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Andéol G, Paraouty N, Giraudet F, Wallaert N, Isnard V, Moulin A, Suied C. Predictors of Speech-in-Noise Understanding in a Population of Occupationally Noise-Exposed Individuals. BIOLOGY 2024; 13:416. [PMID: 38927296 PMCID: PMC11200776 DOI: 10.3390/biology13060416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2024] [Revised: 05/20/2024] [Accepted: 05/21/2024] [Indexed: 06/28/2024]
Abstract
Understanding speech in noise is particularly difficult for individuals occupationally exposed to noise due to a mix of noise-induced auditory lesions and the energetic masking of speech signals. For years, the monitoring of conventional audiometric thresholds has been the usual method to check and preserve auditory function. Recently, suprathreshold deficits, notably, difficulties in understanding speech in noise, has pointed out the need for new monitoring tools. The present study aims to identify the most important variables that predict speech in noise understanding in order to suggest a new method of hearing status monitoring. Physiological (distortion products of otoacoustic emissions, electrocochleography) and behavioral (amplitude and frequency modulation detection thresholds, conventional and extended high-frequency audiometric thresholds) variables were collected in a population of individuals presenting a relatively homogeneous occupational noise exposure. Those variables were used as predictors in a statistical model (random forest) to predict the scores of three different speech-in-noise tests and a self-report of speech-in-noise ability. The extended high-frequency threshold appears to be the best predictor and therefore an interesting candidate for a new way of monitoring noise-exposed professionals.
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Affiliation(s)
- Guillaume Andéol
- Institut de Recherche Biomédicale des Armées, 1 Place Valérie André, 91220 Brétigny sur Orge, France; (V.I.); (C.S.)
| | - Nihaad Paraouty
- iAudiogram—My Medical Assistant SAS, 51100 Reims, France; (N.P.); (N.W.)
| | - Fabrice Giraudet
- Department of Neurosensory Biophysics, INSERM U1107 NEURO-DOL, School of Medecine, Université Clermont Auvergne, 63000 Clermont-Ferrand, France;
| | - Nicolas Wallaert
- iAudiogram—My Medical Assistant SAS, 51100 Reims, France; (N.P.); (N.W.)
- Laboratoire des Systèmes Perceptifs, UMR CNRS 8248, Département d’Etudes Cognitives, Ecole Normale Supérieure, Université Paris Sciences et Lettres (PSL), 75005 Paris, France
- Department of Otorhinolaryngology-Head and Neck Surgery, Rennes University Hospital, 35000 Rennes, France
| | - Vincent Isnard
- Institut de Recherche Biomédicale des Armées, 1 Place Valérie André, 91220 Brétigny sur Orge, France; (V.I.); (C.S.)
| | - Annie Moulin
- Centre de Recherche en Neurosciences de Lyon, CRNL Inserm U1028—CNRS UMR5292—UCBLyon1, Perception Attention Memory Team, Bâtiment 452 B, 95 Bd Pinel, 69675 Bron Cedex, France;
| | - Clara Suied
- Institut de Recherche Biomédicale des Armées, 1 Place Valérie André, 91220 Brétigny sur Orge, France; (V.I.); (C.S.)
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Gauvin DV, McComb M, Tapp R, Yoder J, Zimmermann ZJ. Distortion Product Otoacoustic Emission Test is Not the Test to Use in Nonclinical Safety Assessment. Int J Toxicol 2022; 41:243-252. [PMID: 35443823 DOI: 10.1177/10915818221081841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Ototoxicity and ocular toxicity screening are but two examples of specialty product lines that are often employed as Tier II or III nonclinical safety/hazard screening assessments. Compared to the regulatory guidelines that govern over standard toxicology or neurotoxicology programs, there is a paucity of regulatory strategies to address these specialized product lines. With respect to ototoxicity testing, we argue for the inclusion of the "least burdensome principles" adopted by the US FDA in providing the most pragmatic, efficient, and directed identification of potential harm to auditory function in the nonclinical safety arena. We argue for the exclusive use of the auditory brainstem response and the exclusion of the distortion product otoacoustic emissions (DPOAEs) in these Tiered II safety assessment programs. The inclusion of both are a burden on operational staff and, due to the extended episodes of anesthesia required to conduct both assays, this strategy poses a health and welfare concern for the selected animal species to be used. The DPOAE does not provide any sufficiently valid or reliable data above and beyond the gold standard ABR data, followed by complete oto-histopathology and cytocochleogram combination designs.
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Affiliation(s)
| | - Margaret McComb
- Neurobehavioral Studies, 537465Charles River Laboratories, Inc., Mattawan, Mattawan, MI, USA
| | - Rachel Tapp
- Neurobehavioral Studies, 537465Charles River Laboratories, Inc., Mattawan, Mattawan, MI, USA
| | - Joshua Yoder
- Neurobehavioral Studies, 537465Charles River Laboratories, Inc., Mattawan, Mattawan, MI, USA
| | - Zachary J Zimmermann
- Neurobehavioral Studies, 537465Charles River Laboratories, Inc., Mattawan, Mattawan, MI, USA
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3
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Tai Y, Mertes IB, Chappell J, Jeon CB, Husain FT. Comparison of otoacoustic emissions in tinnitus and hyperacusis in adults with normal hearing sensitivity. Int J Audiol 2022; 62:442-452. [PMID: 35439083 DOI: 10.1080/14992027.2022.2052980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To investigate the effect of tinnitus and/or hyperacusis on distortion product otoacoustic emission (DPOAE) measures in adults with normal hearing thresholds from 0.25 to 8 kHz, while accounting for extended high-frequency (EHF) thresholds.Design: A behavioural study consisted of comprehensive audiological assessment, validated tinnitus and hyperacusis questionnaires, DPOAE amplitudes and input/output (I/O) functions.Study sample: Data of 56 participants with normal hearing were included for the analysis. Participants were categorised into four groups: (1) without tinnitus or hyperacusis, (2) with tinnitus only, (3) with hyperacusis only, and (4) with both tinnitus and hyperacusis.Results: The groups with tinnitus showed elevated EHF thresholds compared with those without tinnitus. DPOAE amplitudes were not significantly affected by tinnitus and/or hyperacusis status; however, they were significantly affected by EHF thresholds. Further, no appreciable differences in DPOAE I/O functions were found across groups.Conclusions: The reported non-significant differences in DPOAEs in individuals with tinnitus and/or hyperacusis do not support a peripheral mechanism or an interaction between peripheral and central mechanisms underlying tinnitus or hyperacusis. Our findings, however, suggest the need to assess basal cochlear function (e.g. EHF thresholds) for a better understanding of differences in DPOAE measures in tinnitus and/or hyperacusis.
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Affiliation(s)
- Yihsin Tai
- Department of Speech and Hearing Science, University of Illinois at Urbana-Champaign, Champaign, IL, USA.,Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Champaign, IL, USA.,Department of Speech Pathology and Audiology, Ball State University, Muncie, IN, USA
| | - Ian B Mertes
- Department of Speech and Hearing Science, University of Illinois at Urbana-Champaign, Champaign, IL, USA
| | - Jenise Chappell
- Department of Speech and Hearing Science, University of Illinois at Urbana-Champaign, Champaign, IL, USA
| | - Carolyn B Jeon
- Department of Speech and Hearing Science, University of Illinois at Urbana-Champaign, Champaign, IL, USA
| | - Fatima T Husain
- Department of Speech and Hearing Science, University of Illinois at Urbana-Champaign, Champaign, IL, USA.,Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Champaign, IL, USA.,Neuroscience Program, University of Illinois at Urbana-Champaign, Champaign, IL, USA
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Bramhall NF, Reavis KM, Feeney MP, Kampel SD. The Impacts of Noise Exposure on the Middle Ear Muscle Reflex in a Veteran Population. Am J Audiol 2022; 31:126-142. [PMID: 35050699 PMCID: PMC10831927 DOI: 10.1044/2021_aja-21-00133] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
PURPOSE Human studies of noise-induced cochlear synaptopathy using physiological indicators identified in animal models (auditory brainstem response [ABR] Wave I amplitude, envelope following response [EFR], and middle ear muscle reflex [MEMR]) have yielded mixed findings. Differences in the population studied may have contributed to the differing results. For example, due to differences in the intensity level of the noise exposure, noise-induced synaptopathy may be easier to detect in a military Veteran population than in populations with recreational noise exposure. We previously demonstrated a reduction in ABR Wave I amplitude and EFR magnitude for young Veterans with normal audiograms reporting high levels of noise exposure compared to non-Veteran controls. In this article, we expand on the previous analysis in the same population to determine if MEMR magnitude is similarly reduced. METHOD Contralateral MEMR growth functions were obtained in 92 young Veterans and non-Veterans with normal audiograms, and the relationship between noise exposure history and MEMR magnitude was assessed. Associations between MEMR magnitude and distortion product otoacoustic emission, EFR, and ABR measurements collected in the same sample were also evaluated. RESULTS The results of the statistical analysis, although not conventionally statistically significant, suggest a reduction in mean MEMR magnitude for Veterans reporting high noise exposure compared with non-Veteran controls. In addition, the MEMR appears relatively insensitive to subclinical outer hair cell dysfunction, as measured by distortion product otoacoustic emissions, and is not well correlated with ABR and EFR measurements. CONCLUSIONS When combined with our previous ABR and EFR findings in the same population, these results suggest that noise-induced synaptopathy occurs in humans. In addition, the findings indicate that the MEMR may be a good candidate for noninvasive diagnosis of cochlear synaptopathy/deafferentation and that the MEMR may reflect the integrity of different neural populations than the ABR and EFR. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.18665645.
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Affiliation(s)
- Naomi F Bramhall
- VA RR&D National Center for Rehabilitative Auditory Research, VA Portland Health Care System, OR
- Department of Otolaryngology - Head & Neck Surgery, Oregon Health & Science University, Portland
| | - Kelly M Reavis
- VA RR&D National Center for Rehabilitative Auditory Research, VA Portland Health Care System, OR
| | - M Patrick Feeney
- VA RR&D National Center for Rehabilitative Auditory Research, VA Portland Health Care System, OR
- Department of Otolaryngology - Head & Neck Surgery, Oregon Health & Science University, Portland
| | - Sean D Kampel
- VA RR&D National Center for Rehabilitative Auditory Research, VA Portland Health Care System, OR
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Noise exposure levels predict blood levels of the inner ear protein prestin. Sci Rep 2022; 12:1154. [PMID: 35064195 PMCID: PMC8783004 DOI: 10.1038/s41598-022-05131-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 12/30/2021] [Indexed: 12/20/2022] Open
Abstract
Serological biomarkers of inner ear proteins are a promising new approach for studying human hearing. Here, we focus on the serological measurement of prestin, a protein integral to a human’s highly sensitive hearing, expressed in cochlear outer hair cells (OHCs). Building from recent nonhuman studies that associated noise-induced OHC trauma with reduced serum prestin levels, and studies suggesting subclinical hearing damage in humans regularly engaging in noisy activities, we investigated the relation between serum prestin levels and environmental noise levels in young adults with normal clinical audiograms. We measured prestin protein levels from circulating blood and collected noise level data multiple times over the course of the experiment using body-worn sound recorders. Results indicate that serum prestin levels have a negative relation with noise exposure: individuals with higher routine noise exposure levels tended to have lower prestin levels. Moreover, when grouping participants based on their risk for a clinically-significant noise-induced hearing loss, we found that prestin levels differed significantly between groups, even though behavioral hearing thresholds were similar. We discuss possible interpretations for our findings including whether lower serum levels may reflect subclinical levels of OHC damage, or possibly an adaptive, protective mechanism in which prestin expression is downregulated in response to loud environments.
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Bramhall NF. Use of the auditory brainstem response for assessment of cochlear synaptopathy in humans. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2021; 150:4440. [PMID: 34972291 PMCID: PMC10880747 DOI: 10.1121/10.0007484] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 11/07/2021] [Indexed: 06/14/2023]
Abstract
Although clinical use of the auditory brainstem response (ABR) to detect retrocochlear disorders has been largely replaced by imaging in recent years, the discovery of cochlear synaptopathy has thrown this foundational measure of auditory function back into the spotlight. Whereas modern imaging now allows for the noninvasive detection of vestibular schwannomas, imaging technology is not currently capable of detecting cochlear synaptopathy, the loss of the synaptic connections between the inner hair cells and afferent auditory nerve fibers. However, animal models indicate that the amplitude of the first wave of the ABR, a far-field evoked potential generated by the synchronous firing of auditory nerve fibers, is highly correlated with synaptic integrity. This has led to many studies investigating the use of the ABR as a metric of synaptopathy in humans. However, these studies have yielded mixed results, leading to a lack of consensus about the utility of the ABR as an indicator of synaptopathy. This review summarizes the animal and human studies that have investigated the ABR as a measure of cochlear synaptic function, discusses factors that may have contributed to the mixed findings and the lessons learned, and provides recommendations for future use of this metric in the research and clinical settings.
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Affiliation(s)
- Naomi F Bramhall
- Veterans Affairs (VA) Rehabilitation Research & Development Service (RR&D) National Center for Rehabilitative Auditory Research (NCRAR), VA Portland Health Care System Portland, Oregon 97239, USA
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Garinis A, Konrad-Martin D, Bramhall N. Ototoxicity and Noise Damage: From Preclinical Findings to Audiological Management. Am J Audiol 2021; 30:797-799. [PMID: 34606329 DOI: 10.1044/2021_aja-21-00153] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
[Figure: see text].
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Affiliation(s)
- Angela Garinis
- Oregon Health & Science University, West Campus, Beaverton
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Mepani AM, Verhulst S, Hancock KE, Garrett M, Vasilkov V, Bennett K, de Gruttola V, Liberman MC, Maison SF. Envelope following responses predict speech-in-noise performance in normal-hearing listeners. J Neurophysiol 2021; 125:1213-1222. [PMID: 33656936 DOI: 10.1152/jn.00620.2020] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Permanent threshold elevation after noise exposure or aging is caused by loss of sensory cells; however, animal studies show that hair cell loss is often preceded by degeneration of the synapses between sensory cells and auditory nerve fibers. Silencing these neurons is likely to degrade auditory processing and may contribute to difficulties understanding speech in noisy backgrounds. Reduction of suprathreshold ABR amplitudes can be used to quantify synaptopathy in inbred mice. However, ABR amplitudes are highly variable in humans, and thus more challenging to use. Since noise-induced neuropathy preferentially targets fibers with high thresholds and low spontaneous rate and because phase locking to temporal envelopes is particularly strong in these fibers, measuring envelope following responses (EFRs) might be a more robust measure of cochlear synaptopathy. A recent auditory model further suggests that modulation of carrier tones with rectangular envelopes should be less sensitive to cochlear amplifier dysfunction and, therefore, a better metric of cochlear neural damage than sinusoidal amplitude modulation. In this study, we measure performance scores on a variety of difficult word-recognition tasks among listeners with normal audiograms and assess correlations with EFR magnitudes to rectangular versus sinusoidal modulation. Higher harmonics of EFR magnitudes evoked by a rectangular-envelope stimulus were significantly correlated with word scores, whereas those evoked by sinusoidally modulated tones did not. These results support previous reports that individual differences in synaptopathy may be a source of speech recognition variability despite the presence of normal thresholds at standard audiometric frequencies.NEW & NOTEWORTHY Recent studies suggest that millions of people may be at risk of permanent impairment from cochlear synaptopathy, the age-related and noise-induced degeneration of neural connections in the inner ear. This study examines electrophysiological responses to stimuli designed to improve detection of neural damage in subjects with normal hearing sensitivity. The resultant correlations with word recognition performance are consistent with a contribution of cochlear neural damage to deficits in hearing in noise abilities.
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Affiliation(s)
- Anita M Mepani
- Eaton-Peabody Laboratories, Massachusetts Eye and Ear, Boston, Massachusetts
| | - Sarah Verhulst
- Department of Information Technology, Ghent University, Ghent, Belgium
| | - Kenneth E Hancock
- Eaton-Peabody Laboratories, Massachusetts Eye and Ear, Boston, Massachusetts.,Department of Otolaryngology-Head & Neck Surgery, Harvard Medical School, Boston, Massachusetts
| | - Markus Garrett
- Department of Information Technology, Ghent University, Ghent, Belgium.,Department of Medical Physics and Acoustics, University of Oldenburg, Oldenburg, Germany
| | | | - Kara Bennett
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Victor de Gruttola
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - M Charles Liberman
- Eaton-Peabody Laboratories, Massachusetts Eye and Ear, Boston, Massachusetts.,Department of Otolaryngology-Head & Neck Surgery, Harvard Medical School, Boston, Massachusetts.,Harvard Program in Speech and Hearing Bioscience and Technology, Harvard University, Boston, Massachusetts
| | - Stéphane F Maison
- Eaton-Peabody Laboratories, Massachusetts Eye and Ear, Boston, Massachusetts.,Department of Otolaryngology-Head & Neck Surgery, Harvard Medical School, Boston, Massachusetts.,Harvard Program in Speech and Hearing Bioscience and Technology, Harvard University, Boston, Massachusetts
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