Onset of basilar membrane non-linearity reflected in cubic distortion tone input-output functions

The Effect of Stimuli Level on Distortion Product Otoacoustic Emission in Normal Hearing Adults

The goal of this study is to compare three of the most commonly used primary-level relation paradigms (i.e., Scissors, Boys Town 'Optimal', and Equal-Level) in generation of distortion product otoacoustic emissions (DPOAEs) in normal hearing adults. The generator and reflection components were extracted from DPOAEs in each paradigm. The generator and reflection component levels and input/output (I/O) functions were compared across paradigms and primary-tone levels. The results showed a different I/O function growth behavior across frequency and levels among paradigms. The Optimal paradigm showed a systematic change in the generator and reflection component levels and I/O slopes across primary levels among subjects. Moreover, the levels and slopes in the Optimal paradigm were more distinct across levels with less variations across frequency leading to a systematic change in the DPOAE fine structure across levels. The I/O functions were found to be more sensitive to the selected paradigm; especially the I/O function for the reflection component. The I/O functions of the reflection components showed large variability across frequencies due to different frequency shifts in their microstructure depending on the paradigm. The findings of this study suggested the Optimal paradigm as the proper primary-level relation to study cochlear amplification/compression. The findings of this study shows that care needs to be taken in comparing the findings of different studies that generated DPOAEs with a different level-relation paradigm.

Understanding degraded speech leads to perceptual gating of a brainstem reflex in human listeners

The ability to navigate "cocktail party" situations by focusing on sounds of interest over irrelevant, background sounds is often considered in terms of cortical mechanisms. However, subcortical circuits such as the pathway underlying the medial olivocochlear (MOC) reflex modulate the activity of the inner ear itself, supporting the extraction of salient features from auditory scene prior to any cortical processing. To understand the contribution of auditory subcortical nuclei and the cochlea in complex listening tasks, we made physiological recordings along the auditory pathway while listeners engaged in detecting non(sense) words in lists of words. Both naturally spoken and intrinsically noisy, vocoded speech-filtering that mimics processing by a cochlear implant (CI)-significantly activated the MOC reflex, but this was not the case for speech in background noise, which more engaged midbrain and cortical resources. A model of the initial stages of auditory processing reproduced specific effects of each form of speech degradation, providing a rationale for goal-directed gating of the MOC reflex based on enhancing the representation of the energy envelope of the acoustic waveform. Our data reveal the coexistence of 2 strategies in the auditory system that may facilitate speech understanding in situations where the signal is either intrinsically degraded or masked by extrinsic acoustic energy. Whereas intrinsically degraded streams recruit the MOC reflex to improve representation of speech cues peripherally, extrinsically masked streams rely more on higher auditory centres to denoise signals.

Distortion Product Otoacoustic Emission (DPOAE) Growth in Aging Ears with Clinically Normal Behavioral Thresholds

Age-related hearing loss (ARHL) is a devastating public health issue. To successfully address ARHL using existing and future treatments, it is imperative to detect the earliest signs of age-related auditory decline and understand the mechanisms driving it. Here, we explore early signs of age-related auditory decline by characterizing cochlear function in 199 ears aged 10-65 years, all of which had clinically defined normal hearing (i.e., behavioral thresholds ≤ 25 dB HL from .25 to 8 kHz bilaterally) and no history of noise exposure. We characterized cochlear function by measuring behavioral thresholds in two paradigms (traditional audiometric thresholds from .25 to 8 kHz and Békésy tracking thresholds from .125 to 20 kHz) and distortion product otoacoustic emission (DPOAE) growth functions at f₂ = 2, 4, and 8 kHz. Behavioral thresholds through a standard clinical frequency range (up to 8 kHz) showed statistically, but not clinically, significant declines across increasing decades of life. In contrast, DPOAE growth measured in the same frequency range showed clear declines as early 30 years of age, particularly across moderate stimulus levels (L₂ = 25-45 dB SPL). These substantial declines in DPOAE growth were not fully explained by differences in behavioral thresholds measured in the same frequency region. Additionally, high-frequency Békésy tracking thresholds above ~11.2 kHz showed frank declines with increasing age. Collectively, these results suggest that early age-related cochlear decline (1) begins as early as the third or fourth decade of life, (2) is greatest in the cochlear base but apparent through the length of the cochlear partition, (3) cannot be detected fully by traditional clinical measures, and (4) is likely due to a complex mix of etiologies.

Examining the Factors that Contribute to Non-Monotonic Growth of the [Formula: see text] Otoacoustic Emission in Humans

Cubic distortion product otoacoustic emission input-output functions in humans show a complex pattern of growth. To further investigate the growth of the [Formula: see text] otoacoustic emission, magnitude and phase input-output functions were obtained from human subjects using a range of stimulus levels, frequencies, and frequency ratios. Three factors related to cochlear nonlinearity may produce non-monotonic input-output functions: a two-component interaction, an operating point shift, and two-tone suppression. To complement data interpretation, a local model of distortion product otoacoustic emission generation was fit to the magnitude spectrum of the averaged ear canal sound pressure recording to quantify operating point shift. Results obtained are consistent with non-monotonic growth occurring primarily as a result of two-tone suppression and/or a two-component interaction. These two mechanisms are expected to operate at different stimulus levels, with different signature magnitude and phase patterns, and are unlikely to overlap in producing non-monotonic growth. An operating point shift was suggested in three cases. These results support multiple factors contributing to the complexity of growth of the [Formula: see text] otoacoustic emission in humans and highlight the importance of looking at phase in addition to magnitude when interpreting distortion product otoacoustic emission growth.

Auditory Brainstem Response Altered in Humans With Noise Exposure Despite Normal Outer Hair Cell Function

OBJECTIVES

Recent animal studies demonstrated that cochlear synaptopathy, a partial loss of inner hair cell-auditory nerve fiber synapses, can occur in response to noise exposure without any permanent auditory threshold shift. In animal models, this synaptopathy is associated with a reduction in the amplitude of wave I of the auditory brainstem response (ABR). The goal of this study was to determine whether higher lifetime noise exposure histories in young people with clinically normal pure-tone thresholds are associated with lower ABR wave I amplitudes.

DESIGN

Twenty-nine young military Veterans and 35 non Veterans (19 to 35 years of age) with normal pure-tone thresholds were assigned to 1 of 4 groups based on their self-reported lifetime noise exposure history and Veteran status. Suprathreshold ABR measurements in response to alternating polarity tone bursts were obtained at 1, 3, 4, and 6 kHz with gold foil tiptrode electrodes placed in the ear canal. Wave I amplitude was calculated from the difference in voltage at the positive peak and the voltage at the following negative trough. Distortion product otoacoustic emission input/output functions were collected in each participant at the same four frequencies to assess outer hair cell function.

RESULTS

After controlling for individual differences in sex and distortion product otoacoustic emission amplitude, the groups containing participants with higher reported histories of noise exposure had smaller ABR wave I amplitudes at suprathreshold levels across all four frequencies compared with the groups with less history of noise exposure.

CONCLUSIONS

Suprathreshold ABR wave I amplitudes were reduced in Veterans reporting high levels of military noise exposure and in non Veterans reporting any history of firearm use as compared with Veterans and non Veterans with lower levels of reported noise exposure history. The reduction in ABR wave I amplitude in the groups with higher levels of noise exposure cannot be accounted for by sex or variability in outer hair cell function. This change is similar to the decreased ABR wave I amplitudes observed in animal models of noise-induced cochlear synaptopathy. However, without post mortem examination of the temporal bone, no direct conclusions can be drawn concerning the presence of synaptopathy in the study groups with higher noise exposure histories.

Reliability of distortion-product otoacoustic emissions and their relation to loudness

The reliability of distortion-product otoacoustic emission (DPOAE) measurements and their relation to loudness measurements was examined in 16 normal-hearing subjects and 58 subjects with hearing loss. The level of the distortion product (L(d)) was compared across two sessions and resulted in correlations that exceeded 0.90. The reliability of DPOAEs was less when parameters from nonlinear fits to the input/output (I/O) functions were compared across visits. Next, the relationship between DPOAE I/O parameters and the slope of the low-level portion of the categorical loudness scaling (CLS) function (soft slope) was assessed. Correlations of 0.65, 0.74, and 0.81 at 1, 2, and 4 kHz were observed between CLS soft slope and combined DPOAE parameters. Behavioral threshold had correlations of 0.82, 0.83, and 0.88 at 1, 2, and 4 kHz with CLS soft slope. Combining DPOAEs and behavioral threshold provided little additional information. Lastly, a multivariate approach utilizing the entire DPOAE I/O function was used to predict the CLS rating for each input level (dB SPL). Standard error of the estimate when using this method ranged from 2.4 to 3.0 categorical units (CU), suggesting that DPOAE I/O functions can predict CLS measures within the CU step size used in this study (5).

In search of basal distortion product generators

The 2f1-f2 distortion product otoacoustic emission (DPOAE) is thought to arise primarily from the complex interaction of components that come from two different cochlear locations. Such distortion has its origin in the nonlinear interaction on the basilar membrane of the excitation patterns resulting from the two stimulus tones, f1 and f2. Here we examine the spatial extent of initial generation of the 2f1-f2 OAE by acoustically traumatizing the base of the cochlea and so eliminating the contribution of the basal region of the cochlea to the generation of 2f1-f2. Explicitly, amplitude-modulated, or continuously varying in level, stimulus tones with f2/f1= 1.2 and f2 =8000-8940 Hz were used to generate the 2f1-f2 DPOAE in guinea pig before and after acoustically traumatizing the basal region of the cochlea (the origin of any basal-to-f2 distortion product generators). It was found, based on correlation analysis, that there does not appear to be a basal-to-f2 distortion product generation mechanism contributing significantly to the guinea pig 2f1-f2 OAE up to L1 = 80 dB sound pressure level (SPL).

A comparison of OAEs arising from different generation mechanisms in guinea pig

Otoacoustic emissions provide unambiguous evidence that the cochlea supports energy propagation both towards, and away from, the stapes. The standard wave model for energy transport and cochlear mechanical amplification provides for compressional and inertial waves to transport this energy, the compressional wave through the fluids and the inertial wave along the basilar membrane via fluid coupling. It is generally accepted that energy propagation away from the stapes is dominated by a traveling wave mechanism along the basilar membrane. The mechanism by which energy is predominantly transported back to the stapes remains controversial. Here, we compared signal onset delay measurements and rise/steady-state/fall times for SFOAEs and 2f1-f2 OAEs (f2/f1=1.2) obtained using a pulsed-tone paradigm in guinea pig. Comparison of 2f1-f2 OAE signal onset delay for the OAE arising from the f2 region with SFOAE signal onset delay (matched to the f2 stimulus frequency) based on signal onset occurring at 10% of the peak signal amplitude was suggestive of a bi-directional traveling wave mechanism. However, significant variability in signal onset delay and signal rise, steady-state duration, and fall times for both the 2f1-f2 OAE and SFOAE was found, qualifying this interpretation. Such variability requires explanation, awaiting further studies.

Simultaneous recording of stimulus-frequency and distortion-product otoacoustic emission input-output functions in human ears

Stimulus frequency otoacoustic emission (SFOAE) input-output (I/O) functions were elicited in normal-hearing adults using unequal-frequency primaries in equal-level and fixed-suppressor level (Ls) conditions. Responses were repeatable and similar across a range of primary frequency ratios in the fixed-Ls condition. In comparison to equal-frequency primary conditions [Schairer, Fitzpatrick, and Keefe, J. Acoust. Soc. Am. 114, 944-966 (2003)], the unequal-frequency, fixed-Ls condition appears to be more useful for characterizing SFOAE response growth and relating it to basilar-membrane response growth, and for testing the ability to predict audiometric thresholds. Simultaneously recorded distortion-product OAE (DPOAE) I/O functions had higher thresholds than SFOAE I/O functions, and they identified the onset of the nonlinear-distortion mechanism in SFOAEs. DPOAE threshold often corresponded to nonmonotonicities in SFOAE I/O functions. This suggests that the level-dependent nonmonotonicities and associated phase shifts in SFOAE I/O functions were due to varying degrees of cancellation of two sources of SFOAE, such as coherent reflection and distortion mechanisms. Level-dependent noise was observed on-band (at the frequencies of the stimuli) but not off-band, or in the DPOAEs. The variability was observed in ears with normal hearing and ears with cochlear implants. In general, these results indicate the source of the variability is biological, possibly from within the middle ear.

Inferring basilar-membrane motion from tone-burst otoacoustic emissions and psychoacoustic measurements

The amplitude of otoacoustic emissions, which arise on the basilar membrane, is assumed to be proportional to basilar-membrane motion. It should then be possible to assess basilar-membrane motion on the basis of otoacoustic emissions. The present study provides support for this possibility by comparing basilar-membrane motion inferred from emissions to that inferred from psychoacoustic measures. Three psychoacoustic measurements believed to be associated with basilar-membrane motion were investigated: (1) pulsation threshold; (2) loudness functions derived from temporal integration; and (3) loudness functions derived from loudness matches between pure tones and multitone complexes. Results of the psychoacoustic measurements and of the tone-burst otoacoustic emissions led to very similar estimations of basilar-membrane motion. Accordingly, emissions could serve as an excellent tool--one that is objective, noninvasive, and rapid--for estimating relative basilar-membrane motion.

Delay dependence for the origin of the nonlinear derived transient evoked otoacoustic emission

In the guinea pig it has been shown that the nonlinear derived transient evoked otoacoustic emission (TEOAEnl) is comprised of significant amounts of intermodulation distortion energy. It is expected that intermodulation distortion arising from a nonlinear distortion mechanism will contribute to the overall TEOAE in a stimulus-level-dependent manner, being greatest when basilar-membrane vibration in response to a click stimulus is greatest; with decay of vibration of the basilar membrane subsequent to stimulation by a click, nonlinear interaction along the cochlear partition should reduce and so provide for a linear mechanism to dominate TEOAEnl generation, i.e., the contributions of each of these mechanisms should be delay dependent. To examine this delay dependence, TEOAEnl evoked by acoustic clicks of varying bandwidth were time-domain windowed using a recursive exponential filter in an attempt to separate two components with amplitude and phase properties consistent with different mechanisms of OAE generation. It was found that the part of the TEOAEnl occurring first in time can have a relatively constant amplitude and shallow phase slope, consistent with a nonlinear distortion mechanism. The latter part of the TEOAEnl has an amplitude microstructure and a phase response more consistent with a place-fixed mechanism.

Modeling the growth rate of distortion product otoacoustic emissions by active nonlinear oscillators

In this work, growth-rate curves of the 2 f1-f2 distortion product otoacoustic emission (DPOAE) are analyzed in a population of 30 noise exposed subjects, including both normal-hearing and hearing impaired subjects. A particular embedded limit-cycle oscillator equation is used to model the cochlear resonant response at the cochlear places of the primary and secondary tone frequencies (f2 and 2 f1-f2). The parameters of the oscillator equation can be directly interpreted in terms of effectiveness of the cochlear feedback mechanisms associated with the active filter amplification. A two-sources paradigm is included in the model, in agreement with experimental evidence and with the assumptions of more detailed full cochlear models based on the transmission line formalism. According to this paradigm, DPOAEs are nonlinearly generated at the cochlear place that is resonant at frequency f2, and coherently reflected at the 2 f1-f2 place. The analysis shows that the model, which had been previously used to describe the relaxation dynamics of transient evoked otoacoustic emissions (TEOAEs), also correctly predicts the observed growth rate of the DPOAE response as a function of the primary tones amplitude. A significant difference is observed between normal and impaired ears. The comparison between the growth rate curves at different frequencies provides information about the dependence of cochlear tuning on frequency.

Otoacoustic emissions without somatic motility: can stereocilia mechanics drive the mammalian cochlea?

Distortion product otoacoustic emissions (DPOAEs) evoked by low-level tones are a sensitive indicator of outer hair cell (OHC) function. High-level DPOAEs are less vulnerable to cochlear insult, and their dependence on the OHC function is more controversial. Here, the mechanism underlying high-level DPOAE generation is addressed using a mutant mouse line lacking prestin, the molecular motor driving OHC somatic motility, required for cochlear amplification. With prestin deletion, attenuated DPOAEs were measurable at high sound levels. DPOAE thresholds were shifted by approximately 50 dB, matching the loss of cochlear amplifier gain measured in compound action potentials. In contrast, at high sound levels, distortion products in the cochlear microphonic (CM) of mutants were not decreased re wildtypes (expressed re CM at the primaries). Distortion products in both CM and otoacoustic emissions disappeared rapidly after death. The results show that OHC somatic motility is not necessary for the production of DPOAEs at high SPLs. They also suggest that the small, physiologically vulnerable DPOAE that remains without prestin-based motility is due directly to the mechanical nonlinearity associated with stereociliary transduction, and that this stereocilia mechanical nonlinearity is robustly coupled to the motion of the cochlear partition to the extent that it can drive the middle ear.

The effects of window delay, delinearization, and frequency on tone-burst otoacoustic emission input/output measurements

Tone-burst otoacoustic emissions (TBOAEs) are a potential tool for objectively examining cochlear activity in humans. However, their use requires knowledge of how the TBOAE input/output depends on measurement and analysis paradigms. The present experiment examined the effect of variations in response-window timing, response delinearization, and local changes in stimulus frequency on TBOAE input/output measurement. None of these experimental manipulations had a profound effect on TBOAE measurements as long as reasonable parameter choices were made. Nonetheless, judicial choice of the experimental parameters can optimize the assessment of BM I/O functions. It is concluded that the consistency of TBOAE I/O across the parameters tested makes it a viable tool to consider for examining human cochlear activity.

Mechanisms of Mammalian Otoacoustic Emission and their Implications for the Clinical Utility of Otoacoustic Emissions

We review recent progress in understanding the physical and physiological mechanisms that generate otoacoustic emissions (OAEs). Until recently, the conceptual model underlying the interpretation of OAEs has been an integrated view that regards all OAEs as manifestations of cochlear nonlinearity. However, OAEs appear to arise by at least two fundamentally different mechanisms within the cochlea: nonlinear distortion and linear reflection. These differences in mechanism have be used to construct a new taxonomy for OAEs that identifies OAEs based on their mechanisms of generation rather than the details of their measurement. The mechanism-based taxonomy provides a useful conceptual framework for understanding and interpreting otoacoustic responses. As commonly measured in the clinic, distortion-product and other evoked OAEs comprise a mixtures of emissions produced by both mechanisms. This mixing precludes any fixed correspondence with the conventional, measurement-based nomenclature. We discuss consequences of the taxonomy for the clinical measurement and interpretation of OAEs.

Cochlear delays measured with amplitude-modulated tone-burst-evoked OAEs

Delay times in the mammalian cochlea, whether from measurement of basilar membrane (BM) vibration or otoacoustic emissions (OAEs) have, to date, been largely based on phase-gradient estimates from steady-state responses. Here we report cochlear delays measured directly in the time domain from OAEs evoked by amplitude-modulated tone-burst (AMTB) stimuli. Measurement using OAEs provides a non-invasive estimate of cochlear delay but is confounded by the complexity of generation of such OAEs. At low to moderate stimulus levels, and provided that the stimulus frequency range does not include a region of the cochlea where there is a large change in effective reflectance, AMTB stimuli evoke an OAE with an envelope shape that is similar to the stimulus and allow a direct calculation of cochlear group delay. Such delays are commensurate with BM estimates of delay, estimates of cochlear delay inferred from neural recordings, and previous OAE measures of delay in the guinea pig. However, a nonlinear distortion mechanism, variation in effective reflectance, and intermodulation distortion products generated by the nonlinear interaction in the cochlea of the carrier and sidebands of the AMTB stimulus, may all contribute to OAEs arising with envelope shapes that are not a scaled representation of the stimulus, confounding the estimation of cochlear group delay.

Sources and Mechanisms of DPOAE Generation: Implications for the Prediction of Auditory Sensitivity

Otoacoustic emissions (OAEs) have become a commonly used clinical tool for assessing cochlear health status, in particular, the integrity of the cochlear amplifier or motor component of cochlear function. Predicting hearing thresholds from OAEs, however, remains a research challenge. Models and experimental data suggest that there are two mechanisms involved in the generation of OAEs. For distortion product, transient, and high-level stimulus frequency emissions, the interaction of multiple sources of emissions in the cochlea leads to amplitude variation in the composite ear canal signal. Multiple sources of emissions complicate simple correlations between audiometric test frequencies and otoacoustic emission frequencies. Current research offers new methods for estimating the individual components of OAE generation. Input-output functions and DP-grams of the nonlinear component of the 2f2-f2 DPOAE may ultimately show better correlations with hearing thresholds. This paper reviews models of OAE generation and methods for estimating the contribution of source components to the composite emission that is recorded in the ear canal. The clinical implications of multiple source components are discussed.

Input-output functions for stimulus-frequency otoacoustic emissions in normal-hearing adult ears

Input-output (I/O) functions for stimulus-frequency (SFOAE) and distortion-product (DPOAE) otoacoustic emissions were recorded in 30 normal-hearing adult ears using a nonlinear residual method. SFOAEs were recorded at half octaves from 500-8000 Hz in an L1=L2 paradigm with L2=0 to 85 dB SPL, and in a paradigm with L1 fixed and L2 varied. DPOAEs were elicited with primary levels of Kummer et al. [J. Acoust. Soc. Am. 103, 3431-3444 (1998)] at f2 frequencies of 2000 and 4000 Hz. Interpretable SFOAE responses were obtained from 1000-6000 Hz in the equal-level paradigm. SFOAE levels were larger than DPOAEs levels, signal-to-noise ratios were smaller, and I/O functions were less compressive. A two-slope model of SFOAE I/O functions predicted the low-level round-trip attenuation, the breakpoint between linearity and compression, and compressive slope. In ear but not coupler recordings, the noise at the SFOAE frequency increased with increasing level (above 60 dB SPL), whereas noise at adjacent frequencies did not. This suggests the existence of a source of signal-dependent noise producing cochlear variability, which is predicted to influence basilar-membrane motion and neural responses. A repeatable pattern of notched SFOAE I/O functions was present in some ears, and explained using a two-source mechanism of SFOAE generation.

One source for distortion product otoacoustic emissions generated by low- and high-level primaries

Distortion product otoacoustic emissions (DPOAE) elicited by tones below 60-70 dB sound pressure level (SPL) are significantly more sensitive to cochlear insults. The vulnerable, low-level DPOAE have been associated with the postulated active cochlear process, whereas the relatively robust high-level DPOAE component has been attributed to the passive, nonlinear macromechanical properties of the cochlea. However, it is proposed that the differences in the vulnerability of DPOAEs to high and low SPLs is a natural consequence of the way the cochlea responds to high and low SPLs. An active process boosts the basilar membrane (BM) vibrations, which are attenuated when the active process is impaired. However, at high SPLs the contribution of the active process to BM vibration is small compared with the dominating passive mechanical properties of the BM. Consequently, reduction of active cochlear amplification will have greatest effect on BM vibrations and DPOAEs at low SPLs. To distinguish between the "two sources" and the "single source" hypotheses we analyzed the level dependence of the notch and corresponding phase discontinuity in plots of DPOAE magnitude and phase as functions of the level of the primaries. In experiments where furosemide was used to reduce cochlear amplification, an upward shift of the notch supports the conclusion that both the low- and high-level DPOAEs are generated by a single source, namely a nonlinear amplifier with saturating I/O characteristic.

Spectral shapes of forward and reverse transfer functions between ear canal and cochlea estimated using DPOAE input/output functions

It is widely assumed that the distortion characteristics of the cochlea are uniform across its length, or at least across some portion of its length. For each distortion product otoacoustic emission (DPOAE) input/output (I/O) function across frequency, there is a corresponding cochlear I/O function defined over the cochlear source region. An assumption of distortion invariance is adopted such that these cochlear I/O functions are identical across tonotopic place, which is testable in the sense that a single nonlinear function should adequately describe the set of DPOAE I/O functions across frequency. If so, the differences in measured DPOAE I/O functions across frequency are produced by differences in the forward stimulus transmission to the generation site, and reverse DP transmission back to the ear canal. The absolute transfer-function magnitude is not determined by this technique, but the spectral shapes across frequency and between ears are determined. The role of middle-ear functioning is implicit in the I/O functions because of its controlling influence on these transfer functions. Results have been obtained using the average DPOAE I/O functions measured in a population of healthy ears [Gorga et al., J. Acoust. Soc. Am. 107, 2128-2135 (2000)], and support the hypothesis of cochlear-distortion invariance. The measured forward and reverse transfer functions have a general bandpass characteristic, and a more narrow-band structure with similarities to the behavioral threshold curve.

Origin of cubic difference tones generated by high-intensity stimuli: effect of ischemia and auditory fatigue on the gerbil cochlea

Cubic difference tone (CDT) otoacoustic emissions are thought to arise from the feedback loop allowing outer hair cells to enhance the sensitivity and tuning of the organ of Corti. The existence of residual CDTs during complete cochlear ischemia is therefore disturbing. That stimulus intensities must exceed 50-60 dB SPL for residual CDTs to be recorded and for level notches to be present in CDT growth functions is often cited as evidence for a two-component, "active/passive" model: one component, the residual one, would originate from a passive, hardly vulnerable mechanism and thus be unsuitable for hearing screening purposes. This model was probed in gerbil ears after complete interruption of the cochlear blood flow. Cochlear potentials and CDTs were controlled simultaneously through continuous monitoring of CDT level and phase for 50 and 60 dB SPL stimuli and group-delay measurements. After a clear initial decay, CDT levels elicited at 60 dB SPL plateaued for several minutes at about 20 dB below initial level, and when early level notches were observed, CDT phase changes remained minor. The CDT group delays decreased by less than 30%. Later CDT level notches were associated with sharp phase reversals but the similarity between CDT characteristics before and after a notch was hardly consistent with a two-component interpretation. When mild sound overexposure (pure tone, 90-95 dB SPL, 15-30 min) had been performed prior to ischemia, little or no ischemic CDT came from the frequency bands where auditory fatigue had been detected (within 1 kHz), irrespective of the stimulus intensity. It suggests that instead of being passive, residual ischemic CDTs were vulnerable and produced according to a near-normal tonotopy by the same mechanisms that were sensitive to auditory fatigue. All the results lined up with a simple feedback model of cochlear function assuming a single CDT source related to mechano-electrical transduction in outer hair cells. More parsimonious than a two-component model, it posits that although early stages of ischemia dramatically impair the overall performance of the cochlea, the nonlinear mechanical stages responsible for the existence of CDTs keep working albeit at higher intensities.

Distortion product otoacoustic emissions in human hypercholesterolemia

Epidemiological and experimental studies suggest that hypercholesterolemia promotes the development of sensorineural hearing loss; however, the underlying cellular pathomechanism remains obscure. In the present study, 20 healthy subjects and 20 patients with familial hypercholesterolemia were compared with respect to their hearing function. None of the 40 persons reported any history of hearing disorder. In accordance with this subjective impression, mean hearing thresholds were within the normal, age-dependent ranges in both groups. In contrast, the single-generator distortion product otoacoustic emissions (sgDPOAE) were reduced at and above 4 kHz. Input-output functions of DPOAE could be subdivided into three groups: (i) normal, with unity slope at low intensities and slope less than unity (0.24+/-0.07 dB/dB at higher intensities; (ii) pathologic, described by a single straight line; (iii) ill-defined, with data usually indistinguishable from the background noise level. The ill-defined DPOAE behavior was only found in patients with hypercholesterolemia; namely, for 25% of patients at f(2)=1.5 kHz and for 50% at f(2)=4 kHz. Patients belonging to the pathologic and ill-defined DPOAE groups had significantly (P<0.05) higher total serum cholesterol and LDL-cholesterol levels compared with subjects from the normal DPOAE group. While hearing thresholds of patients with ill-defined growth functions were not statistically different from those of normal subjects, speech scores were significantly reduced in these cases. The data imply that nonlinear mechanical processes in the cochlea are compromised in hypercholesterolemic patients.

Nonlinear interactions that could explain distortion product interference response areas

Suppression and/or enhancement of third- and fifth-order distortion products by a third tone that can have a frequency more than an octave above and a level more than 40 dB below the primary tones have recently been measured by Martin et al. [Hear. Res. 136, 105-123 (1999)]. Contours of iso-suppression and iso-enhancement that are plotted as a function of third-tone frequency and level are called interference response areas. After ruling out order aliasing, two possible mechanisms for this effect have been developed, a harmonic mechanism and a catalyst mechanism. The harmonic mechanism produces distortion products by mixing a harmonic of one of the primary tones with the other primary tone. The catalyst mechanism produces distortion products by mixing one or more intermediate distortion products that are produced by the third tone with one or more of the input tones. The harmonic mechanism does not need a third tone and the catalyst mechanism does. Because the basilar membrane frequency response is predicted to affect each of these mechanisms differently, it is concluded that the catalyst mechanism will be dominant in the high-frequency regions of the cochlea and the harmonic mechanism will have significant strength in the low-frequency regions of the cochlea. The mechanisms are dependent on the existence of both even- and odd-order distortion, and significant even- and odd-order distortion have been measured in the experimental animals. Furthermore, the nonlinear part of the cochlear mechanical response must be well into saturation when input tones are 50 or more dB SPL.