hearing

听证
  • 文章类型: Journal Article
    夜间狩猎谷仓猫头鹰的声音定位行为及其潜在的神经计算是神经行为学的教科书示例。在两个耳朵的声音定时和水平的差异被整合在一系列良好表征的步骤中,从脑干到下丘(IC),导致听觉空间的地形神经表示。这仍然是大脑进化的一个重要问题:这种特殊情况是如何从更多形性的模式中得出的?本研究是第一个在非猫头鹰禽类IC中匹配生理和解剖子区域的研究。测试了鸡IC中的单个单元响应对不同频率和双耳差异线索的选择性。在电解病变和IC不同亚区的免疫组织化学鉴定的帮助下,重建了它们的解剖起源,根据猫头鹰和鸡的先前特征。与谷仓猫头鹰相比,不同亚区的反应没有明显差异。我们发现了两种双耳线索的神经拓扑,但没有证据表明听觉空间的连贯表示。结果与先前在鸽子IC和鸡高阶中脑中的工作一致,并表明中脑多感觉整合的多形性条件由横向全景视觉主导。
    The sound localization behavior of the nocturnally hunting barn owl and its underlying neural computations is a textbook example of neuroethology. Differences in sound timing and level at the two ears are integrated in a series of well-characterized steps, from brainstem to inferior colliculus (IC), resulting in a topographical neural representation of auditory space. It remains an important question of brain evolution: How is this specialized case derived from a more plesiomorphic pattern? The present study is the first to match physiology and anatomical subregions in the non-owl avian IC. Single-unit responses in the chicken IC were tested for selectivity to different frequencies and to the binaural difference cues. Their anatomical origin was reconstructed with the help of electrolytic lesions and immunohistochemical identification of different subregions of the IC, based on previous characterizations in owl and chicken. In contrast to barn owl, there was no distinct differentiation of responses in the different subregions. We found neural topographies for both binaural cues but no evidence for a coherent representation of auditory space. The results are consistent with previous work in pigeon IC and chicken higher-order midbrain and suggest a plesiomorphic condition of multisensory integration in the midbrain that is dominated by lateral panoramic vision.
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  • 文章类型: Journal Article
    背景:老年人感觉障碍与抑郁症状和孤独感增加有关。这里,我们检查了听力的影响,愿景,和嗅觉障碍对美国老年人心理健康结果的影响。
    方法:我们研究了国家社会生活的前三轮(2005/6,2010/11和2015/16)的受访者,健康和老龄化项目,全国代表,对美国老年人的纵向研究。通过结构化的采访者评分(听力和视力)和客观评估(嗅觉)评估感觉功能。Cox比例风险模型和趋势的一个自由度测试用于分析感觉残疾与自我评估的心理健康之间的关系。常见的抑郁症状,频繁的感知压力,频繁的焦虑症状,随着时间的推移,频繁的孤独症状,适应人口统计,健康行为,合并症,和认知功能。
    结果:我们分析了超过10年随访的3940名受访者的数据。更多的感觉障碍与自我评价较低的心理健康的更大风险相关,常见的抑郁症状,频繁的感知压力,和频繁的孤独症状随着时间的推移(p≤0.003,所有)。在调整协变量后,具有较多感觉障碍的老年人具有较低的自我评估心理健康的风险更大(HR=1.22,CI=[1.08,1.38],p=0.002)和孤独症状(HR=1.13,CI=[1.05,1.22],p=0.003)在我们的趋势测试中随着时间的推移。在我们的Cox比例风险模型中,有视力障碍的老年人自评心理健康风险更大(HR=1.34,95%CI=[1.05,1.72],p=0.02)和孤独症状(HR=1.21,CI=[1.04,1.41],p=0.01)。
    结论:有更多感觉障碍的美国老年人随后面临更糟糕的心理健康。未来的纵向研究剖析所有五种经典感官的关系将有助于进一步了解改善感官功能如何改善老年人的心理健康。
    BACKGROUND: Sensory disability in older adults is associated with increased rates of depressive symptoms and loneliness. Here, we examined the impact of hearing, vision, and olfaction disability on mental health outcomes in older US adults.
    METHODS: We studied respondents from the first three rounds (2005/6, 2010/11, and 2015/16) of the National Social Life, Health and Aging Project, a nationally representative, longitudinal study of older US adults. Sensory function was assessed by structured interviewer ratings (hearing and vision) and objective assessment (olfaction). Cox proportional hazards models and one degree of freedom tests for trend were utilized to analyze the relationships between sensory disability and self-rated mental health, frequent depressive symptoms, frequent perceived stress, frequent anxiety symptoms, and frequent loneliness symptoms over time, adjusting for demographics, health behaviors, comorbidities, and cognitive function.
    RESULTS: We analyzed data from 3940 respondents over 10 years of follow-up. A greater number of sensory disabilities was associated with greater hazard of low self-rated mental health, frequent depressive symptoms, frequent perceived stress, and frequent loneliness symptoms over time (p ≤ 0.003, all). After adjusting for covariates, older adults with a greater number of sensory disabilities had greater hazard of low self-rated mental health (HR = 1.22, CI = [1.08, 1.38], p = 0.002) and loneliness symptoms (HR = 1.13, CI = [1.05, 1.22], p = 0.003) over time in our tests for trend. In our Cox proportional hazards model, older adults with vision disability had greater hazard of low self-rated mental health (HR = 1.34, 95% CI = [1.05, 1.72], p = 0.02) and loneliness symptoms (HR = 1.21, CI = [1.04, 1.41], p = 0.01).
    CONCLUSIONS: Older US adults with greater numbers of sensory disabilities face worse subsequent mental health. Future longitudinal studies dissecting the relationship of all five classical senses will be helpful in further understanding how improving sensory function might improve mental health in older adults.
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  • 文章类型: Journal Article
    Palatine和咽扁桃体肥大可能由于感染倾向而导致听觉管功能障碍,有可能引起中耳炎.这是一个定量和纵向的研究,从2019年到2021年,在坎皮纳斯州立大学(UNICAMP)开发。研究样本包括15名5至12岁(平均7.9岁)的参与者,12男3女,分为两组:诊断为咽部和/或腭扁桃体肥大的儿童,他们是手术的候选人(G1),以及术后评估的儿童(G2)。作为测试的一部分,耳镜检查和测听测量,纯音阈值测听法,宽带鼓室测压(环境和峰值压力),和耳声发射(TEOAE和DPOAE,在环境压力和峰值压力下)均进行。纯音测听法各阶段之间存在统计学上的显着差异,就226赫兹鼓室测压而言,峰值压力条件下的宽带鼓室测压,在两种压力条件下的振幅测量TEOAE中,在环境压力条件下的DPOAE中,以及DPOAE中两种压力下的信号/噪声测量。总的来说,研究发现,与术后组相比,腭和咽扁桃体肥大的受试者的听力测试不同。
    Palatine and pharyngeal tonsil hypertrophy may lead to dysfunction of the auditory tube due to a propensity for infection, potentially giving rise to otitis media. This is a quantitative and longitudinal study, developed from 2019 to 2021, at the State University of Campinas (UNICAMP). The studied sample comprised 15 participants aged 5 to 12 years (mean 7.9 years), 12 male and 3 female, arranged into two groups: children diagnosed with pharyngeal and/or palatine tonsil hypertrophy who were candidates for surgery (G1), and children who were later evaluated after surgery (G2). As part of the test, an otoscopy and measurements of logoaudiometry, pure-tone threshold audiometry, wideband tympanometry (ambient and peak pressure), and otoacoustic emissions (TEOAEs and DPOAEs, both at ambient and peak pressure) were all performed. There were statistically significant differences between phases in pure-tone audiometry, in terms of 226 Hz tympanometry, wideband tympanometry in peak pressure conditions, in the amplitude measurement TEOAEs in both pressure conditions, in DPOAEs in ambient pressure conditions, and in the signal/noise measurement in both pressures in DPOAEs. Overall, it was found that hearing tests were different for subjects with palatine and pharyngeal tonsil hypertrophy compared to the post-surgical group.
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  • 文章类型: Journal Article
    在行为期间,运动皮层将运动相关信号的副本发送到感觉皮层。这里,我们将闭环行为与大规模生理学相结合,特定于投影模式的录音,和电路扰动表明小鼠次级运动皮层(M2)中的神经元编码感觉并受期望的影响。当一个动作意外地产生声音时,M2变得由声音诱发的活动主导。M2中的声音反应部分从听觉皮层继承,并返回听觉皮层,为行为过程中感觉运动信息的相互交换提供了一条路径。当运动的声学后果变得可预测时,对自产生的声音的M2响应被选择性地关闭。这些单细胞反应的变化反映在种群动态中,受感觉和期望的影响。一起,这些发现揭示了运动皮层活动中的感觉和期望信号的嵌入。
    During behavior, the motor cortex sends copies of motor-related signals to sensory cortices. Here, we combine closed-loop behavior with large-scale physiology, projection-pattern-specific recordings, and circuit perturbations to show that neurons in mouse secondary motor cortex (M2) encode sensation and are influenced by expectation. When a movement unexpectedly produces a sound, M2 becomes dominated by sound-evoked activity. Sound responses in M2 are inherited partially from the auditory cortex and are routed back to the auditory cortex, providing a path for the reciprocal exchange of sensory-motor information during behavior. When the acoustic consequences of a movement become predictable, M2 responses to self-generated sounds are selectively gated off. These changes in single-cell responses are reflected in population dynamics, which are influenced by both sensation and expectation. Together, these findings reveal the embedding of sensory and expectation signals in motor cortical activity.
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  • 文章类型: Journal Article
    目的:从随机对照试验(RCT)中评估氧氟沙星滴耳液与不干预治疗外伤性鼓膜(TM)穿孔的有效性。数据来源:Medline/PubMed,中部,临床试验。政府,谷歌学者。研究选择:纳入标准:(1)英语;(2)RCT研究;(3)报告了氧氟沙星应用的结果和自发愈合的结果。排除标准:(1)没有对照组的研究;(2)患有严重耳科疾病的患者,如慢性化脓性中耳炎或听骨破裂或颅脑损伤的患者;(3)没有治疗前价值的研究或单臂临床研究。数据提取:国家/地区,出版年份,每个手臂的参与者数量,患者特征,如年龄,性别,干预细节,偏侧性,TM穿孔的原因,穿孔位置,随访时间,听力增益,TM闭合率,和关闭时间。结果:共分析6项RCTs研究。共有502名参与者被纳入;氧氟沙星治疗的闭合率的相对风险为1.18[95%置信区间(CI),1.08至1.28,P<.001],愈合时间的平均差异(MD)为-18.4(95%CI,-19.96至-16.82,P<.001),表明氧氟沙星对TM穿孔的闭合有显着影响。然而,氧氟沙星组的听力无临床显著影响(SMD:0.21,95%CI,0.02~0.40,P=.03).此外,氧氟沙星组患者与观察组患者相比感染风险降低13%,但这一估计没有统计学意义。结论:氧氟沙星用于外伤性TM穿孔患者可有效缩短愈合时间,提高TM穿孔闭合率。当向患有创伤性TM穿孔的患者开具氧氟沙星时,没有证据表明听力损失或感染率增加。
    Objectives: To evaluate the effectiveness of ofloxacin ear drops versus no intervention in the repair of traumatic tympanic membrane (TM) perforations from randomized controlled trials (RCTs). Data Sources: Medline/PubMed, CENTRAL, Clinical Trials.Gov, and Google Scholar. Study Selection: Inclusion criteria: (1) English language; (2) RCT studies; (3) reported the outcomes on the application of ofloxacin and outcomes of spontaneous healing. Exclusion criteria: (1) studies without a control group; (2) patient with severe otologic disease such as chronic suppurative otitis media or ossicular disruption or patients with craniocerebral injury; (3) studies with no pretreatment values or single-arm clinical studies. Data Extraction: Country, year of publication, number of participants in each arm, patient characteristics such as age, sex, intervention details, laterality, cause of TM perforation, position of perforation, follow-up time, hearing gain, rate of TM closure, and closure time. Results: A total of 6 RCTs studies were analyzed. A total of 502 participants were included; the relative risk for closure rate of ofloxacin treatment was 1.18 [95% confidence interval (CI), 1.08 to 1.28, P < .001] and the mean difference (MD) for healing time was -18.4 (95% CI, -19.96 to -16.82, P < .001), suggesting ofloxacin has a significant effect on closure of TM perforations. However, no clinically significant effect in hearing (SMD: 0.21, 95% CI, 0.02 to 0.40, P = .03) was seen in ofloxacin group. Also, patients in the ofloxacin group were associated with a 13% reduction in the risk of infections compared to their observation-assigned counterparts, but this estimate was not statistically significant. Conclusion: Ofloxacin use in patients with traumatic TM perforation is effective in reducing healing time and increasing rate of TM perforation closure. No evidence of increased risk of hearing loss or infection rates are encountered when ofloxacin is prescribed to patients with traumatic TM perforation.
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  • 文章类型: Journal Article
    处理水平(LoP)假设假定,根据刺激处理的深度,从感知到感知的视觉刺激的过渡是分级的或二分的。人类可以逐渐意识到低级特征,如颜色或形状,而高级功能,例如语义类别,以全然或无的方式进入意识。与视觉不同,声音总是在时间上展开,这可能需要与视觉处理不同的机制。我们首次通过向参与者展示不同类别的单词来测试LoP假设,在感知阈值附近以不同的音调说话。我们还评估了意识的不同电生理相关性,听觉意识消极(AAN)和晚期积极(LP),与LoP有关。我们的发现表明LoP也适用于听觉模态。AAN是独立于LoP的意识的早期相关因素,而LP是由意识调节的,性能准确性和处理水平。
    The level-of-processing (LoP) hypothesis postulates that transition from unaware to aware visual stimuli is either graded or dichotomous depending on the depth of stimulus processing. Humans can be progressively aware of the low-level features, such as colors or shapes, while the high-level features, such as semantic category, enter consciousness in an all-or none fashion. Unlike in vision, sounds always unfold in time, which might require mechanisms dissimilar from visual processing. We tested the LoP hypothesis in hearing for the first time by presenting participants with words of different categories, spoken in different pitches near the perceptual threshold. We also assessed whether different electrophysiological correlates of consciousness, the auditory awareness negativity (AAN) and late positivity (LP), were associated with LoP. Our findings indicate that LoP also applies to the auditory modality. AAN is an early correlate of awareness independent of LoP, while LP was modulated by awareness, performance accuracy and the level of processing.
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  • 文章类型: Journal Article
    定位诸如猎物或捕食者之类的声源对于许多脊椎动物的生存至关重要。陆地脊椎动物通过测量每个ear1-5处的声压的时间延迟和强度差来定位源。水下,然而,声音的物理特性使得耳间信号非常小,这表明鱼的定向听力几乎不可能6。然而,定向听证已经在行为上得到确认,尽管其机制几十年来一直未知。已经提出了几个假设来解释这种非凡的能力,包括鱼类对微小的耳间差异进化出极端敏感的可能性,或者鱼类可能将声压与质点运动信号进行比较7,8。然而,实验挑战长期以来一直阻碍着明确的解释。在这里,我们在透明硬骨鱼大脑中对这些模型进行了实证检验,最小的椎骨之一9,10.通过选择性地控制压力和粒子运动,我们剖析了定向声惊吓的感觉算法。我们发现,这两个线索对于这种行为都是必不可少的,并且它们的相对相位控制着其方向。使用微型计算机断层扫描和光学振动测量,我们进一步证明D.cerebrum具有实现这一机制的感觉结构。D.大脑与超过15%的活脊椎动物物种共享这些结构,提出了一种推断声音方向的广泛机制。
    Locating sound sources such as prey or predators is critical for survival in many vertebrates. Terrestrial vertebrates locate sources by measuring the time delay and intensity difference of sound pressure at each ear1-5. Underwater, however, the physics of sound makes interaural cues very small, suggesting that directional hearing in fish should be nearly impossible6. Yet, directional hearing has been confirmed behaviourally, although the mechanisms have remained unknown for decades. Several hypotheses have been proposed to explain this remarkable ability, including the possibility that fish evolved an extreme sensitivity to minute interaural differences or that fish might compare sound pressure with particle motion signals7,8. However, experimental challenges have long hindered a definitive explanation. Here we empirically test these models in the transparent teleost Danionella cerebrum, one of the smallest vertebrates9,10. By selectively controlling pressure and particle motion, we dissect the sensory algorithm underlying directional acoustic startles. We find that both cues are indispensable for this behaviour and that their relative phase controls its direction. Using micro-computed tomography and optical vibrometry, we further show that D. cerebrum has the sensory structures to implement this mechanism. D. cerebrum shares these structures with more than 15% of living vertebrate species, suggesting a widespread mechanism for inferring sound direction.
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  • 文章类型: Journal Article
    儿童人工耳蜗植入后的口语发育需要快速高效的处理,退化的听觉信号和语言信息。这些对快速适应的要求降低了接受人工耳蜗植入的儿童的信息处理速度能力。这项研究调查了4-6岁的语前聋儿童人工耳蜗植入后信息处理能力的速度与口语结果的关系。两个领域-一般(视觉,对21名植入人工耳蜗的学龄前儿童和23名听力正常的同龄人进行了非语言)信息处理速度测量。语音识别的措施,语言(词汇和理解),非语言智力,和执行功能技能也从每个参与者获得。在植入人工耳蜗的学龄前儿童中,信息处理速度与语音识别和语言技能呈正相关,而在听力正常的同龄人中则不相关。在控制听力组后,这种关联仍然显著,年龄,非语言智力,和执行功能技能。这些发现与模型一致,这些模型表明,快速高效的信息处理速度是适应植入后的语音感知和语言学习的基础。以信息处理速度为目标的评估和干预策略可以更好地理解和发展人工耳蜗植入后的语言技能。
    Spoken language development after pediatric cochlear implantation requires rapid and efficient processing of novel, degraded auditory signals and linguistic information. These demands for rapid adaptation tax the information processing speed ability of children who receive cochlear implants. This study investigated the association of speed of information processing ability with spoken language outcomes after cochlear implantation in prelingually deaf children aged 4-6 years. Two domain-general (visual, non-linguistic) speed of information processing measures were administered to 21 preschool-aged children with cochlear implants and 23 normal-hearing peers. Measures of speech recognition, language (vocabulary and comprehension), nonverbal intelligence, and executive functioning skills were also obtained from each participant. Speed of information processing was positively associated with speech recognition and language skills in preschool-aged children with cochlear implants but not in normal-hearing peers. This association remained significant after controlling for hearing group, age, nonverbal intelligence, and executive functioning skills. These findings are consistent with models suggesting that domain-general, fast-efficient information processing speed underlies adaptation to speech perception and language learning following implantation. Assessment and intervention strategies targeting speed of information processing may provide better understanding and development of speech-language skills after cochlear implantation.
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  • 文章类型: Journal Article
    目的:在过去几年中,长期保留人工耳蜗植入后的残余听力已成为主要目标。本研究的目的是使用中期scala电极评估长期随访中的残余听力。
    方法:在本回顾性研究中,单中心研究,我们收集了2014年至2015年间使用中缝电极植入低频范围残余听力的27例患者的数据.术后(手术后第1天)和长期随访43.7±6.9个月直接进行听力阈值的测量。听力学听力保留程度的计算是使用Skarsynski的HEARRING组公式确定的。
    结果:在250Hz至1kHz的低频范围内,有69.2%的病例实现了残余听力的术后保留,其中89.5%的患者有建议使用电声刺激(EAS)的频率。在长期随访中,30.8%的患者表现出残余听力;然而,57.1%的人显然受益于EAS。
    结论:保留残余听力在长期使用中电极是可行的。术后,超过一半的患者受益于EAS策略.长期随访显示残余听力有一定程度的下降。然而,这些结果与其他类型电极的研究相当。未来应进行进一步的研究,以更好地评估长期随访中的听力损失,与直接术后听力学结果相比。
    OBJECTIVE: The long-term preservation of residual hearing after cochlear implantation has become a major goal over the past few years. The aim of the present study was to evaluate residual hearing in the long-term follow-up using mid-scala electrodes.
    METHODS: In this retrospective, single-center study, we collected data from 27 patients who were implanted between 2014 and 2015 with residual hearing in the low-frequency range using a mid-scala electrode. Measurements of the hearing thresholds were carried out directly postoperatively (day 1 after surgery) and in the long-term follow-up 43.7 ± 6.9 months. The calculation of the extent of audiological hearing preservation was determined using the HEARRING group formula by Skarsynski.
    RESULTS: Postoperative preservation of residual hearing was achieved in 69.2% of the cases in the low-frequency range between 250 Hz and 1 kHz, of which 89.5% of the patients had frequencies that suggested using electroacoustic stimulation (EAS). In the long-term follow-up, 30.8% of the patients showed residual hearing; however, 57.1% had apparently benefited from EAS.
    CONCLUSIONS: Preservation of residual hearing is feasible in the long term using mid-scala electrodes. Postoperatively, there is over the half of patients who benefit from an EAS strategy. The long-term follow-up shows a certain decrease in residual hearing. However, these results are comparable to studies relating to other types of electrodes. Further research should be conducted in future to better evaluate hearing loss in long-term follow-up, compared to direct postoperative audiological results.
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  • 文章类型: Journal Article
    年龄相关的听力困难具有复杂的病因,包括感觉耳蜗的退行性过程。耳蜗包括传入的开始,上行听觉通路,但也接受传出反馈神经支配的两个独立群体的脑干神经元:内侧耳蜗和外侧耳蜗途径,支配外毛细胞和听觉神经纤维在内毛细胞上突触,分别。人们认为,在困难的条件下,会改善听力,例如高背景噪声。这里,我们比较了年轻成年沙鼠和老年沙鼠沿音调轴的橄榄耳蜗传出神经支配密度(约为其最大寿命潜力的50%),与年龄相关的听力损失的经典动物模型。
    用抗突触蛋白和抗肌球蛋白VIIa免疫组织化学标记传入突触末端和感觉毛细胞,分别。毛细胞的数量,传出端子的数量,并在Corti器官的七个位置对传出神经支配区域进行了量化。
    沙鼠中人工耳蜗神经支配的位素分布与先前显示的其他物种相似,假定的外侧耳蜗神经支配(内毛细胞区域)有轻微的顶端耳蜗偏向,和假定的内侧橄榄耳蜗神经支配的宽中耳蜗峰(外毛细胞区域)。我们发现有意义,与年龄相关的内毛细胞和外毛细胞区域的总体传出神经支配下降。然而,在计算传出目标结构中与年龄相关的损失时,在内毛细胞区域中存活元素的神经支配密度没有变化。对于外毛细胞,孤儿的外毛细胞明显增加,即,缺乏传出神经支配,被观察到。仍然受到神经支配的存活外毛细胞保留了几乎正常的神经支配。
    跨物种的比较表明了一种基本的衰老情况,即外部毛细胞,I型传入,以及与之相关的传出者,随着年龄的增长稳步消亡,但是保留幸存的耳蜗电路基本完好无损,直到高龄,超过物种最大寿命潜力的50%。在外毛细胞区域,MOC变性可能先于外毛细胞死亡,留下假定的瞬时孤儿外毛细胞群,不再受到传出控制。
    UNASSIGNED: Age-related hearing difficulties have a complex etiology that includes degenerative processes in the sensory cochlea. The cochlea comprises the start of the afferent, ascending auditory pathway, but also receives efferent feedback innervation by two separate populations of brainstem neurons: the medial olivocochlear and lateral olivocochlear pathways, innervating the outer hair cells and auditory-nerve fibers synapsing on inner hair cells, respectively. Efferents are believed to improve hearing under difficult conditions, such as high background noise. Here, we compare olivocochlear efferent innervation density along the tonotopic axis in young-adult and aged gerbils (at ~50% of their maximum lifespan potential), a classic animal model for age-related hearing loss.
    UNASSIGNED: Efferent synaptic terminals and sensory hair cells were labeled immunohistochemically with anti-synaptotagmin and anti-myosin VIIa, respectively. Numbers of hair cells, numbers of efferent terminals, and the efferent innervation area were quantified at seven tonotopic locations along the organ of Corti.
    UNASSIGNED: The tonotopic distribution of olivocochlear innervation in the gerbil was similar to that previously shown for other species, with a slight apical cochlear bias in presumed lateral olivocochlear innervation (inner-hair-cell region), and a broad mid-cochlear peak for presumed medial olivocochlear innervation (outer-hair-cell region). We found significant, age-related declines in overall efferent innervation to both the inner-hair-cell and the outer-hair-cell region. However, when accounting for the age-related losses in efferent target structures, the innervation density of surviving elements proved unchanged in the inner-hair-cell region. For outer hair cells, a pronounced increase of orphaned outer hair cells, i.e., lacking efferent innervation, was observed. Surviving outer hair cells that were still efferently innervated retained a nearly normal innervation.
    UNASSIGNED: A comparison across species suggests a basic aging scenario where outer hair cells, type-I afferents, and the efferents associated with them, steadily die away with advancing age, but leave the surviving cochlear circuitry largely intact until an advanced age, beyond 50% of a species\' maximum lifespan potential. In the outer-hair-cell region, MOC degeneration may precede outer-hair-cell death, leaving a putatively transient population of orphaned outer hair cells that are no longer under efferent control.
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