The inferior colliculus (IC) is a central hub for auditory information processing that receives widespread convergent projections. The IC comprises three main subdivisions: the central nucleus of the IC (ICC), the dorsal cortex (DC), and the lateral cortex (LC). While the ICC receives primarily ascending auditory information, DC and LC receive major cortical and multisensory projections. The LC has repeated molecular motifs that govern its input-output relationships. However, because the LC is buried deep within a sulcus, it is difficult to image in behaving animals, making it challenging to answer questions about its functional organization. Here, we describe a protocol for coupling two-photon microscopy with a microprism to obtain cellular-resolution sagittal views of functional LC maps. We employed this novel approach to investigate neuronal responses to pure tones in relation to LC motifs. This method will not only provide new insights into the auditory system but will also permit imaging of hidden brain regions previously inaccessible by conventional means. © 2025 The Author(s). Current Protocols published by Wiley Periodicals LLC. Basic Protocol 1 : Craniotomy and implantation of the microprism. Basic Protocol 2 : Data acquisition from sound-responsive neurons. Basic protocol 3 : Confirming the microprism location. Basic Protocol 4 : Analyzing the time traces of neuronal responses and generating a best-frequency tuning Map.

Ultrafast ultrasound offers a unique route to cross-scale neurovascular phenotyping by integrating functional ultrasound (fUS), ultrasound localization microscopy (ULM), and functional ULM (fULM). Yet the baseline variability, longitudinal stability, and biological safety of such multimodal imaging in awake animals remain insufficiently defined, limiting its use for detecting subtle disease-associated neurovascular changes. Here, an awake longitudinal fUS-ULM-fULM framework is established and validated in mice over five months. Structural vascularity, microvascular flow velocity, mesoscale hemodynamic responses, and microvascular functional responses are repeatedly quantified in the same animals during monthly imaging sessions. Across all metrics, no significant longitudinal drift is detected (p > 0.60). Structural and flow-derived measures are markedly more reproducible than functional readouts, with within-subject coefficients of variation of 5.1% for mean flow velocity and 7.3% for vascularity, compared with 25.0% for fUS-derived cerebral blood volume responses and 53.2% for fULM-derived microvascular functional responses. Mean flow velocity shows the strongest longitudinal consistency (ICC = 0.70) and the lowest detection threshold. Behavioral testing and GFAP/Iba1 staining further reveal no memory impairment or chronic neuroinflammation. This study defines quantitative baselines, reproducibility limits, and safety evidence for awake cross-scale ultrasound imaging, providing a reference framework for longitudinal neurovascular phenotyping in preclinical disease models.

Background: The mammalian auditory cortex can be parcellated into multiple functional subfields, with each subfield making a distinct contribution to sound processing. For example, primary fields consisting of primary auditory cortex and anterior auditory field are the first to receive information from the thalamus, and the neurons in each of these fields have different properties in terms of latency and response duration. Non-primary auditory fields consist of secondary auditory cortex, which is involved in object recognition and emotional conditioning, while dorsal auditory fields are more responsive during locomotion and spatial tasks. What is currently unknown is how the structure of each auditory cortical subfield relates to function. Thus, it is imperative to understand how anatomical substrates that make up each field contribute to function. Summary: In this review, we suggest that myelin may serve as a structural anchor for the organization of auditory cortical subfields. Myelination patterns among mammals that have been studied (primates, carnivores, rodents, and bats) show that primary auditory cortical fields are more heavily myelinated than non-primary auditory cortical fields, and upper cortical layers are less myelinated than middle and deep layers. Myelin also demonstrates experience-dependent plasticity and can be measured with a variety of invasive and noninvasive methods, and demyelination has been linked to cognitive decline. Conversely, the archicortex is lightly myelinated, and we speculate that because myelin inhibits axonal and synaptic plasticity, it would not be advantageous for the archicortex to be myelin-dense, as it has greater requirements for flexibility for learning and memory. Key Messages: This is the first review, to our knowledge, that uses a comprehensive comparative approach across mammals to determine the distribution of myelin across auditory cortical subfields. We argue that a detailed map of the myeloarchitecture of the auditory cortex must be directly aligned to the functional maps of the auditory cortex to account for individual variability and identify subfields accurately. Furthermore, myelin maps need to be compared with other anatomical markers as well to improve our understanding of the role of myelin. Finally, a detailed histological myelin map can serve as a ground truth for comparisons to noninvasive measures of myelin.

Ultrasound localization microscopy (ULM) is an emerging imaging modality that resolves microvasculature in deep tissues with high spatial resolution. However, existing preclinical ULM applications are largely constrained to anesthetized animals, introducing confounding vascular effects such as vasodilation and altered hemodynamics. As such, ULM quantifications (e.g., vessel diameter, density, and flow velocity) may be confounded by the use of anesthesia, undermining the usefulness of ULM in practice. Here we introduce a method to address this limitation and achieve ULM imaging in awake mouse brain. Pupillary monitoring was used to support the presence of the awake state during ULM imaging. Vasodilation induced by isoflurane was observed by ULM. Upon recovery to the awake state, reductions in vessel density and flow velocity were observed across different brain regions. In the cortex, the effects induced by isoflurane are more pronounced on venous flow than on arterial flow. In addition, serial in vivo imaging of the same animal brain at weekly intervals demonstrated the highly robust longitudinal imaging capability of the proposed technique. The consistency was further verified through quantitative analysis on individual vessels, cortical regions of arteries and veins, and subcortical regions. This study demonstrates longitudinal ULM imaging in the awake mouse brain, which is crucial for many ULM brain applications that require awake and behaving animals.

Polychlorinated biphenyls (PCBs), a class of persistent endocrine-disrupting chemicals, continue to pose significant risks to human and environmental health due to their widespread distribution, lipophilicity, and ability to bioaccumulate. Of particular concern is exposure during critical periods of neurodevelopment, which has been associated with long-lasting effects on sensory systems, including auditory processing. This review elaborates findings from both human epidemiological studies and animal models to examine the effects of PCBs on auditory function across the peripheral and central auditory pathways. Evidence indicates that PCB exposure during gestation and early postnatal life can lead to permanent auditory deficits. At the level of the auditory periphery, reductions in distortion-product otoacoustic emissions (DPOAEs) and auditory brainstem responses (ABRs) suggest cochlear outer hair cell dysfunction, potentially mediated by oxidative stress. Centrally, alterations in the primary auditory cortex and inferior colliculus have been observed, including disrupted tonotopic organization, excitation–inhibition imbalance, and impaired neuroplasticity. Notably, such central neural changes can occur out of proportion to abnormalities in ABRs, pointing to central auditory vulnerabilities. Epidemiological data in humans further support these findings, with certain PCB congeners linked to a significantly elevated risk of hearing impairment in children. PCB exposure coupled with loud noise exposure, which is growing in prevalence, leads to cumulative deficits in auditory processing. Together, these findings highlight the multi-level impact of PCB exposure on the auditory system and highlight the need for further investigation into the molecular and circuit-level mechanisms underlying these effects. Understanding the actions of PCB congeners on the auditory system in various human population cohorts is important to inform risk assessment and guide future public health policies.

GABAergic neurons in the inferior colliculus (IC) play a crucial role in auditory processing by extracting specific features of sounds (Ono et al., 2005). The Gad67-GFP mouse model developed by Tamamaki et al. in 2003 on a Swiss background facilitates studying these neurons by using a green fluorescent protein that is expressed endogenously via the GAD67 promoter. Unfortunately, this mouse suffers from accelerated aging-related hearing loss, limiting its utility in studying the auditory system. Here, we report the results of an 8-generation backcross of this line onto CBA/CaJ mice, which produces mice with stable low-threshold hearing while retaining GFP expression in GAD+ neurons. Additionally, this study investigates mechanisms that underlie hearing loss in the Gad67-GFP mouse model by focusing specifically on cochlear hair cells (HCs) and ribbon synapses, which may contribute to both model-specific hearing loss and clinical disorders like presbycusis. Findings revealed the newly generated F1 mouse model that resulted from the Gad67-GFP x CBA/CaJ backcross maintained better hearing thresholds when compared to ABR data for Gad67 and Swiss mice and very closely resembled those of the CBA/CaJ mice, mirroring progression of presbycusis in humans. Additionally, all morphological changes observed in cochlear structure correlated to ABR thresholds. F1 mice continued maintained expression of the GAD67 promoter in the IC via immunostaining.

To navigate real-world listening conditions, the auditory system relies on the integration of multiple sources of information. However, to avoid inappropriate cross-talk between inputs, highly connected neural systems need to strike a balance between integration and segregation. Here, we develop a novel approach to examine how repeated neurochemical modules in the mouse inferior colliculus lateral cortex (LC) allow controlled integration of its multimodal inputs. The LC had been impossible to study via imaging because it is buried in a sulcus. Therefore we coupled two-photon microscopy with the use of a microprism to reveal the first-ever sagittal views of the LC to examine neuronal responses with respect to its neurochemical motifs under anesthetized and awake conditions. This approach revealed marked differences in the acoustic response properties of LC and neighboring nonlemniscal portions of the inferior colliculus. In addition, we observed that the module and matrix cellular motifs of the LC displayed distinct somatosensory and auditory responses. Specifically, neurons in modules demonstrated primarily offset responses to acoustic stimuli with enhancement in responses to bimodal stimuli, whereas matrix neurons showed onset response to acoustic stimuli and suppressed responses to bimodal stimulation. Thus, this new approach revealed that the repeated structural motifs of the LC permit functional integration of multimodal inputs while retaining distinct response properties.

BACKGROUND:This study investigated the potential of phosphorylated plasma Tau217 ratio (pTau217R) and plasma amyloid beta (Aβ) 42/Aβ40 in predicting brain amyloid levels measured by positron emission tomography (PET) Centiloid (CL) for Alzheimer's disease (AD) staging and screening. METHODS:Quantification of plasma pTau217R and Aβ42/Aβ40 employed immunoprecipitation-mass spectrometry. CL prediction models were developed on a cohort of 904 cognitively unimpaired, preclinical and early AD subjects and validated on two independent cohorts. RESULTS:Models integrating pTau217R outperformed Aβ42/Aβ40 alone, predicting amyloid levels up to 89.1 CL. High area under the receiver operating characteristic curve (AUROC) values (89.3% to 94.7%) were observed across a broad CL range (15 to 90). Utilizing pTau217R-based models for low amyloid levels reduced PET scans by 70.5% to 78.6%. DISCUSSION:pTau217R effectively predicts brain amyloid levels, surpassing cerebrospinal fluid Aβ42/Aβ40's range. Combining it with plasma Aβ42/Aβ40 enhances sensitivity for low amyloid detection, reducing unnecessary PET scans and expanding clinical utility. CLINICALTRIALS: GOV IDENTIFIERS:NCT02956486 (MissionAD1), NCT03036280 (MissionAD2), NCT04468659 (AHEAD3-45), NCT03887455 (ClarityAD) HIGHLIGHTS: Phosphorylated plasma Tau217 ratio (pTau217R) effectively predicts amyloid-PET Centiloid (CL) across a broad spectrum. Integrating pTau217R with Aβ42/Aβ40 extends the CL prediction upper limit to 89.1 CL. Combined model predicts amyloid status with high accuracy, especially in cognitively unimpaired individuals. This model identifies subjects above or below various CL thresholds with high accuracy. pTau217R-based models significantly reduce PET scans by up to 78.6% for screening out individuals with no/low amyloid.

Increasing evidence has suggested a link between cerebrovascular disease and the cognitive impairment of patients with Alzheimer’s disease. However, cerebrovascular disease and Alzheimer’s disease share several risk factors making it unclear whether cerebrovascular deficiency and Alzheimer’s disease pathology have additive effects on cognition or if cerebrovascular impairment merely exacerbates existing Alzheimer’s disease-associated cognitive decline. Additionally, early-stage Alzheimer’s disease typically involves hippocampal atrophy, complicating most efforts to elucidate the interplay between cerebral microvascular function and Alzheimer’s disease progression due to the necessity of probing deep-brain structures. The purpose of this study was to demonstrate the use of ultrasound localization microscopy on the 5xFAD mouse model of Alzheimer’s disease (3-month and 6-month-old cohorts) in comparison to age-matched wild-type controls, revealing microvascular scale reconstructions throughout the whole brain depth, to visualize and quantify Alzheimer’s disease-associated vascular impairments. We found that functional decreases in hippocampal and entorhinal flow velocity preceded structural derangements in regional vascular density. In addition to providing global vascular quantifications of deep brain structures with a high local resolution, this technology also permitted hierarchical analysis of individual vessels and, in some cases, potentially allowed for decoupling of arteriole and venous flow contributions. Co-registered histological sectioning confirmed the regionalized hypo-perfusion deficits seen on ultrasound imaging, which were co-localized with amyloid beta plaque deposition. Significance statement The study of the impact of cerebrovascular disease on Alzheimer’s disease pathology is complicated by the need to image deep-brain structures with high vascular fidelity. We demonstrate that ultrasound localization microscopy, a super-resolution acoustic imaging technique, is capable of imaging cerebrovasculature throughout the entire depth of the brain at a microvascular scale. This technology was applied to the 5xFAD mouse model of Alzheimer’s disease, where it was found that 5xFAD animals have significant impairments in vascular function in the entorhinal cortex and hippocampal region in comparison to age matched controls at the 3-month timepoint. Structural derangements in cerebrovasculature were only observed in the 6-month-old animal cohorts, with a maintained impairment in vascular function.

BACKGROUND:This study examines whether phosphorylated plasma Tau217 ratio (pTau217R) can predict tau accumulation in different brain regions, as measured by positron emission tomography (PET) standardized uptake value ratio (SUVR), for staging Alzheimer's disease (AD). METHODS:Plasma pTau217R was measured using immunoprecipitation-mass spectrometry. Models for predicting tau PET SUVR, developed with 144 early AD individuals using [18F]MK6240, were validated in two validation sets, VS1 (98 early AD) and VS2 (47 preclinical/early AD with a different tracer, flortaucipir (Tauvid)), all amyloid-beta positive (Aβ+). RESULTS:The pTau217R-based model predicted tau levels up to an SUVR of 2 in multiple brain regions, effectively assessing tau status at different tau levels with receiver operating characteristic (ROC) curve areas of 0.84-0.95 in VS1 and 0.71-0.88 in VS2 (using a different tracer). It reduced PET scan needs by 65% while maintaining 95% sensitivity. DISCUSSION:PTau217R reliably predicts regional tau accumulation in early AD, reducing reliance on tau PET scans and broadening its clinical application. CLINICAL TRIAL REGISTRATION NUMBER:NCT03887455 (ClarityAD) HIGHLIGHTS: Developed a model using plasma pTau217R to predict tau levels across brain regions. pTau217R model outperformed models based on clinical, MRI, and other blood biomarkers. The model reliably predicted tau levels exceeding tau positivity and higher thresholds. Screening with pTau217R could reduce tau PET scans by 65% at 95% sensitivity. pTau217R model aids in disease staging and monitoring in early AD.

AbstractPlasma pTau181, a marker of amyloid and tau burden, was evaluated as a prognostic predictor of clinical decline and Alzheimer's disease (AD) progression of amyloid‐positive (Aβ+) patients with mild cognitive impairment (MCI). The training cohort for constructing the Bayesian prediction models comprised 135 Aβ+ MCI clinical trial placebo subjects. Performance was evaluated in two validation cohorts. An 18‐month ≥1 increase in the Clinical Dementia Rating Sum of Boxes was the clinical decline criterion. Baseline plasma pTau181 concentration matched clinical assessments’ prediction performance. Adding pTau181 to clinical assessments significantly improved the prediction of an 18‐month clinical decline and the 36‐month progression from Aβ+ MCI to AD. The area under the receiver operating characteristic curve for the latter increased from 71.8% to 79%, and the hazard ratio for time‐to‐progression improved from 2.26 to 3.11 (p < 0.0001). Baseline plasma pTau181 has the potential for identifying Aβ+ MCI subjects with faster clinical decline over time.Highlights This study assessed pTau181 as a prognostic predictor of 18‐month clinical decline and extended progression to Alzheimer's disease (AD) in amyloid‐positive patients with mild cognitive impairment (Aβ+ MCI). The research findings underscore the promise of baseline plasma pTau181 as a screening tool for identifying Aβ+ MCI individuals with accelerated clinical decline within a standard 18‐month clinical trial period. The predictive accuracy is notably enhanced when combined with clinical assessments. Similar positive outcomes were noted in forecasting the extended progression of Aβ+ MCI subjects to AD.

There are no currently approved drug therapies to assist in the recovery from aphasia. However, there is suggestive evidence from the animal literature that behavioral training, coupled with pharmacotherapy, can enhance recovery from motor stroke. Most of the pharmacologic interventions used in these studies involved sympathomimetic drugs, although other mechanisms were used as well, such enhancement in cholinergic signaling. A number of studies have been performed using human patients with aphasia. These studies are also suggestive of enhancement in recovery when sympathomimetic drugs are used in conjunction with speech and language therapy. There are also data to support cholinesterase inhibitors memantine and piracetam. In addition, other drugs, such as barbiturates, antipsychotics, and anticonvulsants, may slow recovery. Although more work is needed, these studies, which are critically reviewed herein, suggest that thoughtful use of pharmacologic agents in conjunction with speech and language therapy can enhance recovery from aphasic stroke.

BACKGROUND:Models for forecasting individual clinical progression trajectories in early Alzheimer's disease (AD) are needed for optimizing clinical studies and patient monitoring. METHODS:Prediction models were constructed using a clinical trial training cohort (TC; n = 934) via a gradient boosting algorithm and then evaluated in two validation cohorts (VC 1, n = 235; VC 2, n = 421). Model inputs included baseline clinical features (cognitive function assessments, APOE ε4 status, and demographics) and brain magnetic resonance imaging (MRI) measures. RESULTS:The model using clinical features achieved R2 of 0.21 and 0.31 for predicting 2-year cognitive decline in VC 1 and VC 2, respectively. Adding MRI features improved the R2 to 0.29 in VC 1, which employed the same preprocessing pipeline as the TC. Utilizing these model-based predictions for clinical trial enrichment reduced the required sample size by 20% to 49%. DISCUSSION:Our validated prediction models enable baseline prediction of clinical progression trajectories in early AD, benefiting clinical trial enrichment and various applications.

Understanding functional correlations between the activities of neuron populations is vital for the analysis of neuronal networks. Analyzing large-scale neuroimaging data obtained from hundreds of neurons simultaneously poses significant visualization challenges. We developed V-NeuroStack, a novel network visualization tool to visualize data obtained using calcium imaging of spontaneous activity of neurons in a mouse brain slice as well as in vivo using two-photon imaging. V-NeuroStack creates 3D time stacks by stacking 2D time frames for a time-series dataset. It provides a web interface to explore and analyze data using both 3D and 2D visualization techniques. Previous attempts to analyze such data have been limited by the tools available to visualize large numbers of correlated activity traces. V-NeuroStack's 3D view is used to explore patterns in dynamic large-scale correlations between neurons over time. The 2D view is used to examine any timestep of interest in greater detail. Furthermore, a dual-line graph provides the ability to explore the raw and first-derivative values of activity from an individual or a functional cluster of neurons. V-NeuroStack can scale to datasets with at least a few thousand temporal snapshots. It can potentially support future advancements in in vitro and in vivo data capturing techniques to bring forth novel hypotheses by allowing unambiguous visualization of massive patterns in neuronal activity data.

Ultrafast ultrasound imaging is essential for advanced ultrasound imaging techniques such as ultrasound localization microscopy (ULM) and functional ultrasound (fUS). Current ultrafast ultrasound imaging is challenged by the ultrahigh data bandwidth associated with the radio frequency (RF) signal, and by the latency of the computationally expensive beamforming process. As such, continuous ultrafast data acquisition and beamforming remain elusive with existing software beamformers based on CPUs or GPUs. To address these challenges, the proposed work introduces a novel method of implementing an ultrafast ultrasound beamformer specifically for ultrafast plane wave imaging (PWI) on a field programmable gate array (FPGA) by using high-level synthesis. A parallelized implementation of the beamformer on a single FPGA was proposed by 1) utilizing a delay compression technique to reduce the delay profile size, which enables both run-time pre-calculated delay profile loading from external memory and delay reuse, 2) vectorizing channel data fetching which is enabled by delay reuse, and 3) using fixed summing networks to reduce consumption of logic resources. Our proposed method presents two unique advantages over current FPGA beamformers: 1) high scalability that allows fast adaptation to different FPGA resources and beamforming speed demands by using Xilinx High-Level Synthesis as the development tool, and 2) allow a compact form factor design by using a single FPGA to complete the beamforming instead of multiple FPGAs. Current Xilinx FPGAs provide the capabilities of connecting up to 1024 ultrasound channels with a single FPGA and the newest JESD204B interface analog front end (AFE). This channel count is much more than the channel count needed by current linear arrays, which normally have 128 or 256 channels. With the proposed method, a sustainable average beamforming rate of 4.83 G samples/second in terms of input raw RF sample was achieved. The resulting image quality of the proposed beamformer was compared with the software beamformer on the Verasonics Vantage system for both phantom imaging and in vivo imaging of a mouse brain. Multiple imaging schemes including B-mode, power Doppler and ULM were assessed to verify that the image quality was not compromised for speed.

The amyloid beta, tau, neurodegenerative markers framework has been proposed to serve as a system to classify and combine biomarkers for Alzheimer's Disease (AD). Although cerebrospinal (CSF) fluid AT (amyloid beta and tau)-based biomarkers have a well-established track record to distinguish AD from control subjects and to predict conversion from mild cognitive impairment (MCI) to AD, there is not an established non-tau based neurodegenerative ("N") marker from CSF. Here, we examine the ability of several candidate peptides in the CSF to serve as "N" markers to both classify disease state and predict MCI to AD conversion. We observed that although many putative N markers involved in synaptic processing and neuroinflammation were able to, when examined in isolation, distinguish MCI converters from non-converters, a derivative from VGF, when combined with AT markers, most strongly enhanced prediction of MCI to AD conversion. Low CSF VGF levels were also predictive of MCI to dementia conversion in the setting of normal AT markers, suggesting that it may serve as a very early predictor of dementia conversion. Other markers derived from neuronal pentraxin 2, GAP-43 and a 14-3-3 protein were also able to enhance MCI to AD prediction when used as a marker of neurodegeneration, but VGF had the highest predictive capacity. Thus, we propose that low levels of VGF in CSF may serve as "N" in the amyloid beta, tau, neurodegenerative markers framework to enhance the prediction of MCI to AD conversion.

Tinnitus affects roughly 15-20% of the population while severely impacting 10% of those afflicted. Tinnitus pathology is multifactorial, generally initiated by damage to the auditory periphery, resulting in a cascade of maladaptive plastic changes at multiple levels of the central auditory neuraxis as well as limbic and non-auditory cortical centers. Using a well-established condition-suppression model of tinnitus, we measured tinnitus-related changes in the microcircuits of excitatory/inhibitory neurons onto layer 5 pyramidal neurons (PNs), as well as changes in the excitability of vasoactive intestinal peptide (VIP) neurons in primary auditory cortex (A1). Patch-clamp recordings from PNs in A1 slices showed tinnitus-related increases in spontaneous excitatory postsynaptic currents (sEPSCs) and decreases in spontaneous inhibitory postsynaptic currents (sIPSCs). Both measures were directly correlated to the rat’s behavioral evidence of tinnitus. Tinnitus-related changes in PN excitability were independent of changes in A1 excitatory or inhibitory cell numbers. VIP neurons, part of an A1 local circuit that can disinhibit layer 5 PNs, showed significant tinnitus-related increases in excitability that directly correlated with the rat’s behavioral tinnitus score. That PN and VIP changes directly correlated to tinnitus behavior, suggests an essential role in A1 tinnitus pathology. Tinnitus-related A1 changes were similar to findings in studies of neuropathic pain in somatosensory cortex suggesting a common pathology of these troublesome perceptual impairments. Improved understanding between excitatory, inhibitory and disinhibitory sensory cortical circuits can serve as a model for testing therapeutic approaches to the treatment of tinnitus and chronic pain. Key points Identify tinnitus-related changes in synaptic function of specific neuronal subtypes in a reliable animal model of tinnitus. Finding show direct and indirect tinnitus-related losses of normal inhibitory function at A1 layer 5 pyramidal cells, and increased VIP excitability. Findings are similar to what has been shown for neuropathic pain suggesting that restoring normal inhibitory function at synaptic inputs onto A1 pyramidal neurons could conceptually reduce tinnitus discomfort.

Exposure to combinations of environmental toxins is growing in prevalence; and therefore, understanding their interactions is of increasing societal importance. Here, we examined the mechanisms by which two environmental toxins, polychlorinated biphenyls (PCBs) and high-amplitude acoustic noise, interact to produce dysfunction in central auditory processing. PCBs are well established to impose negative developmental impacts on hearing. However, it is not known whether developmental exposure to this ototoxin alters the sensitivity to other ototoxic exposures later in life. Here, male mice were exposed to PCBs in utero, and later as adults were exposed to 45 min of high-intensity noise. We then examined the impacts of the two exposures on hearing and the organization of the auditory midbrain using two-photon imaging and analysis of the expression of mediators of oxidative stress. We observed that developmental exposure to PCBs blocked hearing recovery from acoustic trauma.In vivotwo-photon imaging of the inferior colliculus (IC) revealed that this lack of recovery was associated with disruption of the tonotopic organization and reduction of inhibition in the auditory midbrain. In addition, expression analysis in the inferior colliculus revealed that reduced GABAergic inhibition was more prominent in animals with a lower capacity to mitigate oxidative stress. These data suggest that combined PCBs and noise exposure act nonlinearly to damage hearing and that this damage is associated with synaptic reorganization, and reduced capacity to limit oxidative stress. In addition, this work provides a new paradigm by which to understand nonlinear interactions between combinations of environmental toxins.SIGNIFICANCE STATEMENTExposure to common environmental toxins is a large and growing problem in the population. This work provides a new mechanistic understanding of how the prenatal and postnatal developmental changes induced by polychlorinated biphenyls (PCBs) could negatively impact the resilience of the brain to noise-induced hearing loss (NIHL) later in adulthood. The use of state-of-the-art tools, includingin vivomultiphoton microscopy of the midbrain helped in identifying the long-term central changes in the auditory system after the peripheral hearing damage induced by such environmental toxins. In addition, the novel combination of methods employed in this study will lead to additional advances in our understanding of mechanisms of central hearing loss in other contexts.