RESUMEN
BACKGROUND AND OBJECTIVE: Tinnitus is a neuropathological condition that results in mild buzzing or ringing of the ears without an external sound source. Current tinnitus diagnostic methods often rely on subjective assessment and require intricate medical examinations. This study aimed to propose an interpretable tinnitus diagnostic framework using auditory late response (ALR) and electroencephalogram (EEG), inspired by the gap-prepulse inhibition (GPI) paradigm. METHODS: We collected spontaneous EEG and ALR data from 44 patients with tinnitus and 47 hearing loss-matched controls using specialized hardware to capture responses to sound stimuli with embedded gaps. In this cohort study of tinnitus and control groups, we examined EEG spectral and ALR features of N-P complexes, comparing the responses to gap durations of 50 and 20 ms alongside no-gap conditions. To this end, we developed an interpretable tinnitus diagnostic model using ALR and EEG metrics, boosting machine learning architecture, and explainable feature attribution approaches. RESULTS: Our proposed model achieved 90 % accuracy in identifying tinnitus, with an area under the performance curve of 0.89. The explainable artificial intelligence approaches have revealed gap-embedded ALR features such as the GPI ratio of N1-P2 and EEG spectral ratio, which can serve as diagnostic metrics for tinnitus. Our method successfully provides personalized prediction explanations for tinnitus diagnosis using gap-embedded auditory and neurological features. CONCLUSIONS: Deficits in GPI alongside activity in the EEG alpha-beta ratio offer a promising screening tool for assessing tinnitus risk, aligning with current clinical insights from hearing research.
Asunto(s)
Electroencefalografía , Potenciales Evocados Auditivos , Acúfeno , Humanos , Acúfeno/fisiopatología , Acúfeno/diagnóstico , Electroencefalografía/métodos , Femenino , Masculino , Adulto , Persona de Mediana Edad , Estimulación Acústica , Aprendizaje Automático , Estudios de Casos y Controles , Estudios de Cohortes , AncianoRESUMEN
Tinnitus, or the perception of a sound in the absence of an external acoustic stimulus, is a common condition that cannot yet be objectively diagnosed. Current diagnostic tests of tinnitus consist of case history and behavioral measures that rely on subjective responses. This study examined electrophysiological measures, specifically the auditory late response (ALR), mismatch negativity (MMN), and P300 as potential neural biomarkers of tinnitus in both a tinnitus and non-tinnitus control group while utilizing the pitch-matched tinnitus frequencies as the test stimuli. Results of this study found differences in MMN amplitudes and area under the curve, and in P300 topographic maps between tinnitus and control subjects. The differences in MMN responses across groups suggest that dysfunctional processing of acoustic stimuli located near the tinnitus frequency in individuals with tinnitus manifests as soon as 200 ms after initial onset of the stimulus. In addition, results from a global field power analysis and differences in spatial distributions on topographical maps indicate that deficits persist through higher levels of cortical processing. A secondary goal of this study was to determine if electrophysiological measures correlated with reported tinnitus severity on questionnaires. This analysis indicated that P2 latency was a significant predictor of Tinnitus Reaction Questionnaire, Tinnitus Handicap Inventory, and percent of the time participant's tinnitus was considered bothersome, suggesting that this measure could potentially be used to assess the efficacy of treatment programs for tinnitus.
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Estimulación Acústica , Electroencefalografía , Potenciales Evocados Auditivos , Acúfeno , Humanos , Acúfeno/fisiopatología , Femenino , Masculino , Potenciales Evocados Auditivos/fisiología , Persona de Mediana Edad , Adulto , Electroencefalografía/métodos , Estimulación Acústica/métodos , Potenciales Relacionados con Evento P300/fisiología , Corteza Auditiva/fisiopatología , Encuestas y Cuestionarios , Percepción Auditiva/fisiologíaRESUMEN
Children are disadvantaged compared to adults when they perceive speech in a noisy environment. Noise reduces their ability to extract and understand auditory information. Auditory-Evoked Late Responses (ALRs) offer insight into how the auditory system can process information in noise. This study investigated how noise, signal-to-noise ratio (SNR), and stimulus type affect ALRs in children and adults. Fifteen participants from each group with normal hearing were studied under various conditions. The findings revealed that both groups experienced delayed latencies and reduced amplitudes in noise but that children had fewer identifiable waves than adults. Babble noise had a significant impact on both groups, limiting the analysis to one condition: the /da/ stimulus at +10 dB SNR for the P1 wave. P1 amplitude was greater in quiet for children compared to adults, with no stimulus effect. Children generally exhibited longer latencies. N1 latency was longer in noise, with larger amplitudes in white noise compared to quiet for both groups. P2 latency was shorter with the verbal stimulus in quiet, with larger amplitudes in children than adults. N2 latency was shorter in quiet, with no amplitude differences between the groups. Overall, noise prolonged latencies and reduced amplitudes. Different noise types had varying impacts, with the eight-talker babble noise causing more disruption. Children's auditory system responded similarly to adults but may be more susceptible to noise. This research emphasizes the need to understand noise's impact on children's auditory development, given their exposure to noisy environments, requiring further exploration of noise parameters in children.
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Estimulación Acústica , Potenciales Evocados Auditivos , Ruido , Humanos , Femenino , Masculino , Potenciales Evocados Auditivos/fisiología , Niño , Adulto , Estimulación Acústica/métodos , Adulto Joven , Percepción Auditiva/fisiología , Electroencefalografía/métodos , Tiempo de Reacción/fisiología , Relación Señal-Ruido , AdolescenteRESUMEN
OBJECTIVES: To examine the differences in auditory evoked cortical responses that may underlie the tendency of some people to perceive tinnitus. The study hypothesis is that the mean ALR and P300 amplitudes in normal hearing adults who perceive temporary tinnitus after exposure to sustained silence will be larger than the mean ALR and P300 amplitudes in normal hearing adults who do not perceive temporary tinnitus after exposure to sustained silence. DESIGN: This was a prospective cross-sectional study. The approval for the study was obtained from the IRB and COVID ramp up committee of University of North Carolina Greensboro (UNCG). Participants completed comprehensive hearing screening and preand postsilence ALR and P300 recordings were obtained. After the first ALR/P300 recording participants were exposed to ten minutes of silence. Participants completed a Qualtrics questionnaire to report any tinnitus perception that emerged during silence exposure. Absolute N1, P2 and P300 waveform amplitudes and latencies were identified and were entered into an SPSS spreadsheet for data analysis. RESULTS: Thirty adult females with normal pure tone hearing thresholds and no history of persistent tinnitus were included in the study. The mean age of the participants was 22.5 ± 3.9 years. When exposed to silence, eight (26.7%) participants perceived temporary tinnitus. N1 and P300 waveforms were smaller in amplitude and faster in latency in the tinnitus perception group; however, the ALR and P300 waveform latencies and amplitudes did not statistically differ significantly between the participants who perceived temporary tinnitus in silence and those who did not (p>0.05). The difference in waveform morphology between the tinnitus perception group and the non-tinnitus perception group revealed a greater difference in P300 amplitude after exposure to silence. CONCLUSION: Differences in ALR and P300 latencies and amplitudes were observed between the tinnitus perception group and non-tinnitus perception group, with smaller P300 amplitudes appearing in the group perceiving tinnitus. While the results did not statistically significant, this pattern may reflect a mismatch between the neuronal response in the auditory cortex (N1 and P2 amplitudes and latencies) and the neuronal activity in the modulatory network regions (P300).
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Acúfeno , Adulto , Femenino , Humanos , Adulto Joven , Estudios Transversales , Potenciales Evocados Auditivos/fisiología , Estudios Prospectivos , Acúfeno/diagnóstico , Acúfeno/etiología , SonidoRESUMEN
The common marmoset (Callithrix jacchus), a New World monkey, serves as a useful animal model in clinical and basic neuroscience. The present study recorded scalp auditory evoked potentials (AEP) in non-sedated common marmoset monkeys (n = 4) using a noninvasive method similar to that used in humans, and aimed to identify nonhuman primate correlates of the human AEP components. A pure tone stimulus was presented while electroencephalograms were recorded using up to 16 disk electrodes placed on the scalp and earlobes. Candidate homologues of two categories of the human AEP, namely, the middle latency responses (MLR; Na, Pa, Nb, and Pb) and the cortical auditory evoked potentials (CAEP; P1, N1, P2, N2, and the sustained potential, SP) were identified in the marmoset. These waves were labeled as CjNa, CjPa, CjNb, CjPb, CjP1, CjN1, CjP2, CjN2, and CjSP, where Cj stands for Callithrix jacchus. The last MLR component, CjPb, was identical to the first CAEP component, CjP1, similar to the relationship between Pb and P1 in humans. The peak latencies of the marmoset MLR and CAEP were generally shorter than in humans, which suggests a shorter integration time in neural processing. To our knowledge, the present study represents the first scalp recorded MLR and CAEP in the alert common marmoset. Further use of these recording methods would enable valid species comparisons of homologous brain indices between humans and animals.
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Callithrix , Potenciales Evocados Auditivos , Cuero Cabelludo , Estimulación Acústica , Animales , Electroencefalografía , Plomo , Tiempo de ReacciónRESUMEN
Short-duration speech-like stimuli, for example, excised from running speech, can be used in the clinical setting to assess the integrity of the human auditory pathway at the level of the cortex. Modeling of the cochlear response to these stimuli demonstrated an imprecision in the location of the spectrotemporal energy, giving rise to uncertainty as to what and when of a stimulus caused any evoked electrophysiological response. This article reports the development and assessment of four short-duration, limited-bandwidth stimuli centered at low, mid, mid-high, and high frequencies, suitable for free-field delivery and, in addition, reproduction via hearing aids. The durations were determined by the British Society of Audiology recommended procedure for measuring Cortical Auditory-Evoked Potentials. The levels and bandwidths were chosen via a computational model to produce uniform cochlear excitation over a width exceeding that likely in a worst-case hearing-impaired listener. These parameters produce robustness against errors in insertion gains, and variation in frequency responses, due to transducer imperfections, room modes, and age-related variation in meatal resonances. The parameter choice predicts large spectral separation between adjacent stimuli on the cochlea. Analysis of the signals processed by examples of recent digital hearing aids mostly show similar levels of gain applied to each stimulus, independent of whether the stimulus was presented in isolation, bursts, continuous, or embedded in continuous speech. These stimuli seem to be suitable for measuring hearing-aided Cortical Auditory-Evoked Potentials and have the potential to be of benefit in the clinical setting.
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Audiología/métodos , Percepción Auditiva , Audífonos/normas , Estimulación Acústica , Vías Auditivas , Percepción Auditiva/fisiología , Cóclea/fisiología , Potenciales Evocados Auditivos/fisiología , Femenino , Pérdida Auditiva , Humanos , Masculino , Habla , Percepción del Habla/fisiología , Factores de TiempoRESUMEN
The present study aimed to investigate whether gap-prepulse inhibition (GPI) deficit in patients with tinnitus occurred in the N1-P2 complex of the cortical auditory evoked potential. Auditory late responses to the intense sound of the GPI paradigm were obtained from 16 patients with tinnitus and 18 age- and hearing loss-matched controls without tinnitus. The inhibition degrees of the N1-P2 complex were assessed at 100-, 50-, and 20-ms gap durations with tinnitus-pitch-matched and non-matched frequency background noises. At the 20-ms gap condition with the tinnitus-pitch-matched frequency background noise, only the tinnitus group showed an inhibition deficit of the N1-P2 complex. The inhibition deficits were absent in both groups with longer gap durations. These findings suggested that the effect of tinnitus emerged depending on the cue onset timing and duration of the gap-prepulse. Since inhibition deficits were observed in both groups at the same 20-ms gap condition, but with the tinnitus-pitch-non-matched frequency background noise, the present study did not offer proof of concept for tinnitus filling in the gap. Additional studies on the intrinsic effects of different background frequencies on the gap processing are required in the future.
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Estimulación Acústica , Corteza Auditiva/fisiología , Potenciales Evocados Auditivos/fisiología , Inhibición Prepulso , Acúfeno/fisiopatología , Acústica , Adulto , Anciano , Percepción Auditiva , Umbral Auditivo/fisiología , Parpadeo , Estudios de Casos y Controles , Electrodos , Electromiografía , Femenino , Humanos , Masculino , Persona de Mediana Edad , Ruido , Tiempo de Reacción , Reflejo de Sobresalto/fisiologíaRESUMEN
The gap-startle paradigm has been used as a behavioral method for tinnitus screening in animal studies. This study aimed to investigate gap prepulse inhibition (GPI) of the auditory late response (ALR) as the objective response of the gap-intense sound paradigm in humans. ALRs were recorded in response to gap-intense and no-gap-intense sound stimuli in 27 healthy subjects. The amplitudes of the baseline-to-peak (N1, P2, and N2) and the peak-to-peak (N1P2 and P2N2) were compared between two averaged ALRs. The variations in the inhibition ratios of N1P2 and P2N2 during the experiment were analyzed by increasing stimuli repetitions. The effect of stimulus parameter adjustments on GPI ratios was evaluated. No-gap-intense sound stimuli elicited greater peak amplitudes than gap-intense sound stimuli, and significant differences were found across all peaks. The overall mean inhibition ratios were significantly lower than 1.0, where the value 1.0 indicates that there were no differences between gap-intense and no-gap-intense sound responses. The initial decline in GPI ratios was shown in N1P2 and P2N2 complexes, and this reduction was nearly complete after 100 stimulus repetitions. Significant effects of gap length and interstimulus interval on GPI ratios were observed. We found significant inhibition of ALR peak amplitudes in performing the gap-intense sound paradigm in healthy subjects. The N1P2 complex represented GPI well in terms of suppression degree and test-retest reliability. Our findings offer practical information for the comparative study of healthy subjects and tinnitus patients using the gap-intense sound paradigm with the ALR.
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Corteza Auditiva/fisiología , Potenciales Evocados Auditivos/fisiología , Inhibición Prepulso/fisiología , Reflejo de Sobresalto/fisiología , Estimulación Acústica , Adulto , Femenino , Voluntarios Sanos , Humanos , Masculino , Adulto JovenRESUMEN
Scalp-recorded evoked potentials (EP) provide researchers and clinicians with irreplaceable means for recording stimulus-related neural activities in the human brain, due to its high temporal resolution, handiness, and, perhaps more importantly, non-invasiveness. This work recorded the scalp cortical auditory EP (CAEP) in unanesthetized monkeys by using methods that are essentially identical to those applied to humans. Young adult rhesus monkeys (Macaca mulatta, 5-7 years old) were seated in a monkey chair, and their head movements were partially restricted by polystyrene blocks and tension poles placed around their head. Individual electrodes were fixated on their scalp using collodion according to the 10-20 system. Pure tone stimuli were presented while electroencephalograms were recorded from up to nineteen channels, including an electrooculogram channel. In all monkeys (n = 3), the recorded CAEP comprised a series of positive and negative deflections, labeled here as macaque P1 (mP1), macaque N1 (mN1), macaque P2 (mP2), and macaque N2 (mN2), and these transient responses to sound onset were followed by a sustained potential that continued for the duration of the sound, labeled the macaque sustained potential (mSP). mP1, mN2 and mSP were the prominent responses, and they had maximal amplitudes over frontal/central midline electrode sites, consistent with generators in auditory cortices. The study represents the first noninvasive scalp recording of CAEP in alert rhesus monkeys, to our knowledge.
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Corteza Auditiva/fisiología , Electroencefalografía/métodos , Potenciales Evocados Auditivos , Estimulación Acústica , Animales , Audiometría de Tonos Puros , Electrooculografía , Femenino , Macaca mulatta , Masculino , Modelos Animales , Valor Predictivo de las Pruebas , Cuero Cabelludo , Procesamiento de Señales Asistido por Computador , Factores de Tiempo , VigiliaRESUMEN
Gap detection threshold (GDT), the shortest silent interval a person can perceive, is a commonly used measure of temporal processing resolution. The purposes of this study were: (1) to examine the effects of noise vocoding, which has been used to simulate what signals sound like through a cochlear implant, on GDTs in normal-hearing subjects, and (2) to further the understanding of neural mechanisms underlying gap detection using the Auditory Late Response (ALR). Thirteen normal listeners participated. In behavioral tests, the GDTs were determined for the original and vocoded stimuli. In ALR recordings, the subjects were presented with auditory stimuli with and without containing gaps and stimuli with and without being vocoded. Results showed that GDTs were significantly elevated for vocoded stimuli with spectral resolutions of 4 and 20 channels compared to those for the original stimuli. A gap effect was observed in the post-gap ALR. Current densities for N1 peaks evoked by stimuli with zero- vs. non-zero ms gaps, pre- vs. post-gap markers, and original vs. vocoded stimuli were obtained using the standardized low-resolution brain electromagnetic tomography (sLORETA) method. Paired comparisons of pre- and post-gap current density values were made. Results showed a statistical difference between the N1s evoked by pre- vs. post-gap markers, with the activation in the middle frontal gyrus and precentral gyrus. The results suggest that: (1) noise vocoding does affect temporal processing resolution assessed with GDTs, (2) gap detection may involve the recruitment of cognitive neural resources, and (3) the ALR has a potential value of objectively estimating temporal processing resolution.