Biomedical subjects

M Furst

Publications and source records attributed to M Furst.

At least 19 recordsLinked to original sources

PubMed2001

A model for sound lateralization.

Recent studies of multiple sclerosis (MS) and stroke patients suggested a correlation between two patterns of abnormal performance in lateralization tasks and two sites of pontine lesions. Most patients who had lesions below or at the superior olivary complex (SOC) perceived all interaural differences in binaural stimuli as small, while most patients who had lesions above the SOC perceived all interaural differences as large. The two abnormal performance patterns occurred for interaural time differences (ITD) and/or for interaural level differences (ILD). The present model proposes a multi-level hierarchical brainstem structure that estimates ITD and ILD. The first level seeks dissimilarity between the left and right inputs and a second level looks for similarity between the two sides' inputs. Each level is modeled as an ensemble of neural arrays in which each unit performs a logic or arithmetic function. The inputs are simulations of auditory nerve responses to broadband stimuli. Simulations yield good correspondence to the effect of both locations of pontine lesions on binaural performance.

Auditory Pathways↗

PubMed2000

Sound lateralization and interaural discrimination. Effects of brainstem infarcts and multiple sclerosis lesions.

Subjects with brainstem lesions due to either an infarct or multiple sclerosis (MS) underwent two types of binaural testing (lateralization testing and interaural discrimination) for three types of sounds (clicks and high and low frequency narrow-band noise) with two kinds of interaural differences (level and time). Two major types of abnormalities were revealed in the lateralization performances: perception of all stimuli, regardless of interaural differences (time and/or level) in the center of the head (center-oriented), or lateralization of all stimuli to one side or the other of the head (side-oriented). Similar patterns of abnormal lateralization (center-oriented and side-oriented) occurred for MS and stroke patients. A subject's pattern of abnormal lateralization testing was the same regardless of the type of stimulus or type of interaural disparity. Lateralization testing was a more sensitive test than interaural discrimination testing for both types of subjects. Magnetic resonance image (MRI) scanning in three orthogonal planes of the brainstem was used to detect lesions. A semi-automated algorithm superimposed the auditory pathway onto each MRI section. Whenever a lesion overlapped the auditory pathway, some binaural performance was abnormal and vice versa. Given a lateralization test abnormality, whether the pattern was center-oriented or side-oriented was mainly determined by lesion site. Center-oriented performance was principally associated with caudal pontine lesions and side-oriented performance with lesions rostral to the superior olivary complex. For lesions restricted to the lateral lemniscus and/or inferior colliculus, whether unilateral or bilateral, just noticeable differences (JNDs) were nearly always abnormal, but for caudal pontine lesions JNDs could be normal or abnormal. MS subjects were more sensitive to interaural time delays than interaural level differences particularly for caudal pontine lesions, while stroke patients showed no differential sensitivity to the two kinds of interaural differences. These results suggest that neural processing of binaural stimuli is multilevel and begins with independent interaural time and level analyzers in the caudal pons.

Adult↗

PubMed2000

Objective detection and localization of multiple sclerosis lesions on magnetic resonance brainstem images: validation with auditory evoked potentials.

To develop an objective method for detecting multiple sclerosis (MS) brainstem lesions, magnetic resonance (MR) images (multiple planar, spin-echo, acquired in three planes of section) of sixteen MS patients and fourteen normal subjects were analyzed with an algorithm that detected regions with a relatively increased intensity on both a spin-echo image and a T2 image. To be considered a lesion, such regions had to overlap in at least two orthogonal planes. Using a digitized atlas of the human brainstem, the lesion locations were mapped with respect to the brainstem anatomy. This method was evaluated by comparing the location of MS lesions with the brainstem auditory evoked potentials obtained from these subjects. Brainstem lesions were detected in five MS patients; four had lesions impinging upon the auditory system and one did not. All four had abnormal evoked potentials. The fourteen normal subjects, the one MS patient with brainstem lesions outside the auditory pathway, and the eleven other MS patients with no brainstem lesions all had normal evoked potentials. The requirement that lesions be detected in at least two planes of section greatly improved the specificity of the algorithm. The consistency between the MR and brainstem auditory evoked potentials results supports the validity of this imaging analysis algorithm for objectively localizing brainstem lesions.

Adult↗

PubMed1998

Effects of localized pontine lesions on auditory brain-stem evoked potentials and binaural processing in humans.

OBJECTIVES AND METHODS: Four sets of measurements were obtained from 11 patients (44-80 years old) with small, localized pontine lesions due to vascular disease: (1) Monaural auditory brain-stem evoked potentials (ABEPs; peaks I to VI); (2) Binaural ABEPs processed for their binaural interaction components (BICs) in the latency range of peaks IV to VI; (3) magnetic resonance imaging (MRI) of the brain-stem; and (4) psychoacoustics of interaural time disparity measures of binaural localization. ABEPs and BICs were analyzed for peak latencies and interpeak latency differences. Three-channel Lissajous' trajectories (3-CLTs) were derived for ABEPs and BICs and the latencies and orientations of the equivalent dipoles of ABEP and BICs were inferred from them. RESULTS: Intercomponent latency measures of monaurally evoked ABEPs were abnormal in only 3 of the 11 patients. Consistent correlations between sites of lesion and neurophysiological abnormality were obtained in 9 of the 11 patients using 3-CLT measures of BICs. Six of the 11 patients had absence of one or more BIC components. Seven of the 11 had BICs orientation abnormality and 3 had latency abnormalities. Trapezoid body (TB) lesions (6 patients) were associated with an absent (two patients with ventral-caudal lesions) or abnormal (one patient with ventral-rostral lesions) dipole orientation of the first component (at the time of ABEPs IV), and sparing of this component with midline ventral TB lesions (two patients). A deviant orientation of the second BICs component (at the time of ABEPs V) was observed with ventral TB lesions. Psychoacoustic lateralization in these patients was biased toward the center. Rostral lateral lemniscus (LL) lesions (3 patients) were associated with absent (one patient) or abnormal (two patients) orientation of the third BICs component (at the time of ABEPs VI); and a side-biased lateralization with behavioral testing. CONCLUSIONS: These results indicate that: (1) the BICs component occurring at the time of ABEPs peak IV is dependent on ventral-caudal TB integrity; (2) the ventral TB contributes to the BICs component at the time of ABEPs peak V; and (3) the rostral LL is a contributing generator of the BICs component occurring at the time of ABEP peak VI.

Adolescent↗

PubMed1998

Lateralization and binaural discrimination of patients with pontine lesions.

Lateralization and just-noticeable difference (jnd) measurements relative to the center were tested in a large group of patients with pontine lesions caused either by stroke or multiple sclerosis. Stimuli included binaural clicks, and low- and high-frequency narrow-band noise bursts. Two major types of abnormalities were revealed in the lateralization performances: perception of all stimuli, regardless of interaural differences (time and/or level) in the center of head (center-oriented), or lateralization of all stimuli to one side or the other of the head (side-oriented). The only significant correlation between jnd and lateralization performances was that an elevated jnd was always manifested in abnormal lateralization, while abnormality in lateralization did not necessarily indicate an abnormal jnd. Center-oriented lateralization was observed either for both interaural differences or only for one of them, and was found in both MS and stroke patients. All side-oriented stroke patients were similarly unable to center binaural stimuli for both time and level cues, whereas only one MS patient had this abnormality for interaural time differences, while his level performance was normal. More abnormalities were detected in the narrow band stimuli tests, although in some cases performance was more degraded for click stimuli. Lateralization tasks with high-frequency stimuli were more sensitive detectors of abnormality than jnd for any kind of stimulus, or lateralization tasks with low-frequency stimuli or clicks.

Adult↗

PubMed1995

Effect of hypoxemia and ethacrynic acid on ABR and distortion product emission thresholds.

Various studies have shown that induction of hypoxemia in animals such that arterial blood oxygen tensions reach 20-30 mm Hg is accompanied by reversible threshold elevations of the auditory nerve-brain-stem evoked response (ABR). In this state, the endocochlear potential (EP) is depressed, causing a smaller potential difference across the hair cells and/or reduced activity of the cochlear amplifier of the outer hair cells. In order to test these possibilities, ABR threshold (an expression of the overall sensitivity of the cochlea) and changes in threshold of the cubic (2f1-f2) distortion product emissions (DPE) (an expression of activity of the cochlear amplifier) were measured in the same cats while the EP was depressed by hypoxemia or by ethacrynic acid. During the episodes of hypoxemia, DPE thresholds were elevated by 10 dB while ABR thresholds were elevated by 22.8 dB. Therefore, it seems that a normal EP is necessary both for normal cochlear transduction (inner hair cells) and for normal cochlear amplification (outer hair cells). The human fetus in utero is relatively hypoxic and there is evidence that its auditory threshold is also similarly elevated. Therefore the threshold elevation in the fetus in utero, estimated to be about 20 dB, is a consequence of both reduced transduction current through the inner hair cells (about 10 dB) and an additional 10 dB reduction in the activity of the cochlear amplifier of the outer hair cells.

Animals↗

PubMed1995

Brainstem lesions and click lateralization in patients with multiple sclerosis.

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.

Audiometry↗

PubMed1995

Noise-induced otoacoustic emission loss with or without hearing loss.

The association between audiometric hearing thresholds and click-evoked otoacoustic emission (CEOAE) spectral properties was examined in 129 adult subjects with and without a noise-induced hearing loss (NIHL). Subjects were grouped according to their "beginning of hearing loss frequency" and their exposure to hazardous noise. Emissions were recorded with an ILO88 Otodynamic Analyzer (Version 2.9) used in the default mode. CEOAE levels decreased as the hearing threshold increased at each of the test frequencies (1,2,3, and 4 kHz). At frequencies where hearing thresholds were worse than 20 dB HL, CEOAEs could not be recorded. Thus as the "beginning of hearing loss frequency" decreased, the frequency range of the emissions became narrower. The hearing threshold for which emissions were not recorded varied significantly between subjects, such that even at frequencies where the hearing threshold was 0 dB HL emissions were not always observed. Noise-exposed, normal-hearing subjects had reduced overall CEOAE power with a narrow frequency range as compared with normal-hearing, nonexposed to noise subjects. For our test conditions, the presence of CEOAEs necessarily suggests hearing thresholds of 20 dB HL or less at the corresponding frequency. A lack of emissions does not necessarily indicate hearing thresholds beyond 20 dB HL.

Acoustic Stimulation↗

PubMed1995

Lateralization and discrimination of dichotic clicks: evidence from patients with brainstem lesions and normal cohorts.

The ability to lateralize and discriminate dichotic clicks was tested in multiple sclerosis patients with normal audiograms and in normal cohorts. Lateral position spread over a greater range with interaural level differences than with interaural time differences, and was related to the two asymmetries by different functions. Measures of binaural acuity were inversely related to the slopes of the two functions. One group of patients performed normally with both types of interaural asymmetry, another group performed normally only with level differences; a third group of patients could not perform normally with either.

Adult↗

PubMed1994

Multiple sclerosis lesions of the auditory pons are not silent.

To understand the relationship between brainstem lesions and auditory neurology in patients with multiple sclerosis, we compared behavioural, electrophysiological and imaging data in 38 patients with probable or definite multiple sclerosis and normal or near normal hearing. Behavioural measures included (i) general hearing tests (audiogram, speech discrimination) and (ii) hearing tests likely to be critically dependent upon brainstem processing (masking level difference, interaural time and level discrimination). Brainstem auditory evoked potentials provided the electrophysiological data. Multiplanar high-resolution MRI of the brainstem provided the anatomical data. Interaural time discrimination for high-frequency sounds was by far the most sensitive of all tests with abnormalities in 71% of all subjects. Whenever any other test was abnormal this test was always abnormal. Interaural time discrimination for low-frequency sounds and evoked potentials were closely related and next most sensitive with abnormalities in approximately 40% of all subjects. Interaural level discrimination and masking level difference were least sensitive with abnormalities in < 10% of subjects. Speech discrimination scores correlated significantly with the masking level differences, as well as with interaural time discrimination for high-frequency sounds. Pontine lesions were found in five of the 16 patients, in whom an objective method for detecting magnetic resonance lesions could be applied. All four with lesions involving the pontine auditory pathway had marked abnormalities in interaural time discrimination and evoked potentials. None of the other 12 had evoked potentials abnormalities. We conclude that neurological tests requiring precise neural timing can reveal behavioural deficits for multiple sclerosis lesions of the auditory pons that are otherwise 'silent'. Of all neurological systems the auditory system at the level of the pons is probably the most sensitive to multiple sclerosis lesions, because of its exceptional dependence upon neural timing in the microsecond range and the lack of redundancy in the encoding of high-frequency sounds. Precise neural timing may be critical for some aspects of speech processing.

Adult↗

PubMed1993

Binaural auditory processing in multiple sclerosis subjects.

In order to relate human auditory processing to physiological and anatomical experimental animal data, we have examined the interrelationships between behavioral, electrophysiological and anatomical data obtained from human subjects with focal brainstem lesions. Thirty-eight subjects with multiple sclerosis were studied with tests of interaural time and level discrimination (just noticeable differences or jnds), brainstem auditory evoked potentials and magnetic resonance (MR) imaging. Interaural testing used two types of stimuli, high-pass (> 4000 Hz) and low-pass (< 1000 Hz) noise bursts. Abnormal time jnds (Tjnd) were far more common than abnormal level jnds (70% vs 11%); especially for the high-pass (Hp) noise (70% abnormal vs 40% abnormal for low-pass (Lp) noise). The HpTjnd could be abnormal with no other abnormalities; however, whenever the BAEPs, LpTjnd and/or level jnds were abnormal HpTjnd was always abnormal. Abnormal wave III amplitude was associated with abnormalities in both time jnds, but abnormal wave III latency with only abnormal HpTjnds. Abnormal wave V amplitude, when unilateral, was associated with a major HpTjnd abnormality, and, when bilateral, with both HpTjnd and LpTjnd major abnormalities. Sixteen of the subjects had their MR scans obtained with a uniform protocol and could be analyzed with objective criteria. In all four subjects with lesions involving the pontine auditory pathway, the BAEPs and both time jnds were abnormal. Of the twelve subjects with no lesions involving the pontine auditory pathway, all had normal BAEPs and level jnds, ten had normal LpTjnds, but only five had normal HpTjnds. We conclude that interaural time discrimination is closely related to the BAEPs and is dependent upon the stimulus spectrum. Redundant encoding of low-frequency sounds in the discharge patterns of auditory neurons, may explain why the HpTjnd is a better indicator of neural desynchrony than the LpTjnd. Encroachment of MS lesions upon the pontine auditory pathway always is associated with abnormal BAEPs and abnormal interaural time discrimination but may have normal interaural level discrimination. Our data provide one of the most direct demonstrations in humans of relationships among auditory performance, evoked potentials and anatomy. We present a model showing that many of these interrelationships can be readily interpreted using ideas developed from work on animals, even though these relationships could not have been predicted with confidence beforehand. This work provides a clear advance in our understanding of human auditory processing and should serve as a basis for future studies.

Acoustic Stimulation↗

PubMed1993

Effects of multiple sclerosis brainstem lesions on sound lateralization and brainstem auditory evoked potentials.

Magnetic resonance (MR) imaging, brainstem auditory evoked potentials (BAEPs), and tests of interaural time and level discrimination were performed on sixteen subjects with multiple sclerosis (MS). Objective criteria were used to define MR lesions. Of the eleven subjects in whom no pontine lesions were detected and the one subject who had pontine lesions that did not encroach upon the auditory pathways, all had normal BAEPs and interaural level discrimination, although a few had abnormal interaural time discrimination. Of four subjects with lesions involving the pontine auditory pathway, all had both abnormal BAEPs and abnormal interaural time discrimination; one also had abnormal interaural level discrimination. Analysis of the data suggest the following: waves I and II are generated peripheral to the middle of the ventral acoustic stria (VAS); wave III is generated ipsilaterally in the region of the rostral VAS, caudal superior olivary complex (SOC) and trapezoid body (TB); and waves V and L are generated contralaterally, rostral to the SOC-TB. The region of the ipsilateral rostral SOC-TB is implicated as part of the pathway involved in the generation of waves V and L. Interaural time discrimination of both high and low frequency stimuli were affected by all brainstem lesions that encroached on auditory pathways. A unilateral lesion in the region of the LL affected interaural time discrimination for low-frequency stimuli less severely than bilateral lesions of the LL or a unilateral lesion of the VAS. The only interaural level discrimination abnormality occurred for a subject with a unilateral lesion involving the entire rostral VAS. It appears that detailed analysis of lesion locations coupled with electrophysiological and psychophysical data holds promise for testing hypotheses concerning the function of various human auditory brainstem structures.

Acoustic Stimulation↗

PubMed1993

Characteristics of click-evoked otoacoustic emissions in ears with normal hearing and with noise-induced hearing loss.

The clinical application of click-evoked otoacoustic emissions (EOAE) in the assessment of noise-induced hearing loss (NIHL) was examined in a group of 72 ears with NIHL and 61 ears with normal hearing (NH). The characteristics of the EOAE in ears with NIHL significantly differed from the NH, according to all EOAE parameters tested in the present study. The mean overall EOAE level was lower and the mean EOAE nonlinearity threshold was worse in the NIHL group. In 95% of the NH ears the EOAE spectrum range was wide, while in 91.5% of the NIHL ears the range was narrow. Moreover, in 94% of the ears with NIHL, the frequency at which the hearing loss began (BHL) was at or above the frequency of the last peak in the EOAE spectrum (FLP). Furthermore, combination of EOAE spectral measures correctly discriminate on average 93.5% of ears with NH from NIHL (sensitivity) and 92% of ears with NIHL from NH (specificity). In contrast, the nonlinearity threshold and the overall level of EOAE yielded lower specificity of less than 33%. It was therefore concluded that EOAE spectrum may serve as a useful and objective tool in screening adults with suspected noise-induced high frequency hearing loss.

Adolescent↗

PubMed1992

Manifestations of intense noise stimulation on spontaneous otoacoustic emission and threshold microstructure: experiment and model.

Comparison between changes that occur simultaneously on spontaneous otoacoustic emissions (SOAEs) and on other cochlear origin phenomena can contribute to the understanding of cochlear micromechanical activity. The temporary changes that arise after short noise exposure are investigated in the following paper. The effects of noise exposure on the threshold microstructure near an SOAE and on the amplitude and frequency of the SOAE were measured. These experimental results indicate the following: (1) exposure to wideband noise for a short time causes a temporary reduction in the SOAE frequency and amplitude, and alters reversibly the threshold microstructure in the vicinity of the SOAE. The difference between the minimum and maximum in the threshold microstructure is reduced, and the frequency that yields the minimum threshold decreases; (2) the threshold at the SOAE frequency is most sensitive to noise exposure; (3) intense stimulation causes a relatively small increase, or even a decrease, in threshold at frequencies near the SOAE. The experimental results are interpreted in terms of a nonlinear transmission line model which includes nonlinear amplifiers. The effect of the noise exposure is modeled by reduction in the cochlear partition amplification term. Most of the experimental results are predicted by this model.

Auditory Fatigue↗

PubMed1991

Optimal a posteriori time domain filter for average evoked potentials.

Evoked potentials measured with scalp electrodes are often described as a deterministic process corrupted by unrelated noise. The common procedure to determine the signal is to average N repetitive measurements. By obtaining additional information from the N measurements, signal detection can be improved. An algorithm that estimates the signal autocorrelation from N given measurements is proposed. The estimator is consistent and unbiased, and its variance tends to 0 as o(N). Two filters that are applied to the average response are introduced. Both depend on the estimation of the signal and the noise autocorrelations. One filter is based on the assumption that the average response is a stationary process. The second filter coefficients are obtained by minimizing the mean squared error (MSE) of an optimal filter of a nonstationary process applied on a single sweep. When a small number of sweeps are averaged, the stationary assumption is adequate, and the MSE of the stationary optimal filter is two to five times less than the MSE of the average response. When a large number of measurements are considered, the error in estimating the autocorrelations decreases. In this case, applying the optimal filter for a nonstationary process leads to a significant improvement in the signal estimation.

Algorithms↗

PubMed1990

Prediction of binaural click lateralization by brainstem auditory evoked potentials.

A previous study by Furst et al. (1985) has shown that in healthy subjects brainstem responses evoked by binaural auditory stimuli with interaural time difference (ITD) and interaural level difference (ILD) include information about the integration of data received by both ears. A correlation was found between the first major peak of the binaural difference waveform and perception of click lateralization and fusion. We have now tested whether a similar correlation exists in patients with multiple sclerosis (MS). The ability to lateralize dichotic clicks was tested in MS patients with normal audiograms. Two kinds of psychoacoustical experiments were employed: (1) A matching experiment in which the subject was asked to match the perceived positions of two click trains, one of which consisted of dichotic clicks with ILD and the other dichotic clicks with ITD; and (2) A positional JND experiment in which the subject was asked to determine the difference in perceived position of two successive click trains. Two reference positions were tested, the head center and the side of the head near the ear, while the control was either on ITD or on ILD. According to the psychoacoustical performances, three groups of patients were identified. Group I consisted of patients who performed normally in all the psychoacoustical experiments. Group II patients were able to lateralize binaural clicks but performed abnormally in the matching experiment and in the position discrimination experiment when the control was on ITD and the reference position was the head center. The patients in Group II performed normally in the discrimination experiments when the control was on ILD, and when the control was on ITD but the reference position was the head side. Group III consisted of those who were not able to perform either one of the psychoacoustical experiments. They perceived the same binaural clicks in different positions in different times. Brainstem auditory potentials evoked by dichotic clicks with different ILDs and ITDs were measured in all the MS patients, and the corresponding binaural difference (BD) waveforms were calculated. Whenever beta, the first major peak of BD, was identified it was used to obtain a physiological matching curve. It was derived by matching an ILD on the basis of similar beta latencies. For every patient, in either Group I or II, the physiological matching curve was very similar to his psychoacoustical matching curve.

Acoustic Stimulation↗

PubMed1988

Ear canal acoustic distortion at 2f1-f2 from human ears: relation to other emissions and perceived combination tones.

Two aspects of the intermodulation distortion product at 2f1-f2 generated by normal human ears and measured acoustically in the ear canal were studied: (1) its relation to tone-evoked and spontaneous otoacoustic emissions, and (2) its relation to the perceived combination tone at the same frequency. With regard to (1), substantial differences among ears in the detectability of emissions were observed; ears tended to exhibit all or none of the emission types that were sought. Within ears possessing emissions, the magnitudes of tone-evoked emissions and acoustic distortion showed a similar dependence on frequency. With regard to (2), a three-primary-tone stimulus was employed to ask whether the ear canal acoustic distortion tone is canceled under the same stimulus conditions that produce perceptual cancellation. Simultaneous cancellation of perceptual and acoustic distortion was produced rarely. Results are interpreted qualitatively with a model in which primary tones produce distortion at their interaction region within the cochlea; this distortion propagates to the distortion-frequency place where it mediates perception. This same distortion wave produces emission components at additional locations, including the primary-tone interaction region, which sum vectorially to mediate the emitted acoustic distortion product.

Acoustic Stimulation↗

PubMed1988

A cochlear model for acoustic emissions.

Variability in cochlear emission properties among different species, particularly humans and small mammals, and within individuals in the same species, is modeled by a cochlear nonlinear transmission line. The difference between humans and animals is largely explained by a lower cochlear input impedance in human ears than in cats, gerbils, or chinchillas. Inconstancy in emission properties among individual human or animal subjects is related to structural variability among ears, which can be the result of a nonuniform connection between the outer hair cells cilia and the tectorial membrane. These structural differences are modeled by a nonuniform cochlear partition resistance along the cochlear length. The model predicts that an ear which has a uniform cochlear partition resistance and an adequate cochlear input impedance will emit acoustic distortion products (ADP), but not spontaneous acoustic emission (SAE), nor click-evoked emission (CE). Only a nonuniform cochlea emits SAE and CE in addition to enhanced ADPs. The model predictions agree quantitatively with cochlear emission data from humans and animals.

Acoustic Stimulation↗