Exploring the relationship between physiological measures of cochlear and brainstem function

Speech auditory brainstem response in audiological practice: a systematic review

BACKGROUND

Speech-ABR is an auditory brainstem response that evaluates the integrity of the temporal and spectral coding of speech in the upper levels of the brainstem. It reflects the acoustic properties of the stimulus used and consists of seven major waves. Waves V and A represent the onset of the response; wave C transition region; D, E, and F waves periodic region (frequency following response); and wave O reflects the offset of the response.

PURPOSE

The aim of this study is to evaluate the clinical availability of the speech-ABR procedure through a literature review.

METHODS

Literature search was conducted in Pubmed, Google Scholar, Scopus and Science Direct databases. Clinical studies of the last 15 years have been included in this review and 60 articles have been reviewed.

RESULTS

As a result of the articles reviewed, it was seen that most of the studies on speech ABR were conducted with children and young people and generally focused on latency analysis measurements. Most used stimulus is the /da/ syllable.

CONCLUSIONS

Speech ABR can objectively measure the auditory cues important for speech recognition and has many clinical applications. It can be used as a biomarker for auditory processing disorders, learning disorders, dyslexia, otitis media, hearing loss, language disorders and phonological disorders. S-ABR is an effective procedure that can be used in speech and language evaluations in people with hearing aids or cochlear implant. It may also be of benefit to the aging auditory system's ability to encode temporal cues.

External and middle ear influence on envelope following responses

Considerable between-subject variability in envelope following response (EFR) amplitude limits its clinical translation. Based on a pattern of lower amplitude and larger variability in the low (<1.2 kHz) and high (>8 kHz), relative to mid (1-3 kHz) frequency carriers, we hypothesized that the between-subject variability in external and middle ear (EM) contribute to between-subject variability in EFR amplitude. It is predicted that equalizing the stimulus reaching the cochlea by accounting for EM differences using forward pressure level (FPL) calibration would at least partially improve response amplitude and reduce between-subject variability. In 21 young normal hearing adults, EFRs of four modulation rates (91, 96, 101, and 106 Hz) were measured concurrently from four frequency bands [low (0.091-1.2 kHz), mid (1-3 kHz), high (4-5.4 kHz), and very high (vHigh; 8-9.4 kHz)], respectively, with 12 harmonics each. The results indicate that FPL calibration in-ear and in a coupler leads to larger EFR amplitudes in the low and vHigh frequency bands relative to conventional coupler root-mean-square calibration. However, improvement in variability was modest with FPL calibration. This lack of a statistically significant improvement in variability suggests that the dominant source of variability in EFR amplitude may arise from cochlear and/or neural processing.

A Home-Based Approach to Auditory Brainstem Response Measurement: Proof-of-Concept and Practical Guidelines

Broad-scale neuroscientific investigations of diverse human populations are difficult to implement. This is because the primary neuroimaging methods (magnetic resonance imaging, electroencephalography [EEG]) historically have not been portable, and participants may be unable or unwilling to travel to test sites. Miniaturization of EEG technologies has now opened the door to neuroscientific fieldwork, allowing for easier access to under-represented populations. Recent efforts to conduct auditory neuroscience outside a laboratory setting are reviewed and then an in-home technique for recording auditory brainstem responses (ABRs) and frequency-following responses (FFRs) in a home setting is introduced. As a proof of concept, we have conducted two in-home electrophysiological studies: one in 27 children aged 6 to 16 years (13 with autism spectrum disorder) and another in 12 young adults aged 18 to 27 years, using portable electrophysiological equipment to record ABRs and FFRs to click and speech stimuli, spanning rural and urban and multiple homes and testers. We validate our fieldwork approach by presenting waveforms and data on latencies and signal-to-noise ratio. Our findings demonstrate the feasibility and utility of home-based ABR/FFR techniques, paving the course for larger fieldwork investigations of populations that are difficult to test or recruit. We conclude this tutorial with practical tips and guidelines for recording ABRs and FFRs in the field and discuss possible clinical and research applications of this approach.

Rapid Enhancement of Subcortical Neural Responses to Sine-Wave Speech

The efferent auditory nervous system may be a potent force in shaping how the brain responds to behaviorally significant sounds. Previous human experiments using the frequency following response (FFR) have shown efferent-induced modulation of subcortical auditory function online and over short- and long-term time scales; however, a contemporary understanding of FFR generation presents new questions about whether previous effects were constrained solely to the auditory subcortex. The present experiment used sine-wave speech (SWS), an acoustically-sparse stimulus in which dynamic pure tones represent speech formant contours, to evoke FFR_SWS. Due to the higher stimulus frequencies used in SWS, this approach biased neural responses toward brainstem generators and allowed for three stimuli (/bɔ/, /bu/, and /bo/) to be used to evoke FFR_SWSbefore and after listeners in a training group were made aware that they were hearing a degraded speech stimulus. All SWS stimuli were rapidly perceived as speech when presented with a SWS carrier phrase, and average token identification reached ceiling performance during a perceptual training phase. Compared to a control group which remained naïve throughout the experiment, training group FFR_SWS amplitudes were enhanced post-training for each stimulus. Further, linear support vector machine classification of training group FFR_SWS significantly improved post-training compared to the control group, indicating that training-induced neural enhancements were sufficient to bolster machine learning classification accuracy. These results suggest that the efferent auditory system may rapidly modulate auditory brainstem representation of sounds depending on their context and perception as non-speech or speech.

Auditory neurophysiology reveals central nervous system dysfunction in HIV-infected individuals

OBJECTIVE

To test the hypothesis that human immunodeficiency virus (HIV) affects auditory-neurophysiological functions.

METHODS

A convenience sample of 68 HIV+ and 59 HIV- normal-hearing adults was selected from a study set in Dar es Salaam, Tanzania. The speech-evoked frequency-following response (FFR), an objective measure of auditory function, was collected. Outcome measures were FFRs to the fundamental frequency (F0) and to harmonics corresponding to the first formant (F1), two behaviorally relevant cues for understanding speech.

RESULTS

The HIV+ group had weaker responses to the F1 than the HIV- group; this effect generalized across multiple stimuli (d = 0.59). Responses to the F0 were similar between groups.

CONCLUSIONS

Auditory-neurophysiological responses differ between HIV+ and HIV- adults despite normal hearing thresholds.

SIGNIFICANCE

The FFR may reflect HIV-associated central nervous system dysfunction that manifests as disrupted auditory processing of speech harmonics corresponding to the first formant.

Tinnitus Impacts on Speech and Non-speech Stimuli

OBJECTIVE

To investigate how tinnitus affects the processing of speech and non-speech stimuli at the subcortical level.

STUDY DESIGN

Cross-sectional analytical study.

SETTING

Academic, tertiary referral center.

PATIENTS

Eighteen individuals with tinnitus and 20 controls without tinnitus matched based on their age and sex. All subjects had normal hearing sensitivity.

INTERVENTION

Diagnostic.

MAIN OUTCOME MEASURES

The effect of tinnitus on the parameters of auditory brainstem responses (ABR) to non-speech (click-ABR), and speech (sABR) stimuli was investigated.

RESULTS

Latencies of click ABR in waves III, V, and Vn, as well as inter-peak latency (IPL) of I to V were significantly longer in individuals with tinnitus compared with the controls. Individuals with tinnitus demonstrated significantly longer latencies of all sABR waves than the control group. The tinnitus patients also exhibited a significant decrease in the slope of the V-A complex and reduced encoding of the first and higher formants. A significant difference was observed between the two groups in the spectral magnitudes, the first formant frequency range (F1) and a higher frequency region (HF).

CONCLUSIONS

Our findings suggest that maladaptive neural plasticity resulting from tinnitus can be subcortically measured and affects timing processing of both speech and non-speech stimuli. The findings have been discussed based on models of maladaptive plasticity and the interference of tinnitus as an internal noise in synthesizing speech auditory stimuli.

An Analysis of The Parameters Used In Speech ABR Assessment Protocols

The aim of this study was to assess the parameters of choice, such as duration, intensity, rate, polarity, number of sweeps, window length, stimulated ear, fundamental frequency, first formant, and second formant, from previously published speech ABR studies. To identify candidate articles, five databases were assessed using the following keyword descriptors: speech ABR, ABR-speech, speech auditory brainstem response, auditory evoked potential to speech, speech-evoked brainstem response, and complex sounds. The search identified 1288 articles published between 2005 and 2015. After filtering the total number of papers according to the inclusion and exclusion criteria, 21 studies were selected. Analyzing the protocol details used in 21 studies suggested that there is no consensus to date on a speech-ABR protocol and that the parameters of analysis used are quite variable between studies. This inhibits the wider generalization and extrapolation of data across languages and studies.

Frequency-Following Response with Speech Stimulus: Comparison between Two Methods of Stimulation

Introduction  Frequency-following response with speech stimulus (FFR-speech) is a subcortical potential that satisfactorily evaluates the processing of verbal information. However, there still are differences in the literature regarding its analysis and stimulation protocol. Objective  To compare two stimulation protocols for the capture of FFR-speech, to identify the percentage of occurrence of the waves among them and to compare it with the specialized literature, as well as to describe the interpeaks of its waves. Method  Considering the eligibility criteria, the sample consisted of 30 normal-hearing adults, with no complaints of speech comprehension. All of them were submitted to a basic audiological evaluation, to brainstem auditory evoked potential with click stimulus, and to FFR-speech. In the latter, 2 types of stimulation were performed, 3 series of 1,000 sweeps, and 2 series of 3,000 sweeps, for subsequent analysis of the resulting wave, in which we tried to mark the peak V followed by valleys A, C, D, E, F, and O. Results  Differences in latency and interpeaks were not found between the protocols. In general, a higher occurrence of waves in the stimulation of 2 series of 3,000 sweeps was observed, but only the A valley presented a significant difference. When the values of the waves were compared with the literature, the V and A waves showed fewer occurrences in the present study. Conclusion  The protocol of 2 series of 3,000 sweeps was better for FFR-speech in the studied equipment, considering the higher occurrence of waves, even though it is inferior to the specialized literature. Furthermore, it was possible to describe interpeak values and to observe no difference between the studied protocols.

Evaluation of dichotic listening performance in normal-hearing, noise-exposed young females

Recent animal studies have shown that intense noise exposures that produce robust temporary threshold shift (TTS) can inflict irreversible damage to the synaptic connections between the inner hair cells and auditory neurons. It was hypothesized that noise-induced cochlear synaptopathy may cause impaired acoustic encoding in the central auditory nervous system leading to impaired speech perception, particularly in challenging listening situations. The aim of the study was to evaluate the influence of high noise exposure background (NEB) on dichotic listening performance, speech-in-noise performance, and auditory brainstem responses (ABR) measured in young females with normal audiograms. The central hypothesis was that individuals with high NEB would exhibit reduced ABR wave I amplitude and subsequently would exhibit poorer performance on speech-in-noise and dichotic listening. In a sample of 32 females (14 with high NEB and 18 with low NEB) aged 18-35 years, the study compared behavioral hearing thresholds (from 250 to 16000 Hz), distortion-product otoacoustic emissions (DPOAEs, 1000-16000 Hz), click-evoked ABR, QuickSIN signal-to-noise ratio (SNR) loss and dichotic digit test (DDT). The results showed no clear association between NEB, and hearing thresholds, DPOAEs, click-evoked ABR measures, and QuickSIN SNR loss. Individuals with high NEB revealed significantly lower DDT scores and evidence of reduced right ear advantage compared to individuals with low NEB. The poorer performance in DDT and the ear asymmetry in DDT scores with normal ABR findings suggest that high NEB might alter the hemispheric organization of speech-sound processing and cognitive control. The clinical significance of the present findings is discussed.

Parameters for Applying the Brainstem Auditory Evoked Potential with Speech Stimulus: Systematic Review

Introduction  Studies using the Brainstem Auditory Evoked Potential with speech stimulus are increasing in Brazil, and there are divergences between the methodologies used for testing.

Objectives  To analyze the parameters used in the study of the Brainstem Auditory Evoked Potentials with speech stimulus.

Data Synthesis  The survey was performed using electronic databases. The search strategy was as follows: “Evoked potentials, auditory” OR “Brain stem” OR “Evoked potentials, auditory, brain stem” AND “Speech.” The survey was performed from June to July of 2016. The criteria used for including articles in this study were: being written in Portuguese, English or Spanish; presenting the description of the testing parameters and the description of the sample. In the databases selected, 2,384 articles were found, and 43 articles met all of the inclusion criteria. The predominance of the following parameters was observed to achieve the potential during study: stimulation with the syllable /da/; monaural presentation with greater use of the right ear; intensity of 80 dB SPL; vertical placement of electrodes; use of in-ear headphones; patient seated, distracted in awake state; alternating polarity; use of speech synthesizer software for the elaboration of stimuli; presentation rate of 10.9/s; and sampling rate of 20 kHz.

Conclusions  The theme addressed in this systematic review is relatively recent. However, the results are significant enough to encourage the use of the procedure in clinical practice and advise clinicians about the most used procedures in each parameter.

Speech-evoked Brainstem Auditory Responses and Auditory Processing Skills: A Correlation in Adults with Hearing Loss

Introduction  The auditory system consists of sensory structures and central connections. The evaluation of the auditory pathway at a central level can be performed through behavioral and electrophysiological tests, because they are complementary to each other and provide important information about comprehension. Objective  To correlate the findings of speech brainstem-evoked response audiometry with the behavioral tests Random Gap Detection Test and Masking Level Difference in adults with hearing loss. Methods  All patients were submitted to a basic audiological evaluation, to the aforementioned behavioral tests, and to an electrophysiological assessment, by means of click-evoked and speech-evoked brainstem response audiometry. Results  There were no statistically significant values among the electrophysiological test and the behavioral tests. However, there was a significant correlation between the V and A waves, as well as the D and F waves, of the speech-evoked brainstem response audiometry peaks. Such correlations are positive, indicating that the increase of a variable implies an increase in another and vice versa. Conclusion  It was possible to correlate the findings of the speech-evoked brainstem response audiometry with those of the behavioral tests Random Gap Detection and Masking Level Difference. However, there was no statistically significant correlation between them. This shows that the electrophysiological evaluation does not depend uniquely on the behavioral skills of temporal resolution and selective attention.

Age-related changes in envelope-following responses at equalized peripheral or central activation

Previous work has debated about the comparisons of hearing abilities faced with alterations in hearing thresholds and evoked potentials between groups following acoustic trauma- or age-related changes. This study compares envelope-following responses (EFRs) of young and aged rats when sound levels were matched according to (1) wave I amplitudes of auditory brainstem responses (ABRs) elicited by 8-kHz tones or (2) EFR amplitudes evoked by sinusoidally amplitude-modulated (SAM) tones at 100% depth. Matched wave I amplitudes across age corresponded to approximately 20-dB sound level differences. For matched wave I, no age-related differences were observed in wave V amplitudes. However, EFRs recorded in silence were enhanced with aging at 100% but not at 25% depth, consistent with enhanced central gain in aging. For matched EFRs, there were no age-related differences in EFRs of amplitude modulation (AM) depth and AM frequency processing. These results suggest novel, objective measures beyond threshold to compensate for differences in auditory nerve activation and to differentiate peripheral and central contributions of EFRs.

Effect of hearing aids use on speech stimulus decoding through speech-evoked ABR

INTRODUCTION

The electrophysiological responses obtained with the complex auditory brainstem response (cABR) provide objective measures of subcortical processing of speech and other complex stimuli. The cABR has also been used to verify the plasticity in the auditory pathway in the subcortical regions.

OBJECTIVE

To compare the results of cABR obtained in children using hearing aids before and after 9 months of adaptation, as well as to compare the results of these children with those obtained in children with normal hearing.

METHODS

Fourteen children with normal hearing (Control Group - CG) and 18 children with mild to moderate bilateral sensorineural hearing loss (Study Group - SG), aged 7-12 years, were evaluated. The children were submitted to pure tone and vocal audiometry, acoustic immittance measurements and ABR with speech stimulus, being submitted to the evaluations at three different moments: initial evaluation (M0), 3 months after the initial evaluation (M3) and 9 months after the evaluation (M9); at M0, the children assessed in the study group did not use hearing aids yet.

RESULTS

When comparing the CG and the SG, it was observed that the SG had a lower median for the V-A amplitude at M0 and M3, lower median for the latency of the component V at M9 and a higher median for the latency of component O at M3 and M9. A reduction in the latency of component A at M9 was observed in the SG.

CONCLUSION

Children with mild to moderate hearing loss showed speech stimulus processing deficits and the main impairment is related to the decoding of the transient portion of this stimulus spectrum. It was demonstrated that the use of hearing aids promoted neuronal plasticity of the Central Auditory Nervous System after an extended time of sensory stimulation.

Speech-evoked brainstem response in normal adolescent and children speakers of Brazilian Portuguese

This study aimed to analyze the coding responses of speech sounds (syllable/da/) in children and adolescent speakers of Brazilian Portuguese with typical development and normal hearing, aged between 8 and 16 years, in order to establish normative data of speech ABR response. This normative data can be used as a reference for speech ABR responses and also to enable the diagnosis in individuals with different pathologies. The analyze for absolute latency of speech sounds, more specifically the syllable/da/, for speech-ABR in children and adolescent speakers of Brazilian Portuguese with typical development were: right ear - wave V (6,43-6,57), wave A (7,35-7,57), wave C (18,19-18,46), wave D (21,99-22,42), wave E (30,73-31,05), wave F (39,19-39,55) and wave O (47,75-48,24) and left ear - wave V (6,44-6,57), wave A (7,36-7,59), wave C (18,26-18,55), wave D (22,22 -22,50), wave E (30,58-30,97), wave F (39,05-39,35) and wave O (47,78-48,13). For the amplitude values (μv), the responses were within the following ranges: right ear - wave V (0,10-0,14), wave A (0,19-0,25), wave C (0,08-0,13), wave D (0,11-0,17), wave E (0,17-0,42), wave F (0,14-0,33) and wave O (0,11-0,31) and left ear - wave V (0,09-0,13), wave A (0,08-0,23), wave C (0,08-0,14), wave D (0,10-0,15), wave E (0,20-0,26), wave F (0,16-0,22) and wave O (0,12-0,20). For the values of complex VA (slope: μv/ms and area μv x ms) the follow values obtained were: right ear - slope (0,32-0,42) and area (0,29-0,38) and left ear - slope (0,30-0,39) and area (0,27-0,35).

Cortical and subcortical processing of short duration speech stimuli in trained rock musicians: a pilot study

Most trained musicians are actively involved in rigorous practice from several years to achieve a high level of proficiency. Therefore, musicians are best group to research changes or modification in brain structures and functions across several information processing systems. This study aimed to investigate cortical and subcortical processing of short duration speech stimuli in trained rock musicians and non-musicians. Two groups of participant (experimental and control groups) in the age range of 18-25 years were selected for the study. Experimental group includes 15 rock musicians who had minimum professional training of 5 years of rock music, and each member had to be a regular performer of rock music for at least 15 h a week. Further age-matched 15 participants who were not having any formal training of any music served as non-musicians, in the control group. The speech-evoked ABR (S-ABR) and speech-evoked ALLR (S-LLR) with short duration speech 'synthetic /da/' was elicited in both groups. Different measures were analyzed for S-ABR and S-LLR. For S-ABR, MANOVA revealed significant main effect of groups on latencies of wave V, wave A, and amplitude of wave V/A slope. Similarly, Kruskal-Wallis test showed significantly higher F ₀ amplitude in rock musicians compared with non-musicians. For S-LLR, MANOVA showed statistically significant differences observed for latencies of wave P2 and N2 and amplitude measures of P2-N2 amplitude. This study indicated better neural processing of short duration speech stimuli at subcortical as well as cortical level among rock musicians when compared with non-musicians.

Cochlear Delay and Medial Olivocochlear Functioning in Children with Suspected Auditory Processing Disorder

Behavioral manifestations of processing deficits associated with auditory processing disorder (APD) have been well documented. However, little is known about their anatomical underpinnings, especially cochlear processing. Cochlear delays, a proxy for cochlear tuning, measured using stimulus frequency otoacoustic emission (SFOAE) group delay, and the influence of the medial olivocochlear (MOC) system activation at the auditory periphery was studied in 23 children suspected with APD (sAPD) and 22 typically developing (TD) children. Results suggest that children suspected with APD have longer SFOAE group delays (possibly due to sharper cochlear tuning) and reduced MOC function compared to TD children. Other differences between the groups include correlation between MOC function and SFOAE delay in quiet in the TD group, and lack thereof in the sAPD group. MOC-mediated changes in SFOAE delay were in opposite directions between groups: increase in delay in TD vs. reduction in delay in the sAPD group. Longer SFOAE group delays in the sAPD group may lead to longer cochlear filter ringing, and potential increase in forward masking. These results indicate differences in cochlear and MOC function between sAPD and TD groups. Further studies are warranted to explore the possibility of cochlea as a potential site for processing deficits in APD.

Mismatch negativity in children with specific language impairment and auditory processing disorder

Introduction

Mismatch negativity, an electrophysiological measure, evaluates the brain's capacity to discriminate sounds, regardless of attentional and behavioral capacity. Thus, this auditory event-related potential is promising in the study of the neurophysiological basis underlying auditory processing.

Objective

To investigate complex acoustic signals (speech) encoded in the auditory nervous system of children with specific language impairment and compare with children with auditory processing disorders and typical development through the mismatch negativity paradigm.

Methods

It was a prospective study. 75 children (6–12 years) participated in this study: 25 children with specific language impairment, 25 with auditory processing disorders, and 25 with typical development. Mismatch negativity was obtained by subtracting from the waves obtained by the stimuli /ga/ (frequent) and /da/ (rare). Measures of mismatch negativity latency and two amplitude measures were analyzed.

Results

It was possible to verify an absence of mismatch negativity in 16% children with specific language impairment and 24% children with auditory processing disorders. In the comparative analysis, auditory processing disorders and specific language impairment showed higher latency values and lower amplitude values compared to typical development.

Conclusion

These data demonstrate changes in the automatic discrimination of crucial acoustic components of speech sounds in children with specific language impairment and auditory processing disorders. It could indicate problems in physiological processes responsible for ensuring the discrimination of acoustic contrasts in pre-attentional and pre-conscious levels, contributing to poor perception.

Sensitivity, specificity and efficiency of speech-evoked ABR

We determined the sensitivity, specificity and efficiency of speech-evoked Auditory Brainstem Response (ABR) as a diagnostic support for Auditory Processing Disorder (APD) and specific language impairment (SLI). Speech-evoked ABRs were elicited using the five-formant syllable/da/. The waveforms V, A, C, D, E, F, and O of all groups were analyzed. The sensitivity and specificity were calculated, and receiver operating characteristic analyses were performed to determine the optimum cut-off. Seventy-five children who were native speakers of Brazilian-Portuguese participated. The participants included 25 children with APD, 25 children with SLI and 25 with typical development. Statistical analysis demonstrated a cut-off for latency values of 6.48, 7.51, 17.82, 22.33, 30.79, 39.54 and 48.00 for V, A, C, D, E, F, and O waves, respectively. The A wave exhibited superior balance for the APD group. For the SLI group, the A, D and O waves exhibited the best balance. Furthermore, when analyzing the APD and SLI groups separately, better sensitivity values were observed for the SLI group than the APD group. Speech-evoked ABR is a useful test to identify auditory processing disorders and language impairment. Furthermore, this study represented an important step forward in establishing the clinical utility of speech-evoked ABR in Brazilian Portuguese-speaking children.

The auditory brain-stem response to complex sounds: a potential biomarker for guiding treatment of psychosis

Cognitive deficits limit psychosocial functioning in schizophrenia. For many patients, cognitive remediation approaches have yielded encouraging results. Nevertheless, therapeutic response is variable, and outcome studies consistently identify individuals who respond minimally to these interventions. Biomarkers that can assist in identifying patients likely to benefit from particular forms of cognitive remediation are needed. Here, we describe an event-related potential (ERP) biomarker - the auditory brain-stem response (ABR) to complex sounds (cABR) - that appears to be particularly well-suited for predicting response to at least one form of cognitive remediation that targets auditory information processing. Uniquely, the cABR quantifies the fidelity of sound encoded at the level of the brainstem and midbrain. This ERP biomarker has revealed auditory processing abnormalities in various neurodevelopmental disorders, correlates with functioning across several cognitive domains, and appears to be responsive to targeted auditory training. We present preliminary cABR data from 18 schizophrenia patients and propose further investigation of this biomarker for predicting and tracking response to cognitive interventions.

Stability and plasticity of auditory brainstem function across the lifespan

The human auditory brainstem is thought to undergo rapid developmental changes early in life until age ∼2 followed by prolonged stability until aging-related changes emerge. However, earlier work on brainstem development was limited by sparse sampling across the lifespan and/or averaging across children and adults. Using a larger dataset than past investigations, we aimed to trace more subtle variations in auditory brainstem function that occur normally from infancy into the eighth decade of life. To do so, we recorded auditory brainstem responses (ABRs) to a click stimulus and a speech syllable (da) in 586 normal-hearing healthy individuals. Although each set of ABR measures (latency, frequency encoding, response consistency, nonstimulus activity) has a distinct developmental profile, across all measures developmental changes were found to continue well past age 2. In addition to an elongated developmental trajectory and evidence for multiple auditory developmental processes, we revealed a period of overshoot during childhood (5-11 years old) for latency and amplitude measures, when the latencies are earlier and the amplitudes are greater than the adult value. Our data also provide insight into the capacity for experience-dependent auditory plasticity at different stages in life and underscore the importance of using age-specific norms in clinical and experimental applications.

Effects of congenital blindness on the subcortical representation of speech cues

Human modalities play a vital role in the way the brain produces mental representations of the world around us. Although congenital blindness limits the understanding of the environment in some aspects, blind individuals may have other superior capabilities from long-term experience and neural plasticity. This study investigated the effects of congenital blindness on temporal and spectral neural encoding of speech at the subcortical level. The study included 26 congenitally blind individuals and 24 normal-sighted individuals with normal hearing. Auditory brainstem response (ABR) was recorded with both click and speech synthetic 40-ms /da/ stimuli. No significant difference was observed between the two groups in wave latencies or amplitudes of click ABR. Latencies of speech ABR D (p=0.012) and O (p=0.014) waves were significantly shorter in blind individuals than in normal-sighted individuals. Amplitudes of the A (p<0.001) and E (p=0.001) speech ABR (sABR) waves were also significantly higher in blind subjects. Blind individuals had significantly better results for duration (p<0.001) amplitude (p=0.015) and slope of the V-A complex (p=0.004), signal-to-noise ratio (p<0.001), and amplitude of the stimulus fundamental frequency (F0) (p=0.009), first formant (F1) (p<0.001) and higher-frequency region (HF) (p<0.001) ranges. Results indicate that congenitally blind subjects have improved hearing function in response to the /da/ syllable in both source and filter classes of sABR. It is possible that these subjects have enhanced neural representation of vocal cord vibrations and improved neural synchronization in temporal encoding of the onset and offset parts of speech stimuli at the brainstem level. This may result from the compensatory mechanism of neural reorganization in blind subjects influenced from top-down corticofugal connections with the auditory cortex.

Mode-locking neurodynamics predict human auditory brainstem responses to musical intervals

The auditory nervous system is highly nonlinear. Some nonlinear responses arise through active processes in the cochlea, while others may arise in neural populations of the cochlear nucleus, inferior colliculus and higher auditory areas. In humans, auditory brainstem recordings reveal nonlinear population responses to combinations of pure tones, and to musical intervals composed of complex tones. Yet the biophysical origin of central auditory nonlinearities, their signal processing properties, and their relationship to auditory perception remain largely unknown. Both stimulus components and nonlinear resonances are well represented in auditory brainstem nuclei due to neural phase-locking. Recently mode-locking, a generalization of phase-locking that implies an intrinsically nonlinear processing of sound, has been observed in mammalian auditory brainstem nuclei. Here we show that a canonical model of mode-locked neural oscillation predicts the complex nonlinear population responses to musical intervals that have been observed in the human brainstem. The model makes predictions about auditory signal processing and perception that are different from traditional delay-based models, and may provide insight into the nature of auditory population responses. We anticipate that the application of dynamical systems analysis will provide the starting point for generic models of auditory population dynamics, and lead to a deeper understanding of nonlinear auditory signal processing possibly arising in excitatory-inhibitory networks of the central auditory nervous system. This approach has the potential to link neural dynamics with the perception of pitch, music, and speech, and lead to dynamical models of auditory system development.

Neurodynamics, tonality, and the auditory brainstem response

Tonal relationships are foundational in music, providing the basis upon which musical structures, such as melodies, are constructed and perceived. A recent dynamic theory of musical tonality predicts that networks of auditory neurons resonate nonlinearly to musical stimuli. Nonlinear resonance leads to stability and attraction relationships among neural frequencies, and these neural dynamics give rise to the perception of relationships among tones that we collectively refer to as tonal cognition. Because this model describes the dynamics of neural populations, it makes specific predictions about human auditory neurophysiology. Here, we show how predictions about the auditory brainstem response (ABR) are derived from the model. To illustrate, we derive a prediction about population responses to musical intervals that has been observed in the human brainstem. Our modeled ABR shows qualitative agreement with important features of the human ABR. This provides a source of evidence that fundamental principles of auditory neurodynamics might underlie the perception of tonal relationships, and forces reevaluation of the role of learning and enculturation in tonal cognition.

Sex differences in auditory subcortical function

OBJECTIVE

Sex differences have been demonstrated in the peripheral auditory system as well as in higher-level cognitive processing. Here, we aimed to determine if the subcortical response to a complex auditory stimulus is encoded differently between the sexes.

METHODS

Using electrophysiological techniques, we assessed the auditory brainstem response to a synthesized stop-consonant speech syllable [da] in 76 native-English speaking, young adults (38 female). Timing and frequency components of the response were compared between males and females to determine which aspects of the response are affected by sex.

RESULTS

A dissimilarity between males and females was seen in the neural response to the components of the speech stimulus that change rapidly over time; but not in the slower changing, lower frequency information in the stimulus. We demonstrate that, in agreement with the click-evoked brainstem response, females have earlier peaks relative to males in the subcomponents of the response representing the onset of the speech sound. In contrast, the response peaks comprising the frequency-following response, which encode the fundamental frequency (F(0)) of the stimulus, as well as the spectral amplitude of the response to the F(0), is not affected by sex. Notably, the higher-frequency elements of the speech syllable are encoded differently between males and females, with females having greater representation of spectrotemporal information for frequencies above the F(0).

CONCLUSIONS

Our results provide a baseline for interpreting the higher incidence of language impairment (e.g. dyslexia, autism, specific language impairment) in males, and the subcortical deficits associated with these disorders.

SIGNIFICANCE

These results parallel the subcortical encoding patterns that are documented for good and poor readers in that poor readers differ from good readers on encoding fast but not slow components of speech. This parallel may thus help to explain the higher incidence of reading impairment in males compared to females.

Correlation between speech-evoked auditory brainstem responses and transient evoked otoacoustic emissions

OBJECTIVE

To investigate the correlation between cochlear processing and brainstem processing.

METHOD

Transient evoked otoacoustic emissions and speech-evoked auditory brainstem responses were recorded in 40 ears of normal-hearing individuals aged 18 to 23 years. Correlation analyses compared transient evoked otoacoustic emission parameters with speech-evoked auditory brainstem response parameters.

RESULTS

There was a significant correlation between speech-evoked auditory brainstem response wave V latency and transient evoked otoacoustic emission global emission strength; there were no other significant correlations between the two tests.

CONCLUSION

Tests for transient evoked otoacoustic emissions and speech-evoked auditory brainstem responses provide unique and functionally independent information about the integrity and sensitivity of the auditory system. Therefore, combining both tests will provide a more sensitive clinical battery with which to identify the location of different disorders (e.g. language-based learning impairments and hearing impairments).

Neural Encoding of Speech and Music: Implications for Hearing Speech in Noise

Understanding speech in a background of competing noise is challenging, especially for individuals with hearing loss or deficits in auditory processing ability. The ability to hear in background noise cannot be predicted from the audiogram, an assessment of peripheral hearing ability; therefore, it is important to consider the impact of central and cognitive factors on speech-in-noise perception. Auditory processing in complex environments is reflected in neural encoding of pitch, timing, and timbre, the crucial elements of speech and music. Musical expertise in processing pitch, timing, and timbre may transfer to enhancements in speech-in-noise perception due to shared neural pathways for speech and music. Through cognitive-sensory interactions, musicians develop skills enabling them to selectively listen to relevant signals embedded in a network of melodies and harmonies, and this experience leads in turn to enhanced ability to focus on one voice in a background of other voices. Here we review recent work examining the biological mechanisms of speech and music perception and the potential for musical experience to ameliorate speech-in-noise listening difficulties.

Speech and non-speech processing in children with phonological disorders: an electrophysiological study

OBJECTIVE

To determine whether neurophysiological auditory brainstem responses to clicks and repeated speech stimuli differ between typically developing children and children with phonological disorders.

INTRODUCTION

Phonological disorders are language impairments resulting from inadequate use of adult phonological language rules and are among the most common speech and language disorders in children (prevalence: 8 - 9%). Our hypothesis is that children with phonological disorders have basic differences in the way that their brains encode acoustic signals at brainstem level when compared to normal counterparts.

METHODS

We recorded click and speech evoked auditory brainstem responses in 18 typically developing children (control group) and in 18 children who were clinically diagnosed with phonological disorders (research group). The age range of the children was from 7-11 years.

RESULTS

The research group exhibited significantly longer latency responses to click stimuli (waves I, III and V) and speech stimuli (waves V and A) when compared to the control group.

DISCUSSION

These results suggest that the abnormal encoding of speech sounds may be a biological marker of phonological disorders. However, these results cannot define the biological origins of phonological problems. We also observed that speech-evoked auditory brainstem responses had a higher specificity/sensitivity for identifying phonological disorders than click-evoked auditory brainstem responses.

CONCLUSIONS

Early stages of the auditory pathway processing of an acoustic stimulus are not similar in typically developing children and those with phonological disorders. These findings suggest that there are brainstem auditory pathway abnormalities in children with phonological disorders.

Sensory-cognitive interaction in the neural encoding of speech in noise: a review

BACKGROUND

Speech-in-noise (SIN) perception is one of the most complex tasks faced by listeners on a daily basis. Although listening in noise presents challenges for all listeners, background noise inordinately affects speech perception in older adults and in children with learning disabilities. Hearing thresholds are an important factor in SIN perception, but they are not the only factor. For successful comprehension, the listener must perceive and attend to relevant speech features, such as the pitch, timing, and timbre of the target speaker's voice. Here, we review recent studies linking SIN and brainstem processing of speech sounds.

PURPOSE

To review recent work that has examined the ability of the auditory brainstem response to complex sounds (cABR), which reflects the nervous system's transcription of pitch, timing, and timbre, to be used as an objective neural index for hearing-in-noise abilities.

STUDY SAMPLE

We examined speech-evoked brainstem responses in a variety of populations, including children who are typically developing, children with language-based learning impairment, young adults, older adults, and auditory experts (i.e., musicians).

DATA COLLECTION AND ANALYSIS

In a number of studies, we recorded brainstem responses in quiet and babble noise conditions to the speech syllable /da/ in all age groups, as well as in a variable condition in children in which /da/ was presented in the context of seven other speech sounds. We also measured speech-in-noise perception using the Hearing-in-Noise Test (HINT) and the Quick Speech-in-Noise Test (QuickSIN).

RESULTS

Children and adults with poor SIN perception have deficits in the subcortical spectrotemporal representation of speech, including low-frequency spectral magnitudes and the timing of transient response peaks. Furthermore, auditory expertise, as engendered by musical training, provides both behavioral and neural advantages for processing speech in noise.

CONCLUSIONS

These results have implications for future assessment and management strategies for young and old populations whose primary complaint is difficulty hearing in background noise. The cABR provides a clinically applicable metric for objective assessment of individuals with SIN deficits, for determination of the biologic nature of disorders affecting SIN perception, for evaluation of appropriate hearing aid algorithms, and for monitoring the efficacy of auditory remediation and training.

Test-retest reliability of the speech-evoked auditory brainstem response

OBJECTIVE

The speech-evoked auditory brainstem response (ABR) provides an objective measure of subcortical encoding of complex acoustic features. However, the intrasubject reliability of this response in both optimal and challenging listening conditions has not yet been systematically documented. This study aimed to evaluate test-retest reliability of the speech-evoked ABR in young adults.

METHODS

In each of two sessions, ABRs were obtained with: (1) a 170 ms /da/ syllable presented in quiet as well as 2-talker and 6-talker babble background noise conditions and (2) a 40 ms /da/ syllable presented in quiet. Test-retest reliability of the responses was analyzed in the frequency and time domains.

RESULTS

The speech-evoked ABR does not vary significantly across sessions within individuals on measures of temporal encoding (i.e., peak latencies, stimulus-to-response and response-to-response measures), frequency representation and response magnitude.

CONCLUSIONS

The subcortical auditory pathway produces a response to a complex sound that is stable and replicable from session to session.

SIGNIFICANCE

By demonstrating the high degree of replicability in optimal and challenging listening conditions, the applicability of the speech-evoked ABR may be increased to examining a range of auditory processing abilities in clinical and research settings.

Rapid acoustic processing in the auditory brainstem is not related to cortical asymmetry for the syllable rate of speech

OBJECTIVE

Temporal acuity in the auditory brainstem is correlated with left-dominant patterns of cortical asymmetry for processing rapid speech-sound stimuli. Here we investigate whether a similar relationship exists between brainstem processing of rapid speech components and cortical processing of syllable patterns in speech.

METHODS

We measured brainstem and cortical evoked potentials in response to speech tokens in 23 children. We used established measures of auditory brainstem and cortical activity to examine functional relationships between these structures.

RESULTS

We found no relationship between brainstem responses to fast acoustic elements of speech and right-dominant cortical processing of syllable patterns.

CONCLUSIONS

Brainstem processing of rapid elements in speech is not functionally related to rightward cortical asymmetry associated with the processing of syllable-rate features in speech. Viewed together with previous evidence linking brainstem timing with leftward cortical asymmetry for faster acoustic features, findings support the existence of distinct mechanisms for encoding rapid vs. slow elements of speech.

SIGNIFICANCE

Results provide a fundamental advance in our knowledge of the segregation of sub-cortical input associated with cortical asymmetries for acoustic rate processing in the human auditory system. Implications of these findings for auditory perception, reading ability and development are discussed.

Auditory brain stem response to complex sounds: a tutorial

This tutorial provides a comprehensive overview of the methodological approach to collecting and analyzing auditory brain stem responses to complex sounds (cABRs). cABRs provide a window into how behaviorally relevant sounds such as speech and music are processed in the brain. Because temporal and spectral characteristics of sounds are preserved in this subcortical response, cABRs can be used to assess specific impairments and enhancements in auditory processing. Notably, subcortical auditory function is neither passive nor hardwired but dynamically interacts with higher-level cognitive processes to refine how sounds are transcribed into neural code. This experience-dependent plasticity, which can occur on a number of time scales (e.g., life-long experience with speech or music, short-term auditory training, on-line auditory processing), helps shape sensory perception. Thus, by being an objective and noninvasive means for examining cognitive function and experience-dependent processes in sensory activity, cABRs have considerable utility in the study of populations where auditory function is of interest (e.g., auditory experts such as musicians, and persons with hearing loss, auditory processing, and language disorders). This tutorial is intended for clinicians and researchers seeking to integrate cABRs into their clinical or research programs.

Stimulus rate and subcortical auditory processing of speech

Many sounds in the environment, including speech, are temporally dynamic. The auditory brainstem is exquisitely sensitive to temporal features of the incoming acoustic stream, and by varying the speed of presentation of these auditory signals it is possible to investigate the precision with which temporal cues are represented at a subcortical level. Therefore, to determine the effects of stimulation rate on the auditory brainstem response (ABR), we recorded evoked responses to both a click and a consonant-vowel speech syllable (/da/) presented at three rates (15.4, 10.9 and 6.9 Hz). We hypothesized that stimulus rate affects the onset to speech-evoked responses to a greater extent than click-evoked responses and that subcomponents of the speech- ABR are distinctively affected. While the click response was invariant with changes in stimulus rate, timing of the onset response to /da/ varied systematically, increasing in peak latency as presentation rate increased. Contrasts between the click- and speech-evoked onset responses likely reflect acoustic differences, where the speech stimulus onset is more gradual, has more delineated spectral information, and is more susceptible to backward masking by the subsequent formant transition. The frequency-following response (FFR) was also rate dependent, with response magnitude of the higher frequencies (>400 Hz), but not the frequencies corresponding to the fundamental frequency, diminishing with increasing rate. The selective impact of rate on high-frequency components of the FFR implicates the involvement of distinct underlying neural mechanisms for high- versus low-frequency components of the response. Furthermore, the different rate sensitivities of the speech-evoked onset response and subcomponents of the FFR support the involvement of different neural streams for these two responses. Taken together, these differential effects of rate on the ABR components likely reflect distinct aspects of auditory function such that varying rate of presentation of complex stimuli may be expected to elicit unique patterns of abnormality, depending on the clinical population.

Selective subcortical enhancement of musical intervals in musicians

By measuring the auditory brainstem response to two musical intervals, the major sixth (E3 and G2) and the minor seventh (E3 and F#2), we found that musicians have a more specialized sensory system for processing behaviorally relevant aspects of sound. Musicians had heightened responses to the harmonics of the upper tone (E), as well as certain combination tones (sum tones) generated by nonlinear processing in the auditory system. In music, the upper note is typically carried by the upper voice, and the enhancement of the upper tone likely reflects musicians' extensive experience attending to the upper voice. Neural phase locking to the temporal periodicity of the amplitude-modulated envelope, which underlies the perception of musical harmony, was also more precise in musicians than nonmusicians. Neural enhancements were strongly correlated with years of musical training, and our findings, therefore, underscore the role that long-term experience with music plays in shaping auditory sensory encoding.