Auditory neuropathy/dys-synchrony: diagnosis and management

Auditory brainstem responses (ABRs) and otoacoustic emissions (OAEs) are objective measures of auditory function, but are not hearing tests. Normal OAEs reflect normal cochlear outer hair cell function, and an ABR indicates a synchronous neural response. It is quite possible for a patient to have normal OAEs but absent or grossly abnormal ABR and a behavioral audiogram that is inconsistent with either test. These patients, who may constitute as much as 10% of the diagnosed deaf population, have auditory neuropathy/dys-synchrony (AN/AD). To diagnose AN/AD accurately, ABRs are obtained in response to condensation and rarefaction clicks to distinguish cochlear microphonics (CM) from neural responses. Appropriate management is confounded by variation among patients and changes in auditory function in some patients over time. Recommendations for management include visual language exposure through methods such as American Sign Language (ASL), Cued Speech, or baby signs, and closely following patients.     

The use of averaged electroencephalic response techniques in the study of auditory processing related to speech and language

This paper reviews a number of studies done by the authors and others, who have utilized various averaged electroencephalic response (AER) techniques to study speech and language processing. Pertinent studies are described in detail. A relatively new AER technique, auditory brainstem responses (ABR), is described and its usefulness in studying auditory processing activity related to speech and language is outlined. In addition, a series of ABR studies, that have demonstrated significant male—female differences in ABR auditory processing abilities, is presented and the relevance of these data to already established differences in male—female language, hearing, and cognitive abilities is discussed.     

脑干诱发电位在言语感知研究中的应用

脑干诱发电位是一种考察听觉脑干加工声音信号时神经活动的非侵入性技术, 近年来被广泛用于探索言语感知的神经基础。相关研究主要集中在考察成年人和正常发展儿童语音编码时脑干的活动特征及发展模式, 探讨发展性阅读障碍及其他语言损伤的语音编码缺陷及其神经表现等方面。在已有研究的基础上进一步探索初级语音编码和高级言语加工之间的相互作用机制, 考察阅读障碍的底层神经基础将成为未来该技术在言语感知研究中应用的重点。     

The AXS battery and “neurological fingerprints”: Meeting the challenge of individual differences in human brain/behavior relations

A new test battery, the Auditory Cross-Section (AXS) Battery, offers a relatively inexpensive, noninvasive means of describing a “neurological fingerprint” for each individual. The battery’s “access to axes” combines physiological and behavioral measures so that a large set of dependent variables can be used to profile an individual and can serve as a context for additional anatomical, behavioral, and physiological data for the same subject. Physiological tests included in the battery described here include (1) otoacoustic emissions (OAEs); (2) the repeated evoked potentials version of the auditory brainstem response (REPs/ABR); and (3) quantitative electroencephalography (qEEG). Complementary behavioral tests were chosen to assess capabilities related to functional asymmetries, such as phonemic awareness and fine motor control, and/or to demonstrate temporal correlations that link behavioral and neural function. Applications of the AXS battery include (1) documentation of individual differences and similarities in neural organization that are related to specific behaviors, such as learning styles or clinical symptoms; (2) provision of contextual data for neuroimaging studies that aid in interpreting individually specific patterns of activation; and (3) development of a neurotypology of human brain/behavior relations, linking characteristics of neuroanatomy and neurophysiology with features of behavior, and general body health.     

Brainstem correlates of temporal auditory processing in children with specific language impairment

Deficits in identification and discrimination of sounds with short inter-stimulus intervals or short formant transitions in children with specific language impairment (SLI) have been taken to reflect an underlying temporal auditory processing deficit. Using the sustained frequency following response (FFR) and the onset auditory brainstem responses (ABR) we evaluated if children with SLI show abnormalities at the brainstem level consistent with a temporal processing deficit. To this end, the neural encoding of tonal sweeps, as reflected in the FFR, for different rates of frequency change, and the effects of reducing inter-stimulus interval on the ABR components were evaluated in 10 4–11-year-old SLI children and their age-matched controls. Results for the SLI group showed degraded FFR phase-locked neural activity that failed to faithfully track the frequency change presented in the tonal sweeps, particularly at the faster sweep rates. SLI children also showed longer latencies for waves III and V of the ABR and a greater prolongation of wave III at high stimulus rates (>30/sec), suggesting greater susceptibility to neural adaptation. These results taken together appear to suggest a disruption in the temporal pattern of phase-locked neural activity necessary to encode rapid frequency change and an increased susceptibility to desynchronizing factors related to faster rates of stimulus presentation in children with SLI.     

Sex and ear differences in spontaneous and click-evoked otoacoustic emissions in young adults

Effects of sex and handedness on the production of spontaneous and click-evoked otoacoustic emissions (OAEs) were explored in a non-hearing impaired population (ages 17-25 years). A sex difference in OAEs, either produced spontaneously (spontaneous OAEs or SOAEs) or in response to auditory stimuli (click-evoked OAEs or CEOAEs) has been reported in infants and children, but healthy young adults seldom have been the target of study. In the current data, a robust sexual dimorphism was confirmed, with women producing more numerous and stronger SOAEs, and CEOAEs with greater response amplitude compared to men. A right-ear advantage was found for the number of SOAEs produced and, in women, for SOAE power. Although handedness did not moderate the ear asymmetry in production, exploratory analyses revealed that departures from strong right hand preference were associated in the present sample with reduced numbers or strengths of OAEs. The results are discussed with respect to differential exposure to androgens during prenatal development.     

Brainstem frequency-following response recorded from one vertical and three horizontal electrode derivations

The human brainstem frequency-following response reflects neural activity to periodic auditory stimuli. Responses were simultaneously recorded from one vertically oriented and three horizontally oriented electrode derivations. Nine participants each received a total of 16,000 tone repetitions, 4,000 for each of four stimulus frequencies: 222, 266, 350, and 450 Hz. The responses were digitally filtered, quantified by correlation and spectral analysis, and statistically evaluated by repeated measure analysis of variance. While the various horizontal derivation responses did not differ from each other in latency (values tightly clustered around M= 2.60 msec.), the vertical derivation response occurred significantly later (M=4.38 msec.). The smaller latency for the horizontal responses suggests an origin within the acoustic nerve, while the larger latency for the vertical response suggests a central brainstem origin. The largest response amplitude resulted from gold "tiptrode" electrodes placed in each auditory meatus, suggesting that this electrode derivation provided the most accurate (noninvasive) assessment of short-latency events originating at the level of the auditory nerve.     

What Do Sex, Twins, Spotted Hyenas, ADHD, and Sexual Orientation Have in Common?

ABSTRACT— The otoacoustic emissions (OAEs) measured in a collection of special populations of humans and certain nonhuman species suggest that OAEs may provide a window into some processes of human prenatal development and sexual differentiation. For reasons that are unclear, OAEs appear to be highly sensitive to events occurring during prenatal development that seem to be related to the degree of exposure to androgens a fetus receives. The (largely circumstantial) evidence for a relationship between androgen exposure and OAE strength comes from a series of studies of twins, children with attention-deficit/hyperactivity disorder, people of differing sexual orientations, and spotted hyenas, among others. Some conclusions are bolstered by parallel studies using auditory evoked potentials (AEPs). OAEs and AEPs are simple, objective, noninvasive measures that appear to have potential as tools of value to researchers working on a wide variety of basic and applied topics beyond audition.     

Developmental trends in auditory processing can provide early predictions of language acquisition in young infants

Auditory processing capabilities at the subcortical level have been hypothesized to impact an individual's development of both language and reading abilities. The present study examined whether auditory processing capabilities relate to language development in healthy 9‐month‐old infants. Participants were 71 infants (31 boys and 40 girls) with both Auditory Brainstem Response (ABR) and language assessments. At 6 weeks and/or 9 months of age, the infants underwent ABR testing using both a standard hearing screening protocol with 30 dB clicks and a second protocol using click pairs separated by 8, 16, and 64‐ms intervals presented at 80 dB. We evaluated the effects of interval duration on ABR latency and amplitude elicited by the second click. At 9 months, language development was assessed via parent report on the Chinese Communicative Development Inventory ‐ Putonghua version (CCDI‐P). Wave V latency z‐scores of the 64‐ms condition at 6 weeks showed strong direct relationships with Wave V latency in the same condition at 9 months. More importantly, shorter Wave V latencies at 9 months showed strong relationships with the CCDI‐P composite consisting of phrases understood, gestures, and words produced. Likewise, infants who had greater decreases in Wave V latencies from 6 weeks to 9 months had higher CCDI‐P composite scores. Females had higher language development scores and shorter Wave V latencies at both ages than males. Interestingly, when the ABR Wave V latencies at both ages were taken into account, the direct effects of gender on language disappeared. In conclusion, these results support the importance of low‐level auditory processing capabilities for early language acquisition in a population of typically developing young infants. Moreover, the auditory brainstem response in this paradigm shows promise as an electrophysiological marker to predict individual differences in language development in young children.     

Speech‐evoked auditory brainstem responses reflect familial and cognitive influences

Cortical function and related cognitive, language, and communication skills are genetically influenced. The auditory brainstem response to speech is linked to language skill, reading ability, cognitive skills, and speech‐in‐noise perception; however, the impact of shared genetic and environmental factors on the response has not been investigated. We assessed auditory brainstem responses to speech presented in quiet and background noise from (1) 23 pairs of same sex, same learning diagnosis siblings (Siblings), (2) 23 unrelated children matched on age, sex, IQ, and reading ability to one of the siblings (Reading‐Matched), and (3) 22 pairs of unrelated children matched on age and sex but not on reading ability to the same sibling (Age/Sex‐Matched). By quantifying response similarity as the intersubject response‐to‐response correlation for sibling pairs, reading‐matched pairs, and age‐ and sex‐matched pairs, we found that siblings had more similar responses than age‐ and sex‐matched pairs and reading‐matched pairs. Similarity of responses between siblings was as high as the similarity of responses collected from an individual over the course of the recording session. Responses from unrelated children matched on reading were more similar than responses from unrelated children matched only on age and sex, supporting previous data linking variations in auditory brainstem activity with variations in reading ability. These results suggest that auditory brainstem function can be influenced by siblingship and auditory‐based communication skills such as reading, motivating the use of speech‐evoked auditory brainstem responses for assessing risk of reading and communication impairments in family members.     

Biological Bases of Extraversion Psychophysiological Evidence

There is a good deal of evidence, particularly from electrodermal and electrocortical recording procedures, that introverts exhibit greater reactivity to sensory stimulation than extraverts. There is little evidence that introverts and extraverts differ in base level of arousal in neutral conditions, and there is no clear evidence that their differences in sensitivity to stimulation are determined by differences in attentional state. Faster auditory brainstem evoked response latencies observed for introverts implicate differences in peripheral sensory processes that are not determined by mechanisms in the reticular system as proposed in the arousal hypothesis. There is also evidence that individual differences in the expression of motor activity between introverts and extraverts involve differences in motoneuronal excitability.     

Brainstem auditory evoked potentials in receptive developmental language disorder

It has been hypothesized that receptive developmental language disorder (RDLD) may be explained by an auditory processing deficit. The neuroanatomical locus of this deficit is unknown. Brainstem auditory evoked potentials (BAEPs) reflect the functioning of the auditory nerve and auditory brainstem pathways to high-frequency acoustical stimulation in humans and reflect the first stages of auditory processing. These were studied in 12 subjects with RDLD (four females and eight males, ages 12 to 19) and twelve control subjects (three females and nine males, ages 14 to 24). Click intensity and rate of stimulation were varied. The BAEPs for the RDLD group were comparable to the control group as well as to hospital norms across intensity levels and stimulation rates. The evidence obtained suggests that a disorder in the neurophysiological systems underlying the BAEPs and reflecting initial stages of auditory processing is not essential for RDLD.     

Cocaine-induced brainstem seizures and behavior.

A variety of abnormal sensory/motor behaviors associated with electrical discharges recorded from the bilateral brainstem were induced in adult WKY rats by mechanical (electrode implants) and DC electrical current stimulations and by acute and chronic administration of cocaine. The electrode implant implicated one side or the other of the reticular system of the brainstem but subjects were not incapacitated by the stimulations. Cocaine (40 mg/kg) was injected subcutaneously for an acute experiment and subsequent 20 mg/kg doses twice daily for 3 days in a chronic study. Cocaine generated more abnormal behaviors in the brainstem perturbation group, especially the electrically perturbated subjects. The abnormal behaviors were yawning, retrocollis, hyperactivity, hypersensitivity, "beating drum" behavior, squealing, head bobbing, circling, sniffing, abnormal posturing, and facial twitching. Shifts in the power frequency spectra of the discharge patterns were noted between quiet and pacing behavioral states. Hypersensitivity to various auditory, tactile, and visual stimulation was present and shifts in the brainstem ambient power spectral frequency occurred in response to tactile stimulation. These findings suggest that the brainstem generates and propagates pathological discharges that can be elicited by mechanical and DC electrical perturbation. Cocaine was found to activate the discharge system and thus induce abnormal behaviors that are generated at the discharge site and at distant sites to which the discharge propagates. Cognitive functions may also be involved since dopaminergic and serotonergic cellular elements at the brainstem level are also implicated.     

Cocaine-induced brainstem seizures and behavior

A variety of abnormal sensory/motor behaviors associated with electrical discharges recorded from the bilateral brainstem were induced in adult WKY rats by mechanical (electrode implants) and DC electrical current stimulations and by acute and chronic administration of cocaine. The electrode implant implicated one side or the other of the reticular system of the brainstem but subjects were not incapacitated by the stimulations. Cocaine (40 mg/kg) was injected subcutaneously for an acute experiment and subsequent 20 mg/kg doses twice daily for 3 days in a chronic study. Cocaine generated more abnormal behaviors in the brainstem perturbation group, especially the electrically perturbated subjects. The abnormal behaviors were yawning, retrocollis, hyperactivity, hypersensitivity, “beating drum” behavior, squealing, head bobbing, circling, sniffing, abnormal posturing, and facial twitching. Shifts in the power frequency spectra of the discharge patterns were noted between quiet and pacing behavioral states. Hypersensitivity to various auditory, tactile, and visual stimulation was present and shifts in the brainstem ambient power spectral frequency occurred in response to tactile stimulation. These findings suggest that the brainstem generates and propagates pathological discharges that can be elicited by mechanical and DC electrical perturbation. Cocaine was found to activate the discharge system and thus induce abnormal behaviors that are generated at the discharge site and at distant sites to which the discharge propagates. Cognitive functions may also be involved since dopaminergic and serotonergic cellular elements at the brainstem level are also implicated.     

The language environment of the young infant: implications for early perceptual development

The purpose of this article is to review recent research on the young infant's use of voice-specific as well as voice-nonspecific auditory information during early language processing, to suggest a possible mechanism that biases the young infant towards this information, and to discuss potential implications of the early saliency of this information for later language development. Auditory preferences expressed by young infants are of interest because they demonstrate which properties of complex auditory events are effective in capturing the infant's attention. Moreover, the presence of such auditory preferences has led to speculations about their possible origins in both pre- and postnatal auditory experience. Research examining the role of early auditory experience in the formation of preferences is presented, along with a discussion of how the constrained nature of early auditory experience (particularly prenatal) may bias the young infant towards specific features of maternal as well as nonmaternal speech.     

Brainstem auditory electrical response characteristics of stutterers and nonstutterers: A preliminary report

In the present study, eight adult male stutterers and nonstutterers showed no significant latency or amplitude differences in BSERs recorded in response to monaural and binaural clicks. However, significantly greater variance was found in the stutterers' group under the monaural stimulation condition at click rates of 12/sec and 5/sec. Left and right monaural waveforms were subtracted individually from the binaural waveform. The resultant binaural interaction difference traces were examined to determine auditory tract preference for binaural stimulation. While some subjects from both groups showed no auditory tract preference, it was found that the significant variance between groups for wave V latency was attributable to the subset of stutterers without auditory tract preference. This finding is interpreted as evidence of neurological differences in stutterers' auditory processing at the brainstem level.     

Auditory evoked response in chinchilla: Application to animal audiometry

In chinchilla a neural response to tone pips or the onset of pure tones can be recorded from scalp electrodes. If 64 responses are averaged by a computer the response can be recognized reliably at sound pressure levels at or near chinchilla’s usual behavioral thresholds of hearing. Detection is possible at slightly lower levels if the number of responses is increased to 500 to 1000. The response is an initiallypositive diphasic wave with latency to foot between 1.6 and 4.0 msec. It apparently arises from several structures in the brainstem but chiefly from the inferior colliculus. The technique may be useful in assessing quickly the sensitivity of the peripheral auditory mechanism in small laboratory animals.     

Sexual dimorphism of auditory activity in the zebra finch song system

While the tracheosyringeal motor neurons of anesthetized male zebra finches fire in response to acoustic stimuli, the same motor neurons in females show no such response. Females masculinized by estradiol implants on Days 1 or 2 after hatching may develop auditory responses in their tracheosyringeal motor neurons; the presence of the response is directly related to the degree of masculinization of the estradiol-treated females' telencephalic song centers. In male zebra finches, neurons in HVc (Hyperstriatum Ventrale pars caudalis) respond to sound, and the HVc is necessary for the tracheosyringeal auditory response. Multiunit auditory activity was demonstrated in the HVc of female zebra finches. A single 20-microA pulse delivered to the male HVc elicits a large volley in the tracheosyringeal nerve; microstimulating the female HVc does not evoke a response in the motor nerve. This failure of both auditory and HVc stimulation to elicit a response in the female tracheosyringeal nerve is attributed to the lack of a functional HVc-nucleus Robustus Archistriatalis projection in females. If, as has been suggested, the tracheosyringeal auditory response may be important for the processing of song, female zebra finches might not process song in the same manner as do males.     

Accessory stimulation in the time course of visuomotor information processing: stimulus intensity effects on reaction time and response force

A series of three visual choice-reaction time experiments were performed to systematically investigate the effects of accessory auditory stimulation on response time (RT) and response force (RF). In Experiment 1, the effect of accessory auditory stimulation on early visual information processing was investigated. Experiments 2 and 3 were designed to examine the effects of accessory intensity on RT and RF across the entire time course of sensorimotor processing. Accessory stimulation accelerated response speed only when presented within 100 ms after onset of the visual response signal. An enhancing effect of accessory stimulation on RF, however, was found as late as 220 ms after onset of the response signal. These findings support the notion that response speed and response dynamics represent functionally independent sensorimotor phenomena.