A non-invasive test for stria vascularis dysfunction

Age-related hearing loss is common in the human population but it is highly heterogeneous in aetiology which has hampered efforts to develop ways of stopping its progression. Three major sites of the initial dysfunction are the sensory hair cells, their innervation, and the stria vascularis which generates the high potassium endolymph maintained at a high endocochlear potential bathing the apical surface of hair cells. Treatments aimed at the initial site-of-lesion may be useful, and diagnostic tools to distinguish the primary site would help stratify clinical trials and facilitate selection of the most suitable treatment for each person. Our goal is to identify a suitable diagnostic tool using a panel of mouse mutants, males and females, with well-characterized primary sites of dysfunction. Here we report a new non-invasive test that distinguishes mutant mice with known stria vascularis dysfunction and reduced endocochlear potential from mice with sensory hair cell or neural defects but with normal endocochlear potential. It is based on measuring auditory brainstem responses to individual stimuli and assessing the coherence between them. Mice with reduced strial function show good inter-trial coherence relative to the amplitude of the averaged response, while mice with sensory or neural deficits show poor coherence. This method might be useful in humans to predict whether they have reduced strial function, which cannot be measured directly, and identify who would benefit from treatments aimed at boosting strial function.