Effects of Selective Serotonin Reuptake Inhibitors on Auditory Processing: Case Study

Kamakshi V. Gopal; D. Michael Daly; Raymond G. Daniloff; Lori Pennartz

doi:10.1055/s-0042-1748133

Journal of the American Academy of Audiology, Table of Contents

J Am Acad Audiol 2000; 11(08): 454-463
DOI: 10.1055/s-0042-1748133

Original Article

Effects of Selective Serotonin Reuptake Inhibitors on Auditory Processing: Case Study

Kamakshi V. Gopal

Department of Speech and Hearing Sciences, University of North Texas, Denton, Texas

,

D. Michael Daly

Daly Associates, Dallas, Texas

,

Raymond G. Daniloff

Department of Speech and Hearing Sciences, University of North Texas, Denton, Texas

,

Lori Pennartz

Department of Speech and Hearing Sciences, University of North Texas, Denton, Texas

› Author Affiliations

Abstract

PDF Download

Abstract

Auditory sensitivity and processing ability were evaluated in a patient who suffered from hyperacusis, difficulty understanding speech, withdrawn depression, lethargy, and hypersensitivity to touch, pressure, and light. Treatment with fluvoxamine and fluoxetine (selective serotonin reuptake inhibitors) reversibly alleviated complaints. Testing while medicated and unmedicated (after voluntary withdrawal from medication for several weeks) revealed no difference in pure-tone thresholds, speech thresholds, word recognition scores, tympanograms, or acoustic reflex thresholds. Medicated SCAN ● A (a screening test for central auditory processing disorders) results were normal, and unmedicated results were abnormal. Unmedicated transient otoacoustic emissions and auditory brainstem response waves I, III, and V were significantly larger bilaterally. Uncomfortable loudness levels indicated greater tolerance during the medicated condition. Central processing and vigilance were evaluated with analog-synthesized three-formant consonant-vowel syllables. While medicated, responses to stimuli at each ear revealed well-defined, labeling crossovers of about 90 msec. Vowel identification matched normal subject responses; labeling of /gE/jE/ and /bE/wE/ continua was well defined but all crossover points differed from normals (p < .0001). During unmedicated testing, responses to /gE/jE/ began at medicated levels but approached chance levels for the entire continuum within 10 min; labeling of /bE/wE/ was consistent with medicated responses throughout with earlier than normal crossover points.

Abbreviations: ABRs = auditory brainstem responses, ALRs = auditory late potentials, CNS = central nervous system, GABA = gamma-aminobutyric acid, 5–HT = 5–hydroxytryptamine, OCB = olivocochlear bundle, SAS = sparse acoustic stimuli, SSRIs = selective serotonin reuptake inhibitors, TEOAEs = transient evoked otoacoustic emissions, UCL = uncomfortable loudness level

Key Words

Auditory brainstem responses - central auditory processing - depression - hyperacusis - phoneme identification - selective serotonin reuptake inhibitors - serotonin

PDF (874 kb)

References

REFERENCES
Anderson SD, Kemp DT. (1979). The evoked cochlear mechanical response in laboratory primates. Arch Otolaryngol 224:47–54.
Bhargava VK, McKean CM. (1977). Role of 5–hydroxy-tryptamine in the modulation of acoustic brainstem (far-field) potentials. Neuropharmacology 16:447–449.
Brownell WE. (1990). Outer hair cell electromotility and otoacoustic emissions. Ear Hear 11:82–93.
Calogero B, Nistico G, Rotiroti D, Giannini P, Olivieri G, Gargiulo G. (1977). Involvement of serotonergic mechanism in the control of chick auditory evoked response. Rev Laryngol Otol Rhinol 98:233–241.
Concu A, Carcassi AM, Piras MB, Bianco S, Argiolas A. (1978). Evidence for a correlation between the latency of an early component of auditory evoked potentials and brain levels of serotonin in albino rats. Experenientia 34:375–377.
Cransac H, Cottet-Emard J, Hellstrom S, Peyrin L. (1998). Specific sound-induced noradrenergic activation in central auditory structures. Hear Res 118:151–156.
Daly DM, Daly DD, Wada JA, Drane JW. (1980). Evidence concerning neurobiologie basis of speech perception. J Neurophysiol 44:200–222.
Davis M, Astrachan DI, Kass E. (1980). Excitatory and inhibitory effects of serotonin on sensorimotor reactivity measured with acoustic startle. Science 209:521–523.
Ebert U, Ostwald J. (1992). Serotonin modulates auditory information processing in the cochlear nucleus of the rat. Neurosci Lett 145:51–54.
Franklin DJ, McCoy MJ, Martin GK, Lonsbury-Martin BL. (1992). Test/retest reliability of distortion-product and transiently evoked otoacoustic emissions. Ear Hear 13:417–429.
Gil-Loyzaga P, Bartolome MV, Vicente-Torres MA. (1997). Serotonergic innervation of the organ of Corti of the cat cochlea. NeuroReport 8:3519–3522.
Gopal KV, Kowalski J. (1999). Slope analysis of auditory brainstem responses in children at risk for central auditory processing disorders. Scand Audiol 27:1–6.
Harper MS, Wallace MN. (1995). Changes in density of brainstem afferente in ferret primary auditory cortex (AI) during postnatal development. J Anat 186:373–382.
Hawkins DB. (1980). Loudness discomfort levels: a clinical procedure for hearing aid evaluations. J Speech Hear Disord 45:3–15.
Hegerl U, Gallinat J, Mrowinski D. (1994). Intensity dependence of auditory evoked dipole source activity. Int J Psychophysiol 17:1–13.
Hegerl U, Juckel G. (1993). Intensity dependence of auditory evoked potentials as an indicator of central serotonergic neurotransmission: a new hypothesis. Biol Psychiatry 33:173–187.
Hegerl U, Juckel G, Mackert A, Rao ML, Stieglitz RD, Volz HP, Muller-Oerlinghausen B. (1991a). Auditory evoked potentials and clinical response to antidepressive treatment with fluvoxamine. Biol Psychiatry 29:602S.
Hegerl U, Juckel G, Rao ML, Muller-Oerlinghausen B. (1991b). Blood serotonin and auditory evoked potentials under fluvoxamine challenge and phototherapy. In: Cassano GB, Akiskal HS, eds. Serotonin-Related Psychiatric Syndromes: Clinical and Therapeutic Links. London: Royal Society of Medicine, 163—170.
Hegerl U, Lipperheide K, Juckel G, Schmidt LG, Rommei-spacher H. (1995). Antisocial tendencies and cortical sensory-evoked responses in alcoholism. Alcohol Clin Exp Res 19(l):31–36.
Hiemke C, Hartter S. (2000). Pharmacokinetics of selective serotonin reuptake inhibitors. Pharmacol Ther 85:11–28.
Hughes CW, Petty F, Sheikha S, Kramer GL. (1996). Whole-blood serotonin in children and adolescents with mood and behavior disorders. Psychiatry Res 65:79–95.
Johnson RG, Stevens KE, Rose GM. (1998). 5–Hydroxytryptamine₂ receptors modulate auditory filtering in the rat. J Pharmacol Exp Ther 285:643–650.
Juckel G, Molnar M, Hegerl U, Csepe V, Karmos G. (1997). Auditory-evoked potentials as indicator of brain serotonergic activity—first evidence in behaving cats. Biol Psychiatry 41:1181–1195.
Keith RW. (1986). SCAN: A Screening Test for Auditory Processing Disorders. San Antonio, TX: The Psychology Corporation.
Kropp P, Gerber WD. (1993). Is increased amplitude of contingent negative variation in migraine due to cortical hyperactivity or to reduced habituation? Cephalagia 13:37–41.
Leonard BE. (1992). Pharmacological differences of serotonin reuptake inhibitors and possible clinical relevance. Drugs 43(Suppl 2):3–10.
Lewis DA, Campbell MJ, Foote SL, Morrison JH. (1986). The monoaminergic innervation of primate neocortex. Hum Neurobiol 5:181–188.
Liberman AM. (1996). Speech: A Special Code. Cambridge, MA: Bradford Books/MIT Press.
Lucas RA. (1992). The human pharmacology of fluoxetine. Int J Obes 16(4):S49–S54.
Marriage J, Barnes NM. (1995). Is central hyperacusis a symptom of 5–hydroxytryptamine (5–HT) dysfunction? JLaryngol Otol 109:915–921.
Marshall L, Heller LM. (1998). Transient-evoked oto-acoustic emissions as a measure of noise-induced threshold shift. J Speech Hear Lang Res 41:1319–1334.
Mountain DC. (1980). Changes in endolymphatic potential and crossed olivo-cochlear bundle stimulation alter cochlear mechanics. Science 210:71—72.
Musiek F, Baran JA, Pinheiro ML. (1994). Neuro-audiology: Case Studies. San Diego: Singular.
Narayan M, Anderson G, Cellar J, Mallison RT, Price LH, Nelson JC. (1998). Serotonin transporter blocking properties of Nefazodone assessed by measurement of platelet serotonin. J Clin Psychopharmacol 18:67–71.
Perez V, Bel N, Celada P, Ortiz J, Alvarez E, Artigas F. (1998). Relationship between blood serotonergic variables, melancholic traits, and response to antidepressant treatments. J Clin Psychopharmacol 18:222–230.
Pinder RM. (1997). Designing a new generation of antidepressant drugs. Acta Psychiatr Scand 96(Suppl 391):7–13.
Proietti-Cecchini A, Afra J, Schoenen J. (1997). Intensity dependence of the cortical auditory evoked potentials as a surrogate marker of central nervous system serotonin transmission in man: demonstration of a central effect for the 5HT 1B/1D agonist zolmitriptan (311C90, omig). Cephalalgia 17:849–854.
Schoenen J, Wang W, Albert A, Delwaide PIJ. (1995). Potentiation instead of habituation characterizes visual evoked potentials in migraine patients between attacks. Eur J Neurol 2:115–122.
Sheldon PW, Aghajanian GK. (1990). Serotonin (5–HT) induces IPSPs pyramidal layer cells of rat piriform cortex: evidence for involvement of 5–HT₂–activated interneuron. Brain Res 506:62–69.
Sheldon PW, Aghajanian GK (1991). Excitatory responses to serotonin (5–HT) in neurons of the rat piriform cortex: evidence for involvement of a 5–HT_lc receptors in pyramidal cells and 5–HT₂ receptors in interneurons. Synapse 9:208–218.
Shemen L. (1998). Fluoxetine for treatment of tinnitus. Otolaryngol Head Neck Surg 118:421.
Siegel JH, Kim DO. (1982). Efferent neural control of cochlear mechanics? Olivocochlear bundle stimulation effects cochlear biomechanical nonlinearity. Hear Res 6:171–182.
Steckler T, Sahgal A. (1995). The role of serotonergic cholinergic interactions in the mediation of cognitive behavior. Behav Brain Res 57:165–199.
Stevens KN. (1998). Acoustic Phonetics. Cambridge, MA: MIT Press.
Thompson GC, Thompson AM, Garrett KM, Britton BH. (1994). Serotonin and serotonin receptors in the central auditory system. Otolaryngol Head Neck Surg 110:93–102.
Vandermaelen CP. (1985). Serotonin. In: Rogawski MA, Barker JL, eds. Neurotransmitter Actions in the Vertebrate Neruous System. New York: Plenum Press, 201–240.
Wang WBM, Timsit-Berthier M, Schoenen J. (1996). Intensity dependence of auditory evoked potentials is pronounced in migraine: an indication of cortical potentiation and low serotonergic neurotransmission? Neurology 46:1404–1409.
Wong DT, Bymaster FP, Engleman EA. (1995). Prozac (fluoxetine, Lilly 110140), the first selective serotonin uptake inhibitor and an antidepressant drug: twenty years since its first publication. Life Sei 57:411–441.
Wu MF, Siegel JM. (1990). Facilitation of the acoustic startle reflex by ponto-geniculo-occipital waves: effects of PCPA. Brain Res 532:237–241.