Teste GIN (Gaps-in-Noise) em ouvintes normais com e sem zumbido

Hearing loss and tinnitus: association studies for complex-hearing disorders in mouse and man

Genome-wide association studies (GWAS) provide an unbiased first look at genetic loci involved in aging and noise-induced sensorineural hearing loss and tinnitus. The hearing phenotype, whether audiogram-based or self-report, is regressed against genotyped information at representative single nucleotide polymorphisms (SNPs) across the genome. Findings include the fact that both hearing loss and tinnitus are polygenic disorders, with up to thousands of genes, each of effect size of < 0.02. Smaller human GWAS' were able to use objective measures and identified a few loci; however, hundreds of thousands of participants have been required for the statistical power to identify significant variants, and GWAS is unable to assess rare variants with mean allele frequency < 1%. Animal studies are required as well because of inability to access the human cochlea. Mouse GWAS builds on linkage techniques and the known phenotypic differences in auditory function between inbred strains. With the advantage that the laboratory environment can be controlled for noise and aging, the Hybrid Mouse Diversity Panel (HDMP) combines 100 strains sequenced at high resolution. Lift-over regions between mice and humans have identified over 17,000 homologous genes. Since most significant SNPs are either intergenic or in introns, and binding sites between species are poorly preserved between species, expression quantitative trait locus information is required to bring humans and mice into agreement. Transcriptome-wide analysis studies (TWAS) can prioritize putative causal genes and tissues. Diverse species, each making a distinct contribution, carry a synergistic advantage in the quest for treatment and ultimate cure of sensorineural hearing difficulties.

Tinnitus impairs segregation of competing speech in normal-hearing listeners

Many tinnitus patients report difficulties understanding speech in noise or competing talkers, despite having "normal" hearing in terms of audiometric thresholds. The interference caused by tinnitus is more likely central in origin. Release from informational masking (more central in origin) produced by competing speech may further illuminate central interference due to tinnitus. In the present study, masked speech understanding was measured in normal hearing listeners with or without tinnitus. Speech recognition thresholds were measured for target speech in the presence of multi-talker babble or competing speech. For competing speech, speech recognition thresholds were measured for different cue conditions (i.e., with and without target-masker sex differences and/or with and without spatial cues). The present data suggest that tinnitus negatively affected masked speech recognition even in individuals with no measurable hearing loss. Tinnitus severity appeared to especially limit listeners' ability to segregate competing speech using talker sex differences. The data suggest that increased informational masking via lexical interference may tax tinnitus patients' central auditory processing resources.

Comparison of Silent Gap in Noise Cortical Auditory Evoked Potentials in Matched Tinnitus and No-Tinnitus Control Subjects

Purpose Previous research suggests the existence of gap detection impairments because of tinnitus. The current study aimed to determine whether there was objective evidence of gap impairment in individuals with tinnitus by recording silent gap in white noise cortical auditory evoked potentials (CAEPs) in a chronic tinnitus group and a no-tinnitus group. The results were compared to previous gap-evoked potential and behavioral gap detection studies. Method Chronic tinnitus and no-tinnitus groups were formed by matching pairs of subjects ( n = 26) based on age, gender, and hearing thresholds. Behaviorally determined gap detection thresholds were used to define the electrophysiological gap duration conditions of subthreshold, threshold, and suprathreshold gaps in white noise. Amplitude, latency, and area of the CAEP were analyzed by group and condition using mixed-model analyses of variance. Results Across all participants, as the duration of the gap increased, amplitude and area of the CAEP increased. There were no significant differences by tinnitus status between groups for any outcome measures, except for a significant interaction between group and gap duration for P1 latency. Conclusions Silent gap-evoked CAEPs can be recorded in adults with and without tinnitus. Amplitude and area were sensitive to gap duration across groups; latency was not. Contrary to hypotheses, there was little evidence supporting differences in gap-evoked CAEPs between the tinnitus and control groups. Stimulus and other factors that may have contributed to the lack of a group difference in the current study are discussed, as well as implications for future studies of objective measures of tinnitus perception. Supplemental Material https://doi.org/10.23641/asha.7822601.

Auditory brainstem, middle and late latency responses to short gaps in noise at different presentation rates

OBJECTIVE

The effects of rate on auditory-evoked potentials (AEP) to short noise gaps (12 ms) recorded at high sampling rates using wide-band filters were investigated.

DESIGN

Auditory brainstem (ABR), middle latency (MLR), late latency (LLR) and steady-state (ASSR) responses were simultaneously recorded in adult subjects at four gap rates (0.5, 1, 5 and 40 Hz). Major components (V, Na, Pa, Nb, Pb, N1 and P2) were identified at each rate and analysed for latency/amplitude characteristics. Gap responses at 40 Hz were recovered from Quasi-ASSRs (QASSR) using the CLAD deconvolution method.

STUDY SAMPLE

Fourteen right ears of young normal hearing subjects were tested.

RESULTS

All major components were present in all subjects at 1 Hz. P1 (P50) appeared as a low-pass filtered component of Pa and Pb waves. At higher rates, N1 and P2 disappeared completely while major ABR-MLR components were identified. Peak latencies were mostly determined by noise onsets slightly delayed by offset responses.

CONCLUSIONS

Major AEP components can be recorded to short gaps at 1 Hz using high sampling rates and wide-band filters. At higher rates, only ABR and MLRs can be recorded. Such simultaneous recordings may provide a complete assessment of temporal resolution and processing at different levels of auditory pathways.

Estudo comparativo dos resultados de testes de resolução temporal em jovens adultos

RESUMO Objetivo: comparar o desempenho de universitários nos testes de resolução temporal, Gaps In Noise e Randon Gap Detection Test. Métodos: a população avaliada foi composta por 51 adultos, de ambos os sexos, na faixa etária de 18 a 35 anos, com ausência de histórico otológico e/ou audiológico, sem alterações neurológicas e transtornos de aprendizagem. Os procedimentos utilizados na pesquisa foram os testes Randon Gap Detection Test e Gaps In Noise, realizado a 40 dBNS. Resultados: os resultados demonstraram diferença estatisticamente significante na comparação entre o tempo de percepção dos intervalos de silêncio nos testes Randon Gap Detection Test e Gaps In Noise, para ambos os sexos. Não houve diferença estatisticamente significante com relação à orelha em que o teste Gaps In Noise foi iniciado. Os limiares de detecção do gap de silêncio no teste Gaps In Noise foram menores em milissegundos com relação aos limiares obtidos no Randon Gap Detection Test. Conclusão: há influência do sexo nos resultados do teste Randon Gap Detection Test, com melhor desempenho do sexo masculino. Para o teste Gaps In Noise, os critérios de sexo e orelha em que o teste foi iniciado, não influenciaram os resultados. A comparação entre os testes Randon Gap Detection Test e Gaps In Noise, para ambos os sexos, demonstrou melhor desempenho para o teste Gaps In Noise, com a percepção do gap em intervalos de tempo menores.

Psychoacoustic Characteristics of Tinnitus versus Temporal Resolution in Subjects with Normal Hearing Sensitivity

Introduction Cochlear or neural mechanisms of tinnitus generation may affect auditory temporal resolution in tinnitus patients even with normal audiometry. Thus, studying the correlation between tinnitus characteristics and auditory temporal resolution in subjects with tinnitus may help in proper modification of tinnitus management strategy.

Objective This study aims to examine the relationship between the psychoacoustic measures of tinnitus and the auditory temporal resolution in subjects with normal audiometry.

Methods Two normal hearing groups with ages ranging from 20 to 45 years were involved: control group of 15 adults (30 ears) without tinnitus and study group of 15 adults (24 ears) with tinnitus. Subjective scaling of annoyance and sleep disturbance caused by tinnitus, basic audiological evaluation, tinnitus psychoacoustic measures and Gaps in Noise test were performed. Data from both groups were compared using independent sample t-test. Psychoacoustic measures of tinnitus and Gaps in Noise test parameters of the tinnitus group were correlated with Pearson's correlation coefficient.

Results Significantly higher hearing threshold, higher approximate threshold and lower correct Gaps in Noise scores were observed in tinnitus ears. There was no significant correlation between psychoacoustic measures of tinnitus and Gaps in Noise test parameters of the tinnitus group.

Conclusion Auditory temporal resolution impairment was found in tinnitus patients, which could be attributed to cochlear impairment or altered neural firing within the auditory pathway. It is recommended to include temporal resolution testing in the tinnitus evaluation battery to provide a proper management planning.

Temporal resolution in individuals with neurological disorders

OBJECTIVE

Temporal processing refers to the ability of the central auditory nervous system to encode and detect subtle changes in acoustic signals. This study aims to investigate the temporal resolution ability of individuals with mesial temporal sclerosis and to determine the sensitivity and specificity of the gaps-in-noise test in identifying this type of lesion.

METHOD

This prospective study investigated differences in temporal resolution between 30 individuals with normal hearing and without neurological lesions (G1) and 16 individuals with both normal hearing and mesial temporal sclerosis (G2). Test performances were compared, and the sensitivity and specificity were calculated.

RESULTS

There was no difference in gap detection thresholds between the two groups, although G1 revealed better average thresholds than G2 did. The sensitivity and specificity of the gaps-in-noise test for neurological lesions were 68% and 98%, respectively.

CONCLUSIONS

Temporal resolution ability is compromised in individuals with neurological lesions caused by mesial temporal sclerosis. The gaps-in-noise test was shown to be a sensitive and specific measure of central auditory dysfunction in these patients.

Critérios de normalidade dos testes de resolução temporal: random gap detection test e gaps-in-noise

OBJETIVO: avaliar a resolução temporal em indivíduos audiologicamente normais entre 20 e 60 anos. MÉTODOS: 40 indivíduos de ambos os sexos, de 20 aos 60 anos de idade, divididos em quatro grupos etários contendo 10 indivíduos em cada grupo: Grupo I de 20 a 30 anos; Grupo II de 31 a 40 anos; Grupo III de 41 a 50 anos e Grupo IV de 51 a 60. Todos foram submetidos a procedimentos que fazem parte da rotina audiológica para caracterizar a audição periférica, e central com destaque nos testes de resolução temporal com tons puros, o Randon-gap-detection-test, e com ruído o Gaps-in-noise. RESULTADOS: os valores médios obtidos para o limiar de detecção de gap no teste Gaps-in-noise encontram-se em torno de seis milissegundos para os grupos 1 e 2 e de oito, nos grupos 3 e 4. Verificou-se limiar de detecção de gap obtido no teste Random-gap-detection-test com valor médio de 10 milissegundos para os grupos 1 e 2 e entre 10 e 15ms nos grupos 3 e 4. CONCLUSÃO: a habilidade de resolução temporal piora com o aumento da idade. Os valores de normalidade dos testes com segmentos de ruído (teste GIN - Gaps In Noise) e tom puro (teste RGDT - Random Gap Test Detection) são crescentes de acordo com a faixa etária avaliada.

The effects of unilateral tinnitus on auditory temporal resolution: gaps-in-noise performance

BACKGROUND AND OBJECTIVES

The Gaps-In-Noise (GIN) test is a measure to assess auditory temporal resolution, which is the ability to follow rapid changes in the envelope of a sound stimulus over time. We investigated whether unilateral tinnitus affects temporal resolution by the GIN performance.

SUBJECTS AND METHODS

Hearing tests including the GIN test were performed in 120 ears of 60 patients with unilateral tinnitus who showed symmetric hearing within 20 dB HL difference up to 8 kHz (tinnitus-affected ears, 14.6±11.2 dB HL; non-tinnitus ears 15.1±11.5 dB HL) and 60 ears of 30 subjects with normal hearing. Comparisons were made between tinnitus and non-tinnitus side of patients and normal ears of controls.

RESULTS

There was no significant difference of the mean GIN thresholds among tinnitus-affected ears (5.18±0.6 ms), non-tinnitus ears (4.98±0.6 ms) and normal ears (4.97±0.8 ms). The mean percentage of correct answers in tinnitus side (67.3±5.5%) was slightly less than that in non-tinnitus side (70.0±5.5%) but it was not significantly different from that in normal ears (69.4±7.5%). Neither the GIN threshold nor the GIN perception level in tinnitus ears has relation to sex, frequency and loudness of tinnitus, and audiometric data. Age only showed a significant correlation with the GIN performance.

CONCLUSIONS

We found no evidence which supported the influence of unilateral tinnitus on auditory temporal resolution. These results imply that tinnitus may not simply fill in the silent gaps in the background noise.

Resolução temporal auditiva na migrânea menstrual

Objetivo verificar o comportamento auditivo de resolução temporal em mulheres com Migrânea Menstrual. Métodos participaram 40 mulheres, na faixa etária de 18 a 31 anos, das quais 20 apresentaram migrânea menstrual (grupo estudo) e 20 não apresentaram (grupo controle). Todas foram submetidas a procedimentos que fazem parte da rotina audiológica para caracterizar a audição periférica e excluir pessoas com perdas auditivas. Ainda, foram submetidas a um questionário elaborado pela pesquisadora e a uma aplicação do teste Gap in noise. Os procedimentos foram realizados na fase subfolicular precoce e na subfase lútea tardia para voluntárias que não faziam uso de anticoncepcional, uma vez que nestas fases a taxa de hormônios femininos esta mais elevada e semelhante daquelas que faziam uso de anticoncepcional. Resultados os valores dos limiares de gap e porcentagem de acertos da orelha esquerda, no grupo de estudo foram significantemente e estatisticamente diferentes em relação ao grupo controle. Em relação à orelha direita, os achados foram similares entre os grupos. Conclusão a resolução temporal em mulheres com migrânea menstrual, medida a um segmento de ruído, na orelha direita foi semelhante à das mulheres sem essa queixa, já na orelha esquerda os grupos se diferenciaram e os com migrânea obtiveram os piores limiares.

Central auditory processing and word discrimination in patients with multiple sclerosis

Many multiple sclerosis (MS) patients with normal pure tone threshold suffer from difficulties in their hearing especially speech perception in background noise, which is possibly because of incompetence of central auditory processing in this group. Three audiologic tests including gap in noise test (GIN), duration pattern sequence test (DPST) and word discrimination score (WDS) were used for comparing a number of aspects of central auditory processing between patients with MS and normal subjects. Approximate threshold and percent of correct answers in GIN test, percent of correct answers in DPST test and monosyllabic discrimination in WDS test were obtained through cross-sectional non-invasive study conducted on 26 subjects with relapsing-remitting multiple sclerosis who had mean age of 28.9 (SD 4.1) years, and 26 18-40-year-old ones with normal hearing and mean age of 27.7 (SD 5.2). Results of this study demonstrate increased approximate threshold and reduction of percent of correct answers obtained from GIN test in patients with multiple sclerosis (Pv = 0.0001). Furthermore in patients with MS, the average of correct answers in DPST was lower than normal subjects and finally performance of MS subjects in WDS test in quiet environment was correlated with GIN threshold (r = -/624, Pr = /003). Results of the present study showed that patients with MS had defect in aspects of central auditory processing consisting of temporal resolution, auditory pattern and the memory for auditory task and difficulty in discrimination of speech in noisy environment that are related to the involvement of central nervous system.

Does tinnitus affect the sound localization ability?

OBJECTIVE

To investigate whether tinnitus affects sound localization ability.

STUDY DESIGN

Prospective controlled study.

SETTING

Tertiary referral center.

PATIENTS

Forty tinnitus patients (mean age, 36.7 ± 14.3 yr; hearing threshold, <20 dB HL; tinnitus group) and 40 controls (mean age, 39.3 ± 12.9 yr; hearing threshold, <20 dB HL; control group).

METHODS

We performed a sound localization test (SLT) with 7 speakers positioned in a semicircle on the horizontal plane at a distance of 1 m from the subject, at 30-degree intervals. Subjects were asked to identify the stimulus-presenting speaker, through a forced-choice procedure. The error score was calculated by scoring 1 point for each 30 degrees of difference between the stimulus-presenting speaker and the speaker identified by the subject.

RESULTS

The mean SLT total error score (TES) of the tinnitus group (18.8 ± 9.2) was significantly higher than that of the control group (13.1 ± 7.5) (p < 0.05). Regarding SLT responses for stimulation from speakers located at each side of the listener, mean TES in patients with tinnitus on the same side as the speaker was higher than that in patients with opposite side or bilateral tinnitus. Age showed a positive correlation with TES in the tinnitus (r = 0.44, p < 0.05) and control groups (r = 0.35, p < 0.05).

CONCLUSION

We consider that tinnitus interferes with sound localization ability and that interference is worse for sound originating from the same side as the tinnitus. Age is a worsening factor in sound localization ability.