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First auditory brainstem implantation in Poland: auditory perception results over 12 months.

Auditory brainstem implants (ABIs) are a modern method of treatment of total bilateral deafness in cases of extracochlear origin. In most cases therapy is applied in patients with neurofibromatosis type 2 (NF2). This paper presents the results of surgical treatment and rehabilitation in a 28-year-old woman with bilateral, multiple tumours of the central nervous system causing total deafness. Simultaneous removal of the tumours and implantation of ABI allowed treatment of the potentially lethal pathology and hearing restoration. Improving auditory skills and excellent tests results were noted in the year following implantation.

Adult↗

Auditory perception of fractal contours.

A series of experiments examined auditory contour formation, investigating listeners' sensitivities to a family of random fractals known as fractional Brownian noises. Experiments 1A and 1B looked at identification of contours when 3 different noises were portrayed using variations in the pitch, duration, or loudness of successive notes of a sequence. Listeners could categorize pitch and loudness encodings, but not duration mappings. Experiment 2 looked at the effect of simultaneous presentation of pitch and loudness information, finding that these dimensions combined additively to increase identification of the noise distributions. Experiment 3 looked at discrimination of pitch contours as a function of changing fractal dimension. Discrimination curves approximated an inverted U shape, a finding that is not understandable in terms of sensitivity to differences in fractal dimension per se, nor in terms of "tuned" perceptual sensitivity to statistical regularities of the environment.

Acoustic Stimulation↗

Auditory perception and speech identification in children with cochlear implants tested with the EARS protocol.

The performance of children who receive a cochlear implant may be dependent on both age of the child at implantation and the amount of experience with the implant. In the present study, changes in auditory perception and speech identification were investigated with experience of 71 children who had received a cochlear implant. The children were divided into three groups, those above and those below the age of 7 years at the time of implantation, and those aged 3 years or younger deafened by meningitis. The children received either the Nucleus 22, the Nucleus 24 or the Med El C40+ implant. The test material was a reduced form of the EARS evaluation protocol developed by Med El into a multi-language format. Tests were performed pre-operatively, within 2-5 days of first fitting of the speech processor, then at 1, 3 and 6 months and every 6 months thereafter, for a total period of 24 months. The results indicated that all children showed improvement after 6-12 months. The rate of improvement differed between age groups. Children over 7 years of age had pre-operatively higher test scores than younger children, presumably because of their previous experience with hearing aids. These children showed an immediate post-operative drop in performance that recovered 1-3 months later. The children aged under 7 years started at lower performance levels but approached those of the older children after 12 months' cochlear implant use because their post-operative drop was less significant and their performance improved faster. Children who had been deafened by meningitis and implanted at the age of 3 or less made little progress over the first 6 months but approached test levels of the under-7-year-olds by 18 months or later. All three components of the evaluation protocol employed the Listening Progress Profile (LiP), the Monosyllabic-Trochee-Polysyllabic Test (MTP) and the Meaningful Auditory Integration Scale (MAIS) and proved to be valuable in demonstrating improvement in performance of cochlear implant children in all age groups once the immediate post-operative drop had been overcome.

Child↗

Three young adult patients with Pelizaeus-Merzbacher disease who showed only waves I and II in auditory brainstem responses but had good auditory perception.

Three young adult males with Pelizaeus-Merzbacher disease have been followed up since childhood. This disease is thought to be a dysmyelinating disorder of the brain during the prenatal period caused by gene mutations. The patients manifested horizontal nystagmus and severe rigidity of the extremities. Although the patients showed only waves I and II in auditory brainstem responses, they had relatively good hearing ability at approximately equal to dB. They could not speak words at all but could hear well and enjoy listening to conversation and music. One of them had a normal hearing threshold in pure-tone audiometry and a normal speech discrimination rate in speech audiometry. This can be explained by a nerve conduction blockade through dysmyelinated axons or the desynchronization of neurons and nerves responsible for the waves following waves I and II. At present, all three patients are living with their families. We report their present hearing, speech and language abilities.

Adult↗

Auditory perception in patients with CVA without aphasia.

Tests of central auditory function were performed variously on 64 patients with hemiplegia who had suffered a single stroke but with minimal or no aphasia symptoms and with essentially normal hearing. Both right and left hemisphere lesions were represented for comparison of effects on the tests. Reports of central auditory dysfunction generally assume localization in the temporal lobes. Since it was apparent that our tests were revealing positive findings in patients in whom there was no recognized evidence of temporal lobe involvement we deliberately selected for one study 34 patients without clinical signs of such lesions. The tests required selective listening in which patients had to a) perceive and repeat a prime message in the presence of a simultaneously competing meaningful message, either under earphones or in the sound field (loudspeaker), and b) repeat all words in a classic dichotic listening task. The tests reveal different dysfunctions in right vs left hemisphere damage and document that compensatory transfer of function from the usually dominant left side to the fight hemisphere usually occurs only in young children. The dysfunctions appear to be unrelated to temporal lobe lesions.

Adult↗

Auditory perception of sound source velocity.

In this study we investigate the perception of the velocity of linearly moving sound sources passing in front of a listener. The binaural simulation of motion used in two psychoacoustical experiments includes changes in the overall sound pressure level, the Doppler effect, and changes in interaural time differences. These changes are considered as cues for the perception of velocity. The present experiments are an extension of the experiments performed by Lutfi and Wang [J. Acoust. Soc. Am. 106, 919-928 (1999)]. The results of Experiment I show that the differential velocity threshold is independent of the reference velocity (10, 20, 30, and 40 m/s), varying across listeners from 1.5 to 4.6 m/s. In Experiment II, a method based on the successive elimination of cues in compared pairs of signals was employed to estimate the weights of potential cues for velocity discrimination. The magnitudes of all underlying cues at thresholds are reported. The experimental results show the subject's preference for the Doppler cue and a weakest sensitivity to the cue related with interaural time differences. Finally, it was found that spatial differences in the source location at the endpoints of the motion trajectory are not a significant factor in the velocity discrimination task.

Adult↗

Quantitative comparison of electrically and acoustically evoked auditory perception: implications for the location of perceptual mechanisms.

Electrical stimulation of the human auditory system produces different patterns of spatial and temporal neural activity than those that occur in the normal, acoustically stimulated system. Quantitative comparison of psychophysical performance measured with acoustic and electrical stimulation may allow us to infer the physiological locus of perceptual mechanisms. In this paper we compare psychophysical data on temporal resolution from normal-hearing listeners, cochlear implant listeners, and patients electrically stimulated on the cochlear nucleus. Measures of gap detection, forward masking, and modulation detection will be compared. These comparisons demonstrate that temporal processing is relatively similar across these three groups once the obvious differences in dynamic range are taken into consideration. In addition, preliminary results with speech processors indicate that implant patients can utilize all temporal information in speech. Thus, implant patients have relatively normal temporal resolution and can integrate temporal cues normally for the recognition of complex acoustic patterns such as speech. These results imply that the central auditory systems of implant patients are able to fully utilize the non-natural patterns of temporal neural information produced by electrical stimulation. The differences in the microstructure of the neural pattern (phase locking, stochastic independence of fibers, spatial distribution of activity, etc.) between electrical and acoustic stimulation are apparently not necessary for temporal processing. Thus, the physiological locus of temporal processing mechanisms must be more central in the auditory system than the cochlea and cochlear nucleus.

Acoustic Stimulation↗