Age-related differences in gap detection: effects of task difficulty and cognitive ability

Exploring auditory temporal resolution and dichotic listening skills among individuals with type 2 diabetes mellitus

The study aimed to explore the auditory temporal resolution and dichotic listening skills in patients with type 2 diabetes mellitus (T2DM) and identify associated health-related factors. Using a cross-sectional design, 87 adults with T2DM and 48 non-diabetic controls, all with normal hearing, participated. The two central auditory processing (CAP) skills were assessed through the Gaps-In-Noise (GIN) and Dichotic-Digits Listening (DDL) tests. T2DM participants underwent blood tests to measure various health-related factors. In the GIN test, the shortest gap threshold (GapTh) obtained across both ears was significantly higher in the diabetic group (9.1 ± 2.4 ms) compared to the non-diabetic group (7.5 ± 1.5 ms), and the score of correctly identified gaps (GapSc) in the diabetic group (45±11 %) was significantly lower than GapSc in the non-diabetic group (52±9 %), p < 0.001. In the DDL test, the free-recall score (73.8 ± 18.5 %) across both ears and the right-ear advantage (-1.3 ± 20.6 %) in the diabetic group were significantly lower than the free-recall score (85.8 ± 11.9 %) and right-ear advantage (6.9 ± 11.9 %) in the non-diabetic group, p < 0.005. Furthermore, the duration of diabetes, eGFR level, retinopathy, carotid plaque, fasting blood glucose level, and HDL-C (good cholesterol) level were factors significantly associated with performances in the GIN and/or DDL tests for T2DM participants. In conclusion, individuals with T2DM are at risk of reduced auditory processing skills in temporal resolution and dichotic listening, impacting their speech understanding. Six health-related factors were identified as significantly associated with CAP skills in T2DM patients.

Spectral degradation and carrier sentences increase age-related temporal processing deficits in a cue-specific manner

Advancing age is associated with decreased sensitivity to temporal cues in word segments, particularly when target words follow non-informative carrier sentences or are spectrally degraded (e.g., vocoded to simulate cochlear-implant stimulation). This study investigated whether age, carrier sentences, and spectral degradation interacted to cause undue difficulty in processing speech temporal cues. Younger and older adults with normal hearing performed phonemic categorization tasks on two continua: a Buy/Pie contrast with voice onset time changes for the word-initial stop and a Dish/Ditch contrast with silent interval changes preceding the word-final fricative. Target words were presented in isolation or after non-informative carrier sentences, and were unprocessed or degraded via sinewave vocoding (2, 4, and 8 channels). Older listeners exhibited reduced sensitivity to both temporal cues compared to younger listeners. For the Buy/Pie contrast, age, carrier sentence, and spectral degradation interacted such that the largest age effects were seen for unprocessed words in the carrier sentence condition. This pattern differed from the Dish/Ditch contrast, where reducing spectral resolution exaggerated age effects, but introducing carrier sentences largely left the patterns unchanged. These results suggest that certain temporal cues are particularly susceptible to aging when placed in sentences, likely contributing to the difficulties of older cochlear-implant users in everyday environments.

Neural hyperactivity and altered envelope encoding in the central auditory system: Changes with advanced age and hearing loss

Temporal modulations are ubiquitous features of sound signals that are important for auditory perception. The perception of temporal modulations, or temporal processing, is known to decline with aging and hearing loss and negatively impact auditory perception in general and speech recognition specifically. However, neurophysiological literature also provides evidence of exaggerated or enhanced encoding of specifically temporal envelopes in aging and hearing loss, which may arise from changes in inhibitory neurotransmission and neuronal hyperactivity. This review paper describes the physiological changes to the neural encoding of temporal envelopes that have been shown to occur with age and hearing loss and discusses the role of disinhibition and neural hyperactivity in contributing to these changes. Studies in both humans and animal models suggest that aging and hearing loss are associated with stronger neural representations of both periodic amplitude modulation envelopes and of naturalistic speech envelopes, but primarily for low-frequency modulations (<80 Hz). Although the frequency dependence of these results is generally taken as evidence of amplified envelope encoding at the cortex and impoverished encoding at the midbrain and brainstem, there is additional evidence to suggest that exaggerated envelope encoding may also occur subcortically, though only for envelopes with low modulation rates. A better understanding of how temporal envelope encoding is altered in aging and hearing loss, and the contexts in which neural responses are exaggerated/diminished, may aid in the development of interventions, assistive devices, and treatment strategies that work to ameliorate age- and hearing-loss-related auditory perceptual deficits.

Effects of Auditory Training in Older Adults

PURPOSE

This study examines the effects of an auditory training program on the auditory and cognitive abilities of older adults. Auditory rehabilitation programs are generally designed for hearing aid users, and studies have demonstrated benefits for them. In this study, we seek to understand whether such a training program can also benefit older adults who do not wear hearing aids. We also examined if cognitive benefits can indeed be observed as a result of the training.

METHOD

Sixty-four older adults were recruited and assigned into three groups: the experimental group (n = 20), the active control group (n = 21), and the no-training control group (n = 23). The experimental group underwent an auditory training program (Listening and Communication Enhancement [LACE]) during the training phase. Meanwhile, the active control group listened to short audio clips and the no-training control group did not participate in any program. An auditory test (Quick Speech-in-Noise [QuickSIN]) and a battery of cognitive tests were conducted before and after the training to examine the participants' performance on auditory ability, short-term memory, and attention.

RESULTS

The results showed improvements in auditory and cognitive abilities during the training period. When assessing the training effects by comparing the pre- and the posttraining performances, a significant improvement on the QuickSIN task was found in the training group but not in the other two groups. However, other cognitive tests did not show any significant improvement. That is, the LACE training did not benefit short-term memory and attention. The improved performance on short-term memory during the training was not maintained in the posttraining session.

CONCLUSION

Overall, the study has extended the auditory benefit from the LACE training to the typical aging population in terms of improved communication ability, but the effect of training on auditory abilities did not transfer to gains in cognitive abilities.

Stability of neural representations in the auditory midbrain across the lifespan despite age-related brainstem delays

The extent to which aging of the central auditory pathway impairs auditory perception in the elderly independent of peripheral cochlear decline is debated. To cause auditory deficits in normal hearing elderly, central aging needs to degrade neural sound representations at some point along the auditory pathway. However, inaccessible to psychophysical methods, the level of the auditory pathway at which aging starts to effectively degrade neural sound representations remains poorly differentiated. Here we tested how potential age-related changes in the auditory brainstem affect the stability of spatiotemporal multiunit complex speech-like sound representations in the auditory midbrain of old normal hearing CBA/J mice. Although brainstem conduction speed slowed down in old mice, the change was limited to the sub-millisecond range and only minimally affected temporal processing in the midbrain (i.e. gaps-in-noise sensitivity). Importantly, besides the small delay, multiunit complex temporal sound representations in the auditory midbrain did not differ between young and old mice. This shows that although small age-related neural effects in simple sound parameters in the lower brainstem may be present in aging they do not effectively deteriorate complex neural population representations at the level of the auditory midbrain when peripheral hearing remains normal. This result challenges the widespread belief of 'pure' central auditory decline as an automatic consequence of aging, at least up to the inferior colliculus. However, the stability of midbrain processing in aging emphasizes the role of undetected 'hidden' peripheral damage and accumulating effects in higher cortical auditory-cognitive processing explaining perception deficits in 'normal hearing' elderly.

Relationship Between Central Auditory Processing Abilities and Working Memory During Adolescence

Purpose

Adolescence is a period of transformation in humans with changes in the neural physiology at subcortical and cortical levels. However, its significance on auditory processing skills and working memory skills and their association is yet to be well understood. Hence, the current study was designed to evaluate and establish the association between auditory processing skills and working memory abilities in adolescents.

Method

A total of 125 adolescents within the age range of 10 to 15 years participated in the current study. All of them had normal hearing sensitivity and no associated obvious peripheral or central deficits. All the participants underwent auditory closure ability assessment using quick speech perception in noise test in Kannada, binaural integration ability assessment using dichotic CV test, and temporal processing assessment using gap detection test. Auditory working memory abilities were assessed using auditory digit span and digit sequencing.

Results

Spearman correlation was done to assess the correlation between auditory processing skills and working memory abilities. Results revealed a significant negative correlation between most of the central auditory processing abilities and all the working memory spans.

Conclusions

Findings of the current study indicate that individuals with poor working memory abilities have difficulty in auditory processing abilities.

Rate Discrimination Training May Partially Restore Temporal Processing Abilities from Age-Related Deficits

The ability to understand speech in complex environments depends on the brain's ability to preserve the precise timing characteristics of the speech signal. Age-related declines in temporal processing may contribute to the older adult's experience of communication difficulty in challenging listening conditions. This study's purpose was to evaluate the effects of rate discrimination training on auditory temporal processing. A double-blind, randomized control design assigned 77 young normal-hearing, older normal-hearing, and older hearing-impaired listeners to one of two treatment groups: experimental (rate discrimination for 100- and 300-Hz pulse trains) and active control (tone detection in noise). All listeners were evaluated during pre- and post-training sessions using perceptual rate discrimination of 100-, 200-, 300-, and 400-Hz band-limited pulse trains and auditory steady-state responses (ASSRs) to the same stimuli. Training generalization was evaluated using several temporal processing measures and sentence recognition tests that included time-compressed and reverberant speech stimuli. Results demonstrated a session × training group interaction for perceptual and ASSR testing to the trained frequencies (100 and 300 Hz), driven by greater improvements in the training group than in the active control group. Further, post-test rate discrimination of the older listeners reached levels that were equivalent to those of the younger listeners at pre-test. Generalization was observed in significant improvement in rate discrimination of untrained frequencies (200 and 400 Hz) and in correlations between performance changes in rate discrimination and sentence recognition of reverberant speech. Further, non-auditory inhibition/attention performance predicted training-related improvement in rate discrimination. Overall, the results demonstrate the potential for auditory training to partially restore temporal processing in older listeners and highlight the role of cognitive function in these gains.

The New Coronavirus Infection (COVID-19) and Hearing Function in Adults

In this study, we assessed the impact of COVID-19 on the hearing function in adults. A total of 161 subjects were examined, and the results of a previous audiological examination of 24 patients were reviewed. Pure tone audiometry, impedancemetry, speech audiometry in quiet and noise, the Binaural Fusion Test, the dichotic digits test, and a cognitive status examination were performed. A total of 81% of patients complained about hearing disorders, and 43% noted memory impairment. According to pure tone audiometry, 24% of the subjects had normal hearing, while 76% had some degree of hearing loss. No significant changes in hearing thresholds were found in comparison with audiological examinations performed before COVID-19. Disorder of monosyllabic words’ intelligibility in quiet was found in 33% of patients, and in 42% in noise, along with low indicators in the dichotic digits test in 54% of patients. Moreover, 71% of patients had low scores on the MoCA scale that indicated cognitive impairment. Conclusions: The deterioration of speech test scores in patients after COVID-19 can occur due to central auditory processing disorders (CAPD), memory impairment, or changes in cognitive status in general.

Effects of aging and hearing loss on perceptual and electrophysiological measures of pulse-rate discrimination

Auditory temporal processing declines with age, leading to potential deleterious effects on communication. In young normal-hearing listeners, perceptual rate discrimination is rate limited around 300 Hz. It is not known whether this rate limitation is similar in older listeners with hearing loss. The purpose of this study was to investigate age- and hearing-loss-related rate limitations on perceptual rate discrimination, and age- and hearing-loss-related effects on neural representation of these stimuli. Younger normal-hearing, older normal-hearing, and older hearing-impaired listeners performed a pulse-rate discrimination task at rates of 100, 200, 300, and 400 Hz. Neural phase locking was assessed using the auditory steady-state response. Finally, a battery of non-auditory cognitive tests was administered. Younger listeners had better rate discrimination, higher phase locking, and higher cognitive scores compared to both groups of older listeners. Aging, but not hearing loss, diminished neural-rate encoding and perceptual performance; however, there was no relationship between the perceptual and neural measures. Higher cognitive scores were correlated with improved perceptual performance, but not with neural phase locking. This study shows that aging, rather than hearing loss, may be a stronger contributor to poorer temporal processing, and cognitive factors such as processing speed and inhibitory control may be related to these declines.

Temporal acuity is preserved in the auditory midbrain of aged mice

Impaired temporal resolution of the central auditory system has long been suggested to contribute to speech understanding deficits in the elderly. However, it has been difficult to differentiate between direct age-related central deficits and indirect effects of confounding peripheral age-related hearing loss on temporal resolution. To differentiate this, we measured temporal acuity in the inferior colliculus (IC) of aged CBA/J and C57BL/6 mice, as a model of aging with and without concomitant hearing loss. We used two common measures of auditory temporal processing: gap detection as a measure of temporal fine structure and amplitude-modulated noise as a measure of envelope sensitivity. Importantly, auditory temporal acuity remained precise in the IC of old CBA/J mice when no or only minimal age-related hearing loss was present. In contrast, temporal acuity was only indirectly reduced by the presence of age-related hearing loss in aged C57BL/6 mice, not by affecting the brainstem precision, but by affecting the signal-to-noise ratio of the neuronal activity in the IC. This demonstrates that indirect effects of age-related peripheral hearing loss likely remain an important factor for temporal processing in aging in comparison to 'pure' central auditory decline itself. It also draws attention to the issue that the threshold difference between 'nearly normal' or 'clinically normal' hearing aging subjects in comparison to normal hearing young subjects still can have indirect effects on central auditory neural representations of temporal processing.

Relationship Between Peripheral and Central Auditory Abilities and Iron Deficiency Anemia in Adolescent Girls

PURPOSE

This study evaluated the peripheral hearing and central auditory processing abilities in Indian adolescent girls with iron deficiency anemia (IDA).

METHOD

The participants consisted of 75 adolescent girls with IDA, 50 adolescent girls without IDA, and 50 adolescent boys without IDA. Participants underwent a test battery to evaluate auditory processing and peripheral hearing assessment. In this study, central auditory processing abilities were assessed using Speech Perception in Noise test in Kannada (SPIN-K) and quick speech perception in noise tests in Kannada, dichotic consonant-vowel test, gap detection threshold (GDT), and auditory digit sequencing and auditory digit span tests.

RESULTS

Results showed that the hearing thresholds at extremely low and high frequencies (250 and 8000 Hz), although within clinically normal limits, were poorer in girls with IDA than in the control groups. Also, girls with IDA performed poorly in SPIN-K of the right ear, GDT, and auditory backward digit span tests.

CONCLUSION

These subtle auditory deficiencies may be attributed to the compromised blood supply to the central auditory nervous system, as observed in the current study.

The Relationship Between Central Auditory Tests and Neurocognitive Domains in Adults Living With HIV

Objective: Tests requiring central auditory processing, such as speech perception-in-noise, are simple, time efficient, and correlate with cognitive processing. These tests may be useful for tracking brain function. Doing this effectively requires information on which tests correlate with overall cognitive function and specific cognitive domains. This study evaluated the relationship between selected central auditory focused tests and cognitive domains in a cohort of normal hearing adults living with HIV and HIV- controls. The long-term aim is determining the relationships between auditory processing and neurocognitive domains and applying this to analyzing cognitive function in HIV and other neurocognitive disorders longitudinally. Method: Subjects were recruited from an ongoing study in Dar es Salaam, Tanzania. Central auditory measures included the Gap Detection Test (Gap), Hearing in Noise Test (HINT), and Triple Digit Test (TDT). Cognitive measures included variables from the Test of Variables of Attention (TOVA), Cogstate neurocognitive battery, and Kiswahili Montreal Cognitive Assessment (MoCA). The measures represented three cognitive domains: processing speed, learning, and working memory. Bootstrap resampling was used to calculate the mean and standard deviation of the proportion of variance explained by the individual central auditory tests for each cognitive measure. The association of cognitive measures with central auditory variables taking HIV status and age into account was determined using regression models. Results: Hearing in Noise Tests and TDT were significantly associated with Cogstate learning and working memory tests. Gap was not significantly associated with any cognitive measure with age in the model. TDT explained the largest mean proportion of variance and had the strongest relationship to the MoCA and Cogstate tasks. With age in the model, HIV status did not affect the relationship between central auditory tests and cognitive measures. Age was strongly associated with multiple cognitive tests. Conclusion: Central auditory tests were associated with measures of learning and working memory. Compared to the other central auditory tests, TDT was most strongly related to cognitive function. These findings expand on the association between auditory processing and cognitive domains seen in other studies and support evaluating these tests for tracking brain health in HIV and other neurocognitive disorders.

Relation Between the Screening Checklist for Auditory Processing in Adults and Diagnostic Auditory Processing Test Performance

Purpose The aim of the study was to evaluate the relationship between the Screening Checklist for Auditory Processing in Adults and the performance of older adults on a battery of diagnostic tests for auditory processing. This was done for two versions of the checklist, one answered by older individuals at risk for auditory processing disorder (APD) and the other by the family of the older adults. Method Forty-nine older adults and 34 of their family members were initially tested with the screening checklist, each being tested with the version developed for them. Approximately half of the older adults had normal pure-tone thresholds, while the others had mild-moderate hearing loss above 2 kHz. The older adults were administered tests of auditory separation/closure, auditory integration, temporal resolution, temporal patterning, and auditory memory and sequencing. Results Most of the older adults and their family members reported of the presence of auditory processing difficulties on the screening checklist. On the diagnostic test battery, many of the older adults, irrespective of their high-frequency hearing sensitivity, failed the tests measuring temporal resolution and auditory integration. The sensitivity and specificity of the checklist answered by the older individuals were 69.05% and 71.43%, respectively. On the other hand, for the checklist answered by the family members, it was 77.78% and 33.33%, respectively. The test-retest reliability of the two versions of the checklist was found to be good. Conclusions As the specificity of the checklist answered by the family members was considerably lower than that answered by the older adults, the use of the version for the latter group is recommended. However, the checklist answered by the caregivers could be used to complement information obtained from the older adults at risk for APD when the older adults are unable to give valid responses.

Selective auditory attention modulates cortical responses to sound location change in younger and older adults

The present study measured scalp potentials in response to low-frequency, narrowband noise bursts changing location in the front, azimuthal plane. At question was whether selective auditory attention has a modulatory effect on the cortical encoding of spatial change and whether older listeners with normal-hearing thresholds would show depressed cortical representation for spatial changes relative to younger listeners. Young and older normal-hearing listeners were instructed to either passively listen to the stimulus presentation or actively attend to a single location (either 30° left or right of midline) and detect when a noise stream moved to the attended location. Prominent peaks of the electroencephalographic scalp waveforms were compared across groups, locations, and attention conditions. In addition, an opponent-channel model of spatial coding was performed to capture the effect of attention on spatial-change tuning. Younger listeners showed not only larger responses overall but a greater dynamic range in their response to location changes. Results suggest that younger listeners were acquiring and encoding key spatial cues at early cortical processing areas. On the other hand, each group exhibited modulatory effects of attention to spatial-change tuning, indicating that both younger and older listeners selectively attend to space in a manner that amplifies the available signal.NEW & NOTEWORTHY In complex acoustic scenes, listeners take advantage of spatial cues to selectively attend to sounds that are deemed immediately relevant. At the neural level, selective attention amplifies electrical responses to spatial changes. We tested whether older and younger listeners have comparable modulatory effects of attention to stimuli moving in the free field. Results indicate that although older listeners do have depressed overall responses, selective attention enhances spatial-change tuning in younger and older listeners alike.

Factors Underlying Individual Differences in Speech-Recognition Threshold (SRT) in Noise Among Older Adults

Many older adults have difficulty understanding speech in noisy backgrounds. In this study, we examined peripheral auditory, higher-level auditory, and cognitive factors that may contribute to such difficulties. A convenience sample of 137 volunteer older adults, 90 women, and 47 men, ranging in age from 47 to 94 years (M = 69.2 and SD = 10.1 years) completed a large battery of tests. Auditory tests included measures of pure-tone threshold, clinical and psychophysical, as well as two measures of gap-detection threshold and four measures of temporal-order identification. The latter included two monaural and two dichotic listening conditions. In addition, cognition was assessed using the complete Wechsler Adult Intelligence Scale-3rd Edition (WAIS-III). Two monaural measures of speech-recognition threshold (SRT) in noise, the QuickSIN, and the WIN, were obtained from each ear at relatively high presentation levels of 93 or 103 dB SPL to minimize audibility concerns. Group data, both aggregate and by age decade, were evaluated initially to allow comparison to data in the literature. Next, following the application of principal-components factor analysis for data reduction, individual differences in speech-recognition-in-noise performance were examined using multiple-linear-regression analyses. Excellent fits were obtained, accounting for 60-77% of the total variance, with most accounted for by the audibility of the speech and noise stimuli and the severity of hearing loss with the balance primarily associated with cognitive function.

The effects of sleep on objective measures of gap detection using a time-efficient multi-deviant paradigm

Auditory temporal resolution, measured through gap detection, is critical for the perception of speech. A time-efficient multi-deviant paradigm has previously been developed for gap detection. The purpose of the present study was to determine if this multi-deviant paradigm could be used for gap detection during NREM sleep. ERPs were recorded in 10 young adults while awake and during the first two hours of NREM sleep. A multi-deviant paradigm was employed with six different deviants varying in gap duration, ranging from 2 to 40 ms. During waking, a DRN was observed for the 10, 20, 30 and 40 ms gaps. The DRN was absent during sleep. A P2 was present in NREM for the 20, 30 and 40 ms gaps followed by a P3a to the 30 and 40 ms gaps. An N350 was observed following the 10, 20, 30 and 40 ms gaps. Previous studies have reported significant ERPs to gaps having shorter durations than the present study. The multi-deviant paradigm may not be suitable for the determination of gap threshold during sleep. Nevertheless, it provides an exquisite means to determine perceptibility and the extent of processing of longer duration, supra-threshold gaps during sleep.

Pre-attentive auditory change detection for rapid auditory transient combinations: Insight from age-related processing changes

The N1 event-related potential (ERP) enhancement to auditory transients preceded briefly by another transient has been interpreted as a reflection of latent inhibition, or alternatively, as a superimposing mismatch negativity (MMN) to rare transient event combinations. In a previous study (Volosin, Gaál, & Horváth, 2017a), when rare glides preceded frequent gaps by 150 ms in continuous tones, gap-related N1 was enhanced in younger adults while P2 was attenuated both in younger and older adults, which could be parsimoniously explained by MMN overlap which was delayed with aging. The present study replicated and extended these results with a condition in which the roles of the two event types were reversed. Transients separated by 150 ms elicited delayed MMN in older adults, supporting the MMN interpretation over the latent inhibition account. Furthermore, the divergence of N1 and MMN elicitation patterns demonstrated the independence of N1 and MMN.

Longitudinal Changes in Auditory and Cognitive Function in Middle-Aged and Older Adults

Purpose This article aimed to document longitudinal changes in auditory function, including measures of temporal processing, and to examine the associations between observed changes in auditory and cognitive function in middle-aged and older adults. Method This was a prospective longitudinal study of 98 adults (66 women) with baseline ages ranging from 40 to 85 years. The mean interval between T1 baseline and T2 follow-up measurements was 8.8 years with a range of 7-11 years. Measures of hearing threshold, gap detection, and auditory temporal-order identification were completed at T1 and T2. Cognitive measures completed at T1 and T2 were the 13 scales of the Wechsler Adult Intelligence Scale-Third Edition. Three approaches were taken to analyze these data: (a) examination of changes over time in group performance, (b) correlations and slopes between auditory and cognitive measures to examine concomitant rates of decline over the 9-year T1-to-T2 period, and (c) regression analyses examining associations between auditory performance at T1 and cognitive performance 9 years later at T2. Results For the group data, there were significant declines in hearing loss, gap-detection thresholds at one frequency, and process-type measures of cognitive function from T1 to T2 matching the trends in the baseline cross-sectional data. Regression analyses of the longitudinal data revealed the strongest connection between auditory temporal-order processing and cognitive processing typically explaining 10%-15% of the variance. Conclusions A significant amount of variance in rates of cognitive decline, T1 to T2, and subsequent cognitive performance (T2) was explained by measures of auditory function. Although hearing loss occasionally emerged as a significant factor, auditory temporal-order identification emerged much more frequently as the auditory measure most strongly associated with cognitive function.

Associations Between Measures of Auditory Function and Brief Assessments of Cognition

Purpose The two primary purposes of this report are (a) to compare the results of three brief cognitive screens in older adults and (b) to examine associations between performance on each of the screens and auditory function measured either concurrently or 9 years earlier. Method This was a prospective longitudinal study of 98 adults (66 women) with baseline ages ranging from 40 to 85 years. The mean interval between T1 baseline and T2 follow-up measurements was 8.8 years with a range from 7 to 11 years. Measures of hearing threshold, gap detection, and auditory temporal-order identification were completed at T1 and T2. The Mini-Mental State Examination was completed at T1 and T2, whereas the Montreal Cognitive Assessment (MoCA) and A Quick Test were completed at T2 only. Results Higher scores and pass rates were obtained for the Mini-Mental State Examination than for the MoCA or the A Quick Test. The measures were moderately correlated among themselves and with the Wechsler Adult Intelligence Scale-Third Edition. Significant associations emerged frequently between auditory and cognitive functions, most often for the auditory measure of temporal-order identification, including dichotic measures of this ability. Conclusions From this evaluation, the MoCA emerged as the preferred test for clinicians desiring a quick assessment of the cognitive function of their older patients. Auditory temporal-order identification is associated with cognitive function and explains about 10%-20% of the variation in cognitive function independent of age and hearing loss. Supplemental Material https://doi.org/10.23641/asha.12986021.

Effect of age on the gap-prepulse inhibition of the cortical N1-P2 complex in humans as a step towards an objective measure of tinnitus

The gap-prepulse inhibition of the acoustic startle reflex has been widely used as a behavioral method for tinnitus screening in animal studies. The cortical-evoked potential gap-induced inhibition has also been investigated in animals as well as in human subjects. The present study aimed to investigate the effect of age on the cortical N1-P2 complex in the gap-prepulse inhibition paradigm. Fifty-seven subjects, aged 20 to 68 years, without continuous tinnitus, were tested with two effective gap conditions (embedded gap of 50- or 20-ms duration). Retest sessions were performed within one month. A significant gap-induced inhibition of the N1-P2 complex was found in both gap durations. Age differently affected the inhibition, depending on gap duration. With a 50-ms gap, the inhibition decreased significantly with the increase in age. This age-inhibition relationship was not found when using a 20-ms gap. The results were reproducible in the retest session. Our findings suggest that the interaction between age and gap duration should be considered when applying the gap-induced inhibition of the cortical-evoked potential as an objective measure of tinnitus in human subjects. Further studies with tinnitus patients are warranted to identify gap duration that would minimize the effects of age and maximize the difference in the inhibition between those with and without tinnitus.

Nicotinic Receptor Subunit Distribution in Auditory Cortex: Impact of Aging on Receptor Number and Function

The presence of novel or degraded communication sounds likely results in activation of basal forebrain cholinergic neurons increasing release of ACh onto presynaptic and postsynaptic nAChRs in primary auditory cortex (A1). nAChR subtypes include high-affinity heteromeric nAChRs commonly composed of α4 and β2 subunits and low-affinity homomeric nAChRs composed of α7 subunits. In young male FBN rats, we detail the following: (1) the distribution/expression of nAChR subunit transcripts in excitatory (VGluT1) and inhibitory (VGAT) neurons across A1 layers; (2) heteromeric nAChR binding across A1 layers; and (3) nAChR excitability in A1 layer (L) 5 cells. In aged rats, we detailed the impact of aging on A1 nAChR subunit expression across layers, heteromeric nAChR receptor binding, and nAChR excitability of A1 L5 cells. A majority of A1 cells coexpressed transcripts for β2 and α4 with or without α7, while dispersed subpopulations expressed β2 and α7 or α7 alone. nAChR subunit transcripts were expressed in young excitatory and inhibitory neurons across L2-L6. Transcript abundance varied across layers, and was highest for β2 and α4. Significant age-related decreases in nAChR subunit transcript expression (message) and receptor binding (protein) were observed in L2-6, most pronounced in infragranular layers. In vitro patch-clamp recordings from L5B pyramidal output neurons showed age-related nAChR subunit-selective reductions in postsynaptic responses to ACh. Age-related losses of nAChR subunits likely impact ways in which A1 neurons respond to ACh release. While the elderly require additional resources to disambiguate degraded speech codes, resources mediated by nAChRs may be compromised with aging.SIGNIFICANCE STATEMENT When attention is required, cholinergic basal forebrain neurons may trigger increased release of ACh onto auditory neurons in primary auditory cortex (A1). Laminar and phenotypic differences in neuronal nAChR expression determine ways in which A1 neurons respond to release of ACh in challenging acoustic environments. This study detailed the distribution and expression of nAChR subunit transcript and protein across A1 layers in young and aged rats. Results showed a differential distribution of nAChR subunits across A1 layers. Age-related decreases in transcript/protein expression were reflected in age-related subunit specific functional loss of nAChR signaling to ACh application in A1 layer 5. Together, these findings could reflect the age-related decline in selective attention observed in the elderly.

Evidence for independent peripheral and central age-related hearing impairment

Deleterious age-related changes in the central auditory nervous system have been referred to as central age-related hearing impairment (ARHI) or central presbycusis. Central ARHI is often assumed to be the consequence of peripheral ARHI. However, it is possible that certain aspects of central ARHI are independent from peripheral ARHI. A confirmation of this possibility could lead to significant improvements in current rehabilitation practices. The major difficulty in addressing this issue arises from confounding factors, such as other age-related changes in both the cochlea and central non-auditory brain structures. Because gap detection is a common measure of central auditory temporal processing, and gap detection thresholds are less influenced by changes in other brain functions such as learning and memory, we investigated the potential relationship between age-related peripheral hearing loss (i.e., audiograms) and age-related changes in gap detection. Consistent with previous studies, a significant difference was found for gap detection thresholds between young and older adults. However, among older adults, no significant associations were observed between gap detection ability and several other independent variables including the pure tone audiogram average, the Wechsler Adult Intelligence Scale-Vocabulary score, gender, and age. Statistical analyses showed little or no contributions from these independent variables to gap detection thresholds. Thus, our data indicate that age-related decline in central temporal processing is largely independent of peripheral ARHI.

Age-Related Changes in Temporal Resolution Revisited: Electrophysiological and Behavioral Findings From Cochlear Implant Users

OBJECTIVES

The mechanisms underlying age-related changes in speech perception are still unclear, most likely multifactorial and often can be difficult to parse out from the effects of hearing loss. Age-related changes in temporal resolution (i.e., the ability to track rapid changes in sounds) have long been associated with speech perception declines exhibited by many older individuals. The goals of this study were as follows: (1) to assess age-related changes in temporal resolution in cochlear implant (CI) users, and (2) to examine the impact of changes in temporal resolution and cognition on the perception of speech in noise. In this population, it is possible to bypass the cochlea and stimulate the auditory nerve directly in a noninvasive way. Additionally, CI technology allows for manipulation of the temporal properties of a signal without changing its spectrum.

DESIGN

Twenty postlingually deafened Nucleus CI users took part in this study. They were divided into groups of younger (18 to 40 years) and older (68 to 82 years) participants. A cross-sectional study design was used. The speech processor was bypassed and a mid-array electrode was used for stimulation. We compared peripheral and central physiologic measures of temporal resolution with perceptual measures obtained using similar stimuli. Peripherally, temporal resolution was assessed with measures of the rate of recovery of the electrically evoked compound action potential (ECAP), evoked using a single pulse and a pulse train as maskers. The acoustic change complex (ACC) to gaps in pulse trains was used to assess temporal resolution more centrally. Psychophysical gap detection thresholds were also obtained. Cognitive assessment included two tests of processing speed (Symbol Search and Coding) and one test of working memory (Digit Span Test). Speech perception was tested in the presence of background noise (QuickSIN test). A correlational design was used to explore the relationship between temporal resolution, cognition, and speech perception.

RESULTS

The only metric that showed significant age effects in temporal processing was the ECAP recovery function recorded using pulse train maskers. Younger participants were found to have faster rates of neural recovery following presentation of pulse trains than older participants. Age was not found to have a significant effect on speech perception. When results from both groups were combined, digit span was the only measure significantly correlated with speech perception performance.

CONCLUSIONS

In this sample of CI users, few effects of advancing age on temporal resolution were evident. While this finding would be consistent with a general lack of aging effects on temporal resolution, it is also possible that aging effects are influenced by processing peripheral to the auditory nerve, which is bypassed by the CI. However, it is known that cross-fiber neural synchrony is improved with electrical (as opposed to acoustic) stimulation. This change in neural synchrony may, in turn, make temporal cues more robust/perceptible to all CI users. Future studies involving larger sample sizes should be conducted to confirm these findings. Results of this study also add to the growing body of literature that suggests that working memory is important for the perception of degraded speech.

Cingulo-opercular adaptive control for younger and older adults during a challenging gap detection task

Cingulo-opercular activity is hypothesized to reflect an adaptive control function that optimizes task performance through adjustments in attention and behavior, and outcome monitoring. While auditory perceptual task performance appears to benefit from elevated activity in cingulo-opercular regions of frontal cortex before stimuli are presented, this association appears reduced for older adults compared to younger adults. However, adaptive control function may be limited by difficult task conditions for older adults. An fMRI study was used to characterize adaptive control differences while 15 younger (average age = 24 years) and 15 older adults (average age = 68 years) performed a gap detection in noise task designed to limit age-related differences. During the fMRI study, participants listened to a noise recording and indicated with a button-press whether it contained a gap. Stimuli were presented between sparse fMRI scans (TR = 8.6 s) and BOLD measurements were collected during separate listening and behavioral response intervals. Age-related performance differences were limited by presenting gaps in noise with durations calibrated at or above each participant's detection threshold. Cingulo-opercular BOLD increased significantly throughout listening and behavioral response intervals, relative to a resting baseline. Correct behavioral responses were significantly more likely on trials with elevated pre-stimulus cingulo-opercular BOLD, consistent with an adaptive control framework. Cingulo-opercular adaptive control estimates appeared higher for participants with better gap sensitivity and lower response bias, irrespective of age, which suggests that this mechanism can benefit performance across the lifespan under conditions that limit age-related performance differences.

Gaps-In-Noise Test Performance in Children with Speech Sound Disorder and Cognitive Difficulty

Background and Objectives

The Gaps-In-Noise (GIN) test is a clinically effective measure of the integrity of the central auditory nervous system. The GIN procedure can be applied to a pediatric population above 7 years of age. The present study conducted the GIN test to compare the abilities of auditory temporal resolution among typically developing children, children with speech sound disorder (SSD), and children with cognitive difficulty (CD).

Subjects and Methods

Children aged 8 to 11 years-(total n=30) participated in this study. There were 10 children in each of the following three groups: typically developing children, children with SSD, and children with CD. The Urimal Test of Articulation and Phonology was conducted as a clinical assessment of the children’s articulation and phonology. The Korean version of the Wechsler Intelligence Scale for Children-III (K-WISC-III) was administered as a screening test for general cognitive function. According to the procedure of Musiek, the pre-recorded stimuli of the GIN test were presented at 50 dB SL. The results were scored by the approximated threshold and the overall percent correct score (%).

Results

All the typically developing children had normal auditory temporal resolution based on the clinical cutoff criteria of the GIN test. The children with SSD or CD had significantly reduced gap detection performance compared to age-matched typically developing children. The children’s intelligence score measured by the K-WISC-III test explained 37% of the variance in the percent-correct score.

Conclusions

Children with SSD or CD exhibited poorer ability to resolve rapid temporal acoustic cues over time compared to the age-matched typically developing children. The ability to detect a brief temporal gap embedded in a stimulus may be related to the general cognitive ability or phonological processing.

Aging Impairs Temporal Sensitivity, but not Perceptual Synchrony, Across Modalities

Encoding the temporal properties of external signals that comprise multimodal events is a major factor guiding everyday experience. However, during the natural aging process, impairments to sensory processing can profoundly affect multimodal temporal perception. Various mechanisms can contribute to temporal perception, and thus it is imperative to understand how each can be affected by age. In the current study, using three different temporal order judgement tasks (unisensory, multisensory, and sensorimotor), we investigated the effects of age on two separate temporal processes: synchronization and integration of multiple signals. These two processes rely on different aspects of temporal information, either the temporal alignment of processed signals or the integration/segregation of signals arising from different modalities, respectively. Results showed that the ability to integrate/segregate multiple signals decreased with age regardless of the task, and that the magnitude of such impairment correlated across tasks, suggesting a widespread mechanism affected by age. In contrast, perceptual synchrony remained stable with age, revealing a distinct intact mechanism. Overall, results from this study suggest that aging has differential effects on temporal processing, and general impairments with aging may impact global temporal sensitivity while context-dependent processes remain unaffected.

Mice heterozygous for the Cdh23/Ahl1 mutation show age-related deficits in auditory temporal processing

A mutation in the Cdh23 gene is implicated in both syndromic and nonsyndromic hearing loss in humans and age-related hearing loss in C57BL/6 mice. It is generally assumed that human patients (as well as mouse models) only have a hearing loss phenotype if the mutation is homozygous. However, a major complaint for patients with a hearing disability is a reduced speech intelligibility that may be related to temporal processing deficits rather than just elevated thresholds. In this study, we used the amplitude modulation following response (AMFR) to test whether mice heterozygous for Cdh23^{735A > G} have an auditory phenotype that includes temporal processing deficits. The hearing of mice heterozygous for the Cdh23^{735A > G} mutation was compared with age-matched mice homozygous for either the mutation or the wild type in 3 cohorts of mice of both sexes at 2-3, 6, and 12 months of age. The AMFR technique was used to generate objective hearing thresholds for all mice across their range of hearing and to test their temporal processing. We found a genotype-dependent hearing loss in mice homozygous for the mutation starting at 5-11 weeks of age, an age when mice on the C57BL/6 background are often presumed to have normal hearing. The heterozygous animals retained normal hearing thresholds up to one year of age. Nevertheless, the heterozygous animals showed a decline in temporal processing abilities at one year of age that was independent of their hearing thresholds. These results suggest that mice heterozygous for the Cdh23 mutation do not have truly normal hearing.

Perceptual sensitivity to, and electrophysiological encoding of, a complex periodic signal: effects of age

Objective: The purpose of this study was to investigate perceptual and electrophysiological encoding of complex periodic signals as a function of age. Design: Two groups of adults completed three listening tasks: a behavioural task of detection of a mistuned harmonic component in a complex tone, an electrophysiological measure of speech-evoked auditory brainstem response (sABR), and a speech-in-noise measure. Between group comparisons were undertaken for each task as well as pairwise correlation analyses for all tasks. Study sample: One group of younger adults (n = 20) and one group of older adults (n = 20) participated. All listeners had relatively normal audiometric thresholds (≤20 dB HL) from 250-4000 Hz. Results: Younger adults had better results than the older adults on all three tasks: sensitivity for detecting a mistuned harmonic, spectral encoding for sABR, and release from masking for the speech-in-noise test. There were no significant correlations between measures when evaluating the older adults in isolation. Conclusions: The results are consistent with the body of literature that demonstrates reduced temporal processing abilities for older adults. The combined method approach undertaken in this investigation did not result in correlations between the perceptual and electrophysiological measures of temporal processing.

Effects of Aging on Perceptual and Electrophysiological Responses to Acoustic Pulse Trains as a Function of Rate

Purpose As pulse rate increases beyond a few hundred Hertz, younger normal-hearing (NH) participants' ability to encode temporal information in band-limited acoustic pulse trains decreases, demonstrating a rate limitation in processing rapid temporal information. Rate discrimination abilities, however, have yet to be investigated in older NH participants-a population that experiences age-related temporal processing deficits. It was hypothesized that age-related temporal processing deficits lead to decreased temporal rate discrimination abilities in older compared with younger NH participants, which could be observed in both perceptual and electrophysiological measurements. Method Fifteen younger and 15 older NH participants were presented acoustic pulse trains with a 4-kHz center frequency and 1-kHz bandwidth at 75 dB SPL monaurally. The pulse rate was 80, 200, or 400 Hz. Just noticeable differences were obtained using an adaptive procedure that instructed the participants to identify the pulse train with the highest pitch. Auditory steady-state responses (ASSRs) were recorded to the same pulse trains with 2 additional rates-20 and 40 Hz. The Digit Symbol Coding and Digit Symbol Search subtests of the Wechsler Adult Intelligence Scale ( Wechsler, 1997 ) were measured as correlates to domain-general cognitive processing speed. Results As rate increased from 80 to 400 Hz, performance on the perceptual rate discrimination task worsened in both groups. ASSR spectral energy also decreased, but only in the older group. Perceptual performance was equivalent between groups across rates. The older group had lower ASSR spectral energy (lower signal-to-noise ratios) at the 400-Hz rate than the younger group, but there were no group differences for the other rates. The overall strength of neural rate representation, along with speed of processing performance, predicted perceptual performance for the 400-Hz rate. Conclusion These results suggest that neural representation at early levels of the auditory system and processing speed are factors in perceptual auditory temporal processing performance, especially in older adults.

Listening Effort by Native and Nonnative Listeners Due to Noise, Reverberation, and Talker Foreign Accent During English Speech Perception

Purpose Understanding speech in complex realistic acoustic environments requires effort. In everyday listening situations, speech quality is often degraded due to adverse acoustics, such as excessive background noise level (BNL) and reverberation time (RT), or talker characteristics such as foreign accent ( Mattys, Davis, Bradlow, & Scott, 2012 ). In addition to factors affecting the quality of the input acoustic signals, listeners' individual characteristics such as language abilities can also make it more difficult and effortful to understand speech. Based on the Framework for Understanding Effortful Listening ( Pichora-Fuller et al., 2016 ), factors such as adverse acoustics, talker accent, and listener language abilities can all contribute to increasing listening effort. In this study, using both a dual-task paradigm and a self-report questionnaire, we seek to understand listening effort in a wide range of realistic classroom acoustic conditions as well as varying talker accent and listener English proficiency. Method One hundred fifteen native and nonnative adult listeners with normal hearing were tested in a dual task of speech comprehension and adaptive pursuit rotor (APR) under 15 acoustic conditions from combinations of BNLs and RTs. Listeners provided responses on the NASA Task Load Index (TLX) questionnaire immediately after completing the dual task under each acoustic condition. The NASA TLX surveyed 6 dimensions of perceived listening effort: mental demand, physical demand, temporal demand, effort, frustration, and perceived performance. Fifty-six listeners were tested with speech produced by native American English talkers; the other 59 listeners, with speech from native Mandarin Chinese talkers. Based on their 1st language learned during childhood, 3 groups of listeners were recruited: listeners who were native English speakers, native Mandarin Chinese speakers, and native speakers of other languages (e.g., Hindu, Korean, and Portuguese). Results Listening effort was measured objectively through the APR task performance and subjectively using the NASA TLX questionnaire. Performance on the APR task did not vary with changing acoustic conditions, but it did suggest increased listening effort for native listeners of other languages compared to the 2 other listener groups. From the NASA TLX, listeners reported feeling more frustrated and less successful in understanding Chinese-accented speech. Nonnative listeners reported more listening effort (i.e., physical demand, temporal demand, and effort) than native listeners in speech comprehension under adverse acoustics. When listeners' English proficiency was controlled, higher BNL was strongly related to a decrease in perceived performance, whereas such relationship with RT was much weaker. Nonnative listeners who shared the foreign talkers' accent reported no change in listening effort, whereas other listeners reported more difficulty in understanding the accented speech. Conclusions Adverse acoustics required more effortful listening as measured subjectively with a self-report NASA TLX. This subjective scale was more sensitive than a dual task that involved speech comprehension, which was beyond sentence recall. It was better at capturing the negative impacts on listening effort from acoustic factors (i.e., both BNL and RT), talker accent, and listener language abilities.

Effects of Amplification on Neural Phase Locking, Amplitude, and Latency to a Speech Syllable

OBJECTIVE

Older adults often have trouble adjusting to hearing aids when they start wearing them for the first time. Probe microphone measurements verify appropriate levels of amplification up to the tympanic membrane. Little is known, however, about the effects of amplification on auditory-evoked responses to speech stimuli during initial hearing aid use. The present study assesses the effects of amplification on neural encoding of a speech signal in older adults using hearing aids for the first time. It was hypothesized that amplification results in improved stimulus encoding (higher amplitudes, improved phase locking, and earlier latencies), with greater effects for the regions of the signal that are less audible.

DESIGN

Thirty-seven adults, aged 60 to 85 years with mild to severe sensorineural hearing loss and no prior hearing aid use, were bilaterally fit with Widex Dream 440 receiver-in-the-ear hearing aids. Probe microphone measures were used to adjust the gain of the hearing aids and verify the fitting. Unaided and aided frequency-following responses and cortical auditory-evoked potentials to the stimulus /ga/ were recorded in sound field over the course of 2 days for three conditions: 65 dB SPL and 80 dB SPL in quiet, and 80 dB SPL in six-talker babble (+10 signal to noise ratio).

RESULTS

Responses from midbrain were analyzed in the time regions corresponding to the consonant transition (18 to 68 ms) and the steady state vowel (68 to 170 ms). Generally, amplification increased phase locking and amplitude and decreased latency for the region and presentation conditions that had lower stimulus amplitudes-the transition region and 65 dB SPL level. Responses from cortex showed decreased latency for P1, but an unexpected decrease in N1 amplitude. Previous studies have demonstrated an exaggerated cortical representation of speech in older adults compared to younger adults, possibly because of an increase in neural resources necessary to encode the signal. Therefore, a decrease in N1 amplitude with amplification and with increased presentation level may suggest that amplification decreases the neural resources necessary for cortical encoding.

CONCLUSION

Increased phase locking and amplitude and decreased latency in midbrain suggest that amplification may improve neural representation of the speech signal in new hearing aid users. The improvement with amplification was also found in cortex, and, in particular, decreased P1 latencies and lower N1 amplitudes may indicate greater neural efficiency. Further investigations will evaluate changes in subcortical and cortical responses during the first 6 months of hearing aid use.

Time-Compressed Speech Identification Is Predicted by Auditory Neural Processing, Perceptuomotor Speed, and Executive Functioning in Younger and Older Listeners

Older adults typically have difficulty identifying speech that is temporally distorted, such as reverberant, accented, time-compressed, or interrupted speech. These difficulties occur even when hearing thresholds fall within a normal range. Auditory neural processing speed, which we have previously found to predict auditory temporal processing (auditory gap detection), may interfere with the ability to recognize phonetic features as they rapidly unfold over time in spoken speech. Further, declines in perceptuomotor processing speed and executive functioning may interfere with the ability to track, access, and process information. The current investigation examined the extent to which age-related differences in time-compressed speech identification were predicted by auditory neural processing speed, perceptuomotor processing speed, and executive functioning. Groups of normal-hearing (up to 3000 Hz) younger and older adults identified 40, 50, and 60 % time-compressed sentences. Auditory neural processing speed was defined as the P1 and N1 latencies of click-induced auditory-evoked potentials. Perceptuomotor processing speed and executive functioning were measured behaviorally using the Connections Test. Compared to younger adults, older adults exhibited poorer time-compressed speech identification and slower perceptuomotor processing. Executive functioning, P1 latency, and N1 latency did not differ between age groups. Time-compressed speech identification was independently predicted by P1 latency, perceptuomotor processing speed, and executive functioning in younger and older listeners. Results of model testing suggested that declines in perceptuomotor processing speed mediated age-group differences in time-compressed speech identification. The current investigation joins a growing body of literature suggesting that the processing of temporally distorted speech is impacted by lower-level auditory neural processing and higher-level perceptuomotor and executive processes.

Age-Related Effects on Cross-Modal Duration Perception

Reliable duration perception of external events is necessary to coordinate perception with action, precisely discriminate speech, and for other daily functions. Visual duration perception can be heavily influenced by concurrent auditory signals; however, age-related effects on this process have received minimal attention. In the present study, we examined the effect of aging on duration perception by quantifying (1) duration discrimination thresholds, (2) auditory temporal dominance, and (3) visual duration expansion/compression percepts induced by an accompanying auditory stimulus of longer/shorter duration. Duration discrimination thresholds were significantly greater for visual than auditory tasks in both age groups, however there was no effect of age. While the auditory modality retained dominance in duration perception with age, older adults still performed worse than young adults when comparing durations of two target stimuli (e.g., visual) in the presence of distractors from the other modality (e.g., auditory). Finally, both age groups perceived similar visual duration compression, whereas older adults exhibited visual duration expansion over a wider range of auditory durations compared to their younger counterparts. Results are discussed in terms of multisensory integration and possible decision strategies that change with age.

Auditory temporal processing, reading, and phonological awareness among aging adults

Auditory temporal processing (ATP) has been related in the literature to both speech perception as well as reading and phonological awareness. In aging adults, it is known to be related to difficulties in speech perception. In the present study, we aimed to test whether an age-related deficit in ATP would also be accompanied by poor reading and phonological awareness. Thirty-eight aging adults were compared to 55 readers with dyslexia and 42 young normal readers on temporal order judgment (TOJ), speech perception, reading, and phonological awareness tests. Aging adults had longer TOJ thresholds than young normal readers, but shorter than readers with dyslexia; however, they had lower speech perception accuracy than both groups. Phonological awareness of the aging adults was better than readers with dyslexia, but poorer than young normal readers, although their reading accuracy was similar to that of the young controls. This is the first report on poor phonological awareness among aging adults. Suprisingly, it was not accompanied by difficulties in reading ability, and might instead be related to aging adults' difficulties in speech perception. This newly discovered relationship between ATP and phonological awareness among aging adults appears to extend the existing understanding of this relationship, and suggests it should be explored in other groups with ATP deficits.

Subcortical pathways: Towards a better understanding of auditory disorders

Hearing loss is a significant problem that affects at least 15% of the population. This percentage, however, is likely significantly higher because of a variety of auditory disorders that are not identifiable through traditional tests of peripheral hearing ability. In these disorders, individuals have difficulty understanding speech, particularly in noisy environments, even though the sounds are loud enough to hear. The underlying mechanisms leading to such deficits are not well understood. To enable the development of suitable treatments to alleviate or prevent such disorders, the affected processing pathways must be identified. Historically, mechanisms underlying speech processing have been thought to be a property of the auditory cortex and thus the study of auditory disorders has largely focused on cortical impairments and/or cognitive processes. As we review here, however, there is strong evidence to suggest that, in fact, deficits in subcortical pathways play a significant role in auditory disorders. In this review, we highlight the role of the auditory brainstem and midbrain in processing complex sounds and discuss how deficits in these regions may contribute to auditory dysfunction. We discuss current research with animal models of human hearing and then consider human studies that implicate impairments in subcortical processing that may contribute to auditory disorders.

Auditory brainstem, middle and late latency responses to short gaps in noise at different presentation rates

OBJECTIVE

The effects of rate on auditory-evoked potentials (AEP) to short noise gaps (12 ms) recorded at high sampling rates using wide-band filters were investigated.

DESIGN

Auditory brainstem (ABR), middle latency (MLR), late latency (LLR) and steady-state (ASSR) responses were simultaneously recorded in adult subjects at four gap rates (0.5, 1, 5 and 40 Hz). Major components (V, Na, Pa, Nb, Pb, N1 and P2) were identified at each rate and analysed for latency/amplitude characteristics. Gap responses at 40 Hz were recovered from Quasi-ASSRs (QASSR) using the CLAD deconvolution method.

STUDY SAMPLE

Fourteen right ears of young normal hearing subjects were tested.

RESULTS

All major components were present in all subjects at 1 Hz. P1 (P50) appeared as a low-pass filtered component of Pa and Pb waves. At higher rates, N1 and P2 disappeared completely while major ABR-MLR components were identified. Peak latencies were mostly determined by noise onsets slightly delayed by offset responses.

CONCLUSIONS

Major AEP components can be recorded to short gaps at 1 Hz using high sampling rates and wide-band filters. At higher rates, only ABR and MLRs can be recorded. Such simultaneous recordings may provide a complete assessment of temporal resolution and processing at different levels of auditory pathways.

Receptive Vocabulary, Cognitive Flexibility, and Inhibitory Control Differentially Predict Older and Younger Adults' Success Perceiving Speech by Talkers With Dysarthria

PURPOSE

Previous research has demonstrated equivocal findings related to the effect of listener age on intelligibility ratings of dysarthric speech. The aim of the present study was to investigate the mechanisms that support younger and older adults' perception of speech by talkers with dysarthria.

METHOD

Younger and older adults identified words in phrases produced by talkers with dysarthria. Listeners also completed assessments on peripheral hearing, receptive vocabulary, and executive control functions.

RESULTS

Older and younger adults did not differ in their ability to perceive speech by talkers with dysarthria. Younger adults' success in identifying words produced by talkers with dysarthria was associated only with their hearing acuity. In contrast, older adults showed effects of working memory and cognitive flexibility and interactions between hearing acuity and receptive vocabulary and between hearing acuity and inhibitory control.

CONCLUSIONS

Although older and younger adults had equivalent performance identifying words produced by talkers with dysarthria, older adults appear to utilize more cognitive support to identify those words.

Age-related deficits in auditory temporal processing: unique contributions of neural dyssynchrony and slowed neuronal processing

This study was guided by the hypothesis that the aging central nervous system progressively loses its ability to process rapid acoustic changes that are important for speech recognition. Specifically, we hypothesized that age-related deficits in neural synchrony and neuronal oscillatory activity occur independently in older adults and disrupt auditory temporal processing. Neural synchrony is largely dependent on phase locking within the central auditory pathway, beginning at the auditory nerve. In contrast, the resonance characteristics of oscillatory activity are dependent on the integrity and structure of long range cortical connections. We tested our hypotheses by assessing age-related differences in electrophysiologic correlates of neural synchrony and peak oscillatory frequency in younger and older adults with normal hearing and determining their associations with a behavioral measure of gap detection. Phase-locking values were smaller (poorer neural synchrony) and peak alpha frequency was lower for older than younger adults and decreased as gap detection thresholds increased; variations in phase-locking values and peak alpha frequency uniquely predicted gap detection thresholds. These effects were driven, in large part, by associations in older adults. These results reveal dissociable neural mechanisms associated with distinct underlying pathology that may differentially be present in older adults and contribute to auditory processing declines.

Self-Assessed Hearing Handicap in Older Adults With Poorer-Than-Predicted Speech Recognition in Noise

PURPOSE

Even older adults with relatively mild hearing loss report hearing handicap, suggesting that hearing handicap is not completely explained by reduced speech audibility.

METHOD

We examined the extent to which self-assessed ratings of hearing handicap using the Hearing Handicap Inventory for the Elderly (HHIE; Ventry & Weinstein, 1982) were significantly associated with measures of speech recognition in noise that controlled for differences in speech audibility.

RESULTS

One hundred sixty-two middle-aged and older adults had HHIE total scores that were significantly associated with audibility-adjusted measures of speech recognition for low-context but not high-context sentences. These findings were driven by HHIE items involving negative feelings related to communication difficulties that also captured variance in subjective ratings of effort and frustration that predicted speech recognition. The average pure-tone threshold accounted for some of the variance in the association between the HHIE and audibility-adjusted speech recognition, suggesting an effect of central and peripheral auditory system decline related to elevated thresholds.

CONCLUSION

The accumulation of difficult listening experiences appears to produce a self-assessment of hearing handicap resulting from (a) reduced audibility of stimuli, (b) declines in the central and peripheral auditory system function, and (c) additional individual variation in central nervous system function.

A review of causal mechanisms underlying the link between age-related hearing loss and cognitive decline

Accumulating evidence points to a link between age-related hearing loss and cognitive decline, but their relationship is not clear. Does one cause the other, or does some third factor produce both? The answer has critical implications for prevention, rehabilitation, and health policy but has been difficult to establish for several reasons. First, determining a causal relationship in natural, correlational samples is problematic, and hearing and cognition are difficult to measure independently. Here, we critically review the evidence for a link between hearing loss and cognitive decline. We conclude that the evidence is convincing, but that the effects are small when hearing is measured audiometrically. We review four different directional hypotheses that have been offered as explanations for such a link, and conclude that no single hypothesis is sufficient. We introduce a framework that highlights that hearing and cognition rely on shared neurocognitive resources, and relate to each other in several different ways. We also discuss interventions for sensory and cognitive decline that may permit more causal inferences.

Auditory gap-in-noise detection behavior in ferrets and humans

The precise encoding of temporal features of auditory stimuli by the mammalian auditory system is critical to the perception of biologically important sounds, including vocalizations, speech, and music. In this study, auditory gap-detection behavior was evaluated in adult pigmented ferrets (Mustelid putorius furo) using bandpassed stimuli designed to widely sample the ferret's behavioral and physiological audiogram. Animals were tested under positive operant conditioning, with psychometric functions constructed in response to gap-in-noise lengths ranging from 3 to 270 ms. Using a modified version of this gap-detection task, with the same stimulus frequency parameters, we also tested a cohort of normal-hearing human subjects. Gap-detection thresholds were computed from psychometric curves transformed according to signal detection theory, revealing that for both ferrets and humans, detection sensitivity was worse for silent gaps embedded within low-frequency noise compared with high-frequency or broadband stimuli. Additional psychometric function analysis of ferret behavior indicated effects of stimulus spectral content on aspects of behavioral performance related to decision-making processes, with animals displaying improved sensitivity for broadband gap-in-noise detection. Reaction times derived from unconditioned head-orienting data and the time from stimulus onset to reward spout activation varied with the stimulus frequency content and gap length, as well as the approach-to-target choice and reward location. The present study represents a comprehensive evaluation of gap-detection behavior in ferrets, while similarities in performance with our human subjects confirm the use of the ferret as an appropriate model of temporal processing.

Comparison of Performance of Older Adults on Two Tests of Temporal Resolution

PURPOSE

Gap-detection thresholds have been reported to vary depending on the type of stimuli used. The current study compared the performance of older adults on 2 tests of temporal resolution, one with random gaps and the other with gaps in the center of a noise signal. The study also determined which of the 2 tests was able to detect more temporal resolution deficits in older individuals.

METHOD

Two tests of temporal resolution, the Gap Detection Test (GDT; Shivaprakash, 2003) and the Gaps-In-Noise test (GIN; Musiek et al., 2005), were administered to 31 older adults with near normal hearing, aged 55 to 70 years. The order in which the tests were administered was randomized.

RESULTS

The gap-detection thresholds obtained using GIN were significantly higher than those obtained using GDT. The difference in thresholds was ascribed to the randomness with which gaps were interspersed within noise segments in the 2 tests. More individuals failed on GIN than GDT. The older adults with high-frequency hearing loss obtained poorer gap thresholds than those with normal hearing.

CONCLUSION

The results indicated that older individuals failed GIN more often compared to GDT. This was attributed to the differences in stimuli and procedure used in the 2 tests.

The effects of noise vocoding on gap detection thresholds

Gap detection threshold (GDT), the shortest silent interval a person can perceive, is a commonly used measure of temporal processing resolution. The purposes of this study were: (1) to examine the effects of noise vocoding, which has been used to simulate what signals sound like through a cochlear implant, on GDTs in normal-hearing subjects, and (2) to further the understanding of neural mechanisms underlying gap detection using the Auditory Late Response (ALR). Thirteen normal listeners participated. In behavioral tests, the GDTs were determined for the original and vocoded stimuli. In ALR recordings, the subjects were presented with auditory stimuli with and without containing gaps and stimuli with and without being vocoded. Results showed that GDTs were significantly elevated for vocoded stimuli with spectral resolutions of 4 and 20 channels compared to those for the original stimuli. A gap effect was observed in the post-gap ALR. Current densities for N1 peaks evoked by stimuli with zero- vs. non-zero ms gaps, pre- vs. post-gap markers, and original vs. vocoded stimuli were obtained using the standardized low-resolution brain electromagnetic tomography (sLORETA) method. Paired comparisons of pre- and post-gap current density values were made. Results showed a statistical difference between the N1s evoked by pre- vs. post-gap markers, with the activation in the middle frontal gyrus and precentral gyrus. The results suggest that: (1) noise vocoding does affect temporal processing resolution assessed with GDTs, (2) gap detection may involve the recruitment of cognitive neural resources, and (3) the ALR has a potential value of objectively estimating temporal processing resolution.

Effects of emotionally charged auditory stimulation on gait performance in the elderly: a preliminary study

OBJECTIVES

To evaluate the effect of a novel divided attention task-walking under auditory constraints-on gait performance in older adults and to determine whether this effect was moderated by cognitive status.

DESIGN

Validation cohort.

SETTING

General community.

PARTICIPANTS

Ambulatory older adults without dementia (N=104).

INTERVENTIONS

Not applicable.

MAIN OUTCOME MEASURES

In this pilot study, we evaluated walking under auditory constraints in 104 older adults who completed 3 pairs of walking trials on a gait mat under 1 of 3 randomly assigned conditions: 1 pair without auditory stimulation and 2 pairs with emotionally charged auditory stimulation with happy or sad sounds.

RESULTS

The mean age of subjects was 80.6±4.9 years, and 63% (n=66) were women. The mean velocity during normal walking was 97.9±20.6cm/s, and the mean cadence was 105.1±9.9 steps/min. The effect of walking under auditory constraints on gait characteristics was analyzed using a 2-factorial analysis of variance with a 1-between factor (cognitively intact and minimal cognitive impairment groups) and a 1-within factor (type of auditory stimuli). In both happy and sad auditory stimulation trials, cognitively intact older adults (n=96) showed an average increase of 2.68cm/s in gait velocity (F1.86,191.71=3.99; P=.02) and an average increase of 2.41 steps/min in cadence (F1.75,180.42=10.12; P<.001) as compared with trials without auditory stimulation. In contrast, older adults with minimal cognitive impairment (Blessed test score, 5-10; n=8) showed an average reduction of 5.45cm/s in gait velocity (F1.87,190.83=5.62; P=.005) and an average reduction of 3.88 steps/min in cadence (F1.79,183.10=8.21; P=.001) under both auditory stimulation conditions. Neither baseline fall history nor performance of activities of daily living accounted for these differences.

CONCLUSIONS

Our results provide preliminary evidence of the differentiating effect of emotionally charged auditory stimuli on gait performance in older individuals with minimal cognitive impairment compared with those without minimal cognitive impairment. A divided attention task using emotionally charged auditory stimuli might be able to elicit compensatory improvement in gait performance in cognitively intact older individuals, but lead to decompensation in those with minimal cognitive impairment. Further investigation is needed to compare gait performance under this task to gait on other dual-task paradigms and to separately examine the effect of physiological aging versus cognitive impairment on gait during walking under auditory constraints.