Sinusoidal amplitude modulation alters contralateral noise suppression of evoked otoacoustic emissions in humans.

It is well established that low-level broad band noise can elicit an amplitude decrease in evoked otoacoustic emissions recorded in the opposite ear. However, the influence of the temporal characteristics of the contralateral stimulus on this effect remains largely unknown. In the present study, otoacoustic emissions evoked by 60 dB SPL clicks were recorded in 19 normal-hearing subjects using the Otodynamics IL088, successively in absence and presence of a contralateral noise that was either steady or modulated sinusoidally in amplitude at different depths (from 25% to 100% in 25 point steps) and rates (from 50 Hz to 800 Hz in half-octave steps). The energy was kept constant whatever the modulation depth. The results showed that the evoked otoacoustic-emission attenuation effect induced by contralateral stimulation varied depending on the modulation depth and frequency of the contralateral amplitude-modulated noise. The largest suppression effect was observed at the 100 Hz modulation frequency and the 100% modulation depth. The 50 Hz modulation resulted in less suppression than with unmodulated noise. An interpretation of these results in terms of the influence of temporal amplitude fluctuations falling within a certain range on medial olivocochlear bundle activity is discussed.

Contralateral frequency-modulated tones suppress transient-evoked otoacoustic emissions in humans.

In order to test the sensitivity of the human medial olivocochlear bundle (MOCB) to stimulus frequency fluctuations, changes in transient-evoked otoacoustic emission (TEOAE) amplitude induced by frequency modulated (FM) tones were measured in 18 normal-hearing subjects. The results revealed that TEOAE amplitude was reduced by contralateral FM tones at 40 dB above pure-tone threshold, with significant influences of both modulation rate (MR) and modulation depth (MD). This finding is discussed in the light of other recent results indicating amplitude fluctuation and frequency bandwidth effects in MOCB activation in humans.

Medial olivocochlear system stabilizes active cochlear micromechanical properties in humans.

To investigate the involvement of the medial olivocochlear system (MOCS) in outer hair cell (OHC) motility stabilization, evoked otoacoustic emissions (EOAEs) were recorded in 20 normal-hearing subjects and in eight vestibular-neurotomized subjects, successively in the presence and absence of low-intensity contralateral acoustic stimulation. Intrasubject EOAE amplitude variability was assessed as the standard deviation computed over several successive recordings. In normal-hearing subjects, a significantly lower EOAE amplitude variability with contralateral acoustic stimulation (CAS) was observed in subjects in whom the CAS induced the greatest EOAE amplitude reduction. This result could not be attributed to the EOAE amplitude reduction itself, since variability was otherwise found to increase when EOAE amplitude decreased. Moreover, statistically significant correlations between EOAE amplitude attenuation and EOAE amplitude variability under CAS were observed. In the eight subjects operated for vestibular neurotomy, no such effect was found. Being sectioned in vestibular-neurotomized subjects, the MOCS can no longer exert its effects. These results strongly support the notion that MOCS activity, as induced by CAS, elicits a reduction in EOAE amplitude variability in normal-hearing subjects. This finding and some of its possible implications for understanding the role of the MOCS in hearing in humans are discussed.

Activation of medial olivocochlear efferent system in humans: influence of stimulus bandwidth.

The activity of the medial olivocochlear bundle (MOCB) can be studied in humans through variations in the level of evoked otoacoustic emissions (EOAEs) elicited by contralateral acoustic stimuli (CAS). The present study sought to investigate how the activity of the MOC system at a given frequency, as measured through the contralateral suppression of tone-pip EOAEs, depends on the bandwidth of the contralateral stimulus. EOAEs were recorded in 155 normal-hearing subjects, successively with and without contralateral stimuli whose bandwidth, center frequency and level were systematically varied. We showed a clear dependence of contralateral EOAE suppression on bandwidth demonstrating increased suppression with increased bandwidth over about two octaves around the center frequency of the noise. This effect was obtained irrespective of whether contralateral noise energy was kept constant independently of bandwidth or not, which indicates a role of bandwidth per se in contralateral EOAE suppression. Results are interpreted in terms of a simple model of MOCB activation mechanisms including peripheral bandpass filtering, within-channel compression and across-channel spatial summation by the afferent paths. Complementary experiments suggested a greater effectiveness of increases in bandwidth on the upper than on the lower side and of frequency components akin to or remote from the test frequency than of intermediate bands. Finally, these results were complemented by detailed spectrum analyses of the EOAE level variations induced by the different noises, which revealed that whilst noise components close to or remote from the center frequency generally attenuated EOAE level, intermediate components could in some cases lead to a relative increase in EOAE level. These results can further be explained by assuming different positive and negative weights on the inputs to the spatial summation process depending on their position relative to the center frequency.

Type of initial brainstem auditory evoked potentials (BAEP) impairment and risk factors in premature infants.

Brainstem auditory evoked potentials (BAEPs) were recorded in 89 premature infants aged between 34 and 52 weeks. 47.2% had normal and 52.8% abnormal BAEPs in at least one ear. Seven risk factors were taken into account: birth weight lower than 1500 g, hypoxia, neurological damage, fetal pathology, associated malformation, the use of ototoxic drugs, and exchange transfusion. The type of BAEP impairment was defined as either endocochlear, transmission or retrocochlear damage. Percentage BAEP impairment was higher in case of hypoxia (63.3%) but remained similar whether the other risk factors were present or absent. Transmission impairment was more frequent in case of birth weight lower than 1500 g, hypoxia or ototoxic drug administration; Endocochlear damage occurred more frequently when ototoxic drugs had been used or exchange transfusion performed. When birth weight was lower than 1500 g, transmission damage was more frequent than when birth weight was higher than 1500 g. In contrast, endocochlear damage was more frequent when birth weight was higher than compared with lower than 1500 g. In male infants, BAEP impairment was more frequent and more often of retrocochlear type than in female infants. BAEP impairment was more frequently of endocochlear type in female compared to male infants. Among the 89 premature infants recorded, 11.2% has endocochlear damage corresponding to potentially handicapping hearing loss. These results are discussed with reference to the literature.

Comprehension of language in congenitally deaf children with and without cochlear implants.

The consequences of profound early deafness on oral language in children are drastic. The modern cochlear implant (CI) has been shown to enhance speech production skills in prelingually deaf children. Many factors may contribute to a poor or an excellent outcome, making it difficult to compare groups of children wearing or not wearing cochlear implants. The present study compared receptive language levels in matched pairs of children from CI group and non-CI groups. The pre-op receptive language development curve suggest a possible growth over time with the maturation and the speech therapy. Comparison showed that the slope for post-op CI children to be greater than for non-CI children, and that this difference is statistically significant, and that the slope for CI children to be greater post- than pre-operatively. The main conclusion is that receptive language scores grow significantly higher over time after surgery in CI than in pair-matched non-CI children, despite better initial pure tone audiometric thresholds of the latter.

[Are we sectioning the cochlear efferent system during vestibular neurotomy?]. / Sectionne-t-on le système efférent cochléaire au cours de la neurotomie vestibulaire?

INTRODUCTION: In addition to sensory neurons which transmit information from the inner ear to the brain, there is a system of efferent feedback fibers, called the olivocochlear system, carrying signals from the brain to the ear. Over the past half-century, the efferent system has been extensively studied in animals and results provided theories as to the functional significance of these efferents: to improve signal-to-noise ratio in the auditory periphery, to mediate selective attention, and to protect the inner ear from acoustic overexposure. The results of several studies conducted in man rely on the study of patients who have undergone a vestibular neurectomy. Indeed, anatomical data show that olivocochlear efferents could travel along or inside the vestibular part of the auditory nerve before reaching the organ of Corti. Therefore, these patients may be considered as an experimental model of unilaterally de-efferented subjects. However, to date, none has reported the existence of olivocohlear efferents in the vestibular section following neurectomy. MATERIALS AND RESULTS: In this study, we present the histological results from 18 vestibular sections and show the absence of olivocochlear efferents. CONCLUSION: These results provide a reason to reconsider the results of previous experiments conducted in similar patients and ask for further studies on the olivocochlear efferents pathways.

[Language comprehension by children with profound congenital deafness after cochlear implant]. / Compréhension du langage par les enfants sourds profonds congénitaux au moyen de l'implant cochléaire.

The consequences of profound deafness on oral language development in children are drastic and well-known. Modern multichannel cochlear implant (CI) has been proven to enhance speech production skills in prelingually deaf children. Speech production skills, however, are known not to be a reliable reflection of oral language competence as a whole. Language is an acquired common code in a specific group, enabling exchange of ideas, feelings and knowledge. In humans, speech is one of the channels conveying language. Assessing language development in CI children is more difficult than simply assessing speech production skills. Many factors may contribute to a poor or an excellent outcome, making it difficult to compare groups of children wearing or not wearing CI. The present study compared receptive language levels in paired matched children from CI and non-CI groups. The main conclusion of this study is that language comprehension scores grow significantly higher over time post-surgery in CI than in paired-matched non-CI children, despite better initial pure tone audiometric thresholds of the latter.

Medial olivocochlear efferent system in humans studied with amplitude-modulated tones.

Evoked otoacoustic emissions (EOAEs) are assumed to be generated by outer hair cells (OHCs). It is now generally accepted that EOAEs represent a means of functional exploration of the active micromechanical properties of OHCs. Efferent fibers of the medial olivocochlear system (MOCS) are connected along the sides and the bases of OHCs. Some studies have shown that a suppression effect on EOAE amplitude is induced by the MOCS neurons during contralateral stimulation, presumably by modification of OHC motility. The contralateral acoustic stimuli used in experiments on the EOAE suppression effect have consisted mainly of sounds without a slow temporal fluctuation in their envelopes (broad-band noise, narrow-band noise, pure tones, or clicks). To elucidate further the parameters of MOCS activation, in the present study we looked at the contralateral suppression effect of amplitude-modulated (AM) tones. The results showed that EOAE amplitude was reduced with AM tones compared with no contralateral acoustic stimulation. The suppression effect mainly depended on three parameters. 1) Contralateral stimulation intensity: EOAE suppression occurred only with intensities > or = 40 dB SL. 2) The greater the modulation depth, the greater the suppression effect: statistical analysis showed a significant effect for 75 and 100% modulation depth. 3) The 100- and 140-Hz modulation frequencies gave the greatest suppression effect for 100 and 75% modulation depths. The suppression effect was frequency specific. The greatest decreases were observed when the carrier frequency of the contralateral AM tone was close to the frequency of the EOAE under study, i.e., 1 and 2 kHz. Acoustic cross talk and middle ear effects, which cannot be completely excluded, are discussed. However, the demonstrated frequency specificity of the EOAE suppression effect, together with observed presence of contralateral EOAE suppression in patients without stapedial reflex and the very weak intensities used (i.e., below acoustic reflex threshold), suggested that it was unlikely that the observed effects were due merely to middle ear reflexes. Our results confirm further the contralateral suppression effect on human cochlea mechanisms and show that the suppression effect can be influenced by amplitude modulations of the suppressor, characteristic of sounds in the environment.

Predicting vulnerability to acoustic injury with a noninvasive assay of olivocochlear reflex strength.

Permanent noise-induced damage to the inner ear is a major cause of hearing impairment, arising from exposures occurring during both work- and pleasure-related activities. Vulnerability to noise-induced hearing loss is highly variable: some have tough, whereas others have tender ears. This report documents, in an animal model, the efficacy of a simple nontraumatic assay of normal ear function in predicting vulnerability to acoustic injury. The assay measures the strength of a sound-evoked neuronal feedback pathway to the inner ear, the olivocochlear efferents, by examining otoacoustic emissions created by the normal ear, which can be measured with a microphone in the external ear. Reflex strength was inversely correlated with the degree of hearing loss after subsequent noise exposure. These data suggest that one function of the olivocochlear efferent system is to protect the ear from acoustic injury. This assay, or a simple modification of it, could be applied to human populations to screen for individuals most at risk in noisy environments.

Influence of focused auditory attention on cochlear activity in humans.

The mammalian auditory system contains descending pathways that originate in the cortex and relay at various intermediate levels before reaching the peripheral sensory organ of Corti. The last link in this chain consists of the olivocochlear bundle. The activity of this bundle can be measured through otoacoustic emissions, which are acoustic signatures of the cochlear biomechanical activity. In the present study, it was hypothesized that frequency-specific activation of the olivocochlear bundle in the contralateral ear would show up as frequency-specific variations in otoacoustic emission amplitude in the ipsilateral ear. Two groups of young adult subjects participated in this experiment. Evoked otoacoustic emissions were recorded in the ipsilateral ear at two test frequencies (1 and 2 kHz). Subjects had to detect probe tones at a given frequency in background noise in the contralateral ear. Larger efferent activation was measured at test frequencies on which attention is focused. This result provides evidence for an influence of attention on the auditory periphery via descending projections.

The medial olivocochlear efferent system in humans: structure and function.

The mammalian cochlea receives innervation from the central nervous system via two efferent systems: the lateral and the medial olivocochlear bundles. Advances in cochlear physiology have clarified the origins and terminations of these fibers. However, to date, while the functional significance of lateral efferents remains totally unknown, that of medial efferents is still controversial. The peripheral effects of medial olivocochlear system activation have been described, but the role of this inhibitory feedback onto the cochlea is still unclear. This overview summarizes the main results of several psychophysiological studies performed in humans dealing with the functional significance of medial olivocochlear efferents in hearing.

Clinical interest of brainstem auditory evoked potentials in 72 children with inadequate language development.

The present study is of brainstem auditory evoked potentials (BAEP) in 72 children, of 2 to 13 years of age, showing inadequate language development. The age of the children was mainly below the age of 4 (39 cases = 54%), peaking between 3 and 4 years of age (33 cases = 46%). Even so, 82% of our patients were 3 years old or over: 64% were boys, 36% girls, the proportion of boys falling off with age 26% (19 cases) of BAEPs recorded were normal, 74% (53 cases) pathological. High prevalence of undiagnosed hearing loss was found. Physiopathological BAEP classification showed endocochlear impairment in 68% (36 cases), conductive impairment in 21% (11 cases) and retrocochlear impairment in 11% (6 cases) of subjects. Unilateral impairment (20 cases = 28%) cannot account for inadequate language development; but, in the 8 cases (11%) of total bilateral hearing loss, and the 15 cases (21%) of partial bilateral impairment, hearing loss more or equal to 50 dB HL, impaired hearing would play a role in the retardation.

Contralateral suppression of transiently evoked otoacoustic emissions by harmonic complex tones in humans.

Variations in the amplitude of transiently evoked otoacoustic emissions (TEOAEs) produced by a contralateral complex tone were measured in 26 normal-hearing human subjects. TEOAEs were evoked using a 1-kHz tone pip at 60 dB SPL. The contralateral complex consisted of harmonic components with frequencies between 400 and 2000 Hz; it was presented at levels ranging from 40 to 50 dB SL and its fundamental frequency (F0) was varied. In experiment 1, the dependence of TEOAE amplitude variations on the F0 of the contralateral complex was measured by varying the F0 from 50 to 400 Hz in octave steps. The results revealed a nonmonotonic dependence of TEOAE amplitude variations on contralateral F0, with significantly larger TEOAE suppression for F0's of 100 and 200 Hz than for F0's of 50 and 400 Hz. Experiment 2, in which the harmonics were summed in alternating sine-cosine phase instead of constant sine phase, showed a shift of the function relating TEOAE attenuation to F0 towards lower F0's, indicating that the waveform repetition rate, rather than harmonic spacing, was the actual factor of the dependence of contralateral TEOAE attenuation on F0. Furthermore, significantly smaller suppression was observed with the alternating-phase complexes than with the sine-phase complexes, suggesting an influence of the waveform crest factor. Experiment 3 showed no difference between the contralateral TEOAE attenuation effects produced by positive and negative Schroeder-phase complexes. Overall, these results bring further arguments for the notion that contralaterally induced medial olivocochlear bundle (MOCB) activity, as measured through the contralateral suppression of TEOAEs in humans, is sensitive to the rate of temporal envelope fluctuations of the contralateral stimulus, with preferential rates around 100-200 Hz.

Delay and temporal integration in medial olivocochlear bundle activation in humans.

OBJECTIVE: Contralateral suppression of the transient-evoked otoacoustic emissions (TEOAEs) provides a means of studying auditory efferent function, but the temporal dynamics of the reflex are not fully understood. The most fundamental parameter is the time-course of activation of contralateral suppression. The stimulus parameters are likely to be important; this may include temporal dynamics of the suppressor itself. This investigation thus was devoted to the further study of 1) delay of contralateral suppression of TEOAEs-effect of delay of the ipsilateral probe-and 2) temporal variation of the suppressor-effect of amplitude modulation of the contralateral noise stimulus. DESIGN: Measurements were made in three samples of normal-hearing subjects (N(total) = 71), employing well-established methods of TEOAE assessment. RESULTS: Statistically significant contralateral suppression occurred some 60 msec after onset of the contralateral noise; thereafter, the effect was essentially constant (i.e., to >180 msec). The results for click delays less than 60 msec, nevertheless, were systematic and readily fitted by a sloping straight line (dB suppression versus time) reminiscent of the concept of threshold power integration. The onset of suppression may thus be characterized by a time constant. The delay of suppression also was found to be reduced by contralateral amplitude-modulated noise. CONCLUSIONS: These findings reinforce a growing consensus in the literature that, despite initiation perhaps some milliseconds after onset of the contralateral stimulus, there is a substantial delay, i.e., in the tens of milliseconds, before maximal suppression is achieved. The exact time constant of this effect appears to depend upon the combination of probe and suppressor levels, including the temporality of the suppressor. These factors are likely to delimit the role/influence of this reflex in real-world function, favoring perhaps more-or-less sustained suppression that is activated in a time-varying sound environment.

Tones disappear faster in the right ear than in the left.

In order to gain further information on the characteristics and physiological correlates of tone decay in humans, the tone decay test was administered to 58 normal-hearing subjects, successively in the left and right ears and in absence and presence of a contralateral noise. The results revealed that tone decay was greater in the right than in the left ear and was increased by contralateral noise. The contralateral effect of this noise on cochlear biomechanisms was then estimated by measuring contralaterally induced variations in the amplitude of click-evoked otoacoustic emissions in the same subjects. In the right ear, the increase in tone decay and the decrease in otoacoustic emission amplitude--both induced by contralateral noise--were positively correlated (r = .315, p = .016). Furthermore, the contralateral changes in otoacoustic emission amplitude were found to be on average larger in the right than in the left ear, this asymmetry being correlated with that observed for the tone decay. These findings are discussed in relation to previous results on simple and induced loudness adaptation in the vicinity of threshold, on contralateral attenuation of otoacoustic emissions and on the influence of the auditory efferents on cochlear biomechanisms.