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Leibold LJ, Buss E, Miller MK, Cowan T, McCreery RW, Oleson J, Rodriguez B, Calandruccio L. Development of the Children's English and Spanish Speech Recognition Test: Psychometric Properties, Feasibility, Reliability, and Normative Data. Ear Hear 2024; 45:860-877. [PMID: 38334698 PMCID: PMC11178473 DOI: 10.1097/aud.0000000000001480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2024]
Abstract
OBJECTIVES The Children's English and Spanish Speech Recognition (ChEgSS) test is a computer-based tool for assessing closed-set word recognition in English and in Spanish, with a masker that is either speech-shaped noise or competing speech. The present study was conducted to (1) characterize the psychometric properties of the ChEgSS test, (2) evaluate feasibility and reliability for a large cohort of Spanish/English bilingual children with normal hearing, and (3) establish normative data. DESIGN Three experiments were conducted to evaluate speech perception in children (4-17 years) and adults (19-40 years) with normal hearing using the ChEgSS test. In Experiment 1, data were collected from Spanish/English bilingual and English monolingual adults at multiple, fixed signal-to-noise ratios. Psychometric functions were fitted to the word-level data to characterize variability across target words in each language and in each masker condition. In Experiment 2, Spanish/English bilingual adults were tested using an adaptive tracking procedure to evaluate the influence of different target-word normalization approaches on the reliability of estimates of masked-speech recognition thresholds corresponding to 70.7% correct word recognition and to determine the optimal number of reversals needed to obtain reliable estimates. In Experiment 3, Spanish/English bilingual and English monolingual children completed speech perception testing using the ChEgSS test to (1) characterize feasibility across age and language group, (2) evaluate test-retest reliability, and (3) establish normative data. RESULTS Experiments 1 and 2 yielded data that are essential for stimulus normalization, optimizing threshold estimation procedures, and interpreting threshold data across test language and masker type. Findings obtained from Spanish/English bilingual and English monolingual children with normal hearing in Experiment 3 support feasibility and demonstrate reliability for use with children as young as 4 years of age. Equivalent results for testing in English and Spanish were observed for Spanish/English bilingual children, contingent on adequate proficiency in the target language. Regression-based threshold norms were established for Spanish/English bilingual and English monolingual children between 4 and 17 years of age. CONCLUSIONS The present findings indicate the ChEgSS test is appropriate for testing a wide age range of children with normal hearing in either Spanish, English, or both languages. The ChEgSS test is currently being evaluated in a large cohort of patients with hearing loss at pediatric audiology clinics across the United States. Results will be compared with normative data established in the present study and with established clinical measures used to evaluate English- and Spanish-speaking children. Questionnaire data from parents and clinician feedback will be used to further improve test procedures.
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Affiliation(s)
- Lori J Leibold
- Boys Town National Research Hospital, Center for Hearing Research, Omaha, Nebraska, USA
| | - Emily Buss
- Department of Otolaryngology/HNS, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Margaret K Miller
- Boys Town National Research Hospital, Center for Hearing Research, Omaha, Nebraska, USA
| | - Tiana Cowan
- Boys Town National Research Hospital, Center for Hearing Research, Omaha, Nebraska, USA
| | - Ryan W McCreery
- Boys Town National Research Hospital, Center for Hearing Research, Omaha, Nebraska, USA
| | - Jacob Oleson
- Department of Biostatistics, University of Iowa, Iowa City, Iowa, USA
| | - Barbara Rodriguez
- Department of Speech and Hearing Sciences, University of New Mexico, Albuquerque, New Mexico, USA
| | - Lauren Calandruccio
- Department of Psychological Sciences, Case Western Reserve University, Cleveland, Ohio, USA
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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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Qiu X, Yang J, Hu X, Li J, Zhao M, Ren F, Weng X, Edden RAE, Gao F, Wang J. Association between hearing ability and cortical morphology in the elderly: multiparametric mapping, cognitive relevance, and neurobiological underpinnings. EBioMedicine 2024; 104:105160. [PMID: 38788630 PMCID: PMC11140565 DOI: 10.1016/j.ebiom.2024.105160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 04/30/2024] [Accepted: 05/06/2024] [Indexed: 05/26/2024] Open
Abstract
BACKGROUND Hearing impairment is a common condition in the elderly. However, a comprehensive understanding of its neural correlates is still lacking. METHODS We recruited 284 elderly adults who underwent structural MRI, magnetic resonance spectroscopy, audiometry, and cognitive assessments. Individual hearing abilities indexed by pure tone average (PTA) were correlated with multiple structural MRI-derived cortical morphological indices. For regions showing significant correlations, mediation analyses were performed to examine their role in the relationship between hearing ability and cognitive function. Finally, the correlation maps between hearing ability and cortical morphology were linked with publicly available connectomic gradient, transcriptomic, and neurotransmitter maps. FINDINGS Poorer hearing was related to cortical thickness (CT) reductions in widespread regions and gyrification index (GI) reductions in the right Area 52 and Insular Granular Complex. The GI in the right Area 52 mediated the relationship between hearing ability and executive function. This mediating effect was further modulated by glutamate and N-acetylaspartate levels in the right auditory region. The PTA-CT correlation map followed microstructural connectomic hierarchy, were related to genes involved in certain biological processes (e.g., glutamate metabolic process), cell types (e.g., excitatory neurons and astrocytes), and developmental stages (i.e., childhood to young adulthood), and covaried with dopamine receptor 1, dopamine transporter, and fluorodopa. The PTA-GI correlation map was related to 5-hydroxytryptamine receptor 2a. INTERPRETATION Poorer hearing is associated with cortical thinning and folding reductions, which may be engaged in the relationship between hearing impairment and cognitive decline in the elderly and have different neurobiological substrates. FUNDING See the Acknowledgements section.
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Affiliation(s)
- Xiaofan Qiu
- Institute for Brain Research and Rehabilitation, South China Normal University, Guangzhou, China
| | - Jing Yang
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Xin Hu
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Junle Li
- Institute for Brain Research and Rehabilitation, South China Normal University, Guangzhou, China
| | - Min Zhao
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Fuxin Ren
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China; Department of Radiology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Xuchu Weng
- Institute for Brain Research and Rehabilitation, South China Normal University, Guangzhou, China; Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, Guangzhou, China; Center for Studies of Psychological Application, South China Normal University, Guangzhou, China; Guangdong Key Laboratory of Mental Health and Cognitive Science, Guangzhou, China
| | - Richard A E Edden
- Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, MD, USA; F. M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, MD, USA
| | - Fei Gao
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China.
| | - Jinhui Wang
- Institute for Brain Research and Rehabilitation, South China Normal University, Guangzhou, China; Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, Guangzhou, China; Center for Studies of Psychological Application, South China Normal University, Guangzhou, China; Guangdong Key Laboratory of Mental Health and Cognitive Science, Guangzhou, China.
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Tomaz A, Peron KA, Suzuki FADB, Monteiro SRG, Chandrasekhar SS, Penido NO. Standard and Extend High-Frequency Audiometry in Sudden Sensorineural Hearing Loss: Impacts on Tinnitus and Mental Health. Otol Neurotol 2024; 45:e366-e375. [PMID: 38511269 DOI: 10.1097/mao.0000000000004168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/22/2024]
Abstract
OBJECTIVE To analyze the results of auditory assessment in standard (SA) and extended high-frequency (EHF) audiometry, associating the findings with sudden tinnitus and mental health of patients with unilateral sudden sensorineural hearing loss (SSNHL). STUDY DESIGN Prospective, cohort study. SETTING Outpatient otology clinic in a tertiary care hospital. SUBJECTS AND METHODS Patients experiencing unilateral SSNHL were evaluated with pure-tone audiometry performed at frequencies of 250 to16,000 Hz, tinnitus pitch and loudness matching tests, Tinnitus Handicap Inventory (THI), Analog and Visual Scale (AVS) for bothersome tinnitus, and the Hospital Anxiety and Depression Scale (HADS). RESULTS Eighteen patients with unilateral SSNHL were assessed. After starting treatment, there was a significant improvement in the SA (71.1 dB to 50 dB; p < 0.001*) and EHF audiometry (64.5 dB to 54.4 dB; p < 0.001*) thresholds at 15 days, and this persisted at 30 days of follow-up. Significant improvements were seen for tinnitus in loudness, VAS, and THI and for mental health in the realms of anxiety and depression by HADS. Despite improvements in SA, persistent EHF hearing loss was accompanied by persistent tinnitus, but it was of diminished loudness. CONCLUSION Despite improvement in pure-tone thresholds by SA, a subset of unilateral SSNHL patients did not experience hearing recovery in EHF thresholds and reported persistent tinnitus. We postulate that their diminished anxiety and better mental health may be related to both hearing improvement in standard audiometry and reduction in tinnitus loudness. This pilot prospective study investigates the utility of performing EHF audiometry to better understand outcomes in patients with SSNHL.
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Affiliation(s)
- Andreza Tomaz
- Department of Otolaryngology Head and Neck Surgery, Universidade Federal de São Paulo/Escola Paulista de Medicina (UNIFESP/EPM), São Paulo, Brazil
| | - Kelly Abdo Peron
- Department of Otolaryngology Head and Neck Surgery, Universidade Federal de São Paulo/Escola Paulista de Medicina (UNIFESP/EPM), São Paulo, Brazil
| | - Flavia Alencar de Barros Suzuki
- Department of Otolaryngology Head and Neck Surgery, Universidade Federal de São Paulo/Escola Paulista de Medicina (UNIFESP/EPM), São Paulo, Brazil
| | - Silvia Roberta Gesteira Monteiro
- Department of Otolaryngology Head and Neck Surgery, Universidade Federal de São Paulo/Escola Paulista de Medicina (UNIFESP/EPM), São Paulo, Brazil
| | | | - Norma Oliveira Penido
- Department of Otolaryngology Head and Neck Surgery, Universidade Federal de São Paulo/Escola Paulista de Medicina (UNIFESP/EPM), São Paulo, Brazil
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Sendesen E, Turkyilmaz D. Investigation of the behavior of tinnitus patients under varying listening conditions with simultaneous electroencephalography and pupillometry. Brain Behav 2024; 14:e3571. [PMID: 38841736 PMCID: PMC11154813 DOI: 10.1002/brb3.3571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 02/05/2024] [Accepted: 05/08/2024] [Indexed: 06/07/2024] Open
Abstract
OBJECTIVE This study aims to control all hearing thresholds, including extended high frequencies (EHFs), presents stimuli of varying difficulty levels, and measures electroencephalography (EEG) and pupillometry responses to determine whether listening difficulty in tinnitus patients is effort or fatigue-related. METHODS Twenty-one chronic tinnitus patients and 26 matched healthy controls having normal pure-tone averages with symmetrical hearing thresholds were included. Subjects were evaluated with 0.125-20 kHz pure-tone audiometry, Montreal Cognitive Assessment Test (MoCA), Tinnitus Handicap Inventory (THI), EEG, and pupillometry. RESULTS Pupil dilatation and EEG alpha power during the "encoding" phase of the presented sentence in tinnitus patients were less in all listening conditions (p < .05). Also, there was no statistically significant relationship between EEG and pupillometry components for all listening conditions and THI or MoCA (p > .05). CONCLUSION EEG and pupillometry results under various listening conditions indicate potential listening effort in tinnitus patients even if all frequencies, including EHFs, are controlled. Also, we suggest that pupillometry should be interpreted with caution in autonomic nervous system-related conditions such as tinnitus.
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Affiliation(s)
- Eser Sendesen
- Department of AudiologyHacettepe UniversityAnkaraTurkey
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Mishra SK, Rodrigo H, Balan JR. Exploring the Influence of Extended High-Frequency Hearing on Cochlear Functioning at Lower Frequencies. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2024:1-10. [PMID: 38820241 DOI: 10.1044/2024_jslhr-23-00652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2024]
Abstract
PURPOSE Diminished basal cochlear function, as indicated by elevated hearing thresholds in the extended high frequencies (EHFs), has been associated with lower levels of click-evoked and distortion-product otoacoustic emissions measured at lower frequencies. However, stimulus-frequency otoacoustic emissions (SFOAEs) at low-probe levels are reflection-source emissions that do not share the same generation mechanism as distortion-source emissions. The primary objective of the present study was to examine the influence of hearing thresholds in the EHFs on SFOAEs measured at lower frequencies. METHOD SFOAEs were recorded from both ears in 45 individuals with normal hearing thresholds in the conventional audiometric frequencies (0.25-8 kHz). Hearing thresholds were also measured at EHFs (10, 12.5, and 16 kHz). SFOAE magnitudes and signal-to-noise ratios (SNRs) were averaged across 1, 2, and 4 kHz probe frequencies and also averaged for high-probe frequencies (2 and 4 kHz). RESULTS SFOAE magnitudes and SNRs were significantly higher for ears with better EHF hearing relative to poorer EHF hearing, categorized based on the median split. In addition, hearing in the EHFs significantly contributed to the variance in all SFOAE measures, except for the high-frequency SFOAE magnitudes model. However, hearing thresholds at the probe frequencies did not significantly contribute to the variance in SFOAEs. CONCLUSIONS The study findings suggest that alterations in the basal cochlea, as revealed by EHF hearing thresholds, could be associated with diminished cochlear functioning in relatively apical regions, shown by SFOAEs at lower frequencies, in individuals with normal audiograms. These findings underscore the significance of considering EHF thresholds in audiological evaluations, as alterations in these frequencies may reflect broader cochlear health status.
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Affiliation(s)
- Srikanta K Mishra
- Department of Speech, Language, and Hearing Sciences, The University of Texas at Austin
| | - Hansapani Rodrigo
- School of Mathematical and Statistical Sciences, The University of Texas Rio Grande Valley, Edinburg
| | - Jithin R Balan
- Department of Speech, Language, and Hearing Sciences, The University of Texas at Austin
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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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Sendesen E, Türkyılmaz MD. Listening handicap in tinnitus patients with normal extended high frequencies from the perspective of the autonomic nervous system-Effort or fatigue? Auris Nasus Larynx 2024; 51:659-665. [PMID: 38704893 DOI: 10.1016/j.anl.2024.04.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Revised: 03/29/2024] [Accepted: 04/25/2024] [Indexed: 05/07/2024]
Abstract
OBJECTIVE In previous studies, the results regarding the presence of listening effort or fatigue in tinnitus patients were inconsistent. The reason for this inconsistency could be that extended high frequencies, which can cause listening handicap, were not within normal limits. Therefore, this study aimed to evaluate the listening skills in tinnitus patients by matching the normal hearing thresholds at all frequencies, including the extended high frequency. METHODS Eighteen chronic tinnitus patients and thirty matched healthy controls having normal pure-tone average with symmetrical hearing thresholds was included. Subjects were evaluated with 0.125-20 kHz pure-tone audiometry, Montreal cognitive assessment test (MoCA), Tinnitus Handicap Inventory (THI), Matrix Test, Pupillometry. RESULTS Pupil dilatation in the 'coding' phase of the sentence presented in tinnitus patients was less than in the control group (p < 0.05). There was no difference between the groups for Matrix test scores (p > 0.05) Also, there was no statistically significant correlation between THI and Pupillometry components nor between MoCA (p > 0.05). CONCLUSION Even though tinnitus patients had normal hearing in the range of 0.125-20 kHz, their autonomic nervous system responses during listening differed from healthy subjects. This difference was interpreted for potential listening fatigue in tinnitus patients.
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Affiliation(s)
- Eser Sendesen
- Department of Audiology, Hacettepe University, Sıhhiye, Ankara 06100, Turkey.
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Schimmel C, Cormier K, Manchaiah V, Swanepoel DW, Sharma A. Digits-in-Noise Test as an Assessment Tool for Hearing Loss and Hearing Aids. Audiol Res 2024; 14:342-358. [PMID: 38666901 PMCID: PMC11047740 DOI: 10.3390/audiolres14020030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Revised: 03/28/2024] [Accepted: 04/04/2024] [Indexed: 04/29/2024] Open
Abstract
The aim of this study was to examine the relationship between an American English Digits in Noise (DIN) test and commonly used audiological measures to evaluate the DIN test's ability to detect hearing loss and validate hearing aid fitting. QuickSIN and DIN tests were completed by participants with untreated hearing loss (n = 46), prescription hearing aids (n = 15), and over-the-counter (OTC) hearing aids (n = 12). Performance on the QuickSIN showed moderate positive correlations with DIN for untreated hearing loss participants and prescription hearing aid users, but not for OTC hearing aid users. For untreated hearing loss participants, both QuickSIN and DIN tests showed positive moderate to strong correlations with high frequency puretone averages. In OTC users, DIN scores did not significantly change over a 6-month time period and were better when conducted remotely compared to in-person testing. Our results suggest that the DIN test may be a feasible monitoring option for individuals with hearing loss and those fitted with hearing aids. However, due to small sample size in this pilot study, future research is needed to examine DIN test's utility for fitting and validating OTC hearing aids.
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Affiliation(s)
- Carly Schimmel
- Department of Speech, Language, and Hearing Sciences, University of Colorado Boulder, Boulder, CO 80309, USA; (C.S.); (K.C.)
| | - Kayla Cormier
- Department of Speech, Language, and Hearing Sciences, University of Colorado Boulder, Boulder, CO 80309, USA; (C.S.); (K.C.)
| | - Vinaya Manchaiah
- Department of Otolaryngology-Head and Neck Surgery, University of Colorado School of Medicine, Aurora, CO 80045, USA; (V.M.); (D.W.S.)
- UCHealth Hearing and Balance, University of Colorado Hospital, Aurora, CO 80045, USA
- Virtual Hearing Laboratory, Collaborative Initiative between University of Colorado School of Medicine and University of Pretoria, Aurora, CO 80045, USA
- Department of Speech-Language Pathology and Audiology, University of Pretoria, Pretoria 0002, South Africa
- Department of Speech and Hearing, School of Allied Health Sciences, Manipal Academy of Higher Education, Manipal 576104, India
| | - De Wet Swanepoel
- Department of Otolaryngology-Head and Neck Surgery, University of Colorado School of Medicine, Aurora, CO 80045, USA; (V.M.); (D.W.S.)
- Virtual Hearing Laboratory, Collaborative Initiative between University of Colorado School of Medicine and University of Pretoria, Aurora, CO 80045, USA
- Department of Speech-Language Pathology and Audiology, University of Pretoria, Pretoria 0002, South Africa
| | - Anu Sharma
- Department of Speech, Language, and Hearing Sciences, University of Colorado Boulder, Boulder, CO 80309, USA; (C.S.); (K.C.)
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Patro C, Monfiletto A, Singer A, Srinivasan NK, Mishra SK. Midlife Speech Perception Deficits: Impact of Extended High-Frequency Hearing, Peripheral Neural Function, and Cognitive Abilities. Ear Hear 2024:00003446-990000000-00269. [PMID: 38556645 DOI: 10.1097/aud.0000000000001504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/02/2024]
Abstract
OBJECTIVES The objectives of the present study were to investigate the effects of age-related changes in extended high-frequency (EHF) hearing, peripheral neural function, working memory, and executive function on speech perception deficits in middle-aged individuals with clinically normal hearing. DESIGN We administered a comprehensive assessment battery to 37 participants spanning the age range of 20 to 56 years. This battery encompassed various evaluations, including standard and EHF pure-tone audiometry, ranging from 0.25 to 16 kHz. In addition, we conducted auditory brainstem response assessments with varying stimulation rates and levels, a spatial release from masking (SRM) task, and cognitive evaluations that involved the Trail Making test (TMT) for assessing executive function and the Abbreviated Reading Span test (ARST) for measuring working memory. RESULTS The results indicated a decline in hearing sensitivities at EHFs and an increase in completion times for the TMT with age. In addition, as age increased, there was a corresponding decrease in the amount of SRM. The declines in SRM were associated with age-related declines in hearing sensitivity at EHFs and TMT performance. While we observed an age-related decline in wave I responses, this decline was primarily driven by age-related reductions in EHF thresholds. In addition, the results obtained using the ARST did not show an age-related decline. Neither the auditory brainstem response results nor ARST scores were correlated with the amount of SRM. CONCLUSIONS These findings suggest that speech perception deficits in middle age are primarily linked to declines in EHF hearing and executive function, rather than cochlear synaptopathy or working memory.
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Affiliation(s)
- Chhayakanta Patro
- Department of Speech Language Pathology & Audiology, Towson University, Towson, Maryland, USA
| | - Angela Monfiletto
- Department of Speech Language Pathology & Audiology, Towson University, Towson, Maryland, USA
| | - Aviya Singer
- Department of Speech Language Pathology & Audiology, Towson University, Towson, Maryland, USA
| | - Nirmal Kumar Srinivasan
- Department of Speech Language Pathology & Audiology, Towson University, Towson, Maryland, USA
| | - Srikanta Kumar Mishra
- Department of Speech, Language and Hearing Sciences, The University of Texas at Austin, Austin, Texas, USA
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Colak H, Sendesen E, Turkyilmaz MD. Subcortical auditory system in tinnitus with normal hearing: insights from electrophysiological perspective. Eur Arch Otorhinolaryngol 2024:10.1007/s00405-024-08583-3. [PMID: 38555317 DOI: 10.1007/s00405-024-08583-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 02/26/2024] [Indexed: 04/02/2024]
Abstract
PURPOSE The mechanism of tinnitus remains poorly understood; however, studies have underscored the significance of the subcortical auditory system in tinnitus perception. In this study, our aim was to investigate the subcortical auditory system using electrophysiological measurements in individuals with tinnitus and normal hearing. Additionally, we aimed to assess speech-in-noise (SiN) perception to determine whether individuals with tinnitus exhibit SiN deficits despite having normal-hearing thresholds. METHODS A total 42 normal-hearing participants, including 22 individuals with chronic subjective tinnitus and 20 normal individuals, participated in the study. We recorded auditory brainstem response (ABR) and speech-evoked frequency following response (sFFR) from the participants. SiN perception was also assessed using the Matrix test. RESULTS Our results revealed a significant prolongation of the O peak, which encodes sound offset in sFFR, for the tinnitus group (p < 0.01). The greater non-stimulus-evoked activity was also found in individuals with tinnitus (p < 0.01). In ABR, the tinnitus group showed reduced wave I amplitude and prolonged absolute wave I, III, and V latencies (p ≤ 0.02). Our findings suggested that individuals with tinnitus had poorer SiN perception compared to normal participants (p < 0.05). CONCLUSION The deficit in encoding sound offset may indicate an impaired inhibitory mechanism in tinnitus. The greater non-stimulus-evoked activity observed in the tinnitus group suggests increased neural noise at the subcortical level. Additionally, individuals with tinnitus may experience speech-in-noise deficits despite having a normal audiogram. Taken together, these findings suggest that the lack of inhibition and increased neural noise may be associated with tinnitus perception.
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Affiliation(s)
- Hasan Colak
- Biosciences Institute, Newcastle University, Newcastle Upon Tyne, UK.
| | - Eser Sendesen
- Department of Audiology, Hacettepe University, Ankara, Turkey
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12
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Feng B, Dong T, Song X, Zheng X, Jin C, Cheng Z, Liu Y, Zhang W, Wang X, Tao Y, Wu H. Personalized Porous Gelatin Methacryloyl Sustained-Release Nicotinamide Protects Against Noise-Induced Hearing Loss. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2024; 11:e2305682. [PMID: 38225752 DOI: 10.1002/advs.202305682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 11/11/2023] [Indexed: 01/17/2024]
Abstract
There are no Food and Drug Administration-approved drugs for treating noise-induced hearing loss (NIHL), reflecting the absence of clear specific therapeutic targets and effective delivery strategies. Noise trauma is demonstrated results in nicotinamide adenine dinucleotide (NAD+) downregulation and mitochondrial dysfunction in cochlear hair cells (HCs) and spiral ganglion neurons (SGNs) in mice, and NAD+ boosted by nicotinamide (NAM) supplementation maintains cochlear mitochondrial homeostasis and prevents neuroexcitatory toxic injury in vitro and ex vivo, also significantly ameliorated NIHL in vivo. To tackle the limited drug delivery efficiency due to sophisticated anatomical barriers and unique clearance pathway in ear, personalized NAM-encapsulated porous gelatin methacryloyl (PGMA@NAM) are developed based on anatomy topography of murine temporal bone by micro-computed tomography and reconstruction of round window (RW) niche, realizing hydrogel in situ implantation completely, NAM sustained-release and long-term auditory preservation in mice. This study strongly supports personalized PGMA@NAM as NIHL protection drug with effective inner ear delivery, providing new inspiration for drug-based treatment of NIHL.
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Affiliation(s)
- Baoyi Feng
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, No.639, Zhizaoju Road, Shanghai, 200011, P. R. China
- Ear Institute, Shanghai Jiao Tong University School of Medicine, No.115, Jinzun Road, Shanghai, 200125, P. R. China
- Shanghai Key Laboratory of Translation Medicine on Ear and Nose Disease, No.115, Jinzun Road, Shanghai, 200125, P. R. China
| | - Tingting Dong
- Ear Institute, Shanghai Jiao Tong University School of Medicine, No.115, Jinzun Road, Shanghai, 200125, P. R. China
- Shanghai Key Laboratory of Translation Medicine on Ear and Nose Disease, No.115, Jinzun Road, Shanghai, 200125, P. R. China
- Biobank of Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, No.115, Jinzun Road, Shanghai, 200125, P. R. China
| | - Xinyu Song
- Department of Prosthodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, P. R. China
| | - Xiaofei Zheng
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, No.639, Zhizaoju Road, Shanghai, 200011, P. R. China
- Ear Institute, Shanghai Jiao Tong University School of Medicine, No.115, Jinzun Road, Shanghai, 200125, P. R. China
- Shanghai Key Laboratory of Translation Medicine on Ear and Nose Disease, No.115, Jinzun Road, Shanghai, 200125, P. R. China
| | - Chenxi Jin
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, No.639, Zhizaoju Road, Shanghai, 200011, P. R. China
- Ear Institute, Shanghai Jiao Tong University School of Medicine, No.115, Jinzun Road, Shanghai, 200125, P. R. China
- Shanghai Key Laboratory of Translation Medicine on Ear and Nose Disease, No.115, Jinzun Road, Shanghai, 200125, P. R. China
| | - Zhenzhe Cheng
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, No.639, Zhizaoju Road, Shanghai, 200011, P. R. China
- Ear Institute, Shanghai Jiao Tong University School of Medicine, No.115, Jinzun Road, Shanghai, 200125, P. R. China
- Shanghai Key Laboratory of Translation Medicine on Ear and Nose Disease, No.115, Jinzun Road, Shanghai, 200125, P. R. China
| | - Yiqing Liu
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, No.639, Zhizaoju Road, Shanghai, 200011, P. R. China
- Ear Institute, Shanghai Jiao Tong University School of Medicine, No.115, Jinzun Road, Shanghai, 200125, P. R. China
- Shanghai Key Laboratory of Translation Medicine on Ear and Nose Disease, No.115, Jinzun Road, Shanghai, 200125, P. R. China
| | - Wenjie Zhang
- Department of Prosthodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, P. R. China
| | - Xueling Wang
- Ear Institute, Shanghai Jiao Tong University School of Medicine, No.115, Jinzun Road, Shanghai, 200125, P. R. China
- Shanghai Key Laboratory of Translation Medicine on Ear and Nose Disease, No.115, Jinzun Road, Shanghai, 200125, P. R. China
- Biobank of Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, No.115, Jinzun Road, Shanghai, 200125, P. R. China
| | - Yong Tao
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, No.639, Zhizaoju Road, Shanghai, 200011, P. R. China
- Ear Institute, Shanghai Jiao Tong University School of Medicine, No.115, Jinzun Road, Shanghai, 200125, P. R. China
- Shanghai Key Laboratory of Translation Medicine on Ear and Nose Disease, No.115, Jinzun Road, Shanghai, 200125, P. R. China
| | - Hao Wu
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, No.639, Zhizaoju Road, Shanghai, 200011, P. R. China
- Ear Institute, Shanghai Jiao Tong University School of Medicine, No.115, Jinzun Road, Shanghai, 200125, P. R. China
- Shanghai Key Laboratory of Translation Medicine on Ear and Nose Disease, No.115, Jinzun Road, Shanghai, 200125, P. R. China
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Buss E, Kane SG, Young KS, Gratzek CB, Bishop DM, Miller MK, Porter HL, Leibold LJ, Stecker GC, Monson BB. Effects of Stimulus Type on 16-kHz Detection Thresholds. Ear Hear 2024; 45:486-498. [PMID: 38178308 PMCID: PMC10922353 DOI: 10.1097/aud.0000000000001446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2024]
Abstract
OBJECTIVES Audiometric testing typically does not include frequencies above 8 kHz. However, recent research suggests that extended high-frequency (EHF) sensitivity could affect hearing in natural communication environments. Clinical assessment of hearing often employs pure tones and frequency-modulated (FM) tones interchangeably regardless of frequency. The present study was designed to evaluate how the stimulus chosen to measure EHF thresholds affects estimates of hearing sensitivity. DESIGN The first experiment used standard audiometric procedures to measure 8- and 16-kHz thresholds for 5- to 28-year olds with normal hearing in the standard audiometric range (250 to 8000 Hz). Stimuli were steady tones, pulsed tones, and FM tones. The second experiment tested 18- to 28-year olds with normal hearing in the standard audiometric range using psychophysical procedures to evaluate how changes in sensitivity as a function of frequency affect detection of stimuli that differ with respect to bandwidth, including bands of noise. Thresholds were measured using steady tones, pulsed tones, FM tones, narrow bands of noise, and one-third-octave bands of noise at a range of center frequencies in one ear. RESULTS In experiment 1, thresholds improved with increasing age at 8 kHz and worsened with increasing age at 16 kHz. Thresholds for individual participants were relatively similar for steady, pulsed, and FM tones at 8 kHz. At 16 kHz, mean thresholds were approximately 5 dB lower for FM tones than for steady or pulsed tones. This stimulus effect did not differ as a function of age. Experiment 2 replicated this greater stimulus effect at 16 kHz than at 8 kHz and showed that the slope of the audibility curve accounted for these effects. CONCLUSIONS Contrary to prior expectations, there was no evidence that the choice of stimulus type affected school-age children more than adults. For individual participants, audiometric thresholds at 16 kHz were as much as 20 dB lower for FM tones than for steady tones. Threshold differences across stimuli at 16 kHz were predicted by differences in audibility across frequency, which can vary markedly between listeners. These results highlight the importance of considering spectral width of the stimulus used to evaluate EHF thresholds.
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Affiliation(s)
- Emily Buss
- Department of Otolaryngology/Head and Neck Surgery, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Stacey G. Kane
- Department of Otolaryngology/Head and Neck Surgery, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Department of Health Sciences, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Kathryn S. Young
- Department of Health Sciences, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Chloe B. Gratzek
- Department of Health Sciences, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Danielle M. Bishop
- Center for Hearing Research, Boys Town National Research Hospital, Omaha, Nebraska, USA
| | - Margaret K. Miller
- Center for Hearing Research, Boys Town National Research Hospital, Omaha, Nebraska, USA
| | - Heather L. Porter
- Center for Hearing Research, Boys Town National Research Hospital, Omaha, Nebraska, USA
| | - Lori J. Leibold
- Center for Hearing Research, Boys Town National Research Hospital, Omaha, Nebraska, USA
| | | | - Brian B. Monson
- Department of Speech and Hearing Science, University of Illinois at Urbana-Champaign, Champaign, USA
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14
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Liu Y, Hu J, Yang S, Xie H, Wang Y, Ni T, Han Z. Tinnitus pitch does not always fall within the frequency range of hearing loss - a cross-sectional study on the mechanism of tinnitus production. Acta Otolaryngol 2024; 144:226-232. [PMID: 38847804 DOI: 10.1080/00016489.2024.2355227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Accepted: 05/09/2024] [Indexed: 06/20/2024]
Abstract
BACKGROUND Clinically, we find that tinnitus patients often have hearing loss. According to the most accepted mechanism of tinnitus, that is, the spontaneous discharge and abnormal synchronization of neurons after afferent reduction, tinnitus frequency is closely related to the frequency of hearing loss. OBJECTIVE The purpose of this study was to investigate the correlation of tinnitus pitch with the frequency of hearing loss. MATERIALS AND METHODS A total of 500 patients with unilateral or bilateral chronic tinnitus were enrolled in this study. All patients underwent pure tone audiometry (PTA) and tinnitus acoustic examination. Hearing loss levels and frequencies were recorded. The relationship between tinnitus pitch and hearing loss level and frequency was statistically analyzed. RESULTS Our results showed that 96.6% of the 500 tinnitus patients had hearing loss. Statistical analysis showed that low frequency (LF) tinnitus was correlated with LF hearing loss, but moderate frequency & high frequency (MF&HF) tinnitus was not significantly associated with MF&HF hearing loss. The coincidence of tinnitus pitch with the highest hearing threshold correlated with the degree of hearing loss. CONCLUSION AND SIGNIFICANCE The vast majority of patients with chronic subjective tinnitus had hearing loss, and the frequency of tinnitus correlated with the degree and frequency of hearing loss but not exactly fall within the frequency range of hearing loss.
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Affiliation(s)
- Yuehong Liu
- Department of Otorhinolaryngology Head & Neck Surgery, Huadong Hospital affiliated Fudan University, Shanghai, China
| | - Jiahua Hu
- Department of Otorhinolaryngology Head & Neck Surgery, Huadong Hospital affiliated Fudan University, Shanghai, China
| | - Siyi Yang
- Department of Otorhinolaryngology Head & Neck Surgery, Huadong Hospital affiliated Fudan University, Shanghai, China
| | - Hongbo Xie
- Department of Otorhinolaryngology Head & Neck Surgery, Huadong Hospital affiliated Fudan University, Shanghai, China
| | - Yulu Wang
- Department of Otorhinolaryngology Head & Neck Surgery, Huadong Hospital affiliated Fudan University, Shanghai, China
| | - Tianyi Ni
- Department of Otorhinolaryngology Head & Neck Surgery, Huadong Hospital affiliated Fudan University, Shanghai, China
| | - Zhao Han
- Department of Otorhinolaryngology Head & Neck Surgery, Huadong Hospital affiliated Fudan University, Shanghai, China
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15
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Saade M, Fernandez K, Little C, Schwam ZG, Cosetti M. Utility of Extended High-Frequency Audiograms in Clinical Practice. Laryngoscope 2024; 134:907-910. [PMID: 37497866 DOI: 10.1002/lary.30890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 05/22/2023] [Accepted: 07/01/2023] [Indexed: 07/28/2023]
Abstract
OBJECTIVES Extended high-frequency (EHF) audiometry elicits pure-tone thresholds at frequencies above 8 kHz, which are not included in routine clinical testing. This study explores the utility of EHF audiometry in patients with various audiologic symptoms despite normal-hearing thresholds at ≤8 kHz. METHODS A retrospective review was performed of all patients receiving conventional (250-8 kHz) and EHF (9-20 kHz) audiometry at a tertiary otological referral center between April 2021 and August 2022. Only patients with audiologic symptoms and pure-tone thresholds ≤25 dB HL at ≤8 kHz bilaterally on routine testing were included in subsequent analysis. EHF-PTA was defined for each ear as an average of the air conduction thresholds at 9.0, 10.0, 11.2, 12.5, 14.0, 16.0, 18.0, and 20.0 kHz. RESULTS Of the 50 patients who received EHF testing, 40 had audiologic symptoms and normal conventional audiograms at ≤8 kHz. Twenty-five of the 40 (62.5%) were found to have hearing loss in the highest frequencies. Patients with EHF hearing loss (EHF-HL) were more likely to report subjective hearing loss. Age was significantly greater in those with EHF-HL compared with those without EHF-HL, and age was positively correlated with the degree of EHF-HL. CONCLUSION EHF testing correlates with audiologic symptoms in patients with normal testing at ≤8 kHz and may be considered when standard audiometry is normal. Additional data are warranted to create an evidenced-based, clinical algorithm for EHF audiometry that can guide treatment, direct mitigation strategies, and potentially identify those at higher risk of hearing loss over time. LEVEL OF EVIDENCE 4 Laryngoscope, 134:907-910, 2024.
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Affiliation(s)
- Mia Saade
- Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Karla Fernandez
- Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Christine Little
- Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Zachary G Schwam
- Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Maura Cosetti
- Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA
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Sendesen E, Turkyilmaz D. WITHDRAWN: Listening handicap in tinnitus patients by controlling extended high frequencies - Effort or fatigue? Auris Nasus Larynx 2024; 51:198-205. [PMID: 37137796 DOI: 10.1016/j.anl.2023.04.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 03/30/2023] [Accepted: 04/25/2023] [Indexed: 05/05/2023]
Abstract
This article has been withdrawn: please see Elsevier Policy on Article Withdrawal (https://www.elsevier.com/about/policies/article-withdrawal). This article has been withdrawn at the request of the editor and publisher. The publisher regrets that an error occurred which led to the premature publication of this paper. This error bears no reflection on the article or its authors. The publisher apologizes to the authors and the readers for this unfortunate error.
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Affiliation(s)
- Eser Sendesen
- Department of Audiology, Hacettepe University, Ankara, Turkey.
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Çolak H, Aydemir BE, Sakarya MD, Çakmak E, Alniaçik A, Türkyilmaz MD. Subcortical Auditory Processing and Speech Perception in Noise Among Individuals With and Without Extended High-Frequency Hearing Loss. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2024; 67:221-231. [PMID: 37956878 DOI: 10.1044/2023_jslhr-23-00023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2023]
Abstract
PURPOSE The significance of extended high-frequency (EHF) hearing (> 8 kHz) is not well understood so far. In this study, we aimed to understand the relationship between EHF hearing loss (EHFHL) and speech perception in noise (SPIN) and the associated physiological signatures using the speech-evoked frequency-following response (sFFR). METHOD Sixteen young adults with EHFHL and 16 age- and sex-matched individuals with normal hearing participated in the study. SPIN performance in right speech-right noise, left speech-left noise, and binaural listening conditions was evaluated using the Turkish Matrix Test. Additionally, subcortical auditory processing was assessed by recording sFFRs elicited by 40-ms /da/ stimuli. RESULTS Individuals with EHFHL demonstrated poorer SPIN performances in all listening conditions (p < .01). Longer latencies were observed in the V (onset) and O (offset) peaks in these individuals (p ≤ .01). However, only the V/A peak amplitude was found to be significantly reduced in individuals with EHFHL (p < .01). CONCLUSIONS Our findings highlight the importance of EHF hearing and suggest that EHF hearing should be considered among the key elements in SPIN. Individuals with EHFHL show a tendency toward weaker subcortical auditory processing, which likely contributes to their poorer SPIN performance. Thus, routine assessment of EHF hearing should be implemented in clinical settings, alongside the evaluation of standard audiometric frequencies (0.25-8 kHz).
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Affiliation(s)
- Hasan Çolak
- Department of Audiology, Baskent University, Ankara, Turkey
- Department of Audiology, Hacettepe University, Ankara, Turkey
| | | | | | - Eda Çakmak
- Department of Audiology, Baskent University, Ankara, Turkey
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18
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Polspoel S, Moore DR, Swanepoel DW, Kramer SE, Smits C. Sensitivity of the antiphasic digits-in-noise test to simulated unilateral and bilateral conductive hearing loss. Int J Audiol 2023; 62:1022-1030. [PMID: 36121040 DOI: 10.1080/14992027.2022.2119611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Accepted: 08/28/2022] [Indexed: 11/05/2022]
Abstract
OBJECTIVES The objective of this study is (1) to assess whether the presentation level of the antiphasic digits-in-noise (DIN) test affects the speech recognition threshold (SRT), (2) to evaluate how accurately simulated unilateral and bilateral conductive hearing loss is detected (CHL) and (3) to determine whether increasing the presentation level normalises the antiphasic DIN SRT. DESIGN Participants performed antiphasic and diotic DINs at different presentation levels with unilateral, bilateral or no earplugs. STUDY SAMPLE Twenty-four and twelve normal hearing adults. RESULTS Without earplugs, antiphasic DIN SRTs did not differ between 60 and 80 dB SPL. At 60 dB SPL, the antiphasic DIN correctly classified 92% of the unilateral earplug cases; the diotic DIN 25%. The binaural intelligibility level difference did not differ between the no-earplug condition and the condition with bilateral earplugs when the presentation was increased with the attenuation level. CONCLUSIONS In normal hearing participants, diotic and antiphasic DIN SRTs are independent of presentation level above a minimum level of 60 dB SPL. The antiphasic DIN is more sensitive than the diotic DIN for detecting unilateral CHL; not for bilateral CHL. The effect of CHL on DIN SRTs can be largely compensated by increasing the presentation level. Audibility plays an important role in the antiphasic and diotic DIN.
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Affiliation(s)
- Sigrid Polspoel
- Otolaryngology-Head and Neck Surgery, Section Ear and Hearing, Amsterdam UMC location Vrije Universiteit Amsterdam, Amsterdam, De Boelelaan, The Netherlands
- Amsterdam Public Health Research Institute, Quality of Care, Amsterdam, The Netherlands
| | - David R Moore
- Communication Sciences Research Center, Cincinnati Childrens' Hospital Medical Center and University of Cincinnati, Cincinnati, OH, USA
- Manchester Centre for Audiology and Deafness, University of Manchester, Manchester, UK
| | - De Wet Swanepoel
- Ear Sciences Centre, School of Surgery, University of Western Australia, Perth, WA, Australia
- Department of Speech-Language Pathology and Audiology, University of Pretoria, Pretoria, South Africa
| | - Sophia E Kramer
- Otolaryngology-Head and Neck Surgery, Section Ear and Hearing, Amsterdam UMC location Vrije Universiteit Amsterdam, Amsterdam, De Boelelaan, The Netherlands
- Amsterdam Public Health Research Institute, Quality of Care, Amsterdam, The Netherlands
| | - Cas Smits
- Amsterdam Public Health Research Institute, Quality of Care, Amsterdam, The Netherlands
- Amsterdam UMC location University of Amsterdam, Otolaryngology-Head and Neck Surgery, Ear and Hearing, Meibergdreef, Amsterdam, The Netherlands
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Sendesen E, Kılıç S, Erbil N, Aydın Ö, Turkyilmaz D. An Exploratory Study of the Effect of Tinnitus on Listening Effort Using EEG and Pupillometry. Otolaryngol Head Neck Surg 2023; 169:1259-1267. [PMID: 37172313 DOI: 10.1002/ohn.367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Revised: 03/24/2023] [Accepted: 04/23/2023] [Indexed: 05/14/2023]
Abstract
OBJECTIVE Previous behavioral studies on listening effort in tinnitus patients did not consider extended high-frequency hearing thresholds and had conflicting results. This inconsistency may be related that listening effort is not evaluated by the central nervous system (CNS) and autonomic nervous system (ANS), which are directly related to tinnitus pathophysiology. This study matches hearing thresholds at all frequencies, including the extended high-frequency and reduces hearing loss to objectively evaluate listening effort over the CNS and ANS simultaneously in tinnitus patients. STUDY DESIGN Case-control study. SETTING University hospital. METHODS Sixteen chronic tinnitus patients and 23 matched healthy controls having normal pure-tone averages with symmetrical hearing thresholds were included. Subjects were evaluated with 0.125 to 20 kHz pure-tone audiometry, Montreal Cognitive Assessment Test (MoCA), Tinnitus Handicap Inventory (THI), Visual Analog Scale (VAS), electroencephalography (EEG), and pupillometry. RESULTS Pupil dilation and EEG alpha band in the "coding" phase of the sentence presented in tinnitus patients was less than in the control group (p < .05). VAS score was higher in the tinnitus group (p < .01). Also, there was no statistically significant relationship between EEG and pupillometry components and THI or MoCA (p > .05). CONCLUSION This study suggests that tinnitus patients may need to make an extra effort to listen. Also, pupillometry may not be sufficiently reliable to assess listening effort in ANS-related pathologies. Considering the possible listening difficulties in tinnitus patients, reducing the listening difficulties, especially in noisy environments, can be added to the goals of tinnitus therapy protocols.
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Affiliation(s)
- Eser Sendesen
- Department of Audiology, Hacettepe University, Ankara, Turkey
| | - Samet Kılıç
- Department of Audiology, Hacettepe University, Ankara, Turkey
| | - Nurhan Erbil
- Department of Biophysics, Hacettepe University, Ankara, Turkey
| | - Özgür Aydın
- Department of Biophysics, Hacettepe University, Ankara, Turkey
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Balan JR, Rodrigo H, Saxena U, Mishra SK. Explainable machine learning reveals the relationship between hearing thresholds and speech-in-noise recognition in listeners with normal audiograms. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2023; 154:2278-2288. [PMID: 37823779 DOI: 10.1121/10.0021303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 09/17/2023] [Indexed: 10/13/2023]
Abstract
Some individuals complain of listening-in-noise difficulty despite having a normal audiogram. In this study, machine learning is applied to examine the extent to which hearing thresholds can predict speech-in-noise recognition among normal-hearing individuals. The specific goals were to (1) compare the performance of one standard (GAM, generalized additive model) and four machine learning models (ANN, artificial neural network; DNN, deep neural network; RF, random forest; XGBoost; eXtreme gradient boosting), and (2) examine the relative contribution of individual audiometric frequencies and demographic variables in predicting speech-in-noise recognition. Archival data included thresholds (0.25-16 kHz) and speech recognition thresholds (SRTs) from listeners with clinically normal audiograms (n = 764 participants or 1528 ears; age, 4-38 years old). Among the machine learning models, XGBoost performed significantly better than other methods (mean absolute error; MAE = 1.62 dB). ANN and RF yielded similar performances (MAE = 1.68 and 1.67 dB, respectively), whereas, surprisingly, DNN showed relatively poorer performance (MAE = 1.94 dB). The MAE for GAM was 1.61 dB. SHapley Additive exPlanations revealed that age, thresholds at 16 kHz, 12.5 kHz, etc., on the order of importance, contributed to SRT. These results suggest the importance of hearing in the extended high frequencies for predicting speech-in-noise recognition in listeners with normal audiograms.
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Affiliation(s)
- Jithin Raj Balan
- Department of Speech, Language and Hearing Sciences, The University of Texas at Austin, Austin, Texas 78712, USA
| | - Hansapani Rodrigo
- School of Mathematical and Statistical Sciences, The University of Texas Rio Grande Valley, Edinburg, Texas 78539, USA
| | - Udit Saxena
- Department of Audiology and Speech-Language Pathology, Gujarat Medical Education and Research Society, Medical College and Hospital, Ahmedabad, 380060, India
| | - Srikanta K Mishra
- Department of Speech, Language and Hearing Sciences, The University of Texas at Austin, Austin, Texas 78712, USA
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21
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Roup CM, Ferguson SD, Lander D. The relationship between extended high-frequency hearing and the binaural spatial advantage in young to middle-aged firefightersa). THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2023; 154:2055-2059. [PMID: 37782123 DOI: 10.1121/10.0021172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 09/13/2023] [Indexed: 10/03/2023]
Abstract
Relationships between extended high-frequency (EHF) thresholds and speech-in-spatialized noise were examined in firefighters with a history of occupational noise and airborne toxin exposure. Speech recognition thresholds were measured for co-located and spatially separated (±90° azimuth) sentences in a competing signal using the Listening in Spatialized Noise-Sentences test. EHF hearing was significantly correlated with the spatial advantage, indicating that firefighters with poorer EHF thresholds experienced less benefit from spatial separation. The correlation between EHF thresholds and spatial hearing remained significant after controlling for age. Deficits in EHF and spatial hearing suggest firefighters may experience compromised speech understanding in job-related complex acoustic environments.
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Affiliation(s)
- Christina M Roup
- Department of Speech and Hearing Science, The Ohio State University, 1070 Carmack Road, 110 Pressey Hall, Columbus, Ohio 43210, USA
| | - Sarah D Ferguson
- Department of Speech and Hearing Science, The Ohio State University, 1070 Carmack Road, 110 Pressey Hall, Columbus, Ohio 43210, USA
| | - Devan Lander
- Department of Speech and Hearing Science, The Ohio State University, 1070 Carmack Road, 110 Pressey Hall, Columbus, Ohio 43210, USA
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22
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Jacewicz E, Fox RA, Holt CE. Dialect and gender perception in relation to the intelligibility of low-pass and high-pass filtered spontaneous speecha). THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2023; 154:1667-1683. [PMID: 37702431 PMCID: PMC10501805 DOI: 10.1121/10.0020906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 07/28/2023] [Accepted: 08/22/2023] [Indexed: 09/14/2023]
Abstract
Most cues to speech intelligibility are within a narrow frequency range, with its upper limit not exceeding 4 kHz. It is still unclear whether speaker-related (indexical) information is available past this limit or how speaker characteristics are distributed at frequencies within and outside the intelligibility range. Using low-pass and high-pass filtering, we examined the perceptual salience of dialect and gender cues in both intelligible and unintelligible speech. Setting the upper frequency limit at 11 kHz, spontaneously produced unique utterances (n = 400) from 40 speakers were high-pass filtered with frequency cutoffs from 0.7 to 5.56 kHz and presented to listeners for dialect and gender identification and intelligibility evaluation. The same material and experimental procedures were used to probe perception of low-pass filtered and unmodified speech with cutoffs from 0.5 to 1.1 kHz. Applying statistical signal detection theory analyses, we found that cues to gender were well preserved at low and high frequencies and did not depend on intelligibility, and the redundancy of gender cues at higher frequencies reduced response bias. Cues to dialect were relatively strong at low and high frequencies; however, most were in intelligible speech, modulated by a differential intelligibility advantage of male and female speakers at low and high frequencies.
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Affiliation(s)
- Ewa Jacewicz
- Department of Speech and Hearing Science, The Ohio State University, 1070 Carmack Road, Columbus, Ohio 43210, USA
| | - Robert A Fox
- Department of Speech and Hearing Science, The Ohio State University, 1070 Carmack Road, Columbus, Ohio 43210, USA
| | - Christopher E Holt
- Department of Speech and Hearing Science, The Ohio State University, 1070 Carmack Road, Columbus, Ohio 43210, USA
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23
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Wasiuk PA, Calandruccio L, Oleson JJ, Buss E. Predicting speech-in-speech recognition: Short-term audibility and spatial separation. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2023; 154:1827-1837. [PMID: 37728286 DOI: 10.1121/10.0021069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 08/28/2023] [Indexed: 09/21/2023]
Abstract
Quantifying the factors that predict variability in speech-in-speech recognition represents a fundamental challenge in auditory science. Stimulus factors associated with energetic and informational masking (IM) modulate variability in speech-in-speech recognition, but energetic effects can be difficult to estimate in spectro-temporally dynamic speech maskers. The current experiment characterized the effects of short-term audibility and differences in target and masker location (or perceived location) on the horizontal plane for sentence recognition in two-talker speech. Thirty young adults with normal hearing (NH) participated. Speech reception thresholds and keyword recognition at a fixed signal-to-noise ratio (SNR) were measured in each spatial condition. Short-term audibility for each keyword was quantified using a glimpsing model. Results revealed that speech-in-speech recognition depended on the proportion of audible glimpses available in the target + masker keyword stimulus in each spatial condition, even across stimuli presented at a fixed global SNR. Short-term audibility requirements were greater for colocated than spatially separated speech-in-speech recognition, and keyword recognition improved more rapidly as a function of increases in target audibility with spatial separation. Results indicate that spatial cues enhance glimpsing efficiency in competing speech for young adults with NH and provide a quantitative framework for estimating IM for speech-in-speech recognition in different spatial configurations.
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Affiliation(s)
- Peter A Wasiuk
- Department of Communication Disorders, 493 Fitch Street, Southern Connecticut State University, New Haven, Connecticut 06515, USA
| | - Lauren Calandruccio
- Department of Psychological Sciences, 11635 Euclid Avenue, Case Western Reserve University, Cleveland, Ohio 44106, USA
| | - Jacob J Oleson
- Department of Biostatistics, 145 North Riverside Drive N300, College of Public Health, University of Iowa, Iowa City, Iowa 52242, USA
| | - Emily Buss
- Department of Otolaryngology/Head and Neck Surgery, 170 Manning Drive, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599, USA
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24
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Hamza Y, Farhadi A, Schwarz DM, McDonough JM, Carney LH. Representations of fricatives in subcortical model responses: Comparisons with human consonant perception. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2023; 154:602-618. [PMID: 37535429 PMCID: PMC10550336 DOI: 10.1121/10.0020536] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 07/11/2023] [Accepted: 07/13/2023] [Indexed: 08/05/2023]
Abstract
Fricatives are obstruent sound contrasts made by airflow constrictions in the vocal tract that produce turbulence across the constriction or at a site downstream from the constriction. Fricatives exhibit significant intra/intersubject and contextual variability. Yet, fricatives are perceived with high accuracy. The current study investigated modeled neural responses to fricatives in the auditory nerve (AN) and inferior colliculus (IC) with the hypothesis that response profiles across populations of neurons provide robust correlates to consonant perception. Stimuli were 270 intervocalic fricatives (10 speakers × 9 fricatives × 3 utterances). Computational model response profiles had characteristic frequencies that were log-spaced from 125 Hz to 8 or 20 kHz to explore the impact of high-frequency responses. Confusion matrices generated by k-nearest-neighbor subspace classifiers were based on the profiles of average rates across characteristic frequencies as feature vectors. Model confusion matrices were compared with published behavioral data. The modeled AN and IC neural responses provided better predictions of behavioral accuracy than the stimulus spectra, and IC showed better accuracy than AN. Behavioral fricative accuracy was explained by modeled neural response profiles, whereas confusions were only partially explained. Extended frequencies improved accuracy based on the model IC, corroborating the importance of extended high frequencies in speech perception.
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Affiliation(s)
- Yasmeen Hamza
- Department of Biomedical Engineering, University of Rochester, Rochester, New York 14627, USA
| | - Afagh Farhadi
- Department of Electrical and Computer Engineering, University of Rochester, Rochester, New York 14627, USA
| | - Douglas M Schwarz
- Depts. of Neuroscience and Biomedical Engineering, University of Rochester, Rochester, New York 14627, USA
| | - Joyce M McDonough
- Department of Linguistics, University of Rochester, Rochester, New York 14627, USA
| | - Laurel H Carney
- Depts. of Biomedical Engineering, Neuroscience, and Electrical and Computer Engineering, University of Rochester, Rochester, New York 14627, USA
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25
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Zadeh LM, Brennan V, Swanepoel DW, Lin L, Moore DR. Remote self-report and speech-in-noise measures predict clinical audiometric thresholds. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2022.05.09.22274843. [PMID: 35821983 PMCID: PMC9275664 DOI: 10.1101/2022.05.09.22274843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Developments in smartphone technology and the COVID-19 pandemic have highlighted the feasibility and need for remote, but reliable hearing tests. Previous studies used remote testing but did not directly compare results in the same listeners with standard lab or clinic testing. This study investigated reliability of remote, self-administered digits-in-noise (remote-DIN) compared with lab-based, supervised (lab-DIN) testing. Predictive validity was further examined in relation to a commonly used self-report, Speech, Spatial, and Qualities of Hearing (SSQ-12), and lab-based, pure tone audiometry. DIN speech reception thresholds (SRTs) of adults (18-64 y/o) with normal-hearing (NH, N=16) and hearing loss (HL, N=18), were measured using English-language digits (0-9), binaurally presented as triplets in one of four speech-shaped noise maskers (broadband, low-pass filtered at 2, 4, 8 kHz) and two digit phases (diotic, antiphasic). High, significant intraclass correlation coefficients indicated strong internal consistency of remote-DIN SRTs, which also correlated significantly with lab-DIN SRTs. There was no significant mean difference between remote- and lab-DIN on any tests. NH listeners had significantly higher SSQ scores, and remote- and lab-DIN SRTs than listeners with HL. All versions of remote-DIN SRTs correlated significantly with pure-tone-average (PTA), with the 2-kHz filtered test the best predictor, explaining 50% of variance in PTA. SSQ total score also significantly and independently predicted PTA (17% of variance) and all test versions of the remote-DIN, except the antiphasic BB test. This study shows that remote SSQ-12 and remote-DIN are sensitive tools for capturing important aspects of auditory function.
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Affiliation(s)
- Lina Motlagh Zadeh
- Communication Sciences Research Center, Cincinnati Children’s Hospital, Cincinnati, OH 45229, USA
| | - Veronica Brennan
- Communication Sciences Research Center, Cincinnati Children’s Hospital, Cincinnati, OH 45229, USA
| | - De Wet Swanepoel
- Department of Speech-Language Pathology and Audiology, University of Pretoria, Hatfield 0028, SA
| | - Li Lin
- Communication Sciences Research Center, Cincinnati Children’s Hospital, Cincinnati, OH 45229, USA
| | - David R. Moore
- Communication Sciences Research Center, Cincinnati Children’s Hospital, Cincinnati, OH 45229, USA
- Department of Otolaryngology, College of Medicine, University of Cincinnati, Cincinnati, OH 45267, USA
- Manchester Centre for Audiology and Deafness, University of Manchester, Manchester M13 9PL, UK
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26
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Koerner TK, Gallun FJ. Speech understanding and extended high-frequency hearing sensitivity in blast-exposed veteransa). THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2023; 154:379-387. [PMID: 37462921 DOI: 10.1121/10.0020174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 06/29/2023] [Indexed: 07/21/2023]
Abstract
Auditory difficulties reported by normal-hearing Veterans with a history of blast exposure are primarily thought to stem from processing deficits in the central nervous system. However, previous work on speech understanding in noise difficulties in this patient population have only considered peripheral hearing thresholds in the standard audiometric range. Recent research suggests that variability in extended high-frequency (EHF; >8 kHz) hearing sensitivity may contribute to speech understanding deficits in normal-hearing individuals. Therefore, this work was designed to identify the effects of blast exposure on several common clinical speech understanding measures and EHF hearing sensitivity. This work also aimed to determine whether variability in EHF hearing sensitivity contributes to speech understanding difficulties in normal-hearing blast-exposed Veterans. Data from 41 normal- or near-normal-hearing Veterans with a history of blast exposure and 31 normal- or near-normal-hearing control participants with no history of head injury were employed in this study. Analysis identified an effect of blast exposure on several speech understanding measures but showed no statistically significant differences in EHF thresholds between participant groups. Data showed that variability in EHF hearing sensitivity did not contribute to group-related differences in speech understanding, although study limitations impact interpretation of these results.
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Affiliation(s)
- Tess K Koerner
- Department of Veterans Affairs (VA) Rehabilitation Research and Development (RR & D), National Center for Rehabilitative Auditory Research (NCRAR), VA Portland Health Care System, Portland, Oregon 97239, USA
| | - Frederick J Gallun
- Department of Veterans Affairs (VA) Rehabilitation Research and Development (RR & D), National Center for Rehabilitative Auditory Research (NCRAR), VA Portland Health Care System, Portland, Oregon 97239, USA
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27
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Monson BB, Ananthanarayana RM, Trine A, Delaram V, Christopher Stecker G, Buss E. Differential benefits of unmasking extended high-frequency content of target or background speech. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2023; 154:454-462. [PMID: 37489913 PMCID: PMC10371353 DOI: 10.1121/10.0020175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 06/14/2023] [Accepted: 06/29/2023] [Indexed: 07/26/2023]
Abstract
Current evidence supports the contribution of extended high frequencies (EHFs; >8 kHz) to speech recognition, especially for speech-in-speech scenarios. However, it is unclear whether the benefit of EHFs is due to phonetic information in the EHF band, EHF cues to access phonetic information at lower frequencies, talker segregation cues, or some other mechanism. This study investigated the mechanisms of benefit derived from a mismatch in EHF content between target and masker talkers for speech-in-speech recognition. EHF mismatches were generated using full band (FB) speech and speech low-pass filtered at 8 kHz. Four filtering combinations with independently filtered target and masker speech were used to create two EHF-matched and two EHF-mismatched conditions for one- and two-talker maskers. Performance was best with the FB target and the low-pass masker in both one- and two-talker masker conditions, but the effect was larger for the two-talker masker. No benefit of an EHF mismatch was observed for the low-pass filtered target. A word-by-word analysis indicated higher recognition odds with increasing EHF energy level in the target word. These findings suggest that the audibility of target EHFs provides target phonetic information or target segregation and selective attention cues, but that the audibility of masker EHFs does not confer any segregation benefit.
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Affiliation(s)
- Brian B Monson
- Department of Speech and Hearing Science, University of Illinois Urbana-Champaign, Champaign, Illinois 61820, USA
| | - Rohit M Ananthanarayana
- Department of Speech and Hearing Science, University of Illinois Urbana-Champaign, Champaign, Illinois 61820, USA
| | - Allison Trine
- Department of Speech and Hearing Science, University of Illinois Urbana-Champaign, Champaign, Illinois 61820, USA
| | - Vahid Delaram
- Department of Speech and Hearing Science, University of Illinois Urbana-Champaign, Champaign, Illinois 61820, USA
| | - G Christopher Stecker
- Spatial Hearing Laboratory, Boys Town National Research Hospital, Omaha, Nebraska 68131, USA
| | - Emily Buss
- Department of Otolaryngology/HNS, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599, USA
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28
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Karunathilake IMD, Dunlap JL, Perera J, Presacco A, Decruy L, Anderson S, Kuchinsky SE, Simon JZ. Effects of aging on cortical representations of continuous speech. J Neurophysiol 2023; 129:1359-1377. [PMID: 37096924 PMCID: PMC10202479 DOI: 10.1152/jn.00356.2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 04/04/2023] [Accepted: 04/20/2023] [Indexed: 04/26/2023] Open
Abstract
Understanding speech in a noisy environment is crucial in day-to-day interactions and yet becomes more challenging with age, even for healthy aging. Age-related changes in the neural mechanisms that enable speech-in-noise listening have been investigated previously; however, the extent to which age affects the timing and fidelity of encoding of target and interfering speech streams is not well understood. Using magnetoencephalography (MEG), we investigated how continuous speech is represented in auditory cortex in the presence of interfering speech in younger and older adults. Cortical representations were obtained from neural responses that time-locked to the speech envelopes with speech envelope reconstruction and temporal response functions (TRFs). TRFs showed three prominent peaks corresponding to auditory cortical processing stages: early (∼50 ms), middle (∼100 ms), and late (∼200 ms). Older adults showed exaggerated speech envelope representations compared with younger adults. Temporal analysis revealed both that the age-related exaggeration starts as early as ∼50 ms and that older adults needed a substantially longer integration time window to achieve their better reconstruction of the speech envelope. As expected, with increased speech masking envelope reconstruction for the attended talker decreased and all three TRF peaks were delayed, with aging contributing additionally to the reduction. Interestingly, for older adults the late peak was delayed, suggesting that this late peak may receive contributions from multiple sources. Together these results suggest that there are several mechanisms at play compensating for age-related temporal processing deficits at several stages but which are not able to fully reestablish unimpaired speech perception.NEW & NOTEWORTHY We observed age-related changes in cortical temporal processing of continuous speech that may be related to older adults' difficulty in understanding speech in noise. These changes occur in both timing and strength of the speech representations at different cortical processing stages and depend on both noise condition and selective attention. Critically, their dependence on noise condition changes dramatically among the early, middle, and late cortical processing stages, underscoring how aging differentially affects these stages.
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Affiliation(s)
- I M Dushyanthi Karunathilake
- Department of Electrical and Computer Engineering, University of Maryland, College Park, Maryland, United States
| | - Jason L Dunlap
- Department of Hearing and Speech Sciences, University of Maryland, College Park, Maryland, United States
| | - Janani Perera
- Department of Hearing and Speech Sciences, University of Maryland, College Park, Maryland, United States
| | - Alessandro Presacco
- Institute for Systems Research, University of Maryland, College Park, Maryland, United States
| | - Lien Decruy
- Institute for Systems Research, University of Maryland, College Park, Maryland, United States
| | - Samira Anderson
- Department of Hearing and Speech Sciences, University of Maryland, College Park, Maryland, United States
| | - Stefanie E Kuchinsky
- Audiology and Speech Pathology Center, Walter Reed National Military Medical Center, Bethesda, Maryland, United States
| | - Jonathan Z Simon
- Department of Electrical and Computer Engineering, University of Maryland, College Park, Maryland, United States
- Institute for Systems Research, University of Maryland, College Park, Maryland, United States
- Department of Biology, University of Maryland, College Park, Maryland, United States
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29
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Mishra SK, Fu QJ, Galvin JJ, Galindo A. Suprathreshold auditory processes in listeners with normal audiograms but extended high-frequency hearing lossa). THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2023; 153:2745. [PMID: 37133816 DOI: 10.1121/10.0019337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Accepted: 04/17/2023] [Indexed: 05/04/2023]
Abstract
Hearing loss in the extended high-frequency (EHF) range (>8 kHz) is widespread among young normal-hearing adults and could have perceptual consequences such as difficulty understanding speech in noise. However, it is unclear how EHF hearing loss might affect basic psychoacoustic processes. The hypothesis that EHF hearing loss is associated with poorer auditory resolution in the standard frequencies was tested. Temporal resolution was characterized by amplitude modulation detection thresholds (AMDTs), and spectral resolution was characterized by frequency change detection thresholds (FCDTs). AMDTs and FCDTs were measured in adults with or without EHF loss but with normal clinical audiograms. AMDTs were measured with 0.5- and 4-kHz carrier frequencies; similarly, FCDTs were measured for 0.5- and 4-kHz base frequencies. AMDTs were significantly higher with the 4 kHz than the 0.5 kHz carrier, but there was no significant effect of EHF loss. There was no significant effect of EHF loss on FCDTs at 0.5 kHz; however, FCDTs were significantly higher at 4 kHz for listeners with than without EHF loss. This suggests that some aspects of auditory resolution in the standard audiometric frequency range may be compromised in listeners with EHF hearing loss despite having a normal audiogram.
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Affiliation(s)
- Srikanta K Mishra
- Department of Speech, Language and Hearing Sciences, The University of Texas at Austin, Austin, Texas 78712, USA
| | - Qian-Jie Fu
- Department of Head and Neck Surgery, David Geffen School of Medicine, University of California at Los Angeles (UCLA), Los Angeles, California 90095, USA
| | - John J Galvin
- House Institute Foundation, Los Angeles, California 90075, USA
| | - Andrea Galindo
- Department of Communication Sciences and Disorders, The University of Texas Rio Grande Valley, Edinburg, Texas 78539, USA
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30
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Hunter LL, Blankenship CM, Shinn-Cunningham B, Hood L, Zadeh LM, Moore DR. Brainstem auditory physiology in children with listening difficulties . Hear Res 2023; 429:108705. [PMID: 36709582 PMCID: PMC10152893 DOI: 10.1016/j.heares.2023.108705] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2022] [Revised: 01/06/2023] [Accepted: 01/19/2023] [Indexed: 01/22/2023]
Abstract
Children who have listening difficulties (LiD) despite having normal audiometry are often diagnosed as having an auditory processing disorder. A lack of evidence regarding involvement of specific auditory mechanisms has limited development of effective treatments for these children. Here, we examined electrophysiologic evidence for brainstem pathway mechanisms in children with and without defined LiD. We undertook a prospective controlled study of 132 children aged 6-14 years with normal pure tone audiometry, grouped into LiD (n = 63) or Typically Developing (TD; n = 69) based on scores on the Evaluation of Children's Listening and Processing Skills (ECLiPS), a validated caregiver report. The groups were matched on age at test, sex, race, and ethnicity. Neither group had diagnoses of major neurologic disorder, intellectual disability, or brain injuries. Both groups received a test battery including a measure of receptive speech perception against distractor speech, Listening in Spatialized Noise - Sentences (LiSN-S), along with multiple neurophysiologic measures that tap afferent and efferent auditory subcortical pathways. Group analysis showed that participants with LiD performed significantly poorer on all subtests of the LiSN-S. The LiD group had significantly greater wideband middle ear muscle reflex (MEMR) growth functions in the left ear, and shorter Wave III and Wave V latencies in auditory brainstem responses (ABR). Across individual participants, shorter latency ABR Wave V correlated significantly with poorer parent report of LiD (ECLiPS composite). Greater MEMR growth functions also correlated with poorer ECLiPS scores and reduced LiSN-S talker advantage. The LiD and TD groups had equivalent summating potentials, compound action potentials, envelope-following responses, and binaurally activated medial olivocochlear reflexes. In conclusion, there was no evidence for auditory synaptopathy for LiD. Evidence for brainstem differences in the LiD group was interpreted as increased central gain, with shorter ABR Wave III and V latencies and steeper MEMR growth curves. These differences were related to poorer parent report and speech perception in competing speech ability.
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Affiliation(s)
- Lisa L Hunter
- Communication Sciences Research Center, Research in Patient Services, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA; Research in Patient Services, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA; College of Medicine, Otolaryngology and College of Allied Health Sciences, Communication Sciences and Disorders, University of Cincinnati, Cincinnati, Ohio, USA; College of Allied Health Sciences, Communication Sciences and Disorders, University of Cincinnati, Cincinnati, Ohio, USA.
| | - Chelsea M Blankenship
- Communication Sciences Research Center, Research in Patient Services, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA; Research in Patient Services, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | | | - Linda Hood
- Vanderbilt University Medical Center, Nashville, TN, USA
| | - Lina Motlagh Zadeh
- Communication Sciences Research Center, Research in Patient Services, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA; Research in Patient Services, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - David R Moore
- Communication Sciences Research Center, Research in Patient Services, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA; Research in Patient Services, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA; College of Medicine, Otolaryngology and College of Allied Health Sciences, Communication Sciences and Disorders, University of Cincinnati, Cincinnati, Ohio, USA; Manchester Centre for Audiology and Deafness, University of Manchester, U.K
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31
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Sendesen E, Colak H, Korkut Y, Yalcınkaya E, Sennaroglu G. The right ear advantage – a perspective from speech perception in noise test. HEARING, BALANCE AND COMMUNICATION 2023. [DOI: 10.1080/21695717.2023.2181562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Affiliation(s)
- Eser Sendesen
- Department of Audiology, Hacettepe University, Ankara, Turkey
| | - Hasan Colak
- Department of Audiology, Hacettepe University, Ankara, Turkey
- Department of Audiology, Baskent University, Ankara, Turkey
| | - Yagız Korkut
- Department of Audiology, Hacettepe University, Ankara, Turkey
| | - Eda Yalcınkaya
- Department of Audiology, Hacettepe University, Ankara, Turkey
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Monson BB, Trine A. Extending the High-Frequency Bandwidth and Predicting Speech-in-Noise Recognition: Building on the Work of Pat Stelmachowicz. Semin Hear 2023; 44:S64-S74. [PMID: 36970650 PMCID: PMC10033195 DOI: 10.1055/s-0043-1764133] [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] [Indexed: 03/05/2023] Open
Abstract
Recent work has demonstrated that high-frequency (>6 kHz) and extended high-frequency (EHF; >8 kHz) hearing is valuable for speech-in-noise recognition. Several studies also indicate that EHF pure-tone thresholds predict speech-in-noise performance. These findings contradict the broadly accepted "speech bandwidth" that has historically been limited to below 8 kHz. This growing body of work is a tribute to the work of Pat Stelmachowicz, whose research was instrumental in revealing the limitations of the prior speech bandwidth work, particularly for female talkers and child listeners. Here, we provide a historical review that demonstrates how the work of Stelmachowicz and her colleagues paved the way for subsequent research to measure effects of extended bandwidths and EHF hearing. We also present a reanalysis of previous data collected in our lab, the results of which suggest that 16-kHz pure-tone thresholds are consistent predictors of speech-in-noise performance, regardless of whether EHF cues are present in the speech signal. Based on the work of Stelmachowicz, her colleagues, and those who have come afterward, we argue that it is time to retire the notion of a limited speech bandwidth for speech perception for both children and adults.
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Affiliation(s)
- Brian B. Monson
- Department of Speech and Hearing Science, University of Illinois Urbana-Champaign, Champaign, Illinois
- Department of Biomedical and Translational Sciences, Carle Illinois College of Medicine, Urbana, Illinois
- Neuroscience Program, University of Illinois Urbana-Champaign, Champaign, Illinois
| | - Allison Trine
- Department of Speech and Hearing Science, University of Illinois Urbana-Champaign, Champaign, Illinois
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33
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Park Y, Shin SH, Byun SW, Lee ZY, Lee HY. Audiological and psychological assessment of tinnitus patients with normal hearing. Front Neurol 2023; 13:1102294. [PMID: 36712420 PMCID: PMC9878854 DOI: 10.3389/fneur.2022.1102294] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 12/29/2022] [Indexed: 01/15/2023] Open
Abstract
Introduction This study was performed to assess identifiable abnormalities in tinnitus patients with normal hearing. Methods The medical records of subjective non-pulsatile tinnitus patients with normal hearing confirmed by conventional pure-tone audiometry who visited our tinnitus clinic between March 2020 and May 2022 were reviewed. The loudness discomfort level (LDL), extended high-frequency hearing loss (EHFHL), summating potential (SP)/action potential (AP) ratio, distortion product otoacoustic emission (DPOAE), thresholds of auditory brainstem response (ABR) wave V, somatic modulation, and psychiatric symptoms, such as anxiety, depression, and stress were evaluated by questionnaires. Results Decreased LDL (n = 48, 59.8%) was the most frequent finding, followed by EHFHL (n = 29, 35.4%), increased SP/AP ratio (n = 27, 32.9%), psychiatric symptoms (n = 24, 29.3%), decreased DPOAE (n = 17, 20.7%), somatic modulation (n = 8, 9.8%), and increased ABR threshold (n = 3, 3.7%); 75.6% of patients had one or more of these findings. The presence of psychiatric symptoms was independently associated with the Tinnitus Handicap Inventory (THI) score. Conclusion Tinnitus in patients with normal hearing may be accompanied by a combination of various subclinical abnormal audiological findings. However, the presence of psychiatric symptoms alone was independently associated with tinnitus distress.
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34
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Guo Z, Wang J, Liu D, Tian E, Chen J, Kong W, Zhang S. Early detection and monitoring of hearing loss in vestibular migraine: Extended high-frequency hearing. Front Aging Neurosci 2023; 14:1090322. [PMID: 36704499 PMCID: PMC9871761 DOI: 10.3389/fnagi.2022.1090322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Accepted: 12/09/2022] [Indexed: 01/11/2023] Open
Abstract
Background Vestibular migraine (VM) presents mainly with recurrent vestibular symptoms and migraine. A great number of patients with VM have cochlea symptoms such as tinnitus, hearing loss. Methods A cross-sectional study was conducted on patients with definite VM (dVM) and probable VM (pVM) who met the diagnostic criteria. Auditory-vestibular tests and psychological assessments were performed. Logistic regression was used to evaluate the predictive effect of EHF pure tone audiometry (PTA) for standard frequency (SF) hearing loss. Results Fifteen patients with pVM and 22 patients with dVM were recruited. Overall, the two most vertigo types were vestibulo-visual symptoms (83.78%) and internal vertigo (54.05%). A vertigo attack persisted for <5 min in approximately 57% of patients, compared with 5 min to 72 h in 43%, and lasted longer than 72 h in 8%. Approximately 87% of patients had psychological disorders. Most patients with VM (92%) suffered from some degree of EHF hearing impairment, and 68% had SF hearing loss, which is substantially higher than their complaints (43%). Moreover, the mean EHF hearing threshold cutoff value (57 dB HL) worked well in predicting SF hearing loss (area under curve, AUC, 0.827), outperforming distortion product optoacoustic emission (AUC, 0.748). Conclusion VM has a wide range of clinical manifestations. Hearing loss had a considerably higher rate compared to actual complaints. Moreover, patients with VM tended to have bilateral EHF and high-frequency hearing loss. The effectiveness of the mean EHF hearing threshold cutoff value in predicting hearing loss supported its use in the early detection of hearing loss and monitoring disease progression.
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Affiliation(s)
- Zhaoqi Guo
- Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Jun Wang
- Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Dan Liu
- Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - E. Tian
- Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Jingyu Chen
- Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Weijia Kong
- Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China,Union Hospital, Institute of Otorhinolaryngology, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Sulin Zhang
- Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China,Union Hospital, Institute of Otorhinolaryngology, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China,*Correspondence: Sulin Zhang ✉
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35
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Gómez-Álvarez M, Johannesen PT, Coelho-de-Sousa SL, Klump GM, Lopez-Poveda EA. The Relative Contribution of Cochlear Synaptopathy and Reduced Inhibition to Age-Related Hearing Impairment for People With Normal Audiograms. Trends Hear 2023; 27:23312165231213191. [PMID: 37956654 PMCID: PMC10644751 DOI: 10.1177/23312165231213191] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 10/18/2023] [Accepted: 10/23/2023] [Indexed: 11/15/2023] Open
Abstract
Older people often show auditory temporal processing deficits and speech-in-noise intelligibility difficulties even when their audiogram is clinically normal. The causes of such problems remain unclear. Some studies have suggested that for people with normal audiograms, age-related hearing impairments may be due to a cognitive decline, while others have suggested that they may be caused by cochlear synaptopathy. Here, we explore an alternative hypothesis, namely that age-related hearing deficits are associated with decreased inhibition. For human adults (N = 30) selected to cover a reasonably wide age range (25-59 years), with normal audiograms and normal cognitive function, we measured speech reception thresholds in noise (SRTNs) for disyllabic words, gap detection thresholds (GDTs), and frequency modulation detection thresholds (FMDTs). We also measured the rate of growth (slope) of auditory brainstem response wave-I amplitude with increasing level as an indirect indicator of cochlear synaptopathy, and the interference inhibition score in the Stroop color and word test (SCWT) as a proxy for inhibition. As expected, performance in the auditory tasks worsened (SRTNs, GDTs, and FMDTs increased), and wave-I slope and SCWT inhibition scores decreased with ageing. Importantly, SRTNs, GDTs, and FMDTs were not related to wave-I slope but worsened with decreasing SCWT inhibition. Furthermore, after partialling out the effect of SCWT inhibition, age was no longer related to SRTNs or GDTs and became less strongly related to FMDTs. Altogether, results suggest that for people with normal audiograms, age-related deficits in auditory temporal processing and speech-in-noise intelligibility are mediated by decreased inhibition rather than cochlear synaptopathy.
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Affiliation(s)
- Marcelo Gómez-Álvarez
- Instituto de Neurociencias de Castilla y León, Universidad de Salamanca, Salamanca, Spain
- Instituto de Investigación Biomédica de Salamanca, Universidad de Salamanca, Salamanca, Spain
| | - Peter T. Johannesen
- Instituto de Neurociencias de Castilla y León, Universidad de Salamanca, Salamanca, Spain
- Instituto de Investigación Biomédica de Salamanca, Universidad de Salamanca, Salamanca, Spain
| | - Sónia L. Coelho-de-Sousa
- Instituto de Neurociencias de Castilla y León, Universidad de Salamanca, Salamanca, Spain
- Instituto de Investigación Biomédica de Salamanca, Universidad de Salamanca, Salamanca, Spain
| | - Georg M. Klump
- Department of Neuroscience and Cluster of Excellence “Hearing4all”, Carl von Ossietzky University of Oldenburg, Oldenburg, Germany
| | - Enrique A. Lopez-Poveda
- Instituto de Neurociencias de Castilla y León, Universidad de Salamanca, Salamanca, Spain
- Instituto de Investigación Biomédica de Salamanca, Universidad de Salamanca, Salamanca, Spain
- Departamento de Cirugía, Facultad de Medicina, Universidad de Salamanca, Salamanca, Spain
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36
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Shehabi AM, Prendergast G, Guest H, Plack CJ. Binaural temporal coding and the middle ear muscle reflex in audiometrically normal young adults. Hear Res 2023; 427:108663. [PMID: 36502543 DOI: 10.1016/j.heares.2022.108663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 11/11/2022] [Accepted: 11/29/2022] [Indexed: 12/07/2022]
Abstract
Noise exposure may damage the synapses that connect inner hair cells with auditory nerve fibers, before outer hair cells are lost. In humans, this cochlear synaptopathy (CS) is thought to decrease the fidelity of peripheral auditory temporal coding. In the current study, the primary hypothesis was that higher middle ear muscle reflex (MEMR) thresholds, as a proxy measure of CS, would be associated with smaller values of the binaural intelligibility level difference (BILD). The BILD, which is a measure of binaural temporal coding, is defined here as the difference in thresholds between the diotic and the antiphasic versions of the digits in noise (DIN) test. This DIN BILD may control for factors unrelated to binaural temporal coding such as linguistic, central auditory, and cognitive factors. Fifty-six audiometrically normal adults (34 females) aged 18 - 30 were tested. The test battery included standard pure tone audiometry, tympanometry, MEMR using a 2 kHz elicitor and 226 Hz and 1 kHz probes, the Noise Exposure Structured Interview, forward digit span test, extended high frequency (EHF) audiometry, and diotic and antiphasic DIN tests. The study protocol was pre-registered prior to data collection. MEMR thresholds did not predict the DIN BILD. Secondary analyses showed no association between MEMR thresholds and the individual diotic and antiphasic DIN thresholds. Greater lifetime noise exposure was non-significantly associated with higher MEMR thresholds, larger DIN BILD values, and lower (better) antiphasic DIN thresholds, but not with diotic DIN thresholds, nor with EHF thresholds. EHF thresholds were associated with neither MEMR thresholds nor any of the DIN outcomes, including the DIN BILD. Results provide no evidence that young, audiometrically normal people incur CS with impacts on binaural temporal processing.
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Affiliation(s)
- Adnan M Shehabi
- Manchester Centre for Audiology and Deafness, University of Manchester, UK; Department of Audiology and Speech Therapy, Birzeit University, Palestine.
| | | | - Hannah Guest
- Manchester Centre for Audiology and Deafness, University of Manchester, UK
| | - Christopher J Plack
- Manchester Centre for Audiology and Deafness, University of Manchester, UK; Department of Psychology, Lancaster University, UK
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37
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Saxena U, Mishra SK, Rodrigo H, Choudhury M. Functional consequences of extended high frequency hearing impairment: Evidence from the speech, spatial, and qualities of hearing scale. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2022; 152:2946. [PMID: 36456291 DOI: 10.1121/10.0015200] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Accepted: 11/01/2022] [Indexed: 06/17/2023]
Abstract
Hearing loss in the extended high frequencies, despite a normal audiogram, could affect speech-in-noise recognition. However, it is not known if extended high frequency (EHF) hearing loss is associated with everyday listening and communication deficits. The present study aimed to determine the functional effects of impaired EHF hearing among adults using the Speech, Spatial, and Qualities of Hearing Scale (SSQ). A secondary objective was to evaluate the relationship between objective (speech-in-noise recognition) and subjective (SSQ) measures of hearing function. Listeners with EHF hearing loss provided lower SSQ ratings compared with their EHF-normal counterparts. The lower ratings could not be attributed to the age or standard audiogram of the listeners. Ratings from more than 50% of EHF-impaired listeners were below the 2 SD cutoff point obtained from EHF-normal listeners. The mean speech recognition threshold was poorer for EHF-impaired listeners, and a poorer speech recognition threshold was associated with lower SSQ ratings, i.e., poorer self-reported hearing ability. For some listeners, EHF hearing loss could be the missing link between self-reported hearing difficulty in the presence of a normal audiogram. These findings provide evidence for the functional deficits associated with EHF hearing loss and invoke the need for future investigations into the management of EHF loss.
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Affiliation(s)
- Udit Saxena
- Department of Audiology & Speech Language Pathology, GMERS Medical College & Hospital, Ahmedabad 380060, India
| | - Srikanta K Mishra
- Department of Speech, Language and Hearing Sciences, The University of Texas at Austin, Austin, Texas 78712, USA
| | - Hansapani Rodrigo
- School of Mathematical and Statistical Sciences, The University of Texas Rio Grande Valley, Edinburg, Texas 78539, USA
| | - Moumita Choudhury
- Department of Speech, Language and Hearing Sciences, Texas Tech University Health Sciences Center, Lubbock, Texas 79430, USA
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38
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A Systematic Review and Meta-Analysis of Extended High-Frequency Hearing Thresholds in Tinnitus With a Normal Audiogram. Ear Hear 2022; 43:1643-1652. [PMID: 35612517 DOI: 10.1097/aud.0000000000001229] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVES Current evidence supports the growing application of extended high-frequency (EHF: 9 to 20 kHz) audiometry in hearing research, which likely results from the high vulnerability of this frequency region to damage induced by known auditory risk factors. The present systematic review and meta-analysis were performed to investigate whether adults with a normal audiogram and tinnitus show increased EHF hearing thresholds relative to control peers. DESIGN A comprehensive search was undertaken on electronic databases consisting of PubMed, ScienceDirect, Wiley, and Google Scholar using combined keywords: "tinnitus," "extended high frequency," "normal audiogram," and "hidden hearing loss." RESULTS From 261 articles found by searching databases, nine studies met the inclusion criteria for the meta-analysis. A significant difference was observed between tinnitus and control groups in the effect size analysis of hearing thresholds at 10, 12.5, 14, 16, and 18 kHz ( p ≤ 0.001), and the I-square heterogeneity analysis was below 50% in all studies ( p ≥ 0.131). Visual inspection by the Funnel plot and Egger's regression test ( p ≥ 0.211) also exhibited no publication bias in the meta-analyses. CONCLUSIONS Our findings are in support of the idea that in most cases, tinnitus is associated with some degree of cochlear mechanical dysfunction, which may not be detected by conventional audiometry alone. This finding underscores the significance of EHF audiometry in clinical practice, which may help both early identification of individuals susceptible to developing tinnitus and reduce the number of new cases through preventive counseling programs.
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39
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Mishra SK, Saxena U, Rodrigo H. Hearing Impairment in the Extended High Frequencies in Children Despite Clinically Normal Hearing. Ear Hear 2022; 43:1653-1660. [PMID: 35470812 DOI: 10.1097/aud.0000000000001225] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVES Pediatric hearing impairment, regardless of degree and type, has a detrimental effect on speech perception, cognition, oral language development, academic outcomes, and literacy. Hearing assessment in the clinic is limited to 8 kHz although humans can hear up to 20 kHz. Hearing impairment in the extended high frequencies (EHFs > 8 kHz) can occur despite clinically normal hearing. However, to date, the nature and effects of EHF hearing impairment in children remain unknown. The goals of the present study were to determine the effects of EHF hearing impairment on speech-in-noise recognition in children and to examine whether hearing impairment in the EHFs is associated with altered cochlear functioning in the standard frequencies. DESIGN A volunteer sample of 542 participants (4 to 19 years) with clinically normal audiograms were tested. Participants identified with EHF impairment were assigned as cases in a subsequent case-control study. EHF loss was defined as hearing thresholds greater than 20 dB in at least one EHFs (10, 12.5, or 16 kHz). Speech recognition thresholds in multi-talker babble were measured using the digit triplet test. Distortion product otoacoustic emissions ( f2 = 2, 3, 4, and 5 kHz) were measured to assess cochlear functioning. RESULTS Thresholds in the EHFs were as reliable as those in the standard frequency range. Thirty-eight children had EHF hearing impairment regardless of a clinically normal audiogram. A linear mixed-effects model revealed that children with EHF hearing impairment had higher (poorer) mean speech recognition threshold than children with normal EHF sensitivity ( estimate = 2.14 dB, 95% CI: 1.36 to 3.92; effect size = small). The overall magnitude of distortion product otoacoustic emissions was lower for children with EHF impairment ( estimate = -2.47 dB, 95% CI: -4.60 to -0.73; effect size = medium). In addition, the pure-tone average for standard audiometric frequencies was relatively higher for EHF-impaired children ( estimate = 3.68 dB, 95% CI: 2.56 to 4.80; effect size = small). CONCLUSIONS Hearing impairment in the EHFs is common in children despite clinically normal hearing and can occur without a history of otitis media. EHF impairment is associated with poorer speech-in-noise recognition and preclinical cochlear deficits in the lower frequencies where hearing thresholds are normal. This study highlights the clinical need to identify EHF impairments in children.
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Affiliation(s)
- Srikanta K Mishra
- Department of Communication Sciences & Disorders, University of Texas Rio Grande Valley, Edinburg, Texas, USA
| | - Udit Saxena
- MAA Institute of Speech & Hearing, Hyderabad, India
| | - Hansapani Rodrigo
- School of Mathematical and Statistical Sciences, The University of Texas Rio Grande Valley, Edinburg, Texas, USA
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40
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Sanchez VA, Arnold ML, Moore DR, Clavier O, Abrams HB. Speech-in-noise testing: Innovative applications for pediatric patients, underrepresented populations, fitness for duty, clinical trials, and remote services. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2022; 152:2336. [PMID: 36319253 PMCID: PMC9722269 DOI: 10.1121/10.0014418] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 08/24/2022] [Accepted: 09/15/2022] [Indexed: 06/16/2023]
Abstract
Speech perception testing, defined as providing standardized speech stimuli and requiring a listener to provide a behavioral and scored response, has been an integral part of the audiologic test battery since the beginning of the audiology profession. Over the past several decades, limitations in the diagnostic and prognostic validity of standard speech perception testing as routinely administered in the clinic have been noted, and the promotion of speech-in-noise testing has been highlighted. This review will summarize emerging and innovative approaches to speech-in-noise testing with a focus on five applications: (1) pediatric considerations promoting the measurement of sensory and cognitive components separately; (2) appropriately serving underrepresented populations with special attention to racial, ethnic, and linguistic minorities, as well as considering biological sex and/or gender differences as variables of interest; (3) binaural fitness for duty assessments of functional hearing for occupational settings that demand the ability to detect, recognize, and localize sounds; (4) utilization of speech-in-noise tests in pharmacotherapeutic clinical trials with considerations to the drug mechanistic action, the patient populations, and the study design; and (5) online and mobile applications of hearing assessment that increase accessibility and the direct-to-consumer market.
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Affiliation(s)
- Victoria A Sanchez
- Department of Otolaryngology-Head and Neck Surgery, University of South Florida, 12901 Bruce B. Downs Boulevard, MDC 73, Tampa, Florida 33612, USA
| | - Michelle L Arnold
- Department of Communication Sciences and Disorders, University of South Florida, Tampa, Florida 33612, USA
| | - David R Moore
- Communication Sciences Research Center, Cincinnati Children's Hospital, Cincinnati, Ohio 45229, USA
| | | | - Harvey B Abrams
- Department of Communication Sciences and Disorders, University of South Florida, Tampa, Florida 33612, USA
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Li C, Xiong Z, Zhou L, Huang W, He Y, Li L, Shi H, Lu J, Wang J, Li D, Yin S. Interfacing Perforated Eardrums with Graphene-Based Membranes for Broadband Hearing Recovery. Adv Healthc Mater 2022; 11:e2201471. [PMID: 35899802 DOI: 10.1002/adhm.202201471] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2022] [Indexed: 01/28/2023]
Abstract
Eardrum perforation and associated hearing loss is a global health problem. Grafting perforated eardrum with autologous tissues in clinic can restore low-frequency hearing but often leaves poor recovery of high-frequency hearing. In this study, the potential of incorporating a thin multilayered graphene membrane (MGM) into the eardrum for broadband hearing recovery in rats is examined. The MGM shows good biocompatibility and biostability to promote the growth of eardrum cells in a regulated manner with little sign of tissue rejection and inflammatory response. After three weeks of implantation, the MGM is found to be encapsulated by a thin layer of newly grown tissue on both sides without a significant folded overgrowth that is often seen in natural healing. The perforation is well sealed, and broadband hearing recovery (1-32 kHz) is enabled and maintained for at least 2 months. Mechanical simulations show that the high elastic modulus of MGM and thin thickness of the reconstructed eardrum play a critical role in the recovery of high-frequency hearing. This work demonstrates the promise of the use of MGM as a functional graft for perforated eardrum to recover hearing in the broadband frequency region and suggests a new acoustics-related medical application for graphene-related 2D materials.
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Affiliation(s)
- Chunyan Li
- Department of Otorhinolaryngology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, 200233, China
| | - Zhiyuan Xiong
- Department of Chemical Engineering, The University of Melbourne, Melbourne, Victoria, 3010, Australia
| | - Lei Zhou
- Department of Otorhinolaryngology-Head and Neck Surgery, Zhongshan Hospital affiliated to Fudan University, Shanghai, 200032, China
| | | | - Yushi He
- Shanghai Electrochemical Energy Devices Research Center, School of Chemistry and Chemical Engineering, Shanghai Jiao Tong University, Shanghai, 200240, China
| | - Linpeng Li
- Department of Otorhinolaryngology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, 200233, China
| | - Haibo Shi
- Department of Otorhinolaryngology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, 200233, China
| | - Jiayu Lu
- Department of Stomatology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, 200233, China
| | - Jian Wang
- School of Communication Science and Disorders, Dalhousie University, Halifax, B3J 1Y6, Canada
| | - Dan Li
- Department of Chemical Engineering, The University of Melbourne, Melbourne, Victoria, 3010, Australia
| | - Shankai Yin
- Department of Otorhinolaryngology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, 200233, China
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Monson BB, Buss E. On the use of the TIMIT, QuickSIN, NU-6, and other widely used bandlimited speech materials for speech perception experiments. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2022; 152:1639. [PMID: 36182310 PMCID: PMC9473723 DOI: 10.1121/10.0013993] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 07/20/2022] [Accepted: 08/20/2022] [Indexed: 05/29/2023]
Abstract
The use of spectrally degraded speech signals deprives listeners of acoustic information that is useful for speech perception. Several popular speech corpora, recorded decades ago, have spectral degradations, including limited extended high-frequency (EHF) (>8 kHz) content. Although frequency content above 8 kHz is often assumed to play little or no role in speech perception, recent research suggests that EHF content in speech can have a significant beneficial impact on speech perception under a wide range of natural listening conditions. This paper provides an analysis of the spectral content of popular speech corpora used for speech perception research to highlight the potential shortcomings of using bandlimited speech materials. Two corpora analyzed here, the TIMIT and NU-6, have substantial low-frequency spectral degradation (<500 Hz) in addition to EHF degradation. We provide an overview of the phenomena potentially missed by using bandlimited speech signals, and the factors to consider when selecting stimuli that are sensitive to these effects.
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Affiliation(s)
- Brian B Monson
- Department of Speech and Hearing Science, University of Illinois Urbana-Champaign, Champaign, Illinois 61820, USA
| | - Emily Buss
- Department of Otolaryngology/HNS, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27514, USA
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43
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Jagadeesh AB, Uppunda AK. Effect of Age on Informational Masking: Differential Effects of Phonetic and Semantic Information in the Masker. Am J Audiol 2022; 31:707-718. [PMID: 35926084 DOI: 10.1044/2022_aja-22-00029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
PURPOSE Speech recognition in noise is a ubiquitous problem in older listeners. Speech, the most commonly encountered noise in the real world, causes greater masking than noise maskers, a phenomenon called informational masking (IM). This is due to the lexical-semantic and/or acoustic-phonetic information present in speech maskers. In this study, we aimed to observe the age-related differences in speech recognition and the magnitudes of IM when the maskers varied in the type of linguistic information. METHOD In 30 young and 30 older individuals, we measured the signal-to-noise ratio required to obtain 50% correct identification under four-talker babble (lexical-semantic and acoustic-phonetic information), four-talker reverse babble (predominantly acoustic-phonetic information), and speech-shaped noise (SSN; energetic). RESULTS In both groups, the four-talker babble caused the greatest masking effect (worst performances), whereas the SSN resulted in the least masking effect (best performances). The effectiveness of IM due to the lexical-semantic information was comparable between the two groups. However, the effectiveness of IM due to the acoustic-phonetic information was significantly higher in the older listeners, causing worse performances. CONCLUSIONS The greater effectiveness of IM due to the acoustic-phonetic information (worse performance) could be due to the minimal-to-mild high-frequency hearing loss and the consequent temporal processing deficits observed in the older listeners. However, it is possible that the older listeners can employ compensatory mechanisms (such as life experiences, contextual cues, employing higher listening efforts, among many possible other mechanisms) to overcome some of these deficits. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.20405730.
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Affiliation(s)
- Anoop Basavanahalli Jagadeesh
- Auditory Neuroscience Laboratory, Roxelyn and Richard Pepper Department of Communication Sciences and Disorders, Northwestern University, Evanston, IL
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Clinical Performance, Safety, and Patient-Reported Outcomes of an Active Osseointegrated Steady-State Implant System. Otol Neurotol 2022; 43:827-834. [PMID: 35878640 PMCID: PMC9348816 DOI: 10.1097/mao.0000000000003590] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
OBJECTIVE To investigate the clinical performance, safety, and patient-reported outcomes of an active osseointegrated steady-state implant system that uses piezoelectric technology. STUDY DESIGN A prospective, multicenter, open-label, single-arm, within-subject clinical investigation. SETTING Three tertiary referral clinical centers located in Melbourne, Sydney, and Hong Kong. PATIENTS Twenty-nine adult subjects, 24 with mixed hearing loss or conductive hearing loss and 5 with single-sided sensorineural deafness. INTERVENTION Implantation with the Cochlear Osia 2 System. MAIN OUTCOME MEASURES Audiological threshold evaluation and speech recognition in quiet and in noise. Patient satisfaction and safety. RESULTS At 6-month follow-up after surgery, a mean improvement in pure-tone average of 26.0 dB hearing level and a mean improvement of 8.8 dB signal-to-noise ratio in speech reception threshold in noise was achieved with the investigational device as compared with the unaided situation. Usability of the investigational device was rated 71.4/100 mm for sound processor retention and 81.4/100 mm for overall comfort using a visual analog scale. CONCLUSION These outcomes confirm the clinical safety, performance, and benefit of an innovative active transcutaneous bone conduction implant using a piezoelectric transducer design in subjects with conductive hearing loss, mixed hearing loss, or single-sided sensorineural deafness.
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Joris PX. In praise of adventitious sounds. Hear Res 2022; 425:108592. [DOI: 10.1016/j.heares.2022.108592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 07/13/2022] [Accepted: 07/26/2022] [Indexed: 11/04/2022]
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Jain S, Narne VK, Nataraja NP, Madhukesh S, Kumar K, Moore BCJ. The effect of age and hearing sensitivity at frequencies above 8 kHz on auditory stream segregation and speech perception. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2022; 152:716. [PMID: 35931505 DOI: 10.1121/10.0012917] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Accepted: 07/07/2022] [Indexed: 06/06/2023]
Abstract
The effects of age and mild hearing loss over the extended high-frequency (EHF) range from 9000 to 16 000 Hz on speech perception and auditory stream segregation were assessed using four groups: (1) young with normal hearing threshold levels (HTLs) over both the conventional and EHF range; (2) older with audiograms matched to those for group 1; (3) young with normal HTLs over the conventional frequency range and elevated HTLs over the EHF range; (4) older with audiograms matched to those for group 3. For speech in quiet, speech recognition thresholds and speech identification scores did not differ significantly across groups. For monosyllables in noise, both greater age and hearing loss over the EHF range adversely affected performance, but the effect of age was much larger than the effect of hearing status. Stream segregation was assessed using a rapid sequence of vowel stimuli differing in fundamental frequency (F0). Larger differences in F0 were required for stream segregation for the two groups with impaired hearing in the EHF range, but there was no significant effect of age. It is argued that impaired hearing in the EHF range is associated with impaired auditory function at lower frequencies, despite normal audiometric thresholds at those frequencies.
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Affiliation(s)
- Saransh Jain
- All India Institute of Speech and Hearing, University of Mysore, Mysuru-570006 (Kar.), India
| | - Vijaya Kumar Narne
- Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha 61481, Saudi Arabia
| | - N P Nataraja
- JSS Institute of Speech and Hearing, University of Mysore, Mysuru-570004 (Kar.), India
| | - Sanjana Madhukesh
- Department of Speech and Hearing, Manipal College of Health Professionals, Manipal-576104 (Kar.), India
| | - Kruthika Kumar
- District Disabled Rehabilitation Centre, Chikmagalur-577126 (Kar.), India
| | - Brian C J Moore
- Cambridge Hearing Group, Department of Psychology, University of Cambridge, Cambridge, CB2 3EB, United Kingdom
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van Wieringen A, Wouters J. Lilliput: speech perception in speech-weighted noise and in quiet in young children. Int J Audiol 2022:1-9. [PMID: 35732012 DOI: 10.1080/14992027.2022.2086491] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE The aim of this study was to develop an open-set word recognition task in speech-weighted noise and in quiet for young children and examine age effects for open versus closed response formats. DESIGN Dutch monosyllabic words were presented in quiet and in stationary speech-weighted noise to 4- and 5-year-old children as well as to young adults in an open-set response format. Additionally, performance in open and closed context was assessed, as well as in a picture-pointing paradigm. STUDY SAMPLE More than 200 children and 50 adults with normal hearing participated in the various validation phases. RESULTS Average fitted speech reception thresholds (50%) yielded an age effect between 4-year and 5-year olds (and adults), both in speech-weighted noise and in quiet. The closed-set format yielded lower (better) SNRs than the open-set format, and children benefitted to the same extent as adults from phonetically similar words in speech-weighted noise. Additionally, the 4 AFC picture-pointing paradigm can be used to assess word recognition in quiet from 3 years of age. CONCLUSIONS The same materials reveal performance differences between 4 and 5 years of age (and adults), both in quiet and speech-weighted noise using an open-set response format. This relatively small yet significant difference in SRT for a gap of only 1 year shows a developmental change for word recognition in speech-weighted noise and in quiet in the first decade of life.The study is part of the protocol registered on ClinicalTrials.gov (ID = NCT04063748).
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Affiliation(s)
- Astrid van Wieringen
- Department of Neurosciences, Research Group Experimental Oto-rhino-laryngology, KU Leuven - University of Leuven, Leuven, Belgium
| | - Jan Wouters
- Department of Neurosciences, Research Group Experimental Oto-rhino-laryngology, KU Leuven - University of Leuven, Leuven, Belgium
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Dillon MT, O'Connell BP, Canfarotta MW, Buss E, Hopfinger J. Effect of Place-Based Versus Default Mapping Procedures on Masked Speech Recognition: Simulations of Cochlear Implant Alone and Electric-Acoustic Stimulation. Am J Audiol 2022; 31:322-337. [PMID: 35394798 DOI: 10.1044/2022_aja-21-00123] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
PURPOSE Cochlear implant (CI) recipients demonstrate variable speech recognition when listening with a CI-alone or electric-acoustic stimulation (EAS) device, which may be due in part to electric frequency-to-place mismatches created by the default mapping procedures. Performance may be improved if the filter frequencies are aligned with the cochlear place frequencies, known as place-based mapping. Performance with default maps versus an experimental place-based map was compared for participants with normal hearing when listening to CI-alone or EAS simulations to observe potential outcomes prior to initiating an investigation with CI recipients. METHOD A noise vocoder simulated CI-alone and EAS devices, mapped with default or place-based procedures. The simulations were based on an actual 24-mm electrode array recipient, whose insertion angles for each electrode contact were used to estimate the respective cochlear place frequency. The default maps used the filter frequencies assigned by the clinical software. The filter frequencies for the place-based maps aligned with the cochlear place frequencies for individual contacts in the low- to mid-frequency cochlear region. For the EAS simulations, low-frequency acoustic information was filtered to simulate aided low-frequency audibility. Performance was evaluated for the AzBio sentences presented in a 10-talker masker at +5 dB signal-to-noise ratio (SNR), +10 dB SNR, and asymptote. RESULTS Performance was better with the place-based maps as compared with the default maps for both CI-alone and EAS simulations. For instance, median performance at +10 dB SNR for the CI-alone simulation was 57% correct for the place-based map and 20% for the default map. For the EAS simulation, those values were 59% and 37% correct. Adding acoustic low-frequency information resulted in a similar benefit for both maps. CONCLUSIONS Reducing frequency-to-place mismatches, such as with the experimental place-based mapping procedure, produces a greater benefit in speech recognition than maximizing bandwidth for CI-alone and EAS simulations. Ongoing work is evaluating the initial and long-term performance benefits in CI-alone and EAS users. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.19529053.
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Affiliation(s)
- Margaret T. Dillon
- Department of Otolaryngology/Head & Neck Surgery, University of North Carolina at Chapel Hill
- Division of Speech and Hearing Sciences, Department of Allied Health Sciences, University of North Carolina at Chapel Hill
| | - Brendan P. O'Connell
- Department of Otolaryngology/Head & Neck Surgery, University of North Carolina at Chapel Hill
| | - Michael W. Canfarotta
- Department of Otolaryngology/Head & Neck Surgery, University of North Carolina at Chapel Hill
| | - Emily Buss
- Department of Otolaryngology/Head & Neck Surgery, University of North Carolina at Chapel Hill
| | - Joseph Hopfinger
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill
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Le Prell CG. Prevention of Noise-Induced Hearing Loss Using Investigational Medicines for the Inner Ear: Previous Trial Outcomes Should Inform Future Trial Design. Antioxid Redox Signal 2022; 36:1171-1202. [PMID: 34346254 PMCID: PMC9221155 DOI: 10.1089/ars.2021.0166] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Accepted: 07/25/2021] [Indexed: 11/13/2022]
Abstract
Significance: Noise-induced hearing loss (NIHL) is an important public health issue resulting in decreased quality of life for affected individuals, and significant costs to employers and governmental agencies. Recent Advances: Advances in the mechanistic understanding of NIHL have prompted a growing number of proposed, in-progress, and completed clinical trials for possible protections against NIHL via antioxidants and other drug agents. Thirty-one clinical trials evaluating prevention of either temporary or permanent NIHL were identified and are reviewed. Critical Issues: This review revealed little consistency in the noise-exposed populations in which drugs are evaluated or the primary outcomes used to measure NIHL prevention. Changes in pure-tone thresholds were the most common primary outcomes; specific threshold metrics included both average hearing loss and incidence of significant hearing loss. Changes in otoacoustic emission (OAE) amplitude were relatively common secondary outcomes. Extended high-frequency (EHF) hearing and speech-in-noise perception are commonly adversely affected by noise exposure but are not consistently included in clinical trials assessing prevention of NIHL. Future Directions: Multiple criteria are available for monitoring NIHL, but the specific criterion to be used to define clinically significant otoprotection remains a topic of discussion. Audiogram-based primary outcome measures can be combined with secondary outcomes, including OAE amplitude, EHF hearing, speech-in-noise testing, tinnitus surveys, and patient-reported outcomes. Standardization of test protocols for the above primary and secondary outcomes, and associated reporting criterion for each, would facilitate clinical trial design and comparison of results across investigational drug agents. Antioxid. Redox Signal. 36, 1171-1202.
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Affiliation(s)
- Colleen G. Le Prell
- Department of Speech, Language, and Hearing Science, University of Texas at Dallas, Richardson, Texas, USA
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Foster AC, Szobota S, Piu F, Jacques BE, Moore DR, Sanchez VA, Anderson JJ. A neurotrophic approach to treating hearing loss: Translation from animal models to clinical proof-of-concept. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2022; 151:3937. [PMID: 35778165 DOI: 10.1121/10.0011510] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Accepted: 05/10/2022] [Indexed: 06/15/2023]
Abstract
Currently, there are no approved medicines available for the treatment of hearing loss. However, research over the past two decades has contributed to a growing understanding of the pathological mechanisms in the cochlea that result in hearing difficulties. The concept that a loss of the synapses connecting inner hair cells with the auditory nerve (cochlear synaptopathy) contributes to hearing loss has gained considerable attention. Both animal and human post-mortem studies support the idea that these synapses (ribbon synapses) are highly vulnerable to noise, ototoxicity, and the aging process. Their degeneration has been suggested as an important factor in the speech-in-noise difficulties commonly experienced by those suffering with hearing loss. Neurotrophins such as brain derived neurotrophic factor (BDNF) have the potential to restore these synapses and provide improved hearing function. OTO-413 is a sustained exposure formulation of BDNF suitable for intratympanic administration that in preclinical models has shown the ability to restore ribbon synapses and provide functional hearing benefit. A phase 1/2 clinical trial with OTO-413 has provided initial proof-of-concept for improved speech-in-noise hearing performance in subjects with hearing loss. Key considerations for the design of this clinical study, including aspects of the speech-in-noise assessments, are discussed.
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Affiliation(s)
- Alan C Foster
- Research and Preclinical Development, Otonomy Inc., 4796 Executive Drive, San Diego, California 92121, USA
| | - Stephanie Szobota
- Research and Preclinical Development, Otonomy Inc., 4796 Executive Drive, San Diego, California 92121, USA
| | - Fabrice Piu
- Research and Preclinical Development, Otonomy Inc., 4796 Executive Drive, San Diego, California 92121, USA
| | - Bonnie E Jacques
- Research and Preclinical Development, Otonomy Inc., 4796 Executive Drive, San Diego, California 92121, USA
| | - David R Moore
- Communication Sciences Research Center, Cincinnati Children's Hospital, 3333 Burnet Avenue, Cincinnati, Ohio 45229-3026, USA
| | - Victoria A Sanchez
- Department of Otolaryngology - Head & Neck Surgery, University of South Florida, 12901 Bruce B. Downs Blvd., MDC 73, Tampa, Florida 33620, USA
| | - Jeffery J Anderson
- Clinical Sciences, Otonomy Inc., 4796 Executive Drive, San Diego, California 92121, USA
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