Measurement of the distribution of medial olivocochlear acoustic reflex strengths across normal-hearing individuals via otoacoustic emissions

Human Olivocochlear Effects: A Statistical Detection Approach Applied to the Cochlear Microphonic Evoked by Swept Tones

The human medial olivocochlear (MOC) reflex was assessed by observing the effects of contralateral acoustic stimulation (CAS) on the cochlear microphonic (CM) across a range of probe frequencies. A frequency-swept probe tone (125-4757 Hz, 90 dB SPL) was presented in two directions (up sweep and down sweep) to normal-hearing young adults. This study assessed MOC effects on the CM in individual participants using a statistical approach that calculated minimum detectable changes in magnitude and phase based on CM signal-to-noise ratio (SNR). Significant increases in CM magnitude, typically 1-2 dB in size, were observed for most participants from 354 to 1414 Hz, where the size and consistency of these effects depended on participant, probe frequency, sweep direction, and SNR. CAS-related phase lags were also observed, consistent with CM-based MOC studies in laboratory animals. Observed effects on CM magnitude and phase were in the opposite directions of reported effects on otoacoustic emissions (OAEs). OAEs are sensitive to changes in the motility of outer hair cells located near the peak region of the traveling wave, while the effects of CAS on the CM likely originate from MOC-related changes in the conductance of outer hair cells located in the basal tail of the traveling wave. Thus, MOC effects on the CM are complementary to those observed for OAEs.

A Clinically Viable Medial Olivocochlear Reflex Assay Using Transient-Evoked Otoacoustic Emissions

OBJECTIVES

The contralateral medial olivocochlear reflex (MOCR) strength may indicate various auditory conditions in humans, but a clinically viable assay and equipment are needed for quick, accurate, and reliable measurements. The first experiment compared an earlier version of the assay, which used a nonlinear-mode chirp stimulus, with a new assay using a linear-mode click stimulus, designed to give reliable MOCR measurements in most normal-hearing ears. The second experiment extended the improved assay on a purpose-built binaural hardware platform that used forward-pressure level (FPL) calibration for both the stimulus and the contralateral MOCR elicitor.

DESIGN

Transient-evoked otoacoustic emission (TEOAE) tests were measured with and without a 60-dB SPL MOCR-evoking contralateral broadband noise. The normalized MOCR strength (MOCR%) was derived from the TEOAE responses for each trial pair using the complex pressure difference weighted by the TEOAE magnitude. Experiment 1 compared MOCR% within-subject and across-day using two TEOAE stimuli: nonlinear-mode chirps (50 dB SPL, bandpass 1-5 kHz, 14 ms window delayed by 2 ms) and linear-mode clicks (50 dB SPL, bandpass 0.5-2.5 kHz, 13 ms window delayed by 5 ms). TEOAE responses were analyzed in the 0.5 to 2.5 kHz band. Thirty adult participants with normal hearing (30 ears) completed the study. The TEOAE stimulus was calibrated in situ using spectral flattening, and the contralateral noise was calibrated in a coupler. Twelve TEOAE trial pairs were collected for each participant and condition. Experiment 2 used a purpose-built binaural system. The TEOAE stimuli were linear-mode clicks (50 dB SPL, bandpass 1-3 kHz, 13 ms window delayed by 5 ms), analyzed in the 1 to 3 kHz band over ~12 trial pairs. After a probe refit, an additional trial pair was collected for the two early-stopping signal-to-noise ratio criteria (15 and 20 dB). They were evaluated for single-trial reliability and test time. Nineteen adult participants with normal hearing (38 ears) completed the study. The TEOAE clicks and contralateral elicitor noise were calibrated in situ using FPL and delivered with automated timing.

RESULTS

MOCR% for linear-mode clicks was distinguishable from measurement variability in 98% to 100% of participants' ears (both experiments), compared with only 73% for the nonlinear-mode chirp (experiment 1). MOCR detectability was assessed using the MOCR% across-subject/within-subject variance ratio. The ratio in experiment 1 for linear-mode clicks was higher (8.0) than for nonlinear-mode chirps (6.4). The ratio for linear-mode clicks (8.9) in experiment 2 was slightly higher than for the comparable linear-mode stimulus (8.0) in experiment 1. TEOAEs showed excellent reliability with high signal-to-noise ratios in both experiments, but reliability was higher for linear-mode clicks than nonlinear-mode chirps. MOCR reliability for the two stimuli was comparable. The FPL pressure response retest reliability derived from the SPL at the microphone was higher than the SPL retest reliability across 0.4 to 8 kHz. Stable results required 2 to 3 trial pairs for the linear-mode click (experiments 1 and 2) and three for the nonlinear-mode chirp (experiment 1), taking around 2 min on average.

CONCLUSIONS

The linear-mode click assay produced measurable, reliable, and stable TEOAE and MOCR results on both hardware platforms in around 2 min per ear. The stimulus design and response window ensured that any stimulus artifact in linear mode was unlikely to confound the results. The refined assay is ready to produce high-quality data quickly for clinical and field studies to develop population norms, recognize diagnostic patterns, and determine risk profiles.

Speech Perception in Noise and Medial Olivocochlear Reflex: Effects of Age, Speech Stimulus, and Response-Related Variables

PURPOSE

The role of the medial olivocochlear system in speech perception in noise has been debated over the years, with studies showing mixed results. One possible reason for this could be the dependence of this relationship on the parameters used in assessing the speech perception ability (age, stimulus, and response-related variables).

METHODS

The current study assessed the influence of the type of speech stimuli (monosyllables, words, and sentences), the signal-to-noise ratio (+5, 0, -5, and -10 dB), the metric used to quantify the speech perception ability (percent-correct, SNR-50, and slope of the psychometric function) and age (young vs old) on the relationship between medial olivocochlear reflex (quantified by contralateral inhibition of transient evoked otoacoustic emissions) and speech perception in noise.

RESULTS

A linear mixed-effects model revealed no significant contributions of the medial olivocochlear reflex to speech perception in noise.

CONCLUSION

The results suggest that there was no evidence of any modulatory influence of the indirectly measured medial olivocochlear reflex strength on speech perception in noise.

Auditory Deprivation during Development Alters Efferent Neural Feedback and Perception

Auditory experience plays a critical role in hearing development. Developmental auditory deprivation because of otitis media, a common childhood disease, produces long-standing changes in the central auditory system, even after the middle ear pathology is resolved. The effects of sound deprivation because of otitis media have been mostly studied in the ascending auditory system but remain to be examined in the descending pathway that runs from the auditory cortex to the cochlea via the brainstem. Alterations in the efferent neural system could be important because the descending olivocochlear pathway influences the neural representation of transient sounds in noise in the afferent auditory system and is thought to be involved in auditory learning. Here, we show that the inhibitory strength of the medial olivocochlear efferents is weaker in children with a documented history of otitis media relative to controls; both boys and girls were included in the study. In addition, children with otitis media history required a higher signal-to-noise ratio on a sentence-in-noise recognition task than controls to achieve the same criterion performance level. Poorer speech-in-noise recognition, a hallmark of impaired central auditory processing, was related to efferent inhibition, and could not be attributed to the middle ear or cochlear mechanics.SIGNIFICANCE STATEMENT Otitis media is the second most common reason children go to the doctor. Previously, degraded auditory experience because of otitis media has been associated with reorganized ascending neural pathways, even after middle ear pathology resolved. Here, we show that altered afferent auditory input because of otitis media during childhood is also associated with long-lasting reduced descending neural pathway function and poorer speech-in-noise recognition. These novel, efferent findings may be important for the detection and treatment of childhood otitis media.

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.

Lack of correlation between medial olivocochlear reflex strength and sentence recognition in noise

OBJECTIVE

The medial olivocochlear (MOC) reflex provides unmasking of sounds in noise, but its contribution to speech-in-noise perception remains unclear due to conflicting results. This study determined associations between MOC reflex strength and sentence recognition in noise in individuals with normal hearing.

DESIGN

MOC reflex strength was assessed using contralateral inhibition of transient-evoked otoacoustic emissions (TEOAEs). Scores on the AzBio sentence task were quantified at three signal-to-noise ratios (SNRs). Additionally, slope and threshold of the psychometric function were computed. Associations between MOC reflex strength and speech-in-noise outcomes were assessed using Spearman rank correlations.

STUDY SAMPLE

Nineteen young adults with normal hearing participated, with data from 17 individuals (mean age = 21.8 years) included in the analysis.

RESULTS

Contralateral noise significantly decreased the amplitude of TEOAEs. A range of contralateral inhibition values was exhibited across participants. Scores increased significantly with increasing SNR. Contrary to hypotheses, there were no significant correlations between MOC reflex strength and score, nor were there any significant correlations between MOC reflex strength and measures of the psychometric function.

CONCLUSIONS

Results found no significant monotonic relationship between MOC reflex strength and sentence recognition in noise. Future work is needed to determine the functional role of the MOC reflex.

Medial olivocochlear reflex reliability: The effects of averaging and presence of synchronized spontaneous otoacoustic emissions

The medial olivocochlear reflex (MOCR), usually assessed by the inhibition of transiently evoked otoacoustic emissions (TEOAEs) with contralateral noise, is a very small effect. In understanding the origin of the MOCR, it is crucial to obtain data of the highest accuracy, i.e., with a high signal-to-noise ratio (SNR), which in turn largely depends on the number of signal averages. This study investigates how the reliability of MOCR measures is affected by the number of averages. At the same time, the effect of the presence of synchronized spontaneous otoacoustic emissions (SSOAEs) is taken into account, as it is known that this factor significantly affects TEOAE amplitudes and SNRs. Each recording session consisted of two series of four measurements, allowing comparison of MOCR magnitude based on 250, 500, 750, and 1000 averages. Reliability was based on comparing the two series. The results show that, for a good quality MOCR measure (i.e., intraclass correlation above 0.9), the required number of averages is at least double that obtainable from a standard TEOAE test (i.e., 500 compared to 250). Ears without SSOAEs needed a higher number of averages to reach a correlation of 0.9 than ears with SSOAEs.

Fluctuations of Otoacoustic Emissions and Medial Olivocochlear Reflexes: Tracking One Subject over a Year

The purpose of the study was to measure the variability of transiently evoked otoacoustic emissions (TEOAEs) and the medial olivocochlear reflex (MOCR) over a long period of time in one person. TEOAEs with and without contralateral acoustic stimulation (CAS) by white noise were measured, from which MOCR strength could be derived as either a dB or % change. In this longitudinal case study, measurements were performed on the right and left ears of a young, normally hearing adult female once a week for 1 year. The results showed that TEOAE level and MOCR strength fluctuated over the year but tended to remain close to a baseline level, with standard deviations of around 0.5 dB and 0.05 dB, respectively. The TEOAE latencies at frequencies from 1 to 4 kHz were relatively stable, with maximum changes ranging from 0.5 ms for the 1 kHz band to 0.08 ms for the 4 kHz band. TEOAE levels and MOCR strengths were strongly and negatively correlated, meaning that the higher the TEOAE level, the lower the MOCR. Additionally, comparison of fluctuations between the ears revealed positive correlation, i.e., the higher the TEOAE level or MOCR in one ear, the higher in the second ear.

Contralateral noise effects on otoacoustic emissions and electrophysiologic responses in normal-hearing adults

Contralateral noise inhibits the amplitudes of cochlear and neural responses. These measures may hold potential diagnostic utility. The medial olivocochlear (MOC) reflex underlies the inhibition of cochlear responses but the extent to which it contributes to inhibition of neural responses remains unclear. Mertes and Leek [J. Acoust. Soc. Am. 140, 2027-2038 (2016)] recently examined contralateral inhibition of cochlear responses [transient-evoked otoacoustic emissions (TEOAEs)] and neural responses [auditory steady-state responses (ASSRs)] in humans and found that the two measures were not correlated, but potential confounds of older age and hearing loss were present. The current study controlled for these confounds by examining a group of young, normal-hearing adults. Additionally, measurements of the auditory brainstem response (ABR) were obtained. Responses were elicited using clicks with and without contralateral broadband noise. Changes in TEOAE and ASSR magnitude as well as ABR wave V latency were examined. Results indicated that contralateral inhibition of ASSRs was significantly larger than that of TEOAEs and that the two measures were uncorrelated. Additionally, there was no significant change in wave V latency. Results suggest that further work is needed to understand the mechanism underlying contralateral inhibition of the ASSR.

The Reliability of Contralateral Suppression of Otoacoustic Emissions Is Greater in Women than in Men

The aim of this study was to compare the reliability of the medial olivocochlear reflex (MOCR) between men and women. The strength of the MOCR was measured in terms of the suppression of transiently evoked otoacoustic emissions (TEOAEs) by contralateral acoustic stimulation (CAS). The difference between TEOAEs with and without CAS (white noise) was calculated as raw decibel TEOAE suppression as well as normalized TEOAE suppression expressed in percent. In each subject, sets of measurements were performed twice. Reliability was evaluated by calculating the intraclass correlation coefficient, the standard error of measurement, and the minimum detectable change (MDC). The study included 40 normally hearing subjects (20 men; 20 women). The estimates of MOCR for both genders were similar. Nevertheless, the reliability of the MOCR was poorer in men, with an MDC around twice that of women. This can be only partially attributed to slightly lower signal-to-noise ratios (SNRs) in men, since we used strict procedures calling for high SNRs (around 20 dB on average). Furthermore, even when we compared subgroups with similar SNRs, there was still lower MOCR reliability in men.

A Time-Course-Based Estimation of the Human Medial Olivocochlear Reflex Function Using Clicks

The auditory efferent system, especially the medial olivocochlear reflex (MOCR), is implicated in both typical auditory processing and in auditory disorders in animal models. Despite the significant strides in both basic and translational research on the MOCR, its clinical applicability remains under-utilized in humans due to the lack of a recommended clinical method. Conventional tests employ broadband noise in one ear while monitoring change in otoacoustic emissions (OAEs) in the other ear to index efferent activity. These methods, (1) can only assay the contralateral MOCR pathway and (2) are unable to extract the kinetics of the reflexes. We have developed a method that re-purposes the same OAE-evoking click-train to also concurrently elicit bilateral MOCR activity. Data from click-train presentations at 80 dB peSPL at 62.5 Hz in 13 young normal-hearing adults demonstrate the feasibility of our method. Mean MOCR magnitude (1.7 dB) and activation time-constant (0.2 s) are consistent with prior MOCR reports. The data also suggest several advantages of this method including, (1) the ability to monitor MEMR, (2) obtain both magnitude and kinetics (time constants) of the MOCR, (3) visual and statistical confirmation of MOCR activation.

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).

Short-Term Test-Retest Reliability of Contralateral Suppression of Click-Evoked Otoacoustic Emissions in Normal-Hearing Subjects

Purpose The objective of the current study was to investigate the short-term test-retest reliability of contralateral suppression (CS) of click-evoked otoacoustic emissions (CEOAEs) using commercially available otoacoustic emission equipment. Method Twenty-three young normal-hearing subjects were tested. An otoscopic evaluation, admittance measures, pure-tone audiometry, measurements of CEOAEs without and with contralateral acoustic stimulation (CAS) to determine CS were performed at baseline (n = 23), an immediate retest without and with refitting of the probe (only CS of CEOAEs; n = 11), and a retest after 1 week (n = 23) were performed. Test-retest reliability parameters were determined on CEOAE response amplitudes without and with CAS, and on raw and normalized CS indices between baseline and the other test moments. Results Repeated-measures analysis of variance indicated no random or systematic changes in CEOAE response amplitudes without and with CAS, and in raw and normalized CS indices between the test moments. Moderate-to-high intraclass correlation coefficients with mostly high significant between-subjects variability between baseline and each consecutive test moment were found for CEOAE response amplitude without and with CAS, and for the raw and normalized CS indices. Other reliability parameters deteriorated between CEOAE response amplitudes with CAS as compared to without CAS, between baseline and retest with probe refitting, and after 1 week, as well as for frequency-specific raw and normalized CS indices as compared to global CS indices. Conclusions There was considerable variability in raw and normalized CS indices as measured using CEOAEs with CAS using commercially available otoacoustic emission equipment. More research is needed to optimize the measurement of CS of CEOAEs and to reduce influencing factors, as well as to make generalization of test-retest reliability data possible.

Medial olivocochlear reflex effects on amplitude growth functions of long- and short-latency components of click-evoked otoacoustic emissions in humans

Functional outcomes of medial olivocochlear reflex (MOCR) activation, such as improved hearing in background noise and protection from noise damage, involve moderate to high sound levels. Previous noninvasive measurements of MOCR in humans focused primarily on otoacoustic emissions (OAEs) evoked at low sound levels. Interpreting MOCR effects on OAEs at higher levels is complicated by the possibility of the middle-ear muscle reflex and by components of OAEs arising from different locations along the length of the cochlear spiral. We overcame these issues by presenting click stimuli at a very slow rate and by time-frequency windowing the resulting click-evoked (CE)OAEs into short-latency (SL) and long-latency (LL) components. We characterized the effects of MOCR on CEOAE components using multiple measures to more comprehensively assess these effects throughout much of the dynamic range of hearing. These measures included CEOAE amplitude attenuation, equivalent input attenuation, phase, and slope of growth functions. Results show that MOCR effects are smaller on SL components than LL components, consistent with SL components being generated slightly basal of the characteristic frequency region. Amplitude attenuation measures showed the largest effects at the lowest stimulus levels, but slope change and equivalent input attenuation measures did not decrease at higher stimulus levels. These latter measures are less commonly reported and may provide insight into the variability in listening performance and noise susceptibility seen across individuals.NEW & NOTEWORTHY The auditory efferent system, operating at moderate to high sound levels, may improve hearing in background noise and provide protection from noise damage. We used otoacoustic emissions to measure these efferent effects across a wide range of sound levels and identified level-dependent and independent effects. Previous reports have focused on level-dependent measures. The level-independent effects identified here may provide new insights into the functional relevance of auditory efferent activity in humans.

No Change in Medial Olivocochlear Efferent Activity during an Auditory or Visual Task: Dual Evidence from Otoacoustic Emissions and Event-Related Potentials

The medial olivocochlear (MOC) system is thought to be responsible for modulation of peripheral hearing through descending (efferent) pathways. This study investigated the connection between peripheral hearing function and conscious attention during two different modality tasks, auditory and visual. Peripheral hearing function was evaluated by analyzing the amount of suppression of otoacoustic emissions (OAEs) by contralateral acoustic stimulation (CAS), a well-known effect of the MOC. Simultaneously, attention was evaluated by event-related potentials (ERPs). Although the ERPs showed clear differences in processing of auditory and visual tasks, there were no differences in the levels of OAE suppression. We also analyzed OAEs for the highest magnitude resonant mode signal detected by the matching pursuit method, but again did not find a significant effect of task, and no difference in noise level or number of rejected trials. However, for auditory tasks, the amplitude of the P3 cognitive wave negatively correlated with the level of OAE suppression. We conclude that there seems to be no change in MOC function when performing different modality tasks, although the cortex still remains able to modulate some aspects of MOC activity.

Efferent-induced shifts in synchronized-spontaneous-otoacoustic-emission magnitude and frequency

Synchronized-spontaneous otoacoustic emissions (SSOAEs) present as slow-decaying emission energy that persists after the transient-evoked otoacoustic emission (TEOAE). SSOAEs possess high amplitudes and signal-to-noise ratios, making them potentially ideal candidates to assay the medial-olivocochlear reflex (MOCR). The current work quantified MOCR-induced changes to SSOAEs over a 36-dB stimulus level range and compared MOCR effects between TEOAE- and SSOAE-based assays. Otoacoustic emissions were evoked using band limited clicks from 52 to 88 dB peak sound pressure level (pSPL) with and without contralateral-acoustic stimulation (CAS) in 25 normal-hearing, female adults. The CAS was 50-dB sound pressure level (SPL) broadband noise and served to activate the MOCR. The number of SSOAEs increased with the stimulus level through approximately 70 dB pSPL. The presentation of CAS resulted in fewer SSOAEs. SSOAEs exhibited compressive growth and approached saturation for stimulus levels of 70 dB pSPL. The primary effects of CAS were a reduction in the SSOAE magnitude and an upward shift in the SSOAE frequency. These changes were not strongly affected by the stimulus level. Time-domain analysis of the SSOAE revealed an increase in the CAS-induced magnitude shift during the decay portion of the SSOAE. Compared to CAS-induced TEOAE magnitude shifts, SSOAE magnitude shifts were typically 2-3 dB larger. Findings support SSOAEs as a means to assay the MOCR.

Adaptation to Noise in Human Speech Recognition Depends on Noise-Level Statistics and Fast Dynamic-Range Compression

Human hearing adapts to background noise, as evidenced by the fact that listeners recognize more isolated words when words are presented later rather than earlier in noise. This adaptation likely occurs because the leading noise shifts ("adapts") the dynamic range of auditory neurons, which can improve the neural encoding of speech spectral and temporal cues. Because neural dynamic range adaptation depends on stimulus-level statistics, here we investigated the importance of "statistical" adaptation for improving speech recognition in noisy backgrounds. We compared the recognition of noised-masked words in the presence and in the absence of adapting noise precursors whose level was either constant or was changing every 50 ms according to different statistical distributions. Adaptation was measured for 28 listeners (9 men) and was quantified as the recognition improvement in the precursor relative to the no-precursor condition. Adaptation was largest for constant-level precursors and did not occur for highly fluctuating precursors, even when the two types of precursors had the same mean level and both activated the medial olivocochlear reflex. Instantaneous amplitude compression of the highly fluctuating precursor produced as much adaptation as the constant-level precursor did without compression. Together, results suggest that noise adaptation in speech recognition is probably mediated by neural dynamic range adaptation to the most frequent sound level. Further, they suggest that auditory peripheral compression per se, rather than the medial olivocochlear reflex, could facilitate noise adaptation by reducing the level fluctuations in the noise.SIGNIFICANCE STATEMENT Recognizing speech in noise is challenging but can be facilitated by noise adaptation. The neural mechanisms underlying this adaptation remain unclear. Here, we report some benefits of adaptation for word-in-noise recognition and show that (1) adaptation occurs for stationary but not for highly fluctuating precursors with equal mean level; (2) both stationary and highly fluctuating noises activate the medial olivocochlear reflex; and (3) adaptation occurs even for highly fluctuating precursors when the stimuli are passed through a fast amplitude compressor. These findings suggest that noise adaptation reflects neural dynamic range adaptation to the most frequent noise level and that auditory peripheral compression, rather than the medial olivocochlear reflex, could facilitate noise adaptation.

The role of efferents in human auditory development: efferent inhibition predicts frequency discrimination in noise for children

The descending corticofugal fibers originate from the auditory cortex and exert control on the periphery via the olivocochlear efferents. Medial efferents are thought to enhance the discriminability of transient sounds in background noise. In addition, the observation of deleterious long-term effects of efferent sectioning on the response properties of auditory nerve fibers in neonatal cats supports an efferent-mediated control of normal development. However, the role of the efferent system in human hearing remains unclear. The objective of the present study was to test the hypothesis that the medial efferents are involved in the development of frequency discrimination in noise. The hypothesis was examined with a combined behavioral and physiological approach. Frequency discrimination in noise and efferent inhibition were measured in 5- to 12-yr-old children (n = 127) and young adults (n = 37). Medial efferent strength was noninvasively assayed with a rigorous otoacoustic emission protocol. Results revealed an age-mediated relationship between efferent inhibition and frequency discrimination in noise. Efferent inhibition strongly predicted frequency discrimination in noise for younger children (5-9 yr). However, for older children (>9 yr) and adults, efferent inhibition was not related to frequency discrimination in noise. These findings support the role of efferents in the development of hearing-in-noise in humans; specifically, younger children compared with older children and adults are relatively more dependent on efferent inhibition for extracting relevant cues in noise. Additionally, the present findings caution against postulating an oversimplified relationship between efferent inhibition and measures of auditory perception in humans.NEW & NOTEWORTHY Despite several decades of research, the functional role of medial olivocochlear efferents in humans remains controversial and is thought to be insignificant. Here it is shown that medial efferent inhibition strongly predicts frequency discrimination in noise for younger children but not for older children and adults. Young children are relatively more dependent on the efferent system for listening-in-noise. This study highlights the role of the efferent system in hearing-in-noise during childhood development.

The Medial Olivocochlear Reflex Is Unlikely to Play a Role in Listening Difficulties in Children

The medial olivocochlear reflex (MOCR) has been implicated in several auditory processes. The putative role of the MOCR in improving speech perception in noise is particularly relevant for children who complain of listening difficulties (LiD). The hypothesis that the MOCR may be impaired in individuals with LiD or auditory processing disorder has led to several investigations but without consensus. In two related studies, we compared the MOCR functioning of children with LiD and typically developing (TD) children in the same age range (7-17 years). In Study 1, we investigated ipsilateral, contralateral, and bilateral MOCR using forward-masked click-evoked otoacoustic emissions (CEOAEs; n = 17 TD, 17 LiD). In Study 2, we employed three OAE types: CEOAEs (n = 16 TD, 21 LiD), stimulus frequency OAEs (n = 21 TD, 30 LiD), and distortion product OAEs (n = 17 TD, 22 LiD) in a contralateral noise paradigm. Results from both studies suggest that the MOCR functioning is not significantly different between the two groups. Some likely reasons for differences in findings among published studies could stem from the lack of strict data quality measures (e.g., high signal-to-noise ratio, control for the middle ear muscle reflex) that were enforced in the present study. The inherent variability of the MOCR, the subpar reliability of current MOCR methods, and the heterogeneity in auditory processing deficits that underlie auditory processing disorder make detecting clinically relevant differences in MOCR function impractical using current methods.

Jittering stimulus onset attenuates short-latency, synchronized-spontaneous otoacoustic emission energy

Synchronized-spontaneous otoacoustic emissions (SSOAEs) are slow-decaying otoacoustic emissions (OAEs) that persist up to several hundred milliseconds following presentation of a transient stimulus. If the inter-stimulus interval is sufficiently short, SSOAEs will contaminate the stimulus window of the adjacent epoch. In medial-olivocochlear reflex (MOCR) assays, SSOAE contamination can present as a change in the stimulus between quiet and noise conditions, since SSOAEs are sensitive to MOCR activation. Traditionally, a change in the stimulus between MOCR conditions implicates acoustic reflex activation by the contralateral noise; however, this interpretation is potentially confounded by SSOAEs. This study examined the utility of jittering stimulus onset to desynchronize and cancel short-latency SSOAE energy. Transient-evoked (TE) OAEs and SSOAEs were measured from 39 subjects in contralateral-quiet and -noise conditions. Clicks were presented at fixed and quasi-random intervals (by introducing up to 8 ms of jitter). For the fixed-interval condition, spectral differences in the stimulus window between quiet and noise conditions mirrored those in the SSOAE analysis window, consistent with SSOAE contamination. In contrast, spectral differences stemming from SSOAEs were attenuated and/or absent in the stimulus window for the jitter conditions. The use of jitter did not have a statistically significant effect on either TEOAE level or the estimated MOCR.

Medial olivocochlear reflex effects on synchronized spontaneous otoacoustic emissions

This study characterized medial olivocochlear (MOC) reflex activity on synchronized spontaneous otoacoustic emissions (SSOAEs) as compared to transient-evoked otoacoustic emissions (TEOAEs) in normal-hearing adults. Using two time windows, changes in TEOAE and SSOAE magnitude and phase due to a MOC reflex elicitor were quantified from 1 to 4 kHz. In lower frequency bands, changes in TEOAE and SSOAE magnitude were significantly correlated and were significantly larger for SSOAEs. Changes in TEOAE and SSOAE phase were not significantly different, nor were they significantly correlated. The larger effects on SSOAE magnitude may improve the sensitivity for detecting the MOC reflex.

Exploring the Role of Medial Olivocochlear Efferents on the Detection of Amplitude Modulation for Tones Presented in Noise

The medial olivocochlear reflex has been hypothesized to improve the detection and discrimination of dynamic signals in noisy backgrounds. This hypothesis was tested here by comparing behavioral outcomes with otoacoustic emissions. The effects of a precursor on amplitude-modulation (AM) detection were measured for a 1- and 6-kHz carrier at levels of 40, 60, and 80 dB SPL in a two-octave-wide noise masker with a level designed to produce poor, but above-chance, performance. Three types of precursor were used: a two-octave noise band, an inharmonic complex tone, and a pure tone. Precursors had the same overall level as the simultaneous noise masker that immediately followed the precursor. The noise precursor produced a large improvement in AM detection for both carrier frequencies and at all three levels. The complex tone produced a similarly large improvement in AM detection at the highest level but had a smaller effect for the two lower carrier levels. The tonal precursor did not significantly affect AM detection in noise. Comparisons of behavioral thresholds and medial olivocochlear efferent effects on stimulus frequency otoacoustic emissions measured with similar stimuli did not support the hypothesis that efferent-based reduction of cochlear responses contributes to the precursor effects on AM detection.

Olivocochlear Efferent Activity Is Associated With the Slope of the Psychometric Function of Speech Recognition in Noise

OBJECTIVES

The medial olivocochlear (MOC) efferent system can modify cochlear function to improve sound detection in noise, but its role in speech perception in noise is unclear. The purpose of this study was to determine the association between MOC efferent activity and performance on two speech-in-noise tasks at two signal-to-noise ratios (SNRs). It was hypothesized that efferent activity would be more strongly correlated with performance at the more challenging SNR, relative to performance at the less challenging SNR.

DESIGN

Sixteen adults aged 35 to 73 years participated. Subjects had pure-tone averages ≤25 dB HL and normal middle ear function. High-frequency pure-tone averages were computed across 3000 to 8000 Hz and ranged from 6.3 to 48.8 dB HL. Efferent activity was assessed using contralateral suppression of transient-evoked otoacoustic emissions (TEOAEs) measured in right ears, and MOC activation was achieved by presenting broadband noise to left ears. Contralateral suppression was expressed as the decibel change in TEOAE magnitude obtained with versus without the presence of the broadband noise. TEOAE responses were also examined for middle ear muscle reflex activation and synchronous spontaneous otoacoustic emissions (SSOAEs). Speech-in-noise perception was assessed using the closed-set coordinate response measure word recognition task and the open-set Institute of Electrical and Electronics Engineers sentence task. Speech and noise were presented to right ears at two SNRs. Performance on each task was scored as percent correct. Associations between contralateral suppression and speech-in-noise performance were quantified using partial rank correlational analyses, controlling for the variables age and high-frequency pure-tone average.

RESULTS

One subject was excluded due to probable middle ear muscle reflex activation. Subjects showed a wide range of contralateral suppression values, consistent with previous reports. Three subjects with SSOAEs had similar contralateral suppression results as subjects without SSOAEs. The magnitude of contralateral suppression was not significantly correlated with speech-in-noise performance on either task at a single SNR (p > 0.05), contrary to hypothesis. However, contralateral suppression was significantly correlated with the slope of the psychometric function, computed as the difference between performance levels at the two SNRs divided by 3 (decibel difference between the 2 SNRs) for the coordinate response measure task (partial rs = 0.59; p = 0.04) and for the Institute of Electrical and Electronics Engineers task (partial rs = 0.60; p = 0.03).

CONCLUSIONS

In a group of primarily older adults with normal hearing or mild hearing loss, olivocochlear efferent activity assessed using contralateral suppression of TEOAEs was not associated with speech-in-noise performance at a single SNR. However, auditory efferent activity appears to be associated with the slope of the psychometric function for both a word and sentence recognition task in noise. Results suggest that individuals with stronger MOC efferent activity tend to be more responsive to changes in SNR, where small increases in SNR result in better speech-in-noise performance relative to individuals with weaker MOC efferent activity. Additionally, the results suggest that the slope of the psychometric function may be a more useful metric than performance at a single SNR when examining the relationship between speech recognition in noise and MOC efferent activity.

Olivocochlear efferent contributions to speech-in-noise recognition across signal-to-noise ratios

The medial olivocochlear (MOC) efferent system modifies cochlear output to aid signal detection in noise, but the precise role of efferents in speech-in-noise understanding remains unclear. The current study examined the contribution of the MOC reflex for speech recognition in noise in 30 normal-hearing young adults (27 females, mean age = 22.7 yr). The MOC reflex was assessed using contralateral inhibition of transient-evoked otoacoustic emissions. Speech-in-noise perception was evaluated using the coordinate response measure presented in ipsilateral speech-shaped noise at signal-to-noise ratios (SNRs) ranging from -12 to 0 dB. Performance was assessed without and with the presence of contralateral noise to activate the MOC reflex. Performance was significantly better with contralateral noise only at the lowest SNR. There was a trend of better performance with increasing contralateral inhibition at the lowest SNR. Threshold of the psychometric function was significantly correlated with contralateral inhibition. Response time on the speech task was not significantly correlated with contralateral inhibition. Results suggest that the MOC reflex contributes to listening in low SNRs and the relationship between the MOC reflex and perception is highly dependent upon the task characteristics.

Human medial efferent activity elicited by dynamic versus static contralateral noises

The medial olivocochlear reflex (MOCR) modifies cochlear amplifier function to improve encoding of signals in static noise, but conflicting results have been reported regarding how the MOCR responds to dynamic, temporally-complex noises. The current study utilized three MOCR elicitors with identical spectral content but different temporal properties: broadband noise, amplitude-modulated noise, and speech envelope-modulated noise. MOCR activity was assessed using contralateral inhibition of transient-evoked otoacoustic emissions in 27 normal-hearing young adults. Elicitors were presented contralaterally at two intensities of 50 and 60 dB SPL. Magnitude and growth of contralateral inhibition with increasing elicitor intensity were compared across the three elicitor types. Results revealed that contralateral inhibition was significantly larger at the elicitor intensity of 60 dB SPL than at 50 dB SPL, but there were no significant differences in the magnitude and growth of inhibition across the three elicitors, contrary to hypothesis. These results suggest that the MOCR responds similarly to both static and dynamic noise.

Psychoacoustic measurements of ipsilateral cochlear gain reduction as a function of signal frequency

Forward masking experiments at 4 kHz have demonstrated that preceding sound can elicit changes in masking patterns consistent with a change in cochlear gain. However, the acoustic environment is filled with complex sounds, often dominated by lower frequencies, and ipsilateral cochlear gain reduction at frequencies below 4 kHz is largely unstudied in the forward masking literature. In this experiment, the magnitude of ipsilateral cochlear gain reduction was explored at 1, 2, and 4 kHz using forward masking techniques in an effort to evaluate a range of frequencies in listeners with normal hearing. Gain reduction estimates were not significantly different at 2 and 4 kHz using two forward masking measurements. Although the frequency was a significant factor in the analysis, post hoc testing supported the interpretation that gain reduction estimates measured without a masker were not significantly different at 1, 2, and 4 kHz. A second experiment provided evidence that forward masking in this paradigm at 1 kHz cannot be explained by excitation alone. This study provides evidence of ipsilateral cochlear gain reduction in humans at frequencies below the 4 kHz region.

Olivocochlear Efferents in Animals and Humans: From Anatomy to Clinical Relevance

Olivocochlear efferents allow the central auditory system to adjust the functioning of the inner ear during active and passive listening. While many aspects of efferent anatomy, physiology and function are well established, others remain controversial. This article reviews the current knowledge on olivocochlear efferents, with emphasis on human medial efferents. The review covers (1) the anatomy and physiology of olivocochlear efferents in animals; (2) the methods used for investigating this auditory feedback system in humans, their limitations and best practices; (3) the characteristics of medial-olivocochlear efferents in humans, with a critical analysis of some discrepancies across human studies and between animal and human studies; (4) the possible roles of olivocochlear efferents in hearing, discussing the evidence in favor and against their role in facilitating the detection of signals in noise and in protecting the auditory system from excessive acoustic stimulation; and (5) the emerging association between abnormal olivocochlear efferent function and several health conditions. Finally, we summarize some open issues and introduce promising approaches for investigating the roles of efferents in human hearing using cochlear implants.

Efferent-induced alterations in distortion and reflection otoacoustic emissions in children

The medial olivocochlear efferent fibers control outer hair cell responses and inhibit the cochlear-amplifier gain. Measuring efferent function is both theoretically and clinically relevant. In humans, medial efferent inhibition can be assayed via otoacoustic emissions (OAEs). OAEs arise by two fundamentally different mechanisms-nonlinear distortion and coherent reflection. Distortion and reflection emissions are typically applied in isolation for studying the efferent inhibition. Such an approach inadvertently assumes that efferent-induced shifts in distortion and reflection emissions provide redundant information. In this study, efferent-induced shifts in distortion and reflection emissions (click-evoked and stimulus frequency OAEs) were measured in the same subjects-5- to 10-yr-old children. Consistent with the OAE generation theory, efferent-induced shifts in distortion and reflection emissions did not correlate, whereas the two reflection emission shifts correlated. This suggests that using either OAE types provides fragmented information on efferent inhibition and highlights the need to use both distortion and reflection emissions for describing efferent effects.

Olivocochlear efferents: Their action, effects, measurement and uses, and the impact of the new conception of cochlear mechanical responses

The anatomy and physiology of olivocochlear (OC) efferents are reviewed. To help interpret these, recent advances in cochlear mechanics are also reviewed. Lateral OC (LOC) efferents innervate primary auditory-nerve (AN) fiber dendrites. The most important LOC function may be to reduce auditory neuropathy. Medial OC (MOC) efferents innervate the outer hair cells (OHCs) and act to turn down the gain of cochlear amplification. Cochlear amplification had been thought to act only through basilar membrane (BM) motion, but recent reports show that motion near the reticular lamina (RL) is amplified more than BM motion, and that RL-motion amplification extends to several octaves below the local characteristic frequency. Data on efferent effects on AN-fiber responses, otoacoustic emissions (OAEs) and human psychophysics are reviewed and reinterpreted in the light of the new cochlear-mechanical data. The possible origin of OAEs in RL motion is considered. MOC-effect measuring methods and MOC-induced changes in human responses are also reviewed, including that ipsilateral and contralateral sound can produce MOC effects with different patterns across frequency. MOC efferents help to reduce damage due to acoustic trauma. Many, but not all, reports show that subjects with stronger contralaterally-evoked MOC effects have better ability to detect signals (e.g. speech) in noise, and that MOC effects can be modulated by attention.

Efferent modulation of pre-neural and neural distortion products

Distortion product otoacoustic emissions (DPOAEs) and distortion product frequency following responses (DPFFRs) are respectively pre-neural and neural measurements associated with cochlear nonlinearity. Because cochlear nonlinearity is putatively linked to outer hair cell electromotility, DPOAEs and DPFFRs may provide complementary measurements of the human medial olivocochlear (MOC) reflex, which directly modulates outer hair cell function. In this study, we first quantified MOC reflex-induced DPOAE inhibition at spectral fine structure peaks in 22 young human adults with normal hearing. The f1 and f2 tone pairs producing the largest DPOAE fine structure peak for each subject were then used to evoke DPFFRs with and without MOC reflex activation to provide a related neural measure of efferent inhibition. We observed significant positive relationships between DPOAE fine structure peak inhibition and inhibition of DPFFR components representing neural phase locking to f2 and 2f1-f2, but not f1. These findings may support previous observations that the MOC reflex inhibits DPOAE sources differentially. That these effects are maintained and represented in the auditory brainstem suggests that the MOC reflex may exert a potent influence on subsequent subcortical neural representation of sound.

Synchronized Spontaneous Otoacoustic Emissions Provide a Signal-to-Noise Ratio Advantage in Medial-Olivocochlear Reflex Assays

Detection of medial olivocochlear-induced (MOC) changes to transient-evoked otoacoustic emissions (TEOAE) requires high signal-to-noise ratios (SNR). TEOAEs associated with synchronized spontaneous (SS) OAEs exhibit higher SNRs than TEOAEs in the absence of SSOAEs, potentially making the former well suited for MOC assays. Although SSOAEs may complicate interpretation of MOC-induced changes to TEOAE latency, recent work suggests SSOAEs are not a problem in non-latency-dependent MOC assays. The current work examined the potential benefit of SSOAEs in TEOAE-based assays of the MOC efferents. It was hypothesized that the higher SNR afforded by SSOAEs would permit detection of smaller changes to the TEOAE upon activation of the MOC reflex. TEOAEs were measured in 24 female subjects in the presence and absence of contralateral broadband noise. Frequency bands with and without SSOAEs were identified for each subject. The prevalence of TEOAEs and statistically significant MOC effects were highest in frequency bands that also contained SSOAEs. The median TEOAE SNR in frequency bands with SSOAEs was approximately 8 dB higher than the SNR in frequency bands lacking SSOAEs. After normalizing by TEOAE amplitude, MOC-induced changes to the TEOAE were similar between frequency bands with and without SSOAEs. Smaller MOC effects were detectable across a subset of the frequency bands with SSOAEs, presumably due to a higher TEOAE SNR. These findings demonstrate that SSOAEs are advantageous in assays of the MOC reflex.

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.

Contralateral Inhibition of Click- and Chirp-Evoked Human Compound Action Potentials

Cochlear outer hair cells (OHC) receive direct efferent feedback from the caudal auditory brainstem via the medial olivocochlear (MOC) bundle. This circuit provides the neural substrate for the MOC reflex, which inhibits cochlear amplifier gain and is believed to play a role in listening in noise and protection from acoustic overexposure. The human MOC reflex has been studied extensively using otoacoustic emissions (OAE) paradigms; however, these measurements are insensitive to subsequent "downstream" efferent effects on the neural ensembles that mediate hearing. In this experiment, click- and chirp-evoked auditory nerve compound action potential (CAP) amplitudes were measured electrocochleographically from the human eardrum without and with MOC reflex activation elicited by contralateral broadband noise. We hypothesized that the chirp would be a more optimal stimulus for measuring neural MOC effects because it synchronizes excitation along the entire length of the basilar membrane and thus evokes a more robust CAP than a click at low to moderate stimulus levels. Chirps produced larger CAPs than clicks at all stimulus intensities (50-80 dB ppeSPL). MOC reflex inhibition of CAPs was larger for chirps than clicks at low stimulus levels when quantified both in terms of amplitude reduction and effective attenuation. Effective attenuation was larger for chirp- and click-evoked CAPs than for click-evoked OAEs measured from the same subjects. Our results suggest that the chirp is an optimal stimulus for evoking CAPs at low stimulus intensities and for assessing MOC reflex effects on the auditory nerve. Further, our work supports previous findings that MOC reflex effects at the level of the auditory nerve are underestimated by measures of OAE inhibition.

Electrically Evoked Medial Olivocochlear Efferent Effects on Stimulus Frequency Otoacoustic Emissions in Guinea Pigs

Stimulus frequency otoacoustic emissions (SFOAEs) are produced by cochlear irregularities reflecting energy from the peak region of the traveling wave (TW). Activation of medial olivocochlear (MOC) efferents reduces cochlear amplification and otoacoustic emissions (OAEs). In other OAEs, MOC activation can produce enhancements. The extent of MOC enhancements of SFOAEs has not been previously studied. In anesthetized guinea pigs, we electrically stimulated MOC fibers and recorded their effects on SFOAEs. MOC stimulation mostly inhibited SFOAEs but sometimes enhanced them. Some enhancements were not near response dips and therefore cannot be explained by a reduction of wavelet cancelations. MOC stimulation always inhibited auditory-nerve compound action potentials showing that cochlear-amplifier gain was not increased. We propose that some SFOAE enhancements arise because shocks excite only a small number of MOC fibers that inhibit a few scattered outer hair cells thereby changing (perhaps increasing) cochlear irregularities and SFOAE amplitudes. Contralateral sound activation is expected to excite approximately one third of MOC efferents and may also change cochlear irregularities. Some papers suggest that large SFOAE components originate far basal of the TW peak, basal of the region that receives cochlear amplification. Using a time-frequency analysis, we separated SFOAEs into components with different latencies. At all SFOAE latencies, most SFOAE components were inhibited by MOC stimulation, but some were enhanced. The MOC inhibition of short-latency SFOAE components is consistent with these components being produced in the cochlear-amplified region near the TW peak.

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.

Efferent Modulation of Stimulus Frequency Otoacoustic Emission Fine Structure

Otoacoustic emissions, sounds generated in the inner ear, have become a convenient non-invasive tool to examine the efferent modulation of cochlear mechanics. Activation of the medial olivocochlear (MOC) efferents has been shown to alter the magnitude of these emissions. When the effects of efferent activation on the detailed spectral structures of these emissions have been examined, a shift of the spectral patterns toward higher frequencies has been reported for distortion product and spontaneous otoacoustic emissions. Stimulus frequency otoacoustic emissions (SFOAEs) have been proposed as the preferred emission type in the study of efferent modulation due to the simplicity of their production leading to the possibility of clearer interpretation of results. The effects of efferent activation on the complex spectral patterns of SFOAEs have not been examined to the best of our knowledge. We have examined the effects of activating the MOC efferents using broadband noise in normal-hearing humans. The detailed spectral structure of SFOAEs, known as fine structure, was recorded with and without contralateral acoustic stimulation. Results indicate that SFOAEs are reduced in magnitude and their fine structure pushed to higher frequencies by contralateral acoustic stimulation. These changes are similar to those observed in distortion product or spontaneous otoacoustic emissions and behavioral hearing thresholds. Taken together with observations made about magnitude and phase changes in otoacoustic emissions and hearing thresholds upon contralateral acoustic stimulation, all changes in otoacoustic emission and hearing threshold fine structure appear to be driven by a common set of mechanisms. Specifically, frequency shifts in fine structure patterns appear to be linked to changes in SFOAE phase due to contralateral acoustic stimulation.

Individual differences reveal correlates of hidden hearing deficits

Clinical audiometry has long focused on determining the detection thresholds for pure tones, which depend on intact cochlear mechanics and hair cell function. Yet many listeners with normal hearing thresholds complain of communication difficulties, and the causes for such problems are not well understood. Here, we explore whether normal-hearing listeners exhibit such suprathreshold deficits, affecting the fidelity with which subcortical areas encode the temporal structure of clearly audible sound. Using an array of measures, we evaluated a cohort of young adults with thresholds in the normal range to assess both cochlear mechanical function and temporal coding of suprathreshold sounds. Listeners differed widely in both electrophysiological and behavioral measures of temporal coding fidelity. These measures correlated significantly with each other. Conversely, these differences were unrelated to the modest variation in otoacoustic emissions, cochlear tuning, or the residual differences in hearing threshold present in our cohort. Electroencephalography revealed that listeners with poor subcortical encoding had poor cortical sensitivity to changes in interaural time differences, which are critical for localizing sound sources and analyzing complex scenes. These listeners also performed poorly when asked to direct selective attention to one of two competing speech streams, a task that mimics the challenges of many everyday listening environments. Together with previous animal and computational models, our results suggest that hidden hearing deficits, likely originating at the level of the cochlear nerve, are part of "normal hearing."

The influence of cochlear spectral processing on the timing and amplitude of the speech-evoked auditory brain stem response

The speech-evoked auditory brain stem response (speech ABR) is widely considered to provide an index of the quality of neural temporal encoding in the central auditory pathway. The aim of the present study was to evaluate the extent to which the speech ABR is shaped by spectral processing in the cochlea. High-pass noise masking was used to record speech ABRs from delimited octave-wide frequency bands between 0.5 and 8 kHz in normal-hearing young adults. The latency of the frequency-delimited responses decreased from the lowest to the highest frequency band by up to 3.6 ms. The observed frequency-latency function was compatible with model predictions based on wave V of the click ABR. The frequency-delimited speech ABR amplitude was largest in the 2- to 4-kHz frequency band and decreased toward both higher and lower frequency bands despite the predominance of low-frequency energy in the speech stimulus. We argue that the frequency dependence of speech ABR latency and amplitude results from the decrease in cochlear filter width with decreasing frequency. The results suggest that the amplitude and latency of the speech ABR may reflect interindividual differences in cochlear, as well as central, processing. The high-pass noise-masking technique provides a useful tool for differentiating between peripheral and central effects on the speech ABR. It can be used for further elucidating the neural basis of the perceptual speech deficits that have been associated with individual differences in speech ABR characteristics.

The olivocochlear reflex strength and cochlear sensitivity are independently modulated by auditory cortex microstimulation

In mammals, efferent projections to the cochlear receptor are constituted by olivocochlear (OC) fibers that originate in the superior olivary complex. Medial and lateral OC neurons make synapses with outer hair cells and with auditory nerve fibers, respectively. In addition to the OC system, there are also descending projections from the auditory cortex that are directed towards the thalamus, inferior colliculus, cochlear nucleus, and superior olivary complex. Olivocochlear function can be assessed by measuring a brainstem reflex mediated by auditory nerve fibers, cochlear nucleus neurons, and OC fibers. Although it is known that the OC reflex is activated by contralateral acoustic stimulation and produces a suppression of cochlear responses, the influence of cortical descending pathways in the OC reflex is largely unknown. Here, we used auditory cortex electrical microstimulation in chinchillas to study a possible cortical modulation of cochlear and auditory nerve responses to tones in the absence and presence of contralateral noise. We found that cortical microstimulation produces two different peripheral modulations: (i) changes in cochlear sensitivity evidenced by amplitude modulation of cochlear microphonics and auditory nerve compound action potentials and (ii) enhancement or suppression of the OC reflex strength as measured by auditory nerve responses, which depended on the intersubject variability of the OC reflex. Moreover, both corticofugal effects were not correlated, suggesting the presence of two functionally different efferent pathways. These results demonstrate that auditory cortex electrical microstimulation independently modulates the OC reflex strength and cochlear sensitivity.

Stability of the medial olivocochlear reflex as measured by distortion product otoacoustic emissions

PURPOSE

The purpose of this study was to assess the repeatability of a fine-resolution, distortion product otoacoustic emission (DPOAE)-based assay of the medial olivocochlear (MOC) reflex in normal-hearing adults.

METHOD

Data were collected during 36 test sessions from 4 normal-hearing adults to assess short-term stability and 5 normal-hearing adults to assess long-term stability. DPOAE level and phase measurements were recorded with and without contralateral acoustic stimulation. MOC reflex indices were computed by (a) noting contralateral acoustic stimulation-induced changes in DPOAE level (both absolute and normalized) at fine-structure peaks, (b) recording the effect as a vector difference, and (c) separating DPOAE components and considering a component-specific metric.

RESULTS

Analyses indicated good repeatability of all indices of the MOC reflex in most frequency ranges. Short- and long-term repeatability were generally comparable. Indices normalized to a subject's own baseline fared best, showing strong short- and long-term stability across all frequency intervals.

CONCLUSIONS

These results suggest that fine-resolution DPOAE-based measures of the MOC reflex measured at strategic frequencies are stable, and natural variance from day-to-day or week-to-week durations is small enough to detect between-group differences and possibly to monitor intervention-related success. However, this is an empirical question that must be directly tested to confirm its utility.

Otoacoustic-emission-based medial-olivocochlear reflex assays for humans

Otoacoustic emission (OAE) tests of the medial-olivocochlear reflex (MOCR) in humans were assessed for viability as clinical assays. Two reflection-source OAEs [TEOAEs: transient-evoked otoacoustic emissions evoked by a 47 dB sound pressure level (SPL) chirp; and discrete-tone SFOAEs: stimulus-frequency otoacoustic emissions evoked by 40 dB SPL tones, and assessed with a 60 dB SPL suppressor] were compared in 27 normal-hearing adults. The MOCR elicitor was a 60 dB SPL contralateral broadband noise. An estimate of MOCR strength, MOCR%, was defined as the vector difference between OAEs measured with and without the elicitor, normalized by OAE magnitude (without elicitor). An MOCR was reliably detected in most ears. Within subjects, MOCR strength was correlated across frequency bands and across OAE type. The ratio of across-subject variability to within-subject variability ranged from 2 to 15, with wideband TEOAEs and averaged SFOAEs giving the highest ratios. MOCR strength in individual ears was reliably classified into low, normal, and high groups. SFOAEs using 1.5 to 2 kHz tones and TEOAEs in the 0.5 to 2.5 kHz band gave the best statistical results. TEOAEs had more clinical advantages. Both assays could be made faster for clinical applications, such as screening for individual susceptibility to acoustic trauma in a hearing-conservation program.

Medial efferent mechanisms in children with auditory processing disorders

Auditory processing disorder (APD) affects about 2–5% of children. However, the nature of this disorder is poorly understood. Children with APD typically have difficulties in complex listening situations. One mechanism thought to aid in listening-in-noise is the medial olivocochlear (MOC) inhibition. The purpose of this review was to critically analyze the published data on MOC inhibition in children with APD to determine whether the MOC efferents are involved in these individuals. The otoacoustic emission (OAE) methods used to assay MOC reflex were examined in the context of the current understanding of OAE generation mechanisms. Relevant literature suggests critical differences in the study population and OAE methods. Variables currently known to influence MOC reflex measurements, for example, middle-ear muscle reflexes or OAE signal-to-noise ratio, were not controlled in most studies. The use of potentially weaker OAE methods and the remarkable heterogeneity across studies does not allow for a definite conclusion whether or not the MOC reflex is altered in children with APD. Further carefully designed studies are needed to confirm the involvement of MOC efferents in APD. Knowledge of efferent functioning in children with APD would be mechanistically and clinically beneficial.

Olivocochlear efferent function: issues regarding methods and the interpretation of results

As studies of the olivocochlear (OC) efferent system have matured, issues have been identified that need to be taken into account in the design of new studies and in the interpretation of existing work. The need for high signal-to-noise ratios (SNRs), multiple alternations of conditions, and avoiding middle-ear-muscle activation have been previously highlighted. Less well-known issues include: Contralateral medial OC (MOC) effects may not be good proxies for ipsilateral (ipsi) MOC effects; MOC-induced changes in otoacoustic emissions (OAEs) may not accurately show MOC-induced changes in auditory-nerve (AN) responses; measuring OAE differences from before to after psychophysical trials yields the transient OAE change but not tonic MOC activation; tonic MOC activation may be measurable by several techniques including by OAE differences in trials in which the subject’s judgment was correct vs. trials that were incorrect; SNRs can be preserved by Bootstrap statistical tests; differences in task difficulty may outweigh differences in subject attention; lateral efferent effects are little understood and may be tied to MOC effects; to assess whether MOC strength predicts protection from acoustic trauma, prospective tests in humans are needed.

Efferent feedback slows cochlear aging

The inner ear receives two types of efferent feedback from the brainstem: one pathway provides gain control on outer hair cells' contribution to cochlear amplification, and the other modulates the excitability of the cochlear nerve. Although efferent feedback can protect hair cells from acoustic injury and thereby minimize noise-induced permanent threshold shifts, most prior studies focused on high-intensity exposures (>100 dB SPL). Here, we show that efferents are essential for long-term maintenance of cochlear function in mice aged 1 year post-de-efferentation without purposeful acoustic overexposure. Cochlear de-efferentation was achieved by surgical lesion of efferent pathways in the brainstem and was assessed by quantitative analysis of immunostained efferent terminals in outer and inner hair cell areas. The resultant loss of efferent feedback accelerated the age-related amplitude reduction in cochlear neural responses, as seen in auditory brainstem responses, and increased the loss of synapses between hair cells and the terminals of cochlear nerve fibers, as seen in confocal analysis of the organ of Corti immunostained for presynaptic and postsynaptic markers. This type of neuropathy, also seen after moderate noise exposure, has been termed "hidden hearing loss", because it does not affect thresholds, but can be seen in the suprathreshold amplitudes of cochlear neural responses, and likely causes problems with hearing in a noisy environment, a classic symptom of age-related hearing loss in humans. Since efferent reflex strength varies among individuals and can be measured noninvasively, a weak reflex may be an important risk factor, and prognostic indicator, for age-related hearing impairment.