Central Auditory Processing Research Articles

The impact of migraine on central auditory processing and cognitive functions

The impact of migraine on central auditory processing and cognitive functions

Enhanced Dichotic Listening and Temporal Sequencing Ability in Early-Blind Individuals.

Several studies have reported the better auditory performance of early-blind subjects over sighted subjects. However, few studies have compared the auditory functions of both hemispheres or evaluated interhemispheric transfer and binaural integration in blind individuals. Therefore, we evaluated whether there are differences in dichotic listening, auditory temporal sequencing ability, or speech perception in noise (all of which have been used to diagnose central auditory processing disorder) between early-blind subjects and sighted subjects. The study included 23 early-blind subjects and 22 age-matched sighted subjects. In the dichotic listening test (three-digit pair), the early-blind subjects achieved higher scores than the sighted subjects in the left ear (p = 0.003, Bonferroni’s corrected α = 0.05/6 = 0.008), but not in the right ear, indicating a right ear advantage in sighted subjects (p < 0.001) but not in early-blind subjects. In the frequency patterning test (five tones), the early-blind subjects performed better (both ears in the humming response, but the left ear only in the labeling response) than the sighted subjects (p < 0.008, Bonferroni’s corrected α = 0.05/6 = 0.008). Monosyllable perception in noise tended to be better in early-blind subjects than in sighted subjects at a signal-to-noise ratio of –8 (p = 0.054), the results at signal-to-noise ratios of –4, 0, +4, and +8 did not differ. Acoustic change complex responses to/ba/in babble noise, recorded with electroencephalography, showed a greater N1 peak amplitude at only FC5 electrode under a signal-to-noise ratio of –8 and –4 dB in the early-blind subjects than in the sighted subjects (p = 0.004 and p = 0.003, respectively, Bonferroni’s corrected α = 0.05/5 = 0.01). The results of this study revealed early-blind subjects exhibited some advantages in dichotic listening, and temporal sequencing ability compared to those shown in sighted subjects. These advantages may be attributable to the enhanced activity of the central auditory nervous system, especially the right hemisphere function, and the transfer of auditory information between the two hemispheres.

Auditory and language skills in children with cleft lip and palate

Objectivesto investigate auditory and language skills in children with repaired cleft lip and palate. MethodsThe sample was composed of 22 children registered at the hospital where the study was conducted, seven to nine years old, 50% being female, with repaired unilateral cleft lip and palate (right or left), without associated malformations. Auditory skills were assessed using four central auditory processing tests: Random Gap Detection Test, Dichotic Digit Test, Dichotic Non-Verbal Test, Sustained Auditory Attention Ability Test. Language performance was evaluated by four standardized instruments: Illinois Psycholinguistic Skills Test, Peabody Picture Vocabulary Test, Token Test and Phonological Skills Profile. The association between auditory and language skills was evaluated by the Fisher exact test at a significance level of 5% (p<.05). ResultsThe central auditory processing tests evidenced that only one child presented adequate performance in all skills analysed, five children presented impaired performance in all skills, and 16 exhibited deteriorations in one to three auditory skills, highlighting that temporal resolution was the most impaired skill (81%). Concerning language, three children presented adequate performance in all tests applied, and Visual Association and Auditory Association were the most impaired skills (40%). No association was observed between deteriorations in auditory and language skills. ConclusionThere was high occurrence of impairment of auditory skills, which compose the central auditory processing, as well as of language skills, with greatest impairment of receptive language.

Efficacy of computer-assisted rehabilitation program for central auditory processing disorder on auditory perception and dictation of students with reading disorder

Efficacy of computer-assisted rehabilitation program for central auditory processing disorder on auditory perception and dictation of students with reading disorder

Loss of \u03b24-spectrin impairs Nav channel clustering at the heminode and temporal fidelity of presynaptic spikes in developing auditory brain

Beta-4 (β4)-spectrin, encoded by the gene Sptbn4, is a cytoskeleton protein found at nodes and the axon initial segments (AIS). Sptbn4 mutations are associated with myopathy, neuropathy, and auditory deficits in humans. Related to auditory dysfunction, however, the expression and roles of β4-spectrin at axon segments along the myelinated axon in the developing auditory brain are not well explored. We found during postnatal development, β4-spectrin is critical for voltage-gated sodium channel (Nav) clustering at the heminode along the nerve terminal, but not for the formation of nodal and AIS structures in the auditory brainstem. Presynaptic terminal recordings in Sptbn4geo mice, β4-spectrin null mice, showed an elevated threshold of action potential and increased failures during action potential train at high-frequency. Sptbn4geo mice exhibited a slower central conduction and showed no startle responses, but had normal cochlear function. Taken together, the lack of β4-spectrin impairs Nav clustering at the heminode along the nerve terminal and the temporal fidelity and reliability of presynaptic spikes, leading to central auditory processing deficits during postnatal development.

Auditory Processing Skills in Patients with Multiple Sclerosis

Background and Aim: Multiple sclerosis (MS) is neurological disease of the central nervous system. Central auditory nervous system can also be affected by MS. The present study aimed to evaluate monaural and binaural auditory processing in patients with MS. Methods: This cross-sectional study was conducted on 45 patients with MS and 45 normal peers as controls aged 25–45 years. They underwent a central auditory processing test battery including the Persian versions of Buffalo model questionnaire (BMQ), staggered spondee word (SSW) test, quick speech in noise test (QSIN), phonemic synthesis test (PST), and two- pair dichotic digit test (DDT). Results: The results of SSW test, QSIN test, PST, DDT and BMQ in the MS group were significantly different than in the control group (p≤0.001). The results showed the poor performance of patients compared to controls in some monaural and binaural auditory processing skills. Conclusion: Central auditory processing disorder is common among patients with MS. The BMQ is a suitable screening tool for identifying affected people. Dichotic listening skills, phonemic processing and speech perception in noise are impaired in MS patients which can have significant impacts on their quality of life. Keywords: Auditory processing; multiple sclerosis, central auditory nervous system; adults; speech perception

Evaluating central auditory processing in Veterans using population-appropriate norms

Increasing numbers of military Veterans have reported substantive self-perceived hearing handicap despite normal/near normal hearing on standard audiometric testing. These hearing difficulties are especially true for Veterans with histories of blast exposure and presumed mild traumatic brain injury, with many of these Veterans also being comorbid for post-traumatic stress disorder (PTSD). Clinical tests of Central Auditory Processing Disorder (CAPD) commonly are used to investigate their hearing concerns, but performance on CAPD tests typically is compared to published norms established from non-Veteran populations. Since Veterans and non-Veterans differ significantly in many relevant domains, using non-Veteran norms is potentially problematic for the interpretation of CAPD test results. Veterans (n = 217; with and without histories of blast exposure and PTSD) completed a large CAPD test battery. An N = 1 approach was used to compare the performance of the blast-exposed Veterans and those with PTSD to published norms and data from the Veterans without histories of blast exposure and PTSD (control group). The number of abnormal cases identified based on the Veteran control group was lower than that found with the published norms for all tests. Therefore, establishing and using population-appropriate norms are critical for accurately diagnosing CAPD in Veterans.

Portable automated rapid testing in Spanish: Validation and norms of central hearing processes on a Mexican population

Portable automated rapid testing of central auditory processing measures implemented in the app PART (https://braingamecenter.ucr.edu/games/p-a-r-t/) were adapted for Spanish-speaking populations. This adaptation included the generation of a corpus equivalent to the CRM to test a speech-on-speech masking task, in addition to frequency modulation tasks, temporal gap, temporal, spectral and spectro-temporal modulations, and pure tone detection in noise. This battery of tests was selected for its potential clinical utility and its previous validation across several settings including remote testing with participant-owned headphones, tablets or smartphones. Here, we tested 96 young adults in Mexico City (ages 18–45) with normal hearing. As expected, distributions of scores were similar to previously reported norms for the English-language version of the battery in English-speaking populations. Scores for the newly developed Spanish-language speech-on-speech masking tests were also similar to data previously reported in English-speaking populations. Furthermore, there was no significant effects of age or subjective hearing handicap (HHIA) in any of the tests. This study can be now used as a normative dataset, and the adapted battery can be used as an accsessible tool (available freely online) for valid and reliable testing of central auditory processing measures in Spanish-language populations.

Deficits in Acoustic Startle Reactivity and Auditory Temporal Processing after Traumatic Brain Injury.

Traumatic brain injury (TBI) exacts significant neurological and financial costs on patients and their families. In adult patients with moderate-to-severe TBI, central auditory impairments have been reported. These auditory impairments may interfere with language receptivity, as observed in children with developmental brain injury. Although rodent models of TBI have been widely used to examine behavioral outcomes, few studies have evaluated how TBI affects higher-order central auditory processing across a range of cue complexities. Here, auditory processing was assessed using a modified acoustic startle paradigm. We used a battery of progressively complex stimuli (single-tone, silent gaps in white noise, and frequency-modulated [FM] sweeps) in adult rats that received unilateral controlled cortical impact injury. TBI subjects showed significant reductions in acoustic startle absolute responses across nearly all stimuli, regardless of cue, duration of stimuli, or cue complexity. Despite this overall reduction of startle magnitudes in injured animals, the detection of single-tone stimuli was comparable between TBI and sham-injured subjects, indicating intact hearing after TBI. TBI subjects showed deficits in rapid gap (5 ms) and FM sweep (175 ms) detection, and, in contrast to shams, they did not improve on detecting silent gaps and FM sweeps across days of testing. Our findings provide evidence for both low-level (brainstem-mediated) and higher-order central auditory processing deficits in a rodent model of TBI, which parallel sensory impairments observed in TBI patients. The present findings support the use of modified pre-pule auditory detection paradigms to investigate clinically relevant processes in TBI.

Effects of aging on dichotic listening ability

BackgroundElderly patients frequently suffer from problems in speech discrimination especially in noisy situation, and they also have several problems from using amplifications devices especially binaural amplification. This necessitates the need for central auditory evaluation in association of peripheral auditory evaluation. The aim of the present study was to explore the effects of aging on dichotic listening performance. This was a case-control study conducted at the Audiology Unit, ENT Department. Participant were 46 individuals within the age range of 60 to 89 years with no history of neurological disorder or cognitive impairment, and all the participants were of high social class. Forty-five adult individuals (control group) with the age range 32–57 years, with no history of neurological disorders. Both cases and control groups were subjected to otological examination, immittancemetry, puretone audiometry, speech audiometry, and central auditory processing assessment by the use of central questionnaire for elderly and dichotic digits (version II) test.ResultsThe elderly group scored significantly depressed scores of dichotic digits’ test, especially in the left ear than in the adult group.ConclusionDichotic listening ability was significantly affected in elderly patients.

Central Auditory Functions of Alzheimer's Disease and Its Preclinical Stages: A Systematic Review and Meta-Analysis.

In 2020, 55 million people worldwide were living with dementia, and this number is projected to reach 139 million in 2050. However, approximately 75% of people living with dementia have not received a formal diagnosis. Hence, they do not have access to treatment and care. Without effective treatment in the foreseeable future, it is essential to focus on modifiable risk factors and early intervention. Central auditory processing is impaired in people diagnosed with Alzheimer’s disease (AD) and its preclinical stages and may manifest many years before clinical diagnosis. This study systematically reviewed central auditory processing function in AD and its preclinical stages using behavioural central auditory processing tests. Eleven studies met the full inclusion criteria, and seven were included in the meta-analyses. The results revealed that those with mild cognitive impairment perform significantly worse than healthy controls within channel adaptive tests of temporal response (ATTR), time-compressed speech test (TCS), Dichotic Digits Test (DDT), Dichotic Sentence Identification (DSI), Speech in Noise (SPIN), and Synthetic Sentence Identification-Ipsilateral Competing Message (SSI-ICM) central auditory processing tests. In addition, this analysis indicates that participants with AD performed significantly worse than healthy controls in DDT, DSI, and SSI-ICM tasks. Clinical implications are discussed in detail.

Characterizing Electrophysiological Response Properties of the Peripheral Auditory System Evoked by Phonemes in Normal and Hearing Impaired Ears.

This study aimed to characterize time and spectral domain characteristics of the phoneme-evoked electrocochleography (ECochG) response and explore potential associations between the ECochG spectral content, word recognition scores (WRSs), residual hearing, and aging in normal and hearing-impaired listeners. This was a prospective study with 25 adult participants. All participants underwent intraoperative ECochG testing and responses were recorded from the round window niche. Participants were divided into two groups based on their preoperative pure tone average: normal/mild sensorineural hearing loss and moderate/moderately-severe sensorineural hearing loss. Target stimuli were a 40 ms /da/ and an 80 ms /ba/ presented in alternating polarity (rarefaction/condensation). Waveform response patterns were analyzed including amplitude, latency, and spectra. Structural similarity index measure (SSIM) was used to determine similarity between the stimulus spectrum and that of the ECochG differential waveform. Correlation analyses were carried out among pure tone average, SSIM, age, and WRS. ECochG alternating waveform morphology evoked by the /da/ stimulus consisted of five prominent peaks labeled N 1 -N 5 . Its spectrum was dominated by the fundamental (F 0 ) frequency. The ECochG alternating response evoked by /ba/ consisted of nine prominent peaks labeled N 1 -N 9 and was also dominated by F 0 . Amplitudes and latencies were not statistically different between groups for both stimuli. Significant positive correlations were found between SSIM and WRS for responses evoked by /da/ (r = 0.56) and responses evoked by /ba/ (r = 0.67). High frequency pure tone average and the /ba/ SSIM were found to have a significant negative correlation (r = -0.58). Speech-like stimuli have become increasingly utilized in the assessment of auditory function. Here, we provided the groundwork for understanding how commonly employed syllable stimuli are encoded by the peripheral auditory system in regard to temporal and spectral characteristics. Expanding this work to include measurements of central auditory processing in conjunction with cochlear physiology is warranted to further understand the relationship between peripheral and central encoding of speech-like stimuli.

Central Auditory Processing and the Relationship to Perceived Hearing Difficulty: The Jackson Heart Study.

There are limited population-based studies of central auditory processing (CAP). We aimed to determine the relationship between CAP measures and perceived hearing difficulty (PHD) despite normal pure-tone audiometry in an African-American population. Cross-sectional. Jackson Heart Study (JHS), Jackson, MS. Participants of an African-American cohort (26% men; age 54.2, standard deviations [SD] 9.2) who self-reported hearing difficulty despite normal hearing sensitivity defined as audiometric pure-tone average (PTA-4: average of 500, 1000, 2000, and 4000 Hz) less than or equal to 25 dBHL (n = 911) or across all tested frequencies (PT-AF: 250-8000 Hz) less than or equal to 25 dBHL (n = 516). The Quick Speech-in-Noise (QuickSIN) and Dichotic Digits, Double Pairs (DDT2) tests were used to assess CAP. Logistic regression was used to examine the association between measures of CAP and PHD; adjusted for age, sex, education, and pure tone audiogram. PHD was present in 251 (28%) and 137 (27%) of participants using the PTA-4 and PT-AF models, respectively. Fully adjusted regression models revealed that each one-point increase in QuickSIN increased the odds of reporting PHD by 13.7% (odds ratio [OR] 1.14, p < 0.01, 95% CI: 1.08, 1.19) using the PTA-4 model and 15.0% (OR 1.15, p < 0.01, 95% CI: 1.08, 1.23) using the PT-AF model. For DDT2 testing, each 1% reduction in score, increased the odds of reporting PHD by 7.7% (OR 0.92, p < 0.01, 95% CI: 0.88, 0.97) in a fully adjusted PTA-4 model and 6.6% (OR 0.93, p = 0.04, 95% CI: 0.87, 0.99) in the PT-AF model. CAP deficits were associated with increased odds of PHD in normal hearing participants within the JHS cohort.

Case study of a 7-years old patient with central auditory processing disorder on the autism spectrum disorder – Department of Pediatric Otolaryngology, Medical University of Warsaw

Central Auditory Processing Disorder (CAPD) is a condition in which sounds are not processed well by the auditory cortex. This disorder is often associated with others, such as dyslexia or autism spectrum disorder. Nowadays, there are many therapeutic methods for CAPD. One of them is active auditory training Neuroflow. Seven-years old boy on the autism spectrum disorder underwent the CAPD diagnostics using Neuroflow tests. He reported troubles with concentration, aural memory, understanding speech and hyperacusis. He also has significant problems in school due to that disturbances. After starting Neuroflow therapy, significant, but gradual progress was noticed in his both everyday and school life. Two more diagnostic sessions were performed and the results were getting better every time. Neuroflow is a tool used in various therapeutic disciplines. It is distinguished by its versatility, online conducting and parental participation. This type of therapy can be helpful in the treatment of not only CAPD, but also similar disorders, such as ASD.

Auditory phoneme discrimination, articulation, and language disorders in patients with genetic epilepsy with febrile seizures plus: A case-control study

IntroductionGenetic epilepsy with febrile seizures plus (GEFS+) is an epilepsy syndrome with clinical heterogeneity that was first described in 1997. Central auditory processing (CAP) is defined as the neurophysiological process in decoding sound waves from the outer ear to the auditory cortex. The present study aimed to analyze CAP and phonological disorders in preschool-age children with GEFS+. Material and MethodThis is a prospective case-control study. Twenty-seven patients diagnosed with GEFS+ aged between 4 years and 6 years and 6 months and 31 healthy controls in the same age range were included in the study. Phonological sensitivity test (SAT) and auditory discrimination test (İAT) were applied to both groups, and the results of both groups were statistically compared. ResultsThe SAT and İAT raw and Z scores of the subjects in the study group were found to be significantly higher than those of the control group (p = 0.001; p < 0.01). Electroencephalography (EEG) status of the patients or the duration of antiseizure medication use did not have a statistically significant effect on the outcome. ConclusionPatients with GEFS+ have a significantly high impairment in both articulation and auditory discrimination of phonemes compared with the healthy population. Early diagnosis and early treatment of this condition can prevent potential literacy problems and the development of dyslexia in the future.

HP02: Auditory pathways and epilepsy as part of language development impairment (a preliminary study)

To estimate the impact of child epilepsy on brainstem auditory pathways as part of language development impairment. Introduction: Epilepsy is commonly associated with a language development impairment (LDI). In fact, neurophysiological maturation of cortical neuronal networks are impaired and can result in troubles of the acquisition of cognitive skills that are fundamental to the learning process particularly language. Then language is clearly caused by cortical hyperexcitability of neurons, but involvement of subcortical pathways still unclear. Materials and methods: It’s a retrospective study that collected data of children aged between two and six years-old referred for an LDI exploration. BER and electroencephalogram (EEG) were performed. Children were divided into two groups: 1st group (G1) with a pathological EEG and 2nd group (G2) with a normal EEG. They were matched in age. Children with a non-epileptic encephalopathy were excluded. Latency I, I-III, III-V and I-V intervals were compared between the two groups. t-Student test was used. Results: G1 and G2 included 15 subjects each one. Their mean-age was 3,7±0,9 years-old. Each group included pathological (G1: n=11; G2: n=7) and normal BER. G1 had longer mean I-latency (1,7±0,36 ms) and increased I-III (2,4±0,32 ms), III-V (1,9±0,42 ms) and I-V intervals (4,4±0,54 ms) than G2 (respectively: 1,6±0,25 ms; 2,3±0,15 ms; 1,8±0,19 ms; 4,2±0,23 ms) without a statistical significance. Conclusions: Children with epilepsy showed more altered BER, which could be explained by maturational delay of auditory pathways secondary to epilepsy independently to the impairment of central temporal auditory processing and language skills.

Open-Set Phoneme Recognition Performance With Varied Temporal Cues in Younger and Older Cochlear Implant Users.

The goal of this study was to investigate the effect of age on phoneme recognition performance in which the stimuli varied in the amount of temporal information available in the signal. Chronological age is increasingly recognized as a factor that can limit the amount of benefit an individual can receive from a cochlear implant (CI). Central auditory temporal processing deficits in older listeners may contribute to the performance gap between younger and older CI users on recognition of phonemes varying in temporal cues. Phoneme recognition was measured at three stimulation rates (500, 900, and 1800 pulses per second) and two envelope modulation frequencies (50 Hz and unfiltered) in 20 CI participants ranging in age from 27 to 85 years. Speech stimuli were multiple word pairs differing in temporal contrasts and were presented via direct stimulation of the electrode array using an eight-channel continuous interleaved sampling strategy. Phoneme recognition performance was evaluated at each stimulation rate condition using both envelope modulation frequencies. Duration of deafness was the strongest subject-level predictor of phoneme recognition, with participants with longer durations of deafness having poorer performance overall. Chronological age did not predict performance for any stimulus condition. Additionally, duration of deafness interacted with envelope filtering. Participants with shorter durations of deafness were able to take advantage of higher frequency envelope modulations, while participants with longer durations of deafness were not. Age did not significantly predict phoneme recognition performance. In contrast, longer durations of deafness were associated with a reduced ability to utilize available temporal information within the signal to improve phoneme recognition performance.

Association between hearing impairment, school performance and cognitive function in children and adolescents with sickle cell disease.

To investigate the association among hearing impairment, school performance, and cognitive function in children and adolescents with sickle cell disease. Thirty-one participants with sickle cell disease (SCD) and 31 healthy participants in the control-comparison group (CG), both aged 8-17years underwent auditory system evaluation (pure tone audiometry and acoustic reflex), were screened for the risks of (central) auditory processing disorder and dysfunction of cognitive function using the Scale of Auditory Behaviors (SAB) and the Mini-Mental State Examination (MMSE), respectively, and were interviewed to obtain clinical data and data on school performance. In the SCD group, eight (25.8%) participants presented with sensorineural hearing loss (SNHL). The group with SCD and SNHL presented a higher occurrence of poor school performance than the group of participants with SCD without SNHL (p=0.016). The MMSE score for aspects related to attention and calculation in the SCD group with SNHL was lower than in the SCD group without SNHL (p=0.016). In the SAB, the SCD group with SNHL presented a lower score than the SCD group without SNHL in aspects related to academic performance and attention. Hearing impairment in children and adolescents with SCD, specifically SNHL, is associated with poor school performance and enhances the risk of cognitive impairment in terms of attention and calculation.

The Laterality of Early Age-Related Hearing Loss and Brain β-Amyloid.

Worse hearing was linked to higher brain β-amyloid, a pathologic hallmark of Alzheimer's disease, in a recent study. We analyze the associations between β-amyloid and early age-related hearing loss in the right versus left ear to explore the laterality of this relationship. Cross-sectional analysis of a prospective cohort study. Tertiary referral center. Ninety-eight late middle-age adults. None. The primary outcome was whole brain and regional β-amyloid standardized uptake value ratio (SUVR) on positron emission tomography. The exposure was hearing in the right and left ear, measured by pure tone average (PTA) and word recognition score (WRS). Linear regression analyzed the association between β-amyloid and hearing in each ear, adjusting for potential confounders, including age, gender, education, cardiovascular disease, and hearing aid use. Mean age ± standard deviation was 64.3 ± 3.5 years. Mean PTA was 20.4 ± 8.8 dB. Multivariable regression adjusting for covariates demonstrated that a 10 dB worsening in PTA in the left ear was associated with significantly higher β-amyloid (SUVR) in the bilateral cingulate gyri (right coefficient: 0.029 [95% confidence interval: 0.003-0.054]; left: 0.029 [0.003-0.055]), bilateral frontal lobes (right: 0.024 [0.002-0.047]; left: 0.028 [0.006-0.049]), and the right temporal lobe (0.019 [0.002-0.037]). Consistent results were observed when WRS served as the exposure. No associations were observed between β-amyloid and PTA or WRS in the right ear. Worse hearing in the left ear, but not the right ear, was associated with higher β-amyloid. This might relate to asymmetric central auditory processing.

The Resting State Central Auditory Network: a Potential Marker of HIV-Related Central Nervous System Alterations.

HIV positive (HIV+) individuals with otherwise normal hearing ability show central auditory processing deficits as evidenced by worse performance in speech-in-noise perception compared with HIV negative (HIV-) controls. HIV infection and treatment are also associated with lower neurocognitive screening test scores, suggesting underlying central nervous system damage. To determine how central auditory processing deficits in HIV+ individuals relate to brain alterations in the cortex involved with auditory processing, we compared auditory network (AN) functional connectivity between HIV+ adults with or without speech-in-noise perception difficulties and age-matched HIV- controls using resting-state fMRI. Based on the speech recognition threshold of the hearing-in-noise test, twenty-seven HIV+ individuals were divided into a group with speech-in-noise perception abnormalities (HIV+SPabnl, 38.2 ± 6.8 years; 11 males and 2 females) and one without (HIV+SPnl 34.4 ± 8.8 years; 14 males). An HIV- group with normal speech-in-noise perception (HIV-, 31.3 ± 5.2 years; 9 males and 3 females) was also enrolled. All of these younger and middle-aged adults had normal peripheral hearing determined by audiometry. Participants were studied using resting-state fMRI. Independent component analysis was applied to identify the AN. Group differences in the AN were identified using statistical parametric mapping. Both HIV+ groups had increased functional connectivity (FC) in parts of the AN including the superior temporal gyrus, middle temporal gyrus, supramarginal gyrus, and Rolandic operculum compared to the HIV- group. Compared with the HIV+SPnl group, the HIV+SPabnl group showed greater FC in parts of the AN including the middle frontal and inferior frontal gyri. The classical auditory areas in the temporal lobe are affected by HIV regardless of speech perception ability. Increased temporal FC in HIV+ individuals might reflect functional compensation to achieve normal primary auditory perception. Furthermore, increased frontal FC in the HIV+SPabnl group compared with the HIV+SPnl group suggest that speech-in-noise perception difficulties in HIV-infected adults also affect areas involved in higher-level cognition, providing imaging evidence consistent with the hypothesis that HIV-related neurocognitive deficits can include central auditory processing deficits.