Neuronal responses in cat primary auditory cortex to electrical cochlear stimulation: IV. Activation pattern for sinusoidal stimulation

On the interplay between speech perception and production: insights from research and theories

The study of spoken communication has long been entrenched in a debate surrounding the interdependence of speech production and perception. This mini review summarizes findings from prior studies to elucidate the reciprocal relationships between speech production and perception. We also discuss key theoretical perspectives relevant to speech perception-production loop, including hyper-articulation and hypo-articulation (H&H) theory, speech motor theory, direct realism theory, articulatory phonology, the Directions into Velocities of Articulators (DIVA) and Gradient Order DIVA (GODIVA) models, and predictive coding. Building on prior findings, we propose a revised auditory-motor integration model of speech and provide insights for future research in speech perception and production, focusing on the effects of impaired peripheral auditory systems.

Structural neuroimaging of the altered brain stemming from pediatric and adolescent hearing loss-Scientific and clinical challenges

There has been a spurt in structural neuroimaging studies of the effect of hearing loss on the brain. Specifically, magnetic resonance imaging (MRI) and diffusion tensor imaging (DTI) technologies provide an opportunity to quantify changes in gray and white matter structures at the macroscopic scale. To date, there have been 32 MRI and 23 DTI studies that have analyzed structural differences accruing from pre- or peri-lingual pediatric hearing loss with congenital or early onset etiology and postlingual hearing loss in pre-to-late adolescence. Additionally, there have been 15 prospective clinical structural neuroimaging studies of children and adolescents being evaluated for cochlear implants. The results of the 70 studies are summarized in two figures and three tables. Plastic changes in the brain are seen to be multifocal rather than diffuse, that is, differences are consistent across regions implicated in the hearing, speech and language networks regardless of modes of communication and amplification. Structures in that play an important role in cognition are affected to a lesser extent. A limitation of these studies is the emphasis on volumetric measures and on homogeneous groups of subjects with hearing loss. It is suggested that additional measures of morphometry and connectivity could contribute to a greater understanding of the effect of hearing loss on the brain. Then an interpretation of the observed macroscopic structural differences is given. This is followed by discussion of how structural imaging can be combined with functional imaging to provide biomarkers for longitudinal tracking of amplification. This article is categorized under: Developmental Biology > Developmental Processes in Health and Disease Translational, Genomic, and Systems Medicine > Translational Medicine Laboratory Methods and Technologies > Imaging.

Assessing Fine-Grained Speech Discrimination in Young Children With Bilateral Cochlear Implants

HYPOTHESIS

Children of 2 to 3 years old with cochlear implants can perform consonant discriminations using fine-grained acoustic cues.

BACKGROUND

Children born with severe-to-profound deafness are provided with early cochlear implantation (<2 yr) to maximize oral communication outcomes. Little is known regarding their abilities to discriminate consonant contrasts for accurately identifying speech sounds.

METHODS

Using a Reaching for Sound paradigm to collect behavioral responses, consonant contrast discrimination was measured in 13 children with bilateral cochlear implants (BiCIs; aged 28-37 mo), and 13 age-matched normal-hearing (NH) children. Four contrast pairs were tested: 1) place + voicing, 2) place, 3) voicing, and 4) reduced voice-onset-time cue. Using standard processing strategies, electrodograms showing pulsatile stimulation patterns were created retrospectively to assess the spectral-temporal cues delivered through the clinical speech processors.

RESULTS

As a group, children with BiCIs were able to discriminate all consonant contrasts at a level that was above chance, but their performance was poorer than NH children. Larger individual variability in discrimination performance was found in children with BiCIs. Stepwise regression revealed that, in the place contrast, chronological age was correlated with improved discrimination performance among children with BiCIs.

CONCLUSION

Children with BiCIs were able to discriminate consonant contrasts using fine-grained spectral-temporal cues above chance level but more poorly than their NH peers. Electrodogram analysis confirmed the access to spectral-temporal cues in the consonant contrasts through clinical speech processors. However, the cue saliency might not have be enough for children with BiCIs to achieve the same discrimination accuracy as NH children.

The Acoustics of Word-Initial Fricatives and Their Effect on Word-Level Intelligibility in Children With Bilateral Cochlear Implants

OBJECTIVES

Previous research has found that relative to their peers with normal hearing (NH), children with cochlear implants (CIs) produce the sibilant fricatives /s/ and /∫/ less accurately and with less subphonemic acoustic contrast. The present study sought to further investigate these differences across groups in two ways. First, subphonemic acoustic properties were investigated in terms of dynamic acoustic features that indexed more than just the contrast between /s/ and /∫/. Second, the authors investigated whether such differences in subphonemic acoustic contrast between sibilant fricatives affected the intelligibility of sibilant-initial single word productions by children with CIs and their peers with NH.

DESIGN

In experiment 1, productions of /s/ and /∫/ in word-initial prevocalic contexts were elicited from 22 children with bilateral CIs (aged 4 to 7 years) who had at least 2 years of CI experience and from 22 chronological age-matched peers with NH. Acoustic features were measured from 17 points across the fricatives: peak frequency was measured to index the place of articulation contrast; spectral variance and amplitude drop were measured to index the degree of sibilance. These acoustic trajectories were fitted with growth-curve models to analyze time-varying spectral change. In experiment 2, phonemically accurate word productions that were elicited in experiment 1 were embedded within four-talker babble and played to 80 adult listeners with NH. Listeners were asked to repeat the words, and their accuracy rate was used as a measure of the intelligibility of the word productions. Regression analyses were run to test which acoustic properties measured in experiment 1 predicted the intelligibility scores from experiment 2.

RESULTS

The peak frequency trajectories indicated that the children with CIs produced less acoustic contrast between /s/ and /∫/. Group differences were observed in terms of the dynamic aspects (i.e., the trajectory shapes) of the acoustic properties. In the productions by children with CIs, the peak frequency and the amplitude drop trajectories were shallower, and the spectral variance trajectories were more asymmetric, exhibiting greater increases in variance (i.e., reduced sibilance) near the fricative-vowel boundary. The listeners' responses to the word productions indicated that when produced by children with CIs, /∫/-initial words were significantly more intelligible than /s/-initial words. However, when produced by children with NH, /s/-initial words and /∫/-initial words were equally intelligible. Intelligibility was partially predicted from the acoustic properties (Cox & Snell pseudo-R > 0.190), and the significant predictors were predominantly dynamic, rather than static, ones.

CONCLUSIONS

Productions from children with CIs differed from those produced by age-matched NH controls in terms of their subphonemic acoustic properties. The intelligibility of sibilant-initial single-word productions by children with CIs is sensitive to the place of articulation of the initial consonant (/∫/-initial words were more intelligible than /s/-initial words), but productions by children with NH were equally intelligible across both places of articulation. Therefore, children with CIs still exhibit differential production abilities for sibilant fricatives at an age when their NH peers do not.

Coding of electric pulse trains presented through cochlear implants in the auditory midbrain of awake rabbit: comparison with anesthetized preparations

Cochlear implant (CI) listeners show limits at high frequencies in tasks involving temporal processing such as rate pitch and interaural time difference discrimination. Similar limits have been observed in neural responses to electric stimulation in animals with CI; however, the upper limit of temporal coding of electric pulse train stimuli in the inferior colliculus (IC) of anesthetized animals is lower than the perceptual limit. We hypothesize that the upper limit of temporal neural coding has been underestimated in previous studies due to the confound of anesthesia. To test this hypothesis, we developed a chronic, awake rabbit preparation for single-unit studies of IC neurons with electric stimulation through CI. Stimuli were periodic trains of biphasic pulses with rates varying from 20 to 1280 pulses per second. We found that IC neurons in awake rabbits showed higher spontaneous activity and greater sustained responses, both excitatory and suppressive, at high pulse rates. Maximum pulse rates that elicited synchronized responses were approximately two times higher in awake rabbits than in earlier studies with anesthetized animals. Here, we demonstrate directly that anesthesia is a major factor underlying these differences by monitoring the responses of single units in one rabbit before and after injection of an ultra-short-acting barbiturate. In general, the physiological rate limits of IC neurons in the awake rabbit are more consistent with the psychophysical limits in human CI subjects compared with limits from anesthetized animals.

Primary auditory cortical responses to electrical stimulation of the thalamus

Cochlear implant electrical stimulation of the auditory system to rehabilitate deafness has been remarkably successful. Its deployment requires both an intact auditory nerve and a suitably patent cochlear lumen. When disease renders prerequisite conditions impassable, such as in neurofibromatosis type II and cochlear obliterans, alternative treatment targets are considered. Electrical stimulation of the cochlear nucleus and midbrain in humans has delivered encouraging clinical outcomes, buttressing the promise of central auditory prostheses to mitigate deafness in those who are not candidates for cochlear implantation. In this study we explored another possible implant target: the auditory thalamus. In anesthetized cats, we first presented pure tones to determine frequency preferences of thalamic and cortical sites. We then electrically stimulated tonotopically organized thalamic sites while recording from primary auditory cortical sites using a multichannel recording probe. Cathode-leading biphasic thalamic stimulation thresholds that evoked cortical responses were much lower than published accounts of cochlear and midbrain stimulation. Cortical activation dynamic ranges were similar to those reported for cochlear stimulation, but they were narrower than those found through midbrain stimulation. Our results imply that thalamic stimulation can activate auditory cortex at low electrical current levels and suggest an auditory thalamic implant may be a viable central auditory prosthesis.

Reorganization of the connectivity of cortical field DZ in congenitally deaf cat

Psychophysics and brain imaging studies in deaf patients have revealed a functional crossmodal reorganization that affects the remaining sensory modalities. Similarly, the congenital deaf cat (CDC) shows supra-normal visual skills that are supported by specific auditory fields (DZ-dorsal zone and P-posterior auditory cortex) but not the primary auditory cortex (A1). To assess the functional reorganization observed in deafness we analyzed the connectivity pattern of the auditory cortex by means of injections of anatomical tracers in DZ and A1 in both congenital deaf and normally hearing cats. A quantitative analysis of the distribution of the projecting neurons revealed the presence of non-auditory inputs to both A1 and DZ of the CDC which were not observed in the hearing cats. Firstly, some visual (areas 19/20) and somatosensory (SIV) areas were projecting toward DZ of the CDC but not in the control. Secondly, A1 of the deaf cat received a weak projection from the visual lateral posterior nuclei (LP). Most of these abnormal projections to A1 and DZ represent only a small fraction of the normal inputs to these areas. In addition, most of the afferents to DZ and A1 appeared normal in terms of areal specificity and strength of projection, with preserved but smeared nucleotopic gradient of A1 in CDCs. In conclusion, while the abnormal projections revealed in the CDC can participate in the crossmodal compensatory mechanisms, the observation of a limited reorganization of the connectivity pattern of the CDC implies that functional reorganization in congenital deafness is further supported also by normal cortico-cortical connectivity.

Developmental neuroplasticity after cochlear implantation

Cortical development is dependent on stimulus-driven learning. The absence of sensory input from birth, as occurs in congenital deafness, affects normal growth and connectivity needed to form a functional sensory system, resulting in deficits in oral language learning. Cochlear implants bypass cochlear damage by directly stimulating the auditory nerve and brain, making it possible to avoid many of the deleterious effects of sensory deprivation. Congenitally deaf animals and children who receive implants provide a platform to examine the characteristics of cortical plasticity in the auditory system. In this review, we discuss the existence of time limits for, and mechanistic constraints on, sensitive periods for cochlear implantation and describe the effects of multimodal and cognitive reorganization that result from long-term auditory deprivation.

A map of periodicity orthogonal to frequency representation in the cat auditory cortex

Harmonic sounds, such as voiced speech sounds and many animal communication signals, are characterized by a pitch related to the periodicity of their envelopes. While frequency information is extracted by mechanical filtering of the cochlea, periodicity information is analyzed by temporal filter mechanisms in the brainstem. In the mammalian auditory midbrain envelope periodicity is represented in maps orthogonal to the representation of sound frequency. However, how periodicity is represented across the cortical surface of primary auditory cortex (AI) remains controversial. Using optical recording of intrinsic signals, we here demonstrate that a periodicity map exists in primary AI of the cat. While pure tone stimulation confirmed the well-known frequency gradient along the rostro-caudal axis of AI, stimulation with harmonic sounds revealed segregated bands of activation, indicating spatially localized preferences to specific periodicities along a dorso-ventral axis, nearly orthogonal to the tonotopic gradient. Analysis of the response locations revealed an average gradient of - 100 degrees +/- 10 degrees for the periodotopic, and -12 degrees +/- 18 degrees for the tonotopic map resulting in a mean angle difference of 88 degrees . The gradients were 0.65 +/- 0.08 mm/octave for periodotopy and 1.07 +/- 0.16 mm/octave for tonotopy indicating that more cortical territory is devoted to the representation of an octave along the tonotopic than along the periodotopic gradient. Our results suggest that the fundamental importance of pitch, as evident in human perception, is also reflected in the layout of cortical maps and that the orthogonal spatial organization of frequency and periodicity might be a more general cortical organization principle.

Simulating the effect of spread of excitation in cochlear implants

A model was developed to simulate acoustically the effects of excitation spread in cochlear implants (CI). Based on neurophysiologic data, the proposed model simulates the electrical-current decay rate associated with broad and narrow types of excitation, such as those produced by monopolar and bipolar electrode configurations. The effect of excitation spread on speech intelligibility was simulated in normal-hearing subjects by varying the slopes of the synthesis bands in the noise vocoder. Sentences and monosyllabic words processed via 4-16 channels of stimulation with varying degrees of excitation spread were presented to normal-hearing listeners for identification. Results showed significant interaction between spectral resolution (number of channels) and spread of excitation. The effect of narrowing the excitation spread was minimal when the spectral resolution was sufficiently good (>8 channels) but it was significant when the spectral resolution was poor (4 channels). A significant decrement in performance was observed for extremely narrow excitation spread. This outcome is partly consistent with behavioral data obtained with cochlear implant studies in that CI users tend to do as well or better with monopolar stimulation than with bipolar stimulation.

Cochlear implants and brain plasticity

Cochlear implants have been implanted in over 110,000 deaf adults and children worldwide and provide these patients with important auditory cues necessary for auditory awareness and speech perception via electrical stimulation of the auditory nerve (AN). In 1942, Woolsey and Walzl presented the first report of cortical responses to localised electrical stimulation of different sectors of the AN in normal hearing cats, and established the cochleotopic organization of the projections to primary auditory cortex. Subsequently, individual cortical neurons in normal hearing animals have been shown to have well characterized input-output functions for electrical stimulation and decreasing response latencies with increasing stimulus strength. However, the central auditory system is not immutable, and has a remarkable capacity for plastic change, even into adulthood, as a result of changes in afferent input. This capacity for change is likely to contribute to the ongoing clinical improvements observed in speech perception for cochlear implant users. This review examines the evidence for changes of the response properties of neurons in, and consequently the functional organization of, the central auditory system produced by chronic, behaviourally relevant, electrical stimulation of the AN in profoundly deaf humans and animals.

Spatial selectivity to intracochlear electrical stimulation in the inferior colliculus is degraded after long-term deafness in cats

In an animal model of electrical hearing in prelingually deaf adults, this study examined the effects of deafness duration on response thresholds and spatial selectivity (i.e., cochleotopic organization, spatial tuning and dynamic range) in the central auditory system to intracochlear electrical stimulation. Electrically evoked auditory brain stem response (EABR) thresholds and neural response thresholds in the external (ICX) and central (ICC) nuclei of the inferior colliculus were estimated in cats after varying durations of neonatally induced deafness: in animals deafened <1.5 yr (short-deafened unstimulated, SDU cats) with a mean spiral ganglion cell (SGC) density of approximately 45% of normal and in animals deafened >2.5 yr (long-deafened, LD cats) with severe cochlear pathology (mean SGC density <7% of normal). LD animals were subdivided into unstimulated cats and those that received chronic intracochlear electrical stimulation via a feline cochlear implant. Acutely deafened, implanted adult cats served as controls. Independent of their stimulation history, LD animals had significantly higher EABR and ICC thresholds than SDU and control animals. Moreover, the spread of electrical excitation was significantly broader and the dynamic range significantly reduced in LD animals. Despite the prolonged durations of deafness the fundamental cochleotopic organization was maintained in both the ICX and the ICC of LD animals. There was no difference between SDU and control cats in any of the response properties tested. These findings suggest that long-term auditory deprivation results in a significant and possibly irreversible degradation of response thresholds and spatial selectivity to intracochlear electrical stimulation in the auditory midbrain.

Auditory cortex mapmaking: principles, projections, and plasticity

Maps of sensory receptor epithelia and computed features of the sensory environment are common elements of auditory, visual, and somatic sensory representations from the periphery to the cerebral cortex. Maps enhance the understanding of normal neural organization and its modification by pathology and experience. They underlie the derivation of the computational principles that govern sensory processing and the generation of perception. Despite their intuitive explanatory power, the functions of and rules for organizing maps and their plasticity are not well understood. Some puzzles of auditory cortical map organization are that few complete receptor maps are available and that even fewer computational maps are known beyond primary cortical areas. Neuroanatomical evidence suggests equally organized connectional patterns throughout the cortical hierarchy that might underlie map stability. Here, we consider the implications of auditory cortical map organization and its plasticity and evaluate the complementary role of maps in representation and computation from an auditory perspective.

Evidence of a tonotopic organization of the auditory cortex in cochlear implant users

Deprivation from normal sensory input has been shown to alter tonotopic organization of the human auditory cortex. In this context, cochlear implant subjects provide an interesting model in that profound deafness is made partially reversible by the cochlear implant. In restoring afferent activity, cochlear implantation may also reverse some of the central changes related to deafness. The purpose of the present study was to address whether the auditory cortex of cochlear implant subjects is tonotopically organized. The subjects were thirteen adults with at least 3 months of cochlear implant experience. Auditory event-related potentials were recorded in response to electrical stimulation delivered at different intracochlear electrodes. Topographic analysis of the auditory N1 component (approximately 85 ms latency) showed that the locations on the scalp and the relative amplitudes of the positive/negative extrema differ according to the stimulated electrode, suggesting that distinct sets of neural sources are activated. Dipole modeling confirmed electrode-dependent orientations of these sources in temporal areas, which can be explained by nearby, but distinct sites of activation in the auditory cortex. Although the cortical organization in cochlear implant users is similar to the tonotopy found in normal-hearing subjects, some differences exist. Nevertheless, a correlation was found between the N1 peak amplitude indexing cortical tonotopy and the values given by the subjects for a pitch scaling task. Hence, the pattern of N1 variation likely reflects how frequencies are coded in the brain.

Threshold and channel interaction in cochlear implant users: evaluation of the tripolar electrode configuration

The efficacy of cochlear implants is limited by spatial and temporal interactions among channels. This study explores the spatially restricted tripolar electrode configuration and compares it to bipolar and monopolar stimulation. Measures of threshold and channel interaction were obtained from nine subjects implanted with the Clarion HiFocus-I electrode array. Stimuli were biphasic pulses delivered at 1020 pulses/s. Threshold increased from monopolar to bipolar to tripolar stimulation and was most variable across channels with the tripolar configuration. Channel interaction, quantified by the shift in threshold between single- and two-channel stimulation, occurred for all three configurations but was largest for the monopolar and simultaneous conditions. The threshold shifts with simultaneous tripolar stimulation were slightly smaller than with bipolar and were not as strongly affected by the timing of the two channel stimulation as was monopolar. The subjects' performances on clinical speech tests were correlated with channel-to-channel variability in tripolar threshold, such that greater variability was related to poorer performance. The data suggest that tripolar channels with high thresholds may reveal cochlear regions of low neuron survival or poor electrode placement.

Hearing loss raises excitability in the auditory cortex

Developmental hearing impairments compromise sound discrimination, speech acquisition, and cognitive function; however, the adjustments of functional properties in the primary auditory cortex (A1) remain unknown. We induced sensorineural hearing loss (SNHL) in developing gerbils and then reared the animals for several days. The intrinsic membrane and synaptic properties of layer 2/3 pyramidal neurons were subsequently examined in a thalamocortical brain slice preparation with whole-cell recordings and electron microscopic immunocytochemistry. SNHL neurons displayed a depolarized resting membrane potential, an increased input resistance, and a higher incidence of sustained firing. They also exhibited significantly larger thalamocortically and intracortically evoked excitatory synaptic responses, including a greater susceptibility to the NMDA receptor antagonist AP-5 and the NR2B subunit antagonist ifenprodil. This correlated with an increase in NR2B labeling of asymmetric synapses, as visualized ultrastructurally. Furthermore, decreased frequency and increased amplitude of miniature EPSCs (mEPSCs) in SNHL neurons suggest that a decline in presynaptic release properties is compensated by an increased excitatory response. To verify that the increased thalamocortical excitation was elicited by putative monosynaptic connections, minimum amplitude ventral medial geniculate nucleus-evoked EPSCs were recorded. These minimum-evoked responses were of larger amplitude, and the NMDAergic currents were also larger and longer in SNHL neurons. These findings were supported by significantly longer AP-5-sensitive durations and larger amplitudes of mEPSCs. Last, the amplitudes of intracortically evoked monosynaptic and polysynaptic GABAergic inhibitory synaptic responses were significantly smaller in SNHL neurons. These alterations in cellular properties after deafness reflect an attempt by A1 to sustain an operative level of cortical excitability that may involve homeostatic mechanisms.

Cochlear implants: the view from the brain

The cochlear implant arguably is the most successful neural prosthesis. Studies of the responses of the central auditory system to prosthetic electrical stimulation of the cochlea are revealing the success with which electrical stimulation of a deaf ear can mimic acoustic stimulation of a normal-hearing ear. Understanding of the physiology of central auditory structures can lead to improved restoration of hearing with cochlear implants. In turn, the cochlear implant can be exploited as an experimental tool for examining central hearing mechanisms isolated from the effects of cochlear mechanics and transduction.

Cochlear implants and brain stem implants

This chapter describes the development of two implantable prosthetic neurostimulators which, in the last 20 years, have revolutionised the management of severe-to-profound sensorineural deafness. We have witnessed their rapid evolution from the realms of esoteric laboratory abstraction, with many critics and little perceived clinical use, to a routine treatment which is safe, effective and, indeed, cost effective. It is one of the great triumphs of biomedical and surgical collaboration, and is without any doubt the greatest ever advance in the treatment of deafness.