Frank E. Musiek

Gin (gaps-in-noise) Test Performance In Subjects With Confirmed Central Auditory Nervous System Involvement

Objective: The purpose of the present study was to investigate the value of a new gap detection procedure called Gaps-In-Noise (GIN) for assessment of temporal resolution in a clinical population. Design: The test consists of 0 to 3 silent intervals ranging from 2 to 20 msec embedded in 6-sec segments of white noise. The location, number, and duration of the gaps per noise segment vary throughout the test for a total of 60 gaps presented in each of four lists. The GIN procedure was administered to 50 normal-hearing listeners (group I) and 18 subjects with confirmed neurological involvement of the central auditory nervous system (group II). Results: Results showed mean approximated gap detection thresholds of 4.8 msec for the left ear and 4.9 msec for the right ear for group I. In comparison, results for group II demonstrated a statistically significant increase in gap detection thresholds, with approximated thresholds of 7.8 msec and 8.5 msec being noted for the left and right ears, respectively. Significant mean differences were also observed in the overall performance scores (i.e., the identification of the presence of the gaps within the noise segments) of the two groups of subjects. Finally, psychometric functions, although similar for short and long duration gaps, were highly different for gaps in the 4- to 10-msec range for the two groups. Conclusions: A variety of psychoacoustic procedures are available to assess temporal resolution; however, the clinical use of these procedures is minimal at best. Results of the present study show that the GIN test holds promise as a clinically useful tool in the assessment of temporal resolution in the clinical arena.

Aetiology and clinical presentations of auditory processing disorders--a review.

Auditory processing disorders may have detrimental consequences on a childs life, if undiagnosed and untreated. We review causes of auditory processing disorders in order to raise clinical awareness. Auditory processing disorders may present against a background of neurological disease or developmental disorders, as well as in isolation. Clinicians need to be aware of potential causes and implications of auditory processing disorders.

Assessment of Central Auditory Dysfunction: the Dichotic Digit Test Revisited

A dichotic digit test was administered to 21 subjects with intracranial lesions. Twelve subjects had lesions limited to the cortex and nine had brain stem disorders. The dichotic digit test appeared to be a sensitive measure for detecting cortex and brain stem lesions. Laterality data indicated markedly reduced performance for the ear contralateral to the hemispheric lesion. Overall results were similar to previous reports on dichotic digits, supporting the use of this test as a screening procedure or part of a test battery for CNS evaluation.

Duration Pattern Recognition in Normal Subjects and Patients with Cerebral and Cochlear Lesions

Three groups of subjects were tested on a duration pattern recognition task. The groups included normal subjects, subjects with cochlear hearing loss, and subjects with lesions involving but not limited to the auditory areas of the cerebrum. Results indicated no significant difference in pattern recognition between the normal subjects and subjects with cochlear hearing loss. However, the subjects with cerebral lesions performed significantly more poorly than either the normal subjects or those with cochlear hearing loss. In comparing pattern recognition performance for the ears ipsilateral and contralateral to the lesioned hemispheres no differences were noted. Rather, when a central lesion was present, both ears generally yielded abnormal scores.

Frequency patterns in cochlear, brainstem, and cerebral lesions

Three groups of patients with different pathologies (cerebral, brainstem, and cochlear lesions) were tested and compared for performance on frequency patterns. Results indicated that the frequency pattern test was highly sensitive to cerebral lesions (83%), but not as sensitive to brainstem lesions (45%). There was very little overlap between results of subjects with cochlear hearing loss and those with cerebral lesions. The specificity of frequency patterns for detecting cerebral lesions (the number of true negative results divided by the number of cochlear subjects) was 88.2%.

The insula (Island of Reil) and its role in auditory processing

The insular cortex is a complex structure which contains areas that subserve visceral sensory, motor, vestibular, and somatosensory functions. The role of the insular cortex in auditory processing was poorly understood until recently. However, recent case studies indicate that bilateral damage to the insulae may result in total auditory agnosia. Functional imaging studies demonstrate that the insulae participate in several key auditory processes, such as allocating auditory attention and tuning in to novel auditory stimuli, temporal processing, phonological processing and visual-auditory integration. These studies do not clarify the issue of further specialisation within the insular cortex, e.g. whether the posterior insulae are primarily sensory areas, while the anterior insulae serve mainly as integration/association auditory areas, two hypotheses that would be compatible with the cytoarchitectonic structure and connectivity of the insulae. The functional characterisation of the insulae remains incomplete, underlining the need for further studies.

Indication of a Lombard vocal response in the St. Lawrence River beluga

Noise pollution is recognized as a potential danger to marine mammals in general, and to the St. Lawrence beluga in particular. One method of determining the impacts of noise on an animals communication is to observe a natural and repeatable response of the vocal system to variations in noise level. This is accomplished by observing intensity changes in animal vocalizations in response to environmental noise. One such response observed in humans, songbirds, and some primates is the Lombard vocal response. This response represents a vocal system reaction manifested by changes in vocalization level in direct response to changes in the noise field. In this research, a population of belugas in the St. Lawrence River Estuary was tested to determine whether a Lombard response existed by using hidden Markhov-classified vocalizations as targets for acoustical analyses. Correlation and regression analyses of signals and noise indicated that the phenomenon does exist. Further, results of human subjects experiments [Egan, J. J. (1966), Ph.D. dissertation; Scheifele, P. M. (2003), Ph.D. dissertation], along with previously reported data from other animal species, are similar to those exhibited by the belugas. Overall, findings suggest that typical noise levels in the St. Lawrence River Estuary have a detectable effect on the communication of the beluga.

Auditory temporal processing deficits in patients with insular stroke

Objective: To assess central auditory function in a series of patients with stroke of the insula and adjacent areas. Methods: The authors recruited eight patients with stroke affecting the insula and adjacent areas and eight neurologically normal controls (matched to the patients for age, sex, handedness, and hearing thresholds). The lesion spared the adjacent auditory areas in three patients and included other auditory structures in five cases. The authors conducted pure-tone audiometry and tympanometry and a central auditory test battery, which included the dichotic digits, and three temporal tests, the duration pattern, frequency pattern, and gaps in noise tests. They collected information from the hospital notes on symptoms at presentation and neuropsychological assessment data during the acute phase. Results: The central auditory tests gave normal results in all controls. The temporal tests gave abnormal results in all three cases in which other auditory areas were spared, as well as in the other five cases. Results of the gaps in noise test were abnormal contralaterally to the lesion in three and bilaterally in five cases. The central auditory deficits did not cosegregate with the presence of cognitive impairment during the acute stage. Conclusion: Insular lesions may affect central auditory function and, in particular, temporal resolution and sequencing, consistent with neuroimaging studies.

Music perception and cognition following bilateral lesions of auditory cortex

We present experimental and anatomical data from a case study of impaired auditory perception following bilateral hemispheric strokes. To consider the cortical representation of sensory, perceptual, and cognitive functions mediating tonal information processing in music, pure tone sensation thresholds, spectral intonation judgments, and the associative priming of spectral intonation judgments by harmonic context were examined, and lesion localization was analyzed quantitatively using straight-line two-dimensional maps of the cortical surface reconstructed from magnetic resonance images. Despite normal pure tone sensation thresholds at 2508000 Hz, the perception of tonal spectra was severely impaired, such that harmonic structures (major triads) were almost uniformly judged to sound dissonant; yet, the associative priming of spectral intonation judgments by harmonic context was preserved, indicating that cognitive representations of tonal hierarchies in music remained intact and accessible. Brainprints demonstrated complete bilateral lesions of the transverse gyri of Heschl and partial lesions of the right and left superior temporal gyri involving 98 and 20% of their surface areas, respectively. In the right hemisphere, there was partial sparing of the planum temporale, temporoparietal junction, and inferior parietal cortex. In the left hemisphere, all of the superior temporal region anterior to the transverse gyrus and parts of the planum temporale, temporoparietal junction, inferior parietal cortex, and insula were spared. These observations suggest that (1) sensory, perceptual, and cognitive functions mediating tonal information processing in music are neurologically dissociable; (2) complete bilateral lesions of primary auditory cortex combined with partial bilateral lesions of auditory association cortex chronically impair tonal consonance perception; (3) cognitive functions that hierarchically structure pitch information and generate harmonic expectancies during music perception do not rely on the integrity of primary auditory cortex; and (4) musical priming may be mediated by broadly tuned subcomponents of the thala-mocortical auditory system.

Three Commonly Asked Questions About Central Auditory Processing DisordersAssessment

Because the topic of selecting tests for assessing central auditory processing disorders (CAPD) is complex and lengthy, we will cover only the main points. The authors are not in favor of using the same central test battery for all patients. Because certain tests are appropriate for specific situations and patients, a tailored set of tests should be chosen for each situation. The following general points should be considered when choosing tests to assess CAPD.