Skip to main content
NCBI home page
The Journal of Clinical Investigation logoLink to The Journal of Clinical Investigation
. 1968 Jun;47(6):1269–1280. doi: 10.1172/JCI105819

Auditory detection and perception in normal man and in patients with adrenal cortical insufficiency: effect of adrenal cortical steroids

Robert I Henkin 1,2, Robert L Daly 1,2
PMCID: PMC297283  PMID: 4298249

Abstract

Auditory detection thresholds for sinusoidal tones and various tests of auditory perception were determined in 12 patients with adrenal cortical insufficiency (seven with Addison's disease and five with panhypopituitarism) and compared to those in normal volunteers. In adrenal cortical insufficiency auditory detection sensitivity was significantly more acute than normal, and judgments of loudness and of the contralateral threshold shift were made at levels more than 20 db below those of normal subjects. Thus both the lower and the upper limits of the dynamic auditory range are significantly decreased in these patients. Speech discrimination ability of the patients was significantly impaired as was their difference limens, their alternate binaural loudness balances, and their ability to localize tones in space.

Treatment of the patients with deoxycorticosterone acetate decreased serum potassium concentration, raised serum sodium concentration, and produced gains in body weight but did not alter auditory detection or perception.

Treatment with prednisolone or with maintenance doses of carbohydrate-active steroids returned auditory detection and perception to normal in every patient tested.

The inability of the untreated patients to perform the various auditory perception tasks indicates that they have a defect in their ability to integrate incoming sensory stimuli. This defect may be related to the alteration in the timing of transmission of neural impulses along axons and across synapses which occurs in these patients when their carbohydrate-active steroid is removed. This decreased integrative capacity occurs at the same time that they are able to detect many types of sensory stimuli significantly better than normal subjects. This interrelationship between increased detection sensitivity and decreased perceptual ability is dependent upon the absence of carbohydrate-active steroids, for when these steroids are replaced both detection sensitivity and perceptual ability revert to normal.

Full text

PDF
1269

Images in this article

1277Image
on p.1277

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. DAVIS H., KRANZ F. W. THE INTERNATIONAL STANDARD REFERENCE ZERO FOR PURE-TONE AUDIOMETERS AND ITS RELATION TO THE EVALUATION ON IMPAIRMENT OF HEARING. J Speech Hear Res. 1964 Mar;7:7–16. doi: 10.1044/jshr.0701.07. [DOI] [PubMed] [Google Scholar]
  2. DENES P., NAUNTON R. F. The clinical detection of auditory recruitment. J Laryngol Otol. 1950 Jul;64(7):375–398. doi: 10.1017/s0022215100012214. [DOI] [PubMed] [Google Scholar]
  3. FELDMAN S. Electrophysiological alterations in adrenalectomy. Changes in brain stem conduction, excitability, and sensitivity to anesthesia in adren-alectomized cats. Arch Neurol. 1962 Nov;7:460–470. doi: 10.1001/archneur.1962.04210050096011. [DOI] [PubMed] [Google Scholar]
  4. FELDMAN S., TODT J. C., PORTER R. W. Effect of adrenocortical hormones on evoked potentials in the brain stem. Neurology. 1961 Feb;11:109–115. doi: 10.1212/wnl.11.2.109. [DOI] [PubMed] [Google Scholar]
  5. FLETCHER J. L., LOEB M. The influence of different acoustical stimuli on the threshold of the contralateral ear: a possible index of attenuation by the intratympanic reflex. Acta Otolaryngol. 1962 Jan;54:33–37. doi: 10.3109/00016486209126920. [DOI] [PubMed] [Google Scholar]
  6. Fowler E. P. Some attributes of "loudness recruitment" and "loudness decruitment". Trans Am Otol Soc. 1965;53:78–84. [PubMed] [Google Scholar]
  7. Gouras P. The effects of light-adaptation on rod and cone receptive field organization of monkey ganglion cells. J Physiol. 1967 Oct;192(3):747–760. doi: 10.1113/jphysiol.1967.sp008328. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. HIRSH I. J., PALVA T., GOODMAN A. Difference limen and recruitment. AMA Arch Otolaryngol. 1954 Nov;60(5):525–540. doi: 10.1001/archotol.1954.00720010540001. [DOI] [PubMed] [Google Scholar]
  9. Henkin R. I., Bartter F. C. Studies on olfactory thresholds in normal man and in patients with adrenal cortical insufficiency: the role of adrenal cortical steroids and of serum sodium concentration. J Clin Invest. 1966 Oct;45(10):1631–1639. doi: 10.1172/JCI105470. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Henkin R. I., Gill J. R., Bartter F. C. STUDIES ON TASTE THRESHOLDS IN NORMAL MAN AND IN PATIENTS WITH ADRENAL CORTICAL INSUFFICIENCY: THE ROLE OF ADRENAL CORTICAL STEROIDS AND OF SERUM SODIUM CONCENTRATION. J Clin Invest. 1963 May;42(5):727–735. doi: 10.1172/JCI104765. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Henkin R. I., McGlone R. E., Daly R., Bartter F. C. Studies on auditory thresholds in normal man and in patients with adrenal cortical insufficiency: the role of adrenal cortical steroids. J Clin Invest. 1967 Mar;46(3):429–435. doi: 10.1172/JCI105544. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. JERGER J. F., HARFORD E. R. Alternate and simultaneous binaural balancing of pure tones. J Speech Hear Res. 1960 Mar;3:15–30. doi: 10.1044/jshr.0301.15. [DOI] [PubMed] [Google Scholar]
  13. JERGER J. F. Observations on auditory behavior in lesions of the central auditory pathways. AMA Arch Otolaryngol. 1960 May;71:797–806. doi: 10.1001/archotol.1960.03770050057009. [DOI] [PubMed] [Google Scholar]
  14. JERGER J. Audiological manifestations of lesions in the auditory nervous system. Laryngoscope. 1960 Apr;70:417–425. doi: 10.1288/00005537-196004000-00008. [DOI] [PubMed] [Google Scholar]
  15. Johnson E. W. Auditory test results in 110 surgically confirmed retrocochlear lesions. J Speech Hear Disord. 1965 Nov;30(4):307–317. doi: 10.1044/jshd.3004.307. [DOI] [PubMed] [Google Scholar]
  16. Kosowicz J., Pruszewicz A. The "taste" test in adrenal insufficiency. J Clin Endocrinol Metab. 1967 Feb;27(2):214–218. doi: 10.1210/jcem-27-2-214. [DOI] [PubMed] [Google Scholar]
  17. LUSCHER E. Unsere Bestimmung der Unterschiedsschwelle der Intensitätsmodulation reiner töne, deren Auswertung und deren topisch-diagnostische Leistungsfähigkeit. Acta Otolaryngol. 1955 Sep-Oct;45(5):402–415. doi: 10.3109/00016485509124296. [DOI] [PubMed] [Google Scholar]
  18. Ojemann G. A., Henkin R. I. Steroid dependent changes in human visual evoked potentials. Life Sci. 1967 Feb 1;6(3):327–334. doi: 10.1016/0024-3205(67)90163-4. [DOI] [PubMed] [Google Scholar]
  19. SILVERMAN J. PERCEPTUAL CONTROL OF STIMULUS INTENSITY IN PARANOID AND NONPARANOID SCHIZOPHRENIA. J Nerv Ment Dis. 1964 Dec;139:545–549. doi: 10.1097/00005053-196412000-00007. [DOI] [PubMed] [Google Scholar]
  20. Silverman J. Variations in cognitive control and psychophysiological defense in the schizophrenias. Psychosom Med. 1967 May-Jun;29(3):225–251. doi: 10.1097/00006842-196705000-00002. [DOI] [PubMed] [Google Scholar]
  21. WRIGHT E. B., LESTER E. J. Effect of adrenalectomy and cortisone on peripheral nerve function. Am J Physiol. 1959 May;196(5):1057–1062. doi: 10.1152/ajplegacy.1959.196.5.1057. [DOI] [PubMed] [Google Scholar]

Articles from Journal of Clinical Investigation are provided here courtesy of American Society for Clinical Investigation

RESOURCES