06/10/2019
ABSTRACT 2020.
TITLE: COGNITIVE DEGRADATION AND HOW IT OCCURS.
Acquired hearing losses mostly occur as a direct result of noise impact on the auditory systems of humans. These are clearly visible on audiograms, and thus far, hearing aids and cochlear implants have been quite successful in helping hearing impaired people to cope up with aided hearing.
What has also been researched , is the increased prevalence of cognitive degradation during the process of a progressive sensorineural hearing loss which does not display a clear cut etiology, and is variously attributed to diseases in the brain , and/or brain damage.
I propose that sensorineural hearing loss that is progressive and irreversible creates an infusion of mechanical energy in the process of hearing treatment (non-medical), due to deployment of excessive physical forces in the cochlear mechanism and the neural tracts from the cochlea to the hippocampus in the temporal cortex.
Leakages in the ionic transport and transfer of action potentials takes place in the axonal transportation takes place due to sustained acoustic insults causing nerve leaks, and affecting critical velocities and inconsistency in neurotransmitter sequences in the nerve train delivering variable inputs in the entorhinal cortex that may be sensed as variable values of action potentials at the sub-processing stage. These changes will then alter the locational neurotransmitter adjustments and change the flow of information by re-assigning gating and channeling, thus creating incorrect destinations for the potentials, leading to inaccurate perceptions and processing targets in the hippocampus. The variations also create difficulties in the memory forming mechanisms, and cognitive sequences that have been stored as fixed inputs, and have perception accuracies that remain consistent in the prefrontal cortex, the amygdala, and the Cornu Ammonis complex of the hippocampus, which are largely the data fixation points for permanent storage of long-term memory.
The resulting progressive changes puts neurons (pyramidal) into overload as the cognitive changes send back efferent responses in a attempt to correct the negative affects of incorrect action potential and neurotransmitter values. Both these steps need 100% consistencies to maintain correct comprehension, and cognitive derivations. The faltering cognitive sequences perceived by the patient cannot be corrected due to the speed of inflow of information at the moment of need. The mental confusion is obvious!
Back to physiologic changes: overpressure of sound inputs, means that a lot of extraneous sound needs to be sifted and processed within the scala media, by the duality of inner hair cell and outer hair cell actions. Assigning the correct neurotransmitter values inside the outer hair cells needs proper identification of speech and other relevant sounds, without the overlapping negative influence of noise. The action potentials that depart the spiral ganglion fibers have changing values, along with excessive neurotransmitter pressures that physically bloat the nerves and “pressurize” the myelin sheath that serves the critical protective function and preservation of forward induction velocity to the traveling action potential. The myelin sheath begins to degenerate and crack up due to excessive physical pressure that also creates variable ‘bloating sequences’ within the nerve. Repairs need to be generated with ionic transportation of sodium ions that adds to the internal pressure. Over time the myelin sheath begins to weaken and leaks emanate that reduce conduction velocities from an average of 120 m/s down to 50m/s. The forward flow of information is significantly disrupted and if the potentials are speech induced, then the perception to the patient creates speech identification and speech recognition difficulties. Loss of action potential energy at the nodes of Ranvier degrades the informational quality, and upsets the synchronous rhythm of sound patterns. As hearing loss accelerates the difficulty in sound processing at the organ of Corti, the processing overload at the CA complex is obvious, leading to difficulties in forming new memories, and difficulties in memory interfacing at the prefrontal cortex, leading to memory recall difficulties. Eventually, pyramidal neurons at the CA begin to degrade and memory loss is now a certainty, with dementia symptoms.
It must be noted that speech is not a sound, but a code. Speech detection is a prelude to speech identification, and speech processing, and all are necessary steps before speech understanding. The cognitive steps involve the element of time flow between the codified expressions. Disruption of the time flow takes place due to demyelination of the axons between the cochlea and the temporal cortices.
I have two solutions to hearing aid adjustment and noise reduction technology that I have tried on my patients with significant success. But the degeneration of myelin sheath needs pharmacological intervention, besides hearing aid and CI technology changes.
Anjan Muhury HAD. April 4, 2019.
Auditory Researcher.
