BI-3231, an enzymatic inhibitor of HSD17B13, reduces lipotoxic effects induced by palmitic acid in murine and human hepatocytes

17-β-hydroxysteroid dehydrogenase 13 (HSD17B13), a lipid droplet-associated enzyme, is primarily expressed in the liver and plays an important role in lipid metabolism. Targeted inhibition of enzymatic function is a potential therapeutic strategy for treating steatotic liver disease (SLD). The present study is aimed at investigating the effects of the first selective HSD17B13 inhibitor, BI-3231, in a model of hepatocellular lipotoxicity using human cell lines and primary mouse hepatocytes in vitro. Lipotoxicity was induced with palmitic acid in HepG2 cells and freshly isolated mouse hepatocytes and the cells were coincubated with BI-3231 to assess the protective effects. Under lipotoxic stress, triglyceride (TG) accumulation was significantly decreased in the BI-3231-treated cells compared with that of the control untreated human and mouse hepatocytes. In addition, treatment with BI-3231 led to considerable improvement in hepatocyte proliferation, cell differentiation, and lipid homeostasis. Mechanistically, BI-3231 increased the mitochondrial respiratory function without affecting β-oxidation. BI-3231 inhibited the lipotoxic effects of palmitic acid in hepatocytes, highlighting the potential of targeting HSD17B13 as a specific therapeutic approach in steatotic liver disease.NEW & NOTEWORTHY 17-β-Hydroxysteroid dehydrogenase 13 (HSD17B13) is a lipid droplet protein primarily expressed in the liver hepatocytes. HSD17B13 is associated with the clinical outcome of chronic liver diseases and is therefore a target for the development of drugs. Here, we demonstrate the promising therapeutic effect of BI-3231 as a potent inhibitor of HSD17B13 based on its ability to inhibit triglyceride accumulation in lipid droplets (LDs), restore lipid metabolism and homeostasis, and increase mitochondrial activity in vitro.

The Role of Hypoxia-Inducible Factor 1 Alpha in Acute-on-Chronic Liver Failure

Acute-on-chronic liver failure (ACLF) is associated with increased mortality. Specific therapy options are limited. Hypoxia-inducible factor 1 alpha (HIF-1α) has been linked to the pathogenesis of chronic liver disease (CLD), but the role of HIF-1α in ACLF is poorly understood. In the current study, different etiologies of CLD and precipitating events triggering ACLF were used in four rodent models. HIF-1α expression and the intracellular pathway of HIF-1α induction were investigated using real-time quantitative PCR. The results were verified by Western blotting and immunohistochemistry for extrahepatic HIF-1α expression using transcriptome analysis. Exploratory immunohistochemical staining was performed to assess HIF-1α in human liver tissue. Intrahepatic HIF-1α expression was significantly increased in all animals with ACLF, regardless of the underlying etiology of CLD or the precipitating event. The induction of HIF-1α was accompanied by the increased mRNA expression of NFkB1 and STAT3 and resulted in a marked elevation of mRNA levels of its downstream genes. Extrahepatic HIF-1α expression was not elevated. In human liver tissue samples, HIF-1α expression was elevated in CLD and ACLF. Increased intrahepatic HIF-1α expression seems to play an important role in the pathogenesis of ACLF, and future studies are pending to investigate the role of therapeutic HIF inhibitors in ACLF.

Differential Lipidomics, Metabolomics and Immunological Analysis of Alcoholic and Non-Alcoholic Steatohepatitis in Mice

Non-alcoholic steatohepatitis (NASH) and alcoholic steatohepatitis (ASH) are the leading causes of liver disease worldwide. To identify disease-specific pathomechanisms, we analyzed the lipidome, metabolome and immune cell recruitment in livers in both diseases. Mice harboring ASH or NASH had comparable disease severities regarding mortality rate, neurological behavior, expression of fibrosis marker and albumin levels. Lipid droplet size was higher in NASH than ASH and qualitative differences in the lipidome were mainly based on incorporation of diet-specific fatty acids into triglycerides, phosphatidylcholines and lysophosphatidylcholines. Metabolomic analysis showed downregulated nucleoside levels in both models. Here, the corresponding uremic metabolites were only upregulated in NASH suggesting stronger cellular senescence, which was supported by lower antioxidant levels in NASH as compared to ASH. While altered urea cycle metabolites suggest increased nitric oxide synthesis in both models, in ASH, this depended on increased L-homoarginine levels indicating a cardiovascular response mechanism. Interestingly, only in NASH were the levels of tryptophan and its anti-inflammatory metabolite kynurenine upregulated. Fittingly, high-content immunohistochemistry showed a decreased macrophage recruitment and an increased polarization towards M2-like macrophages in NASH. In conclusion, with comparable disease severity in both models, higher lipid storage, oxidative stress and tryptophan/kynurenine levels were seen in NASH, leading to distinct immune responses.

Janus kinase 2 inhibition by pacritinib as potential therapeutic target for liver fibrosis

BACKGROUND AND AIMS

Janus kinase 2 (JAK2) signaling is increased in human and experimental liver fibrosis with portal hypertension. JAK2 inhibitors, such as pacritinib, are already in advanced clinical development for other indications and might also be effective in liver fibrosis. Here, we investigated the antifibrotic role of the JAK2 inhibitor pacritinib on activated hepatic stellate cells (HSCs) in vitro and in two animal models of liver fibrosis in vivo .

APPROACH AND RESULTS

Transcriptome analyses of JAK2 in human livers and other targets of pacritinib have been shown to correlate with profibrotic factors. Although transcription of JAK2 correlated significantly with type I collagen expression and other profibrotic genes, no correlation was observed for interleukin-1 receptor-associated kinase and colony-stimulating factor 1 receptor. Pacritinib decreased gene expression of fibrosis markers in mouse primary and human-derived HSCs in vitro . Moreover, pacritinib decreased the proliferation, contraction, and migration of HSCs. C 57 BL/6J mice received ethanol in drinking water (16%) or Western diet in combination with carbon tetrachloride intoxication for 7 weeks to induce alcoholic or nonalcoholic fatty liver disease. Pacritinib significantly reduced liver fibrosis assessed by gene expression and Sirius red staining, as well as HSC activation assessed by alpha-smooth muscle actin immunostaining in fibrotic mice. Furthermore, pacritinib decreased the gene expression of hepatic steatosis markers in experimental alcoholic liver disease. Additionally, pacritinib protected against liver injury as assessed by aminotransferase levels.

CONCLUSIONS

This study demonstrates that the JAK2 inhibitor pacritinib may be promising for the treatment of alcoholic and nonalcoholic liver fibrosis and may be therefore relevant for human pathology.

Neprilysin-dependent neuropeptide Y cleavage in the liver promotes fibrosis by blocking NPY-receptor 1

Development of liver fibrosis is paralleled by contraction of hepatic stellate cells (HSCs), the main profibrotic hepatic cells. Yet, little is known about the interplay of neprilysin (NEP) and its substrate neuropeptide Y (NPY), a potent enhancer of contraction, in liver fibrosis. We demonstrate that HSCs are the source of NEP. Importantly, NPY originates majorly from the splanchnic region and is cleaved by NEP in order to terminate contraction. Interestingly, NEP deficiency (Nep-/-) showed less fibrosis but portal hypertension upon liver injury in two different fibrosis models in mice. We demonstrate the incremental benefit of Nep-/- in addition to AT1R blocker (ARB) or ACE inhibitors for fibrosis and portal hypertension. Finally, oral administration of Entresto, a combination of ARB and NEP inhibitor, decreased hepatic fibrosis and portal pressure in mice. These results provide a mechanistic rationale for translation of NEP-AT1R-blockade in human liver fibrosis and portal hypertension.

The non-selective Rho-kinase inhibitors Y-27632 and Y-33075 decrease contraction but increase migration in murine and human hepatic stellate cells

BACKGROUND

The Rho-kinase ROCK II plays a major role in the activation of hepatic stellate cells (HSC), which are the key profibrotic and contractile cells contributing to the development of chronic liver disease. Inhibition of ROCK II ultimately blocks the phosphorylation of the myosin light chain (MLC) and thus inhibits stress fibre assembly and cell contraction. We investigated the effects of the ROCK inhibitors Y-33075 as well as Y-27632 in murine and human hepatic stellate cells.

METHODS

Primary isolated HSC from FVB/NJ mice and the immortalized human HSC line TWNT-4 were culture-activated and incubated with Y-27632 and Y-33075 (10nM to 10μM) for 24h. Protein expression levels were analyzed by Western Blots and transcriptional levels of pro-fibrotic markers and proliferative markers were evaluated using real-time qPCR. Migration was investigated by wound-healing assay. Proliferation was assessed by BrdU assay. Contraction of HSC was measured using 3D collagen matrices after incubation with Y-27632 or Y-33075 in different doses.

RESULTS

Both Rho-kinase inhibitors, Y-27632 and Y-33075, reduced contraction, fibrogenesis and proliferation in activated primary mouse HSC (FVB/NJ) and human HSC line (TWNT-4) significantly. Y-33075 demonstrated a 10-times increased potency compared to Y-27632. Surprisingly, both inhibitors mediated a substantial and unexpected increase in migration of HSC in FVB/NJ.

CONCLUSION

ROCK inhibition by the tested compounds decreased contraction but increased migration. Y-33075 proved more potent than Y27632 in the inhibition of contraction of HSCs and should be further evaluated in chronic liver disease.

Trait anxiety is linked to increased usage of priors in a perceptual decision making task

Current predictive processing accounts consider negative affect to result from elevated rates of prediction error, thereby motivating changes in the degree with which prior expectancies and sensory evidence influence our perceptions. Trait anxiety is associated with the amount of negative affect a person is experiencing and has been linked to aberrant strategies in decision making and belief updating. Here, we assessed the degree to which induced prior expectancies influenced motion judgements in a simple perceptual decision making task in 117 healthy participants with varying levels of trait anxiety. High trait anxious individuals showed increased usage of priors, independent from the amount of sensory uncertainty that was perceived. This finding demonstrates aberrant strategies of belief updating in anxiety even in evaluating nonthreatening visual motion stimuli, and thus suggest an influential role of affective traits in processes of perceptual inference.

Circulating adiponectin concentrations during the transition from pregnancy to lactation in high-yielding dairy cows: testing the effects of farm, parity, and dietary energy level in large animal numbers

Dairy cows experience a negative energy balance due to increasing energy demands and insufficient voluntary feed intake in the transition from late pregnancy to early lactation. For supplying sufficient energy toward the conceptus and the mammary gland, insulin sensitivity in peripheral tissues is reduced leading to adipose tissue mobilization. Adiponectin, an insulin-sensitizing adipokine, is presumably related to energy metabolism and could play an important role in these metabolic adaptations. We hypothesize (1) that primiparous cows would differ from pluriparous cows in their circulating adiponectin concentrations during the transition from late pregnancy to early lactation and (2) that feeding different energy levels would affect the adiponectin concentrations during early lactation in dairy cows. For the first hypothesis, we examined 201 primiparous and 456 pluriparous Holstein dairy cows on three experimental farms. Ante partum, primiparous cows had lower adiponectin and greater NEFA concentrations than pluriparous cows, but vice versa post partum. Hence, adiponectin might be involved in the energy partitioning in primiparous cows (conceptus and lactation vs other still growing body tissues) with changing priorities from pregnancy to lactation. For the second hypothesis, 110 primiparous and 558 pluriparous Holstein and Simmental dairy cows in six experimental farms received either roughage with 6.1 or 6.5 MJ NEl/kg dry matter (adjusted with different amounts of wheat straw) ad libitum, combined with either 150 or 250 g concentrates/kg energy corrected milk. Greater amounts of concentrate lead to greater milk yield, but did not affect the blood variables. The higher energy level in the roughage led to greater glucose and IGF-1 but lower adiponectin in pluriparous cows. Further studies are needed to elucidate the mechanisms behind the roughage effect and its metabolic consequences.

Short communication: Pro- and antioxidative indicators in serum of dairy cows during late pregnancy and early lactation: Testing the effects of parity, different dietary energy levels, and farm

Dairy cows face metabolic challenges in the transition from late pregnancy to early lactation. The energy demands for the growing fetus and the onset of milk production are increasing but voluntary feed intake often decreases around parturition and cannot meet these demands. This energy balance, among others, can change the oxidative status. Oxidative stress occurs when antioxidant defense mechanisms are not sufficient to cope with the increasing generation of reactive oxygen species. Our objectives were to investigate (1) the effect of parity on the oxidative status of dairy cows (n = 247) in late pregnancy and early lactation; and (2) the effect of different inclusion rates of concentrate feeding (150 vs. 250 g/kg of energy-corrected milk) during early lactation on 2 farms including 87 cows in total. In addition, we aimed to compare the oxidative status across the 2 farms using equal portions of concentrate feeding. For these purposes, we measured concentrations of the derivatives of reactive oxygen metabolites (dROM) and the ferric reducing ability (FRAP) in serum on d -50, -14, +8, +28, and +100 relative to calving. Furthermore, we calculated the oxidative status index (OSi) as dROM/FRAP × 100. Data were analyzed using a linear mixed model. Cows in the first and second lactations had greater dROM, FRAP, and OSi than cows in their third and greater lactations. Hence, supporting the antioxidative side of the balance might be of particular importance in the first and second lactations. Feeding different amounts of concentrates did not affect dROM, FRAP, or OSi under our experimental conditions, suggesting that the relatively small differences in energy intake were not affecting the oxidative status. Comparing farms, cows from one farm were notable for having greater dROM and lower FRAP, resulting in a greater OSi compared with cows on the other farm. Milk yield showed a time by farm interaction with 7% less milk on d 100 on the farm with the greater OSi. Moreover, cows on that farm had 1.4-fold greater β-hydroxybutyrate concentrations. Our results emphasize the value of assessing oxidative status with regard to both the pro- and antioxidative sides, and support the association between oxidative and metabolic status. Further investigations are needed to determine the applicability of OSi as a prognostic tool during early lactation and to determine which factors have the greatest influence on oxidative status.

[Injuries of the acromioclavicular joint in athletes]

Acromioclavicular joint (ACJ) dislocation is a common injury to the shoulder girdle, especially in contact and high velocity sports. Besides the severity of the injury, and particularly in competitive and elite athletes and the type of sports, individual career plans and in and out of season injuries have to be taken into account when advising treatment for athletes. Conservative treatment is reserved for low-grade dislocations and in-season athletes. The aim is fast pain relief and a safe return to competitive sport. High-grade ACJ dislocations in athletes should be treated surgically. Arthroscopic and arthroscopically-assisted techniques can offer a lower risk of infection, a higher patient acceptance in terms of cosmetic perspectives and the potential to treat concomitant glenohumeral lesions and may avoid potential disadvantages of open techniques, such as secondary obligatory implant removal and extensive soft tissue preparation with a relevant approach morbidity.

Musicians have fine-tuned neural distinction of speech syllables

One of the benefits musicians derive from their training is an increased ability to detect small differences between sounds. Here, we asked whether musicians' experience discriminating sounds on the basis of small acoustic differences confers advantages in the subcortical differentiation of closely related speech sounds (e.g., /ba/ and /ga/), distinguishable only by their harmonic spectra (i.e., their second formant trajectories). Although the second formant is particularly important for distinguishing stop consonants, auditory brainstem neurons do not phase-lock to its frequency range (above 1000 Hz). Instead, brainstem neurons convert this high-frequency content into neural response timing differences. As such, speech tokens with higher formant frequencies elicit earlier brainstem responses than those with lower formant frequencies. By measuring the degree to which subcortical response timing differs to the speech syllables /ba/, /da/, and /ga/ in adult musicians and nonmusicians, we reveal that musicians demonstrate enhanced subcortical discrimination of closely related speech sounds. Furthermore, the extent of subcortical consonant discrimination correlates with speech-in-noise perception. Taken together, these findings show a musician enhancement for the neural processing of speech and reveal a biological mechanism contributing to musicians' enhanced speech perception in noise.

Frequency-dependent effects of background noise on subcortical response timing

The addition of background noise to an auditory signal delays brainstem response timing. This effect has been extensively documented using manual peak selection. Peak picking, however, is impractical for large-scale studies of spectrotemporally complex stimuli, and leaves open the question of whether noise-induced delays are frequency-dependent or occur across the frequency spectrum. Here we use an automated, objective method to examine phase shifts between auditory brainstem responses to a speech sound (/da/) presented with and without background noise. We predicted that shifts in neural response timing would also be reflected in frequency-specific phase shifts. Our results indicate that the addition of background noise causes phase shifts across the subcortical response spectrum (70-1000 Hz). However, this noise-induced delay is not uniform such that some frequency bands show greater shifts than others: low-frequency phase shifts (300-500 Hz) are largest during the response to the consonant-vowel formant transition (/d/), while high-frequency shifts (720-1000 Hz) predominate during the response to the steady-state vowel (/a/). Most importantly, phase shifts occurring in specific frequency bands correlate strongly with shifts in the latencies of the predominant peaks in the auditory brainstem response, while phase shifts in other frequency bands do not. This finding confirms the validity of phase shift detection as an objective measure of timing differences and reveals that this method detects noise-induced shifts in timing that may not be captured by traditional peak latency measurements.

Context-dependent encoding in the auditory brainstem subserves enhanced speech-in-noise perception in musicians

Musical training strengthens speech perception in the presence of background noise. Given that the ability to make use of speech sound regularities, such as pitch, underlies perceptual acuity in challenging listening environments, we asked whether musicians' enhanced speech-in-noise perception is facilitated by increased neural sensitivity to acoustic regularities. To this aim we examined subcortical encoding of the same speech syllable presented in predictable and variable conditions and speech-in-noise perception in 31 musicians and nonmusicians. We anticipated that musicians would demonstrate greater neural enhancement of speech presented in the predictable compared to the variable condition than nonmusicians. Accordingly, musicians demonstrated more robust neural encoding of the fundamental frequency (i.e., pitch) of speech presented in the predictable relative to the variable condition than nonmusicians. The degree of neural enhancement observed to predictable speech correlated with subjects' musical practice histories as well as with their speech-in-noise perceptual abilities. Taken together, our findings suggest that subcortical sensitivity to speech regularities is shaped by musical training and may contribute to musicians' enhanced speech-in-noise perception.

[Arthroscopic stabilization of acute acromioclavicular joint dislocation]

During the past few years arthroscopic and minimal invasive techniques for stabilization of acromioclavicular (AC) joint dislocations have gained increasing interest. Well established procedures for open surgery were modified and implemented to attain an arthroscopic level. Furthermore implants were developed which enable these reconstructive techniques to be performed arthroscopically without the disadvantages of open procedures. The short to mid-term results described so far concerning the clinical and radiological outcome of arthroscopic stabilization techniques show an at least equal outcome to those presented in open surgery.

Exploring the relationship between physiological measures of cochlear and brainstem function

OBJECTIVE

Otoacoustic emissions and the speech-evoked auditory brainstem response are objective indices of peripheral auditory physiology that are used clinically for assessing hearing function. While each measure has been extensively explored, their interdependence and the relationships between them remain relatively unexplored.

METHODS

Distortion product otoacoustic emissions (DPOAEs) and speech-evoked auditory brainstem responses (sABRs) were recorded from 28 normal-hearing adults. Through correlational analyses, DPOAE characteristics were compared to measures of sABR timing and frequency encoding. Data were organized into two DPOAE (Strength and Structure) and five brainstem (Onset, Spectrotemporal, Harmonics, Envelope Boundary, and Pitch) composite measures.

RESULTS

DPOAE Strength shows significant relationships with sABR Spectrotemporal and Harmonics measures. DPOAE Structure shows significant relationships with sABR Envelope Boundary. Neither DPOAE Strength nor Structure is related to sABR Pitch.

CONCLUSIONS

The results of the present study show that certain aspects of the speech-evoked auditory brainstem responses are related to, or covary with, cochlear function as measured by distortion product otoacoustic emissions.

SIGNIFICANCE

These results form a foundation for future work in clinical populations. Analyzing cochlear and brainstem function in parallel in different clinical populations will provide a more sensitive clinical battery for identifying the locus of different disorders (e.g., language based learning impairments, hearing impairment).

Deficient brainstem encoding of pitch in children with Autism Spectrum Disorders

OBJECTIVE

Deficient prosody is a hallmark of the pragmatic (socially contextualized) language impairment in Autism Spectrum Disorders (ASD). Prosody communicates emotion and intention and is conveyed through acoustic cues such as pitch contour. Thus, the objective of this study was to examine the subcortical representations of prosodic speech in children with ASD.

METHODS

Using passively evoked brainstem responses to speech syllables with descending and ascending pitch contours, we examined sensory encoding of pitch in children with ASD who had normal intelligence and hearing and were age-matched with typically developing (TD) control children.

RESULTS

We found that some children on the autism spectrum show deficient pitch tracking (evidenced by increased Frequency and Slope Errors and reduced phase locking) compared with TD children.

CONCLUSIONS

This is the first demonstration of subcortical involvement in prosody encoding deficits in this population of children.

SIGNIFICANCE

Our findings may have implications for diagnostic and remediation strategies in a subset of children with ASD and open up an avenue for future investigations.

On the relationship between speech- and nonspeech-evoked auditory brainstem responses

Auditory brainstem response (ABR) reflects activation of the neural generators along the ascending auditory pathway when a sound is heard. In this study, we explored the relationship between brainstem encoding of click and speech signals in normal-learning children and in those with language-based learning problems. To that end, ABR was recorded from both types of stimuli. We found that the normal pattern of correlation between click- and speech-evoked ABRs was disrupted when speech-evoked ABRs were delayed. Thus, delayed responses to speech were not indicative of clinically abnormal responses to clicks. We conclude that these two responses reflect largely separate neural processes and that only processes involved in encoding complex signals such as speech are impaired in children with learning problems.

Abnormal neural encoding of repeated speech stimuli in noise in children with learning problems

OBJECTIVES

This study investigated whether neurophysiologic responses to repeated speech stimuli, presented in quiet and noise, differed between normal children (NL) and children with learning problems (LP).

METHODS

Subjects were normal-hearing, school-age children. NL subjects scored significantly better than LP subjects on measures of reading, spelling and speech sound discrimination. Stimuli (40 ms /da/) were presented to the right ear at 80 dB SPL. Stimuli were presented in trains of four, separated within trains by 360 ms. The interval between trains was 1060 ms. Stimuli were presented in quiet and in white noise (S/N+15). Cortical responses were recorded from an electrode placed along the midline at Cz.

RESULTS

Correlations between the first and 4th responses were lower in noise than in quiet for LP subjects only. Response correlations in quiet were no different between groups. There were no root-mean-square (RMS) amplitude differences between groups.

CONCLUSIONS

Response correlation in noise suggested that the LP population consisted of two subgroups, one whose responses appeared relatively normal, and another whose responses were severely degraded by repetition in noise. Response correlations in noise were related to behavioral measures of auditory processing and spelling. These findings suggest that abnormal, asynchronous, auditory cortical encoding may underlie some language-based learning problems.

Auditory pathway encoding and neural plasticity in children with learning problems

An inability to process auditory information, especially speech, characterizes many children with learning and attention problems. Our working hypothesis is that these speech-sound perception problems arise, at least in some cases, from faulty representation of the speech signal in central auditory centers. Preconscious neurophysiologic representation of sound structure by central auditory pathway neurons can be reflected by subcortical and cortical aggregate neural responses. These neurophysiologic responses can be modified by perceptual learning. Our research has shown that some children with learning problems demonstrate abnormal perception and neural representation of certain speech sounds. Differences between normal and learning-impaired groups can be attributable to aspects of neural synchrony that are reflected in aggregate neural responses. Deficiencies in neural synchrony in these children are apparent in subcortical (as well as cortical) representations of speech-sound structure, and these timing deficits are related to performance on speech-sound perception and learning measures. Moreover, impaired perception and neurophysiologic encoding of speech sounds can be improved with cue enhancement and can be modified by perceptual learning associated with auditory training.

Long-term habituation of the speech-elicited mismatch negativity

A significant issue in the use of the mismatch negativity evoked potential (MMN) concerns its low signal-to-noise ratio (SNR). One can improve the noise level by increasing the number of samples included in the averaged response. However, improvement achieved in this way assumes that the signal, the MMN, remains stable for extended test times, an assumption which has not been tested. If the MMN is not stable, or exhibits habituation over the test session, then SNR would be adversely affected. MMN response magnitude was measured in 5-min intervals over the course of a test session in response to various speech syllable contrasts. Significant long-term habituation of MMN was observed for all three subject populations tested: young adults, school-age children, and guinea pigs. The time course of the habituation and the stimulus conditions under which it occurs have important implications for research and clinical applications of the MMN. Recording procedures that minimize habituation effects may be used to advantage to improve the signal-to-noise ratio of the MMN.

Neurobiologic responses to speech in noise in children with learning problems: deficits and strategies for improvement

OBJECTIVES

Some children with learning problems (LP) experience speech-sound perception deficits that worsen in background noise. The first goal was to determine whether these impairments are associated with abnormal neurophysiologic representation of speech features in noise reflected at brain-stem and cortical levels. The second goal was to examine the perceptual and neurophysiological benefits provided to an impaired system by acoustic cue enhancements.

METHODS

Behavioral speech perception measures (just noticeable difference scores), auditory brain-stem responses, frequency-following responses and cortical-evoked potentials (P1, N1, P1', N1') were studied in a group of LP children and compared to responses in normal children.

RESULTS

We report abnormalities in the fundamental sensory representation of sound at brain-stem and cortical levels in the LP children when speech sounds were presented in noise, but not in quiet. Specifically, the neurophysiologic responses from these LP children displayed a different spectral pattern and lacked precision in the neural representation of key stimulus features. Cue enhancement benefited both behavioral and neurophysiological responses.

CONCLUSIONS

Overall, these findings contribute to our understanding of the preconscious biological processes underlying perception deficits and may assist in the design of effective intervention strategies.

Central auditory plasticity: changes in the N1-P2 complex after speech-sound training

OBJECTIVE

To determine whether the N1-P2 complex reflects training-induced changes in neural activity associated with improved voice-onset-time (VOT) perception.

DESIGN

Auditory cortical evoked potentials N1 and P2 were obtained from 10 normal-hearing young adults in response to two synthetic speech variants of the syllable /ba/. Using a repeated measures design, subjects were tested before and after training both behaviorally and neurophysiologically to determine whether there were training-related changes. In between pre- and post-testing sessions, subjects were trained to distinguish the -20 and -10 msec VOT /ba/ syllables as being different from each other. Two stimulus presentation rates were used during electrophysiologic testing (390 msec and 910 msec interstimulus interval).

RESULTS

Before training, subjects perceived both the -20 msec and -10 msec VOT stimuli as /ba/. Through training, subjects learned to identify the -20 msec VOT stimulus as "mba" and -10 msec VOT stimulus as "ba." As subjects learned to correctly identify the difference between the -20 msec and -10 msec VOT syllabi, an increase in N1-P2 peak-to-peak amplitude was observed. The effects of training were most obvious at the slower stimulus presentation rate.

CONCLUSIONS

As perception improved, N1-P2 amplitude increased. These changes in waveform morphology are thought to reflect increases in neural synchrony as well as strengthened neural connections associated with improved speech perception. These findings suggest that the N1-P2 complex may have clinical applications as an objective physiologic correlate of speech-sound representation associated with speech-sound training.

Speech-evoked neurophysiologic responses in children with learning problems: development and behavioral correlates of perception

OBJECTIVES

To evaluate the maturational progression of speech-evoked P1/N1/N2 cortical responses over the life span, determine whether responses are distinctive in clinical populations experiencing learning problems and elucidate the functional significance of these responses.

DESIGN

The P1/N1/N2 complex was measured in 150 normal subjects (5 to 78 yr) and 86 subjects with learning problems (LP) (8 to 15 yr) to a synthetic CV syllable. Analyses included description and comparison of the developmental time course in both groups and evaluation of the relationship between P1/N1/N2 and children's performance on speech discrimination tasks and standardized learning measures.

RESULTS

Findings revealed significant changes in waveform morphology, latency and amplitude as a function of age. Maturational patterns in the group of children with learning problems did not differ from the normal group. P1/N1/N2 parameters were significantly correlated with standardized tests of Spelling, Auditory Processing and Listening Comprehension in the LP group. Moreover, there was a predictive relationship between Auditory Processing and N2 latency.

CONCLUSIONS

The P1/N1/N2 complex changes throughout life from school-age to old age. The developmental sequence throughout the school-age years is similar in normal and LP children. Thus, differences in the rate of P1/Nl/N2 latency and amplitude development do not appear to be distinctive in these two populations. The relationship between P1/N1/N2 parameters and standardized measures of learning (particularly between Auditory Processing and N2 latency) provides new information about the role of these responses in hearing and highlights the potential value in characterizing auditory processing deficits.

Neural representation of consciously imperceptible speech sound differences

The concept of subliminal perception has been a subject of interest and controversy for decades. Of interest in the present investigation was whether a neurophysiologic index of stimulus change could be elicited to speech sound contrasts that were consciously indiscriminable. The stimuli were chosen on the basis of each individual subject's discrimination threshold. The speech stimuli (which varied along an F3 onset frequency continuum from /da/ to /ga/) were synthesized so that the acoustical properties of the stimuli could be tightly controlled. Subthreshold and suprathreshold stimuli were chosen on the basis of behavioral ability demonstrated during psychophysical testing. A significant neural representation of stimulus change, reflected by the mismatch negativity response, was obtained in all but 1 subject in response to subthreshold stimuli. Grand average responses differed significantly from responses obtained in a control condition consisting of physiologic responses elicited by physically identical stimuli. Furthermore, responses to suprathreshold stimuli (close to threshold) did not differ significantly from subthreshold responses with respect to latency, amplitude, or area. These results suggest that neural representation of consciously imperceptible stimulus differences occurs and that this representation occurs at a preattentive level.

Speech sound representation in the brain

Biologic processes underlying speech sound perception and learning have been addressed using the mismatch negativity (MMN) evoked response. First is a consideration of how the acoustic properties of the signal affect the neural mechanisms and brain regions engaged. Because the MMN differs depending on the acoustic characteristics of the stimuli used to elicit the response, it has been used to probe mechanisms underlying the neural representation of stimuli along the auditory pathway. Second is a consideration of neurophysiologic correlates of speech sound perception and learning. Detailed is a 'behavioral-neurophysiologic, acoustic-phonetic approach', used to link perception with underlying physiologic processes in humans. The focus here is on children and what has been learned about normal maturation of speech sound perception and its disruption in certain children with learning disorders. The last topic is a consideration of central nervous system changes with perceptual learning. This includes long-term experience with one's native language and short-term auditory training in the laboratory. Limitations and future challenges are discussed.

Consequences of neural asynchrony: a case of auditory neuropathy

The neural representation of sensory events depends upon neural synchrony. Auditory neuropathy, a disorder of stimulus-timing-related neural synchrony, provides a model for studying the role of synchrony in auditory perception. This article presents electrophysiological and behavioral data from a rare case of auditory neuropathy in a woman with normal hearing thresholds, making it possible to separate audibility from neuropathy. The experimental results, which encompass a wide range of auditory perceptual abilities and neurophysiologic responses to sound, provide new information linking neural synchrony with auditory perception. Findings illustrate that optimal eighth nerve and auditory brainstem synchrony do not appear to be essential for understanding speech in quiet listening situations. However, synchrony is critical for understanding speech in the presence of noise.

Aging affects hemispheric asymmetry in the neural representation of speech sounds

Hemispheric asymmetries in the processing of elemental speech sounds appear to be critical for normal speech perception. This study investigated the effects of age on hemispheric asymmetry observed in the neurophysiological responses to speech stimuli in three groups of normal hearing, right-handed subjects: children (ages, 8-11 years), young adults (ages, 20-25 years), and older adults (ages > 55 years). Peak-to-peak response amplitudes of the auditory cortical P1-N1 complex obtained over right and left temporal lobes were examined to determine the degree of left/right asymmetry in the neurophysiological responses elicited by synthetic speech syllables in each of the three subject groups. In addition, mismatch negativity (MMN) responses, which are elicited by acoustic change, were obtained. Whereas children and young adults demonstrated larger P1-N1-evoked response amplitudes over the left temporal lobe than over the right, responses from elderly subjects were symmetrical. In contrast, MMN responses, which reflect an echoic memory process, were symmetrical in all subject groups. The differences observed in the neurophysiological responses were accompanied by a finding of significantly poorer ability to discriminate speech syllables involving rapid spectrotemporal changes in the older adult group. This study demonstrates a biological, age-related change in the neural representation of basic speech sounds and suggests one possible underlying mechanism for the speech perception difficulties exhibited by aging adults. Furthermore, results of this study support previous findings suggesting a dissociation between neural mechanisms underlying those processes that reflect the basic representation of sound structure and those that represent auditory echoic memory and stimulus change.

Mismatch negativity (MMN) as a tool for investigating auditory discrimination and sensory memory in infants and children

For decades behavioral methods, such as the head-turning or sucking paradigms, have been the primary methods to investigate auditory discrimination, learning and the function of sensory memory in infancy and early childhood. During recent years, however, a new method for investigating these issues in children has emerged. This method makes use of the mismatch negativity (MMN), the brain's automatic change-detection response, which has been used intensively in both basic and clinical studies in adults for twenty years. This review demonstrates that, unlike many other components of event-related potentials, the MMN is developmentally quite stable and can be obtained even from pre-term infants. Further, MMN amplitude is only slightly smaller in infants than is usually reported in school-age children and it does not seem to differ much from that obtained in adults. MMN latency has been reported to be slightly longer in infants than in adults but reaches adult values by the early school-age years. Child MMN does not seem to be analogous to adult MMN, however. For example, contrary to the results of adult studies, a prominent MMN can be obtained from in all waking- and sleep states in infants. Moreover, MMN scalp distribution seems to be broader and more central in children than in adults.

Effects of lengthened formant transition duration on discrimination and neural representation of synthetic CV syllables by normal and learning-disabled children

In order to investigate the precise acoustic features of stop consonants that pose perceptual difficulties for some children with learning problems, discrimination thresholds along two separate synthetic /da-ga/ continua were compared in a group of children with learning problems (LP) and a group of normal children. The continua differed only in the duration of the formant transitions. Results showed that simply lengthening the formant transition duration from 40 to 80 ms did not result in improved discrimination thresholds for the LP group relative to the normal group. Consistent with previous findings, an electrophysiologic response that is known to reflect the brain's representation of a change from one auditory stimulus to another--the mismatch negativity (MMN)--indicated diminished responses in the LP group relative to the normal group to /da/ versus /ga/ when the transition duration was 40 ms. In the lengthened transition duration condition the MMN responses from the LP group were more similar to those from the normal group, and were enhanced relative to the short transition duration condition. These data suggest that extending the duration of the critical portion of the acoustic stimulus can result in enhanced encoding at a preattentive neural level; however, this stimulus manipulation on its own is not a sufficient acoustic enhancement to facilitate increased perceptual discrimination of this place-of-articulation contrast.

Speech-sound discrimination in school-age children: psychophysical and neurophysiologic measures

This study measured behavioral speech-sound discrimination and a neurophysiologic correlate of discrimination in normal school-age children (ages 6 to 15) to determine if developmental effects exist. Just noticeable differences (JNDs) and mismatch responses (MMNs) were assessed for synthetic syllables that differed in third-formant onset frequency (/da-ga/) and formant transition duration (/ba-wa/). These stimuli were selected because children with learning problems often find it difficult to discriminate rapid spectrotemporal changes like /da-ga/, whereas the ability to distinguish /ba-wa/ is relatively unimpaired. Results indicate that JNDs for /da-ga/ show no developmental effects and that JNDs for /ba-wa/ decrease slightly with age (although likely for task-related reasons). MMNs elicited by two /da-ga/ stimulus pairs (onset frequency differences = 20 Hz, 280 Hz) and three /ba-wa/ stimulus pairs (transition duration differences = 3, 5, 15 ms) showed no systematic or significant differences for onset latency, duration, or area as a function of age. Normative JND and MMN data are provided. These norms provide a metric against which children with suspected central auditory processing difficulties or auditory-based language disorders can be compared.

Acoustic-phonetic approach toward understanding neural processes and speech perception

This review paper describes an "acoustic-phonetic" experimental approach aimed at understanding normal and abnormal speech perception processes from both a behavioral and an electrophysiologic perspective. First, we consider the relevant acoustic characteristics of speech and identify a set of acoustic-phonetic classes that represent the parameters most important for making an acoustic signal sound like speech. Second, we review what is known about the neurophysiologic representation of acoustic-phonetic speech parameters in animal and human subjects. Third, we describe how an acoustic-phonetic approach has been useful in understanding the biologic basis of some auditory learning problems in children and in characterizing the behavioral and neurophysiologic changes resulting from speech-sound training. Finally, we discuss these findings and how they may expand the diagnostic and rehabilitative repertoire of practicing audiologists.

Thalamic asymmetry is related to acoustic signal complexity

Hemispheric asymmetries in response to speech sounds are well documented. However, it is not known if these asymmetries reflect only cortical hemispheric specialization to language or whether they also reflect pre-conscious encoding of signals at lower levels of the auditory pathway. This study examined differences in neural representations of signals with acoustic properties inherent to speech in the left versus right side of the thalamus. Specifically, 2000 Hz tone bursts, clicks and synthesized forms of the phoneme /da/ were presented to anesthetized guinea pigs. Evoked responses were recorded simultaneously from aggregate cell groups in the left and right medial geniculate bodies. Results showed an asymmetric response to complex auditory stimuli between the left versus right auditory thalamus, but not to the simple tonal signal. Moreover, asymmetries differed in male versus female animals.

Speech sound perception and learning: biologic bases

Historically, auditory research has focused predominantly on how relatively simple acoustic signals are represented in the neuronal responses of the auditory periphery. However, in order to understand the neurophysiology underlying speech perception, the ultimate objective is to discover how speech sounds are represented in the central auditory system and to relate that representation to the perception of speech as a meaningful acoustic signal. This paper reviews three areas pertaining to the central auditory representation of speech: (1) the differences in neural representation of speech sounds at different levels of the auditory system, (2) the relation between the representation of sound in the auditory pathway and the perception/misperception of speech, and (3) the plasticity of speech-sound neural representation and speech perception.

Speech sound perception, neurophysiology, and plasticity

An approach to understanding biological processes underlying speech perception, is to discover how speech sounds are represented in the central auditory system and to relate that representation to the perception of speech as a meaningful acoustic signal. Research from our group that pertains to the neurophysiologic representation of speech in the central pathways is reviewed here. Specifically considered is the relation between the representation of sound in the auditory pathway and the perception/misperception of speech, and neurophysiologic plasticity associated with speech-sound perceptual learning.

The time course of auditory perceptual learning: neurophysiological changes during speech-sound training

Here we report that training-associated changes in neural activity can precede behavioral learning. This finding suggests that speech-sound learning occurs at a pre-attentive level which can be measured neurophysiologically (in the absence of a behavioral response) to assess the efficacy of training. Children with biologically based perceptual learning deficits as well as people who wear cochlear implants or hearing aids undergo various forms of auditory training. The effectiveness of auditory training can be difficult to assess using behavioral methods because these populations are communicatively impaired and may have attention and/or cognitive deficits. Based on our findings, if neurophysiological changes are seen during auditory training, then the training method is effectively altering the neural representation of the speech/sounds and changes in behavior are likely to follow.

Molecular cloning of cDNA encoding the alpha unit of CNGC gene from human fetal heart

Cyclic nucleotide-gated ion channels (CNGCs) play crucial roles in visual and olfactory signal transduction. As a first step to explore the presence of a CNGC gene in human heart, we cloned a human heart CNGC gene. The sequence consists of 111 bp 5' non-coding region and a 2064 bp open reading frame which is followed by a 459 bp 3' non-coding region. The predicted protein consists of 688 amino acids with a short highly charged segment rich in lysine and glutamate. Sequence comparison indicates that the human heart cDNA is almost identical to the retinal rod photo receptor CNGC cDNA. However, the human cardiac cDNA is lacking a 205 bp Alu fragment in the 5'-uncoding region, has a glutamic acid residue at amino acid position 129, and has a replacement of glutamic acid with a lysine residue at amino acid position 99. Data obtained with northern blot analysis confirm the presence of RNA for the CNGC alpha chain. This channel might play a role in cyclic nucleotide-mediated cellular processes, such as the inotropic effect in the heart.

Speech sound representation, perception, and plasticity: a neurophysiologic perceptive

Historically, auditory research has focused predominately upon how relatively simple acoustic signals are represented in the neuronal responses of the auditory periphery. However, in order to understand the neurophysiology underlying speech perception, the ultimate objective is to discover how speech sounds are represented in the central auditory system and to relate that representation to the perception of speech as a meaningful acoustic signal. This paper reviews three areas that pertain to the central auditory representation of speech: (1) the differences in neural representation of speech sounds at different levels of the auditory system; (2) the relation between the representation of sound in the auditory pathway and the perception/misperception of speech, and (3) the training-related plasticity of speech sound neural representation and speech perception.

Central auditory system plasticity: generalization to novel stimuli following listening training

Behavioral perceptual abilities and neurophysiologic changes observed after listening training can generalize to other stimuli not used in the training paradigm, thereby demonstrating behavioral "transfer of learning" and plasticity in underlying physiologic processes. Nine normal-hearing monolingual English-speaking adults were trained to identify a prevoiced labial stop sound (one that is not used phonemically in the English language). After training, the subjects were asked to discriminate and identify a prevoiced alveolar stop. Mismatch negativity cortical evoked responses (MMN) were recorded to both labial and alveolar stimuli before and after training. Behavioral performance and MMNs also were evaluated in an age-matched control group that did not receive training. Listening training improved the experimental group's ability to discriminate and identify an unfamiliar VOT contrast. That enhanced ability transferred from one place of articulation (labial) to another (alveolar). The behavioral training effects were reflected in the MMN, which showed an increase in duration and area when elicited by the training stimuli as well as a decrease in onset latency when elicited by the transfer stimuli. Interestingly, changes in the MMN were largest over the left hemisphere. The results demonstrate that training can generalize to listening situations beyond those used in training sessions, and that the preattentive central neurophysiology underlying perceptual learning are altered through auditory training.

Developmental changes in P1 and N1 central auditory responses elicited by consonant-vowel syllables

Normal maturation and functioning of the central auditory system affects the development of speech perception and oral language capabilities. This study examined maturation of central auditory pathways as reflected by age-related changes in the P1/N1 components of the auditory evoked potential (AEP). A synthesized consonant-vowel syllable (ba) was used to elicit cortical AEPs in 86 normal children ranging in age from 6 to 15 years and ten normal adults. Distinct age-related changes were observed in the morphology of the AEP waveform. The adult response consists of a prominent negativity (N1) at about 100 ms, preceded by a smaller P1 component at about 50 ms. In contrast, the child response is characterized by a large P1 response at about 100 ms. This wave decreases significantly in latency and amplitude up to about 20 years of age. In children, P1 is followed by a broad negativity at about 200 ms which we term N1b. Many subjects (especially older children) also show an earlier negativity (N1a). Both N1a and N1b latencies decrease significantly with age. Amplitudes of N1a and N1b do not show significant age-related changes. All children have the N1b; however, the frequency of occurrence of N1a increases with age. Data indicate that the child P1 develops systematically into the adult response; however, the relationship of N1a and N1b to the adult N1 is unclear. These results indicate that maturational changes in the central auditory system are complex and extend well into the second decade of life.

Is it really a mismatch negativity? An assessment of methods for determining response validity in individual subjects

Mismatch negativity (MMN) responses were collected from 86 normal school-age children in response to synthesized speech syllables, /wa/and two variants of /ba/. Waveform characteristics and statistical properties of the responses were analyzed across stimulus conditions in order to assess methods for determining response validity in individuals. Methods were compared using signal detection theory techniques. Criteria based on measurements of response area, onset latency, and duration were the best indicators of response validity. Also a promising indicator of validity was the interval of significance based on Z transformations determined by considering the variance of the underlying noise distribution. Correlations of individual responses with the grand average and integral calculations of the response negativity showed somewhat lower d' values. Statistical methods which utilized response subaverages were the poorest indicators of response validity. Likely the methods are limited primarily by the signal to noise ratio of the MMN compared to the underlying physiologic noise. Improvement of the signal to noise ratio remains a significant factor in the interpretation of MMN for individual subjects.

Auditory neurophysiologic responses and discrimination deficits in children with learning problems

Children with learning problems often cannot discriminate rapid acoustic changes that occur in speech. In this study of normal children and children with learning problems, impaired behavioral discrimination of a rapid speech change (/dalpha/versus/galpha/) was correlated with diminished magnitude of an electrophysiologic measure that is not dependent on attention or a voluntary response. The ability of children with learning problems to discriminate another rapid speech change (/balpha/versus/walpha/) also was reflected in the neurophysiology. These results indicate that some children's discrimination deficits originate in the auditory pathway before conscious perception and have implications for differential diagnosis and targeted therapeutic strategies for children with learning disabilities and attention disorders.

Acoustic elements of speechlike stimuli are reflected in surface recorded responses over the guinea pig temporal lobe

Auditory evoked potentials measured from the guinea pig temporal lobe surface reflect acoustic elements of synthesized speech syllables. Eliciting stimuli included a four formant anchor stimulus /ba/, with a 40-ms formant transition duration. The other stimuli differed from /ba/ along simple acoustic dimensions. The /pa/ stimuli differed on a VOT continuum; /da/ stimuli had a higher frequency F2 onset; /wa/ had a longer (80 ms) formant transition duration; and /bi/ differed in three vowel formant frequencies. The /ba/ and /da/ onset response latencies decreased systematically with increasing F2 onset frequency. The response to the /pa/ voicing increased in latency with increasing VOT and showed a physiologic discontinuity at VOT of 15-20 ms. Responses to /ba/ and /wa/ showed similar onset morphology but significant amplitude differences at latencies corresponding to vowel onset. Significant amplitude differences in /ba/ and /bi/ responses corresponded in latency to both consonant and vowel portions of the syllables. Similar to previous reports in the awake monkey for VOT, these results demonstrate in the anesthetized guinea pig that acoustic elements essential to speech perception are reflected in aggregate response of ensembles of cortical neurons.