Objectives: To assess the processing of spectrotemporal sound patterns in multiple sclerosis by using auditory evoked potentials (AEPs) to complex harmonic tones. Methods: 22 patients with definite multiple sclerosis but mild disability and no auditory complaints were compared with 15 normal controls. Short latency AEPs were recorded using standard methods. Long latency AEPs were recorded to synthesised musical instrument tones, at onset every two seconds, at abrupt frequency changes every two seconds, and at the end of a two second period of 16/s frequency changes. The subjects were inattentive but awake, reading irrelevant material. Results: Short latency AEPs were abnormal in only 4 of 22 patients, whereas long latency AEPs were abnormal to one or more stimuli in 17 of 22. No significant latency prolongation was seen in response to onset and infrequent frequency changes (P1, N1, P2) but the potentials at the end of 16/s frequency modulations, particularly the P2 peaking approximately 200 ms after the next expected change, were significantly delayed.
Conclusion:The delayed responses appear to be a mild disorder in the processing of change in temporal sound patterns. The delay may be conceived of as extra time taken to compare the incoming sound with the contents of a temporally ordered sensory memory store (the long auditory store or echoic memory), which generates a response when the next expected frequency change fails to occur. The defect cannot be ascribed to lesions of the afferent pathways and so may be due to disseminated brain lesions visible or invisible on magnetic resonance imaging.A large proportion of patients with established multiple sclerosis (MS) have lesions of central auditory pathways, which can be shown by using short latency auditory evoked potentials (AEPs).1 Abnormalities are also often observed in long latency event related potentials (ERPs). These, however, cannot usually be ascribed to afferent pathway lesions but presumably to localised or diffuse lesions within the brain.2 Most patients in the advanced stages of MS exhibit some degree of cognitive impairment.3 Minor cognitive deficits have also been noted in the early stages, for example, in the performance of verbal memory and abstract reasoning tasks. 4 In a group of mildly affected MS patients whose clinical symptoms were entirely attributable to disease of the spinal cord, the P3 component of the ERP was yet found to be significantly altered as compared with control subjects during performance of auditory and visual working memory tasks. 5 An earlier ERP component reflecting short term memory processes is the mismatch negativity. 6 This potential is elicited automatically (that is, not requiring the conscious attention of the subject) by discrete sounds that differ in some respect from the preceding sequence of sounds. The mismatch negativity appears to depend on retention of the sounds in a sensory memory store, the long auditory store or echoic memory, which decays over a period of a few seconds. 7 The chief distinction betwe...