Functional imaging of the auditory system: the use of positron emission tomography

Multivariate fMRI responses in superior temporal cortex predict visual contributions to, and individual differences in, the intelligibility of noisy speech

Humans have the unique ability to decode the rapid stream of language elements that constitute speech, even when it is contaminated by noise. Two reliable observations about noisy speech perception are that seeing the face of the talker improves intelligibility and the existence of individual differences in the ability to perceive noisy speech. We introduce a multivariate BOLD fMRI measure that explains both observations. In two independent fMRI studies, clear and noisy speech was presented in visual, auditory and audiovisual formats to thirty-seven participants who rated intelligibility. An event-related design was used to sort noisy speech trials by their intelligibility. Individual-differences multidimensional scaling was applied to fMRI response patterns in superior temporal cortex and the dissimilarity between responses to clear speech and noisy (but intelligible) speech was measured. Neural dissimilarity was less for audiovisual speech than auditory-only speech, corresponding to the greater intelligibility of noisy audiovisual speech. Dissimilarity was less in participants with better noisy speech perception, corresponding to individual differences. These relationships held for both single word and entire sentence stimuli, suggesting that they were driven by intelligibility rather than the specific stimuli tested. A neural measure of perceptual intelligibility may aid in the development of strategies for helping those with impaired speech perception.

PET/CT background noise and its effect on speech recognition

Positron emission tomography (PET) has been successfully used to investigate central nervous processes, including the central auditory pathway. Unlike early water-cooled PET-scanners, novel PET/CT scanners employ air cooling and include a CT system, both of which result in higher background noise levels. In the present study, we describe the background noise generated by two state-of-the-art air-cooled PET/CT scanners. We measured speech recognition in background noise: recorded PET noise and a speech-shaped noise applied in clinical routine to subjects with normal hearing. Background noise produced by air-cooled PET/CT is considerable: 75.1 dB SPL (64.5 dB(A)) for the Philips Gemini TF64 and 76.9 dB SPL (68.4 dB(A)) for the Philips Vereos PET/CT (Philips Healthcare, The Netherlands). Subjects with normal hearing exhibited better speech recognition in recorded PET background noise compared with clinically applied speech-shaped noise. Speech recognition in both background noises correlated significantly. Background noise generated by PET/CT scanners should be considered when PET is used for the investigation of the central auditory pathway. Speech in PET noise is better than in speech-shaped noise because of the minor masking effect of the background noise of the PET/CT.

[Tinnitus: clinical and pathogenetic aspects]

The article discusses the pathogenetic and clinical features of tinnitus. It is emphasized that various causes contribute to the appearance of tinnitus, including somatic diseases, excess body weight, iatrogenies, otological diseases with an outcome in hearing loss. The anatomical and physiological features of the structure of the central part of the auditory system are considered. It is suggested that the occurrence of tinnitus is associated with the processes of maladaptive neuroplasticity caused by pathological changes in the neuronal activity of cortical structures of the CNS, and not with changes in the peripheral part of the auditory analyzer - the structures of the cochlea. The results of recent studies, including those using functional neuroimaging methods, indicate the significance of cortical connection disorders (human connectome) in patients with tinnitus. In patients with tinnitus, there are changes in regional neuronal activity and connections not only in the auditory cortex, but also in areas not directly related to the analysis of auditory afferentation. Thus, tinnitus can be considered as one of the variants of dysfunction of the human connectome, triggered primarily from the «auditory input».

Functional neuroimaging in hearing research and audiology

The various methods of medical imaging are essential for many diagnostic issues in clinical routine, e.g., for the diagnostics and localisation of tumorous diseases, or for the clarification of other lesions in the central nervous system. In addition to these classical roles both positron emission tomography (PET) and magnetic resonance imaging (MRI) allow for the investigation of functional processes in the human brain, when used in a specific way. The last 25 years have seen great progress, especially with respect to functional MRI, in terms of the available experimental paradigms as well as the data analysis strategies, so that a directed investigation of neurophysiological correlates of psychoacoustic performance is possible. This covers fundamental measures of sound perception like loudness and pitch, specific audiological symptoms like tinnitus, which often accompanies hearing disorders, but it also includes experiments on speech perception or on virtual acoustic environments. One important aspect common to many auditory neuroimaging studies is the central question at what stage in the human auditory pathway the sensory coding of the incoming sound is transformed into a universal and context-dependent perceptual representation, which is the basis for what we hear. This overview summarises findings from the literature as well as a few studies from our lab, to discuss the possibilities and the limits of the adoption of functional neuroimaging methods in audiology. Up to this stage, most auditory neuroimaging studies have investigated basic processes in normal hearing listeners. However, the hitherto existing results suggest that the methods of auditory functional neuroimaging - possibly complemented by electrophysiological methods like EEG and MEG - have a great potential to contribute to a deeper understanding of the processes and the impact of hearing disorders.

Neural metabolic activity in idiopathic tinnitus patients after repetitive transcranial magnetic stimulation

BACKGROUND

The central mechanism of idiopathic tinnitus is related to hyperactivity of cortical and subcortical auditory and non-auditory areas. Repetitive transcranial magnetic stimulation (rTMS) is a well-tolerated, non-invasive potential treatment option for tinnitus.

AIM

To investigate the changes of neural metabolic activity after rTMS in chronic idiopathic tinnitus (IT) patients.

METHODS

Eleven patients underwent rTMS (1 Hz, 90% motor threshold, 1000 stimuli/day for consecutive 10 d) on the left temporoparietal region cortex. Tinnitus handicap inventory (THI) and visual analogue score (VAS) were assessed at baseline and posttreatment. All patients underwent ¹⁸F-fluorodeoxyglucose (FDG) positron emission tomography to evaluate the neural metabolic activity. Data were preprocessed using statistical parametric mapping and Gretna software to extract the regions of interest (ROIs). The correlation between brain areas involved and THI scores was analyzed.

RESULTS

Baseline and posttreatment parameters showed no significant difference regarding THI score (t = 1.019, P = 0.342 > 0.05) and VAS (t = 0.00, P = 1.0 > 0.05). Regions with the highest FDG uptake were the right inferior temporal gyrus (ITG), right parahippocampa gyrus (PHG), right hippocampus, rectus gyrus, left middle frontal gyrus, and right inferior frontal gyrus in IT patients. After rTMS treatment, IT patients showed increased activities in the right PHG, right superior temporal gyrus, right superior frontal gyrus, anterior insula, left inferior parietal lobule, and left precentral gyrus, and decreased activities in the left postcentral gyrus and left ITG. The ROIs in the right parahippocampa gyrus and right superior frontal gyrus were positively correlated with THI scores (r = 0.737, P = 0.037 < 0.05; r = 0.735, P = 0.038 < 0.05).

CONCLUSION

Our study showed that 1-Hz rTMS directed to the left temporo-parietal junction resulted no statistically significant symptom alleviation. After treatment, brain areas of the limbic and prefrontal system showed high neutral metabolic activity. The auditory and non-auditory systems together will be the target for rTMS treatment.

Measuring Cortical Activity During Auditory Processing with Functional Near-Infrared Spectroscopy

Functional near-infrared spectroscopy (fNIRS) is an optical, non-invasive neuroimaging technique that investigates human brain activity by calculating concentrations of oxy- and deoxyhemoglobin. The aim of this publication is to review the current state of the art as to how fNIRS has been used to study auditory function. We address temporal and spatial characteristics of the hemodynamic response to auditory stimulation as well as experimental factors that affect fNIRS data such as acoustic and stimulus-driven effects. The rising importance that fNIRS is generating in auditory neuroscience underlines the strong potential of the technology, and it seems likely that fNIRS will become a useful clinical tool.

Activation in the auditory pathway of the gerbil studied with 18F-FDG PET: effects of anesthesia

Here, we present results from an ¹⁸F-fluorodeoxyglucose (¹⁸F-FDG) positron emission tomography (PET) study in the Mongolian gerbil, a preferred animal model in auditory research. One major issue in preclinical nuclear imaging, as well as in most of the neurophysiological methods investigating auditory processing, is the need of anesthesia. We compared the usability of two types of anesthesia which are frequently employed in electrophysiology, ketamine/xylazine (KX), and fentanyl/midazolam/medetomidine (FMM), for valid measurements of auditory activation with ¹⁸F-FDG PET. Gerbils were placed in a sound-shielding box and injected with ¹⁸F-FDG. Two acoustic free-field conditions were used: (1) baseline (no stimulation, 25 dB background noise) and (2) 90 dB frequency-modulated tones (FM). After 40 min of ¹⁸F-FDG uptake, a 30 min acquisition was performed using a small animal PET/CT system. Blood glucose levels were measured after the uptake phase before scanning. Standardized uptake value ratios for relevant regions were determined after implementing image and volume of interest templates. Scans demonstrated a significantly higher uptake in the inferior colliculus with FM stimulation compared to baseline in awake subjects (+ 12%; p = 0.02) and with FMM anesthesia (+ 13%; p = 0.0012), but not with KX anesthesia. In non-auditory brain regions, no significant difference was detected. Blood glucose levels were significantly higher under KX compared to FMM anesthesia (17.29 ± 0.42 mmol/l vs. 14.30 ± 1.91 mmol/l; p = 0.024). These results suggest that valid ¹⁸F-FDG PET measurements of auditory activation comparable to electrophysiology can be obtained from gerbils during opioid-based anesthesia due to its limited effects on interfering blood glucose levels.

Feasibility of 15O-water PET studies of auditory system activation during general anesthesia in children

Background

¹⁵O-Water positron emission tomography (PET) enables functional imaging of the auditory system during stimulation via a promontory electrode or cochlear implant, which is not possible using functional magnetic resonance imaging (fMRI). Although PET has been introduced in this context decades ago, its feasibility when performed during general anesthesia has not yet been explored. However, due to a shift to earlier (and bilateral) auditory implantation, the need to study children during general anesthesia appeared, since they are not able to cooperate during scanning. Therefore, we evaluated retrospectively results of individual SPM (statistical parametric mapping) analysis of ¹⁵O-water PET in 17 children studied during general anesthesia and compared them to those in 9 adults studied while awake. Specifically, the influence of scan duration, smoothing filter kernel employed during preprocessing, and cut-off value used for statistical inferences were evaluated. Frequencies, peak heights, and extents of activations in auditory and extra-auditory brain regions (AR and eAR) were registered.

Results

It was possible to demonstrate activations in auditory brain regions during general anesthesia; however, the frequency and markedness of positive findings were dependent on some of the abovementioned influence factors. Scan duration (60 vs. 90 s) had no significant influence on peak height of auditory cortex activations. To achieve a similar frequency and extent of AR activations during general anesthesia compared to waking state, a lower cut-off for statistical inferences (p < 0.05 or p < 0.01 vs. p < 0.001) had to be applied. However, this lower cut-off was frequently associated with unexpected, “artificial” activations in eAR. These activations in eAR could be slightly reduced by the use of a stronger smoothing filter kernel during preprocessing of the data (e.g., [30 mm]³).

Conclusions

Our data indicate that it is feasible to detect auditory cortex activations in ¹⁵O-water PET during general anesthesia. Combined with the improved signal to noise ratios of modern PET scanners, this suggests reasonable prospects for further evaluation of the method for clinical use in auditory implant users. Adapted parameters for data analysis seem to be helpful to improve the proportion of signals in AR versus eAR.

Musicogenic reflex seizures in epilepsy with glutamic acid decarbocylase antibodies

BACKGROUND

Musicogenic reflex seizures (MRS) are a rare form of seizures described in patients with temporal lobe epilepsy (TLE), mainly of unknown etiology. Epilepsy with antibodies against glutamic acid decarboxylase (GAD-ab) is a form of autoimmune epilepsy for which no specific semiology has been described.

AIM OF THE STUDY

To retrospectively review the incidence of MRS in the general epileptic population and in the series of patients with epilepsy and GAD-ab and to describe its clinical and paraclinical characteristics.

METHODS

Patients recorded between January 2010 and January 2016 in the Database of Bellvitge Hospital Epilepsy Unit were reviewed.

RESULTS

From a group of 1510 epileptic patients, three reported MRS (0.0019%) (two patients with epilepsy and GAD-ab and one patient with cryptogenic TLE). The incidence of MRS in patients with epilepsy and GAD-ab was 2 of 22 (9%). Both patients had a normal magnetic resonance Imaging (MRI), but FDG-PET showed medial temporal lobe hypometabolism (unilateral or bilateral) in both and also in the insula in one of them. MRS (recorded via video-EEG[electroencephalography] in one patient) arose from the right temporal lobe.

CONCLUSIONS

MRS may be a distinctive seizure type in patients with epilepsy and antiGADab. Determination of GAD-ab should be carried out in all cases of MRS, even those with normal structural MRI.

The Callosal Relay Model of Interhemispheric Communication: New Evidence from Effective Connectivity Analysis

Interhemispheric auditory connectivity via the corpus callosum has been demonstrated to be important for normal speech processing. According to the callosal relay model, directed information flow from the right to the left auditory cortex has been suggested, but this has not yet been proven. For this purpose, 33 healthy participants were investigated with 64-channel EEG while performing the dichotic listening task in which two different consonant–vowel syllables were presented simultaneously to the left (LE) and right ear (RE). eLORETA source estimation was used to investigate the functional (lagged phase synchronization/LPS) and effective (isolated effective coherence/ICoh) connectivity between right and left primary (PAC) and secondary auditory cortices (SAC) in the gamma-band (30–100 Hz) during right and left ear reports. The major finding was a significantly increased effective connectivity in the gamma-band from the right to the left SAC during conscious perception of LE stimuli. In addition, effective and functional connectivity was significantly enhanced during LE as compared to RE reports. These findings give novel insight into transcallosal information transfer during auditory perception by showing that LE performance requires causal interhemispheric inputs from the right to the left auditory cortices, and that this interaction is mediated by synchronized gamma-band oscillations.

Human Auditory and Adjacent Nonauditory Cerebral Cortices Are Hypermetabolic in Tinnitus as Measured by Functional Near-Infrared Spectroscopy (fNIRS)

Tinnitus is the phantom perception of sound in the absence of an acoustic stimulus. To date, the purported neural correlates of tinnitus from animal models have not been adequately characterized with translational technology in the human brain. The aim of the present study was to measure changes in oxy-hemoglobin concentration from regions of interest (ROI; auditory cortex) and non-ROI (adjacent nonauditory cortices) during auditory stimulation and silence in participants with subjective tinnitus appreciated equally in both ears and in nontinnitus controls using functional near-infrared spectroscopy (fNIRS). Control and tinnitus participants with normal/near-normal hearing were tested during a passive auditory task. Hemodynamic activity was monitored over ROI and non-ROI under episodic periods of auditory stimulation with 750 or 8000 Hz tones, broadband noise, and silence. During periods of silence, tinnitus participants maintained increased hemodynamic responses in ROI, while a significant deactivation was seen in controls. Interestingly, non-ROI activity was also increased in the tinnitus group as compared to controls during silence. The present results demonstrate that both auditory and select nonauditory cortices have elevated hemodynamic activity in participants with tinnitus in the absence of an external auditory stimulus, a finding that may reflect basic science neural correlates of tinnitus that ultimately contribute to phantom sound perception.

Temporal Cortex Activation to Audiovisual Speech in Normal-Hearing and Cochlear Implant Users Measured with Functional Near-Infrared Spectroscopy

BACKGROUND

Speech understanding may rely not only on auditory, but also on visual information. Non-invasive functional neuroimaging techniques can expose the neural processes underlying the integration of multisensory processes required for speech understanding in humans. Nevertheless, noise (from functional MRI, fMRI) limits the usefulness in auditory experiments, and electromagnetic artifacts caused by electronic implants worn by subjects can severely distort the scans (EEG, fMRI). Therefore, we assessed audio-visual activation of temporal cortex with a silent, optical neuroimaging technique: functional near-infrared spectroscopy (fNIRS).

METHODS

We studied temporal cortical activation as represented by concentration changes of oxy- and deoxy-hemoglobin in four, easy-to-apply fNIRS optical channels of 33 normal-hearing adult subjects and five post-lingually deaf cochlear implant (CI) users in response to supra-threshold unisensory auditory and visual, as well as to congruent auditory-visual speech stimuli.

RESULTS

Activation effects were not visible from single fNIRS channels. However, by discounting physiological noise through reference channel subtraction (RCS), auditory, visual and audiovisual (AV) speech stimuli evoked concentration changes for all sensory modalities in both cohorts (p < 0.001). Auditory stimulation evoked larger concentration changes than visual stimuli (p < 0.001). A saturation effect was observed for the AV condition.

CONCLUSIONS

Physiological, systemic noise can be removed from fNIRS signals by RCS. The observed multisensory enhancement of an auditory cortical channel can be plausibly described by a simple addition of the auditory and visual signals with saturation.

Tinnitus Annoyance in Normal-Hearing Individuals: Correlation With Depression and Anxiety

OBJECTIVE

To assess and correlate tinnitus annoyance in normal-hearing patients with auditory brainstem response and with anxiety/depression.

METHODS

A sample of 84 individuals with tinnitus and normal hearing levels (pure-tone thresholds ≤25 dB HL) was compared to a matched control group of 47 normal-hearing individuals without tinnitus. All participants underwent auditory brainstem response testing. Tinnitus annoyance was assessed using the Tinnitus Handicap Inventory and depression and anxiety using the Beck Depression Inventory and Beck Anxiety Inventory, respectively. We compared auditory brainstem response and anxiety/depression symptoms between groups. In the study group, we correlated the degree of tinnitus annoyance with normal/abnormal auditory brainstem response and presence/level of anxiety/depression symptoms.

RESULTS

All controls had normal auditory brainstem response; 30 patients with tinnitus had abnormal results. Thirty-five patients with tinnitus had depression and 41 anxiety, while only 2 controls had depression and none had anxiety, with a significant between-group difference (P < .001). Normal/abnormal auditory brainstem response showed no association with tinnitus annoyance, anxiety, or depression. A higher degree of tinnitus annoyance was associated with severity of depression and anxiety.

CONCLUSIONS

Increased tinnitus annoyance was positively correlated with greater severity of anxiety and depression in normal-hearing patients but was unrelated to normal/abnormal auditory brainstem response.

Positron Emission Tomography Imaging Reveals Auditory and Frontal Cortical Regions Involved with Speech Perception and Loudness Adaptation

Considerable progress has been made in the treatment of hearing loss with auditory implants. However, there are still many implanted patients that experience hearing deficiencies, such as limited speech understanding or vanishing perception with continuous stimulation (i.e., abnormal loudness adaptation). The present study aims to identify specific patterns of cerebral cortex activity involved with such deficiencies. We performed O-15-water positron emission tomography (PET) in patients implanted with electrodes within the cochlea, brainstem, or midbrain to investigate the pattern of cortical activation in response to speech or continuous multi-tone stimuli directly inputted into the implant processor that then delivered electrical patterns through those electrodes. Statistical parametric mapping was performed on a single subject basis. Better speech understanding was correlated with a larger extent of bilateral auditory cortex activation. In contrast to speech, the continuous multi-tone stimulus elicited mainly unilateral auditory cortical activity in which greater loudness adaptation corresponded to weaker activation and even deactivation. Interestingly, greater loudness adaptation was correlated with stronger activity within the ventral prefrontal cortex, which could be up-regulated to suppress the irrelevant or aberrant signals into the auditory cortex. The ability to detect these specific cortical patterns and differences across patients and stimuli demonstrates the potential for using PET to diagnose auditory function or dysfunction in implant patients, which in turn could guide the development of appropriate stimulation strategies for improving hearing rehabilitation. Beyond hearing restoration, our study also reveals a potential role of the frontal cortex in suppressing irrelevant or aberrant activity within the auditory cortex, and thus may be relevant for understanding and treating tinnitus.

Cortical cross-modal plasticity following deafness measured using functional near-infrared spectroscopy

Evidence from functional neuroimaging studies suggests that the auditory cortex can become more responsive to visual and somatosensory stimulation following deafness, and that this occurs predominately in the right hemisphere. Extensive cross-modal plasticity in prospective cochlear implant recipients is correlated with poor speech outcomes following implantation, highlighting the potential impact of central auditory plasticity on subsequent aural rehabilitation. Conversely, the effects of hearing restoration with a cochlear implant on cortical plasticity are less well understood, since the use of most neuroimaging techniques in CI recipients is either unsafe or problematic due to the electromagnetic artefacts generated by CI stimulation. Additionally, techniques such as functional magnetic resonance imaging (fMRI) are confounded by acoustic noise produced by the scanner that will be perceived more by hearing than by deaf individuals. Subsequently it is conceivable that auditory responses to acoustic noise produced by the MR scanner may mask auditory cortical responses to non-auditory stimulation, and render inter-group comparisons less significant. Uniquely, functional near-infrared spectroscopy (fNIRS) is a silent neuroimaging technique that is non-invasive and completely unaffected by the presence of a CI. Here, we used fNIRS to study temporal-lobe responses to auditory, visual and somatosensory stimuli in thirty profoundly-deaf participants and thirty normally-hearing controls. Compared with silence, acoustic noise stimuli elicited a significant group fNIRS response in the temporal region of normally-hearing individuals, which was not seen in profoundly-deaf participants. Visual motion elicited a larger group response within the right temporal lobe of profoundly-deaf participants, compared with normally-hearing controls. However, bilateral temporal lobe fNIRS activation to somatosensory stimulation was comparable in both groups. Using fNIRS these results confirm that auditory deprivation is associated with cross-modal plasticity of visual inputs to auditory cortex. Although we found no evidence for plasticity of somatosensory inputs, it is possible that our recordings may have included activation of somatosensory cortex that masked any group differences in auditory cortical responses due to the limited spatial resolution associated with fNIRS.

Tinnitus: a large VBM-EEG correlational study

A surprising fact in voxel-based morphometry (VBM) studies performed in tinnitus is that not one single region is replicated in studies of different centers. The question then rises whether this is related to the low sample size of these studies, the selection of non-representative patient subgroups, or the absence of stratification according to clinical characteristics. Another possibility is that VBM is not a good tool to study functional pathologies such as tinnitus, in contrast to pathologies like Alzheimer's disease where it is known the pathology is related to cell loss. In a large sample of 154 tinnitus patients VBM and QEEG (Quantitative Electroencephalography) was performed and evaluated by a regression analysis. Correlation analyses are performed between VBM and QEEG data. Uncorrected data demonstrated structural differences in grey matter in hippocampal and cerebellar areas related to tinnitus related distress and tinnitus duration. After control for multiple comparisons, only cerebellar VBM changes remain significantly altered. Electrophysiological differences are related to distress, tinnitus intensity, and tinnitus duration in the subgenual anterior cingulate cortex, dorsal anterior cingulate cortex, hippocampus, and parahippocampus, which confirms previous results. The absence of QEEG-VBM correlations suggest functional changes are not reflected by co-occurring structural changes in tinnitus, and the absence of VBM changes (except for the cerebellum) that survive correct statistical analysis in a large study population suggests that VBM might not be very sensitive for studying tinnitus.

Increased cortical thickness and altered functional connectivity of the right superior temporal gyrus in left-handers

Altered structure in the temporal cortex has been implicated in the variable language laterality of left-handers (LH). The neuroanatomy of language lateralization and the corresponding synchronous functional connectivity (FC) in handedness cohorts are not, however, fully understood. We used structural and resting-state functional magnetic resonance imaging (fMRI) data to investigate the effect of altered cortical thickness on FC in LH and right-handers (RH). Whole-brain cortical thickness was calculated and compared between the LH and RH. We observed increased cortical thickness in the right superior temporal gyrus (STG) in the LH. A further FC analysis was conducted between the right STG and the remaining voxels in the brain. Compared with RH, the LH showed significantly higher FC in the left STG, right occipital cortex, and lower FC in the left inferior frontal gyrus and supramarginal gyrus. Our findings suggest that LH have atypical connectivity in the language network, with an enhanced role of the STG, findings which provide novel insights into the structural and functional substrates underlying the atypical language development of left-handed individuals.

Conscious auditory perception related to long-range synchrony of gamma oscillations

While the role of synchronized oscillatory activity in the gamma-band frequency range for conscious perception is well established in the visual domain, there is limited evidence concerning neurophysiological mechanisms in conscious auditory perception. In the current study, we addressed this issue with 64-channel EEG and a dichotic listening (DL) task in twenty-five healthy participants. The typical finding of DL is a more frequent conscious perception of the speech syllable presented to the right ear (RE), which is attributed to the supremacy of the contralateral pathways running from the RE to the speech-dominant left hemisphere. In contrast, the left ear (LE) input initially accesses the right hemisphere and needs additional transfer via interhemispheric pathways before it is processed in the left hemisphere. Using lagged phase synchronization (LPS) analysis and eLORETA source estimation we examined the functional connectivity between right and left primary and secondary auditory cortices in the main frequency bands (delta, theta, alpha, beta, gamma) during RE/LE-reports. Interhemispheric LPS between right and left primary and secondary auditory cortices was specifically increased in the gamma-band range, when participants consciously perceived the syllable presented to the LE. Our results suggest that synchronous gamma oscillations are involved in interhemispheric transfer of auditory information.

Generalized versus partial reflex seizures: a review

In this review we assess our currently available knowledge about reflex seizures with special emphasis on the difference between "generalized" reflex seizures induced by visual stimuli, thinking, praxis and language tasks, and "focal" seizures induced by startle, eating, music, hot water, somatosensory stimuli and orgasm. We discuss in particular evidence from animal, clinical, neurophysiological and neuroimaging studies supporting the concept that "generalized" reflex seizures, usually occurring in the setting of IGE, should be considered as focal seizures with quick secondary generalization. We also review recent advances in genetic and therapeutic approach of reflex seizures.

Mapping tinnitus-related brain activation: an activation-likelihood estimation metaanalysis of PET studies

In tinnitus, PET and other functional imaging modalities have shown functional changes not only in the auditory cortex but also in nonauditory regions such as the limbic, frontal, and parietal areas. Nonetheless, disparities in task dimension among studies, low statistical power due to small sample size, and the intrinsic uncertainty of a modality that measures activity indirectly limit the comprehensive understanding of the results from PET studies. These difficulties prompted us to undertake a metaanalysis of PET studies on tinnitus using a coordinate-based technique (activation-likelihood estimation) to retrieve the most consistent activation areas across different task dimensions and to compare the results with those from other imaging modalities.

METHODS

We performed 2 activation-likelihood estimation metaanalyses on data from 10 studies with 56 foci in which we examined the contrast between tinnitus individuals and controls and the difference in activation between sound stimuli and resting state in tinnitus individuals.

RESULTS

The studies show that the most consistently activated regions in tinnitus subjects, compared with controls, were the left primary and bilateral secondary auditory cortices, left middle and bilateral inferior temporal gyri, left parahippocampal area, left geniculum body, left precuneus, right anterior cingulate cortex, right claustrum, right middle and inferior frontal gyri, and right angular gyrus. The relatively activated area under sound stimuli, compared with resting state, in tinnitus subjects was the secondary auditory cortex. Our study reconfirms the findings of previous quantitative electroencephalography or magnetoencephalography studies because most of the 14 brain areas with significant activation found in our metaanalysis replicate these earlier data. Our results suggest that the areas described in the tinnitus network are solidly replicable regardless of the applied functional imaging technique.

CONCLUSION

This study proves that PET is a useful modality for tinnitus research and solidifies human tinnitus research itself by confirming previously described brain areas involved in the generation and maintenance of tinnitus.

High fidelity tonotopic mapping using swept source functional magnetic resonance imaging

Tonotopy, the topographic encoding of sound frequency, is the fundamental property of the auditory system. Invasive techniques lack the spatial coverage or frequency resolution to rigorously investigate tonotopy. Conventional auditory fMRI is corrupted by significant image distortion, sporadic acoustic noise and inadequate frequency resolution. We developed an efficient and high fidelity auditory fMRI method that integrates continuous frequency sweeping stimulus, distortion free MRI sequence with stable scanner noise and Fourier analysis. We demonstrated this swept source imaging (SSI) in the rat inferior colliculus and obtained tonotopic maps with ~2 kHz resolution and 40 kHz bandwidth. The results were vastly superior to those obtained by conventional fMRI mapping approach and in excellent agreement with invasive findings. We applied SSI to examine tonotopic injury following developmental noise exposure and observed that the tonotopic organization was significantly disrupted. With SSI, we also observed the subtle effects of sound pressure level on tonotopic maps, reflecting the complex neuronal responses associated with asymmetric tuning curves. This in vivo and noninvasive technique will greatly facilitate future investigation of tonotopic plasticity and disorders and auditory information processing. SSI can also be adapted to study topographic organization in other sensory systems such as retinotopy and somatotopy.

The brain basis of language processing: from structure to function

Language processing is a trait of human species. The knowledge about its neurobiological basis has been increased considerably over the past decades. Different brain regions in the left and right hemisphere have been identified to support particular language functions. Networks involving the temporal cortex and the inferior frontal cortex with a clear left lateralization were shown to support syntactic processes, whereas less lateralized temporo-frontal networks subserve semantic processes. These networks have been substantiated both by functional as well as by structural connectivity data. Electrophysiological measures indicate that within these networks syntactic processes of local structure building precede the assignment of grammatical and semantic relations in a sentence. Suprasegmental prosodic information overtly available in the acoustic language input is processed predominantly in a temporo-frontal network in the right hemisphere associated with a clear electrophysiological marker. Studies with patients suffering from lesions in the corpus callosum reveal that the posterior portion of this structure plays a crucial role in the interaction of syntactic and prosodic information during language processing.

Repetition enhancement for frequency-modulated but not unmodulated sounds: a human MEG study

Background

Decoding of frequency-modulated (FM) sounds is essential for phoneme identification. This study investigates selectivity to FM direction in the human auditory system.

Methodology/Principal Findings

Magnetoencephalography was recorded in 10 adults during a two-tone adaptation paradigm with a 200-ms interstimulus-interval. Stimuli were pairs of either same or different frequency modulation direction. To control that FM repetition effects cannot be accounted for by their on- and offset properties, we additionally assessed responses to pairs of unmodulated tones with either same or different frequency composition. For the FM sweeps, N1m event-related magnetic field components were found at 103 and 130 ms after onset of the first (S1) and second stimulus (S2), respectively. This was followed by a sustained component starting at about 200 ms after S2. The sustained response was significantly stronger for stimulation with the same compared to different FM direction. This effect was not observed for the non-modulated control stimuli.

Conclusions/Significance

Low-level processing of FM sounds was characterized by repetition enhancement to stimulus pairs with same versus different FM directions. This effect was FM-specific; it did not occur for unmodulated tones. The present findings may reflect specific interactions between frequency separation and temporal distance in the processing of consecutive FM sweeps.

The mechanisms of tinnitus: perspectives from human functional neuroimaging

In this review, we highlight the contribution of advances in human neuroimaging to the current understanding of central mechanisms underpinning tinnitus and explain how interpretations of neuroimaging data have been guided by animal models. The primary motivation for studying the neural substrates of tinnitus in humans has been to demonstrate objectively its representation in the central auditory system and to develop a better understanding of its diverse pathophysiology and of the functional interplay between sensory, cognitive and affective systems. The ultimate goal of neuroimaging is to identify subtypes of tinnitus in order to better inform treatment strategies. The three neural mechanisms considered in this review may provide a basis for TI classification. While human neuroimaging evidence strongly implicates the central auditory system and emotional centres in TI, evidence for the precise contribution from the three mechanisms is unclear because the data are somewhat inconsistent. We consider a number of methodological issues limiting the field of human neuroimaging and recommend approaches to overcome potential inconsistency in results arising from poorly matched participants, lack of appropriate controls and low statistical power.

Acoustic, psychophysical, and neuroimaging measurements of the effectiveness of active cancellation during auditory functional magnetic resonance imaging

Functional magnetic resonance imaging (fMRI) is one of the principal neuroimaging techniques for studying human audition, but it generates an intense background sound which hinders listening performance and confounds measures of the auditory response. This paper reports the perceptual effects of an active noise control (ANC) system that operates in the electromagnetically hostile and physically compact neuroimaging environment to provide significant noise reduction, without interfering with image quality. Cancellation was first evaluated at 600 Hz, corresponding to the dominant peak in the power spectrum of the background sound and at which cancellation is maximally effective. Microphone measurements at the ear demonstrated 35 dB of acoustic attenuation [from 93 to 58 dB sound pressure level (SPL)], while masked detection thresholds improved by 20 dB (from 74 to 54 dB SPL). Considerable perceptual benefits were also obtained across other frequencies, including those corresponding to dips in the spectrum of the background sound. Cancellation also improved the statistical detection of sound-related cortical activation, especially for sounds presented at low intensities. These results confirm that ANC offers substantial benefits for fMRI research.

Videopolygraphic and functional MRI study of musicogenic epilepsy. A case report and literature review

A 36-year-old right-handed man, who had experienced partial seizures since the age of 24 every time he played or listened to music with a strong emotional charge, underwent videopolygraphic recording, including autonomic variables, and brain fMRI study during which he listened to both "neutral" and "emotionally charged" music. Three right temporal seizures recorded during videopolygraphic monitoring were elicited by listening to the triggering song. The fMRI study disclosed activation in right acoustic areas during "neutral music," whereas an "emotionally charged melody" provoked widespread activation over the right fronto-temporo-occipital area before seizure onset. The literature review disclosed 110 published cases of musicogenic epilepsy that seemed to suggest a right-sided predominance of the epileptogenic zone. Our results support the role of the right temporal lobe in musicogenic epilepsy and demonstrate that the cerebral areas activated during the period of strong emotion leading to the seizures encompass the auditory cortex activated by neutral music.

Effects of repetitive transcranial magnetic stimulation on chronic tinnitus: a randomised, crossover, double blind, placebo controlled study

BACKGROUND

Chronic tinnitus is a disabling, almost untreatable, condition, usually accompanied by psychiatric distress. In patients with complex neuropsychiatric diseases, such as chronic pain, with which tinnitus shares pathophysiological similarities, placebo effects may be pronounced. Moreover, it may be difficult to distinguish actual repetitive transcranial magnetic stimulation (rTMS) induced clinical benefits beyond placebo effects in neuropsychiatric patients.

METHODS

16 patients with chronic tinnitus underwent a randomised, double blind, crossover, placebo controlled trial of 1 Hz rTMS (120% of motor threshold; 1200 stimuli/day for 5 days) of the left temporoparietal region. Patients were screened for psychiatric comorbidity; additionally, anxiety and depression were monitored throughout the study. Moreover, an original placebo rTMS procedure produced the same activation of ipsilateral face muscles (a condition which may per se change the subjective rating of tinnitus) as the real rTMS.

RESULTS

There were 8 out of 14 responders. Two patients dropped out for transient worsening of tinnitus. Active rTMS induced an overall significant, but transient, improvement (35% of the basal score) of subjective tinnitus perception that was independent of either tinnitus laterality or mood or anxiety changes. No correlations were found between response to rTMS and tinnitus duration, initial subjective score or patient age. When asked after the study was over, 71.4% of patients failed to identify the temporal sequence of the real or sham rTMS interventions.

CONCLUSION

The beneficial effects of rTMS on tinnitus are independent of mood changes. Moreover, they appear in the context of an original placebo stimulation designed to more closely replicate the somatic sensation of active stimulation. Because of the limited temporal duration of the clinical benefit, these neuromodulatory effects could be mediated by transient functional changes taking place in the neural circuits underlying tinnitus processing.

Lateralization of functional magnetic resonance imaging (fMRI) activation in the auditory pathway of patients with lateralized tinnitus

INTRODUCTION

Tinnitus is hypothesized to be an auditory phantom phenomenon resulting from spontaneous neuronal activity somewhere along the auditory pathway. We performed fMRI of the entire auditory pathway, including the inferior colliculus (IC), the medial geniculate body (MGB) and the auditory cortex (AC), in 42 patients with tinnitus and 10 healthy volunteers to assess lateralization of fMRI activation.

METHODS

Subjects were scanned on a 3T MRI scanner. A T2*-weighted EPI silent gap sequence was used during the stimulation paradigm, which consisted of a blocked design of 12 epochs in which music presented binaurally through headphones, which was switched on and off for periods of 50 s. Using SPM2 software, single subject and group statistical parametric maps were calculated. Lateralization of activation was assessed qualitatively and quantitatively.

RESULTS

Tinnitus was lateralized in 35 patients (83%, 13 right-sided and 22 left-sided). Significant signal change (P(corrected) < 0.05) was found bilaterally in the primary and secondary AC, the IC and the MGB. Signal change was symmetrical in patients with bilateral tinnitus. In patients with lateralized tinnitus, fMRI activation was lateralized towards the side of perceived tinnitus in the primary AC and IC in patients with right-sided tinnitus, and in the MGB in patients with left-sided tinnitus. In healthy volunteers, activation in the primary AC was left-lateralized.

CONCLUSION

Our paradigm adequately visualized the auditory pathways in tinnitus patients. In lateralized tinnitus fMRI activation was also lateralized, supporting the hypothesis that tinnitus is an auditory phantom phenomenon.

Functional imaging of the central auditory system using PET

In the last few decades functional neuroimaging tools have emerged to study the function of the human brain in vivo. These techniques have increased the knowledge of how the brain processes stimuli of different sensory modalities, including auditory processing. Positron emission tomography (PET) has been used for nearly 20 years to study changes in cerebral blood flow associated with auditory stimulation in normal and hearing impaired subjects. PET studies gave insight into the neural base of processing basic sound features such as frequency and intensity, but complex stimuli such as speech and music have also been investigated extensively. Knowledge of the normal auditory function of the brain helps us to understand the neural base of hearing deficits and provides ideas for possible treatments. Although functional magnetic resonance imaging (fMRI) is replacing PET in many neuroimaging studies nowadays, PET still holds unique advantages and can give us valuable knowledge about the auditory cortex and auditory perception.

Neuronavigierte repetitive transkranielle Magnetstimulation (rTMS)

BACKGROUND AND OBJECTIVE

Idiopathic tinnitus is a frequent and debilitating disorder of largely unknown pathophysiology. Focal brain activation in the auditory cortex has recently been demonstrated in chronic tinnitus. Low-frequency rTMS can reduce cortical hyperexcitability.

PATIENTS AND METHODS

In 12 patients with chronic tinnitus, fusion of [18F]deoxyglucose-PET and structural MRI (T1, MPRAGE) scans allowed the area of increased metabolic activity in the auditory cortex to be exactly identified; this area was selected as the target for rTMS. A neuronavigational system adapted for TMS positioning enabled the relative positions of the figure-8 coil and the target area to be monitored. Repetitive TMS (110% motor threshold; 1 Hz; 2000 stimuli per day over 5 days) was performed using a placebo-controlled crossover design. A sham coil system was used for the placebo stimulation. Treatment outcome was assessed with a specific tinnitus questionnaire (Goebel and Hiller).

RESULTS

In all 12 patients an asymmetrically increased metabolic activation of the gyrus of Heschl was detected. The tinnitus score was significantly improved after 5 days of active rTMS, an effect not seen after placebo stimulation.

CONCLUSION

These preliminary results show that neuronavigated rTMS may improve our understanding and treatment of chronic tinnitus.

The effects of nembutal anesthesia on the auditory steady-state response (ASSR) from the inferior colliculus and auditory cortex of the chinchilla

We examined the effects of nembutal anesthesia on the amplitude of the auditory steady-state response (ASSR) in the inferior colliculus (IC) and auditory cortex (AC) of the chinchilla. Tungsten electrodes were chronically implanted following anesthesia with ketamine/acepromazine. After a recovery period, the chinchillas were placed in a passive restraining device and put in a sound-attenuating booth. Recordings were made from the right IC and AC simultaneously, while a two-tone stimulus was presented to the left ear. The stimuli consisted of two equal-level tones (F1 and F2) that were mixed acoustically; F1 remained constant at 2000 Hz, while F2 varied between 2029 and 2249 Hz, in steps of approximately 20 Hz. The stimuli decreased in 10 dB steps from 80 to 30 dB pSPL. Animals were evaluated when unanesthetized, as well as when anesthetized with nembutal (on separate days). In the IC, the administration of nembutal resulted in either no change in ASSR amplitude or an amplitude increase for difference tone (DT) frequencies below 90 Hz, while an amplitude decrease was typically seen for DT frequencies at or above 90 Hz. In the AC, a decrease in amplitude was seen across DT frequencies and stimulus levels after the administration of nembutal anesthesia. Our results suggest that both the AC and IC may contribute to the scalp-recorded ASSR in the awake state. However, in the nembutal-anesthetized state, it seems unlikely that the AC contributes substantially to the surface-recorded ASSR, as the AC response was greatly attenuated under nembutal anesthesia. In contrast, the IC ASSR responses remained robust, which makes it a likely contributor to the surface-recorded responses under nembutal anesthesia.

Cortical responses to promontorial stimulation in postlingual deafness

Electrical stimulation with a transtympanic electrode on the promontory of the middle ear allows the tasks of gap detection and temporal difference limen (TDL) to be carried out by both normally hearing and deaf subjects. Previous neuroimaging of normally hearing subjects revealed a region in the right posterior temporal lobe that is crucial to duration discrimination. The present study tested the hypothesis that postlingually deaf subjects recruit this area when they make subtle temporal discriminations. Fourteen postlingually deaf adult cochlear implant candidates were stimulated in the ear chosen for implantation. Altered cerebral activity was recorded with positron emission tomography as incremental 15-O-labelled water uptake. On stimulation with tone bursts, we found bilateral activity close to the primary auditory cortex in all subjects. However, subjects performing well on the TDL task demonstrated right-lateralized fronto-temporal and left-lateralized temporal activity in the respective TDL and gap-detection tasks, while subjects who failed to detect duration differences of less than 200 ms in the TDL discrimination task only had frontal and occipital rather than temporal lobe activation. We conclude that the ability to involve the right posterior temporal region is important to duration discrimination. This ability can be evaluated pre-operatively.

Functional neuroanatomy of non-verbal semantic sound processing in humans

Environmental sounds convey specific meanings and the neural circuitry for their recognition may have preceded language. To dissociate semantic mnemonic from sensory perceptual processing of non-verbal sound stimuli we systematically altered the inherent semantic properties of non-verbal sounds from natural and man-made sources while keeping their acoustic characteristics closely matched. We hypothesized that acoustic analysis of complex non-verbal sounds would be right lateralized in auditory cortex regardless of meaning content and that left hemisphere regions would be engaged when meaningful concept could be extracted. Using H(2) (15)O-PET imaging and SPM data analysis, we demonstrated that activation of the left superior temporal and left parahippocampal gyrus along with left inferior frontal regions was specifically associated with listening to meaningful sounds. In contrast, for both types of sounds, acoustic analysis was associated with activation of right auditory cortices. We conclude that left hemisphere brain regions are engaged when sounds are meaningful or intelligible.

Long-term effects of repetitive transcranial magnetic stimulation (rTMS) in patients with chronic tinnitus

OBJECTIVES

The pathophysiologic mechanisms of idiopathic tinnitus remain unclear. Recent studies demonstrated focal brain activation in the auditory cortex of patients with chronic tinnitus. Low-frequency repetitive transcranial magnetic stimulation (rTMS) is able to reduce cortical hyperexcitability.

STUDY DESIGN

Fusing of the individual PET-scan with the structural MRI-scan (T1, MPRAGE) allowed us to identify exactly the area of increased metabolic activity in the auditory cortex of patients with chronic tinnitus. With the use of a neuronavigational system, this target area was exactly stimulated by the figure 8-shaped magnetic coil. In a prospective study, rTMS (110% motor threshold; 1 Hz; 2000 stimuli/day over 5 days) was performed using a placebo controlled cross-over design. Patients were blinded regarding the stimulus condition. For the sham stimulation a specific sham-coil system was used. Fourteen patients were followed for 6 months. Treatment outcome was assessed with a specific tinnitus questionnaire (Goebel and Hiller).

SETTING

Tertiary referral medical center.

RESULTS

Increased metabolic activation in the auditory cortex was verified in all patients. After 5 days of verum rTMS, a highly significant improvement of the tinnitus score was found whereas the sham treatment did not show any significant changes. The treatment outcome after 6 months still demonstrated significant reduction of tinnitus score.

CONCLUSION

These preliminary results demonstrate that neuronavigated rTMS offers new possibilities in the understanding and treatment of chronic tinnitus.

Acute alcohol effects on neuronal and attentional processing: striatal reward system and inhibitory sensory interactions under acute ethanol challenge

The acute influence of ethanol on cerebral activity induces complex psycho-physiological effects that are considerably more pronounced during acute ethanol influx than during maximal blood alcohol concentration (elimination phase). Despite the psychiatric and forensic relevance of these different ethanol effects, the underlying neuronal mechanisms are still unclear. In total, 20 male healthy volunteers were investigated each with three different experimental conditions in a randomized order using an intravenous ethanol challenge (40 g bolus infusion): during influx phase, elimination phase, and under placebo condition. During and after the ethanol (or placebo) infusion, neuropsychological testing of divided attention for visual and auditory stimuli was performed with subsequent 18-FDG PET acquisition. The PET data were analysed using SPM99. Ethanol influx and elimination phase showed focal activations in the bilateral striatum and frontal cortex and deactivations in the occipital cortex. The comparison of influx phase vs elimination phase revealed activations in the anterior cingulate and right prefrontal cortex, relevant deactivations were found in the left superior temporal cortex including Wernicke's area. Neuropsychological testing showed an attentional impairment under ethanol influx compared to ethanol elimination and placebo with an inverse correlation of the attentional performance for auditory stimuli to occipital activity and for visual stimuli to the left temporal (including auditory) cortex. Acute ethanol administration in healthy volunteers stimulates those striatal regions that are considered to have a particular relevance for alcohol craving ('reward system'). Modality specific reciprocal inhibition of sensory cortex activity seems to be relevant for attentional performance during acute alcohol impact.

Determination of activation areas in the human auditory cortex by means of synthetic aperture magnetometry

In this study we applied synthetic aperture magnetometry (SAM) to investigate active cortical areas associated with magnetically recorded transient and steady-state auditory evoked responses. For transient evoked responses, SAM images reveal an activated volume of cortical tissue within the lateral aspect of the superior temporal plane. The volume of cortical activation for steady-state responses was located more medially than that for transient evoked responses. Additionally, SAM also reveals a small overlap of activated areas between transient and steady-state evoked responses, which has not be demonstrated when using equivalent current dipole (ECD) source modeling. Source waveforms from SAM and ECD analyses show comparable temporal information. Results from this study suggest that SAM is a useful technique for imaging cortical structures involved in processing perceptual information.

Single-dipole analyses of the N100m are not suitable for characterizing the cortical representation of pitch

In several previous studies, the deflection N100m of the auditory evoked field (AEF), occurring about 100 ms after the onset of a sound, has been used to investigate whether complex tones are represented in the auditory cortex by their spectrum or their periodicity pitch. However, the results partially contradict each other. Moreover, the basic assumption that N100m originates from a single cortical source has been questioned. To gain clarity, the AEF elicited by a complex tone with a periodicity of 4 ms (pitch 250 Hz) and a spectrum between 1000 and 2000 Hz was compared with the AEF in response to pure tones of 250 and 1000 Hz, respectively (on 12 subjects). While a previous analysis [Audiol Neurootol 2001;6: 263-278] was exclusively devoted to the N100m latency, this article presents source analyses with two variants of a single-dipole model (moving dipole and fixed dipole). Earlier reports, suggesting that N100m arises from a cortical source representing the pitch rather than the spectrum of the sound, could not be reproduced, independent of the method used. It appears that an investigation of the functional organization of the human auditory cortex based on N100m source modeling requires a much higher degree of sophistication than a single-dipole model can provide.

Studies of tonotopy based on wave N100 of the auditory evoked field are problematic

There is still dissension as to whether the auditory evoked field (AEF) reflects tonotopy in the auditory cortex. That notwithstanding, particularly the pronounced AEF wave occurring about 100 ms after stimulus onset (N100 m) is increasingly used for the investigation of issues such as cortical reorganization and representation of virtual pitch. Thus, it appears to be time for a critical revaluation of the supposed tonotopic organization of the N100 m generator. In the present magnetoencephalography study, the response to tonebursts of 500 ms duration, monaurally presented 60 dB above threshold, was recorded with a 37-channel axial gradiometer system over the hemisphere contralateral to the side of stimulation. The stimulus frequencies were 250, 500, 1000, and 2000 Hz. About 250 stimuli of each type were presented in random order in four independent sessions at intervals uniformly distributed between 2 and 2.8 s. An analysis of 19 hemispheres in 10 normal-hearing subjects showed a high intraindividual reproducibility, but also a substantial interindividual variability. In most cases, the dipole location either exhibited no significant frequency dependence at all, the dipoles for the four frequencies were not orderly aligned, or the data disagreed with the single-dipole model. In the few cases showing an arrangement of dipoles consistent with the assumption of an orderly tonotopic cortical map, the most relevant coordinate varied from subject to subject. Regarding theses results, it seems crucial to understand wave N100 m on the basis of individual subjects, whereas conclusions relying on mean dipole locations for groups of subjects are problematic.

The neuroanatomical and functional organization of speech perception

A striking property of speech perception is its resilience in the face of acoustic variability (among speech sounds produced by different speakers at different times, for example). The robustness of speech perception might, in part, result from multiple, complementary representations of the input, which operate in both acoustic-phonetic feature-based and articulatory-gestural domains. Recent studies of the anatomical and functional organization of the non-human primate auditory cortical system point to multiple, parallel, hierarchically organized processing pathways that involve the temporal, parietal and frontal cortices. Functional neuroimaging evidence indicates that a similar organization might underlie speech perception in humans. These parallel, hierarchical processing 'streams', both within and across hemispheres, might operate on distinguishable, complementary types of representations and subserve complementary types of processing. Two long-opposing views of speech perception have posited a basis either in acoustic feature processing or in gestural motor processing; the view put forward here might help reconcile these positions.

Relationships between human auditory cortical structure and function

The human auditory cortex comprises multiple areas, largely distributed across the supratemporal plane, but the precise number and configuration of auditory areas and their functional significance have not yet been clearly established. In this paper, we discuss recent research concerning architectonic and functional organisation within the human auditory cortex, as well as architectonic and neurophysiological studies in non-human species, which can provide a broad conceptual framework for interpreting functional specialisation in humans. We review the pattern in human auditory cortex of the functional responses to various acoustic cues, such as frequency, pitch, sound level, temporal variation, motion and spatial location, and we discuss their correspondence to what is known about the organisation of the auditory cortex in other primates. There is some neuroimaging evidence of multiple tonotopically organised fields in humans and of functional specialisations of the fields in the processing of different sound features. It is thought that the primary area, on Heschl's gyrus, may have a larger involvement in processing basic sound features, such as frequency and level, and that posterior non-primary areas on the planum temporale may play a larger role in processing more spectrotemporally complex sounds. Ways in which current knowledge of auditory cortical organisation and different data analysis approaches may benefit future functional neuroimaging studies which seek to link auditory cortical structure and function are discussed.