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Quantitative Assessment of Cortical Auditory-tactile Processing in Children with Disabilities
Published on: January 29, 2014
Reduced bilateral auditory cortex activation during pure-tone perception in pediatric HIV
Keri J Woods1,2, Tzy-Jyun Yao3, Barbara Laughton4
1Biomedical Engineering Research Centre (BMERC), Division of Biomedical Engineering, Department of Human Biology, University of Cape Town, Cape Town, South Africa.
Insights
Children with perinatally acquired HIV (CPHIV) on antiretroviral therapy (ART) show reduced auditory cortex responses, indicating central auditory system changes. These findings suggest potential impacts on speech and learning despite normal peripheral hearing.
Area of Science:
- Neuroscience
- Pediatrics
- Infectious Diseases
Background:
- Children with perinatally acquired HIV (CPHIV) face neurodevelopmental risks, including hearing impairments.
- Antiretroviral therapy (ART) initiation has reduced but not eliminated these risks.
- Central auditory system function in CPHIV is not well understood.
Purpose of the Study:
- To investigate central auditory processing in children with perinatally acquired HIV.
- To compare auditory cortex responses between CPHIV and HIV-uninfected children.
- To understand how HIV impacts neural responses to sound.
Main Methods:
- Functional MRI (fMRI) was used to measure brain activity.
- 108 11-year-old children (60 CPHIV, 48 controls) participated.
- Participants listened to pure tones at 500 Hz, 1,500 Hz, and 4,000 Hz.
Main Results:
- CPHIV had slightly poorer hearing sensitivity but no difference in diagnosed hearing loss prevalence.
- Both groups showed auditory cortex activation, decreasing with higher frequencies.
- CPHIV exhibited significantly reduced bilateral auditory cortex responses compared to controls.
Conclusions:
- CPHIV on ART show altered central auditory processing despite normal peripheral hearing.
- These auditory cortex differences suggest vulnerability in the central auditory system.
- Central auditory system alterations may contribute to neurodevelopmental challenges in CPHIV.
Introduction:
Children with perinatally acquired HIV (CPHIV) are at increased risk of neurodevelopmental difficulties, including hearing-related impairments, despite early initiation of antiretroviral therapy (ART). Previous studies have reported a higher prevalence of hearing loss in CPHIV compared with uninfected children; however, the contribution of the central auditory system to these auditory differences remains unclear. Understanding central auditory processing in CPHIV is important, as even subtle auditory difficulties during childhood can negatively affect speech and language development, academic performance, and quality of life.
Methods:
Functional MRI was used to examine neural responses to auditory stimulation in 108 11-year-old children (60 CPHIV and 48 children without HIV). During scanning, participants listened to pure tones at low (500 Hz), middle (1,500 Hz), and high (4,000 Hz) frequencies.
Results:
CPHIV demonstrated modestly elevated hearing thresholds (reflecting poorer hearing sensitivity) at several frequencies; however, the prevalence of clinically defined hearing loss did not differ between groups. Across all children, pure-tone stimulation elicited robust bilateral activation of the auditory cortices, with both the spatial extent and magnitude of activation decreasing as tone frequency increased. Relative to controls, CPHIV exhibited significantly reduced bilateral auditory cortex responses across frequencies. These group differences persisted after accounting for sex and handedness and after excluding children with hearing loss. Associations between hearing thresholds and auditory cortex activation were generally weak, except at 4,000 Hz in CPHIV, where poorer hearing was associated with stronger auditory cortex activation, consistent with a compensatory neural response.
Discussion:
Despite largely normal peripheral hearing, CPHIV receiving ART exhibited reduced bilateral auditory cortex responses during pure-tone processing. These findings suggest that alterations within the central auditory system may contribute to auditory vulnerability in CPHIV.
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