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Introduction: Aided auditory late latency response (LLR) serves as an objective tool for evaluating auditory cortical maturation following cochlear implantation in children. While aided LLR is commonly measured using sound-field acoustic stimulation, recording electrically evoked LLR (eLLR) offer distinct advantages, such as improved stimulus control and the capability for single electrode stimulation. Hence, the study aimed to compare eLLR responses with single electrode stimulation in the apical, middle, and basal regions and to evaluate their relationship with speech perception in paediatric cochlear implant (CI) recipients. Method: eLLR responses with single electrode stimulation were measured in 27 paediatric unilateral CI users with an active recording electrode placed at Cz. The stimuli consisted of 36 msec biphasic pulse trains presented across three electrode sites (apical-E20, middle-E11, and basal-E03). eLLR responses were compared across these electrode sites, and the relationship between speech recognition scores in quiet and age at implantation with eLLR components was evaluated. Results: eLLR responses were detected in 77 out of 81 tested electrodes of all participants combined (27 for apical, 26 for middle, and 24 for basal stimulation). There were no significant differences in P1, N1 latencies and P1 amplitude across electrode site. However, significantly larger N1 and P1-N1 amplitudes were observed for apical stimulations compared to basal stimulations. No differences in N1 amplitude were found between middle and apical stimulations, and the P1-N1 amplitude was significantly larger for middle compared to basal electrode stimulation, with no difference between the apical and middle electrodes stimulation. A moderate positive correlation was present between speech recognition scores in quiet and both N1, P1-N1 amplitudes for apical stimulation. Age at implantation was negatively correlated with N1 amplitude for the apical and P1-N1 amplitude for basal stimulation. Discussion: eLLR responses could be elicited in majority of paediatric CI users across electrode sites. Variations in eLLR responses across electrode sites suggest disparities in auditory cortical maturation. The findings underscore the significance of the N1 biomarker in evaluating higher-order auditory cortical development. Therefore, utilizing eLLR with single electrode stimulation may serve as a valuable tool for assessing post-cochlear implantation maturational changes in paediatric populations. [ABSTRACT FROM AUTHOR]

Abstract Background Cortical auditory evoked potentials (CAEPs) display both auditory processing and neurological activity in the auditory cortex. The purpose of this research is to evaluate the importance of CAEPs in identifying auditory processing disorders in patients with peripheral neuropathy (PN) in different pathologies. Sixty cases with PN of different pathologies represented the study group which was classified into two subgroups according to the underlying pathology of PN: those with either axonal PN (44 patients) and those with demyelinating PN (16 patients). The current study also included a control group of 40 healthy volunteers who did not have any peripheral or central auditory neurological disorders. CAEPs were recorded in both groups. Results The study group’s CAEP response showed significantly delayed latencies than the control groups. Comparing the two study subgroups revealed that the axonal PN group had significant delayed latencies of N1 and P2 components in comparison to the demyelinating PN group. Conclusion Cortical auditory evoked potentials can be used efficiently to diagnosis central auditory processing disorders in patients with PN. CAEP latencies can be employed alone or in conjunction with amplitudes; however, CAEP latencies are more significant than amplitudes for such purpose. Both demyelinating and axonal PN are associated with impaired auditory processing; however, axonal PN patients are more likely to be affected, suggesting that axonal PN has a significantly drastic effect on the central auditory nervous system.

Background: Cortical auditory evoked potentials (CAEPs) display both auditory processing and neurological activity in the auditory cortex. The purpose of this research is to evaluate the importance of CAEPs in identifying auditory processing disorders in patients with peripheral neuropathy (PN) in different pathologies. Sixty cases with PN of different pathologies represented the study group which was classified into two subgroups according to the underlying pathology of PN: those with either axonal PN (44 patients) and those with demyelinating PN (16 patients). The current study also included a control group of 40 healthy volunteers who did not have any peripheral or central auditory neurological disorders. CAEPs were recorded in both groups. Results: The study group's CAEP response showed significantly delayed latencies than the control groups. Comparing the two study subgroups revealed that the axonal PN group had significant delayed latencies of N1 and P2 components in comparison to the demyelinating PN group. Conclusion: Cortical auditory evoked potentials can be used efficiently to diagnosis central auditory processing disorders in patients with PN. CAEP latencies can be employed alone or in conjunction with amplitudes; however, CAEP latencies are more significant than amplitudes for such purpose. Both demyelinating and axonal PN are associated with impaired auditory processing; however, axonal PN patients are more likely to be affected, suggesting that axonal PN has a significantly drastic effect on the central auditory nervous system. [ABSTRACT FROM AUTHOR]

Simple Summary: Many individuals report difficulty perceiving speech in background noise. Research has shown that one factor in this type of processing is the effect of noise on the brain's response to speech. Different types of noise affect the strength of the neural encoding of speech to varying degrees, with greater informational masking causing greater degradation. Previous research has focused on the effects of attention in noise, which tends to enhance the neural encoding of the speech signal via inhibitory mechanisms. However, there is a pre-attentive stage of inhibition, sensory gating, which has been linked to speech perception in noise. The impact of noise on the neural response during this phase remains unclear. This preliminary study investigated the gating response, recorded via high-density EEG in fifteen normal-hearing adults, in quiet and noise conditions with low and high informational masking. Scalp maps were generated to observe brain activation in each condition. Significant gating occurred in quiet, while noise conditions resulted in a significantly decreased gating response. The gating function was significantly degraded in noise with less informational masking content, coinciding with a reduced activation of inhibitory gating networks. These findings illustrate the adverse effect of noise on pre-attentive inhibition related to speech perception. Cortical auditory evoked potentials (CAEPs) indicate that noise degrades auditory neural encoding, causing decreased peak amplitude and increased peak latency. Different types of noise affect CAEP responses, with greater informational masking causing additional degradation. In noisy conditions, attention can improve target signals' neural encoding, reflected by an increased CAEP amplitude, which may be facilitated through various inhibitory mechanisms at both pre-attentive and attentive levels. While previous research has mainly focused on inhibition effects during attentive auditory processing in noise, the impact of noise on the neural response during the pre-attentive phase remains unclear. Therefore, this preliminary study aimed to assess the auditory gating response, reflective of the sensory inhibitory stage, to repeated vowel pairs presented in background noise. CAEPs were recorded via high-density EEG in fifteen normal-hearing adults in quiet and noise conditions with low and high informational masking. The difference between the average CAEP peak amplitude evoked by each vowel in the pair was compared across conditions. Scalp maps were generated to observe general cortical inhibitory networks in each condition. Significant gating occurred in quiet, while noise conditions resulted in a significantly decreased gating response. The gating function was significantly degraded in noise with less informational masking content, coinciding with a reduced activation of inhibitory gating networks. These findings illustrate the adverse effect of noise on pre-attentive inhibition related to speech perception. [ABSTRACT FROM AUTHOR]

IntroductionAided auditory late latency response (LLR) serves as an objective tool for evaluating auditory cortical maturation following cochlear implantation in children. While aided LLR is commonly measured using sound-field acoustic stimulation, recording electrically evoked LLR (eLLR) offer distinct advantages, such as improved stimulus control and the capability for single electrode stimulation. Hence, the study aimed to compare eLLR responses with single electrode stimulation in the apical, middle, and basal regions and to evaluate their relationship with speech perception in paediatric cochlear implant (CI) recipients.MethodeLLR responses with single electrode stimulation were measured in 27 paediatric unilateral CI users with an active recording electrode placed at Cz. The stimuli consisted of 36 msec biphasic pulse trains presented across three electrode sites (apical-E20, middle-E11, and basal-E03). eLLR responses were compared across these electrode sites, and the relationship between speech recognition scores in quiet and age at implantation with eLLR components was evaluated.ResultseLLR responses were detected in 77 out of 81 tested electrodes of all participants combined (27 for apical, 26 for middle, and 24 for basal stimulation). There were no significant differences in P1, N1 latencies and P1 amplitude across electrode site. However, significantly larger N1 and P1-N1 amplitudes were observed for apical stimulations compared to basal stimulations. No differences in N1 amplitude were found between middle and apical stimulations, and the P1-N1 amplitude was significantly larger for middle compared to basal electrode stimulation, with no difference between the apical and middle electrodes stimulation. A moderate positive correlation was present between speech recognition scores in quiet and both N1, P1-N1 amplitudes for apical stimulation. Age at implantation was negatively correlated with N1 amplitude for the apical and P1-N1 amplitude for basal stimulation.DiscussioneLLR responses could be elicited in majority of paediatric CI users across electrode sites. Variations in eLLR responses across electrode sites suggest disparities in auditory cortical maturation. The findings underscore the significance of the N1 biomarker in evaluating higher-order auditory cortical development. Therefore, utilizing eLLR with single electrode stimulation may serve as a valuable tool for assessing post-cochlear implantation maturational changes in paediatric populations.

Purpose:The use of objective electrophysiological tests of hearing with the approaches of threshold estimation, otoneurology diagnosis, as well as evaluating the usefulness of hearing prostheses, including hearing aids and cochlear implants, have been of interest to clinicians and researchers in the field of hearing sciences since the beginning. Among the existing objective hearing tests, the recording of auditory late responses (ALRs) is a sign of detecting auditory stimuli in the auditory cortical areas and provides information on the correct functioning of the cortical and subcortical auditory areas. This information cannot be obtained using objective and routine tests such as auditory brainstem responses (ABRs). The purpose of the present study is to review the practical and multiple approaches of this tool in the test battery approach in order to evaluate the hearing system of children and adults and the usefulness of rehabilitation in hearing impaired individuals.Methods:This study is a narrative review and searches for sources using the keywords "cortical auditory evoked potentials", "auditory late responses", "N1-P2", "hearing aids", "cochlear implantation", "auditory training", and "auditory threshold" between the period of 2000 and 2023 in Google Scholar, PubMed, SID, and Magiran databases were performed.Results:Among the studies found, duplicates were removed and those with available full text were used in this study. By evaluating the results obtained from them, the use of ALRs in estimating the hearing threshold of children and adults is confirmed, and this test can be used to evaluate the usefulness of the chosen rehabilitation strategy, including hearing aid, cochlear implantation, and auditory training.Conclusion:The study showed that ALRs are a useful tool for evaluating the cortical auditory areas and can, along with other electrophysiological hearing tests such as ABRs, provide more awareness in a wider range of the auditory system, especially for diagnostic approaches and evaluation of the usefulness of rehabilitation interventions, especially at a young age, for therapists.

Cortical auditory evoked potentials (CAEPs) indicate that noise degrades auditory neural encoding, causing decreased peak amplitude and increased peak latency. Different types of noise affect CAEP responses, with greater informational masking causing additional degradation. In noisy conditions, attention can improve target signals’ neural encoding, reflected by an increased CAEP amplitude, which may be facilitated through various inhibitory mechanisms at both pre-attentive and attentive levels. While previous research has mainly focused on inhibition effects during attentive auditory processing in noise, the impact of noise on the neural response during the pre-attentive phase remains unclear. Therefore, this preliminary study aimed to assess the auditory gating response, reflective of the sensory inhibitory stage, to repeated vowel pairs presented in background noise. CAEPs were recorded via high-density EEG in fifteen normal-hearing adults in quiet and noise conditions with low and high informational masking. The difference between the average CAEP peak amplitude evoked by each vowel in the pair was compared across conditions. Scalp maps were generated to observe general cortical inhibitory networks in each condition. Significant gating occurred in quiet, while noise conditions resulted in a significantly decreased gating response. The gating function was significantly degraded in noise with less informational masking content, coinciding with a reduced activation of inhibitory gating networks. These findings illustrate the adverse effect of noise on pre-attentive inhibition related to speech perception.

Objectives The objective assessment tests overcome the variability of subjective methods. Cortical recordings with gap pre-pulse inhibition of the acoustic startle reflex stimulus have been used as objective tinnitus assessments in humans. This study aims to investigate this possible objective tinnitus test and compare gap-induced inhibition in different stimulus parameters and brain regions. Materials & Methods Twenty People (18-50 years old) without hearing loss and tinnitus were included. The sound stimuli consisted of continuous background noise with a loud startle tone preceded by a silent gap (20 and 40 ms duration, 120 and 150 ms distance from the startle). The N1-P2 complex amplitude and topoplot maps were extracted in 27-channel cortical response recording after signal processing. Four brain regions of interest (ROI) of anterio-frontal, centro-frontal, right, and left temporal were investigated. Results The results showed that the maximum inhibition occurred in a 40 ms gap duration and 150 ms distance in all 4 ROIs. In comparing ROIs, the centro-frontal and left temporal regions revealed the most inhibition (p<0.05). The decrease in the amplitude of the N1 and P2 in that region could also be traced in the 100 and 200 ms topoplots. Conclusion Gap-induced inhibition was observed in all gap-embedded stimuli and all ROIs. However, the 40-150 mode and centro-frontal and left temporal regions had maximum inhibition in normal subjects. It provides a promising tool for objectively assessing tinnitus in humans with particular implications in children. [ABSTRACT FROM AUTHOR]

Background: Among individuals with vestibular dysfunction, the loss of vestibular sensory information is found to alter cognitive abilities that coordinate spatial and non-spatial information. P300 is an event-related potential commonly used to assess cognitive processing. The aim of the present study was to compare the latency and amplitude of cortical auditory evoked potential and P300 between individuals with vestibular dysfunction and individuals with no vestibular dysfunction. Methods: Forty adults with a mean age of 40.5 ± 13.07 participated in the study. Group I included 20 adults diagnosed with vestibular dysfunction and group II included 20 age-matched adults with no vestibular dysfunction. The P300 was recorded from the electrode site Cz and Pz. It was elicited using pure-tones in odd-ball paradigm. The latency and amplitude of peaks P1, N1, P2, and N2 of the cortical auditory evoked potential and the P300 were measured. Results: Significant amplitude difference was observed in cortical potentials at Cz and Pz. The P300 was present only in 70% of individuals with vestibular dysfunction compared to 100% among individuals with no vestibular dysfunction. The mean amplitude of the P300 was slightly larger in group 1 compared to group 2 and the mean latency of the P300 was similar in both groups. However, the difference in amplitude of the P300 between groups was not statistically significant. Conclusions: Knowing the cognitive function of individuals with vestibular dysfunction enables planning vestibular rehabilitation therapy, which enhances the quality of life in these individuals by improving their vestibular and cognitive functions.

Differences in the timing and intensity of sounds arriving at the two ears provide fundamental binaural cues that help us localize and segregate sounds in the environment. Neural encoding of these cues is commonly represented asymmetrically in the cortex with stronger activation in the hemisphere contralateral to the perceived spatial location. Although advancing age is known to degrade the perception of binaural cues, less is known about how the neural representation of such cues is impacted by age. Here, we use electroencephalography (EEG) to investigate age-related changes in the hemispheric distribution of interaural time difference (ITD) encoding based on cortical auditory evoked potentials (CAEPs) and derived binaural interaction component (BIC) measures in ten younger and ten older normalhearing adults. Sensor-level analyses of the CAEP and BIC showed age-related differences in global field power, where older listeners had significantly larger responses than younger for both binaural metrics. Source-level analyses showed hemispheric differences in auditory cortex activity for left and right lateralized stimuli in younger adults, consistent with a contralateral activation model for processing ITDs. Older adults, however, showed reduced hemispheric asymmetry across ITDs, despite having overall larger responses than younger adults. Further, when averaged across ITD condition to evaluate changes in cortical asymmetry over time, there was a significant shift in laterality corresponding to the peak components (P1, N1, P2) in the source waveform that also was affected by age. These novel results demonstrate across-hemisphere cortical dynamics during binaural temporal processing that are altered with advancing age. [ABSTRACT FROM AUTHOR]

Differences in the timing and intensity of sounds arriving at the two ears provide fundamental binaural cues that help us localize and segregate sounds in the environment. Neural encoding of these cues is commonly represented asymmetrically in the cortex with stronger activation in the hemisphere contralateral to the perceived spatial location. Although advancing age is known to degrade the perception of binaural cues, less is known about how the neural representation of such cues is impacted by age. Here, we use electroencephalography (EEG) to investigate age-related changes in the hemispheric distribution of interaural time difference (ITD) encoding based on cortical auditory evoked potentials (CAEPs) and derived binaural interaction component (BIC) measures in ten younger and ten older normal-hearing adults. Sensor-level analyses of the CAEP and BIC showed age-related differences in global field power, where older listeners had significantly larger responses than younger for both binaural metrics. Source-level analyses showed hemispheric differences in auditory cortex activity for left and right lateralized stimuli in younger adults, consistent with a contralateral activation model for processing ITDs. Older adults, however, showed reduced hemispheric asymmetry across ITDs, despite having overall larger responses than younger adults. Further, when averaged across ITD condition to evaluate changes in cortical asymmetry over time, there was a significant shift in laterality corresponding to the peak components (P1, N1, P2) in the source waveform that also was affected by age. These novel results demonstrate across-hemisphere cortical dynamics during binaural temporal processing that are altered with advancing age.

Background: Vestibular dysfunction is known to affect cognitive abilities related to the processing of spatial and non-spatial information. P300 is an event-related potential (ERP) used to assess cognitive function. Studies have shown abnormalities in P300 in individuals with vestibular hypofunction. However, the literature shows equivocal findings for P300 in individuals with vestibular dysfunction. The aim of present study was to compare the latency and amplitude of cortical auditory evoked potential and P300 between individuals with vestibular dysfunction and individuals with no vestibular dysfunction. Methods: Forty adults with a mean age of 40.5 years participated in the study. Group I included 20 adults diagnosed with vestibular dysfunction and group II included 20 age-matched adults with no vestibular dysfunction. The P300 was recorded using pure-tones in an odd-ball paradigm, from electrode sites Cz and Pz. The latency and amplitude of peaks P1, N1, P2, N2 P300, and N4 were measured. Results: The results showed no significant difference in the latency and amplitude of peaks P1, N1, P2, and N2 of the cortical auditory potentials between groups. The P300 was absent in approximately 30% of individuals with vestibular dysfunction meanwhile, it was present in all individuals in group II. The mean latency and amplitude of the P300 and latency of N4 were not significantly different between the groups. However, a significant difference was observed in N4 amplitude between groups at both electrode sites. And, no correlation was observed between the DHI score and the P300 parameters in group I. Conclusions: the P300 was absent in a greater number of individuals with vestibular dysfunction, suggesting cognitive impairment. However, when the P300 was present the peak latency and amplitude showed no significant difference in both groups.

Background: Among individuals with vestibular dysfunction, the loss of vestibular sensory information is found to alter cognitive abilities that coordinate spatial and non-spatial information. P300 is an event-related potential commonly used to assess cognitive processing. The aim of the present study was to compare the latency and amplitude of cortical auditory evoked potential and P300 between individuals with vestibular dysfunction and individuals with no vestibular dysfunction. Methods: Forty adults with a mean age of 40.5 ± 13.07 participated in the study. Group I included 20 adults diagnosed with vestibular dysfunction and group II included 20 age-matched adults with no vestibular dysfunction. The P300 was recorded from the electrode site Cz and Pz. It was elicited using pure-tones in odd-ball paradigm. The latency and amplitude of peaks P1, N1, P2, and N2 of the cortical auditory evoked potential and the P300 were measured. Results: Significant amplitude difference was observed in cortical potentials at Cz and Pz. The P300 was present only in 70% of individuals with vestibular dysfunction compared to 100% among individuals with no vestibular dysfunction. The mean amplitude of the P300 was slightly larger in group 1 compared to group 2 and the mean latency of the P300 was similar in both groups. However, the difference in amplitude of the P300 between groups was not statistically significant. Conclusions: Knowing the cognitive function of individuals with vestibular dysfunction enables planning vestibular rehabilitation therapy, which enhances the quality of life in these individuals by improving their vestibular and cognitive functions.

Age-related hearing loss is one of the most prevalent health conditions in older adults. Although hearing aid technology has advanced dramatically, a large percentage of older adults do not use hearing aids. This untreated hearing loss may accelerate declines in cognitive and neural function and dramatically affect the quality of life. Our previous findings have shown that the use of hearing aids improves cortical and cognitive function and offsets subcortical physiological decline. The current study tested the time course of neural adaptation to hearing aids over the course of 6 months and aimed to determine whether early measures of cortical processing predict the capacity for neural plasticity. Seventeen (9 females) older adults (mean age = 75 years) with age-related hearing loss with no history of hearing aid use were fit with bilateral hearing aids and tested in six testing sessions. Neural changes were observed as early as 2 weeks following the initial fitting of hearing aids. Increases in N1 amplitudes were observed as early as 2 weeks following the hearing aid fitting, whereas changes in P2 amplitudes were not observed until 12 weeks of hearing aid use. The findings suggest that increased audibility through hearing aids may facilitate rapid increases in cortical detection, but a longer time period of exposure to amplified sound may be required to integrate features of the signal and form auditory object representations. The results also showed a relationship between neural responses in earlier sessions and the change predicted after 6 months of the use of hearing aids. This study demonstrates rapid cortical adaptation to increased auditory input. Knowledge of the time course of neural adaptation may aid audiologists in counseling their patients, especially those who are struggling to adjust to amplification. A future comparison of a control group with no use of hearing aids that undergoes the same testing sessions as the study's group will validate these findings. [ABSTRACT FROM AUTHOR]

Age-related hearing loss is one of the most prevalent health conditions in older adults. Although hearing aid technology has advanced dramatically, a large percentage of older adults do not use hearing aids. This untreated hearing loss may accelerate declines in cognitive and neural function and dramatically affect the quality of life. Our previous findings have shown that the use of hearing aids improves cortical and cognitive function and offsets subcortical physiological decline. The current study tested the time course of neural adaptation to hearing aids over the course of 6 months and aimed to determine whether early measures of cortical processing predict the capacity for neural plasticity. Seventeen (9 females) older adults (mean age = 75 years) with age-related hearing loss with no history of hearing aid use were fit with bilateral hearing aids and tested in six testing sessions. Neural changes were observed as early as 2 weeks following the initial fitting of hearing aids. Increases in N1 amplitudes were observed as early as 2 weeks following the hearing aid fitting, whereas changes in P2 amplitudes were not observed until 12 weeks of hearing aid use. The findings suggest that increased audibility through hearing aids may facilitate rapid increases in cortical detection, but a longer time period of exposure to amplified sound may be required to integrate features of the signal and form auditory object representations. The results also showed a relationship between neural responses in earlier sessions and the change predicted after 6 months of the use of hearing aids. This study demonstrates rapid cortical adaptation to increased auditory input. Knowledge of the time course of neural adaptation may aid audiologists in counseling their patients, especially those who are struggling to adjust to amplification. A future comparison of a control group with no use of hearing aids that undergoes the same testing sessions as the study’s group will validate these findings.

Objective: The objective of the study is to establish normative values of cortical evoked response audiometry (CERA) in a heterogeneous Indian population and correlate CERA threshold with pure tone audiometric (PTA) threshold values. Materials and Methods: A prospective study was carried out on 31 volunteers (n = 62) who had no otological or neurological complaints. Two study groups were formed; Group 1 with individuals from 20 to 40 years (mean age of 29.1 years) and Group 2 with individuals from 41 to 60 years (mean age of 46.2 years). The latencies and amplitudes of the waves of P1, N1, and P2 at threshold and 70 dBnHL were measured. Results: Twenty-nine participants (94% of the ears) had CERA threshold within 20 dB of true behavioral threshold with only 6% having a difference of >20 dB with their PTA thresholds. There was a significant difference (P < 0.05) at 70 dB in amplitudes for waves P1, N1, and P2 at 2 kHz and additionally at 1 kHz for N1 between the two groups. Conclusion: Normative values for CERA in a heterogeneous Indian population at 70 dB nHL using tone burst stimulus was found to have an average latency of 46.5, 90.1, and 155.5 ms for P1, N1, and P2, respectively. The average amplitude of P1 at 70 dB nHL was 4.3 μV, N1, was 6.5 μV and P2 was 3.2 μV. Hearing threshold obtained with CERA gave a good indication of the actual behavioral hearing threshold of the normal controls, and the age of an individual had a significant effect on the values obtained during CERA testing with N1 being significantly larger at 1 kHz and 2 kHz in older adults when compared to young adults.

Background and Objectives: Tinnitus is a complex condition that varies in loudness, quality, location, and distress. Different definitions, heterogeneity, and lack of objective measuring have challenged the understanding the mechanisms involved and definitive cure. The integrative model correlates each of these characteristics to separate parallel and overlapping subnetworks that process tinnitus’s perception and emotional reaction. Many of these networks are common with the gap pre-pulse inhibition of acoustic startle (GPIAS) neural circuity. GPIAS, which measures tinnitus in animals, has recently been used for humans with various recording methods. The present study aimed to review the evidence achieved with gap stimuli in patients with tinnitus to support the potential of cortical responses recorded with the GPIAS stimulus and to objectively detect tinnitus in humans. Methods: Studies were identified by searching electronic databases with relevant keywords. Results: The role of the auditory cortex in processing short gaps, the possibility of evaluating the gap detection ability with GPIAS, and the advantage of cortical responses in reflecting both stimulus properties and different aspects of tinnitus emphasize the importance of this issue. The results of most studies have proven the gap detection deficiency in tinnitus. However, the validity of the auditory startle reflex still needs to be verified due to the inherent variability and different methods. Conclusion: Further human studies are recommended because the perception of tinnitus can be controlled. An appealing research line in this area is multi-channel cortical evoked potentials. Defects of GPIAS with cortical recording can indicate tinnitus.

Background: Late latency auditory evoked potentials (LLAEPs) provide objective evidence of an individual's central auditory processing abilities. Electrically evoked cortical auditory evoked potentials (eCAEPs) are a type of LLAEP that provides an objective measure of aided speech perception and auditory processing abilities in cochlear implant (CI) recipients.Aim: To determine the short-term test-retest reliability of eCAEPs in adult CI recipients.Design: An explorative, within-subject repeated measures research design was employed.Study Sample: The study sample included 12 post-lingually deafened, unilaterally implanted adult CI recipients with at least 9 months of CI experience.Method: eCAEPs representing basal, medial and apical cochlear regions were recorded in the implanted ears of each participant. Measurements were repeated 7 days after the initial assessment.Results: No significant differences between either median latencies or amplitudes at test and retest sessions (p > 0.05) were found when results for apical, medial and basal electrodes were averaged together. Mean intraclass correlation coefficient (ICC) scores averaged across basal, medial and apical cochlear stimulus regions indicated that both consistency and agreement were statistically significant and ranged from moderate to good (ICC = 0.58–0.86, p < 0.05). ICC confidence intervals did demonstrate considerable individual variability in both latency and amplitudes.Conclusion: eCAEP latencies and amplitudes demonstrated moderate to good short-term test-retest reliability. However, confidence intervals indicated individual variability in measurement consistency which is likely linked to attention and listening effort required from the CI recipients.

Background/aim: The aim of this study was to determine the age-related latency interval of P1 latencies of children with normal hearing, and to evaluate the P1 latency changes after surgery in children who underwent cochlear implantation. Materials and methods: We evaluated 60 children with normal hearing and 16 children with cochlear implants aged 0-6 years using cortical auditory evoked potentials. P1 latencies were measured only once in the children with normal hearing, and on the postoperative first day, and the first, third, and sixth postoperative months in the children with cochlear implants. Results: There was a statistically significant decrease in the P1 latencies as the age increased in children with normal hearing (P < 0.001). It was determined that when the external partof the cochlear implant was applied, the P1 latencies of children with cochlear implants were significantly longer than those of age-matched children with normal hearing (P < 0.001). This difference disappeared in 10 children with implants at the third and sixth months, but significant differences remained in 6 children. Conclusion: P1 latency could be used as an objective tool to evaluate the normal development of auditory pathways, and may be helpful in the effective programming of children undergoing cochlear implantation. [ABSTRACT FROM AUTHOR]

Objective: The objective of the study is to establish normative values of cortical evoked response audiometry (CERA) in a heterogeneous Indian population and correlate CERA threshold with pure tone audiometric (PTA) threshold values. Materials and Methods: A prospective study was carried out on 31 volunteers (n = 62) who had no otological or neurological complaints. Two study groups were formed; Group 1 with individuals from 20 to 40 years (mean age of 29.1 years) and Group 2 with individuals from 41 to 60 years (mean age of 46.2 years). The latencies and amplitudes of the waves of P1, N1, and P2 at threshold and 70 dBnHL were measured. Results: Twenty-nine participants (94% of the ears) had CERA threshold within 20 dB of true behavioral threshold with only 6% having a difference of >20 dB with their PTA thresholds. There was a significant difference (P < 0.05) at 70 dB in amplitudes for waves P1, N1, and P2 at 2 kHz and additionally at 1 kHz for N1 between the two groups. Conclusion: Normative values for CERA in a heterogeneous Indian population at 70 dB nHL using tone burst stimulus was found to have an average latency of 46.5, 90.1, and 155.5 ms for P1, N1, and P2, respectively. The average amplitude of P1 at 70 dB nHL was 4.3 μV, N1, was 6.5 μV and P2 was 3.2 μV. Hearing threshold obtained with CERA gave a good indication of the actual behavioral hearing threshold of the normal controls, and the age of an individual had a significant effect on the values obtained during CERA testing with N1 being significantly larger at 1 kHz and 2 kHz in older adults when compared to young adults. [ABSTRACT FROM AUTHOR]

Background: Late latency auditory evoked potentials (LLAEPs) provide objective evidence of an individual's central auditory processing abilities. Electrically evoked cortical auditory evoked potentials (eCAEPs) are a type of LLAEP that provides an objective measure of aided speech perception and auditory processing abilities in cochlear implant (CI) recipients. Aim: To determine the short-term test-retest reliability of eCAEPs in adult CI recipients. Design: An explorative, within-subject repeated measures research design was employed. Study Sample: The study sample included 12 post-lingually deafened, unilaterally implanted adult CI recipients with at least 9 months of CI experience. Method: eCAEPs representing basal, medial and apical cochlear regions were recorded in the implanted ears of each participant. Measurements were repeated 7 days after the initial assessment. Results: No significant differences between either median latencies or amplitudes at test and retest sessions (p > 0.05) were found when results for apical, medial and basal electrodes were averaged together. Mean intraclass correlation coefficient (ICC) scores averaged across basal, medial and apical cochlear stimulus regions indicated that both consistency and agreement were statistically significant and ranged from moderate to good (ICC = 0.58–0.86, p < 0.05). ICC confidence intervals did demonstrate considerable individual variability in both latency and amplitudes. Conclusion: eCAEP latencies and amplitudes demonstrated moderate to good short-term test-retest reliability. However, confidence intervals indicated individual variability in measurement consistency which is likely linked to attention and listening effort required from the CI recipients. [ABSTRACT FROM AUTHOR]

Individuals with Autism Spectrum Disorder (ASD) experience challenges with social communication, often involving emotional elements of language. This may stem from underlying auditory processing difficulties, especially when incoming speech is nuanced or complex. This study explored the effects of auditory training on social perception abilities of children with ASD. The training combined use of a remote-microphone hearing system and computerized emotion perception training. At baseline, children with ASD had poorer social communication scores and delayed mismatch negativity (MMN) compared to typically developing children. Behavioral results, measured pre- and post-intervention, revealed increased social perception scores in children with ASD to the extent that they outperformed their typically developing peers post-intervention. Electrophysiology results revealed changes in neural responses to emotional speech stimuli. Post-intervention, mismatch responses of children with ASD more closely resembled their neurotypical peers, with shorter MMN latencies, a significantly heightened P2 wave, and greater differentiation of emotional stimuli, consistent with their improved behavioral results. This study sets the foundation for further investigation into connections between auditory processing difficulties and social perception and communication for individuals with ASD, and provides a promising indication that combining amplified hearing and computer-based targeted social perception training using emotional speech stimuli may have neuro-rehabilitative benefits.

Auditory neuropathy/spectrum disorder (ANSD), also referred to as auditory neuropathy/dys-synchrony (AN/AD) is a recently described form of hearing impairment. Many studies have shown that changing the pattern of afferent input to the cortex significantly affects cortical organization and there is little studies about cortical neuromaturation and plasticity in children with ANSD. Study of P1 component of cortical auditory evoked potentials (CAEPs) in children with ANSD. This survey was descriptive cross-sectional. During that 97 hearing impairment children were under hearing screening tests. Of these, 14 selected subjects (ear = 28) diagnosed with ANSD (an average age of 8.5 years) and evaluated by P1 component of CAEPs. Based on latency results of p1 wave, the ears of the subjects fell into two seperate groups: Control (normal: n = 10) and case {total: n = 18 (delayed: n = 12) + (absent: n = 6)}. The averages of mean latency of P1 components of the case group in the right and the left ears compared to the control group had significant differences (p < 0.05). Abnormal latency of p1 component in ANSD children shows the possibility of different scales of disturbances in cortical auditory maturation and grow. [ABSTRACT FROM AUTHOR]

Decreased central inhibition, possibly related to hearing loss, may contribute to chronic tinnitus. However, many individuals with normal hearing thresholds report tinnitus, suggesting that the percept in this population may arise from sources other than peripheral deafferentation. One measure of inhibition is sensory gating. Sensory gating involves the suppression of non-novel input, and is measured through cortical auditory evoked potential (CAEP) responses to paired stimuli. In typical gating function, amplitude suppression is observed in the second CAEP response when compared to the first CAEP response, illustrating inhibitory activity. Using this measure, we investigated central inhibitory processes in normal hearing young adults with and without mild tinnitus to determine whether inhibition may be a contributing factor to the tinnitus percept. Results showed that gating function was impaired in the tinnitus group, with the CAEP Pa component significantly correlated with tinnitus severity. Further exploratory analyses were conducted to evaluate variability in gating function within the tinnitus group, and findings showed that high CAEP amplitude suppressors demonstrated gating performance comparable to adults without tinnitus, while low amplitude suppressors exhibited atypical gating function.

Background: Among individuals with vestibular dysfunction, the loss of vestibular sensory information is found to alter cognitive abilities that coordinate spatial and non-spatial information. P300 is an event-related potential commonly used to assess cognitive processing. The aim of the present study was to compare the latency and amplitude of cortical auditory evoked potential and P300 between individuals with vestibular dysfunction and individuals with no vestibular dysfunction. Methods: Forty adults with a mean age of 40.5 ± 13.07 participated in the study. Group I included 20 adults diagnosed with vestibular dysfunction and group II included 20 age-matched adults with no vestibular dysfunction. The P300 was recorded from the electrode site Cz and Pz. It was elicited using pure-tones in odd-ball paradigm. The latency and amplitude of peaks P1, N1, P2, and N2 of the cortical auditory evoked potential and the P300 were measured. Results: Significant amplitude difference was observed in cortical potentials at Cz and Pz. The P300 was present only in 70% of individuals with vestibular dysfunction compared to 100% among individuals with no vestibular dysfunction. The mean amplitude of the P300 was slightly larger in group 1 compared to group 2 and the mean latency of the P300 was similar in both groups. However, the difference in amplitude of the P300 between groups was not statistically significant. Conclusions: Knowing the cognitive function of individuals with vestibular dysfunction enables planning vestibular rehabilitation therapy, which enhances the quality of life in these individuals by improving their vestibular and cognitive functions., Competing Interests: No competing interests were disclosed., (Copyright: © 2023 Kumar K et al.)

Objectives: The objective assessment tests overcome the variability of subjective methods. Cortical recordings with gap pre-pulse inhibition of the acoustic startle reflex stimulus have been used as objective tinnitus assessments in humans. This study aims to investigate this possible objective tinnitus test and compare gap-induced inhibition in different stimulus parameters and brain regions., Materials & Methods: Twenty People (18-50 years old) without hearing loss and tinnitus were included. The sound stimuli consisted of continuous background noise with a loud startle tone preceded by a silent gap (20 and 40 ms duration, 120 and 150 ms distance from the startle). The N1-P2 complex amplitude and topoplot maps were extracted in 27-channel cortical response recording after signal processing. Four brain regions of interest (ROI) of anterior-frontal, centro-frontal, right, and left temporal were investigated., Results: The results showed that the maximum inhibition occurred in a 40 ms gap duration and 150 ms distance in all 4 ROIs. In comparing ROIs, the centro-frontal and left temporal regions revealed the most inhibition (p<0.05). The decrease in the amplitude of the N1 and P2 in that region could also be traced in the 100 and 200 ms topoplots., Conclusion: Gap-induced inhibition was observed in all gap-embedded stimuli and all ROIs. However, the 40-150 mode and centro-frontal and left temporal regions had maximum inhibition in normal subjects. It provides a promising tool for objectively assessing tinnitus in humans with particular implications in children., Competing Interests: The authors have no relevant financial or non-financial interests to disclose., (© 2023 The Authors.)

Abstract Hearing loss can impair auditory discrimination, especially in noisy environments, requiring greater listening effort, which can impact socio-occupational life. To assess the impact of hearing loss in noisy environments, clinicians may use subjective or objective methods. Subjective methods, such as speech audiometry in noise, are used in clinical practice to assess reported discomfort. Objective methods, such as cortical auditory evoked potentials (CAEPs), are mainly used in research. Subjective methods mainly comprise speech audiometry in noise, in which the signal-to-noise ratio can be varied so as to determine the individual speech recognition threshold, with and without hearing rehabilitation, the aim being to highlight any improvement in auditory performance. Frequency discrimination analysis is also possible. Objective methods assess auditory discrimination without the patient's active participation. One technique used for patients with auditory rehabilitation is the study of auditory responses by CAEPs. This electrophysiological examination studies cortical auditory rehabilitation oddball paradigms, enabling wave recordings such as mismatch negativity, P300 or N400, and analysis of neurophysiological markers according to auditory performance. The present article reviews all these methods, in order to better understand and evaluate the impact of hearing loss in everyday life. [ABSTRACT FROM AUTHOR]

Decreased central inhibition, possibly related to hearing loss, may contribute to chronic tinnitus. However, many individuals with normal hearing thresholds report tinnitus, suggesting that the percept in this population may arise from sources other than peripheral deafferentation. One measure of inhibition is sensory gating. Sensory gating involves the suppression of non-novel input, and is measured through cortical auditory evoked potential (CAEP) responses to paired stimuli. In typical gating function, amplitude suppression is observed in the second CAEP response when compared to the first CAEP response, illustrating inhibitory activity. Using this measure, we investigated central inhibitory processes in normal hearing young adults with and without mild tinnitus to determine whether inhibition may be a contributing factor to the tinnitus percept. Results showed that gating function was impaired in the tinnitus group, with the CAEP Pa component sig-nificantly correlated with tinnitus severity. Further exploratory analyses were conducted to evaluate variability in gating function within the tinnitus group, and findings showed that high CAEP amplitude suppressors demonstrated gating performance comparable to adults without tinnitus, while low amplitude suppressors exhibited atypical gating function. [ABSTRACT FROM AUTHOR]

Cortical auditory evoked potentials represent summation of neural activity in the auditory pathways in response to sounds. They provide an objective measure of the brain’s response to sound. For this reason, they are an effective tool for scientists and audiologists for investigating auditory function in normal people and those with hearing loss. The main objective of this study is to determine what components among the P1, N1, P2, N2, or P3 are most beneficial in assessing the speech detection and discrimination abilities of adult sensorineural hearing loss population. This study also intends to investigate whether changes in the amplitudes and latencies of these components occurring with sensorineural hearing loss and hearing aids differ in responses reflecting different stages of auditory processing. Auditory Potentials were recorded to /ba/ and /da/ stimuli from two Malay adult groups. A control group of 12 right-handed having normal hearing and a group of 10 right-handed with sensorineural hearing loss. The results showed that P2 and P3 components had the most benefits from the use of hearing aids in the hearing loss subjects and therefore could be used in both clinical and research applications as a predictor and objective indicator of hearing aids performance in speech perception. The study also showed that the brain processes both stimuli in a different pattern for both the normal and the aided hearing loss subjects. The present study could provide more diagnostic information for clinicians and could also offer better speech perception benefits for hearing-impaired individuals from their personal hearing aids. The findings also suggest that the aided hearing loss subjects, despite the benefits they get from the hearing aids, find it difficult to detect and discriminate the acoustic differences between the two speech stimuli. [ABSTRACT FROM AUTHOR]

The effects of background noise on speech-evoked cortical auditory evoked potentials ( CAEPs) can provide insight into the physiology of the auditory system. The purpose of this study was to determine background noise effects on neural coding of different phonemes within a syllable. CAEPs were recorded from 15 young normal-hearing adults in response to speech signals /s/, /ɑ/, and /sɑ/. Signals were presented at varying signal-to-noise ratios ( SNRs). The effects of SNR and context (in isolation or within syllable) were analyzed for both phonemes. For all three stimuli, latencies generally decreased and amplitudes generally increased as SNR improved, and context effects were not present; however, the amplitude of the /ɑ/ response was the exception, showing no SNR effect and a significant context effect. Differential coding of /s/ and /ɑ/ likely result from level and timing differences. Neural refractoriness may result in the lack of a robust SNR effect on amplitude in the syllable context. The stable amplitude across SNRs in response to the vowel in /sɑ/ suggests the combined effects of (1) acoustic characteristics of the syllable and noise at poor SNRs and (2) refractory effects resulting from phoneme timing at good SNRs. Results provide insights into the coding of multiple-onset speech syllables in varying levels of background noise and, together with behavioral measures, may help to improve our understanding of speech-perception-in-noise difficulties. [ABSTRACT FROM AUTHOR]

Recording of free-field cortical auditory evoked potential (CAEP) responses to speech tokens was introduced into the audiology management for infants with a permanent childhood hearing impairment (PCHI) during 2011–2015 at a U.K. service. Children with bilateral PCHI were studied from two sequential cohorts. Thirty-four children had followed an audiology pathway prior to CAEP introduction, and 44 children followed a pathway after the introduction of CAEP and were tested with unaided and aided CAEP responses. Data analysis explored the age of diagnosis, hearing aid fitting, and referral for cochlear implant (CI) assessment for each of these groups. CAEP offered a novel educative process for the parents and audiologists supporting decision-making for hearing aid fitting and CI referral. Delays in hearing aid fitting and CI referral were categorized as being due to the audiologist’s recommendation or parental choice. Results showed that the median age of hearing aid fitting prior to CAEP introduction was 9.2 months. After the inclusion of CAEP recording in the infant pathways, it was 3.9 months. This reduction was attributable to earlier fitting of hearing aids for children with mild and moderate hearing losses, for which the median age fell from 19 to 5 months. Children with profound hearing loss were referred for CI assessment at a significantly earlier age following the introduction of CAEP. Although there has also been a national trend for earlier hearing aid fitting in children, the current study demonstrates that the inclusion of CAEP recording in the pathway facilitated earlier hearing aid fitting for milder impairments. [ABSTRACT FROM AUTHOR]

Aphasia is an acquired language impairment affecting speaking, listening, reading, and writing. Aphasia occurs in about a third of patients who have ischemic stroke and significantly affects functional recovery and return to work. Stroke is more common in older individuals but also occurs in young adults and children. Because people experiencing a stroke are typically aged between 65 and 84 years, hearing loss is common and can potentially interfere with rehabilitation. There is some evidence for increased risk and greater severity of sensorineural hearing loss in the stroke population and hence it has been recommended that all people surviving a stroke should have a hearing test. Auditory processing difficulties have also been reported poststroke. The International Classifi- cation of Functioning, Disability and Health (ICF) can be used as a basis for describing the effect of aphasia, hearing loss, and auditory processing difficulties on activities and participation. Effects include reduced participation in activities outside the home such as work and recreation and difficulty engaging in social interaction and communicating needs. A case example of a youngman (M) in his 30s who experienced a left-hemisphere ischemic stroke is presented. M has normal hearing sensitivity but has aphasia and auditory processing difficulties based on behavioral and cortical evoked potential measures. His principal goal is to return to work. Although auditory processing difficulties (and hearing loss) are acknowledged in the literature, clinical protocols typically do not specify routine assessment. The literature and the case example presented here suggest a need for further research in this area and a possible change in practice toward more routine assessment of auditory function post-stroke. [ABSTRACT FROM AUTHOR]

Background and Objectives: P300 has been studied with a variety of stimuli. However, the nature of P300 has not been investigated for deviant stimuli which change its characteristics from standard stimuli after a period of time from onset. Subjects and Methods: Nine young adults with normal hearing participated in the study. The P300 was elicited using an oddball paradigm, the probability of standard and deviant stimuli was 80% and 20% respectively. Six stimuli were used to elicit P300, it included two pure-tones (1,000 Hz and 2,000 Hz) and four tone-complexes (tones with frequency changes). Among these stimuli, 1,000 Hz tone served as standard while others served as deviant stimuli. The P300 was recorded in five separate blocks, with one of the deviant stimuli as target in each block. Electroencephalographic was recorded from electrode sites Fz, Cz, C3, C4, and Pz. Latency and amplitude of components of the cortical auditory evoked potentials were measured at Cz. Results: Waveforms obtained in the present study shows that, all the deviant stimuli elicited obligatory P1-N1-P2 for stimulus onset. 2,000 Hz deviant tone elicited P300 at a latency of 300 ms. While, tone-complexes elicited acoustic change complex (ACC) for frequency changes and finally elicited P300 at a latency of 600 ms. In addition, the results showed shorter latency and larger amplitude ACC and P300 for rising tone-complexes compared to falling tone-complexes. Conclusions: Tone-complexes elicited distinct waveforms compared to 2,000 Hz deviant tone. Rising tone-complexes which had an increase in frequency elicited shorter latency and larger amplitude responses, which could be attributed to perceptual bias for frequency changes. [ABSTRACT FROM AUTHOR]

Hearing loss has been linked to many types of cognitive decline in adults, including an association between hearing loss severity and dementia. However, it remains unclear whether cortical re-organization associated with hearing loss occurs in early stages of hearing decline and in early stages of auditory processing. In this study, we examined compensatory plasticity in adults with mild-moderate hearing loss using obligatory, passively-elicited, cortical auditory evoked potentials (CAEP). High density EEG elicited by speech stimuli was recorded in adults with hearing loss and age-matched normal hearing controls. Latency, amplitude and source localization of the P1, N1, P2 components of the CAEP were analyzed. Adults with mild-moderate hearing loss showed increases in latency and amplitude of the P2 CAEP relative to control subjects. Current density reconstructions revealed decreased activation in temporal cortex and increased activation in frontal cortical areas for hearing-impaired listeners relative to normal hearing listeners. Participants’ behavioral performance on a clinical test of speech perception in noise was significantly correlated with the increases in P2 latency. Our results indicate that changes in cortical resource allocation are apparent in early stages of adult hearing loss, and that these passively-elicited cortical changes are related to behavioral speech perception outcome.

Cortical auditory evoked potentials (CAEPs) are included in guidelines for assessment of auditory processing disorder (APD), but their diagnostic value and their use as a measure of treatment effectiveness have not been fully explored. The current study has three main aims: (1) to assess if there are differences in CAEPs recorded in quiet and in noise in children with APD compared to a control group of typically developing (TD) children, (2) to investigate the test-retest reliability of CAEPs, and (3) to determine whether participation in discrimination or language with or without support of personal frequency modulation (FM) resulted in significant changes in auditory function as measured by CAEPs. Fifty-five children with APD and 22 TD children age 7 to 13 years participated. There were group differences between TD children and children with APD for CAEP P1 and N250 amplitudes. CAEPs assessed on two occasions (separated by 7 to 10 days) showed a significant reduction in N250 amplitude on the second visit, highlighting the importance of establishing a stable baseline for CAEPs to more clearly delineate the effects of training from other factors influencing measurements. Participants with APD were randomly assigned to five treatment groups, including a no training group, two groups receiving discrimination training (one of these also used personal FM), and two groups receiving language training (one of these also used personal FM). N250 amplitudes changed during the baseline period, in the absence of any specific training, and hence a control group alone is insufficient for establishing intervention effectiveness; establishing a stable pretraining baseline for electrophysiological (and other) outcome measurements is also important. After 6 weeks training, children with APD in the discrimination treatment group showed a further significant change in N250 amplitudes, beyond the change that occurred during the baseline period. These results are limited by the small numbers of participants in each treatment group; however, the finding of some CAEP changes after training is consistent with published evidence for cortical changes after short-term auditory training. [ABSTRACT FROM AUTHOR]