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Schirmer J, Wolpert S, Dapper K, Rühle M, Wertz J, Wouters M, Eldh T, Bader K, Singer W, Gaudrain E, Başkent D, Verhulst S, Braun C, Rüttiger L, Munk MHJ, Dalhoff E, Knipper M. Neural Adaptation at Stimulus Onset and Speed of Neural Processing as Critical Contributors to Speech Comprehension Independent of Hearing Threshold or Age. J Clin Med 2024; 13:2725. [PMID: 38731254 PMCID: PMC11084258 DOI: 10.3390/jcm13092725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Revised: 04/24/2024] [Accepted: 04/26/2024] [Indexed: 05/13/2024] Open
Abstract
Background: It is assumed that speech comprehension deficits in background noise are caused by age-related or acquired hearing loss. Methods: We examined young, middle-aged, and older individuals with and without hearing threshold loss using pure-tone (PT) audiometry, short-pulsed distortion-product otoacoustic emissions (pDPOAEs), auditory brainstem responses (ABRs), auditory steady-state responses (ASSRs), speech comprehension (OLSA), and syllable discrimination in quiet and noise. Results: A noticeable decline of hearing sensitivity in extended high-frequency regions and its influence on low-frequency-induced ABRs was striking. When testing for differences in OLSA thresholds normalized for PT thresholds (PTTs), marked differences in speech comprehension ability exist not only in noise, but also in quiet, and they exist throughout the whole age range investigated. Listeners with poor speech comprehension in quiet exhibited a relatively lower pDPOAE and, thus, cochlear amplifier performance independent of PTT, smaller and delayed ABRs, and lower performance in vowel-phoneme discrimination below phase-locking limits (/o/-/u/). When OLSA was tested in noise, listeners with poor speech comprehension independent of PTT had larger pDPOAEs and, thus, cochlear amplifier performance, larger ASSR amplitudes, and higher uncomfortable loudness levels, all linked with lower performance of vowel-phoneme discrimination above the phase-locking limit (/i/-/y/). Conslusions: This study indicates that listening in noise in humans has a sizable disadvantage in envelope coding when basilar-membrane compression is compromised. Clearly, and in contrast to previous assumptions, both good and poor speech comprehension can exist independently of differences in PTTs and age, a phenomenon that urgently requires improved techniques to diagnose sound processing at stimulus onset in the clinical routine.
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Affiliation(s)
- Jakob Schirmer
- Department of Otolaryngology, Head and Neck Surgery, University of Tübingen, Elfriede-Aulhorn-Str. 5, 72076 Tübingen, Germany; (J.S.); (S.W.); (K.D.); (M.R.); (J.W.); (T.E.); (K.B.); (W.S.); (L.R.)
| | - Stephan Wolpert
- Department of Otolaryngology, Head and Neck Surgery, University of Tübingen, Elfriede-Aulhorn-Str. 5, 72076 Tübingen, Germany; (J.S.); (S.W.); (K.D.); (M.R.); (J.W.); (T.E.); (K.B.); (W.S.); (L.R.)
| | - Konrad Dapper
- Department of Otolaryngology, Head and Neck Surgery, University of Tübingen, Elfriede-Aulhorn-Str. 5, 72076 Tübingen, Germany; (J.S.); (S.W.); (K.D.); (M.R.); (J.W.); (T.E.); (K.B.); (W.S.); (L.R.)
- Department of Biology, Technical University Darmstadt, 64287 Darmstadt, Germany
| | - Moritz Rühle
- Department of Otolaryngology, Head and Neck Surgery, University of Tübingen, Elfriede-Aulhorn-Str. 5, 72076 Tübingen, Germany; (J.S.); (S.W.); (K.D.); (M.R.); (J.W.); (T.E.); (K.B.); (W.S.); (L.R.)
| | - Jakob Wertz
- Department of Otolaryngology, Head and Neck Surgery, University of Tübingen, Elfriede-Aulhorn-Str. 5, 72076 Tübingen, Germany; (J.S.); (S.W.); (K.D.); (M.R.); (J.W.); (T.E.); (K.B.); (W.S.); (L.R.)
| | - Marjoleen Wouters
- Department of Information Technology, Ghent University, Technologiepark 126, 9052 Zwijnaarde, Belgium; (M.W.); (S.V.)
| | - Therese Eldh
- Department of Otolaryngology, Head and Neck Surgery, University of Tübingen, Elfriede-Aulhorn-Str. 5, 72076 Tübingen, Germany; (J.S.); (S.W.); (K.D.); (M.R.); (J.W.); (T.E.); (K.B.); (W.S.); (L.R.)
| | - Katharina Bader
- Department of Otolaryngology, Head and Neck Surgery, University of Tübingen, Elfriede-Aulhorn-Str. 5, 72076 Tübingen, Germany; (J.S.); (S.W.); (K.D.); (M.R.); (J.W.); (T.E.); (K.B.); (W.S.); (L.R.)
| | - Wibke Singer
- Department of Otolaryngology, Head and Neck Surgery, University of Tübingen, Elfriede-Aulhorn-Str. 5, 72076 Tübingen, Germany; (J.S.); (S.W.); (K.D.); (M.R.); (J.W.); (T.E.); (K.B.); (W.S.); (L.R.)
| | - Etienne Gaudrain
- Lyon Neuroscience Research Center, Centre National de la Recherche Scientifique UMR5292, Inserm U1028, Université Lyon 1, Centre Hospitalier Le Vinatier-Bâtiment 462–Neurocampus, 95 Boulevard Pinel, 69675 Bron CEDEX, France;
- Department of Otorhinolaryngology, University Medical Center Groningen (UMCG), Hanzeplein 1, BB21, 9700 RB Groningen, The Netherlands;
| | - Deniz Başkent
- Department of Otorhinolaryngology, University Medical Center Groningen (UMCG), Hanzeplein 1, BB21, 9700 RB Groningen, The Netherlands;
| | - Sarah Verhulst
- Department of Information Technology, Ghent University, Technologiepark 126, 9052 Zwijnaarde, Belgium; (M.W.); (S.V.)
| | - Christoph Braun
- Magnetoencephalography-Centre and Hertie Institute for Clinical Brain Research, University of Tübingen, Otfried-Müller-Straße 27, 72076 Tübingen, Germany;
- Center for Mind and Brain Research, University of Trento, Palazzo Fedrigotti-corso Bettini 31, 38068 Rovereto, Italy
| | - Lukas Rüttiger
- Department of Otolaryngology, Head and Neck Surgery, University of Tübingen, Elfriede-Aulhorn-Str. 5, 72076 Tübingen, Germany; (J.S.); (S.W.); (K.D.); (M.R.); (J.W.); (T.E.); (K.B.); (W.S.); (L.R.)
| | - Matthias H. J. Munk
- Department of Biology, Technical University Darmstadt, 64287 Darmstadt, Germany
- Department of Psychiatry & Psychotherapy, University of Tübingen, Calwerstraße 14, 72076 Tübingen, Germany
| | - Ernst Dalhoff
- Department of Otolaryngology, Head and Neck Surgery, University of Tübingen, Elfriede-Aulhorn-Str. 5, 72076 Tübingen, Germany; (J.S.); (S.W.); (K.D.); (M.R.); (J.W.); (T.E.); (K.B.); (W.S.); (L.R.)
| | - Marlies Knipper
- Department of Otolaryngology, Head and Neck Surgery, University of Tübingen, Elfriede-Aulhorn-Str. 5, 72076 Tübingen, Germany; (J.S.); (S.W.); (K.D.); (M.R.); (J.W.); (T.E.); (K.B.); (W.S.); (L.R.)
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Stevenson LJ, Biagio-de Jager L, Graham MA, Swanepoel DW. Extended High-Frequency Audiometry for Ototoxicity Monitoring: A Longitudinal Evaluation of Drug-Resistant Tuberculosis Treatment. Am J Audiol 2023; 32:70-80. [PMID: 36490390 DOI: 10.1044/2022_aja-22-00039] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
PURPOSE The aim of this study was to describe extended high-frequency (EHF) pure-tone audiometry monitoring of ototoxicity in a longitudinal treatment program for drug-resistant tuberculosis (DRTB). METHOD This was a retrospective record review of longitudinal conventional (0.25-8 kHz) and EHF (9-16 kHz) audiometry for ototoxicity monitoring of DRTB patients undergoing treatment at community-based clinics between 2013 and 2017. Data from 69 patients with an average age of 37.9 years (SD = 11.2, range: 16.0-63.8 years) were included. Patients were assessed by primary health care audiologists (87%) or community health workers (13%) using portable audiological equipment. The average length of time between initial and exit assessments was 84.6 days (SD = 74.2, range: 2-335 days). RESULTS EHF ototoxicity of a mild or greater degree of hearing loss (> 25 dB HL in one or both ears across frequencies) was evident in 85.5% of patients' posttreatment, compared with 47.8% of patients across conventional frequencies. EHF audiometry demonstrated an ototoxic shift (American Speech-Language-Hearing Association criteria) in 56.5% of cases compared with 31.9% when only conventional audiometry was considered. Mean hearing deterioration for patients was significant across EHFs (9-16 kHz) bilaterally (p < .05). Absent EHF thresholds at the initial assessment, owing to maximum output limits, was a limitation that occurred most frequently at 16 kHz (17.4%, 24/138). CONCLUSIONS EHF audiometry is most sensitive for the early detection of ototoxicity and should be included in monitoring programs. Clinical ototoxicity monitoring protocols should consider shortened assessment approaches that target frequencies most sensitive to ototoxicity, including EHFs. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.21651242.
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Affiliation(s)
- Lucia Jane Stevenson
- Department of Speech-Language Pathology and Audiology, Faculty of Humanities, University of Pretoria, South Africa
| | - Leigh Biagio-de Jager
- Department of Speech-Language Pathology and Audiology, Faculty of Humanities, University of Pretoria, South Africa
| | - Marien Alet Graham
- Department of Science, Mathematics and Technology Education, Faculty of Education, University of Pretoria, South Africa
| | - De Wet Swanepoel
- Department of Speech-Language Pathology and Audiology, Faculty of Humanities, University of Pretoria, South Africa.,Ear Science Institute Australia, Perth, Western Australia
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Sanchez-Lopez R, Nielsen SG, El-Haj-Ali M, Bianchi F, Fereczkowski M, Cañete OM, Wu M, Neher T, Dau T, Santurette S. Auditory Tests for Characterizing Hearing Deficits in Listeners With Various Hearing Abilities: The BEAR Test Battery. Front Neurosci 2021; 15:724007. [PMID: 34658768 PMCID: PMC8512168 DOI: 10.3389/fnins.2021.724007] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Accepted: 08/11/2021] [Indexed: 11/15/2022] Open
Abstract
The Better hEAring Rehabilitation (BEAR) project aims to provide a new clinical profiling tool-a test battery-for hearing loss characterization. Although the loss of sensitivity can be efficiently measured using pure-tone audiometry, the assessment of supra-threshold hearing deficits remains a challenge. In contrast to the classical "attenuation-distortion" model, the proposed BEAR approach is based on the hypothesis that the hearing abilities of a given listener can be characterized along two dimensions, reflecting independent types of perceptual deficits (distortions). A data-driven approach provided evidence for the existence of different auditory profiles with different degrees of distortions. Ten tests were included in a test battery, based on their clinical feasibility, time efficiency, and related evidence from the literature. The tests were divided into six categories: audibility, speech perception, binaural processing abilities, loudness perception, spectro-temporal modulation sensitivity, and spectro-temporal resolution. Seventy-five listeners with symmetric, mild-to-severe sensorineural hearing loss were selected from a clinical population. The analysis of the results showed interrelations among outcomes related to high-frequency processing and outcome measures related to low-frequency processing abilities. The results showed the ability of the tests to reveal differences among individuals and their potential use in clinical settings.
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Affiliation(s)
- Raul Sanchez-Lopez
- Hearing Systems Section, Department of Health Technology, Technical University of Denmark, Kgs. Lyngby, Denmark,Interacoustics Research Unit, Kgs. Lyngby, Denmark,*Correspondence: Raul Sanchez-Lopez
| | - Silje Grini Nielsen
- Hearing Systems Section, Department of Health Technology, Technical University of Denmark, Kgs. Lyngby, Denmark
| | - Mouhamad El-Haj-Ali
- Institute of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Federica Bianchi
- Hearing Systems Section, Department of Health Technology, Technical University of Denmark, Kgs. Lyngby, Denmark,Oticon Medical, Smørum, Denmark
| | - Michal Fereczkowski
- Hearing Systems Section, Department of Health Technology, Technical University of Denmark, Kgs. Lyngby, Denmark,Institute of Clinical Research, University of Southern Denmark, Odense, Denmark,Research Unit for ORL-Head & Neck Surgery and Audiology, Odense University Hospital & University of Southern Denmark, Odense, Denmark
| | - Oscar M. Cañete
- Hearing Systems Section, Department of Health Technology, Technical University of Denmark, Kgs. Lyngby, Denmark
| | - Mengfan Wu
- Institute of Clinical Research, University of Southern Denmark, Odense, Denmark,Research Unit for ORL-Head & Neck Surgery and Audiology, Odense University Hospital & University of Southern Denmark, Odense, Denmark
| | - Tobias Neher
- Institute of Clinical Research, University of Southern Denmark, Odense, Denmark,Research Unit for ORL-Head & Neck Surgery and Audiology, Odense University Hospital & University of Southern Denmark, Odense, Denmark
| | - Torsten Dau
- Hearing Systems Section, Department of Health Technology, Technical University of Denmark, Kgs. Lyngby, Denmark,Torsten Dau
| | - Sébastien Santurette
- Hearing Systems Section, Department of Health Technology, Technical University of Denmark, Kgs. Lyngby, Denmark,Centre for Applied Audiology Research, Oticon A/S, Smørum, Denmark,Sébastien Santurette
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Kuo CY, Hung CL, Chen HC, Shih CP, Lu RH, Chen CW, Hung LW, Lin YC, Chen HK, Chu DM, Lin YY, Chen YC, Wang CH. The Immediate and Long-Term Impact of Military Aircraft Noise on Hearing: A Cross-Sectional Comparison of Fighter Pilots and Ground Staff. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18062982. [PMID: 33799421 PMCID: PMC7999744 DOI: 10.3390/ijerph18062982] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Revised: 03/03/2021] [Accepted: 03/09/2021] [Indexed: 11/16/2022]
Abstract
We examined the immediate and long-term impacts of military aircraft noise exposure on noise-induced hearing loss (NIHL) in fighter pilots and ground staff. We recruited 40 pilots, 40 ground staff, and 136 age-matched controls; all participants underwent hearing tests, including conventional pure-tone audiometry (PTA) (0.25–8.0 kHz), extended high-frequency (EHF) audiometry (9.0–18.0 kHz), and distortion-product otoacoustic emission (DPOAE) as a recent reference. A subsequent hearing test immediately after flight-mission noise exposure was requested. The results revealed higher recent hearing thresholds in pilots and ground staff than in controls. Threshold shifts at many octave band frequencies were also significantly elevated in ground staff. The grouped frequency threshold was significantly elevated in the 4–8 kHz high-frequency range. After a single flight-mission noise exposure, both ground staff and pilots showed decreased signal-to-noise ratios for DPOAE (1–8 kHz), whereas only ground staff showed significantly elevated left-ear hearing thresholds at 3, 11.2, and 12.5 kHz by conventional and EHF PTA. Fighter pilots and ground staff serve in hazardous noise-exposed environments that cause hearing damage and subsequent NIHL, but ground staff may be more vulnerable. A comprehensive hearing conservation program should be implemented to protect high-risk service members, and especially ground staff, from high-intensity noise exposure.
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Affiliation(s)
- Chao-Yin Kuo
- Department of Otolaryngology-Head and Neck Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan; (C.-Y.K.); (H.-C.C.); (C.-P.S.); (R.-H.L.); (L.-W.H.); (H.-K.C.); (Y.-Y.L.)
- Institute of Cognitive Neuroscience, National Central University, Taoyuan 32001, Taiwan
| | - Chia-Lien Hung
- Taichung Armed Forces General Hospital, Taichung 41168, Taiwan;
| | - Hsin-Chien Chen
- Department of Otolaryngology-Head and Neck Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan; (C.-Y.K.); (H.-C.C.); (C.-P.S.); (R.-H.L.); (L.-W.H.); (H.-K.C.); (Y.-Y.L.)
| | - Cheng-Ping Shih
- Department of Otolaryngology-Head and Neck Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan; (C.-Y.K.); (H.-C.C.); (C.-P.S.); (R.-H.L.); (L.-W.H.); (H.-K.C.); (Y.-Y.L.)
| | - Rou-Huei Lu
- Department of Otolaryngology-Head and Neck Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan; (C.-Y.K.); (H.-C.C.); (C.-P.S.); (R.-H.L.); (L.-W.H.); (H.-K.C.); (Y.-Y.L.)
| | - Chen-Wai Chen
- School of Public Health, National Defense Medical Center, Taipei 11490, Taiwan; (C.-W.C.); (D.-M.C.)
| | - Li-Wen Hung
- Department of Otolaryngology-Head and Neck Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan; (C.-Y.K.); (H.-C.C.); (C.-P.S.); (R.-H.L.); (L.-W.H.); (H.-K.C.); (Y.-Y.L.)
| | - Yi-Chun Lin
- Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei 11490, Taiwan;
| | - Hang-Kang Chen
- Department of Otolaryngology-Head and Neck Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan; (C.-Y.K.); (H.-C.C.); (C.-P.S.); (R.-H.L.); (L.-W.H.); (H.-K.C.); (Y.-Y.L.)
- Taichung Armed Forces General Hospital, Taichung 41168, Taiwan;
| | - Da-Ming Chu
- School of Public Health, National Defense Medical Center, Taipei 11490, Taiwan; (C.-W.C.); (D.-M.C.)
| | - Yuan-Yung Lin
- Department of Otolaryngology-Head and Neck Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan; (C.-Y.K.); (H.-C.C.); (C.-P.S.); (R.-H.L.); (L.-W.H.); (H.-K.C.); (Y.-Y.L.)
- Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei 11490, Taiwan;
| | - Yueh-Chun Chen
- School of Public Health, National Defense Medical Center, Taipei 11490, Taiwan; (C.-W.C.); (D.-M.C.)
- Correspondence: (Y.-C.C.); (C.-H.W.); Tel.: +886-2-27303742 (Y.-C.C.); +886-2-87927192 (C.-H.W.); Fax: +886-2-27303742 (Y.-C.C.); +886-2-87927193 (C.-H.W.)
| | - Chih-Hung Wang
- Department of Otolaryngology-Head and Neck Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan; (C.-Y.K.); (H.-C.C.); (C.-P.S.); (R.-H.L.); (L.-W.H.); (H.-K.C.); (Y.-Y.L.)
- Taichung Armed Forces General Hospital, Taichung 41168, Taiwan;
- Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei 11490, Taiwan;
- Correspondence: (Y.-C.C.); (C.-H.W.); Tel.: +886-2-27303742 (Y.-C.C.); +886-2-87927192 (C.-H.W.); Fax: +886-2-27303742 (Y.-C.C.); +886-2-87927193 (C.-H.W.)
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