Journal of the Association for Research in Otolaryngology

As part of cochlear innate immunity, cochlear resident macrophages regulate different aspects of tissue maturation, cochlear homeostasis, and injury response. Cochlear resident macrophages exhibit dynamic changes in morphology, distribution, and abundance after cochlear injury. However, in the absence of pathology, regulation of cochlear innate immunity is poorly understood. Since loss of cochlear outer hair cells (OHCs) are indicators of cochlear pathology, we hypothesize that cochlear innate immunity might be sensitive to changes in OHC function. Calcium homeostasis in OHCs is necessary for auditory function, and its dysregulation is associated with hearing loss. However, it is unknown if changes in OHC Ca2+ homeostasis are sufficient to alter cochlear innate immunity. Here, we investigate alterations in cochlear innate immunity in a mouse model lacking oncomodulin (OCM), an OHC-specific calcium buffer. Our study focused on the osseous spiral lamina (OSL), a region adjacent to cochlear hair cells. At 1 month, wild-type (WT) mice and Ocm knockout (KO) mice have similar hearing thresholds and no evidence of cochlear damage. However, in KO mice, OSL resident macrophages show increased density, altered morphology, and increased spatial segregation closer to the sensory epithelium. Despite these changes in OSL resident macrophages, cytokine profiling revealed no remarkable differences. At 5 months, Ocm KO mice show a progressive hearing loss with a frequency dependent loss of OHCs and inner hair cell ribbon synapses, but the density of OSL macrophages remained unchanged. Prior to hearing onset, there was no significant difference in immune cell numbers between Ocm WT and KO mice. These findings suggest that cochlear innate immunity is sensitive to OHC calcium buffering following hearing onset.

Distinct auditory nerve (AN) fiber populations with varying thresholds and vulnerabilities to synaptopathy are observable in animal models, but standard non-invasive human measures lack the resolution to differentiate these groups of fibers. This fundamental limitation hinders the translation of findings in animals to human auditory pathologies. To overcome this, we developed a novel refractoriness-masking paradigm to non-invasively isolate threshold-specific AN fiber responses in humans. By presenting rapid click trains with cumulatively rising levels (45 to 105 dB peSPL) at a 250-microsecond inter-click interval, we sequentially masked lower-threshold fibers. Using a tympanic membrane electrode, we recorded compound action potentials (CAPs) in adults with normal hearing and isolated threshold-specific responses via waveform subtraction. Our results demonstrated that the isolated CAPs exhibited decreased latencies with increasing levels and a non-linear amplitude growth, plateauing at 90 dB peSPL before sharply increasing at 105 dB peSPL. This pattern reflects the sequential recruitment of AN fiber that were not effectively recruited by the preceding clicks. Validate conditions, in which the final two clicks had equal levels, produced substantially smaller CAPs, consistent with response suppression by refractoriness. Overall, this paradigm establishes a human measurement approach for characterizing level-threshold-dependent AN responses, providing a potential way to better investigate different AN pathologies, such as cochlear synaptopathy or auditory neuropathy.

Hearing loss and deafness as a result of hair cell loss cannot be restored due to the incapacity of spontaneous regeneration of these cells. Compounds that manipulate key signaling pathways can potentially regenerate cochlear hair cells. In order to test different compounds that promote hair cell regeneration in vitro models can be used. Three-dimensional cultures have allowed the expansion and experimentation of human and mouse inner ear organoids. This is mainly performed in the embryonic or the early postnatal developmental stage. However, since the majority of patients with hearing loss are adult, it is crucial to understand the adult inner ear regenerative capacity. Here, we evaluated progenitor cell markers in the adult human and mouse inner ear and the generation, expansion and differentiation of cochlear organoids derived from the adult human and mouse inner ear. Cochlear and vestibular sensory epithelium from adult humans; and from adult and aged mice express the progenitor markers SOX2 and LGR5; and can generate organoids in vitro. By optimizing the culture conditions, organoids derived from the cochlea and vestibular organ from adult human and adult and aged mouse differentiated to Myosin 7A positive cells. This indicates that the adult inner ear has regenerative capacity. These findings are encouraging for future regenerative therapies to cure hair cell-related hearing loss and deafness.

Standard hearing tests miss cochlear neural degeneration (CND), the loss of synapses between inner hair cells and auditory nerve fibers that may underlie unexplained hearing difficulty in roughly one in ten adults. Envelope following responses (EFRs) can index this neural loss noninvasively, but conventional protocols are too slow for clinical use. We tested a dynamic amplitude-modulated (dAM) EFR that sweeps the full modulation spectrum in a single brief stimulus. In Mongolian gerbils with histologically verified CND, dAM EFRs revealed selective deficits at fast modulation rates without threshold elevation. A machine-learning classifier distinguished young from middle-aged animals with high accuracy; additionally, its most informative feature, power near 400-500 Hz, tracked synapse counts, indicating a readout of cochlear neural health rather than age. Applied without retraining to 56 human listeners, the gerbil-trained classifier separated age groups above chance. dAM EFRs thus offer a rapid, objective and clinically viable marker of CND.

Purpose: Otoacoustic emissions (OAEs) are used to assess outer hair cell (OHC) function. Clinical interpretation of OAE responses, however, is often limited to a present/absent binary since both physiological factors and measurement variability affect the measured OAE amplitude. Prior work showed elevated OAE responses in sedated compared to awake chinchillas, pointing to the potential influence of the medial olivocochlear (MOC) efferents on amplitudes, but this finding is inconsistent across species and OAE type. Here, we aimed to further investigate the effect of anesthesia on distortion- and reflection-type emissions in chinchillas using swept stimuli and more reliable calibration methods. Methods: Swept distortion-product (DP) and stimulus-frequency (SF) OAEs were measured in chinchillas with and without ketamine/xylazine sedation. Stimuli were presented using in-ear forward pressure level calibrations. DPOAE and SFOAE amplitudes and estimated Qerb from SFOAE group delays were compared across the two conditions. Results: We found that low-frequency DPOAE amplitudes were elevated when animals were sedated. The difference in SFOAE amplitudes was more variable across animals but appeared mildly reduced in sedated animals. Qerb estimates were slightly higher in sedated animals at some frequencies. The effect of sedation was not different across sexes. Conclusion: Taken together, these findings suggest that sedation impacts OAE measurements in chinchillas. MOC modulation could account for the present findings and differences across species. For diagnostic precision, OAE responses should be considered in the context of not only intrinsic OHC function but also extrinsic physiological processes that can modulate OHCs.

Sensorineural hearing loss can result from different pathologies, but the primary diagnostic method is a threshold-based audiogram, which is insensitive to some forms of cochlear dysfunction. Individuals may experience difficulty understanding speech in noise despite normal audiometric thresholds. Because most cochlear insults damage both inner (IHCs) and outer hair cells (OHCs), the contribution of IHC dysfunction to auditory-nerve coding has been difficult to isolate. We used the IHC-selective ototoxicity of carboplatin in chinchillas to examine how IHC dysfunction, with preserved OHC function, affects temporal-envelope coding in auditory-nerve fibers (ANFs). Carboplatin produced 10 to 20% IHC loss with stereocilia damage in surviving IHCs, while OHC-dependent measures such as DPOAEs and ANF thresholds were unchanged. Suprathreshold ABR wave 1 was reduced, whereas wave 5 was preserved, suggesting central compensation. Both spontaneous and driven firing rates decreased following exposure. Mean vector strength to amplitude-modulated tones was unchanged, but response variability increased. Neurometric analysis and mutual information showed degraded AM detection in carboplatin-exposed fibers, an effect accounted for by reduced driven rate (i.e., normalizing spike counts across groups removed the group difference). Background noise degraded AM coding similarly in both groups. Pooled-neurometric modeling showed that population redundancy compensated for impaired fibers in quiet, but not in noise, where carboplatin-exposed pools remained worse. These findings indicate that IHC dysfunction degrades envelope coding by reducing neural output rather than by altering temporal synchrony. This study suggests IHC dysfunction is a phenotype consistent with "hidden hearing loss" (but distinct from cochlear synaptopathy), and motivates suprathreshold clinical assays.

Noise exposure can produce lasting auditory dysfunction in the absence of permanent threshold shifts or hair cell loss, yet the functional consequences of temporary threshold shift (TTS) remain poorly defined in translational models. We assessed auditory brainstem responses (ABRs) and distortion product otoacoustic emissions (DPOAEs) in rhesus macaques (n = 13) at 2 and 9-10 months following a single moderate noise exposure that induced TTS. Previous histological analyses of these macaques showed no significant loss of hair cells or ribbon synapses but revealed persistent broadening of inner and outer hair cell ribbon-volume distributions. After exposure, DPOAE amplitudes and thresholds and ABR thresholds returned to pre-exposure values and showed low-frequency enhancement at later time points. Suprathreshold click- and tone-evoked ABR amplitudes were largely preserved or enhanced after exposure, consistent with compensatory gain. In contrast, macaque-specific chirp-evoked ABRs showed modest amplitude reductions and latency prolongation across waves, indicating altered neural synchrony at standard stimulus presentation rates, but with variable time courses. More temporally demanding paradigms revealed persistent impairments. ABRs to faster click rates and shorter paired-click intervals showed reduced adaptability in response amplitude and timing after normalization, with deficits persisting through 9-10 months. Increased inner hair cell ribbon-volume variability was more consistently associated with temporal response measures, including latency, paired-click recovery, and rate adaptation, than with amplitude-based ABR measures. Together, these findings reveal a lasting dissociation between response magnitude and fidelity after TTS: suprathreshold responses may be preserved or enhanced, while neural synchrony and temporal adaptability remain impaired. Increased presynaptic ribbon volume variability may serve as a structural marker of synaptic remodeling accompanying hidden auditory dysfunction, rather than as a direct determinant of suprathreshold response magnitude. Temporally demanding ABR paradigms may supplement threshold-based diagnostics for detecting persistent noise-induced auditory dysfunction.

The vestibular system consists of peripheral end organs that provide the brain with temporally precise information about head position in space required for motor coordination and postural stability. Irregular vestibular afferents of the inner ear are particularly sensitive to rapid changes in acceleration, or jerk, which is necessary for making quick, corrective movements and postural adjustments. Vestibular short-latency evoked potentials (VsEPs) are waveforms that provide a measure of synchronous irregular afferent activity originating from peripheral (early peaks) and central (later peaks) vestibular pathways. These VsEPs are elicited by head jerk stimuli, commonly used preclinically. Previous studies have shown that early VsEP waves are dependent upon jerks of an adequate intensity, number, and duration. However, less is known about jerk characteristics necessary for generation of reliable VsEP signals centrally (later peaks). The present study examines the precise temporal dynamics of peripheral and central vestibular centers across a broad range of mechanical vestibular load in rats. We found differential changes in synchrony and timing driven by jerk repetition, intensity, and duration between early and late VsEP waves representing distinct anatomical components of the vestibular circuit. Our results suggest that central components are uniquely sensitive to jerk duration, intensity, and repetition, indicating a disconnect between peripheral and central neuronal recruitment, adaptive plasticity, and time-frequency dynamics. This work provides a foundation for using VsEP to assess jerk-induced physiological vestibular dysfunction and to understand how central relays differentially adapt to variations of mechanical vestibular stress compared with the precise, high-fidelity transmission observed in the periphery.

Emerging MEMS-based audio devices generate ultrasonic acoustic output, but little is known about long-term biological effects of such exposures, which vary in frequency, intensity, duration, and coupling pathway. In this study, a novel transducer was characterized for its ultrasonic acoustic output, generating amplitude-modulated (AM) pressure pulses at a carrier frequency of approximately 200 kHz and operating frequency of approximately 100 kHz. To understand ultrasonic pressure wave transmission through the human middle and inner ear, sound pressure levels in the ear canal (PEC) and mechanical vibration velocities at the stapes (VST) and promontory (VPRM) were measured in human cadaveric temporal bones across frequencies up to 240 kHz. This represents the first such measurements at ultrasonic frequencies in human temporal bone specimens. Results demonstrated relatively consistent PEC measurements at ultrasonic frequencies across specimens, with minimal inter-specimen variation. At the operating frequency (~100 kHz), overall PEC was 82.2 dB SPL (SNR = 40.6 dB), while at the carrier frequency (~200 kHz), PEC increased to 90.6 dB SPL (SNR = 34.8 dB). VST and VPRM measurements at the operating frequency remained relatively independent of audio stimulus-drive frequency and voltage, with comparable magnitudes, suggesting that bone conduction pathways contribute significantly to inner ear ultrasonic exposure. When compared to existing safety guidelines, this device appears to meet specified criteria; however, given the limited scientific basis for these guidelines and unknown long-term effects, cautious application is recommended.

The feline auditory cortex is understood to consist of 13 distinct subregions with unique anatomical and functional properties. Differential patterns of SMI-32 immunoreactivity are commonly used to identify the borders between these subregions; however, the detailed description of areal differences that is commonly cited did not include descriptions of the patterns observed along the posterior ectosylvian gyrus. Thus, the current manuscript aims to provide a more complete data set that can used to delineate the dorsal, intermediate, and ventral divisions of the posterior ectosylvian gyrus (auditory cortical regions dPE, iPE, and vPE, respectively) based on SMI-32 reactivity using the same methods and measures. Taken together, the current data and those published previously allow for a standardized approach to identifying all 13 auditory cortical subregions in this essential model of auditory cortical structure and function.

Cochlear implant (CI) candidates with residual low frequency hearing increasingly receive hearing preserving electrode arrays to enable electric acoustic stimulation (EAS). However, assessing very low frequency hearing in newborns and young children remains difficult. Previous work has shown that acoustic stimulation can mask electrically evoked auditory percepts when stimulation sites are spatially separated. Whether such masking also occurs when electric stimulation is delivered near the round window (RW), prior to cochlear insertion, remains unclear. This study investigated ipsilateral acoustic masking of electric stimulation delivered at apical, basal, and near RW sites in 12 EAS users with residual low frequency hearing implanted with short or partially inserted electrode arrays. Using a psychophysical paradigm, threshold elevations of electric pulse trains were measured during simultaneous acoustic stimulation. Electric stimulation was applied at extra cochlear RW locations and intra cochlear basal and apical electrodes, while stimulation parameters were systematically varied. Electric stimulation near the RW reliably evoked auditory percepts without side effects, though optimal stimulation parameters and masking strength varied across participants. Strong acoustic masking was consistently observed for apical stimulation, whereas weaker but measurable masking occurred for basal and RW stimulation. A cochlear lumped parameter model indicated that approximately 5% of current delivered at the RW can reach apical regions, explaining the observed masking by low frequency acoustic tones. Masking strength correlated with residual hearing for apical stimulation only. These findings indicate that acoustic masking of apical electric stimulation, which correlated with residual hearing, holds potential as a diagnostic tool for assessing low frequency hearing post operatively. The detection of masking during both RW and basal stimulation represents a promising result, indicating that these stimulation paradigms can produce quantifiable effects. Given the considerable variability observed among participants, further investigation is required to establish the extent to which masking measures reflect residual hearing or hearing loss. Nonetheless, these results provide novel insight into auditory perception and side effects associated with basal and extra cochlear electric stimulation, informing future efforts to optimize this approach for low-frequency hearing assessment.

The inflammatory foreign body response that follows cochlear implantation produces intracochlear fibrosis, neo-ossification, and elevated electrode impedances that can compromise implant performance. Dexamethasone-eluting cochlear implants reduce this response, but the durability of their anti-inflammatory effect over long implantation intervals has not been established. Using a murine model of chronic cochlear implantation in CX3CR1+/eGFP Thy1+/eYFP dual-reporter mice, we compared dexamethasone-eluting and standard mouse cochlear implants at 224 and 336 days post-implantation. Density of CX3CR1+ macrophages, MHCII+CX3CR1+ antigen-presenting macrophages, -SMA+ fibrosis, and neo-ossification were quantified in the scala tympani, Rosenthal canal, and lateral wall of the basal turn. Standard implants produced persistent macrophage and antigen-presenting macrophage infiltration, accompanied by an -SMA+ fibrotic response and neo-ossification. Dexamethasone-eluting implants suppressed macrophage infiltration in all three regions out to 336 days and reduced fibrosis at 224 days. In the subset of cochleae with electrode array translocation, dexamethasone-eluting implants attenuated macrophage infiltration and confined the fibrotic and osseous response to the site of translocation, whereas standard implants produced a widespread response. A reduction in immune cell density was also observed in the contralateral, unimplanted cochleae of animals implanted with dexamethasone-eluting implants, suggesting a wider component to the drug's effect. Dexamethasone-eluting cochlear implants therefore provide sustained, long-term suppression of the cochlear foreign body response in mice, supporting their continued translation toward clinical application. This effect was associated with continued low-level dexamethasone elution out to 336 days post-implantation; further work is needed to assess the durability of this effect at the conclusion of drug elution.

Auditory confounds have proven to be a major hurdle in the elucidation of veridical neuromodulation effects with transcranial ultrasound stimulation (TUS). Auditory noise masks are an essential method to reduce the audibility of TUS and have shown promise in several studies. Here we describe a novel approach for design, calibration, and psychometric validation of auditory noise masks to reduce the perceptibility of TUS. White noise masks and spectrum-tuned masks matched to a TUS protocol that generates highly salient auditory costimulation (487.5 Hz pulse repetition frequency, 10% duty cycle, 68 W/cm2 pulse-peak average intensity, 500 kHz acoustic frequency) were generated, and dB(A) levels were calibrated with an artificial ear. The masker levels needed to reduce TUS detection performance in a two-interval forced choice task were determined with an adaptive QUEST+ staircase in 20 neurotypical participants. Detection performance of this highly salient TUS protocol was driven to near chance performance (<55%) in 17/20 participants with white-noise and 18/20 participants with spectrum-tuned noise. However, high masker levels approaching safety limits were needed to render TUS inaudible for the majority of participants, indicating the need for formal masker calibration for these TUS settings. Additionally, against expectation the spectrum-tuned masker did not significantly outperform the white-noise masker, suggesting that perceptibility of TUS auditory costimulation does not lawfully follow the sound expected from its pulse envelope and the known spectrum of human hearing.

BackgroundHearing aids and cochlear implants (CIs) are the primary interventions for sensorineural hearing loss, restoring auditory function through amplification and intracochlear electrical stimulation, respectively. For those with residual low-frequency hearing, the combined electric-acoustic stimulation (EAS) has demonstrated superior speech perception, particularly in noisy environments, compared to either modality. However, CI surgery carries inherent risks, including postoperative hearing loss, which undermines EAS benefits and limits future rehabilitation options. To overcome these limitations, we propose a non-invasive alternative: extracochlear electric and acoustic stimulation (EEAS), delivering electrical stimulation via transcutaneous electrodes without surgery. Here, we present a first systematic investigation of non-invasive extracochlear electrical stimulation using ear canal electrode montages, evaluating its feasibility, perceptual effects, and key parameters across diverse hearing statuses. MethodsWe conducted a controlled, within-subject study with 15 participants: 5 with normal hearing (NH), 5 with high-frequency hearing loss (HI), and 5 with severe-to-profound deafness (PL). We used charge-balanced sinusoidal stimuli (125-4000 Hz) applied via an ear canal electrode and four return electrode montages, including contralateral ear canal, contralateral mastoid, ipsilateral mastoid, and forehead electrodes. Participants rated auditory sensations, including loudness, sound quality, and lateralization, as well as side effects on separate 0-10 scales, with current intensity increased up to 2 mA/cm{superscript 2}. Thresholds and perceptual responses were analyzed across frequencies, electrode configurations, and hearing groups. ResultsReliable auditory percepts were elicited across all groups. NH participants reported pure-tone sensations, whereas HI and PL participants perceived broadband, noise-like sounds. Loudness decreased with increasing frequency, particularly for HI and PL, with minimal responses in the high-frequency range. The current threshold increased with stimulation frequency, whereas the threshold expressed as charge per phase remained constant, suggesting that charge per phase primarily determines neural activation, whereas current amplitude is more closely associated with the intensity of auditory and side effect perception. Contralateral montages produced significantly higher loudness ratings than ipsilateral or forehead configurations. The forehead montage was poorly tolerated, leading to early termination due to discomforting side effects. Sound lateralization was predominantly central or bilateral with contralateral setups, while ipsilateral and forehead configurations yielded ipsilateral perceptions. ConclusionsNon-invasive extracochlear electrical stimulation via ear canal electrodes is feasible and perceptually effective across a spectrum of hearing statuses. Perceptive outcomes are strongly influenced by electrode montage and residual hearing, with evidence of electrophonic excitation in NH individuals and electroneural activation in HI and PL participants. Contralateral mastoid electrode configurations offer the optimal balance of perceptual strength, tolerability, and spatial localization. These findings establish a critical foundation for the development of EEAS devices, demonstrating that non-invasive electrical stimulation can generate meaningful auditory percepts, paving the way for safe, accessible, and integrated hearing rehabilitation solutions. This work informs future EEAS developments and advances the path toward clinically viable, non-invasive cochlear stimulation.

Computational models of the middle ear are typically developed within the linear range of the middle ear's response, which corresponds to typical sounds in daily life. Understanding middle-ear biomechanics under high-intensity sounds is also important for assessing potential auditory damage under adverse conditions. In this study, a finite-element (FE) model of the human middle ear plus the external ear canal is presented, employing a first-order Ogden hyperelastic material formulation and time-domain nonlinear analysis to capture nonlinear deformation of soft tissues and the resulting middle-ear response. The model was analyzed using pure-tone pressure excitations applied at the ear canal entrance over the 80 Hz to 8 kHz frequency range and 110 to 180 dB sound pressure levels (SPL). The ear canal pressure near the tympanic membrane (TM) and full-field three-dimensional response of the middle ear structures were examined. Across the investigated frequency range, the simulated middle-ear motion exhibited a transition from predominantly piston-like behavior at low frequencies, up to 1 kHz, to increasingly intricate multi-modal and multi-directional vibration patterns at higher frequencies. Nonlinear behaviors became increasingly significant at high frequencies and high stimulus levels, including compressive/expansive pressure-displacement relationships, waveform distortions, and the emergence of non-harmonic spectral components. The model developed in this study provides a computational framework for studying nonlinear sound transmission through the middle ear and its implications for high-intensity acoustic exposure. The findings contribute to a better understanding of middle-ear mechanics under adverse conditions and support future investigations of acoustic trauma and hearing protection strategies.

Objectives: The purpose of this pilot study was to investigate (1) if the Speech Intelligibility Index (SII) could be used to identify ears that meet cochlear implant (CI) candidacy beyond the "60/60" referral guidelines and (2) investigate the relationship between SII from patients' own hearing aids (HAs) and SII from optimally fit clinic-stock HAs such that a patient's own HAs can act as a proxy for an optimally fit HA and thus as a referral metric. Design: Prospective study of 23 participants ([&ge;] 18 years) with bilateral moderate to profound sensorineural hearing loss who were CI candidates in at least one ear. SII-Clinic (SII-C) values were recorded with probe-microphone measures using a Verifit II device (NAL-N2 targets) with speech stimuli presented at 60 dB A during patient CI evaluation in either their own HAs or clinic-stock HAs. SII values from participants' own HAs were recorded as part of a larger research protocol, thus SII-Personal (SII-P), with probe-microphone measures using a Verifit I device (NAL-RP targets) with pink noise stimuli presented at 65 dB A. Participants that did not wear HAs did not have SII-P calculated. Data was collapsed across ears. Correlation analysis between SII and best-aided consonant-nucleus-consonant (CNC) was conducted. Benchmark SII values were extrapolated using a best-fit line and CI candidacy rates reflecting various aided CNC scores that could be applied across CI centers. Nested logistic regression models were used to determine if the SII-C could improve model fit beyond the revised ear-specific 60/60 referral guideline. The relationship between SII-C and SII-P was assessed with Wilcoxon signed-rank test and Spearman correlation. Results: Correlation between SII-C and aided CNC score was r = 0.82 (p < 0.001), and the correlation between SII-P and aided CNC was r = 0.46 (p = 0.014). Extrapolated benchmarks of SII were calculated based on different CNC candidacy cutoffs, and benchmarks were able to capture at least 83% of the ears that met CNC candidacy cutoffs. SII was also found to improve model fit with word recognition score (WRS) and pure tone average (PTA) for 60% CNC candidacy cutoff ({chi}2 = 9.7; p = 0.002) and increased discrimination (AUC = 0.89 to AUC = 0.99). There was no significant difference between SII-C and SII-P using the Wilcoxon signed-rank test (p = 0.559). Conclusions: A larger study is needed that includes more ears that do not qualify for a CI; however, the results of this study demonstrate that (1) SII has the potential to be used in conjunction with the 60/60 referral guideline for CI candidacy evaluations and (2) SII can be used as a marker of audibility across different devices, including patients' own HAs, making SII an accessible metric during HA fittings and fine tunings.

Aminoglycoside antibiotics such as kanamycin induce sensorineural hearing loss by killing hair cells, resulting in secondary degeneration of spiral ganglion neurons (SGNs). Previous studies show that anti-inflammatory agents reduce SGN death, implicating a causal role of the immune response. This is consistent with observations of increased numbers of macrophages and lymphocytes, including T and NK cells, in the spiral ganglion after exposure to aminoglycosides. Here, we directly test the role of T cells and other lymphocytes in SGN degeneration in kanamycin-deafened rats. Homozygous RNU nude rats that lack T cells - but retain NK and B cells- show neurodegeneration similar to rats with a normal T cell complement, indicating that T cells are not necessary for neurodegeneration. Homozygous SRG rats lacking all lymphocytes (i.e., T, B, and NK cell-deficient), exhibit remarkable regional variation in the pattern of spiral ganglion degeneration post-deafening. In the basal half of the ganglion, SGN degeneration is significantly reduced in deafened SRG rats, implying a role for lymphocytes, presumably NK cells of the innate immune system, in SGN death. In the apical half of the deafened ganglion, SGN degeneration is not significantly affected by the lack of all lymphocytes, implying a role for other cellular mechanisms.

The inferior colliculus (IC) is a major midbrain convergence site critical for processing complex sounds and undergoes fundamental changes with age-related hearing loss (ARHL). Local field potentials (LFPs) represent pre-synaptic integration of excitatory and inhibitory signals in local neural populations. Here, we assessed age-related changes in sound-evoked IC LFPs in the CBA/CaJ mouse model of ARHL across the tonotopic axis. We recorded from 495 sites across four age groups (young: 4-6 months; middle: 8-14 months; old: 24-25 months; oldest old: 27-31 months), examining LFP responses from dorsal (low-frequency), medial (mid-frequency), and ventral (high-frequency) IC regions. Analysis of the onset depolarization (N1 component) in response to broadband noise bursts revealed significant age-related hyperexcitability in medial and dorsal regions, with oldest old animals showing enhanced responses while ventral regions were unaffected. Amplitude-intensity functions demonstrated significant age x level interactions across all regions, with oldest old animals exhibiting level-dependent hyperexcitability most pronounced at suprathreshold intensities. Time-frequency analysis of LFP spectral content (30-100 Hz) revealed a crossover pattern across medial and dorsal regions, with oldest old animals showing reduced power at low-to-moderate stimulus levels but enhanced power at high stimulus levels. Ventral regions showed a low-level reduction without suprathreshold enhancement. These findings reveal paradoxical enhancement of neural activity in the aging IC, with the most pronounced changes in dorsal and medial regions rather than ventral regions most affected by peripheral hearing loss, suggesting that central hyperexcitability depends on residual afferent drive and implicating region-specific alterations in excitatory-inhibitory balance underlying central presbycusis.

Tinnitus is one of the most common hearing disorders affecting one-third of Americans and is defined as the buzzing or ringing sound one perceives in one or both ears in the absence of an acoustic stimulus. One objective method for tinnitus screening in rodents is gap prepulse inhibition of the acoustic startle reflex (GPIAS), a reduction in the abrupt motor response elicited by an intense auditory stimulus following a silent gap in noise. Reduced inhibition by gaps embedded in narrow-band noise is hypothesized to reflect the primary tinnitus pitch, as the tinnitus "fills-in" the gap. However, Lobarinas et al. (2013) identified a critical limitation: after acoustic trauma or hearing loss, rodents often exhibit markedly diminished acoustic startle reflexes, creating a "floor effect" where further suppression becomes undetectable even if gap perception remains intact, leading to false-positive tinnitus screening results. To address this limitation, we utilized the CBA/CaJ mouse model to assess tactile airpuff modification efficacy and employed a machine learning algorithm to classify startle responses, achieving 98% accuracy in differentiating startles from non-startles. We induced unilateral conductive hearing loss via ear plugging and found enhanced gap detection ability, contrasting with false-positive tinnitus indicators observed in rats by Lobarinas and colleagues. We also pharmacologically induced tinnitus via sodium salicylate, revealing frequency-specific alterations in gap detection patterns. Our findings suggest that differences in data analysis methodology, specifically using a machine learning algorithm to filter non-startle responses, may explain species-specific differences between mouse and rat models and significantly improve GPIAS validity as a tinnitus screening assessment tool.

Aging has profound effects on sensory systems, such that older adults can report problems in hearing despite having normal audiometric thresholds. While it is known that older listeners have poorer temporal processing than younger listeners, there is limited understanding of how these deficits interact with effects of sound level, in particular when they are above conversational level (e.g., > 65 dB SPL). Here we wanted to investigate the link between temporal processing and sound level as a function of age in normal-hearing listeners. Using a forward-masking paradigm, auditory brainstem responses (ABRs) and behavioral detection thresholds were measured at different masker levels. It was found that with increasing age and masker sound level, the Wave V amplitudes of older listeners decreased and directly correlated with behavioral detection thresholds of the probe stimulus in the forward-masking paradigm. These results elucidate the fundamental effects of aging on temporal processing and its interactions with sound level in the central auditory system. The results of this study have clinical implications for the concept of normal hearing in the aging population and how older listeners may struggle in different listening environments that are not captured by simple audiometry. Further delineating the important effects of aging will pave the way for earlier clinical diagnosis of hearing disorders and personalized treatments for different forms of age-related hearing loss.