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Early changes of auditory brain stem evoked response after radiotherapy for nasopharyngeal carcinoma--a prospective study.

A prospective study of the effect of radiotherapy for nasopharyngeal carcinoma on hearing was carried out on 49 patients who had pure tone, impedance audiometry and auditory brain stem evoked response (ABR) recordings before, immediately, three, six and 12 months after radiotherapy. Fourteen patients complained of intermittent tinnitus after radiotherapy. We found that 11 initially normal ears of nine patients developed a middle ear effusion, three to six months after radiotherapy. There was mixed sensorineural and conductive hearing impairment after radiotherapy. Persistent impairment of ABR was detected immediately after completion of radiotherapy. The waves I-III and I-V interpeak latency intervals were significantly prolonged one year after radiotherapy. The study shows that radiotherapy for nasopharyngeal carcinoma impairs hearing by acting on the middle ear, the cochlea and the brain stem auditory pathway.

Adult↗

Transfer characteristics of the hair cell's afferent synapse.

The sense of hearing depends on fast, finely graded neurotransmission at the ribbon synapses connecting hair cells to afferent nerve fibers. The processing that occurs at this first chemical synapse in the auditory pathway determines the quality and extent of the information conveyed to the central nervous system. Knowledge of the synapse's input-output function is therefore essential for understanding how auditory stimuli are encoded. To investigate the transfer function at the hair cell's synapse, we developed a preparation of the bullfrog's amphibian papilla. In the portion of this receptor organ representing stimuli of 400-800 Hz, each afferent nerve fiber forms several synaptic terminals onto one to three hair cells. By performing simultaneous voltage-clamp recordings from presynaptic hair cells and postsynaptic afferent fibers, we established that the rate of evoked vesicle release, as determined from the average postsynaptic current, depends linearly on the amplitude of the presynaptic Ca(2+) current. This result implies that, for receptor potentials in the physiological range, the hair cell's synapse transmits information with high fidelity.

Animals↗

Auditory deficits in rats exposed to an environmental PCB mixture during development.

Previous studies have indicated that developmental exposure to polychlorinated biphenyls (PCBs) may result in hearing impairment in rats. The cochlea is the suggested site of action, based upon one study demonstrating a loss of outer hair cells on the basilar membrane, and another demonstrating deficits in distortion product otoacoustic emissions (DPOAEs). The current study was conducted to assess the possible ototoxic effects of a unique PCB mixture formulated to model the congener profile of PCBs found in fish consumed by a human population in northeastern Wisconsin. Female Long-Evans rats were dosed orally with the PCB mixture beginning 28 days prior to breeding and continuing until the pups were weaned. Dams were fed one-half of a cookie onto which was pipetted 0, 1, 3, or 6 mg/kg of the PCB mixture dissolved in a corn oil vehicle. On postnatal day (PND) 21, pups were weaned, and one male and one female from each litter were randomly selected for auditory assessment. DPOAEs were measured to assess cochlear function, and auditory brainstem responses (ABRs) were measured to determine effects on central nervous system auditory pathways. DPOAE amplitudes were decreased, and DPOAE and ABR thresholds were elevated across a range of frequencies in PCB-exposed rats. These results support and extend previous reports of auditory impairment in PCB-exposed rats. Developmental exposure to PCBs may also result in subtle auditory impairments in humans, and if so, this may contribute to some of the cognitive deficits that have been observed in epidemiological studies.

Administration, Oral↗

Inferior colliculus. II. Development of tuning characteristics and tonotopic organization in central nucleus of the neonatal cat.

Tuning curves were measured for 65 units in the inferior colliculus of seven anesthetized kittens aged from 6 to 28 days. At 2 days of age the inferior colliculus was divisible into central, pericentral, and external nuclei. Evidence was found for broader tuning curves to occur in the pericentral nucleus compared with the central nucleus, as has been observed in the adult. The middle ear was filled with serous fluid to 6 days, while the external auditory meatus remained collapsed until 10 days. Central nucleus tuning curves in kittens were relatively flat with high thresholds. Best-frequency thresholds diminished from a mean of near 100 dB SPL at 6-11 days to near 50 dB in the adult. The marked drop in thresholds between days 22 and 21 led to the adoption of the sharp form of tuning curve common for adults. Tonotopic organization of the central nucleus was clear at day 11. Speculations were advanced about the dependence of central auditory maturations on cochlear development, axon myelination in the auditory pathway, and changes in synaptic density as a function of age.

Animals↗

Investigation of auditory brainstem function in diabetic patients.

We performed brainstem auditory evoked potential (BAEP) examinations in 15 patients with long-standing type 1 diabetes mellitus. We applied cardiovascular reflex tests for assessment of autonomic neuropathy. The aim of our investigation was to compare the BAEP results of this patient group with those of controls and to look for the possible correlation between alteration of the auditory brainstem function and cardiovascular autonomic neuropathy. Analysis of the latencies (waves I, II, III, and V) and the interpeak latencies (I-III and I-V) of BAEP revealed a significant difference between those of diabetics and those of healthy controls. The amplitudes of waves I, III, and V were definitely lower in comparison with amplitudes of healthy controls. We observed a positive correlation between the overall autonomic score and the latencies (waves III and V) and interpeak latencies (I-III, I-V). These data support the hypothesis that long-standing diabetes mellitus and diabetic neuropathy might be revealed as a cause of certain dysfunctions of the central auditory pathways.

Adult↗

[What should be expected of oto-acoustic emissions? A critical analysis of clinical applications of oto-acoustic emissions].

The aim of this article is to carry out a critical analysis of the clinical applications of acoustic oto-emissions based on analysis of more than 1,000 adult and pediatric audiometric records. The principal technical and clinical properties of acoustic oto-emissions are described. The clinical value would seem to be very limited in adult audiology, whereas this examination would appear to be a reliable and non invasive method for screening in children at risk of cochlear deafness. In this respect, the investigation is principally limited by middle ear pathology and involvement of the central auditory pathways.

Acoustic Stimulation↗

[Long-term study of age-related changes in brain stem potentials in the guinea pig].

The purpose of this study was to investigate the time-related influence of aging on the lower parts of the auditory pathway. Furthermore it was intended to examine as to how far recently obtained results of studies of two different collectives correspond to individual changes correlated with age. For this purpose, auditory brain stem responses were periodically recorded in the same guinea-pigs between the age of six months and three years. Not only the thresholds, but also the latencies and amplitudes of the individual potentials were analyzed for suprathreshold stimuli. A distinct threshold elevation was found at an age of two years. The further loss of sensitivity occurring up to an age of three years was less marked. The amplitudes of all potentials showed a uniform reduction with advancing age, whereas the latencies did not differ. These age-related changes correspond to results obtained previously in two different groups.

Aging↗

Effect of docosahexaenoic acid content of maternal diet on auditory brainstem conduction times in rat pups.

Previous studies of dietary docosahexaenoic acid (DHA; 22:6n-3) effects on neurodevelopment have focused mainly on effects on the visual system; these studies may be confounded by effects on the retina rather than on neural pathways. Auditory brainstem conduction times (ABCTs) provide an alternate measure of central neural development. We conducted a dose-response study in which ABCTs were measured in pups whose dams were fed diets containing one of three levels of DHA (2, 4 or 6% of total fatty acids) from a single cell oil. Diets were fed during pregnancy and lactation, and pups were randomly cross-fostered on postnatal day 3 to minimize litter effects. ABCTs showed a dose-response effect, with higher levels of dietary DHA being associated with longer conduction times on postnatal day 31 (p < 0.05). Higher dietary DHA was reflected in pup cerebrums collected on postnatal days 3 and 31, and levels of arachidonic acid (AA, 20:4n-6) were inversely related to levels of DHA. This study demonstrated that the auditory brainstem response is sensitive for identifying effects of diet on neurodevelopment, and that supplementing the maternal diet with high levels of DHA may negatively impact development of the central auditory system of offspring.

Animals↗

[Anatomical references in auditory brainstem implant surgery].

UNLABELLED: The auditory brainstem implant (ABI) is an option for deaf patients who do not have the whole of their auditory pathways preserved. The surgery, because of its anatomical and functional complexity, requires specific training of the surgeon in an anatomy lab. AIM: To study the surgical anatomy of the surgery for auditory brainstem implant. STUDY DESIGN: Anatomic study. MATERIAL AND METHOD: In this exercise we dissected a fresh cadaver prepared with a dye solution injected into the arteries and intra-cranial veins. The location for the insertion of the electrode for the ABI has been studied through the translabyrinthine access. RESULTS: The surgical technique used for implanting the electrode of the brainstem is similar to that used in the removal of the schwannoma vestibular. The cochlear nucleus complex, composed of the ventral and dorsal cochlear nuclei is the location for placing the electrode. The ventral cochlear nucleus is the principal nucleus for transmission of neural impulses from the VIII par and form the main ascendant route of the cochlear nerve. Neither the ventral nor the dorsal nuclei are visible during surgery and their location depends on the identification of adjacent anatomical structures. CONCLUSION: The region for the implantation of the electrode in the auditory brainstem implant presents anatomical references that allow its easy identification during surgery.

Auditory Brain Stem Implants↗

Brain-stem auditory evoked potentials (BAEPs) from basal surface of temporal lobe recorded from chronic subdural electrodes.

BAEPs were recorded from the basal surface of the temporal lobe by subdural electrodes chronically implanted in 6 patients who were evaluated for surgical management of intractable partial seizures. Near-field recordings were obtained by recording between the subdural electrode closest and most distant to the brain-stem. Far-field recordings were obtained by recording between the subdural electrodes and an indifferent electrode over the spinal process of the seventh cervical vertebrae. The recordings were compared with standard ear-vertex recordings. After ipsilateral ear stimulation, the subdural electrode closest to the brain-stem recorded large amplitude waves I and II followed by less well-defined waves of longer latencies. Recordings to contralateral stimulation showed no clearly defined waves I and II and a large amplitude wave Vn. Waves III, IV, V, Vn and VI were of opposite polarity after ipsi- and contralateral stimulation. These findings indicate that waves I and II are generated ipsilaterally to the stimulation side, whereas wave Vn has a contralateral origin. Wave Vn may be generated in the brachium of the inferior colliculus, as suggested from dipole configuration studies. This conclusion is consistent with the classical anatomical observations that the supracollicular auditory pathways are predominantly crossed.

Acoustic Stimulation↗

Effect of high altitude on human auditory brainstem responses.

The effect of hypobaric hypoxia on Brain Stem Auditory evoked potentials (BAERs) were studied. BAERs were recorded in 30 volunteers at sea level (SL) and then at high altitude (HA) of 3200 m (HA I) and 4300 m (HA II) in Eastern Himalayas and on return to sea level (RSL). The BAERs were recorded using Nicolet Compact - 4 (USA) in response to monaural auditory stimuli consisting of clicks of 100 ps square pulse at a rate of 15/sec. The BAERs were recorded on day 4 of their stay at 3200 m and 4300 m respectively. Findings indicated an increase in absolute peak latencies of wave V at 3200 m, which was statistically significant. On further ascent to 4300 m there was an increase in absolute peak latencies of wave I and III indicating delay in sensory conduction at the medullo-pontine auditory pathways.

Adult↗

Ontogeny of electrically evoked brain stem potentials in neonatally deafened gerbils (Meriones unguiculatus) after cochlear implantation.

To investigate the ontogeny of the electrically evoked auditory brainstem response (E-ABR) we used an animal model of neonatally deafened gerbils with an intracochlear implanted electrode. The E-ABR were recorded in three groups: normal hearing animals (NORM) and binaural deafened without chronical electrostimulation (BD) in comparison to binaural deafened animals with chronical stimulation (BDS). In group BD the deafening lead to inter-peak-latency II-V increase and histological degeneration in the Cochlear Nucleus. In chronical stimulated animals (BDS) we could not observe significant differences compared to unstimulated gerbils until the day after birth. In further studies longer stimulation periods, recordings of electrically evoked middle latency response as well as histological examinations of more central parts of the auditory pathway will be included.

Animals↗

Auditory brain-stem evoked potentials in cat after kainic acid induced neuronal loss. II. Cochlear nucleus.

Auditory brain-stem potentials (ABRs) were studied in cats for up to 6 weeks after kainic acid had been injected unilaterally into the cochlear nucleus (CN) producing extensive neuronal destruction. The ABR components were labeled by the polarity at the vertex (P, for positive) and their order of appearance (the arabic numerals 1, 2, etc.). Component P1 can be further subdivided into 2 subcomponents, P1a and P1b. The assumed correspondence between the ABR components in cat and man is indicated by providing human Roman numeral designations in parentheses following the feline notation, e.g., P2 (III). To stimulation of the ear ipsilateral to the injection, the ABR changes consisted of a loss of components P2 (III) and P3 (IV), and an attenuation and prolongation of latency of components P4 (V) and P5 (VI). The sustained potential shift from which the components arose was not affected. Wave P1a (I) was also slightly but significantly attenuated compatible with changes of excitability of nerve VIII in the cochlea secondary to cochlear nucleus destruction. Unexpectedly, to stimulation of the ear contralateral to the injection side, waves P2 (III), P3 (IV), and P4 (V) were also attenuated and delayed in latency but to a lesser degree than to stimulation of the ear ipsilateral to the injection. Changes in binaural interaction of the ABR following cochlear nucleus lesions were similar to those produced in normal animals by introducing a temporal delay of the input to one ear. The results of the present set of studies using kainic acid to induce neuronal loss in auditory pathway when combined with prior lesion and recording experiments suggest that each of the components of the ABR requires the integrity of an anatomically diffuse system comprising a set of neurons, their axons, and the neurons on which they terminate. Disruption of any portion of the system will alter the amplitude and/or the latency of that component.

Animals↗

Cochlear microphonics recorded from fetal and newborn sheep.

PURPOSE: Sounds present within the uterus stimulate the fetal inner ear and central auditory pathway. This study was undertaken to determine the efficiency of transmission of exogenous airborne stimuli to the fetal inner ear. In this way, we may quantify the extent to which the fetal auditory system is isolated from sounds produced outside the mother. MATERIALS AND METHODS: Cochlear microphonics were recorded from fetal and newborn sheep to evaluate the extent to which the fetus is isolated from sounds exogenous to the ewe. Electrodes were surgically placed in contact with the round window membrane in nine near-term fetal sheep. Cochlear microphonics were recorded in response to 1/3 octave-band noises (0.125 to 2.0 kHz) delivered through a loudspeaker 1.8 m from one side of the pregnant ewe. Sound pressure levels generated by the noises were simultaneously recorded ex utero with a microphone and in utero with a hydrophone previously sutured to the fetal neck. After cochlear microphonic amplitudes were recorded, the fetus was delivered through an abdominal incision. Recordings were repeated from the newborn lamb. Fetal sound isolation was calculated as the difference between the sound pressure levels that were necessary to evoke equal cochlear microphonic amplitudes from the fetus and from the newborn lamb. RESULTS: The sound attenuation observed was variable for all frequencies. The fetus was isolated from external sounds by 11.1 dB for 0.125 kHz, 19.8 dB for 0.25 kHz, 35.3 dB for 0.5 kHz, 38.2 dB for 1.0 kHz, and 45.0 dB for 2.0 kHz. CONCLUSIONS: Other investigators have demonstrated that the immature auditory system is more susceptible to damage produced by noise exposure than is the mature auditory system. Low-frequency noise produces damaged cells that later in life code higher frequencies. A possibility of fetal hearing loss produced by intense noise exposure needs more careful evaluation.

Animals↗

Effects of masker component phase on the forward masking produced by complex tones in normally hearing and hearing-impaired subjects.

For normally hearing subjects, harmonic complex tones that give "peaky" waveforms on the basilar membrane (Schroeder-positive phase, sine phase or cosine phase) lead to less forward masking than complex tones that give less peaky waveforms (Schroeder-negative phase or random phase), but have the same power spectrum. This difference has been attributed mainly to the combined effects of peripheral compression and suppression, both of which depend on the operation of the active mechanism in the cochlea. If this explanation is correct, the phase effect should be reduced or absent for subjects with moderate cochlear hearing loss. We measured growth-of-masking functions for forward maskers containing the first 40 harmonics of a 100-Hz fundamental, with components added either in cosine phase or random phase, using both normally hearing subjects and subjects with moderate cochlear hearing loss. The signal frequency was 1 or 2 kHz. For the normally hearing subjects, the mean slopes of the growth-of-masking functions at 1 and 2 kHz, respectively, were 0.53 and 0.44 for the random-phase masker and 0.31 and 0.26 for the cosine-phase masker. For high masker levels, the former produced considerably more masking than the latter. The phase effect was smaller for the hearing-impaired than for the normally hearing subjects, which is consistent with the idea that it is partly caused by peripheral compression and suppression. However, three of the five hearing-impaired subjects showed a significant effect of masker phase for at least one signal frequency. In one case, this occurred when the hearing loss at the signal frequency was 65 dB. The slopes of the growth-of-masking functions were consistently less than one for the hearing-impaired subjects. Further testing suggested that the efferent system was not involved in producing the phase effect.

Acoustic Stimulation↗

Midbrain, diencephalic and cortical relationships of the basal nucleus of Meynert and associated structures in primates.

The structure and connectivity of the basal nucleus of Meynert, the substantia innominata in which it lies, and certain related areas have been examined in New World and Old World Monkeys, using retrograde and anterograde axonal transport methods. Experiments using the retrograde, horseradish peroxidase method confirm the observations of Kievet and Kuypers ('75) that the basal nucleus and substantia innominata project directly, heavily and with a somewhat crude topography upon the neocortex. Experiments involving the anterograde, autoradiographic method show that the basal nucleus and substantia innominata form part of a complex pathway that links them together with the lateral hypothalamus, certain parts of the amygdala and the peripeduncular nucleus of the midbrain. The peripeduncular nucleus is often regarded as a part of the central auditory pathway; it gives rise to a fiber bundle of considerable size that ascends on the dorsal surface of the ipsilateral optic tract and terminates ultimately in the lateral hypothalamic area of both sides. As well as distributing fibers to the basal nucleus, substantia innominata and lateral hypothalamus, this pathway provides a heavy projection to a cytoarchitectonically distinct posterior part of the lateral nucleus of the amygdala, the medial and intercalated nuclei of the amygdala and a less dense projection to the bed nucleus of the stria terminalis. Certain parts of the hypothalamus and possibly the preoptic areas give rise to a complementary descending pathway that distributes fibers to the ipsilateral basal nucleus, substantia innominata and amygdala, and ends in the peripeduncular nuclei of both sides. Decussating fibers in both the ascending and descending pathways cross in the ventral supraoptic commissure. It is concluded that the basal nucleus should include most of the aggregated and unaggregated large cells that lie in the substantia innominata and which in places intrude upon the preoptic regions and the nucleus of the diagnonal band of Broca. Together, these may form a complex that receives inputs from a variety of brainstem sources, and projects widely and diffusely upon all cortical structures of the telencephalon.

Amygdala↗

Brainstem auditory evoked potentials in hepatic encephalopathy.

Brainstem auditory evoked potentials were obtained from 30 patients primarily with viral hepatitis to determine the functional status of the brainstem in hepatic encephalopathy. The patients were divided into four groups: Group 1 with compensated hepatic diseases; Group 2 with hepatic failure but no hepatic encephalopathy; Group 3 with Grade 1 or 2 hepatic encephalopathy, and Group 4 with Grade 3 or 4 hepatic encephalopathy. The brainstem auditory evoked potential central conduction times (I-V interval) of four patient groups were not significantly different from that of the age-matched control group. The present data suggest that the brainstem auditory pathways remain undisturbed in hepatic encephalopathy.

Adult↗

Otoacoustic emission, evoked potential, and behavioral auditory thresholds in the rhesus monkey (Macaca mulatta).

Distortion product otoacoustic emission (DPOAE), auditory brainstem evoked response (ABR), and behavioral thresholds were recorded in a group of 15 adult rhesus monkeys with normal auditory function. DPOAE thresholds were recorded with stimulus parameters selected to maximize signal-to-noise ratio. Additional averaging at the lowest frequencies ensured comparable noise levels across frequencies. DPOAE thresholds decreased with increasing frequency (f(2)=0.5-16 kHz) and at 16 kHz were close to 0 dB SPL. ABR thresholds were best from 1 through 16 kHz (32-38 dB peSPL); higher at 0.5 (45 dB peSPL), 24 (39 dB peSPL), and 30 kHz (49 dB peSPL). At all levels including threshold, the early ABR waves (II and I) were more prominent at the high frequencies while the later waves (IV and V) were more prominent at the low frequencies. The behavioral thresholds recorded were similar to those reported by other researchers although elevated by about 10 dB presumably because of the complexity of the threshold task. DPOAE and ABR thresholds can be reliably and efficiently recorded in the rhesus monkey and provide information concerning site of processing in the auditory pathway not directly available from behavioral data.

Acoustic Stimulation↗