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Schirmer J, Wolpert S, Dapper K, Rühle M, Wertz J, Wouters M, Eldh T, Bader K, Singer W, Gaudrain E, Başkent D, Verhulst S, Braun C, Rüttiger L, Munk MHJ, Dalhoff E, Knipper M. Neural Adaptation at Stimulus Onset and Speed of Neural Processing as Critical Contributors to Speech Comprehension Independent of Hearing Threshold or Age. J Clin Med 2024; 13:2725. [PMID: 38731254 PMCID: PMC11084258 DOI: 10.3390/jcm13092725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Revised: 04/24/2024] [Accepted: 04/26/2024] [Indexed: 05/13/2024] Open
Abstract
Background: It is assumed that speech comprehension deficits in background noise are caused by age-related or acquired hearing loss. Methods: We examined young, middle-aged, and older individuals with and without hearing threshold loss using pure-tone (PT) audiometry, short-pulsed distortion-product otoacoustic emissions (pDPOAEs), auditory brainstem responses (ABRs), auditory steady-state responses (ASSRs), speech comprehension (OLSA), and syllable discrimination in quiet and noise. Results: A noticeable decline of hearing sensitivity in extended high-frequency regions and its influence on low-frequency-induced ABRs was striking. When testing for differences in OLSA thresholds normalized for PT thresholds (PTTs), marked differences in speech comprehension ability exist not only in noise, but also in quiet, and they exist throughout the whole age range investigated. Listeners with poor speech comprehension in quiet exhibited a relatively lower pDPOAE and, thus, cochlear amplifier performance independent of PTT, smaller and delayed ABRs, and lower performance in vowel-phoneme discrimination below phase-locking limits (/o/-/u/). When OLSA was tested in noise, listeners with poor speech comprehension independent of PTT had larger pDPOAEs and, thus, cochlear amplifier performance, larger ASSR amplitudes, and higher uncomfortable loudness levels, all linked with lower performance of vowel-phoneme discrimination above the phase-locking limit (/i/-/y/). Conslusions: This study indicates that listening in noise in humans has a sizable disadvantage in envelope coding when basilar-membrane compression is compromised. Clearly, and in contrast to previous assumptions, both good and poor speech comprehension can exist independently of differences in PTTs and age, a phenomenon that urgently requires improved techniques to diagnose sound processing at stimulus onset in the clinical routine.
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Affiliation(s)
- Jakob Schirmer
- Department of Otolaryngology, Head and Neck Surgery, University of Tübingen, Elfriede-Aulhorn-Str. 5, 72076 Tübingen, Germany; (J.S.); (S.W.); (K.D.); (M.R.); (J.W.); (T.E.); (K.B.); (W.S.); (L.R.)
| | - Stephan Wolpert
- Department of Otolaryngology, Head and Neck Surgery, University of Tübingen, Elfriede-Aulhorn-Str. 5, 72076 Tübingen, Germany; (J.S.); (S.W.); (K.D.); (M.R.); (J.W.); (T.E.); (K.B.); (W.S.); (L.R.)
| | - Konrad Dapper
- Department of Otolaryngology, Head and Neck Surgery, University of Tübingen, Elfriede-Aulhorn-Str. 5, 72076 Tübingen, Germany; (J.S.); (S.W.); (K.D.); (M.R.); (J.W.); (T.E.); (K.B.); (W.S.); (L.R.)
- Department of Biology, Technical University Darmstadt, 64287 Darmstadt, Germany
| | - Moritz Rühle
- Department of Otolaryngology, Head and Neck Surgery, University of Tübingen, Elfriede-Aulhorn-Str. 5, 72076 Tübingen, Germany; (J.S.); (S.W.); (K.D.); (M.R.); (J.W.); (T.E.); (K.B.); (W.S.); (L.R.)
| | - Jakob Wertz
- Department of Otolaryngology, Head and Neck Surgery, University of Tübingen, Elfriede-Aulhorn-Str. 5, 72076 Tübingen, Germany; (J.S.); (S.W.); (K.D.); (M.R.); (J.W.); (T.E.); (K.B.); (W.S.); (L.R.)
| | - Marjoleen Wouters
- Department of Information Technology, Ghent University, Technologiepark 126, 9052 Zwijnaarde, Belgium; (M.W.); (S.V.)
| | - Therese Eldh
- Department of Otolaryngology, Head and Neck Surgery, University of Tübingen, Elfriede-Aulhorn-Str. 5, 72076 Tübingen, Germany; (J.S.); (S.W.); (K.D.); (M.R.); (J.W.); (T.E.); (K.B.); (W.S.); (L.R.)
| | - Katharina Bader
- Department of Otolaryngology, Head and Neck Surgery, University of Tübingen, Elfriede-Aulhorn-Str. 5, 72076 Tübingen, Germany; (J.S.); (S.W.); (K.D.); (M.R.); (J.W.); (T.E.); (K.B.); (W.S.); (L.R.)
| | - Wibke Singer
- Department of Otolaryngology, Head and Neck Surgery, University of Tübingen, Elfriede-Aulhorn-Str. 5, 72076 Tübingen, Germany; (J.S.); (S.W.); (K.D.); (M.R.); (J.W.); (T.E.); (K.B.); (W.S.); (L.R.)
| | - Etienne Gaudrain
- Lyon Neuroscience Research Center, Centre National de la Recherche Scientifique UMR5292, Inserm U1028, Université Lyon 1, Centre Hospitalier Le Vinatier-Bâtiment 462–Neurocampus, 95 Boulevard Pinel, 69675 Bron CEDEX, France;
- Department of Otorhinolaryngology, University Medical Center Groningen (UMCG), Hanzeplein 1, BB21, 9700 RB Groningen, The Netherlands;
| | - Deniz Başkent
- Department of Otorhinolaryngology, University Medical Center Groningen (UMCG), Hanzeplein 1, BB21, 9700 RB Groningen, The Netherlands;
| | - Sarah Verhulst
- Department of Information Technology, Ghent University, Technologiepark 126, 9052 Zwijnaarde, Belgium; (M.W.); (S.V.)
| | - Christoph Braun
- Magnetoencephalography-Centre and Hertie Institute for Clinical Brain Research, University of Tübingen, Otfried-Müller-Straße 27, 72076 Tübingen, Germany;
- Center for Mind and Brain Research, University of Trento, Palazzo Fedrigotti-corso Bettini 31, 38068 Rovereto, Italy
| | - Lukas Rüttiger
- Department of Otolaryngology, Head and Neck Surgery, University of Tübingen, Elfriede-Aulhorn-Str. 5, 72076 Tübingen, Germany; (J.S.); (S.W.); (K.D.); (M.R.); (J.W.); (T.E.); (K.B.); (W.S.); (L.R.)
| | - Matthias H. J. Munk
- Department of Biology, Technical University Darmstadt, 64287 Darmstadt, Germany
- Department of Psychiatry & Psychotherapy, University of Tübingen, Calwerstraße 14, 72076 Tübingen, Germany
| | - Ernst Dalhoff
- Department of Otolaryngology, Head and Neck Surgery, University of Tübingen, Elfriede-Aulhorn-Str. 5, 72076 Tübingen, Germany; (J.S.); (S.W.); (K.D.); (M.R.); (J.W.); (T.E.); (K.B.); (W.S.); (L.R.)
| | - Marlies Knipper
- Department of Otolaryngology, Head and Neck Surgery, University of Tübingen, Elfriede-Aulhorn-Str. 5, 72076 Tübingen, Germany; (J.S.); (S.W.); (K.D.); (M.R.); (J.W.); (T.E.); (K.B.); (W.S.); (L.R.)
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Sonstrom Malowski K, Gollihugh LH, Malyuk H, Le Prell CG. Auditory changes following firearm noise exposure, a review. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2022; 151:1769. [PMID: 35364940 DOI: 10.1121/10.0009675] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 02/10/2022] [Indexed: 06/14/2023]
Abstract
Firearms produce peak sound pressure levels (peak SPL) between ∼130 and 175 dB peak SPL, creating significant risk of noise-induced hearing loss (NIHL) in those exposed to firearm noise during occupational, recreational, and/or military operations. Noise-induced tinnitus and hearing loss are common in military service members, public safety officers, and hunters/shooters. Given the significant risk of NIHL due to firearm and other noise sources, there is an interest in, and demand for, interventions to prevent and/or treat NIHL in high-risk populations. However, research and clinical trial designs assessing NIHL prevention have varied due to inconsistent data from the literature, specifically with end point definitions, study protocols, and assessment methodologies. This article presents a scoping review of the literature pertaining to auditory changes following firearm noise exposure. Meta-analysis was not possible due to heterogeneity of the study designs. Recommendations regarding audiologic test approach and monitoring of populations at risk for NIHL are presented based on critical review of the existing literature.
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Affiliation(s)
| | - Lindsay H Gollihugh
- School of Speech-Language Pathology and Audiology, The University of Akron, Akron, Ohio 44325, USA
| | - Heather Malyuk
- School of Speech-Language Pathology and Audiology, The University of Akron, Akron, Ohio 44325, USA
| | - Colleen G Le Prell
- Department of Speech, Language, and Hearing, The University of Texas at Dallas, Richardson, Texas 75080, USA
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Auditory Neuropathy Spectrum Disorders: From Diagnosis to Treatment: Literature Review and Case Reports. J Clin Med 2020; 9:jcm9041074. [PMID: 32290039 PMCID: PMC7230308 DOI: 10.3390/jcm9041074] [Citation(s) in RCA: 49] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 03/21/2020] [Accepted: 04/01/2020] [Indexed: 12/21/2022] Open
Abstract
Auditory neuropathy spectrum disorder (ANSD) refers to a range of hearing impairments characterized by deteriorated speech perception, despite relatively preserved pure-tone detection thresholds. Affected individuals usually present with abnormal auditory brainstem responses (ABRs), but normal otoacoustic emissions (OAEs). These electrophysiological characteristics have led to the hypothesis that ANSD may be caused by various dysfunctions at the cochlear inner hair cell (IHC) and spiral ganglion neuron (SGN) levels, while the activity of outer hair cells (OHCs) is preserved, resulting in discrepancies between pure-tone and speech comprehension thresholds. The exact prevalence of ANSD remains unknown; clinical findings show a large variability among subjects with hearing impairment ranging from mild to profound hearing loss. A wide range of prenatal and postnatal etiologies have been proposed. The study of genetics and of the implicated sites of lesion correlated with clinical findings have also led to a better understanding of the molecular mechanisms underlying the various forms of ANSD, and may guide clinicians in better screening, assessment and treatment of ANSD patients. Besides OAEs and ABRs, audiological assessment includes stapedial reflex measurements, supraliminal psychoacoustic tests, electrocochleography (ECochG), auditory steady-state responses (ASSRs) and cortical auditory evoked potentials (CAEPs). Hearing aids are indicated in the treatment of ANSD with mild to moderate hearing loss, whereas cochlear implantation is the first choice of treatment in case of profound hearing loss, especially in case of IHC presynaptic disorders, or in case of poor auditory outcomes with conventional hearing aids.
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