consequently, it is necessary to replicate absent FFRs and concomitant SIN difficulties in patients with multiple sources and clinical presentations of neuropathy to elucidate fully the importance of subcortical neural synchrony for the FFR and SIN recognition.

DESIGN

Case series. Three children with auditory neuropathy (two males with neuropathy attributed to hyperbilirubinemia, one female with a rare missense mutation in the OPA1 gene) were compared to age-matched controls with normal hearing (52 for electrophysiology and 48 for speech recognition testing). Tests included standard audiological evaluations, FFRs, and sentence recognition in noise. The three children with neuropathy had a range of clinical presentations, including moderate sensorineural hearing loss, use of a cochlear implant, and a rapid progressive hearing loss.

RESULTS

Children with neuropathy generally had good speech recognition in quiet but substantial difficulties in noise. These SIN difficulties were somewhat mitigated by a clear speaking style and presenting words in a high semantic context. In the children with neuropathy, FFRs were absent from all tested stimuli. In contrast, age-matched controls had reliable FFRs.

CONCLUSION

Subcortical synchrony is subject to multiple forms of disruption but results in a consistent phenotype of an absent FFR and substantial difficulties recognizing SIN. These results support the hypothesis that subcortical synchrony is necessary for the FFR. Thus, in healthy listeners, the FFR may reflect subcortical neural processes important for SIN recognition.

Cortical hemisphere preference and brainstem ear asymmetry reflect experience-dependent functional modulation of pitch

Temporal attributes of pitch processing at cortical and subcortical levels are differentially weighted and well-coordinated. The question is whether language experience induces functional modulation of hemispheric preference complemented by brainstem ear symmetry for pitch processing. Brainstem frequency-following and cortical pitch responses were recorded concurrently from Mandarin and English participants. A Mandarin syllable with a rising pitch contour was presented to both ears with monaural stimulation. At the cortical level, left ear stimulation in the Chinese group revealed an experience-dependent response for pitch processing in the right hemisphere, consistent with a functionalaccount. The English group revealed a contralateral hemisphere preference consistent with a structuralaccount. At the brainstem level, Chinese participants showed a functional leftward ear asymmetry, whereas English were consistent with a structural account. Overall, language experience modulates both cortical hemispheric preference and brainstem ear asymmetry in a complementary manner to optimize processing of temporal attributes of pitch.

Non-stimulus-evoked activity as a measure of neural noise in the frequency-following response

BACKGROUND

The frequency-following response, or FFR, is a neurophysiologic response that captures distinct aspects of sound processing. Like all evoked responses, FFR is susceptible to electric and myogenic noise contamination during collection. Click-evoked auditory brainstem response collection standards have been adopted for FFR collection, however, whether these standards sufficiently limit FFR noise contamination is unknown. Thus, a critical question remains: to what extent do distinct FFR components reflect noise contamination? This is especially relevant for prestimulus amplitude (i.e., activity preceding the evoked response), as this measure has been used to index both noise contamination and neural noise.

NEW METHOD

We performed two experiments. First, using >1000 young-adult FFRs, we ran regressions to determine the variance explained by myogenic and electrical noise, as indexed by artifact rejection count and electrode impedance, on each FFR component. Second, we reanalyzed prestimulus amplitude differences attributed to athletic experience and socioeconomic status, adding covariates of artifact rejection and impedance.

RESULTS

We found that non-neural noise marginally contributed to FFR components and could not explain group differences on prestimulus amplitude.

COMPARISON WITH EXISTING METHOD

Prestimulus amplitude has been considered a measure of non-neural noise contamination. However, non-neural noise was not the sole contributor to variance in this measure and did not explain group differences.

CONCLUSIONS

Results from the two experiments suggest that the effects of non-neural noise on FFR components are minimal and do not obscure individual differences in the FFR and that prestimulus amplitude indexes neural noise.

Attention reinforces human corticofugal system to aid speech perception in noise

Perceiving speech-in-noise (SIN) demands precise neural coding between brainstem and cortical levels of the hearing system. Attentional processes can then select and prioritize task-relevant cues over competing background noise for successful speech perception. In animal models, brainstem-cortical interplay is achieved via descending corticofugal projections from cortex that shape midbrain responses to behaviorally-relevant sounds. Attentional engagement of corticofugal feedback may assist SIN understanding but has never been confirmed and remains highly controversial in humans. To resolve these issues, we recorded source-level, anatomically constrained brainstem frequency-following responses (FFRs) and cortical event-related potentials (ERPs) to speech via high-density EEG while listeners performed rapid SIN identification tasks. We varied attention with active vs. passive listening scenarios whereas task difficulty was manipulated with additive noise interference. Active listening (but not arousal-control tasks) exaggerated both ERPs and FFRs, confirming attentional gain extends to lower subcortical levels of speech processing. We used functional connectivity to measure the directed strength of coupling between levels and characterize "bottom-up" vs. "top-down" (corticofugal) signaling within the auditory brainstem-cortical pathway. While attention strengthened connectivity bidirectionally, corticofugal transmission disengaged under passive (but not active) SIN listening. Our findings (i) show attention enhances the brain's transcription of speech even prior to cortex and (ii) establish a direct role of the human corticofugal feedback system as an aid to cocktail party speech perception.

Neural generators of the frequency-following response elicited to stimuli of low and high frequency: A magnetoencephalographic (MEG) study

The frequency-following response (FFR) to periodic complex sounds has gained recent interest in auditory cognitive neuroscience as it captures with great fidelity the tracking accuracy of the periodic sound features in the ascending auditory system. Seminal studies suggested the FFR as a correlate of subcortical sound encoding, yet recent studies aiming to locate its sources challenged this assumption, demonstrating that FFR receives some contribution from the auditory cortex. Based on frequency-specific phase-locking capabilities along the auditory hierarchy, we hypothesized that FFRs to higher frequencies would receive less cortical contribution than those to lower frequencies, hence supporting a major subcortical involvement for these high frequency sounds. Here, we used a magnetoencephalographic (MEG) approach to trace the neural sources of the FFR elicited in healthy adults (N = 19) to low (89 Hz) and high (333 Hz) frequency sounds. FFRs elicited to the high and low frequency sounds were clearly observable on MEG and comparable to those obtained in simultaneous electroencephalographic recordings. Distributed source modeling analyses revealed midbrain, thalamic, and cortical contributions to FFR, arranged in frequency-specific configurations. Our results showed that the main contribution to the high-frequency sound FFR originated in the inferior colliculus and the medial geniculate body of the thalamus, with no significant cortical contribution. In contrast, the low-frequency sound FFR had a major contribution located in the auditory cortices, and also received contributions originating in the midbrain and thalamic structures. These findings support the multiple generator hypothesis of the FFR and are relevant for our understanding of the neural encoding of sounds along the auditory hierarchy, suggesting a hierarchical organization of periodicity encoding.

Subcortical rather than cortical sources of the frequency-following response (FFR) relate to speech-in-noise perception in normal-hearing listeners

Scalp-recorded frequency-following responses (FFRs) reflect a mixture of phase-locked activity across the auditory pathway. FFRs have been widely used as a neural barometer of complex listening skills, especially speech-in noise (SIN) perception. Applying individually optimized source reconstruction to speech-FFRs recorded via EEG (FFR_EEG), we assessed the relative contributions of subcortical [auditory nerve (AN), brainstem/midbrain (BS)] and cortical [bilateral primary auditory cortex, PAC] source generators with the aim of identifying which source(s) drive the brain-behavior relation between FFRs and SIN listening skills. We found FFR strength declined precipitously from AN to PAC, consistent with diminishing phase-locking along the ascending auditory neuroaxis. FFRs to the speech fundamental (F0) were robust to noise across sources, but were largest in subcortical sources (BS > AN > PAC). PAC FFRs were only weakly observed above the noise floor and only at the low pitch of speech (F0≈100 Hz). Brain-behavior regressions revealed (i) AN and BS FFRs were sufficient to describe listeners' QuickSIN scores and (ii) contrary to neuromagnetic (MEG) FFRs, neither left nor right PAC FFR_EEG related to SIN performance. Our findings suggest subcortical sources not only dominate the electrical FFR but also the link between speech-FFRs and SIN processing in normal-hearing adults as observed in previous EEG studies.

Combination of absolute pitch and tone language experience enhances lexical tone perception

Absolute pitch (AP), a unique ability to name or produce pitch without any reference, is known to be influenced by genetic and cultural factors. AP and tone language experience are both known to promote lexical tone perception. However, the effects of the combination of AP and tone language experience on lexical tone perception are currently not known. In the current study, using behavioral (Categorical Perception) and electrophysiological (Frequency Following Response) measures, we investigated the effect of the combination of AP and tone language experience on lexical tone perception. We found that the Cantonese speakers with AP outperformed the Cantonese speakers without AP on Categorical Perception and Frequency Following Responses of lexical tones, suggesting an additive effect due to the combination of AP and tone language experience. These findings suggest a role of basic sensory pre-attentive auditory processes towards pitch encoding in AP. Further, these findings imply a common mechanism underlying pitch encoding in AP and tone language perception.

Frequency Following Response and Speech Recognition Benefit for Combining a Cochlear Implant and Contralateral Hearing Aid

Multiple studies have shown significant speech recognition benefit when acoustic hearing is combined with a cochlear implant (CI) for a bimodal hearing configuration. However, this benefit varies greatly between individuals. There are few clinical measures correlated with bimodal benefit and those correlations are driven by extreme values prohibiting data-driven, clinical counseling. This study evaluated the relationship between neural representation of fundamental frequency (F0) and temporal fine structure via the frequency following response (FFR) in the nonimplanted ear as well as spectral and temporal resolution of the nonimplanted ear and bimodal benefit for speech recognition in quiet and noise. Participants included 14 unilateral CI users who wore a hearing aid (HA) in the nonimplanted ear. Testing included speech recognition in quiet and in noise with the HA-alone, CI-alone, and in the bimodal condition (i.e., CI + HA), measures of spectral and temporal resolution in the nonimplanted ear, and FFR recording for a 170-ms/da/stimulus in the nonimplanted ear. Even after controlling for four-frequency pure-tone average, there was a significant correlation (r = .83) between FFR F0 amplitude in the nonimplanted ear and bimodal benefit. Other measures of auditory function of the nonimplanted ear were not significantly correlated with bimodal benefit. The FFR holds potential as an objective tool that may allow data-driven counseling regarding expected benefit from the nonimplanted ear. It is possible that this information may eventually be used for clinical decision-making, particularly in difficult-to-test populations such as young children, regarding effectiveness of bimodal hearing versus bilateral CI candidacy.

Case studies in neuroscience: cortical contributions to the frequency-following response depend on subcortical synchrony

Frequency-following responses to musical notes spanning the octave 65-130 Hz were elicited in a person with auditory neuropathy, a disorder of subcortical neural synchrony, and a control subject. No phaselocked responses were observed in the person with auditory neuropathy. The control subject had robust responses synchronized to the fundamental frequency and its harmonics. Cortical onset responses to each note in the series were present in both subjects. These results support the hypothesis that subcortical neural synchrony is necessary to generate the frequency-following response-including for stimulus frequencies at which a cortical contribution has been noted. Although auditory cortex ensembles may synchronize to fundamental frequency cues in speech and music, subcortical neural synchrony appears to be a necessary antecedent.NEW & NOTEWORTHY A listener with auditory neuropathy, an absence of subcortical neural synchrony, did not have electrophysiological frequency-following responses synchronized to an octave of musical notes, with fundamental frequencies ranging from 65 to 130 Hz. A control subject had robust responses that phaselocked to each note. Although auditory cortex may contribute to the scalp-recorded frequency-following response in healthy listeners, our results suggest this phenomenon depends on subcortical neural synchrony.

Objective evidence of temporal processing deficits in older adults

The older listener's ability to understand speech in challenging environments may be affected by impaired temporal processing. This review summarizes objective evidence of degraded temporal processing from studies that have used the auditory brainstem response, auditory steady-state response, the envelope- or frequency-following response, cortical auditory-evoked potentials, and neural tracking of continuous speech. Studies have revealed delayed latencies and reduced amplitudes/phase locking in subcortical responses in older vs. younger listeners, in contrast to enhanced amplitudes of cortical responses in older listeners. Reconstruction accuracy of responses to continuous speech (e.g., cortical envelope tracking) shows over-representation in older listeners. Hearing loss is a factor in many of these studies, even though the listeners would be considered to have clinically normal hearing thresholds. Overall, the ability to draw definitive conclusions regarding these studies is limited by the use of multiple stimulus conditions, small sample sizes, and lack of replication. Nevertheless, these objective measures suggest a need to incorporate new clinical measures to provide a more comprehensive assessment of the listener's speech understanding ability, but more work is needed to determine the most efficacious measure for clinical use.

Meter enhances the subcortical processing of speech sounds at a strong beat

The temporal structure of sound such as in music and speech increases the efficiency of auditory processing by providing listeners with a predictable context. Musical meter is a good example of a sound structure that is temporally organized in a hierarchical manner, with recent studies showing that meter optimizes neural processing, particularly for sounds located at a higher metrical position or strong beat. Whereas enhanced cortical auditory processing at times of high metric strength has been studied, there is to date no direct evidence showing metrical modulation of subcortical processing. In this work, we examined the effect of meter on the subcortical encoding of sounds by measuring human auditory frequency-following responses to speech presented at four different metrical positions. Results show that neural encoding of the fundamental frequency of the vowel was enhanced at the strong beat, and also that the neural consistency of the vowel was the highest at the strong beat. When comparing musicians to non-musicians, musicians were found, at the strong beat, to selectively enhance the behaviorally relevant component of the speech sound, namely the formant frequency of the transient part. Our findings indicate that the meter of sound influences subcortical processing, and this metrical modulation differs depending on musical expertise.

Auditory neurophysiology reveals central nervous system dysfunction in HIV-infected individuals

OBJECTIVE

To test the hypothesis that human immunodeficiency virus (HIV) affects auditory-neurophysiological functions.

METHODS

A convenience sample of 68 HIV+ and 59 HIV- normal-hearing adults was selected from a study set in Dar es Salaam, Tanzania. The speech-evoked frequency-following response (FFR), an objective measure of auditory function, was collected. Outcome measures were FFRs to the fundamental frequency (F0) and to harmonics corresponding to the first formant (F1), two behaviorally relevant cues for understanding speech.

RESULTS

The HIV+ group had weaker responses to the F1 than the HIV- group; this effect generalized across multiple stimuli (d = 0.59). Responses to the F0 were similar between groups.

CONCLUSIONS

Auditory-neurophysiological responses differ between HIV+ and HIV- adults despite normal hearing thresholds.

SIGNIFICANCE

The FFR may reflect HIV-associated central nervous system dysfunction that manifests as disrupted auditory processing of speech harmonics corresponding to the first formant.

Baseline profiles of auditory, vestibular, and visual functions in youth tackle football players

Aim

Neurosensory tests have emerged as components of sport-related concussion management. Limited normative data are available in healthy, nonconcussed youth athletes.

Patients & methods/results

In 2017 and 2018, we tested 108 youth tackle football players immediately before their seasons on the frequency-following response, Balance Error Scoring System, and King-Devick test. We compared results with published data in older and/or and nonathlete populations. Performance on all tests improved with age. Frequency-following response and Balance Error Scoring System results aligned with socioeconomic status. Performance was not correlated across neurosensory domains.

Conclusion

Baseline neurosensory functions in seven 14-year-old male tackle football players are consistent with previously published data. Results reinforce the need for individual baselines or demographic-specific norms and the use of multiple neurosensory measures in sport-related concussion management.

Play Sports for a Quieter Brain: Evidence From Division I Collegiate Athletes

BACKGROUND

Playing sports has many benefits, including boosting physical, cardiovascular, and mental fitness. We tested whether athletic benefits extend to sensory processing-specifically auditory processing-as measured by the frequency-following response (FFR), a scalp-recorded electrophysiological potential that captures neural activity predominately from the auditory midbrain to complex sounds.

HYPOTHESIS

Given that FFR amplitude is sensitive to experience, with enrichment enhancing FFRs and injury reducing them, we hypothesized that playing sports is a form of enrichment that results in greater FFR amplitude.

STUDY DESIGN

Cross-sectional study.

LEVEL OF EVIDENCE

Level 3.

METHODS

We measured FFRs to the speech syllable "da" in 495 student-athletes across 19 Division I teams and 493 age- and sex-matched controls and compared them on 3 measures of FFR amplitude: amplitude of the response, amplitude of the background noise, and the ratio of these 2 measures.

RESULTS

Athletes have larger responses to sound than nonathletes, driven by a reduction in their level of background neural noise.

CONCLUSION

These findings suggest that playing sports increases the gain of an auditory signal by turning down the background noise. This mode of enhancement may be tied to the overall fitness level of athletes and/or the heightened need of an athlete to engage with and respond to auditory stimuli during competition.

CLINICAL RELEVANCE

These results motivate athletics overall and engagement in athletic interventions for populations that struggle with sensory processing, such as individuals with language disorders. Also, because head injuries can disrupt these same auditory processes, it is important to consider how auditory processing enhancements may offset injury.

Analyzing the FFR: A tutorial for decoding the richness of auditory function

The frequency-following response, or FFR, is a neurophysiological response to sound that precisely reflects the ongoing dynamics of sound. It can be used to study the integrity and malleability of neural encoding of sound across the lifespan. Sound processing in the brain can be impaired with pathology and enhanced through expertise. The FFR can index linguistic deprivation, autism, concussion, and reading impairment, and can reflect the impact of enrichment with short-term training, bilingualism, and musicianship. Because of this vast potential, interest in the FFR has grown considerably in the decade since our first tutorial. Despite its widespread adoption, there remains a gap in the current knowledge of its analytical potential. This tutorial aims to bridge this gap. Using recording methods we have employed for the last 20 + years, we have explored many analysis strategies. In this tutorial, we review what we have learned and what we think constitutes the most effective ways of capturing what the FFR can tell us. The tutorial covers FFR components (timing, fundamental frequency, harmonics) and factors that influence FFR (stimulus polarity, response averaging, and stimulus presentation/recording jitter). The spotlight is on FFR analyses, including ways to analyze FFR timing (peaks, autocorrelation, phase consistency, cross-phaseogram), magnitude (RMS, SNR, FFT), and fidelity (stimulus-response correlations, response-to-response correlations and response consistency). The wealth of information contained within an FFR recording brings us closer to understanding how the brain reconstructs our sonic world.