Asymmetric Cochlear Processing Mimics Hemispheric Specialization

Auditory Effects of Acoustic Noise From 3-T Brain MRI in Neonates With Hearing Protection

BACKGROUND

Neonates with immature auditory function (eg, weak/absent middle ear muscle reflex) could conceivably be vulnerable to noise-induced hearing loss; however, it is unclear if neonates show evidence of hearing loss following MRI acoustic noise exposure.

PURPOSE

To explore the auditory effects of MRI acoustic noise in neonates.

STUDY TYPE

Prospective.

SUBJECTS

Two independent cohorts of neonates (N = 19 and N = 18; mean gestational-age, 38.75 ± 2.18 and 39.01 ± 1.83 weeks).

FIELD STRENGTH/SEQUENCE

T1-weighted three-dimensional gradient-echo sequence, T2-weighted fast spin-echo sequence, single-shot echo-planar imaging-based diffusion-tensor imaging, single-shot echo-planar imaging-based diffusion-kurtosis imaging and T2-weighted fluid-attenuated inversion recovery sequence at 3.0 T.

ASSESSMENT

All neonates wore ear protection during scan protocols lasted ~40 minutes. Equivalent sound pressure levels (SPLs) were measured for both cohorts. In cohort1, left- and right-ear auditory brainstem response (ABR) was measured before (baseline) and after (follow-up) MRI, included assessment of ABR threshold, wave I, III and V latencies and interpeak interval to determine the functional status of auditory nerve and brainstem. In cohort2, baseline and follow-up left- and right-ear distortion product otoacoustic emission (DPOAE) amplitudes were assessed at 1.2 to 7.0 kHz to determine cochlear function.

STATISTICAL TEST

Wilcoxon signed-rank or paired t-tests with Bonferroni's correction were used to compare the differences between baseline and follow-up ABR and DPOAE measures.

RESULTS

Equivalent SPLs ranged from 103.5 to 113.6 dBA. No significant differences between baseline and follow-up were detected in left- or right-ear ABR measures (P > 0.999, Bonferroni corrected) in cohort1, or in DPOAE levels at 1.2 to 7.0 kHz in cohort2 (all P > 0.999 Bonferroni corrected except for left-ear levels at 3.5 and 7.0 kHz with corrected P = 0.138 and P = 0.533).

DATA CONCLUSION

A single 40-minute 3-T MRI with equivalent SPLs of 103.5-113.6 dBA did not result in significant transient disruption of auditory function, as measured by ABR and DPOAE, in neonates with adequate hearing protection.

EVIDENCE LEVEL

2.

TECHNICAL EFFICACY

Stage 5.

Influence of tinnitus, lifetime noise exposure, and firearm use on hearing thresholds, distortion product otoacoustic emissions, and their relative metric

Distortion product otoacoustic emissions (DPOAEs) and hearing thresholds (HTs) are widely used to evaluate auditory physiology. DPOAEs are sensitive to cochlear amplification processes, while HTs are additionally dependent upon inner hair cells, synaptic junctions, and the auditory nervous system. These distinctions between DPOAEs and HTs might help differentially diagnose auditory dysfunctions. This study aims to differentially diagnose auditory dysfunctions underlying tinnitus, firearm use, and high lifetime noise exposure (LNE) using HTs, DPOAEs, and a derived metric comparing HTs and DPOAEs, in a sample containing overlapping subgroups of 133 normal-hearing young adults (56 with chronic tinnitus). A structured interview was used to evaluate LNE and firearm use. Linear regression was used to model the relationship between HTs and DPOAEs, and their regression residuals were used to quantify their relative agreement. Participants with chronic tinnitus showed significantly elevated HTs, yet DPOAEs remained comparable to those without tinnitus. In contrast, firearm users revealed elevated HTs and significantly lower DPOAEs than predicted from HTs. High LNE was associated with elevated HTs and a proportional decline in DPOAEs, as predicted from HTs. We present a theoretical model to interpret the findings, which suggest neural (or synaptic) dysfunction underlying tinnitus and disproportional mechanical dysfunction underlying firearm use.

The effect of noise on the cortical activity patterns of speech processing in adults with single-sided deafness

The most common complaint in people with single-sided deafness (SSD) is difficulty in understanding speech in a noisy environment. Moreover, the neural mechanism of speech-in-noise (SiN) perception in SSD individuals is still poorly understood. In this study, we measured the cortical activity in SSD participants during a SiN task to compare with a speech-in-quiet (SiQ) task. Dipole source analysis revealed left hemispheric dominance in both left- and right-sided SSD group. Contrary to SiN listening, this hemispheric difference was not found during SiQ listening in either group. In addition, cortical activation in the right-sided SSD individuals was independent of the location of sound whereas activation sites in the left-sided SSD group were altered by the sound location. Examining the neural-behavioral relationship revealed that N1 activation is associated with the duration of deafness and the SiN perception ability of individuals with SSD. Our findings indicate that SiN listening is processed differently in the brains of left and right SSD individuals.

Sexual Dimorphism in the Functional Development of the Cochlear Amplifier in Humans

OBJECTIVES

Otoacoustic emissions, a byproduct of active cochlear mechanisms, exhibit a higher magnitude in females than in males. The relatively higher levels of androgen exposure in the male fetus are thought to cause this difference. Postnatally, the onset of puberty is also associated with the androgen surge in males. In this study, we investigated sexual dimorphism in age-related changes in stimulus-frequency otoacoustic emissions for children.

DESIGN

In a retrospective design, stimulus-frequency otoacoustic emissions were analyzed from a cross-sectional sample of 170 normal-hearing children (4 to 12 years) and 67 young adults. Wideband acoustic immittance and efferent inhibition measures were analyzed to determine the extent to which middle ear transmission and efferent inhibition can account for potential sex differences in stimulus-frequency otoacoustic emissions.

RESULTS

Male children showed a significant reduction in otoacoustic emission magnitudes with age, whereas female children did not show any such changes. Females showed higher stimulus-frequency otoacoustic emission magnitudes compared with males. However, the effect size of sex differences in young adults was larger compared with children. Unlike the otoacoustic emission magnitude, the noise floor did not show sexual dimorphism; however, it decreased with age. Neither the wideband absorbance nor efferent inhibition could account for the sex differences in stimulus-frequency otoacoustic emissions.

CONCLUSIONS

The cochlear-amplifier function remains robust in female children but diminishes in male children between 4 and 12 years of age. We carefully eliminated lifestyle, middle ear, and efferent factors to conclude that the androgen surge associated with puberty likely caused the observed masculinization of stimulus-frequency otoacoustic emissions in male children. These findings have significant theoretical consequences. The cochlea is considered mature at birth; however, the present findings highlight that functional cochlear maturation, as revealed by otoacoustic emissions, can be postnatally influenced by endogenous hormonal factors, at least in male children. Overall, work reported here demonstrates sexual dimorphism in the functional cochlear maturational processes during childhood.

Neonatal Hearing Screening: Prevalence of Unilateral and Bilateral Hearing Loss and Associated Risk Factors

INTRODUCTION

Newborn hearing screening is essential for early identification of hearing loss to decrease the adverse effects of hearing loss. The objective of this study was to determine the prevalence of hearing loss and risk factors of congenital hearing loss in newborns.

METHODS

In this analytical case-control study, a hearing screening test was performed for all newborns aged 3-14 days.

RESULTS

Of 5,500 newborns evaluated, 24 newborns had hearing loss. The prevalence of hearing loss was 4.36 per 1,000. Of 24 hearing-impaired newborns, 15 had bilateral hearing loss (BHL) (62.5%) and nine had unilateral hearing loss (UHL) (37.5%). Among the neonates with hearing loss, the prevalence of hearing loss was higher (77.8%) in the right ear. The main risk factors identified in this study were low gestational age (P=0.001), hospitalization in the neonatal intensive care unit (NICU) (P=0.008), exposure to ototoxic drugs (P=0.001), gestational diabetes P=0.01), craniofacial anomalies (P=0.01), convulsion (P=0.03), consanguineous marriage of parents (P=0.001), low birth weight (P=0.01), and hyperbilirubinemia (P=0.001).

CONCLUSION

The prevalence of hearing loss was higher in the right ear than in the left ear. NICU stay, use of ototoxic drugs, low gestational age (<35 weeks), gestational diabetes, craniofacial anomalies, convulsion, consanguineous marriage of parents, low birth weight, and hyperbilirubinemia were significant risk factors for congenital hearing loss in studied newborns.

Effect of Contralateral Noise on Speech Intelligibility

In patients with strong asymmetric hearing loss, standard clinical practice involves testing speech intelligibility in the ear with the higher hearing threshold by simultaneously presenting noise to the other ear. However, psychoacoustic and functional magnetic resonance imaging (fMRI) studies indicate that this approach may be problematic as contralateral noise has a disruptive effect on task processing. Furthermore, fMRI studies have revealed that the effect of contralateral noise on brain activity depends on the lateralization of task processing. The effect of contralateral noise is stronger when task-relevant stimuli are presented ipsilaterally to the hemisphere that is processing the task. In the present study, we tested the effect of four different levels of contralateral noise on speech intelligibility using the Oldenburg sentence test (OLSA). Cortical lateralization of speech processing was assessed upfront by using a visual speech test with fMRI. Contralateral OLSA noise of 65 or 80 dB SPL significantly reduced word intelligibility irrespective of which ear the speech was presented to. In participants with left-lateralized speech processing, 50 dB SPL contralateral OLSA noise led to a significant reduction in speech intelligibility when speech was presented to the left ear, i.e. when speech was presented ipsilaterally to the hemisphere that is mainly processing speech. Thus, contralateral noise, as used in standard clinical practice, not only prevents listeners from using the information in the better-hearing ear but may also have the unintended effect of hampering central processing of speech.

Transient Otoacoustic Emissions and Auditory Brainstem Responses in Low-Risk Cohort of Newborn and One-Month-Old Infants: Assessment of Infant Auditory System Physiology in the Prenatal Alcohol in SIDS and Stillbirth Network Safe Passage Study

BACKGROUND

The Prenatal Alcohol and Sudden Infant Death Syndrome and Stillbirth Network, known as the "Safe Passage Study," enrolled approximately 12,000 pregnant women from the United States and South Africa and followed the development of their babies through pregnancy and the infant's first year of life to investigate the role of prenatal alcohol exposure in the risk for sudden infant death syndrome (SIDS) and adverse pregnancy outcomes, such as stillbirth and fetal alcohol spectrum disorders.

PURPOSE

Auditory system tests were included in the physiologic test battery used to study the effects of prenatal alcohol exposure on neurophysiology and neurodevelopment, as well as potential causal relationships between neurodevelopmental disorders and SIDS and/or stillbirth. The purpose of this manuscript is to describe normative results when using the auditory test battery applied.

RESEARCH DESIGN

The test battery included the auditory brainstem response (ABR) and transient-evoked otoacoustic emissions (TEOAEs). Data were collected on individual ears of newborns and 1-month-old infants.

STUDY SAMPLE

From a cohort of 6,070 with auditory system exams, a normative subsample of 325 infants were selected who were not exposed prenatally to alcohol, cigarette smoke, or drugs nor were they preterm or low birthweight. The subsample is small relative to the overall study because of strict criteria for no exposure to substances known to be associated with SIDS or stillbirth and the exclusion of preterm and low birthweight infants. Expectant mothers were recruited from general maternity at two comprehensive clinical sites, in the northern plains in the United States and in Cape Town, South Africa. These populations were selected for study because both were known to be at high-risk for SIDS and stillbirth.

DATA COLLECTION AND ANALYSIS

ABR and TEOAE recordings were stored electronically. Peak latency and amplitude analysis of ABRs were determined by study personnel, and results were evaluated for differences by age, sex, test site, race, and ear (left versus right).

RESULTS

TEOAE findings were consistent with existing literature including the increase in signal-to-noise (SNR) over the first month of life. The SNR increase is due to an increase in amplitude of the emission. TEOAE amplitude asymmetry favoring the right ear was found, whereas SNR asymmetry was not, perhaps because of the small sample size. A nonsignificant trend toward larger responses in female babies was found; a result that is generally statistically significant in studies with larger samples. Latencies were found to be shorter in ABRs elicited in the right ear with amplitudes that were slightly bigger on average. An expected decrease in wave V latency was observed from birth to 1-month of age, but the finding was of borderline significance (p = 0.058).

CONCLUSIONS

One month is a short time to judge development of the auditory system; however, the ABR and TEOAE findings were consistent with current literature. We conclude that the auditory system data acquired for the Safe Passage Study, as reflected in the data obtained from this cohort of "unexposed" infants, is consistent with published reports of these auditory system measures in the general population.

Effects of stimulus conditions on vestibular evoked myogenic potentials in healthy subjects

BACKGROUND

Characteristics of vestibular evoked myogenic potentials (VEMPs) depend on stimulus conditions.

OBJECTIVE

To determine the optimal stimulus conditions for cervical and ocular VEMPs.

METHODS

Participants were 23 healthy subjects. We compared air-conducted cervical and ocular VEMPs elicited by various tone-burst conditions (frequencies 500-1,000 Hz, rise/fall times 1-2 ms, and plateau times 0-6 ms) with an intensity of 105 dB normal hearing level. Effects of simultaneous contralateral masking noise on VEMPs were also evaluated.

RESULTS

The largest cervical VEMP amplitudes were elicited by 500-750 Hz and 2-6 ms plateau time-tone-bursts, and the largest ocular VEMP amplitudes by 750 Hz and 2-4 ms plateau time-tone-bursts. Repeatability of the latency was better at 1 ms than at 2 ms rise/fall time in both VEMPs. In both VEMPs, masking noise reduced amplitude, and in ocular VEMP, amplitudes were significantly larger at the left ear stimulation than the right.

CONCLUSION

Optimal tone-burst stimulation for both VEMPs seemed to be 500-750 Hz frequency and 1/2/1 ms rise/plateau/fall time without contralateral masking noise. Ocular VEMP amplitudes from left ear stimulation were originally larger than those from right ear stimulation.

Developmental Coordination Disorder: The Importance of Grounded Assessments and Interventions

This focused review is based on earlier studies which have shown that both children and adults diagnosed as having developmental coordination disorder (DCD), benefited from sensorimotor therapy according to the method Retraining for Balance (RB). Different approaches and assessments for children and adults in regard to DCD are scrutinized and discussed in comparison to RB which mainly includes (a) vestibular assessment and stimulation (b) assessment and integration of aberrant primary reflexes and (c) assessment and stimulation of auditory and visual perception. Earlier results indicate that the process of Sensorimotor therapy using RB techniques could be described according to a conceptual Kinesthetic-Vestibular Developmental Model (KVDM) whereby the training elicited temporary physical and psychological regressions followed by transformations i.e., positive physical and psychological development. We have also seen that this recurring pattern is similar for children and adults. In our conceptual model vestibular stimulation (perceptual priming) stimulates the nervous system, which might enhance object-related priming. This perceptual priming will also assist the suppression of persistent aberrant primary reflexes. In order to develop effective methods for assessment and intervention of DCD over the life span the importance of primary reflex inhibition and vestibular stimulation as well as a combination of bottom-up and top-down approaches have to be considered.

JJ. Auditory Attention Reduced Ear-Canal Noise in Humans by Reducing Subject Motion, Not by Medial Olivocochlear Efferent Inhibition: Implications for Measuring Otoacoustic Emissions During a Behavioral Task

Otoacoustic emissions (OAEs) are often measured to non-invasively determine activation of medial olivocochlear (MOC) efferents in humans. Usually these experiments assume that ear-canal noise remains constant. However, changes in ear-canal noise have been reported in some behavioral experiments. We studied the variability of ear-canal noise in eight subjects who performed a two-interval-forced-choice (2IFC) sound-level-discrimination task on monaural tone pips in masker noise. Ear-canal noise was recorded directly from the unstimulated ear opposite the task ear. Recordings were also made with similar sounds presented, but no task done. In task trials, ear-canal noise was reduced at the time the subject did the discrimination, relative to the ear-canal noise level earlier in the trial. In two subjects, there was a decrease in ear-canal noise, primarily at 1-2 kHz, with a time course similar to that expected from inhibition by MOC activity elicited by the task-ear masker noise. These were the only subjects with spontaneous OAEs (SOAEs). We hypothesize that the SOAEs were inhibited by MOC activity elicited by the task-ear masker. Based on the standard rationale in OAE experiments that large bursts of ear-canal noise are artifacts due to subject movement, ear-canal noise bursts above a sound-level criterion were removed. As the criterion was lowered and more high- and moderate-level ear-canal noise bursts were removed, the reduction in ear-canal noise level at the time of the 2IFC discrimination decreased to almost zero, for the six subjects without SOAEs. This pattern is opposite that expected from MOC-induced inhibition (which is greater on lower-level sounds), but can be explained by the hypothesis that subjects move less and create fewer bursts of ear-canal noise when they concentrate on doing the task. In no-task trials for these six subjects, the ear-canal noise level was little changed throughout the trial. Our results show that measurements of MOC effects on OAEs must measure and account for changes in ear-canal noise, especially in behavioral experiments. The results also provide a novel way of showing the time course of the buildup of attention via the time course of the reduction in ear-canal noise.

Catching-up: Children with developmental coordination disorder compared to healthy children before and after sensorimotor therapy

The aims of the present study were to (a) compare healthy children in terms of sensorimotor maturity to untreated children diagnosed with developmental coordination disorder (DCD) and (b) compare healthy children to diagnosed children following completed treatment with sensorimotor therapy. Participants were 298 children, 196 boys and 102 girls, distributed into a Norm group of healthy children (n = 99) and a group of children diagnosed with DCD (n = 199) with a total mean age of 8.77 years (SD = 2.88). Participants in both groups were assessed on instruments aimed to detect sensorimotor deviations. The children in the DCD group completed, during on average 36 months, sensorimotor therapy which comprised stereotypical fetal- and infant movements, vestibular stimulation, tactile stimulation, auditory stimulation, complementary play exercises, gross motor milestones, and sports-related gross motor skills. At the final visit a full assessment was once more performed. Results showed that the Norm group performed better on all sensorimotor tests as compared to the untreated children from the DCD group, with the exception of an audiometric test where both groups performed at the same level. Girls performed better on tests assessing proprioceptive and balance abilities. Results also showed, after controls for natural maturing effects, that the children from the DCD group after sensorimotor therapy did catch up with the healthy children. The concept of "catching-up" is used within developmental medicine but has not earlier been documented with regard to children and youth in connection with DCD.

Low-frequency bias tone suppression of auditory-nerve responses to low-level clicks and tones

We used low-frequency "bias" tones (BT's) to explore whether click and tone responses are affected in the same way by cochlear active processes. In nonlinear systems the responses to clicks are not always simply related to the responses to tones. Cochlear amplifier gain depends on the incremental slope of the outer-hair-cell (OHC) stereocilia mechano-electric transduction (MET) function. BTs transiently change the operating-point of OHC MET channels and can suppress cochlear-amplifier gain by pushing OHC METs into low-slope saturation regions. BT effects on single auditory-nerve (AN) fibers have been studied on tone responses but not on click responses. We recorded from AN fibers in anesthetized cats and compared tone and click responses using 50 Hz BTs at 70-120 dB SPL to manipulate OHC stereocilia position. BTs can also excite and thereby obscure the BT suppression. We measured AN-fiber response synchrony to BTs alone so that we could exclude suppression measurements when the BT synchrony might obscure the suppression. BT suppression of low-level tone and click responses followed the traditional pattern of twice-a-BT-cycle suppression with more suppression at one phase than the other. The major suppression phases of most fibers were tightly grouped with little difference between click and tone suppressions, which is consistent with low-level click and tone responses being amplified in the same way. The data are also consistent with the operating point of the OHC MET function varying smoothly from symmetric in the base to offset in the apex, and, in contrast, with the IHC MET function being offset throughout the cochlea. As previously reported, bias-tones presented alone excited AN fibers at one or more phases, a phenomena termed "peak splitting" with most BT excitation phases ∼¼ cycle before or after the major suppression phase. We explain peak splitting as being due to distortion in multiple fluid drives to inner-hair-cell stereocilia.

Pediatric Auditory Brainstem Implant Surgery

Auditory brainstem implants (ABIs) provide auditory perception in patients with profound hearing loss who are not candidates for the cochlear implant (CI) because of anatomic constraints or failed CI surgery. Herein, the authors discuss (1) preoperative evaluation of pediatric ABI candidates, (2) surgical approaches, and (3) contemporary ABI devices and their use in the pediatric population. The authors also review the surgical and audiologic outcomes following pediatric ABI surgery. The authors' institutional experience and the nearly 200 cases performed in Europe and the United States indicate that ABI surgery in children can be safe and effective.

Effects of Age and Implanted Ear on Speech Recognition in Adults with Unilateral Cochlear Implants

The objective of this study was to examine how age and implanted ear contribute to functional outcomes with cochlear implantation (CI). A retrospective review was performed on 96 adults who underwent unilateral CI. Older adults with right-ear implants had higher Hearing in Noise Test (HINT) scores at 1 year by 10.3% (p = 0.06). When adjusted to rationalized arcsine units (rau), right-ear HINT scores in older adults were higher by 12.1 rau (p = 0.04). Older adults had an 8.9% advantage on the right side compared to the left in post- versus preimplant scores for consonant-vowel nucleus-consonant words (p = 0.05). No significant differences were observed for younger adults. In conclusion, although adults of all ages experience improvements in speech perception following CI, there might be a subtle but consistent right-ear advantage in older adults.

Knowledge About Sounds-Context-Specific Meaning Differently Activates Cortical Hemispheres, Auditory Cortical Fields, and Layers in House Mice

Activation of the auditory cortex (AC) by a given sound pattern is plastic, depending, in largely unknown ways, on the physiological state and the behavioral context of the receiving animal and on the receiver's experience with the sounds. Such plasticity can be inferred when house mouse mothers respond maternally to pup ultrasounds right after parturition and naïve females have to learn to respond. Here we use c-FOS immunocytochemistry to quantify highly activated neurons in the AC fields and layers of seven groups of mothers and naïve females who have different knowledge about and are differently motivated to respond to acoustic models of pup ultrasounds of different behavioral significance. Profiles of FOS-positive cells in the AC primary fields (AI, AAF), the ultrasonic field (UF), the secondary field (AII), and the dorsoposterior field (DP) suggest that activation reflects in AI, AAF, and UF the integration of sound properties with animal state-dependent factors, in the higher-order field AII the news value of a given sound in the behavioral context, and in the higher-order field DP the level of maternal motivation and, by left-hemisphere activation advantage, the recognition of the meaning of sounds in the given context. Anesthesia reduced activation in all fields, especially in cortical layers 2/3. Thus, plasticity in the AC is field-specific preparing different output of AC fields in the process of perception, recognition and responding to communication sounds. Further, the activation profiles of the auditory cortical fields suggest the differentiation between brains hormonally primed to know (mothers) and brains which acquired knowledge via implicit learning (naïve females). In this way, auditory cortical activation discriminates between instinctive (mothers) and learned (naïve females) cognition.

Right-ear advantage drives the link between olivocochlear efferent 'antimasking' and speech-in-noise listening benefits

The mammalian cochlea receives feedback from the brainstem medial olivocochlear (MOC) efferents, whose putative 'antimasking' function is to adjust cochlear amplification and enhance peripheral signal detection in adverse listening environments. Human studies have been inconsistent in demonstrating a clear connection between this corticofugal system and behavioral speech-in-noise (SIN) listening skills. To elucidate the role of brainstem efferent activity in SIN perception, we measured ear-specific contralateral suppression of transient-evoked otoacoustic emissions (OAEs), a proxy measure of MOC activation linked to auditory learning in noisy environments. We show that suppression of cochlear emissions is stronger with a more basal cochlear bias in the right ear compared with the left ear. Moreover, a strong negative correlation was observed between behavioral SIN performance and right-ear OAE suppression magnitudes, such that lower speech reception thresholds in noise were predicted by larger amounts of MOC-related activity. This brain-behavioral relation was not observed for left ear SIN perception. The rightward bias in contralateral MOC suppression of OAEs, coupled with the stronger association between physiological and perceptual measures, is consistent with left-hemisphere cerebral dominance for speech-language processing. We posit that corticofugal feedback from the left cerebral cortex through descending MOC projections sensitizes the right cochlea to signal-in-noise detection, facilitating figure-ground contrast and improving degraded speech analysis. Our findings demonstrate that SIN listening is at least partly driven by subcortical brain mechanisms; primitive stages of cochlear processing and brainstem MOC modulation of (right) inner ear mechanics play a critical role in dictating SIN understanding.

Conjugating time and frequency: hemispheric specialization, acoustic uncertainty, and the mustached bat

A prominent hypothesis of hemispheric specialization for human speech and music states that the left and right auditory cortices (ACs) are respectively specialized for precise calculation of two canonically-conjugate variables: time and frequency. This spectral-temporal asymmetry does not account for sex, brain-volume, or handedness, and is in opposition to closed-system hypotheses that restrict this asymmetry to humans. Mustached bats have smaller brains, but greater ethological pressures to develop such a spectral-temporal asymmetry, than humans. Using the Heisenberg-Gabor Limit (i.e., the mathematical basis of the spectral-temporal asymmetry) to frame mustached bat literature, we show that recent findings in bat AC (1) support the notion that hemispheric specialization for speech and music is based on hemispheric differences in temporal and spectral resolution, (2) discredit closed-system, handedness, and brain-volume theories, (3) underscore the importance of sex differences, and (4) provide new avenues for phonological research.

Adults with sensorimotor disorders: enhanced physiological and psychological development following specific sensorimotor training

The aim of the study was to investigate, for the first time, if it is possible to integrate primary reflexes in adults with sensorimotor disorders through sensorimotor therapy (SMT). Participants consisted of 14 adults, one man and 13 women, with an average age of 35 years who completed a SMT program over 3 years. They were compared with a reference group of 100 youngsters spanning from 11 to 17 years. Procedures were the same for both youngsters and adults including regular visits to a therapist and training ~15 min each day at home throughout therapy. Assessments of sensorimotor abilities were made before and after the therapy. Results showed significant improvements on all measurements with regard to treatment for both age groups and the main picture indicated small differences between age groups. After therapy adults were better on balance and orientation tests while the youngsters performed better on sports related gross motor movements, processing of speech sounds and had acquired a better relation between visual skills and vestibular function. Conclusions were that motor problems do not disappear with age and that the same diagnostic instruments and treatment methods can be used for both children and adults with sensorimotor difficulties.

Click-evoked otoacoustic emissions in children and adolescents with gender identity disorder

Click-evoked otoacoustic emissions (CEOAEs) are echo-like sounds that are produced by the inner ear in response to click-stimuli. CEOAEs generally have a higher amplitude in women compared to men and neonates already show a similar sex difference in CEOAEs. Weaker responses in males are proposed to originate from elevated levels of testosterone during perinatal sexual differentiation. Therefore, CEOAEs may be used as a retrospective indicator of someone's perinatal androgen environment. Individuals diagnosed with Gender Identity Disorder (GID), according to DSM-IV-TR, are characterized by a strong identification with the other gender and discomfort about their natal sex. Although the etiology of GID is far from established, it is hypothesized that atypical levels of sex steroids during a critical period of sexual differentiation of the brain might play a role. In the present study, we compared CEOAEs in treatment-naïve children and adolescents with early-onset GID (24 natal boys, 23 natal girls) and control subjects (65 boys, 62 girls). We replicated the sex difference in CEOAE response amplitude in the control group. This sex difference, however, was not present in the GID groups. Boys with GID showed stronger, more female-typical CEOAEs whereas girls with GID did not differ in emission strength compared to control girls. Based on the assumption that CEOAE amplitude can be seen as an index of relative androgen exposure, our results provide some evidence for the idea that boys with GID may have been exposed to lower amounts of androgen during early development in comparison to control boys.

Spectrotemporal resolution tradeoff in auditory processing as revealed by human auditory brainstem responses and psychophysical indices

Auditory filter theory dictates a physiological compromise between frequency and temporal resolution of cochlear signal processing. We examined neurophysiological correlates of these spectrotemporal tradeoffs in the human auditory system using auditory evoked brain potentials and psychophysical responses. Temporal resolution was assessed using scalp-recorded auditory brainstem responses (ABRs) elicited by paired clicks. The inter-click interval (ICI) between successive pulses was parameterized from 0.7 to 25 ms to map ABR amplitude recovery as a function of stimulus spacing. Behavioral frequency difference limens (FDLs) and auditory filter selectivity (Q10 of psychophysical tuning curves) were obtained to assess relations between behavioral spectral acuity and electrophysiological estimates of temporal resolvability. Neural responses increased monotonically in amplitude with increasing ICI, ranging from total suppression (0.7 ms) to full recovery (25 ms) with a temporal resolution of ∼3-4 ms. ABR temporal thresholds were correlated with behavioral Q10 (frequency selectivity) but not FDLs (frequency discrimination); no correspondence was observed between Q10 and FDLs. Results suggest that finer frequency selectivity, but not discrimination, is associated with poorer temporal resolution. The inverse relation between ABR recovery and perceptual frequency tuning demonstrates a time-frequency tradeoff between the temporal and spectral resolving power of the human auditory system.

Function and plasticity of the medial olivocochlear system in musicians: a review

The outer hair cells of the organ of Corti are the target of abundant efferent projections from the olivocochlear system. This peripheral efferent auditory subsystem is currently thought to be modulated by central activity via corticofugal descending auditory system, and to modulate active cochlear micromechanics. Although the function of this efferent subsystem remains unclear, physiological, psychophysical, and modeling data suggest that it may be involved in ear protection against noise damage and auditory perception, especially in the presence of background noise. Moreover, there is mounting evidence that its activity is modulated by auditory and visual attention. A commonly used approach to measure olivocochlear activity noninvasively in humans relies on the suppression of otoacoustic emissions by contralateral noise. Previous studies have found substantial interindividual variability in this effect, and statistical differences have been observed between professional musicians and non-musicians, with stronger bilateral suppression effects in the former. In this paper, we review these studies and discuss various possible interpretations for these findings, including experience-dependent neuroplasticity. We ask whether differences in olivocochlear function between musicians and non-musicians reflect differences in peripheral auditory function or in more central factors, such as top-down attentional modulation.

Jervell and Lange-Nielsen syndrome in a father and daughter from a large highly inbred family: a 16-year follow-up of 59 living members

OBJECTIVE

To report the autosomal dominant inheritance of the Jervell and Lange-Nielsen syndrome in a highly inbred family, the initiation of Torsades de Pointes, and the natural history of the syndrome based on a 16-year follow-up of the kindred.

METHOD

A family tree was constructed that included 66 blood relatives from three successive generations. Electrocardiograms were obtained from 59 living members including the proband, four members from a nuclear family, and 54 from the extended family. Evoked response audiometry was recorded for the proband and the nuclear family. All 59 family members were followed up regularly for 16 years.

RESULTS

A total of 24 living members were affected--QTc: 480-680 ms. The proband had long QTc, bilateral high-tone sensorineural deafness, recurrent syncope, and Torsades de Pointes. The asymptomatic father had long QTc and unilateral high-tone sensorineural deafness that involved specifically the left ear. One asymptomatic sibling of the proband had long QTc and normal hearing. The mother and another sibling were asymptomatic; QTc and hearing were normal in both. A total of 21 affected members from the extended family had only long QTc, and all were asymptomatic. There were three congenitally deaf first cousins who had recurrent syncope and adrenergic-triggered sudden death. In all, seven of 10 parents had consanguineous marriage to a first cousin. Each affected offspring had at least one affected parent. The severely symptomatic proband who received only β-blocker therapy and the 23 affected members without antiadrenergic therapy, all remained asymptomatic throughout the 16-year follow-up period.

CONCLUSION

Jervell and Lange-Nielsen syndrome was inherited as autosomal dominant in this kindred. The majority of the affected members had a mild phenotype. The severity of auditory and cardiac phenotypes corresponded.

Perspectives on asymmetry: the Erickson Lecture

Topics discussed include asymmetry of the brain; prosopagnosia with asymmetric involvement; the blaspheming brain; effects of the numbers of X chromosomes on brain asymmetry; normal facial asymmetry; kissing asymmetry; left- and right-handedness; left-sided baby cradling; Nodal signaling and left/right asymmetry; primary cilium and left/right asymmetry in zebrafish; right/left asymmetry in snails; species differences in Shh and Fgf8; primary cilium in vertebrate asymmetry; Hedgehog signaling on the cilium; Wnt signaling on the cilium; situs solitus, situs inversus, and situs ambiguus (heterotaxy); ciliopathies; right-sided injuries in trilobites; unilateral ocular use in the octopus; fiddler crabs; scale-eating cichlids; narwhals; left-footed parrots; asymmetric whisker use in rats; and right-sided fatigue fractures in greyhounds.

Experience-dependent plasticity in pitch encoding: from brainstem to auditory cortex

Linguistic and musical pitch provide an analytic window to evaluate how neural representations of important pitch attributes of a sound undergo transformation from early sensory to later cognitive stages of processing in the human brain, and how pitch-relevant experience shapes these representations. These pitch attributes are shaped differentially depending on their functional relevance to a listener. Neural encoding of pitch-relevant information is shaped by the perceptual salience of domain-specific features at subcortical (auditory brainstem) and cortical stages of processing. The emergence of a functional ear asymmetry in the neural encoding of pitch-relevant information at a lower sensory processing level supports the view that local and feedforward and feedback mechanisms are involved in pitch-relevant processing. A theoretical framework for a neural network is proposed involving coordination between local, feedforward, and feedback components that can account for experience-induced enhancement of pitch representations at multiple levels of the auditory pathway.

Assessment of the influence of whole body vibration on Cochlear function

Background

Whole body vibration (WBV) is a potentially harmful consequence resulting from the dissipation of energy by industrial machineries. The result of WBV exposure on the auditory system remains unknown. The objective of the present research was to evaluate the influence of WBV on cochlear function, in particular outer hair cell function. It is hypothesized that WBV impairs cochlear function resulting in decreased Distortion Product Otoacoustic Emission (DPOAE) levels (L_dp) in rabbits subjected to WBV.

Methods

Twelve rabbits were equally divided into vibration and control groups. Animals in vibration group were exposed to 1.0 ms^-2 r.m.s vertical WBV at 4–8 Hz for 8 h/day during 5 consecutive days. Outer hair cell function was assessed by comparing repeated-measurements of DPOAE levels (L_dp) across a range of f₂ frequencies in rabbits both exposed and unexposed to WBV. DPOAE level shifts (LS_dp) were compared across ears, frequencies, groups, and times.

Results

No differences were seen over time in DPOAE levels in the non-exposed rabbits (p = 0.082). Post-exposure L_dp in rabbits exposed to WBV were significantly increased at all test frequencies in both ears compared to baseline measures (p = 0.021). The greatest increase in L_dp following exposure was seen at 5888.5 Hz (mean shift = 13.25 dB). Post-exposure L_dp in rabbits exposed to WBV were not significantly different between the right and left ears (p = 0.083).

Conclusion

WBV impairs cochlear function resulting in increased DPOAE responses in rabbits exposed to WBV. DPOAE level shifts occurred over a wide range of frequencies following prolonged WBV in rabbits.

Effects of whole body vibration on outer hair cells' hearing response to distortion product otoacoustic emissions

Whole body vibration (WBV) is one of the most vexing problems in industries. There is a debate about the effect of WBV exposure on hearing system as vibration-induced hearing loss. The purpose of this study was to investigate outer hair cells' (OHCs') hearing response hearing response to distortion product otoacoustic emissions (DPOAEs) in rabbits exposed to WBV. It was hypothesized that the DPOAE response amplitudes (A(dp)) in rabbits exposed to WBV would be lower than those in control rabbits not exposed to WBV. New Zealand white (NZW) rabbits as vibration group (n = 6, exposed to WBV in the z-axis at 4-8 Hz and 1.0 ms(-2) root mean square for 8 h per day during five consecutive days) and NZW rabbits as control group (n = 6, not exposed to any WBV) were participated. A(dp) and noise floor levels (L(nf)) were examined on three occasions: day 0 (i.e., baseline), day 8 (i.e., immediately 1 h after exposure), and day 11 (i.e., 72 h following exposure) with f(2) frequencies ranging from 500 to 10,000 Hz and primaries L(1) and L(2) levels of 65 and 55 dB sound pressure level, respectively. Main effects were statistically found to be significant for group, time, and frequency (p < 0.05). DPOAE amplitudes were significantly larger for rabbits exposed to WBV, larger on day 8 and larger for mid to high f(2) frequencies (at and above 5,888.50 Hz). Main effects were not statistically found to be significant for ear (p > 0.05). Also, four statistically significant interactions including time by ear, time by frequency, group by frequency, and group by time were detected (p < 0.05). Contrary to the main hypothesis, DPOAE amplitudes were significantly larger for rabbits exposed to WBV. WBV exposure significantly led to enhanced mean A(dp) at mid to high frequencies rather than at low ones.

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.

Measurement of medial olivocochlear efferent activity in humans: comparison of different distortion product otoacoustic emission-based paradigms

OBJECTIVE

To assess the suitability of contralateral suppression (CS) of distortion product otoacoustic emissions (DPOAEs) for measurement of activity of the medial olivocochlear (MOC) efferents.

BACKGROUND

The MOC efferent system has been shown to be involved in sound discrimination, selective attention to tones, sound localization, and protection of the cochlea against noise. A great variety of paradigms for measurement of MOC activity by CS of OAE (MOC reflex [MOCR]), has been described. An issue of this approach is the dependence of the CS values on stimulus parameters, especially when DPOAE are used.

METHODS

Four different measurement paradigms, which used different combinations of stimulus frequencies and primary tone levels, were applied in 16 human subjects.

RESULTS

Mean absolute values of CS were in the range of 1.2 to 2.6 dB. The use of different stimulus parameters produced not only MOCR values of different size-which was expected-but, in many cases, also different relative classifications of the subjects according to their MOCR strength.

CONCLUSION

The suppression effects on DPOAE demonstrated in this study reflect MOC activity. However, the new conclusion from our data is that CS of DPOAE measurements, as they were used in this study, may not allow for a consistent quantitative classification of human subjects according to their MOCR strength. This finding concerns interpretation of previous studies using CS of DPOAE and analogous future studies. One future approach may lie in the separation of the DPOAE components to distinguish interference phenomena, which complicate interpretation of CS values.

Functional ear (a)symmetry in brainstem neural activity relevant to encoding of voice pitch: a precursor for hemispheric specialization?

Pitch processing is lateralized to the right hemisphere; linguistic pitch is further mediated by left cortical areas. This experiment investigates whether ear asymmetries vary in brainstem representation of pitch depending on linguistic status. Brainstem frequency-following responses (FFRs) were elicited by monaural stimulation of the left and right ear of 15 native speakers of Mandarin Chinese using two synthetic speech stimuli that differ in linguistic status of tone. One represented a native lexical tone (Tone 2: T2); the other, T2', a nonnative variant in which the pitch contour was a mirror image of T2 with the same starting and ending frequencies. Two 40-ms portions of f(0) contours were selected in order to compare two regions (R1, early; R2 late) differing in pitch acceleration rate and perceptual saliency. In R2, linguistic status effects revealed that T2 exhibited a larger degree of FFR rightward ear asymmetry as reflected in f(0) amplitude relative to T2'. Relative to midline (ear asymmetry=0), the only ear asymmetry reaching significance was that favoring left ear stimulation elicited by T2'. By left- and right-ear stimulation separately, FFRs elicited by T2 were larger than T2' in the right ear only. Within T2', FFRs elicited by the earlier region were larger than the later in both ears. Within T2, no significant differences in FFRS were observed between regions in either ear. Collectively, these findings support the idea that origins of cortical processing preferences for perceptually-salient portions of pitch are rooted in early, preattentive stages of processing in the brainstem.

The MOC reflex during active listening to speech

PURPOSE

The purpose of this study was to test the hypothesis that active listening to speech would increase medial olivocochlear (MOC) efferent activity for the right vs. the left ear.

METHOD

Click-evoked otoacoustic emissions (CEOAEs) were evoked by 60-dB p.e. SPL clicks in 13 normally hearing adults in 4 test conditions for each ear: (a) in quiet; (b) with 60-dB SPL contralateral broadband noise; (c) with words embedded (at -3-dB signal-to-noise ratio [SNR]) in 60-dB SPL contralateral noise during which listeners directed attention to the words; and (d) for the same SNR as in the 3rd condition, with words played backwards.

RESULTS

There was greater suppression during active listening compared with passive listening that was apparent in the latency range of 6- to 18-ms poststimulus onset. Ear differences in CEOAE amplitude were observed in all conditions, with right-ear amplitudes larger than those for the left. The absolute difference between CEOAE amplitude in quiet and with contralateral noise, a metric of suppression, was equivalent for right and left ears. When the amplitude differences were normalized, suppression was greater for noise presented to the right and the effect measured for a probe in the left ear.

CONCLUSION

The findings support the theory that cortical mechanisms involved in listening to speech affect cochlear function through the MOC efferent system.

Auditory efferents facilitate sound localization in noise in humans

The mammalian auditory system contains descending neural pathways, some of which project onto the cochlea via the medial olivocochlear (MOC) system. The function of this efferent auditory system is not entirely clear. Behavioral studies in animals with olivocochlear (OC) lesions suggest that the MOC serves to facilitate sound localization in noise. In the current work, noise-induced OC activity (the OC reflex) and sound-localization performance in noise were measured in normal-hearing humans. Consistent with earlier studies, both measures were found to vary substantially across individuals. Importantly, significant correlations were observed between OC-reflex strength and the effect of noise on sound-localization performance; the stronger the OC reflex, the less marked the effect of noise. These results suggest that MOC activation by noise helps to counteract the detrimental effects of background noise on neural representations of direction-dependent spectral features, which are especially important for accurate localization in the up/down and front/back dimensions.

Laterality of basic auditory perception

Laterality (left-right ear differences) of auditory processing was assessed using basic auditory skills: (1) gap detection, (2) frequency discrimination, and (3) intensity discrimination. Stimuli included tones (500, 1000, and 4000 Hz) and wide-band noise presented monaurally to each ear of typical adult listeners. The hypothesis tested was that processing of tonal stimuli would be enhanced by left ear (LE) stimulation and noise by right ear (RE) presentations. To investigate the limits of laterality by (1) spectral width, a narrow-band noise (NBN) of 450-Hz bandwidth was evaluated using intensity discrimination, and (2) stimulus duration, 200, 500, and 1000 ms duration tones were evaluated using frequency discrimination. A left ear advantage (LEA) was demonstrated with tonal stimuli in all experiments, but an expected REA for noise stimuli was not found. The NBN stimulus demonstrated no LEA and was characterised as a noise. No change in laterality was found with changes in stimulus durations. The LEA for tonal stimuli is felt to be due to more direct connections between the left ear and the right auditory cortex, which has been shown to be primary for spectral analysis and tonal processing. The lack of a REA for noise stimuli is unexplained. Sex differences in laterality for noise stimuli were noted but were not statistically significant. This study did establish a subtle but clear pattern of LEA for processing of tonal stimuli.

Maturation of the auditory system: 1. Transient otoacoustic emissions as an index of inner ear maturation

The transiently evoked otoacoustic emission amplitude of 42 preterm babies (84 ears; post-conceptional age [PCA] 30-36 weeks) was compared with the TEOAE amplitude of 39 full-term babies (78 ears; PCA 37-45 weeks) in order to trace the inner ear maturation characteristics. An ILO-92 otoacoustic emission recording system was used with linear clicks of 70 dB peak equivalent SPL. The results obtained indicated: (1) There was no statistically significant difference between preterm and full-term ears; (2) There was no significant difference between males and females; (3) There was a significant difference between left and right ear TEOAE amplitude; (4) The interaction of ear with age in relation to TEOAE amplitude was statistically significant; (5) Noise and stimulus parameters did not reveal any significant differences between right and left ears; (6) A positive correlation existed between birthweight and TEOAE amplitude; and (7) A negative correlation existed between aminoglycoside treatment and TEOAE amplitude. The results indicate subtle changes in TEOAE amplitude over time, showing a natural development of the inner ear function during the process of maturation.

Sensorimotor Therapy: Using Stereotypic Movements and Vestibular Stimulation to Increase Sensorimotor Proficiency of Children with Attentional and Motor Difficulties

The current naturalistic study examined whether sensorimotor therapy utilizing the training program, Retraining for Balance, might be an appropriate technique for sensorimotor proficiency. The 232 children (181 boys, 51 girls), whose mean age was 9.3 yr. ( SD = 2.7), presented attentional and motor difficulties (according to the School Health Care) as indicated by their parents before starting therapy. The children were divided into three groups, i.e., a younger group (7 yr. old or younger, n = 65), a middle group (8 to 10 yr. old, n = 91), and an older group (11 yr. old or older, n = 76). The program has seven parts, including fetal and neonatal movements, vestibular and auditory perceptual stimulation, and gross motor movements, among others. The treatment period was close to 3 yr. on the average. Analyses in a repeated-measures design indicated significant improvement of sensorimotor skills among the three age groups, but the older children performed better than the others on several tests. There were only a few sex differences. Retraining for Balance may be a functional technique for training children and youth with sensorimotor difficulties and might constitute a complement to regular treatment of Developmental Coordination Disorder, Learning Disability, and ADHD, but controlled studies are necessary before more decisive conclusions can be drawn.

Tone burst evoked otoacoustic emissions in neonates

Aim

Materials and Methods

Study

Results

Conclusion

Is there a difference in activation or in inhibition of cortical auditory centers depending on the ear that is stimulated?

CONCLUSIONS

1.With auditory stimuli cortical activation of Brodmann's areas 39 and 40 and inhibition of area 38 is bilateral. Inhibitory and excitatory relays play a role in the auditory pathways. 2. A statistically significant increased activation on the left side in areas 39 and 40, regardless of the stimulated ear, is suggestive that pure tones are preferably processed in the left hemisphere. 3. The significant difference in central inhibition depending on which ear is stimulated is supportive of the idea of a leading ear.

OBJECTIVES

The objectives were to determine cortical activation/inhibition, ipsi/contralateral in response to monaural stimulation with pure tones, and if the response differs for right/left ear stimulation.

SUBJECTS AND METHODS

Tc99m-HMPAO brain perfusion SPECT was done during monaural stimulation with pure tones in 10 volunteers. Ears were tested independently.

RESULTS

During auditory stimulation perfusion increased in both hemispheres in Brodmann's areas 39-40 and decreased in area 38,>2 SD above and below the normal mean respectively, in both hemispheres, regardless of which side was stimulated. A significantly more intense response was seen in left versus right in areas 39 and 40. In area 38 there was bilateral inhibition, significantly more intense in response to left than right ear stimulation.

Detecting incipient inner-ear damage from impulse noise with otoacoustic emissions

Audiometric thresholds and otoacoustic emissions (OAEs) were measured in 285 U.S. Marine Corps recruits before and three weeks after exposure to impulse-noise sources from weapons' fire and simulated artillery, and in 32 non-noise-exposed controls. At pre-test, audiometric thresholds for all ears were <or=25 dB HL from 0.5 to 3 kHz and <or=30 dB HL at 4 kHz. Ears with low-level or absent OAEs at pre-test were more likely to be classified with significant threshold shifts (STSs) at post-test. A subgroup of 60 noise-exposed volunteers with complete data sets for both ears showed significant decreases in OAE amplitude but no change in audiometric thresholds. STSs and significant emission shifts (SESs) between 2 and 4 kHz in individual ears were identified using criteria based on the standard error of measurement from the control group. There was essentially no association between the occurrence of STS and SES. There were more SESs than STSs, and the group of SES ears had more STS ears than the group of no-SES ears. The increased sensitivity of OAEs in comparison to audiometric thresholds was shown in all analyses, and low-level OAEs indicate an increased risk of future hearing loss by as much as ninefold.