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Advanced Diagnostic Audiology > W7: ACNF & FFR > Flashcards

W7: ACNF & FFR Flashcards

1
Q

What is the framework developed by Dr. Nina Kraus?

A

Auditory cognitive neuroscience framework

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2
Q

The auditory cognitive neuroscience framework is completely based on what?

A

plasticity in the auditory system

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3
Q

FFR is used in the ____ and ____ of APD

A

Ax, Mgmt

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4
Q

What is Dr. Nina Kraus’ lab called?

A

Auditory Neuroscience Lab (BrainVolts)

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5
Q

There is a lack of clarity and confidence among clinicians regarding what 3 things of APD?

A

etiology, diagnosis, management

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6
Q

What are the 2 frameworks underlying APD?

A

1) a traditional site-of-lesion framework (SLF) / auditory driven framework
2) auditory cognitive neuroscience framework (ACNF) / cognitive driven concept

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7
Q

Explain the SLF

A
  • aka auditory driven framework
  • deficits stem from impaired function in specialized subunits of the auditory nervous system
  • however, most cases of APD do not have identifiable lesions
  • limited to lesions or structural/functional disorders of the auditory system
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8
Q

What is the problem with SLF?

A
  • APD cannot be limited to the auditory system because the auditory system is associated through the whole brain through afferent and efferent fibers.
  • not a good FW for describing a case with APD
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9
Q

Explain the ACNF

A
  • cognitive driven framework
  • the whole brain including the auditory system serves as a flexible scaffold and is influenced by cognitive interactions
  • APD stems from a combination of auditory and cognitive dysfunction
  • it might be auditory driven, cognitive driven, or both
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10
Q

The ACNF proposes what 2 things:

A
  • afferent and efferent auditory pathways interact with cognitive, sensorimotor, and reward brain centers, leading to neuroplasticity
  • using the FFR as a biomarker to examine the impact of auditory expertise and disorder on brain function
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11
Q

What are the 2 things FFR looks at:

A

1) auditory enrichment/expertise (musicianship or bilingualism)
2) auditory deprivation/disorder (auditory based learning disorders including CAPD, poverty, head injury)

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12
Q

Explain the afferent and efferent projections of the auditory system

A
  • the auditory system is a distributed and integrated circuit with a network of afferent (ear to brain / bottom up) and efferent (brain to ear / top down)
  • successful auditory learning engages cognitive, sensorimotor, and reward networks and the intersection of these circuits guides neuroplasticity
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13
Q

What is unique about the low brainstem that isn’t part of the high brainstem / auditory cortex?

A
  • It is associated with better synchrony (this is why we can exactly track changes in speech stimuli)
  • When we go up in the brainstem, synchronicity decreases
  • We wouldn’t be able to track this in upper parts of the brain
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14
Q

What are the limitations of classic models of auditory processing/SLF?

A

rely on sequential information processing through specialized stations of the auditory system

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15
Q

With HL, will FFR be normal?

A

No

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16
Q

What is FFR?

A
  • a scalp recorded auditory evoked potential (AEP)
  • reflects sustained phase locked activity in a population of neural units within the brainstem
  • thus, it is a periodic wave that mimics the individual cycles of the stimulus waveform
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17
Q

The FFR is a ____ auditory stimuli

A

complex

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18
Q

What are the 2 stimuli in FFR?

A
  • music tones (piano or guitar tone)
  • speech syllables (da, ba, ga, pa)
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19
Q

What is FFR phase locked on?

A
  • the physical properties of periodic /da/ presentation
  • mimics the exact details of the stimuli (locked on the acoustic details)
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20
Q

What happens in the FFR if someone has APD?

A

if they arent able to “lock” to the stimuli, it could indicate APD, dyslexia, etc

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21
Q

It can either be called the ____ or ____ response

A

speech ABR (sABR), complex ABR (cABR)

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22
Q

Explain the picture of cABR

A
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23
Q

What is the FFR source/origin?

A

the inferior colliculus (IC), a hub for multisensory afferent and efferent information processing

24
Q

What are the 6 parameters for sABR and FFR interpretation?

A

1) latency and amplitude of aABR waves
2) V-A slope
3) FFR response similarity to the stimulus (correlation)
4) F0 amplitude
5) FFR peak timing (especially for F0)
6) response consistency (correlation between the first and second half of the FFR response)

25
Q

What is F0?

A

fundamental frequency of speech

26
Q

What are the 3 ways FFR has been used?

A

1) using FFR to track auditory enrichment: musicians
2) using FFR to track auditory based learning disorders
3) using FFR to track APD in head trauma

27
Q

FFR has been widely used to study experience based plasticity / auditory enrichment in ____ and ____

A

musicians, bilinguals

28
Q

What are 7 FFR findings in musicians compared to non musicians?

A

1) structural brain differences (enhanced processing of sound)
2) more robust and precise neural encoding of speech music (very sharp responses)
3) positive correlation of music effects with the lengths of musicianship
4) distinct effects of music experience in FFRs by different types of instruments
5) better speech in noise perception
6) stronger and more precise representation of auditory timing processing (better temporal encoding, more precise latencies)
7) lower impact of aging on neural processing (offsetting age-related decrements)

29
Q

Why are musicians responses more sharp?

A

their auditory system is trained (long term plasticity)

30
Q

Explain why aging is delayed on musicians?

A

Aging is delayed due to long term plasticity of the auditory system, cognition, and speech and language perception

31
Q

What do findings on musicians and bilinguals state?

A

findings support incorporating music into APD treatment given the benefits of music training for more effectively extracting meaning from specific sound features

32
Q

Explain the evidence of auditory enrichment in musicians: musicians vs non musicians (picture)

A
33
Q

Explain the evidence of auditory enrichment in musicians: older adults vs younger adults (picture)

A
34
Q

What are the 5 benefits of bilingualism vs monolingualism in FFR?

A

1) enhances subcortical encoding of F0
2) better cognitive functions in tasks involving executive function and cognitive control
3) delaying age related neural decline
4) more robust FFRs
5) better FFR in noise (compared to monolinguals)

latency is the same, but amplitude is higher

35
Q

What are 3 examples of auditory based learning disorders?

A
  • APD
  • dyslexia / reading difficulty
  • specific language impairments (SLI)
36
Q

What are the 3 FFR characteristics in auditory based learning disorders?

A

1) slower (prolonged latency) and less robust FFR (reduced response similarity to the stimulus)
2) reduced encoding of speech harmonics (lower F0 harmonics amplitude)
3) deficiencies in rapid sound perception (reduced neural synchrony)

37
Q

What are the 2 current limitations of FFR in tracking auditory based learning disorders?

A

1) there are overlaps in the FFR results
2) difficulties in differentiating subtypes of auditory based learning disorders (but WE are able to differentiate, the test cant)

38
Q

Why can the FFR not differentiate between auditory based learning disorders?

A

Still difficult to differentiate between these using FFR (all show significant difficulties in speech processing and FFR parameters, but its difficult to differentiate between them); the case might be APD, dyslexia, or SLI (they all have the below results); it isn’t tough to differentiate

39
Q

How do WE differentiate auditory based learning disorders?

A

How do we differentiate them:
- Use a multidisciplinary approach
- Family/teacher information
- Use checklists / questionnaires
- If a case shows significant difficulty in reading and other checklists / questionnaires confirm this, results are in favour of dyslexia

40
Q

WHat did results show for cABR and APD tests after treatment with Fast ForWord Training (picture)

A
41
Q

Neurological insults like ____ or ____ can impair auditory processing

A

blast exposure, concussion

42
Q

What are 2 FFR characteristics in mTBI/head trauma?

A

1) reduced F0 encoding
- following concussion (football players)
- it may be observed even after a single concussion but partially recovers over time
2) prolonged FFR peak latencies (D, E, F waves)
- be aware that this is different from APD

43
Q

Head trauma can cause ____ or ____.

A

short term APD, long term APD

44
Q

If a case of short term APD shows that after 3 months they have no difficulty, how could you demonstrate this?

A

Through improvement of speech ABR

45
Q

____ could be used as a biomarker for APD in head trauma/mTBI

A

FFR

46
Q

If you had to choose an AEP test for clinic, what would you choose?

A

In clinic, speech ABR could be a great AEP test because of feasibility, well supported test, and literature supports the application of speech ABR in clinical practice

47
Q

Dr. Kraus suggests the use of speech ABR with the 3 following TB domains:

A

Audition
Attention
Working memory

48
Q

What are the two suggested treatments for individuals with poor FFR results?

A

1) auditory training (improvements by FFR findings post auditory training)
2) remote microphones and FM systems

49
Q

What is the recommended training?

A

auditory training PLUS use of remote mic/FM system

50
Q

What are 5 auditory training programs?

A
51
Q

C: ACNF is similar to or in support of the ____

A

cognitive driven framework of APD

52
Q

C: ACNF emphasizes the interplay between ____ and ____

A

audition, cognition

53
Q

C: ACNF possess a ____ to APD assessment and management

A

holistic

54
Q

C: FFR response can be used to ____ as past of the TB, BUT…

A

assess APD, BUT cannot be used as a single test for APD Ax

55
Q

C: FFR response could be used to track ____

A

treatment outcomes

56
Q

C: FFR findings should be should be…

A

…interpreted along with other assessments

Advanced Diagnostic Audiology (11 decks)

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