scholarly journals Cortical Auditory Evoked Potentials in Cognitive Impairment and Their Relevance to Hearing Loss: A Systematic Review Highlighting the Evidence Gap

2021 ◽  
Vol 15 ◽  
Author(s):  
Hanne Gommeren ◽  
Joyce Bosmans ◽  
Emilie Cardon ◽  
Griet Mertens ◽  
Patrick Cras ◽  
...  
Keyword(s):  
Systematic Review ◽  
Hearing Loss ◽  
Cognitive Impairment ◽  
Cognitive Decline ◽  
Auditory Processing ◽  
Auditory Evoked Potentials ◽  
Event Related Potential ◽  
Auditory Evoked Potential ◽  
Publication Date ◽  
Reference List

Background: Alzheimer’s disease (AD) is the most prevalent cause of dementia which affects a growing number of people worldwide. Early identification of people at risk to develop AD should be prioritized. Hearing loss is considered an independent potentially modifiable risk factor for accelerated cognitive decline and dementia in older adults. The main outcome of interest of this review is the alteration of Cortical Auditory Evoked Potential (CAEP) morphology in an AD or mild cognitive impairment (MCI) population with and without hearing loss.Methods: Two investigators independently and systematically searched publications regarding auditory processing on a cortical level in people with cognitive impairment (MCI or AD) with and without hearing loss. Only articles which mentioned at least one auditory elicited event-related potential (ERP) component and that were written in English or Dutch were included. Animal studies were excluded. No restrictions were imposed regarding publication date. The reference list of potential sources were screened for additional articles.Results: This systematic review found no eligible articles that met all inclusion criteria. Therefore, no results were included, resulting in an empty systematic review.Conclusion: In general, dysfunction – being either from cognitive or auditory origin – reduces CAEP amplitudes and prolongs latencies. Therefore, CAEPs may be a prognostic indicator in the early stages of cognitive decline. However, it remains unclear which CAEP component alteration is due to cognitive impairment, and which is due to hearing loss (or even both). In addition, vestibular dysfunction – associated with hearing loss, cognitive impairment and AD – may also alter CAEP responses. Further CAEP studies are warranted, integrating cognitive, hearing, and vestibular evaluations.

Informational Masking Effects of Speech Versus Nonspeech Noise on Cortical Auditory Evoked Potentials

2021 ◽  
Vol 64 (10) ◽  
pp. 4014-4029
Author(s):  
Kathy R. Vander Werff ◽  
Christopher E. Niemczak ◽  
Kenneth Morse
Keyword(s):  
Auditory Processing ◽  
Auditory Evoked Potentials ◽  
Spectral Characteristics ◽  
Auditory Evoked Potential ◽  
Informational Masking ◽  
Neural Encoding ◽  
Speech Stimuli ◽  
Typical Morphology ◽  
Cortical Auditory Evoked Potentials ◽  
Speech Information

Purpose Background noise has been categorized as energetic masking due to spectrotemporal overlap of the target and masker on the auditory periphery or informational masking due to cognitive-level interference from relevant content such as speech. The effects of masking on cortical and sensory auditory processing can be objectively studied with the cortical auditory evoked potential (CAEP). However, whether effects on neural response morphology are due to energetic spectrotemporal differences or informational content is not fully understood. The current multi-experiment series was designed to assess the effects of speech versus nonspeech maskers on the neural encoding of speech information in the central auditory system, specifically in terms of the effects of speech babble noise maskers varying by talker number. Method CAEPs were recorded from normal-hearing young adults in response to speech syllables in the presence of energetic maskers (white or speech-shaped noise) and varying amounts of informational maskers (speech babble maskers). The primary manipulation of informational masking was the number of talkers in speech babble, and results on CAEPs were compared to those of nonspeech maskers with different temporal and spectral characteristics. Results Even when nonspeech noise maskers were spectrally shaped and temporally modulated to speech babble maskers, notable changes in the typical morphology of the CAEP in response to speech stimuli were identified in the presence of primarily energetic maskers and speech babble maskers with varying numbers of talkers. Conclusions While differences in CAEP outcomes did not reach significance by number of talkers, neural components were significantly affected by speech babble maskers compared to nonspeech maskers. These results suggest an informational masking influence on neural encoding of speech information at the sensory cortical level of auditory processing, even without active participation on the part of the listener.

scholarly journals Hearing Loss Treatment in Older Adults With Cognitive Impairment: A Systematic Review

2018 ◽  
Vol 61 (10) ◽  
pp. 2589-2603 ◽  
Author(s):  
Sara K. Mamo ◽  
Nicholas S. Reed ◽  
Carrie Price ◽  
Dona Occhipinti ◽  
Alexandra Pletnikova ◽  
...  
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
Hearing Loss ◽  
Cognitive Impairment ◽  
Hearing Aids ◽  
Controlled Trial ◽  
Controlled Vocabulary ◽  
Assessment Tools ◽  
Cochrane Library ◽  
Full Text Review

Purpose The purpose of this systematic review was to assess studies of treating hearing loss in older adults with cognitive impairment. Of interest to this review is identifying clinical adaptations that may be used to tailor hearing loss treatment to older adults with cognitive impairment in order to better serve this vulnerable population. Method A systematic search with controlled vocabulary and key word terms was applied to PubMed, the Cochrane Library, Embase, CINAHL, and PsycINFO. Search concepts included terms related to hearing loss and cognitive impairment. The overall search resulted in 4,945 unique references, 50 of which were eligible for full-text review and 13 of which were included in the final review. Included manuscripts were categorized according to the American Speech-Language-Hearing Association's levels of evidence and the National Institutes of Health Quality Assessment Tools. Results Only 1 study implemented a randomized controlled trial design to assess cognitive function and behavioral symptoms after treatment with hearing aids. Other quasiexperimental studies evaluated dementia-related symptoms and/or auditory function after treating hearing loss in pre/post research designs. Finally, evidence from case studies suggested that hearing loss treatment is feasible, reduces stressful communication for caregivers, and improves dementia-related behavior problems. Conclusion Based on the systematic review, evidence suggests that treating hearing loss in persons with cognitive impairment can have benefits to communication and quality of life. Because of the quasi- and nonexperimental nature of most of the evidence found in this review, further studies are necessary to understand the effect of treatment in the context of a variable and progressive disease.

scholarly journals Protocols for cognitive enhancement. A user manual for Brain Health Services—part 5 of 6

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Andrea Brioschi Guevara ◽  
Melanie Bieler ◽  
Daniele Altomare ◽  
Marcelo Berthier ◽  
Chantal Csajka ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cognitive Impairment ◽  
Executive Functions ◽  
Cognitive Decline ◽  
Physical Training ◽  
Cognitive Enhancement ◽  
Memory Performance ◽  
Subjective Cognitive Decline ◽  
Strategic Learning

AbstractCognitive complaints in the absence of objective cognitive impairment, observed in patients with subjective cognitive decline (SCD), are common in old age. The first step to postpone cognitive decline is to use techniques known to improve cognition, i.e., cognitive enhancement techniques.We aimed to provide clinical recommendations to improve cognitive performance in cognitively unimpaired individuals, by using cognitive, mental, or physical training (CMPT), non-invasive brain stimulations (NIBS), drugs, or nutrients. We made a systematic review of CMPT studies based on the GRADE method rating the strength of evidence.CMPT have clinically relevant effects on cognitive and non-cognitive outcomes. The quality of evidence supporting the improvement of outcomes following a CMPT was high for metamemory; moderate for executive functions, attention, global cognition, and generalization in daily life; and low for objective memory, subjective memory, motivation, mood, and quality of life, as well as a transfer to other cognitive functions. Regarding specific interventions, CMPT based on repeated practice (e.g., video games or mindfulness, but not physical training) improved attention and executive functions significantly, while CMPT based on strategic learning significantly improved objective memory.We found encouraging evidence supporting the potential effect of NIBS in improving memory performance, and reducing the perception of self-perceived memory decline in SCD. Yet, the high heterogeneity of stimulation protocols in the different studies prevent the issuing of clear-cut recommendations for implementation in a clinical setting. No conclusive argument was found to recommend any of the main pharmacological cognitive enhancement drugs (“smart drugs”, acetylcholinesterase inhibitors, memantine, antidepressant) or herbal extracts (Panax ginseng, Gingko biloba, and Bacopa monnieri) in people without cognitive impairment.Altogether, this systematic review provides evidence for CMPT to improve cognition, encouraging results for NIBS although more studies are needed, while it does not support the use of drugs or nutrients.

scholarly journals Going beyond rote auditory learning: Neural patterns of generalized auditory learning

2021 ◽  
Author(s):  
Shannon L.M. Heald ◽  
Stephen C. Van Hedger ◽  
John Veillette ◽  
Katherine Reis ◽  
Joel S. Snyder ◽  
...  
Keyword(s):  
Speech Perception ◽  
Sensory Processing ◽  
Auditory Processing ◽  
Auditory Evoked Potentials ◽  
Brain Regions ◽  
Auditory Evoked Potential ◽  
Cortical Processing ◽  
Rote Learning ◽  
Neural Responses ◽  
Auditory Learning

AbstractThe ability to generalize rapidly across specific experiences is vital for robust recognition of new patterns, especially in speech perception considering acoustic-phonetic pattern variability. Behavioral research has demonstrated that listeners are rapidly able to generalize their experience with a talker’s speech and quickly improve understanding of a difficult-to-understand talker without prolonged practice, e.g., even after a single training session. Here, we examine the differences in neural responses to generalized versus rote learning in auditory cortical processing by training listeners to understand a novel synthetic talker using a Pretest-Posttest design with electroencephalography (EEG). Participants were trained using either (1) a large inventory of words where no words repeated across the experiment (generalized learning) or (2) a small inventory of words where words repeated (rote learning). Analysis of long-latency auditory evoked potentials at Pretest and Posttest revealed that while rote and generalized learning both produce rapid changes in auditory processing, the nature of these changes differed. In the context of adapting to a talker, generalized learning is marked by an amplitude reduction in the N1-P2 complex and by the presence of a late-negative (LN) wave in the auditory evoked potential following training. Rote learning, however, is marked only by temporally later source configuration changes. The early N1-P2 change, found only for generalized learning, suggests that generalized learning relies on the attentional system to reorganize the way acoustic features are selectively processed. This change in relatively early sensory processing (i.e. during the first 250ms) is consistent with an active processing account of speech perception, which proposes that the ability to rapidly adjust to the specific vocal characteristics of a new talker (for which rote learning is rare) relies on attentional mechanisms to adaptively tune early auditory processing sensitivity.Statement of SignificancePrevious research on perceptual learning has typically examined neural responses during rote learning: training and testing is carried out with the same stimuli. As a result, it is not clear that findings from these studies can explain learning that generalizes to novel patterns, which is critical in speech perception. Are neural responses to generalized learning in auditory processing different from neural responses to rote learning? Results indicate rote learning of a particular talker’s speech involves brain regions focused on the memory encoding and retrieving of specific learned patterns, whereas generalized learning involves brain regions involved in reorganizing attention during early sensory processing. In learning speech from a novel talker, only generalized learning is marked by changes in the N1-P2 complex (reflective of secondary auditory cortical processing). The results are consistent with the view that robust speech perception relies on the fast adjustment of attention mechanisms to adaptively tune auditory sensitivity to cope with acoustic variability.

scholarly journals Research Insights on Neural Effects of Auditory Deprivation and Restoration in Unilateral Hearing Loss: A Systematic Review

2020 ◽  
Vol 9 (3) ◽  
pp. 812 ◽  
Author(s):  
Jolijn Vanderauwera ◽  
Elisabeth Hellemans ◽  
Nicolas Verhaert
Keyword(s):  
Systematic Review ◽  
Hearing Loss ◽  
Auditory Processing ◽  
Onset Time ◽  
Unilateral Hearing Loss ◽  
Auditory Input ◽  
Number Of Patients ◽  
Magnetic Resonance Imaging Mri ◽  
Functional Neuroplasticity ◽  
The Impact

Neuroplasticity following bilateral deafness and auditory restoration has been repeatedly investigated. In clinical practice, however, a significant number of patients present a severe-to-profound unilateral hearing loss (UHL). To date, less is known about the neuroplasticity following monaural hearing deprivation and auditory input restoration. This article provides an overview of the current research insights on the impact of UHL on the brain and the effect of auditory input restoration with a cochlear implant (CI). An exhaustive systematic review of the literature was performed selecting 38 studies that apply different neural analyses techniques. The main results show that the hearing ear becomes functionally dominant after monaural deprivation, reshaping the lateralization of the neural network for auditory processing, a process that can be considered to influence auditory restoration. Furthermore, animal models predict that the onset time of UHL impacts auditory restoration. Hence, the results seem to advocate for early restoration of UHL, although further research is required to disambiguate the effects of duration and onset of UHL on auditory restoration and on structural neuroplasticity following UHL deprivation and restoration. Ongoing developments on CI devices compatible with Magnetic Resonance Imaging (MRI) examinations will provide a unique opportunity to investigate structural and functional neuroplasticity following CI restoration more directly.

scholarly journals Sensorial frailty: age-related hearing loss and the risk of cognitive impairment and dementia in later life

2018 ◽  
Vol 10 ◽  
pp. 204062231881100 ◽  
Author(s):  
Francesco Panza ◽  
Madia Lozupone ◽  
Rodolfo Sardone ◽  
Petronilla Battista ◽  
Marco Piccininni ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Cognitive Impairment ◽  
Cognitive Decline ◽  
Clinical Condition ◽  
Oldest Old ◽  
Population Based ◽  
Older Age ◽  
Age Related ◽  
Increased Risk ◽  
Age Related Hearing Loss

The peripheral hearing alterations and central auditory processing disorder (CAPD) associated with age-related hearing loss (ARHL), may impact cognitive disorders in older age. In older age, ARHL is also a significant marker for frailty, another age-related multidimensional clinical condition with a nonspecific state of vulnerability, reduced multisystem physiological reserve, and decreased resistance to different stressors (i.e. sensorial impairments, psychosocial stress, diseases, injuries). The multidimensional nature of frailty required an approach based on different pathogeneses because this clinical condition may include sensorial, physical, social, nutritional, cognitive, and psychological phenotypes. In the present narrative review, the cumulative epidemiological evidence coming from several longitudinal population-based studies, suggested convincing links between peripheral ARHL and incident cognitive decline and dementia. Moreover, a few longitudinal case-control and population-based studies also suggested that age-related CAPD in ARHL, may be central in determining an increased risk of incident cognitive decline, dementia, and Alzheimer’s disease (AD). Cumulative meta-analytic evidence confirmed cross-sectional and longitudinal association of both peripheral ARHL and age-related CAPD with different domains of cognitive functions, mild cognitive impairment, and dementia, while the association with dementia subtypes such as AD and vascular dementia remained unclear. However, ARHL may represent a modifiable condition and a possible target for secondary prevention of cognitive impairment in older age, social isolation, late-life depression, and frailty. Further research is required to determine whether broader hearing rehabilitative interventions including coordinated counseling and environmental accommodations could delay or halt cognitive and global decline in the oldest old with both ARHL and dementia.

Impact of Personal Frequency Modulation Systems on Behavioral and Cortical Auditory Evoked Potential Measures of Auditory Processing and Classroom Listening in School-Aged Children with Auditory Processing Disorder

2018 ◽  
Vol 29 (07) ◽  
pp. 568-586 ◽  
Author(s):  
Jennifer L. Smart ◽  
Suzanne C. Purdy ◽  
Andrea S. Kelly
Keyword(s):  
Frequency Modulation ◽  
Auditory Processing ◽  
Repeated Measures ◽  
Auditory Evoked Potentials ◽  
Auditory Evoked Potential ◽  
Auditory Processing Disorder ◽  
Behavioral Measures ◽  
Frequency Pattern ◽  
School Aged Children ◽  
The Impact

AbstractPersonal frequency modulation (FM) systems are often recommended for children diagnosed with auditory processing disorder (APD) to improve their listening environment in the classroom. Further evidence is required to support the continuation of this recommendation.To determine whether personal FM systems enhance auditory processing abilities and classroom listening in school-aged children with APD.Two baseline assessments separated by eight weeks were undertaken before a 20-week trial of bilateral personal FM in the classroom. The third assessment was completed immediately after the FM trial. A range of behavioral measures and speech-evoked cortical auditory evoked potentials (CAEPs) in quiet and in noise were used to assess auditory processing and FM outcomes. Perceived listening ability was assessed using the Listening Inventory for Education–United Kingdom version (LIFE-UK) questionnaire student and teacher versions, and a modified version of the LIFE-UK questionnaire for parents.Twenty-eight children aged 7–12 years were included in this intervention study. Of the 28 children, there were 22 males and six females.APD Tests scores and CAEP peak latencies and amplitudes were analyzed using repeated measures analysis of variance to determine whether results changed over the two baseline assessments and after the FM trial. The LIFE-UK was administered immediately before and after the FM trial. Student responses were analyzed using paired t-tests. Results are described for the (different) pre- and post-trial teacher versions of the LIFE-UK.Speech in spatial noise (SSN) scores improved by 13% on average when participants wore the FM system in the laboratory. Noise resulted in increased P1 and N2 latencies and reduced N2 amplitudes. The impact of noise on CAEP latencies and amplitudes was significantly reduced when participants wore the FM. Participants’ LIFE-UK responses indicated significant improvements in their perceived listening after the FM trial. Most teachers (74%) reported the trial as successful, based on LIFE-UK ratings. Teachers’ and parents’ questionnaire ratings indicated good agreement regarding the outcomes of the FM trial. There was no change in compressed and reverberated words, masking level difference, and sustained attention scores across visits. Gaps in noise, dichotic digits test, and SSN (hard words) showed practice effects. Frequency pattern test and SSN easy word scores did not change between baseline visits, and improved significantly after the FM trial. CAEP N2 latencies and amplitudes changed significantly across visits; changes occurred across the baseline and the FM trial period.Personal FM systems produce immediate speech perception benefits and enhancement of speech-evoked cortical responses in noise in the laboratory. The 20-week FM trial produced significant improvements in behavioral measures of auditory processing and participants’ perceptions of their listening skills. Teacher and parent questionnaires also indicated positive outcomes.

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