Daily sound exposure of hearing aids users during COVID-19 pandemic in Europe

Introduction

This study aimed to investigate the daily sound exposure of hearing aid (HA) users during the COVID-19 pandemic, with a specific focus on the impact of different governance intervention levels.

Methods

Modern HA technology was employed to measure and compare the sound exposure of HA users in three distinct periods: pre-pandemic, and two 14-day periods during the pandemic, corresponding to varying levels of governance interventions. The study sample comprised a total of 386 HA users in Europe during the pandemic, with daily sound exposure data collected as part of the main dataset.

Results

The results revealed that, during the pandemic, the equivalent continuous sound pressure level (SPL) experienced by HA users decreased, while the signal-to-noise ratio (SNR) increased compared to the pre-pandemic period. Notably, this impact was found to be more pronounced (p < 0.05) when individuals were subjected to stronger governance intervention levels, characterized by lower SPL and higher SNR.

Discussion

This study highlights the changes in daily sound exposure experienced by HA users during the COVID-19 pandemic, particularly influenced by the extent of governance interventions that restricted social activities. These findings emphasize the importance of considering the effects of pandemic-related governance measures on the sound environments of HA users and have implications for audiological interventions and support strategies during similar crises.

Depolarization shift in the resting membrane potential of inferior colliculus neurons explains their hyperactivity induced by an acoustic trauma

Introduction

Neuronal hyperactivity has been associated with many brain diseases. In the auditory system, hyperactivity has been linked to hyperacusis and tinnitus. Previous research demonstrated the development of hyperactivity in inferior colliculus (IC) neurons after sound overexposure, but the underlying mechanism of this hyperactivity remains unclear. The main goal of this study was to determine the mechanism of this hyperactivity.

Methods

Experiments were performed on CBA/CaJ mice in a restrained, unanesthetized condition using intracellular recordings with sharp microelectrodes. Recordings were obtained from control (unexposed) and unilaterally sound overexposed groups of mice.

Results

Our data suggest that sound exposure-induced hyperactivity was due to a depolarizing shift of the resting membrane potential (RMP) in the hyperactive neurons. The half width of action potentials in these neurons was also decreased after sound exposure. Surprisingly, we also found an RMP gradient in which neurons have more hyperpolarized RMPs with increasing depth in the IC. This gradient was altered in the overexposed animals.

Effect of Real-Ear Adjusted Stimuli on Vestibular Evoked Myogenic Potential Variability in Children and Young Adults

OBJECTIVES

There is large variability in cervical and ocular vestibular evoked myogenic potential (c- and oVEMP) amplitudes. One potential source of variability is differences in ear canal shape and size. Real ear-to-coupler difference (RECD) values are used to measure the acoustic environment of an individual's ear canal. RECD may be a useful measure to calibrate air conducted VEMP stimuli, which are elicited at high intensities and may put patients at risk of unsafe sound exposure. A recommendation for avoiding unsafe exposure is to use a 125 dB SPL stimulus for individuals with an equivalent ear canal volume (ECV) ≥ 0.9 mL and a 120 dB SPL stimulus for individuals with a smaller ECV. The purpose of this project was to determine if using a stimulus calibrated in the ear using RECD values significantly reduces intra-subject and inter-subject VEMP amplitude variability. We hypothesized that using a RECD-calibrated stimulus would significantly reduce inter-subject amplitude variability but not significantly reduce intra-subject variability. We further hypothesized that an RECD-adjusted VEMP stimulus would better protect against delivering unsafe sound exposure compared to the method of using ECV alone.

DESIGN

Eleven children (4 to 9 years), 10 adolescents (10 to 18 years), and 10 young adults (20 to 40 years) with normal hearing, tympanometry, vestibular and neurological function participated. On all subjects, RECD was measured twice per ear to account for test-retest reliability. cVEMP and oVEMP were then recorded bilaterally with a 500 Hz tone burst at a traditional and an adjusted VEMP intensity level. The traditional intensity level was 125 dB SPL for individuals with ≥ 0.9 mL ECV and 120 dB SPL for individuals with ≤ 0.8 mL ECV. The adjusted intensity level was calculated by subtracting the average 500 Hz RECD measured values from the 500 Hz normative RECD value. This value was applied as a correction factor to a 125 dB SPL stimulus. Peak to peak amplitudes were recorded and used to calculate asymmetry ratios.

RESULTS

Young children had significantly smaller ECVs compared to adolescents and young adults. Young children had larger RECDs; however, this was not significant in post hoc analyses. The method of calibration had no significant effect on intra-subject variability for cVEMP [ F (1, 27)= 0.996, p = 0.327] or oVEMP [ F (1, 25)= 1.679, p = 0.206]. The method of calibration also had no significant effect on inter-subject amplitude variability for cVEMP [ F (1, 120)= 0.721, p = 0.397] or oVEMP [ F (1, 120)= 0.447, p = 0.505]. Both methods of calibration adequately protected against unsafe exposure levels. However, there were subjects with ECVs ≥ 0.9 mL who approached unsafe exposure levels from the ECV-calibrated stimulus, suggesting there may be rare cases in which a 125 dB SPL stimulus is unsafe, even for patients with larger ECVs.

CONCLUSIONS

The calibration method made no significant difference in intra- or inter-subject variability, indicating that the acoustic environment of the outer ear is not significantly contributing to VEMP amplitude variability. The RECD-adjusted stimulus is effective in protecting against unsafe exposure levels for two trials of both c- and oVEMPs. There may be instances where more than two trials of each test are required, which increases the effective stimulation level. Clinicians should be cautious when delivering VEMPs and not unnecessarily expose patients to unsafe levels of sound.

Quantification of Sound Exposure from Wind Turbines in France

The WHO guidelines on environmental noise highlight that evidence on the health effects of wind turbine sound levels is either non-existent or of poor quality. In this context, a feasibility study was conducted in France in 2017. The objective was to suggest a methodology for calculating wind turbine sound levels in order to quantify the number of windfarms' residents exposed to this sound. Based on a literature review, the Harmonoise model was selected for sound exposure calculation. It was validated by quantifying its uncertainties, and finally used to estimate the population exposed to wind turbine sound in metropolitan France. Compared to other environmental noise sources (e.g., transportation), sound exposure is very moderate, with more than 80% of the exposed people exposed to sound levels below 40 dBA. The total number of people exposed to more than 30 dBA is about 686,000 and 722,000 people for typical daytime and night-time meteorological conditions respectively, i.e., about 1% of the French population in 2017. These results represent the first ever assessment of sound exposure from wind turbines at the scale of the entire metropolitan France.

University Marching Band Members' Noise Dosages and Hearing Health-Related Knowledge

Objectives: (1) To measure sound exposures of marching band and non-marching band students during a football game, (2) to compare these to sound level dose limits set by NIOSH, and (3) to assess the perceptions of marching band students about their hearing health risk from loud sound exposure and their use of hearing protection devices (HPDs). Methods: Personal noise dosimetry was completed on six marching band members and the band director during rehearsals and performances. Dosimetry measurements for two audience members were collected during the performances. Noise dose values were calculated using NIOSH criteria. One hundred twenty-three marching band members responded to a questionnaire analyzing perceptions of loud music exposure, the associated hearing health risks, and preventive behavior. Results: Noise dose values exceeded the NIOSH recommended limits among all six marching band members during rehearsals and performances. Higher sound levels were recorded during performances compared to rehearsals. The audience members were not exposed to hazardous levels. Most marching band members reported low concern for health effects from high sound exposure and minimal use of HPDs. Conclusion: High sound exposure and low concern regarding hearing health among marching band members reflect the need for comprehensive hearing conservation programs for this population.

Effect of Unilateral Acoustic Trauma on Neuronal Firing Activity in the Inferior Colliculus of Mice

Neural hyperactivity induced by sound exposure often correlates with the development of hyperacusis and/or tinnitus. In laboratory animals, hyperactivity is typically induced by unilateral sound exposure to preserve one ear for further testing of hearing performance. Most ascending fibers in the auditory system cross into the superior olivary complex and then ascend contralaterally. Therefore, unilateral exposure should be expected to mostly affect the contralateral side above the auditory brain stem. On the other hand, it is well known that a significant number of neurons have crossing fibers at every level of the auditory pathway, which may spread the effect of unilateral exposure onto the ipsilateral side. Here we demonstrate that unilateral sound exposure causes development of hyperactivity in both the contra and ipsilateral inferior colliculus in mice. We found that both the spontaneous firing rate and bursting activity were increased significantly compared to unexposed mice. The neurons with characteristic frequencies at or above the center frequency of exposure showed the greatest increase. Surprisingly, this increase was more pronounced in the ipsilateral inferior colliculus. This study highlights the importance of considering both ipsi- and contralateral effects in future studies utilizing unilateral sound exposure.

Population-level effects of acoustic disturbance in Atlantic cod: a size-structured analysis based on energy budgets

Anthropogenic underwater noise may negatively affect marine animals. Yet, while fishes are highly sensitive to sounds, effects of acoustic disturbances on fishes have not been extensively studied at the population level. In this study, we use a size-structured model based on energy budgets to analyse potential population-level effects of anthropogenic noise on Atlantic cod (Gadus morhua). Using the model framework, we assess the impact of four possible effect pathways of disturbance on the cod population growth rate. Through increased stress, changes in foraging and movement behaviour, and effects on the auditory system, anthropogenic noise can lead to (i) increased energy expenditure, (ii) reduced food intake, (iii) increased mortality, and (iv) reduced reproductive output. Our results show that population growth rates are particularly sensitive to changes in energy expenditure and food intake because they indirectly affect the age of maturation, survival and fecundity. Sub-lethal effects of sound exposure may thus affect populations of cod and fishes with similar life histories more than lethal effects of sound exposure. Moreover, anthropogenic noise may negatively affect populations when causing persistent increases of energy expenditure or decreases of food intake. Effects of specific acoustic pollutants on energy acquisition and expenditure should therefore be further investigated.

Evidence of Hyperacusis in Adult Rats Following Non-traumatic Sound Exposure

Manipulations that enhance neuroplasticity may inadvertently create opportunities for maladaptation. We have previously used passive exposures to non-traumatic white noise to open windows of plasticity in the adult rat auditory cortex and induce frequency-specific functional reorganizations of the tonotopic map. However, similar reorganizations in the central auditory pathway are thought to contribute to the generation of hearing disorders such as tinnitus and hyperacusis. Here, we investigate whether noise-induced reorganizations are accompanied by electrophysiological or behavioral evidence of tinnitus or hyperacusis in adult Long-Evans rats. We used a 2-week passive exposure to moderate-intensity (70 dB SPL) broadband white noise to reopen a critical period for spectral tuning such that a second 1-week exposure to 7 kHz tone pips produced an expansion of the 7 kHz frequency region in the primary auditory cortex (A1). We demonstrate for the first time that this expansion also takes place in the ventral auditory field (VAF). Sound exposure also led to spontaneous and sound-evoked hyperactivity in the anterior auditory field (AAF). Rats were assessed for behavioral evidence of tinnitus or hyperacusis using gap and tone prepulse inhibition of the acoustic startle response. We found that sound exposure did not affect gap-prepulse inhibition. However, sound exposure led to an improvement in prepulse inhibition when the prepulse was a 7 kHz tone, showing that exposed rats had enhanced sensorimotor gating for the exposure frequency. Together, our electrophysiological and behavioral results provide evidence of hyperacusis but not tinnitus in sound-exposed animals. Our findings demonstrate that periods of prolonged noise exposure may open windows of plasticity that can also be understood as windows of vulnerability, potentially increasing the likelihood for maladaptive plasticity to take place.

Behavioral Animal Model of the Emotional Response to Tinnitus and Hearing Loss

Increased prevalence of emotional distress is associated with tinnitus and hearing loss. The underlying mechanisms of the negative emotional response to tinnitus and hearing loss remain poorly understood, and it is challenging to disentangle the emotional consequences of hearing loss from those specific to tinnitus in listeners experiencing both. We addressed these questions in laboratory rats using three common rodent anxiety screening assays: elevated plus maze, open field test, and social interaction test. Open arm activity in the elevated plus maze decreased substantially after one trial in controls, indicating its limited utility for comparing pre- and post-treatment behavior. Open field exploration and social interaction behavior were consistent across multiple sessions in control animals. Individual sound-exposed and salicylate-treated rats showed a range of phenotypes in the open field, including reduced entries into the center in some subjects and reduced locomotion overall. In rats screened for tinnitus, less locomotion was associated with higher tinnitus scores. In salicylate-treated animals, locomotion was correlated with age. Sound-exposed and salicylate-treated rats also showed reduced social interaction. These results suggest that open field exploratory activity is a selective measure for identifying tinnitus distress in individual animals, whereas social interaction reflects the general effects of hearing loss. This animal model will facilitate future studies of the structural and functional changes in the brain pathways underlying emotional distress associated with hearing dysfunction, as well as development of novel interventions to ameliorate or prevent negative emotional responses.

Modulation of azimuth tuning plasticity in rat primary auditory cortex by medial prefrontal cortex

Neurons in the primary auditory cortex (A1) of adult animals exhibit short-term plasticity of frequency selectivity and tonotopic organization in behavioral contexts ranging from classical conditioning to attention tasks. However, it is still largely unknown whether short-term plasticity of spatial tuning takes place in A1 of adult animals and whether this spatial turning plasticity in A1 of adults is mediated by medial prefrontal cortex (mPFC) as there are reciprocal connection between mPFC and auditory cortex (AC). In the present study, we used extracellular recordings to test whether azimuth tuning in A1 of anesthetized rats can be reshaped by repeated sound stimuli at neurons' non-preferred azimuth. We also identified whether and how such A1 azimuth tuning plasticity was modulated by the neural activities of mPFC. Our results showed that A1 neurons in adult rats have azimuth tuning plasticity when repeated acoustic stimuli were delivered at the azimuth with a deviation by less than 15° from the best azimuth (BA). The BA shifted toward the exposure azimuth when repeated acoustic stimuli were played for 20-60min and plasticity decayed within one hour. The less the angle deviated from the BA, the shorter exposure time and longer decay time were required to induce azimuth tuning plasticity. Neural activity in mPFC modulated azimuth tuning plasticity of A1 neurons as reflected by the shorter induction time when mPFC was activated by focal electrical stimulation and the longer induction time when mPFC was inactivated by drug application. Our results suggest that spatial location selectivity in A1 neurons remains plastic in mature animals and that short-term plasticity of spatial tuning can be modulated by the neural activities of mPFC.

Improving the Reliability of Tinnitus Screening in Laboratory Animals

Behavioral screening remains a contentious issue for animal studies of tinnitus. Most paradigms base a positive tinnitus test on an animal's natural tendency to respond to the "sound" of tinnitus as if it were an actual sound. As a result, animals with tinnitus are expected to display sound-conditioned behaviors when no sound is present or to miss gaps in background sounds because tinnitus "fills in the gap." Reliable confirmation of the behavioral indications of tinnitus can be problematic because the reinforcement contingencies of conventional discrimination tasks break down an animal's tendency to group tinnitus with sound. When responses in silence are rewarded, animals respond in silence regardless of their tinnitus status. When responses in silence are punished, animals stop responding. This study introduces stimulus classification as an alternative approach to tinnitus screening. Classification procedures train animals to respond to the common perceptual features that define a group of sounds (e.g., high pitch or narrow bandwidth). Our procedure trains animals to drink when they hear tinnitus and to suppress drinking when they hear other sounds. Animals with tinnitus are revealed by their tendency to drink in the presence of unreinforced probe sounds that share the perceptual features of the tinnitus classification. The advantages of this approach are illustrated by taking laboratory rats through a testing sequence that includes classification training, the experimental induction of tinnitus, and postinduction screening. Behavioral indications of tinnitus are interpreted and then verified by simulating a known tinnitus percept with objective sounds.

Norepinephrine is necessary for experience-dependent plasticity in the developing mouse auditory cortex

Critical periods are developmental windows during which the stimuli an animal encounters can reshape response properties in the affected system to a profound degree. Despite this window's importance, the neural mechanisms that regulate it are not completely understood. Pioneering studies in visual cortex initially indicated that norepinephrine (NE) permits ocular dominance column plasticity during the critical period, but later research has suggested otherwise. More recent work implicating NE in experience-dependent plasticity in the adult auditory cortex led us to re-examine the role of NE in critical period plasticity. Here, we exposed dopamine β-hydroxylase knock-out (Dbh(-/-)) mice, which lack NE completely from birth, to a biased acoustic environment during the auditory cortical critical period. This manipulation led to a redistribution of best frequencies (BFs) across auditory cortex in our control mice, consistent with prior work. By contrast, Dbh(-/-) mice failed to exhibit the expected redistribution of BFs, even though NE-deficient and NE-competent mice showed comparable auditory cortical organization when reared in a quiet colony environment. These data suggest that while intrinsic tonotopic patterning of auditory cortical circuitry occurs independently from NE, NE is required for critical period plasticity in auditory cortex.

Behavioral changes in response to sound exposure and no spatial avoidance of noisy conditions in captive zebrafish

Auditory sensitivity in fish serves various important functions, but also makes fish susceptible to noise pollution. Human-generated sounds may affect behavioral patterns of fish, both in natural conditions and in captivity. Fish are often kept for consumption in aquaculture, on display in zoos and hobby aquaria, and for medical sciences in research facilities, but little is known about the impact of ambient sounds in fish tanks. In this study, we conducted two indoor exposure experiments with zebrafish (Danio rerio). The first experiment demonstrated that exposure to moderate sound levels (112 dB re 1 μPa) can affect the swimming behavior of fish by changing group cohesion, swimming speed and swimming height. Effects were brief for both continuous and intermittent noise treatments. In the second experiment, fish could influence exposure to higher sound levels by swimming freely between an artificially noisy fish tank (120-140 dB re 1 μPa) and another with ambient noise levels (89 dB re 1 μPa). Despite initial startle responses, and a brief period in which many individuals in the noisy tank dived down to the bottom, there was no spatial avoidance or noise-dependent tank preference at all. The frequent exchange rate of about 60 fish passages per hour between tanks was not affected by continuous or intermittent exposures. In conclusion, small groups of captive zebrafish were able to detect sounds already at relatively low sound levels and adjust their behavior to it. Relatively high sound levels were at least at the on-set disturbing, but did not lead to spatial avoidance. Further research is needed to show whether zebrafish are not able to avoid noisy areas or just not bothered. Quantitatively, these data are not directly applicable to other fish species or other fish tanks, but they do indicate that sound exposure may affect fish behavior in any captive condition.

Impact of sound exposure and aging on brain-derived neurotrophic factor and tyrosine kinase B receptors levels in dorsal cochlear nucleus 80 days following sound exposure

Recent studies suggested that acute sound exposure resulting in a temporary threshold shift in young adult animals within a series of maladaptive plasticity changes in central auditory structures. Brain-derived neurotrophic factor (BDNF), a member of the neurotrophin family, is involved in post-trauma peripheral hair cell and spiral ganglion cell survival and has been shown to modulate synaptic strength in cochlear nucleus following sound exposure. The present study evaluated levels of BDNF and its receptor (tyrosine kinase B, [TrkB]) in the dorsal cochlear nucleus (DCN) following a unilateral moderate sound exposure in young (7-8 months) and aged (28-29 months) Fischer Brown Norway (FBN) rats. Eighty days post-exposure, auditory brainstem response (ABR) thresholds for young exposed rats approached control values while aged exposed rats showed residual permanent threshold shifts (PTS) relative to aged controls. BDNF protein levels were significantly up-regulated by 9% in young exposed fusiform cells ipsilateral to the exposure. BDNF levels in aged sound-exposed fusiform cells increased 31% ipsilateral to the exposure. Protein levels of the BDNF receptor, TrkB, were also significantly increased in aged but not in young sound-exposed DCN fusiform cells. The present findings suggest a relationship between the up-regulation of BDNF/TrkB and the increase in spontaneous and driven activity previously observed for aged and sound-exposed fusiform cells. This might be due to a selective maladaptive compensatory down-regulation of glycinergic inhibition in DCN fusiform cells.