New insights from animal studies of noise-induced and age-related hearing loss suggest that the most vulnerable elements in the inner ear are the synaptic connections between the sensory inner hair cells (IHCs) and the afferent neurons that communicate the information they receive to higher centers. When less than total, IHC synapse loss does not elevate thresholds. This means that it can be widespread in ears with intact hair cell populations and normal audiograms, where it has been called “hidden hearing loss”. Cochlear synapse loss is a likely contributor to difficulties understanding speech in a noisy environment and may be an instigating factor in the generation of tinnitus and hyperacusis, even when thresholds are normal. Beyond noise and aging, cochlear synaptopathy may be widespread in acquired sensorineural hearing loss of other etiologies and degrees of hair cell damage and loss. Normal thresholds or not, this loss of IHC – neural communication is expected to have significant perceptual consequences.
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Learning Outcomes
- After this course, learners will be able to explain the function of normal cochlear synapses, define synaptopathy and list some of its causes.
- After this course, learners will be able to discuss synaptopathy in relation to: hair cell loss; DPOAEs; and audiometric thresholds.
- After this course, learners will be able to describe what is meant by the term hidden hearing loss.
- After this course, learners will be able to discuss synaptopathy research in humans as compared to animal models, including challenges and limitations in translating findings to clinical procedures, as well as future directions.
Course created on August 14, 2017
Reviews
1624 ReviewsPresented By
Sharon G. Kujawa
PhD
Sharon G. Kujawa, PhD is an Associate Professor of Otology and Laryngology, Harvard Medical School. She is the Director of Audiology Research and a Senior Scientist in the Eaton-Peabody Laboratories, Massachusetts Eye and Ear Infirmary, Boston, MA. She serves on the faculty of the Program in Speech and Hearing Biosciences and Technology at Harvard University. Work in Kujawa laboratory seeks to clarify how cochlear structures and functions are altered in common forms of acquired sensorineural hearing loss (e.g., by exposure to noise and ototoxic drugs, and by aging), and how vulnerability is shaped by genetic background, efferent activity and exposure history. A focus of much current work is on the cochlear neurodegenerative consequences of noise and aging: determining the functional deficits that arise because of that loss, and how the degeneration can be manipulated pharmacologically to reveal mechanisms and suggest treatments.
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