PubMed · 13551091
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A R TUNTURI. 1958. Discussion on function of auditory cortex.. https://doi.org/10.1002/lary.5540680322
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The authors present the anatomical and clinical features of cortical auditory dysfunction in two patients, in whom hypertensive bleedings destroyed the cortical auditory centres in both hemispheres. The second haemorrhage occurred four years after the first bleeding in both cases. The bleedings isolated the cortical hearing centres due to the destruction of the right and left temporal white matter. During the clinical course the symptomatology has changed in both patients: pure word deafness has transformed to cortical deafness and generalised auditory agnosia. Normal pattern of brain stem auditory evoked potentials suggested intact auditory pathways. Authors conclude that transformation of clinical forms of cortical auditory disorder can be explained by the tissue reaction to the subcortical bleeding in the cortical auditory centres.
Tinnitus is likely initiated by a discontinuity in the spontaneous or low-level-stimulus induced neural activity across auditory nerve fibers with different characteristic frequency (CF). This discontinuity may be caused by functional loss of outer hair cells in those regions where inner hair cells are preserved. The reduced spontaneous activity for nerve fibers with CFs in the hearing loss range may result in a reduction of lateral inhibition at more central levels. This reduced lateral inhibition of neurons with CFs close to the edge frequency of the audiogram induces hypersensitivity and hyperactivity in these neurons. Persistent changes in lateral inhibition result in increased numbers of neurons that are tuned to a limited range of frequencies at the edge of the cochlear lesion. Thus, the frequency map in auditory cortex, the tonotopic map, becomes reorganized as it reflects these changes. The spontaneous neuronal firings in the auditory cortex after insults that cause tinnitus show increased synchrony, thereby mimicking one aspect of the responses to normal sound stimulation. All long-standing tinnitus may thus be called central tinnitus, despite the fact that it is initiated by cochlear hearing loss or is localized to the hearing loss ear.
This article present a review of recent work on cognitive neuroscience approaches of schizophrenia. Some of the symptoms displayed by schizophrenic patients can be reconsidered within the framework of disorganization of well identified cognitive functions, like self-recognition. Neuroimaging techniques can reveal in these patients disruption of neural networks normally involved in such functions.