Impaired Binaural Hearing in Adults: A Selected Review of the Literature

Development of audiometric parameters throughout the lifespan. I: Auditory data

Age-related hearing loss (presbycusis) is a nonsyndromic sensorineural condition that affects the inner ear, auditory pathway, and related cortical regions to varying degrees, typically beginning around age 65. However, hearing can start to deteriorate as early as age 18 and can be negatively influenced by several external factors throughout the lifespan. Depending on the location and severity of the pathology, different aspects of hearing may be affected, resulting in various phenotypes of hearing loss. The aim of this study is to determine average data for a complex battery of auditory tests for different age groups along life span. Two hundred ninety (116 males and 174 females) volunteers between 18 and 87 years of age were enrolled in this study. All volunteers underwent meticulous auditory examination on our custom made audiometric device that consisted of following tests: pure tone audiometry (PTA) in quiet and noise (PTAN), high frequency hearing thresholds (PTAhf), detection of short tones (STD), sensitivity to interaural time delay (ITD), sensitivity to amplitude (AMT) and frequency modulation (FMT), gap in noise detection threshold (GDT), identification of frequency (FPT) and duration patterns (DPT), speech audiometry in babble noise (SIN), and gated (interrupted) speech audiometry (GS). The data are presented as group means and standard deviations in six 10-year age categories (from 20 to 80) and also as regression fits along with the corresponding prediction bands. All reported results show a significant effect of aging on examined auditory parameters; however, the effect of aging differs. In following tests, the dependence is continuous and starts relatively early in life: PTA, PTAhf, STD, AMT, GDT, FPT; whereas in following tests the effect of aging becomes apparent only after the age of 60: PTAN, ITD, FMT, DPT, SIN, GS. Altogether, the results demonstrate clear, yet diverse effects of aging on various aspects of auditory processing and provide a baseline for future experimental and clinical investigations.

Age-Related Differences in Comprehending Speech in Competition

PURPOSE

The ability to discriminate speech with background noise decreases with age. This study examined the effect of masker type and spatial location in older and young adults.

METHOD

Using Portable Automated Rapid Testing software on an iPad, participants were asked to understand target speech (always simulated at 0° azimuth) in the presence of speech or "garbled speech" maskers (simulated from 0°, 6°, or 45° azimuth spatial locations). Additionally, suprathreshold sensitivities to temporal (TM), spectral (SM), and spectrotemporal (STM) modulation as well as binaural temporal fine structure (TFS) were estimated.

RESULTS

Older adults showed worse speech in competition (SiC) performance with 6° and 45°, but not 0°, masker spatial locations and benefited less from only 45° of spatial separation compared to young controls for speech masking. For garbled-speech masking, older adults showed worse performance overall, but benefited similarly from spatial separation compared to young controls. Older adults also showed worse sensitivity for binaural TFS, but comparable TM, SM, and STM sensitivity. Age as well as TM and SM sensitivities predicted SiC performance, whereas STM and binaural TFS sensitivities did not.

CONCLUSION

These findings expand our knowledge of how aging and suprathreshold sensitivities affect SiC comprehension.

Degradation in Binaural and Spatial Hearing, and Auditory Temporal Processing Abilities, as a Function of Aging

Objectives

Sensorineural hearing loss is common with advancing age, but even with normal or near-normal hearing in older persons, performance deficits are often seen for suprathreshold listening tasks such as understanding speech in background noise or localizing sound direction. This suggests there is also a more central source of the problem. Objectives of this study were to examine as a function of age (young adult to septuagenarian) performance on: 1) a spatial acuity task examining localization ability, and a spatial speech-in-noise (SSIN) recognition task, both measured in a hemi-anechoic sound field using a circular horizontal-plane loudspeaker array, and 2) a suprathreshold auditory temporal processing task and a spectro-temporal processing task, both measured under headphones. Further, we examined any correlations between age, hearing thresholds including extended high frequency (EHF: >8000 Hz), and these measures.

Design

Subjects were 48 adults, aged 21 to 78, with either normal hearing or only a mild sensorineural hearing loss through 4000 Hz. The localization task measured minimum audible angle (MAA) for 500 and 4000 Hz 1/3 rd octave narrowband noise (NBN) in diffuse background noise for both an on-axis (reference source 0°) and off-axis (reference source 45°) listening condition at signal-to-noise ratios (SNRs) of -3, -6, -9, and -12 dB. SSIN testing was also completed for key word recognition in sentences in multi-talker babble noise; specifically, the separation between speech and noise loudspeakers was adaptively varied to determine the difference needed for 40% and 80% correct performance levels. Finally, auditory temporal processing ability was examined using the Temporal Fine Structure (TFS) test, and the Spectro-Temporal Modulation (STM) test.

Results

Spatial acuity was poorer (larger MAAs) in older compared to younger subjects, particularly in the more adverse listening conditions (off-axis, and poorer SNRs). The SSIN data also showed declining mean performance with age at both criterion levels, emerging in the middle age group (> 40 years), but was not correlated with standard audiometric hearing thresholds. Decreased performance on the TFS and STM tasks was dependent on age, emerging only in the older (> 60 years) and middle (>40 years) age groups, respectively; neither was dependent on hearing thresholds. Results of multiple regression analyses suggest that SSIN recognition scales with the ability of the subjects to use both low-frequency binaural temporal fine structure as well as higher-frequency binaural envelope cues, both of which are impacted by aging but not necessarily audiometric hearing thresholds. Finally, EHF range hearing thresholds significantly decreased with age, but performance on tasks remained significantly correlated with age when controlled for EHF hearing.

Conclusions

Particularly for more adverse listening conditions, age-related deficits, but not hearing-threshold-related deficits, were found on both of the spatial hearing tasks and in temporal and spectro-temporal processing abilities. It may be that deficits in temporal processing ability contribute to poorer spatial hearing performance in older subjects due to inaccurate coding of binaural/interaural timing information sent from the periphery to the binaural brainstem. In addition, EHF hearing loss may be a coexisting factor in the reduced performance seen in older subjects.

Evaluating binaural hearing capabilities in individuals with sensorineural hearing loss through bilateral bone conduction stimulation

This study investigated the impact of bilateral bone conduction (BC) stimulation and sensorineural hearing loss on spatial release from masking, binaural intelligibility level difference, and lateralization. The study involved two groups of adults with mild to moderate sensorineural hearing loss: one group of 21 participants with symmetric hearing loss and another group of nine participants with asymmetric hearing loss. All tests were conducted through BC and air conduction (AC) headsets with non-individualized virtual positions of the sound sources and linear amplification based on individual hearing thresholds. The findings revealed a bilateral benefit for both groups of hearing-impaired individuals, with symmetric hearing loss yielding better results than asymmetric hearing loss. AC stimulation provided approximately twice the benefit in terms of dB compared to BC stimulation. A large part of this benefit originated from a favorable signal-to-noise ratio due to noise reduction from the head shadow. However, binaural processing was present in both hearing-impaired groups with bilateral BC stimulation. The ability to lateralize sounds based on interaural time delays was significantly impaired in participants with both types of hearing loss when stimulation was by BC. Despite these challenges, the study underscores the benefits of bilateral fitting of BC hearing aids, even in individuals with mild to moderate sensorineural hearing loss, whether symmetric or asymmetric.

Speech Recognition and Spatial Hearing in Young Adults With Down Syndrome: Relationships With Hearing Thresholds and Auditory Working Memory

OBJECTIVES

Individuals with Down syndrome (DS) have a higher incidence of hearing loss (HL) compared with their peers without developmental disabilities. Little is known about the associations between HL and functional hearing for individuals with DS. This study investigated two aspects of auditory functions, "what" (understanding the content of sound) and "where" (localizing the source of sound), in young adults with DS. Speech reception thresholds in quiet and in the presence of interferers provided insight into speech recognition, that is, the "what" aspect of auditory maturation. Insights into "where" aspect of auditory maturation were gained from evaluating speech reception thresholds in colocated versus separated conditions (quantifying spatial release from masking) as well as right versus left discrimination and sound location identification. Auditory functions in the "where" domain develop during earlier stages of cognitive development in contrast with the later developing "what" functions. We hypothesized that young adults with DS would exhibit stronger "where" than "what" auditory functioning, albeit with the potential impact of HL. Considering the importance of auditory working memory and receptive vocabulary for speech recognition, we hypothesized that better speech recognition in young adults with DS, in quiet and with speech interferers, would be associated with better auditory working memory ability and receptive vocabulary.

DESIGN

Nineteen young adults with DS (aged 19 to 24 years) participated in the study and completed assessments on pure-tone audiometry, right versus left discrimination, sound location identification, and speech recognition in quiet and with speech interferers that were colocated or spatially separated. Results were compared with published data from children and adults without DS and HL, tested using similar protocols and stimuli. Digit Span tests assessed auditory working memory. Receptive vocabulary was examined using the Peabody Picture Vocabulary Test Fifth Edition.

RESULTS

Seven participants (37%) had HL in at least 1 ear; 4 individuals had mild HL, and 3 had moderate HL or worse. Participants with mild or no HL had ≥75% correct at 5° separation on the discrimination task and sound localization root mean square errors (mean ± SD: 8.73° ± 2.63°) within the range of adults in the comparison group. Speech reception thresholds in young adults with DS were higher than all comparison groups. However, spatial release from masking did not differ between young adults with DS and comparison groups. Better (lower) speech reception thresholds were associated with better hearing and better auditory working memory ability. Receptive vocabulary did not predict speech recognition.

CONCLUSIONS

In the absence of HL, young adults with DS exhibited higher accuracy during spatial hearing tasks as compared with speech recognition tasks. Thus, auditory processes associated with the "where" pathways appear to be a relative strength than those associated with "what" pathways in young adults with DS. Further, both HL and auditory working memory impairments contributed to difficulties in speech recognition in the presence of speech interferers. Future larger-sized samples are needed to replicate and extend our findings.

Age-Related Deficits in Binaural Hearing: Contribution of Peripheral and Central Effects

Pure-tone audiograms often poorly predict elderly humans' ability to communicate in everyday complex acoustic scenes. Binaural processing is crucial for discriminating sound sources in such complex acoustic scenes. The compromised perception of communication signals presented above hearing threshold has been linked to both peripheral and central age-related changes in the auditory system. Investigating young and old Mongolian gerbils of both sexes, an established model for human hearing, we demonstrate age-related supra-threshold deficits in binaural hearing using behavioral, electrophysiological, anatomical, and imaging methods. Binaural processing ability was measured as the binaural masking level difference (BMLD), an established measure in human psychophysics. We tested gerbils behaviorally with "virtual headphones," recorded single-unit responses in the auditory midbrain and evaluated gross midbrain and cortical responses using positron emission tomography (PET) imaging. Furthermore, we obtained additional measures of auditory function based on auditory brainstem responses, auditory-nerve synapse counts, and evidence for central inhibitory processing revealed by PET. BMLD deteriorates already in middle-aged animals having normal audiometric thresholds and is even worse in old animals with hearing loss. The magnitude of auditory brainstem response measures related to auditory-nerve function and binaural processing in the auditory brainstem also deteriorate. Furthermore, central GABAergic inhibition is affected by age. Because the number of synapses in the apical turn of the inner ear was not reduced in middle-aged animals, we conclude that peripheral synaptopathy contributes little to binaural processing deficits. Exploratory analyses suggest increased hearing thresholds, altered binaural processing in the brainstem and changed central GABAergic inhibition as potential contributors.

Longitudinal observations of the effects of ischemic stroke on binaural perception

Acute ischemic stroke, characterized by a localized reduction in blood flow to specific areas of the brain, has been shown to affect binaural auditory perception. In a previous study conducted during the acute phase of ischemic stroke, two tasks of binaural hearing were performed: binaural tone-in-noise detection, and lateralization of stimuli with interaural time- or level differences. Various lesion-specific, as well as individual, differences in binaural performance between patients in the acute phase of stroke and a control group were demonstrated. For the current study, we re-invited the same group of patients, whereupon a subgroup repeated the experiments during the subacute and chronic phases of stroke. Similar to the initial study, this subgroup consisted of patients with lesions in different locations, including cortical and subcortical areas. At the group level, the results from the tone-in-noise detection experiment remained consistent across the three measurement phases, as did the number of deviations from normal performance in the lateralization task. However, the performance in the lateralization task exhibited variations over time among individual patients. Some patients demonstrated improvements in their lateralization abilities, indicating recovery, whereas others' lateralization performance deteriorated during the later stages of stroke. Notably, our analyses did not reveal consistent patterns for patients with similar lesion locations. These findings suggest that recovery processes are more individual than the acute effects of stroke on binaural perception. Individual impairments in binaural hearing abilities after the acute phase of ischemic stroke have been demonstrated and should therefore also be targeted in rehabilitation programs.

Neurodegeneration after repeated noise trauma in the mouse lower auditory pathway

High intensity noise exposure leads to a permanent shift in auditory thresholds (PTS), affecting both peripheral (cochlear) tissue and the central auditory system. Studies have shown that a noise-induced hearing loss results in significant cell loss in several auditory structures. Degeneration can be demonstrated within hours after noise exposure, particularly in the lower auditory pathway, and continues to progress over days and weeks following the trauma. However, there is limited knowledge about the effects of recurring acoustic trauma. Repeated noise exposure has been demonstrated to increase neuroplasticity and neural activity. Thus, the present study aimed to investigate the influence of a second noise exposure on the cytoarchitecture of key structures of the auditory pathway, including spiral ganglion neurons (SGN), the ventral and dorsal cochlear nucleus (VCN and DCN, respectively), and the inferior colliculus (IC). In the experiments, young adult normal hearing mice were exposed to noise once or twice (with the second trauma applied one week after the initial exposure) for 3 h, using broadband white noise (5 - 20 kHz) at 115 dB SPL. The cell densities in the investigated auditory structures significantly decreased in response to the initial noise exposure compared to unexposed control animals. These findings are consistent with earlier research, which demonstrated degeneration in the auditory pathway within the first week after acoustic trauma. Additionally, cell densities were significantly decreased after the second trauma, but this effect was only observed in the VCN, with no similar effects seen in the SGN, DCN, or IC. These results illustrate how repeated noise exposure influences the cytoarchitecture of the auditory system. It appears that an initial noise exposure primarily damages the lower auditory pathway, but surviving cellular structures may develop resistance to additional noise-induced injury.

The Impact of Traumatic Brain Injury on Binaural Processing in Young and Middle-Age Adults

PURPOSE

This study examined the impact of traumatic brain injury (TBI) on self-perceived hearing and suprathreshold binaural processing in young and middle-age adults.

METHOD

Ninety-three adults with normal hearing (thresholds ≤ 25 dB HL, 250-4000 Hz) participated in one of four groups: 38 young adults, 23 young adults with TBI, 16 middle-age adults, and 16 middle-age adults with TBI. Self-perceived hearing difficulty was measured via questionnaires. Binaural processing was measured using dichotic word recognition, the Listening in Spatialized Noise-Sentences Test (LiSN-S), and the 500-Hz masking level difference (MLD). For each participant, a composite binaural processing (CBP) score was calculated to obtain a global metric of binaural processing performance. The CBP was composed of six measures from the three behavioral tests, including the S0N0 and SπN0 thresholds from the 500-Hz MLD, the low- and high-cue speech recognition thresholds from the LiSN-S, and the free and directed recall ear advantages from the dichotic word test.

RESULTS

The middle-age TBI group reported significantly greater degrees of self-perceived hearing difficulty than the other groups. On average, the middle-age TBI group performed poorer on the individual binaural processing tests; however, the differences were significant for the S0N0 and SπN0 MLD thresholds only. Results for the global metric of binaural processing revealed significantly poorer CBP scores for the middle-age TBI group compared to the other groups.

CONCLUSIONS

Results demonstrate that both age and a positive history of TBI contributed to deficits in suprathreshold binaural processing. Middle-age adults with a history of TBI are at risk for experiencing presenescent deficits in suprathreshold binaural processing deficits, despite having clinically normal hearing.

Listening with an Ageing Brain - a Cognitive Challenge

Hearing impairment has been recently identified as a major modifiable risk factor for cognitive decline in later life and has been becoming of increasing scientific interest. Sensory and cognitive decline are connected by complex bottom-up and top-down processes, a sharp distinction between sensation, perception, and cognition is impossible. This review provides a comprehensive overview on the effects of healthy and pathological aging on auditory as well as cognitive functioning on speech perception and comprehension, as well as specific auditory deficits in the 2 most common neurodegenerative diseases in old age: Alzheimer disease and Parkinson syndrome. Hypotheses linking hearing loss to cognitive decline are discussed, and current knowledge on the effect of hearing rehabilitation on cognitive functioning is presented. This article provides an overview of the complex relationship between hearing and cognition in old age.

Effects of acute ischemic stroke on binaural perception

Stroke-induced lesions at different locations in the brain can affect various aspects of binaural hearing, including spatial perception. Previous studies found impairments in binaural hearing, especially in patients with temporal lobe tumors or lesions, but also resulting from lesions all along the auditory pathway from brainstem nuclei up to the auditory cortex. Currently, structural magnetic resonance imaging (MRI) is used in the clinical treatment routine of stroke patients. In combination with structural imaging, an analysis of binaural hearing enables a better understanding of hearing-related signaling pathways and of clinical disorders of binaural processing after a stroke. However, little data are currently available on binaural hearing in stroke patients, particularly for the acute phase of stroke. Here, we sought to address this gap in an exploratory study of patients in the acute phase of ischemic stroke. We conducted psychoacoustic measurements using two tasks of binaural hearing: binaural tone-in-noise detection, and lateralization of stimuli with interaural time- or level differences. The location of the stroke lesion was established by previously acquired MRI data. An additional general assessment included three-frequency audiometry, cognitive assessments, and depression screening. Fifty-five patients participated in the experiments, on average 5 days after their stroke onset. Patients whose lesions were in different locations were tested, including lesions in brainstem areas, basal ganglia, thalamus, temporal lobe, and other cortical and subcortical areas. Lateralization impairments were found in most patients with lesions within the auditory pathway. Lesioned areas at brainstem levels led to distortions of lateralization in both hemifields, thalamus lesions were correlated with a shift of the whole auditory space, whereas some cortical lesions predominantly affected the lateralization of stimuli contralateral to the lesion and resulted in more variable responses. Lateralization performance was also found to be affected by lesions of the right, but not the left, basal ganglia, as well as by lesions in non-auditory cortical areas. In general, altered lateralization was common in the stroke group. In contrast, deficits in tone-in-noise detection were relatively scarce in our sample of lesion patients, although a significant number of patients with multiple lesion sites were not able to complete the task.

Volume electron microscopy reveals age-related circuit remodeling in the auditory brainstem

The medial nucleus of the trapezoid body (MNTB) is an integral component of the auditory brainstem circuitry involved in sound localization. The giant presynaptic nerve terminal with multiple active zones, the calyx of Held (CH), is a hallmark of this nucleus, which mediates fast and synchronized glutamatergic synaptic transmission. To delineate how these synaptic structures adapt to reduced auditory afferents due to aging, we acquired and reconstructed circuitry-level volumes of mouse MNTB at different ages (3 weeks, 6, 18, and 24 months) using serial block-face electron microscopy. We used C57BL/6J, the most widely inbred mouse strain used for transgenic lines, which displays a type of age-related hearing loss. We found that MNTB neurons reduce in density with age. Surprisingly we observed an average of approximately 10% of poly-innervated MNTB neurons along the mouse lifespan, with prevalence in the low frequency region. Moreover, a tonotopy-dependent heterogeneity in CH morphology was observed in young but not in older mice. In conclusion, our data support the notion that age-related hearing impairments can be in part a direct consequence of several structural alterations and circuit remodeling in the brainstem.

Masked Speech Recognition by Normal-Hearing 6-13-Year-Olds in Conditions With and Without Interaural Difference Cues

Using the Danish 'børneDAT' corpus, the current study aimed to (1) collect normative masked speech recognition data for 6-13-year-olds in conditions with and without interaural difference cues, (2) evaluate the test-retest reliability of these measurements, and (3) compare two widely used measures of binaural/spatial benefit in terms of the obtained scores. Seventy-four children and 17 young adults with normal hearing participated. Using headphone presentation, speech recognition thresholds (SRTs) were measured twice at two separate visits in four conditions. In the first two conditions, børneDAT sentences were presented in diotic stationary speech-shaped noise, with the sentences either interaurally in-phase ('N0S0') or interaurally out-of-phase ('N0S180'). In the other two conditions, børneDAT sentences were simulated to come from 0° azimuth and two running speech maskers from either 0° azimuth ('co-located') or ±90° azimuth ('spatially separated'). In relative terms, the children achieved lower SRTs in stationary noise than in competing speech, whereas the adults showed the opposite pattern. 12-13-year-old children achieved adult-like performance in all but the co-located condition. Younger children showed generally immature speech recognition abilities. Test-retest reliability was highest for the SRTs in stationary noise and lowest for the spatial benefit scores. Mean benefit was comparable for the two measures and participant groups, and the two sets of scores were not correlated with each other. Developmental effects were most pronounced in the conditions with interaural difference cues. In conclusion, reference data for the børneDAT corpus obtained under different acoustic conditions are available that can guide future research and potential clinical applications.

The Core Rehabilitation Outcome Set for Single-Sided Deafness (CROSSSD) study: International consensus on outcome measures for trials of interventions for adults with single-sided deafness

Background

Single-sided deafness (SSD) has functional, psychological, and social consequences. Interventions for adults with SSD include hearing aids and auditory implants. Benefits and harms (outcome domains) of these interventions are until now reported inconsistently in clinical trials. Inconsistency in reporting outcome measures prevents meaningful comparisons or syntheses of trial results. The Core Rehabilitation Outcome Set for Single-Sided Deafness (CROSSSD) international initiative used structured communication techniques to achieve consensus among healthcare users and professionals working in the field of SSD. The novel contribution is a set of core outcome domains that experts agree are critically important to assess in all clinical trials of SSD interventions.

Methods

A long list of candidate outcome domains compiled from a systematic review and published qualitative data, informed the content of a two-round online Delphi survey. Overall, 308 participants from 29 countries were enrolled. Of those, 233 participants completed both rounds of the survey and scored each outcome domain on a 9-point scale. The set of core outcome domains was finalised via a web-based consensus meeting with 12 participants. Votes involved all stakeholder groups, with an approximate 2:1 ratio of professionals to healthcare users participating in the Delphi survey, and a 1:1 ratio participating in the consensus meeting.

Results

The first round of the survey listed 44 potential outcome domains, organised thematically. A further five outcome domains were included in Round 2 based on participant feedback. The structured voting at round 2 identified 17 candidate outcome domains which were voted on at the consensus meeting. Consensus was reached for a core outcome domain set including three outcome domains: spatial orientation, group conversations in noisy social situations, and impact on social situations. Seventy-seven percent of the remaining Delphi participants agreed with this core outcome domain set.

Conclusions

Adoption of the internationally agreed core outcome domain set would promote consistent assessment and reporting of outcomes that are meaningful and important to all relevant stakeholders. This consistency will in turn enable comparison of outcomes reported across clinical trials comparing SSD interventions in adults and reduce research waste. Further research will determine how those outcome domains should best be measured.

Supplementary Information

The online version contains supplementary material available at 10.1186/s13063-022-06702-1.

Effects of better-ear glimpsing, binaural unmasking, and spectral resolution on spatial release from masking in cochlear-implant users

Bilateral cochlear-implant (BICI) listeners obtain less spatial release from masking (SRM; speech-recognition improvement for spatially separated vs co-located conditions) than normal-hearing (NH) listeners, especially for symmetrically placed maskers that produce similar long-term target-to-masker ratios at the two ears. Two experiments examined possible causes of this deficit, including limited better-ear glimpsing (using speech information from the more advantageous ear in each time-frequency unit), limited binaural unmasking (using interaural differences to improve signal-in-noise detection), or limited spectral resolution. Listeners had NH (presented with unprocessed or vocoded stimuli) or BICIs. Experiment 1 compared natural symmetric maskers, idealized monaural better-ear masker (IMBM) stimuli that automatically performed better-ear glimpsing, and hybrid stimuli that added worse-ear information, potentially restoring binaural cues. BICI and NH-vocoded SRM was comparable to NH-unprocessed SRM for idealized stimuli but was 14%-22% lower for symmetric stimuli, suggesting limited better-ear glimpsing ability. Hybrid stimuli improved SRM for NH-unprocessed listeners but degraded SRM for BICI and NH-vocoded listeners, suggesting they experienced across-ear interference instead of binaural unmasking. In experiment 2, increasing the number of vocoder channels did not change NH-vocoded SRM. BICI SRM deficits likely reflect a combination of across-ear interference, limited better-ear glimpsing, and poorer binaural unmasking that stems from cochlear-implant-processing limitations other than reduced spectral resolution.

Age-Related Changes in Interaural-Level-Difference-Based Across-Frequency Binaural Interference

Low-frequency interaural time differences and high-frequency interaural level differences (ILDs) are used to localize sounds in the horizontal plane. Older listeners appear to be worse at horizontal-plane sound localization to compared younger listeners, but little is understood about age-related changes to across-frequency binaural processing. This study investigated if the frequency dependence of across-frequency ILD processing is altered for older compared to younger listeners, which was done by using an across-frequency binaural interference task (when the interaural difference sensitivity for a target sound is decreased by a spectrally remote interfering sound with zero interaural differences). It was hypothesized that as listeners experience advancing age and age-related high-frequency hearing loss (i.e., presbycusis), they will demonstrate worse binaural performance and experience more across-channel binaural interference (because of age-related temporal processing deficits), and will increasingly be affected by interferers at lower frequencies (because of age-related hearing loss) when compared to younger listeners. There were 11 older (>65 yrs) and 20 younger (<30 yrs) listeners with normal to near-normal audiometric thresholds up to 2 kHz. They were tested using a left-right ILD lateralization discrimination task. Single-tone ILD discrimination thresholds and across-frequency binaural interference were measured at 0.5, 1, 2, 4, and 8 kHz. ILD thresholds and interference were about twice as large for older compared to younger listeners. Interferers ≤1 kHz produced 2-3 times as much across-frequency binaural interference for older compared to younger listeners. Hearing thresholds were significant predictors of single-tone ILD thresholds; in addition, both target and interferer hearing thresholds were significant predictors of binaural interference. The results suggest a reweighting of binaural information that occurs with advancing age and age-related high-frequency hearing loss. This evidence of plasticity may help explain some of the age-related changes in spatial-hearing abilities.

Relating Suprathreshold Auditory Processing Abilities to Speech Understanding in Competition

(1) Background: Difficulty hearing in noise is exacerbated in older adults. Older adults are more likely to have audiometric hearing loss, although some individuals with normal pure-tone audiograms also have difficulty perceiving speech in noise. Additional variables also likely account for speech understanding in noise. It has been suggested that one important class of variables is the ability to process auditory information once it has been detected. Here, we tested a set of these “suprathreshold” auditory processing abilities and related them to performance on a two-part test of speech understanding in competition with and without spatial separation of the target and masking speech. Testing was administered in the Portable Automated Rapid Testing (PART) application developed by our team; PART facilitates psychoacoustic assessments of auditory processing. (2) Methods: Forty-one individuals (average age 51 years), completed assessments of sensitivity to temporal fine structure (TFS) and spectrotemporal modulation (STM) detection via an iPad running the PART application. Statistical models were used to evaluate the strength of associations between performance on the auditory processing tasks and speech understanding in competition. Age and pure-tone-average (PTA) were also included as potential predictors. (3) Results: The model providing the best fit also included age and a measure of diotic frequency modulation (FM) detection but none of the other potential predictors. However, even the best fitting models accounted for 31% or less of the variance, supporting work suggesting that other variables (e.g., cognitive processing abilities) also contribute significantly to speech understanding in noise. (4) Conclusions: The results of the current study do not provide strong support for previous suggestions that suprathreshold processing abilities alone can be used to explain difficulties in speech understanding in competition among older adults. This discrepancy could be due to the speech tests used, the listeners tested, or the suprathreshold tests chosen. Future work with larger numbers of participants is warranted, including a range of cognitive tests and additional assessments of suprathreshold auditory processing abilities.

Bilateral Interactions in the Mouse Dorsal Inferior Colliculus Enhance the Ipsilateral Neuronal Responses and Binaural Hearing

The inferior colliculus (IC) is a critical centre for the binaural processing of auditory information. However, previous studies have mainly focused on the central nucleus of the inferior colliculus (ICC), and less is known about the dorsal nucleus of the inferior colliculus (ICD). Here, we first examined the characteristics of the neuronal responses in the mouse ICD and compared them with those in the inferior colliculus under binaural and monaural conditions using in vivo loose-patch recordings. ICD neurons exhibited stronger responses to ipsilateral sound stimulation and better binaural summation than those of ICC neurons, which indicated a role for the ICD in binaural hearing integration. According to the abundant interactions between bilateral ICDs detected using retrograde virus tracing, we further studied the effect of unilateral ICD silencing on the contralateral ICD. After lidocaine was applied, the responses of some ICD neurons (13/26), especially those to ipsilateral auditory stimuli, decreased. Using whole-cell recording and optogenetic methods, we investigated the underlying neuronal circuits and synaptic mechanisms of binaural auditory information processing in the ICD. The unilateral ICD provides both excitatory and inhibitory projections to the opposite ICD, and the advantaged excitatory inputs may be responsible for the enhanced ipsilateral responses and binaural summation of ICD neurons. Based on these results, the contralateral ICD might modulate the ipsilateral responses of the neurons and binaural hearing.

Visual and Auditory Spatial Localization in Younger and Older Adults

Visual and auditory localization abilities are crucial in real-life tasks such as navigation and social interaction. Aging is frequently accompanied by vision and hearing loss, affecting spatial localization. The purpose of the current study is to elucidate the effect of typical aging on spatial localization and to establish a baseline for older individuals with pathological sensory impairment. Using a verbal report paradigm, we investigated how typical aging affects visual and auditory localization performance, the reliance on vision during sound localization, and sensory integration strategies when localizing audiovisual targets. Fifteen younger adults (N = 15, mean age = 26 years) and thirteen older adults (N = 13, mean age = 68 years) participated in this study, all with age-adjusted normal vision and hearing based on clinical standards. There were significant localization differences between younger and older adults, with the older group missing peripheral visual stimuli at significantly higher rates, localizing central stimuli as more peripheral, and being less precise in localizing sounds from central locations when compared to younger subjects. Both groups localized auditory targets better when the test space was visible compared to auditory localization when blindfolded. The two groups also exhibited similar patterns of audiovisual integration, showing optimal integration in central locations that was consistent with a Maximum-Likelihood Estimation model, but non-optimal integration in peripheral locations. These findings suggest that, despite the age-related changes in auditory and visual localization, the interactions between vision and hearing are largely preserved in older individuals without pathological sensory impairments.

Modelling binaural unmasking and the intelligibility of speech in noise and reverberation for normal-hearing and hearing-impaired listeners

This study investigated the effect of hearing loss on binaural unmasking (BU) for the intelligibility of speech in noise. Speech reception thresholds (SRTs) were measured with normal-hearing (NH) listeners and older mildly hearing-impaired (HI) listeners while varying the presentation level of the stimuli, reverberation, modulation of the noise masker, and spatial separation of the speech and noise sources. On average across conditions, the NH listeners benefited more (by 0.6 dB) from BU than HI listeners. The binaural intelligibility model developed by Vicente, Lavandier, and Buchholz [J. Acoust. Soc. Am. 148, 3305-3317 (2020)] was used to describe the data, accurate predictions were obtained for the conditions considering moderate noise levels [50 and 60 dB sound pressure level (SPL)]. The interaural jitters that were involved in the prediction of BU had to be revised to describe the data measured at a lower level (40 dB SPL). Across all tested conditions, the correlation between the measured and predicted SRTs was 0.92, whereas the mean prediction error was 0.9 dB.

Training with an auditory perceptual learning game transfers to speech in competition

Understanding speech in the presence of acoustical competition is a major complaint of those with hearing difficulties. Here, a novel perceptual learning game was tested for its effectiveness in reducing difficulties with hearing speech in competition. The game was designed to train a mixture of auditory processing skills thought to underlie speech in competition, such as spectral-temporal processing, sound localization, and auditory working memory. Training on these skills occurred both in quiet and in competition with noise. Thirty college-aged participants without any known hearing difficulties were assigned either to this mixed-training condition or an active control consisting of frequency discrimination training within the same gamified setting. To assess training effectiveness, tests of speech in competition (primary outcome), as well as basic supra-threshold auditory processing and cognitive processing abilities (secondary outcomes) were administered before and after training. Results suggest modest improvements on speech in competition tests in the mixed-training compared to the frequency-discrimination control condition (Cohen’s d = 0.68). While the sample is small, and in normally hearing individuals, these data suggest promise of future study in populations with hearing difficulties.