Effect of aspirin on phase gradient of 2F1-F2 distortion product otoacoustic emissions

Extended High-frequency Hearing Impairment Despite a Normal Audiogram: Relation to Early Aging, Speech-in-noise Perception, Cochlear Function, and Routine Earphone Use

OBJECTIVES

Humans can hear up to 20 kHz. Emerging evidence suggests that hearing in the extended high frequencies (EHFs; >8 kHz) contributes to speech perception in noise. The objective of the present study was to describe the features of EHF hearing impairment in young adults with normal standard audiograms (0.25-8 kHz). Specifically, the study goals were to: (1) characterize the EHF hearing impairment and identify potential risk factors; (2) elucidate the age-related changes in EHF hearing; (3) determine the effect of EHF hearing impairment on speech-in-noise recognition; and (4) examine the extent to which EHF hearing impairment influences cochlear functioning in the standard frequencies.

DESIGN

Hearing thresholds at standard frequencies and EHFs (10, 12.5, 14, and 16 kHz), and speech recognition thresholds (SRTs) using digit triplets in multi-talker babble were measured in both ears from 222 participants (19-38 years; n = 444 ears) with normal audiograms (≤20 dB HL at standard frequencies). Test-retest measurement of hearing thresholds was obtained in a subset of 50 participants (100 ears), and clinical distortion product otoacoustic emissions (f2 frequency = 2, 3, 4, and 5 kHz) were recorded in 49 participants (98 ears).

RESULTS

Forty-two of 222 participants had EHF hearing impairment (>20 dB HL for at least one EHF in either ear). Only seven individuals with EHF impairment had significant case history and/or listening-in-noise complaints. A breakpoint in the threshold-age function was observed for the EHFs for males but not for females. Linear mixed models revealed a significant effect of age, pure-tone averages for speech frequencies (0.5, 1, 2, and 4 kHz), and EHFs and group (NH versus EHF hearing impairment) independent of each other on the SRTs. Individuals with EHF hearing impairment had less measurable emissions and when present, had a lower magnitude of otoacoustic emissions relative to NH controls. There was no difference in hearing thresholds, SRTs, or otoacoustic emissions between earphone users and nonusers.

CONCLUSIONS

The hearing thresholds for the EHFs exhibit signs of early auditory aging. Age-related deterioration in auditory function can be observed in the third decade of human life. A breakpoint in the threshold-age function suggests that rapid aging processes are operational at a relatively younger age (21 years) for males. The audibility of EHFs contributes to speech-in-noise recognition. EHF hearing impairment independent of age and speech frequencies can affect speech-in-noise recognition. Reduced distortion product otoacoustic emissions in the standard frequencies may suggest preclinical cochlear degeneration in individuals with EHF hearing impairment.

Cochlear Mechanisms and Otoacoustic Emission Test Performance

OBJECTIVES

This study aims to determine the impact of controlling cochlear-source mechanism on the accuracy with which auditory status is identified using otoacoustic emissions (OAEs) in two groups of subjects with normal hearing (NH) and subjects with mild to moderate hearing loss.

DESIGN

Data were collected from 212 subjects with NH and with mild to moderate hearing loss who fell into two categories based on a distortion product OAE (DPOAE) screening protocol: the uncertain-identification group (where errors were likely) and the certain-identification group (where errors were unlikely). DPOAE fine-structure patterns were recorded at intervals surrounding f2 = 1, 2 and 4 kHz (f2/f1 ratio = 1.22), with L2 = 35, 45, and 55 dB SPL (L1/L2 ratio = 10 dB). The discrete cosine transform was used to smooth fine structure, limiting the source contribution to the distortion source only. Reflection-source OAEs were also recorded using amplitude-modulated stimulus frequency OAEs (AM-SFOAE). Area under the relative operating characteristic (AROC) curve was used to quantify test accuracy when the source contribution was controlled versus the condition where both sources contribute. Additionally, failure rate, fixed at 5% for NH ears, as a function of behavioral-threshold category was evaluated.

RESULTS

When data for the entire subject group were examined, reducing the reflection-source contribution to the DPOAE did not result in better test performance than the best control condition at any frequency tested. When the subjects with NH were restricted to those with confirmed fine structure, AROC analyses indicated that reducing the reflection-source contribution resulted in several small increases in the accuracy (2%-5%) with which auditory status was identified relative to the best control condition. This improvement was observed for the lowest stimulus levels (i.e., L2 = 35 or 45 dB SPL). In this subset of subjects, distortion-source DPOAEs resulted in more accurate identification of mild hearing loss for a fixed false-positive rate of 5% in NH ears at lower L2's, conditions with poor accuracy in the larger group of subjects. The impact of controlling the source contribution on the identification of moderate losses was less clear in the reduced subject group, with some conditions where the distortion-source DPOAE was more accurate than the control condition and other conditions where there was no change. There was no evidence that reflection-source AM-SFOAEs more accurately identified ears with hearing loss when compared to any of the DPOAE conditions in either the large or reduced group of subjects.

CONCLUSION

While improvements in test accuracy were observed for some subjects and some conditions (e.g., mild hearing losses and low stimulus levels in the reduced subset of subjects), these results suggest that restricting cochlear source contribution by "smoothing" DPOAE fine structure is not expected to improve DPOAE test accuracy in a general population of subjects. Likewise, recording reflection-source OAEs using the AM-SFOAE technique would not be expected to more accurately identify hearing status compared to mixed- or single-source DPOAEs.

DNA methylation of the prestin gene and outer hair cell electromotileresponse of the cochlea in salicylate administration

Background/aim: Activity of the prestin gene may have a role in the pathogenesis of salicylate-induced ototoxicity. We investigated DNA methylation for prestin gene exon 1 in salicylate-injected guinea pigs.Materials and methods: Fifteen guinea pigs (30 ears) underwent audiological evaluation including 1000 Hz probe-tone tympanometry and a distortion product otoacoustic emission (DPOAE) test. The animals were randomly divided into three groups. Groups 2 (8 ears) and 3 (14 ears) were injected with intramuscular saline and sodium salicylate (200 mg/kg), respectively twice daily for 2 weeks. Group 1 (8 ears) received no injection. DPOAE measurements were performed at baseline; after 1, 2, 4, and 8 h (acute effect); and after 1 and 2 weeks (chronic effect). After audiological measurements, the animals were sacrificed for DNA isolation.Results: While a significant decrease (P < 0.01) was found for the acute effect in all frequencies in Group 3 according to baseline measurements, there was no difference in terms of chronic effect. DNA methylation increased during the acute phase of salicylate administration, whereas it returned to initial levels during the chronic phase.Conclusion: Salicylate-induced changes in DPOAE responses may be related to prestin-gene methylation. These results may have important implications for salicylate ototoxicity.

Concentration-Response Relationship of Hearing Impairment Caused by Quinine and Salicylate: Pharmacological Similarities but Different Molecular Mechanisms

This review has the purpose to summarize concentration-effect studies made with quinine and to compare the effects on hearing between quinine and salicylate. Quinine and salicylate have roles in experimental hearing research and may induce pronounced and reversible hearing impairment when administered in sizeable doses. The quinine-induced increase in hearing threshold and its recovery can be analysed according to 'the psychophysical power function'. The power function is a special case of the Hill equation when the stimulus (e.g. a drug concentration) is exceedingly small compared with the concentration that would elicit a half-maximum response. Quinine and salicylate induce sensorineural hearing impairment and tinnitus when given in higher dose ranges in man. The drugs influence the presence, magnitude, and quality of audiological responses, such as spontaneous and evoked otoacoustic emissions. Quinine reversibly reduces frequency selectivity and hearing sensitivity, whereas the self-attained most comfortable speech level and the acoustic stapedius reflex are not affected, that is the dynamic range of hearing is reversibly reduced. This observation supports the view that quinine acts on the outer hair cell of the cochlea. Both drugs share a protective effect against the permanent hearing damages caused by gentamicin. This action is interpreted as a request for functioning mechanoelectric transducer (MET) channels to elicit the ill effect of aminoglycosides. Both drugs may interfere with the cochlear amplifier through blocking MET channels and the motor protein prestin. This review finds considerable overlap between type and extent of pharmacological actions of quinine and salicylate, supposedly caused by partly shared mechanisms of action but performed with different molecular mechanisms.

Ubiquitous aspirin: a systematic review of its impact on sensorineural hearing loss

OBJECTIVE

This systematic review evaluates the impact of aspirin on audiometric outcomes with respect to: (1) doses exceeding 325 mg daily, (2) doses of 325 mg daily or less, (3) studies applicable to the general populace, and (4) studies applicable to those with inflammatory conditions. It also assesses the impact of aspirin on (a) self-reported hearing loss, (b) noise-induced audiometric changes, and (c) the adverse otological effects of aminoglycoside therapy.

DATA SOURCES

Computerized searches of MEDLINE, PubMed, Cochrane, and EMBASE databases were performed, updated through January 2014, and supplemented by manual searches and inquiries to topic experts.

REVIEW METHODS

A systematic review was performed according to an a priori protocol. Data extraction was performed by 2 independent parties and focused on relevant audiological measurements, potential confounders, and study design elements associated with risk of bias, including utilization of randomization, prospective/retrospective data collection, and incorporation of blinding.

RESULTS

The 37 criterion-meeting studies included a combined total of 185,155 participants. Aspirin ingestion ≥ 1.95 g/d was associated with worse audiometric results (4-112 dB threshold shift); the effect was dose dependent and reversible in the short term. There were no audiometric data that confirm that long-term doses of 81 mg or 325 mg daily have no hearing consequences. Paradoxically, aspirin (in doses shown to be detrimental in isolation) had a protective effect when co-administered with intravenous gentamicin.

CONCLUSIONS

With the large-scale population utilization of aspirin for cardiovascular prophylaxis, the potential risks to hearing health should be considered for future longitudinal study, particularly given that short-term effects may be reversible.

Wavelet and matching pursuit estimates of the transient-evoked otoacoustic emission latency

Different time-frequency techniques may be used to investigate the relation between latency and frequency of transient-evoked otoacoustic emissions. In this work, the optimization of these techniques and the interpretation of the experimental result are discussed. Time-frequency analysis of click-evoked otoacoustic emissions of 42 normal-hearing young subjects has been performed, using both wavelet and matching pursuit algorithms. Wavelet techniques are very effective to provide fast and reliable evaluation of the average latency of large samples of subjects. A major advantage of the matching pursuit technique, as observed by Jedrzejczak et al. [J. Acoust. Soc. Am. 115, 2148-2158 (2004)], is to provide detailed information about the time evolution of the response of single ears at selected frequencies. A hybrid matching pursuit algorithm that includes Fourier spectral information was developed, capable of speeding-up computation times and of identifying "spurious" atoms, whose latency-frequency relation is apparently anomalous. These atoms could be associated with several known phenomena, either intrinsic, such as intermodulation distortion, spontaneous emissions and multiple internal reflections, or extrinsic, such as instrumental noise, linear ringing and the acquisition window onset. A correct interpretation of these phenomena is important to get accurate estimates of the otoacoustic emission latency.

Effects of mobile phone exposure on time frequency fine structure of transiently evoked otoacoustic emissions

Mobile phones have become very commonly used worldwide within a short period of time. To date there is only limited knowledge about interaction between electromagnetic fields (EMFs) emitted by mobile phones and the auditory function. Moreover, there is widespread concern that there may be potential for harm. The aim of this study was to assess potential subtle changes in cochlear function by measuring the temporal and spectral fine structure of transiently evoked otoacoustic emissions (TEOAE) in normal hearing subjects after exposure to EMFs emitted by Global System for Mobile Communication (GSM) mobile phones. TEOAEs were recorded in 27 healthy young adults before and after 10 min of real or sham exposure in a double-blind design. TEOAE data were analyzed both globally (broadband analysis) and using the Wavelet Transform (analysis of the time-frequency fine structure). The broadband analysis revealed no significant effect on TEOAEs related to exposure, confirming results of previous studies; in addition, no significant change was detected in the analysis of the elementary wavelet components, suggesting that the temporal and spectral fine structure of TEOAEs is not affected by 10 min exposure to low-intensity EMFs emitted by GSM mobile phones.

Influence on the mechanisms of generation of distortion product otoacoustic emissions of mobile phone exposure

Mobile phones have become very commonly used throughout the world within a short period of time. Although there is no clear evidence to show harmful physiological effects of electromagnetic fields (EMF) at the levels used by mobile phones, there is widespread public concern that there may be potential for harm. Because mobile phones are usually held close to the ear, it is appropriate to study effects on hearing. In this study, the outer hair cell function of 15 subjects was assessed by DPOAE recording before and after a controlled EMF exposure. To increase the sensitivity of DPOAE recording to identify even small changes in hearing function, an inverse fast Fourier transform (IFFT) analysis and time-domain windowing was applied to separate the two generation mechanisms of DPOAE, the so-called place-fixed and wave-fixed mechanisms, in order to verify if EMF can affects the two DPOAE emission mechanisms. Statistical analysis of the data showed that 10 min of EMF exposure at the maximum power (2 W at 900 MHz or 1 W at 1800 MHz) does not induce any changes in either DPOAE generation mechanism.