Loudness and auditory steady-state responses in normal-hearing subjects

Clinical and investigational tools for monitoring noise-induced hyperacusis

Hyperacusis is a recognized perceptual consequence of acoustic overexposure that can lead to debilitating psychosocial effects. Despite the profound impact of hyperacusis on quality of life, clinicians and researchers lack objective biomarkers and standardized protocols for its assessment. Outcomes of conventional audiologic tests are highly variable in the hyperacusis population and do not adequately capture the multifaceted nature of the condition on an individual level. This presents challenges for the differential diagnosis of hyperacusis, its clinical surveillance, and evaluation of new treatment options. Multiple behavioral and objective assays are emerging as contenders for inclusion in hyperacusis assessment protocols but most still await rigorous validation. There remains a pressing need to develop tools to quantify common nonauditory symptoms, including annoyance, fear, and pain. This review describes the current literature on clinical and investigational tools that have been used to diagnose and monitor hyperacusis, as well as those that hold promise for inclusion in future trials.

Neural Representation of Loudness: Cortical Evoked Potentials in an Induced Loudness Reduction Experiment

Loudness context effects comprise differences in judgments of the loudness of a target stimulus depending on the presence of a preceding inducer tone. Interstimulus intervals (ISIs) between inducer tone and target tone of about 200 ms and above cause an induced loudness reduction (ILR) of the target tone. As the ILR increases, respectively, the perceived loudness of the target stimuli decreases with increasing ISI. This in turn means that identical stimuli in a different context have a differently perceived loudness. A correlation between specific characteristics in the electroencephalography responses and perceived loudness in an ILR experiment would therefore provide a neurophysiological indication of loudness processing beyond a neural representation of stimulus intensity only. To examine if such a correlation exists, we investigated cortical electroencephalography responses in a latency range from 75 to 510 ms during a psychoacoustical ILR experiment with different ISIs. With increasing ISI, the strength of the N1-P2 deflection of the respective electroencephalography response decreases similarly to the loudness perception of the target tone pulse. This indicates a representation based on loudness rather than on intensity at the corresponding processing stage.

On the loudness of low-frequency sounds with fluctuating amplitudes

Some environmental sounds have strong amplitude fluctuations that may affect their perceived loudness and annoyance. This study assessed the effect of beat rate (f_b) and center frequency (f_c) on the loudness of low-frequency beating tones. The loudness of two-tone complexes (TTCs) with f_c = 40, 63, 80, and 1000 Hz was matched with that of unmodulated tones (UTs). Frequency differences between the TTC components, corresponding to f_b = 1, 2, 5, and 12 Hz, were used. To compensate for the steep decline in hearing sensitivity below 100 Hz, prior to the loudness match, subjects adjusted the relative levels (ΔL) of the TTC components to give maximum beat perception. Twenty-four normal-hearing subjects were tested. The values of ΔL giving best beats were well predicted from the transfer function of the middle ear and the estimated shapes of the auditory filters, assuming that the auditory filter whose output dominated the beat percept was centered somewhat above f_c. At the same root-mean-square level and independent of f_c, TTCs were perceived as louder than UTs for f_b ≤ 2 Hz, had roughly equal loudness to UTs for f_b = 5 Hz, and were less loud than UTs for f_b = 12 Hz.

Enhanced Central Neural Gain Compensates Acoustic Trauma-induced Cochlear Impairment, but Unlikely Correlates with Tinnitus and Hyperacusis

For successful future therapeutic strategies for tinnitus and hyperacusis, a subcategorization of both conditions on the basis of differentiated neural correlates would be of invaluable advantage. In the present study, we used our refined operant conditioning animal model to divide equally noise-exposed rats into groups with either tinnitus or hyperacusis, with neither condition, or with both conditions co-occurring simultaneously. Using click stimulus and noise burst-evoked Auditory Brainstem Responses (ABR) and Distortion Product Otoacoustic Emissions, no hearing threshold difference was observed between any of the groups. However, animals with neither tinnitus nor hyperacusis responded to noise trauma with shortened ABR wave I and IV latencies and elevated central neuronal gain (increased ABR wave IV/I amplitude ratio), which was previously assumed in most of the literature to be a neural correlate for tinnitus. In contrast, animals with tinnitus had reduced neural response gain and delayed ABR wave I and IV latencies, while animals with hyperacusis showed none of these changes. Preliminary studies, aimed at establishing comparable non-invasive objective tools for identifying tinnitus in humans and animals, confirmed reduced central gain and delayed response latency in human and animals. Moreover, the first ever resting state functional Magnetic Resonance Imaging (rs-fMRI) analyses comparing humans and rats with and without tinnitus showed reduced rs-fMRI activities in the auditory cortex in both patients and animals with tinnitus. These findings encourage further efforts to establish non-invasive diagnostic tools that can be used in humans and animals alike and give hope for differentiated classification of tinnitus and hyperacusis.

Auditory Brainstem and Middle Latency Responses Measured Pre- and Posttreatment for Hyperacusic Hearing-Impaired Persons Successfully Treated to Improve Sound Tolerance and to Expand the Dynamic Range for Loudness: Case Evidence

In this report of three cases, we consider electrophysiologic measures from three hyperacusic hearing-impaired individuals who, prior to treatment to expand their dynamic ranges for loudness, were problematic hearing aid candidates because of their diminished sound tolerance and reduced dynamic ranges. Two of these individuals were treated with structured counseling combined with low-level broadband sound therapy from bilateral sound generators and the third case received structured counseling in combination with a short-acting placebo sound therapy. Each individual was highly responsive to his or her assigned treatment as revealed by expansion of the dynamic range by at least 20 dB at one or more frequencies posttreatment. Of specific interest in this report are their latency and amplitude measures taken from tone burst-evoked auditory brainstem response (ABR) and cortically derived middle latency response (MLR) recordings, measured as a function of increasing loudness at 500 and 2,000 Hz pre- and posttreatment. The resulting ABR and MLR latency and amplitude measures for each case are considered here in terms of pre- and posttreatment predictions. The respective pre- and posttreatment predictions anticipated larger pretreatment response amplitudes and shorter pretreatment response latencies relative to typical normal control values and smaller normative-like posttreatment response amplitudes and longer posttreatment response latencies relative to the corresponding pretreatment values for each individual. From these results and predictions, we conjecture about the neural origins of the hyperacusis conditions (i.e., brainstem versus cortical) and the neuronal sites responsive to treatment. The only consistent finding in support of the pre- and posttreatment predictions and, thus, the strongest index of hyperacusis and positive treatment-related effects was measured for MLR latency responses for wave Pa at 2,000 Hz. Other response indices, including ABR wave V latency and wave V-V' amplitude and MLR wave Na-Pa amplitude for 500 and 2,000 Hz, appear either ambiguous across and/or within these individuals. Notwithstanding significant challenges for interpreting these findings, including associated confounding effects of their sensorineural hearing losses and differences in the presentation levels of the toneburst stimuli used to collect these measures for each individual, our limited analyses of three cases suggest measures of MLR wave Pa latency at 2,000 Hz (reflecting cortical contributions) may be a promising objective indicator of hyperacusis and dynamic range expansion treatment effects.

Frequency characteristics of neuromagnetic auditory steady-state responses to sinusoidally amplitude-modulated sweep tones

OBJECTIVE

This study aimed to capture the neuronal frequency characteristics, as indexed by the auditory steady-state response (ASSR), relative to physical characteristics of constant sound pressure levels (SPLs). Relationship with perceptual characteristics (loudness model) was also examined.

METHODS

Neuromagnetic 40-Hz ASSR was recorded in response to sinusoidally amplitude-modulated sweep tones with carrier frequency covering the frequency range of 0.1-12.5kHz. Sound intensity was equalized at 50-, 60-, and 70-dB SPL with an accuracy of ±0.5-dB SPL at the phasic peak of the modulation frequency. Corresponding loudness characteristics were modeled by substituting the detected individual hearing thresholds into a standard formula (ISO226:2003(E)).

RESULTS

The strength of the ASSR component was maximum at 0.5kHz, and it decreased linearly on logarithmic scale toward lower and higher frequencies. Loudness model was plateaued between 0.5 and 4kHz.

CONCLUSIONS

Frequency characteristics of the ASSR were not equivalent to those of SPL and loudness model. Factors other than physical and perceptual frequency characteristics may contribute to characterizing the ASSR.

SIGNIFICANCE

The results contribute to the discussion of the most efficient signal summation for the generation of the ASSR at 0.5kHz and efficient neuronal processing at higher frequencies, which require less energy to retain equal perception.

Loudness modulation after transient and permanent hearing loss: implications for tinnitus and hyperacusis

Loudness is the primary perceptual correlate of sound intensity. The relationship between sound intensity and loudness is not fixed, and can be modified by short-term sound deprivation or stimulation. Deprivation increases sound sensitivity, whereas stimulation decreases it. We review the effects of short-term auditory deprivation and stimulation on the auditory central nervous system of humans and animals, and we extend the discussion to permanent auditory deprivation (hearing loss) and auditory pathologies of loudness perception. Although there is sufficient evidence to conclude that loudness can be modulated in normal hearing listeners by temporary sound deprivation and stimulation, evidence is scanter for the hearing-impaired listeners. In addition, cortical effects of sound deprivation and stimulation in humans, which may correlate with loudness coding, are still largely unknown and should be the target of future research.