Voluntary contraction of middle ear muscles: effects on input impedance, energy reflectance and spontaneous otoacoustic emissions

Muscles in and around the ear as the source of "physiological noise" during auditory selective attention: A review and novel synthesis

The sensitivity of the auditory system is regulated via two major efferent pathways: the medial olivocochlear system that connects to the outer hair cells, and by the middle ear muscles-the tensor tympani and stapedius. The role of the former system in suppressing otoacoustic emissions has been extensively studied, but that of the complementary network has not. In studies of selective attention, decreases in otoacoustic emissions from contralateral stimulation have been ascribed to the medial olivocochlear system, but the acknowledged problem is that the results can be confounded by parallel muscle activity. Here, the potential role of the muscle system is examined through a wide but not exhaustive review of the selective attention literature, and the unifying hypothesis is made that the prominent "physiological noise" detected in such experiments, which is reduced during attention, is the sound produced by the muscles in proximity to the ear-including the middle ear muscles. All muscles produce low-frequency sound during contraction, but the implications for selective attention experiments-in which muscles near the ear are likely to be active-have not been adequately considered. This review and synthesis suggests that selective attention may reduce physiological noise in the ear canal by reducing the activity of muscles close to the ear. Indeed, such an experiment has already been done, but the significance of its findings have not been widely appreciated. Further sets of experiments are needed in this area.

Spontaneous Otoacoustic Emissions Reveal an Efficient Auditory Efferent Network

PURPOSE

Understanding speech often involves processing input from multiple modalities. The availability of visual information may make auditory input less critical for comprehension. This study examines whether the auditory system is sensitive to the presence of complementary sources of input when exerting top-down control over the amplification of speech stimuli.

METHOD

Auditory gain in the cochlea was assessed by monitoring spontaneous otoacoustic emissions (SOAEs), which are by-products of the amplification process. SOAEs were recorded while 32 participants (23 women, nine men; Mage = 21.13) identified speech sounds such as "ba" and "ga." The speech sounds were presented either alone or with complementary visual input, as well as in quiet or with 6-talker babble.

RESULTS

Analyses revealed that there was a greater reduction in the amplification of noisy auditory stimuli compared with quiet. This reduced amplification may aid in the perception of speech by improving the signal-to-noise ratio. Critically, there was a greater reduction in amplification when speech sounds were presented bimodally with visual information relative to when they were presented unimodally. This effect was evidenced by greater changes in SOAE levels from baseline to stimuli presentation in audiovisual trials relative to audio-only trials.

CONCLUSIONS

The results suggest that even the earliest stages of speech comprehension are modulated by top-down influences, resulting in changes to SOAEs depending on the presence of bimodal or unimodal input. Neural processes responsible for changes in cochlear function are sensitive to redundancy across auditory and visual input channels and coordinate activity to maximize efficiency in the auditory periphery.

Effects of cochlear synaptopathy on middle-ear muscle reflexes in unanesthetized mice

Cochlear synaptopathy, i.e. the loss of auditory-nerve connections with cochlear hair cells, is seen in aging, noise damage, and other types of acquired sensorineural hearing loss. Because the subset of auditory-nerve fibers with high thresholds and low spontaneous rates (SRs) is disproportionately affected, audiometric thresholds are relatively insensitive to this primary neural degeneration. Although suprathreshold amplitudes of wave I of the auditory brainstem response (ABR) are attenuated in synaptopathic mice, there is not yet a robust diagnostic in humans. The middle-ear muscle reflex (MEMR) might be a sensitive metric (Valero et al., 2016), because low-SR fibers may be important drivers of the MEMR (Liberman and Kiang, 1984; Kobler et al., 1992). Here, to test the hypothesis that narrowband reflex elicitors can identify synaptopathic cochlear regions, we measured reflex growth functions in unanesthetized mice with varying degrees of noise-induced synaptopathy and in unexposed controls. To separate effects of the MEMR from those of the medial olivocochlear reflex, the other sound-evoked cochlear feedback loop, we used a mutant mouse strain with deletion of the acetylcholine receptor required for olivocochlear function. We demonstrate that the MEMR is normal when activated from non-synaptopathic cochlear regions, is greatly weakened in synaptopathic regions, and is a more sensitive indicator of moderate synaptopathy than the suprathreshold amplitude of ABR wave I.

Changes in otoacoustic emissions during selective auditory and visual attention

Previous studies have demonstrated that the otoacoustic emissions (OAEs) measured during behavioral tasks can have different magnitudes when subjects are attending selectively or not attending. The implication is that the cognitive and perceptual demands of a task can affect the first neural stage of auditory processing-the sensory receptors themselves. However, the directions of the reported attentional effects have been inconsistent, the magnitudes of the observed differences typically have been small, and comparisons across studies have been made difficult by significant procedural differences. In this study, a nonlinear version of the stimulus-frequency OAE (SFOAE), called the nSFOAE, was used to measure cochlear responses from human subjects while they simultaneously performed behavioral tasks requiring selective auditory attention (dichotic or diotic listening), selective visual attention, or relative inattention. Within subjects, the differences in nSFOAE magnitude between inattention and attention conditions were about 2-3 dB for both auditory and visual modalities, and the effect sizes for the differences typically were large for both nSFOAE magnitude and phase. These results reveal that the cochlear efferent reflex is differentially active during selective attention and inattention, for both auditory and visual tasks, although they do not reveal how attention is improved when efferent activity is greater.

Low-frequency sound affects active micromechanics in the human inner ear

Noise-induced hearing loss is one of the most common auditory pathologies, resulting from overstimulation of the human cochlea, an exquisitely sensitive micromechanical device. At very low frequencies (less than 250 Hz), however, the sensitivity of human hearing, and therefore the perceived loudness is poor. The perceived loudness is mediated by the inner hair cells of the cochlea which are driven very inadequately at low frequencies. To assess the impact of low-frequency (LF) sound, we exploited a by-product of the active amplification of sound outer hair cells (OHCs) perform, so-called spontaneous otoacoustic emissions. These are faint sounds produced by the inner ear that can be used to detect changes of cochlear physiology. We show that a short exposure to perceptually unobtrusive, LF sounds significantly affects OHCs: a 90 s, 80 dB(A) LF sound induced slow, concordant and positively correlated frequency and level oscillations of spontaneous otoacoustic emissions that lasted for about 2 min after LF sound offset. LF sounds, contrary to their unobtrusive perception, strongly stimulate the human cochlea and affect amplification processes in the most sensitive and important frequency range of human hearing.

Contralateral suppression of distortion-product otoacoustic emissions: a potential diagnostic tool to evaluate the vestibular nerve

The amplitude of distortion-product otoacoustic emission (DPOAE) is suppressed in one ear when the contralateral ear is subjected to sound stimulation. Contralateral suppression of DPOAE is the phenomenon resulted by the efferent cochlear innervation on the outer hair cells via medial olivocochlear bundle (MOCB) and inferior vestibular nerve. We assumed that DPOAE would not be suppressed by contralateral sound stimulation in patients with vestibular nerve lesion as long as the specific pathway conveying that efferent innervation is affected. To test this hypothesis, we compared the amount of DPOAE contralateral suppression in patients with vestibular neuritis and healthy controls. Twenty healthy volunteers without hearing loss and vestibulopathy, and 13 patients with vestibular neuritis were recruited. DP audiogram was measured without contralateral sound stimulation and then with contralateral sound stimulation (70 dB HL of 2 kHz narrow band noise, NBN). The suppression value of DPOAE was evaluated according to the f2 frequency and was defined as the amount of DPOAE suppression: An-Ao, where An represents the DPOAE amplitude in the presence of contralateral NBN, and Ao represents the DPOAE amplitude in the absence of NBN. Cervical vestibular evoked myogenic potential (cVEMP) was performed in some patients with vestibular neuritis. The suppression values of DPOAE were compared between groups and were analyzed according to the results of cVEMP. The amount of suppression of DPOAE during contralateral sound stimulation was significantly reduced in the patient group compared to control at the f2 frequencies of 1257, 1587, and 2002 Hz (P=0.045, P<0.001, P=0.009, respectively). However, the results of contralateral suppression of DPOAE were not consistent with the results of cVEMP in this study. Efferent cochlear innervation was affected in vestibular neuritis. Evaluation of contralateral suppression of DPOAE can be a potential diagnostic tool to evaluate the functional integrity of the vestibular nerve. Further studies are necessary to clarify this mechanism.

The effect of contralateral acoustic stimulation on spontaneous otoacoustic emissions

Evoked otoacoustic emissions are often used to study the medial olivocochlear (MOC) efferents in humans. There has been concern that the emission-evoking stimulus may itself elicit efferent activity and alter the evoked otoacoustic emission. Spontaneous otoacoustic emissions (SOAEs) are hence advantageous as no external stimulation is necessary to record the response in the test ear. Contralateral acoustic stimulation (CAS) has been shown to suppress SOAE level and elevate SOAE frequency, but the time course of these effects is largely unknown. By utilizing the Choi-Williams distribution, here we report a gradual adaptation during the presence of CAS and an overshoot following CAS offset in both SOAE magnitude and frequency from six normal-hearing female human subjects. Furthermore, we have quantified the time constants of both magnitude and frequency shifts at the onset, presence, and offset of four levels of CAS. Most studies using contralateral elicitors do not stringently control the middle-ear muscle (MEM) reflex, leaving the results difficult to interpret. In addition to clinically available measures of the MEM reflex, we have incorporated a sensitive laboratory technique to monitor the MEM reflex in our subjects, allowing us to interpret the results with greater confidence.

Long-term stability of spontaneous otoacoustic emissions

Spontaneous otoacoustic emissions (SOAEs) were measured longitudinally for durations up to 19.5 years. Initial ages of the subjects ranged from 6 to 41 years. The most compelling finding was a decrease in frequency of all emissions in all subjects, which was approximately linear in %/year and averaged 0.25%/year. SOAE levels also tended to decrease with age, a trend that was significant, but not consistent across emissions, either within or across subjects. Levels of individual SOAEs might decrease, increase, or remain relatively constant with age. Several types of frequency/level instabilities were noted in which some SOAEs within an ear interacted such that their levels were negatively correlated. These instabilities often persisted for many years. SOAEs were also measured in two females over the course of their pregnancies. No changes in SOAE levels or frequencies were seen, that were larger than have been reported in females over a menstrual cycle, suggesting that levels of female gonadal hormones do not have a significant direct effect on SOAE frequencies or levels.

Contralateral suppression of distortion product otoacoustic emissions and the middle-ear muscle reflex in human ears

Distortion product otoacoustic emissions (DPOAEs) were measured in the absence and presence of contralateral noise at five levels--below, equal to, and above the middle-ear muscle (MEM) reflex threshold. The resultant changes in DPOAE level and phase were dependent on stimulus frequency and noise level. Both low-level noise, believed to elicit the medial olivocochlear (MOC) reflex, and high-level noise, thought to activate both MOC and MEM reflexes, significantly decreased the DPOAE level. However, the shift from sole MOC effect to mixed MOC and MEM effects was not as dramatic as we thought. While low-level noise resulted in a minimum DPOAE phase change, high-level noise caused a substantial phase lead for 1 and 2kHz. With increasing frequency, phase lag became more notable. The present study suggests the following: (1) DPOAE contralateral suppression by low-level sound most likely does not involve the effect of the MEM reflex and signal crossover; and (2) combined analysis of DPOAE level and phase changes warrants further investigations to overcome the difficulty in separating the effects of MOC efferents and MEM contraction. The results also imply that OAE measurement has the potential for being used to investigate the effect of the MEM reflex on sound transmission.

A Clinical Study of the Efferent Auditory System in Patients With Normal Hearing Who Have Acute Tinnitus

OBJECTIVE

Etiological diagnosis and treatment of tinnitus still remain challenging in clinical practice. The aim of this study was to determine the potential contribution of a defective cochlear efferent innervation to the onset of tinnitus in patients with normal hearing.

STUDY DESIGN

Prospective randomized controlled study.

SETTING

Otorhinolaryngology department of a general hospital.

PATIENTS

The patient group consisted of 18 normal-hearing adults (7 men, 11 women) with acute tinnitus (bilateral in 3 patients).

INTERVENTIONS

Tympanogram, stapedial muscle reflex, pure tone audiometry, tinnitus pitch matching, spontaneous otoacoustic emissions, and distortion product otoacoustic emissions (DPOAEs) in the absence and presence of contralateral suppression by white noise.

MAIN OUTCOME MEASURE

DPOAEs suppression amplitudes recorded from tinnitus and nontinnitus ears of the patients' group were compared with each other and with a control group.

RESULTS

The contralateral application of white noise induced the enhancement of DPOAE amplitudes in some patients. The suppression of DPOAE amplitudes by contralateral white noise did not reach statistically significant levels in either ear (with or without tinnitus). On the contrary, under the same conditions, our control group demonstrated statistically significant reduction of DPOAE amplitudes at all frequencies.

CONCLUSION

Patients with normal hearing acuity who have acute tinnitus seem to have a less effective functioning of the cochlear efferent system because the application of contralateral noise enhanced the DPOAEs or suppressed them less intensely than it did in a control group. Further studies may establish the clinical applications for the diagnosis of changes in efferent function, in the subjective evaluation, patient etiological grouping, treatment, or prognosis of tinnitus.

Simultaneous measurement of noise-activated middle-ear muscle reflex and stimulus frequency otoacoustic emissions

Otoacoustic emissions serve as a noninvasive probe of the medial olivocochlear (MOC) reflex. Stimulus frequency otoacoustic emissions (SFOAEs) elicited by a low-level probe tone may be the optimal type of emission for studying MOC effects because at low levels, the probe itself does not elicit the MOC reflex [Guinan et al. (2003) J. Assoc. Res. Otolaryngol. 4:521]. Based on anatomical considerations, the MOC reflex activated by ipsilateral acoustic stimulation (mediated by the crossed olivocochlear bundle) is predicted to be stronger than the reflex to contralateral stimulation. Broadband noise is an effective activator of the MOC reflex; however, it is also an effective activator of the middle-ear muscle (MEM) reflex, which can make results difficult to interpret. The MEM reflex may be activated at lower levels than measured clinically, and most previous human studies have not explicitly included measurements to rule out MEM reflex contamination. The current study addressed these issues using a higher-frequency SFOAE probe tone to test for cochlear changes mediated by the MOC reflex, while simultaneously monitoring the MEM reflex using a low-frequency probe tone. Broadband notched noise was presented ipsilaterally at various levels to elicit probe-tone shifts. Measurements are reported for 15 normal-hearing subjects. With the higher-frequency probe near 1.5 kHz, only 20% of subjects showed shifts consistent with an MOC reflex in the absence of an MEM-induced shift. With the higher-frequency probe near 3.5 kHz, up to 40% of subjects showed shifts in the absence of an MEM-induced shift. However, these responses had longer time courses than expected for MOC-induced shifts, and may have been dominated by other cochlear processes, rather than MOC reflex. These results suggest caution in the interpretation of effects observed using ipsilaterally presented acoustic activators intended to excite the MOC reflex.

Central auditory pathways mediating the rat middle ear muscle reflexes

The middle ear muscle (MEM) reflexes function to protect the inner ear from intense acoustic stimuli and to reduce acoustic masking. Sound presented to the same side or to the opposite side activates the MEM reflex on both sides. The ascending limbs of these pathways must be the auditory nerve fibers originating in the cochlea and terminating in the cochlear nucleus, the first relay station for all ascending auditory information. The descending limbs project from the motoneurons in the brainstem to the MEMs on both sides, causing their contraction. Although the ascending and descending pathways are well described, the cochlear nucleus interneurons that mediate these reflex pathways have not been identified. In order to localize the MEM reflex interneurons, we developed a physiologically based reflex assay in the rat that can be used to determine the integrity of the reflex pathways after experimental manipulations. This assay monitored the change in tone levels and distortion product otoacoustic emissions within the ear canal in one ear during the presentation of a reflex-eliciting sound stimulus in the contralateral ear. Preliminary findings using surgical transection and focal lesioning of the auditory brainstem to interrupt the MEM reflexes suggest that MEM reflex interneurons are located in the ventral cochlear nucleus.

Outer and Middle Ear Status and Distortion Product Otoacoustic Emissions in Children With Sickle Cell Disease

The purpose of this study was to investigate distortion product otoacoustic emissions (DPOAEs) and outer/middle ear status in 12 African American children with normal hearing and homozygous sickle cell disease (SCD) and age-, gender-, and ear-matched African American controls. C. R. Downs, A. Stuart, & D. Holbert (2000) reported that DPOAE amplitudes were significantly larger for children with SCD. Because the integrity of the middle ear system directly influences OAE characteristics, it was felt that concurrent investigation of DPOAE amplitudes and outer/middle ear function in children with SCD was warranted. DPOAEs were evoked by 13 primary-tone pairs with f 2 frequencies ranging from 1000 to 4500 Hz. Outer/middle ear status was assessed with tympanometry through indices of peak compensated static acoustic admittance, tympanometric width, tympanometric peak pressure, ear canal volume, and middle ear resonance frequency. Tympanograms were recorded with probe-tone frequencies of 226 and 678 Hz. DPOAE amplitudes were significantly larger for children with SCD ( p < .05). There were no group differences in any of the middle ear indices ( p > .05). These findings suggest that increased DPOAE amplitudes for children with SCD cannot be attributed to differences in outer/middle ear function as assessed with tympanometry.

Mammalian spontaneous otoacoustic emissions are amplitude-stabilized cochlear standing waves

Mammalian spontaneous otoacoustic emissions (SOAEs) have been suggested to arise by three different mechanisms. The local-oscillator model, dating back to the work of Thomas Gold, supposes that SOAEs arise through the local, autonomous oscillation of some cellular constituent of the organ of Corti (e.g., the "active process" underlying the cochlear amplifier). Two other models, by contrast, both suppose that SOAEs are a global collective phenomenon--cochlear standing waves created by multiple internal reflection--but differ on the nature of the proposed power source: Whereas the "passive" standing-wave model supposes that SOAEs are biological noise, passively amplified by cochlear standing-wave resonances acting as narrow-band nonlinear filters, the "active" standing-wave model supposes that standing-wave amplitudes are actively maintained by coherent wave amplification within the cochlea. Quantitative tests of key predictions that distinguish the local-oscillator and global standing-wave models are presented and shown to support the global standing-wave model. In addition to predicting the existence of multiple emissions with a characteristic minimum frequency spacing, the global standing-wave model accurately predicts the mean value of this spacing, its standard deviation, and its power-law dependence on SOAE frequency. Furthermore, the global standing-wave model accounts for the magnitude, sign, and frequency dependence of changes in SOAE frequency that result from modulations in middle-ear stiffness. Although some of these SOAE characteristics may be replicable through artful ad hoc adjustment of local-oscillator models, they all arise quite naturally in the standing-wave framework. Finally, the statistics of SOAE time waveforms demonstrate that SOAEs are coherent, amplitude-stabilized signals, as predicted by the active standing-wave model. Taken together, the results imply that SOAEs are amplitude-stabilized standing waves produced by the cochlea acting as a biological, hydromechanical analog of a laser oscillator. Contrary to recent claims, spontaneous emission of sound from the ear does not require the autonomous mechanical oscillation of its cellular constituents.

Estimating the acoustic reflex threshold from wideband measures of reflectance, admittance, and power

OBJECTIVE

A method was developed to estimate the contralateral acoustic reflex threshold using shifts in wideband energy reflectance, admittance magnitude and power.

DESIGN

In the first experiment contralateral reflex thresholds for a noise activator were estimated on three adult participants using reflectance, admittance and power measurements at frequencies from 250 to 8000 Hz. The reflex threshold was defined using a magnitude and a correlation technique, both having the property of examining the pattern of the reflex-induced shift across a fairly broad frequency range (250 to 2000 Hz). In the second experiment, the magnitude method was modified to include an F test for the comparison of the magnitude of reflex-induced shifts in reflectance, admittance and power relative to response differences in a no-activator baseline condition. Data from four additional participants then were analyzed across a broader frequency range using a method that combined magnitude and correlation methods of estimating reflex thresholds.

RESULTS

Acoustic reflex thresholds were obtained using reflectance, admittance and power-level measures in all subjects in both experiments. Individual reflex threshold estimates were as much as 24 dB lower than with the clinical system, with an average of approximately 14 dB lower for the three participants in the first experiment, and approximately 18 dB lower for the four participants in the second experiment.

CONCLUSIONS

Wideband measures of reflectance, admittance and power were successfully used to estimate acoustic reflex thresholds in seven participants. A reflex threshold test was devised based on the magnitude of the response shift in the presence of a contralateral activator, and the similarity of the response shift spectra across frequency between successive activator levels. Across all participants in the study, the new test yielded a more sensitive measure of the acoustic reflex threshold than the clinical method. This finding has both clinical and theoretical implications for the study of the acoustic reflex.

Middle ear influence on otoacoustic emissions. I: noninvasive investigation of the human transmission apparatus and comparison with model results

Evoked otoacoustic emissions (EOAEs) are generated within the cochlea in response to external sounds, and they can be acoustically detected in the external auditory meatus after backward propagation through the middle ear. In addition to being used to probe the cochlear mechanisms, they are expected to be sensitive to minute changes in middle ear impedance. Systematic measurements of the changes in the vectorial components of EOAEs were carried out after various manipulations of the human middle ear in order to characterize the influence of stiffness and inertia of the stapes and tympanic-membrane systems. For this purpose, stapedius muscle contractions were elicited by high-level contralateral sound, controlled changes in middle ear pressure (range +/-100 daPa) were produced and the tympanic membrane was loaded with water droplets. A computer model of the middle ear network was implemented using a standard lumped-element electric analog of the middle ear (Zwislocki's model). Forward and backward transmission changes were simulated and model predictions were compared to experimental data. Apart from the case of positive middle ear pressures, a close qualitative correspondence was found between model and real-ear results. Each of the effects was characterized by a unique pattern of phase and magnitude changes as a function of frequency, in relation to the mechanical characteristics of the involved subsystem (i.e. stapes stiffness, tympanic-membrane stiffness or mass) and its resonance properties. Owing to their high sensitivity, EOAEs could be helpful for an accurate individual multifrequency analysis of middle ear impedance by comparisons under rest and test conditions.

Olivocochlear efferent vs. middle-ear contributions to the alteration of otoacoustic emissions by contralateral noise

The medial olivocochlear efferent bundle is the key element of a bilateral efferent reflex activated by sound in either ear and acting directly on cochlear outer hair cells (OHC) via numerous cholinergic synapses. It probably contributes to regulating the mechanical activity of the cochlea. Otoacoustic emissions, being sounds emitted by the cochlea as a reflection of its activity and suppressed by efferent activation, are increasingly considered to be the privileged tool for a noninvasive assessment of the efferent reflex. However, confounding effects on otoacoustic emissions can occur. A primary influence is middle-ear muscle reflex activation, which shares common features with the effects of cochlear efferent activation. We report a systematic comparison of the responses of human otoacoustic emissions to efferent activation by low-level noise in the contralateral ear to various middle-ear manipulations (reflex contractions of the stapedius muscle induced by high-level contralateral noise; moderate middle-ear pressure changes). The profiles of level and phase changes of otoacoustic emissions as a function of frequency were highly specific to the origin of the effects. The changes induced by middle-ear manipulations matched the predictions computed from a standard lumped-element middle-ear model, with one or two peaks around the resonance frequency(ies) of the involved subsystem, stapes or tympanic membrane. In contrast, the efferent effect was completely different, exhibiting a broadband-level suppression associated with a small phase lead. We propose that a careful vector analysis of otoacoustic emission modifications enables the identification of the contribution of the efferent reflex without ambiguity even when it is mixed with middle-ear effects. Thereby, otoacoustic emissions can be used more reliably as noninvasive probes of efferent olivocochlear function.

Acoustic reflex detection using wide-band acoustic reflectance, admittance, and power measurements

The measurement of the acoustic reflex threshold is a basic component of the diagnostic audiological test battery that may subject patients to potentially harmful sound pressures. A wide-band acoustic impedance and reflectance system (D. H. Keefe, R. Ling, & J. C. Bulen, 1992) was investigated as a means of obtaining reflex thresholds at a reduced level and as a means of providing a more complete characterization of the reflex than current clinical methods provide. Reflex thresholds obtained by measuring changes in wide-band admittance, reflectance, and power were at least 8 dB lower than those obtained with the standard clinical technique. These reflex-induced changes were accounted for by a simple oscillator model of the middle ear, assuming that the acoustic reflex results in an increase in stiffness. The results support further investigation of reflectance-based measures of the acoustic reflex as a clinical tool and as a means of studying the reflex mechanism.

Long-term and short-term variations in amplitude and frequency of spontaneous otoacoustic emissions in pre-term infants

In pre-term infants, spontaneous otoacoustic emission (SOAE) frequencies show an upward shift with time. The present study aimed to monitor the SOAE amplitude variation during this frequency shift. A long-term observation of 87 SOAE frequencies from 18 pre-term infants yielded a positive frequency shift of 0.72 per cent per week, which was not accompanied by a simultaneous amplitude shift, as the mean variations in SOAE amplitude were practically zero. Furthermore, there was no relationship between the short-term SOAE amplitude variation and the infant's post-conceptional age. Only the absolute amount of SOAE amplitude variation seemed to grow with time. Comparison with induced variations in SOAE frequency argues against a middle ear influence on the SOAE frequency shift. In our view, the absence of any amplitude shift during the upward SOAE frequency shift further suggests cochlear development during the last period of gestation.

Frequency shift of individual spontaneous otoacoustic emissions in preterm infants

In adults, spontaneous otoacoustic emissions (SOAE) have shown a considerable frequency stability. In preterm infants, however, the SOAE proved to show an apparent and consistent upward shift of frequency at increasing postconceptional age (PCA). In 25 ears of 14 preterm infants (PCA, 29.1-41.3 wk) a total of 66 SOAE frequencies were monitored, ranging from 1611 to 5774 Hz. All but one of the SOAE frequencies shifted toward higher frequency. The SOAE frequency shift rate in Hertz per week was proportionally constant relative to the SOAE frequency. The mean shift rate was 0.74 +/- 0.39%/wk. At increasing PCA, the SOAE frequency shift rate tended to slow down. A linear fit through the data predicted the SOAE frequency to stop at about 45-50-wk PCA. The frequency dependence and time course of the SOAE frequency shift strongly suggest cochlear maturation during the last period of gestation.

Influence of contralateral noise on distortion product latency in humans: is the medial olivocochlear efferent system involved?

To test the hypothesis of temporal modifications of cochlear responses when medial efferents are activated, otoacoustic emission latencies were estimated in 16 normal human subjects, in the presence and absence of a contralateral broadband noise, using measurements of the phase of the 2f1-f2 distortion product (group latency method). Significant decrease in the latency of lower frequency (0.8-2.7 kHz) emissions was found in the presence of increasing levels of contralateral sound, and this effect disappeared when the primary-tone levels increased to 60 dB SPL. To ensure that effects were not attributable to mechanisms involving middle ear structures, susceptible to activation by contralateral sound, latency measures were performed in seven subjects whose efferents were severed during a vestibular neurotomy and in two subjects with paralyzed stapedial muscle. Results in patients were compared to those obtained in three surgical control patients with intact efferent bundle, and in eight other normal subjects. All the subject groups exhibited a decrease in latency under contralateral sound except the patients with the severed efferent system who showed increased latencies.

Frequency summation observed in the human acoustic reflex

It is known that the threshold of an acoustically induced middle-ear-muscle (MEM) reflex can be lowered by the simultaneous presentation of a second tone (facilitator), which is presented to the ipsilateral or contralateral ear at a level below the acoustic reflex threshold (ART) of the facilitator itself (Sesterhenn and Breuninger, 1976; Blood and Greenberg, 1981). In the present study, a primary elicitor and a facilitator were presented to the ear contralateral to that used for measurement of the acoustic reflex (AR), and the effects of changing frequencies and sound levels of the facilitator were investigated in human subjects with normal ears. The sound levels of facilitators, which caused a significant reduction of ART for the primary elicitors (facilitation thresholds), showed an asymmetrical pattern as a function of frequency of the facilitators. The facilitation thresholds tended to be lower when a facilitator with a frequency lower than the frequency of the elicitor (1 kHz) was used. In addition, effects of the elicitor on the masked thresholds of the facilitator were examined to observe the possible interaction between elicitor and facilitator from the viewpoint of 'spread of excitation'. The underlying mechanism of summation effects of two tones are discussed based on the possible input mechanism involved in the acoustically induced MEM reflex are.

On the role of the olivocochlear bundle in hearing: 16 case studies

Earlier we presented data (Scharf et al. (1994) Hear. Res. 75, 11-26) from a young patient (S.B.) who had undergone a vestibular neurotomy, during which the olivocochlear bundle (OCB) was severed. Those data are complemented by measurements on 15 other patients-some like S.B. with normal audiometric thresholds, none with a loss greater than 35 dB at experimental frequencies. Comparisons of performance for the same ear before and after surgery or between the operated and healthy ears do not provide evidence that the lack of OCB input impairs the following psychoacoustical functions: (1) detection of tonal signals, (2) intensity discrimination, (3) frequency selectivity, (4) loudness adaptation, (5) frequency discrimination within a tonal series, (6) in-head lateralization. Data on single-tone frequency discrimination are equivocal. These mostly negative results apply to listening both in the quiet and, where relevant, in noise. The only clear change in hearing after a vestibular neurotomy is that most patients detect signals at unexpected frequencies better than before. This change suggests an impaired ability to focus attention in the frequency domain. Although limited in scope, our finding that human hearing without OCB input is essentially normal agrees with much of the relevant literature on animal behavior and with the patients' self-reports.

Otoacoustic emissions in preterm infants: indications for cochlear development?

A longitudinal study of click-evoked otoacoustic emissions (CEOAEs) in 19 ears of 11 preterm infants--post-conceptional age (PCA): 30 to 39 weeks--resulted in a total of 90 CEOAE recordings. All but one of the 19 ears showed an increase of CEOAE amplitude at increasing PCA. The mean increase rate was 1.36 dB per week (dB/wk) for the left ears (n = 11, SD = 1.04 dB/wk), and 1.17 dB/wk for the right ears (n = 8, SD = 0,87 dB/wk). In six ears of three infants we were able to follow a total of 15 frequencies of spontaneous otoacoustic emissions (SOAEs). All of the monitored SOAE frequencies showed a positive shift in frequency with time, ranging from about 10 Hz/wk around 2000 Hz to about 50 Hz/wk around 5000 Hz. This increase of CEOAE amplitude and SOAE frequency indicates that OAE properties are not fully developed in preterm infants. Although the influence of middle ear properties cannot be excluded or proved, the observed SOAE frequency shift suggests development of the fine structures in the cochlea itself.

Anticipatory EMG responses of pericranial muscles in relation to heart rate during a warned simple reaction time task

Obrist's cardiac-somatic coupling hypothesis predicts a widespread inhibition of heart rate and task-irrelevant muscle activity during expectancy situations. This hypothesis was tested by measuring heart rate and pericranial electromyographic (EMG) activity during a warned simple reaction time task with visual or auditory reaction signals and hand or foot responses. In each of three groups of 24 participants, EMG activity of three different facial, masticatory, or neck muscles was recorded. During the warning interval preceding the presentation of the reaction signal, masticatory and lower facial muscles predominantly showed a gradual inhibition in activity concomitant with heart rate deceleration. In contrast, two upper facial muscles showed increasing activity. Pericranial EMG responses were little affected by reaction signal modality and were independent of responding limb. Greater heart rate deceleration was associated with greater inhibition and weaker facilitation of EMG responses. The results suggest a functional role of inhibitory EMG responses in increasing the perceptual sensitivity to expected signals.

Contralateral acoustic stimulation induces a phase advance in evoked otoacoustic emissions in humans

In 28 normal-hearing human subjects, the medial olivocochlear efferent system was activated by contralateral acoustic stimulation which is able to mimic the inhibitory effects of electrical stimulation of the crossed olivocochlear bundle. A first experiment on 16 subjects demonstrated that a contralateral white noise of 35 dB SL was able to induce temporal changes on transiently evoked otoacoustic emissions in response to clicks of 63 dB SPL. These temporal changes consisted of an advance of click-evoked otoacoustic signals in 87% of cases and is referred to as phase-shift effect. The phase advance, quantified using two signal processing methods in both time and frequency domains, was found to be mainly associated with lower frequencies, with a maximal effect at 1.5 kHz and minimal effects around 3.5 and 4 kHz. In a second experiment, carried out on 12 subjects, a negative relationship was found to exist between the ipsilateral stimulation level (level of clicks ranging from 57 to 69 dB SPL) and the phase-shift effect (PSE). Specifically in the range of levels tested (25-45 dB SL), a linear relationship presenting no obvious saturation effect was observed between the contralateral level and the PSE. The PSE was examined in 6 additional subjects exhibiting pathological symptoms; 2 of 3 individuals, who had no contralateral stapedial reflexes unilaterally, showed the PSE whereas this response was reduced or absent in 3 other subjects in the ear with severed efferents associated with a vestibular neurotomy. The integrity of olivocochlear efferents was, therefore, necessary to obtain a full effect, but the absence of stapedial reflex did not prevent the effect from occurring.

Evidence of a medial olivocochlear involvement in contralateral suppression of otoacoustic emissions in humans

Otoacoustic emissions (OAEs) evoked by click stimuli were recorded in both ears of 20 normal human subjects, in the presence and absence of a contralateral masking broad band noise. No difference in the amplitude of OAE suppression was noted between the first tested ear and the second one. In addition, 20 pathological subjects were tested according to the same protocol. Ten of them belonged to a group of patients whose vestibular nerve was sectioned on one side to relieve incapacitating vertigo and thus represented a group in whom olivocochlear efferents were severed. A great reduction of suppression observed in the operated ear suggested that olivocochlear efferent fibers are necessary to obtain a full suppressive effect. Three of the pathological subjects were patients who had undergone a decompression of the facial nerve which necessitated the same surgical approach as vestibular neurotomy, but without any section of vestibular fibers. This surgical control group demonstrated that the surgical act by itself cannot explain the difference observed in the neurotomized group. Finally, seven of the pathological subjects were patients with Bell's palsy, which paralyses the facial nerve and abolishes the stapedial reflex. No suppression difference was observed between healthy ears and ears without stapedial reflex. Therefore, it appeared that the stapedial reflex was not involved in the contralateral suppression of EOAEs. However, as the tensor tympani muscle remained functional in these patients, its involvement in the suppressive effect cannot be excluded.

Pitch is influenced by differences in gas pressure between the middle ear and the external auditory canal. A tentative explanation based on a new aspect in inner ear theory

When the pressure in the external auditory canal is changed (as during tympanometry), the pitch rises by about 6 Hz on average (at +/- 400 mm H2O). Apparently, the travelling wave breaks earlier, as impedance increases, with the sound being projected to a site farther basal. At this site a vibration at the local resonant frequency is elicited. In keeping with the chaos theory, its amplitude is amplified by self-organisation. This is a purely mechanical process which does not involve perception in terms of neural stimulation. But through this mechanical pre-processing step the amplitude becomes high enough to be recognised as a signal by the outer hair cells.

Contralateral auditory stimulation and otoacoustic emissions: a review of basic data in humans

The influence of contralateral auditory stimulation on otoacoustic emissions (OAE), spontaneous OAE, evoked OAE and acoustic distortion products, can be summarized as follows: (1) alteration (mainly a decrease) of OAE amplitude; (2) alteration of response spectrum (upward shift frequency of SOAE); (3) alteration of phase; (4) effect dependent on intensity of contralateral stimulation; (5) effect inversely dependent on intensity of ipsilateral stimulation; (6) frequency specificity of the suppressive effect. Involvement of the medial olivocochlear bundle is highly probable but one cannot exclude a double pathway including also the acoustic reflex.

Covariation of binaural, concurrently-measured spontaneous otoacoustic emissions

Simultaneous recordings of binaural spontaneous otoacoustic emissions (SOAEs) were made for 2 female subjects. For SOAEs below about 3.6 kHz measured within a testing session, the frequencies of nearby monaural and binaural SOAEs tended to move in tandem, whereas widely separated SOAEs did not. Across many testing sessions spanning a menstrual cycle, all monaural and binaural SOAE frequencies shifted in tandem. Possible mechanisms consistent with these results are discussed.