Cochlear synaptopathy: new findings in animal and human research.

In animal models, prolonged exposure (2 h) to high-level noise causes an irreparable damage to the synapses between the inner hair cells and auditory nerve fibers within the cochlea. Nevertheless, this injury does not necessarily alter the hearing threshold. Similar findings have been observed as part of typical aging in animals. This type of cochlear synaptopathy, popularly called "hidden hearing loss," has been a significant issue in neuroscience research and clinical audiology scientists. The results obtained in different investigations are inconclusive in their diagnosis and suggest new strategies for both prognosis and treatment of cochlear synaptopathy. Here we review the major physiological findings regarding cochlear synaptopathy in animals and humans and discuss mathematical models. We also analyze the potential impact of these results on clinical practice and therapeutic options.

Contralateral efferent suppression of human hearing sensitivity.

The present study aimed at characterizing the suppressing effect of contralateral medial olivocochlear (MOC) efferents on human auditory sensitivity and mechanical cochlear responses at sound levels near behavioral thresholds. Absolute thresholds for pure tones of 500 and 4000 Hz with durations between 10-500 ms were measured in the presence and in the absence of a contralateral broadband noise. The intensity of the noise was fixed at 60 dB SPL to evoke the contralateral MOC reflex without evoking the middle-ear muscle reflex. In agreement with previously reported findings, thresholds measured without the contralateral noise decreased with increasing tone duration, and the rate of decrease was faster at 500 than at 4000 Hz. Contralateral stimulation increased thresholds by 1.07 and 1.72 dB at 500 and 4000 Hz, respectively. The mean increase (1.4 dB) just missed statistical significance (p = 0.08). Importantly, the across-frequency mean threshold increase was significantly greater for long than for short probes. This effect was more obvious at 4000 Hz than at 500 Hz. Assuming that thresholds depend on the MOC-dependent cochlear mechanical response followed by an MOC-independent, post-mechanical detection mechanism, the present results at 4000 Hz suggest that MOC efferent activation suppresses cochlear mechanical responses more at lower than at higher intensities across the range of intensities near threshold, while the results at 500 Hz suggest comparable mechanical suppression across the threshold intensity range. The results are discussed in the context of central masking and of auditory models of efferent suppression of cochlear mechanical responses.

Contralateral efferent regulation of human cochlear tuning: behavioural observations and computer model simulations.

In binaural listening, the two cochleae do not act as independent sound receptors; their functioning is linked via the contralateral medial olivo-cochlear reflex (MOCR), which can be activated by contralateral sounds. The present study aimed at characterizing the effect of a contralateral white noise (CWN) on psychophysical tuning curves (PTCs). PTCs were measured in forward masking for probe frequencies of 500 Hz and 4 kHz, with and without CWN. The sound pressure level of the probe was fixed across conditions. PTCs for different response criteria were measured by using various masker-probe time gaps. The CWN had no significant effects on PTCs at 4 kHz. At 500 Hz, by contrast, PTCs measured with CWN appeared broader, particularly for short gaps, and they showed a decrease in the masker level. This decrease was greater the longer the masker-probe time gap. A computer model of forward masking with efferent control of cochlear gain was used to explain the data. The model accounted for the data based on the assumption that the sole effect of the CWN was to reduce the cochlear gain by ∼6.5 dB at 500 Hz for low and moderate levels. It also suggested that the pattern of data at 500 Hz is the result of combined broad bandwidth of compression and off-frequency listening. Results are discussed in relation with other physiological and psychoacoustical studies on the effect of activation of MOCR on cochlear function.

Contralateral efferent reflex effects on threshold and suprathreshold psychoacoustical tuning curves at low and high frequencies.

Medial olivocochlear efferent neurons can control cochlear frequency selectivity and may be activated in a reflexive manner by contralateral sounds. The present study investigated the significance of the contralateral medial olivocochlear reflex (MOCR) on human psychoacoustical tuning curves (PTCs), a behavioral correlate of cochlear tuning curves. PTCs were measured using forward masking in the presence and in the absence of a contralateral white noise, assumed to elicit the MOCR. To assess MOCR effects on apical and basal cochlear regions over a wide range of sound levels, PTCs were measured for probe frequencies of 500 Hz and 4 kHz and for near- and suprathreshold conditions. Results show that the contralateral noise affected the PTCs predominantly at 500 Hz. At near-threshold levels, its effect was obvious only for frequencies in the tails of the PTCs; at suprathreshold levels, its effects were obvious for all frequencies. It was verified that the effects were not due to the contralateral noise activating the middle-ear muscle reflex or changing the postmechanical rate of recovery from forward masking. A phenomenological computer model of forward masking with efferent control was used to explain the data. The model supports the hypothesis that the behavioral results were due to the contralateral noise reducing apical cochlear gain in a frequency- and level-dependent manner consistent with physiological evidence. Altogether, this shows that the contralateral MOCR may be changing apical cochlear responses in natural, binaural listening situations.