The functional significance of age-related pathology of the auditory cortex is not well established. The purpose of this study was to elucidate the activation pattern of the auditory cortex in aged subjects in response to speech signals. Functional magnetic resonance imaging was performed on 12 elderly subjects with normal hearing acuity during selective listening with both ears to speech sounds in quiet and in white noise. Twelve young, normal-hearing subjects served as controls. Our results showed that activation of the auditory cortex during selective listening to speech decreased in elderly subjects compared to young subjects, especially in noise. Reduced activation occurred in the anterior and posterior regions of the bilateral superior temporal gyrus (STG), but mainly in the posterior part of the left STG. In addition, background noise had a greater masking effect on speech perception in the elderly subjects than in the young ones. These findings suggest that early functional changes associated with central presbycusis occur mainly in the posterior part of the left STG.
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