Longitudinal observations of the effects of ischemic stroke on binaural perception.

Acute ischemic stroke, characterized by a localized reduction in blood flow to specific areas of the brain, has been shown to affect binaural auditory perception. In a previous study conducted during the acute phase of ischemic stroke, two tasks of binaural hearing were performed: binaural tone-in-noise detection, and lateralization of stimuli with interaural time- or level differences. Various lesion-specific, as well as individual, differences in binaural performance between patients in the acute phase of stroke and a control group were demonstrated. For the current study, we re-invited the same group of patients, whereupon a subgroup repeated the experiments during the subacute and chronic phases of stroke. Similar to the initial study, this subgroup consisted of patients with lesions in different locations, including cortical and subcortical areas. At the group level, the results from the tone-in-noise detection experiment remained consistent across the three measurement phases, as did the number of deviations from normal performance in the lateralization task. However, the performance in the lateralization task exhibited variations over time among individual patients. Some patients demonstrated improvements in their lateralization abilities, indicating recovery, whereas others' lateralization performance deteriorated during the later stages of stroke. Notably, our analyses did not reveal consistent patterns for patients with similar lesion locations. These findings suggest that recovery processes are more individual than the acute effects of stroke on binaural perception. Individual impairments in binaural hearing abilities after the acute phase of ischemic stroke have been demonstrated and should therefore also be targeted in rehabilitation programs.

Corrigendum: Effects of acute ischemic stroke on binaural perception.

[This corrects the article DOI: 10.3389/fnins.2022.1022354.].

Effects of acute ischemic stroke on binaural perception.

Stroke-induced lesions at different locations in the brain can affect various aspects of binaural hearing, including spatial perception. Previous studies found impairments in binaural hearing, especially in patients with temporal lobe tumors or lesions, but also resulting from lesions all along the auditory pathway from brainstem nuclei up to the auditory cortex. Currently, structural magnetic resonance imaging (MRI) is used in the clinical treatment routine of stroke patients. In combination with structural imaging, an analysis of binaural hearing enables a better understanding of hearing-related signaling pathways and of clinical disorders of binaural processing after a stroke. However, little data are currently available on binaural hearing in stroke patients, particularly for the acute phase of stroke. Here, we sought to address this gap in an exploratory study of patients in the acute phase of ischemic stroke. We conducted psychoacoustic measurements using two tasks of binaural hearing: binaural tone-in-noise detection, and lateralization of stimuli with interaural time- or level differences. The location of the stroke lesion was established by previously acquired MRI data. An additional general assessment included three-frequency audiometry, cognitive assessments, and depression screening. Fifty-five patients participated in the experiments, on average 5 days after their stroke onset. Patients whose lesions were in different locations were tested, including lesions in brainstem areas, basal ganglia, thalamus, temporal lobe, and other cortical and subcortical areas. Lateralization impairments were found in most patients with lesions within the auditory pathway. Lesioned areas at brainstem levels led to distortions of lateralization in both hemifields, thalamus lesions were correlated with a shift of the whole auditory space, whereas some cortical lesions predominantly affected the lateralization of stimuli contralateral to the lesion and resulted in more variable responses. Lateralization performance was also found to be affected by lesions of the right, but not the left, basal ganglia, as well as by lesions in non-auditory cortical areas. In general, altered lateralization was common in the stroke group. In contrast, deficits in tone-in-noise detection were relatively scarce in our sample of lesion patients, although a significant number of patients with multiple lesion sites were not able to complete the task.

Cortical Processing of Binaural Cues as Shown by EEG Responses to Random-Chord Stereograms.

Spatial hearing facilitates the perceptual organization of complex soundscapes into accurate mental representations of sound sources in the environment. Yet, the role of binaural cues in auditory scene analysis (ASA) has received relatively little attention in recent neuroscientific studies employing novel, spectro-temporally complex stimuli. This may be because a stimulation paradigm that provides binaurally derived grouping cues of sufficient spectro-temporal complexity has not yet been established for neuroscientific ASA experiments. Random-chord stereograms (RCS) are a class of auditory stimuli that exploit spectro-temporal variations in the interaural envelope correlation of noise-like sounds with interaurally coherent fine structure; they evoke salient auditory percepts that emerge only under binaural listening. Here, our aim was to assess the usability of the RCS paradigm for indexing binaural processing in the human brain. To this end, we recorded EEG responses to RCS stimuli from 12 normal-hearing subjects. The stimuli consisted of an initial 3-s noise segment with interaurally uncorrelated envelopes, followed by another 3-s segment, where envelope correlation was modulated periodically according to the RCS paradigm. Modulations were applied either across the entire stimulus bandwidth (wideband stimuli) or in temporally shifting frequency bands (ripple stimulus). Event-related potentials and inter-trial phase coherence analyses of the EEG responses showed that the introduction of the 3- or 5-Hz wideband modulations produced a prominent change-onset complex and ongoing synchronized responses to the RCS modulations. In contrast, the ripple stimulus elicited a change-onset response but no response to ongoing RCS modulation. Frequency-domain analyses revealed increased spectral power at the fundamental frequency and the first harmonic of wideband RCS modulations. RCS stimulation yields robust EEG measures of binaurally driven auditory reorganization and has potential to provide a flexible stimulation paradigm suitable for isolating binaural effects in ASA experiments.

Resolving front-back ambiguity with head rotation: The role of level dynamics.

Making small head movements facilitates spatial hearing by resolving front-back confusions, otherwise common in free field sound source localization. The changes in interaural time difference (ITD) in response to head rotation provide a robust front-back cue, but whether interaural level difference (ILD) can be used as a dynamic cue is not clear. Therefore, the purpose of the present study was to assess the usefulness of dynamic ILD as a localization cue. The results show that human listeners were capable of correctly indicating the front-back dimension of high-frequency sinusoids based on level dynamics in free field conditions, but only if a wide movement range was allowed (±40∘). When the free field conditions were replaced by simplistic headphone stimulation, front-back responses were in agreement with the simulated source directions even with relatively small movement ranges (±5∘), whenever monaural sound level and ILD changed monotonically in response to head rotation. In conclusion, human listeners can use level dynamics as a front-back localization cue when the dynamics are monotonic. However, in free field conditions and particularly for narrowband target signals, this is often not the case. Therefore, the primary limiting factor in the use of dynamic level cues resides in the acoustic domain behavior of the cue itself, rather than in potential processing limitations or strategies of the human auditory system.