Brainstem lesions and click lateralization in patients with multiple sclerosis

doi:10.1016/0378-5955(94)00170-U

Hearing Research

Volume 82, Issue 1, January 1995, Pages 109-124

https://doi.org/10.1016/0378-5955(94)00170-U Get rights and content

Abstract

The ability to lateralize dichotic clicks with either interaural time delays (ITD) or interaural level differences (ILD) was tested in seven multiple sclerosis (MS) subjects who had normal audiograms. Along with the psychoacoustical tests, magnetic resonance images (MRI) of the subjects' brainstem were obtained. After matching each MRI section with the corresponding section of a computerized atlas of the brainstem, the parts of the auditory pathway affected by each MS lesion were determined. Of the seven subjects two performed normally with both types of interaural asymmetry and had no brainstem lesions involving the auditory pathway. Two subjects performed normally only with level differences, but perceived all the dichotic clicks with different ITDs in the center of the head; both had lesions involving the trapezoid body. Three subjects could not perform normally with either task, perceiving the clicks to the sides and never in the center for both ITDs and ILDs; all three had unilateral lesions of the lateral lemniscus. A multi-level decision making model is proposed to account for these results.

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Citation Excerpt :
SRM tends to be largest when the target and interference are easily confusable, e.g., when both have similar linguistic content and are spoken by a same-sex speaker. Under such circumstances SRM for adult listeners can be as great as 12 dB23,30. While pwMS are known to have deficits in the processing of ITDs, the extent to which those deficits are associated with deficits in SRM is unknown.
People with multiple sclerosis (pwMS) frequently present with deficits in binaural processing used for sound localization. This study examined spatial release from speech-on-speech masking in pwMS, which involves binaural processing and additional higher level mechanisms underlying streaming, such as spatial attention.
26 pwMS with mild severity (Expanded Disability Status Scale score <3) and 20 age-matched controls listened via headphones to pre-recorded sentences from a standard list presented simultaneously with eight-talker babble. Virtual acoustic techniques were used to simulate sentences originating from 0°, 20°, or 50° on the interaural horizontal plane around the listener whilst babble was presented continuously at 0° azimuth, and participants verbally repeated the target sentence. In a separate task, two simultaneous sentences both containing a colour and number were presented, and participants were required to report the target colour and number. Both competing sentences could originate from 0°, 20°, or 50° on the azimuthal plane. Participants also completed a series of neuropsychological assessments, an auditory questionnaire, and a three-alternative forced-choice task that involved the detection of interaural time differences (ITDs) in noise bursts.
Spatial release from masking was observed in both pwMS and controls, as response accuracy in the two speech discrimination tasks improved in the spatially separated conditions (20° and 50°) compared with the co-localised condition. However, pwMS demonstrated significantly less spatial release (18%) than controls (28%) when discriminating colour/number coordinates. At 50° separation, pwMS discriminated significantly fewer coordinates (77%) than controls (89%). In contrast, pwMS had similar performances to controls when sentences were presented in babble, and for the basic ITD discrimination task. Significant correlations between speech discrimination performance and standardized neuropsychological scores were observed across all spatial conditions.
Our findings suggest that spatial hearing is likely to be implicated in pwMS, thereby affecting the perception of competing speech originating from various locations.
How to detect and track chronic neurologic sequelae of COVID-19? Use of auditory brainstem responses and neuroimaging for long-term patient follow-up
2020, Brain, Behavior, and Immunity - Health
Citation Excerpt :
These behavioral tests are low-cost and could be a good alternative to ABR which need specific devices and expertise. Studies with MS cases documented by MRI have shown that behavioral tests are reliable, although they can be time-consuming (Levine et al., 1994; Furst et al., 1995, 2000). Nevertheless, duration for clinical versions of these tests can be shortened (Moore and Sek, 2009; Füllgrabe and Moore, 2017).
This review intends to provide an overview of the current knowledge on neurologic sequelae of COVID-19 and their possible etiology, and, based on available data, proposes possible improvements in current medical care procedures. We conducted a thorough review of the scientific literature on neurologic manifestations of COVID-19, the neuroinvasive propensity of known coronaviruses (CoV) and their possible effects on brain structural and functional integrity. It appears that around one third of COVID-19 patients admitted to intensive care units (ICU) for respiratory difficulties exhibit neurologic symptoms. This may be due to progressive brain damage and dysfunction triggered by severe hypoxia and hypoxemia, heightened inflammation and SARS-CoV-2 dissemination into brain parenchyma, as suggested by current reports and analyses of previous CoV outbreaks. Viral invasion of the brain may particularly target and alter brainstem and thalamic functions and, consequently, result in sensorimotor dysfunctions and psychiatric disorders. Moreover, data collected from other structurally homologous CoV suggest that SARS-CoV-2 infection may lead to brain cell degeneration and demyelination similar to multiple sclerosis (MS). Hence, current evidence warrants further evaluation and long-term follow-up of possible neurologic sequelae in COVID-19 patients. It may be particularly relevant to evaluate brainstem integrity in recovered patients, as it is suspected that this cerebral area may particularly be dysfunctional following SARS-CoV-2 infection. Because CoV infection can potentially lead to chronic neuroinflammation and progressive demyelination, neuroimaging features and signs of MS may also be evaluated in the long term in recovered COVID-19 patients.
Auditory spatial deficits in brainstem disorders
2015, Neurologia i Neurochirurgia Polska
Citation Excerpt :
However, 4 of 5 patients with MS had abnormal BAEPs with abnormal sound localization (Tables 2 and 3). According to Furst et al. [18], in a demyelinatined lesion the neural impulses are conducted through the lesion but at a reduced conduction velocity. It was suggested that the pathology on the level of the VIII nerve does not always have to cause incorrect BAEPs results, but the pathology of higher structures such as the cochlear nuclei, the superior olivary complex, the trapezoid body, the lateral lemniscus or the inferior colliculus, characteristic for IS or MS usually cause incorrect BAEPs and HMAAT results [31].
Brainstem disorders seem to negatively influence the central auditory system, causing spatial hearing deficits.
We tested 11 patients with brainstem lesions due to ischemic stroke (IS), multiple sclerosis (MS), or cerebellopontine angle tumor (CPAT) together with 50 age- and sex-matched healthy volunteers. We used pure tone audiometry (PTAud), brainstem auditory evoked potentials (BAEPs) and the horizontal minimum audible angle test (HMAAT) for 8 azimuths with binaural stimulation.
The chosen patients and the controls had normal or near normal hearing in PTAud. BAEPs interaural wave I–V latency difference was over 7 times longer in the patients group compared to the controls. Additionally, 9 of the 11 patients (81.1%) had abnormal HMAAT results. The biggest quantitative disturbances in HMAAT were present in the CPAT and the MS patients. The sound localization ability in HMAAT was significantly worse in the patients in 0° azimuth in comparison with the controls, and in 45° and 90° azimuth in patients with auditory pathway involvement compared with the ones without the involvement.
Our study confirms the strong relationship between various brainstem pathologies and sound localization disability and sheds some light on the complexity of the relationship.
Disorders of Audition
2015, Brain Mapping: An Encyclopedic Reference
This article is concerned with pathologies of the human auditory system beyond the cochlea. Auditory processing necessarily involves the organization of information with temporal, spectral, and spatial components into a form that can be perceived, attended, recognized, and retained. Disorders of each of these processes can occur together or in isolation.
We begin by outlining those disorders that are inherent to the auditory system, employing the approach of systematically ascending the auditory pathway. Later, we discuss more generalized cognitive disorders that give rise to auditory symptoms.
Psychophysical and behavioral peripheral and central auditory tests
2015, Handbook of Clinical Neurology
Diagnostic batteries to assess the integrity of the central auditory nervous system (CANS) include behavioral (i.e., psychophysical) tests, electrophysiologic procedures, and to some degree, electroacoustic procedures. In this chapter, we focus on behavioral tests used to identify lesions (including diffuse lesions), abnormalities, or dysfunction of the CANS, as well as identify associated functional deficits (e.g., listening in noise deficits). Following a brief review of several tests considered more peripheral in their application (e.g., pure-tone thresholds, otoacoustic emissions, acoustic reflex), we provide some historic context and a review of tests currently in use which are sensitized by design to measure central auditory function, as well as others which have not been adopted clinically and new tests and procedures which hold promise for clinical diagnosis. Tests reviewed include those of dichotic listening, temporal processing (e.g., temporal resolution and temporal patterning), binaural interaction (e.g., masking level differences), monaural low-redundancy measures (e.g., speech in noise or competition, filtered speech, time-compressed speech), and new paradigms which measure auditory evoked potentials in response to test stimuli typically used in behavioral tests.
Hearing disorders in brainstem lesions
2015, Handbook of Clinical Neurology
Auditory processing can be disrupted by brainstem lesions. It is estimated that approximately 57% of brainstem lesions are associated with auditory disorders. However diseases of the brainstem usually involve many structures, producing a plethora of other neurologic deficits, often relegating “auditory symptoms in the background.”
Lesions below or within the cochlear nuclei result in ipsilateral auditory-processing abnormalities detected in routine testing; disorders rostral to the cochlear nuclei may result in bilateral abnormalities or may be silent.
Lesions in the superior olivary complex and trapezoid body show a mixture of ipsilateral, contralateral, and bilateral abnormalities, whereas lesions of the lateral lemniscus, inferior colliculus, and medial geniculate body do not affect peripheral auditory processing and result in predominantly subtle contralateral abnormalities that may be missed by routine auditory testing.
In these cases psychophysical methods developed for the evaluation of central auditory function should be employed (e.g., dichotic listening, interaural time perception, sound localization). The extensive connections of the auditory brainstem nuclei not only are responsible for binaural interaction but also assure redundancy in the system. This redundancy may explain why small brainstem lesions are sometimes clinically silent.
Any disorder of the brainstem (e.g., neoplasms, vascular disorders, infections, trauma, demyelinating disorders, neurodegenerative diseases, malformations) that involves the auditory pathways and/or centers may produce hearing abnormalities.

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Brainstem lesions and click lateralization in patients with multiple sclerosis

Abstract

Brain Res.

Hear. Res.

Hear. Res.

Hear. Res.

J. Neurol. Sci.

Lancet

Binaural summation and lateralization of transients: a combined analysis

J. Acoust. Soc. Am.

Processing of binaural stimuli by cat superior olivary complex neurons

Exp. Brain Res.

Coincidence model of MSO responses

Hear. Res.

Binaural directional hearing-impairments and aids

Binaural click lateralization: evidence from psychophysics and brainstem auditory evoked potentials in normal subjects and multiple sclerosis patients

Prediction of binaural click lateralization by brainstem auditory evoked potentials

Hear. Res.