Olivocochlear Efferents in Animals and Humans: From Anatomy to Clinical Relevance

Surface electrical stimulation of the auditory cortex preserves efferent medial olivocochlear neurons and reduces cochlear traits of age-related hearing loss

The auditory cortex is the source of descending connections providing contextual feedback for auditory signal processing at almost all levels of the lemniscal auditory pathway. Such feedback is essential for cognitive processing. It is likely that corticofugal pathways are degraded with aging, becoming important players in age-related hearing loss and, by extension, in cognitive decline. We are testing the hypothesis that surface, epidural stimulation of the auditory cortex during aging may regulate the activity of corticofugal pathways, resulting in modulation of central and peripheral traits of auditory aging. Increased auditory thresholds during ongoing age-related hearing loss in the rat are attenuated after two weeks of epidural stimulation with direct current applied to the surface of the auditory cortex for two weeks in alternate days (Fernández del Campo et al., 2024). Here we report that the same cortical electrical stimulation protocol induces structural and cytochemical changes in the aging cochlea and auditory brainstem, which may underlie recovery of age-degraded auditory sensitivity. Specifically, we found that in 18 month-old rats after two weeks of cortical electrical stimulation there is, relative to age-matched non-stimulated rats: a) a larger number of choline acetyltransferase immunoreactive neuronal cell body profiles in the ventral nucleus of the trapezoid body, originating the medial olivocochlear system.; b) a reduction of age-related dystrophic changes in the stria vascularis; c) diminished immunoreactivity for the pro-inflammatory cytokine TNFα in the stria vascularis and spiral ligament. d) diminished immunoreactivity for Iba1 and changes in the morphology of Iba1 immunoreactive cells in the lateral wall, suggesting reduced activation of macrophage/microglia; d) Increased immunoreactivity levels for calretinin in spiral ganglion neurons, suggesting excitability modulation by corticofugal stimulation. Altogether, these findings support that non-invasive neuromodulation of the auditory cortex during aging preserves the cochlear efferent system and ameliorates cochlear aging traits, including stria vascularis dystrophy, dysregulated inflammation and altered excitability in primary auditory neurons.

Alpha9alpha10 knockout mice show altered physiological and behavioral responses to signals in masking noise

Medial olivocochlear (MOC) efferents modulate outer hair cell motility through specialized nicotinic acetylcholine receptors to support encoding of signals in noise. Transgenic mice lacking the alpha9 subunits of these receptors (α9KOs) have normal hearing in quiet and noise, but lack classic cochlear suppression effects and show abnormal temporal, spectral, and spatial processing. Mice deficient for both the alpha9 and alpha10 receptor subunits (α9α10KOs) may exhibit more severe MOC-related phenotypes. Like α9KOs, α9α10KOs have normal auditory brainstem response (ABR) thresholds and weak MOC reflexes. Here, we further characterized auditory function in α9α10KO mice. Wild-type (WT) and α9α10KO mice had similar ABR thresholds and acoustic startle response amplitudes in quiet and noise, and similar frequency and intensity difference sensitivity. α9α10KO mice had larger ABR Wave I amplitudes than WTs in quiet and noise. Other ABR metrics of hearing-in-noise function yielded conflicting findings regarding α9α10KO susceptibility to masking effects. α9α10KO mice also had larger startle amplitudes in tone backgrounds than WTs. Overall, α9α10KO mice had grossly normal auditory function in quiet and noise, although their larger ABR amplitudes and hyperreactive startles suggest some auditory processing abnormalities. These findings contribute to the growing literature showing mixed effects of MOC dysfunction on hearing.

Subcortical auditory model including efferent dynamic gain control with inputs from cochlear nucleus and inferior colliculus

An auditory model has been developed with a time-varying, gain-control signal based on the physiology of the efferent system and subcortical neural pathways. The medial olivocochlear (MOC) efferent stage of the model receives excitatory projections from fluctuation-sensitive model neurons of the inferior colliculus (IC) and wide-dynamic-range model neurons of the cochlear nucleus. The response of the model MOC stage dynamically controls cochlear gain via simulated outer hair cells. In response to amplitude-modulated (AM) noise, firing rates of most IC neurons with band-enhanced modulation transfer functions in awake rabbits increase over a time course consistent with the dynamics of the MOC efferent feedback. These changes in the rates of IC neurons in awake rabbits were employed to adjust the parameters of the efferent stage of the proposed model. Responses of the proposed model to AM noise were able to simulate the increasing IC rate over time, whereas the model without the efferent system did not show this trend. The proposed model with efferent gain control provides a powerful tool for testing hypotheses, shedding insight on mechanisms in hearing, specifically those involving the efferent system.

Alpha9alpha10 knockout mice show altered physiological and behavioral responses to signals in masking noise

Medial olivocochlear (MOC) efferents modulate outer hair cell motility through specialized nicotinic acetylcholine receptors to support encoding of signals in noise. Transgenic mice lacking the alpha9 subunits of these receptors (α9KOs) have normal hearing in quiet and noise, but lack classic cochlear suppression effects and show abnormal temporal, spectral, and spatial processing. Mice deficient for both the alpha9 and alpha10 receptor subunits (α9α10KOs) may exhibit more severe MOC-related phenotypes. Like α9KOs, α9α10KOs have normal auditory brainstem response (ABR) thresholds and weak MOC reflexes. Here, we further characterized auditory function in α9α10KO mice. Wildtype and α9α10KO mice had similar ABR thresholds and acoustic startle response (ASR) amplitudes in quiet and noise, and similar frequency and intensity difference sensitivity. α9α10KO mice had larger ABR Wave I amplitudes than wildtypes in quiet and noise, but the noise:quiet amplitude ratio suggested α9α10KOs were more susceptible to masking effects for some stimuli. α9α10KO mice also had larger startle amplitudes in tone backgrounds than wildtypes. Overall, α9α10KO mice had grossly normal auditory function in quiet and noise, though their larger ABR amplitudes and hyperreactive startles suggest some auditory processing abnormalities. These findings contribute to the growing literature showing mixed effects of MOC dysfunction on hearing.

The nuclei of the lateral lemniscus: unexpected players in the descending auditory pathway

Introduction

In the mammalian auditory pathway, the nuclei of the lateral lemniscus (NLL) are thought to be exclusively involved in the bottom-up transmission of auditory information. However, our repeated observation of numerous NLL neurons labeled after injection of retrograde tracers into the superior olivary complex (SOC) led us to systematically investigate with retrograde tracers the descending projections from the NLL to the SOC of the rat.

Methods

We performed large injections of FluoroGold into the SOC to determine NLL contributions to descending projections, and focal injections of biotinylated dextran amine (BDA) to pinpoint the specific nuclei of the SOC innervated by each NLL.

Results

The SOC is innervated by thousands of neurons distributed across four nuclei or regions associated with the lateral lemniscus: the ipsilateral ventral and intermediate nuclei of the lateral lemniscus (VNLL and INLL); the medial paralemniscal region (PL) of both sides; and the ipsilateral semilunar nucleus (SLN), a previously unrecognized nucleus that wraps around the INLL dorsally, medially, and caudally and consists of small, flat neurons. In some experiments, at least 30% of neurons in the VNLL and INLL were retrogradely labeled. All nuclei of the SOC, except the medial and lateral superior olives, are innervated by abundant lemniscal neurons, and each SOC nucleus receives a unique combination of lemniscal inputs. The primary target of the projections from the VNLL is the ventral nucleus of the trapezoid body (VNTB), followed by the superior paraolivary nucleus (SPON), and the medial nucleus of the trapezoid body (MNTB). The INLL selectively innervates the VNTB. The PL innervates dorsal periolivary regions bilaterally. The SLN preferentially innervates the MNTB and may provide the first identified non-calyceal excitatory input to MNTB neurons.

Discussion

Our novel findings have strong implications for understanding acoustic information processing in the initial stages of the auditory pathway. Based on the proportion of lemniscal neurons involved in all the projections described, the NLL should be considered major players in the descending auditory pathway.

Auditory brainstem mechanisms likely compensate for self-imposed peripheral inhibition

Feedback networks in the brain regulate downstream auditory function as peripheral as the cochlea. However, the upstream neural consequences of this peripheral regulation are less understood. For instance, the medial olivocochlear reflex (MOCR) in the brainstem causes putative attenuation of responses generated in the cochlea and cortex, but those generated in the brainstem are perplexingly unaffected. Based on known neural circuitry, we hypothesized that the inhibition of peripheral input is compensated for by positive feedback in the brainstem over time. We predicted that the inhibition could be captured at the brainstem with shorter (1.5 s) than previously employed long duration (240 s) stimuli where this inhibition is likely compensated for. Results from 16 normal-hearing human listeners support our hypothesis in that when the MOCR is activated, there is a robust reduction of responses generated at the periphery, brainstem, and cortex for short-duration stimuli. Such inhibition at the brainstem, however, diminishes for long-duration stimuli suggesting some compensatory mechanisms at play. Our findings provide a novel non-invasive window into potential gain compensation mechanisms in the brainstem that may have implications for auditory disorders such as tinnitus. Our methodology will be useful in the evaluation of efferent function in individuals with hearing loss.

The Magnitude of Contralateral Suppression of Otoacoustic Emissions Is Ear- and Age-Dependent

The maturation of the uncrossed medial olivocochlear (UMOC) efferent remains poorly documented to date. The UMOC efferent system allows listeners to not only detect but also to process, recognize, and discriminate auditory stimuli. Its fibers can be explored non-invasively by recording the effect of contralateral acoustic stimulation (CAS), resulting in a decrease in the amplitude of transient evoked otoacoustic emissions (TEOAE). The objective of the present cross-sectional study was to investigate how the effectiveness of this system varies with age in healthy subjects aged 8 years to adulthood. For this purpose, 120 right-handed native French-speaking subjects (57 females and 63 males) were divided into five age groups of 24 subjects each: 8y-10y, 10y-11y6m, 11y6m-13y, 13y-17y, and ≥18y. TEOAE amplitudes with and without CAS were recorded. The equivalent attenuation (EA) was calculated, corresponding to the change in TEOAE amplitude equivalent to the effect generated by CAS. General linear models were performed to control for the effect of ear, sex, and age on EA. No sex effect was found. A stronger EA was consistently found regardless of age group in the right ear compared to the left. In contrast to the right ear, for which, on average, EA remained constant across age groups, an increasingly weaker TEOAE suppression effect with age was found in the left ear, reinforcing the asymmetrical functioning of the UMOC efferent system in favor of the right ear in adulthood. Further studies are needed to investigate the lateralization of the UMOC efferent system and its changes over time in cases of atypical or reversed cortical asymmetries, especially in subjects with specific learning disorders.

Asymmetry of Occupational Noise Induced Hearing Loss: An Electrophysiological Approach

Introduction  The question as to whether occupational noise exposure causes symmetrical or asymmetrical hearing loss is still controversial and incompletely understood. Objective  Two electrophysiological methods (cortical evoked response audiometry: CERA and auditory steady state responses: ASSR) were used to address this issue. Method  156 subjects with a well-documented history of noise exposure, a wide range of noise induced hearing loss (NIHL) and without middle ear pathology underwent both a CERA and an ASSR examination in the context of an exhaustive medicolegal expert assessment intended for possible compensation. Results  Whatever the method (CERA or ASSR), the average electrophysiological hearing thresholds (1-2-3 kHz) are significantly worse in the left ear. The right - left differences in CERA and ASSR thresholds are strongly correlated with each other. No significant effect of frequency is found. No correlation is observed between right - left differences in hearing thresholds and either age or degree of hearing loss. Conclusion  In NIHL, there is an actual average right - left difference of about 2.23 dB, i.e., 3.2%, the left ear being more impaired.

Adaptation in auditory processing

Adaptation is an essential feature of auditory neurons, which reduces their responses to unchanging and recurring sounds and allows their response properties to be matched to the constantly changing statistics of sounds that reach the ears. As a consequence, processing in the auditory system highlights novel or unpredictable sounds and produces an efficient representation of the vast range of sounds that animals can perceive by continually adjusting the sensitivity and, to a lesser extent, the tuning properties of neurons to the most commonly encountered stimulus values. Together with attentional modulation, adaptation to sound statistics also helps to generate neural representations of sound that are tolerant to background noise and therefore plays a vital role in auditory scene analysis. In this review, we consider the diverse forms of adaptation that are found in the auditory system in terms of the processing levels at which they arise, the underlying neural mechanisms, and their impact on neural coding and perception. We also ask what the dynamics of adaptation, which can occur over multiple timescales, reveal about the statistical properties of the environment. Finally, we examine how adaptation to sound statistics is influenced by learning and experience and changes as a result of aging and hearing loss.

Assessing Medial Olivocochlear Reflex Strengths via Auditory Brainstem Response: Measurement and Variability in Normal-Hearing Individuals

PURPOSE

Optimal measurement settings to measure the medial olivocochlear reflex (MOCR) in humans have not yet been defined. The purpose of this study was to advance the representation of the MOCR in auditory brainstem response (ABR) as an addition to the current diagnostic portfolio.

PARTICIPANTS AND METHOD

Twelve female and 14 male normal-hearing adults participated in the study. Potential effects of a contralateral acoustic stimulus (CAS) on amplitude changes were investigated by recording ABR waveform profiles on the left side at click intensities of 50/60/70 dB nHL with and without CAS (60 dB SPL). Secondly, to detect potential chronological order influences, measurement settings were rearranged on the right side and measurements were repeated. Additionally, ABR thresholds were recorded with and without a CAS in 10 patients.

RESULTS

When the effect of contralateral suppression was analyzed on the basis of amplitude changes, there was a change under administration of the CAS signal that was statistically significant. Interestingly, the order of recordings affected the degree of amplitude change. In three out of 10 patients, reproducible suppression effects on ABR thresholds were detectable upon CAS presentation.

CONCLUSIONS

To our knowledge, this is the largest study dealing with the recording of the MOCR elicited by a contralateral noise via ABR in normal-hearing individuals. Effects of MOCR are measurable via amplitude changes upon CAS administration. Chronological orders influence the impact of this effect on amplitude changes. Optimal measurement settings have not yet been defined. However, experiments such as this study may help to further improve measurements, and thus advance the representation of the MOC reflex in ABR as an addition to the current diagnostic portfolio.

The auditory efferent system in mosquitoes

Whilst acoustic communication forms an integral component of the mating behavior of many insect species, it is particularly crucial for disease-transmitting mosquitoes; swarming males rely on hearing the faint sounds of flying females for courtship initiation. That males can hear females within the din of a swarm is testament to their fabulous auditory systems. Mosquito hearing is highly frequency-selective, remarkably sensitive and, most strikingly, supported by an elaborate system of auditory efferent neurons that modulate the auditory function - the only documented example amongst insects. Peripheral release of octopamine, serotonin and GABA appears to differentially modulate hearing across major disease-carrying mosquito species, with receptors from other neurotransmitter families also identified in their ears. Because mosquito mating relies on hearing the flight tones of mating partners, the auditory efferent system offers new potential targets for mosquito control. It also represents a unique insect model for studying auditory efferent networks. Here we review current knowledge of the mosquito auditory efferent system, briefly compare it with its counterparts in other species and highlight future research directions to unravel its contribution to mosquito auditory perception.

Lack of correlation between medial olivocochlear reflex strength and sentence recognition in noise

OBJECTIVE

The medial olivocochlear (MOC) reflex provides unmasking of sounds in noise, but its contribution to speech-in-noise perception remains unclear due to conflicting results. This study determined associations between MOC reflex strength and sentence recognition in noise in individuals with normal hearing.

DESIGN

MOC reflex strength was assessed using contralateral inhibition of transient-evoked otoacoustic emissions (TEOAEs). Scores on the AzBio sentence task were quantified at three signal-to-noise ratios (SNRs). Additionally, slope and threshold of the psychometric function were computed. Associations between MOC reflex strength and speech-in-noise outcomes were assessed using Spearman rank correlations.

STUDY SAMPLE

Nineteen young adults with normal hearing participated, with data from 17 individuals (mean age = 21.8 years) included in the analysis.

RESULTS

Contralateral noise significantly decreased the amplitude of TEOAEs. A range of contralateral inhibition values was exhibited across participants. Scores increased significantly with increasing SNR. Contrary to hypotheses, there were no significant correlations between MOC reflex strength and score, nor were there any significant correlations between MOC reflex strength and measures of the psychometric function.

CONCLUSIONS

Results found no significant monotonic relationship between MOC reflex strength and sentence recognition in noise. Future work is needed to determine the functional role of the MOC reflex.

Efferent Control in Musicians: A Review

It is widely established that musicians possess a higher level in certain auditory perceptual abilities when compared to non-musicians. This improvement may be mediated, at least in part, by changes in the cochlear response induced by reflex activation of the olivocochlear efferent system. In this review, we describe and analyze the scientific evidence regarding possible differences in the efferent response in musicians and non-musicians. The main evidence observed is that musicians present a greater robustness of the efferent olivocochlear reflex when measured by suppression of otoacoustic emissions and compared to non-musicians. Analyzing the articles presented in this review, it is possible to point out that the differential role of the efferent effect in musicians is not yet established. There is not enough evidence to support the idea that the olivocochlear system favors comparative changes in the properties of musicians' auditory filters. New studies with psychoacoustic techniques, among others, are needed to measure the effect of the olivocochlear reflex on tuning, gain, compression, or temporal resolution in musicians and non-musicians.

Contralateral inhibition of distortion product otoacoustic emissions in young noise-exposed Veterans

Although animal models show a clear link between noise exposure and damage to afferent cochlear synapses, the relationship between noise exposure and efferent function appears to be more complex. Animal studies indicate that high intensity noise exposure reduces efferent medial olivocochlear (MOC) reflex strength, whereas chronic moderate noise exposure is associated with a conditioning effect that enhances the MOC reflex. The MOC reflex is predicted to improve speech-in-noise perception and protects against noise-induced auditory damage by reducing cochlear gain. In humans, MOC reflex strength can be estimated by measuring contralateral inhibition of distortion product otoacoustic emissions (DPOAEs). The objective of this study was to determine the impact of military noise exposure on efferent auditory function by measuring DPOAE contralateral inhibition in young Veterans and non-Veterans with normal audiograms. Compared with non-Veteran controls, Veterans with high levels of reported noise exposure demonstrated a trend of reduced contralateral inhibition across a broad frequency range, suggesting efferent damage. Veterans with moderate noise exposure showed trends of reduced inhibition from 3 to 4 kHz but greater inhibition from 1 to 1.5 kHz, consistent with conditioning. These findings suggest that, in humans, the impact of noise exposure on the MOC reflex differs depending on the noise intensity and duration.

Modeling temporal information encoding by the population of fibers in the healthy and synaptopathic auditory nerve

We report a theoretical study aimed at investigating the impact of cochlear synapse loss (synaptopathy) on the encoding of the envelope (ENV) and temporal fine structure (TFS) of sounds by the population of auditory nerve fibers. A computational model was used to simulate auditory-nerve spike trains evoked by sinusoidally amplitude-modulated (AM) tones at 10 Hz with various carrier frequencies and levels. The model included 16 cochlear channels with characteristic frequencies (CFs) from 250 Hz to 8 kHz. Each channel was innervated by 3, 4 and 10 fibers with low (LSR), medium (MSR), and high spontaneous rates (HSR), respectively. For each channel, spike trains were collapsed into three separate 'population' post-stimulus time histograms (PSTHs), one per fiber type. Information theory was applied to reconstruct the stimulus waveform, ENV, and TFS from one or more PSTHs in a mathematically optimal way. The quality of the reconstruction was regarded as an estimate of the information present in the used PSTHs. Various synaptopathy scenarios were simulated by removing fibers of specific types and/or cochlear regions before stimulus reconstruction. We found that the TFS was predominantly encoded by HSR fibers at all stimulus carrier frequencies and levels. The encoding of the ENV was more complex. At lower levels, the ENV was predominantly encoded by HSR fibers with CFs near the stimulus carrier frequency. At higher levels, the ENV was equally well or better encoded by HSR fibers with CFs different from the AM carrier frequency as by LSR fibers with CFs at the carrier frequency. Altogether, findings suggest that a healthy population of HSR fibers (i.e., including fibers with CFs around and remote from the AM carrier frequency) might be sufficient to encode the ENV and TFS over a wide range of stimulus levels. Findings are discussed regarding their relevance for diagnosing synaptopathy using non-invasive ENV- and TFS-based measures.

Visual attention does not affect the reliability of otoacoustic emission or medial olivocochlear reflex

This study investigated whether visual attention affects the reliability (i.e., repeatability) of transiently evoked otoacoustic emission (TEOAE) magnitudes or of medial olivocochlear reflex (MOCR) estimates. TEOAEs were measured during three visual attentional conditions: control (subject were seated with eyes closed); passive (subjects looked at a pattern of squares on a computer screen); and active (subjects silently counted an occasionally inverted pattern). To estimate reliability, the whole recording session was repeated the next day. The results showed that visual attention does not significantly affect TEOAE or MOCR magnitudes-or their reliability. It is therefore possible to employ visual stimuli (e.g., watching a silent movie) during TEOAE experiments, a procedure sometimes used during testing to prevent subjects from falling asleep or to keep children still and quiet.

Medial olivocochlear reflex reliability: The effects of averaging and presence of synchronized spontaneous otoacoustic emissions

The medial olivocochlear reflex (MOCR), usually assessed by the inhibition of transiently evoked otoacoustic emissions (TEOAEs) with contralateral noise, is a very small effect. In understanding the origin of the MOCR, it is crucial to obtain data of the highest accuracy, i.e., with a high signal-to-noise ratio (SNR), which in turn largely depends on the number of signal averages. This study investigates how the reliability of MOCR measures is affected by the number of averages. At the same time, the effect of the presence of synchronized spontaneous otoacoustic emissions (SSOAEs) is taken into account, as it is known that this factor significantly affects TEOAE amplitudes and SNRs. Each recording session consisted of two series of four measurements, allowing comparison of MOCR magnitude based on 250, 500, 750, and 1000 averages. Reliability was based on comparing the two series. The results show that, for a good quality MOCR measure (i.e., intraclass correlation above 0.9), the required number of averages is at least double that obtainable from a standard TEOAE test (i.e., 500 compared to 250). Ears without SSOAEs needed a higher number of averages to reach a correlation of 0.9 than ears with SSOAEs.

Noise-induced hearing loss vulnerability in type III intermediate filament peripherin gene knockout mice

In the post-natal mouse cochlea, type II spiral ganglion neurons (SGNs) innervating the electromotile outer hair cells (OHCs) of the ‘cochlear amplifier' selectively express the type III intermediate filament peripherin gene (Prph). Immunolabeling showed that Prph knockout (KO) mice exhibited disruption of this (outer spiral bundle) afferent innervation, while the radial fiber (type I SGN) innervation of the inner hair cells (~95% of the SGN population) was retained. Functionality of the medial olivocochlear (MOC) efferent innervation of the OHCs was confirmed in the PrphKO, based on suppression of distortion product otoacoustic emissions (DPOAEs) via direct electrical stimulation. However, “contralateral suppression” of the MOC reflex neural circuit, evident as a rapid reduction in cubic DPOAE when noise is presented to the opposite ear in wildtype mice, was substantially disrupted in the PrphKO. Auditory brainstem response (ABR) measurements demonstrated that hearing sensitivity (thresholds and growth-functions) were indistinguishable between wildtype and PrphKO mice. Despite this comparability in sound transduction and strength of the afferent signal to the central auditory pathways, high-intensity, broadband noise exposure (108 dB SPL, 1 h) produced permanent high frequency hearing loss (24–32 kHz) in PrphKO mice but not the wildtype mice, consistent with the attenuated contralateral suppression of the PrphKO. These data support the postulate that auditory neurons expressing Prph contribute to the sensory arm of the otoprotective MOC feedback circuit.

Fluctuations of Otoacoustic Emissions and Medial Olivocochlear Reflexes: Tracking One Subject over a Year

The purpose of the study was to measure the variability of transiently evoked otoacoustic emissions (TEOAEs) and the medial olivocochlear reflex (MOCR) over a long period of time in one person. TEOAEs with and without contralateral acoustic stimulation (CAS) by white noise were measured, from which MOCR strength could be derived as either a dB or % change. In this longitudinal case study, measurements were performed on the right and left ears of a young, normally hearing adult female once a week for 1 year. The results showed that TEOAE level and MOCR strength fluctuated over the year but tended to remain close to a baseline level, with standard deviations of around 0.5 dB and 0.05 dB, respectively. The TEOAE latencies at frequencies from 1 to 4 kHz were relatively stable, with maximum changes ranging from 0.5 ms for the 1 kHz band to 0.08 ms for the 4 kHz band. TEOAE levels and MOCR strengths were strongly and negatively correlated, meaning that the higher the TEOAE level, the lower the MOCR. Additionally, comparison of fluctuations between the ears revealed positive correlation, i.e., the higher the TEOAE level or MOCR in one ear, the higher in the second ear.

ISL1 is necessary for auditory neuron development and contributes toward tonotopic organization

A cardinal feature of the auditory pathway is frequency selectivity, represented in a tonotopic map from the cochlea to the cortex. The molecular determinants of the auditory frequency map are unknown. Here, we discovered that the transcription factor ISL1 regulates the molecular and cellular features of auditory neurons, including the formation of the spiral ganglion and peripheral and central processes that shape the tonotopic representation of the auditory map. We selectively knocked out Isl1 in auditory neurons using Neurod1Cre strategies. In the absence of Isl1, spiral ganglion neurons migrate into the central cochlea and beyond, and the cochlear wiring is profoundly reduced and disrupted. The central axons of Isl1 mutants lose their topographic projections and segregation at the cochlear nucleus. Transcriptome analysis of spiral ganglion neurons shows that Isl1 regulates neurogenesis, axonogenesis, migration, neurotransmission-related machinery, and synaptic communication patterns. We show that peripheral disorganization in the cochlea affects the physiological properties of hearing in the midbrain and auditory behavior. Surprisingly, auditory processing features are preserved despite the significant hearing impairment, revealing central auditory pathway resilience and plasticity in Isl1 mutant mice. Mutant mice have a reduced acoustic startle reflex, altered prepulse inhibition, and characteristics of compensatory neural hyperactivity centrally. Our findings show that ISL1 is one of the obligatory factors required to sculpt auditory structural and functional tonotopic maps. Still, upon Isl1 deletion, the ensuing central plasticity of the auditory pathway does not suffice to overcome developmentally induced peripheral dysfunction of the cochlea.

Does glutaric aciduria type 1 affect hearing function?

This study aimed to evaluate audiological findings among patients with glutaric aciduria type 1 (GA-1). We used a large test battery for the audiological evaluation of 17 individuals with GA-1 (the study group) and 20 healthy individuals (the control group). Conventional audiometry (0.125-8 kHz), distortion product otoacoustic emissions (DPOAEs) (1, 1.5, 2, 3, 4, 6, and 8 kHz), contralateral suppression of otoacoustic emissions, and auditory brainstem response (ABR) ( 30, 50, 70 and 90 dB nHL) were measured for all participants (n = 37). Mild sensorineural hearing loss was found in 77.47% (n = 13) of the patients with GA-1, and normal hearing thresholds were seen in 23.53% (n = 4). There were three asymptomatic patients at the time of diagnosis [two developed mild mental motor retardation (MMR) and one developed severe MMR during the follow-up], one with a normal hearing threshold and two with mild hearing loss), and 14 symptomatic patients (three with normal hearing thresholds and 11 with mild hearing loss). Seven of the symptomatic patients diagnosed following an encephalopathic crisis required intensive care and showed significantly worse hearing thresholds than those without symptoms [20.86 ± 4.47 vs. 15.44 ± 3.96 decibel hearing level (dB HL), p = 0.039*], while five had mild-to-moderate hearing loss. Acute encephalopathic crisis had a negative effect on hearing function in the symptomatic patients. The emission and contralateral suppression amplitude values of the study group were significantly lower compared to the control group (p < 0.05). The I-V interpeak latency and absolute latencies of ABR waves I, III, and V of the study group were observed to be significantly prolonged and morphologically distorted compared to those of the control group (p < 0.05). Five patients had MMR, and three had moderate MMR; all eight had mild-to-moderate hearing loss. In addition, of the eight patients with mild MMR, four had mild hearing loss. In particular, the morphological findings of ABR waves were significantly worse in the patients with severe and moderate MMR (p < 0.05). There was a significant correlation between a macrocephaly history (12 patients) and hearing loss (p = 0.041*). Magnetic resonance imaging findings were evaluated in all the 17 patients with GA-1, and typical fronto-temporal atrophy and sylvian fissure enlargement were observed. Our findings support that GA-1 is associated with auditory impairment, primarily in symptomatic patients. Adequate audiological test battery evaluation is essential in this context, particularly for symptomatic patients with a history of encephalopathic crises.

Firing Rate Adaptation of the Human Auditory Nerve Optimizes Neural Signal-to-Noise Ratios

Several physiological mechanisms act on the response of the auditory nerve (AN) during acoustic stimulation, resulting in an adjustment in auditory gain. These mechanisms include-but are not limited to-firing rate adaptation, dynamic range adaptation, the middle ear muscle reflex, and the medial olivocochlear reflex. A potential role of these mechanisms is to improve the neural signal-to-noise ratio (SNR) at the output of the AN in real time. This study tested the hypothesis that neural SNRs, inferred from non-invasive assessment of the human AN, improve over the duration of acoustic stimulation. Cochlear potentials were measured in response to a series of six high-level clicks embedded in a series of six lower-level broadband noise bursts. This paradigm elicited a compound action potential (CAP) in response to each click and to the onset of each noise burst. The ratio of CAP amplitudes elicited by each click and noise burst pair (i.e., neural SNR) was tracked over the six click/noise bursts. The main finding was a rapid (< 24 ms) increase in neural SNR from the first to the second click/noise burst, consistent with a real-time adjustment in the response of the auditory periphery toward improving the SNR of the signal transmitted to the brainstem. Analysis of cochlear microphonic and ear canal sound pressure recordings, as well as the time course for this improvement in neural SNR, supports the conclusion that firing rate adaptation is likely the primary mechanism responsible for improving neural SNR, while dynamic range adaptation, the middle ear muscle reflex, and the medial olivocochlear reflex played a secondary role on the effects observed in this study. Real-time improvements in neural SNR are significant because they may be essential for robust encoding of speech and other relevant stimuli in the presence of background noise.

Opioid receptor activation modulates the calcium current in the cochlear outer hair cells of the rat

Previous works showed that opioid peptides are produced by olivocochlear efferent neurons, while cochlear hair cells express opioid receptors. It has been proposed that opioids protect the auditory system from damage by intense stimulation, although their use for therapeutic or illicit purposes links to hearing impairment. Therefore, it is relevant to study the effect of opioids in the auditory system to define their functional expression and mechanism of action. This study investigated the modulation of the Ca²⁺ currents by opioid peptides in the rat outer hair cells (OHC) using the whole-cell patch-clamp technique. The influence of agonists of the three opioid receptor subtypes (μ, δ, and κ) was studied. The κ opioid receptor agonist U-50488 inhibits the Ca²⁺ currents in a partially reversible form. Coincidently, norbinaltorphimine (a κ receptor antagonist) blocked the U-50488 inhibitory effect on the Ca²⁺ current. The δ- and the μ opioid receptor agonists did not significantly affect the Ca²⁺ currents. These results indicate that the κ opioid receptor activation inhibits the Ca²⁺ current in OHC, modulating the intracellular Ca²⁺ concentration when OHCs depolarize. The modulation of the auditory function by opioids constitutes a relevant mechanism with a potential role in the physiopathology of auditory disturbances.

ASK1 is a novel molecular target for preventing aminoglycoside-induced hair cell death

Aminoglycoside antibiotics are lifesaving medicines, crucial for the treatment of chronic or drug resistant infections. However, aminoglycosides are toxic to the sensory hair cells in the inner ear. As a result, aminoglycoside-treated individuals can develop permanent hearing loss and vestibular impairment. There is considerable evidence that reactive oxygen species (ROS) production and the subsequent phosphorylation of c-Jun N-terminal kinase (JNK) and P38 mitogen-activated protein kinase (P38) drives apoptosis in aminoglycoside-treated hair cells. However, treatment strategies that directly inhibit ROS, JNK, or P38 are limited by the importance of these molecules for normal cellular function. Alternatively, the upstream regulator apoptosis signal-regulating kinase 1 (ASK1/MAP3K5) is a key mediator of ROS-induced JNK and P38 activation under pathologic but not homeostatic conditions. We investigated ASK1 as a mediator of drug-induced hair cell death using cochlear explants from Ask1 knockout mice, demonstrating that Ask1 deficiency attenuates neomycin-induced hair cell death. We then evaluated pharmacological inhibition of ASK1 with GS-444217 as a potential otoprotective therapy. GS-444217 significantly attenuated hair cell death in neomycin-treated explants but did not impact aminoglycoside efficacy against P. aeruginosa in the broth dilution test. Overall, we provide significant pre-clinical evidence that ASK1 inhibition represents a novel strategy for preventing aminoglycoside ototoxicity. KEY MESSAGES: • ASK1 is an upstream, redox-sensitive regulator of P38 and JNK, which are known mediators of hair cell death. • Ask1 knockout does not affect hair cell development in vivo, but significantly reduces aminoglycoside-induced hair cell death in vitro. • A small-molecule inhibitor of ASK1 attenuates neomycin-induced hair cell death, and does not impact antibiotic efficacy in vitro. • ASK1 may be a novel molecular target for preventing aminoglycoside-induced hearing loss.

The Relationship between Contralateral Suppression of Transient Evoked Otoacoustic Emission and Unmasking of Speech Evoked Auditory Brainstem Response

Introduction Several studies have shown that efferent pathways of the auditory system improve perception of speech-in-noise. But, the majority of investigations assessing the role of efferent pathways on speech perception have used contralateral suppression of otoacoustic emissions as a measure of efferent activity. By studying the effect of efferent activity on the speech-evoked auditory brainstem response (ABR), some more light could be shed on the effect of efferent pathways on the encoding of speech in the auditory pathway.

Objectives To investigate the relationship between contralateral suppression of transient evoked otoacoustic emission (CSTEOAE) and unmasking of speech ABR.

Methods A total of 23 young adults participated in the study. The CSTEOAE was measured using linear clicks at 60 dB peSPL and white noise at 60 dB sound pressure level (SPL). The speech ABR was recorded using the syllable /da/ at 80 dB SPL in quiet, ipsilateral noise, and binaural noise conditions. In the ipsilateral noise condition, white noise was presented to the test ear at 60 dB SPL, and, in the binaural noise condition, two separate white noises were presented to both ears.

Results The F0 amplitude of speech ABR was higher in quiet condition; however, the mean amplitude of F0 was not significantly different across conditions. Correlation analysis showed a significant positive correlation between the CSTEOAE and the magnitude of unmasking of F0 amplitude of speech ABR.

Conclusions The findings of the present study suggests that the efferent pathways are involved in speech-in-noise processing.

Magnitude of the contralateral efferent olivocochlear effect as a function of the frequency

Background

The activation of the medial olivocochlear reflex reduces the cochlear gain, which is manifested perceptually as decreased auditory sensitivity. However, it has remained unclear whether the extent of this suppression varies according to the cochlear region involved. Here we aims to assess the magnitude of contralateral efferent suppression across human cochlea, at low levels, and its impact on hearing sensitivity.

Methods

Assuming that acoustic stimulation activates the contralateral medial olivocochlear reflex, we evaluated the magnitude of the suppressive effect as a function of frequency in 17 subjects with normal hearing. Absolute thresholds were measured for bursts tones of various durations (10, 100, and 500 ms) and frequencies (250, 500, 1000, 4000, and 8000 Hz) in the presence or absence of contralateral white noise at 60 dB SPL.

Results

We found that contralateral noise raised the absolute threshold for the burst tones evaluated. The effect was greater at lower than higher frequencies (3.85 dB at 250 Hz vs. 2.22 dB at 8000 Hz).

Conclusions

Our findings suggest that in humans, the magnitude of this suppression varies according to the cochlear region stimulated, with a greater effect towards the apex (lower frequencies) than the base (higher frequencies) of the cochlea.

Loss of central mineralocorticoid or glucocorticoid receptors impacts auditory nerve processing in the cochlea

The key auditory signature that may associate peripheral hearing with central auditory cognitive defects remains elusive. Suggesting the involvement of stress receptors, we here deleted the mineralocorticoid and glucocorticoid receptors (MR and GR) using a CaMKIIα-based tamoxifen-inducible Cre^ERT2/loxP approach to generate mice with single or double deletion of central but not cochlear MR and GR. Hearing thresholds of MRGR^{CaMKIIαCreERT2} conditional knockouts (cKO) were unchanged, whereas auditory nerve fiber (ANF) responses were larger and faster and auditory steady state responses were improved. Subsequent analysis of single MR or GR cKO revealed discrete roles for both, central MR and GR on cochlear functions. Limbic MR deletion reduced inner hair cell (IHC) ribbon numbers and ANF responses. In contrast, GR deletion shortened the latency and improved the synchronization to amplitude-modulated tones without affecting IHC ribbon numbers. These findings imply that stress hormone-dependent functions of central MR/GR contribute to “precognitive” sound processing in the cochlea.

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Top-down MR/GR signaling differentially contributes to cochlear sound processing

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Limbic MR stimulates auditory nerve fiber discharge rates

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Central GR deteriorates auditory nerve fiber synchrony

Adaptation to noise in normal and impaired hearing

Many aspects of hearing function are negatively affected by background noise. Listeners, however, have some ability to adapt to background noise. For instance, the detection of pure tones and the recognition of isolated words embedded in noise can improve gradually as tones and words are delayed a few hundred milliseconds in the noise. While some evidence suggests that adaptation to noise could be mediated by the medial olivocochlear reflex, adaptation can occur for people who do not have a functional reflex. Since adaptation can facilitate hearing in noise, and hearing in noise is often harder for hearing-impaired than for normal-hearing listeners, it is conceivable that adaptation is impaired with hearing loss. It remains unclear, however, if and to what extent this is the case, or whether impaired adaptation contributes to the greater difficulties experienced by hearing-impaired listeners understanding speech in noise. Here, we review adaptation to noise, the mechanisms potentially contributing to this adaptation, and factors that might reduce the ability to adapt to background noise, including cochlear hearing loss, cochlear synaptopathy, aging, and noise exposure. The review highlights few knowns and many unknowns about adaptation to noise, and thus paves the way for further research on this topic.

Contralateral noise effects on otoacoustic emissions and electrophysiologic responses in normal-hearing adults

Contralateral noise inhibits the amplitudes of cochlear and neural responses. These measures may hold potential diagnostic utility. The medial olivocochlear (MOC) reflex underlies the inhibition of cochlear responses but the extent to which it contributes to inhibition of neural responses remains unclear. Mertes and Leek [J. Acoust. Soc. Am. 140, 2027-2038 (2016)] recently examined contralateral inhibition of cochlear responses [transient-evoked otoacoustic emissions (TEOAEs)] and neural responses [auditory steady-state responses (ASSRs)] in humans and found that the two measures were not correlated, but potential confounds of older age and hearing loss were present. The current study controlled for these confounds by examining a group of young, normal-hearing adults. Additionally, measurements of the auditory brainstem response (ABR) were obtained. Responses were elicited using clicks with and without contralateral broadband noise. Changes in TEOAE and ASSR magnitude as well as ABR wave V latency were examined. Results indicated that contralateral inhibition of ASSRs was significantly larger than that of TEOAEs and that the two measures were uncorrelated. Additionally, there was no significant change in wave V latency. Results suggest that further work is needed to understand the mechanism underlying contralateral inhibition of the ASSR.

Speech Perception in Bilateral Hearing Aid Users With Different Grades of Asymmetric Hearing Loss

Hearing loss is associated with decreased speech perception as well as with changes in the auditory pathway. The effects of those changes on binaural speech perception with hearing aids are not yet fully understood. To provide further evidence on the functional changes of the auditory pathway, several speech perception tests (unilateral and bilateral, aided and unaided, in quiet, and in noise) were conducted in a population of 370 bilateral hearing aid users covering the entire range of the World Health Organization’s most recent classification of hearing loss. To characterize the effects of asymmetric hearing thresholds, a generalized linear model was used for regression analysis. The model revealed a detrimental effect of the poorer ears’ thresholds on both the unaided and the aided unilateral word recognition scores that were attained by the better ear. Moreover, aided binaural word recognition (in quiet and in noise) was affected to a degree that cannot be explained on the sole basis of bilateral summation. Thus, this study provides evidence that there is reorganization and altered functioning of the afferent and efferent auditory pathways due to asymmetric hearing loss. Consequently, more attention should be paid to provision with a hearing aid as early as possible, and separately for each ear.

The Reliability of Contralateral Suppression of Otoacoustic Emissions Is Greater in Women than in Men

The aim of this study was to compare the reliability of the medial olivocochlear reflex (MOCR) between men and women. The strength of the MOCR was measured in terms of the suppression of transiently evoked otoacoustic emissions (TEOAEs) by contralateral acoustic stimulation (CAS). The difference between TEOAEs with and without CAS (white noise) was calculated as raw decibel TEOAE suppression as well as normalized TEOAE suppression expressed in percent. In each subject, sets of measurements were performed twice. Reliability was evaluated by calculating the intraclass correlation coefficient, the standard error of measurement, and the minimum detectable change (MDC). The study included 40 normally hearing subjects (20 men; 20 women). The estimates of MOCR for both genders were similar. Nevertheless, the reliability of the MOCR was poorer in men, with an MDC around twice that of women. This can be only partially attributed to slightly lower signal-to-noise ratios (SNRs) in men, since we used strict procedures calling for high SNRs (around 20 dB on average). Furthermore, even when we compared subgroups with similar SNRs, there was still lower MOCR reliability in men.

A Time-Course-Based Estimation of the Human Medial Olivocochlear Reflex Function Using Clicks

The auditory efferent system, especially the medial olivocochlear reflex (MOCR), is implicated in both typical auditory processing and in auditory disorders in animal models. Despite the significant strides in both basic and translational research on the MOCR, its clinical applicability remains under-utilized in humans due to the lack of a recommended clinical method. Conventional tests employ broadband noise in one ear while monitoring change in otoacoustic emissions (OAEs) in the other ear to index efferent activity. These methods, (1) can only assay the contralateral MOCR pathway and (2) are unable to extract the kinetics of the reflexes. We have developed a method that re-purposes the same OAE-evoking click-train to also concurrently elicit bilateral MOCR activity. Data from click-train presentations at 80 dB peSPL at 62.5 Hz in 13 young normal-hearing adults demonstrate the feasibility of our method. Mean MOCR magnitude (1.7 dB) and activation time-constant (0.2 s) are consistent with prior MOCR reports. The data also suggest several advantages of this method including, (1) the ability to monitor MEMR, (2) obtain both magnitude and kinetics (time constants) of the MOCR, (3) visual and statistical confirmation of MOCR activation.

Corollary discharge enables proprioception from lateral line sensory feedback

Animals modulate sensory processing in concert with motor actions. Parallel copies of motor signals, called corollary discharge (CD), prepare the nervous system to process the mixture of externally and self-generated (reafferent) feedback that arises during locomotion. Commonly, CD in the peripheral nervous system cancels reafference to protect sensors and the central nervous system from being fatigued and overwhelmed by self-generated feedback. However, cancellation also limits the feedback that contributes to an animal's awareness of its body position and motion within the environment, the sense of proprioception. We propose that, rather than cancellation, CD to the fish lateral line organ restructures reafference to maximize proprioceptive information content. Fishes' undulatory body motions induce reafferent feedback that can encode the body's instantaneous configuration with respect to fluid flows. We combined experimental and computational analyses of swimming biomechanics and hair cell physiology to develop a neuromechanical model of how fish can track peak body curvature, a key signature of axial undulatory locomotion. Without CD, this computation would be challenged by sensory adaptation, typified by decaying sensitivity and phase distortions with respect to an input stimulus. We find that CD interacts synergistically with sensor polarization to sharpen sensitivity along sensors' preferred axes. The sharpening of sensitivity regulates spiking to a narrow interval coinciding with peak reafferent stimulation, which prevents adaptation and homogenizes the otherwise variable sensor output. Our integrative model reveals a vital role of CD for ensuring precise proprioceptive feedback during undulatory locomotion, which we term external proprioception.

Understanding degraded speech leads to perceptual gating of a brainstem reflex in human listeners

The ability to navigate "cocktail party" situations by focusing on sounds of interest over irrelevant, background sounds is often considered in terms of cortical mechanisms. However, subcortical circuits such as the pathway underlying the medial olivocochlear (MOC) reflex modulate the activity of the inner ear itself, supporting the extraction of salient features from auditory scene prior to any cortical processing. To understand the contribution of auditory subcortical nuclei and the cochlea in complex listening tasks, we made physiological recordings along the auditory pathway while listeners engaged in detecting non(sense) words in lists of words. Both naturally spoken and intrinsically noisy, vocoded speech-filtering that mimics processing by a cochlear implant (CI)-significantly activated the MOC reflex, but this was not the case for speech in background noise, which more engaged midbrain and cortical resources. A model of the initial stages of auditory processing reproduced specific effects of each form of speech degradation, providing a rationale for goal-directed gating of the MOC reflex based on enhancing the representation of the energy envelope of the acoustic waveform. Our data reveal the coexistence of 2 strategies in the auditory system that may facilitate speech understanding in situations where the signal is either intrinsically degraded or masked by extrinsic acoustic energy. Whereas intrinsically degraded streams recruit the MOC reflex to improve representation of speech cues peripherally, extrinsically masked streams rely more on higher auditory centres to denoise signals.

Age-Related Changes in the Cochlea and Vestibule: Shared Patterns and Processes

Both age-related hearing loss (ARHL) and age-related loss in vestibular function (ARVL) are prevalent conditions with deleterious consequences on the health and quality of life. Age-related changes in the inner ear are key contributors to both conditions. The auditory and vestibular systems rely on a shared sensory organ - the inner ear - and, like other sensory organs, the inner ear is susceptible to the effects of aging. Despite involvement of the same sensory structure, ARHL and ARVL are often considered separately. Insight essential for the development of improved diagnostics and treatments for both ARHL and ARVL can be gained by careful examination of their shared and unique pathophysiology in the auditory and vestibular end organs of the inner ear. To this end, this review begins by comparing the prevalence patterns of ARHL and ARVL. Next, the normal and age-related changes in the structure and function of the auditory and vestibular end organs are compared. Then, the contributions of various molecular mechanisms, notably inflammaging, oxidative stress, and genetic factors, are evaluated as possible common culprits that interrelate pathophysiology in the cochlea and vestibular end organs as part of ARHL and ARVL. A careful comparison of these changes reveals that the patterns of pathophysiology show similarities but also differences both between the cochlea and vestibular end organs and among the vestibular end organs. Future progress will depend on the development and application of new research strategies and the integrated investigation of ARHL and ARVL using both clinical and animal models.

Binaural Background Noise Enhances Neuromagnetic Responses from Auditory Cortex

The presence of binaural low-level background noise has been shown to enhance the transient evoked N1 response at about 100 ms after sound onset. This increase in N1 amplitude is thought to reflect noise-mediated efferent feedback facilitation from the auditory cortex to lower auditory centers. To test this hypothesis, we recorded auditory-evoked fields using magnetoencephalography while participants were presented with binaural harmonic complex tones embedded in binaural or monaural background noise at signal-to-noise ratios of 25 dB (low noise) or 5 dB (higher noise). Half of the stimuli contained a gap in the middle of the sound. The source activities were measured in bilateral auditory cortices. The onset and gap N1 response increased with low binaural noise, but high binaural and low monaural noise did not affect the N1 amplitudes. P1 and P2 onset and gap responses were consistently attenuated by background noise, and noise level and binaural/monaural presentation showed distinct effects. Moreover, the evoked gamma synchronization was also reduced by background noise, and it showed a lateralized reduction for monaural noise. The effects of noise on the N1 amplitude follow a bell-shaped characteristic that could reflect an optimal representation of acoustic information for transient events embedded in noise.

Controlled (re)evaluation of the relationship between speech perception in noise and contralateral suppression of otoacoustic emissions

In people with normal hearing (NH), speech perception in noise (SPIN) improves when the speech signal is presented not gated with noise but after a delay. The medial olivocochlear reflex (MOCR) was thought to be involved in the neural dynamic range adaptation (NDRA) responsible for this adaptive SPIN; however, some of the recent studies do not support this hypothesis and suggest that adaptive SPIN involves the NDRA to noise-level statistics, irrespective of MOCR activation. A plausible reason for this discrepancy could be the variations and limitations of the experimental designs used in different studies. Using a relatively controlled and comprehensive study design, this study attempts to verify whether a delay between the delivery of speech and the noise improves the SPIN and whether MOCR mediates such effects. The SPIN was estimated by measuring speech reception thresholds (SRT) in noise under simultaneous-onset and delayed-onset (noise precedes speech onset by 300 ms) conditions. The SPIN in both ears was independently examined for ipsilateral, contralateral, and bilateral noise in women with normal hearing (N = 18; age range, 18-25 years). Contralateral suppression of transient-evoked otoacoustic emissions (CSOAEs) was used to estimate the MOCR based cochlear gain reduction. Under all test conditions, SPIN was improved in delayed-onset than in simultaneous-onset conditions, and the mean improvement in the SRT ranged from 0.7±1.7 to 1.8±1.8 dB. No significant correlation was obtained between CSOAEs and the mean temporal improvement in SRT, suggesting that MOCR may not be a predominant mechanism for the temporal improvement in SPIN.

Speech-in-Noise Recognition With More Realistic Implementations of a Binaural Cochlear-Implant Sound Coding Strategy Inspired by the Medial Olivocochlear Reflex

OBJECTIVES

Cochlear implant (CI) users continue to struggle understanding speech in noisy environments with current clinical devices. We have previously shown that this outcome can be improved by using binaural sound processors inspired by the medial olivocochlear (MOC) reflex, which involve dynamic (contralaterally controlled) rather than fixed compressive acoustic-to-electric maps. The present study aimed at investigating the potential additional benefits of using more realistic implementations of MOC processing.

DESIGN

Eight users of bilateral CIs and two users of unilateral CIs participated in the study. Speech reception thresholds (SRTs) for sentences in competition with steady state noise were measured in unilateral and bilateral listening modes. Stimuli were processed through two independently functioning sound processors (one per ear) with fixed compression, the current clinical standard (STD); the originally proposed MOC strategy with fast contralateral control of compression (MOC1); a MOC strategy with slower control of compression (MOC2); and a slower MOC strategy with comparatively greater contralateral inhibition in the lower-frequency than in the higher-frequency channels (MOC3). Performance with the four strategies was compared for multiple simulated spatial configurations of the speech and noise sources. Based on a previously published technical evaluation of these strategies, we hypothesized that SRTs would be overall better (lower) with the MOC3 strategy than with any of the other tested strategies. In addition, we hypothesized that the MOC3 strategy would be advantageous over the STD strategy in listening conditions and spatial configurations where the MOC1 strategy was not.

RESULTS

In unilateral listening and when the implant ear had the worse acoustic signal-to-noise ratio, the mean SRT was 4 dB worse for the MOC1 than for the STD strategy (as expected), but it became equal or better for the MOC2 or MOC3 strategies than for the STD strategy. In bilateral listening, mean SRTs were 1.6 dB better for the MOC3 strategy than for the STD strategy across all spatial configurations tested, including a condition with speech and noise sources colocated at front where the MOC1 strategy was slightly disadvantageous relative to the STD strategy. All strategies produced significantly better SRTs for spatially separated than for colocated speech and noise sources. A statistically significant binaural advantage (i.e., better mean SRTs across spatial configurations and participants in bilateral than in unilateral listening) was found for the MOC2 and MOC3 strategies but not for the STD or MOC1 strategies.

CONCLUSIONS

Overall, performance was best with the MOC3 strategy, which maintained the benefits of the originally proposed MOC1 strategy over the STD strategy for spatially separated speech and noise sources and extended those benefits to additional spatial configurations. In addition, the MOC3 strategy provided a significant binaural advantage, which did not occur with the STD or the original MOC1 strategies.

Effects of Multisession Anodal Electrical Stimulation of the Auditory Cortex on Temporary Noise-Induced Hearing Loss in the Rat

The protective effect of the efferent system against acoustic trauma (AT) has been shown by several experimental approaches, including damage to one ear, sectioning of the olivocochlear bundle (OCB) in the floor of the IV ventricle, and knock-in mice overexpressing outer hair cell (OHC) cholinergic receptors, among others. Such effects have been related to changes in the regulation of the cholinergic efferent system and in cochlear amplification, which ultimately reverse upon protective hearing suppression. In addition to well-known circuits of the brainstem, the descending corticofugal pathway also regulates efferent neurons of the olivary complex. In this study, we applied our recently developed experimental paradigm of multiple sessions of electrical stimulation (ES) to activate the efferent system in combination with noise overstimulation. ABR thresholds increased 1 and 2 days after AT (8-16 kHz bandpass noise at 107 dB for 90 min) recovering at AT + 14 days. However, after multiple sessions of epidural anodal stimulation, no changes in thresholds were observed following AT. Although an inflammatory response was also observed 1 day after AT in both groups, the counts of reactive macrophages in both experimental conditions suggest decreased inflammation in the epidural stimulation group. Quantitative immunocytochemistry for choline acetyltransferase (ChAT) showed a significant decrease in the size and optical density of the efferent terminals 1 day after AT and a rebound at 14 days, suggesting depletion of the terminals followed by a long-term compensatory response. Such a synthesis recovery was significantly higher upon cortical stimulation. No significant correlation was found between ChAT optical density and size of the buttons in sham controls (SC) and ES/AT + 1day animals; however, significant negative correlations were shown in all other experimental conditions. Therefore, our comparative analysis suggests that cochleotopic cholinergic neurotransmission is also better preserved after multisession epidural stimulation.

The role of the medial olivocochlear reflex in psychophysical masking and intensity resolution in humans: a review

This review addresses the putative role of the medial olivocochlear (MOC) reflex in psychophysical masking and intensity resolution in humans. A framework for interpreting psychophysical results in terms of the expected influence of the MOC reflex is introduced. This framework is used to review the effects of a precursor or contralateral acoustic stimulation on 1) simultaneous masking of brief tones, 2) behavioral estimates of cochlear gain and frequency resolution in forward masking, 3) the buildup and decay of forward masking, and 4) measures of intensity resolution. Support, or lack thereof, for a role of the MOC reflex in psychophysical perception is discussed in terms of studies on estimates of MOC strength from otoacoustic emissions and the effects of resection of the olivocochlear bundle in patients with vestibular neurectomy. Novel, innovative approaches are needed to resolve the dissatisfying conclusion that current results are unable to definitively confirm or refute the role of the MOC reflex in masking and intensity resolution.

The relationship between ipsilateral cochlear gain reduction and speech-in-noise recognition at positive and negative signal-to-noise ratios

Active mechanisms that regulate cochlear gain are hypothesized to influence speech-in-noise perception. However, evidence of a relationship between the amount of cochlear gain reduction and speech-in-noise recognition is mixed. Findings may conflict across studies because different signal-to-noise ratios (SNRs) were used to evaluate speech-in-noise recognition. Also, there is evidence that ipsilateral elicitation of cochlear gain reduction may be stronger than contralateral elicitation, yet, most studies have investigated the contralateral descending pathway. The hypothesis that the relationship between ipsilateral cochlear gain reduction and speech-in-noise recognition depends on the SNR was tested. A forward masking technique was used to quantify the ipsilateral cochlear gain reduction in 24 young adult listeners with normal hearing. Speech-in-noise recognition was measured with the PRESTO-R sentence test using speech-shaped noise presented at -3, 0, and +3 dB SNR. Interestingly, greater cochlear gain reduction was associated with lower speech-in-noise recognition, and the strength of this correlation increased as the SNR became more adverse. These findings support the hypothesis that the SNR influences the relationship between ipsilateral cochlear gain reduction and speech-in-noise recognition. Future studies investigating the relationship between cochlear gain reduction and speech-in-noise recognition should consider the SNR and both descending pathways.

Efferent feedback controls bilateral auditory spontaneous activity

In the developing auditory system, spontaneous activity generated in the cochleae propagates into the central nervous system to promote circuit formation. The effects of peripheral firing patterns on spontaneous activity in the central auditory system are not well understood. Here, we describe wide-spread bilateral coupling of spontaneous activity that coincides with the period of transient efferent modulation of inner hair cells from the brainstem medial olivocochlear system. Knocking out α9/α10 nicotinic acetylcholine receptors, a requisite part of the efferent pathway, profoundly reduces bilateral correlations. Pharmacological and chemogenetic experiments confirm that the efferent system is necessary for normal bilateral coupling. Moreover, auditory sensitivity at hearing onset is reduced in the absence of pre-hearing efferent modulation. Together, these results demonstrate how afferent and efferent pathways collectively shape spontaneous activity patterns and reveal the important role of efferents in coordinating bilateral spontaneous activity and the emergence of functional responses during the prehearing period.

Otoacoustic Emissions Evoked by the Time-Varying Harmonic Structure of Speech

The human auditory system is exceptional at comprehending an individual speaker even in complex acoustic environments. Because the inner ear, or cochlea, possesses an active mechanism that can be controlled by subsequent neural processing centers through descending nerve fibers, it may already contribute to speech processing. The cochlear activity can be assessed by recording otoacoustic emissions (OAEs), but employing these emissions to assess speech processing in the cochlea is obstructed by the complexity of natural speech. Here, we develop a novel methodology to measure OAEs that are related to the time-varying harmonic structure of speech [speech-distortion-product OAEs (DPOAEs)]. We then employ the method to investigate the effect of selective attention on the speech-DPOAEs. We provide tentative evidence that the speech-DPOAEs are larger when the corresponding speech signal is attended than when it is ignored. Our development of speech-DPOAEs opens up a path to further investigations of the contribution of the cochlea to the processing of complex real-world signals.

On the importance of interaural noise coherence and the medial olivocochlear reflex for binaural unmasking in free-field listening

For speech in competition with a noise source in the free field, normal-hearing (NH) listeners recognize speech better when listening binaurally than when listening monaurally with the ear that has the better acoustic signal-to-noise ratio (SNR). This benefit from listening binaurally is known as binaural unmasking and indicates that the brain combines information from the two ears to improve intelligibility. Here, we address three questions pertaining to binaural unmasking for NH listeners. First, we investigate if binaural unmasking results from combining the speech and/or the noise from the two ears. In a simulated acoustic free field with speech and noise sources at 0° and 270°azimuth, respectively, we found comparable unmasking regardless of whether the speech was present or absent in the ear with the worse SNR. This indicates that binaural unmasking probably involves combining only the noise at the two ears. Second, we investigate if having binaurally coherent location cues for the noise signal is sufficient for binaural unmasking to occur. We found no unmasking when location cues were coherent but noise signals were generated incoherent or were processed unilaterally through a hearing aid with linear, minimal amplification. This indicates that binaural unmasking requires interaurally coherent noise signals, source location cues, and processing. Third, we investigate if the hypothesized antimasking benefits of the medial olivocochlear reflex (MOCR) contribute to binaural unmasking. We found comparable unmasking regardless of whether speech tokens (words) were sufficiently delayed from the noise onset to fully activate the MOCR or not. Moreover, unmasking was absent when the noise was binaurally incoherent whereas the physiological antimasking effects of the MOCR are similar for coherent and incoherent noises. This indicates that the MOCR is unlikely involved in binaural unmasking.

Cochlear activity in silent cue-target intervals shows a theta-rhythmic pattern and is correlated to attentional alpha and theta modulations

BACKGROUND

A long-standing debate concerns where in the processing hierarchy of the central nervous system (CNS) selective attention takes effect. In the auditory system, cochlear processes can be influenced via direct and mediated (by the inferior colliculus) projections from the auditory cortex to the superior olivary complex (SOC). Studies illustrating attentional modulations of cochlear responses have so far been limited to sound-evoked responses. The aim of the present study is to investigate intermodal (audiovisual) selective attention in humans simultaneously at the cortical and cochlear level during a stimulus-free cue-target interval.

RESULTS

We found that cochlear activity in the silent cue-target intervals was modulated by a theta-rhythmic pattern (~ 6 Hz). While this pattern was present independently of attentional focus, cochlear theta activity was clearly enhanced when attending to the upcoming auditory input. On a cortical level, classical posterior alpha and beta power enhancements were found during auditory selective attention. Interestingly, participants with a stronger release of inhibition in auditory brain regions show a stronger attentional modulation of cochlear theta activity.

CONCLUSIONS

These results hint at a putative theta-rhythmic sampling of auditory input at the cochlear level. Furthermore, our results point to an interindividual variable engagement of efferent pathways in an attentional context that are linked to processes within and beyond processes in auditory cortical regions.

Olivocochlear efferent effects on perception and behavior

The role of the mammalian auditory olivocochlear efferent system in hearing has long been the subject of debate. Its ability to protect against damaging noise exposure is clear, but whether or not this is the primary function of a system that evolved in the absence of industrial noise remains controversial. Here we review the behavioral consequences of olivocochlear activation and diminished olivocochlear function. Attempts to demonstrate a role for hearing in noise have yielded conflicting results in both animal and human studies. A role in selective attention to sounds in the presence of distractors, or attention to visual stimuli in the presence of competing auditory stimuli, has been established in animal models, but again behavioral studies in humans remain equivocal. Auditory processing deficits occur in models of congenital olivocochlear dysfunction, but these deficits likely reflect abnormal central auditory development rather than direct effects of olivocochlear feedback. Additional proposed roles in age-related hearing loss, tinnitus, hyperacusis, and binaural or spatial hearing, are intriguing, but require additional study. These behavioral studies almost exclusively focus on medial olivocochlear effects, and many relied on lesioning techniques that can have unspecific effects. The consequences of lateral olivocochlear and of corticofugal pathway activation for perception remain unknown. As new tools for targeted manipulation of olivocochlear neurons emerge, there is potential for a transformation of our understanding of the role of the olivocochlear system in behavior across species.

Correlation and Reliability of Behavioral and Otoacoustic-Emission Estimates of Contralateral Medial Olivocochlear Reflex Strength in Humans

The roles of the medial olivocochlear reflex (MOCR) in human hearing have been widely investigated but remain controversial. We reason that this may be because the effects of MOCR activation on cochlear mechanical responses can be assessed only indirectly in healthy humans, and the different methods used to assess those effects possibly yield different and/or unreliable estimates. One aim of this study was to investigate the correlation between three methods often employed to assess the strength of MOCR activation by contralateral acoustic stimulation (CAS). We measured tone detection thresholds (N = 28), click-evoked otoacoustic emission (CEOAE) input/output (I/O) curves (N = 18), and distortion-product otoacoustic emission (DPOAE) I/O curves (N = 18) for various test frequencies in the presence and the absence of CAS (broadband noise of 60 dB SPL). As expected, CAS worsened tone detection thresholds, suppressed CEOAEs and DPOAEs, and horizontally shifted CEOAE and DPOAE I/O curves to higher levels. However, the CAS effect on tone detection thresholds was not correlated with the horizontal shift of CEOAE or DPOAE I/O curves, and the CAS-induced CEOAE suppression was not correlated with DPOAE suppression. Only the horizontal shifts of CEOAE and DPOAE I/O functions were correlated with each other at 1.5, 2, and 3 kHz. A second aim was to investigate which of the methods is more reliable. The test–retest variability of the CAS effect was high overall but smallest for tone detection thresholds and CEOAEs, suggesting that their use should be prioritized over the use of DPOAEs. Many factors not related with the MOCR, including the limited parametric space studied, the low resolution of the I/O curves, and the reduced numbers of observations due to data exclusion likely contributed to the weak correlations and the large test–retest variability noted. These findings can help us understand the inconsistencies among past studies and improve our understanding of the functional significance of the MOCR.