Feasibility exploration of cortical auditory evoked potentials evoked by spectro-temporal modulation signals.

BACKGROUND: An objective measurement of speech perception would be valuable in hearing-impaired patients who are unable to perform auditory tasks reliably. OBJECTIVES: To investigate the feasibility of cortical auditory evoked potentials (CAEPs) evoked by different spectro-temporal modulation (STM) signals and provide reference for the further exploration of acoustic change complex (ACC) in hearing-impaired patients. METHOD: 29 normal hearing (NH) adults were recruited and stimulated randomly by STM signals at 6 spectral modulation rates: 0, 1, 2, 4, 8, 16 cycles/octave, at each of 4 temporal modulation rates: 0, 2, 4, 8 Hz, to elicit ACC response. RESULTS: The change of spectral modulation rates ≤ 16 cycles/octave at 0 Hz temporal modulation rate had different impacts on latency. 0, 1 cycles/octave, and 4, 8 Hz made a difference to the P2-N1 amplitude easily. 8, 16 cycles/octave were more unstable in rejection rate. No significant difference existed in waveform repetition rate among different STM rates. No significant interaction effect existed in spectral and temporal modulation. CONCLUSIONS: STM as a stimulus signal to induce ACC response had its feasibility. 2 cycles/octave at spectral modulation rate and 2 Hz at temporal modulation rate had better stability and waveform repeatability in NH adults.

Central Auditory Changes Associated with Age-related Hearing Loss.

Objective. This study aimed to investigate age-related changes in cortical auditory evoked potentials (CAEPs) while considering three crucial factors: aging, high-frequency hearing loss and sensation level of the CAEP stimulus. Method. The electrophysiological and audiometric data of 71 elderly participants were analyzed using multiple regression analysis to investigate the association of CAEPs with the factors of aging, high-frequency hearing loss and sensation level of the CAEP test stimulus. Results. Aging was significantly associated with prolonged N1 and P2 latencies and reduced P2 amplitude. Elevated thresholds related to the sensation level of the CAEP stimulus were significantly associated with increased N1 and P2 amplitudes and decreased N1 latency. A significant relationship was detected between high-frequency hearing thresholds and the shortening of P2 latencies and the reduction of P2 amplitudes. Conclusion. The results of this study highlight the complex interplay of aging, high-frequency hearing loss and the sensation level of the CAEP stimulus on CAEP components in elderly people. These factors should be considered in future research using CAEPs to enhance overall understanding of auditory processing in the aging population.

Auditory cortical stimulability in non habilitated individuals - An evidence from CAEPs.

Objective: The effect of long term auditory deprivation on Cortical Auditory Evoked Potentials (CAEPs) especially in human models is not well explored. Hence, the current study was aimed to investigate the effects of long-term auditory deprivation and stimulability of auditory cortex in non habilitated congenitally deaf adolescents and adults using CAEPs. Methods and Results: A total of 27 non-habilitated congenitally deaf adolescents/adults with age and gender matched normal hearing adolescents/adults participated in the study. The congenitally deaf group was fitted with high gain hearing aids (first fit). Further, the CAEPs were recorded. The obtained CAEP components were assessed for group effect, source and topographical differences. The between group analysis for CAEP responses showed a significant difference only for P2 latency and amplitude. The source analysis revealed that, in the normal hearing group for CAEPs, the sources were within the temporal regions. However, in the congenitally deaf group, along with the temporal cortex, the bilateral prefrontal cortex also was activated. Conclusion: The findings revealed that it is possible to stimulate and evoke a matured CAEP response from a long deprived auditory system with adequate acoustic stimulation. The presence of CAEP responses is indicative of the functionality of the innate auditory pathway and the crossmodal plasticity in long auditory deprived individuals.

Assessment of cognitive function in young children with type 1 diabetes mellitus using electrophysiological tests.

BACKGROUND/OBJECTIVES: Diabetes mellitus is a chronic disease that affects many body systems, including the nervous and auditory systems. It is noted that there is a scarcity of research on the effect of diabetes on cognitive functions in particular and auditory functions in general in children with type 1 diabetes. Therefore, this study was designed to assess cognitive and auditory functions in children with type 1 diabetes mellitus and to correlate the reflection of diabetes control on cognitive functions. METHODS: This study is a case-control study that included 100 children divided into two groups, the patient group, which includes 50 children with type 1 diabetes, and the control group, which consists of 50 healthy children. Subjects in the current study were submitted to pure tone audiometry, speech recognition threshold test, immittancemetry study, and measurement of cortical auditory evoked and P300 potentials (CAEPs and P300). These audiometric measures were statistically analyzed and correlated with the clinical characteristics of the study group. RESULTS: The latency of P300 and CAEPs was significantly increased while the amplitude of P300 and CAEPs was significantly decreased in the patient group compared to the control group (p < 0.001). P300 and CAEPs latency has a positive correlation with HbA1c levels (r = 0.460). In addition, there was significant differences between the two groups regarding the hearing threshold at 8000 Hz, and 28% of patients had bilateral sensorineural hearing loss (SNHL) at 8 kHz. CONCLUSION: The prolonged P300 and CAEPs latency and decreased amplitude in patients indicate a cognitive decline in individuals with type 1 diabetes compared to healthy individuals. HbA1c levels may increase the risk of cognitive impairment in children. In addition, the risk of bilateral SNHL increased at 8 kHz in children with type 1 diabetes mellitus.

Infant repetition effects and change detection: Are they related to adaptive skills?

Repetition effects and change detection response have been proposed as neuro-electrophysiological correlates of fundamental learning processes. As such, they could be a good predictor of brain maturation and cognitive development. We recorded high density EEG in 71 healthy infants (32 females) aged between 3 and 9 months, while they listened to vowel sequences (standard /a/a/a/i/ [80%] and deviant /a/a/a/a/ [20%]). Adaptive skills, a surrogate of cognitive development, were measured via the parent form of the Adaptive Behavior Assessment System Second Edition (ABAS-II). Cortical auditory-evoked potentials (CAEPs) analyses, time-frequency analyses and a statistical approach using linear mixed models (LMMs) and linear regression models were performed. Age and adaptive skills were tested as predictors. Age modulation of repetition effects and change detection response was observed in theta (3-5 Hz), alpha (5-10 Hz) and high gamma (80-90 Hz) oscillations and in all CAEPs. Moreover, adaptive skills modulation of repetition effects was evidenced in theta (3-5 Hz), high gamma oscillations (80-90 Hz), N250/P350 peak-to-peak amplitude and P350 latency. Finally, adaptive skills modulation of change detection response was observed in the N250/P350 peak-to-peak amplitude. Our results confirm that repetition effects and change detection response evolve with age. Moreover, our results suggest that repetition effects and change detection response vary according to adaptive skills displayed by infants during the first year of life, demonstrating their predictive value for neurodevelopment.

Assessment of Cortical Auditory Function Using Electrophysiological and Neuropsychological Measurements in Children with Bone-Anchored Hearing Aids.

Children suffering from conductive or mixed hearing loss may benefit from a bone-anchored hearing aid system (BAHA Attract implantable prosthesis). After audiological rehabilitation, different aspects of development are improving. The objective of this case report is to propose a comprehensive framework for monitoring cortical auditory function after implantation of a bone-anchored hearing aid system by using electrophysiological and neuropsychological measurements. We present the case of a seven-year-old boy with a congenital hearing loss due to a plurimalformative syndrome, including outer and middle ear malformation. After the diagnosis of hearing loss and the audiological rehabilitation with a BAHA Attract implantable prosthesis, the cortical auditory evoked potentials were recorded. We performed a neuropsychological evaluation using the Wechsler Intelligence Scale for Children - Fourth Edition, which was applied according to a standard procedure. The P1 latency was delayed according to the age (an objective biomarker for quantifying cortical auditory function). The neuropsychological evaluation revealed that the child's working memory and verbal reasoning abilities were in the borderline range comparing with his nonverbal reasoning abilities and processing abilities, which were in the average and below-average range, respectively. Cortical auditory evoked potentials, along with neuropsychological evaluation, could be an essential tool for monitoring cortical auditory function in children with hearing loss after a bone-anchored hearing aid implantation.

Cortical auditory evoked potentials and hemispheric specialization of speech in individuals with learning disability and healthy controls: A preliminary study.

Background: Dichotic listening (DL) technique is a behavioral non-invasive tool which is used in studying hemispheric lateralization. Previous studies using behavioral DL have hypothesized that individuals with learning disabilities (LD) exhibit a lack of cortical specialization for processing speech stimulus. However, there is no event related potential (ERP) evidence, hence the main objective of the study is to explore hemispheric asymmetry using cortical auditory evoked potential (CAEPs) in normal hearing adults and also to compare the same in children with LD and healthy controls. Methods: CAEPs were recorded in 16 normal hearing young adults, eight right-handed children with LD and their age matched controls. Two stop constants (/Pa/ - voiceless, bilabial, stop: /Ta/ - voiceless, alveolar, stop) were chosen for this experiment and presented in each ear and dichotically in two different orders (/pa-ta/, /ta-pa/). ERPs were processed using a standard pipeline, and electrodes readings over the left and right hemispheres were averaged to create left and right regions of interest (ROI). The CAEPs were analyzed for mean amplitude and peak latency of P1-N1-P2 components. Results: The current study results suggest no statistically significant difference between the two stimulus in monaural condition and absence of order effect in dichotic condition. In healthy controls the CAEP latencies were shorter over the left hemisphere in both monaural and dichotic conditions in adults and control children. However, it was very evident that such a difference was lacking in children with LD. Conclusions: Hemispheric asymmetry can be detected using CAEPs for speech stimulus. The measures are consistent and void of stimulus or order effect. Taken together, the findings of current study, both monaural and dichotic condition illustrates the hemispheric differences in processing speech stimuli in normal hearers. Absence of latency differences between hemispheres in children with LD indicate a lack of hemispheric asymmetry.

Cortical auditory evoked potentials in children who stutter.

INTRODUCTION: It has been hypothesized that impaired auditory processing influence the occurrence of stuttering. Also, it is suggested that speech perception in children who stutter differed from normal. Auditory processing should be investigated in children who stutter shortly after the onset of stuttering in order to evaluate the extent to which impaired auditory processing contributes to the development of stuttering. CAEPs provide the necessary temporal and spatial resolution to detect differences in auditory processing and the neural activity that is related or time-locked to the auditory stimulus. The primary goal of the present study was to determine the difference in latency and amplitude of P1-N2 complex between children who stutter and non-stuttering children in response to speech stimuli. MATERIAL & METHODS: This case-control study was performed over 60children, 30were non-stuttering children (control group) and 30were children who stutter (study group) ranging in severity from Bloodstien I to Bloodstien IV in the age range of 8-18 years. RESULTS: CAEPs of children who stutter with stuttering severity Bloodstien IV showed significant prolonged latencies and reduced amplitudes when blocks and IPDs were the most predominant core behaviors. P1 and N1 were prolonged in concomitant behaviors. CONCLUSION: It could be speculated that speech processing was affected in children who stutter with stuttering severity Bloodstien IV at the level of early perceptual auditory cortex.

Speech processing in children with cochlear implant.

UNLABELLED: Cochlear implants (CIs) can be used effectively in the profoundly impaired children individuals. OBJECTIVES: This work was designed to assess speech processing at brainstem and cortical level in children fitted with CIs to investigate the possible influence of brainstem processing of speech on the cortical processing in those children. METHOD: Twenty children fitted with CIs underwent aided sound-field audiologic evaluation, speech evoked cortical auditory evoked potentials (S-CAEPs) and according to the results, children were classified into two groups: group I with good cortical response and group II with poor cortical response. This was followed by speech evoked ABR (S-ABR) recoding. RESULTS: P1 component of CAEPs was recorded in all children while other component showed variable results. S-ABR was recorded in all children even those with poor S-CAEPs response who showed delayed D, E, F and O latencies. However, S-ABR amplitudes did not show any significant difference between both groups. CONCLUSIONS: Children fitted with CI showed immediate cortical activation following device programming and this activity depends on the age of implantation as well as the child's age. S-ABR provides a new clinical tool that showed an important role of brainstem in complex sound processing that contribute to cortical processing.

Maturation of cortical auditory evoked potentials (CAEPs) to speech recorded from frontocentral and temporal sites: three months to eight years of age.

The goal of the current analysis was to examine the maturation of cortical auditory evoked potentials (CAEPs) from three months of age to eight years of age. The superior frontal positive-negative-positive sequence (P1, N2, P2) and the temporal site, negative-positive-negative sequence (possibly, Na, Ta, Tb of the T-complex) were examined. Event-related potentials were recorded from 63 scalp sites to a 250-ms vowel. Amplitude and latency of peaks were measured at left and right frontal sites (near Fz) and at left and right temporal sites (T7 and T8). In addition, the largest peak (typically corresponding to P1) was selected from global field power (GFP). The results revealed a large positive peak (P1) easily identified at frontal sites across all ages. The N2 emerged after 6 months of age and the following P2 between 8 and 30 months of age. The latencies of these peaks decreased exponentially with the most rapid decrease observed for P1. For amplitude, only P1 showed a clear relationship with age, becoming more positive in a somewhat linear fashion. At the temporal sites only a negative peak, which might be Na, was clearly observed at both left and right sites in children older than 14 months and peaking between 100 and 200 ms. P1 measures at frontal sites and Na peak latencies were moderately correlated. The temporal negative peak latency showed a different maturational timecourse (linear in nature) than the P1 peak, suggesting at least partial independence. Distinct Ta (positive) and Tb (negative) peaks, following Na and peaking between 120 and 220 ms were not consistently found in most age groups of children, except Ta which was present in 7 year olds. Future research, which includes manipulation of stimulus factors, and use of modeling techniques will be needed to explain the apparent, protracted maturation of the temporal site measures in the current study.

A clinical study of cortical auditory evoked potentials in cochlear implantees.

Normal maturation of central auditory pathways is a precondition for the optimal development of speech and language skills in children. The temporal cortex gets acoustically tagged due to auditory stimulation and important changes occur in the higher auditory centers due to hearing loss of any type and degree. Cochlear implantation increases auditory sensitivity by direct electrical activation of auditory nerve fibers, enabling phonemic awareness, discrimination and identification ultimately yielding speech understanding. Early implantation stimulates a brain that has not been re-organized and will therefore be more receptive to auditory input and greater auditory capacity. Cortical potentials have enabled us to objectively study this phenomenon. To assess the outcomes of Cochlear implants on the auditory cortex by analyzing cortical auditory evoked potentials (CAEPs) in the habilitation period. This prospective clinical study was performed in 30 pre-lingual candidates with varied etiology of deafness who underwent cochlear implantation at our institute over the last 1 year. The study group had two cohorts (group-1: 0-8 years and group-2: 8-15 years) which included candidates with normal inner ear and no syndromes or handicaps. All implantees in the study group underwent CAEP testing at 6 months and 1 year post-implantation and comparison of the CAEP wave parameters (P1 amplitude, P1 latency and P1 morphology) were done between the two cohorts. In children Implanted early (group-1) there was an early onset rapid increase in P1 amplitude along with a decrease in P1 latency during the follow-up period. Significant change in the CAEP wave morphology was also notable in group-1 unlike in group-2. Candidates who experienced less than 3 years of auditory deprivation before implantation showed P1 latencies, which fell into the range of normal children within 6 months of habilitation. Children with more than 6 years of auditory deprivation, however, generally did not develop normal P1 latencies or morphology even after 1 year of habilitation. The overall outcome with CAEP was much better in group-1 as compared to group-2 and the observations were is in comparison with the existing world literature. The advent of CAEP has objectively proved beyond doubt that there is a critical age for stimulating the auditory brain via cochlear implantation. There is considerable evidence for a developmental sensitive period, during which the auditory cortex is highly plastic. If sensory input is deprived to the auditory system during this sensitive period, then the central auditory system is susceptible to large scale reorganization. Restoring input to the auditory system by Cochlear Implant at an early age can provide the stimulation necessary to preserve the auditory pathways. However, if auditory input is not restored until after this developmental period, then the cross-modal reorganized pathways may exhibits abnormal functional characteristics as observed in recorded P1 amplitude, latencies and morphologies of CAEPs.