Evidence of orderly spatial representations of the organ of Corti at the lower levels of the auditory pathway has been reported by many investigators. These patterns seem to be in accord with the place theory of the cochlear analysis of sound. Physiological evidence of tuning of the auditory system also has been obtained by recording with the electrical potentials from individual neurons at various levels. Most neurons of the auditory pathway show a “best frequency”—i.e., a frequency to which the individual neuron responds at minimal intensity. This finding is entirely compatible with experimental evidence of frequency tuning of the hair cells. With each increase in the intensity of the sound stimulus, the neuron is able to respond to a wider band of frequencies, thus reflecting the broad tuning of the basilar membrane. With sounds of lower frequency, the rate of impulses fired by the neuron reflects the stimulus frequency, and the response often reveals phase-locking with the stimulus; that is, the nerve fibres are stimulated at regularly recurring intervals, corresponding to a particular position or phase, of each sound wave. Increased intensity of stimulation causes a more rapid rate of responding. In general, the pitch of a sound tends to be coded in terms of which neurons are responding, and its loudness is determined by the rate of response and the total number of neurons activated.

Although extensive studies have been made of the responses of single cortical neurons, the data do not yet fit any comprehensive theory of auditory analysis. Experiments in animals have indicated that the cortex is not even necessary for frequency recognition, which can be carried out at lower levels, but that it is essential for the recognition of temporal patterns of sound. It appears likely, therefore, that in humans the cortex is reserved for the analysis of more complex auditory stimuli, such as speech and music, for which the temporal sequence of sounds is equally important.

Presumably it is also at the cortical level that the meaning of sounds is interpreted and behaviour is adjusted in accordance with their significance. Such functions were formerly attributed to an “auditory association area” immediately surrounding the primary area, but they probably should be thought of as involving much more of the cerebral cortex, thanks to the multiple, parallel interconnections between the various areas.

The localization of sounds from a stationary source in the horizontal plane is known to depend on the recognition of minute differences in the intensity and time of arrival of the sound at the two ears. A sound that arrives at the right ear a few microseconds sooner than it does at the left or that registers a few decibels louder in that ear is recognized as coming from the right. In a real-life situation the head may also be turned to pinpoint the sound by facing it and thus canceling these differences. For low-frequency tones a difference in phase at the two ears is the criterion for localization, but for higher frequencies the difference in loudness caused by the sound shadow of the head becomes all-important. Such comparisons and discriminations appear to be carried out at brainstem and midbrain levels of the central auditory pathway. The spectral shapes of sounds have been shown to be most important for determining the elevation of a source that is not in the horizontal plane. Localization of sound that emanates from a moving source is a more complicated task for the nervous system, apparently involving the cerebral cortex and short-term memory. Experiments in animals have shown that injury to the auditory area of the cortex on one side of the brain interferes with the localization of a moving sound source on the opposite side of the body.

Each cochlear nucleus receives impulses only from the ear of the same side. A comparison between the responses of the two ears first becomes possible at the superior olivary complex, which receives fibres from both cochlear nuclei. Electrophysiological experiments in animals have shown that some neurons of the accessory nucleus of the olivary complex respond to impulses from both ears. Others respond to impulses from one side exclusively, but their response is modified by the simultaneous arrival of impulses from the other side.

The system appears to be capable of making the extraordinarily fine discriminations of time and intensity that are necessary for sound localization. By virtue of such bilateral neural interconnections in the brain, the two ears together can be much more effective than one ear alone in picking out a particular sound in the presence of a background of noise. They also permit attention to be directed to a single source of sound, such as one instrument in an orchestra or one voice in a crowd. This is one aspect of the “cocktail party effect,” whereby a listener with normal hearing can attend to different conversations in turn or concentrate on one speaker despite the surrounding babble. Whether the muscles within the ear play a part in filtering out unwanted sounds during such selective listening has not been established. The less-favourable aspect of the cocktail party effect is that such background noises mask dialogue, making it difficult for persons with sensorineural impairment, such as many elderly individuals, to follow a conversation. In such a situation a single hearing aid may be of little use, but one in each ear may be of more help.