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Igamberdiev AU. Reflexive neural circuits and the origin of language and music codes. Biosystems 2024; 246:105346. [PMID: 39349135 DOI: 10.1016/j.biosystems.2024.105346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2024] [Revised: 09/23/2024] [Accepted: 09/26/2024] [Indexed: 10/02/2024]
Abstract
Conscious activity is grounded in the reflexive self-awareness in sense perception, through which the codes signifying sensual perceptive events operate and constrain human behavior. These codes grow via the creative generation of hypertextual statements. We apply the model of Vladimir Lefebvre (Lefebvre, V.A., 1987, J. Soc. Biol. Struct. 10, 129-175) to reveal the underlying structures on which the perception and creative development of language and music codes are based. According to this model, the reflexive structure of conscious subject is grounded in three thermodynamic cycles united by the control of the basic functional cycle by the second one, and resulting in the internal action that it turn is perceived by the third cycle evaluating this action. In this arrangement, the generative language structures are formed and the frequencies of sounds that form musical phrases and patterns are selected. We discuss the participation of certain neural brain structures and the establishment of reflexive neural circuits in the ad hoc transformation of perceptive signals, and show the similarities between the processes of perception and of biological self-maintenance and morphogenesis. We trace the peculiarities of the temporal encoding of emotions in music and musical creativity, as well as the principles of sharing musical information between the performing and the perceiving individuals.
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Affiliation(s)
- Abir U Igamberdiev
- Department of Biology, Memorial University of Newfoundland, St. John's, NL A1C 5S7, Canada.
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2
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Kim DO, Carney L, Kuwada S. Amplitude modulation transfer functions reveal opposing populations within both the inferior colliculus and medial geniculate body. J Neurophysiol 2020; 124:1198-1215. [PMID: 32902353 PMCID: PMC7717166 DOI: 10.1152/jn.00279.2020] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 08/21/2020] [Accepted: 08/22/2020] [Indexed: 11/22/2022] Open
Abstract
Based on single-unit recordings of modulation transfer functions (MTFs) in the inferior colliculus (IC) and the medial geniculate body (MGB) of the unanesthetized rabbit, we identified two opposing populations: band-enhanced (BE) and band-suppressed (BS) neurons. In response to amplitude-modulated (AM) sounds, firing rates of BE and BS neurons were enhanced and suppressed, respectively, relative to their responses to an unmodulated noise with a one-octave bandwidth. We also identified a third population, designated hybrid neurons, whose firing rates were enhanced by some modulation frequencies and suppressed by others. Our finding suggests that perception of AM may be based on the co-occurrence of enhancement and suppression of responses of the opposing populations of neurons. Because AM carries an important part of the content of speech, progress in understanding auditory processing of AM sounds should lead to progress in understanding speech perception. Each of the BE, BS, and hybrid types of MTFs comprised approximately one-third of the total sample. Modulation envelopes having short duty cycles of 20-50% and raised-sine envelopes accentuated the degree of enhancement and suppression and sharpened tuning of the MTFs. With sinusoidal envelopes, peak modulation frequencies were centered around 32-64 Hz among IC BE neurons, whereas the MGB peak frequencies skewed toward lower frequencies, with a median of 16 Hz. We also tested an auditory-brainstem model and found that a simple circuit containing fast excitatory synapses and slow inhibitory synapses was able to reproduce salient features of the BE- and BS-type MTFs of IC neurons.NEW & NOTEWORTHY Opposing populations of neurons have been identified in the mammalian auditory midbrain and thalamus. In response to amplitude-modulated sounds, responses of one population (band-enhanced) increased whereas responses of another (band-suppressed) decreased relative to their responses to an unmodulated sound. These opposing auditory populations are analogous to the ON and OFF populations of the visual system and may improve transfer of information carried by the temporal envelopes of complex sounds such as speech.
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Affiliation(s)
- Duck O Kim
- Department of Neuroscience, University of Connecticut Health Center, Farmington, Connecticut
| | - Laurel Carney
- Department of Biomedical Engineering, Neurobiology and Anatomy, University of Rochester, Rochester, New York
| | - Shigeyuki Kuwada
- Department of Neuroscience, University of Connecticut Health Center, Farmington, Connecticut
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3
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Hancock KE, Chung Y, McKinney MF, Delgutte B. Temporal Envelope Coding by Inferior Colliculus Neurons with Cochlear Implant Stimulation. J Assoc Res Otolaryngol 2017; 18:771-788. [PMID: 28717877 DOI: 10.1007/s10162-017-0638-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2016] [Accepted: 07/07/2017] [Indexed: 11/26/2022] Open
Abstract
Modulations in temporal envelopes are a ubiquitous property of natural sounds and are especially important for hearing with cochlear implants (CIs) because these devices typically discard temporal fine structure information. With few exceptions, neural temporal envelope processing has been studied in both normal hearing (NH) and CI animals using only pure sinusoidal amplitude modulation (SAM) which poorly represents the diversity of envelope shapes contained in natural sounds because it confounds repetition rate and the width of each modulation cycle. Here, we used stimuli that allow independent manipulation of the two parameters to characterize envelope processing by inferior colliculus (IC) neurons in barbiturate-anesthetized cats with CIs. Specifically, the stimuli were amplitude modulated, high rate pulse trains, where the envelope waveform interleaved single cycles ("bursts") of a sinusoid with silent intervals. We found that IC neurons vary widely with respect to the envelope parameters that maximize their firing rates. In general, pure SAM was a relatively ineffective stimulus. The majority of neurons (60 %) preferred a combination of short bursts and low repetition rates (long silent intervals). Others preferred low repetition rates with minimal dependence on envelope width (17 %), while the remainder responded most strongly to brief bursts with lesser sensitivity to repetition rate (23 %). A simple phenomenological model suggests that a combination of inhibitory and intrinsic cellular mechanisms suffices to account for the wide variation in optimal envelope shapes. In contrast to the strong dependence of firing rate on envelope shape, neurons tended to phase lock precisely to the envelope regardless of shape. Most neurons tended to fire specifically near the peak of the modulation cycle, with little phase dispersion within or across neurons. Such consistently precise timing degrades envelope coding compared to NH processing of real-world sounds, because it effectively eliminates spike timing as a cue to envelope shape.
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Affiliation(s)
- Kenneth E Hancock
- Eaton-Peabody Laboratories, Massachusetts Eye and Ear, Boston, MA, 02114, USA.
- Department of Otolaryngology, Harvard Medical School, Boston, MA, 02115, USA.
| | - Yoojin Chung
- Eaton-Peabody Laboratories, Massachusetts Eye and Ear, Boston, MA, 02114, USA
- Department of Otolaryngology, Harvard Medical School, Boston, MA, 02115, USA
| | | | - Bertrand Delgutte
- Eaton-Peabody Laboratories, Massachusetts Eye and Ear, Boston, MA, 02114, USA
- Department of Otolaryngology, Harvard Medical School, Boston, MA, 02115, USA
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Zuk N, Delgutte B. Neural coding of time-varying interaural time differences and time-varying amplitude in the inferior colliculus. J Neurophysiol 2017; 118:544-563. [PMID: 28381487 DOI: 10.1152/jn.00797.2016] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2016] [Revised: 03/29/2017] [Accepted: 03/31/2017] [Indexed: 11/22/2022] Open
Abstract
Binaural cues occurring in natural environments are frequently time varying, either from the motion of a sound source or through interactions between the cues produced by multiple sources. Yet, a broad understanding of how the auditory system processes dynamic binaural cues is still lacking. In the current study, we directly compared neural responses in the inferior colliculus (IC) of unanesthetized rabbits to broadband noise with time-varying interaural time differences (ITD) with responses to noise with sinusoidal amplitude modulation (SAM) over a wide range of modulation frequencies. On the basis of prior research, we hypothesized that the IC, one of the first stages to exhibit tuning of firing rate to modulation frequency, might use a common mechanism to encode time-varying information in general. Instead, we found weaker temporal coding for dynamic ITD compared with amplitude modulation and stronger effects of adaptation for amplitude modulation. The differences in temporal coding of dynamic ITD compared with SAM at the single-neuron level could be a neural correlate of "binaural sluggishness," the inability to perceive fluctuations in time-varying binaural cues at high modulation frequencies, for which a physiological explanation has so far remained elusive. At ITD-variation frequencies of 64 Hz and above, where a temporal code was less effective, noise with a dynamic ITD could still be distinguished from noise with a constant ITD through differences in average firing rate in many neurons, suggesting a frequency-dependent tradeoff between rate and temporal coding of time-varying binaural information.NEW & NOTEWORTHY Humans use time-varying binaural cues to parse auditory scenes comprising multiple sound sources and reverberation. However, the neural mechanisms for doing so are poorly understood. Our results demonstrate a potential neural correlate for the reduced detectability of fluctuations in time-varying binaural information at high speeds, as occurs in reverberation. The results also suggest that the neural mechanisms for processing time-varying binaural and monaural cues are largely distinct.
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Affiliation(s)
- Nathaniel Zuk
- Eaton-Peabody Laboratories, Massachusetts Eye and Ear, Boston, Massachusetts.,Speech and Hearing Bioscience and Technology Program, Harvard-MIT Division of Health Sciences and Technology, Cambridge, Massachusetts; and
| | - Bertrand Delgutte
- Eaton-Peabody Laboratories, Massachusetts Eye and Ear, Boston, Massachusetts; .,Speech and Hearing Bioscience and Technology Program, Harvard-MIT Division of Health Sciences and Technology, Cambridge, Massachusetts; and.,Department of Otolaryngology, Harvard Medical School, Boston, Massachusetts
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Loftus WC, Bishop DC, Oliver DL. Differential patterns of inputs create functional zones in central nucleus of inferior colliculus. J Neurosci 2010; 30:13396-408. [PMID: 20926666 PMCID: PMC2966845 DOI: 10.1523/jneurosci.0338-10.2010] [Citation(s) in RCA: 65] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2010] [Revised: 07/07/2010] [Accepted: 08/04/2010] [Indexed: 11/21/2022] Open
Abstract
Distinct pathways carry monaural and binaural information from the lower auditory brainstem to the central nucleus of the inferior colliculus (ICC). Previous anatomical and physiological studies suggest that differential ascending inputs to regions of the ICC create functionally distinct zones. Here, we provide direct evidence of this relationship by combining recordings of single unit responses to sound in the ICC with focal, iontophoretic injections of the retrograde tracer Fluoro-Gold at the physiologically characterized sites. Three main patterns of anatomical inputs were observed. One pattern was identified by inputs from the cochlear nucleus and ventral nucleus of the lateral lemniscus in isolation, and these injection sites were correlated with monaural responses. The second pattern had inputs only from the ipsilateral medial and lateral superior olive, and these sites were correlated with interaural time difference (ITD)-sensitive responses to low frequency (<500 Hz). A third pattern had inputs from a variety of olivary and lemniscal sources, notably the contralateral lateral superior olive and dorsal nucleus of the lateral lemniscus. These were correlated with high-frequency ITD sensitivity to complex acoustic stimuli. These data support the notion of anatomical regions formed by specific patterns of anatomical inputs to the ICC. Such synaptic domains may represent functional zones in ICC.
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Affiliation(s)
- William C. Loftus
- Department of Neuroscience, University of Connecticut Health Center, Farmington, Connecticut 06030-3401
| | - Deborah C. Bishop
- Department of Neuroscience, University of Connecticut Health Center, Farmington, Connecticut 06030-3401
| | - Douglas L. Oliver
- Department of Neuroscience, University of Connecticut Health Center, Farmington, Connecticut 06030-3401
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Devore S, Ihlefeld A, Hancock K, Shinn-Cunningham B, Delgutte B. Accurate sound localization in reverberant environments is mediated by robust encoding of spatial cues in the auditory midbrain. Neuron 2009; 62:123-34. [PMID: 19376072 DOI: 10.1016/j.neuron.2009.02.018] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2008] [Revised: 11/24/2008] [Accepted: 02/24/2009] [Indexed: 10/20/2022]
Abstract
In reverberant environments, acoustic reflections interfere with the direct sound arriving at a listener's ears, distorting the spatial cues for sound localization. Yet, human listeners have little difficulty localizing sounds in most settings. Because reverberant energy builds up over time, the source location is represented relatively faithfully during the early portion of a sound, but this representation becomes increasingly degraded later in the stimulus. We show that the directional sensitivity of single neurons in the auditory midbrain of anesthetized cats follows a similar time course, although onset dominance in temporal response patterns results in more robust directional sensitivity than expected, suggesting a simple mechanism for improving directional sensitivity in reverberation. In parallel behavioral experiments, we demonstrate that human lateralization judgments are consistent with predictions from a population rate model decoding the observed midbrain responses, suggesting a subcortical origin for robust sound localization in reverberant environments.
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Affiliation(s)
- Sasha Devore
- Eaton Peabody Laboratory, Massachusetts Eye & Ear Infirmary, Boston, MA 02114, USA.
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Colburn HS, Chung Y, Zhou Y, Brughera A. Models of brainstem responses to bilateral electrical stimulation. J Assoc Res Otolaryngol 2008; 10:91-110. [PMID: 18941838 DOI: 10.1007/s10162-008-0141-z] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2007] [Accepted: 09/15/2008] [Indexed: 10/21/2022] Open
Abstract
A simple, biophysically specified cell model is used to predict responses of binaurally sensitive neurons to patterns of input spikes that represent stimulation by acoustic and electric waveforms. Specifically, the effects of changes in parameters of input spike trains on model responses to interaural time difference (ITD) were studied for low-frequency periodic stimuli, with or without amplitude modulation. Simulations were limited to purely excitatory, bilaterally driven cell models with basic ionic currents and multiple input fibers. Parameters explored include average firing rate, synchrony index, modulation frequency, and latency dispersion of the input trains as well as the excitatory conductance and time constant of individual synapses in the cell model. Results are compared to physiological recordings from the inferior colliculus (IC) and discussed in terms of ITD-discrimination abilities of listeners with cochlear implants. Several empirically observed aspects of ITD sensitivity were simulated without evoking complex neural processing. Specifically, our results show saturation effects in rate-ITD curves, the absence of sustained responses to high-rate unmodulated pulse trains, the renewal of sensitivity to ITD in high-rate trains when inputs are amplitude-modulated, and interactions between envelope and fine-structure delays for some modulation frequencies.
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Affiliation(s)
- H Steven Colburn
- Department of Biomedical Engineering, Center for Hearing Research, Boston University, Boston, MA 02215, USA.
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Soeta Y, Nakagawa S. Auditory evoked magnetic fields in relation to interaural time delay and interaural correlation. Hear Res 2006; 220:106-15. [PMID: 16934951 DOI: 10.1016/j.heares.2006.07.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2005] [Revised: 07/06/2006] [Accepted: 07/13/2006] [Indexed: 11/26/2022]
Abstract
The detection of interaural time differences (ITD) for sound localization depends on the similarity between the left and right ear signals, namely interaural correlation (IAC). Human localization performance deteriorates with decreasing IACs. In order to examine activity related to localization performance in the human cortex, auditory evoked magnetic fields to the ITD of bandpass noises with different IACs were analyzed. When the IAC was 0.95, the N1m amplitudes, i.e., the estimated equivalent current dipole moments, increased with increasing ITD. However the effect of ITD on the N1m amplitudes was not significant when the IAC was 0.5. When the ITD was 0.7 ms, the N1m amplitudes decreased with decreasing IACs. There were no systematic changes in the source location of N1m in the auditory cortex related to changes in ITD or IAC. The results suggest that localization performance is reflected in N1m amplitudes.
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Affiliation(s)
- Yoshiharu Soeta
- Institute for Human Science and Biomedical Engineering, National Institute of Advanced Industrial Science and Technology (AIST), 1-8-31Midorigaoka, Ikeda, Osaka 563-8577, Japan.
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Lane CC, Delgutte B. Neural correlates and mechanisms of spatial release from masking: single-unit and population responses in the inferior colliculus. J Neurophysiol 2005; 94:1180-98. [PMID: 15857966 PMCID: PMC2014717 DOI: 10.1152/jn.01112.2004] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Spatial release from masking (SRM), a factor in listening in noisy environments, is the improvement in auditory signal detection obtained when a signal is separated in space from a masker. To study the neural mechanisms of SRM, we recorded from single units in the inferior colliculus (IC) of barbiturate-anesthetized cats, focusing on low-frequency neurons sensitive to interaural time differences. The stimulus was a broadband chirp train with a 40-Hz repetition rate in continuous broadband noise, and the unit responses were measured for several signal and masker (virtual) locations. Masked thresholds (the lowest signal-to-noise ratio, SNR, for which the signal could be detected for 75% of the stimulus presentations) changed systematically with signal and masker location. Single-unit thresholds did not necessarily improve with signal and masker separation; instead, they tended to reflect the units' azimuth preference. Both how the signal was detected (through a rate increase or decrease) and how the noise masked the signal response (suppressive or excitatory masking) changed with signal and masker azimuth, consistent with a cross-correlator model of binaural processing. However, additional processing, perhaps related to the signal's amplitude modulation rate, appeared to influence the units' responses. The population masked thresholds (the most sensitive unit's threshold at each signal and masker location) did improve with signal and masker separation as a result of the variety of azimuth preferences in our unit sample. The population thresholds were similar to human behavioral thresholds in both SNR value and shape, indicating that these units may provide a neural substrate for low-frequency SRM.
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Affiliation(s)
- Courtney C Lane
- Eaton-Peabody Laboratory, Massachusetts Eye and Ear Infirmary, Boston, MA, USA.
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Sivaramakrishnan S, Sterbing-D'Angelo SJ, Filipovic B, D'Angelo WR, Oliver DL, Kuwada S. GABA( A) synapses shape neuronal responses to sound intensity in the inferior colliculus. J Neurosci 2005; 24:5031-43. [PMID: 15163696 PMCID: PMC6729375 DOI: 10.1523/jneurosci.0357-04.2004] [Citation(s) in RCA: 55] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Neurons in the inferior colliculus (IC) change their firing rates with sound pressure level. Some neurons maintain monotonic increases in firing rate over a wide range of sound intensities, whereas other neurons are monotonic over limited intensity ranges. We examined the conditions necessary for monotonicity in this nucleus in vitro in rat brain slices and in vivo in the unanesthetized rabbit. Our in vitro recordings indicate that concurrent activation of GABA(A) synapses with excitatory inputs facilitates monotonic increases in firing rate with increases in stimulus strength. In the absence of synaptic inhibition, excitatory input to IC neurons causes large depolarizations that result in firing block and nonmonotonicity. In vivo, although GABA(A) synapses decrease the firing rate in all IC neurons, they can have opposing effects on rate-level functions. GABAergic inputs activated by all sound intensities maintain monotonicity by keeping the postsynaptic potential below the level at which depolarization block occurs. When these inputs are blocked, firing block can occur and rate-level functions become nonmonotonic. High-threshold GABAergic inputs, in contrast, cause nonmonotonic responses by decreasing the firing rate at high intensities. Our results suggest that a dynamic regulation of the postsynaptic membrane potential by synaptic inhibition is necessary to allow neurons to respond monotonically to a wide range of sound intensities.
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Affiliation(s)
- Shobhana Sivaramakrishnan
- Department of Neuroscience, University of Connecticut Health Center, Farmington, Connecticut 06030, USA
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D'Angelo WR, Sterbing SJ, Ostapoff EM, Kuwada S. Role of GABAergic inhibition in the coding of interaural time differences of low-frequency sounds in the inferior colliculus. J Neurophysiol 2005; 93:3390-400. [PMID: 15647399 DOI: 10.1152/jn.00956.2004] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
A major cue for the localization of sound in space is the interaural time difference (ITD). We examined the role of inhibition in the shaping of ITD responses in the inferior colliculus (IC) by iontophoretically ejecting gamma-aminobutyric acid (GABA) antagonists and GABA itself using a multibarrel pipette. The GABA antagonists block inhibition, whereas the applied GABA provides a constant level of inhibition. The effects on ITD responses were evaluated before, during and after the application of the drugs. If GABA-mediated inhibition is involved in shaping ITD tuning in IC neurons, then applying additional amounts of this inhibitory transmitter should alter ITD tuning. Indeed, for almost all neurons tested, applying GABA reduced the firing rate and consequently sharpened ITD tuning. Conversely, blocking GABA-mediated inhibition increased the activity of IC neurons, often reduced the signal-to-noise ratio and often broadened ITD tuning. Blocking GABA could also alter the shape of the ITD function and shift its peak suggesting that the role of inhibition is multifaceted. These effects indicate that GABAergic inhibition at the level of the IC is important for ITD coding.
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Affiliation(s)
- W R D'Angelo
- Department of Neuroscience, University of Connecticut Health Center, 263 Farmington Avenue, Farmington, CT 06030, USA
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Sterbing SJ, D'Angelo WR, Ostapoff EM, Kuwada S. Effects of amplitude modulation on the coding of interaural time differences of low-frequency sounds in the inferior colliculus. I. Response properties. J Neurophysiol 2003; 90:2818-26. [PMID: 12890792 DOI: 10.1152/jn.00268.2003] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Most sounds in the natural environment are amplitude-modulated (AM). To determine if AM alters the neuronal sensitivity to interaural time differences (ITDs) in low-frequency sounds, we tested neuronal responses to a binaural beat stimulus with and without modulation. We recorded from single units in the inferior colliculus of the unanesthetized rabbit. We primarily used low frequency ( approximately 25 Hz) modulation that was identical at both ears. We found that modulation could enhance, suppress, or not affect the discharge rate. In extreme cases, a neuron that showed no response to the unmodulated binaural beat did so when modulation was added to both ears. At the other extreme, a neuron that showed sensitivity to the unmodulated binaural beat ceased firing with modulation. Modulation could also affect the frequency range of ITD sensitivity, best ITD, and ITD tuning width. Despite these changes in individual neurons, averaging across all neurons, the peak and width of the population ITD function remained unchanged. Because ITD-sensitive neurons also time-locked to the modulation frequency, the location and sound attributes are processed simultaneously by these neurons.
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Affiliation(s)
- S J Sterbing
- Department of Neuroscience, University of Connecticut Health Center, Farmington, Connecticut 06030, USA
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