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 incl...
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| Veröffentlicht in: | Brain (London, England : 1878) England : 1878), 1994-10, Vol.117 (5), p.1127-1141 |
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| container_title | Brain (London, England : 1878) |
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| creator | Levine, Robert A. Gardner, Jill C. Fullerton, Barbara C. Stufflebeam, Steven M. Furst, Miriam Rosen, Bruce R. |
| description | 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 ∼40% of all subjects. Interaural level discrimination and masking level difference were least sensitive with abnormalities in |
| doi_str_mv | 10.1093/brain/117.5.1127 |
| format | Article |
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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 ∼40% of all subjects. Interaural level discrimination and masking level difference were least sensitive with abnormalities in <I0% 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.</description><identifier>ISSN: 0006-8950</identifier><identifier>EISSN: 1460-2156</identifier><identifier>DOI: 10.1093/brain/117.5.1127</identifier><identifier>PMID: 7953594</identifier><identifier>CODEN: BRAIAK</identifier><language>eng</language><publisher>Oxford: Oxford University Press</publisher><subject>Adult ; Auditory Perception ; Biological and medical sciences ; Discrimination (Psychology) ; evoked potentials ; Evoked Potentials, Auditory, Brain Stem ; Female ; Humans ; interaural discrimination ; Male ; masking level difference ; Medical sciences ; Middle Aged ; Multiple Sclerosis - physiopathology ; Multiple sclerosis and variants. Guillain barré syndrome and other inflammatory polyneuropathies. Leukoencephalitis ; Neurology ; speech discrimination ; Speech Perception</subject><ispartof>Brain (London, England : 1878), 1994-10, Vol.117 (5), p.1127-1141</ispartof><rights>1995 INIST-CNRS</rights><rights>Copyright Oxford University Press(England) Oct 1994</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c450t-6066f64abbde8aebcd01df08fbcd80e2c6c1f6e620522805e5ec88855662d2b33</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,777,781,27905,27906</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=3327544$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/7953594$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Levine, Robert A.</creatorcontrib><creatorcontrib>Gardner, Jill C.</creatorcontrib><creatorcontrib>Fullerton, Barbara C.</creatorcontrib><creatorcontrib>Stufflebeam, Steven M.</creatorcontrib><creatorcontrib>Furst, Miriam</creatorcontrib><creatorcontrib>Rosen, Bruce R.</creatorcontrib><title>Multiple sclerosis lesions of the auditory pons are not silent</title><title>Brain (London, England : 1878)</title><addtitle>Brain</addtitle><description>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 ∼40% of all subjects. Interaural level discrimination and masking level difference were least sensitive with abnormalities in <I0% 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.</description><subject>Adult</subject><subject>Auditory Perception</subject><subject>Biological and medical sciences</subject><subject>Discrimination (Psychology)</subject><subject>evoked potentials</subject><subject>Evoked Potentials, Auditory, Brain Stem</subject><subject>Female</subject><subject>Humans</subject><subject>interaural discrimination</subject><subject>Male</subject><subject>masking level difference</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Multiple Sclerosis - physiopathology</subject><subject>Multiple sclerosis and variants. Guillain barré syndrome and other inflammatory polyneuropathies. Leukoencephalitis</subject><subject>Neurology</subject><subject>speech discrimination</subject><subject>Speech Perception</subject><issn>0006-8950</issn><issn>1460-2156</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1994</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkU2LFDEQhoMo67h69yI0It56tvJRSfoiyKKOsOqCH4iXkE5XY9ZM95h0g_vv7XGGOXjZU4V6nyqoPIw95bDm0MiLNvs4XHBu1rjmXJh7bMWVhlpw1PfZCgB0bRuEh-xRKTcAXEmhz9iZaVBio1bs1Yc5TXGXqCohUR5LLFWiEsehVGNfTT-p8nMXpzHfVrt902eqhnGqSkw0TI_Zg96nQk-O9Zx9ffvmy-Wmvvr07v3l66s6KISp1qB1r5Vv246spzZ0wLsebL-8LJAIOvBekxaAQlhAQgrWWkStRSdaKc_Zy8PeXR5_z1Qmt40lUEp-oHEuzmgL3Bh-JyhAK4uNvRPk2nJQChbw-X_gzTjnYbnW8QaVQMRmgeAAheULS6be7XLc-nzrOLi9KffPlFtMOXR7U8vIs-Peud1Sdxo4qlnyF8fcl-BTn_0QYjlhUgqDao_VByyWif6cYp9_OW2kQbf5_sN93oiP_Fpeu2_yL7VLqow</recordid><startdate>19941001</startdate><enddate>19941001</enddate><creator>Levine, Robert A.</creator><creator>Gardner, Jill C.</creator><creator>Fullerton, Barbara C.</creator><creator>Stufflebeam, Steven M.</creator><creator>Furst, Miriam</creator><creator>Rosen, Bruce R.</creator><general>Oxford University Press</general><general>Oxford Publishing Limited (England)</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QP</scope><scope>7QR</scope><scope>7TK</scope><scope>8FD</scope><scope>FR3</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>P64</scope><scope>7X8</scope></search><sort><creationdate>19941001</creationdate><title>Multiple sclerosis lesions of the auditory pons are not silent</title><author>Levine, Robert A. ; Gardner, Jill C. ; Fullerton, Barbara C. ; Stufflebeam, Steven M. ; Furst, Miriam ; Rosen, Bruce R.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c450t-6066f64abbde8aebcd01df08fbcd80e2c6c1f6e620522805e5ec88855662d2b33</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1994</creationdate><topic>Adult</topic><topic>Auditory Perception</topic><topic>Biological and medical sciences</topic><topic>Discrimination (Psychology)</topic><topic>evoked potentials</topic><topic>Evoked Potentials, Auditory, Brain Stem</topic><topic>Female</topic><topic>Humans</topic><topic>interaural discrimination</topic><topic>Male</topic><topic>masking level difference</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Multiple Sclerosis - physiopathology</topic><topic>Multiple sclerosis and variants. Guillain barré syndrome and other inflammatory polyneuropathies. Leukoencephalitis</topic><topic>Neurology</topic><topic>speech discrimination</topic><topic>Speech Perception</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Levine, Robert A.</creatorcontrib><creatorcontrib>Gardner, Jill C.</creatorcontrib><creatorcontrib>Fullerton, Barbara C.</creatorcontrib><creatorcontrib>Stufflebeam, Steven M.</creatorcontrib><creatorcontrib>Furst, Miriam</creatorcontrib><creatorcontrib>Rosen, Bruce R.</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Chemoreception Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Brain (London, England : 1878)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Levine, Robert A.</au><au>Gardner, Jill C.</au><au>Fullerton, Barbara C.</au><au>Stufflebeam, Steven M.</au><au>Furst, Miriam</au><au>Rosen, Bruce R.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Multiple sclerosis lesions of the auditory pons are not silent</atitle><jtitle>Brain (London, England : 1878)</jtitle><addtitle>Brain</addtitle><date>1994-10-01</date><risdate>1994</risdate><volume>117</volume><issue>5</issue><spage>1127</spage><epage>1141</epage><pages>1127-1141</pages><issn>0006-8950</issn><eissn>1460-2156</eissn><coden>BRAIAK</coden><abstract>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 ∼40% of all subjects. Interaural level discrimination and masking level difference were least sensitive with abnormalities in <I0% 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.</abstract><cop>Oxford</cop><pub>Oxford University Press</pub><pmid>7953594</pmid><doi>10.1093/brain/117.5.1127</doi><tpages>15</tpages></addata></record> |
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| ispartof | Brain (London, England : 1878), 1994-10, Vol.117 (5), p.1127-1141 |
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| source | MEDLINE; Oxford University Press Journals Digital Archive Legacy |
| subjects | Adult Auditory Perception Biological and medical sciences Discrimination (Psychology) evoked potentials Evoked Potentials, Auditory, Brain Stem Female Humans interaural discrimination Male masking level difference Medical sciences Middle Aged Multiple Sclerosis - physiopathology Multiple sclerosis and variants. Guillain barré syndrome and other inflammatory polyneuropathies. Leukoencephalitis Neurology speech discrimination Speech Perception |
| title | Multiple sclerosis lesions of the auditory pons are not silent |
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