Auditory Brainstem Pathology in Autism Spectrum Disorder: A Review.

Atypical responses to sound are common in individuals with autism spectrum disorder (ASD), and growing evidence suggests an underlying auditory brainstem pathology. This review of the literature provides a comprehensive account of the structural and functional evidence for auditory brainstem abnormalities in ASD. The studies reviewed were published between 1975 and 2016 and were sourced from multiple online databases. Indices of both the quantity and quality of the studies reviewed are considered. Findings show converging evidence for auditory brainstem pathology in ASD, although the specific functions and anatomical structures involved remain equivocal. Two main trends emerge from the literature: (1) abnormalities occur mainly at higher levels of the auditory brainstem, according to structural imaging and electrophysiology studies; and (2) brainstem abnormalities appear to be more common in younger than older children with ASD. These findings suggest delayed maturation of neural transmission pathways between lower and higher levels of the brainstem and are consistent with the auditory disorders commonly observed in ASD, including atypical sound sensitivity, poor sound localization, and difficulty listening in background noise. Limitations of existing studies are discussed, and recommendations for future research are offered.

Adaptation of high-gamma responses in human auditory association cortex.

This study investigates adaptation of high-frequency cortical responses [>60 Hz; high-gamma (HG)] to simple and complex sounds in human nonprimary auditory cortex. We used intracranial electrocorticographic recordings to measure event-related changes in HG power as a function of stimulus probability. Tone and speech stimuli were presented in a series of traditional oddball and control paradigms. We hypothesized that HG power attenuates with stimulus repetition over multiple concurrent time scales in auditory association cortex. Time-frequency analyses were performed to identify auditory-responsive sites. Single-trial analyses and quantitative modeling were then used to measure trial-to-trial changes in HG power for high (frequent), low (infrequent), and equal (control) stimulus probabilities. Results show strong reduction of HG responses to frequently repeated tones and speech, with no differences in responses to infrequent and equal-probability stimuli. Adaptation of the HG frequent response, and not stimulus-acoustic differences or deviance-detection enhancement effects, accounted for the differential responses observed for frequent and infrequent sounds. Adaptation of HG responses showed a rapid onset (less than two trials) with slower adaptation between consecutive, repeated trials (2-10 s) and across trials in a stimulus block (∼7 min). The auditory-evoked N100 response also showed repetition-related adaptation, consistent with previous human scalp and animal single-unit recordings. These findings indicate that HG responses are highly sensitive to the regularities of simple and complex auditory events and show adaptation on multiple concurrent time scales in human auditory association cortex.

Electrocorticographic functional mapping identifies human cortex critical for auditory and visual naming.

More comprehensive, and efficient, mapping strategies are needed to avoid post-operative language impairments in patients undergoing epilepsy surgery. Conservative resection of dominant anterior frontal or temporal cortex frequently results in post-operative naming deficits despite standard pre-operative electrocortical stimulation mapping of visual object (picture) naming. Naming to auditory description may better simulate word retrieval in human conversation but is not typically tested, in part due to the time demands of electrocortical stimulation mapping. Electrocorticographic high gamma (60-150 Hz) activity, recorded simultaneously through the same electrodes used for stimulation mapping, has recently been used to map brain function more efficiently, and has at times predicted deficits not anticipated based on stimulation mapping alone. The present study investigated electrocorticographic mapping of visual object naming and auditory descriptive naming within conservative dominant temporal or frontal lobe resection boundaries in 16 patients with 933 subdural electrodes implanted for epilepsy surgery planning. A logistic regression model showed that electrodes within traditional conservative dominant frontal or temporal lobe resection boundaries were significantly more likely to record high gamma activity during auditory descriptive naming than during visual object naming. Eleven patients ultimately underwent resection and 7 demonstrated post-operative language deficits not anticipated based on electrocortical stimulation mapping alone. Four patients with post-operative deficits underwent a resection that included sites where high gamma activity was observed during naming. These findings indicate that electrocorticographic mapping of auditory descriptive naming may reduce the risk of permanent post-operative language deficits following dominant temporal or frontal resection.

Proceedings of the Second International Workshop on Advances in Electrocorticography.

The Second International Workshop on Advances in Electrocorticography (ECoG) was convened in San Diego, CA, USA, on November 11-12, 2010. Between this meeting and the inaugural 2009 event, a much clearer picture has been emerging of cortical ECoG physiology and its relationship to local field potentials and single-cell recordings. Innovations in material engineering are advancing the goal of a stable long-term recording interface. Continued evolution of ECoG-driven brain-computer interface technology is determining innovation in neuroprosthetics. Improvements in instrumentation and statistical methodologies continue to elucidate ECoG correlates of normal human function as well as the ictal state. This proceedings document summarizes the current status of this rapidly evolving field.

Modeling Neural Adaptation in Auditory Cortex.

Neural responses recorded from auditory cortex exhibit adaptation, a stimulus-specific decrease that occurs when the same sound is presented repeatedly. Stimulus-specific adaptation is thought to facilitate perception in noisy environments. Although adaptation is assumed to arise independently from cortex, this has been difficult to validate directly in vivo. In this study, we used a neural network model of auditory cortex with multicompartmental cell modeling to investigate cortical adaptation. We found that repetitive, non-adapted inputs to layer IV neurons in the model elicited frequency-specific decreases in simulated single neuron, population-level and local field potential (LFP) activity, consistent with stimulus-specific cortical adaptation. Simulated recordings of LFPs, generated solely by excitatory post-synaptic inputs and recorded from layers II/III in the model, showed similar waveform morphologies and stimulus probability effects as auditory evoked responses recorded from human cortex. We tested two proposed mechanisms of cortical adaptation, neural fatigue and neural sharpening, by varying the strength and type of inter- and intra-layer synaptic connections (excitatory, inhibitory). Model simulations showed that synaptic depression modeled in excitatory (AMPA) synapses was sufficient to elicit a reduction in neural firing rate, consistent with neural fatigue. However, introduction of lateral inhibition from local layer II/III interneurons resulted in a reduction in the number of responding neurons, but not their firing rates, consistent with neural sharpening. These modeling results demonstrate that adaptation can arise from multiple neural mechanisms in auditory cortex.

Complex Modulation Method for Measuring Cross-Frequency Coupling of Neural Oscillations.

There is growing evidence from human intracranial electrocorticography (ECoG) studies that interactions between cortical frequencies are important for sensory perception, cognition and inter-regional neuronal communication. Recent studies have focused mainly on the strength of phase-amplitude coupling in cross-frequency interactions. Here, we introduce a complex modulation method based on measures of coherence to investigate cross-frequency coupling in the neural time series. This novel approach uses complex demodulation transform and coherence measures from the transformed signals. We used this method to quantify power coupling between two cortical frequency bands: theta (47 Hz) and high gamma (70-150 Hz) in ECoG signals recorded during an auditory task. We compared complex modulation results with traditional phase-amplitude coupling measures (PAC) derived from the same ECoG dataset. Our results suggest that cross-frequency coupling may involve changes in both phase-amplitude and power relationships between frequencies, reflecting the complexity of neuronal oscillatory interactions.

Multi-Regional Adaptation in Human Auditory Association Cortex.

In auditory cortex, neural responses decrease with stimulus repetition, known as adaptation. Adaptation is thought to facilitate detection of novel sounds and improve perception in noisy environments. Although it is well established that adaptation occurs in primary auditory cortex, it is not known whether adaptation also occurs in higher auditory areas involved in processing complex sounds, such as speech. Resolving this issue is important for understanding the neural bases of adaptation and to avoid potential post-operative deficits after temporal lobe surgery for treatment of focal epilepsy. Intracranial electrocorticographic recordings were acquired simultaneously from electrodes implanted in primary and association auditory areas of the right (non-dominant) temporal lobe in a patient with complex partial seizures originating from the inferior parietal lobe. Simple and complex sounds were presented in a passive oddball paradigm. We measured changes in single-trial high-gamma power (70-150 Hz) and in regional and inter-regional network-level activity indexed by cross-frequency coupling. Repetitive tones elicited the greatest adaptation and corresponding increases in cross-frequency coupling in primary auditory cortex. Conversely, auditory association cortex showed stronger adaptation for complex sounds, including speech. This first report of multi-regional adaptation in human auditory cortex highlights the role of the non-dominant temporal lobe in suppressing neural responses to repetitive background sounds (noise). These results underscore the clinical utility of functional mapping to avoid potential post-operative deficits including increased listening difficulties in noisy, real-world environments.

Cross-frequency coupling during auditory perception in human cortex.

Cross-frequency coupling plays an important role in coordinating neuronal computations underlying human perception, learning and memory. Here we compared four methods for measuring phase/amplitude coupling (PAC) of theta (4-7 Hz) and high-gamma (70-150 Hz) in intracranial electrocorticographic (ECoG) recordings. Time-frequency spectral and time-domain evoked responses were derived for comparison. All four methods showed significant increases in theta/high-gamma PAC in auditory cortex at sites where significant event-related increases in high-gamma power were also observed. Similarly, all PAC methods revealed stimulus effects (type, probability). However, the patterns of PAC increases differed across methods. Results suggest that PAC measures may be differentially sensitive to the underlying neural activity, including high-gamma amplitude, phase locking, and response timing.

Spatial-temporal functional mapping of language at the bedside with electrocorticography.

OBJECTIVE: To investigate the feasibility and clinical utility of using passive electrocorticography (ECoG) for online spatial-temporal functional mapping (STFM) of language cortex in patients being monitored for epilepsy surgery. METHODS: We developed and tested an online system that exploits ECoG's temporal resolution to display the evolution of statistically significant high gamma (70-110 Hz) responses across all recording sites activated by a discrete cognitive task. We illustrate how this spatial-temporal evolution can be used to study the function of individual recording sites engaged during different language tasks, and how this approach can be particularly useful for mapping eloquent cortex. RESULTS: Using electrocortical stimulation mapping (ESM) as the clinical gold standard for localizing language cortex, the average sensitivity and specificity of online STFM across 7 patients were 69.9% and 83.5%, respectively. Moreover, relative to regions of interest where discrete cortical lesions have most reliably caused language impairments in the literature, the sensitivity of STFM was significantly greater than that of ESM, while its specificity was also greater than that of ESM, though not significantly so. CONCLUSIONS: This study supports the feasibility and clinical utility of online STFM for mapping human language function, particularly under clinical circumstances in which time is limited and comprehensive ESM is impractical.

A Dynamic Directional Model for Effective Brain Connectivity using Electrocorticographic (ECoG) Time Series.

We introduce a dynamic directional model (DDM) for studying brain effective connectivity based on intracranial electrocorticographic (ECoG) time series. The DDM consists of two parts: a set of differential equations describing neuronal activity of brain components (state equations), and observation equations linking the underlying neuronal states to observed data. When applied to functional MRI or EEG data, DDMs usually have complex formulations and thus can accommodate only a few regions, due to limitations in spatial resolution and/or temporal resolution of these imaging modalities. In contrast, we formulate our model in the context of ECoG data. The combined high temporal and spatial resolution of ECoG data result in a much simpler DDM, allowing investigation of complex connections between many regions. To identify functionally segregated sub-networks, a form of biologically economical brain networks, we propose the Potts model for the DDM parameters. The neuronal states of brain components are represented by cubic spline bases and the parameters are estimated by minimizing a log-likelihood criterion that combines the state and observation equations. The Potts model is converted to the Potts penalty in the penalized regression approach to achieve sparsity in parameter estimation, for which a fast iterative algorithm is developed. The methods are applied to an auditory ECoG dataset.

Auditory processing following consecutive right temporal lobe resections: a prospective case study.

BACKGROUND: The role of the right temporal lobe in processing speech is not well understood. Although the left temporal lobe has long been recognized as critical for speech perception, there is growing evidence for right hemisphere involvement. To investigate whether the right temporal lobe is critical for auditory speech processing, we studied prospectively a normal-hearing patient who underwent consecutive right temporal lobe resections for treatment of medically intractable seizures. PURPOSE: To test the hypothesis that the right temporal lobe is critical for auditory speech processing. RESEARCH DESIGN: We used a prospective, repeated-measure, single-case design. Auditory processing was evaluated using behavioral tests of speech recognition (words, sentences) under multiple listening conditions (e.g., quiet, background noise, etc.). Auditory processing of nonspeech sounds was measured by pitch pattern sequencing and environmental sound recognition tasks. DATA COLLECTION: Repeat behavioral testing was performed at four time points over a 2 yr period: before and after consecutive right temporal lobe resection surgeries. RESULTS: Before surgery, the patient demonstrated normal speech recognition in quiet and under real-world listening conditions (background noise, filtered speech). After the initial right anterior temporal resection, speech recognition scores declined under adverse listening conditions, especially for the left ear, but remained largely within normal limits. Following resection of the right superior temporal gyrus 1 yr later, speech recognition in quiet and nonspeech sound processing (pitch patterns, environmental sounds) remained intact. However, speech recognition under adverse listening conditions was severely impaired. CONCLUSIONS: The right superior temporal gyrus appears to be critical for auditory processing of speech under real-world listening conditions.

Reliability of early cortical auditory gamma-band responses.

OBJECTIVE: To evaluate the test-retest reliability of event-related power changes in the 30-150 Hz gamma frequency range occurring in the first 150 ms after presentation of an auditory stimulus. METHODS: Repeat intracranial electrocorticographic (ECoG) recordings were performed with 12 epilepsy patients, at ≥1-day intervals, using a passive odd-ball paradigm with steady-state tones. Time-frequency matching pursuit analysis was used to quantify changes in gamma-band power relative to pre-stimulus baseline. Test-retest reliability was estimated based on within-subject comparisons (paired t-test, McNemar's test) and correlations (Spearman rank correlations, intra-class correlations) across sessions, adjusting for within-session variability. Reliability estimates of gamma-band response robustness, spatial concordance, and reproducibility were compared with corresponding measurements from concurrent auditory evoked N1 responses. RESULTS: All patients showed increases in gamma-band power, 50-120 ms post-stimulus onset, that were highly robust across recordings, comparable to the evoked N1 responses. Gamma-band responses occurred regardless of patients' performance on behavioral tests of auditory processing, medication changes, seizure focus, or duration of test-retest interval. Test-retest reproducibility was greatest for the timing of peak power changes in the high-gamma range (65-150 Hz). Reliability of low-gamma responses and evoked N1 responses improved at higher signal-to-noise levels. CONCLUSIONS: Early cortical auditory gamma-band responses are robust, spatially concordant, and reproducible over time. SIGNIFICANCE: These test-retest ECoG results confirm the reliability of auditory gamma-band responses, supporting their utility as objective measures of cortical processing in clinical and research studies.

Cortical high-gamma responses in auditory processing.

PURPOSE: This tutorial provides an introduction to cortical auditory spectral responses, focusing on event-related activity in the high-gamma frequencies (60-150 Hz), their recent emergence in neuroscience research, and potential clinical applications. METHOD: Auditory high-gamma responses are described and compared with traditional cortical evoked responses, including the auditory evoked N1 response. Methods for acquiring and analyzing spectral responses, including time-frequency analyses, are discussed and contrasted with more familiar time-domain averaging approaches. Four cases are presented illustrating high-gamma response patterns associated with normal and impaired auditory processing. CONCLUSIONS: Cortical auditory high-gamma responses may provide a useful clinical measure of auditory processing.

Language mapping in multilingual patients: electrocorticography and cortical stimulation during naming.

Multilingual patients pose a unique challenge when planning epilepsy surgery near language cortex because the cortical representations of each language may be distinct. These distinctions may not be evident with routine electrocortical stimulation mapping (ESM). Electrocorticography (ECoG) has recently been used to detect task-related spectral perturbations associated with functional brain activation. We hypothesized that using broadband high gamma augmentation (HGA, 60-150 Hz) as an index of cortical activation, ECoG would complement ESM in discriminating the cortical representations of first (L1) and second (L2) languages. We studied four adult patients for whom English was a second language, in whom subdural electrodes (a total of 358) were implanted to guide epilepsy surgery. Patients underwent ECoG recordings and ESM while performing the same visual object naming task in L1 and L2. In three of four patients, ECoG found sites activated during naming in one language but not the other. These language-specific sites were not identified using ESM. In addition, ECoG HGA was observed at more sites during L2 versus L1 naming in two patients, suggesting that L2 processing required additional cortical resources compared to L1 processing in these individuals. Post-operative language deficits were identified in three patients (one in L2 only). These deficits were predicted by ECoG spectral mapping but not by ESM. These results suggest that pre-surgical mapping should include evaluation of all utilized languages to avoid post-operative functional deficits. Finally, this study suggests that ECoG spectral mapping may potentially complement the results of ESM of language.

Cognitive and EEG fluctuation in benign childhood epilepsy with central-temporal spikes: a case series.

Aware of parental reports of academic variability, we investigated month-to-month fluctuations in cognitive abilities and EEG status by repeated measures testing in six children with benign epilepsy with central-temporal spikes (BECTS). All showed greater than normal test-retest variability. Daytime EEG abnormalities were also variable. Short-term fluctuations in cognitive function appear common in children with BECTS, potentially impacting academic performance.

Quantifying auditory event-related responses in multichannel human intracranial recordings.

Multichannel intracranial recordings are used increasingly to study the functional organization of human cortex. Intracranial recordings of event-related activity, or electrocorticography (ECoG), are based on high density electrode arrays implanted directly over cortex, combining good temporal and spatial resolution. Developing appropriate statistical methods for analyzing event-related responses in these high dimensional ECoG datasets remains a major challenge for clinical and systems neuroscience. We present a novel methodological framework that combines complementary, existing methods adapted for statistical analysis of auditory event-related responses in multichannel ECoG recordings. This analytic framework integrates single-channel (time-domain, time-frequency) and multichannel analyses of event-related ECoG activity to determine statistically significant evoked responses, induced spectral responses, and effective (causal) connectivity. Implementation of this quantitative approach is illustrated using multichannel ECoG data from recent studies of auditory processing in patients with epilepsy. Methods described include a time-frequency matching pursuit algorithm adapted for modeling brief, transient cortical spectral responses to sound, and a recently developed method for estimating effective connectivity using multivariate autoregressive modeling to measure brief event-related changes in multichannel functional interactions. A semi-automated spatial normalization method for comparing intracranial electrode locations across patients is also described. The individual methods presented are published and readily accessible. We discuss the benefits of integrating multiple complementary methods in a unified and comprehensive quantitative approach. Methodological considerations in the analysis of multichannel ECoG data, including corrections for multiple comparisons are discussed, as well as remaining challenges in the development of new statistical approaches.