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Evoked dipole source potentials of the human auditory cortex.

A new description of evoked potential activity in terms of 'dipole source potentials' is presented, based on the physical laws relating intracranial electrical activity and scalp potentials. Recorded at a sufficiently distant electrode, the electrical activity of a spatially restricted region can be approximated uniquely by a time varying dipole vector field with stationary equivalent dipole location. Each of its 3 projections on a 3-dimensional coordinate system presents an accordingly defined 'dipole source component.' Magnitudes of these components are functions of time, named 'dipole source potentials.' The 2-dimensional coronal scalp distribution of middle and late AEPs, obtained in 15 normal subjects, could best be decomposed into tangential and radial dipole source components, originating from the auditory structures in both temporal lobes. Initial tangential activity (N19t-P30t) appeared to arise in primary auditory cortex, and initial radial activity (N27r-P39r) in secondary auditory cortex, in view of the similarity with intracranial records (Celesia 1976). Unilateral lesions of the acoustic radiation abolished ipsilateral MAEP dipole source potentials. Lesions involving AI/II and AAI also abolished the LAEP source potentials in the damaged hemisphere. The normal dipole source potentials in the intact hemisphere fully explained scalp distributions in these patients. In cases with assumed interruption of primary cortical input, presence of late dipole source potentials, which were delayed by 20-30 msec, probably reflected cortical activation via commissural fibres.

Adult↗

Auditory cortex responses to sequences of normal and reversed squirrel monkey vocalizations.

Responsiveness of auditory cortex (AC) units of awake squirrel monkeys to a natural sequence of species-specific calls was not significantly different from their responsiveness to a reverse playback of the sequence. No dependency was noted between the percentage of responding units and the average intensity of sounds, their spectral content or their order of presentation. The effectiveness of the sounds in eliciting responses was variable even when the sequence was produced in an unchanging behavioral context. Comparison of these findings with earlier results of individual vocalizations presented normally or backward in an isolated manner suggest that responsiveness of AC neurons to continuous sounds is lower than their responsiveness to isolated sounds, whether natural or artificial.

Animals↗

Encoding of target range and its representation in the auditory cortex of the mustached bat.

The time course of acoustic events is a critical element for the recognition of biologically meaningful sounds. Echolocating bats analyze the time intervals between their emitted biosonar pulses and the echoes returning from objects to assess target distance (range). In this study, we have explored the auditory cortex of the mustached bat, Pteronotus parnellii rubiginosus, using pairs of acoustic stimuli mimicking the multiharmonic biosonar signals (pulses) used by this species and their echoes. A discrete field of auditory cortex dorsorostral to the tonotopically organized primary field contains neurons which are insensitive to pure tone, frequency-modulated (FM), or noise stimuli presented singly. Rather, they respond strongly to pairs of stimuli, specifically, the fundamental FM component of the pulse paired with an FM component of one of the higher harmonics of the echo. We call these neurons FM1-FMn facilitation neurons. There are three separate longitudinal clusters in this cortical area containing FM1-FM2, FM1-FM3, and FM1-FM4 neurons, respectively. Moreover, FM1-FMn neurons are specifically sensitive to the time delay between the two FM components, i.e., the time delay of the echo from the pulse. Thus, they can decode target range. Two types of delay-sensitive neurons were found. Tracking neurons, whose response to echo delay varied according to repetition rate and stimulus duration, were found rarely. Delay-tuned neurons, which were tuned to specific time delays (best delays) of the echo from the pulse, were much more evident. Both types of neurons are organized into columns with similar best delays, and the best delay of delay-tuned neurons was found to increase systematically along the cortical surface in the rostrocaudal direction. This area, therefore, contains a neural representation of target range along this best delay axis. Such an axis exists in each of the clusters of FM1-FM2, FM1-FM3, and FM1-FM4 neurons. This is a new type of cortical organization which is not tonotopic but which represents an important acoustic cue related to the time course of acoustic events.

Animals↗

Spectral response patterns of auditory cortex neurons to harmonic complex tones in alert monkey (Macaca mulatta).

1. The auditory cortex in the superior temporal region of the alert rhesus monkey was explored for neuronal responses to pure and harmonic complex tones and noise. The monkeys had been previously trained to recognize the similarity between harmonic complex tones with and without fundamentals. Because this suggested that they could preceive the pitch of the lacking fundamental similarly to humans, we searched for neuronal responses relevant to this perception. 2. Combination-sensitive neurons that might explain pitch perception were not found in the surveyed cortical regions. Such neurons would exhibit similar responses to stimuli with similar periodicities but differing spectral compositions. The fact that no neuron with responses to a fundamental frequency responded also to a corresponding harmonic complex missing the fundamental indicates that cochlear distortion products at the fundamental may not have been responsible for missing fundamental-pitch perception in these monkeys. 3. Neuronal responses can be expressed as relatively simple filter functions. Neurons with excitatory response areas (tuning curves) displayed various inhibitory sidebands at lower and/or higher frequencies. Thus responses varied along a continuum of combined excitatory and inhibitory filter functions. 4. Five elementary response classes along this continuum are presented to illustrate the range of response patterns. 5. "Filter (F) neurons" had little or no inhibitory sidebands and responded well when any component of a complex tone entered its pure-tone receptive field. Bandwidths increased with intensity. Filter functions of these neurons were thus similar to cochlear nerve-fiber tuning curves. 6. "High-resolution filter (HRF) neurons" displayed narrow tuning curves with narrowband widths that displayed little growth with intensity. Such cells were able to resolve up to the lowest seven components of harmonic complex tones as distinct responses. They also responded well to wideband stimuli. 7. "Fundamental (F0) neurons" displayed similar tuning bandwidths for pure tones and corresponding fundamentals of harmonic complexes. This response pattern was due to lower harmonic complexes. This response pattern was due to lower inhibitory sidebands. Thus these cells cannot respond to missing fundamentals of harmonic complexes. Only physically present components in the pure-tone receptive field would excite such neurons. 8. Cells with no or very weak responses to pure tones or other narrowband stimuli responded well to harmonic complexes or wideband noise.(ABSTRACT TRUNCATED AT 400 WORDS)

Acoustic Stimulation↗

A computational model of mechanisms controlling experience-dependent reorganization of representational maps in auditory cortex.

Cortical representations of sound can be modified by repeatedly pairing presentation of a pure tone with electrical stimulation of neuromodulatory neurons located in the basal forebrain (Bakin & Weinberger, 1996; Kilgard & Merzenich, 1998a). We developed a computational model to investigate the possible effects of basal forebrain modulation on map reorganization in the auditory cortex. The model is a self-organizing map with acoustic response characteristics mimicking those observed in the mammalian auditory cortex. We simulated the effects of basal forebrain modulation, using parameters intrinsic to the self-organizing map, such as the learning rate (controlling the adaptability of map nodes) and the neighborhood function (controlling the excitability of map nodes). Previous research has suggested that both parameters can be useful for characterizing the effects of neuromodulation on plasticity (Kohonen, 1993; Myers et al., 1996; Myers, Ermita, Hasselmo, & Gluck, 1998). The model successfully accounts for experimentally observed effects of pairing basal forebrain stimulation with the presentation of a single tone, but not of two tones, suggesting that auditory cortical plasticity is constrained in ways not accounted for by current theories. Despite this limitation, the model provides a useful framework for describing experience-induced changes in auditory representations and for relating such changes to variations in the excitability and adaptability of cortical neurons produced by neuromodulation.

Animals↗

Processing of complex sounds in the macaque nonprimary auditory cortex.

Neurons in the superior temporal gyrus of anesthetized rhesus monkeys were exposed to complex acoustic stimuli. Bandpassed noise bursts with defined center frequencies evoked responses that were greatly enhanced over those evoked by pure tones. This finding led to the discovery of at least one new cochleotopic area in the lateral belt of the nonprimary auditory cortex. The best center frequencies of neurons varied along a rostrocaudal axis, and the best bandwidths of the noise bursts varied along a mediolateral axis. When digitized monkey calls were used as stimuli, many neurons showed a preference for some calls over others. Manipulation of the calls' frequency structure and playback of separate components revealed different types of spectral integration. The lateral areas of the monkey auditory cortex appear to be part of a hierarchical sequence in which neurons prefer increasingly complex stimuli and may form an important stage in the preprocessing of communication sounds.

Acoustic Stimulation↗

Disrupted tonotopy of the auditory cortex in mice lacking M1 muscarinic acetylcholine receptor.

Sensory cortices have multiple and distinct functional maps that systematically represent environmental information. Development of these maps is precisely controlled by a number of intrinsic and extrinsic factors. Cortical cholinergic regulation is a crucial factor for normal cortical morphogenesis. In this study, we test the role of the M1 muscarinic acetylcholine receptor, the main muscarinic receptor subtype in the neocortex in the development of tonotopic maps in the auditory cortex. Mice lacking M1 receptors have normal hearing sensitivity but exhibit disrupted tonotopic organization and frequency tuning in the auditory cortex. In contrast, tonotopic organization and frequency tuning remain normal in the auditory midbrain. In addition, cortical layer IV neurons of M1 mutants exhibit significantly shorter or sparser dendrites compared to neurons of wildtype mice. In summary, our data suggest that the M1 receptor appears to be critical for the refinement or normal maturation of cortical tonotopy that is guided by thalamocortical inputs during early development.

Acoustic Stimulation↗

Deviant auditory stimuli activate human left and right auditory cortex differently.

Infrequent "deviant' auditory stimuli embedded in a homogeneous sequence of "standard' sounds evoke a neuromagnetic mismatch field (MMF), which is assumed to reflect automatic change detection in the brain. We investigated whether MMFs would reveal hemispheric differences in cortical auditory processing. Seven healthy adults were studied with a whole-scalp neuromagnetometer. The sound sequence, delivered to one ear at time, contained three infrequent deviants (differing from standards in duration, frequency, or interstimulus interval) intermixed with standard tones. MMFs peaked 9-34 msec earlier in the right than in the left hemisphere, irrespective of the stimulated ear. Whereas deviants activated only one MMF source in the left hemisphere, two temporally overlapping but spatially separate sources, one in the temporal lobe and another in the inferior parietal cortex, were necessary to explain the right-hemisphere MMFs. We suggest that the bilateral MMF components originating in the supratemporal cortex are feature specific whereas the right-hemisphere parietal component reflects more global auditory change detection. The results imply hemispheric differences in sound processing and suggest stronger involvement of the right than the left hemisphere in change detection.

Acoustic Stimulation↗

Forward masking in the evoked responses of the guinea pig auditory cortex: effects of variation of the interaural time and phase differences.

In anaesthesized guinea pigs the evoked potentials of the auditory cortex were studied in a forward masking paradigm. In-phase and out-of-phase binaurally presented clicks with interaural time delay (ITD) were used as masker, in-phase click with ITD = 0 served as probe signal. Addition of the masking stimulus suppressed the probe-evoked response that followed the masker. The magnitude of the suppression correlated with the amount of the masker-evoked response: an increase in masker-evoked excitation caused a greater reduction in probe response magnitude. Amplitude of masker-evoked response was seen to be a monotonic or non-monotonic function of ITD. The non-monotonic response exhibited a sensitivity to the interaural phase differences when in-phase and out-of-phase maskers were presented, and showed the tendency to be periodic function of ITD in the expanded range of ITD values. Phase-sensitive responses differed in recovery time following the in-phase and out-of-phase masking stimuli. At near-threshold levels of a forward masker an enhancement of the probe-evoked response was observed.

Acoustic Stimulation↗

Effects of noradrenaline on rate-level function of auditory cortex neurons: is there a "gating" effect of noradrenaline?

To test a potential "gating" effect of noradrenaline (NA) in the auditory cortex, the acoustic threshold was estimated by determining the rate-level function of neurons before, during, and after microiontophoretic application (5-40 nA) of NA. The rationale behind this experiment was that a gating effect should decrease the threshold for acoustic excitatory responses. From 84 recorded neurons, we observed (1) that application of NA increased the threshold for 48 of 84 cells, and (2) that, on average, the slope of the rate-level functions was unchanged. These effects on the threshold are consistent with the fact that the dominant effect of NA on the evoked response is inhibition for 34 of 84 cells; increases in evoked responses were observed for only 14 of 84 cells. GABA application (0-50 nA) also led to increased response threshold for 19 of 24 cells (unaffected, 5 of 24 cells). However, for three cells the effect of GABA application was antagonized by bicuculline application, while on the same cells bicuculline application did not prevent the noradrenergic increase in threshold. The effect induced by NA on the threshold raises questions about the generality of a gating effect of NA in sensory neocortex.

Acoustic Stimulation↗

Effects of putative neurotransmitters on neuronal activity in monkey auditory cortex.

The effects of the putative neurotransmitters norepinephrine (NE), gamma-aminobutyric acid (BAGA), and acetylcholine (ACh) were tested on auditory cortex neurons which were activated acoustically by species-specific vocalizations in awake squirrel monkeys. Five-barrel glass electrodes were used to record the activity single neurons in the superior temporal gyrus and to apply NE, GABA, or ACh microiontophoretically. Poststimulus time histograms and raster displays of neuronal responses to the vocalizations were computed before, during, and after iontophoresis. Dose-dependent inhibition of spontaneous and vocalization-evoked discharge rates was seen with NE and GABA. Generally, excitation was observed with ACh. A given dose of NE or GABA reduced spontaneous activity by a greater proportion than it reduced activity evoked by the vocalizations. During excitatory responses, segments with lower discharge rates were reduced proportionately more than segments with higher discharge rates. Usually, response 'pattern' was not altered by iontophoresis of any of the substances. However, in some cases the differential inhibition of slow activity produced by NE or GABA did result in a 'patern' change. The demonstration that small amounts of locally applied NE and GABA substantially alter the specific neuronal activation produced by vocalizations provides additional evidence that these agents may function as neurotransmitters in this neocortical area and offers clues about their functional significance.

Acetylcholine↗

Encoding of virtual acoustic space stimuli by neurons in ferret primary auditory cortex.

Recent studies from our laboratory have indicated that the spatial response fields (SRFs) of neurons in the ferret primary auditory cortex (A1) with best frequencies > or =4 kHz may arise from a largely linear processing of binaural level and spectral localization cues. Here we extend this analysis to investigate how well the linear model can predict the SRFs of neurons with different binaural response properties and the manner in which SRFs change with increases in sound level. We also consider whether temporal features of the response (e.g., response latency) vary with sound direction and whether such variations can be explained by linear processing. In keeping with previous studies, we show that A1 SRFs, which we measured with individualized virtual acoustic space stimuli, expand and shift in direction with increasing sound level. We found that these changes are, in most cases, in good agreement with predictions from a linear threshold model. However, changes in spatial tuning with increasing sound level were generally less well predicted for neurons whose binaural frequency-time receptive field (FTRF) exhibited strong excitatory inputs from both ears than for those in which the binaural FTRF revealed either a predominantly inhibitory effect or no clear contribution from the ipsilateral ear. Finally, we found (in agreement with other authors) that many A1 neurons exhibit systematic response latency shifts as a function of sound-source direction, although these temporal details could usually not be predicted from the neuron's binaural FTRF.

Acoustic Stimulation↗

[Auditory perception and language: functional imaging of speech sensitive auditory cortex].

Since the description of cortical deafness, it has been known that the superior temporal cortex is bilaterally involved in the initial stages of language auditory perception but the precise anatomical limits and the function of this area remain debated. Here we reviewed more than 40 recent papers of positron emission tomography and functional magnetic resonance imaging related to language auditory perception, and we performed a meta-analysis of the localization of the peaks of activation in the Talairach's space. We found 8 studies reporting word versus non-word listening contrasts with 54 activation peaks in the temporal lobes. These peaks clustered in a bilateral and well-limited area of the temporal superior cortex, which is here operationally defined as the speech sensitive auditory cortex. This area is more than 4cm long, located in the superior temporal gyrus and the superior temporal sulcus, both anterior and posterior to Heschl's gyrus. It do not include the primary auditory cortex nor the ascending part of the planum temporale. The speech sensitive auditory cortex is not activated by pure tones, environmental sounds, or attention directed toward elementary components of a sound such as intensity, pitch, or duration, and thus has some specificity for speech signals. The specificity is not perfect, since we found a number of non-speech auditory stimuli activating the speech sensitive auditory cortex. Yet the latter studies always involve auditory perception mechanisms which are also relevant to speech perception either at the level of primitive auditory scene analysis processes, or at the level of specific schema-based recognition processes. The dorsal part of the speech sensitive auditory cortex may be involved in primitive scene analysis processes, whereas distributed activation of this area may contribute to the emergence of a broad class of "voice" schemas and of more specific "speech schemas/phonetic modules" related to different languages. In addition, this area is activated by language-related lip movement, suggesting that a multimodal integration of the auditory and the visual information relevant in speech perception occurs at this level. Finally, there is a task-related top-down modulation of the pattern of activation of the speech sensitive auditory cortex which may reflect the fact that the different parts of this structure are connected to different down-stream cortical regions involved in the neural processing of different types of tasks.

Auditory Cortex↗

Population responses to multifrequency sounds in the cat auditory cortex: four-tone complexes.

Population responses to two-tone and four-tone sounds were recorded in primary auditory cortex of anesthetized cats. The stimuli were delivered through a sealed, calibrated sound delivery system. The envelope of the neural signal (short time mean absolute value, MABS) was recorded extracellularly from six microelectrodes simultaneously. A new method was developed to describe the responses to the four-tone complexes. The responses were represented as sums of contributions of different orders. The first order contributions described the effect of the single frequencies appearing in the stimulus. The second order contributions described the modulatory effect of the pairs of frequencies. Higher order contributions could in principle be computed. This paper concentrates on the mean onset responses. The extent to which the first and second order contributions described the onset responses was assessed in two ways. First, the actual responses to two-tone stimuli were compared with those predicted using the contributions computed from the four-tone stimuli. Second, the residual variance in the responses, after the subtraction of the first and second order contributions, was computed and compared with the variability in the responses to repetitions of the same stimulus. The first type of analysis showed good quantitative agreement between the predicted and the measured two-tone responses. The second type of analysis showed that the first and second order contributions were often sufficient to predict the responses to four-tone stimuli up to the level of the variability in the responses to repetitions of a single stimulus. In conjunction with the results of the companion paper (Nelken et al., 1994a) it is concluded that the onset responses to multifrequency sounds are shaped mainly by the single frequency content of the sound and by two-tone interactions, and that higher order interactions contribute much less to the responses. It follows that single-tone effects and two-tone interactions are necessary and sufficient to explain the mean population onset responses to the four-tone stimuli. More information can be coded in the temporal evolution of the responses.

Acoustic Stimulation↗

Neuronal responses in cat primary auditory cortex to electrical cochlear stimulation. I. Intensity dependence of firing rate and response latency.

1. Responses of neurons in primary auditory cortex (AI) of the barbiturate anesthetized adult cat were studied using cochlear stimulation with electrical and acoustic stimuli. Acoustic stimulation of the ear ipsilateral to the studied cortical hemisphere with brief biphasic clicks was compared with electrical stimulation of the contralateral cochlea with brief biphasic electrical pulses delivered via a feline cochlear prosthesis. The contralateral ear was deafened immediately before implantation of the cochlear prosthesis. The feline cochlear prosthesis consisted of four bipolar electrode pairs and was placed in the scala tympani. Two bipolar electrode conditions were used for stimulation: one near radial pair with electrode spacing of approximately 0.5 mm, and one longitudinal pair with electrode spacing of approximately 6 mm. 2. The firing rates obtained from single- and multiple-neuron recordings were measured as a function of stimulus intensity for single electrical and acoustic pulses. Resulting rate/level functions were characterized by a fast growing low-level segment and a more slowly growing, saturating, or decreasing high-level segment. The slopes of these two segments as well as the stimulus level and firing rate at the juncture of these two segments (the transition point) provide a complete characterization of the response magnitude behavior as a function of stimulus intensity. 3. The main characteristics of rate/level functions obtained with electrical and acoustic cochlear stimulation were quite similar. However, for any given neuron, differences in the primary growth behavior, such as monotonic or nonmonotonic growth, could be observed between the different stimulation modes. 4. Response latencies from single- and multiple-neuron recordings were obtained as a function of stimulus intensity for electrical and acoustic pulses. Resulting latency/level functions were characterized by a rapidly decreasing low-level segment and a more slowly decreasing high-level segment. The slopes of these two segments as well as the stimulus level and response latency at the juncture of these two segments (the transition point) provide a complete characterization of the response latency behavior as a function of stimulus intensity. Transition point levels for the rate/level function and the latency/level were nearly identical. 5. The characteristic latency behavior for each neuronal response was found to be very similar for acoustic and electrical stimulation. Correlation analysis revealed a close relationship between latency parameters of the two electrical stimulation conditions, a weaker relationship between the longitudinal electrical and the acoustic conditions, and the weakest relationship between the radial electrical and acoustic conditions. 6. Correlation analysis for rate and latency parameters revealed several relationships between these response aspects.(ABSTRACT TRUNCATED AT 400 WORDS)

Acoustic Stimulation↗

Differential acute effects of fluoxetine on frontal and auditory cortex networks in vitro.

Primary cultures of neuronal networks grown on microelectrode arrays were used to quantify acute effects of fluoxetine (Prozac) on spontaneous spike and burst activity. For frontal cortex cultures, fluoxetine showed consistent inhibitory effects and terminated activity at 10-16 microM. IC(50) mean+/-S.E. for spike rates was 5.4+/-0.7 microM (n=15). For auditory cortex cultures, fluoxetine caused excitation at 1-10 microM, initial inhibition at 15 microM, and activity cessation at 20-25 microM. The spike rate IC(50) was 15.9+/-1.0 microM (n=11). Fluoxetine did not change the action potential waveform shape. However, at high concentrations, it caused total cessation of spike activity on all channels. The inhibition caused by fluoxetine was reversible for both tissues. Based on the results, we conclude that cultures showed repeatable, concentration-dependent sensitivities to fluoxetine but demonstrated tissue-specific responses for frontal and auditory cortex networks. These responses may not be due to the interference with serotonin reuptake, but may be due to a secondary effect on ionic channels.

Action Potentials↗

Connections of the dorsal zone of cat auditory cortex.

The present study examined the anatomic connections of the dorsal zone of cat auditory cortex (DZ). The DZ was discriminated physiologically from the primary auditory field (AI) on the basis of neuronal responses with long latency and broad or multipeaked tuning curves. Wheat germ agglutinin-horseradish peroxidase was then injected either by pressure or iontophoretically. The thalamocortical and corticothalamic connections of the DZ were visualized by the presence of retrogradely labeled neurons and anterogradely labeled terminal fields in the thalamus; ipsilateral corticocortical projections from other cortical fields were visualized by the presence of retrogradely labeled cells. Injections of tracer into the DZ retrogradely labeled cells mainly in the lateral division of posterior complex (Po) and in the dorsal division (MGd) of the medial geniculate body (MGB); fewer labeled cells were found in the ventral (MGv) and medial (MGm) divisions of the MGB and in the suprageniculate nucleus. The DZ projection to Po, MGv, and MGd was heavy and was more diffuse than the reciprocal thalamocortical projection; the projection to MGm was light. The corticothalamic terminations and thalamocortical cells projecting to the same part of the DZ were not superimposed rigidly. The DZ received cortical projections from AI and from the second, anterior, and posterior auditory fields, and there were strong intra-DZ connections. Together with the physiological findings, the present results suggest that the DZ is a potentially separate auditory field from AI and is likely to be involved in both temporal and spectral integration of acoustic information.

Animals↗

Noise-induced cell death in the mouse medial geniculate body and primary auditory cortex.

Noise-induced effects within the inner ear have been well investigated for several years. However, this peripheral damage cannot fully explain the audiological symptoms in noise-induced hearing loss (NIHL), e.g. tinnitus, recruitment, reduced speech intelligibility, hyperacusis. There are few reports on central noise effects. Noise can induce an apoptosis of neuronal tissue within the lower auditory pathway. Higher auditory structures (e.g. medial geniculate body, auditory cortex) are characterized by metabolic changes after noise exposure. However, little is known about the microstructural changes of the higher auditory pathway after noise exposure. The present paper was therefore aimed at investigating the cell density in the medial geniculate body (MGB) and the primary auditory cortex (AI) after noise exposure. Normal hearing mice were exposed to noise (10 kHz center frequency at 115 dB SPL for 3 h) at the age of 21 days under anesthesia (Ketamin/Rompun, 10:1). After 1 week, auditory brainstem response recordings (ABR) were performed in noise exposed and normal hearing animals. After fixation, the brain was microdissected and stained (Kluever-Barrera). The cell density in the MGB subdivisions and the AI were determined by counting the cells within a grid. Noise-exposed animals showed a significant ABR threshold shift over the whole frequency range. Cell density was significantly reduced in all subdivisions of the MGB and in layers IV-VI of AI. The present findings demonstrate a significant noise-induced change of the neuronal cytoarchitecture in central key areas of auditory processing. These changes could contribute to the complex psychoacoustic symptoms after NIHL.

Acoustic Stimulation↗