Cortical deafness

Graham, John; Greenwood, R; Lecky, Bryan

doi:10.1016/0022-510x(80)90148-3

Cited by 78 publications

(10 citation statements)

References 32 publications

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“…This is because we are just at the beginning of the development of effective and reliable diagnostic tools for the assessment of central hearing impairments [Divenyi and Robinson, 1989;Griffiths et al, 2001;Bungert-Kahl et al, 2004]. So far, most case reports hardly contain quantifiable data that would enable a reliable evaluation of the severity and specific quality of an auditory impairment across the different tests applied [Graham et al, 1980].…”

mentioning

confidence: 99%

Central Auditory Impairment in Unilateral Diencephalic and Telencephalic Lesions

Biedermann¹,

Bungert²,

Dörrscheidt

et al. 2007

Audiol Neurotol

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The extent of perceptual impairment following unilateral lesions in the auditory cortex, its thalamic or callosal afferents was studied with psychoacoustic tests. Thresholds for the discrimination of signal frequency, intensity and duration were acquired under three different conditions of headphone stimulation (‘monaural’, ‘interaural’, and ‘dichotic signal/noise tests’) using the three-alternative forced-choice procedure. The different test alternatives generated distinct auditory percepts, which is in accordance with the assumption of specific signal processing at the level of the auditory brainstem and at thalamocortical auditory areas. Twenty-one patients from neurology were studied who suffered from unilateral lesions in the auditory cortex, the auditory thalamus, or the acoustic radiation. Location and extent of the lesions were assessed by magnetic resonance imaging. Monaural tests of either ear revealed no deficits in auditory performance. The patients showed impaired discrimination of signal frequency, intensity and duration in the dichotic signal/noise tests, when the signals were presented to the ear contralateral and the noise ipsilateral to the lesion. With inverted signal and noise stimulation, however, the thresholds were in the range of age-matched controls. All patients were able to master the interaural tests, which indicates the preserved ability to lateralize sound sources to the left and to the right with either one of the auditory cortices left intact. Another 24 patients were studied who had lesions mostly close to but sparing the before-mentioned auditory structures. All of them showed unimpaired performance in all test alternatives. The results indicate the specificity of the dichotic signal/noise tests for the identification of unilateral lesions in thalamocortical auditory structures. In addition, the results also point to the capacity of each telencephalic hemisphere to process the full range of auditory lateralization from left to right.

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confidence: 99%

Central Auditory Impairment in Unilateral Diencephalic and Telencephalic Lesions

Biedermann¹,

Bungert²,

Dörrscheidt

et al. 2007

Audiol Neurotol

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“…[29]). In these cases patients often suffer from cortical deafness [28-38], although the patients’ specific impairment depends on the exact location and extent of the lesion [33,35] and possible retrograde fiber degeneration caused by the AC lesion [36]. In cases of complete cortical deafness patients are usually able to react to environmental sounds despite being unaware of hearing them [30].…”

Section: Discussionmentioning

confidence: 99%

“…This phenomenon can be explained by the fact that cortical deaf patients usually display normal auditory brainstem functions, e.g. normal BERA thresholds [29,37,38], despite profound to complete sensori-neural hearing loss on pure tone audiometry.…”

Section: Discussionmentioning

confidence: 99%

Sensory cortex lesion triggers compensatory neuronal plasticity

et al. 2014

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BackgroundLesions to the human brain often cause dramatic impairments in the life of patients because of the very limited capacity of the mammalian nervous system to regenerate. On the other hand, neuronal tissue has a high capacity to reorganize itself so that loss of function due to brain damage may be compensated through neuroplastic reorganization of undamaged tissue in brain regions adjacent or contralateral to the lesion site. In this study we investigated the effect of serial lesions of the auditory cortices (AC) in both hemispheres of Mongolian gerbils on discrimination performance for fast amplitude modulated tones (AM). Healthy animals were trained to discriminate two fast AM, an ability that has previously been shown to critically depend on cortical processing. Their ability to maintain significant discrimination performance was retested after unilateral AC lesion, and again after lesion of the contralateral AC, with 15 days of continuing training in between the two lesions.ResultsAfter bilateral cortical ablation of both AC and 45 days of training the animals show no change in pure tone detection threshold as measured with modulation of the acoustic startle reflex which has been shown to rely on subcortical structures. In contrast to simultaneous bilateral ablation of AC that results in complete loss of AM discrimination ability in this paradigm we found compensatory plasticity that seems to be triggered by unilateral cortical ablation with subsequent training and that is able to almost fully compensate for the lost cortical functions.ConclusionsOur results demonstrate that AM discrimination ability that normally depends on AC may be transferred to other brain regions when the brain has time to activate compensatory plasticity between the lesions of the two AC hemispheres. For this process to take place obviously one intact AC hemisphere is needed. This finding may open perspectives for new therapeutic strategies that may alleviate the impairments after multiple ischemic strokes.

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“…This condition is generally known as “cortical deafness” because in most cases damage to both temporal or temporoparietal lobes is observed, including the primary auditory cortex (Broadmann areas 41 and 42) on both transverse gyri (Heschl). [23]…”

Section: Discussionmentioning

confidence: 99%

“…[2] To date, cortical deafness has been reported in only three cases related to SAH. [569] In the first reported case, an old infarction was found in the left temporal lobe prior to the occurrence of SAH.…”

Section: Discussionmentioning

confidence: 99%

Intraarterial vasodilator therapy immediately rescued pure cortical deafness due to bilateral cerebral vasospasm

Asakuno¹,

Ishida²

2014

Surg Neurol Int

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Background:Cortical deafness is a rare symptom that is associated with bilateral lesions of the auditory cortex. To date, cortical deafness has been reported in only three cases of subarachnoid hemorrhage (SAH).Case Description:This 55-year-old female was admitted to our hospital with SAH caused by a ruptured left internal carotid artery (ICA) paraclinoid aneurysm. Computed tomography (CT) scans showed diffuse thick SAH with no other lesions such as an old infarction or hemorrhage. Emergent stent-assisted coil embolization was performed successfully and subsequent cisternal irrigation with urokinase almost completely washed out the thick SAH. During follow-up, she was alert and without any neurological deficits, however, she developed acute bilateral deafness on day 7 even though she had no history of hearing impairment. Because of the deafness, verbal communication was difficult. She became almost completely unable to hear and communication was confined to writing. Immediate diffusion-weighted (DW) image showed high intensities in bilateral superior temporal gyri due to severe vasospasm of bilateral middle cerebral arteries (MCAs). Immediate angiography showed severe vasospasm especially right MCA. A microcatheter was advanced to the right M1 and papaverine was administered. Soon after that, her hearing impairment dramatically improved. Our simple audiometry showed a hearing threshold average for both 1000 and 4000 Hz at 25 dB in both ears. She was discharged without any deficits in 2 weeks.Conclusions:To our knowledge, this is the first reported case of pure cortical deafness due to bilateral vasospasm, which was immediately resolved by intraarterial administration of papaverine.

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Cortical deafness

Cited by 78 publications

References 32 publications

Central Auditory Impairment in Unilateral Diencephalic and Telencephalic Lesions

Central Auditory Impairment in Unilateral Diencephalic and Telencephalic Lesions

Sensory cortex lesion triggers compensatory neuronal plasticity

Intraarterial vasodilator therapy immediately rescued pure cortical deafness due to bilateral cerebral vasospasm

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