Henning Teismann

Music-induced cortical plasticity and lateral inhibition in the human auditory cortex as foundations for tonal tinnitus treatment

Over the past 15 years, we have studied plasticity in the human auditory cortex by means of magnetoencephalography (MEG). Two main topics nurtured our curiosity: the effects of musical training on plasticity in the auditory system, and the effects of lateral inhibition. One of our plasticity studies found that listening to notched music for 3 h inhibited the neuronal activity in the auditory cortex that corresponded to the center-frequency of the notch, suggesting suppression of neural activity by lateral inhibition. Subsequent research on this topic found that suppression was notably dependent upon the notch width employed, that the lower notch-edge induced stronger attenuation of neural activity than the higher notch-edge, and that auditory focused attention strengthened the inhibitory networks. Crucially, the overall effects of lateral inhibition on human auditory cortical activity were stronger than the habituation effects. Based on these results we developed a novel treatment strategy for tonal tinnitus—tailor-made notched music training (TMNMT). By notching the music energy spectrum around the individual tinnitus frequency, we intended to attract lateral inhibition to auditory neurons involved in tinnitus perception. So far, the training strategy has been evaluated in two studies. The results of the initial long-term controlled study (12 months) supported the validity of the treatment concept: subjective tinnitus loudness and annoyance were significantly reduced after TMNMT but not when notching spared the tinnitus frequencies. Correspondingly, tinnitus-related auditory evoked fields (AEFs) were significantly reduced after training. The subsequent short-term (5 days) training study indicated that training was more effective in the case of tinnitus frequencies ≤ 8 kHz compared to tinnitus frequencies >8 kHz, and that training should be employed over a long-term in order to induce more persistent effects. Further development and evaluation of TMNMT therapy are planned. A goal is to transfer this novel, completely non-invasive and low-cost treatment approach for tonal tinnitus into routine clinical practice.

Short and intense tailor-made notched music training against tinnitus: the tinnitus frequency matters.

Tinnitus is one of the most common diseases in industrialized countries. Here, we developed and evaluated a short-term (5 subsequent days) and intensive (6 hours/day) tailor-made notched music training (TMNMT) for patients suffering from chronic, tonal tinnitus. We evaluated (i) the TMNMT efficacy in terms of behavioral and magnetoencephalographic outcome measures for two matched patient groups with either low (≤8 kHz, N = 10) or high (>8 kHz, N = 10) tinnitus frequencies, and the (ii) persistency of the TMNMT effects over the course of a four weeks post-training phase. The results indicated that the short-term intensive TMNMT took effect in patients with tinnitus frequencies ≤8 kHz: subjective tinnitus loudness, tinnitus-related distress, and tinnitus-related auditory cortex evoked activity were significantly reduced after TMNMT completion. However, in the patients with tinnitus frequencies >8 kHz, significant changes were not observed. Interpreted in their entirety, the results also indicated that the induced changes in auditory cortex evoked neuronal activity and tinnitus loudness were not persistent, encouraging the application of the TMNMT as a longer-term training. The findings are essential in guiding the intended transfer of this neuro-scientific treatment approach into routine clinical practice.

Combining Transcranial Direct Current Stimulation and Tailor-Made Notched Music Training to Decrease Tinnitus-Related Distress – A Pilot Study

The central auditory system has a crucial role in tinnitus generation and maintenance. Curative treatments for tinnitus do not yet exist. However, recent attempts in the therapeutic application of both acoustic stimulation/training procedures and electric/magnetic brain stimulation techniques have yielded promising results. Here, for the first time we combined tailor-made notched music training (TMNMT) with transcranial direct current stimulation (tDCS) in an effort to modulate TMNMT efficacy in the treatment of 32 patients with tonal tinnitus and without severe hearing loss. TMNMT is characterized by regular listening to so-called notched music, which is generated by digitally removing the frequency band of one octave width centered at the individual tinnitus frequency. TMNMT was applied for 10 subsequent days (2.5 hours of daily treatment). During the initial 5 days of treatment and the initial 30 minutes of TMNMT sessions, tDCS (current strength: 2 mA; anodal (N = 10) vs. cathodal (N = 11) vs. sham (N = 11) groups) was applied simultaneously. The active electrode was placed on the head surface over left auditory cortex; the reference electrode was put over right supra-orbital cortex. To evaluate treatment outcome, tinnitus-related distress and perceived tinnitus loudness were assessed using standardized tinnitus questionnaires and a visual analogue scale. The results showed a significant treatment effect reflected in the Tinnitus Handicap Questionnaire that was largest after 5 days of treatment. This effect remained significant at the end of follow-up 31 days after treatment cessation. Crucially, tDCS did not significantly modulate treatment efficacy - it did not make a difference whether anodal, cathodal, or sham tDCS was applied. Possible explanations for the findings and functional modifications of the experimental design for future studies (e.g. the selection of control conditions) are discussed.

Tinnitus: the dark side of the auditory cortex plasticity

Music has increasingly been used as a tool for investigation of human cognition and its underlying brain mechanisms. However, music can be used also for neurorehabilitation. Chronic tinnitus is a symptom with high prevalence, especially in industrialized countries. There is evidence that the tinnitus perception is related to unfavorable cortical plastic changes. Maladaptive auditory cortex reorganization may contribute to the generation and maintenance of tinnitus. Because cortical organization can be modified by behavioral training, potentially via reversing maladaptive auditory cortex reorganization, we attempted to reduce tinnitus loudness by exposing chronic tinnitus patients to self‐chosen, enjoyable music that was modified (“notched”) to contain no energy in the frequency range surrounding the individual tinnitus frequency and thus attracting lateral inhibition to the brain area generating tinnitus. On this basis, we have developed and evaluated a customized music training strategy that appears capable of both reducing cortical tinnitus‐related neuronal activity and alleviating subjective tinnitus perception.

Associations between poor sleep quality and different measures of obesity

OBJECTIVE Poor sleep may be a risk factor for obesity. Previous studies have mainly investigated the effects of sleep duration on body mass index, but research considering overall sleep quality and other anthropometric measures is scarce. The aim of this study was to examine the association between sleep quality and different measures of obesity (general obesity, abdominal obesity, body composition) in a population-based sample of adults. METHODS The study included 753 participants aged 35-65 years from the BiDirect Study, conducted in Münster, Germany. Participants completed the Pittsburgh Sleep Quality Index (PSQI) on sleep characteristics. Weight, height, and waist circumference were measured by trained study nurses. Body composition (fat mass and fat-free mass) was assessed using bioelectrical impedance analysis. The cross-sectional relationship between sleep quality and measures of obesity was investigated using logistic regression analysis. RESULTS Among the participants, 65.3% reported good (PSQI ≤ 5) and 34.7% poor (PSQI > 5) sleep quality. We observed a significant association of poorer sleep quality assessed by the continuous PSQI score with general obesity and high body fat (for both, odds ratio = 1.07, 95% confidence interval = 1.01-1.13), adjusted for socio-demographic and lifestyle factors. Further adjustment for depressive symptoms and somatic comorbidities attenuated the relationship. The observed association was mainly driven by the PSQI components sleep latency, sleep disturbances, and daytime dysfunction. CONCLUSIONS The present study suggests that poor sleep quality may predict obesity and high body fat mass among adults. However, a causal relationship still has to be confirmed by prospective studies with objective measurements of sleep and obesity.

Bottom-up driven involuntary attention modulates auditory signal in noise processing

BackgroundAuditory evoked responses can be modulated by both the sequencing and the signal-to-noise ratio of auditory stimuli. Constant sequencing as well as intense masking sounds basically lead to N1m response amplitude reduction. However, the interaction between these two factors has not been investigated so far. Here, we presented subjects tone stimuli of different frequencies, which were either concatenated in blocks of constant frequency or in blocks of randomly changing frequencies. The tones were presented either in silence or together with broad-band noises of varying levels.ResultsIn silence, tones presented with random sequencing elicited a larger N1m response than tones presented with constant sequencing. With increasing noise level, this difference decreased and even vanished in the condition where noise intensity exceeded the tone intensity by 10 dB. Furthermore, under noisy conditions, the N1m latency was shorter in the constant sequencing condition compared to the random sequencing condition.ConclusionsBesides the well-known neural habituation mechanisms, bottom-up driven attention plays an important role during auditory processing in noisy environments. This bottom-up driven attention would allow us to track a certain auditory signal in noisy situations without voluntarily paying attention to the auditory modality.

Involuntary monitoring of sound signals in noise is reflected in the human auditory evoked N1m response.

Constant sound sequencing as operationalized by repeated stimulation with tones of the same frequency has multiple effects. On the one hand, it activates mechanisms of habituation and refractoriness, which are reflected in the decrease of response amplitude of evoked responses. On the other hand, the constant sequencing acts as spectral cueing, resulting in tones being detected faster and more accurately. With the present study, by means of magnetoencephalography, we investigated the impact of repeated tone stimulation on the N1m auditory evoked fields, while listeners were distracted from the test sounds. We stimulated subjects with trains of either four tones of the same frequency, or with trains of randomly assigned frequencies. The trains were presented either in a silent or in a noisy background. In silence, the patterns of source strength decline originating from repeated stimulation suggested both, refractoriness as well as habituation as underlying mechanisms. In noise, in contrast, there was no indication of source strength decline. Furthermore, we found facilitating effects of constant sequencing regarding the detection of the single tones as indexed by a shortening of N1m latency. We interpret our findings as a correlate of a bottom-up mechanism that is constantly monitoring the incoming auditory information, even when voluntary attention is directed to a different modality.

Constraint-induced sound therapy for sudden sensorineural hearing loss - behavioral and neurophysiological outcomes

Sudden sensorineural hearing loss is characterized by acute, idiopathic hearing deterioration. We report here the development and evaluation of “constraint-induced sound therapy”, which is based on a well-established neuro-rehabilitation approach, and which is characterized by the plugging of the intact ear (“constraint”) and the simultaneous, extensive stimulation of the affected ear with music. The sudden sensorineural hearing loss patients who received the constraint-induced sound therapy in addition to the standard corticosteroid therapy showed significantly better recovery of hearing function compared to those who had only received corticosteroid treatments. Additionally, the brain activity obtained in a subgroup of patients suggested that the constraint-induced sound therapy could have prevented maladaptive auditory cortex reorganization. Constraint-induced sound therapy thus appears to be an effective, practical, and safe treatment option for sudden sensorineural hearing loss.

Broadened population-level frequency tuning in human auditory cortex of portable music player users.

Nowadays, many people use portable players to enrich their daily life with enjoyable music. However, in noisy environments, the player volume is often set to extremely high levels in order to drown out the intense ambient noise and satisfy the appetite for music. Extensive and inappropriate usage of portable music players might cause subtle damages in the auditory system, which are not behaviorally detectable in an early stage of the hearing impairment progress. Here, by means of magnetoencephalography, we objectively examined detrimental effects of portable music player misusage on the population-level frequency tuning in the human auditory cortex. We compared two groups of young people: one group had listened to music with portable music players intensively for a long period of time, while the other group had not. Both groups performed equally and normally in standard audiological examinations (pure tone audiogram, speech test, and hearing-in-noise test). However, the objective magnetoencephalographic data demonstrated that the population-level frequency tuning in the auditory cortex of the portable music player users was significantly broadened compared to the non-users, when attention was distracted from the auditory modality; this group difference vanished when attention was directed to the auditory modality. Our conclusion is that extensive and inadequate usage of portable music players could cause subtle damages, which standard behavioral audiometric measures fail to detect in an early stage. However, these damages could lead to future irreversible hearing disorders, which would have a huge negative impact on the quality of life of those affected, and the society as a whole.

Auditory Evoked Fields Elicited by Spectral, Temporal, and Spectral–Temporal Changes in Human Cerebral Cortex

Natural sounds contain complex spectral components, which are temporally modulated as time-varying signals. Recent studies have suggested that the auditory system encodes spectral and temporal sound information differently. However, it remains unresolved how the human brain processes sounds containing both spectral and temporal changes. In the present study, we investigated human auditory evoked responses elicited by spectral, temporal, and spectral–temporal sound changes by means of magnetoencephalography. The auditory evoked responses elicited by the spectral–temporal change were very similar to those elicited by the spectral change, but those elicited by the temporal change were delayed by 30–50 ms and differed from the others in morphology. The results suggest that human brain responses corresponding to spectral sound changes precede those corresponding to temporal sound changes, even when the spectral and temporal changes occur simultaneously.