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López JR, Legatt AD. Monitoring surgery around the cranial nerves. Handb Clin Neurol 2022; 186:319-351. [PMID: 35772894 DOI: 10.1016/b978-0-12-819826-1.00020-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Intraoperative neurophysiologic monitoring (IONM) of cranial nerve (CN) function is an essential component in multimodality monitoring of surgical procedures where CNs are at risk for injury. In most cases, IONM consists of localizing and mapping CNs and their pathways, and monitoring of CN motor function during surgery. However, CN VIII, which has no motor function, and is at risk for injury in many surgical procedures, can be easily and accurately monitored using brainstem auditory evoked potentials. For motor CNs, the literature is clear that function can be safely and adequately performed using basic electromyographic (EMG) techniques, such as recording of continuous EMG activity and electrically evoked compound muscle actions potentials. Newer techniques, such as corticobulbar motor evoked potentials and reflex studies, show good potential for a greater degree of functional assessment but require further study to determine their clinical utility. EMG remains the basic clinical neurophysiologic technique with the greatest clinical research supporting its utility in IONM of motor CN function and should be used as part of a comprehensive multimodality IONM protocol. Understanding the physiologic basis of EMG and the changes associated with altered motor function will allow the practitioner to alter surgical course to prevent injury and improve patient safety.
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Affiliation(s)
- Jaime R López
- Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford, CA, United States.
| | - Alan D Legatt
- Department of Neurology, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, NY, United States
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Lu Z, Ding S, Wang F, Lv H. Corrigendum: Analysis on the MRI and BAEP results of neonatal brain with different levels of bilirubin. Front Pediatr 2022; 10:1042985. [PMID: 36389364 PMCID: PMC9644200 DOI: 10.3389/fped.2022.1042985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 09/26/2022] [Indexed: 11/13/2022] Open
Abstract
[This corrects the article DOI: 10.3389/fped.2021.719370.].
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Affiliation(s)
- Zhongxing Lu
- Children's Hospital of Soochow University, Suzhou, China.,Neonatology Department, Changzhou Maternal and Child Health Care Hospital, Changzhou, China
| | - Shouling Ding
- Pediatrics Department, Taicang First People's Hospital, Suzhou, China
| | - Fen Wang
- Pediatrics Department, Taicang First People's Hospital, Suzhou, China
| | - Haitao Lv
- Children's Hospital of Soochow University, Suzhou, China
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Ampar N, Mehta A, Mahale RR, Javali M, Pradeep R, Acharya P, Srinivasa R. Electrophysiological Evaluation of Audiovestibular Pathway Dysfunction in Parkinson's Disease and Its Correlates: A Case Control Study. Ann Indian Acad Neurol 2021; 24:531-535. [PMID: 34728946 PMCID: PMC8513948 DOI: 10.4103/aian.aian_1011_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Revised: 11/29/2020] [Accepted: 12/04/2020] [Indexed: 11/16/2022] Open
Abstract
Background: Parkinson's disease (PD) is associated with brainstem dysfunction causing non-motor symptoms. Vestibular evoked myogenic potential (VEMP) and brainstem auditory evoked potential (BAEP) are electrophysiological tests to assess the vestibular and auditory pathways in the brainstem. Objectives: To study the abnormalities of cervical VEMP (cVEMP) and BAEP in PD and to correlate the findings with the symptoms related to brainstem involvement. Patients and Methods: cVEMP and BAEP were recorded in 25 PD patients and compared 25 age matched controls. The PD patients were assessed with the following clinical scales: REM Sleep Disorder Screening Questionnaire (RBD-SQ), Epworth Sleepiness Scale (ESS), mini-BESTest, Geriatric Depression Scale (GDS-15) and MMSE (Mini-mental state examination). The P13 and N23 peak latencies and the P13/N23 amplitude of cVEMP, the latencies of waves I, III and V, and the inter-peak latencies (IPL) of waves I-III, III-V and I-V of BAEP were measured. Results: The PD patients showed prolonged latencies and reduced amplitude in cVEMP responses. They had abnormal BAEP in the form of prolonged absolute latencies of wave V, followed by wave III and I–V IPL with no significant difference in waves I and I–III IPL. The cVEMP abnormality was correlated directly with RBD-SQ and inversely with mini-BESTest scores. There were no correlations between cVEMP/BAEP abnormality and disease severity, GDS-15, ESS and MMSE. Conclusion: PD is associated with cVEMP and BAEP abnormalities that suggest auditory and vestibular pathway dysfunction in the brainstem and cVEMP correlates with the symptoms of brainstem degeneration like RBD and postural instability.
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Affiliation(s)
- Nikith Ampar
- Department of Neurology, Ramaiah Medical College, Bangalore, India
| | - Anish Mehta
- Department of Neurology, Ramaiah Medical College, Bangalore, India
| | - Rohan R Mahale
- Department of Neurology, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
| | - Mahendra Javali
- Department of Neurology, Ramaiah Medical College, Bangalore, India
| | - R Pradeep
- Department of Neurology, Ramaiah Medical College, Bangalore, India
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Aleman MR, True A, Scalco R, Crowe CM, Costa LRR, Chigerwe M. Gentamicin-induced sensorineural auditory loss in healthy adult horses. J Vet Intern Med 2021; 35:2486-2494. [PMID: 34322916 PMCID: PMC8478042 DOI: 10.1111/jvim.16221] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2021] [Revised: 06/24/2021] [Accepted: 07/12/2021] [Indexed: 11/28/2022] Open
Abstract
Background Irreversible sensorineural auditory loss has been reported in humans treated with aminoglycosides but not in horses. Objective Investigate if auditory loss occurs in horses treated using the recommended IV daily dosage of gentamicin for 7 consecutive days. Animals Ten healthy adult horses (7‐15 years; females and males, 5 each). Methods Prospective study. Physical and neurological examinations and renal function tests were performed. Gentamicin sulfate was administered at a dosage of 6.6 mg/kg via the jugular vein on alternating sides for 7 days. Gentamicin peak and trough concentrations were measured. Horses were sedated using detomidine hydrochloride IV to perform brainstem auditory evoked responses (BAER) before the first dose, immediately after the last dose, and 30 days after the last dose. Peaks latencies, amplitudes, and amplitude ratios were recorded. Data from the second and last BAER were compared to results at baseline. Bone conduction was performed to rule out conduction disorders. Results Seven horses had auditory loss: complete bilateral (N = 1), complete unilateral (N = 2), and partial unilateral (N = 4). Based on physical examination and BAER results, sensorineural auditory loss was suspected. Absent bone conduction ruled out a conduction disorder and further supported sensorineural auditory loss in horses with completely absent BAER. Auditory dysfunction was reversible in 4 of 7 horses. Conclusions and Clinical Importance Gentamicin at recommended doses may cause sensorineural auditory loss in horses that might be irreversible. Follow‐up studies are needed to investigate if other dosing protocols present a similar risk.
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Affiliation(s)
- Monica R Aleman
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, California, USA
| | - Alexander True
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, California, USA
| | - Rebeca Scalco
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, California, USA
| | - Chelsea M Crowe
- William R. Pritchard Veterinary Medical Teaching Hospital, School of Veterinary Medicine, University of California, Davis, California, USA
| | - Lais R R Costa
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, California, USA
| | - Munashe Chigerwe
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, California, USA
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Aleman M, Crowe C, Dechant J, Bellone RR, Avila F. Brainstem auditory evoked responses and bone conduction assessment in alpacas. Res Vet Sci 2021; 136:297-302. [PMID: 33740564 DOI: 10.1016/j.rvsc.2021.02.024] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Accepted: 02/26/2021] [Indexed: 11/18/2022]
Abstract
Auditory loss has been reported in camelids using brainstem auditory evoked responses (BAER). Differentiation between conductive versus sensorineural dysfunction has not been investigated. Therefore, the objective of the study was to investigate auditory function using BAER and bone conduction (BC). Twenty-four alpacas: 15 females, 9 intact males (2-16 years of age) were included in a randomized clinical trial. BAER and BC were recorded using two derivations (vertex to mastoid and vertex to cranial aspect of second cervical vertebra). All alpacas underwent complete physical examinations and were sedated with xylazine hydrochloride at 0.6 mg/kg IM. Peaks, when present, were identified and latencies, amplitudes, and amplitude ratios were determined. Eleven alpacas had normal responses and 13 had auditory loss based on BAER. The latter consisted of complete absence of peaks bilaterally (n = 3), absence of peaks unilaterally (n = 1), delayed latencies bilaterally (n = 4), and delayed latencies unilaterally (n = 5). Distinct peaks on BC supported conductive auditory loss in 6 alpacas, difficult to interpret due to stimulus artifact and additional undefined peaks in 4, and absent peaks in 3 alpacas. The cause of auditory loss was presumed to be due to otitis in 6, aging in 4 (10-16 years old), and congenital sensorineural (absent peaks on BAER and BC) in 3 alpacas with unpigmented fiber and irises. BAER and BC are useful and non-invasive to perform techniques for the investigation of auditory loss in alpacas, and further characterization as conductive or sensorineural.
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Affiliation(s)
- M Aleman
- Department of Medicine and Epidemiology, University of California, Davis, USA; School of Veterinary Medicine, University of California, Davis, USA.
| | - C Crowe
- The William R. Pritchard Veterinary Medical Teaching Hospital, University of California, Davis, USA; School of Veterinary Medicine, University of California, Davis, USA
| | - J Dechant
- Department of Surgical and Radiological Sciences, University of California, Davis, USA; School of Veterinary Medicine, University of California, Davis, USA
| | - R R Bellone
- Veterinary Genetics Laboratory, University of California, Davis, USA; Department of Population Health and Reproduction, University of California, Davis, USA; School of Veterinary Medicine, University of California, Davis, USA
| | - F Avila
- Veterinary Genetics Laboratory, University of California, Davis, USA; School of Veterinary Medicine, University of California, Davis, USA
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Lu Z, Ding S, Wang F, Lv H. Analysis on the MRI and BAEP Results of Neonatal Brain With Different Levels of Bilirubin. Front Pediatr 2021; 9:719370. [PMID: 35174111 PMCID: PMC8842724 DOI: 10.3389/fped.2021.719370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Accepted: 10/28/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND To explore whether there is abnormality of neonatal brains' MRI and BAEP with different bilirubin levels, and to provide an objective basis for early diagnosis on the bilirubin induced subclinical damage on brains. METHODS To retrospectively analyze the clinical data of 103 neonatal patients, to conduct routine brain MRI examination and BAEP testing, and to analyze BAEP and MRI image results of the neonatal patients, who were divided into three groups based on the levels of total serum bilirubin concentration (TSB): 16 cases in mild group (TSB: 0.0-229.0 ěmol/L), 49 cases in moderate group (TSB: 229.0-342.0 ěmol/L), and 38 cases in severe group (TSB ≥ 342.0 ěmol/L). RESULTS We found the following: A. Comparison of the bilirubin value of the different group: The bilirubin value of the mild group is 171.99 ± 33.50 ěmol/L, the moderate group is 293.98 ± 32.09 ěmol/L, and the severe group is 375.59 ± 34.25 ěmol/L. The comparison of bilirubin values of the three groups of neonates (p < 0.01) indicates the difference is statistically significant (p < 0.01). B. The weight value of the <2,500 g group is 2.04 ± 0.21 and the ≥2,500 g group is 3.39 ± 0.46; the weight comparison of the two groups indicates that the difference is statistically significant (p < 0.01). C. Comparison of the abnormal MRI of the different groups: The brain MRI result's abnormal ratio of the mild group is 31.25%, the moderate group is 16.33%, and the severe group is 21.05%, but the comparison of brain MRI results of the three neonates groups indicates that the difference is not statistically significant (p > 0.05). D. Comparison of abnormal MRI signal values of globus pallidus on T1WI in different groups: 1. The comparison of normal group signal values with that of mild group (p < 0.05), with that of moderate group, and with that of severe group (p < 0.01) indicates that the difference is statistically significant. CONCLUSION At low level of bilirubin, central nervous system damage may also occur and can be detected as abnormality by MRI and BAEP. Meanwhile, MRI and BAEP can also provide early abnormal information for the judgment of central nervous system damage of the children with NHB who have no acute bilirubin encephalopathy (ABE) clinical features, and provide clues for early treatment and early intervention.
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Affiliation(s)
- Zhongxing Lu
- Neonatology Department, Changzhou Maternal and Child Health Care Hospital, Changzhou, China
| | - Shouling Ding
- Pediatrics Department, Taicang First People's Hospital, Changzhou, China
| | - Fen Wang
- Pediatrics Department, Taicang First People's Hospital, Changzhou, China
| | - Haitao Lv
- Children's Hospital, Soochow University, Changzhou, China
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Abstract
Objectives: The association of hypothyroidism with impairment of hearing is known to occur. It may be of any kind i. e., conductive, sensorineural or mixed. The aim of this study is to assess auditory pathway by brainstem auditory evoked potential (BAEP) in newly diagnosed patients of clinical hypothyroidism and healthy sex- and age-matched controls. Materials and Methods: The study included 25 healthy age- and sex-matched controls (Group I) and 25 patients of newly diagnosed clinical hypothyroidism (Group II). The recording was taken by using RMS EMG EP MK2 equipment. Statistical Analysis Used: Unpaired Student's t test. Results: There was a significant increase in wave IV (5.16 ± 0.85 ms) and wave V (6.17 ± 0.89 ms) latencies of right ear BAEP of Group II in comparison to wave IV (4.66 ± 0.39 ms) and wave V (5.49 ± 0.26 ms) of Group I. Wave V of left ear BAEP of Group II was also prolonged (6 ± 0.61 ms) in comparison to Group I (5.47 ± 0.35 ms). There was a significant difference in inter-peak latencies IPL I -V (4.44 ± 0.66 ms) and IPL III -V (2.2 ± 0.5 ms) of right ear BAEP of Group II in comparison to IPL I -V (3.94 ± 0.31 ms) and IPL III -V (1.84 ± 0.34 ms) of Group I. A significant prolongation was also found of IPL I -V (4.36 ± 0.59 ms) and IPL III -V (2.2 ± 0.42 ms) of left ear BAEP of Group II in comparison to IPL I -V (3.89 ± 0.3 ms) and IPL III -V (1.85 ± 0.3 ms) of Group I. Conclusion: Prolongation of wave IV and V along with inter-peak latencies in BAEP of both ears suggests that central auditory pathway is affected significantly in clinical hypothyroid patients.
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Affiliation(s)
- Kirti Sharma
- Department of Physiology, Shaheed Hasan Khan Mewati Government Medical College, Nalhar, Mewat, India
| | - Naresh Kumar
- Department of Physiology, Shaheed Hasan Khan Mewati Government Medical College, Nalhar, Mewat, India
| | - Joshil Kumar Behera
- Department of Physiology, Government Medical College, Srinagar, Pauri Garhwal, Uttarakhand, India
| | - Sushma Sood
- Department of Physiology, Post Graduate Institute of Medical Sciences, Rohtak, Haryana, India
| | - Sibadatta Das
- Department of Physiology, Shaheed Hasan Khan Mewati Government Medical College, Nalhar, Mewat, India
| | - Harnam Singh Madan
- Department of Orthopedics, Shaheed Hasan Khan Mewati Government Medical College, Nalhar, Mewat, India
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Knopp M, Leese RJ, Martin-Lamb D, Rajabally YA. Optic and auditory pathway dysfunction in demyelinating neuropathies. Acta Neurol Scand 2014; 130:53-7. [PMID: 24571608 DOI: 10.1111/ane.12226] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/14/2014] [Indexed: 11/29/2022]
Abstract
OBJECTIVE The involvement of optic and auditory pathways has rarely been studied in demyelinating polyneuropathies. We here aimed to study this further in a cohort of patients with acquired and gentic demyelinating neuropathy. METHODS We studied eight patients with hereditary neuropathy with liability to pressure palsies (HNPP), six with Charcot-Marie-Tooth disease type 1A (CMT1A), ten with chronic inflammatory demyelinating polyneuropathy (CIDP) and seven with antimyelin-associated glycoprotein (MAG) neuropathy using visual evoked potentials and brainstem auditory evoked potentials. RESULTS Optic pathway dysfunction was detected in 6/7 anti-MAG neuropathy patients, about half of those with CIDP and HNPP, but only in 1/6 patients with CMT1A. Peripheral auditory nerve dysfunction appeared common in all groups except HNPP. Brainstem involvement was exceptional in all groups. CONCLUSIONS We conclude optic nerve involvement may be frequent in all demyelinating polyneuropathies, particularly anti-MAG neuropathy, except in CMT1A. Peripheral auditory nerves may be spared in HNPP possibly due to absence of local compression. Evidence for central brainstem pathology appeared infrequent in all four studied neuropathies. This study suggests that acquired and genetic demyelinating polyneuropathies may be associated with optic and auditory nerve involvement, which may contribute to neurological disability, and require greater awareness.
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Affiliation(s)
- M. Knopp
- Department of Neurology; University Hospitals of Leicester; Leicester UK
| | - R. J. Leese
- Department of Neurophysiology; University Hospitals of Leicester; Leicester UK
| | - D. Martin-Lamb
- Department of Neurophysiology; University Hospitals of Leicester; Leicester UK
| | - Y. A. Rajabally
- Department of Neurology; University Hospitals of Leicester; Leicester UK
- Department of Neurophysiology; University Hospitals of Leicester; Leicester UK
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Stevenson M, McNaughton N. A comparison of phenylketonuria with attention deficit hyperactivity disorder: do markedly different aetiologies deliver common phenotypes? Brain Res Bull 2013; 99:63-83. [PMID: 24140048 DOI: 10.1016/j.brainresbull.2013.10.003] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2013] [Revised: 09/04/2013] [Accepted: 10/07/2013] [Indexed: 01/21/2023]
Abstract
Phenylketonuria (PKU) is a well-defined metabolic disorder arising from a mutation that disrupts phenylalanine metabolism and so produces a variety of neural changes indirectly. Severe cognitive impairment can be prevented by dietary treatment; however, residual symptoms may be reported. These residual symptoms appear to overlap a more prevalent childhood disorder: Attention Deficit/Hyperactivity Disorder (ADHD). However, the aetiology of ADHD is a vast contrast to PKU: it seems to arise from a complex combination of genes; and it has a substantial environmental component. We ask whether these two disorders result from two vastly different genotypes that converge on a specific core phenotype that includes similar dysfunctions of Gray's (Gray, 1982) Behavioural Inhibition System (BIS), coupled with other disorder-specific dysfunctions. If so, we believe comparison of the commonalities will allow greater understanding of the neuropsychology of both disorders. We review in detail the aetiology, treatment, neural pathology, cognitive deficits and electrophysiological abnormalities of PKU; and compare this with selected directly matching aspects of ADHD. The biochemical and neural pathologies of PKU and ADHD are quite distinct in their causes and detail; but they result in the disorder in the brain of large amino acid levels, dopamine and white matter that are very similar and could explain the overlap of symptoms within and between the PKU and ADHD spectra. The common deficits affect visual function, motor function, attention, working memory, planning, and inhibition. For each of PKU and ADHD separately, a subset of deficits has been attributed to a primary dysfunction of behavioural inhibition. In the case of ADHD (excluding the inattentive subtype) this has been proposed to involve a specific failure of the BIS; and we suggest that this is also true of PKU. This accounts for a substantial proportion of the parallels in the superficial symptoms of both disorders and we see this as linked to prefrontal, rather than more general, dysfunction of the BIS.
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Ahveninen J, Kopčo N, Jääskeläinen IP. Psychophysics and neuronal bases of sound localization in humans. Hear Res 2013; 307:86-97. [PMID: 23886698 DOI: 10.1016/j.heares.2013.07.008] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2013] [Revised: 07/02/2013] [Accepted: 07/10/2013] [Indexed: 10/26/2022]
Abstract
Localization of sound sources is a considerable computational challenge for the human brain. Whereas the visual system can process basic spatial information in parallel, the auditory system lacks a straightforward correspondence between external spatial locations and sensory receptive fields. Consequently, the question how different acoustic features supporting spatial hearing are represented in the central nervous system is still open. Functional neuroimaging studies in humans have provided evidence for a posterior auditory "where" pathway that encompasses non-primary auditory cortex areas, including the planum temporale (PT) and posterior superior temporal gyrus (STG), which are strongly activated by horizontal sound direction changes, distance changes, and movement. However, these areas are also activated by a wide variety of other stimulus features, posing a challenge for the interpretation that the underlying areas are purely spatial. This review discusses behavioral and neuroimaging studies on sound localization, and some of the competing models of representation of auditory space in humans. This article is part of a Special Issue entitled Human Auditory Neuroimaging.
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Affiliation(s)
- Jyrki Ahveninen
- Harvard Medical School - Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Charlestown, MA, USA.
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