Goycoolea Marcos, Mena Ismael, Neubauer Sonia
Department of Otorhinolaryngology, Clínica Las Condes, Santiago, Chile.
Acta Otolaryngol. 2006 Apr;126(4):368-74. doi: 10.1080/00016480500416942.
Spontaneous musical auditory perceptions commonly occur in patients who develop abrupt bilateral sensorineural hearing loss. The findings in both subjects who were image tested while having these perceptions are suggestive of a biological substrate for this process and of a central locus for auditory memory seemingly located in and around area 39 of Brodmann. When an individual has abrupt bilateral sensorineural hearing loss, stored musical memory can be released and this person can have musical perceptions without an external source. It is likely that an abrupt bilateral loss of inner ear function might uninhibit neuronal groups storing auditory memory.
The objectives of this study were as follows. (1) To determine if spontaneous musical auditory perceptions occur in patients who develop abrupt bilateral severe sensorineural hearing loss (not necessarily simultaneously). (2) To determine if there is a biological substrate to the process of recalling previous auditory perceptions. (3) To compare these findings with our normal databases of unstimulated and pure tone-stimulated volunteers. (4) To establish a hypothesis for the mechanisms of these occurrences.
Thirty two patients who had had abrupt bilateral severe sensorineural hearing loss (the interval between the losses of both ears could have been years) were contacted. They were asked if they had ever had the sensation of having musical auditory perceptions without external auditory stimuli. Two of these patients were image tested with single photon computerized emission tomography (neuroSPECT) while they were having these perceptions.
All of the 32 subjects had musical auditory perceptions following their hearing loss in the second ear or when hearing loss in both ears occurred simultaneously. The two patients who were image tested with neuroSPECT had similar findings. There was a statistically significant increase in perfusion in area 39 of Brodmann, more intense on the right side, with increased perfusion also in both frontal lobes at the middle gyrus, with bilateral hypoperfusion in area 38 of Brodmann. These findings are similar to those observed in normal volunteers stimulated with pure tones.
突发双侧感音神经性听力损失的患者常出现自发音乐听觉感知。在有这些感知时接受成像检查的两名受试者的研究结果表明,这一过程存在生物学基础,且听觉记忆的中枢位点似乎位于布罗德曼39区及其周围。当个体突发双侧感音神经性听力损失时,储存的音乐记忆可能会被释放,此人可在无外部音源的情况下产生音乐感知。内耳功能的突发双侧丧失可能会解除对储存听觉记忆的神经元群的抑制。
本研究的目的如下。(1)确定突发双侧严重感音神经性听力损失(不一定同时发生)的患者是否会出现自发音乐听觉感知。(2)确定回忆先前听觉感知的过程是否存在生物学基础。(3)将这些结果与我们未受刺激和纯音刺激的正常志愿者数据库进行比较。(4)为这些现象的机制建立一个假设。
联系了32例突发双侧严重感音神经性听力损失(双耳听力损失间隔可能长达数年)的患者。询问他们是否曾在无外部听觉刺激的情况下有过音乐听觉感知。其中两名患者在有这些感知时接受了单光子计算机发射断层扫描(神经SPECT)成像检查。
32名受试者在第二只耳朵听力损失后或双耳同时听力损失时均有音乐听觉感知。接受神经SPECT成像检查的两名患者有类似的结果。布罗德曼39区灌注有统计学意义的增加,右侧更明显,额中回双侧额叶灌注也增加,布罗德曼38区双侧灌注减少。这些结果与正常志愿者接受纯音刺激时观察到的结果相似。