Introduction: Friedreich’s ataxia (FRDA) is an inherited ataxia with a range of progressive features including axonal degeneration of sensory nerves. The aim of this study was to investigate auditory perception in affected individuals. Methods: Fourteen subjects with genetically defined FRDA participated. Two control groups, one consisting of healthy, normally hearing individuals and another comprised of subjects with sensorineural hearing loss, were also assessed. Auditory processing was evaluated using structured tasks designed to reveal the listeners’ ability to perceive temporal and spectral cues. Findings were then correlated with open-set speech understanding. Results: Nine of 14 individuals with FRDA showed evidence of auditory processing disorder. Gap and amplitude modulation detection levels in these subjects were significantly elevated, indicating impaired encoding of rapid signal changes. Electrophysiologic findings (auditory brainstem response, ABR) also reflected disrupted neural activity. Speech understanding was significantly affected in these listeners and the degree of disruption was related to temporal processing ability. Speech analyses indicated that timing cues (notably consonant voice onset time and vowel duration) were most affected. Conclusion: The results suggest that auditory pathway abnormality is a relatively common consequence of FRDA. Regular auditory evaluation should therefore be part of the management regime for all affected individuals. This assessment should include both ABR testing, which can provide insights into the degree to which auditory neural activity is disrupted, and some functional measure of hearing capacity such as speech perception assessment, which can quantify the disorder and provide a basis for intervention.

1.
Atkin N, Fisher I: Articulation Survey, Royal Children’s Hospital Melbourne 1996. http://www.rch.org.au/articsurvey.
2.
Bacon SP, Gleitman RM: Modulation detection in subjects with relatively flat hearing losses. J Speech Hear Res 1992;35:642–653.
3.
Blaney B, Hewlett N: Dysarthria and Friedreich’s Ataxia: what can intelligibility assessment tell us? Int J Lang Commun Dis 2007;42:19–37.
4.
Campuzano V, Montermini L, Molto D, Pianese L, Cossee M, Cavalcanti F, et al: Friedreich’s ataxia: autosomal recessive disease caused by an intronic GAA triplet repeat expansion. Science 1996;271:1423–1427.
5.
Dawson PW, Nott PE, Clark GM, Cowan RSC: A modification of play audiometry in profoundly deaf 2- to 4-year-old children. Ear Hear 1998;19:371–384.
6.
Delatycki MB, Paris DB, Gardner RJ, Nicholson GA, Nassif N, Storey E, et al: Clinical and genetic study of Friedreich ataxia in an Australian population. Am J Med Genet 1999;87:168–174.
7.
Delatycki MB, Williamson R, Forrest SM: Friedreich ataxia: an overview. J Med Genet 2000;37:1–8.
8.
Durr A, Cossee M, Agid Y, Campuzano V, Mignard C, Penet C, et al: Clinical and genetic abnormalities in patients with Friedreich’s ataxia. N Engl J Med 1996;335:1169–1175.
9.
Glasberg BR, Moore BCJ: Auditory filter shapes in subjects with unilateral and bilateral cochlear impairments. J Acoust Soc Am 1986;79:1020–1033.
10.
Glowatzki E, Fuchs PA: Transmitter release at the hair cell ribbon synapse. Nat Neurosci 2002;5:147–154.
11.
Harding AE: Friedreich’s ataxia: a clinical and genetic study of 90 families with an analysis of early diagnostic criteria and intrafamilial clustering of clinical features. Brain 1981;104:589–620.
12.
Hughes JT, Brownell B, Hewer RL: The peripheral sensory pathway in Friedreich’s ataxia. Brain 1968;91:803–817.
13.
Jabbari B, Schwartz DM, MacNeil DM, Coker SB: Early abnormalities of brainstem auditory evoked potentials in Friedreich’s ataxia: evidence of primary brainstem dysfunction. Neurology 1983;33:1071–1074.
14.
Kraus N, Bradlow AR, Cheatham J, Cunningham CD, King DB, Koch TG, et al: Consequences of neural asynchrony: a case of auditory neuropathy. J Assoc Res Otolaryngol 2000;1:33–45.
15.
Lopez-Diaz-de-Leon E, Silva-Rojas A, Ysunza A, Amavisca R, Rivera R: Auditory neuropathy in Friedreich ataxia. Int J Pediatr Otorhinolaryngol 2003;67:641–648.
16.
Miller GA, Nicely PE: An analysis of perceptual confusions among some English consonants. J Acoust Soc Am 1955;27:338–352.
17.
Montermini L, Richter A, Morgan K, Justice CM, Julien D, Castellotti B, et al: Phenotypic variability in Friedreich ataxia: role of the associated GAA triplet repeat expansion. Ann Neurol 1997;41:675–682.
18.
Moore BC: Speech perception in people with cochlear damage; in Moore BCJ (ed): Perceptual Consequences of Cochlear Damage. Oxford, Oxford University Press, 1995, pp 147–172.
19.
Moore BC, Shailer MJ, Schooneveldt GP: Temporal modulation transfer functions for band-limited noise in subjects with cochlear hearing loss. Br J Audiol 1992;26:229–237.
20.
Nolano M, Provitera V, Crisci C, Saltalamaccia AM, Wendelschafer-Crabb G, Kennedy WR, Filla A, Santoro L, Caruso G: Small fibers involvement in Friedreich’s ataxia. Ann Neurol 2001;50:17–25.
21.
Pandolfo M: Friedreich ataxia. Arch Neurol 2008;65:1296–1303.
22.
Rance G: Auditory neuropathy/dys-synchrony and its perceptual consequences. Trends Amplif 2005;9:1–43.
23.
Rance G, Barker E, Mok M, Dowell R, Rincon A, Garratt R: Speech perception in noise for children with auditory neuropathy/dys-synchrony type hearing loss. Ear Hear 2007;28:351–360.
24.
Rance G, Beer DE, Cone-Wesson B, Shepherd RK, King A, Rickards FW, Clark GM: Clinical findings for a group of infants and young children with auditory neuropathy. Ear Hear 1999;20:238–252.
25.
Rance G, Fava R, Baldock H, Chong A, Barker E, Corben L, Delatycki M: Speech perception ability in individuals with Friedreich ataxia. Brain 2008;131:2002–2012.
26.
Rance G, McKay C, Grayden D: Perceptual characterisation of children with auditory neuropathy. Ear Hear 2004;25:34–46.
27.
Satya-Murti S, Cacace A, Hanson P: Auditory dysfunction in Friedreich ataxia: result of spiral ganglion degeneration. Neurology 1980;30:1047–1053.
28.
Spoendlin H: Optic cochleovestibular degenerations in hereditary ataxias. II. Temporal bone pathology in two cases of Friedreich’s ataxia with vestibulo-cochlear disorders. Brain 1974;97:41–48.
29.
Starr A, McPherson D, Patterson J, Don M, Luxford W, Shannon R, Sininger Y, et al: Absence of both auditory evoked potentials and auditory percepts dependent on timing cues. Brain 1991;114:1157–1180.
30.
Starr A, Picton TW, Sininger YS, Hood LJ, Berlin CI: Auditory neuropathy. Brain 1996;119:741–753.
31.
Starr A, Sininger YS, Winter M, Derebery MJ, Oba S, Michalewski HJ: Transient deafness due to temperature-sensitive auditory neuropathy. Ear Hear 1998;19:169–179.
32.
Turner CW, Souza PE, Forget LN: Use of temporal envelope cues in speech recognition by normal and hearing-impaired listeners. J Acoust Soc Am 1995;97:2568–2576.
33.
Viemeister NF: Temporal modulation transfer functions based on modulation thresholds. J Acoust Soc Am 1979;66:1364–1380.
34.
Voncken M, Ioannou P, Delatycki MB: Friedreich ataxia – update on pathogenesis and possible therapies. Neurogenetics 2004;5: 1–8.
35.
Waxman SG: Conduction in myelinated, unmyelinated and demyelinated fibres. Arch Neurol 1977;34:585–589.
36.
Zeng FG, Kong YY, Michalewski HJ, Starr A: Perceptual consequences of disrupted auditory nerve activity. J Neurophysiol 2005;93:3050–3063.
37.
Zeng FG, Liu S: Speech perception in individuals with auditory neuropathy. J Speech Lang Hear Res 2006;49:36.
38.
Zeng FG, Oba S, Garde S, Sininger Y, Starr A: Temporal and speech processing deficits in auditory neuropathy. Neuroreport 1999;10:3429–3435.
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.