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Formby C, Secor CA, Cherri D, Eddins DA. Background and Rationale for a Transitional Intervention for Debilitating Hyperacusis. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2024; 67:1984-1993. [PMID: 38718264 DOI: 10.1044/2023_jslhr-23-00352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2024]
Abstract
PURPOSE This report provides the experimental, clinical, theoretical, and historical background that motivated a patented transitional intervention and its implementation and evaluation in a field trial for mitigation of debilitating loudness-based hyperacusis (LH). BACKGROUND AND RATIONALE Barriers for ameliorating LH, which is differentiated here from other forms of hyperacusis, are delineated, including counterproductive management and treatment strategies that may exacerbate the condition. Evidence for hyper-gain central auditory processes as the bases for LH and the associated LH-induced distress and stress responses are presented. This presentation is followed by an overview of prior efforts to use counseling and therapeutic sound as interventional tools for recalibrating the hyper-gain LH response. We also consider previous efforts to use output-limiting sound-protection devices in the management of LH. This historical background lays the foundation for our transitional intervention protocol and its implementation and evaluation in a field trial. CONCLUSIONS The successful implementation and evaluation of a transitional intervention, which we document in the outcomes of a companion proof-of-concept field trial in this issue, build on our prior efforts and those of others to understand, manage, and treat hyperacusis. These efforts to overcome significant barriers and vexing long-standing challenges in the management and treatment of LH, as reviewed here, are the pillars of the transitional intervention and its primary components, namely, counseling combined with protective sound management and therapeutic sound, which we detail in separate reports in this issue.
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Affiliation(s)
- Craig Formby
- Auditory and Speech Sciences Laboratory, University of South Florida, Tampa
- Department of Communicative Disorders, University of Alabama, Tuscaloosa
| | - Carrie A Secor
- Auditory and Speech Sciences Laboratory, University of South Florida, Tampa
| | - Dana Cherri
- Auditory and Speech Sciences Laboratory, University of South Florida, Tampa
| | - David A Eddins
- Auditory and Speech Sciences Laboratory, University of South Florida, Tampa
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Li KS, Liu YH. Impact of Migraine and Vestibular Migraine on Audiometric Profiles and Quality of Life in Patients With Tinnitus. Otol Neurotol 2024; 45:e443-e449. [PMID: 38728562 DOI: 10.1097/mao.0000000000004196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/12/2024]
Abstract
OBJECTIVE To investigate the clinical manifestations and complete auditory function in primary tinnitus patients with and without migraine or vestibular migraine. DESIGN Retrospective case-control study. SETTING A tertiary referral center. PARTICIPANTS This study enrolled 298 patients from the Kaohsiung Veterans General Hospital. All patients were diagnosed with primary tinnitus by a neurotologist between April 2020 and August 2021. Patients were excluded if they had histories of chronic otitis media, idiopathic sudden sensorineural hearing loss, Ménière's disease, skull base neoplasm, or temporal bone trauma. INTERVENTIONS Twenty-five-item Tinnitus Handicap Inventory (THI), speech audiometry including speech recognition threshold, most comfortable level, uncomfortable loudness levels, dynamic range, and pure-tone audiometry. MAIN OUTCOMES MEASURES Objective hearing loss is defined as a mean threshold greater than 25 dB. Extremely elevated THI is defined as a score greater than 1 standard deviation above the mean THI. RESULTS Among the 298 patients with tinnitus, 149 were women and 149 were men, with a mean age of 57.06 (range, 19.22-94.58) years.A total of 125 patients completed the THI questionnaire during their initial visit. The median THI score was 32 (95% confidence interval: 13.98-56.00), and the mean score was 34.99 with a standard deviation of 21.01. The sole contributing factor significantly associated with higher total THI score was the diagnosis of migraine or vestibular migraine (p < 0.001, odds ratio = 19.41).Tinnitus patients with migraine or vestibular migraine exhibited significantly lower mean pure-tone auditory thresholds (right 22.2 versus 29.5, p = 0.002; left 22.5 versus 30.4, p < 0.001), speech recognition threshold (right 20.0 versus 25.2, p = 0.016; left 20.2 versus 25.5, p = 0.019), and most comfortable levels values (right 46.1 versus 51.4, p = 0.007; left 46.9 versus 51.4, p = 0.021) compared with the tinnitus patients without migraine. CONCLUSIONS In this population-based study, patients with primary tinnitus experienced significantly higher THI scores and exhibited concurrent symptoms, including dizziness/vertigo, cervicalgia, and migraine or vestibular migraine. Among these parameters, the diagnosis of migraine or vestibular migraine was the sole contributor to significant higher THI score.
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Affiliation(s)
- Keng-Sheng Li
- Department of Medical Education and Research, Kaohsiung Veterans General Hospital
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Dias JW, McClaskey CM, Alvey AP, Lawson A, Matthews LJ, Dubno JR, Harris KC. Effects of age and noise exposure history on auditory nerve response amplitudes: A systematic review, study, and meta-analysis. Hear Res 2024; 447:109010. [PMID: 38744019 PMCID: PMC11135078 DOI: 10.1016/j.heares.2024.109010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Revised: 04/08/2024] [Accepted: 04/18/2024] [Indexed: 05/16/2024]
Abstract
Auditory nerve (AN) function has been hypothesized to deteriorate with age and noise exposure. Here, we perform a systematic review of published studies and find that the evidence for age-related deficits in AN function is largely consistent across the literature, but there are inconsistent findings among studies of noise exposure history. Further, evidence from animal studies suggests that the greatest deficits in AN response amplitudes are found in noise-exposed aged mice, but a test of the interaction between effects of age and noise exposure on AN function has not been conducted in humans. We report a study of our own examining differences in the response amplitude of the compound action potential N1 (CAP N1) between younger and older adults with and without a self-reported history of noise exposure in a large sample of human participants (63 younger adults 18-30 years of age, 103 older adults 50-86 years of age). CAP N1 response amplitudes were smaller in older than younger adults. Noise exposure history did not appear to predict CAP N1 response amplitudes, nor did the effect of noise exposure history interact with age. We then incorporated our results into two meta-analyses of published studies of age and noise exposure history effects on AN response amplitudes in neurotypical human samples. The meta-analyses found that age effects across studies are robust (r = -0.407), but noise exposure effects are weak (r = -0.152). We conclude that noise exposure effects may be highly variable depending on sample characteristics, study design, and statistical approach, and researchers should be cautious when interpreting results. The underlying pathology of age-related and noise-induced changes in AN function are difficult to determine in living humans, creating a need for longitudinal studies of changes in AN function across the lifespan and histological examination of the AN from temporal bones collected post-mortem.
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Affiliation(s)
- James W Dias
- Department of Otolaryngology - Head and Neck Surgery, Medical University of South Carolina, 135 Rutledge Avenue, MSC 550, Charleston, SC 29425-5500, United States.
| | - Carolyn M McClaskey
- Department of Otolaryngology - Head and Neck Surgery, Medical University of South Carolina, 135 Rutledge Avenue, MSC 550, Charleston, SC 29425-5500, United States
| | - April P Alvey
- Department of Otolaryngology - Head and Neck Surgery, Medical University of South Carolina, 135 Rutledge Avenue, MSC 550, Charleston, SC 29425-5500, United States
| | - Abigail Lawson
- Department of Otolaryngology - Head and Neck Surgery, Medical University of South Carolina, 135 Rutledge Avenue, MSC 550, Charleston, SC 29425-5500, United States
| | - Lois J Matthews
- Department of Otolaryngology - Head and Neck Surgery, Medical University of South Carolina, 135 Rutledge Avenue, MSC 550, Charleston, SC 29425-5500, United States
| | - Judy R Dubno
- Department of Otolaryngology - Head and Neck Surgery, Medical University of South Carolina, 135 Rutledge Avenue, MSC 550, Charleston, SC 29425-5500, United States
| | - Kelly C Harris
- Department of Otolaryngology - Head and Neck Surgery, Medical University of South Carolina, 135 Rutledge Avenue, MSC 550, Charleston, SC 29425-5500, United States
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Devolder P, Keppler H, Keshishzadeh S, Taghon B, Dhooge I, Verhulst S. The role of hidden hearing loss in tinnitus: Insights from early markers of peripheral hearing damage. Hear Res 2024; 450:109050. [PMID: 38852534 DOI: 10.1016/j.heares.2024.109050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Revised: 05/24/2024] [Accepted: 05/28/2024] [Indexed: 06/11/2024]
Abstract
Since the presence of tinnitus is not always associated with audiometric hearing loss, it has been hypothesized that hidden hearing loss may act as a potential trigger for increased central gain along the neural pathway leading to tinnitus perception. In recent years, the study of hidden hearing loss has improved with the discovery of cochlear synaptopathy and several objective diagnostic markers. This study investigated three potential markers of peripheral hidden hearing loss in subjects with tinnitus: extended high-frequency audiometric thresholds, the auditory brainstem response, and the envelope following response. In addition, speech intelligibility was measured as a functional outcome measurement of hidden hearing loss. To account for age-related hidden hearing loss, participants were grouped according to age, presence of tinnitus, and audiometric thresholds. Group comparisons were conducted to differentiate between age- and tinnitus-related effects of hidden hearing loss. All three markers revealed age-related differences, whereas no differences were observed between the tinnitus and non-tinnitus groups. However, the older tinnitus group showed improved performance on low-pass filtered speech in noise tests compared to the older non-tinnitus group. These low-pass speech in noise scores were significantly correlated with tinnitus distress, as indicated using questionnaires, and could be related to the presence of hyperacusis. Based on our observations, cochlear synaptopathy does not appear to be the underlying cause of tinnitus. The improvement in low-pass speech-in-noise could be explained by enhanced temporal fine structure encoding or hyperacusis. Therefore, we recommend that future tinnitus research takes into account age-related factors, explores low-frequency encoding, and thoroughly assesses hyperacusis.
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Affiliation(s)
- Pauline Devolder
- Hearing Technology @ WAVES, Department of Information Technology, Ghent University, Zwijnaarde, Belgium; Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium.
| | - Hannah Keppler
- Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium; Department of Ear, Nose and Throat, Ghent University Hospital, Ghent, Belgium
| | - Sarineh Keshishzadeh
- Hearing Technology @ WAVES, Department of Information Technology, Ghent University, Zwijnaarde, Belgium
| | - Baziel Taghon
- Hearing Technology @ WAVES, Department of Information Technology, Ghent University, Zwijnaarde, Belgium
| | - Ingeborg Dhooge
- Department of Ear, Nose and Throat, Ghent University Hospital, Ghent, Belgium; Department of Head and Skin, Ghent University, Ghent, Belgium
| | - Sarah Verhulst
- Hearing Technology @ WAVES, Department of Information Technology, Ghent University, Zwijnaarde, Belgium
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Mishra SK, Rodrigo H, Balan JR. Exploring the Influence of Extended High-Frequency Hearing on Cochlear Functioning at Lower Frequencies. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2024:1-10. [PMID: 38820241 DOI: 10.1044/2024_jslhr-23-00652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2024]
Abstract
PURPOSE Diminished basal cochlear function, as indicated by elevated hearing thresholds in the extended high frequencies (EHFs), has been associated with lower levels of click-evoked and distortion-product otoacoustic emissions measured at lower frequencies. However, stimulus-frequency otoacoustic emissions (SFOAEs) at low-probe levels are reflection-source emissions that do not share the same generation mechanism as distortion-source emissions. The primary objective of the present study was to examine the influence of hearing thresholds in the EHFs on SFOAEs measured at lower frequencies. METHOD SFOAEs were recorded from both ears in 45 individuals with normal hearing thresholds in the conventional audiometric frequencies (0.25-8 kHz). Hearing thresholds were also measured at EHFs (10, 12.5, and 16 kHz). SFOAE magnitudes and signal-to-noise ratios (SNRs) were averaged across 1, 2, and 4 kHz probe frequencies and also averaged for high-probe frequencies (2 and 4 kHz). RESULTS SFOAE magnitudes and SNRs were significantly higher for ears with better EHF hearing relative to poorer EHF hearing, categorized based on the median split. In addition, hearing in the EHFs significantly contributed to the variance in all SFOAE measures, except for the high-frequency SFOAE magnitudes model. However, hearing thresholds at the probe frequencies did not significantly contribute to the variance in SFOAEs. CONCLUSIONS The study findings suggest that alterations in the basal cochlea, as revealed by EHF hearing thresholds, could be associated with diminished cochlear functioning in relatively apical regions, shown by SFOAEs at lower frequencies, in individuals with normal audiograms. These findings underscore the significance of considering EHF thresholds in audiological evaluations, as alterations in these frequencies may reflect broader cochlear health status.
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Affiliation(s)
- Srikanta K Mishra
- Department of Speech, Language, and Hearing Sciences, The University of Texas at Austin
| | - Hansapani Rodrigo
- School of Mathematical and Statistical Sciences, The University of Texas Rio Grande Valley, Edinburg
| | - Jithin R Balan
- Department of Speech, Language, and Hearing Sciences, The University of Texas at Austin
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Schmidt FH, Dörmann A, Ehrt K, Grossmann W, Mlynski R, Zhang L. The curvature quantification of wave I in auditory brainstem responses detects cochlear synaptopathy in human beings. Eur Arch Otorhinolaryngol 2024:10.1007/s00405-024-08699-6. [PMID: 38703194 DOI: 10.1007/s00405-024-08699-6] [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: 01/19/2024] [Accepted: 04/18/2024] [Indexed: 05/06/2024]
Abstract
PURPOSE Patients with age-related hearing loss complain often about reduced speech perception in adverse listening environment. Studies on animals have suggested that cochlear synaptopathy may be one of the primary mechanisms responsible for this phenomenon. A decreased wave I amplitude in supra-threshold auditory brainstem response (ABR) can diagnose this pathology non-invasively. However, the interpretation of the wave I amplitude in humans remains controversial. Recent studies in mice have established a robust and reliable mathematic algorithm, i.e., curve curvature quantification, for detecting cochlear synaptopathy. This study aimed to determine whether the curve curvature has sufficient test-retest reliability to detect cochlear synaptopathy in aging humans. METHODS Healthy participants were recruited into this prospective study. All subjects underwent an audiogram examination with standard and extended high frequencies ranging from 0.125 to 16 kHz and an ABR with a stimulus of 80 dB nHL click. The peak amplitude, peak latency, curvature at the peak, and the area under the curve of wave I were calculated and analyzed. RESULTS A total of 80 individuals with normal hearing, aged 18 to 61 years, participated in this study, with a mean age of 26.4 years. Pearson correlation analysis showed a significant negative correlation between curvature and age, as well as between curvature and extended high frequency (EHF) threshold (10-16 kHz). Additionally, the same correlation was observed between age and area as well as age and EHF threshold. The model comparison demonstrated that the curvature at the peak of wave I is the best metric to correlate with EHF threshold. CONCLUSION The curvature at the peak of wave I is the most sensitive metric for detecting cochlear synaptopathy in humans and may be applied in routine diagnostics to detect early degenerations of the auditory nerve.
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Affiliation(s)
- Florian Herrmann Schmidt
- Department of Otorhinolaryngology, Head and Neck Surgery, Otto Körner, Rostock University Medical Center, Doberaner Strasse 137-139, 18057, Rostock, Germany
| | - Alexander Dörmann
- Department of Otorhinolaryngology, Head and Neck Surgery, Otto Körner, Rostock University Medical Center, Doberaner Strasse 137-139, 18057, Rostock, Germany
| | - Karsten Ehrt
- Department of Otorhinolaryngology, Head and Neck Surgery, Otto Körner, Rostock University Medical Center, Doberaner Strasse 137-139, 18057, Rostock, Germany
| | - Wilma Grossmann
- Department of Otorhinolaryngology, Head and Neck Surgery, Otto Körner, Rostock University Medical Center, Doberaner Strasse 137-139, 18057, Rostock, Germany
| | - Robert Mlynski
- Department of Otorhinolaryngology, Head and Neck Surgery, Otto Körner, Rostock University Medical Center, Doberaner Strasse 137-139, 18057, Rostock, Germany
| | - Lichun Zhang
- Department of Otorhinolaryngology, Head and Neck Surgery, Otto Körner, Rostock University Medical Center, Doberaner Strasse 137-139, 18057, Rostock, Germany.
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Temboury-Gutierrez M, Märcher-Rørsted J, Bille M, Yde J, Encina-Llamas G, Hjortkjær J, Dau T. Electrocochleographic frequency-following responses as a potential marker of age-related cochlear neural degeneration. Hear Res 2024; 446:109005. [PMID: 38598943 DOI: 10.1016/j.heares.2024.109005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Revised: 03/19/2024] [Accepted: 04/01/2024] [Indexed: 04/12/2024]
Abstract
Auditory nerve (AN) fibers that innervate inner hair cells in the cochlea degenerate with advancing age. It has been proposed that age-related reductions in brainstem frequency-following responses (FFR) to the carrier of low-frequency, high-intensity pure tones may partially reflect this neural loss in the cochlea (Märcher-Rørsted et al., 2022). If the loss of AN fibers is the primary factor contributing to age-related changes in the brainstem FFR, then the FFR could serve as an indicator of cochlear neural degeneration. In this study, we employed electrocochleography (ECochG) to investigate the effects of age on frequency-following neurophonic potentials, i.e., neural responses phase-locked to the carrier frequency of the tone stimulus. We compared these findings to the brainstem-generated FFRs obtained simultaneously using the same stimulation. We conducted recordings in young and older individuals with normal hearing. Responses to pure tones (250 ms, 516 and 1086 Hz, 85 dB SPL) and clicks were recorded using both ECochG at the tympanic membrane and traditional scalp electroencephalographic (EEG) recordings of the FFR. Distortion product otoacoustic emissions (DPOAE) were also collected. In the ECochG recordings, sustained AN neurophonic (ANN) responses to tonal stimulation, as well as the click-evoked compound action potential (CAP) of the AN, were significantly reduced in the older listeners compared to young controls, despite normal audiometric thresholds. In the EEG recordings, brainstem FFRs to the same tone stimulation were also diminished in the older participants. Unlike the reduced AN CAP response, the transient-evoked wave-V remained unaffected. These findings could indicate that a decreased number of AN fibers contributes to the response in the older participants. The results suggest that the scalp-recorded FFR, as opposed to the clinical standard wave-V of the auditory brainstem response, may serve as a more reliable indicator of age-related cochlear neural degeneration.
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Affiliation(s)
- Miguel Temboury-Gutierrez
- Hearing Systems Section, Department of Health Technology, Technical University of Denmark, Ørsteds Plads, Building 352, DK-2800 Kgs. Lyngby, Denmark.
| | - Jonatan Märcher-Rørsted
- Hearing Systems Section, Department of Health Technology, Technical University of Denmark, Ørsteds Plads, Building 352, DK-2800 Kgs. Lyngby, Denmark
| | - Michael Bille
- Copenhagen Hearing and Balance Center, Ear, Nose and Throat (ENT) and Audiology Clinic, Rigshospitalet, Copenhagen University Hospital, Denmark, Inge Lehmanns Vej 8, DK-2100 København Ø, Denmark
| | - Jesper Yde
- Copenhagen Hearing and Balance Center, Ear, Nose and Throat (ENT) and Audiology Clinic, Rigshospitalet, Copenhagen University Hospital, Denmark, Inge Lehmanns Vej 8, DK-2100 København Ø, Denmark
| | - Gerard Encina-Llamas
- Hearing Systems Section, Department of Health Technology, Technical University of Denmark, Ørsteds Plads, Building 352, DK-2800 Kgs. Lyngby, Denmark; Copenhagen Hearing and Balance Center, Ear, Nose and Throat (ENT) and Audiology Clinic, Rigshospitalet, Copenhagen University Hospital, Denmark, Inge Lehmanns Vej 8, DK-2100 København Ø, Denmark; Faculty of Medicine. University of Vic - Central University of Catalonia (UVic-UCC), Vic, 08500, Catalonia - Spain
| | - Jens Hjortkjær
- Hearing Systems Section, Department of Health Technology, Technical University of Denmark, Ørsteds Plads, Building 352, DK-2800 Kgs. Lyngby, Denmark; Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, Kettegård Allé 30, DK-2650 Hvidovre, Denmark
| | - Torsten Dau
- Hearing Systems Section, Department of Health Technology, Technical University of Denmark, Ørsteds Plads, Building 352, DK-2800 Kgs. Lyngby, Denmark
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Fink D. What is the safe noise exposure level to prevent noise-induced hearing loss? JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2024:10.1038/s41370-024-00660-3. [PMID: 38637639 DOI: 10.1038/s41370-024-00660-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Revised: 03/06/2024] [Accepted: 03/07/2024] [Indexed: 04/20/2024]
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Dias JW, McClaskey CM, Alvey AP, Lawson A, Matthews LJ, Dubno JR, Harris KC. Effects of Age and Noise Exposure History on Auditory Nerve Response Amplitudes: A Systematic Review, Study, and Meta-Analysis. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.03.20.585882. [PMID: 38585917 PMCID: PMC10996537 DOI: 10.1101/2024.03.20.585882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/09/2024]
Abstract
Auditory nerve (AN) function has been hypothesized to deteriorate with age and noise exposure. Here, we perform a systematic review of published studies and find that the evidence for age-related deficits in AN function is largely consistent across the literature, but there are inconsistent findings among studies of noise exposure history. Further, evidence from animal studies suggests that the greatest deficits in AN response amplitudes are found in noise-exposed aged mice, but a test of the interaction between effects of age and noise exposure on AN function has not been conducted in humans. We report a study of our own examining differences in the response amplitude of the compound action potential N1 (CAP N1) between younger and older adults with and without a self-reported history of noise exposure in a large sample of human participants (63 younger adults 18-30 years of age, 103 older adults 50-86 years of age). CAP N1 response amplitudes were smaller in older than younger adults. Noise exposure history did not appear to predict CAP N1 response amplitudes, nor did the effect of noise exposure history interact with age. We then incorporated our results into two meta-analyses of published studies of age and noise exposure history effects on AN response amplitudes in neurotypical human samples. The meta-analyses found that age effects across studies are robust (r=-0.407), but noise-exposure effects are weak (r=-0.152). We conclude that noise-exposure effects may be highly variable depending on sample characteristics, study design, and statistical approach, and researchers should be cautious when interpreting results. The underlying pathology of age-related and noise-induced changes in AN function are difficult to determine in living humans, creating a need for longitudinal studies of changes in AN function across the lifespan and histological examination of the AN from temporal bones collected post-mortem.
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Affiliation(s)
- James W Dias
- Medical University of South Carolina Department of Otolaryngology - Head and Neck Surgery
| | - Carolyn M McClaskey
- Medical University of South Carolina Department of Otolaryngology - Head and Neck Surgery
| | - April P Alvey
- Medical University of South Carolina Department of Otolaryngology - Head and Neck Surgery
| | - Abigail Lawson
- Medical University of South Carolina Department of Otolaryngology - Head and Neck Surgery
| | - Lois J Matthews
- Medical University of South Carolina Department of Otolaryngology - Head and Neck Surgery
| | - Judy R Dubno
- Medical University of South Carolina Department of Otolaryngology - Head and Neck Surgery
| | - Kelly C Harris
- Medical University of South Carolina Department of Otolaryngology - Head and Neck Surgery
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Bidelman GM, Bernard F, Skubic K. Hearing in categories aids speech streaming at the "cocktail party". BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.04.03.587795. [PMID: 38617284 PMCID: PMC11014555 DOI: 10.1101/2024.04.03.587795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/16/2024]
Abstract
Our perceptual system bins elements of the speech signal into categories to make speech perception manageable. Here, we aimed to test whether hearing speech in categories (as opposed to a continuous/gradient fashion) affords yet another benefit to speech recognition: parsing noisy speech at the "cocktail party." We measured speech recognition in a simulated 3D cocktail party environment. We manipulated task difficulty by varying the number of additional maskers presented at other spatial locations in the horizontal soundfield (1-4 talkers) and via forward vs. time-reversed maskers, promoting more and less informational masking (IM), respectively. In separate tasks, we measured isolated phoneme categorization using two-alternative forced choice (2AFC) and visual analog scaling (VAS) tasks designed to promote more/less categorical hearing and thus test putative links between categorization and real-world speech-in-noise skills. We first show that listeners can only monitor up to ~3 talkers despite up to 5 in the soundscape and streaming is not related to extended high-frequency hearing thresholds (though QuickSIN scores are). We then confirm speech streaming accuracy and speed decline with additional competing talkers and amidst forward compared to reverse maskers with added IM. Dividing listeners into "discrete" vs. "continuous" categorizers based on their VAS labeling (i.e., whether responses were binary or continuous judgments), we then show the degree of IM experienced at the cocktail party is predicted by their degree of categoricity in phoneme labeling; more discrete listeners are less susceptible to IM than their gradient responding peers. Our results establish a link between speech categorization skills and cocktail party processing, with a categorical (rather than gradient) listening strategy benefiting degraded speech perception. These findings imply figure-ground deficits common in many disorders might arise through a surprisingly simple mechanism: a failure to properly bin sounds into categories.
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Affiliation(s)
- Gavin M. Bidelman
- Department of Speech, Language and Hearing Sciences, Indiana University, Bloomington, IN, USA
- Program in Neuroscience, Indiana University, Bloomington, IN, USA
- Cognitive Science Program, Indiana University, Bloomington, IN, USA
| | - Fallon Bernard
- School of Communication Sciences & Disorders, University of Memphis, Memphis TN, USA
| | - Kimberly Skubic
- School of Communication Sciences & Disorders, University of Memphis, Memphis TN, USA
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Hao S, Song W, Kong F, Yue X, Meng X, Chen H, Han Y, Yu F. Iron deficiency at birth and risk of hidden hearing loss in infants modification by socioeconomic status: mother-newborn cohort in Shenyang, China. BMC Public Health 2024; 24:953. [PMID: 38570765 PMCID: PMC10988964 DOI: 10.1186/s12889-024-18439-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 03/26/2024] [Indexed: 04/05/2024] Open
Abstract
OBJECTIVE The diagnosis of hidden hearing loss (HHL) in calm state has not yet been determined, while the nutritional status is not involved in its pathogenic risk factors. In utero iron deficiency (ID) may delay auditory neural maturation in infants. We evaluated the association between ID and HHL as well as the modification effect of socioeconomic status (SES) on this association in newborns. STUDY DESIGN We included 859 mother-newborns from the baseline of this observational northeast cohort. Data on exposure assessment included iron status [maternal hemoglobin (Hb) and neonatal heel prick serum ferritin (SF)] and SES (occupation, education and income). Auditory neural maturation was reflected by auditory brainstem response (ABR) testing and electrocochleography (ECochG). RESULTS Iron status and SES were independently and jointly associated with the prediction of neonatal HHL by logistic and linear regression model. The mediation effects were performed by Process. ID increased absolute latency wave V, interpeak latency (IPL) III-V, and summting potentials (SP) /action potentials (AP), which were combined as HHL. Low SES showed the highest risk of HHL and the highest levels of related parameters in ID newborns. Moreover, after Corona Virus Disease 2019 (COVID-19) were positive, preschool children who experience ID in neonatal period were more likely to suffer from otitis media with effusion (OME). High SES also showed similar risk effects. CONCLUSION Both low and high SES may strengthen the risk of ID on neonatal HHL in Northeast China.
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Affiliation(s)
- Shuai Hao
- Department of Otolaryngology, First Affiliated Hospital of China Medical University, No. 155, Nanjing North Street, Heping District, Shenyang, 110001, China.
| | - Wei Song
- School of Public Health, He University, Hunnan New District, No.66 Sishui Street, Shenyang, 110163, China
- Department of Nutrition and Food Hygiene, School of Public Health, China Medical University, Shenyang North New District, No.77 Puhe Road, Shenyang, 110122, China
| | - Fanxue Kong
- Center of Physical Examination, First Affiliated Hospital of Dalian Medical University, No. 193 Lianhe Road, Xigang District, Dalian, 116011, China
| | - Xinxin Yue
- School of Clinical Medicine, He University, Hunnan New District, No.66 Sishui Street, Shenyang, 110163, China
| | - Xinlei Meng
- Department of Nutrition and Food Hygiene, School of Public Health, Dalian Medical University, No.9 West Section of Lvshun South Road, Dalian, 116044, Lvshunkou District, China
| | - Hongyan Chen
- Department of Nutrition and Food Hygiene, School of Public Health, Dalian Medical University, No.9 West Section of Lvshun South Road, Dalian, 116044, Lvshunkou District, China
| | - Yunyan Han
- Department of Nutrition and Food Hygiene, School of Public Health, Dalian Medical University, No.9 West Section of Lvshun South Road, Dalian, 116044, Lvshunkou District, China
| | - Fei Yu
- School of Public Health, He University, Hunnan New District, No.66 Sishui Street, Shenyang, 110163, China.
- Department of Nutrition and Food Hygiene, School of Public Health, China Medical University, Shenyang North New District, No.77 Puhe Road, Shenyang, 110122, China.
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12
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Patro C, Monfiletto A, Singer A, Srinivasan NK, Mishra SK. Midlife Speech Perception Deficits: Impact of Extended High-Frequency Hearing, Peripheral Neural Function, and Cognitive Abilities. Ear Hear 2024:00003446-990000000-00269. [PMID: 38556645 DOI: 10.1097/aud.0000000000001504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/02/2024]
Abstract
OBJECTIVES The objectives of the present study were to investigate the effects of age-related changes in extended high-frequency (EHF) hearing, peripheral neural function, working memory, and executive function on speech perception deficits in middle-aged individuals with clinically normal hearing. DESIGN We administered a comprehensive assessment battery to 37 participants spanning the age range of 20 to 56 years. This battery encompassed various evaluations, including standard and EHF pure-tone audiometry, ranging from 0.25 to 16 kHz. In addition, we conducted auditory brainstem response assessments with varying stimulation rates and levels, a spatial release from masking (SRM) task, and cognitive evaluations that involved the Trail Making test (TMT) for assessing executive function and the Abbreviated Reading Span test (ARST) for measuring working memory. RESULTS The results indicated a decline in hearing sensitivities at EHFs and an increase in completion times for the TMT with age. In addition, as age increased, there was a corresponding decrease in the amount of SRM. The declines in SRM were associated with age-related declines in hearing sensitivity at EHFs and TMT performance. While we observed an age-related decline in wave I responses, this decline was primarily driven by age-related reductions in EHF thresholds. In addition, the results obtained using the ARST did not show an age-related decline. Neither the auditory brainstem response results nor ARST scores were correlated with the amount of SRM. CONCLUSIONS These findings suggest that speech perception deficits in middle age are primarily linked to declines in EHF hearing and executive function, rather than cochlear synaptopathy or working memory.
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Affiliation(s)
- Chhayakanta Patro
- Department of Speech Language Pathology & Audiology, Towson University, Towson, Maryland, USA
| | - Angela Monfiletto
- Department of Speech Language Pathology & Audiology, Towson University, Towson, Maryland, USA
| | - Aviya Singer
- Department of Speech Language Pathology & Audiology, Towson University, Towson, Maryland, USA
| | - Nirmal Kumar Srinivasan
- Department of Speech Language Pathology & Audiology, Towson University, Towson, Maryland, USA
| | - Srikanta Kumar Mishra
- Department of Speech, Language and Hearing Sciences, The University of Texas at Austin, Austin, Texas, USA
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13
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Liu J, Stohl J, Overath T. Hidden hearing loss: Fifteen years at a glance. Hear Res 2024; 443:108967. [PMID: 38335624 DOI: 10.1016/j.heares.2024.108967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 01/15/2024] [Accepted: 01/29/2024] [Indexed: 02/12/2024]
Abstract
Hearing loss affects approximately 18% of the population worldwide. Hearing difficulties in noisy environments without accompanying audiometric threshold shifts likely affect an even larger percentage of the global population. One of the potential causes of hidden hearing loss is cochlear synaptopathy, the loss of synapses between inner hair cells (IHC) and auditory nerve fibers (ANF). These synapses are the most vulnerable structures in the cochlea to noise exposure or aging. The loss of synapses causes auditory deafferentation, i.e., the loss of auditory afferent information, whose downstream effect is the loss of information that is sent to higher-order auditory processing stages. Understanding the physiological and perceptual effects of this early auditory deafferentation might inform interventions to prevent later, more severe hearing loss. In the past decade, a large body of work has been devoted to better understand hidden hearing loss, including the causes of hidden hearing loss, their corresponding impact on the auditory pathway, and the use of auditory physiological measures for clinical diagnosis of auditory deafferentation. This review synthesizes the findings from studies in humans and animals to answer some of the key questions in the field, and it points to gaps in knowledge that warrant more investigation. Specifically, recent studies suggest that some electrophysiological measures have the potential to function as indicators of hidden hearing loss in humans, but more research is needed for these measures to be included as part of a clinical test battery.
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Affiliation(s)
- Jiayue Liu
- Department of Psychology and Neuroscience, Duke University, Durham, USA.
| | - Joshua Stohl
- North American Research Laboratory, MED-EL Corporation, Durham, USA
| | - Tobias Overath
- Department of Psychology and Neuroscience, Duke University, Durham, USA
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14
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Frisby C, Oosthuizen I, Manchaiah V, Swanepoel DW. Hearing help-seeking, hearing device uptake and hearing health outcomes in individuals with subclinical hearing loss: a systematic review. Int J Audiol 2024:1-11. [PMID: 38375662 DOI: 10.1080/14992027.2024.2311660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 01/24/2024] [Indexed: 02/21/2024]
Abstract
OBJECTIVE This systematic review aims to examine the current literature on help-seeking, hearing device uptake, and hearing health outcomes in individuals with subclinical hearing loss. DESIGN Systematic review. STUDY SAMPLE Searches of three databases (CINAHL, MEDLINE (PubMed), and Scopus) yielded nine studies meeting the inclusion criteria. The quality of the included studies was determined using the National Institute of Health quality assessment tool. The studies' level of evidence was determined according to the Centre for Evidence-Based Medicine. RESULTS All included studies involved adult participants. Three studies examined help-seeking. Self-reported difficulty, poor speech-in-noise performance, and emotional responses to the hearing difficulty were identified as factors influencing help-seeking. Six studies examined the use of hearing devices as an intervention, including hearing aids (n = 4), hearables (n = 1), and FM systems (n = 1). Using hearing devices improved self-perceived hearing difficulty, speech-in-noise understanding, and motivation to address hearing difficulties. No studies focused on hearing device uptake. The quality assessment indicated limited methodological rigour across the studies, with varying levels of evidence. CONCLUSIONS Current evidence supports the use of hearing devices as an intervention for individuals with subclinical hearing loss. However, more research is essential, particularly focusing on help-seeking, diagnosis, treatment, and long-term outcomes using well-controlled study designs.
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Affiliation(s)
- Caitlin Frisby
- Department of Speech-Language Pathology and Audiology, University of Pretoria, Pretoria, Gauteng, South Africa
- Virtual Hearing Lab, Collaborative Initiative between the University of Colorado and the University of Pretoria, Aurora, CO, USA
| | - Ilze Oosthuizen
- Department of Speech-Language Pathology and Audiology, University of Pretoria, Pretoria, Gauteng, South Africa
- Virtual Hearing Lab, Collaborative Initiative between the University of Colorado and the University of Pretoria, Aurora, CO, USA
| | - Vinaya Manchaiah
- Department of Speech-Language Pathology and Audiology, University of Pretoria, Pretoria, Gauteng, South Africa
- Virtual Hearing Lab, Collaborative Initiative between the University of Colorado and the University of Pretoria, Aurora, CO, USA
- Department of Otolaryngology-Head and Neck Surgery, University of Colorado School of Medicine, Aurora, CO, USA
- UCHealth Hearing and Balance, University of Colorado Hospital, Aurora, CO, USA
- Department of Speech and Hearing, School of Allied Health Sciences, Manipal University, Manipal, India
| | - De Wet Swanepoel
- Department of Speech-Language Pathology and Audiology, University of Pretoria, Pretoria, Gauteng, South Africa
- Virtual Hearing Lab, Collaborative Initiative between the University of Colorado and the University of Pretoria, Aurora, CO, USA
- Department of Otolaryngology-Head and Neck Surgery, University of Colorado School of Medicine, Aurora, CO, USA
- Ear Science Institute Australia, Subiaco, Australia
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15
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Cassinotti LR, Ji L, Yuk MC, Desai AS, Cass ND, Amir ZA, Corfas G. Hidden hearing loss in hereditary demyelinating neuropathies: insights from Charcot-Marie-Tooth mouse models. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2023.12.14.571732. [PMID: 38168255 PMCID: PMC10760174 DOI: 10.1101/2023.12.14.571732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2024]
Abstract
Hidden hearing loss (HHL) is a recently described auditory neuropathy characterized by normal audiometric thresholds but reduced sound-evoked potentials. It has been proposed that HHL contributes to hearing difficulty in noisy environments in people with normal audiometric thresholds, a widespread complaint. While most studies on HHL pathogenesis have focused on inner hair cell (IHC) synaptopathy, recent research suggests that transient auditory nerve (AN) demyelination may also cause HHL. To test the impact of myelinopathy in a clinically relevant model, we studied a mouse model of Charcot-Marie-Tooth type 1A (CMT1A), the most prevalent hereditary peripheral neuropathy in humans. CMT1A mice exhibit the functional hallmarks of HHL, together with disorganization of AN heminodes near the IHCs with minor loss of AN fibers. Our results support the hypothesis that mild disruptions of AN myelination can cause HHL, and that heminodal defects contribute to the alterations in action potential amplitudes and latencies seen in these models. Also, these findings suggest that patients with CMT1A or other mild peripheral neuropathies are likely to suffer from HHL. Furthermore, these results suggest that studies of hearing in CMT1A patients might help develop robust clinical tests for HHL, which are currently lacking.
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16
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Jukic A, Lei Z, Cebul ER, Pinter K, Mosqueda N, David S, Tarchini B, Kindt K. Presynaptic Nrxn3 is essential for ribbon-synapse assembly in hair cells. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.02.14.580267. [PMID: 38410471 PMCID: PMC10896334 DOI: 10.1101/2024.02.14.580267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/28/2024]
Abstract
Hair cells of the inner ear rely on specialized ribbon synapses to transmit sensory information to the central nervous system. The molecules required to assemble these synapses are not fully understood. We show that Nrxn3, a presynaptic adhesion molecule, is critical for ribbon-synapse assembly in hair cells. In both mouse and zebrafish models, loss of Nrxn3 results in significantly fewer intact ribbon synapses. In zebrafish we demonstrate that a 60% loss of synapses in nrxn3 mutants dramatically reduces both presynaptic responses in hair cells and postsynaptic responses in afferent neurons. Despite a reduction in synapse function in this model, we find no deficits in the acoustic startle response, a behavior reliant on these synapses. Overall, this work demonstrates that Nrxn3 is a critical and conserved molecule required to assemble ribbon synapses. Understanding how ribbon synapses assemble is a key step towards generating novel therapies to treat forms of age-related and noise-induced hearing loss that occur due to loss of ribbon synapses.
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Affiliation(s)
- Alma Jukic
- Section on Sensory Cell Development and Function, National Institute on Deafness and Other Communication Disorders, Bethesda, MD, 20892, USA
| | - Zhengchang Lei
- Section on Sensory Cell Development and Function, National Institute on Deafness and Other Communication Disorders, Bethesda, MD, 20892, USA
| | - Elizabeth R Cebul
- Section on Sensory Cell Development and Function, National Institute on Deafness and Other Communication Disorders, Bethesda, MD, 20892, USA
| | - Katherine Pinter
- Section on Sensory Cell Development and Function, National Institute on Deafness and Other Communication Disorders, Bethesda, MD, 20892, USA
| | - Natalie Mosqueda
- Section on Sensory Cell Development and Function, National Institute on Deafness and Other Communication Disorders, Bethesda, MD, 20892, USA
| | - Sandeep David
- Section on Sensory Cell Development and Function, National Institute on Deafness and Other Communication Disorders, Bethesda, MD, 20892, USA
| | | | - Katie Kindt
- Section on Sensory Cell Development and Function, National Institute on Deafness and Other Communication Disorders, Bethesda, MD, 20892, USA
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17
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Elmazoska I, Mäki-Torkko E, Granberg S, Widén S. Associations Between Recreational Noise Exposure and Hearing Function in Adolescents and Young Adults: A Systematic Review. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2024; 67:688-710. [PMID: 38324255 DOI: 10.1044/2023_jslhr-23-00397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/08/2024]
Abstract
PURPOSE There is an increasing concern regarding hazardous recreational noise exposure among adolescents and young adults. Daily exposure to loud sound levels over a long period of time can increase the risk of noise-induced hearing loss. The full extent of the impact of recreational noise on hearing is not yet fully understood. The purpose of this review was to synthesize research that investigated hearing function in relation to recreational noise exposure in adolescents and young adults. METHOD A systematic literature search of five databases covering the years 2000-2023 was performed. The articles included investigated audiological measurements of hearing function in relation to recreational noise exposure. RESULTS Four hundred sixty records were identified, of which 20 met the inclusion criteria and were included in the results. This review showed that although some recreational noise activities can be potentially harmful, there is an unclear relationship between exposure and outcome. Some findings indicated hearing threshold shifts or reduced otoacoustic emission amplitudes after recreational noise exposure, but most changes were short term and in the extended high-frequency range. CONCLUSIONS There seemed to be inconsistencies regarding the utilization of methods of measuring exposure and outcome between studies. This might be one reason for the differing results in studies on the reported impact on hearing function from recreational noise exposure. To draw more certain conclusions about long-term effects, there is a need for longitudinal research that utilizes sound level measurements to assess low and high degrees of recreational noise exposure in relation to hearing function. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.25114193.
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Affiliation(s)
- Iris Elmazoska
- School of Health Sciences, Örebro University, Sweden
- Audiological Research Centre, Faculty of Medicine and Health, Örebro University, Sweden
| | - Elina Mäki-Torkko
- Audiological Research Centre, Faculty of Medicine and Health, Örebro University, Sweden
- School of Medical Sciences, Örebro University, Sweden
| | - Sarah Granberg
- School of Health Sciences, Örebro University, Sweden
- Audiological Research Centre, Faculty of Medicine and Health, Örebro University, Sweden
- School of Medical Sciences, Örebro University, Sweden
| | - Stephen Widén
- School of Health Sciences, Örebro University, Sweden
- Audiological Research Centre, Faculty of Medicine and Health, Örebro University, Sweden
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18
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Main M, Skoe E. Heightened OAEs in young adult musicians: Influence of current noise exposure and training recency. Hear Res 2024; 442:108925. [PMID: 38141520 PMCID: PMC10843712 DOI: 10.1016/j.heares.2023.108925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 11/26/2023] [Accepted: 12/03/2023] [Indexed: 12/25/2023]
Abstract
Otoacoustic emissions (OAEs) are a non-invasive metric of cochlear function. Studies of OAEs in musicians have yielded mixed results, ranging from evidence of diminished OAEs in musicians-suggesting noise-induced hearing loss-to no difference when compared to non-musicians, or even a trend for stronger OAEs in musicians. The goal of this study was to use a large sample of college students with normal hearing (n = 160) to compare OAE SNRs in musicians and non-musicians and to explore potential effects of training recency and noise exposure on OAEs in these cohorts. The musician cohort included both active musicians (who at the time of enrollment practiced at least weekly) and past musicians (who had at least 6 years of training). All participants completed a questionnaire about recent noise exposure (previous 12 months), and a subset of participants (71 musicians and 15 non-musicians) wore a personal noise dosimeter for one week to obtain a more nuanced and objective measure of exposure to assess how different exposure levels may affect OAEs before the emergence of a clinically significant hearing loss. OAEs were tested using both transient-evoked OAEs (TEOAEs) and distortion-product OAEs (DPOAEs). As predicted from the literature, musicians experienced significantly higher noise levels than non-musicians based on both subjective (self-reported) and objective measures. Yet we found stronger TEOAEs and DPOAEs in musicians compared to non-musicians in the ∼1-5 kHz range. Comparisons between past and active musicians suggest that enhanced cochlear function in young adult musicians does not require active, ongoing musical practice. Although there were no significant relations between OAEs and noise exposure as measured by dosimetry or questionnaire, active musicians had weaker DPOAEs than past musicians when the entire DPOAE frequency range was considered (up to ∼16 kHz), consistent with a subclinical noise-induced hearing loss that only becomes apparent when active musicians are contrasted with a cohort of individuals with comparable training but without the ongoing risks of noise exposure. Our findings suggest, therefore, that separate norms should be developed for musicians for earlier detection of incipient hearing loss. Potential explanations for enhanced cochlear function in musicians include pre-existing (inborn or demographic) differences, training-related enhancements of cochlear function (e.g., upregulation of prestin, stronger efferent feedback mechanisms), or a combination thereof. Further studies are needed to determine if OAE enhancements offer musicians protection against damage caused by noise exposure.
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Affiliation(s)
- Morgan Main
- Department of Speech, Language, and Hearing Sciences, United States; Department of Physiology and Neurobiology, United States; University of Connecticut, Storrs, CT 06269, United States; University of Rochester School of Medicine and Dentistry, Rochester, NY 14642, United States
| | - Erika Skoe
- Department of Speech, Language, and Hearing Sciences, United States; Department of Psychological Sciences, Cognitive Sciences Program, Connecticut Institute for Brain and Cognitive Sciences, United States; University of Connecticut, Storrs, CT 06269, United States.
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19
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Saade M, Fernandez K, Little C, Schwam ZG, Cosetti M. Utility of Extended High-Frequency Audiograms in Clinical Practice. Laryngoscope 2024; 134:907-910. [PMID: 37497866 DOI: 10.1002/lary.30890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 05/22/2023] [Accepted: 07/01/2023] [Indexed: 07/28/2023]
Abstract
OBJECTIVES Extended high-frequency (EHF) audiometry elicits pure-tone thresholds at frequencies above 8 kHz, which are not included in routine clinical testing. This study explores the utility of EHF audiometry in patients with various audiologic symptoms despite normal-hearing thresholds at ≤8 kHz. METHODS A retrospective review was performed of all patients receiving conventional (250-8 kHz) and EHF (9-20 kHz) audiometry at a tertiary otological referral center between April 2021 and August 2022. Only patients with audiologic symptoms and pure-tone thresholds ≤25 dB HL at ≤8 kHz bilaterally on routine testing were included in subsequent analysis. EHF-PTA was defined for each ear as an average of the air conduction thresholds at 9.0, 10.0, 11.2, 12.5, 14.0, 16.0, 18.0, and 20.0 kHz. RESULTS Of the 50 patients who received EHF testing, 40 had audiologic symptoms and normal conventional audiograms at ≤8 kHz. Twenty-five of the 40 (62.5%) were found to have hearing loss in the highest frequencies. Patients with EHF hearing loss (EHF-HL) were more likely to report subjective hearing loss. Age was significantly greater in those with EHF-HL compared with those without EHF-HL, and age was positively correlated with the degree of EHF-HL. CONCLUSION EHF testing correlates with audiologic symptoms in patients with normal testing at ≤8 kHz and may be considered when standard audiometry is normal. Additional data are warranted to create an evidenced-based, clinical algorithm for EHF audiometry that can guide treatment, direct mitigation strategies, and potentially identify those at higher risk of hearing loss over time. LEVEL OF EVIDENCE 4 Laryngoscope, 134:907-910, 2024.
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Affiliation(s)
- Mia Saade
- Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Karla Fernandez
- Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Christine Little
- Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Zachary G Schwam
- Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Maura Cosetti
- Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA
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20
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Çolak H, Aydemir BE, Sakarya MD, Çakmak E, Alniaçik A, Türkyilmaz MD. Subcortical Auditory Processing and Speech Perception in Noise Among Individuals With and Without Extended High-Frequency Hearing Loss. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2024; 67:221-231. [PMID: 37956878 DOI: 10.1044/2023_jslhr-23-00023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2023]
Abstract
PURPOSE The significance of extended high-frequency (EHF) hearing (> 8 kHz) is not well understood so far. In this study, we aimed to understand the relationship between EHF hearing loss (EHFHL) and speech perception in noise (SPIN) and the associated physiological signatures using the speech-evoked frequency-following response (sFFR). METHOD Sixteen young adults with EHFHL and 16 age- and sex-matched individuals with normal hearing participated in the study. SPIN performance in right speech-right noise, left speech-left noise, and binaural listening conditions was evaluated using the Turkish Matrix Test. Additionally, subcortical auditory processing was assessed by recording sFFRs elicited by 40-ms /da/ stimuli. RESULTS Individuals with EHFHL demonstrated poorer SPIN performances in all listening conditions (p < .01). Longer latencies were observed in the V (onset) and O (offset) peaks in these individuals (p ≤ .01). However, only the V/A peak amplitude was found to be significantly reduced in individuals with EHFHL (p < .01). CONCLUSIONS Our findings highlight the importance of EHF hearing and suggest that EHF hearing should be considered among the key elements in SPIN. Individuals with EHFHL show a tendency toward weaker subcortical auditory processing, which likely contributes to their poorer SPIN performance. Thus, routine assessment of EHF hearing should be implemented in clinical settings, alongside the evaluation of standard audiometric frequencies (0.25-8 kHz).
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Affiliation(s)
- Hasan Çolak
- Department of Audiology, Baskent University, Ankara, Turkey
- Department of Audiology, Hacettepe University, Ankara, Turkey
| | | | | | - Eda Çakmak
- Department of Audiology, Baskent University, Ankara, Turkey
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21
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Yang L, Gutierrez DE, Guthrie OW. Systemic health effects of noise exposure. JOURNAL OF TOXICOLOGY AND ENVIRONMENTAL HEALTH. PART B, CRITICAL REVIEWS 2024; 27:21-54. [PMID: 37957800 DOI: 10.1080/10937404.2023.2280837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2023]
Abstract
Noise, any unwanted sound, is pervasive and impacts large populations worldwide. Investigators suggested that noise exposure not only induces auditory damage but also produces various organ system dysfunctions. Although previous reviews primarily focused on noise-induced cardiovascular and cerebral dysfunctions, this narrow focus has unintentionally led the research community to disregard the importance of other vital organs. Indeed, limited studies revealed that noise exposure impacts other organs including the liver, kidneys, pancreas, lung, and gastrointestinal tract. Therefore, the aim of this review was to examine the effects of noise on both the extensively studied organs, the brain and heart, but also determine noise impact on other vital organs. The goal was to illustrate a comprehensive understanding of the systemic effects of noise. These systemic effects may guide future clinical research and epidemiological endpoints, emphasizing the importance of considering noise exposure history in diagnosing various systemic diseases.
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Affiliation(s)
- Li Yang
- Cell & Molecular Pathology Laboratory, Communication Sciences and Disorders, Northern Arizona University, Flagstaff, AZ, USA
- Department of Biological Sciences, Northern Arizona University, Flagstaff, AZ, USA
| | - Daniel E Gutierrez
- Arizona College of Osteopathic Medicine, Midwestern University, Glendale, AZ, USA
| | - O'neil W Guthrie
- Cell & Molecular Pathology Laboratory, Communication Sciences and Disorders, Northern Arizona University, Flagstaff, AZ, USA
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22
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Henry KS, Guo AA, Abrams KS. Normal behavioral discrimination of envelope statistics in budgerigars with kainate-induced cochlear synaptopathy. Hear Res 2024; 441:108927. [PMID: 38096707 PMCID: PMC10775186 DOI: 10.1016/j.heares.2023.108927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 11/27/2023] [Accepted: 12/04/2023] [Indexed: 12/27/2023]
Abstract
Cochlear synaptopathy is a common pathology in humans associated with aging and potentially sound overexposure. Synaptopathy is widely expected to cause "hidden hearing loss," including difficulty perceiving speech in noise, but support for this hypothesis is controversial. Here in budgerigars (Melopsittacus undulatus), we evaluated the impact of long-term cochlear synaptopathy on behavioral discrimination of Gaussian noise (GN) and low-noise noise (LNN) signals processed to have a flatter envelope. Stimuli had center frequencies of 1-3kHz, 100-Hz bandwidth, and were presented at sensation levels (SLs) from 10 to 30dB. We reasoned that narrowband, low-SL stimuli of this type should minimize spread of excitation across auditory-nerve fibers, and hence might reveal synaptopathy-related defects if they exist. Cochlear synaptopathy was induced without hair-cell injury using kainic acid (KA). Behavioral threshold tracking experiments characterized the minimum stimulus duration above which animals could reliably discriminate between LNN and GN. Budgerigar thresholds for LNN-GN discrimination ranged from 40 to 60ms at 30dB SL, were similar across frequencies, and increased for lower SLs. Notably, animals with long-term 39-77% estimated synaptopathy performed similarly to controls, requiring on average a ∼7.5% shorter stimulus duration (-0.7±1.0dB; mean difference ±SE) for LNN-GN discrimination. Decision-variable correlation analyses of detailed behavioral response patterns showed that individual animals relied on envelope cues to discriminate LNN and GN, with lesser roles of FM and energy cues; no difference was found between KA-exposed and control groups. These results suggest that long-term cochlear synaptopathy does not impair discrimination of low-level signals with different envelope statistics.
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Affiliation(s)
- Kenneth S Henry
- Department of Otolaryngology, University of Rochester, NY 14642, USA; Department of Biomedical Engineering, University of Rochester, Rochester, NY 14642, USA; Department of Neuroscience, University of Rochester, Rochester, NY 14642, USA.
| | - Anna A Guo
- Department of Biomedical Engineering, University of Rochester, Rochester, NY 14642, USA
| | - Kristina S Abrams
- Department of Neuroscience, University of Rochester, Rochester, NY 14642, USA
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23
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Casolani C, Borhan-Azad A, Sørensen RS, Schlittenlacher J, Epp B. Evaluation of a Fast Method to Measure High-Frequency Audiometry Based on Bayesian Learning. Trends Hear 2024; 28:23312165231225545. [PMID: 38192152 PMCID: PMC10777778 DOI: 10.1177/23312165231225545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 12/11/2023] [Accepted: 12/13/2023] [Indexed: 01/10/2024] Open
Abstract
This study aimed to assess the validity of a high-frequency audiometry tool based on Bayesian learning to provide a reliable, repeatable, automatic, and fast test to clinics. The study involved 85 people (138 ears) who had their high-frequency thresholds measured with three tests: standard audiometry (SA), alternative forced choice (AFC)-based algorithm, and Bayesian active (BA) learning-based algorithm. The results showed median differences within ±5 dB up to 10 kHz when comparing the BA with the other two tests, and median differences within ±10 dB at higher frequencies. The variability increased from lower to higher frequencies. The BA showed lower thresholds compared to the SA at the majority of the frequencies. The results of the different tests were consistent across groups (age, hearing loss, and tinnitus). The data for the BA showed high test-retest reliability (>90%). The time required for the BA was shorter than for the AFC (4 min vs. 13 min). The data suggest that the BA test for high-frequency audiometry could be a good candidate for clinical screening. It would add reliable and significant information without adding too much time to the visit.
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Affiliation(s)
- Chiara Casolani
- Auditory Physics Group, Hearing Systems section, Department of Health Technology, Technical University of Denmark, Lyngby, Denmark
| | - Ali Borhan-Azad
- Auditory Physics Group, Hearing Systems section, Department of Health Technology, Technical University of Denmark, Lyngby, Denmark
| | - Rikke Skovhøj Sørensen
- Auditory Physics Group, Hearing Systems section, Department of Health Technology, Technical University of Denmark, Lyngby, Denmark
| | | | - Bastian Epp
- Auditory Physics Group, Hearing Systems section, Department of Health Technology, Technical University of Denmark, Lyngby, Denmark
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Hiss MM, Kaul VF, Riggs WJ, Chawla M, Munjal V, Varadarajan VV, Adunka OF. Noise-induced hearing loss in the contralateral ear during otologic and neurotologic surgeries. Am J Otolaryngol 2024; 45:104049. [PMID: 37738880 DOI: 10.1016/j.amjoto.2023.104049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 09/12/2023] [Indexed: 09/24/2023]
Abstract
OBJECTIVE Noise-induced hearing loss in the non-surgical ear during otologic/neurotologic surgery has not been well studied. The purpose of this study was to evaluate changes in hearing that may occur in the contralateral (i.e., non-surgical) ear after various otologic/neurotologic surgeries due to noise generated by drills. We hypothesized that otologic/neurotologic surgeries, longer in duration, would suggest longer drilling times and result in decreased hearing in the contralateral ear as evidenced by a change post-operative pure tone air conduction thresholds when compared to pre-operative thresholds. METHODS A retrospective chart review at a tertiary referral center. Adult patients (18-75 years old) who underwent otologic/neurotologic surgeries from May 1, 2016 through May 1, 2021 were considered for inclusion. Surgeries included vestibular schwannoma resection (translabyrinthine, middle cranial fossa, or retrosigmoid approaches), endolymphatic sac/shunt and labyrinthectomy for Meniere's disease, and tympanomastoid surgery for middle ear pathology (e.g., cholesteatoma). Patient characteristics obtained through record review included age, sex, surgical procedure, pre-operative and post-operative audiometric thresholds and word recognition scores (WRS) for the contralateral ear, and duration of surgery. RESULTS No significant differences were observed for change in audiometric thresholds in the contralateral ear for any surgery when considering individual frequencies. Additionally, no significant change in WRS was observed for any surgical approach. CONCLUSIONS The risk of hearing loss in the non-surgical ear during various otologic/neurotologic surgeries appears to be minimal when measured via routine clinical tests.
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Affiliation(s)
- Meghan M Hiss
- The Ohio State University Wexner Medical Center; Department of Otolaryngology - Head and Neck Surgery; Columbus, OH, USA.
| | - Vivian F Kaul
- The Ohio State University Wexner Medical Center; Department of Otolaryngology - Head and Neck Surgery; Columbus, OH, USA
| | - William J Riggs
- The Ohio State University Wexner Medical Center; Department of Otolaryngology - Head and Neck Surgery; Columbus, OH, USA
| | - Mehak Chawla
- The Ohio State University College of Medicine; Columbus, OH, USA
| | - Vikas Munjal
- The Ohio State University College of Medicine; Columbus, OH, USA
| | - Varun V Varadarajan
- The Ohio State University Wexner Medical Center; Department of Otolaryngology - Head and Neck Surgery; Columbus, OH, USA
| | - Oliver F Adunka
- The Ohio State University Wexner Medical Center; Department of Otolaryngology - Head and Neck Surgery; Columbus, OH, USA
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Kalchev E. Beyond the Sound Waves: A Comprehensive Exploration of the Burn-In Phenomenon in Audio Equipment Across Physiological, Psychological, and Societal Domains. Cureus 2024; 16:e53097. [PMID: 38414701 PMCID: PMC10898501 DOI: 10.7759/cureus.53097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/28/2024] [Indexed: 02/29/2024] Open
Abstract
Audio burn-in, often referred to as the process by which audio equipment undergoes a series of played sounds to achieve optimal performance, remains a topic of significant debate within both audiophile communities and relevant scientific fields. While some attribute perceived changes in sound quality to actual physical changes in the equipment, an emerging perspective points to the interplay of physiological, psychological, and social factors that might influence these perceptions. This narrative review delves into the intricate layers of auditory physiology, cognitive sound interpretation, and the wider societal beliefs around burn-in. We underscore the importance of discerning between actual physical changes in audio gear and the multifaceted human factors that potentially modulate our perception of sound. Through a comprehensive exploration, this article illuminates the complexities of this phenomenon, offering insights for both medical professionals and passionate audio enthusiasts and proposing directions for future research.
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Affiliation(s)
- Emilian Kalchev
- Diagnostic Imaging, St. Marina University Hospital, Varna, BGR
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26
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Grant KW, Phatak SA, Myers JR, Jenkins KA, Kubli LR, Brungart DS. Functional Hearing Difficulties in Blast-Exposed Service Members With Normal to Near-Normal Hearing Thresholds. Ear Hear 2024; 45:130-141. [PMID: 37599415 DOI: 10.1097/aud.0000000000001407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/22/2023]
Abstract
OBJECTIVES Estimated prevalence of functional hearing and communication deficits (FHCDs), characterized by abnormally low speech recognition and binaural tone detection in noise or an abnormally high degree of self-perceived hearing difficulties, dramatically increases in active-duty service members (SMs) who have hearing thresholds slightly above the normal range and self-report to have been close to an explosive blast. Knowing the exact nature of the underlying auditory-processing deficits that contribute to FHCD would not only provide a better characterization of the effects of blast exposure on the human auditory system, but also allow clinicians to prescribe appropriate therapies to treat or manage patient complaints. DESIGN Two groups of SMs were initially recruited: (1) a control group (N = 78) with auditory thresholds ≤20 dB HL between 250 and 8000 Hz, no history of blast exposure, and who passed a short FHCD screener, and (2) a group of blast-exposed SMs (N = 26) with normal to near-normal auditory thresholds between 250 and 4000 Hz, and who failed the FHCD screener (cutoffs based on the study by Grant et al.). The two groups were then compared on a variety of audiometric, behavioral, cognitive, and electrophysiological measures. These tests were selected to characterize various aspects of auditory system processing from the cochlear to the cortex. A third, smaller group of blast-exposed SMs who performed within normal limits on the FHCD screener were also recruited (N = 11). This third subject group was unplanned at the onset of the study and was added to evaluate the effects of blast exposure on hearing and communication regardless of performance on the FHCD screener. RESULTS SMs in the blast-exposed group with FHCD performed significantly worse than control participants on several metrics that measured peripheral and mostly subcortical auditory processing. Cognitive processing was mostly unaffected by blast exposure with the exception of cognitive tests of language-processing speed and working memory. Blast-exposed SMs without FHCD performed similarly to the control group on tests of peripheral and brainstem processing, but performed similarly to blast-exposed SMs with FHCD on measures of cognitive processing. Measures derived from EEG recordings of the frequency-following response revealed that blast-exposed SMs who exhibited FHCD demonstrated increased spontaneous neural activity, reduced amplitude of the envelope-following response, poor internal signal to noise ratio, reduced response stability, and an absent or delayed onset response, compared with the other two participant groups. CONCLUSIONS Degradation in the neural encoding of acoustic stimuli is likely a major contributing factor leading to FHCD in blast-exposed SMs with normal to near-normal audiometric thresholds. Blast-exposed SMs, regardless of their performance on the FHCD screener, exhibited a deficit in language-processing speed and working memory, which could lead to difficulties in decoding rapid speech and in understanding speech in challenging speech communication settings. Further tests are needed to align these findings with clinical treatment protocols being used for patients with suspected auditory-processing disorders.
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Affiliation(s)
- Ken W Grant
- Walter Reed National Military Medical Center, Audiology and Speech Pathology Center, Bethesda, Maryland, USA
| | - Sandeep A Phatak
- Walter Reed National Military Medical Center, Audiology and Speech Pathology Center, Bethesda, Maryland, USA
| | - Jennifer R Myers
- Walter Reed National Military Medical Center, Audiology and Speech Pathology Center, Bethesda, Maryland, USA
| | - Kimberly A Jenkins
- Walter Reed National Military Medical Center, Audiology and Speech Pathology Center, Bethesda, Maryland, USA
| | - Lina R Kubli
- Walter Reed National Military Medical Center, Audiology and Speech Pathology Center, Bethesda, Maryland, USA
- U.S. Department of Veterans Affairs, Washington, District of Columbia, USA
| | - Douglas S Brungart
- Walter Reed National Military Medical Center, Audiology and Speech Pathology Center, Bethesda, Maryland, USA
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Bramhall NF, McMillan GP. Perceptual Consequences of Cochlear Deafferentation in Humans. Trends Hear 2024; 28:23312165241239541. [PMID: 38738337 DOI: 10.1177/23312165241239541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/14/2024] Open
Abstract
Cochlear synaptopathy, a form of cochlear deafferentation, has been demonstrated in a number of animal species, including non-human primates. Both age and noise exposure contribute to synaptopathy in animal models, indicating that it may be a common type of auditory dysfunction in humans. Temporal bone and auditory physiological data suggest that age and occupational/military noise exposure also lead to synaptopathy in humans. The predicted perceptual consequences of synaptopathy include tinnitus, hyperacusis, and difficulty with speech-in-noise perception. However, confirming the perceptual impacts of this form of cochlear deafferentation presents a particular challenge because synaptopathy can only be confirmed through post-mortem temporal bone analysis and auditory perception is difficult to evaluate in animals. Animal data suggest that deafferentation leads to increased central gain, signs of tinnitus and abnormal loudness perception, and deficits in temporal processing and signal-in-noise detection. If equivalent changes occur in humans following deafferentation, this would be expected to increase the likelihood of developing tinnitus, hyperacusis, and difficulty with speech-in-noise perception. Physiological data from humans is consistent with the hypothesis that deafferentation is associated with increased central gain and a greater likelihood of tinnitus perception, while human data on the relationship between deafferentation and hyperacusis is extremely limited. Many human studies have investigated the relationship between physiological correlates of deafferentation and difficulty with speech-in-noise perception, with mixed findings. A non-linear relationship between deafferentation and speech perception may have contributed to the mixed results. When differences in sample characteristics and study measurements are considered, the findings may be more consistent.
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Affiliation(s)
- Naomi F Bramhall
- VA National Center for Rehabilitative Auditory Research, Veterans Affairs Portland Health Care System, Portland, OR, USA
- Department of Otolaryngology/Head & Neck Surgery, Oregon Health & Science University, Portland, OR, USA
| | - Garnett P McMillan
- VA National Center for Rehabilitative Auditory Research, Veterans Affairs Portland Health Care System, Portland, OR, USA
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28
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De Poortere N, Verhulst S, Degeest S, Keshishzadeh S, Dhooge I, Keppler H. Evaluation of Lifetime Noise Exposure History Reporting. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2023; 66:5129-5151. [PMID: 37988687 DOI: 10.1044/2023_jslhr-23-00266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2023]
Abstract
PURPOSE The purpose of this study is to critically evaluate lifetime noise exposure history (LNEH) reporting. First, two different approaches to evaluate the cumulative LNEH were compared. Second, individual LNEH was associated with the subjects' hearing status. Third, loudness estimates of exposure activities, by means of Jokitulppo- and Ferguson-based exposure levels, were compared with dosimeter sound-level measurements. METHOD One hundred one young adults completed the questionnaires, and a subgroup of 30 subjects underwent audiological assessment. Pure-tone audiometry, speech-in-noise intelligibility, distortion product otoacoustic emissions, auditory brainstem responses, and envelope following responses were included. Fifteen out of the 30 subjects took part in a noisy activity while wearing a dosimeter. RESULTS First, results demonstrate that the structured questionnaire yielded a greater amount of information pertaining to the diverse activities, surpassing the insights obtained from an open-ended questionnaire. Second, no significant correlations between audiological assessment and LNEH were found. Lastly, the results indicate that Ferguson-based exposure levels offer a more precise estimation of the actual exposure levels, in contrast to Jokitulppo-based estimates. CONCLUSIONS We propose several recommendations for determining the LNEH. First, it is vital to define accurate loudness categories and corresponding allocated levels, with a preference for the loudness levels proposed by Ferguson et al. (2019), as identified in this study. Second, a structured questionnaire regarding LNEH is recommended, discouraging open-ended questioning. Third, it is essential to include a separate category exclusively addressing work-related activities, encompassing various activities for more accurate surveying.
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Affiliation(s)
- Nele De Poortere
- Department of Rehabilitation Sciences-Audiology, Ghent University, Belgium
| | - Sarah Verhulst
- Department of Information Technology-Hearing Technology at WAVES, Ghent University, Belgium
| | - Sofie Degeest
- Department of Rehabilitation Sciences-Audiology, Ghent University, Belgium
| | - Sarineh Keshishzadeh
- Department of Information Technology-Hearing Technology at WAVES, Ghent University, Belgium
| | - Ingeborg Dhooge
- Department of Ear, Nose and Throat, Ghent University Hospital, Belgium
- Department of Head and Skin, Ghent University, Belgium
| | - Hannah Keppler
- Department of Rehabilitation Sciences-Audiology, Ghent University, Belgium
- Department of Head and Skin, Ghent University, Belgium
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McFarlane KA, Sanchez JT. Exploring Electrode Placements to Optimize the Identification and Measurement of Early Auditory Evoked Potentials. Audiol Res 2023; 13:978-988. [PMID: 38131810 PMCID: PMC10740558 DOI: 10.3390/audiolres13060085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 12/04/2023] [Accepted: 12/07/2023] [Indexed: 12/23/2023] Open
Abstract
Cochlear synaptic loss (termed cochlear synaptopathy) has been suggested to contribute to suprathreshold hearing difficulties. However, its existence and putative effects in humans remain inconclusive, largely due to the heterogeneous methods used across studies to indirectly evaluate the health of cochlear synapses. There is a need to standardize proxies of cochlear synaptopathy to appropriately compare and interpret findings across studies. Early auditory evoked potentials (AEPs), including the compound action potential (AP)/Wave I of the auditory brainstem response are a popular proxy, yet remain variable based on technical considerations. This study evaluated one such consideration-electrode array (i.e., montage)-to optimize the use of early AEP waveforms. In 35 young adults, electrocochleography (ECochG) responses were collected using vertical and horizontal montages. Standard ECochG measures and AP/Wave I and Wave II peak-to-trough amplitudes and latencies were compared between montages. Vertical montage recordings consistently produced significantly larger AP/Wave I peak-to-trough amplitudes compared to horizontal recordings. These findings support the use of a vertical electrode montage for optimal recordings of peripheral cochlear nerve activity. As cochlear synaptopathy continues to be explored in humans, the methods highlighted here should be considered in the development of a standardized assessment.
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Affiliation(s)
- Kailyn A. McFarlane
- Roxelyn and Richard Pepper Department of Communication Sciences and Disorders, Northwestern University, Evanston, IL 60208, USA;
| | - Jason Tait Sanchez
- Roxelyn and Richard Pepper Department of Communication Sciences and Disorders, Northwestern University, Evanston, IL 60208, USA;
- Knowles Hearing Center, Northwestern University, Evanston, IL 60208, USA
- Department of Neurobiology, Northwestern University, Evanston, IL 60208, USA
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30
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Vasilkov V, Caswell-Midwinter B, Zhao Y, de Gruttola V, Jung DH, Liberman MC, Maison SF. Evidence of cochlear neural degeneration in normal-hearing subjects with tinnitus. Sci Rep 2023; 13:19870. [PMID: 38036538 PMCID: PMC10689483 DOI: 10.1038/s41598-023-46741-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 11/04/2023] [Indexed: 12/02/2023] Open
Abstract
Tinnitus, reduced sound-level tolerance, and difficulties hearing in noisy environments are the most common complaints associated with sensorineural hearing loss in adult populations. This study aims to clarify if cochlear neural degeneration estimated in a large pool of participants with normal audiograms is associated with self-report of tinnitus using a test battery probing the different stages of the auditory processing from hair cell responses to the auditory reflexes of the brainstem. Self-report of chronic tinnitus was significantly associated with (1) reduced cochlear nerve responses, (2) weaker middle-ear muscle reflexes, (3) stronger medial olivocochlear efferent reflexes and (4) hyperactivity in the central auditory pathways. These results support the model of tinnitus generation whereby decreased neural activity from a damaged cochlea can elicit hyperactivity from decreased inhibition in the central nervous system.
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Affiliation(s)
- Viacheslav Vasilkov
- Eaton-Peabody Laboratories, Massachusetts Eye and Ear, 243 Charles Street, Boston, MA, 02114, USA
- Department of Otolaryngology, Harvard Medical School, Boston, MA, 02114, USA
| | - Benjamin Caswell-Midwinter
- Eaton-Peabody Laboratories, Massachusetts Eye and Ear, 243 Charles Street, Boston, MA, 02114, USA
- Department of Otolaryngology, Harvard Medical School, Boston, MA, 02114, USA
| | - Yan Zhao
- Eaton-Peabody Laboratories, Massachusetts Eye and Ear, 243 Charles Street, Boston, MA, 02114, USA
| | - Victor de Gruttola
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, 02114, USA
| | - David H Jung
- Eaton-Peabody Laboratories, Massachusetts Eye and Ear, 243 Charles Street, Boston, MA, 02114, USA
- Department of Otolaryngology, Harvard Medical School, Boston, MA, 02114, USA
| | - M Charles Liberman
- Eaton-Peabody Laboratories, Massachusetts Eye and Ear, 243 Charles Street, Boston, MA, 02114, USA
- Department of Otolaryngology, Harvard Medical School, Boston, MA, 02114, USA
| | - Stéphane F Maison
- Eaton-Peabody Laboratories, Massachusetts Eye and Ear, 243 Charles Street, Boston, MA, 02114, USA.
- Department of Otolaryngology, Harvard Medical School, Boston, MA, 02114, USA.
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Lunardelo PP, Meneghelli LC, Zanchetta S. Self-reported hearing difficulties and speech-in-noise test performance - what can we find behind a "normal" audiogram? Codas 2023; 35:e20220111. [PMID: 38018646 DOI: 10.1590/2317-1782/20232022111p] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 11/30/2022] [Indexed: 11/30/2023] Open
Abstract
PURPOSE To investigate complaints of difficulty understanding speech in the presence of noise in subjects without hearing loss and their performance on a speech-in-noise test. METHODS Thirty-nine subjects aged 18 to 59 years and 11 months were divided into four groups according to their decade of life. They underwent audiometry, tympanometry, auditory processing tests, the Mini-Mental State Examination, a self-report on auditory perception combined with the Amsterdam Inventory for Auditory Disability and Handicap (Pt-AIADH), and a sentence test in silence and in noise. RESULTS All groups scored high on the Pt-AIADH domains, with the highest average score obtained for the noise intelligibility domain. There were differences between G18 vs. G40, G18 vs. G50, and G30 vs. G50 for auditory self-perception in noise intelligibility, and differences between the youngest and all other groups on the speech-in-noise test in particular, with a lower signal-to-noise ratio for older adults. We also identified a moderate and significant correlation between intelligibility in noise and the speech-in-noise test. CONCLUSION Normal hearers of all age groups complained of intelligibility in noise. We found that the higher an individual's auditory difficulty in this domain, the worse their performance on the speech-in-noise test; this is especially true for middle-aged adults.
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Affiliation(s)
- Pamela Papile Lunardelo
- Faculdade de Filosofia, Ciências e Letras de Ribeirão Preto - FFCLRP, Universidade de São Paulo - USP - Ribeirão Preto (SP), Brasil
| | - Laura Caetano Meneghelli
- Faculdade de Medicina de Ribeirão Preto - FMRP, Universidade de São Paulo - USP - Ribeirão Preto (SP), Brasil
| | - Sthella Zanchetta
- Faculdade de Medicina de Ribeirão Preto - FMRP, Universidade de São Paulo - USP - Ribeirão Preto (SP), Brasil
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Feder K, Marro L, Portnuff C. Leisure noise exposure and hearing outcomes among Canadians aged 6 to 79 years. Int J Audiol 2023; 62:1031-1047. [PMID: 36036440 DOI: 10.1080/14992027.2022.2114022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Accepted: 08/12/2022] [Indexed: 11/05/2022]
Abstract
OBJECTIVE To examine the association between individual and cumulative leisure noise exposure in addition to acceptable yearly exposure (AYE) and hearing outcomes among a nationally representative sample of Canadians. DESIGN Audiometry, distortion-product otoacoustic emissions (DPOAEs) and in-person questionnaires were used to evaluate hearing and leisure noise exposure across age, sex, and household income/education level. High-risk cumulative leisure noise exposure was defined as 85 dBA or greater for 40 h or more per week, with AYE calculations also based on this occupational limit. STUDY SAMPLE A randomised sample of 10,460 respondents, aged 6-79, completed questionnaires and hearing evaluations between 2012 and 2015. RESULTS Among 50-79 year olds, high-risk cumulative leisure noise was associated with increased odds of a notch while high exposure to farming/construction equipment noise was associated with hearing loss, notches and absent DPOAEs. No associations with hearing loss were found however, non-significant tendencies observed included higher mean hearing thresholds, notches and hearing loss odds. CONCLUSION Educational outreach and monitoring of hearing among young and middle-aged populations exposed to hazardous leisure noise would be beneficial.
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Affiliation(s)
- Katya Feder
- Non-Ionizing Radiation Health Sciences Division, Health Canada, Ottawa, Ontario, Canada
- School of Rehabilitation Sciences, Audiology & Speech-Language Pathology Program, University of Ottawa, Ottawa, Ontario, Canada
| | - Leonora Marro
- Environmental Health Science and Research Bureau, Health Canada, Ottawa, Ontario, Canada
| | - Cory Portnuff
- UCHealth Hearing and Balance Clinic, Aurora, CO, USA
- Otolaryngology, University of Colorado School of Medicine, Aurora, CO, USA
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Schüller A, Schilling A, Krauss P, Rampp S, Reichenbach T. Attentional Modulation of the Cortical Contribution to the Frequency-Following Response Evoked by Continuous Speech. J Neurosci 2023; 43:7429-7440. [PMID: 37793908 PMCID: PMC10621774 DOI: 10.1523/jneurosci.1247-23.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 09/07/2023] [Accepted: 09/21/2023] [Indexed: 10/06/2023] Open
Abstract
Selective attention to one of several competing speakers is required for comprehending a target speaker among other voices and for successful communication with them. It moreover has been found to involve the neural tracking of low-frequency speech rhythms in the auditory cortex. Effects of selective attention have also been found in subcortical neural activities, in particular regarding the frequency-following response related to the fundamental frequency of speech (speech-FFR). Recent investigations have, however, shown that the speech-FFR contains cortical contributions as well. It remains unclear whether these are also modulated by selective attention. Here we used magnetoencephalography to assess the attentional modulation of the cortical contributions to the speech-FFR. We presented both male and female participants with two competing speech signals and analyzed the cortical responses during attentional switching between the two speakers. Our findings revealed robust attentional modulation of the cortical contribution to the speech-FFR: the neural responses were higher when the speaker was attended than when they were ignored. We also found that, regardless of attention, a voice with a lower fundamental frequency elicited a larger cortical contribution to the speech-FFR than a voice with a higher fundamental frequency. Our results show that the attentional modulation of the speech-FFR does not only occur subcortically but extends to the auditory cortex as well.SIGNIFICANCE STATEMENT Understanding speech in noise requires attention to a target speaker. One of the speech features that a listener can use to identify a target voice among others and attend it is the fundamental frequency, together with its higher harmonics. The fundamental frequency arises from the opening and closing of the vocal folds and is tracked by high-frequency neural activity in the auditory brainstem and in the cortex. Previous investigations showed that the subcortical neural tracking is modulated by selective attention. Here we show that attention affects the cortical tracking of the fundamental frequency as well: it is stronger when a particular voice is attended than when it is ignored.
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Affiliation(s)
- Alina Schüller
- Department Artificial Intelligence in Biomedical Engineering, Friedrich-Alexander-University Erlangen-Nürnberg, 91054 Erlangen, Germany
| | - Achim Schilling
- Neuroscience Laboratory, University Hospital Erlangen, 91058 Erlangen, Germany
| | - Patrick Krauss
- Neuroscience Laboratory, University Hospital Erlangen, 91058 Erlangen, Germany
- Pattern Recognition Lab, Department Computer Science, Friedrich-Alexander-University Erlangen-Nürnberg, 91054 Erlangen, Germany
| | - Stefan Rampp
- Department of Neurosurgery, University Hospital Erlangen, 91058 Erlangen, Germany
- Department of Neurosurgery, University Hospital Halle (Saale), 06120 Halle (Saale), Germany
- Department of Neuroradiology, University Hospital Erlangen, 91058 Erlangen, Germany
| | - Tobias Reichenbach
- Department Artificial Intelligence in Biomedical Engineering, Friedrich-Alexander-University Erlangen-Nürnberg, 91054 Erlangen, Germany
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Fitzgerald MB, Gianakas SP, Qian ZJ, Losorelli S, Swanson AC. Preliminary Guidelines for Replacing Word-Recognition in Quiet With Speech in Noise Assessment in the Routine Audiologic Test Battery. Ear Hear 2023; 44:1548-1561. [PMID: 37703127 PMCID: PMC10583951 DOI: 10.1097/aud.0000000000001409] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Accepted: 06/14/2023] [Indexed: 09/15/2023]
Abstract
OBJECTIVES For decades, monosyllabic word-recognition in quiet (WRQ) has been the default test of speech recognition in routine audiologic assessment. The continued use of WRQ scores is noteworthy in part because difficulties understanding speech in noise (SIN) is perhaps the most common complaint of individuals with hearing loss. The easiest way to integrate SIN measures into routine clinical practice would be for SIN to replace WRQ assessment as the primary test of speech perception. To facilitate this goal, we predicted classifications of WRQ scores from the QuickSIN signal to noise ratio (SNR) loss and hearing thresholds. DESIGN We examined data from 5808 patients who underwent audiometric assessment at the Stanford Ear Institute. All individuals completed pure-tone audiometry, and speech assessment consisting of monaural WRQ, and monaural QuickSIN. We then performed multiple-logistic regression to determine whether classification of WRQ scores could be predicted from pure-tone thresholds and QuickSIN SNR losses. RESULTS Many patients displayed significant challenges on the QuickSIN despite having excellent WRQ scores. Performance on both measures decreased with hearing loss. However, decrements in performance were observed with less hearing loss for the QuickSIN than for WRQ. Most important, we demonstrate that classification of good or excellent word-recognition scores in quiet can be predicted with high accuracy by the high-frequency pure-tone average and the QuickSIN SNR loss. CONCLUSIONS Taken together, these data suggest that SIN measures provide more information than WRQ. More important, the predictive power of our model suggests that SIN can replace WRQ in most instances, by providing guidelines as to when performance in quiet is likely to be excellent and does not need to be measured. Making this subtle, but profound shift to clinical practice would enable routine audiometric testing to be more sensitive to patient concerns, and may benefit both clinicians and researchers.
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Affiliation(s)
- Matthew B. Fitzgerald
- Department of Otolaryngology—Head and Neck Surgery, Stanford University, Palo Alto, California, USA
| | - Steven P. Gianakas
- Department of Otolaryngology—Head and Neck Surgery, Stanford University, Palo Alto, California, USA
- Department of Speech-Language-Hearing Sciences, University of Minnesota, Taichung, USA
| | - Z. Jason Qian
- Department of Otolaryngology—Head and Neck Surgery, Stanford University, Palo Alto, California, USA
| | - Steven Losorelli
- Department of Otolaryngology—Head and Neck Surgery, Stanford University, Palo Alto, California, USA
| | - Austin C. Swanson
- Department of Otolaryngology—Head and Neck Surgery, Stanford University, Palo Alto, California, USA
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Snapp HA, Vanlooy L, Kuzbyt B, Kolberg C, Laffitte-Lopez D, Rajguru S. Peripheral vestibular loss in noise-exposed firefighters. Front Integr Neurosci 2023; 17:1236661. [PMID: 37849955 PMCID: PMC10577377 DOI: 10.3389/fnint.2023.1236661] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 08/25/2023] [Indexed: 10/19/2023] Open
Abstract
Introduction Occupational workers are increasingly aware of the risk of noise overexposure to the auditory system but lack awareness about potential risks to the vestibular system. The purpose of this study was to investigate changes in vestibular end organ function in a known at-risk noise-exposed population, firefighters compared to age- and sex-matched controls using electrophysiologic measures of cervical vestibular evoked myogenic potentials (cVEMP). Methods A cross-sectional observational study compared cVEMP response characteristics in 38 noise-exposed firefighters. Firefighters were grouped by years of exposure in the fire service. The cVEMP responses were compared within firefighter groups and between firefighters and age- and sex-matched controls. Dependent variables included the response characteristics of amplitude, latency and threshold. Results cVEMP response amplitudes were significantly decreased in firefighters compared to their age- and sex-matched controls. Threshold of the cVEMP responses were significantly higher in firefighters compared to controls and firefighters had a higher incidence of absent cVEMP responses compared to controls. Response amplitudes decreased with increasing years in the fire-service at an increased rate compared to their age- and sex-matched controls. Latency of the cVEMP response was not significantly different in firefighters compared to controls. These findings are consistent with both animal and human studies suggesting noise-induced changes in the sacculocollic pathway. Discussion In the absence of any reported vestibular symptoms or auditory indicators of noise-induced hearing loss, these early effects on the vestibular system point to a potential hidden vestibular loss.
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Affiliation(s)
- Hillary Anne Snapp
- Department of Otolaryngology, University of Miami, Miami, FL, United States
| | - Lindsey Vanlooy
- Department of Otolaryngology, University of Miami, Miami, FL, United States
| | - Brianna Kuzbyt
- Department of Otolaryngology, University of Miami, Miami, FL, United States
| | - Courtney Kolberg
- Department of Otolaryngology, University of Miami, Miami, FL, United States
| | | | - Suhrud Rajguru
- Department of Otolaryngology, University of Miami, Miami, FL, United States
- Department of Biomedical Engineering, University of Miami, Miami, FL, United States
- Bruce W. Carter Department of Veterans Affairs Medical Center, Miami, FL, United States
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Füllgrabe C, Fontan L, Vidal É, Massari H, Moore BCJ. Effects of hearing loss, age, noise exposure, and listening skills on envelope regularity discrimination. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2023; 154:2453-2461. [PMID: 37850836 DOI: 10.1121/10.0021884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 10/03/2023] [Indexed: 10/19/2023]
Abstract
The envelope regularity discrimination (ERD) test assesses the ability to discriminate irregular from regular amplitude modulation (AM). The measured threshold is called the irregularity index (II). It was hypothesized that the II at threshold should be almost unaffected by the loudness recruitment that is associated with cochlear hearing loss because the effect of recruitment is similar to multiplying the AM depth by a certain factor, and II values depend on the amount of envelope irregularity relative to the baseline modulation depth. To test this hypothesis, the ERD test was administered to 60 older adults with varying degrees of hearing loss, using carrier frequencies of 1 and 4 kHz. The II values for the two carrier frequencies were highly correlated, indicating that the ERD test was measuring a consistent characteristic of each subject. The II values at 1 and 4 kHz were not significantly correlated with the audiometric thresholds at the corresponding frequencies, consistent with the hypothesis. The II values at 4 kHz were significantly positively correlated with age. There was an unexpected negative correlation between II values and a measure of noise exposure. This is argued to reflect the confounding effects of listening skills.
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Affiliation(s)
- Christian Füllgrabe
- Ear Institute, University College London, 332 Gray's Inn Road, London, WC1X 8EE, United Kingdom
| | | | | | | | - Brian C J Moore
- Department of Psychology, University of Cambridge, Downing Street, Cambridge, CB2 3EB, United Kingdom
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Balan JR, Rodrigo H, Saxena U, Mishra SK. Explainable machine learning reveals the relationship between hearing thresholds and speech-in-noise recognition in listeners with normal audiograms. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2023; 154:2278-2288. [PMID: 37823779 DOI: 10.1121/10.0021303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 09/17/2023] [Indexed: 10/13/2023]
Abstract
Some individuals complain of listening-in-noise difficulty despite having a normal audiogram. In this study, machine learning is applied to examine the extent to which hearing thresholds can predict speech-in-noise recognition among normal-hearing individuals. The specific goals were to (1) compare the performance of one standard (GAM, generalized additive model) and four machine learning models (ANN, artificial neural network; DNN, deep neural network; RF, random forest; XGBoost; eXtreme gradient boosting), and (2) examine the relative contribution of individual audiometric frequencies and demographic variables in predicting speech-in-noise recognition. Archival data included thresholds (0.25-16 kHz) and speech recognition thresholds (SRTs) from listeners with clinically normal audiograms (n = 764 participants or 1528 ears; age, 4-38 years old). Among the machine learning models, XGBoost performed significantly better than other methods (mean absolute error; MAE = 1.62 dB). ANN and RF yielded similar performances (MAE = 1.68 and 1.67 dB, respectively), whereas, surprisingly, DNN showed relatively poorer performance (MAE = 1.94 dB). The MAE for GAM was 1.61 dB. SHapley Additive exPlanations revealed that age, thresholds at 16 kHz, 12.5 kHz, etc., on the order of importance, contributed to SRT. These results suggest the importance of hearing in the extended high frequencies for predicting speech-in-noise recognition in listeners with normal audiograms.
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Affiliation(s)
- Jithin Raj Balan
- Department of Speech, Language and Hearing Sciences, The University of Texas at Austin, Austin, Texas 78712, USA
| | - Hansapani Rodrigo
- School of Mathematical and Statistical Sciences, The University of Texas Rio Grande Valley, Edinburg, Texas 78539, USA
| | - Udit Saxena
- Department of Audiology and Speech-Language Pathology, Gujarat Medical Education and Research Society, Medical College and Hospital, Ahmedabad, 380060, India
| | - Srikanta K Mishra
- Department of Speech, Language and Hearing Sciences, The University of Texas at Austin, Austin, Texas 78712, USA
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Bhatt IS, Ramadugu SK, Goodman S, Bhagavan SG, Ingalls V, Dias R, Torkamani A. Polygenic Risk Score-Based Association Analysis of Speech-in-Noise and Hearing Threshold Measures in Healthy Young Adults with Self-reported Normal Hearing. J Assoc Res Otolaryngol 2023; 24:513-525. [PMID: 37783963 PMCID: PMC10695896 DOI: 10.1007/s10162-023-00911-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 09/08/2023] [Indexed: 10/04/2023] Open
Abstract
PURPOSE Speech-in-noise (SIN) traits exhibit high inter-subject variability, even for healthy young adults reporting normal hearing. Emerging evidence suggests that genetic variability could influence inter-subject variability in SIN traits. Genome-wide association studies (GWAS) have uncovered the polygenic architecture of various adult-onset complex human conditions. Polygenic risk scores (PRS) summarize complex genetic susceptibility to quantify the degree of genetic risk for health conditions. The present study conducted PRS-based association analyses to identify PRS risk factors for SIN and hearing threshold measures in 255 healthy young adults (18-40 years) with self-reported normal hearing. METHODS Self-reported SIN perception abilities were assessed by the Speech, Spatial, and Qualities of Hearing Scale (SSQ12). QuickSIN and audiometry (0.25-16 kHz) were performed on 218 participants. Saliva-derived DNA was used for low-pass whole genome sequencing, and 2620 PRS variables for various traits were calculated using the models derived from the polygenic risk score (PGS) catalog. The regression analysis was conducted to identify predictors for SSQ12, QuickSIN, and better ear puretone averages at conventional (PTA0.5-2), high (PTA4-8), and extended-high (PTA12.5-16) frequency ranges. RESULTS Participants with a higher genetic predisposition to HDL cholesterol reported better SSQ12. Participants with high PRS to dementia revealed significantly elevated PTA4-8, and those with high PRS to atrial fibrillation and flutter revealed significantly elevated PTA12.5-16. CONCLUSION These results indicate that healthy individuals with polygenic risk of certain health conditions could exhibit a subclinical decline in hearing health measures at young ages, decades before clinically meaningful SIN deficits and hearing loss could be observed. PRS could be used to identify high-risk individuals to prevent hearing health conditions by promoting a healthy lifestyle.
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Affiliation(s)
- Ishan Sunilkumar Bhatt
- Department of Communication Sciences & Disorders, University of Iowa, 250 Hawkins Dr, Iowa City, IA, 52242, USA.
| | - Sai Kumar Ramadugu
- Department of Communication Sciences & Disorders, University of Iowa, 250 Hawkins Dr, Iowa City, IA, 52242, USA
| | - Shawn Goodman
- Department of Communication Sciences & Disorders, University of Iowa, 250 Hawkins Dr, Iowa City, IA, 52242, USA
| | - Srividya Grama Bhagavan
- Department of Communication Sciences & Disorders, University of Iowa, 250 Hawkins Dr, Iowa City, IA, 52242, USA
| | - Valerie Ingalls
- Department of Communication Sciences & Disorders, University of Iowa, 250 Hawkins Dr, Iowa City, IA, 52242, USA
| | - Raquel Dias
- Department of Microbiology and Cell Science, University of Florida, Gainesville, FL, 32608, USA
| | - Ali Torkamani
- Department of Integrative Structural and Computational Biology, Scripps Science Institute, La Jolla, CA, 92037, USA
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Wang Y, Abrams KS, Youngman M, Henry KS. Histological Correlates of Auditory Nerve Injury from Kainic Acid in the Budgerigar (Melopsittacus undulatus). J Assoc Res Otolaryngol 2023; 24:473-485. [PMID: 37798548 PMCID: PMC10695905 DOI: 10.1007/s10162-023-00910-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Accepted: 09/11/2023] [Indexed: 10/07/2023] Open
Abstract
PURPOSE Loss of auditory nerve afferent synapses with cochlear hair cells, called cochlear synaptopathy, is a common pathology in humans caused by aging and noise overexposure. The perceptual consequences of synaptopathy in isolation from other cochlear pathologies are still unclear. Animal models provide an effective approach to resolve uncertainty regarding the physiological and perceptual consequences of auditory nerve loss, because neural lesions can be induced and readily quantified. The budgerigar, a parakeet species, has recently emerged as an animal model for synaptopathy studies based on its capacity for vocal learning and ability to behaviorally discriminate simple and complex sounds with acuity similar to humans. Kainic acid infusions in the budgerigar produce a profound reduction of compound auditory nerve responses, including wave I of the auditory brainstem response, without impacting physiological hair cell measures. These results suggest selective auditory nerve damage. However, histological correlates of neural injury from kainic acid are still lacking. METHODS We quantified the histological effects caused by intracochlear infusion of kainic acid (1 mM; 2.5 µL), and evaluated correlations between the histological and physiological assessments of auditory nerve status. RESULTS Kainic acid infusion in budgerigars produced pronounced loss of neural auditory nerve soma (60% on average) in the cochlear ganglion, and of peripheral axons, at time points 2 or more months following injury. The hair cell epithelium was unaffected by kainic acid. Neural loss was significantly correlated with reduction of compound auditory nerve responses and auditory brainstem response wave I. CONCLUSION Compound auditory nerve responses and wave I provide a useful index of cochlear synaptopathy in this animal model.
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Affiliation(s)
- Yingxuan Wang
- Department of Biomedical Engineering, University of Rochester, Rochester, NY 14642, USA
| | - Kristina S Abrams
- Department of Neuroscience, University of Rochester, Rochester, NY 14642, USA
| | - Margaret Youngman
- Department of Otolaryngology, University of Rochester, Rochester, NY 14642, USA
| | - Kenneth S Henry
- Department of Biomedical Engineering, University of Rochester, Rochester, NY 14642, USA.
- Department of Neuroscience, University of Rochester, Rochester, NY 14642, USA.
- Department of Otolaryngology, University of Rochester, Rochester, NY 14642, USA.
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40
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Dragon JM, Grewal MR, Irace AL, Morales EG, Golub JS. Prevalence of Subclinical Hearing Loss in the United States. Otolaryngol Head Neck Surg 2023; 169:884-889. [PMID: 36960774 PMCID: PMC10830094 DOI: 10.1002/ohn.326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 01/20/2023] [Accepted: 02/25/2023] [Indexed: 03/25/2023]
Abstract
OBJECTIVE Current definitions of hearing loss (HL) may be insufficiently strict, as subclinical hearing loss (SCHL; >0 and ≤25 dB hearing level) has been associated with deleterious age-related conditions. SCHL prevalence and mean age of HL onset in the United States has not been characterized. STUDY DESIGN A cross-sectional epidemiologic prevalence study. SETTING US Community. METHODS We analyzed cross-sectional audiometric data in the US National Health and Nutrition Examination Survey (2005-2012, 2015-2018, n = 15,649). Results were scaled to the current population using weighting. RESULTS 79.6% of participants (227.32 million Americans) had SCHL. The mean age of HL onset at thresholds of 25, 20, and 15 dB was 74, 66, and 55 years, respectively, for the 4-frequency pure-tone average, and 48, 44, and 35 years for the high-frequency pure-tone average. CONCLUSION We present SCHL prevalence and define HL onset by various sensitive definitions. These results inform ongoing public health efforts to increase hearing aid utilization, particularly given the arrival of over-the-counter hearing aids.
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Affiliation(s)
- Jacqueline M. Dragon
- Department of Otolaryngology–Head and Neck Surgery, Columbia University Vagelos College of Physicians and Surgeons, NewYork-Presbyterian/Columbia University Irving Medical Center, New York City, New York, USA
| | - Maeher R. Grewal
- Department of Otolaryngology–Head and Neck Surgery, Columbia University Vagelos College of Physicians and Surgeons, NewYork-Presbyterian/Columbia University Irving Medical Center, New York City, New York, USA
| | - Alexandria L. Irace
- Department of Otolaryngology–Head and Neck Surgery, Columbia University Vagelos College of Physicians and Surgeons, NewYork-Presbyterian/Columbia University Irving Medical Center, New York City, New York, USA
| | - Emmanuel Garcia Morales
- Department of Epidemiology, Cochlear Center for Hearing and Public Health, Johns Hopkins Bloomberg School of Public Health, Maryland, Baltimore, USA
| | - Justin S. Golub
- Department of Otolaryngology–Head and Neck Surgery, Columbia University Vagelos College of Physicians and Surgeons, NewYork-Presbyterian/Columbia University Irving Medical Center, New York City, New York, USA
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Roup CM, Ferguson SD, Lander D. The relationship between extended high-frequency hearing and the binaural spatial advantage in young to middle-aged firefightersa). THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2023; 154:2055-2059. [PMID: 37782123 DOI: 10.1121/10.0021172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 09/13/2023] [Indexed: 10/03/2023]
Abstract
Relationships between extended high-frequency (EHF) thresholds and speech-in-spatialized noise were examined in firefighters with a history of occupational noise and airborne toxin exposure. Speech recognition thresholds were measured for co-located and spatially separated (±90° azimuth) sentences in a competing signal using the Listening in Spatialized Noise-Sentences test. EHF hearing was significantly correlated with the spatial advantage, indicating that firefighters with poorer EHF thresholds experienced less benefit from spatial separation. The correlation between EHF thresholds and spatial hearing remained significant after controlling for age. Deficits in EHF and spatial hearing suggest firefighters may experience compromised speech understanding in job-related complex acoustic environments.
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Affiliation(s)
- Christina M Roup
- Department of Speech and Hearing Science, The Ohio State University, 1070 Carmack Road, 110 Pressey Hall, Columbus, Ohio 43210, USA
| | - Sarah D Ferguson
- Department of Speech and Hearing Science, The Ohio State University, 1070 Carmack Road, 110 Pressey Hall, Columbus, Ohio 43210, USA
| | - Devan Lander
- Department of Speech and Hearing Science, The Ohio State University, 1070 Carmack Road, 110 Pressey Hall, Columbus, Ohio 43210, USA
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Mohamed T, Melfi V, Colciago A, Magnaghi V. Hearing loss and vestibular schwannoma: new insights into Schwann cells implication. Cell Death Dis 2023; 14:629. [PMID: 37741837 PMCID: PMC10517973 DOI: 10.1038/s41419-023-06141-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 09/05/2023] [Accepted: 09/08/2023] [Indexed: 09/25/2023]
Abstract
Hearing loss (HL) is the most common and heterogeneous disorder of the sensory system, with a large morbidity in the worldwide population. Among cells of the acoustic nerve (VIII cranial nerve), in the cochlea are present the hair cells, the spiral ganglion neurons, the glia-like supporting cells, and the Schwann cells (SCs), which alterations have been considered cause of HL. Notably, a benign SC-derived tumor of the acoustic nerve, named vestibular schwannoma (VS), has been indicated as cause of HL. Importantly, SCs are the main glial cells ensheathing axons and forming myelin in the peripheral nerves. Following an injury, the SCs reprogram, expressing some stemness features. Despite the mechanisms and factors controlling their biological processes (i.e., proliferation, migration, differentiation, and myelination) have been largely unveiled, their role in VS and HL was poorly investigated. In this review, we enlighten some of the mechanisms at the base of SCs transformation, VS development, and progression, likely leading to HL, and we pose great attention on the environmental factors that, in principle, could contribute to HL onset or progression. Combining the biomolecular bench-side approach to the clinical bedside practice may be helpful for the diagnosis, prediction, and therapeutic approach in otology.
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Affiliation(s)
- Tasnim Mohamed
- Department of Pharmacological and Biomolecular Sciences "Rodolfo Paoletti", Università degli Studi di Milano, Via G. Balzaretti 9, 20133, Milan, Italy
| | - Valentina Melfi
- Department of Pharmacological and Biomolecular Sciences "Rodolfo Paoletti", Università degli Studi di Milano, Via G. Balzaretti 9, 20133, Milan, Italy
- Fondazione IRCCS Istituto Nazionale dei Tumori, Via G. Venezian 1, 20133, Milan, Italy
| | - Alessandra Colciago
- Department of Pharmacological and Biomolecular Sciences "Rodolfo Paoletti", Università degli Studi di Milano, Via G. Balzaretti 9, 20133, Milan, Italy
| | - Valerio Magnaghi
- Department of Pharmacological and Biomolecular Sciences "Rodolfo Paoletti", Università degli Studi di Milano, Via G. Balzaretti 9, 20133, Milan, Italy.
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Jahn KN, Polley DB. Asymmetric hearing thresholds are associated with hyperacusis in a large clinical population. Hear Res 2023; 437:108854. [PMID: 37487430 PMCID: PMC11075140 DOI: 10.1016/j.heares.2023.108854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 06/27/2023] [Accepted: 07/12/2023] [Indexed: 07/26/2023]
Abstract
Hyperacusis is a debilitating auditory condition whose characterization is largely qualitative and is typically based on small participant cohorts. Here, we characterize the hearing and demographic profiles of adults who reported hyperacusis upon audiological evaluation at a large medical center. Audiometric data from 626 adults (age 18-80 years) with documented hyperacusis were retrospectively extracted from medical records and compared to an age- and sex-matched reference group of patients from the same clinic who did not report hyperacusis. Patients with hyperacusis had lower (i.e., better) high-frequency hearing thresholds (2000-8000 Hz), but significantly larger interaural threshold asymmetries (250-8000 Hz) relative to the reference group. The probability of reporting hyperacusis was highest for normal, asymmetric, and notched audiometric configurations. Many patients reported unilateral hyperacusis symptoms, a history of noise exposure, and co-morbid tinnitus. The high prevalence of both overt and subclinical hearing asymmetries in the hyperacusis population suggests a central compensatory mechanism that is dominated by input from an intact or minimally damaged ear, and which may lead to perceptual hypersensitivity by overshooting baseline neural activity levels.
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Affiliation(s)
- Kelly N Jahn
- School of Behavioral and Brain Sciences, University of Texas at Dallas, 1966 Inwood Road, Dallas, TX 75235, USA; Eaton-Peabody Laboratories, Massachusetts Eye and Ear, 243 Charles Street, Boston, MA 02114, USA; Department of Otolaryngology - Head and Neck Surgery, Harvard Medical School, 243 Charles Street, Boston, MA 02114, USA.
| | - Daniel B Polley
- Eaton-Peabody Laboratories, Massachusetts Eye and Ear, 243 Charles Street, Boston, MA 02114, USA; Department of Otolaryngology - Head and Neck Surgery, Harvard Medical School, 243 Charles Street, Boston, MA 02114, USA
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44
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Berger JI, Gander PE, Kim S, Schwalje AT, Woo J, Na YM, Holmes A, Hong JM, Dunn CC, Hansen MR, Gantz BJ, McMurray B, Griffiths TD, Choi I. Neural Correlates of Individual Differences in Speech-in-Noise Performance in a Large Cohort of Cochlear Implant Users. Ear Hear 2023; 44:1107-1120. [PMID: 37144890 PMCID: PMC10426791 DOI: 10.1097/aud.0000000000001357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Accepted: 01/11/2023] [Indexed: 05/06/2023]
Abstract
OBJECTIVES Understanding speech-in-noise (SiN) is a complex task that recruits multiple cortical subsystems. Individuals vary in their ability to understand SiN. This cannot be explained by simple peripheral hearing profiles, but recent work by our group ( Kim et al. 2021 , Neuroimage ) highlighted central neural factors underlying the variance in SiN ability in normal hearing (NH) subjects. The present study examined neural predictors of SiN ability in a large cohort of cochlear-implant (CI) users. DESIGN We recorded electroencephalography in 114 postlingually deafened CI users while they completed the California consonant test: a word-in-noise task. In many subjects, data were also collected on two other commonly used clinical measures of speech perception: a word-in-quiet task (consonant-nucleus-consonant) word and a sentence-in-noise task (AzBio sentences). Neural activity was assessed at a vertex electrode (Cz), which could help maximize eventual generalizability to clinical situations. The N1-P2 complex of event-related potentials (ERPs) at this location were included in multiple linear regression analyses, along with several other demographic and hearing factors as predictors of SiN performance. RESULTS In general, there was a good agreement between the scores on the three speech perception tasks. ERP amplitudes did not predict AzBio performance, which was predicted by the duration of device use, low-frequency hearing thresholds, and age. However, ERP amplitudes were strong predictors for performance for both word recognition tasks: the California consonant test (which was conducted simultaneously with electroencephalography recording) and the consonant-nucleus-consonant (conducted offline). These correlations held even after accounting for known predictors of performance including residual low-frequency hearing thresholds. In CI-users, better performance was predicted by an increased cortical response to the target word, in contrast to previous reports in normal-hearing subjects in whom speech perception ability was accounted for by the ability to suppress noise. CONCLUSIONS These data indicate a neurophysiological correlate of SiN performance, thereby revealing a richer profile of an individual's hearing performance than shown by psychoacoustic measures alone. These results also highlight important differences between sentence and word recognition measures of performance and suggest that individual differences in these measures may be underwritten by different mechanisms. Finally, the contrast with prior reports of NH listeners in the same task suggests CI-users performance may be explained by a different weighting of neural processes than NH listeners.
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Affiliation(s)
- Joel I. Berger
- Department of Neurosurgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
| | - Phillip E. Gander
- Department of Neurosurgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
| | - Subong Kim
- Department of Speech, Language, and Hearing Sciences, Purdue University, West Lafayette, Indiana, USA
| | - Adam T. Schwalje
- Department of Otolaryngology – Head and Neck Surgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
| | - Jihwan Woo
- Department of Biomedical Engineering, University of Ulsan, Ulsan, South Korea
| | - Young-min Na
- Department of Biomedical Engineering, University of Ulsan, Ulsan, South Korea
| | - Ann Holmes
- Department of Psychological and Brain Sciences, University of Louisville, Louisville, Kentucky, USA
| | - Jean M. Hong
- Department of Otolaryngology – Head and Neck Surgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
| | - Camille C. Dunn
- Department of Otolaryngology – Head and Neck Surgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
| | - Marlan R. Hansen
- Department of Otolaryngology – Head and Neck Surgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
| | - Bruce J. Gantz
- Department of Otolaryngology – Head and Neck Surgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
| | - Bob McMurray
- Department of Otolaryngology – Head and Neck Surgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
- Department of Psychological and Brain Sciences, University of Iowa, Iowa City, Iowa, USA
- Department of Communication Sciences and Disorders, University of Iowa, Iowa City, Iowa, USA
| | - Timothy D. Griffiths
- Biosciences Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Inyong Choi
- Department of Otolaryngology – Head and Neck Surgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
- Department of Communication Sciences and Disorders, University of Iowa, Iowa City, Iowa, USA
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Zhang Y, Rennig J, Magnotti JF, Beauchamp MS. Multivariate fMRI responses in superior temporal cortex predict visual contributions to, and individual differences in, the intelligibility of noisy speech. Neuroimage 2023; 278:120271. [PMID: 37442310 PMCID: PMC10460966 DOI: 10.1016/j.neuroimage.2023.120271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 06/20/2023] [Accepted: 07/06/2023] [Indexed: 07/15/2023] Open
Abstract
Humans have the unique ability to decode the rapid stream of language elements that constitute speech, even when it is contaminated by noise. Two reliable observations about noisy speech perception are that seeing the face of the talker improves intelligibility and the existence of individual differences in the ability to perceive noisy speech. We introduce a multivariate BOLD fMRI measure that explains both observations. In two independent fMRI studies, clear and noisy speech was presented in visual, auditory and audiovisual formats to thirty-seven participants who rated intelligibility. An event-related design was used to sort noisy speech trials by their intelligibility. Individual-differences multidimensional scaling was applied to fMRI response patterns in superior temporal cortex and the dissimilarity between responses to clear speech and noisy (but intelligible) speech was measured. Neural dissimilarity was less for audiovisual speech than auditory-only speech, corresponding to the greater intelligibility of noisy audiovisual speech. Dissimilarity was less in participants with better noisy speech perception, corresponding to individual differences. These relationships held for both single word and entire sentence stimuli, suggesting that they were driven by intelligibility rather than the specific stimuli tested. A neural measure of perceptual intelligibility may aid in the development of strategies for helping those with impaired speech perception.
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Affiliation(s)
- Yue Zhang
- Department of Neurosurgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States; Department of Neurosurgery, Baylor College of Medicine, Houston, TX, United States
| | - Johannes Rennig
- Division of Neuropsychology, Center of Neurology, Hertie-Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
| | - John F Magnotti
- Department of Neurosurgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Michael S Beauchamp
- Department of Neurosurgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States.
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Hamza Y, Farhadi A, Schwarz DM, McDonough JM, Carney LH. Representations of fricatives in subcortical model responses: Comparisons with human consonant perception. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2023; 154:602-618. [PMID: 37535429 PMCID: PMC10550336 DOI: 10.1121/10.0020536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 07/11/2023] [Accepted: 07/13/2023] [Indexed: 08/05/2023]
Abstract
Fricatives are obstruent sound contrasts made by airflow constrictions in the vocal tract that produce turbulence across the constriction or at a site downstream from the constriction. Fricatives exhibit significant intra/intersubject and contextual variability. Yet, fricatives are perceived with high accuracy. The current study investigated modeled neural responses to fricatives in the auditory nerve (AN) and inferior colliculus (IC) with the hypothesis that response profiles across populations of neurons provide robust correlates to consonant perception. Stimuli were 270 intervocalic fricatives (10 speakers × 9 fricatives × 3 utterances). Computational model response profiles had characteristic frequencies that were log-spaced from 125 Hz to 8 or 20 kHz to explore the impact of high-frequency responses. Confusion matrices generated by k-nearest-neighbor subspace classifiers were based on the profiles of average rates across characteristic frequencies as feature vectors. Model confusion matrices were compared with published behavioral data. The modeled AN and IC neural responses provided better predictions of behavioral accuracy than the stimulus spectra, and IC showed better accuracy than AN. Behavioral fricative accuracy was explained by modeled neural response profiles, whereas confusions were only partially explained. Extended frequencies improved accuracy based on the model IC, corroborating the importance of extended high frequencies in speech perception.
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Affiliation(s)
- Yasmeen Hamza
- Department of Biomedical Engineering, University of Rochester, Rochester, New York 14627, USA
| | - Afagh Farhadi
- Department of Electrical and Computer Engineering, University of Rochester, Rochester, New York 14627, USA
| | - Douglas M Schwarz
- Depts. of Neuroscience and Biomedical Engineering, University of Rochester, Rochester, New York 14627, USA
| | - Joyce M McDonough
- Department of Linguistics, University of Rochester, Rochester, New York 14627, USA
| | - Laurel H Carney
- Depts. of Biomedical Engineering, Neuroscience, and Electrical and Computer Engineering, University of Rochester, Rochester, New York 14627, USA
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Haggerty RA, Hutson KA, Riggs WJ, Brown KD, Pillsbury HC, Adunka OF, Buchman CA, Fitzpatrick DC. Assessment of cochlear synaptopathy by electrocochleography to low frequencies in a preclinical model and human subjects. Front Neurol 2023; 14:1104574. [PMID: 37483448 PMCID: PMC10361575 DOI: 10.3389/fneur.2023.1104574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 06/19/2023] [Indexed: 07/25/2023] Open
Abstract
Cochlear synaptopathy is the loss of synapses between the inner hair cells and the auditory nerve despite survival of sensory hair cells. The findings of extensive cochlear synaptopathy in animals after moderate noise exposures challenged the long-held view that hair cells are the cochlear elements most sensitive to insults that lead to hearing loss. However, cochlear synaptopathy has been difficult to identify in humans. We applied novel algorithms to determine hair cell and neural contributions to electrocochleographic (ECochG) recordings from the round window of animal and human subjects. Gerbils with normal hearing provided training and test sets for a deep learning algorithm to detect the presence of neural responses to low frequency sounds, and an analytic model was used to quantify the proportion of neural and hair cell contributions to the ECochG response. The capacity to detect cochlear synaptopathy was validated in normal hearing and noise-exposed animals by using neurotoxins to reduce or eliminate the neural contributions. When the analytical methods were applied to human surgical subjects with access to the round window, the neural contribution resembled the partial cochlear synaptopathy present after neurotoxin application in animals. This result demonstrates the presence of viable hair cells not connected to auditory nerve fibers in human subjects with substantial hearing loss and indicates that efforts to regenerate nerve fibers may find a ready cochlear substrate for innervation and resumption of function.
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Affiliation(s)
- Raymond A. Haggerty
- Department of Otolaryngology, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Kendall A. Hutson
- Department of Otolaryngology, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - William J. Riggs
- Department of Otolaryngology, The Ohio State University, Columbus, OH, United States
| | - Kevin D. Brown
- Department of Otolaryngology, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
- University of North Carolina School of Medicine, Chapel Hill, NC, United States
| | - Harold C. Pillsbury
- Department of Otolaryngology, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
- University of North Carolina School of Medicine, Chapel Hill, NC, United States
| | - Oliver F. Adunka
- Department of Otolaryngology, The Ohio State University, Columbus, OH, United States
| | - Craig A. Buchman
- Department of Otolaryngology, Washington University in St. Louis, St. Louis, MO, United States
| | - Douglas C. Fitzpatrick
- Department of Otolaryngology, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
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Koerner TK, Gallun FJ. Speech understanding and extended high-frequency hearing sensitivity in blast-exposed veteransa). THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2023; 154:379-387. [PMID: 37462921 DOI: 10.1121/10.0020174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 06/29/2023] [Indexed: 07/21/2023]
Abstract
Auditory difficulties reported by normal-hearing Veterans with a history of blast exposure are primarily thought to stem from processing deficits in the central nervous system. However, previous work on speech understanding in noise difficulties in this patient population have only considered peripheral hearing thresholds in the standard audiometric range. Recent research suggests that variability in extended high-frequency (EHF; >8 kHz) hearing sensitivity may contribute to speech understanding deficits in normal-hearing individuals. Therefore, this work was designed to identify the effects of blast exposure on several common clinical speech understanding measures and EHF hearing sensitivity. This work also aimed to determine whether variability in EHF hearing sensitivity contributes to speech understanding difficulties in normal-hearing blast-exposed Veterans. Data from 41 normal- or near-normal-hearing Veterans with a history of blast exposure and 31 normal- or near-normal-hearing control participants with no history of head injury were employed in this study. Analysis identified an effect of blast exposure on several speech understanding measures but showed no statistically significant differences in EHF thresholds between participant groups. Data showed that variability in EHF hearing sensitivity did not contribute to group-related differences in speech understanding, although study limitations impact interpretation of these results.
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Affiliation(s)
- Tess K Koerner
- Department of Veterans Affairs (VA) Rehabilitation Research and Development (RR & D), National Center for Rehabilitative Auditory Research (NCRAR), VA Portland Health Care System, Portland, Oregon 97239, USA
| | - Frederick J Gallun
- Department of Veterans Affairs (VA) Rehabilitation Research and Development (RR & D), National Center for Rehabilitative Auditory Research (NCRAR), VA Portland Health Care System, Portland, Oregon 97239, USA
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Kempfle JS, Jung DH. Experimental drugs for the prevention or treatment of sensorineural hearing loss. Expert Opin Investig Drugs 2023; 32:643-654. [PMID: 37598357 DOI: 10.1080/13543784.2023.2242253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 07/26/2023] [Indexed: 08/22/2023]
Abstract
INTRODUCTION Sensorineural hearing loss results in irreversible loss of inner ear hair cells and spiral ganglion neurons. Reduced sound detection and speech discrimination can span all ages, and sensorineural hearing rehabilitation is limited to amplification with hearing aids or cochlear implants. Recent insights into experimental drug treatments for inner ear regeneration and otoprotection have paved the way for clinical trials in order to restore a more physiological hearing experience. Paired with the development of innovative minimally invasive approaches for drug delivery to the inner ear, new, emerging treatments for hearing protection and restoration are within reach. AREAS COVERED This expert opinion provides an overview of the latest experimental drug therapies to protect from and to restore sensorineural hearing loss. EXPERT OPINION The degree and type of cellular damage to the cochlea, the responsiveness of remaining, endogenous cells to regenerative treatments, and the duration of drug availability within cochlear fluids will determine the success of hearing protection or restoration.
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Affiliation(s)
- Judith S Kempfle
- Department of Otolaryngology, Massachusetts Eye and Ear, Boston, MA, USA
- Department of Otolaryngology, Head & Neck Surgery, Harvard Medical School, Boston, MA, USA
- Department of Otolaryngology, UMass Memorial Medical Center, Worcester, MA, USA
- Department of Otolaryngology, Head & Neck Surgery, University of Massachusetts Medical School, Worcester, MA, USA
| | - David H Jung
- Department of Otolaryngology, Massachusetts Eye and Ear, Boston, MA, USA
- Department of Otolaryngology, Head & Neck Surgery, Harvard Medical School, Boston, MA, USA
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Bhatt IS, Lichtenhan J, Tyler R, Goodman S. Influence of tinnitus, lifetime noise exposure, and firearm use on hearing thresholds, distortion product otoacoustic emissions, and their relative metric. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2023; 154:418-432. [PMID: 37477366 PMCID: PMC10362977 DOI: 10.1121/10.0019880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 05/22/2023] [Accepted: 06/10/2023] [Indexed: 07/22/2023]
Abstract
Distortion product otoacoustic emissions (DPOAEs) and hearing thresholds (HTs) are widely used to evaluate auditory physiology. DPOAEs are sensitive to cochlear amplification processes, while HTs are additionally dependent upon inner hair cells, synaptic junctions, and the auditory nervous system. These distinctions between DPOAEs and HTs might help differentially diagnose auditory dysfunctions. This study aims to differentially diagnose auditory dysfunctions underlying tinnitus, firearm use, and high lifetime noise exposure (LNE) using HTs, DPOAEs, and a derived metric comparing HTs and DPOAEs, in a sample containing overlapping subgroups of 133 normal-hearing young adults (56 with chronic tinnitus). A structured interview was used to evaluate LNE and firearm use. Linear regression was used to model the relationship between HTs and DPOAEs, and their regression residuals were used to quantify their relative agreement. Participants with chronic tinnitus showed significantly elevated HTs, yet DPOAEs remained comparable to those without tinnitus. In contrast, firearm users revealed elevated HTs and significantly lower DPOAEs than predicted from HTs. High LNE was associated with elevated HTs and a proportional decline in DPOAEs, as predicted from HTs. We present a theoretical model to interpret the findings, which suggest neural (or synaptic) dysfunction underlying tinnitus and disproportional mechanical dysfunction underlying firearm use.
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Affiliation(s)
- Ishan Sunilkumar Bhatt
- Department of Communication Sciences & Disorders, University of Iowa, Iowa City, Iowa 52242, USA
| | - Jeffery Lichtenhan
- Department of Otolaryngology-Head and Neck Surgery, University of South Florida, Tampa, Florida 33612, USA
| | - Richard Tyler
- Department of Communication Sciences & Disorders, University of Iowa, Iowa City, Iowa 52242, USA
| | - Shawn Goodman
- Department of Communication Sciences & Disorders, University of Iowa, Iowa City, Iowa 52242, USA
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