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Ferre, Jeanane M., and Fotini M. Wickman. "Case Studies in Effective Treatment of Central Auditory Processing Disorders." Perspectives on Audiology 4, no. 1 (August 2008): 15–20. http://dx.doi.org/10.1044/poa4.1.15.
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Abstract The behavioral characteristics of central auditory processing disorder (CAPD) are similar to those of other neurocognitive and communicative disorders. Differential diagnosis is used to “tease out” the auditory specific deficit. Differential intervention combines specific management strategies with specific rehabilitative procedures to minimize the impact of the CAPD and improve skills. A compelling body of research supports the use of specific types of therapeutic rehabilitation for listeners with CAPD; however, additional research is needed regarding treatment outcomes for specific auditory deficits. Single-subject case studies can provide evidence of treatment effectiveness in a clinical setting. This paper presents two cases that provide evidence that the inclusion of deficit specific auditory treatment into the overall intervention plan of students with specific central auditory processing disorder can reduce the deficit and minimize its impact in a relatively short period of time.
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Iliadou, Vasiliki Vivian, Gail D. Chermak, and Doris-Eva Bamiou. "Differential Diagnosis of Speech Sound Disorder (Phonological Disorder): Audiological Assessment beyond the Pure-tone Audiogram." Journal of the American Academy of Audiology 26, no. 04 (April 2015): 423–35. http://dx.doi.org/10.3766/jaaa.26.4.9.
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Background: According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, diagnosis of speech sound disorder (SSD) requires a determination that it is not the result of other congenital or acquired conditions, including hearing loss or neurological conditions that may present with similar symptomatology. Purpose: To examine peripheral and central auditory function for the purpose of determining whether a peripheral or central auditory disorder was an underlying factor or contributed to the child’s SSD. Research Design: Central auditory processing disorder clinic pediatric case reports. Study Sample: Three clinical cases are reviewed of children with diagnosed SSD who were referred for audiological evaluation by their speech–language pathologists as a result of slower than expected progress in therapy. Results: Audiological testing revealed auditory deficits involving peripheral auditory function or the central auditory nervous system. These cases demonstrate the importance of increasing awareness among professionals of the need to fully evaluate the auditory system to identify auditory deficits that could contribute to a patient’s speech sound (phonological) disorder. Conclusions: Audiological assessment in cases of suspected SSD should not be limited to pure-tone audiometry given its limitations in revealing the full range of peripheral and central auditory deficits, deficits which can compromise treatment of SSD.
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Elias, Karla M. I. Freiria, Carolina Camargo Oliveira, Marina Junqueira Airoldi, Katia Maria D. Franco, Sônia das Dores Rodrigues, Sylvia Maria Ciasca, and Maria Valeriana L. Moura-Ribeiro. "Central auditory processing outcome after stroke in children." Arquivos de Neuro-Psiquiatria 72, no. 9 (September 2014): 680–86. http://dx.doi.org/10.1590/0004-282x20140107.
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Objective To investigate central auditory processing in children with unilateral stroke and to verify whether the hemisphere affected by the lesion influenced auditory competence. Method 23 children (13 male) between 7 and 16 years old were evaluated through speech-in-noise tests (auditory closure); dichotic digit test and staggered spondaic word test (selective attention); pitch pattern and duration pattern sequence tests (temporal processing) and their results were compared with control children. Auditory competence was established according to the performance in auditory analysis ability. Results Was verified similar performance between groups in auditory closure ability and pronounced deficits in selective attention and temporal processing abilities. Most children with stroke showed an impaired auditory ability in a moderate degree. Conclusion Children with stroke showed deficits in auditory processing and the degree of impairment was not related to the hemisphere affected by the lesion.
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Ludwig, Alexandra Annemarie, Michael Fuchs, Eberhard Kruse, Brigitte Uhlig, Sonja Annette Kotz, and Rudolf Rübsamen. "Auditory Processing Disorders with and without Central Auditory Discrimination Deficits." Journal of the Association for Research in Otolaryngology 15, no. 3 (March 22, 2014): 441–64. http://dx.doi.org/10.1007/s10162-014-0450-3.
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Felipe, Lilian. "Central Auditory Processing Deficits in the Elderly." American Journal of Biomedical Science & Research 3, no. 2 (May 28, 2019): 153–54. http://dx.doi.org/10.34297/ajbsr.2019.03.000654.
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Musiek, Frank E., Lori Charette, Diantha Morse, and Jane A. Baran. "Central Deafness Associated with a Midbrain Lesion." Journal of the American Academy of Audiology 15, no. 02 (February 2004): 133–51. http://dx.doi.org/10.3766/jaaa.15.2.4.
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Central deafness has been linked historically to bihemispheric involvement of the temporal lobe, with more recent findings suggesting that compromise of other cortical and subcortical structures can also result in this disorder. The present investigation extends our understanding of the potential anatomical correlates to central deafness by demonstrating that bilateral involvement of an auditory structure within the midbrain can additionally result in this condition. Our subject was a 21-year-old male with a subarachnoid bleed affecting both inferior colliculi. Significant auditory deficits were noted for the middle and late auditory evoked potentials, while electrophysiologic measures of the periphery indicated normal function. The patient was enrolled in a rehabilitation program for approximately 14 weeks. Although initially unresponsive to sounds, the patient regained most of his auditory abilities during the 10 months he was followed. This case documents the range of auditory deficits that may be associated with damage to the inferior colliculi, and it profiles a hierarchical recovery of auditory function consistent with test findings.
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Baran, Jane A., Richard W. Bothfeld, and Frank E. Musiek. "Central Auditory Deficits Associated with Compromise of the Primary Auditory Cortex." Journal of the American Academy of Audiology 15, no. 02 (February 2004): 106–16. http://dx.doi.org/10.3766/jaaa.15.2.2.
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The subject of this study was a 46-year-old female who had suffered a cerebrovascular accident (CVA). Magnetic resonance imaging revealed damage in the area of the distribution of the middle cerebral artery involving most, if not all, of the primary auditory area of the left hemisphere. No auditory problems were noted prior to the CVA; however, following the CVA, the subject reported a number of auditory difficulties. Pure-tone thresholds were normal post-CVA, and performance on speech recognition testing was good in both ears if ample time was provided between a response and the presentation of the next test item. Duration pattern, intensity discrimination, and middle latency response test results were abnormal for both ears, and right ear deficits were evident on an auditory fusion test and two dichotic speech tests (digits and rhymes). This case is significant in that it demonstrates a good correlation between damage to known key auditory regions and central auditory test results.
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Tepe, Victoria, Melissa Papesh, Shoshannah Russell, M. Samantha Lewis, Nina Pryor, and Lisa Guillory. "Acquired Central Auditory Processing Disorder in Service Members and Veterans." Journal of Speech, Language, and Hearing Research 63, no. 3 (March 23, 2020): 834–57. http://dx.doi.org/10.1044/2019_jslhr-19-00293.
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Purpose A growing body of evidence suggests that military service members and military veterans are at risk for deficits in central auditory processing. Risk factors include exposure to blast, neurotrauma, hazardous noise, and ototoxicants. We overview these risk factors and comorbidities, address implications for clinical assessment and care of central auditory processing deficits in service members and veterans, and specify knowledge gaps that warrant research. Method We reviewed the literature to identify studies of risk factors, assessment, and care of central auditory processing deficits in service members and veterans. We also assessed the current state of the science for knowledge gaps that warrant additional study. This literature review describes key findings relating to military risk factors and clinical considerations for the assessment and care of those exposed. Conclusions Central auditory processing deficits are associated with exposure to known military risk factors. Research is needed to characterize mechanisms, sources of variance, and differential diagnosis in this population. Existing best practices do not explicitly consider confounds faced by military personnel. Assessment and rehabilitation strategies that account for these challenges are needed. Finally, investment is critical to ensure that Veterans Affairs and Department of Defense clinical staff are informed, trained, and equipped to implement effective patient care. Infographic https://doi.org/10.23641/asha.12071232
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Musiek, Frank E., Jane A. Baran, and Jennifer Shinn. "Assessment and Remediation of an Auditory Processing Disorder Associated with Head Trauma." Journal of the American Academy of Audiology 15, no. 02 (February 2004): 117–32. http://dx.doi.org/10.3766/jaaa.15.2.3.
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This case study involves a 41-year-old female who had sustained a mild traumatic brain injury during a horseback riding accident. The patient was seen for medical and neuropsychological testing following this incident and was referred to a speech-language pathologist for rehabilitative services. At 13 months posttrauma, the patient, who was frustrated by a lack of significant progress, requested an audiologic work-up. Results of testing conducted at this time revealed normal peripheral hearing and significant central auditory deficits. Based on these findings, an auditory rehabilitation program was developed and implemented. The components of this patient's rehabilitation program are reviewed, and the posttherapy improvements noted in her auditory functions are detailed. The case is important in that it demonstrates (1) that auditory deficits can be a sequel to minor head injury, (2) that these deficits are often subtle and may not be detected unless central auditory testing is conducted, and (3) that these deficits may be amenable to remediation.
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Musiek, Frank, Linda Guenette, and Krista Fitzgerald. "Lateralized Auditory Symptoms in Central Neuroaudiology Disorder." Journal of the American Academy of Audiology 24, no. 07 (July 2013): 556–63. http://dx.doi.org/10.3766/jaaa.24.7.4.
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Many individuals with central auditory nervous system (CANS) pathology/disorder report a variety of auditory symptoms with difficulty hearing in noise being one of the most common complaints (Chermak and Musiek, 1992) Interestingly, there seems to be a paucity of information in the literature on lateralized hearing loss symptoms in patients with central auditory disorders. Reported here is a case where the patient reported auditory symptoms, specifically hearing loss that was lateralized distinctly to the right ear. This ear was contralateral to a stroke that involved the left hemisphere with neural compromise limited primarily to the left Heschl's gyrus. Although the patient reported other hearing difficulties, the lateralized symptom of right-sided hearing loss seemed to be the most noticed. While the pure-tone audiogram was totally disassociated from the right ear auditory symptoms, central auditory tests revealed a marked and consistent right ear deficit, which was consistent with the site of lesion. It is rare that a relatively small lesion in Heschl's gyrus results in the perception of hearing loss so specifically localized to the right ear. It is also of interest that a patient with definite complaints of hearing loss would yield a normal, highly symmetrical pure-tone audiogram. The triad of patient symptoms, anatomy of the lesion, and central auditory test findings in this case are discussed, and theories as to possible underlying mechanisms for the patient's auditory deficits are provided.
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Pillion, Joseph P. "Speech Processing Disorder in Neural Hearing Loss." Case Reports in Medicine 2012 (2012): 1–7. http://dx.doi.org/10.1155/2012/206716.
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Deficits in central auditory processing may occur in a variety of clinical conditions including traumatic brain injury, neurodegenerative disease, auditory neuropathy/dyssynchrony syndrome, neurological disorders associated with aging, and aphasia. Deficits in central auditory processing of a more subtle nature have also been studied extensively in neurodevelopmental disorders in children with learning disabilities, ADD, and developmental language disorders. Illustrative cases are reviewed demonstrating the use of an audiological test battery in patients with auditory neuropathy/dyssynchrony syndrome, bilateral lesions to the inferior colliculi, and bilateral lesions to the temporal lobes. Electrophysiological tests of auditory function were utilized to define the locus of dysfunction at neural levels ranging from the auditory nerve, midbrain, and cortical levels.
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Molina, Juan L., Yash B. Joshi, John A. Nungaray, Michael L. Thomas, Joyce Sprock, Peter E. Clayson, Victoria A. Sanchez, et al. "Central auditory processing deficits in schizophrenia: Effects of auditory-based cognitive training." Schizophrenia Research 236 (October 2021): 135–41. http://dx.doi.org/10.1016/j.schres.2021.07.033.
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Malhotra, Shveta, Amee J. Hall, and Stephen G. Lomber. "Cortical Control of Sound Localization in the Cat: Unilateral Cooling Deactivation of 19 Cerebral Areas." Journal of Neurophysiology 92, no. 3 (September 2004): 1625–43. http://dx.doi.org/10.1152/jn.01205.2003.
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We examined the ability of mature cats to accurately orient to, and approach, an acoustic stimulus during unilateral reversible cooling deactivation of primary auditory cortex (AI) or 1 of 18 other cerebral loci. After attending to a central visual stimulus, the cats learned to orient to a 100-ms broad-band, white-noise stimulus emitted from a central speaker or 1 of 12 peripheral sites (at 15° intervals) positioned along the horizontal plane. Twenty-eight cats had two to six cryoloops implanted over multiple cerebral loci. Within auditory cortex, unilateral deactivation of AI, the posterior auditory field (PAF) or the anterior ectosylvian sulcus (AES) resulted in orienting deficits throughout the contralateral field. However, unilateral deactivation of the anterior auditory field, the second auditory cortex, or the ventroposterior auditory field resulted in no deficits on the orienting task. In multisensory cortex, unilateral deactivation of neither ventral or dorsal posterior ectosylvian cortices nor anterior or posterior area 7 resulted in any deficits. No deficits were identified during unilateral cooling of the five visual regions flanking auditory or multisensory cortices: posterior or anterior ii suprasylvian sulcus, posterior suprasylvian sulcus or dorsal or ventral posterior suprasylvian gyrus. In motor cortex, we identified contralateral orienting deficits during unilateral cooling of lateral area 5 (5L) or medial area 6 (6m) but not medial area 5 or lateral area 6. In a control visual-orienting task, areas 5L and 6m also yielded deficits to visual stimuli presented in the contralateral field. Thus the sound-localization deficits identified during unilateral deactivation of area 5L or 6m were not unimodal and are most likely the result of motor rather than perceptual impairments. Overall, three regions in auditory cortex (AI, PAF, AES) are critical for accurate sound localization as assessed by orienting.
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Malhotra, Shveta, and Stephen G. Lomber. "Sound Localization During Homotopic and Heterotopic Bilateral Cooling Deactivation of Primary and Nonprimary Auditory Cortical Areas in the Cat." Journal of Neurophysiology 97, no. 1 (January 2007): 26–43. http://dx.doi.org/10.1152/jn.00720.2006.
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Although the contributions of primary auditory cortex (AI) to sound localization have been extensively studied in a large number of mammals, little is known of the contributions of nonprimary auditory cortex to sound localization. Therefore the purpose of this study was to examine the contributions of both primary and all the recognized regions of acoustically responsive nonprimary auditory cortex to sound localization during both bilateral and unilateral reversible deactivation. The cats learned to make an orienting response (head movement and approach) to a 100-ms broad-band noise stimulus emitted from a central speaker or one of 12 peripheral sites (located in front of the animal, from left 90° to right 90°, at 15° intervals) along the horizontal plane after attending to a central visual stimulus. Twenty-one cats had one or two bilateral pairs of cryoloops chronically implanted over one of ten regions of auditory cortex. We examined AI [which included the dorsal zone (DZ)], the three other tonotopic fields [anterior auditory field (AAF), posterior auditory field (PAF), ventral posterior auditory field (VPAF)], as well as six nontonotopic regions that included second auditory cortex (AII), the anterior ectosylvian sulcus (AES), the insular (IN) region, the temporal (T) region [which included the ventral auditory field (VAF)], the dorsal posterior ectosylvian (dPE) gyrus [which included the intermediate posterior ectosylvian (iPE) gyrus], and the ventral posterior ectosylvian (vPE) gyrus. In accord with earlier studies, unilateral deactivation of AI/DZ caused sound localization deficits in the contralateral field. Bilateral deactivation of AI/DZ resulted in bilateral sound localization deficits throughout the 180° field examined. Of the three other tonotopically organized fields, only deactivation of PAF resulted in sound localization deficits. These deficits were virtually identical to the unilateral and bilateral deactivation results obtained during AI/DZ deactivation. Of the six nontonotopic regions examined, only deactivation of AES resulted in sound localization deficits in the contralateral hemifield during unilateral deactivation. Although bilateral deactivation of AI/DZ, PAF, or AES resulted in profound sound localization deficits throughout the entire field, the cats were generally able to orient toward the hemifield that contained the acoustic stimulus, but not accurately identify the location of the stimulus. Neither unilateral nor bilateral deactivation of areas AAF, VPAF, AII, IN, T, dPE, nor vPE had any effect on the sound localization task. Finally, bilateral heterotopic deactivations of AI/DZ, PAF, or AES yielded deficits that were as profound as bilateral homotopic cooling of any of these sites. The fact that deactivation of any one region (AI/DZ, PAF, or AES) was sufficient to produce a deficit indicated that normal function of all three regions was necessary for normal sound localization. Neither unilateral nor bilateral deactivation of AI/DZ, PAF, or AES affected the accurate localization of a visual target. The results suggest that hemispheric deactivations contribute independently to sound localization deficits.
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Chermak, Gail D., and Frank E. Musiek. "Neurological Substrate of Central Auditory Processing Deficits in Children." Current Pediatric Reviews 7, no. 3 (August 1, 2011): 241–51. http://dx.doi.org/10.2174/157339611796548393.
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Nagaraj, Naveen, Sarah Kennett, Meredith Levisee, and Samuel Atcherson. "Overview of Central Auditory Processing Deficits in Older Adults." Seminars in Hearing 36, no. 03 (July 9, 2015): 150–61. http://dx.doi.org/10.1055/s-0035-1555118.
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Bellis, Teri James, Cassie Billiet, and Jody Ross. "The Utility of Visual Analogs of Central Auditory Tests in the Differential Diagnosis of (Central) Auditory Processing Disorder and Attention Deficit Hyperactivity Disorder." Journal of the American Academy of Audiology 22, no. 08 (September 2011): 501–14. http://dx.doi.org/10.3766/jaaa.22.8.3.
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Background: Cacace and McFarland (2005) have suggested that the addition of cross-modal analogs will improve the diagnostic specificity of (C)APD (central auditory processing disorder) by ensuring that deficits observed are due to the auditory nature of the stimulus and not to supra-modal or other confounds. Others (e.g., Musiek et al, 2005) have expressed concern about the use of such analogs in diagnosing (C)APD given the uncertainty as to the degree to which cross-modal measures truly are analogous and emphasize the nonmodularity of the CANs (central auditory nervous system) and its function, which precludes modality specificity of (C)APD. To date, no studies have examined the clinical utility of cross-modal (e.g., visual) analogs of central auditory tests in the differential diagnosis of (C)APD. Purpose: This study investigated performance of children diagnosed with (C)APD, children diagnosed with ADHD (attention deficit hyperactivity disorder), and typically developing children on three diagnostic tests of central auditory function and their corresponding visual analogs. The study sought to determine whether deficits observed in the (C)APD group were restricted to the auditory modality and the degree to which the addition of visual analogs aids in the ability to differentiate among groups. Research Design: An experimental repeated measures design was employed. Study Sample: Participants consisted of three groups of right-handed children (normal control, n = 10; ADHD, n = 10; (C)APD, n = 7) with normal and symmetrical hearing sensitivity, normal or corrected-to-normal visual acuity, and no family or personal history of disorders unrelated to their primary diagnosis. Participants in Groups 2 and 3 met current diagnostic criteria for ADHD and (C)APD. Data Collection and Analysis: Visual analogs of three tests in common clinical use for the diagnosis of (C)APD were used (Dichotic Digits [Musiek, 1983]; Frequency Patterns [Pinheiro and Ptacek, 1971]; and Duration Patterns [Pinheiro and Musiek, 1985]). Participants underwent two 1 hr test sessions separated by at least 1 wk. Order of sessions (auditory, visual) and tests within each session were counterbalanced across participants. ANCOVAs (analyses of covariance) were used to examine effects of group, modality, and laterality (Dichotic/Dichoptic Digits) or response condition (auditory and visual patterning). In addition, planned univariate ANCOVAs were used to examine effects of group on intratest comparison measures (REA, HLD [Humming-Labeling Differential]). Results: Children with both ADHD and (C)APD performed more poorly overall than typically developing children on all tasks, with the (C)APD group exhibiting the poorest performance on the auditory and visual patterns tests but the ADHD and (C)APD group performing similarly on the Dichotic/Dichoptic Digits task. However, each of the auditory and visual intratest comparison measures, when taken individually, was able to distinguish the (C)APD group from both the normal control and ADHD groups, whose performance did not differ from one another. Conclusions: Results underscore the importance of intratest comparison measures in the interpretation of central auditory tests (American Speech-Language-Hearing Association [ASHA], 2005; American Academy of Audiology [AAA], 2010). Results also support the “non-modular” view of (C)APD in which cross-modal deficits would be predicted based on shared neuroanatomical substrates. Finally, this study demonstrates that auditory tests alone are sufficient to distinguish (C)APD from supra-modal disorders, with cross-modal analogs adding little if anything to the differential diagnostic process.
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Sanes, Dan H. "Mild Hearing Loss Can Impair Brain Function." Perspectives of the ASHA Special Interest Groups 1, no. 6 (March 31, 2016): 4–16. http://dx.doi.org/10.1044/persp1.sig6.4.
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The emphasis of hearing loss research has been to establish the long-term consequences of permanent, severe to profound deafness. However, auditory processing deficits can be induced by transient, mild hearing loss during childhood. These deficits in perception, speech, and language processing can persist long after normal audibility is restored. One explanation for the persistence of these deficits is that transient hearing loss causes irreversible changes to the central nervous system (CNS) cellular properties that may lead to degraded stimulus encoding. Therefore, this review evaluates the premise that mild hearing loss during development induces behavioral deficits, and that these auditory deficits are causally related to changes within the CNS.
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Musiek, Frank E., and Jane A. Baran. "Audiological Correlates to a Rupture of a Pontine Arteriovenous Malformation." Journal of the American Academy of Audiology 15, no. 02 (February 2004): 161–71. http://dx.doi.org/10.3766/jaaa.15.2.6.
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This is a report of a female patient in her midthirties who sustained a hemorrhage secondary to an arteriovenous malformation in the region of the pons. The patient's initial symptoms included hearing loss and tinnitus, which were followed by the more characteristic symptoms of headache and loss of consciousness. Results of audiological testing at three months postaccident documented the presence of a hearing loss and a central auditory processing disorder, and the patient was provided an auditory rehabilitation program. Follow-up testing over the course of an additional year documented improvement in both pure-tone threshold and central test results; however, at 15 months postaccident, some auditory deficits remained, especially in the ear ipsilateral to the primary site of lesion. The anatomical correlates of these deficits are discussed, as are the potential contributions of both the auditory rehabilitation program and spontaneous recovery mechanisms to the documented improvements in auditory function.
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Trott, Skylar, Trey Cline, Jeffrey Weihing, Deidra Beshear, Matthew Bush, and Jennifer Shinn. "Hormones and Hearing: Central Auditory Processing in Women." Journal of the American Academy of Audiology 30, no. 06 (June 2019): 493–501. http://dx.doi.org/10.3766/jaaa.17123.
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AbstractEstrogen has been identified as playing a key role in many organ systems. Recently, estrogen has been found to be produced in the human brain and is believed contribute to central auditory processing. After menopause, a low estrogen state, many women report hearing loss but demonstrate no deficits in peripheral hearing sensitivity, which support the notion that estrogen plays an effect on central auditory processing. Although animal research on estrogen and hearing loss is extensive, there is little in the literature on the human model.The aim of this study was to evaluate relationships between hormonal changes and hearing as it relates to higher auditory function in pre- and postmenopausal (Post-M) females.A prospective, group comparison study.Twenty eight women between the ages of 18 and 70 at the University of Kentucky were recruited.Participants were separated into premenopausal and peri-/Post-M groups. Participants had normal peripheral hearing sensitivity and underwent a behavioral auditory processing battery and electrophysiological evaluation. An analysis of variance was performed to address the aims of the study.Results from the study demonstrated statistically significant difference between groups, where Post-M females had difficulties in spatial hearing abilities as reflected on the Listening in Spatialized Noise Test–Sentences test. In addition, measures on the auditory brainstem response and the middle latency response reflected statistically significant differences between groups with Post-M females having longer latencies.Results from the present study demonstrated significant differences between groups, particularly listening in noise. Females who present with auditory complaints in spite of normal hearing thresholds should have a more extensive audiological evaluation to further evaluate possible central deficits.
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Musiek, Frank E., Teri James Bellis, and Gail D. Chermak. "Nonmodularity of the Central Auditory Nervous System." American Journal of Audiology 14, no. 2 (December 2005): 128–38. http://dx.doi.org/10.1044/1059-0889(2005/014).
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This response to A. T. Cacace and D. J. McFarland (2005) identifies points of agreement and disagreement regarding the concept of modularity in the diagnosis of (central) auditory processing disorder [(C)APD]. We concur that the evaluation of (C)APD must take into consideration the influence of higher order global or pansensory issues on performance on tests of central auditory function. To accomplish this goal, multidisciplinary (e.g., multimodal) testing is an integral part of differential diagnosis of (C)APD. We also agree that the efficiency of diagnostic tests of (C)APD should not be evaluated by imprecise criteria [e.g., "presumed" or "suspected" (C)APD], which do not provide accurate measures of the true sensitivity and specificity of these tests. Our conceptualization and recommendations for clinical practice in this area diverge, however, from that of Cacace and McFarland in a number of pivotal ways. Based on the current limitations of multimodal assessment relative to issues related to scope of practice and test efficiency, as well as the accumulated basic science and clinical literature that demonstrates the nonmodularity and interactive organization of the brain, we recommend use of the sensitized test battery of the central auditory nervous system (CANS) in combination with multidisciplinary testing to differentially diagnose (C)APD and to guide treatment of the disorder. We assert that sensitivity and specificity measures derived from individuals with well-circumscribed lesions of the CANS provide an important guide to establishing the validity of central auditory diagnostic tests. We note that researchers in the area of auditory science and (C)APD must acknowledge the challenges of the clinical arena, and we encourage their continued help to develop diagnostic tools that are both efficient and practical for the differential diagnosis of (C)APD. We conclude that our approach, which combines multidisciplinary evaluation and specific tests of central auditory function that have demonstrated sensitivity and specificity for disorders of the CANS, allows us to identify (and thus rehabilitate) the auditory deficits present in individuals with (C)APD in its "purest" form. It also permits the identification and rehabilitation of auditory deficits in individuals who exhibit auditory perceptual problems that coexist with other processing problems, while ruling out those who perform poorly on auditory tests because of a global, supramodal problem involving cognition, attention, language, memory, or related skills.
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Tahaei, Ali Akbar, Hassan Ashayeri, Akram Pourbakht, and Mohammad Kamali. "Speech Evoked Auditory Brainstem Response in Stuttering." Scientifica 2014 (2014): 1–7. http://dx.doi.org/10.1155/2014/328646.
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Auditory processing deficits have been hypothesized as an underlying mechanism for stuttering. Previous studies have demonstrated abnormal responses in subjects with persistent developmental stuttering (PDS) at the higher level of the central auditory system using speech stimuli. Recently, the potential usefulness of speech evoked auditory brainstem responses in central auditory processing disorders has been emphasized. The current study used the speech evoked ABR to investigate the hypothesis that subjects with PDS have specific auditory perceptual dysfunction.Objectives. To determine whether brainstem responses to speech stimuli differ between PDS subjects and normal fluent speakers.Methods. Twenty-five subjects with PDS participated in this study. The speech-ABRs were elicited by the 5-formant synthesized syllable/da/, with duration of 40 ms.Results. There were significant group differences for the onset and offset transient peaks. Subjects with PDS had longer latencies for the onset and offset peaks relative to the control group.Conclusions. Subjects with PDS showed a deficient neural timing in the early stages of the auditory pathway consistent with temporal processing deficits and their abnormal timing may underlie to their disfluency.
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Johnson, Jeremy CS, Chris JD Hardy, Nttawan Utoomprukporn, Jonathan D. Rohrer, Doris-Eva Bamiou, and Jason D. Warren. "270 Queen square test of auditory cognition (QSTAC): diagnosing dementia with sound." Journal of Neurology, Neurosurgery & Psychiatry 90, no. 12 (November 14, 2019): e64.1-e64. http://dx.doi.org/10.1136/jnnp-2019-abn-2.215.
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Hearing impairment has emerged as a potent association of cognitive decline in dementia and a promising treatment target. To realise this promise, we need to resolve fundamental questions concerning the roles of peripheral versus central auditory deficits in different dementias, which hearing measures best capture cognitive symptoms and disability and whether hearing measures predict clinical course and brain atrophy.Using pre-existing and novel stimuli, created at the Dementia Research Centre, University College London, we have designed a unique test battery to assess central auditory function. This will be used to ‘phenotype’ central auditory dysfunction in Alzheimer’s disease (AD) and the primary progressive aphasias (PPA) and compare them with controls as well as across disease groups.This will provide new tools to determine how auditory measures relate to clinical symptoms and daily-life disability and care burden. Using voxel-based morphometry (VBM) we also aim to correlate test measures with regional brain degeneration and measure how hearing deficits predict longitudinal clinical course.Here we present the make-up of the battery, explaining the motivation behind component tests and how they probe different stations of the auditory hierarchy. We also make predictions of likely group-specific outcomes, based on neuroanatomical disease predilection.
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Mendiola, Jessica G., E. S. Lelo de Larrea-Mancera, Frederick J. Gallun, Aaron Seitz, and Anna C. Diedesch. "Evaluating compliance on a gamified auditory training task in Veterans." Journal of the Acoustical Society of America 153, no. 3_supplement (March 1, 2023): A332. http://dx.doi.org/10.1121/10.0019045.
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Service members and Veterans are regularly exposed to environmental factors that have been shown to contribute to hearing deficits. These listening deficits may present as auditory processing complaints such as difficulty listening in background noise in the absence of a peripheral hearing loss. The public app, Listen: An Auditory Training Experience, developed by University of California Riverside Brain Game Center, aims to improve overall speech comprehension by targeting skills related to spectro-temporal modulations, spatialized sound cues, and auditory memory tasks. Ten Veterans participated in a two-week gamified auditory training program. Compliance on the auditory training tasks was assessed by monitoring the number of trials accomplished each day, accuracy above chance, reaction time, and improvements in performance over time. Improvements were also monitored for untrained auditory tasks, such as speech-in-noise performance and a battery of central auditory processing assessments.
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James, Denita, Willem van Steenbrugge, and Keith Chiveralls. "Underlying deficits in language-disordered children with central auditory processing difficulties." Applied Psycholinguistics 15, no. 3 (July 1994): 311–28. http://dx.doi.org/10.1017/s0142716400065917.
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AbstractPhonological working memory and auditory processing skills were investigated in a group of language-disordered children with central auditory processing (CAP) difficulties. Comparisons were made with two groups of control children, one group matched on chronological age and nonverbal intelligence and the other matched on language age. The CAP disordered children showed poorer abilities in nonword repetition and word recall. In agreement with earlier findings in language-disordered children (Gathercole & Baddeley, 1990), the CAP disordered children were sensitive to the phonological similarity and word length of the recall lists. However, contrary to earlier findings, the CAP disordered children in the present study also showed poorer phoneme discrimination skills. These findings may be inconsistent with the notion of one central deficit (poor phonological working memory) in CAP disordered children with a language deficit.
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Bramhall, Naomi F., Christopher E. Niemczak, Sean D. Kampel, Curtis J. Billings, and Garnett P. McMillan. "Evoked Potentials Reveal Noise Exposure–Related Central Auditory Changes Despite Normal Audiograms." American Journal of Audiology 29, no. 2 (June 8, 2020): 152–64. http://dx.doi.org/10.1044/2019_aja-19-00060.
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Purpose Complaints of auditory perceptual deficits, such as tinnitus and difficulty understanding speech in background noise, among individuals with clinically normal audiograms present a perplexing problem for audiologists. One potential explanation for these “hidden” auditory deficits is loss of the synaptic connections between the inner hair cells and their afferent auditory nerve fiber targets, a condition that has been termed cochlear synaptopathy . In animal models, cochlear synaptopathy can occur due to aging or exposure to noise or ototoxic drugs and is associated with reduced auditory brainstem response (ABR) wave I amplitudes. Decreased ABR wave I amplitudes have been demonstrated among young military Veterans and non-Veterans with a history of firearm use, suggesting that humans may also experience noise-induced synaptopathy. However, the downstream consequences of synaptopathy are unclear. Method To investigate how noise-induced reductions in wave I amplitude impact the central auditory system, the ABR, the middle latency response (MLR), and the late latency response (LLR) were measured in 65 young Veterans and non-Veterans with normal audiograms. Results In response to a click stimulus, the MLR was weaker for Veterans compared to non-Veterans, but the LLR was not reduced. In addition, low ABR wave I amplitudes were associated with a reduced MLR, but with an increased LLR. Notably, Veterans reporting tinnitus showed the largest mean LLRs. Conclusions These findings indicate that decreased peripheral auditory input leads to compensatory gain in the central auditory system, even among individuals with normal audiograms, and may impact auditory perception. This pattern of reduced MLR, but not LLR, was observed among Veterans even after statistical adjustment for sex and distortion product otoacoustic emission differences, suggesting that synaptic loss plays a role in the observed central gain. Supplemental Material https://doi.org/10.23641/asha.11977854
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Żelazowska-Sobczyk, Magda, Natalia Czajka, and Piotr Skarżyński. "Ośrodkowe zaburzenia przetwarzania słuchowego u dzieci w wieku szkolnym w świetle uczenia (się) języka angielskiego." Applied Linguistics Papers 4/2022, no. 26 (December 17, 2022): 118–27. http://dx.doi.org/10.32612/uw.25449354.2022.4.pp.118-127.
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Central auditory processing disorders are defined as deficits in the neural processing of auditory information in the central auditory nervous system with simultaneous normal hearing. Due to the inappropriate reception of speech sounds and difficulties in their understanding and reproduction, pupils may have difficulties in learning language, e.g. in earning and remembering vocabulary and pronouncing words correctly which may cause incorrect communication result or even lack of it. It is also worth mentioning that a great number of parents report difficulties in learning foreign language/languages in their children with central auditory processing disorders, especially English. Additionally, there are few studies discussing the topic of learning and teaching a second language among students with central auditory processing disorders. This paper aims to provide the importance and brief characteristics of central auditory processing disorders, as well as a review of the literature and results of questionnaire (about the foreign language learning difficulties) performed in 16 parents whose children were qualified to the listening training.
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McFarland, Dennis J., and Anthony T. Cacace. "Modality Specificity as a Criterion for Diagnosing Central Auditory Processing Disorders." American Journal of Audiology 4, no. 3 (November 1995): 36–48. http://dx.doi.org/10.1044/1059-0889.0403.36.
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A central "auditory" processing disorder (CAPD) is an auditory perceptual dysfunction that cannot be explained on the basis of peripheral hearing loss. As a concept, CAPD has not been completely validated, and many issues continue to be controversial. A primary issue of concern is whether currently used tests to evaluate CAPD are sensitive to factors that are not of an auditory perceptual nature. In this paper, we consider the case for modality specificity as a criterion for improving the specificity of diagnosing CAPD. Demonstrating the modality-specific nature of sensory processing deficits is one way to rule out nonperceptual factors as explanations for observed dysfunction.
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Iliadou, Vassiliki, Doris-Eva Bamiou, Stergios Kaprinis, Dimitrios Kandylis, Nikolaos Vlaikidis, Kalliopi Apalla, Anestis Psifidis, George Psillas, and George St Kaprinis. "Auditory Processing Disorder And Brain Pathology In A Preterm Child With Learning Disabilities." Journal of the American Academy of Audiology 19, no. 07 (July 2008): 557–63. http://dx.doi.org/10.3766/jaaa.19.7.5.
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Background: Auditory processing disorders involve deficits in the processing of information in the auditory domain that are not due to higher order language, cognitive or other related factors. Purpose: To evaluate the possibility of structural brain abnormalities in preterm children manifesting as auditory processing disorders. Research Design : A case report of a young girl, preterm at birth, with language difficulties, learning problems at school, and additional listening problems. Results: A diagnosis of a central auditory processing disorder was made on the basis of severe deficits in three nonspeech temporal tests (the frequency and duration pattern and the random gap detection tests). Her brain MRI revealed large porencephalic cysts and thinning of the corpus callosum. Conclusions: The observed auditory deficits would be compatible with a pressure effect of the cysts at a brainstem or higher level for the random gap detection test, and with the thinning of the corpus callosum for the pattern tests, the latter requiring interhemispheric transfer of information. The case highlights that preterm children with learning difficulties may suffer from an auditory processing disorder, in the presence of structural brain abnormalities that are due to birth and neonatal complications.
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Rance, Gary, Dani Tomlin, Eppie M. Yiu, and Julien Zanin. "Remediation of Perceptual Deficits in Progressive Auditory Neuropathy: A Case Study." Journal of Clinical Medicine 13, no. 7 (April 6, 2024): 2127. http://dx.doi.org/10.3390/jcm13072127.
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Background: Auditory neuropathy (AN) is a hearing disorder that affects neural activity in the VIIIth cranial nerve and central auditory pathways. Progressive forms have been reported in a number of neurodegenerative diseases and may occur as a result of both the deafferentiation and desynchronisation of neuronal processes. The purpose of this study was to describe changes in auditory function over time in a patient with axonal neuropathy and to explore the effect of auditory intervention. Methods: We tracked auditory function in a child with progressive AN associated with Charcot–Marie–Tooth (Type 2C) disease, evaluating hearing levels, auditory-evoked potentials, and perceptual abilities over a 3-year period. Furthermore, we explored the effect of auditory intervention on everyday listening and neuroplastic development. Results: While sound detection thresholds remained constant throughout, both electrophysiologic and behavioural evidence suggested auditory neural degeneration over the course of the study. Auditory brainstem response amplitudes were reduced, and perception of auditory timing cues worsened over time. Functional hearing ability (speech perception in noise) also deteriorated through the first 1.5 years of study until the child was fitted with a “remote-microphone” listening device, which subsequently improved binaural processing and restored speech perception ability to normal levels. Conclusions: Despite the deterioration of auditory neural function consistent with peripheral axonopathy, sustained experience with the remote-microphone listening system appeared to produce neuroplastic changes, which improved the patient’s everyday listening ability—even when not wearing the device.
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Rigo, Thomas G., Shalini Arehole, and Phebe A. Hayes. "Central Auditory Processing Abilities of Low-Achieving Gifted Adolescents." Journal of Secondary Gifted Education 10, no. 1 (August 1998): 217–25. http://dx.doi.org/10.1177/1932202x9801000102.
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In this study, the central auditory processing (CAP) abilities of a group of low-achieving gifted high school students were measured and compared to matching groups of achieving gifted, average, and learning-disabled students. CAP skills were measured behaviorally, utilizing the Test for Auditory Processing Disorders in Adolescents and Children (SCAN:A). Results revealed significant CAP deficits in the low-achieving gifted group when compared to the achieving gifted and the average subjects. Furthermore, the CAP ability of the low-achieving gifted group was similar to that of the learning-disabled subjects. The nature of CAP disorders and suggested management strategies are discussed.
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McLaughlin, Susan A., John C. Thorne, Tracy Jirikowic, Tiffany Waddington, Adrian K. C. Lee, and Susan J. Astley Hemingway. "Listening Difficulties in Children With Fetal Alcohol Spectrum Disorders: More Than a Problem of Audibility." Journal of Speech, Language, and Hearing Research 62, no. 5 (May 21, 2019): 1532–48. http://dx.doi.org/10.1044/2018_jslhr-h-18-0359.
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Purpose Data from standardized caregiver questionnaires indicate that children with fetal alcohol spectrum disorders (FASDs) frequently exhibit atypical auditory behaviors, including reduced responsivity to spoken stimuli. Another body of evidence suggests that prenatal alcohol exposure may result in auditory dysfunction involving loss of audibility (i.e., hearing loss) and/or impaired processing of clearly audible, “suprathreshold” sounds necessary for sound-in-noise listening. Yet, the nexus between atypical auditory behavior and underlying auditory dysfunction in children with FASDs remains largely unexplored. Method To investigate atypical auditory behaviors in FASDs and explore their potential physiological bases, we examined clinical data from 325 children diagnosed with FASDs at the University of Washington using the FASD 4-Digit Diagnostic Code. Atypical behaviors reported on the “auditory filtering” domain of the Short Sensory Profile were assessed to document their prevalence across FASD diagnoses and explore their relationship to reported hearing loss and/or central nervous system measures of cognition, attention, and language function that may indicate suprathreshold processing deficits. Results Atypical auditory behavior was reported among 80% of children with FASDs, a prevalence that did not vary by FASD diagnostic severity or hearing status but was positively correlated with attention-deficit/hyperactivity disorder. In contrast, hearing loss was documented in the clinical records of 40% of children with fetal alcohol syndrome (FAS; a diagnosis on the fetal alcohol spectrum characterized by central nervous system dysfunction, facial dysmorphia, and growth deficiency), 16-fold more prevalent than for those with less severe FASDs (2.4%). Reported hearing loss was significantly associated with physical features characteristic of FAS. Conclusion Children with FAS but not other FASDs may be at a particular risk for hearing loss. However, listening difficulties in the absence of hearing loss—presumably related to suprathreshold processing deficits—are prevalent across the entire fetal alcohol spectrum. The nature and impact of both listening difficulties and hearing loss in FASDs warrant further investigation.
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Marchetta, Philine, Daria Savitska, Angelika Kübler, Giulia Asola, Marie Manthey, Dorit Möhrle, Thomas Schimmang, Lukas Rüttiger, Marlies Knipper, and Wibke Singer. "Age-Dependent Auditory Processing Deficits after Cochlear Synaptopathy Depend on Auditory Nerve Latency and the Ability of the Brain to Recruit LTP/BDNF." Brain Sciences 10, no. 10 (October 6, 2020): 710. http://dx.doi.org/10.3390/brainsci10100710.
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Age-related decoupling of auditory nerve fibers from hair cells (cochlear synaptopathy) has been linked to temporal processing deficits and impaired speech recognition performance. The link between both is elusive. We have previously demonstrated that cochlear synaptopathy, if centrally compensated through enhanced input/output function (neural gain), can prevent age-dependent temporal discrimination loss. It was also found that central neural gain after acoustic trauma was linked to hippocampal long-term potentiation (LTP) and upregulation of brain-derived neurotrophic factor (BDNF). Using middle-aged and old BDNF-live-exon-visualization (BLEV) reporter mice we analyzed the specific recruitment of LTP and the activity-dependent usage of Bdnf exon-IV and -VI promoters relative to cochlear synaptopathy and central (temporal) processing. For both groups, specimens with higher or lower ability to centrally compensate diminished auditory nerve activity were found. Strikingly, low compensating mouse groups differed from high compensators by prolonged auditory nerve latency. Moreover, low compensators exhibited attenuated responses to amplitude-modulated tones, and a reduction of hippocampal LTP and Bdnf transcript levels in comparison to high compensators. These results suggest that latency of auditory nerve processing, recruitment of hippocampal LTP, and Bdnf transcription, are key factors for age-dependent auditory processing deficits, rather than cochlear synaptopathy or aging per se.
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Malhotra, Shveta, G. Christopher Stecker, John C. Middlebrooks, and Stephen G. Lomber. "Sound Localization Deficits During Reversible Deactivation of Primary Auditory Cortex and/or the Dorsal Zone." Journal of Neurophysiology 99, no. 4 (April 2008): 1628–42. http://dx.doi.org/10.1152/jn.01228.2007.
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We examined the contributions of primary auditory cortex (A1) and the dorsal zone of auditory cortex (DZ) to sound localization behavior during separate and combined unilateral and bilateral deactivation. From a central visual fixation point, cats learned to make an orienting response (head movement and approach) to a 100-ms broadband noise burst emitted from a central speaker or one of 12 peripheral sites (located in front of the animal, from left 90° to right 90°, at 15° intervals) along the horizontal plane. Following training, each cat was implanted with separate cryoloops over A1 and DZ bilaterally. Unilateral deactivation of A1 or DZ or simultaneous unilateral deactivation of A1 and DZ (A1/DZ) resulted in spatial localization deficits confined to the contralateral hemifield, whereas sound localization to positions in the ipsilateral hemifield remained unaffected. Simultaneous bilateral deactivation of both A1 and DZ resulted in sound localization performance dropping from near-perfect to chance (7.7% correct) across the entire field. Errors made during bilateral deactivation of A1/DZ tended to be confined to the same hemifield as the target. However, unlike the profound sound localization deficit that occurs when A1 and DZ are deactivated together, deactivation of either A1 or DZ alone produced partial and field-specific deficits. For A1, bilateral deactivation resulted in higher error rates (performance dropping to ∼45%) but relatively small errors (mostly within 30° of the target). In contrast, bilateral deactivation of DZ produced somewhat fewer errors (performance dropping to only ∼60% correct), but the errors tended to be larger, often into the incorrect hemifield. Therefore individual deactivation of either A1 or DZ produced specific and unique sound localization deficits. The results of the present study reveal that DZ plays a role in sound localization. Along with previous anatomical and physiological data, these behavioral data support the view that A1 and DZ are distinct cortical areas. Finally, the findings that deactivation of either A1 or DZ alone produces partial sound localization deficits, whereas deactivation of either posterior auditory field (PAF) or anterior ectosylvian sulcus (AES) produces profound sound localization deficits, suggests that PAF and AES make more significant contributions to sound localization than either A1 or DZ.
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Liu, Xia, Fanfan Wei, Yuan Cheng, Yifan Zhang, Guoqiang Jia, Jie Zhou, Min Zhu, et al. "Auditory Training Reverses Lead (Pb)-Toxicity-Induced Changes in Sound-Azimuth Selectivity of Cortical Neurons." Cerebral Cortex 29, no. 8 (August 23, 2018): 3294–304. http://dx.doi.org/10.1093/cercor/bhy199.
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Abstract Lead (Pb) causes significant adverse effects on the developing brain, resulting in cognitive and learning disabilities in children. The process by which lead produces these negative changes is largely unknown. The fact that children with these syndromes also show deficits in central auditory processing, however, indicates a speculative but disturbing relationship between lead-exposure, impaired auditory processing, and behavioral dysfunction. Here we studied in rats the changes in cortical spatial tuning impacted by early lead-exposure and their potential restoration to normal by auditory training. We found animals that were exposed to lead early in life displayed significant behavioral impairments compared with naïve controls while conducting the sound-azimuth discrimination task. Lead-exposure also degraded the sound-azimuth selectivity of neurons in the primary auditory cortex. Subsequent sound-azimuth discrimination training, however, restored to nearly normal the lead-degraded cortical azimuth selectivity. This reversal of cortical spatial fidelity was paralleled by changes in cortical expression of certain excitatory and inhibitory neurotransmitter receptor subunits. These results in a rodent model demonstrate the persisting neurotoxic effects of early lead-exposure on behavioral and cortical neuronal processing of spatial information of sound. They also indicate that attention-demanding auditory training may remediate lead-induced cortical neurological deficits even after these deficits have occurred.
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Dougherty, Kelsey, Alexandra Hustedt-Mai, Anna Hagedorn, and Hari Bharadwaj. "Central gain in aging, tinnitus, and temporary hearing loss." Journal of the Acoustical Society of America 150, no. 4 (October 2021): A341. http://dx.doi.org/10.1121/10.0008520.
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The nervous system adapts in many ways to changes in the statistics of the inputs it receives. An example of such plasticity observed in animal models is that central auditory neurons tend to retain their driven firing rate outputs despite reductions in cochlear input due to hearing loss or deafferentation. The perceptual consequences of such “central gain” are unknown; pathological versions of such gain are often hypothesized to underlie tinnitus and hyperacusis. To investigate central gain in humans, we designed an electroencephalogram (EEG)-based paradigm that concurrently elicits robust separable responses from different levels of the auditory pathway. Using this measure, we find that cortical responses are relatively invariant despite a large monotonic decrease in auditory nerve responses with age, and that this central gain is also associated with perceptual deficits in co-modulation processing. We then applied the same measures to a cohort of individuals with persistent tinnitus and to a third cohort where a week-long monaural conductive hearing loss was induced using silicone earplugs. Overall, our results suggest that central gain is ubiquitous in response to reduced peripheral input and may affect auditory scene analysis, but does not in itself account for tinnitus perception.
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Vander Werff, Kathy R., and Brian Rieger. "Auditory and Cognitive Behavioral Performance Deficits and Symptom Reporting in Postconcussion Syndrome Following Mild Traumatic Brain Injury." Journal of Speech, Language, and Hearing Research 62, no. 7 (July 15, 2019): 2501–18. http://dx.doi.org/10.1044/2019_jslhr-h-18-0281.
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Purpose This study examined auditory deficits and symptom reporting in individuals with long-term postconcussion symptoms following a single mild traumatic brain injury (mTBI) compared to age- and gender-matched controls without a history of mTBI. Method Case history interviews, symptom questionnaires, and a battery of central auditory and neuropsychological tests were administered to 2 groups. The mTBI group was a civilian population recruited from a local concussion management program who were seeking rehabilitation for postconcussion-related problems in a postacute period between 3 and 18 months following injury. Symptom validity testing was included to assess the rate of possible insufficient test effort and its influence on scores for all outcome measures. Analyses of group differences in test scores were performed both with and without the participants who showed insufficient test effort. Rates of symptom reporting, correlations among symptoms and behavioral test outcomes, and the relationships between auditory and cognitive test performance were analyzed. Results The mTBI group reported a high rate of auditory symptoms and general postconcussion symptoms. Performance on neuropsychological tests of cognitive function showed some differences in raw scores between groups, but when effort was considered, there were no significant differences in the rate of abnormal performance between groups. In contrast, there were significant differences in both raw scores and the rate of abnormal performance between groups for some auditory tests when only considering participants with sufficient effort. Auditory symptoms were strongly correlated with other general postconcussion symptoms. Conclusions Significant auditory symptoms and evidence of long-term central auditory dysfunction were found in a subset of individuals who had chronic postconcussion symptoms after a single mTBI unrelated to blast trauma. The rate of abnormal performance on auditory behavioral tests exceeded the rate of abnormal performance on tests of cognitive function. Supplemental Material https://doi.org/10.23641/asha.8329955
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Innes-Brown, H., S. Rossell, G. Egan, D. Copolov, C. McKay, T. Shea, M. Wright, A. Sergejew, and K. Henshall. "Central auditory processing deficits in patients with auditory hallucinations as shown by event-related potentials: preliminary results." Acta Neuropsychiatrica 18, no. 6 (December 2006): 293. http://dx.doi.org/10.1017/s0924270800031343.
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Tighilet, Brahim, and Christian Chabbert. "Cellular and Molecular Mechanisms of Vestibular Ageing." Journal of Clinical Medicine 12, no. 17 (August 25, 2023): 5519. http://dx.doi.org/10.3390/jcm12175519.
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While age-related auditory deficits and cochlear alterations are well described, those affecting the vestibular sensory organs and more broadly the central vestibular pathways are much less documented. Although there is inter-individual heterogeneity in the phenomenon of vestibular ageing, common tissue alterations, such as losses of sensory hair cells or primary and secondary neurons during the ageing process, can be noted. In this review, we document the cellular and molecular processes that occur during ageing in the peripheral and central vestibular system and relate them to the impact of age-related vestibular deficits based on current knowledge.
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Barbosa, Dayane Aparecida Nascimento, Liliane Aparecida Fagundes Silva, Alessandra Giannella Samelli, José Albino da Paz, and Carla Gentile Matas. "Auditory central pathways in children and adolescents with multiple sclerosis." Arquivos de Neuro-Psiquiatria 81, no. 10 (October 2023): 898–904. http://dx.doi.org/10.1055/s-0043-1775985.
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Abstract Background Multiple sclerosis (MS) is an inflammatory demyelinating disease. Auditory evoked potential studies have demonstrated conduction and neural processing deficits in adults with MS, but little is known about the electrophysiological responses in children and adolescents. Objective to evaluate the central auditory pathway with brainstem auditory evoked potentials (BAEP) and long-latency auditory evoked potentials (LLAEP) in children and adolescents with MS. Methods The study comprised 17 individuals with MS, of both sexes, aged 9 to 18 years, and 17 healthy volunteers, matched for age and sex. All individuals had normal hearing and no middle ear impairments. They were assessed with click-BAEP and LLAEP through oddball paradigm and tone-burst stimuli. Results Abnormal responses were observed in 60% of electrophysiologic assessments of individuals with MS. In BAEP, 58.82% of MS patients had abnormal responses, with longer wave V latency and therefore longer III-V and I-V interpeak latencies than healthy volunteers. In LLAEP, 52.94% of MS patients had abnormal responses. Although statistical differences were found only in P2-N2 amplitude, MS patients had longer latencies and smaller amplitudes than healthy volunteers in all components. Conclusion Children and adolescents with MS had abnormal BAEP responses, with delayed neural conduction between the cochlear nucleus and the lateral lemniscus. Also, abnormal LLAEP results suggest a decrease in neural processing speed and auditory sensory discrimination response.
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Iliadou, Vasiliki Vivian, Doris-Eva Bamiou, Christos Sidiras, Nikolaos P. Moschopoulos, Magda Tsolaki, Ioannis Nimatoudis, and Gail D. Chermak. "The Use of the Gaps-In-Noise Test as an Index of the Enhanced Left Temporal Cortical Thinning Associated with the Transition between Mild Cognitive Impairment and Alzheimer’s Disease." Journal of the American Academy of Audiology 28, no. 05 (May 2017): 463–71. http://dx.doi.org/10.3766/jaaa.16075.
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Background: The known link between auditory perception and cognition is often overlooked when testing for cognition. Purpose: To evaluate auditory perception in a group of older adults diagnosed with mild cognitive impairment (MCI). Research Design: A cross-sectional study of auditory perception. Study Sample: Adults with MCI and adults with no documented cognitive issues and matched hearing sensitivity and age. Data collection: Auditory perception was evaluated in both groups, assessing for hearing sensitivity, speech in babble (SinB), and temporal resolution. Results: Mann–Whitney test revealed significantly poorer scores for SinB and temporal resolution abilities of MCIs versus normal controls for both ears. The right-ear gap detection thresholds on the Gaps-In-Noise (GIN) Test clearly differentiated between the two groups (p < 0.001), with no overlap of values. The left ear results also differentiated the two groups (p < 0.01); however, there was a small degree of overlap #x02DC;8-msec threshold values. With the exception of the left-ear inattentiveness index, which showed a similar distribution between groups, both impulsivity and inattentiveness indexes were higher for the MCIs compared to the control group. Conclusions: The results support central auditory processing evaluation in the elderly population as a promising tool to achieve earlier diagnosis of dementia, while identifying central auditory processing deficits that can contribute to communication deficits in the MCI patient population. A measure of temporal resolution (GIN) may offer an early, albeit indirect, measure reflecting left temporal cortical thinning associated with the transition between MCI and Alzheimer’s disease.
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Iliadou, Vasiliki Vivian, and Nikos Eleftheriadis. "Auditory Processing Disorder as the Sole Manifestation of a Cerebellopontine and Internal Auditory Canal Lesion." Journal of the American Academy of Audiology 28, no. 01 (January 2017): 091–101. http://dx.doi.org/10.3766/jaaa.15127.
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AbstractClinical importance of auditory processing disorder (APD) testing is often overlooked and regarded with skepticism given the challenging interpretation of results and the current growing debate of its nature and clinical entity.Presentation of this case is highly educational as APD is the single clinical manifestation of a large cerebellopontine and internal auditory canal lesion.A case report.The patient underwent a standard audiological evaluation with normal results. She was referred for APD evaluation. The APD test battery consisted of speech in babble (SinB), dichotic digits (DD), frequency and duration of pattern sequence testing, Random Gap Detection Test, and gaps in noise. These were followed by otoacoustic emissions testing, auditory brainstem responses (ABR) and magnetic resonance imaging (MRI).Her auditory processing results showed deficits in SinB and DD limited to the right ear as well as deficits in temporal processing. Both verbal and nonverbal tests exhibited deficits strictly limited to the right ear, which was in accordance with what she was experiencing as reduced loudness for the incoming sounds on the right ear. This less costly evaluation revealed that there was good reason to assess electrophysiologically the auditory system. ABR showed an abnormal waveform with either missing or severely prolongated wave V (depending on stimulus polarity). Otoacoustic emissions were normal. MRI was then implemented revealing a large cerebellopontine and internal auditory canal lesion.This clinical case stresses the importance of testing for APD with a psychoacoustical test battery despite current debate of lack of a gold standard diagnostic approach to APD. In this case, APD diagnosis led to a cerebellopontine lesion identification with extension to the right internal auditory canal. This rare cause of APD demonstrates the efficiency of the current diagnostic test battery in revealing lesional causes of central APD.
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Schecker, M. "1209 – Central auditory processing and meaning: ‘early’ deficits in language processing in sli." European Psychiatry 28 (January 2013): 1. http://dx.doi.org/10.1016/s0924-9338(13)76290-4.
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Howell, Peter, Stuart Rosen, Geraldine Hannigan, and Lena Rustin. "Auditory Backward-Masking Performance by Children Who Stutter and its Relation to Dysfluency Rate." Perceptual and Motor Skills 90, no. 2 (April 2000): 355–63. http://dx.doi.org/10.2466/pms.2000.90.2.355.
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The fluency of people who stutter is affected markedly when auditory feedback is altered suggesting that stuttering may be associated with hearing. Peripheral hearing problems, however, are no more common in people who stutter than in those who do not. Performance was investigated in a task that involves central auditory processing (backward masking). Children who stuttered had deficits in backward masking (indicated by higher thresholds) compared with a group of fluent control children. The backward-masking thresholds were positively correlated with frequency of stuttering.
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Ramamurthy, Deepa L., and Gregg H. Recanzone. "Age-related changes in sound onset and offset intensity coding in auditory cortical fields A1 and CL of rhesus macaques." Journal of Neurophysiology 123, no. 3 (March 1, 2020): 1015–25. http://dx.doi.org/10.1152/jn.00373.2019.
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Inhibition plays a key role in shaping sensory processing in the central auditory system and has been implicated in sculpting receptive field properties such as sound intensity coding and also in shaping temporal patterns of neuronal firing such as onset- or offset-evoked responses. There is substantial evidence supporting a decrease in inhibition throughout the ascending auditory pathway in geriatric animals. We therefore examined intensity coding of onset (ON) and offset (OFF) responses in auditory cortex of aged and young monkeys. A large proportion of cells in the primary auditory cortex (A1) and the caudolateral field (CL) displayed nonmonotonic rate-level functions for OFF responses in addition to nonmonotonic coding of ON responses. Aging differentially affected ON and OFF responses; the magnitude of effects was generally greater for ON responses. In addition to higher firing rates, neurons in old monkeys exhibited a significant increase in the proportion of monotonic rate-level functions and had higher best intensities than those in young monkeys. OFF responses in young monkeys displayed a range of intensity coding relationships with ON responses of the same cells, ranging from highly similar to highly dissimilar. Dissimilarity in ON/OFF coding was greater in CL and was reduced with aging, which was largely explained by a preferential decrease in the percentage of cells with nonmonotonic coding of ON and OFF responses. The changes we observed are consistent with previously demonstrated alterations in inhibition in the ascending auditory pathway of primates and could be involved in age-related deficits in the temporal processing of sounds. NEW & NOTEWORTHY Aging has a major impact on intensity coding of neurons in auditory cortex of rhesus macaques. Neural responses to sound onset and offset were affected to different extents, and their rate-level functions became more mutually similar, which could be accounted for by the loss of nonmonotonic intensity coding in geriatric monkeys. These findings were consistent with weakened inhibition in the central auditory system and could contribute to auditory processing deficits in elderly subjects.
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DeBonis, David. "Response to the Letter to the Editor From Iliadou, Sirimanna, and Bamiou Regarding DeBonis (2015)." American Journal of Audiology 25, no. 4 (December 2016): 371–74. http://dx.doi.org/10.1044/2016_aja-16-0090.
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Purpose The purpose of this letter is to respond to “Central Auditory Processing Disorder Is Classified in ICD-10 and H93.25 and Hearing Evaluation—Not Screening—Should Be Implemented in Children With Verified Communication and/or Listening Deficits” by Iliadou, Sirimanna, and Bamiou (2016). The methodology used involved a close reading of the concerns expressed by Iliadou et al. in view of the central auditory processing disorder (CAPD) literature and the stated purpose of my original article (DeBonis, 2015). The literature used included clinical practice guidelines, respected journals, and recognized authorities on the topic. Many of the objections stated by Iliadou et al. are not well founded (e.g., ICD-10, use of ASHA definition, effect of auditory intervention, lack of research for the model, bias of the article), but their statement that a complete hearing assessment is necessary for students with listening difficulties is an important one that I endorse completely. In conclusion, my original article remains an effective vehicle for discussion about the value of current tests of auditory processing and how to better help students who have listening difficulties.
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Koravand, Amineh, Benoît Jutras, and Maryse Lassonde. "Cortical Auditory Evoked Potentials in Children with a Hearing Loss: A Pilot Study." International Journal of Pediatrics 2012 (2012): 1–8. http://dx.doi.org/10.1155/2012/250254.
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Objective. This study examined the patterns of neural activity in the central auditory system in children with hearing loss.Methods. Cortical potentials and mismatch responses (MMRs) were recorded from ten children aged between 9 and 10 years: five with hearing loss and five with normal hearing in passive oddball paradigms using verbal and nonverbal stimuli.Results. Results indicate a trend toward larger P1 amplitude, a significant reduction in amplitude, and latency of N2 in children with hearing loss compared to control. No significant group differences were observed for the majority of the MMRs conditions.Conclusions. Data suggest that the reduced auditory input affects the pattern of cortical-auditory-evoked potentials in children with a mild to moderately severe hearing loss. Results suggest maturational delays and/or deficits in central auditory processing in children with hearing loss, as indicated by the neurophysiological markers P1 and N2. In contrast, negative MMR data suggest that the amplification provided by the hearing aids could have allowed children with hearing loss to develop adequate discriminative abilities.
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Walker, Kerry A., Carol A. Sammeth, Nathaniel Greene, Achim Klug, and Daniel Tollin. "Aging effects on binaural listening and other auditory system assessments." Journal of the Acoustical Society of America 151, no. 4 (April 2022): A257. http://dx.doi.org/10.1121/10.0011246.
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Older listeners are known to have decreased sound localization and hearing in noise abilities compared to young listeners, even when exhibiting clinically normal hearing. We hypothesize that these deficits may be related to decreased temporal precision of neural activity in the sound localization processing pathway, and/or other central auditory system deficits involving more complex functions such as speech recognition. Presented here are preliminary results from a study underway on the impact of aging on auditory functioning, and in particular, binaural processing. Subjects range from 21 to 89 years of age, have normal or near normal-hearing sensitivity, and are being evaluated on assessments of auditory system integrity and behavioral performance. Primary outcome measures include speech understanding in noise, auditory brainstem responses (ABRs) and the calculated ABR binaural interaction component, behavioral measures of spatial acuity, and a subjective questionnaire of hearing handicap. Secondary measures include temporal fine structure and spectro-temporal modulation sensitivity tests, otoacoustic emissions, and electrocochleography. In addition, extended-high-frequency hearing thresholds are measured and working memory assessed. Early results show an aging effect across decades of life on several of these measures. Greatest aging effects are seen in the more adverse listening conditions from behavioral testing. [Support: R01-DC017924.]
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Koohi, Nehzat, Deborah A. Vickers, Rahul Lakshmanan, Hoskote Chandrashekar, David J. Werring, Jason D. Warren, and Doris-Eva Bamiou. "Hearing Characteristics of Stroke Patients: Prevalence and Characteristics of Hearing Impairment and Auditory Processing Disorders in Stroke Patients." Journal of the American Academy of Audiology 28, no. 06 (June 2017): 491–505. http://dx.doi.org/10.3766/jaaa.15139.
Full textAbstract:
Background: Stroke survivors may suffer from a range of hearing impairments that may restrict their participation in postacute rehabilitation programs. Hearing impairment may have a significant impact on listening, linguistic skills, and overall communication of the affected stroke patient. However, no studies sought to systematically characterize auditory function of stroke patients in detail, to establish the different types of hearing impairments in this cohort of patients. Such information would be clinically useful in understanding and addressing the hearing needs of stroke survivors. Purpose: The present study aimed to characterize and classify the hearing impairments, using a detailed audiological assessment test battery, in order to determine the level of clinical need and inform appropriate rehabilitation for this patient population. Research Design: A case–control study. Study Sample: Forty-two recruited stroke patients who were discharged from a stroke unit and 40 control participants matched for age. Data Collection and Analysis: All participants underwent pure-tone audiometry and immittance measurements including acoustic reflex threshold, transient-evoked otoacoustic emissions, auditory-evoked brainstem response, and a central auditory processing assessment battery, performed in a single session. Hearing impairments were classified as peripheral hearing loss (cochlear and neural type), central auditory processing disorder (CAPD), and as a combination of CAPD and peripheral hearing loss. Results: Overall mean hearing thresholds were not significantly different between the control and stroke groups. The most common type of hearing impairment in stroke patients was the combination type, “peripheral and CAPD,” in the 61- to 80-yr-old subgroup (in 55%), and auditory processing deficits in 18- to 60-yr-olds (in 40%), which were both significantly higher than in controls. Conclusions: This is the first study to examine hearing function in detail in stroke patients. Given the importance of hearing for the efficiency of communication, it is essential to identify hearing impairments and differentiate peripheral and central deficits to define an appropriate intervention plan.
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Fadeev, K. A., and E. V. Orekhova. "Central auditory processing disorders: causes, symptoms, and ways to overcome deficits in the learning environments." Современная зарубежная психология 12, no. 4 (February 1, 2024): 7–21. http://dx.doi.org/10.17759/jmfp.2023120401.
Full textAbstract:
<p style="text-align: justify;">Central Auditory Processing Disorders (CAPD) are impairments in the ability to recognize sounds, localize their sources, and/or determine their identity and meaning due to functional impairments of the central auditory system. CAPD is observed in individuals with normal hearing levels and is not the result of high-level speech or cognitive impairment. This disorder is not well known to Russian specialists in the field of correctional psychology, while according to foreign sources it is observed in 2—7% of schoolchildren and is often combined with other developmental disorders (dyslexia, speech developmental disorders, ASD, ADHD). Here we provide a brief review of CAPD: its causes, symptoms, and approaches to diagnosis. In particular, we draw the readers' attention to the insufficient development of tools and practices for diagnosing and treating CAPD in Russia. Next, we review current approaches to the correction of CAPD, with special emphasis on assistive technologies that improve the signal-to-noise ratio (FM systems). Evidence in the literature indicates that in addition to the immediate effect (improved speech understanding), prolonged use of FM systems has a positive long-term effect based on mechanisms of neural plasticity.</p>