Effects of auditory training in individuals with high-frequency hearing loss

OBJECTIVE:To determine the effects of a formal auditory training program on the behavioral, electrophysiological and subjective aspects of auditory function in individuals with bilateral high-frequency hearing loss.METHOD:A prospective study of seven individuals aged 46 to 57 years with symmetric, moderate high-frequency hearing loss ranging from 3 to 8 kHz was conducted. Evaluations of auditory processing (sound location, verbal and non-verbal sequential memory tests, the speech-in-noise test, the staggered spondaic word test, synthetic sentence identification with competitive ipsilateral and contralateral competitive messages, random gap detection and the standard duration test), auditory brainstem response and long-latency potentials and the administration of the Abbreviated Profile of Hearing Aid Benefit questionnaire were performed in a sound booth before and immediately after formal auditory training.RESULTS:All of the participants demonstrated abnormal pre-training long-latency characteristics (abnormal latency or absence of the P3 component) and these abnormal characteristics were maintained in six of the seven individuals at the post-training evaluation. No significant differences were found between ears in the quantitative analysis of auditory brainstem responses or long-latency potentials. However, the subjects demonstrated improvements on all behavioral tests. For the questionnaire, the difference on the background noise subscale achieved statistical significance.CONCLUSION:Auditory training in adults with high-frequency hearing loss led to improvements in figure-background hearing skills for verbal sounds, temporal ordination and resolution, and communication in noisy environments. Electrophysiological changes were also observed because, after the training, some long latency components that were absent pre-training were observed during the re-evaluation.     

儿童感音神经性聋听觉稳态诱发反应阈与听性脑干反应阈比较

目的研究听觉稳态诱发反应(ASSR)和听性脑干反应(ABR)阈与纯音听阈的差别和相关性。方法选择74例儿童感音神经性聋患者(118耳)分别进行ASSR、ABR和电测听检查,比较ASSR、ABR反应阈及纯音听阈,同时就ASSR、ABR反应阈与纯音听阈进行相关性分析。结果 ASSR和ABR反应阈与纯音听阈均有良好的相关性。ABR的反应阈与纯音听阈阈值接近,而ASSR反应阈与纯音听阈间差值较大。ASSR反应阈与纯音听阈间的相关性要优于ABR反应阈与纯音听阈间的相关性。结论 ASSR和ABR均为较好的评估行为听阈的客观测听方法。     

Plastic changes in the central auditory system after hearing loss,restoration of function,and during learning

Traditionally the auditory system was considered a hard-wired sensory system; this view has been challenged in recent years in light of the plasticity of other sensory systems, particularly the visual and somatosensory systems. Practical experience in clinical audiology together with the use of prosthetic devices, such as cochlear implants, contributed significantly to the present view on the plasticity of the central auditory system, which was originally based on data obtained in animal experiments. The loss of auditory receptors, the hair cells, results in profound changes in the structure and function of the central auditory system, typically demonstrated by a reorganization of the projection maps in the auditory cortex. These plastic changes occur not only as a consequence of mechanical lesions of the cochlea or biochemical lesions of the hair cells by ototoxic drugs, but also as a consequence of the loss of hair cells in connection with aging or noise exposure. In light of the aging world population and the increasing amount of noise in the modern world, understanding the plasticity of the central auditory system has its practical consequences and urgency. In most of these situations, a common denominator of central plastic changes is a deterioration of inhibition in the subcortical auditory nuclei and the auditory cortex. In addition to the processes that are elicited by decreased or lost receptor function, the function of nerve cells in the adult central auditory system may dynamically change in the process of learning. A better understanding of the plastic changes in the central auditory system after sensory deafferentation, sensory stimulation, and learning may contribute significantly to improvement in the rehabilitation of damaged or lost auditory function and consequently to improved speech processing and production.     

Unilateral auditory cortex ablation in macaques results in a contralateral hearing loss

1. The behavioral audiograms of four Japanese macaques (Macaca fuscata) were assessed before and after unilateral ablation of auditory cortex. The tones were presented via insertion earphones so that each ear could be tested separately. 2. Each animal had a hearing loss in the ear contralateral to the lesion, whereas the ipsilateral ear showed no change in sensitivity. The hearing loss initially appeared as a large shift in thresholds followed by rapid but incomplete recovery during the first 3-5 wk after surgery. The initial hearing loss ranged as high as 68 dB at some frequencies, although thresholds at other frequencies were occasionally unchanged. A threshold shift could be demonstrated with broadband noise as well as with tones. Although thresholds for some tones returned to normal within a few weeks, most were still elevated 16 wk after surgery when testing was discontinued. The largest long-term hearing losses occurred at frequencies from 4 to 25 kHz. 3. Analysis of the animals' psychophysical functions suggested that the hearing loss resembled a sensory deficit, as opposed to a nonsensory deficit in attention or vigilance. 4. Testing with binaural stimuli indicated that the hearing loss could best be described as a contralateral "ear" deficit, as opposed to a contralateral "auditory field" deficit. 5. It is suggested that a similar hearing loss occurs in humans after unilateral damage to auditory cortex.     

Detection and differentiation of sensorineural hearing loss in mice using auditory steady-state responses and transient auditory brainstem responses

Sensorineural hearing loss (SNHL) comprises hearing disorders with diverse pathologies of the inner ear and the auditory nerve. To date, an unambiguous phenotypical characterization of the specific pathologies in an affected individual remains impossible. Here, we evaluated the use of scalp-recorded auditory steady-state responses (ASSR) and transient auditory brainstem responses (ABR) for differentiating the disease mechanisms underlying sensorineural hearing loss in well-characterized mouse models. We first characterized the ASSR evoked by sinusoidally amplitude-modulated tones in wild-type mice. ASSR were robustly elicited within three ranges of modulation frequencies below 200 Hz, from 200 to 600 Hz and beyond 600 Hz in most recordings. Using phase information we estimated the apparent ASSR latency to be about 3 ms, suggesting generation in the auditory brainstem. Auditory thresholds obtained by automated and visual analysis of ASSR recordings were comparable to those found with tone-burst evoked ABR in the same mice. We then recorded ASSR and ABR from mouse mutants bearing defects of either outer hair cell amplification (KCNQ4-knockout) or inner hair cell synaptic transmission (Bassoon-mutant). Both mutants showed an increase of ASSR and ABR thresholds of approximately 40 dB versus wild-type when investigated at 8 weeks of age. Mice with defective amplification displayed a steep rise of ASSR and ABR amplitudes with increasing sound intensity, presumably reflecting a strong recruitment of synchronously activated neural elements beyond threshold. In contrast, the amplitudes of ASSR and ABR responses of mice with impaired synaptic transmission grew very little with sound intensity. In summary, ASSR allow for a rapid, objective and frequency-specific hearing assessment and together with ABR and otoacoustic emissions can contribute to the differential diagnosis of SNHL.     

听视觉刺激对长期听力损失患者语言处理的影响

目的:研究听视觉刺激对听力损失患者大脑中与语言处理相关脑区神经活动的影响,为患者的康复治疗提供理论支撑。方法:募集12个听力损失患者和12个性别年龄匹配的正常听力受试者。首先构建每个参与者个体化虚拟数字脑,然后将虚拟视觉刺激信号施加到已构建虚拟数字脑的次级视觉皮层;将虚拟听觉刺激信号施加到已构建虚拟数字脑的初级听觉皮层。最后,观察这些刺激信号在听力损失患者脑皮层中所诱发的神经活动变化。结果:同正常受试者相比,虚拟视觉刺激信号抑制了听力损失患者听觉皮层和布洛卡区的神经活动,并通过最短因果路径削弱了布洛卡区的激活。相反,虚拟听觉刺激信号抑制了听力损失患者视觉皮层的激活,但通过最短因果路径增强了布洛卡区的神经活动。此外,听力损失患者也呈现了减弱的视觉诱发的威尼克区的激活。结论:目前的研究表明,视觉刺激通过削弱听觉皮层和布洛卡区的神经活动抑制了听力损失患者的语言处理。相反,听觉刺激通过抑制视觉皮层的活动,增强布洛卡区的神经活动,从而改善了听力损失患者的语言处理。     

Post-exposure treatment with ginsenoside compound K ameliorates auditory functional injury associated with noise-induced hearing loss in mice

Noise-induced hearing loss (NIHL) is thought to primarily involve damage to the sensory hair cells of the cochlea via mechanical and metabolic mechanisms. Unfortunately, initial studies assessing the effectiveness of post-exposure treatment after hearing loss have yielded largely disappointing results. This study explored the effects of oral treatment with Korean red ginseng (RG) and with two bioavailable ginsenoside metabolites, ginsenoside Rh1 and ginsenoside compound K (GCK), in response to NIHL in a murine model. Pharmacological treatments began 24h after noise exposure and were continued once daily for 7 days. Central auditory function was evaluated using auditory middle latency responses, and cochlear function was determined based on transient evoked otoacoustic emissions. Additionally, cochlear hair cell morphology was investigated after noise exposure. Both Korean red ginseng and compound K reduced threshold shifts, central auditory function damage, and cochlear functional and morphological deficits. In contrast, treatment with ginsenoside Rh1 did not result in recovery of NIHL in mice. These results suggest that consumption of Korean red ginseng may facilitate recovery from noise-induced hearing loss. Furthermore, one of the active constituents in ginseng is likely ginsenoside compound K.     

Biallelic p.V37I variant in GJB2 is associated with increasing incidence of hearing loss with age

PurposeThis study aimed to quantitatively assess the incidence of hearing loss in relation to age in individuals with biallelic p.V37I variant in GJB2.MethodsPopulation screening of the biallelic p.V37I variant was performed in 30,122 individuals aged between 0 and 97 years in Shanghai. Hearing thresholds of the biallelic p.V37I individuals and the controls were determined by click auditory brainstem response or pure tone audiometry.ResultsBiallelic p.V37I was detected in 0.528% (159/30,122) of the subjects. Of the biallelic p.V37I newborns, 43.91% (18/41) passed their distortion-product otoacoustic emissions–based newborn hearing screening or had hearing thresholds lower than 20 decible above normal hearing level. The older newborns had elevated hearing thresholds, with increasing incidence of 9.52%, 23.08%, 59.38%, and 80.00% for moderate or higher grade of hearing loss in age groups of 7 to 15 years, 20 to 40 years, 40 to 60 years, and 60 to 85 years, respectively. Their hearing deteriorated at a rate of 0.40 dB hearing level per year on average; males were more susceptible, and deterioration occurred preferentially at higher sound frequencies.ConclusionThe biallelic p.V37I variant is associated with steadily progressive hearing loss with increasing incidence over the course of life. Most of the biallelic p.V37I individuals may develop significant hearing loss in adulthood and, can benefit from early diagnosis and intervention through wide-spread genetic screening.     

Lymphocyte G-protein-coupled receptor kinase-2 is upregulated in patients with Alzheimer's disease

Alterations in signal transduction pathway of G-protein-coupled receptors (GPCRs) have been found in the cerebrocortex and in the peripheral cultured tissues of patients with Alzheimer's disease (AD). The G-protein-coupled receptor kinase-2 (GRK2) plays an important role in regulating the GPCRs signaling: its increased expression is associated with receptor desensitization. The aim of this study was to explore GRK2 levels in peripheral lymphocytes of AD patients and to establish a correlation between lymphocyte protein concentrations and the degree of cognitive impairment. GRK2 mRNA and protein expression were evaluated in the lymphocytes of AD patients with mild or moderate/severe cognitive impairment and in age-matched healthy subjects. Both GRK2 mRNA and protein expression were higher in AD patients lymphocytes compared to controls. Furthermore, lymphocyte GRK2 levels were significantly correlated to the degree of cognitive decline. Our preliminary data suggest that GRK2 is involved in GPCRs coupling dysfunction observed in AD patients. Further studies are needed in order to verify whether the lymphocyte GRK2 might be utilized as a novel biomarker in AD diagnosis and clinical monitoring.     

A recovery from enhancement of activation in auditory cortex of patients with idiopathic sudden sensorineural hearing loss

OBJECTIVE: We previously reported enhanced activation of auditory cortex in patients with bilateral chronic inner-ear hearing loss. To determine whether this enhancement can exhibit a short-term alteration, we measured auditory evoked magnetic fields (AEFs) in patients with idiopathic sudden sensorineural hearing loss (ISSHL) in the acute phase (AP) and recovery phases (RPs). METHODS: We recorded AEFs in two unilateral ISSHL patients at three time points (AP, RP1, and RP2) using a whole-head neuromagnetometer. Tone bursts of 1 kHz were presented monaurally to the affected and healthy ear at four different intensities (40-70 dB HL). RESULTS: Both patients showed the enhancement of N100 m moment at AP and not at RPs in response to the affected ear stimulation, and stronger N100 m moment in ipsilateral than contralateral hemisphere in response to the healthy ear stimulation at AP. CONCLUSIONS: Enhancement of N100 m amplitude occurs in ISSHL patients and disappears on the scale of days. Enhancement of activity in the auditory cortex derived from inner-ear hearing loss can thus exhibit short-term change. SIGNIFICANCE: The results of this study provide first evidence for a recovery from enhancement of activation in the auditory cortex following injury of peripheral hearing organ.     

Changes in neuronal activity and gene expression in guinea-pig auditory brainstem after unilateral partial hearing loss

Spontaneous neural hyperactivity in the central auditory pathway is often associated with deafness, the most common form of which is partial hearing loss. We quantified both peripheral hearing loss and spontaneous activity in single neurons of the contralateral inferior colliculus in a guinea-pig model 1 week after a unilateral partial deafness induced by cochlear mechanical lesion. We also measured mRNA levels of candidate genes in the same animals using quantitative real-time PCR. Spontaneous hyperactivity was most marked in the frequency region of the peripheral hearing loss. Expression of glutamate decarboxylase 1 (GAD1), GABA-A receptor subunit alpha-1 (GABRA1), and potassium channel subfamily K member 15 (KCNK15) was decreased ipsilaterally in the cochlear nucleus and bilaterally in the inferior colliculus. A member of RAB family of small GTPase (RAB3A) was decreased in both ipsilateral cochlear nucleus and contralateral inferior colliculus. RAB3 GTPase activating protein subunit 1 (RAB3GAP1) and glycine receptor subunit alpha-1 (GLRA1) were reduced ipsilaterally in the cochlear nucleus only. These results suggest that a decrease in inhibitory neurotransmission and an increase in membrane excitability may contribute to elevated neuronal spontaneous activity in the auditory brainstem following unilateral partial hearing loss.     

Identification of three novel hearing loss mouse strains with mutations in the Tmc1 gene

We report the identification of three new mouse models, baringo, nice, and stitch, with recessively inherited sensorineural deafness due to novel mutations in the transmembrane channel-like gene 1 (Tmc1). These strains were generated by N-ethyl-N-nitrosourea mutagenesis. DNA sequence analysis revealed changes in c.545A>G, c.1345T>C, and c.1661G>T, causing p.Y182C, p.Y449H, and p.W554L amino acid substitutions in baringo, nice, and stitch mutants, respectively. The mutations affect amino acid residues that are evolutionarily conserved across species. Similar to the previously reported Beethoven Tmc1 mutant, both p.Y182C and p.W554L are located outside a predicted transmembrane domain, whereas the p.Y449H mutation resides in the predicted transmembrane domain 4. Homozygous stitch-mutant mice have severe hearing loss at the age of 4 weeks and are deaf by the age of 8 weeks, whereas both baringo and nice mutants are profoundly deaf at the age of 4 weeks. None of the strains displays signs of vestibular dysfunction. Scanning electron microscopy revealed degeneration of outer hair cells in the basal region of baringo, nice, and stitch mutants. Immunolocalization studies revealed expression of TMC1 protein in the hair cells, spiral ganglion neurons, supporting cells, and stria ligament in the inner ear. Reduced levels of TMC1 protein were observed in the spiral ligament of mutants when compared with wild-type animals. These three allelic mutants provide valuable models for studying nonsyndromic recessive sensorineural hearing loss (DFNB7/11) in humans.     

大鼠听皮质NMDA受体亚单位NR2B蛋白质的年龄-依赖性表达

目的：研究sD大鼠生后发育过程中,听皮质神经元NMDA受体亚单位NR2B蛋白质的表达规律。方法：采用免疫组织化学反应和蛋白质印迹技术,分别检测生后1、2、3周和成年动物听皮质神经元NMDA受体亚单位NR2B蛋白质的表达。结果：NR2B阳性神经元在生后第1周密度最高,随着生后周龄增长,NR2B阳性神经元密度递减．3周龄后降至成年动物的低表达水平。结论：大鼠生后发育过程巾．听皮质NR2B亚单位蛋白质呈现年龄-依赖性表达,此结果与mRNA水平上的表达趋势一致。     

GJB2 mutations in Iranians with autosomal recessive non-syndromic sensorineural hearing loss

Hereditary hearing loss (HHL) is an extremely common disorder. About 70% of HHL is non-syndromic, with autosomal recessive forms accounting for approximately 85% of the genetic load. Although very heterogeneous, the most common cause of HHL in many different world populations is mutations of GJB2, a gene that encodes the gap junction protein connexin 26 (Cx26). This study investigates the contribution of GJB2 to the autosomal recessive non-syndromic deafness (ARNSD) load in the Iranian population. One hundred sixty eight persons from 83 families were studied. GJB2-related deafness was diagnosed in 9 families (4, 35delG homozygotes; 3, 35delG compound heterozygotes; 1, W24X homozygote; 1, non-35delG compound heterozygote). The carrier frequency of the 35delG allele in this population was approximately 1% (1/83). Because the relative frequency of Cx26 mutations is much less than in the other populations, it is possible that mutations in other genes play a major role in ARNSD in Iran.     

GJB2 mutations in patients with non-syndromic hearing loss from Northeastern Hungary

Mutations in the GJB2 gene encoding the gap-junction protein connexin 26 have been identified in many patients with childhood hearing impairment (HI). One single mutation, c.35delG, accounts for the majority of mutations in Caucasian patients with HI. In the present study we screened 500 healthy control individuals and a group of patients with HI from Northeastern Hungary for GJB2 mutations. The patients' group consisted of 102 familial from 28 families and 92 non-familial cases. The most common mutation in the Hungarian population is the c.35delG, followed by the c.71G>A (p.W24X) mutation. 34.3% of the patients in the familial group were homozygous, and 17.6% heterozygous for 35delG. In the non-familial group the respective values were 37% and 18% (allele frequency: 46.2%). In the general population an allele frequency of 2.4% was determined. Several patients were identified with additional, already described or new GJB2 mutations, mostly in heterozygous state. The mutation c.380G>A (p.R127H) was formerly found only in heterozygous state and its disease relation was controversial. We demonstrated the presence of this mutation in a family with three homozygous patients and 4 heterozygous unaffected family members, a clear indication of recessively inherited HI. Furthermore, we provided evidence for the pathogenic role of two new mutations, c.51C>A (p.S17Y) and c.177G>T (p.G59V), detected in the present study. In the latter case the pattern of inheritance might be dominant. Our results confirm the importance of GJB2 mutations in the Hungarian population displaying mutation frequencies that are comparable with those in the Mediterranean area.     

噪声性聋患者听觉传出神经系统功能的改变

目的： 研究噪声性聋患者听觉传出神经系统功能的改变，为临床对噪声性聋进行早期监测和诊断提供可靠的方法和依据。方法: 以Celesta-503型耳声发射分析仪测试并记录受试者畸变产物耳声发射（DP-gram和2、4、6 kHz的I/O曲线），以对侧宽带噪声（70 dB SPL）刺激后畸变产物耳声发射幅值的改变评价听觉传出神经系统功能的改变。结果: 在DP-gram的测试中，噪声性聋患者的对侧抑制效应在低频（0.75 kHz和1 kHz）明显低于对照组和听阈正常组，而在中高频无显著差异；在I/O曲线测试中，噪声性聋患者对侧抑制效应仅在2 kHz中低强度段低于对照组和听阈正常组受试者，而在4 kHz及6 kHz的测试中，无显著差异。结论: 噪声性聋患者的听觉传出神经功能减弱，对听觉传出神经系统功能的测试可为早期监测和诊断噪声性聋提供依据。     

感音神经性聋小鼠耳蜗外侧壁形态及功能的改变

目的:探讨感音神经性聋发生后小鼠耳蜗外侧壁形态和功能的改变。方法:选用3-4周龄的CBA/J小鼠为实验对象,联合应用卡那霉素及呋塞米致聋。在给药后0.5 d、1 d、2 d、7 d、28 d及112 d监测耳蜗内电位(EP)的改变;应用HE染色、免疫化学和透射电镜方法检测耳蜗外侧壁形态以及2种K+转运蛋白NKCC1和α2Na,K-ATPase的变化。结果:序贯应用卡那霉素及呋塞米后0.5 d小鼠EP开始下降,至1 d进行性下降,至2 d完全恢复正常并在随后长时期保持稳定。HE染色显示毛细胞损失和耳蜗外侧壁萎缩是主要病理改变。免疫化学结果表明耳蜗外侧壁NKCC1和α2Na,K-ATPase蛋白表达明显下降。透射电镜结果显示血管纹厚度在致聋后进行性下降,主要为边缘细胞萎缩造成。结论:萎缩后的耳蜗外侧壁在毛细胞严重缺失的情况下仍然可以保证EP的正常维持。