Central auditory processing and aphasia: A scoping review

Bezerra, Raquel de Oliveira; Santos, Ana Cecília de Brito Vidal; Lima, Daviany de Oliveira; Lima, Ivonaldo Leidson Barbosa; Rosa, Marine Raquel Diniz da

doi:10.1590/1982-0216/20242613823

Brasil

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REVIEW ARTICLES • Rev. CEFAC 26 (1) • 2024 • https://doi.org/10.1590/1982-0216/20242613823 linkcopy

Central auditory processing and aphasia: A scoping review

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Purpose: to report scientific evidence on the impact of aphasia on central auditory processing and map the contribution of auditory training to aphasic individuals.

Methods: a scoping review approaching national and international databases (SciELO, LILACS, PubMed, Scopus, and Cochrane Library) and the gray literature (Google Scholar and Open Grey). The inclusion criteria covered articles that addressed the interface between central auditory processing and aphasia, excluding duplicates, literature reviews, and scientific abstracts.

Literature Review: the review comprised 13 articles that met the eligibility criteria for this study. Seven of the selected articles assessed central auditory processing, four used electrophysiological examinations (such as auditory brainstem response and long-latency auditory evoked potentials) to assess the auditory pathway, and only one analyzed the intervention in aphasic individuals with auditory training.

Conclusion: scientific evidence points to an important change in aphasic people’s central auditory processing, with impaired figure-ground, auditory closure, temporal resolution and ordering, and binaural integration. Moreover, it is relevant to assess auditory processing, given the contribution of auditory training in speech-language-hearing therapy for a better prognosis in the rehabilitation of aphasia.

Keywords: Auditory Perception; Auditory Pathways; Acoustic Stimulation; Aphasia

DATABASE	SEARCH CONDUCTED IN AUGUST 2023
PUBMED	(“Aphasia” [ All Fields] OR “Processing Auditory” [All Fields] OR “Perception auditory” [All Fields] OR “Auditory Pathways” [All Fields] OR “Auditory Cortex Disorder” [All Fields] OR “Auditory Perception Disorders” [All Fields] OR “Acoustic Stimulation” [All Fields] OR “Auditory Perception correction” [All Fields] OR “Neuronal Plasticity”)
LILACS	(“Aphasia” AND “Processing Auditory” AND “Perception auditory” AND “Auditory Pathways” AND “Auditory Cortex Disorder” AND “Auditory Perception Disorders” AND “Acoustic Stimulation” AND “Auditory Perception correction” AND “Neuronal Plasticity” AND “Percepção auditiva” AND “Afasia” AND “Processamento auditivo” AND “Vias Auditivas” AND “Transtorno do cortex auditivo” AND “Distúrbios da percepção Auditiva” AND “Estimulação Acústica” AND “Correção da percepção Auditiva” AND “Plasticidade neuronal”)
SCOPUS	(“Aphasia” AND “Processing Auditory” AND “Perception auditory” AND “Auditory Pathways” AND “Auditory Cortex Disorder” AND “Auditory Perception Disorders” AND “Acoustic Stimulation” AND “Auditory Perception correction” AND “Neuronal Plasticity”)
COCHRANE LIBRARY	(“Aphasia” AND “Processing Auditory” AND “Perception auditory” AND “Auditory Pathways” AND “Auditory Cortex Disorder” AND “Auditory Perception Disorders” AND “Acoustic Stimulation” AND “Auditory Perception correction” AND “Neuronal Plasticity”)
OPEN GREY	(“Aphasia” AND “Processing Auditory” AND “Perception auditory” AND “Auditory Pathways” AND “Auditory Cortex Disorder” AND “Auditory Perception Disorders” AND “Acoustic Stimulation” AND “Auditory Perception correction” AND “Neuronal Plasticity” AND “Percepção auditiva” AND “Afasia” AND “Processamento auditivo” AND “Vias Auditivas” AND “Transtorno do cortex auditivo” AND “Distúrbios da percepção Auditiva” AND “Estimulação Acústica” AND “Correção da percepção Auditiva” AND “Plasticidade neuronal”)
SCIELO	(“Percepção auditiva” AND “Afasia” AND “Processamento auditivo” AND “Vias Aditivas” AND “Transtorno do cortex auditivo” AND “Distúrbios da percepção Auditiva” AND “Estimulação Acústica” AND “Correção da percepção Auditiva” AND “Plasticidade neuronal” AND “Auditory Pathways” AND “Acoustic Stimulation” AND “Auditory Perception Correction” AND “Neuronal Plasticity”)
GOOGLE SCHOLAR	(“Percepção auditiva” OR “Afasia” OR “Processamento auditivo” OR “Vias Aditivas” OR “Transtorno do córtex auditivo” OR “Distúrbios da percepção Auditiva” OR “Estimulação Acústica” OR “Correção da percepção Auditiva” OR “Plasticidade neuronal” OR “Auditory Pathways” OR “Acoustic Stimulation” OR “Auditory Perception Correction” OR “Neuronal Plasticity”)

Author and year of publication	Title	Study type	Methodological design	Outcome
Purdy et al. (2016)²⁰	Aphasia and auditory processing after stroke through an international classification of lens functionality, disability, and health	Clinical case study	A 37-year-old aphasic person with difficulty processing auditory information and speaking at the same time. The CAP test used did not require verbal responses, such as behavioral assessments and a battery of standardized tests.	Behavioral and electrophysiological measures of auditory processing indicated that the participant had difficulty with temporal spectrum discrimination and cortical auditory processing of slow speech stimuli.
Nascimento (2012)²¹	Habilidades auditivas e afasia: um estudo comparativo (Auditory skills and aphasia: A comparative study)	Comparative study	The study encompassed 32 individuals, 16 with (G1) and 16 without aphasia (G2). CAP tests included monotic and dichotic listening tests with sentences, Dichotic Digit Tests, Filtered speech, and Binaural Fusion.	The PSI test result demonstrated that the group with aphasia obtained values lower than those considered normal. The aphasic group performed worse in the filtered speech test. In the binaural fusion test, there was a difference between the average number of correct answers in the group with aphasia and the control group, with a predominant worse performance in the aphasic group.
Silva et al. (2016)²²	Processamento auditivo da informação em sujeitos com afasia (Auditory information processing in subjects with aphasia)	Cross-sectional study	Ten people with aphasia participated in the battery of assessments. CAP assessment used sound localization tests, sequential memory for verbal and non-verbal sounds, frequency pattern and duration tests, dichotic digits tests, compressed speech, and PSI.	All subjects had changes in most auditory skills, having greater difficulty with verbal tasks.
Ortiz et al. (2008)²³	Comprehension of competitive messages in aphasic patients	Cross-sectional study	Twenty aphasic individuals with a neurological and speech-language-hearing diagnosis of aphasia were evaluated. They were submitted to the monotic and dichotic Listening Test with PSI sentences - proposed for the Brazilian population.	The results of the aphasic and control groups revealed significant differences in both contralateral and ipsilateral messages. Performances differed in ipsilateral messages, identifying a greater difficulty.
Zeigelboim et al. (2010)²⁴	Neurophysiologic evaluation of auditory pathways and the balance in Broca's aphasia: presentation of illustrative case	Clinical case study	The CAP assessment included the stages of sound localization; sequential memory for syllables; dichotic listening of alternating disyllables; monotic listening test; and random gap detection test.	CAP results indicated difficulties in binaural integration, sound localization, and binaural interaction tests. The SSW test proved to be useful in the topographic diagnostic investigation of patients.
Dokoza et al. (2020)²⁵	Auditory processing in people with chronic aphasia	Case-control study	Two groups underwent the tests. Group I had 23 individuals with aphasia, and group II had 17 individuals with no neurological pathology. The auditory processing test was carried out in four subtests: filtered words test, speech in noise, and dichotic words.	Statistically lower results were observed in monaural tests, which indicates worse word recognition.
Shanks et al. (1976)²⁶	A comparison of aphasic and non-brain-injured adults in a CV-syllable dichotic listening task	Comparative study	A CV-syllable dichotic listening task was administered to a group of 11 adults without brain injury and a group of 11 aphasic adults to compare their dichotic performances.	The results were analyzed in terms of a functional auditory processing model. The bilateral deficit in the aphasic group’s dichotic performance was explained by their lesion in the dominant left hemisphere.
Kumarsinha et al. (2019) ²⁷	Temporal Resolution in Stroke Patients with Expressive Aphasia	Cross-sectional study	Two groups were formed with 10 subjects each. The study group had post-stroke patients with an established diagnosis of expressive aphasia. The tests included RGDT, GIN, and TMT.	Individuals with aphasia had poor scores on all three tests. Test scores varied in the number of attempts; a poor score was seen in the first attempt and the best score, in the second attempt among normal and expressive aphasic subjects.
Mourad et al. (2017)²⁸	Value of complex evoked auditory brainstem response in patients with post-stroke aphasia (prospective study)	Case-control study	The study group included 30 post-stroke aphasic patients and 30 hearing individuals without neurological deficits. All subjects underwent basic and click audiological assessment on auditory brainstem response to confirm the presence of wave V.	Aphasics had abnormal neural synchrony affecting the source elements (waves D, E, F, and O), but there was no effect on the filtering elements (transient). Auditory brainstem response was related to cortical speech processing, which was abnormal in aphasic patients.
Buriti et al. (2020) ²⁹	Electroacoustic and electrophysiological hearing assessment in aphasic individuals	Case-control study	Twenty individuals, 10 from the aphasic group and 10 without neurological damage participated in the cognitive potential. P300 tone-burst stimuli were used at 1000 Hz for the frequent stimuli and 2000 Hz for the rare and complex stimuli.	In the potential elicited with speech stimuli, a decrease in latency was noted in the aphasic group compared to the control group. In terms of amplitude, it can be inferred that fewer neurons were fired synchronously to form the wave.
Zanatta et al. (2016)³⁰	Study of auditory evoked potentials of late latency and cognitive potential in aphasic individuals	Cross-sectional study	The study assessed 17 aphasic individuals due to stroke, using LLAEP and P3. To investigate exogenous (P1, N1, and P2 complex) and endogenous (N2 and P3) long-latency evoked potentials.	Of the 17 individuals evaluated, only 11 had the presence of waves P1 and N1. Some subjects had values above those indicated in the literature in individual latencies, possibly because of the stroke.
Samelli et al (2010)³¹	Auditory training for auditory processing disorder: a proposal for therapeutic intervention	Cross-sectional study	The study included 10 participants with abnormal auditory processing (eight males and two females). All underwent complete audiological and auditory processing evaluation. After 10 individual training sessions, their auditory processing was reassessed.	Informal auditory training proved to be effective in part of the group of individuals with processing disorders, given the significant differences in the statistics of pre- and post-auditory training assessments, which indicated improvements in abnormal auditory skills.
Szelag et al. (2014)³²	Training in rapid auditory processing ameliorates auditory comprehension in aphasic patients: A randomized controlled pilot study	Blind randomized study	Eighteen aphasics were tested. All presented auditory comprehension deficits were evidenced through the Token Test, Phoneme Discrimination Test (PDT), and Voice Onset Time Test (VOT). Two computerized auditory training procedures were applied: temporal processing training (TT) and non-temporal control training (NT).	After TT, the average percentage of errors tended to be lower than in the pre-training assessment. In the Voice-Onset-Time Test after the TT, the best performance was found in both the voiced and deaf areas. TT in aphasic patients improved significantly for both ordering and linguistic competence - unlike the NT.

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[TFN1] Source: the authors, 2023.