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Background: Auditory perceptual learning persistently modifies neural networks in the central nervous system. Central auditory processing comprises a hierarchy of sound analysis and integration, which transforms an acoustical signal into a meaningful object for perception. Based on latencies and source locations of auditory evoked responses, we investigated which stage of central processing undergoes neuroplastic changes when gaining auditory experience during passive listening and active perceptual training. Young healthy volunteers participated in a five-day training program to identify two pre-voiced versions of the stop-consonant syllable 'ba', which is an unusual speech sound to English listeners. Magnetoencephalographic (MEG) brain responses were recorded during two pre-training and one post-training sessions. Underlying cortical sources were localized, and the temporal dynamics of auditory evoked responses were analyzed., Results: After both passive listening and active training, the amplitude of the P2m wave with latency of 200 ms increased considerably. By this latency, the integration of stimulus features into an auditory object for further conscious perception is considered to be complete. Therefore the P2m changes were discussed in the light of auditory object representation. Moreover, P2m sources were localized in anterior auditory association cortex, which is part of the antero-ventral pathway for object identification. The amplitude of the earlier N1m wave, which is related to processing of sensory information, did not change over the time course of the study., Conclusion: The P2m amplitude increase and its persistence over time constitute a neuroplastic change. The P2m gain likely reflects enhanced object representation after stimulus experience and training, which enables listeners to improve their ability for scrutinizing fine differences in pre-voicing time. Different trajectories of brain and behaviour changes suggest that the preceding effect of a P2m increase relates to brain processes, which are necessary precursors of perceptual learning. Cautious discussion is required when interpreting the finding of a P2 amplitude increase between recordings before and after training and learning.

Auditory training programs are being developed to remediate various types of communication disorders. Biological changes have been shown to coincide with improved perception following auditory training so there is interest in determining if these changes represent biologic markers of auditory learning. Here we examine the role of stimulus exposure and listening tasks, in the absence of training, on the modulation of evoked brain activity. Twenty adults were divided into two groups and exposed to two similar sounding speech syllables during four electrophysiological recording sessions (24 hours, one week, and up to one year later). In between each session, members of one group were asked to identify each stimulus. Both groups showed enhanced neural activity from session-to-session, in the same P2 latency range previously identified as being responsive to auditory training. The enhancement effect was most pronounced over temporal-occipital scalp regions and largest for the group who participated in the identification task. The effects were rapid and long-lasting with enhanced synchronous activity persisting months after the last auditory experience. Physiological changes did not coincide with perceptual changes so results are interpreted to mean stimulus exposure, with and without being paired with an identification task, alters the way sound is processed in the brain. The cumulative effect likely involves auditory memory; however, in the absence of training, the observed physiological changes are insufficient to result in changes in learned behavior.

Older adults often have difficulty understanding speech in a noisy environment or with multiple speakers. In such situations, binaural hearing improves the signal-to-noise ratio. How does this binaural advantage change with increasing age? Using magnetoencephalography, we recorded cortical activity evoked by changes in interaural phase differences of amplitude-modulated tones. These responses occurred for frequencies up to 1225 Hz in young subjects but only up to 940 Hz in middle-aged and 760 Hz in older adults. Behavioral thresholds also decreased with increasing age but were more variable, likely because some older adults make effective use of compensatory mechanisms. The reduced frequency range for binaural hearing became significant in middle age, before decline in hearing sensation and the morphology of cortical responses, which became apparent only in the older subjects. This study provides evidence from human physiological data for the early onset of biological aging in binaural hearing.

Hearing aids help compensate for disorders of the ear by amplifying sound; however, their effectiveness also depends on the central auditory system's ability to represent and integrate spectral and temporal information delivered by the hearing aid. The authors report that the neural detection of time-varying acoustic cues contained in speech can be recorded in adult hearing aid users using the acoustic change complex (ACC). Seven adults (50-76 years) with mild to severe sensorineural hearing participated in the study. When presented with 2 identifiable consonant-vowel (CV) syllables ("shee" and "see"), the neural detection of CV transitions (as indicated by the presence of a P1-N1-P2 response) was different for each speech sound. More specifically, the latency of the evoked neural response coincided in time with the onset of the vowel, similar to the latency patterns the authors previously reported in normal-hearing listeners.

This study investigated how depth variations in the tip of the probe tube affected spectral measures of speech recorded in the external ear canal. Consonant-vowel nonsense syllables were recorded with a probe tube microphone system in 10 adult participants with normal middle ear function. Recordings were made with the probe tube tip placed 1 mm, 5 mm, and 10 mm beyond the medial tip of a custom earmold. The effect of probe depth was evaluated on spectral levels (one-third octave and one- twelfth octave band). Extending the probe tube 10 mm past the medial tip of the earmold gave the most accurate results, with relatively lower sound levels for either the 1-mm or 5-mm insertion depth. In general, the effect of insertion depth was minimal at frequencies below 3 to 4 kHz, although this varied with the specific phoneme and the width of the analysis bands. The authors found no significant difference between 1- and 5-mm insertion depths, suggesting that as long as the tip of the probe tube is sufficiently close to the tympanic membrane to capture the highest frequency of interest, it makes little difference if it is less than 5 mm beyond the earmold tip.

Purpose: The purpose of this article is to review recent research from our laboratory on the topic of aging, and the ear-brain system, as it relates to hearing aid use and auditory rehabilitation. The material described here was presented as part of the forum on the brain and hearing aids, at the 2014 HEaling Across the Lifespan (HEAL) conference. Method: The method involves a narrative review of previously reported electroencephalography (EEG) and magnetoencephalography (MEG) data from our laboratory as they relate to the (a) neural detection of amplified sound and (b) ability to learn new sound contrasts. Conclusions: Results from our studies add to the mounting evidence that there are central effects of biological aging as well as peripheral pathology that affect a person's neural detection and use of sound. What is more, these biological effects can be seen as early as middle age. The accruing evidence has implications for hearing aid use because effective communication relies not only on sufficient detection of sound but also on the individual's ability to learn to make use of these sounds in ever-changing listening environments. [ABSTRACT FROM AUTHOR]

Performance variability among people who wear hearing aids presents a challenge for clinicians. Although some clients appear to make use of amplified signals with little effort, other clients report frustration and may reject their hearing aids altogether. Some of the explanations underlying performance variability likely result from a poorly fitted device; others might result from reasons related to how the amplified signal is being represented in the central auditory system.We believe that perception is dependent on the neural detection, representation, and integration of the amplified speech and noise. For this reason it is important to understand how amplification modifies the acoustic content of a signal as well as the neural representation of the amplified sound. It is therefore necessary to examine the interaction between hearing aid-processed acoustic input and the neural networks that are activated. Here we focus on the role of brainstem encoding to determine if auditory brainstem responses might provide information to help explain why some people are able to make better use of amplified sound than others. More specifically, we review the literature to determine if brainstem measures might someday be used to guide clinicians when fitting a hearing aid. [ABSTRACT FROM AUTHOR]

Hearing aid amplification can be used as a model for studying the effects of auditory stimulation on the central auditory system (CAS). We examined the effects of stimulus presentation level on the physiological detection of sound in unaided and aided conditions. P1, N1, P2, and N2 cortical evoked potentials were recorded in sound field from 13 normal-hearing young adults in response to a 1000-Hz tone presented at seven stimulus intensity levels. As expected, peak amplitudes increased and peak latencies decreased with increasing intensity for unaided and aided conditions. However, there was no significant effect of amplification on latencies or amplitudes. Taken together, these results demonstrate that 20 dB of hearing aid gain affects neural responses differently than 20 dB of stimulus intensity change. Hearing aid signal processing is discussed as a possible contributor to these results. This study demonstrates (1) the importance of controlling for stimulus intensity when evoking responses in aided conditions, and (2) the need to better understand the interaction between the hearing aid and the CAS. [ABSTRACT FROM AUTHOR]

Clinicians have long been aware of the range of performance variability with hearing aids. Despite improvements in technology, there remain many instances of well-selected and appropriately fitted hearing aids whereby the user reports minimal improvement in speech understanding. This review presents a multi-stage framework for understanding how a hearing aid affects performance. Six stages are considered: (1) acoustic content of the signal, (2) modification of the signal by the hearing aid, (3) interaction between sound at the output of the hearing aid and the listener's ear, (4) integrity of the auditory system, (5) coding of available acoustic cues by the listener's auditory system, and (6) correct identification of the speech sound. Within this framework, this review describes methodology and research on 2 new assessment techniques: acoustic analysis of speech measured at the output of the hearing aid and auditory evoked potentials recorded while the listener wears hearing aids. Acoustic analysis topics include the relationship between conventional probe microphone tests and probe microphone measurements using speech, appropriate procedures for such tests, and assessment of signal-processing effects on speech acoustics and recognition. Auditory evoked potential topics include an overview of physiologic measures of speech processing and the effect of hearing loss and hearing aids on cortical auditory evoked potential measurements in response to speech. Finally, the clinical utility of these procedures is discussed. [ABSTRACT FROM AUTHOR]