Lateralized Auditory Symptoms in Central Neuroaudiology Disorder

Abstract

Many individuals with central auditory nervous system (CANS) pathology/disorder report a variety of auditory symptoms with difficulty hearing in noise being one of the most common complaints (Chermak and Musiek, 1992) Interestingly, there seems to be a paucity of information in the literature on lateralized hearing loss symptoms in patients with central auditory disorders. Reported here is a case where the patient reported auditory symptoms, specifically hearing loss that was lateralized distinctly to the right ear. This ear was contralateral to a stroke that involved the left hemisphere with neural compromise limited primarily to the left Heschl's gyrus. Although the patient reported other hearing difficulties, the lateralized symptom of right-sided hearing loss seemed to be the most noticed. While the pure-tone audiogram was totally disassociated from the right ear auditory symptoms, central auditory tests revealed a marked and consistent right ear deficit, which was consistent with the site of lesion. It is rare that a relatively small lesion in Heschl's gyrus results in the perception of hearing loss so specifically localized to the right ear. It is also of interest that a patient with definite complaints of hearing loss would yield a normal, highly symmetrical pure-tone audiogram. The triad of patient symptoms, anatomy of the lesion, and central auditory test findings in this case are discussed, and theories as to possible underlying mechanisms for the patient's auditory deficits are provided.

Early cortical metabolic rearrangement related to clinical data in idiopathic sudden sensorineural hearing loss

“…The relative reduction of the metabolism in the contralateral auditory cortex in the present study could be the metabolic counterpart of ipsilateral hemispheric dominance found in previous functional studies (Suzuki et al, 2002) and contralateral grey matter reductions postulated in a recent resting-state neuroimaging study performed during the acute stage of ISSNHL (Fan et al, 2015). According to these authors, the hypothesized mechanism behind this kind of impairment could be related to the misrepresentation of the perception of intensity at the cortical level (Musiek et al, 2013), where it could be affected by the interaction between excitatory and inhibitory neurons (Fan et al, 2015;Musiek et al, 2013;Phillips et al, 1994). Interestingly, this decrease in grey matter volume (GMV) was found to correlate negatively with disease duration, which is in line with the studies in which a GMV reduction was indeed found in the chronic phase of the disease (Boyen et al, 2013;Yang et al, 2014).…”

Altered Contralateral Auditory Cortical Morphology in Unilateral Sudden Sensorineural Hearing Loss

“…The underlying mechanism of this contralateral cortex impairment could be related to the misrepresentation of the intensity at the cortical level ( 35 ), given that our patients showed no abnormality in the peripheral auditory system. The perception of loudness or intensity at the cortical level could be affected by the interaction between excitatory and inhibitory neurons ( 35 , 36 ). If more excitatory fibers are damaged than inhibitory fibers, then the perception of loudness would decrease.…”

“…To the best of our knowledge, there seems to be a paucity of information in the literature on lateralized brain structural alterations in patients with unilateral SSNHL; in contrast, there was a clear laterality effect of primary auditory cortex in functional studies ( 31 – 34 ). Musiek et al ( 35 ) reported an interesting patient in which a patient had a specific hearing loss that was lateralized distinctly to the right ear, which was contralateral to a stroke that involved the left hemisphere, with neural compromise limited primarily to the left Heschl's gyrus. The underlying mechanism of this contralateral cortex impairment could be related to the misrepresentation of the intensity at the cortical level ( 35 ), given that our patients showed no abnormality in the peripheral auditory system.…”

“…Musiek et al ( 35 ) reported an interesting patient in which a patient had a specific hearing loss that was lateralized distinctly to the right ear, which was contralateral to a stroke that involved the left hemisphere, with neural compromise limited primarily to the left Heschl's gyrus. The underlying mechanism of this contralateral cortex impairment could be related to the misrepresentation of the intensity at the cortical level ( 35 ), given that our patients showed no abnormality in the peripheral auditory system. The perception of loudness or intensity at the cortical level could be affected by the interaction between excitatory and inhibitory neurons ( 35 , 36 ).…”

Altered Resting-State EEG Microstate in Idiopathic Sudden Sensorineural Hearing Loss Patients With Tinnitus

“…To cure ISSNHL subjects with tinnitus effectively, it is necessary to explore the intrinsic mechanism of ISSNHL completely. Previous researches have showed that ISSNHL is correlated with the deviant activity of some central neural networks (Seeley et al, 2009; Musiek et al, 2013; Wang et al, 2014; Zhou and Seeley, 2014; Fan et al, 2015; Zhang et al, 2015; Golden et al, 2016; Xu et al, 2016; Micarelli et al, 2017). The development of ISSNHL is associated with several function networks, including auditory network, default mode network (DMN) and limbic network (Xu et al, 2016; Micarelli et al, 2017).…”