Evidence for an association between allostatic load and multisensory integration in middle-aged and older adults

Multisensory integration, the ability of the brain to integrate information from different sensory modalities, is critical for responding to environmental stimuli. While older adults show changes in multisensory integration with age, the impact of allostatic load (AL) (i.e., the effect of exposure to chronic stress, which can accelerate ageing) on multisensory perception remains understudied. We explored the relationship between multisensory integration and AL in 1,358 adults aged 50+ from The Irish Longitudinal Study on Ageing by performing a Sound Induced Flash Illusion (SIFI) task at multiple audio-visual temporal asynchronies. The AL score was created using a battery of biomarkers representing the activity of four major physiological systems: immunological, cardiovascular, metabolic, and renal. The number of biomarkers for which a participant was categorised in the highest risk quartile using sex-specific cutoffs was used to produce an overall AL score. We accounted for medication use when calculating our AL score. We analysed the accuracy of illusion trials on a SIFI task using generalised logistic mixed effects regression models adjusted for a number of covariates. Observation of cross-sectional and longitudinal results revealed that lower accuracy in integration (i.e., higher SIFI susceptibility with larger temporal asynchronies) was associated with higher AL. This confirmed the distinct patterns of multisensory integration in ageing.

The temporal precision of audiovisual integration is associated with longitudinal fall incidents but not sensorimotor fall risk in older adults

Sustained multisensory integration over long inter-stimulus time delays is typically found in older adults, particularly those with a history of falls. However, the extent to which the temporal precision of audio-visual integration is associated with longitudinal fall or fall risk trajectories is unknown. A large sample of older adults (N = 2319) were grouped into longitudinal trajectories of self-reported fall incidents (i.e., decrease, stable, or increase in number) and, separately, their performance on a standard, objective measure of fall risk, Timed Up and Go (TUG; stable, moderate decline, severe decline). Multisensory integration was measured once as susceptibility to the Sound-Induced Flash Illusion (SIFI) across three stimulus onset asynchronies (SOAs): 70 ms, 150 ms and 230 ms. Older adults with an increasing fall number showed a significantly different pattern of performance on the SIFI than non-fallers, depending on age: For adults with increasing incidents of falls, those aged 53-59 years showed a much smaller difference in illusion susceptibility at 70 ms versus 150 ms than those aged 70 + years. In contrast, non-fallers showed a more comparable difference between these SOA conditions across age groups. There was no association between TUG performance trajectories and SIFI susceptibility. These findings suggests that a fall event is associated with distinct temporal patterns of multisensory integration in ageing and have implications for our understanding of the mechanisms underpinning brain health in older age.

Visual-somatosensory integration (VSI) as a novel marker of Alzheimer’s disease: A comprehensive overview of the VSI study

Identification of novel, non-invasive, non-cognitive based markers of Alzheimer’s disease (AD) and related dementias are a global priority. Growing evidence suggests that Alzheimer’s pathology manifests in sensory association areas well before appearing in neural regions involved in higher-order cognitive functions, such as memory. Previous investigations have not comprehensively examined the interplay of sensory, cognitive, and motor dysfunction with relation to AD progression. The ability to successfully integrate multisensory information across multiple sensory modalities is a vital aspect of everyday functioning and mobility. Our research suggests that multisensory integration, specifically visual-somatosensory integration (VSI), could be used as a novel marker for preclinical AD given previously reported associations with important motor (balance, gait, and falls) and cognitive (attention) outcomes in aging. While the adverse effect of dementia and cognitive impairment on the relationship between multisensory functioning and motor outcomes has been highlighted, the underlying functional and neuroanatomical networks are still unknown. In what follows we detail the protocol for our study, named The VSI Study, which is strategically designed to determine whether preclinical AD is associated with neural disruptions in subcortical and cortical areas that concurrently modulate multisensory, cognitive, and motor functions resulting in mobility decline. In this longitudinal observational study, a total of 208 community-dwelling older adults with and without preclinical AD will be recruited and monitored yearly. Our experimental design affords assessment of multisensory integration as a new behavioral marker for preclinical AD; identification of functional neural networks involved in the intersection of sensory, motor, and cognitive functioning; and determination of the impact of early AD on future mobility declines, including incident falls. Results of The VSI Study will guide future development of innovative multisensory-based interventions aimed at preventing disability and optimizing independence in pathological aging.

[Vestibular compensation and aging: An example of cellular and behavioral resilience over time]

The vestibular system has a remarkable capacity of self-repair. Vestibular compensation, a model of post-lesional plasticity of the central nervous system, refers to a set of endogenous neuroplasticity mechanisms in the vestibular nuclei in response to damage to the peripheral vestibular system, and underlying functional recovery. During aging, this "homeostatic" plasticity, although still present, diminishes and is accompanied by sensorimotor and cognitive disturbances. Regardless of age, vestibular compensation can be improved by pharmacological therapy but also by rehabilitation based on strengthening other sensory modalities such as visual and proprioceptive modalities, but also cognitive and motor components. In this article, we will first discuss neurobiological mechanisms of vestibular compensation, then document the impact of aging on this adaptive plasticity.

Audiovisual integrative training for augmenting cognitive- motor functions in older adults with mild cognitive impairment

BACKGROUND

Previous studies indicated that the behavioral performances of older adults could be enhanced by multisensory integration. This pilot study tested the benefits of an audiovisual integrative (AV) training for improving the cognitive and upper limb motor functions in older adults with mild cognitive impairment (MCI).

METHODS

Twenty participants, according to their MoCA scores, with ten in each of a MCI (mean age = 63.3 years) and healthy older adult group (mean age = 64.7 years), engaged in AV integrative training. They were recruited from the Institute of Active Ageing at the Hong Kong Polytechnic University. The screening was conducted from February to March 2018 and the training program which consisted of three sessions (2 h each) was conducted from 14-28th May 2018. Their executive function, attention and upper limb functions were measured by the Stroop Test and Purdue Pegboard Test respectively.

RESULTS

The mixed linear model analysis results showed significant Time x Group interaction effects in the time used in the Stroop Test (dots) (p = 0.042) and the Purdue Pegboard scores (non-dominant hand use) (p = 0.025). The MCI group exhibited significantly more improvements in attentional control and non-dominant hand motor functions after the training.

CONCLUSIONS

The findings suggest that the AV integrative training has the potential for enhancing the cognitive and motor functions of older adults with MCI. Furthermore, AV integrative training can serve as an alternative non-pharmacological intervention for combating neurodegeneration in older adults.

TRIAL REGISTRATION

This study has been retrospectively registered at the Chinese Clinical Trial Registry which is a World Health Organisation approved registry.

TRIAL REGISTRATION

Current Controlled Trials ChiCTR2000029408, January 29th, 2020.

Does hearing aid use affect audiovisual integration in mild hearing impairment?

There is converging evidence for altered audiovisual integration abilities in hearing-impaired individuals and those with profound hearing loss who are provided with cochlear implants, compared to normal-hearing adults. Still, little is known on the effects of hearing aid use on audiovisual integration in mild hearing loss, although this constitutes one of the most prevalent conditions in the elderly and, yet, often remains untreated in its early stages. This study investigated differences in the strength of audiovisual integration between elderly hearing aid users and those with the same degree of mild hearing loss who were not using hearing aids, the non-users, by measuring their susceptibility to the sound-induced flash illusion. We also explored the corresponding window of integration by varying the stimulus onset asynchronies. To examine general group differences that are not attributable to specific hearing aid settings but rather reflect overall changes associated with habitual hearing aid use, the group of hearing aid users was tested unaided while individually controlling for audibility. We found greater audiovisual integration together with a wider window of integration in hearing aid users compared to their age-matched untreated peers. Signal detection analyses indicate that a change in perceptual sensitivity as well as in bias may underlie the observed effects. Our results and comparisons with other studies in normal-hearing older adults suggest that both mild hearing impairment and hearing aid use seem to affect audiovisual integration, possibly in the sense that hearing aid use may reverse the effects of hearing loss on audiovisual integration. We suggest that these findings may be particularly important for auditory rehabilitation and call for a longitudinal study.

Shifts in Audiovisual Processing in Healthy Aging

Purpose of Review

The integration of information across sensory modalities into unified percepts is a fundamental sensory process upon which a multitude of cognitive processes are based. We review the body of literature exploring aging-related changes in audiovisual integration published over the last five years. Specifically, we review the impact of changes in temporal processing, the influence of the effectiveness of sensory inputs, the role of working memory, and the newer studies of intra-individual variability during these processes.

Recent Findings

Work in the last five years on bottom-up influences of sensory perception has garnered significant attention. Temporal processing, a driving factors of multisensory integration, has now been shown to decouple with multisensory integration in aging, despite their co-decline with aging. The impact of stimulus effectiveness also changes with age, where older adults show maximal benefit from multisensory gain at high signal-to-noise ratios. Following sensory decline, high working memory capacities have now been shown to be somewhat of a protective factor against age-related declines in audiovisual speech perception, particularly in noise. Finally, newer research is emerging focusing on the general intra-individual variability observed with aging.

Summary

Overall, the studies of the past five years have replicated and expanded on previous work that highlights the role of bottom-up sensory changes with aging and their influence on audiovisual integration, as well as the top-down influence of working memory.

Multisensory integration in hemianopia and unilateral spatial neglect: Evidence from the sound induced flash illusion

Recent neuropsychological evidence suggests that acquired brain lesions can, in some instances, abolish the ability to integrate inputs from different sensory modalities, disrupting multisensory perception. We explored the ability to perceive multisensory events, in particular the integrity of audio-visual processing in the temporal domain, in brain-damaged patients with visual field defects (VFD), or with unilateral spatial neglect (USN), by assessing their sensitivity to the 'Sound-Induced Flash Illusion' (SIFI). The study yielded two key findings. Firstly, the 'fission' illusion (namely, seeing multiple flashes when a single flash is paired with multiple sounds) is reduced in both left- and right-brain-damaged patients with VFD, but not in right-brain-damaged patients with left USN. The disruption of the fission illusion is proportional to the extent of the occipital damage. Secondly, a reliable 'fusion' illusion (namely, seeing less flashes when a single sound is paired with multiple flashes) is evoked in USN patients, but neither in VFD patients nor in healthy participants. A control experiment showed that the fusion, but not the fission, illusion is lost in older participants (>50 year-old), as compared with younger healthy participants (<30 year-old). This evidence indicates that the fission and fusion illusions are dissociable multisensory phenomena, altered differently by impairments of visual perception (i.e. VFD) and spatial attention (i.e. USN). The occipital cortex represents a key cortical site for binding auditory and visual stimuli in the SIFI, while damage to right-hemisphere areas mediating spatial attention and awareness does not prevent the integration of audio-visual inputs in the temporal domain.

Visuo-tactile interactions in the congenitally deaf: a behavioral and event-related potential study

Auditory deprivation is known to be accompanied by alterations in visual processing. Yet not much is known about tactile processing and the interplay of the intact sensory modalities in the deaf. We presented visual, tactile, and visuo-tactile stimuli to congenitally deaf and hearing individuals in a speeded detection task. Analyses of multisensory responses showed a redundant signals effect that was attributable to a coactivation mechanism in both groups, although the redundancy gain was less in the deaf. In line with these behavioral results, on a neural level, there were multisensory interactions in both groups that were again weaker in the deaf. In hearing but not deaf participants, somatosensory event-related potential N200 latencies were modulated by simultaneous visual stimulation. A comparison of unisensory responses between groups revealed larger N200 amplitudes for visual and shorter N200 latencies for tactile stimuli in the deaf. Furthermore, P300 amplitudes were also larger in the deaf. This group difference was significant for tactile and approached significance for visual targets. The differences in visual and tactile processing between deaf and hearing participants, however, were not reflected in behavior. Both the behavioral and electroencephalography (EEG) results suggest more pronounced multisensory interaction in hearing than in deaf individuals. Visuo-tactile enhancements could not be explained by perceptual deficiency, but could be partly attributable to inverse effectiveness.