ABR/DPOAE publications

BACKGROUND: Noise-induced hearing loss (NIHL) has been traditionally attributed to outer hair cell (OHC) damage, but synaptic injury at inner hair cell (IHC)–spiral ganglion neuron (SGN) junctions may better explain persistent functional deficits. OBJECTIVE: To test whether IHC ribbon loss and functional synapse loss scale with pathological noise intensity and to define their longitudinal relationship to hearing function. METHODS: A rodent NIHL model was exposed to 100 dB SPL for 2 h or 110 dB SPL for 4 h. Cochleae were immunolabeled for CtBP2 (presynaptic ribbons) and GluA2 (postsynaptic AMPA receptor puncta). Putative functional synapses were quantified as closely apposed CtBP2/GluA2 pairs. Hearing function was assessed longitudinally and correlated with synaptic measures. RESULTS: Both exposure conditions produced graded reductions in IHC ribbon counts and CtBP2/GluA2 pairs, with greater losses after 110 dB/4 h. The number of CtBP2/GluA2 apposed pairs closely tracked preserved hearing function, providing a stronger association with functional outcome than ribbon counts alone. Ribbon loss remained largely stable across post-exposure intervals, whereas functional synapse loss was disproportionately larger at early time points, consistent with transient pre–post misalignment. Over time, CtBP2/GluA2 pairing partially recovered toward levels predicted by surviving ribbons, suggesting re-alignment or reconnection of a subset of remaining synaptic elements. CONCLUSION: Pathological noise intensity drives exposure-dependent IHC synaptopathy in addition to OHC injury. Functional synapse counts (CtBP2/GluA2 pairs) sensitively reflect stored hearing function and indicate a potential post-exposure window for synaptic re-establishment.

Age-related hearing loss (ARHL) is a prevalent sensory deficit characterized by cochlear hair cell apoptosis, yet the underlying epigenetic mechanisms remain unclear. This study investigated the role of E2F1-mediated 53BP2 lactylation in ARHL pathogenesis using naturally aging C57BL/6J mice and HEI-OC1 cochlear hair cell-like cells. We found that E2F1 was significantly upregulated in aged cochleae, correlating with elevated ABR thresholds, hair cell loss, and apoptotic marker expression. In vitro, E2F1 overexpression promoted HEI-OC1 cell apoptosis by stabilizing p53, while E2F1 knockdown attenuated p53 accumulation and cell death under oxidative stress. Mechanistically, mass spectrometry identified 53BP2 lactylation at lysine 476 (K476), which was enhanced by E2F1. The K476R mutation abolished 53BP2-p53 binding, reduced p53 stability, and inhibited apoptosis. Further, E2F1 transcriptionally upregulated p300, a lactyltransferase that directly mediates 53BP2 K476 lactylation. p300 knockdown reversed E2F1-induced 53BP2 lactylation and p53-dependent apoptosis. These findings reveal a novel E2F1-p300-53BP2 lactylation-p53 signaling axis driving cochlear hair cell apoptosis in ARHL, highlighting potential therapeutic targets for age-related hearing loss.

Electromotility in mammalian outer hair cells (OHC) is the mechanism underlying cochlear amplification. It is brought about by the piezoelectric-like property of the membrane protein prestin (Slc26a5) that lies in the OHCs lateral plasma membrane. Prestin connects to an underlying cytoskeletal network of circumferential actin filaments that bridge longitudinal spectrin filaments. This network, in turn, lies between the plasma membrane and a closely apposed ER-like tubular array of subsurface cisternae (SSC). Two previous papers examining spectrin knockouts in embryonic hair cells were confined to analyzing the effects on the apical cuticular plate and overlying stereocilia. In this paper, we examine the effects of conditional knockouts of alpha2 spectrin in postnatal OHCs. We find a significant auditory phenotype likely due to the novel disassociation of prestin's gating charge movement from OHC electromotility. In addition, OHCs show enlargement in their SSC and plasma membrane-SSC space with preserved cuticular plates and overlying stereocilia, the latter contrasts with the findings in embryonic knockouts.

Introduction Cisplatin-induced ototoxicity remains a major clinical challenge in chemotherapy, with limited pharmacological strategies available to prevent auditory damage. In this study, we explored the protective potential of baicalin, a flavonoid compound, against cisplatin-triggered cochlear injury. Methods In vivo, baicalin was administered to C57BL/6 mice prior to cisplatin treatment. Auditory function was assessed using auditory brainstem response (ABR) and distortion product otoacoustic emission measurements, and cochlear hair cell integrity was examined. In vitro, both House Ear Institute-Organ of Corti 1 (HEI-OC1) auditory cells and cochlear explants were used. Cell viability, apoptosis, mitochondrial reactive oxygen species (ROS) accumulation, and mitochondrial membrane potential (ΔΨm) were evaluated using MitoSOX Red, TMRM, and JC-1 fluorescence probes. The involvement of the p38 MAPK pathway was investigated using anisomycin (an activator) and SB203580 (an inhibitor) at the protein level. Results In vivo, baicalin administration significantly mitigated cisplatin-induced hearing loss, as evidenced by improved ABR and distortion product otoacoustic emission thresholds and preserved cochlear outer hair cell structural and functional integrity. In vitro, baicalin pretreatment significantly improved cell viability and attenuated cisplatin-induced apoptosis. Mechanistically, baicalin markedly reduced mitochondrial ROS accumulation and maintained ΔΨm. Furthermore, baicalin pretreatment effectively inhibited p38 MAPK activation; this protective effect was reversed by anisomycin and mimicked by SB203580. Discussion Collectively, these findings demonstrate that baicalin provides robust otoprotection against cisplatin-induced hearing loss. In vitro studies further indicate that this protective effect is associated with the attenuation of oxidative stress, maintenance of mitochondrial integrity, and inhibition of p38 MAPK–mediated apoptosis. Together, the results highlight baicalin as a promising candidate for therapeutic intervention against cisplatin-induced hearing loss.

Introduction Spectral information of speech sounds is spatially arranged from low to high frequencies in the auditory cortex, known as tonotopic maps. Recently, we identified an envelope steepness map encoding the rise-ramp steepness of sounds, which is located orthogonally to the tonotopic map. Temporal components, particularly the sound envelope defined by the rise-ramp steepness, play a crucial role in speech perception. We hypothesized that the ability to sense temporal components of sounds, such as envelope steepness, would be diminished in aged mice. Methods Responses to variations in rise-ramp time were investigated using transcranial macroscale calcium imaging of the auditory cortices of GCaMP6f-expressing mice. Normalized distance relative to the rise-ramp time of 0.01 ms was plotted for each rise-ramp time (0.1, 1, 10, and 100 ms) in the logarithmic scale graph: the steeper the slope of the fitted regression lines, the greater the distance between the peaks of the rise-ramp time of 0.01 ms and 100 ms. The slope of this regression line was compared between the different age groups: 1/3 months and 6/9/12 months after birth. Results The slope of the fitted regression line for 5 kHz in the bilateral anterior auditory field and 20 kHz in the bilateral primary auditory field was significantly less steep in mice at 6/9/12 months after birth than at 1/3 months after birth. Conclusion The shorter distance from the peak of 0.01 ms to 100 ms in animals 6/9/12 months after birth suggests difficulty in the separation of the rise-ramp time in aged animals. These findings may support the cortical mechanisms underlying age-related decline in speech perception.

Cisplatin‐induced ototoxicity is a detrimental side effect of chemotherapy leading to hearing loss, for which no treatments are currently available. Despite the growing recognition of the endocannabinoid (eCB) system (ECS) as a significant contributor to different physiological and pathological processes, its role in hearing remains poorly investigated. To fill this knowledge gap, we performed a molecular profiling of the ECS in auditory hair cell (HC)‐like UB/OC1 cells derived from the mouse organ of Corti (OC), demonstrating the presence of the main eCBs‐binding receptors and metabolic enzymes along with the major eCBs ( N ‐arachidonoylethanolamine, AEA, and 2‐arachidonoylglycerol, 2‐AG) and additional eCB‐like compounds. Subsequently, we established an in vitro model of cisplatin‐induced ototoxicity, which was characterized by the downregulation of the HC marker myosin 7a (Myo 7a), and activation of nuclear factor kappa‐light‐chain‐enhancer of activated B‐cells (NF‐κB) associated with caspase‐3‐mediated cell death. In this model, we observed a downregulation of cannabinoid receptor 2 (CB 2 R), diacylglycerol lipase β (DAGLβ), and α/β hydrolase domain‐containing protein 6 (ABHD6), indicating a perturbation of the 2‐AG metabolic pathway. Furthermore, we validated the observed in vitro alterations in the OC of an in vivo model of cisplatin‐induced ototoxicity, thereby strengthening the physiological relevance of our findings. Finally, we demonstrated that pharmacological blockade of CB 2 R through SR144528 mitigates cisplatin‐induced HC damage via inhibition of caspase‐3 cleavage in UB/OC1 HC‐like cells, thereby providing novel mechanistic insights into the role of CB 2 R in ototoxicity. Overall, our study demonstrates the involvement of selective elements of the ECS in cisplatin‐induced ototoxicity, hence identifying novel potential biomolecular targets for chemotherapy‐related side effects.

Objective: Consequences of hearing abnormalities in migraine remain largely unexplored, particularly regarding peripheral outcomes. This study aims to explore how migraine induces peripheral auditory injury and what role calcitonin gene-related peptide (CGRP) plays in the inner ear, which may contribute to the precise subtyping of migraine and inform targeted auditory-protective therapies. Methods: A mouse model of chronic migraine (CM) was established by intermittent injections of nitroglycerin and validated via mechanical and thermal nociceptive assays. CGRP signaling was assessed by Western blotting and immunofluorescence. Auditory function was evaluated using auditory brainstem response (ABR) and distortion product otoacoustic emissions (DPOAE) in CM and CGRP blockade (Rimegepant-treated) groups. RNA sequencing of cochlear tissue identified dysregulated signaling pathways, which were subsequently validated in vitro using HEI-OC1 auditory cells and in vivo within the inner ear. Results: Repeated nitroglycerin injections induced persistent mechanical and thermal hyperalgesia, confirming successful model establishment. A significant upregulation of CGRP and its receptors, particularly in outer hair cells (OHCs) were confirmed. The CM mouse exhibited elevated ABR, DPOAE thresholds and OHC injury, all of which were mitigated by Rimegepant treatment. CGRP overstimulation triggered mitochondrial stress and mtDNA leakage in HEI-OC1 cells. Cytosolic mtDNA leakage activated the ZBP1-mediated PANoptosis pathway, leading to OHC injury. As proof of concept, ZBP1 knockdown and PANoptosis inhibition mitigated cellular damage and hearing deficits both in vivo and in vitro. Conclusions: We demonstrated OHCs as the key targets in CM-induced, CGRP-mediated peripheral hearing impairment. CGRP exerts its pathogenic role by triggering a cascade of intracellular stress and inflammatory pathways, ultimately leading to cell death. These findings provide a phenotypic basis for a subtype of migraine-induced hearing loss, paving the way for auditory protection strategies.

Melanocytes are important components of the inner-ear cellular architecture. However, limited morphological research hinders our understanding of inner-ear function. Here, we characterize the morphology of inner-ear melanocytes and cells often misidentified as melanocytes. Immunofluorescence, smart-seq, transmission/field emission scanning electron microscopy, and immunoelectron microscopy are used. Cells previously referred to as "perivascular macrophage-like melanocytes" are not observed in the stria vascularis and are actually macrophages; along with melanocytes, they constitute intermediate cells. Cells with a "black ball" appearance in the vestibule are identified as macrophages. We examine variation in melanocytes or macrophages with age, strain, and cisplatin injury. Kir4.1 expression and the greater noise resistance observed in pigmented mice suggest melanocyte functions. Based on melanin distribution in Pou3f4y/- mice, we hypothesize that melanocytes migrate from the modiolus along Reissner's membrane area to the stria vascularis, following a base-to-apex gradient. These findings provide novel ultrastructural and immunological insights into inner-ear function.

Noise‐induced hearing loss (NIHL) is a common cause of acquired sensorineural hearing loss. Excessive endoplasmic reticulum (ER) stress‐induced apoptosis of cochlear hair cells contributes to NIHL. ER autophagy (ER‐phagy) is a critical pathway for maintaining ER homeostasis and cell survival. DDRGK1 (DDRGK domain containing 1) is a crucial receptor in ER‐phagy, essential for the removal of injured ER components. This work investigates the involvement of DDRGK1‐mediated ER‐phagy in NIHL, which has remained unclear. ER‐phagy flux is inhibited in HEI‐OC1 cells treated with hydrogen peroxide. Noise exposure reduces XIAP (X‐linked inhibitor of apoptosis protein) and DDRGK1 protein levels in these cells. Moreover, XIAP binds to DDRGK1, increasing the stability of DDRGK1 and activating ER‐phagy. Notably, in noise‐exposed CBA/CaJ mice, gastrodin, a traditional Chinese medicine ingredient, reduces noise‐induced loss of cochlear hair cells, ribbon synaptic damage, and hearing loss by promoting XIAP expression, thereby increasing DDRGK1 protein levels and activating ER‐phagy. These findings highlight XIAP‐DDRGK1‐mediated ER‐phagy as a novel therapeutic target for NIHL treatment.

Many people have trouble understanding speech in noisy environments despite normal audiometric thresholds, a condition referred to as “hidden hearing loss.” A leading hypothesis attributes this deficit to inner hair cell synaptic pathology (cochlear synaptopathy), which can persist after recovery from noise-induced temporary elevation of audiometric thresholds. This pathology impairs the temporally precise sound encoding necessary for spatial hearing, but direct evidence in primates, human or nonhuman, is lacking. Here, we show that a single noise exposure, producing only a temporary threshold elevation, induced long-lasting alterations in synaptic morphology, without synapse loss, resulting in persistent spatial hearing deficits for up to 11 months post-exposure in nonhuman primates of both sexes. These perceptual deficits were accompanied by a reduction in a neurophysiological measure of binaural processing - the binaural interaction component (BIC) of the auditory brainstem response (ABR). Both behavioral and neural deficits persisted despite full recovery of audiometric thresholds. Together, these findings provide the first evidence in primates that noise exposure disrupts spatial hearing and binaural neural circuit function without loss of hair cells or synapses. Because spatial hearing tests and the ABR/BIC are clinically accessible, this work also establishes translational biomarkers for early neural dysfunction underlying hidden hearing loss.

Sensorineural hearing loss (SNHL) is significantly more prevalent in individuals with chronic kidney disease (CKD) than in the general population. Although a strong independent association has been observed between kidney dysfunction and the risk of hearing loss, the underlying mechanisms linking these conditions remain poorly understood. This study investigated the pathophysiology of hearing impairment using adriamycin nephropathy (AN), a well-established animal model of CKD. AN was induced in male BALB/c mice using 10 or 12 mg/kg of adriamycin (ADR), resulting in severe kidney injury and concurrent hearing loss. ADR-treated mice exhibited significant glomerular injury, podocyte damage, and elevated renal neutrophil gelatinase-associated lipocalin (NGAL), along with increased serum creatinine and blood urea nitrogen levels. Hearing impairment was evident after 4-8 weeks of ADR treatment, as assessed by auditory brainstem response and distortion-product otoacoustic emissions, and was accompanied by cochlear hair cell loss and ribbon synapse degeneration. AN affected cochlear function by altering ion channel expression in the stria vascularis and inducing blood-labyrinth barrier (BLB) hyperpermeability, along with changes in endothelial cells, pericytes, and perivascular-resident macrophage-like melanocytes. AN significantly increased cochlear NGAL and NLRP3 levels at 4 and 8 weeks following ADR administration. NGAL was highly expressed in the tectorial membrane, cochlear neurons, and organ of Corti, while its receptor, 24p3R, was co-localized with NGAL. These findings demonstrated the role of NGAL and BLB disruption in ADR-induced SNHL, providing novel insights into the mechanistic link between CKD and hearing loss.

Although age-related hearing loss (ARHL) is the most common sensory loss in older adults, underlying mechanisms remain unclear. Recent genome-wide association studies (GWAS) linked variation in several genes with ARHL risk, including KLHDC7B , a gene of unknown function not previously linked to hearing. We demonstrate Klhdc7b is expressed exclusively in sensory hair cells in mouse cochlea. Utilizing two independent mouse knockout models ( Klhdc7b IMPC-/- and Klhdc7b Regn Δ/Δ ) we find that absence of Klhdc7b leads to severe early-onset, progressive hearing loss. Hair cells appear to develop normally, but outer hair cells are progressively lost from base-to-apex of the cochlea, a common pathology in ARHL. These results suggest KLHDC7B is required for maintenance rather than development, of auditory function. The validation in mouse of a human ARHL GWAS association suggests other novel candidates should be investigated. Our work provides two mouse models to study KLHDC7B function, and for development of therapeutic tools for ARHL.

Auditory hypersensitivity is a prominent symptom in Fragile X syndrome (FXS), the most prevalent monogenic cause of autism and intellectual disability. FXS arises through the loss of the protein encoded by the FMR1 (Fragile X Messenger Ribonucleoprotein 1) gene, FMRP, required for normal neural circuit excitability. In the brainstem, FMRP is necessary for normal development of acoustic reactivity, and its loss has been implicated in audiogenic seizures (AGS) in Fmr1 knockout (KO) mice, modeling auditory hypersensitivity and seizures in FXS patients. The present study investigated the correlation between auditory brainstem function and behavioral expression of AGS at the early (postnatal day P20, infancy) and late (P32, juvenile) stages of auditory development in Fmr1 KO mice compared with wildtype (WT) mice, and in both females and males. We tested responsiveness to pure tones of select auditory pathway elements through auditory brainstem responses, and neural synchronization to amplitude envelopes of modulated acoustic stimuli through auditory steady‐state responses. AGS behavior was categorized for severity during 5‐min exposure to loud sound. Expression of the immediate early gene cFos was quantified as a marker for neuronal activity in the inferior colliculus. During infancy, more severe AGS expression in Fmr1 KO mice compared with WT mice was accompanied by increased responsiveness to acoustic stimuli at the level of the superior olivary complex and inferior colliculus, and stronger neural synchronicity in subcortical auditory neurons. Fmr1 KO mice also had higher cFos positive cell counts in the inferior colliculus after exposure to loud sound. With age, both AGS susceptibility and exaggerated acoustic stimulus‐evoked activity in the Fmr1 KO mice subsided. Intriguingly, Fmr1 KO mice displayed an altered developmental profile in both the threshold and amplitude of auditory brainstem response. Our findings support evidence that AGS activity relies upon hyperexcitability in the auditory system, including in the lower brainstem, possibly due to disturbed auditory maturation. Hyper‐synchronization to modulated sounds in subcortical auditory neurons seemed to predict AGS severity. The developmental trajectory of the auditory hyperresponsiveness and hypersynchrony suggests a transient processing alteration underlying heightened AGS susceptibility in Fmr1 KO mice. A better understanding of FXS‐related circuit and behavioral symptoms of auditory processing across development provides the potential to identify therapeutic strategies to achieve auditory function recovery in FXS.

No pharmacological interventions exist that can restore or preserve auditory function in the mammalian cochlea. Auditory hair cells (HCs) do not spontaneously regenerate, leading to permanent hearing loss. In non-mammalian vertebrates, HC regeneration happens through proliferation and differentiation of their clonally related supporting cells (SCs). The present study supports the potential of quinoxaline (Qx), a nonsteroidal anti-inflammatory compound, to stimulate SC proliferation in the auditory sensory epithelium, a process that may prime the tissue for future HC regeneration. We synthesized a series of Qx derivatives by introducing various substitutions, ranging from hydrophilic to lipophilic. Seventy analogs were generated and tested in vitro and in vivo. Among those, only one (Qx-100) exhibited the best medicinal chemistry profile and was further modified to expand the structure–activity relationship of the chemotype, develop additional analogs, and optimize potency, bioavailability, and in vivo efficacy. Ten new lead variants were generated. Of those, Qx-294 and Qx-301 demonstrated promising in vitro Absorption, Distribution, Metabolism, and Excretion (ADME) profiles and were selected for further testing. Overall, both compounds were rapidly absorbed in zebrafish and mice and promoted cell proliferation in vitro and in vivo without signs of apoptosis, supporting their potential for sensory HC regeneration.

The gene therapy achieved by AAV-mediated otoferlin-overexpression is an effective therapeutic strategy for congenital deafness. However, achieving its physiological and endogenous patterns of expression remains challenging. Here, we generate the homologous mutation Otof c.1315 C > T (p.R439*), equivalent to OTOF c.1273 C > T (p.R425*) found in humans with profound deafness, to create a nonsense mutation-induced deaf mouse model. We then deliver the ‘RESTART v3’ system, which is a CRISPR-free RNA base editor for nonsense mutation suppression, into the cochlea of the mice. We achieve physiological otoferlin expression, and the edited premature termination codon is reverse-mutated to the original amino acid. We observe significant hearing restoration and enhancement of the behavioral auditory startle reflex. Thus, our study presents a successful RNA editing strategy to significantly restore hereditary deafness in mice carrying the specific Otof nonsense mutation, which holds great promise for future clinical translation.

Ciliogenesis requires an orchestrated interaction between the Golgi apparatus and centrioles via vesicle trafficking, yet this process is still poorly understood. Phosphatidylinositol 4-kinase β (PI4KB) is a conserved kinase that localizes to the Golgi for generating phosphatidylinositol 4-phosphate, an important lipid component related to cilium formation. Here, we demonstrate a previously uncharacterized mechanism of PI4KB in regulating Rab11a to enable proper ciliogenesis. PI4KB kinase activity maintains the normal vesicle density around the Golgi and Rab11a localization to centrioles in ciliogenesis. Inhibition of PI4KB activity leads to the reduced centriole localization but accumulation of Rab11a on the Golgi. We identified that the activation of Rab11a relies on PI4KB activity, while inactive Rab11a–guanosine diphosphate stably associates with Golgi and fails to undergo outward delivery. Autosomal-dominant nonsyndromic sensorineural hearing loss mutations in PI4KB abnormally intensify PI4KB interaction with Rab11a, leading to the aberrant subcellular Rab11a localization and defective ciliogenesis. Collectively, our study delineates a critical role for PI4KB in post–Golgi vesicle formation and ciliogenesis.

Damage to inner hair cells (IHCs) is a leading cause of hearing loss, typically initiating at the base region of the basilar membrane. However, the mechanisms and preventative strategies for IHC damage remain to be elucidated. This study revealed that IHCs in the low-frequency region exhibit a significantly faster calcium clearance rate than high-frequency IHCs. This difference is associated with different PMCA1 expression. We then generated an IHC-specific Pmca1 knockout mouse model ( Pmca1 CKO) exhibiting profound hearing loss and IHC death. Using single-cell RNA-seq analysis, we found that the differentially expressed genes (DEGs) were related to tetrahydrofolate biosynthesis, DNA damage, and DNA repair dysfunction. We therefore treated Pmca1 CKO mice with folic acid and found that it protected IHCs by reducing γ-H2A.X levels. In addition, we found that folic acid protected IHCs from noise-induced damage. Overall, our findings suggest that disrupted calcium homeostasis plays a role in IHC damage and that folic acid may be a promising therapeutic agent for protecting hair cells.

Introduction Age-related hearing loss (presbycusis) is the most common sensory deficit in the elderly, yet it lacks effective pharmacological treatments. The decline of the cyclic AMP (cAMP) signaling pathway is implicated in aging, but its functional role in the auditory system remains largely unknown. Methods To investigate whether enhancing cAMP signaling could counteract presbycusis and elucidate the underlying molecular mechanism, we used a D-galactose-induced cellular senescence model and an in vivo aged mouse model. The effects of the cAMP analog dibutyryl-cAMP (dbcAMP) on cellular senescence, inflammation, mitochondrial function, and cochlear structure were evaluated. The role of Mitofusin-2 (MFN2) was further assessed using siRNA-mediated knockdown. Results dbcAMP potently suppressed cellular senescence and the associated inflammatory phenotype. In addition, cAMP treatment alleviated mitochondrial dysfunction, as indicated by improved mitochondrial bioenergetics and morphology. The anti-senescence effects of cAMP were significantly blunted upon siRNA-mediated knockdown of Mfn2, establishing MFN2 as a key, though perhaps not the sole, component of this protective pathway. Importantly, systemic administration of dbcAMP to aged mice significantly preserved hearing function and protected cochlear hair cells. This in vivo protection was accompanied by an upregulation of cochlear MFN2 and a coordinated suppression of senescence and inflammation markers. Discussion Our study reveals a critical protective role for the cAMP-MFN2 axis in auditory aging by suppressing cellular senescence. These findings identify this axis as a novel and promising therapeutic target for the treatment of age-related hearing loss.

Objectives: Following deafness, a cochlear implant (CI) can be used for the restoration of hearing. CI effectiveness relies on the condition of the auditory nerve, which typically degenerates after deafness. The nerve’s condition can be assessed with the electrically evoked compound action potential (eCAP), the whole-nerve response to an electric pulse. Changes in the eCAP following an increase in the inter-phase gap (IPG) of a biphasic pulse have been reported to be informative of neural survival. This IPG effect can be explained by the temporal separation of the hyperpolarizing phase from the depolarizing phase. We hypothesize that increasing the phase duration (PD) has a similar effect. Design: We investigated the PD effect in normal hearing and in ototoxically deafened guinea pigs (total N = 40) with various conditions of the auditory nerve by recording eCAPs to biphasic current pulses with alternating polarity and with varying PD and IPG. The eCAP data were obtained from both chronically and acutely implanted guinea pigs by using CI stimulation paradigms with a fixed charge and varying PD (30, 50, or 100 µs) and IPG (2.1 or 30 µs). We evaluated six eCAP measures: five derived from the amplitude growth function and the N 1 latency. We examined the relationships of PD and IPG effects with the survival of the spiral ganglion cells. Results: The PD effects were stronger for latency than IPG effects, but weaker for the other five evaluated eCAP measures. The PD effect did not correlate as well with neural survival as the IPG effect. The IPG effect decreased with increasing PD, and accordingly, the stronger correlations between the IPG effect and neural survival were found for a short PD. Notably, the latency increase with increasing PD was greater than 1, which indicates the second phase of the pulse significantly contributes to the eCAP. This second-phase contribution was larger for lower neural survival. Conclusions: The PD effect of latency has predictive power in assessing neural survival. When using other eCAP measures than latency, the best approach to assess neural survival is using the IPG effect with a short PD (around 30 µs).

Background Bmi1, a key component of the Polycomb repressive complex 1, plays a critical role in regulating gene expression by modulating chromatin structure. Its depletion is known to cause hair cell loss in the neonatal mouse cochlea. This study aimed to investigate the epigenetic mechanisms and transcriptional consequences of Bmi1 depletion in the neonatal auditory sensory epithelium. Results Analysis of neonatal Bmi1 knockout mice using H3K27me3 chromatin immunoprecipitation sequencing, assay for transposase-accessible chromatin sequencing, and RNA sequencing revealed significant transcriptional alterations, particularly in genes governing cell proliferation, senescence, and death. Bmi1 depletion resulted in widespread gene upregulation and increased chromatin accessibility, which correlated with reduced H3K27me3 enrichment. Notably, expression of Cdkn2c , a key cell cycle regulator, was significantly upregulated. Inhibition of Cdkn2c rescued the proliferative capacity of inner ear epithelial cells in Bmi1 knockout mice. Conclusions These findings demonstrate that Bmi1 maintains transcriptional repression and chromatin state in the developing cochlea, primarily through H3K27me3 deposition. Depletion disrupts this control, leading to Cdkn2c overexpression and impaired cell proliferation. This identifies Cdkn2c and its regulatory pathway as potential therapeutic targets for hearing loss associated with hair cell depletion.