Simultaneous measurement of noise-activated middle-ear muscle reflex and stimulus frequency otoacoustic emissions

Assessing Medial Olivocochlear Reflex Strengths via Auditory Brainstem Response: Measurement and Variability in Normal-Hearing Individuals

PURPOSE

Optimal measurement settings to measure the medial olivocochlear reflex (MOCR) in humans have not yet been defined. The purpose of this study was to advance the representation of the MOCR in auditory brainstem response (ABR) as an addition to the current diagnostic portfolio.

PARTICIPANTS AND METHOD

Twelve female and 14 male normal-hearing adults participated in the study. Potential effects of a contralateral acoustic stimulus (CAS) on amplitude changes were investigated by recording ABR waveform profiles on the left side at click intensities of 50/60/70 dB nHL with and without CAS (60 dB SPL). Secondly, to detect potential chronological order influences, measurement settings were rearranged on the right side and measurements were repeated. Additionally, ABR thresholds were recorded with and without a CAS in 10 patients.

RESULTS

When the effect of contralateral suppression was analyzed on the basis of amplitude changes, there was a change under administration of the CAS signal that was statistically significant. Interestingly, the order of recordings affected the degree of amplitude change. In three out of 10 patients, reproducible suppression effects on ABR thresholds were detectable upon CAS presentation.

CONCLUSIONS

To our knowledge, this is the largest study dealing with the recording of the MOCR elicited by a contralateral noise via ABR in normal-hearing individuals. Effects of MOCR are measurable via amplitude changes upon CAS administration. Chronological orders influence the impact of this effect on amplitude changes. Optimal measurement settings have not yet been defined. However, experiments such as this study may help to further improve measurements, and thus advance the representation of the MOC reflex in ABR as an addition to the current diagnostic portfolio.

Does the Presence of Spontaneous Components Affect the Reliability of Contralateral Suppression of Evoked Otoacoustic Emissions?

OBJECTIVES

The function of the medial olivocochlear system can be evaluated by measuring the suppression of otoacoustic emissions (OAEs) by contralateral stimulation. One of the obstacles preventing the clinical use of the OAE suppression is that it has considerable variability across subjects. One feature that tends to differentiate subjects is the presence or absence of spontaneous OAEs (SOAEs). The purpose of the present study was to investigate the reliability of contralateral suppression of transiently evoked OAEs (TEOAEs) measured using a commercial device in ears with and without SOAEs.

DESIGN

OAEs were recorded in a group of 60 women with normal hearing. TEOAEs were recorded with a linear protocol (identical stimuli), a constant stimulus level of 65 dB peSPL, and contralateral broadband noise (60 dB SPL) as a suppressor. Each recording session consisted of three measurements: the first two were made consecutively without taking out the probe (the "no refit" condition); the third measurement was made after taking out and refitting the probe (a "refit" condition). Global (for the whole signal) and half-octave band values of TEOAE response levels, signal-to-noise ratios (SNRs), raw dB TEOAE suppression, and normalized TEOAE suppression, and latency were investigated. Each subject was tested for the presence of SOAEs using the synchronized SOAE (SSOAE) technique. Reliability was evaluated by calculating the intraclass correlation coefficient, standard error of measurement (SEM) and minimum detectable change.

RESULTS

The TEOAE suppression was higher in ears with SSOAEs in terms of normalized percentages. However, when calculated in terms of decibels, the effect was not significant. The reliability of the TEOAE suppression as assessed by SEM was similar for ears with and without SSOAEs. The SEM for the whole dataset (with and without SSOAEs) was 0.08 dB for the no-refit condition and 0.13 dB for the refit condition (equivalent to 1.6% and 2.2%, respectively). SEMs were higher for half-octave bands than for global values. TEOAE SNRs were higher in ears with SSOAEs.

CONCLUSIONS

The effect of SSOAEs on reliability of the TEOAE suppression remains complicated. On the one hand, we found that higher SNRs generally provide lower variability of calculated suppressions, and that the presence of SSOAEs favors high SNRs. On the other hand, reliability estimates were not much different between ears with and without SSOAEs. Therefore, in a clinical setting, the presence of SOAEs does not seem to have an effect on suppression measures, at least when testing involves measuring global or half-octave band response levels.

Click evoked middle ear muscle reflex: Spectral and temporal aspects

This study describes a time series-based method of middle ear muscle reflex (MEMR) detection using bilateral clicks. Although many methods can detect changes in the otoacoustic emissions evoking stimulus to monitor the MEMR, they do not discriminate between true MEMR-mediated vs artifactual changes in the stimulus. We measured MEMR in 20 young clinically normal hearing individuals using 1-s-long click trains presented at six levels (65 to 95 dB peak-to-peak sound pressure level in 6 dB steps). Changes in the stimulus levels over the 1 s period were well-approximated by two-term exponential functions. The magnitude of ear canal pressure changes due to MEMR increased monotonically as a function of click level but non-monotonically with frequency when separated into 1/3 octave wide bands between 1 and 3.2 kHz. MEMR thresholds estimated using this method were lower than that obtained from a clinical tympanometer in ∼94% of the participants. A time series-based method, along with statistical tests, may provide additional confidence in detecting the MEMR. MEMR effects were smallest at 2 kHz, between 1 and 3.2 kHz, which may provide avenues for minimizing the MEMR influence while measuring other responses (e.g., the medial olivocochlear reflex).

Muscles in and around the ear as the source of "physiological noise" during auditory selective attention: A review and novel synthesis

The sensitivity of the auditory system is regulated via two major efferent pathways: the medial olivocochlear system that connects to the outer hair cells, and by the middle ear muscles-the tensor tympani and stapedius. The role of the former system in suppressing otoacoustic emissions has been extensively studied, but that of the complementary network has not. In studies of selective attention, decreases in otoacoustic emissions from contralateral stimulation have been ascribed to the medial olivocochlear system, but the acknowledged problem is that the results can be confounded by parallel muscle activity. Here, the potential role of the muscle system is examined through a wide but not exhaustive review of the selective attention literature, and the unifying hypothesis is made that the prominent "physiological noise" detected in such experiments, which is reduced during attention, is the sound produced by the muscles in proximity to the ear-including the middle ear muscles. All muscles produce low-frequency sound during contraction, but the implications for selective attention experiments-in which muscles near the ear are likely to be active-have not been adequately considered. This review and synthesis suggests that selective attention may reduce physiological noise in the ear canal by reducing the activity of muscles close to the ear. Indeed, such an experiment has already been done, but the significance of its findings have not been widely appreciated. Further sets of experiments are needed in this area.

Contralateral suppression of otoacoustic emissions in pre-school children

BACKGROUND

Contralateral suppression of otoacoustic emissions (OAEs) may serve as an index of the medial olivocochlear (MOC) reflex. To date, this index has been studied in various populations but never in pre-school children. The purpose of this study was to fill this gap and describe how the MOC reflex affects the properties of transiently evoked OAEs (TEOAEs) in this age group. In addition, the influence of the presence of spontaneous OAEs (SOAEs) in the studied ear on the suppression of TEOAEs was also investigated.

METHODS

TEOAEs with and without contralateral acoustic stimulation (CAS) by white noise were measured in 126 normally hearing pre-school children aged 3-6 years. The values of response levels, suppression by CAS, and signal-to-noise ratios (SNRs) of TEOAEs were investigated for the whole signal (global) and for half-octave frequency bands from 1 to 4 kHz. Only ears with SNR >6 dB were used in the analyses. SOAEs were acquired using the so-called synchronized SOAEs (SSOAEs) technique.

RESULTS

Ears with SSOAEs had higher response levels and SNRs than ears without SSOAEs, and suppression was lower (0.58 dB compared to 0.85 dB). Only 22% of all studied ears had an SNR >20 dB, a level recommended in some studies for measuring suppression. There were no significant effects of age or gender on TEOAE suppression.

CONCLUSIONS

Suppression levels for pre-school children did not differ appreciably from those of adults measured under similar conditions in other studies. Taken together with no effect of age in the data studied here, it seems that there is no effect of age on TEOAE suppression. However, we did find that the presence of SSOAEs had an effect on TEOAE suppression, a finding which has not been reported in earlier studies on different populations. We suggest that the presence of SSOAEs might be a crucial factor related to MOC function.

Effects of cochlear synaptopathy on middle-ear muscle reflexes in unanesthetized mice

Cochlear synaptopathy, i.e. the loss of auditory-nerve connections with cochlear hair cells, is seen in aging, noise damage, and other types of acquired sensorineural hearing loss. Because the subset of auditory-nerve fibers with high thresholds and low spontaneous rates (SRs) is disproportionately affected, audiometric thresholds are relatively insensitive to this primary neural degeneration. Although suprathreshold amplitudes of wave I of the auditory brainstem response (ABR) are attenuated in synaptopathic mice, there is not yet a robust diagnostic in humans. The middle-ear muscle reflex (MEMR) might be a sensitive metric (Valero et al., 2016), because low-SR fibers may be important drivers of the MEMR (Liberman and Kiang, 1984; Kobler et al., 1992). Here, to test the hypothesis that narrowband reflex elicitors can identify synaptopathic cochlear regions, we measured reflex growth functions in unanesthetized mice with varying degrees of noise-induced synaptopathy and in unexposed controls. To separate effects of the MEMR from those of the medial olivocochlear reflex, the other sound-evoked cochlear feedback loop, we used a mutant mouse strain with deletion of the acetylcholine receptor required for olivocochlear function. We demonstrate that the MEMR is normal when activated from non-synaptopathic cochlear regions, is greatly weakened in synaptopathic regions, and is a more sensitive indicator of moderate synaptopathy than the suprathreshold amplitude of ABR wave I.

The eardrums move when the eyes move: A multisensory effect on the mechanics of hearing

The peripheral hearing system contains several motor mechanisms that allow the brain to modify the auditory transduction process. Movements or tensioning of either the middle ear muscles or the outer hair cells modifies eardrum motion, producing sounds that can be detected by a microphone placed in the ear canal (e.g., as otoacoustic emissions). Here, we report a form of eardrum motion produced by the brain via these systems: oscillations synchronized with and covarying with the direction and amplitude of saccades. These observations suggest that a vision-related process modulates the first stage of hearing. In particular, these eye movement-related eardrum oscillations may help the brain connect sights and sounds despite changes in the spatial relationship between the eyes and the ears.

Interactions between sensory pathways such as the visual and auditory systems are known to occur in the brain, but where they first occur is uncertain. Here, we show a multimodal interaction evident at the eardrum. Ear canal microphone measurements in humans (n = 19 ears in 16 subjects) and monkeys (n = 5 ears in three subjects) performing a saccadic eye movement task to visual targets indicated that the eardrum moves in conjunction with the eye movement. The eardrum motion was oscillatory and began as early as 10 ms before saccade onset in humans or with saccade onset in monkeys. These eardrum movements, which we dub eye movement-related eardrum oscillations (EMREOs), occurred in the absence of a sound stimulus. The amplitude and phase of the EMREOs depended on the direction and horizontal amplitude of the saccade. They lasted throughout the saccade and well into subsequent periods of steady fixation. We discuss the possibility that the mechanisms underlying EMREOs create eye movement-related binaural cues that may aid the brain in evaluating the relationship between visual and auditory stimulus locations as the eyes move.

Differentiating Middle Ear and Medial Olivocochlear Effects on Transient-Evoked Otoacoustic Emissions

The response of the inner ear is modulated by the middle ear muscle (MEM) and olivocochlear (OC) efferent systems. Both systems can be activated reflexively by acoustic stimuli delivered to one or both ears. The acoustic middle ear muscle reflex (MEMR) controls the transmission of acoustic signals through the middle ear, while reflex activation of the medial component of the olivocochlear system (the MOCR) modulates cochlear mechanics. The relative prominence of the two efferent systems varies widely between species. Measuring the effect of either of these systems can be confounded by simultaneously activating the other. We describe a simple, sensitive online method that can identify the effects both systems have on otoacoustic emissions (OAEs) evoked by transient stimuli such as clicks or tone pips (TEOAEs). The method detects directly in the time domain the changes in the stimulus and/or emission pressures caused by contralateral noise. Measurements in human participants are consistent with other reports that the threshold for MOCR activation is consistently lower than for MEMR. The method appears to control for drift and subject-generated noise well enough to avoid the need for post hoc processing, making it promising for application in animal experiments (even if awake) and in the hearing clinic.

Identifying the Origin of Effects of Contralateral Noise on Transient Evoked Otoacoustic Emissions in Unanesthetized Mice

Descending neural pathways in the mammalian auditory system are known to modulate the function of the peripheral auditory system. These pathways include the medial olivocochlear (MOC) efferent innervation to outer hair cells (OHCs) and the acoustic reflex pathways mediating middle ear muscle (MEM) contractions. Based on measurements in humans (Marks and Siegel, companion paper), we applied a sensitive method to attempt to differentiate MEM and MOC reflexes using contralateral acoustic stimulation in mice under different levels of anesthesia. Separation of these effects is based on the knowledge that OHC-generated transient evoked otoacoustic emissions (TEOAE) are delayed relative to the stimulus, and that the MOC reflex affects the emission through its innervation of OHC. In contrast, the MEM-mediated changes in middle ear reflectance alter both the stimulus (with a short delay) and the emission. Using this approach, time averages to transient stimuli were evaluated to determine if thresholds for a contralateral effect on the delayed emission, indicating potential MOC activation, could be observed in the absence of a change in the stimulus pressure. This outcome was not observed in the majority of cases. There were also no statistically significant differences between MEM and putative MOC thresholds, and variability was high for both thresholds regardless of anesthesia level. Since the two reflex pathways could not be differentiated on the basis of activation thresholds, it was concluded that the MEM reflex dominates changes in TEOAEs induced by contralateral noise. This result complicates the identification of purely MOC-induced changes on OAEs in mice unless the MEM reflex is inactivated surgically or pharmacologically.

Effect of Contralateral Medial Olivocochlear Feedback on Perceptual Estimates of Cochlear Gain and Compression

The active cochlear mechanism amplifies responses to low-intensity sounds, compresses the range of input sound intensities to a smaller output range, and increases cochlear frequency selectivity. The gain of the active mechanism can be modulated by the medial olivocochlear (MOC) efferent system, creating the possibility of top-down control at the earliest level of auditory processing. In humans, MOC function has mostly been measured by the suppression of otoacoustic emissions (OAEs), typically as a result of MOC activation by a contralateral elicitor sound. The exact relationship between OAE suppression and cochlear gain reduction, however, remains unclear. Here, we measured the effect of a contralateral MOC elicitor on perceptual estimates of cochlear gain and compression, obtained using the established temporal masking curve (TMC) method. The measurements were taken at a signal frequency of 2 kHz and compared with measurements of click-evoked OAE suppression. The elicitor was a broadband noise, set to a sound pressure level of 54 dB to avoid triggering the middle ear muscle reflex. Despite its low level, the elicitor had a significant effect on the TMCs, consistent with a reduction in cochlear gain. The amount of gain reduction was estimated as 4.4 dB on average, corresponding to around 18 % of the without-elicitor gain. As a result, the compression exponent increased from 0.18 to 0.27.

Medial olivocochlear efferent reflex inhibition of human cochlear nerve responses

Inhibition of cochlear amplifier gain by the medial olivocochlear (MOC) efferent system has several putative roles: aiding listening in noise, protection against damage from acoustic overexposure, and slowing age-induced hearing loss. The human MOC reflex has been studied almost exclusively by measuring changes in otoacoustic emissions. However, to help understand how the MOC system influences what we hear, it is important to have measurements of the MOC effect on the total output of the organ of Corti, i.e., on cochlear nerve responses that couple sounds to the brain. In this work we measured the inhibition produced by the MOC reflex on the amplitude of cochlear nerve compound action potentials (CAPs) in response to moderate level (52-60 dB peSPL) clicks from five, young, normal hearing, awake, alert, human adults. MOC activity was elicited by 65 dB SPL, contralateral broadband noise (CAS). Using tympanic membrane electrodes, approximately 10 h of data collection were needed from each subject to yield reliable measurements of the MOC reflex inhibition on CAP amplitudes from one click level. The CAS produced a 16% reduction of CAP amplitude, equivalent to a 1.98 dB effective attenuation (averaged over five subjects). Based on previous reports of efferent effects as functions of level and frequency, it is possible that much larger effective attenuations would be observed at lower sound levels or with clicks of higher frequency content. For a preliminary comparison, we also measured MOC reflex inhibition of DPOAEs evoked from the same ears with f2's near 4 kHz. The resulting effective attenuations on DPOAEs were, on average, less than half the effective attenuations on CAPs.

Stimulus Frequency Otoacoustic Emissions Provide No Evidence for the Role of Efferents in the Enhancement Effect

Auditory enhancement refers to the perceptual phenomenon that a target sound is heard out more readily from a background sound if the background is presented alone first. Here we used stimulus-frequency otoacoustic emissions (SFOAEs) to test the hypothesis that activation of the medial olivocochlear efferent system contributes to auditory enhancement effects. The SFOAEs were used as a tool to measure changes in cochlear responses to a target component and the neighboring components of a multitone background between conditions producing enhancement and conditions producing no enhancement. In the "enhancement" condition, the target and multitone background were preceded by a precursor stimulus with a spectral notch around the signal frequency; in the control (no-enhancement) condition, the target and multitone background were presented without the precursor. In an experiment using a wideband multitone stimulus known to produce significant psychophysical enhancement effects, SFOAEs showed no changes consistent with enhancement, but some aspects of the results indicated possible contamination of the SFOAE magnitudes by the activation of the middle-ear-muscle reflex. The same SFOAE measurements performed using narrower-band stimuli at lower sound levels also showed no SFOAE changes consistent with either absolute or relative enhancement despite robust psychophysical enhancement effects observed in the same listeners with the same stimuli. The results suggest that cochlear efferent control does not play a significant role in auditory enhancement effects.

Changes in otoacoustic emissions during selective auditory and visual attention

Previous studies have demonstrated that the otoacoustic emissions (OAEs) measured during behavioral tasks can have different magnitudes when subjects are attending selectively or not attending. The implication is that the cognitive and perceptual demands of a task can affect the first neural stage of auditory processing-the sensory receptors themselves. However, the directions of the reported attentional effects have been inconsistent, the magnitudes of the observed differences typically have been small, and comparisons across studies have been made difficult by significant procedural differences. In this study, a nonlinear version of the stimulus-frequency OAE (SFOAE), called the nSFOAE, was used to measure cochlear responses from human subjects while they simultaneously performed behavioral tasks requiring selective auditory attention (dichotic or diotic listening), selective visual attention, or relative inattention. Within subjects, the differences in nSFOAE magnitude between inattention and attention conditions were about 2-3 dB for both auditory and visual modalities, and the effect sizes for the differences typically were large for both nSFOAE magnitude and phase. These results reveal that the cochlear efferent reflex is differentially active during selective attention and inattention, for both auditory and visual tasks, although they do not reveal how attention is improved when efferent activity is greater.

Exploring the role of feedback-based auditory reflexes in forward masking by schroeder-phase complexes

Several studies have postulated that psychoacoustic measures of auditory perception are influenced by efferent-induced changes in cochlear responses, but these postulations have generally remained untested. This study measured the effect of stimulus phase curvature and temporal envelope modulation on the medial olivocochlear reflex (MOCR) and on the middle-ear muscle reflex (MEMR). The role of the MOCR was tested by measuring changes in the ear-canal pressure at 6 kHz in the presence and absence of a band-limited harmonic complex tone with various phase curvatures, centered either at (on-frequency) or well below (off-frequency) the 6-kHz probe frequency. The influence of possible MEMR effects was examined by measuring phase-gradient functions for the elicitor effects and by measuring changes in the ear-canal pressure with a continuous suppressor of the 6-kHz probe. Both on- and off-frequency complex tone elicitors produced significant changes in ear canal sound pressure. However, the pattern of results was not consistent with the earlier hypotheses postulating that efferent effects produce the psychoacoustic dependence of forward-masked thresholds on masker phase curvature. The results also reveal unexpectedly long time constants associated with some efferent effects, the source of which remains unknown.

Wideband detection of middle ear muscle activation using swept-tone distortion product otoacoustic emissions

The measurement of efferent-induced suppression of otoacoustic emissions (OAEs) using contralateral acoustic stimulation (CAS) is complicated by potential contamination by the middle ear muscle reflex (MEMR), particularly at moderate to high CAS levels. When logarithmically sweeping primaries are used to measure distortion product otoacoustic emissions, the level and phase of the primaries at the entrance of the ear canal may be monitored simultaneously along with the OAEs elicited by the swept-tones. A method of detecting MEMR activation using swept-tones is presented in which the differences in the primaries in the ear canal with and without CAS are examined, permitting evaluation of MEMR effects over a broad frequency range. A range of CAS levels above and below expected contralateral acoustic reflex thresholds permitted evaluation of conditions with and without MEMR activation.

Selective attention reduces physiological noise in the external ear canals of humans. I: auditory attention

In this study, a nonlinear version of the stimulus-frequency OAE (SFOAE), called the nSFOAE, was used to measure cochlear responses from human subjects while they simultaneously performed behavioral tasks requiring, or not requiring, selective auditory attention. Appended to each stimulus presentation, and included in the calculation of each nSFOAE response, was a 30-ms silent period that was used to estimate the level of the inherent physiological noise in the ear canals of our subjects during each behavioral condition. Physiological-noise magnitudes were higher (noisier) for all subjects in the inattention task, and lower (quieter) in the selective auditory-attention tasks. These noise measures initially were made at the frequency of our nSFOAE probe tone (4.0 kHz), but the same attention effects also were observed across a wide range of frequencies. We attribute the observed differences in physiological-noise magnitudes between the inattention and attention conditions to different levels of efferent activation associated with the differing attentional demands of the behavioral tasks. One hypothesis is that when the attentional demand is relatively great, efferent activation is relatively high, and a decrease in the gain of the cochlear amplifier leads to lower-amplitude cochlear activity, and thus a smaller measure of noise from the ear.

Separating the contributions of olivocochlear and middle ear muscle reflexes in modulation of distortion product otoacoustic emission levels

OBJECTIVES

Mediated by the medial olivocochlear system (MOCS), distortion product otoacoustic emission (DPOAE) levels are reduced by presentation of contralateral acoustic stimuli. Such acoustic signals can also evoke a middle ear muscle reflex (MEMR) that also attenuates recorded DPOAE levels. Our aim is to clearly differentiate these two inhibitory mechanisms and to analyze each separately, perhaps allowing the development of novel tests of hearing function.

METHODS

DPOAE were recorded in real time from chinchillas with normal auditory brainstem response thresholds and middle ear function. Amplitude reduction and its onset latency caused by contralateral presentation of intermittent narrow-band noise (NBN) were measured. Stapedius and tensor tympani muscle tendons were divided without disturbing the ossicular chain, and DPOAE testing was repeated.

RESULTS

Peak reduction of (2f1 - f2) DPOAE levels occurred when the center frequency of contralateral NBN approximated the primary tone f2, indicating an f2-frequency-specific response. For a 4.5-kHz centered NBN, DPOAE (f2 = 4.4 kHz) inhibition was 0.1 dB (p < 0.001). This response remained present after tendon division, consistent with an MOCS origin. Low-frequency NBN (center frequency: 0.5 kHz) reduced otoacoustic emission levels (0.1 dB, p < 0.001) across a wide range of DPOAE frequencies. This low-frequency response was abolished by division of the middle ear muscle tendons, clearly indicating MEMR involvement.

CONCLUSIONS

Following middle ear muscle tendon division, DPOAE inhibition by contralateral stimuli approximating the primary tone f2 persists, whereas responses evoked by lower contralateral frequencies are abolished. This distinguishes the different roles of the MOCS (f2 frequency specific) and MEMR (low frequency only) in contralateral modulation of DPOAE. This analysis helps clarify the pathways involved in an objective test that might have clinical benefit in the testing of neonates.

Medial olivocochlear-induced transient-evoked otoacoustic emission amplitude shifts in individual subjects

Activation of the medial olivocochlear reflex (MOCR) can be assessed indirectly using transient-evoked otoacoustic emissions (TEOAEs). The change in TEOAE amplitudes when the MOCR is activated (medial olivocochlear (MOC) shift) has most often been quantified as the mean value in groups of subjects. The usefulness of MOC shift measurements may be increased by the ability to quantify significant shifts in individuals. This study used statistical resampling to quantify significant MOC shifts in 16 subjects. TEOAEs were obtained using transient stimuli containing energy from 1 to 10 kHz. A nonlinear paradigm was used to extract TEOAEs. Transient stimuli were presented at 30 dB sensation level (SL) with suppressor stimuli presented 12 dB higher. Contralateral white noise, used to activate the MOCR, was presented at 30 dB SL and was interleaved on and off in 30-s intervals during a 7-min recording period. Confounding factors of middle ear muscle reflex and slow amplitude drifts were accounted for. TEOAEs were analyzed in 11 1/3-octave frequency bands. The statistical significance of each individual MOC shift was determined using a bootstrap procedure. The minimum detectable MOC shifts ranged from 0.10 to 3.25 dB and were highly dependent on signal-to-noise ratio at each frequency. Subjects exhibited a wide range of magnitudes of significant MOC shifts in the 1.0-3.2-kHz region (median = 1.94 dB, range = 0.34-6.51 dB). There was considerable overlap between the magnitudes of significant and nonsignificant shifts. While most subjects had significant MOC shifts in one or more frequency bands below 4 kHz, few had significant shifts in all of these bands. Above 4 kHz, few significant shifts were seen, but this may have been due to lower signal-to-noise ratios. The specific frequency bands containing significant shifts were variable across individuals. Further work is needed to determine the clinical usefulness of examining MOC shifts in individuals.

Loudness functions with air and bone conduction stimulation in normal-hearing subjects using a categorical loudness scaling procedure

In a previous study (Stenfelt and Håkansson, 2002) a loudness balance test between bone conducted (BC) sound and air conducted (AC) sound was performed at frequencies between 0.25 and 4 kHz and at levels corresponding to 30-80 dB HL. The main outcome of that study was that for maintaining equal loudness, the level increase of sound with BC stimulation was less than that of AC stimulation with a ratio between 0.8 and 0.93 dB/dB. However, because it was shown that AC and BC tone cancellation was independent of the stimulation level, the loudness level difference did not originate in differences in basilar membrane stimulation. Therefore, it was speculated that the result could be due to the loudness estimation procedure. To investigate this further, another loudness estimation method (adaptive categorical loudness scaling) was here employed in 20 normal-hearing subjects. The loudness of a low-frequency and a high-frequency noise burst was estimated using the adaptive categorical loudness scaling technique when the stimulation was bilaterally by AC or BC. The sounds where rated on an 11-point scale between inaudible and too loud. The total dynamic range for these sounds was over 80 dB when presented by AC (between inaudible and too loud) and the loudness functions were similar for the low and the high-frequency stimulation. When the stimulation was by BC the loudness functions were steeper and the ratios between the slopes of the AC and BC loudness functions were 0.88 for the low-frequency sound and 0.92 for the high-frequency sound. These results were almost equal to the previous published results using the equal loudness estimation procedure, and it was unlikely that the outcome stems from the loudness estimation procedure itself. One possible mechanism for the result was loudness integration of multi-sensory input. However, no conclusive evidence for such a mechanism could be given by the present study. This article is part of a special issue entitled "MEMRO 2012".

Moments of click-evoked otoacoustic emissions in human ears: group delay and spread, instantaneous frequency and bandwidth

A click-evoked otoacoustic emission (CEOAE) has group delay and spread as first- and second-order temporal moments varying over frequency, and instantaneous frequency and bandwidth as first- and second-order spectral moments varying over time. Energy-smoothed moments were calculated from a CEOAE database over 0.5-15 kHz bandwidth and 0.25-20 ms duration. Group delay and instantaneous frequency were calculated without phase unwrapping using a coherence synchrony measure that accurately classified ears with hearing loss. CEOAE moment measurements were repeatable in individual ears. Group delays were similar for CEOAEs and stimulus-frequency OAEs. Group spread is a frequency-specific measure of temporal spread in an emission, related to spatial spread across tonotopic generation sites along the cochlea. In normal ears, group delay and spread increased with frequency and decreased with level. A direct measure of cochlear tuning above 4 kHz was analyzed using instantaneous frequency and bandwidth. Synchronized spontaneous OAEs were present in most ears below 4 kHz, and confounded interpretation of moments. In ears with sensorineural hearing loss, group delay and spread varied with audiometric classification and amount of hearing loss; group delay differed between older males and females. CEOAE moments reveal clinically relevant information on cochlear tuning in ears with normal and impaired hearing.

Contralateral-noise effects on cochlear responses in anesthetized mice are dominated by feedback from an unknown pathway

Suppression of ipsilateral distortion product otoacoustic emissions (DPOAEs) by contralateral noise is used in humans and animals to assay the strength of sound-evoked negative feedback from the medial olivocochlear (MOC) efferent pathway. However, depending on species and anesthesia, contributions of other feedback systems to the middle or inner ear can cloud the interpretation. Here, contributions of MOC and middle-ear muscle reflexes, as well as autonomic feedback, to contra-noise suppression in anesthetized mice are dissected by selectively eliminating each pathway by surgical transection, pharmacological blockade, or targeted gene deletion. When ipsilateral DPOAEs were evoked by low-level primaries, contra-noise suppression was typically ~1 dB with contra-noise levels around 95 dB SPL, and it always disappeared upon contralateral cochlear destruction. Lack of middle-ear muscle contribution was suggested by persistence of contra-noise suppression after paralysis with curare, tensor tympani cauterization, or section of the facial nerve. Contribution of cochlear sympathetics was ruled out by studying mutant mice lacking adrenergic signaling (dopamine β-hydroxylase knockouts). Surprisingly, contra-noise effects on low-level DPOAEs were also not diminished by eliminating the MOC system pharmacologically (strychnine), surgically, or by deletion of relevant cholinergic receptors (α9/α10). In contrast, when ipsilateral DPOAEs were evoked by high-level primaries, the contra-noise suppression, although comparable in magnitude, was largely eliminated by MOC blockade or section. Possible alternate pathways are discussed for the source of contra-noise-evoked effects at low ipsilateral levels.

The importance of acoustic reflex for communication

PURPOSE

The purpose of the study was to compare the speech recognition capacity between listeners with and without acoustic reflex using different types of noises and intensities.

MATERIALS AND METHODS

We studied 18 women allocated to 2 groups: acoustic reflex present (20 ears) and absent (16 ears). They were presented with 180 disyllable words (90 to each ear), emitted randomly at a fixed intensity of 40 dB above the pure tone average hearing level. At the same time, 3 types of noises were presented ipsilaterally (white, pink, and speech), one at a time, at 3 intensities: 40, 50, and 60 dB above the pure tone average hearing level.

RESULTS

The ages and auditory thresholds were statistically equal between the groups. There was a significant difference in mean number of hits between the 2 groups for the 3 types of noises used. There was also a significant difference in mean number of hits for noise type and intensity when white and pink noise was used at 40 and 50 dB and for all the intensities when speech was used.

CONCLUSION

Acoustic reflex helps communication in high-noise environments and is more efficient for speech sounds.

Fast and slow effects of medial olivocochlear efferent activity in humans

Background

The medial olivocochlear (MOC) pathway modulates basilar membrane motion and auditory nerve activity on both a fast (10–100 ms) and a slow (10–100 s) time scale in guinea pigs. The slow MOC modulation of cochlear activity is postulated to aide in protection against acoustic trauma. However in humans, the existence and functional roles of slow MOC effects remain unexplored.

Methodology/Principal Findings

By employing contralateral noise at moderate to high levels (68 and 83 dB SPL) as an MOC reflex elicitor, and spontaneous otoacoustic emissions (SOAEs) as a non-invasive probe of the cochlea, we demonstrated MOC modulation of human cochlear output both on a fast and a slow time scale, analogous to the fast and slow MOC efferent effects observed on basilar membrane vibration and auditory nerve activity in guinea pigs. The magnitude of slow effects was minimal compared with that of fast effects. Consistent with basilar membrane and auditory nerve activity data, SOAE level was reduced by both fast and slow MOC effects, whereas SOAE frequency was elevated by fast and reduced by slow MOC effects. The magnitudes of fast and slow effects on SOAE level were positively correlated.

Conclusions/Significance

Contralateral noise up to 83 dB SPL elicited minimal yet significant changes in both SOAE level and frequency on a slow time scale, consistent with a high threshold or small magnitude of slow MOC effects in humans.

Overshoot measured physiologically and psychophysically in the same human ears

A nonlinear version of the stimulus-frequency otoacoustic emission (SFOAE) was measured using stimulus waveforms similar to those used for behavioral overshoot. Behaviorally, the seven listeners were as much as 11 dB worse at detecting a brief tonal signal (4.0 kHz, 10 ms in duration) when it occurred soon after the onset of a wideband masking noise (0.1-6.0 kHz; 400 ms in duration) than when it was delayed by about 200 ms, and the nonlinear SFOAE measure exhibited a similar effect. When either lowpass (0.1-3.8 kHz) or bandpass noise (3.8-4.2 kHz) was used instead of the wideband noise, the physiological and behavioral measures again were similar. When a highpass noise (4.2-6.0 kHz) was used, the physiological and behavioral measures both showed no overshoot-like effect for five of the subjects. The physiological response to the tone decayed slowly after the termination of the noise, much like the time course of resetting for behavioral overshoot. One subject exhibited no overshoot behaviorally even though his cochlear responses were like those of the other subjects. Overall, the evidence suggests that some basic characteristics of overshoot are obligatory consequences of cochlear function, as modulated by the olivocochlear efferent system.

Properties of a nonlinear version of the stimulus-frequency otoacoustic emission

A procedure for extracting the nonlinear component of the stimulus-frequency otoacoustic emission (SFOAE) is described. This nSFOAE measures the amount by which the cochlear response deviates from linear additivity when the input stimulus is doubled in amplitude. When a 4.0-kHz tone was presented alone, the magnitude of the nSFOAE response remained essentially constant throughout the 400-ms duration of the tone; response magnitude did increase monotonically with increasing tone level. When a wideband noise was presented alone, nSFOAE magnitude increased over the initial 100- to 200-ms portion of the 400-ms duration of the noise. When the tone and the wideband noise were presented simultaneously, nSFOAE magnitude decreased momentarily, then increased substantially for about the first 100 ms and then remained strong for the remainder of the presentation. Manipulations of the noise bandwidth revealed that the low-frequency components were primarily responsible for this rising, dynamic response; no rising segment was seen with bandpass or highpass noise. The rising, dynamic nSFOAE response is likely attributable to activation of the medial olivocochlear efferent system. This perstimulatory emission appears to have the potential to provide information about the earliest stages of auditory processing for stimuli commonly used in psychoacoustical tasks.

Contralateral acoustic stimulation alters the magnitude and phase of distortion product otoacoustic emissions

Activation of medial olivocochlear efferents through contralateral acoustic stimulation (CAS) has been shown to modulate distortion product otoacoustic emission (DPOAE) level in various ways (enhancement, reduction, or no change). The goal of this study was to investigate the effect of a range of CAS levels on DPOAE fine structure. The 2f(1)-f(2) DPOAE was recorded (f(2)/f(1)=1.22, L(1)=55 dB, and L(2)=40 dB) from eight normal-hearing subjects, using both a frequency-sweep paradigm and a fixed frequency paradigm. Contamination due to the middle ear muscle reflex was avoided by monitoring the magnitude and phase of a probe in the test ear and by monitoring DPOAE stimulus levels throughout testing. Results show modulations in both level and frequency of DPOAE fine structure patterns. Frequency shifts observed at DPOAE level minima could explain reports of enhancement in DPOAE level due to efferent activation. CAS affected the magnitude and phase of the DPOAE component from the characteristic frequency region to a greater extent than the component from the overlap region between the stimulus tones. This differential effect explains the occasional enhancement observed in DPOAE level as well as the frequency shift in fine structure patterns.

The effect of contralateral acoustic stimulation on spontaneous otoacoustic emissions

Evoked otoacoustic emissions are often used to study the medial olivocochlear (MOC) efferents in humans. There has been concern that the emission-evoking stimulus may itself elicit efferent activity and alter the evoked otoacoustic emission. Spontaneous otoacoustic emissions (SOAEs) are hence advantageous as no external stimulation is necessary to record the response in the test ear. Contralateral acoustic stimulation (CAS) has been shown to suppress SOAE level and elevate SOAE frequency, but the time course of these effects is largely unknown. By utilizing the Choi-Williams distribution, here we report a gradual adaptation during the presence of CAS and an overshoot following CAS offset in both SOAE magnitude and frequency from six normal-hearing female human subjects. Furthermore, we have quantified the time constants of both magnitude and frequency shifts at the onset, presence, and offset of four levels of CAS. Most studies using contralateral elicitors do not stringently control the middle-ear muscle (MEM) reflex, leaving the results difficult to interpret. In addition to clinically available measures of the MEM reflex, we have incorporated a sensitive laboratory technique to monitor the MEM reflex in our subjects, allowing us to interpret the results with greater confidence.

Use of stimulus-frequency otoacoustic emissions to investigate efferent and cochlear contributions to temporal overshoot

Behavioral threshold for a tone burst presented in a long-duration noise masker decreases as the onset of the tone burst is delayed relative to masker onset. The threshold difference between detection of early- and late-onset tone bursts is called overshoot. Although the underlying mechanisms are unclear, one hypothesis is that overshoot occurs due to efferent suppression of cochlear nonlinearity [von Klitzing, R., and Kohlrausch, A. (1994). J. Acoust. Soc. Am. 95, 2192-2201]. This hypothesis was tested by using overshoot conditions to elicit stimulus-frequency otoacoustic emissions (SFOAEs), which provide a physiological measure of cochlear nonlinearity. SFOAE and behavioral thresholds were estimated using a modified maximum-likelihood yes-no procedure. The masker was a 400-ms "frozen" notched noise. The signal was a 20-ms, 4-kHz tone burst presented at 1 or 200 ms after the noise onset. Behavioral overshoot results replicated previous studies, but no overshoot was observed in SFOAE thresholds. This suggests that either efferent suppression of cochlear nonlinearity is not involved in overshoot, or a SFOAE threshold estimation procedure based on stimuli similar to those used to study behavioral overshoot is not sensitive enough to measure the effect.

On correlating otoacoustic emissions with blood glucose levels

The long term objective of this research is to develop a new means for diabetic patients to painlessly and non-invasively monitor their blood glucose levels. We propose a novel method for noninvasive glucose monitoring based on measurement and analysis of otoacoustic emissions (OAEs). OAEs are low-intensity sounds generated by the cochlea in response to acoustic stimuli. Evoking and measuring OAEs is done using a tiny speaker and microphone that fit snugly inside the ear canal. The OAE response can be partially masked or reduced in amplitude by presenting competing acoustic stimuli contralaterally (opposite ear), ipsilaterally (same ear), or both. This masking effect is caused by activation of neural efferent pathways from the brain. Neural effects, including evoked responses such as auditory brainstem responses and axonal transmission latencies, are known to correlate with glucose. This suggests that masked OAEs may correlate with glucose since masking is a result of neural activity, and neural activity is affected by glucose levels. Prior to our research, no studies have investigated the correlation of masked OAEs with blood glucose. In this paper we present our preliminary findings, including experimental results that suggest a correlation with blood glucose levels.

Influence of contralateral acoustic stimulation on the quadratic distortion product f2-f1 in humans

Contralateral acoustic stimulation is known to activate the medial olivocochlear system which is capable of modulating the amplification process in the outer hair cells of the inner ear. We investigated the influence of different levels of contralateral broadband noise on distortion product otoacoustic emissions in humans, with a particular focus on the quadratic distortion product at f2-f1. The primary stimulus frequency ratio was optimized to yield maximum f2-f1 level. While the cubic distortion product at 2f1-f2 was not significantly affected during contralateral noise stimulation, the level of f2-f1 was reduced by up to 4.8dB on average (maximum: 10.1dB), with significant suppression occurring for noise levels as low as 40dB SPL. In addition, a significant phase lead was observed. Quadratic distortions are minimal at a symmetrical position of the transfer function of the cochlear amplifier. The observed sensitivity of f2-f1 to contralateral noise stimulation could hence be resulting from a shift of the operating state and/or a change in the gain of the cochlear amplification due to contralateral induced efferent modulation of the outer hair cell properties.

Contralateral suppression of distortion product otoacoustic emissions and the middle-ear muscle reflex in human ears

Distortion product otoacoustic emissions (DPOAEs) were measured in the absence and presence of contralateral noise at five levels--below, equal to, and above the middle-ear muscle (MEM) reflex threshold. The resultant changes in DPOAE level and phase were dependent on stimulus frequency and noise level. Both low-level noise, believed to elicit the medial olivocochlear (MOC) reflex, and high-level noise, thought to activate both MOC and MEM reflexes, significantly decreased the DPOAE level. However, the shift from sole MOC effect to mixed MOC and MEM effects was not as dramatic as we thought. While low-level noise resulted in a minimum DPOAE phase change, high-level noise caused a substantial phase lead for 1 and 2kHz. With increasing frequency, phase lag became more notable. The present study suggests the following: (1) DPOAE contralateral suppression by low-level sound most likely does not involve the effect of the MEM reflex and signal crossover; and (2) combined analysis of DPOAE level and phase changes warrants further investigations to overcome the difficulty in separating the effects of MOC efferents and MEM contraction. The results also imply that OAE measurement has the potential for being used to investigate the effect of the MEM reflex on sound transmission.

Wideband ipsilateral measurements of middle-ear muscle reflex thresholds in children and adults

The goals of the current study were to: 1) evaluate the feasibility of a new wideband approach to measuring middle-ear muscle reflex (MEMR) status, and 2) to test the hypothesis that ipsilateral thresholds elicited with 1 or 2 kHz tones and broadband noise activators on a wideband acoustic transfer function (WATF) system are lower than thresholds elicited on a clinical system. Clinical MEMR tests have limitations, including the need for high activator levels to elicit a shift in a narrowband probe (e.g., a 0.226 or 1 kHz tone). Wideband MEMR tests using WATFs may elicit the reflex at lower levels because a wideband probe (click) is used and the threshold detection criterion can be wideband. Mean wideband MEMR thresholds across 40 normal-hearing adult ears were 2.2-4.0 dB lower than clinical MEMR thresholds, depending on the activator and specific WATF test used (admittance magnitude or energy reflectance). Wideband MEMR has potential clinical utility beyond the adult population, including use in newborn and preschool hearing screenings. In a newborn hearing screening, for example, wideband MEMR could be completed with the same system as otoacoustic emissions. However, further investigations in infants and young children are needed.