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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; 45:1149-1164. [PMID: 38556645 DOI: 10.1097/aud.0000000000001504] [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: 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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Ananthanarayana RM, Buss E, Monson BB. Band importance for speech-in-speech recognition in the presence of extended high-frequency cues. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2024; 156:1202-1213. [PMID: 39158325 PMCID: PMC11335358 DOI: 10.1121/10.0028269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/08/2024] [Revised: 07/15/2024] [Accepted: 07/30/2024] [Indexed: 08/20/2024]
Abstract
Band importance functions for speech-in-noise recognition, typically determined in the presence of steady background noise, indicate a negligible role for extended high frequencies (EHFs; 8-20 kHz). However, recent findings indicate that EHF cues support speech recognition in multi-talker environments, particularly when the masker has reduced EHF levels relative to the target. This scenario can occur in natural auditory scenes when the target talker is facing the listener, but the maskers are not. In this study, we measured the importance of five bands from 40 to 20 000 Hz for speech-in-speech recognition by notch-filtering the bands individually. Stimuli consisted of a female target talker recorded from 0° and a spatially co-located two-talker female masker recorded either from 0° or 56.25°, simulating a masker either facing the listener or facing away, respectively. Results indicated peak band importance in the 0.4-1.3 kHz band and a negligible effect of removing the EHF band in the facing-masker condition. However, in the non-facing condition, the peak was broader and EHF importance was higher and comparable to that of the 3.3-8.3 kHz band in the facing-masker condition. These findings suggest that EHFs contain important cues for speech recognition in listening conditions with mismatched talker head orientations.
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Affiliation(s)
- Rohit M Ananthanarayana
- 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 27599, USA
| | - Brian B Monson
- Department of Speech and Hearing Science, University of Illinois Urbana-Champaign, Champaign, Illinois 61820, USA
- Department of Biomedical and Translational Sciences, Carle Illinois College of Medicine, University of Illinois Urbana-Champaign, Champaign, Illinois 61820, USA
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Bhatt IS, Raygoza Garay JA, Bhagavan SG, Ingalls V, Dias R, Torkamani A. Polygenic Risk Score-Based Association Analysis Identifies Genetic Comorbidities Associated with Age-Related Hearing Difficulty in Two Independent Samples. J Assoc Res Otolaryngol 2024; 25:387-406. [PMID: 38782831 PMCID: PMC11349729 DOI: 10.1007/s10162-024-00947-0] [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: 01/16/2024] [Accepted: 04/18/2024] [Indexed: 05/25/2024] Open
Abstract
PURPOSE Age-related hearing loss is the most common form of permanent hearing loss that is associated with various health traits, including Alzheimer's disease, cognitive decline, and depression. The present study aims to identify genetic comorbidities of age-related hearing loss. Past genome-wide association studies identified multiple genomic loci involved in common adult-onset health traits. Polygenic risk scores (PRS) could summarize the polygenic inheritance and quantify the genetic susceptibility of complex traits independent of trait expression. The present study conducted a PRS-based association analysis of age-related hearing difficulty in the UK Biobank sample (N = 425,240), followed by a replication analysis using hearing thresholds (HTs) and distortion-product otoacoustic emissions (DPOAEs) in 242 young adults with self-reported normal hearing. We hypothesized that young adults with genetic comorbidities associated with age-related hearing difficulty would exhibit subclinical decline in HTs and DPOAEs in both ears. METHODS A total of 111,243 participants reported age-related hearing difficulty in the UK Biobank sample (> 40 years). The PRS models were derived from the polygenic risk score catalog to obtain 2627 PRS predictors across the health spectrum. HTs (0.25-16 kHz) and DPOAEs (1-16 kHz, L1/L2 = 65/55 dB SPL, F2/F1 = 1.22) were measured on 242 young adults. Saliva-derived DNA samples were subjected to low-pass whole genome sequencing, followed by genome-wide imputation and PRS calculation. The logistic regression analyses were performed to identify PRS predictors of age-related hearing difficulty in the UK Biobank cohort. The linear mixed model analyses were performed to identify PRS predictors of HTs and DPOAEs. RESULTS The PRS-based association analysis identified 977 PRS predictors across the health spectrum associated with age-related hearing difficulty. Hearing difficulty and hearing aid use PRS predictors revealed the strongest association with the age-related hearing difficulty phenotype. Youth with a higher genetic predisposition to hearing difficulty revealed a subclinical elevation in HTs and a decline in DPOAEs in both ears. PRS predictors associated with age-related hearing difficulty were enriched for mental health, lifestyle, metabolic, sleep, reproductive, digestive, respiratory, hematopoietic, and immune traits. Fifty PRS predictors belonging to various trait categories were replicated for HTs and DPOAEs in both ears. CONCLUSION The study identified genetic comorbidities associated with age-related hearing loss across the health spectrum. Youth with a high genetic predisposition to age-related hearing difficulty and other related complex traits could exhibit sub-clinical decline in HTs and DPOAEs decades before clinically meaningful age-related hearing loss is observed. We posit that effective communication of genetic risk, promoting a healthy lifestyle, and reducing exposure to environmental risk factors at younger ages could help prevent or delay the onset of age-related hearing difficulty at older ages.
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Affiliation(s)
- Ishan Sunilkumar Bhatt
- Department of Communication Sciences & Disorders, University of Iowa, 250 Hawkins Dr, Iowa City, IA, 52242, USA.
| | - Juan Antonio Raygoza Garay
- Department of Communication Sciences & Disorders, University of Iowa, 250 Hawkins Dr, Iowa City, IA, 52242, USA
- Holden Comprehensive Cancer Center, University of Iowa, Iowa City, IA, 52242, USA
| | - Srividya Grama Bhagavan
- Department of Communication Sciences & Disorders, University of Iowa, 250 Hawkins Dr, Iowa City, IA, 52242, USA
| | - Valerie Ingalls
- Department of Communication Sciences & Disorders, University of Iowa, 250 Hawkins Dr, Iowa City, IA, 52242, USA
| | - Raquel Dias
- Department of Microbiology and Cell Science, University of Florida, Gainesville, FL, 32608, USA
| | - Ali Torkamani
- Department of Integrative Structural and Computational Biology, Scripps Science Institute, La Jolla, CA, 92037, USA
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Helfer KS, Maldonado L, Matthews LJ, Simpson AN, Dubno JR. Extended High-Frequency Thresholds: Associations With Demographic and Risk Factors, Cognitive Ability, and Hearing Outcomes in Middle-Aged and Older Adults. Ear Hear 2024:00003446-990000000-00309. [PMID: 38987892 DOI: 10.1097/aud.0000000000001531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/12/2024]
Abstract
OBJECTIVES This study had two objectives: to examine associations between extended high-frequency (EHF) thresholds, demographic factors (age, sex, race/ethnicity), risk factors (cardiovascular, smoking, noise exposure, occupation), and cognitive abilities; and to determine variance explained by EHF thresholds for speech perception in noise, self-rated workload/effort, and self-reported hearing difficulties. DESIGN This study was a retrospective analysis of a data set from the MUSC Longitudinal Cohort Study of Age-related Hearing Loss. Data from 347 middle-aged adults (45 to 64 years) and 694 older adults (≥ 65 years) were analyzed for this study. Speech perception was quantified using low-context Speech Perception In Noise (SPIN) sentences. Self-rated workload/effort was measured using the effort prompt from the National Aeronautics and Space Administration-Task Load Index. Self-reported hearing difficulty was assessed using the Hearing Handicap Inventory for the Elderly/Adults. The Wisconsin Card Sorting Task and the Stroop Neuropsychological Screening Test were used to assess selected cognitive abilities. Pure-tone averages representing conventional and EHF thresholds between 9 and 12 kHz (PTA(9 - 12 kHz)) were utilized in simple linear regression analyses to examine relationships between thresholds and demographic and risk factors or in linear regression models to assess the contributions of PTA(9 - 12 kHz) to the variance among the three outcomes of interest. Further analyses were performed on a subset of individuals with thresholds ≤ 25 dB HL at all conventional frequencies to control for the influence of hearing loss on the association between PTA(9 - 12 kHz) and outcome measures. RESULTS PTA(9 - 12 kHz) was higher in males than females, and was higher in White participants than in racial Minority participants. Linear regression models showed the associations between cardiovascular risk factors and PTA(9 - 12 kHz) were not statistically significant. Older adults who reported a history of noise exposure had higher PTA(9 - 12 kHz) than those without a history, while associations between noise history and PTA(9 - 12 kHz) did not reach statistical significance for middle-aged participants. Linear models adjusting for age, sex, race and noise history showed that higher PTA(9 - 12 kHz) was associated with greater self-perceived hearing difficulty and poorer speech recognition scores in noise for both middle-aged and older participants. Workload/effort was significantly related to PTA(9 - 12 kHz) for middle-aged, but not older, participants, while cognitive task performance was correlated with PTA(9 - 12 kHz) only for older participants. In general, PTA(9 - 12 kHz)did not account for additional variance in outcome measures as compared to conventional pure-tone thresholds, with the exception of self-reported hearing difficulties in older participants. Linear models adjusting for age and accounting for subject-level correlations in the subset analyses revealed no association between PTA(9 - 12 kHz)and outcomes of interest. CONCLUSIONS EHF thresholds show age-, sex-, and race-related patterns of elevation that are similar to what is observed for conventional thresholds. The current results support the need for more research to determine the utility of adding EHF thresholds to routine audiometric assessment with middle-aged and older adults.
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Affiliation(s)
- Karen S Helfer
- Department of Speech, Language, and Hearing Sciences, University of Massachusetts Amherst, Amherst, Massachusetts, USA
| | - Lizmarie Maldonado
- Department of Healthcare Leadership and Management, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Lois J Matthews
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Annie N Simpson
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Judy R Dubno
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, USA
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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; 67:2473-2482. [PMID: 38820241 DOI: 10.1044/2024_jslhr-23-00652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [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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Bhatt IS, Garay JAR, Bhagavan SG, Ingalls V, Dias R, Torkamani A. A genome-wide association study reveals a polygenic architecture of speech-in-noise deficits in individuals with self-reported normal hearing. Sci Rep 2024; 14:13089. [PMID: 38849415 PMCID: PMC11161523 DOI: 10.1038/s41598-024-63972-2] [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: 11/14/2023] [Accepted: 06/04/2024] [Indexed: 06/09/2024] Open
Abstract
Speech-in-noise (SIN) perception is a primary complaint of individuals with audiometric hearing loss. SIN performance varies drastically, even among individuals with normal hearing. The present genome-wide association study (GWAS) investigated the genetic basis of SIN deficits in individuals with self-reported normal hearing in quiet situations. GWAS was performed on 279,911 individuals from the UB Biobank cohort, with 58,847 reporting SIN deficits despite reporting normal hearing in quiet. GWAS identified 996 single nucleotide polymorphisms (SNPs), achieving significance (p < 5*10-8) across four genomic loci. 720 SNPs across 21 loci achieved suggestive significance (p < 10-6). GWAS signals were enriched in brain tissues, such as the anterior cingulate cortex, dorsolateral prefrontal cortex, entorhinal cortex, frontal cortex, hippocampus, and inferior temporal cortex. Cochlear cell types revealed no significant association with SIN deficits. SIN deficits were associated with various health traits, including neuropsychiatric, sensory, cognitive, metabolic, cardiovascular, and inflammatory conditions. A replication analysis was conducted on 242 healthy young adults. Self-reported speech perception, hearing thresholds (0.25-16 kHz), and distortion product otoacoustic emissions (1-16 kHz) were utilized for the replication analysis. 73 SNPs were replicated with a self-reported speech perception measure. 211 SNPs were replicated with at least one and 66 with at least two audiological measures. 12 SNPs near or within MAPT, GRM3, and HLA-DQA1 were replicated for all audiological measures. The present study highlighted a polygenic architecture underlying SIN deficits in individuals with self-reported normal hearing.
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Affiliation(s)
- Ishan Sunilkumar Bhatt
- Department of Communication Sciences and Disorders, University of Iowa, 250 Hawkins Dr, Iowa City, IA, 52242, USA.
| | - Juan Antonio Raygoza Garay
- Department of Communication Sciences and Disorders, University of Iowa, 250 Hawkins Dr, Iowa City, IA, 52242, USA
- Holden Comprehensive Cancer Center, University of Iowa, Iowa City, IA, 52242, USA
| | - Srividya Grama Bhagavan
- Department of Communication Sciences and Disorders, University of Iowa, 250 Hawkins Dr, Iowa City, IA, 52242, USA
| | - Valerie Ingalls
- Department of Communication Sciences and Disorders, University of Iowa, 250 Hawkins Dr, Iowa City, IA, 52242, USA
| | - Raquel Dias
- Department of Microbiology and Cell Science, University of Florida, Gainesville, FL, 32608, USA
| | - Ali Torkamani
- Department of Integrative Structural and Computational Biology, Scripps Research Institute, La Jolla, CA, 92037, USA
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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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Bidelman GM, Bernard F, Skubic K. Hearing in categories aids speech streaming at the "cocktail party". BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.04.03.587795. [PMID: 38617284 PMCID: PMC11014555 DOI: 10.1101/2024.04.03.587795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/16/2024]
Abstract
Our perceptual system bins elements of the speech signal into categories to make speech perception manageable. Here, we aimed to test whether hearing speech in categories (as opposed to a continuous/gradient fashion) affords yet another benefit to speech recognition: parsing noisy speech at the "cocktail party." We measured speech recognition in a simulated 3D cocktail party environment. We manipulated task difficulty by varying the number of additional maskers presented at other spatial locations in the horizontal soundfield (1-4 talkers) and via forward vs. time-reversed maskers, promoting more and less informational masking (IM), respectively. In separate tasks, we measured isolated phoneme categorization using two-alternative forced choice (2AFC) and visual analog scaling (VAS) tasks designed to promote more/less categorical hearing and thus test putative links between categorization and real-world speech-in-noise skills. We first show that listeners can only monitor up to ~3 talkers despite up to 5 in the soundscape and streaming is not related to extended high-frequency hearing thresholds (though QuickSIN scores are). We then confirm speech streaming accuracy and speed decline with additional competing talkers and amidst forward compared to reverse maskers with added IM. Dividing listeners into "discrete" vs. "continuous" categorizers based on their VAS labeling (i.e., whether responses were binary or continuous judgments), we then show the degree of IM experienced at the cocktail party is predicted by their degree of categoricity in phoneme labeling; more discrete listeners are less susceptible to IM than their gradient responding peers. Our results establish a link between speech categorization skills and cocktail party processing, with a categorical (rather than gradient) listening strategy benefiting degraded speech perception. These findings imply figure-ground deficits common in many disorders might arise through a surprisingly simple mechanism: a failure to properly bin sounds into categories.
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Affiliation(s)
- Gavin M. Bidelman
- Department of Speech, Language and Hearing Sciences, Indiana University, Bloomington, IN, USA
- Program in Neuroscience, Indiana University, Bloomington, IN, USA
- Cognitive Science Program, Indiana University, Bloomington, IN, USA
| | - Fallon Bernard
- School of Communication Sciences & Disorders, University of Memphis, Memphis TN, USA
| | - Kimberly Skubic
- School of Communication Sciences & Disorders, University of Memphis, Memphis TN, USA
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Ma X, Shen W, Yang S, Wang F. The significance of extended high-frequency audiometry in tinnitus patients with normal hearing as evaluated via conventional pure tone audiometry. J Laryngol Otol 2024; 138:381-387. [PMID: 38148683 DOI: 10.1017/s0022215123000920] [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] [Indexed: 12/28/2023]
Abstract
OBJECTIVE This study was designed to determine whether extended high-frequency audiometry was capable of better differentiating between participants with normal hearing who did or did not have subjective tinnitus. METHODS A total of 96 study participants were enrolled: 36 patients with unilateral tinnitus, 28 patients with bilateral tinnitus and 32 volunteers as controls. All 96 participants exhibited normal audiometry findings and hearing thresholds. Extended high-frequency audiometry was used to evaluate these patients. RESULTS There were differences between the extended high-frequency hearing thresholds of affected and unaffected ears in those with unilateral tinnitus, and in the 20-29-year-old bilateral tinnitus group, at 11.2, 12.5 and 14 kHz. Unilateral tinnitus subgroups had higher extended high-frequency hearing thresholds than those in control subjects, at all extended high frequencies. CONCLUSION Extended high-frequency audiometry can offer additional information regarding the hearing status of patients with tinnitus who exhibit normal pure tone thresholds when analysed via conventional hearing thresholds.
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Affiliation(s)
- Xiaoyan Ma
- First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
- Senior Department of Otolaryngology - Head and Neck Surgery, Sixth Medical Center of People's Liberation Army General Hospital, Beijing, China
- National Clinical Research Center for Otolaryngologic Diseases, Beijing, China
- State Key Lab of Hearing Science, Ministry of Education, Beijing, China
- Beijing Key Lab of Hearing Impairment Prevention and Treatment, Beijing, China
| | - Weidong Shen
- Senior Department of Otolaryngology - Head and Neck Surgery, Sixth Medical Center of People's Liberation Army General Hospital, Beijing, China
- National Clinical Research Center for Otolaryngologic Diseases, Beijing, China
- State Key Lab of Hearing Science, Ministry of Education, Beijing, China
| | - Shiming Yang
- Senior Department of Otolaryngology - Head and Neck Surgery, Sixth Medical Center of People's Liberation Army General Hospital, Beijing, China
- National Clinical Research Center for Otolaryngologic Diseases, Beijing, China
- State Key Lab of Hearing Science, Ministry of Education, Beijing, China
| | - Fangyuan Wang
- Senior Department of Otolaryngology - Head and Neck Surgery, Sixth Medical Center of People's Liberation Army General Hospital, Beijing, China
- National Clinical Research Center for Otolaryngologic Diseases, Beijing, China
- State Key Lab of Hearing Science, Ministry of Education, Beijing, 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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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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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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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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14
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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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15
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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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16
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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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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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18
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Remenschneider AK, Cheng JT, Herrmann BS, Rosowski JJ. Characterization and Clinical Use of Bone Conduction Transducers at Extended High Frequencies. Hear Res 2023; 429:108688. [PMID: 36628803 PMCID: PMC9953386 DOI: 10.1016/j.heares.2022.108688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 12/21/2022] [Accepted: 12/27/2022] [Indexed: 01/01/2023]
Abstract
Measurement of bone conduction (BC) hearing thresholds at extended high frequencies (EHF; above 8 kHz) is of clinical interest but is technically complicated by limitations in standard BC transducer output, a lack of calibration standards and sparse clinical data from human subjects. A recently described calibration scheme using an artificial mastoid and interposed accelerometer is applied in this study to characterize and compare acceleration and computed force outputs over the 4-20 kHz range of two standard BC transducers: the RadioEar® B71 and B81, as well as two non-standard, commercially available BC transducers: the Tascam® HP-F200 and the Aftershokz® AS400. Measures of linear output growth, harmonic distortion and acoustic radiation are assessed and compared across devices. A maximum linear input voltage is established for each BC transducer using measurements of linear output growth and total harmonic distortion. At maximum linear input level, the Tascam shows superior force output by 25 to 40 dB above 8 kHz and the widest dynamic EHF range. Acoustic radiation per output force was lowest for the Tascam, whereas the AS400 behaved more like an air conduction earphone than a force generator. In a cohort of 15 normal hearing volunteers, BC thresholds, measured with the Tascam and reported in dB re 1 rms μN, were consistent with historical measures of EHF BC thresholds in similar subjects using an alternative BC transducer.
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Affiliation(s)
- Aaron K Remenschneider
- Department of Otolaryngology, Head and Neck Surgery, Mass Eye and Ear, Harvard Medical School, Boston, MA 02114, USA; Department of Otolaryngology, UMass Memorial Medical Center, UMass Chan Medical School, Worcester, MA 01655, USA.
| | - Jeffrey Tao Cheng
- Department of Otolaryngology, Head and Neck Surgery, Mass Eye and Ear, Harvard Medical School, Boston, MA 02114, USA
| | - Barbara S Herrmann
- Department of Otolaryngology, Head and Neck Surgery, Mass Eye and Ear, Harvard Medical School, Boston, MA 02114, USA
| | - John J Rosowski
- Department of Otolaryngology, Head and Neck Surgery, Mass Eye and Ear, Harvard Medical School, Boston, MA 02114, USA
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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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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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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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22
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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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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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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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Lough M, Plack CJ. Extended high-frequency audiometry in research and clinical practice. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2022; 151:1944. [PMID: 35364938 DOI: 10.1121/10.0009766] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 02/15/2022] [Indexed: 06/14/2023]
Abstract
Audiometric testing in research and in clinical settings rarely considers frequencies above 8 kHz. However, the sensitivity of young healthy ears extends to 20 kHz, and there is increasing evidence that testing in the extended high-frequency (EHF) region, above 8 kHz, might provide valuable additional information. Basal (EHF) cochlear regions are especially sensitive to the effects of aging, disease, ototoxic drugs, and possibly noise exposure. Hence, EHF loss may be an early warning of damage, useful for diagnosis and for monitoring hearing health. In certain environments, speech perception may rely on EHF information, and there is evidence for an association between EHF loss and speech perception difficulties, although this may not be causal: EHF loss may instead be a marker for sub-clinical damage at lower frequencies. If there is a causal relation, then amplification in the EHF range may be beneficial if the technical difficulties can be overcome. EHF audiometry in the clinic presents with no particular difficulty, the biggest obstacle being lack of specialist equipment. Currently, EHF audiometry has limited but increasing clinical application. With the development of international guidelines and standards, it is likely that EHF testing will become widespread in future.
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Affiliation(s)
- Melanie Lough
- Manchester Centre for Audiology and Deafness, The University of Manchester, Oxford Road, Manchester, M13 9PL, United Kingdom
| | - Christopher J Plack
- Manchester Centre for Audiology and Deafness, The University of Manchester, Oxford Road, Manchester, M13 9PL, United Kingdom
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