Electrophysiological Evidence of Auditory and Cognitive Processing Deficits in Parkinson Disease.

BACKGROUND: Parkinson's disease (PD) patients are at increased risk for central auditory processing (CAP) deficits and cognitive dysfunction. However, behavioral assessments of CAP and cognitive processing used in a previous study by our research team found few significant differences in performance between early-stage PD patients and age-matched control subjects. The objective of this study is to use auditory event-related potentials (AERPs) to compare CAP and cognitive functions in a population of PD patients with a group of age-matched control subjects. METHODS: AERPs in response to tonal and speech stimuli were recorded from 35 adults who had a medical diagnosis of PD (23 males and 12 females; mean age = 66.9 ± s.d.11.2 years), and 35 age-matched control subjects who did not have PD or any other neurological disorders (31 males and 4 females; mean age = 65.4 ± s.d.12.3 years). Auditory stimuli included pure tones (500 and 1000 Hz) to elicit the P300 response and a dichotic digits paradigm to elicit the N200 processing negativity. RESULTS: Compared to control subjects, PD patients exhibited significantly longer latencies of P300 and N200 components and smaller amplitude N200 components. Latency and amplitude of the N200 component were significantly correlated with participants' age. N200 amplitude was correlated with results from the Rey Auditory Verbal Learning Test (RAVLT) of cognitive ability. Latency of the P300 and amplitude of the N200 components were significantly correlated with results from the Spatial Release From Masking (SRM) behavioral CAP assessment. CONCLUSIONS: AERP assessments used in this study appear to be sensitive indicators of CAP and cognitive deficits exhibited by early-stage PD patients. While few significant differences in performance on behavioral CAP and cognitive tests were previously observed between this population of PD patients and age-matched control subjects, N200 and P300 components recorded in the present study revealed impaired neural processing by the PD group.

Síndrome del oído musical / Musical ear syndrome

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Hipoacusia unilateral: bases neurobiológicas de la ambliaudia / Unilateral hearing loss: neurobiological basis of amblyaudia

Resumen La hipoacusia unilateral es una alteración prevalente e importante en la población infantil que puede llevar a un deterioro del procesamiento auditivo. Cualquier patología que cause hipoacusia asimétrica (conductiva o sensorioneural) durante ventanas críticas del desarrollo cerebral, puede dar lugar a déficits del procesamiento auditivo que podrían persistir incluso después de la rehabilitación audiológica. Este proceso fisiopatológico se ha denominado "ambliaudia" y los niños que la presentan tienen un mayor riesgo de sufrir retraso en el desarrollo del lenguaje, así como de padecer dificultades académicas, sociales y cognitivas. Por esto, la ambliaudia se presenta como un desafío en audiología, siendo necesario comprender los mecanismos neurobiológicos que la subyacen. Entender de mejor manera cuáles son las consecuencias que tiene la pérdida auditiva asimétrica sobre el desarrollo del sistema nervioso podría ser clave para guiar de mejor forma las intervenciones terapéuticas. En este artículo se revisan trabajos en humanos y en modelos animales que describen las consecuencias neurobiológicas de la deprivación auditiva unilateral durante el desarrollo del sistema nervioso y su posible aplicación a la práctica clínica.

Abstract Unilateral hearing loss is a prevalent and important disorder in children that can lead to an impairment of auditory processing. Any pathology that causes asymmetric (conductive or sensorineural) hearing loss during critical brain development windows can lead to hearing deficits that may persist even after audiological rehabilitation. This pathophysiological process has been referred to as amblyaudia, and children are at greater risk of experiencing language developmental delays as well as academic, social and cognitive impairments. For this reason, amblyaudia presents itself as a challenge in audiology, and it has become necessary to understand its neurobiological mechanisms. A better understanding of the consequences of asymmetric hearing loss on the development of the nervous system may be key to better guiding therapeutic interventions. This article reviews studies performed in humans and animal models that describe the neurobiological consequences of unilateral hearing deprivation during the development of the nervous system and its possible applications to clinical practice.

[Congenital amusia and its effects on non-musical skills]. / Amusia congénita y sus efectos en habilidades no musicales.

INTRODUCTION: Congenital amusia is a specific condition in which the individual is unable to recognise tonal variations in a piece of musical. This cannot be explained by a previous brain injury, hearing loss, cognitive deficit, socio-affective disorder or lack of environmental stimulation. The current estimated prevalence is 1.5% of the world population, with a significant genetic component among those who suffer from it. It has been claimed that certain cognitive abilities in the emotional, spatial and language fields may be affected in people with amusia. AIM: To review the literature describing the effects on non-musical skills that may coexist in individuals with congenital amusia. DEVELOPMENT: Several neuroimaging studies have observed morphological and functional changes in the temporal lobe, as well as in the white matter connections between the superior temporal gyrus and the inferior frontal gyrus. From these affected regions, there may be a deficit in cognitive skills related to adjacent areas. CONCLUSIONS: Congenital amusia has been associated with poor performance in different non-musical cognitive skills, such as visuospatial processing, language processing, reading difficulties, face recognition and emotional aspects.

TITLE: Amusia congénita y sus efectos en habilidades no musicales.Introducción. La amusia congénita es una condición específica en la que el individuo afectado es incapaz de reconocer variaciones tonales en las piezas musicales. Esto no puede explicarse por una lesión encefálica previa, una pérdida auditiva, un déficit cognitivo, un trastorno socioafectivo o una falta de estimulación ambiental. Actualmente se estima una prevalencia del 1,5% de la población mundial, con un importante componente genético entre los afectados. Se ha descrito que en las personas con amusia puede haber afectación de ciertas habilidades cognitivas en el campo emocional, espacial y del lenguaje. Objetivo. Revisar la bibliografía donde se describen los efectos en las habilidades no musicales que pueden coexistir en individuos con amusia congénita. Desarrollo. Varios estudios de neuroimagen han permitido observar cambios morfológicos y funcionales en el lóbulo temporal, así como en las conexiones de la sustancia blanca entre el giro temporal superior y el giro frontal inferior. Partiendo de estas regiones afectadas, podría existir un déficit en habilidades cognitivas relacionadas con áreas adyacentes. Conclusiones. La amusia congénita se ha relacionado con un pobre desempeño en diferentes habilidades cognitivas no musicales, como el procesamiento visuoespacial, el procesamiento del lenguaje, alteraciones de la lectura, el reconocimiento de rostros y aspectos emocionales.

Paradoxical and labile medial olivocochlear functioning as a potential marker of auditory processing disorder in a child with learning disabilities.

INTRODUCTION: The medial olivocochlear system (MOCS) is composed of fibres projecting directly onto outer hair cells and plays a role in improving the signal-to-noise ratio. The MOCS can be evaluated by measuring suppression of the otoacoustic emissions evoked by contralateral acoustic stimulation. Dyslexic children present an increased probability of auditory processing disorder (APD). These children may present paradoxical MOCS dysfunction. CASE REPORT: We report the case of a dyslexic child with APD, who was severely disabled in a noisy environment. Audiometric tests were normal, and the central auditory assessment showed labile MOCS functioning that was not only ineffective, but also potentially deleterious, possibly accounting for this child's hearing impairment in a noisy environment. DISCUSSION: This case illustrates the importance of audiological assessment and objective investigation of MOCS function in children with a learning disability, especially with hearing difficulties in the presence of noise, in whom auditory training can be beneficial.

Comorbidity and cognitive overlap between developmental dyslexia and congenital amusia.

This study investigated whether there is a co-occurrence between developmental dyslexia and congenital amusia in adults. First, a database of online musical tests on 18,000 participants was analysed. Self-reported dyslexic participants performed significantly lower on melodic skills than matched controls, suggesting a possible link between reading and musical disorders. In order to test this relationship more directly, we evaluated 20 participants diagnosed with dyslexia, 16 participants diagnosed with amusia, and their matched controls, with a whole battery of literacy (reading, fluency, spelling), phonological (verbal working memory, phonological awareness) and musical tests (melody, rhythm and metre perception, incidental memory). Amusia was diagnosed in six (30%) dyslexic participants and reading difficulties were found in four (25%) amusic participants. Thus, the results point to a moderate comorbidity between amusia and dyslexia. Further research will be needed to determine what factors at the neural and/or cognitive levels are responsible for this co-occurrence.

The co-occurrence of pitch and rhythm disorders in congenital amusia.

The most studied form of congenital amusia is characterized by a difficulty with detecting pitch anomalies in melodies, also referred to as pitch deafness. Here, we tested for the presence of associated deficits in rhythm processing, beat in particular, in pitch deafness. In Experiment 1, participants performed beat perception and production tasks with musical excerpts of various genres. The results show a beat finding disorder in six of the ten assessed pitch-deaf participants. In order to remove a putative interference of pitch variations with beat extraction, the same participants were tested with percussive rhythms in Experiment 2 and showed a similar impairment. Furthermore, musical pitch and beat processing abilities were correlated. These new results highlight the tight connection between melody and rhythm in music processing that can nevertheless dissociate in some individuals.

The Relationship of Cardiometabolic Risk and Auditory Processing among African Americans: The Jackson Heart Study.

OBJECTIVES: There is limited research in population-based studies on auditory processing. The purpose of this work is to determine the prevalence of auditory processing impairment in the Jackson Heart Study cohort and to identify potential relationships with cardiometabolic risk factors. STUDY DESIGN: Cross-sectional study. SETTING: Jackson Heart Study in Jackson, Mississippi. SUBJECTS: Participants of an all-African American cardiovascular study cohort (n = 1314). METHODS: The Quick Speech-in-Noise and Dichotic Digits, Double Pairs tests were used to assess auditory processing. Logistic regression and multinomial logistic regression models were used to examine how participants' cardiometabolic risk factors and audiologic characteristics were associated with speech perception in noise and binaural integration. RESULTS: Quick Speech-in-Noise and Dichotic Digits, Double Pairs testing showed a prevalence of auditory processing impairment in 69% and 71% of the cohort, respectively, which was significantly related to age, hearing thresholds, sex, and education level. With covariate adjustment in statistical models for age, sex, pure tone average, and education level, waist circumference, systolic blood pressure, and hypertension were statistically predictive of auditory processing impairment ( P < .05). CONCLUSION: The results suggest a high prevalence of auditory processing deficits in the Jackson Heart Study cohort. In addition, cardiometabolic and audiologic factors show a statistically significant independent relationship with auditory impairment measures.

Auditory processing and neuropsychological profiles of children with functional hearing loss.

OBJECTIVES: This paper compares structured history, auditory processing abilities and neuropsychological findings of children with functional hearing loss (FHL) to those with suspected auditory processing disorder without FHL (control). The main aim was to evaluate the value of a holistic assessment protocol for FHL used in a routine pediatric audiology clinic. The protocol incorporated a commercially available test battery for auditory processing disorder (APD), non-verbal intelligence (NVIQ) and tools to screen for common co-existing neurodevelopmental conditions such as attention deficit hyperactivity disorder (ADHD), language impairment (LI) and developmental coordination disorder (DCD). The outcome of such holistic assessment was expected to help in understanding the nature of FHL and to provide individualized support to mitigate their difficulties. METHODS: This retrospective study compared two groups, 40 children (M = 17, F = 23) in each group between seven and sixteen years of age, one group with a history of FHL and the other with suspected APD without FHL (control). The groups were matched against age, gender, hand use, diagnosis of APD or non-APD (31 with APD and 9 without APD in each group) and non-verbal intelligence. All the children were healthy English speaking children attending mainstream schools with no middle or inner ear abnormalities. Structured history was obtained from parents regarding different nonacademic and academic concerns. The SCAN-3:C and SCAN-3:A test batteries were used to assess auditory processing abilities; Lucid Ability test for NVIQ; Children's Communication Checklist-2 (CCC-2) for language ability; Swanson Nolan and Pelham-IV Rating Scale (SNAP-IV) for ADHD; and the manual dexterity components of the Movement Assessment Battery for Children-2 (MABC-2) as a screening tool for DCD. RESULTS: About 60% of children in both the groups had concerns regarding listening in noisy background. In the history, poor attention was reported in 45% of children in the FHL group compared to 82.5% in the control group (p < 0.01). Hyperacusis was present in 35% of children in the FHL group and in 62% of children in the control group (p < 0.05). Concerns about overall academic abilities were present in 59% of children in the FHL group and 75% of the controls (p > 0.05). Only 15% of children in the FHL group had concerns with numeracy skills in contrast to 41% of the controls (p < 0.05). Significantly fewer (p < 0.01) children in the FHL group (41%) received additional support at school than the controls (75%). Fewer children performed poorly in Filtered Words (FW) test of the SCAN-3 batteries, 30% in the FHL group and 17.5% in the control group, in contrast to Auditory Figure Ground 0 (AFG0), 85% in FHL and 80% in the control group. The number of children performing poorly in AFG0 was significantly higher compared to all the other SCAN-3 tests in FHL (P < 0.05), in contrast to FW and Competing Sentences (CS) only in the control group (p < 0.05). The control group had higher prevalence of atypical ear advantage (AEA) in left directed Competing Words (CW) (32.5%) and Time Compressed Sentences (TCS) (32.5%) compared to FW (7.5%). In contrast, FHL group had higher prevalence of AEA in AFG0 (48.7%) compared to CS (21%). High proportions of children in both the groups had LI (80% in FHL and 82.5% in the control group), with significantly lower (p < 0.05) levels of ADHD symptoms in the FHL group (39.5%) compared to the control group (72.5%). Impaired manual dexterity was present in 30.7% of children in FHL group and 47.5% in the controls. CONCLUSIONS: The prevalences of APD and language impairment are high compared to ADHD symptoms in children with FHL, and holistic assessment is recommended. Despite some similarities in the auditory and neuropsychological profiles between children with FHL and those with suspected APD without FHL some differences were noted. The results suggest that children with FHL have genuine difficulties that need to be identified and addressed. Future research is required to identify the neural pathways which could explain the similarities and dissimilarities between the two groups.

Atypical auditory language processing in adolescents with autism spectrum disorder.

OBJECTIVE: Individuals with autism spectrum disorder (ASD) often show characteristic differences in auditory processing. To clarify the mechanisms underlying communication impairment in ASD, we examined auditory language processing with both anatomical and functional methods. METHODS: We assessed the language abilities of adolescents with ASD and typically developing (TD) adolescents, and analyzed the surface-based morphometric structure between the groups using magnetic resonance imaging. Furthermore, we measured cortical responses to an auditory word comprehension task with magnetoencephalography and performed network-based statistics using the phase locking values. RESULTS: We observed no structural differences between the groups. However, the volume of the left ventral central sulcus (vCS) showed a significant correlation with linguistic scores in ASD. Moreover, adolescents with ASD showed weaker cortical activation in the left vCS and superior temporal sulcus. Furthermore, these regions showed differential correlations with linguistic scores between the groups. Moreover, the ASD group had an atypical gamma band (25-40 Hz) network centered on the left vCS. CONCLUSIONS: Adolescents with ASD showed atypical responses on the auditory word comprehension task and functional brain differences. SIGNIFICANCE: Our results suggest that phonological processing and gamma band cortical activity play a critical role in auditory language processing-related pathophysiology in adolescents with ASD.

Assessment of cortical auditory evoked potentials in children with specific language impairment.

The proper course of speech development heavily influences the cognitive and personal development of children. It is a condition for achieving preschool and school successes - it facilitates socializing and expressing feelings and needs. Impairment of language and its development in children represents a major diagnostic and therapeutic challenge for physicians and therapists. Early diagnosis of coexisting deficits and starting the therapy influence the therapeutic success. One of the basic diagnostic tests for children suffering from specific language impairment (SLI) is audiometry, thus far referred to as a hearing test. Auditory processing is just as important as a proper hearing threshold. Therefore, diagnosis of central auditory disorder may be a valuable supplementation of diagnosis of language impairment. Early diagnosis and implementation of appropriate treatment may contribute to an effective language therapy.

Intelligibility of degraded speech and the relationship between symptoms of inattention, hyperactivity/impulsivity and language impairment in children with suspected auditory processing disorder.

OBJECTIVES: To compare the sensitivity and specificity of Auditory Figure Ground sub-tests of the SCAN-3 battery, using signal to noise ratio (SNR) of +8 dB (AFG+8) and 0 dB (AFG0), in identifying auditory processing disorder (APD). A secondary objective was to evaluate any difference in auditory processing (AP) between children with symptoms of inattention versus combined sub-types of Attention Deficit Hyperactivity Disorder (ADHD). METHODS: Data from 201 children, aged 6 to 16 years (mean: 10 years 6 months, SD: 2 years 8 months), who were assessed for suspected APD were reviewed retrospectively. The outcomes of the SCAN-3 APD test battery, Swanson Nolan and Pelham-IV parental rating (SNAP-IV) and Children's Communication Checklist-2 (CCC-2) were analysed. RESULTS: AFG0 had a sensitivity of 56.3% and specificity of 100% in identifying children performing poorly in at least two of six SCAN-3 sub-tests or one of the two questionnaires, in contrast to 42.1% and 80% respectively for AFG+8. Impaired AP was mostly associated with symptoms of ADHD and /or language impairment (LI). LI was present in 92.9% of children with ADHD symptoms. Children with symptoms of combined ADHD plus LI performed significantly poorly (p < 0.05) compared to inattention ADHD plus LI in Filtered Words (FW) sub-test, but not in the rest of the SCAN-3 sub-tests. CONCLUSION: Speech in noise tests using SNR of 0 dB is better than +8 dB in assessing APD. The better FW performance of the inattention ADHD plus LI group can be speculated to be related to known difference in activity in a neural network between different sub-types of ADHD. The findings of the study and existing literature suggest that neural networks connecting the cerebral hemispheres, basal ganglia and cerebellum are involved in APD, ADHD and LI.

Alteraciones del procesamiento preléxico en pacientes hispanohablantes con afasias sensoriales: evidencias neurolingüísticas / Prelexical processing alterations in hispanophone patients with sensitive aphasias: neurolinguistic evidences

La verificación empírica de modelos de conversión acústico-fonémica es una necesidad de la práctica de la neurolingüística en cualquier contexto para optimizar la explicación del patrón neurocognitivo de pacientes con alteraciones del procesamiento preléxico. Por tal razón, en esta investigación se caracterizan los procesos de conversión acústico-fonémica en pacientes hispanohablantes, con el objetivo de obtener y acumular evidencias empíricas que permitan verificar en esta población lingüística el modelo de procesamiento preléxico más aceptado actualmente. Para ello se realizó un estudio descriptivo-transversal, con la participación de 72 pacientes con afasia de comprensión pertenecientes a los Servicios de Logofoniatría de la ciudad de Santiago de Cuba, con edades de 20 a 65 años, y entre 60 y 180 días de recuperación del daño cerebral. Estos fueron sometidos al Test de discriminación fonológica, que es una adaptación local de la «Prueba de discriminación» del Test DIFO de Benedet y Cortés-del-Solar. Se obtuvo que las alteraciones del procesamiento de las características distintivas de los sonidos del habla se distinguen de las alteraciones de la integración perceptual de fonemas. En el primer caso, se registran fallos estables en la ejecución de tareas que implican el procesamiento de unos u otros rasgos distintivos de los sonidos consonánticos del habla, mientras se conserva el procesamiento de rasgos distintivos de los sonidos vocálicos, y viceversa. En el segundo caso, se observan fallos en el procesamiento, tanto de todos los rasgos distintivos de los sonidos consonánticos del habla, como de los rasgos distintivos de los sonidos vocálicos (AU)

The empirical verification of prelexical processing models is necessary for the neurolinguistic practices in any context for optimizing the explanations of neurocognitive model in aphasic patients with disorder in prelexical processing. For this reason, the present investigation shows the characterization of acoustic-phonemic conversion process in aphasic hispanophone patients. The study was executed with the purpose to accumulate and to obtain empirical evidences in this linguistic population, for the practical verification of the most accepted prelexical processing model. A descriptive-transversal study was conducted with the participation of 72 patients with sensitive aphasia, localized in the Phoniatry Services of Santiago de Cuba City, with ages between 20 and 65 years, and not more of 60 to 180 days of brain injury recovery period. The participants performed the Test de discriminación fonológica, that is a contextual adaptation of the task «Prueba de discriminación» of the Test DIFO of Benedet and Cortés-del-Solar. Results revealed that disorders in distinctive characteristics of speech sounds processing are different of phoneme perceptual integration disorders. In the first, affectation in the execution of tasks that implies the processing of some distinctive characteristics of consonant speech sounds was recorded, whereas the processing of other distinctive characteristics of vowel speech sounds are preserved. In the second affectation in the processing of all distinctive characteristics of speech sounds was observed (AU)

Auditory Processing in Children with Migraine: A Controlled Study.

Background This study aimed to investigate central auditory processing performance in children with migraine and compared with controls without headache. Methods Twenty-eight children of both sexes, aged between 8 and 12 years, diagnosed with migraine with and without aura, and a control group of the same age range and with no headache history, were included. Gaps-in-noise (GIN), duration pattern test (DPT), synthetic sentence identification (SSI) test, and nonverbal dichotic test (NVDT) were used to assess central auditory processing performance. Results Children with migraine performed significantly worse in DPT, SSI test, and NVDT when compared with controls without headache; however, no significant differences were found in the GIN test. Conclusions Children with migraine demonstrate impairment in the physiologic mechanism of temporal processing and selective auditory attention. In our short communication, migraine could be related to impaired central auditory processing in children.

Classifying song and speech: effects of focal temporal lesions and musical disorder.

Song and speech represent two auditory categories the brain usually classifies fairly easily. Functionally, this classification ability may depend to a great extent on characteristic features of pitch patterns present in song melody and speech prosody. Anatomically, the temporal lobe (TL) has been discussed as playing a prominent role in the processing of both. Here we tested individuals with congenital amusia and patients with unilateral left and right TL lesions in their ability to categorize song and speech. In a forced-choice paradigm, specifically designed auditory stimuli representing sung, spoken and "ambiguous" stimuli (being perceived as "halfway between" song and speech), had to be classified as either "song" or "speech". Congenital amusics and TL patients, contrary to controls, exhibited a surprising bias to classifying the ambiguous stimuli as "song" despite their apparent deficit to correctly process features typical for song. This response bias possibly reflects a strategy where, based on available context information (here: forced choice for either speech or song), classification of non-processable items may be achieved through elimination of processable classes. This speech-based strategy masks the pitch processing deficit in congenital amusics and TL lesion patients.

Pitch-Responsive Cortical Regions in Congenital Amusia.

Congenital amusia is a lifelong deficit in music perception thought to reflect an underlying impairment in the perception and memory of pitch. The neural basis of amusic impairments is actively debated. Some prior studies have suggested that amusia stems from impaired connectivity between auditory and frontal cortex. However, it remains possible that impairments in pitch coding within auditory cortex also contribute to the disorder, in part because prior studies have not measured responses from the cortical regions most implicated in pitch perception in normal individuals. We addressed this question by measuring fMRI responses in 11 subjects with amusia and 11 age- and education-matched controls to a stimulus contrast that reliably identifies pitch-responsive regions in normal individuals: harmonic tones versus frequency-matched noise. Our findings demonstrate that amusic individuals with a substantial pitch perception deficit exhibit clusters of pitch-responsive voxels that are comparable in extent, selectivity, and anatomical location to those of control participants. We discuss possible explanations for why amusics might be impaired at perceiving pitch relations despite exhibiting normal fMRI responses to pitch in their auditory cortex: (1) individual neurons within the pitch-responsive region might exhibit abnormal tuning or temporal coding not detectable with fMRI, (2) anatomical tracts that link pitch-responsive regions to other brain areas (e.g., frontal cortex) might be altered, and (3) cortical regions outside of pitch-responsive cortex might be abnormal. The ability to identify pitch-responsive regions in individual amusic subjects will make it possible to ask more precise questions about their role in amusia in future work.

Impaired short-term memory for pitch in congenital amusia.

Congenital amusia is a neuro-developmental disorder of music perception and production. The hypothesis is that the musical deficits arise from altered pitch processing, with impairments in pitch discrimination (i.e., pitch change detection, pitch direction discrimination and identification) and short-term memory. The present review article focuses on the deficit of short-term memory for pitch. Overall, the data discussed here suggest impairments at each level of processing in short-term memory tasks; starting with the encoding of the pitch information and the creation of the adequate memory trace, the retention of the pitch traces over time as well as the recollection and comparison of the stored information with newly incoming information. These impairments have been related to altered brain responses in a distributed fronto-temporal network, associated with decreased connectivity between these structures, as well as in abnormalities in the connectivity between the two auditory cortices. In contrast, amusic participants׳ short-term memory abilities for verbal material are preserved. These findings show that short-term memory deficits in congenital amusia are specific to pitch, suggesting a pitch-memory system that is, at least partly, separated from verbal memory. This article is part of a Special Issue entitled SI: Auditory working memory.