Maturation of the human cochlear amplifier: distortion product otoacoustic emission suppression tuning curves recorded at low and high primary tone levels

Spectral Resolution Development in Children With Normal Hearing and With Cochlear Implants: A Review of Behavioral Studies

PURPOSE

This review article provides a theoretical overview of the development of spectral resolution in children with normal hearing (cNH) and in those who use cochlear implants (CIs), with an emphasis on methodological considerations. The aim was to identify key directions for future research on spectral resolution development in children with CIs.

METHOD

A comprehensive literature review was conducted to summarize and synthesize previously published behavioral research on spectral resolution development in normal and impaired auditory systems.

CONCLUSIONS

In cNH, performance on spectral resolution tasks continues to improve through the teenage years and is likely driven by gradual maturation of across-channel intensity resolution. A small but growing body of evidence from children with CIs suggests a more complex relationship between spectral resolution development, patient demographics, and the quality of the CI electrode-neuron interface. Future research should aim to distinguish between the effects of patient-specific variables and the underlying physiology on spectral resolution abilities in children of all ages who are hard of hearing and use auditory prostheses.

Congenital Deafness and Recent Advances Towards Restoring Hearing Loss

Congenital hearing loss is the most common birth defect, estimated to affect 2-3 in every 1000 births. Currently there is no cure for hearing loss. Treatment options are limited to hearing aids for mild and moderate cases, and cochlear implants for severe and profound hearing loss. Here we provide a literature overview of the environmental and genetic causes of congenital hearing loss, common animal models and methods used for hearing research, as well as recent advances towards developing therapies to treat congenital deafness. © 2021 The Authors.

Masked Speech Recognition in School-Age Children

Children who are typically developing often struggle to hear and understand speech in the presence of competing background sounds, particularly when the background sounds are also speech. For example, in many cases, young school-age children require an additional 5- to 10-dB signal-to-noise ratio relative to adults to achieve the same word or sentence recognition performance in the presence of two streams of competing speech. Moreover, adult-like performance is not observed until adolescence. Despite ample converging evidence that children are more susceptible to auditory masking than adults, the field lacks a comprehensive model that accounts for the development of masked speech recognition. This review provides a synthesis of the literature on the typical development of masked speech recognition. Age-related changes in the ability to recognize phonemes, words, or sentences in the presence of competing background sounds will be discussed by considering (1) how masking sounds influence the sensory encoding of target speech; (2) differences in the time course of development for speech-in-noise versus speech-in-speech recognition; and (3) the central auditory and cognitive processes required to separate and attend to target speech when multiple people are speaking at the same time.

Swept-tone stimulus-frequency otoacoustic emissions: Normative data and methodological considerations

Stimulus-frequency otoacoustic emissions (SFOAEs) are reflection-source emissions, and are the least familiar and perhaps most underutilized otoacoustic emission. Here, normative SFOAE data are presented from a large group of 48 young adults at probe levels from 20 to 60 dB sound pressure level (SPL) across a four-octave frequency range to characterize the typical SFOAE and describe recent methodological advances that have made its measurement more efficient. In young-adult ears, SFOAE levels peaked in the low-to-mid frequencies at mean levels of ∼6-7 dB SPL while signal-to-noise ranged from 23 to 34 dB SPL and test-retest reliability was ±4 dB for 90% of the SFOAE data. On average, females had ∼2.5 dB higher SFOAE levels than males. SFOAE input/output functions showed near linear growth at low levels and a compression threshold averaging 35 dB SPL across frequency. SFOAE phase accumulated ∼32-36 cycles across four octaves on average, and showed level effects when converted to group delay: low-level probes produced longer SFOAE delays. A "break" in the normalized SFOAE delay was observed at 1.1 kHz on average, elucidating the location of the putative apical-basal transition. Technical innovations such as the concurrent sweeping of multiple frequency segments, post hoc suppressor decontamination, and a post hoc artifact-rejection technique were tested.

Estimating cochlear tuning dependence on stimulus level and frequency from the delay of otoacoustic emissions

An objective technique based on the time-frequency analysis of otoacoustic emissions is proposed to get fast and stable estimates of cochlear tuning. Time-frequency analysis allows one to get stable measurements of the delay/frequency function, which is theoretically expected to be a function of cochlear tuning. Theoretical considerations and numerical solutions of a nonlinear cochlear model suggest that the average phase-gradient delay of the otoacoustic emission single-reflection components, weighted, for each frequency, by the amplitude of the corresponding wavelet coefficients, approximately scales as the square root of the cochlear quality factor. The application of the method to human stimulus-frequency and transient-evoked otoacoustic emissions shows that tuning decreases approximately by a factor of 2, as the stimulus level increases by 30 dB in a moderate stimulus level range. The results also show a steady increase of tuning with increasing frequency, by a factor of 2 between 1 and 5 kHz. This last result is model-dependent, because it relies on the assumption that cochlear scale-invariance breaking is only due to the frequency dependence of tuning. The application of the method to the reflection component of distortion product otoacoustic emissions, separated using time-frequency filtering, is complicated by the necessity of effectively canceling the distortion component.

Multi-tone suppression of distortion-product otoacoustic emissions in humans

The purpose of this study was to investigate the combined effect of multiple suppressors. Distortion-product otoacoustic emission (DPOAE) measurements were made in normal-hearing participants. Primary tones had fixed frequencies (f2 = 4000 Hz; f1 / f2 = 1.22) and a range of levels. Suppressor tones were at three frequencies (fs = 2828, 4100, 4300 Hz) and range of levels. Decrement was defined as the attenuation in DPOAE level due to the presence of a suppressor. A measure of suppression called suppressive intensity was calculated by an equation previously shown to fit DPOAE suppression data. Suppressor pairs, which were the combination of two different frequencies, were presented at levels selected to have equal single-suppressor decrements. A hybrid model that represents a continuum between additive intensity and additive attenuation best described the results. The suppressor pair with the smallest frequency ratio produced decrements that were more consistent with additive intensity. The suppressor pair with the largest frequency ratio produced decrements at the highest level that were consistent with additive attenuation. Other suppressor-pair conditions produced decrements that were intermediate between these two alternative models. The hybrid model provides a useful framework for representing the observed range of interaction when two suppressors are combined.

Frequency shifts with age in click-evoked otoacoustic emissions of preterm infants

A previous study [Brienesse et al. (1997). Pediatr. Res. 42, 478-483] demonstrated a positive shift with increasing postmenstrual age (PMA) in the frequencies of synchronized spontaneous otoacoustic emissions (SSOAEs) in preterm infants. We used a mixed model approach to describe a shift with PMA in the spectra of click-evoked otoacoustic emissions (CEOAEs) measured in a group of 22 preterm infants. The rate in shift in CEOAE spectral components was found to be frequency dependent, with a mean estimate of 10 Hz/week for frequencies around 2 kHz and 30 Hz/week for frequencies around 4.25 kHz. This rate decreased with increasing PMA. Because SSOAEs are often part of the CEOAE response, a comparison was made between the shifts in SSOAEs and CEOAEs in a sub-group of 16 preterm infants. The results indicate that the shifts found for both types of OAE are similar, which supports a common mechanism for this change in OAE-characteristic. At present it is not clear to what extent developmental processes in the cochlea and the middle ear can account for these frequency shifts in the spectra of CEOAEs and SSOAEs during the preterm period.

Distortion-product otoacoustic-emission suppression tuning in human infants and adults using absorbed sound power

The greatest difference in distortion product otoacoustic emission (DPOAE) suppression tuning curves (STCs) in infant and adult ears occurs at a stimulus frequency of 6 kHz. These infant and adult STCs are much more similar when constructed using the absorbed power level of the stimulus and suppressor tones rather than using sound pressure level. This procedure incorporates age-related differences in forward and reverse transmission of sound power through the ear canal and middle ear. These results support the theory that the cochlear mechanics underlying DPOAE suppression are substantially mature in full-term infants.

Distortion-product otoacoustic emission suppression tuning curves in humans

Distortion-product otoacoustic emission (DPOAE) suppression data as a function of suppressor level (L(3)) for f(2) frequencies from 0.5 to 8 kHz and L(2) levels from 10 to 60 dB sensation level were used to construct suppression tuning curves (STCs). DPOAE levels in the presence of suppressors were converted into decrement versus L(3) functions, and the L(3) levels resulting in 3 dB decrements were derived by transformed linear regression. These L(3) levels were plotted as a function of f(3) to construct STCs. When f(3) is represented on an octave scale, STCs were similar in shape across f(2) frequency. These STCs were analyzed to provide estimates of gain (tip-to-tail difference) and tuning (Q(ERB)). Both gain and tuning decreased as L(2) increased, regardless of f(2), but the trend with f(2) was not monotonic. A roughly linear relation was observed between gain and tuning at each frequency, such that gain increased by 4-16 dB (mean ≈ 5 dB) for every unit increase in Q(ERB), although the pattern varied with frequency. These findings suggest consistent nonlinear processing across a wide frequency range in humans, although the nonlinear operation range is frequency dependent.

Growth of suppression in humans based on distortion-product otoacoustic emission measurements

Distortion-product otoacoustic emissions (DPOAEs) were used to describe suppression growth in normal-hearing humans. Data were collected at eight f(2) frequencies ranging from 0.5 to 8 kHz for L(2) levels ranging from 10 to 60 dB sensation level. For each f(2) and L(2) combination, suppression was measured for nine or eleven suppressor frequencies (f(3)) whose levels varied from -20 to 85 dB sound pressure level (SPL). Suppression grew nearly linearly when f(3) ≈ f(2), grew more rapidly for f(3) < f(2), and grew more slowly for f(3) > f(2). These results are consistent with physiological and mechanical data from lower animals, as well as previous DPOAE data from humans, although no previous DPOAE study has described suppression growth for as wide a range of frequencies and levels. These trends were evident for all f(2) and L(2) combinations; however, some exceptions were noted. Specifically, suppression growth rate was less steep as a function of f(3) for f(2) frequencies ≤ 1 kHz. Thus, despite the qualitative similarities across frequency, there were quantitative differences related to f(2), suggesting that there may be subtle differences in suppression for frequencies above 1 kHz compared to frequencies below 1 kHz.

Low-frequency and high-frequency distortion product otoacoustic emission suppression in humans

Distortion product otoacoustic emission suppression (quantified as decrements) was measured for f(2)=500 and 4000 Hz, for a range of primary levels (L(2)), suppressor frequencies (f(3)), and suppressor levels (L(3)) in 19 normal-hearing subjects. Slopes of decrement-versus-L(3) functions were similar at both f(2) frequencies, and decreased as f(3) increased. Suppression tuning curves, constructed from decrement functions, were used to estimate (1) suppression for on- and low-frequency suppressors, (2) tip-to-tail differences, (3) Q(ERB), and (4) best frequency. Compression, estimated from the slope of functions relating suppression "threshold" to L(2) for off-frequency suppressors, was similar for 500 and 4000 Hz. Tip-to-tail differences, Q(ERB), and best frequency decreased as L(2) increased for both frequencies. However, tip-to-tail difference (an estimate of cochlear-amplifier gain) was 20 dB greater at 4000 Hz, compared to 500 Hz. Q(ERB) decreased to a greater extent with L(2) when f(2)=4000 Hz, but, on an octave scale, best frequency shifted more with level when f(2)=500 Hz. These data indicate that, at both frequencies, cochlear processing is nonlinear. Response growth and compression are similar at the two frequencies, but gain is greater at 4000 Hz and spread of excitation is greater at 500 Hz.

A comparative study of distortion-product-otoacoustic-emission fine structure in human newborns and adults with normal hearing

Distortion product otoacoustic emissions (DPOAE) measured in human newborns are not adult-like. More than a decade of work from various investigators has created a well-developed body of evidence describing these differences but the putative anatomy or physiology has only been partially explained. Recently, Abdala and Keefe [J. Acoust. Soc. Am. 120, 3832-3842 (2006)] have identified outer and middle ear immaturities that at least partially describe the differences observed between newborn and adult input-output functions and suppression tuning curves. DPOAE fine structure characteristics and their maturation have not been examined to any extent in the literature. Fine structure characteristics in two groups of ten newborns and young adults with normal hearing sensitivity are compared here. Consistent with previous reports, the newborns show higher DPOAE levels; greater fine structure depth and wider fine structure spacing is also observed in the newborns. Differences in fine structure morphology are also observed between the two age groups. While some of these findings are attributable to an immature outer and middle ear system in the newborns, it is argued that some observed differences in fine structure characteristics might be due to remnant immaturities in passive motion of the basilar membrane in the newborn cochlea.

Distortion product otoacoustic emission suppression tuning and acoustic admittance in human infants: birth through 6 months

Previous work has reported non-adultlike distortion product otoacoustic emission (DPOAE) suppression in human newborns at f2=6000 Hz, indicating an immaturity in peripheral auditory function. In this study, DPOAE suppression tuning curves (STCs) were recorded as a measure of cochlear function and acoustic admittance/reflectance (YR) in the ear canal recorded as a measure of middle-ear function, in the same 20 infants at birth and through 6 months of age. DPOAE STCs changed little from birth through 6 months, showing excessively narrow and sharp tuning throughout the test period. In contrast, several middle-ear indices at corresponding frequencies shifted systematically with increasing age, although they also remained non-adultlike at 6 months. Linear correlations were conducted between YR and DPOAE suppression features. Only two correlations out of 76 were significant, and all but three YR variables accounted for <10% of the variance in DPOAE suppression tuning. The strongest correlation was noted between admittance phase at 5700 Hz and STC tip-to-tail (R=0.49). The association between middle-ear variables and DPOAE suppression may be stronger during other developmental time periods. Study of older infants and children is needed to fully define postnatal immaturity of human peripheral auditory function.

Effects of middle-ear immaturity on distortion product otoacoustic emission suppression tuning in infant ears

Distortion product otoacoustic emission (DPOAE) measures of cochlear function, including DPOAE suppression tuning curves and input/output (I/O) functions, are not adultlike in human infants. These findings suggest the cochlear amplifier might be functionally immature in newborns. However, many noncochlear factors influence DPOAEs and must be considered. This study examines whether age differences in DPOAE I/O functions recorded from infant and adult ears reflect maturation of ear-canal/middle-ear function or cochlear mechanics. A model based on linear middle-ear transmission and nonlinear cochlear generation was developed to fit the adult DPOAE I/O data. By varying only those model parameters related to middle-ear transmission (and holding cochlear parameters at adult values), the model successfully fitted I/O data from infants at birth through age 6 months. This suggests that cochlear mechanics are mature at birth. The model predicted an attenuation of stimulus energy through the immature ear canal and middle ear, and evaluated whether immaturities in forward transmission could explain the differences consistently observed between infant and adult DPOAE suppression. Results show that once the immaturity was compensated for by providing infants with a relative increase in primary tone level, DPOAE suppression tuning at f2= 6000 Hz was similar in adults and infants.

Distortion-product otoacoustic emission suppression growth in normal and noise-exposed rabbits

This study investigated noise-induced changes in suppression growth (SG) of distortion product otoacoustic emissions (DPOAEs). Detailed measurements of SG were obtained in rabbits as a function of f2 frequencies at four primary-tone levels. SG measures were produced by using suppressor tones (STs) presented at two fixed distances from f2. The magnitude of suppression was calculated for each ST level and depicted as contour plots showing the amount of suppression as a function of the f2 frequency. At each f2, SG indices included slope, suppression threshold, and an estimate of the tip-to-tail value. All suppression measures were obtained before and after producing a cochlear dysfunction using a monaural exposure to a 2-h, 110-dB SPL octave-band noise centered at 2 kHz. The noise exposure produced varying amounts of cochlear damage as revealed by changes in DP-grams and auditory brainstem responses. However, average measures of SG slopes, suppression thresholds, and tip-to-tail values failed to mirror the mean DP-gram loss patterns. When suppression-based parameters were correlated with the amount of DPOAE loss, small but significant correlations were observed for some measures. Overall, the findings suggest that measures derived from DPOAE SG are limited in their ability to detect noise-induced cochlear damage.

Level dependence of distortion-product otoacoustic emissions measured at high frequencies in humans

Given that high-frequency hearing is most vulnerable to cochlear pathology, it is important to characterize distortion-product otoacoustic emissions (DPOAEs) measured with higher-frequency stimuli in order to utilize these measures in clinical applications. The purpose of this study was to explore the dependence of DPOAE amplitude on the levels of the evoking stimuli at frequencies greater than 8 kHz, and make comparisons with those data that have been extensively measured with lower-frequency stimuli. To accomplish this, DPOAE amplitudes were measured at six different f2 frequencies (2, 5, 10, 12, 14, and 16 kHz), with a frequency ratio (f2/f1) of 1.2, at five fixed levels (30 to 70 dB SPL) of one primary (either f1 or f2), while the other primary was varied in level (30 to 70 dB SPL). Generally, the level separation between the two primary tones (L1 > L2) generating the largest DPOAE amplitude (referred to as the "optimal level separation") decreased as the level of the fixed primary increased. Additionally, the optimal level separation was frequency dependent, especially at the lower fixed primary tone levels ( < or = 50 dB SPL). In agreement with previous studies, the DPOAE level exhibited greater dependence on L1 than on L2.

Distortion product otoacoustic emissions for hearing threshold estimation and differentiation between middle-ear and cochlear disorders in neonates

Our aim in the present study was to apply extrapolated DPOAE I/O-functions [J. Acoust. Soc. Am. 111, 1810-1818 (2002); 113, 3275-3284 (2003)] in neonates in order to investigate their ability to estimate hearing thresholds and to differentiate between middle-ear and cochlear disorders. DPOAEs were measured in neonates after birth (mean age = 3.2 days) and 4 weeks later (follow-up) at 11 test frequencies between f2 = 1.5 and 8 kHz and compared to that found in normal hearing subjects and cochlear hearing loss patients. On average, in a single ear hearing threshold estimation was possible at about 2/3 of the test frequencies. A sufficient test performance of the approach is therefore suggested. Thresholds were higher at the first measurement compared to that found at the follow-up measurement. Since thresholds varied with frequency, transitory middle ear dysfunction due to amniotic fluid instead of cochlear immaturity is suggested to be the cause for the change in thresholds. DPOAE behavior in the neonate ears differed from that found in the cochlear hearing loss ears. From a simple model it was concluded that the difference between the estimated DPOAE threshold and the DPOAE detection threshold is able to differentiate between sound conductive and cochlear hearing loss.

An alternate approach to constructing distortion product otoacoustic emission (DPOAE) suppression tuning curves

DPOAE suppression tuning curves (STCs) typically are constructed using suppression criteria of 3 or 6 dB. This paper describes a technique for generating DPOAE STCs using criteria ranging from 3 dB to complete suppression. The criterion effect was examined at various primary levels (f₂ = 4 kHz) in normal-hearing ears. As expected, Q_ERB and tip-to-tail differences decreased as probe level (L₂) increased. Q_ERB values were not systematically dependent on criterion. For low L₂’s, tip-to-tail differences decreased as criterion increased. Given similarities in methodology, DPOAE STCs constructed from completely suppressed responses might be most appropriate for comparison to psychophysical tuning curves.

Distortion product otoacoustic emission (2f1-f2) suppression in 3-month-old infants: evidence for postnatal maturation of human cochlear function?

The complete timeline for maturation of human cochlear function has not been defined. Distortion product otoacoustic emission (DPOAE)-based measures of cochlear function show non-adult-like responses from premature and term-born neonates at high f2 frequencies; however, older infants were not included in these studies. In the present experiment, previously collected DPOAE ipsilateral suppression data from premature neonates were combined with new data collected from adults, term-born neonates, and 3-month-old infants to further examine the time course for maturation of cochlear function. DPOAE suppression tuning curves (STC) and suppression growth patterns were measured in the three age groups at f2 = 6000 Hz, L1 = 65, L2 = 55 dB SPL, with an f2/f1 of 1.2. Results indicate that term-born neonates and 3-month-old infants have non-adult-like STC width, slope on the low-frequency flank, and tip features. However, the two infant groups are not significantly different from one another. Suppression growth patterns for low-frequency suppressor tones show a clear developmental progression. In general, the younger the infant, the more shallow and compressive the suppression growth for the lowest suppressor frequencies. These findings suggest a high-frequency postnatal immaturity in cochlear function as measured by DPOAE suppression. Results may have been influenced by noncochlear factors, such as middle-ear immaturity. These factors are reviewed and considered.

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

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

Development of f2/f1 ratio functions in humans

Otoacoustic emissions (OAEs) presumably represent active processes within the cochlea fundamental to frequency-selectivity in peripheral auditory function. Maturation of the cochlear amplifier, vis-a-vis frequency encoding or selectivity, has yet to be fully characterized in humans. The purpose of this study was to further investigate the maturation of features of the f2/f1 frequency ratio (Distortion Product OAE amplitude X f2/f1 ratio) presumed to reflect cochlear frequency selectivity. A cross-sectional, multivariate study was completed comparing three age groups: pre-term infants, term infants and young adult subjects. Frequency ratio functions were analyzed at three f2 frequencies--2000, 4000 and 6000 Hz. An analysis included an estimation of the optimal ratio (OR) and a bandwidth-like measure (Q3). Analysis revealed significant interactions of age x frequency x gender for optimal ratio and a significant interaction of age x frequency for Q3. Consistent and statistically significant differences for both OR and Q3 were found in female subjects and when f2 = 2 or 6 kHz. This supports research by others [Abdala, J. Acoust. Soc. Am. 114, 3239-3250 (2003)] suggesting that the development of cochlear active mechanisms may still be somewhat in flux at least through term birth. Furthermore, OAEs appear to demonstrate gender differences in the course of such maturational changes.

A longitudinal study of distortion product otoacoustic emission ipsilateral suppression and input/output characteristics in human neonates

Past work has shown that distortion product otoacoustic emission (DPOAE) (2f1-f2) ipsilateral suppression and input/output (I/O) characteristics are not adult-like in prematurely born neonates [Abdala, J. Acoust. Soc. Am. 110, 1465-1476 (2001)]. These age differences are most pronounced at f2 = 6000 Hz and have been interpreted to indicate a subtle immaturity in human cochlear function prior to term birth. It is still not clear, however, whether term-born neonates are completely adult-like in cochlear function. To study this question, DPOAE suppression and I/O functions for f2 = 6000 Hz were measured in a group of prematurely born neonates at weekly intervals over a period of 7-8-weeks, a group of normal-hearing adults, and during a one-time test session in a group of term-born neonates. Results show that there was no significant change in suppression tuning, suppression growth, and various I/O characteristics across test session for premature neonates, but there was an age-group effect; even once prematurely born neonates reached the equivalence of term-like status (38-40-weeks postconceptional weeks), they continued to show narrower suppression tuning than adults, shallower suppression growth for low-frequency side suppressor tones, and an elevated amplitude saturation plateau on the I/O function. Term-born neonates showed DPOAE results that were comparable to those measured from premature neonates and unlike adult findings. These results suggest that a subtle immaturity in cochlear function persists into the postnatal period.

Maturation of cochlear nonlinearity as measured by distortion product otoacoustic emission suppression growth in humans

The growth of distortion product otoacoustic emission (DPOAE) suppression follows a systematic, frequency-dependent pattern. The pattern is consistent with direct measures of basilar-membrane response growth, psychoacoustic measures of masking growth, and measures of neural rate growth. This pattern has its basis in the recognized nonlinear properties of basilar-membrane motion and, as such, the DPOAE suppression growth paradigm can be applied to human neonates to study the maturation of cochlear nonlinearity. The objective of this experiment was to investigate the maturation of human cochlear nonlinearity and define the time course for this maturational process. Normal-hearing adults, children, term-born neonates, and premature neonates, plus a small number of children with sensorineural hearing loss, were included in this experiment. DPOAE suppression growth was measured at two f2 frequencies (1500 and 6000 Hz) and three primary tone levels (55-45, 65-55, and 75-65 dB SPL). Slope of DPOAE suppression growth, as well as an asymmetry ratio (to compare slope for suppressor tones below and above f2 frequency), were generated. Suppression threshold was also measured in all subjects. Findings indicate that both term-born neonates and premature neonates who have attained term-like age, show non-adult-like DPOAE suppression growth for low-frequency suppressor tones. These age effects are most evident at f2 = 6000 Hz. In neonates, suppression growth is shallower and suppression thresholds are elevated for suppressor tones lower in frequency than f2. Additionally, the asymmetry ratio is smaller in neonates, indicating that the typical frequency-dependent pattern of suppression growth is not present. These findings suggest that an immaturity of cochlear nonlinearity persists into the first months of postnatal life. DPOAE suppression growth examined for a small group of hearing-impaired children also showed abnormalities.

Ipsilateral distortion product otoacoustic emission (2f1-f2) suppression in children with sensorineural hearing loss

Distortion product otoacoustic emission (DPOAE) ipsilateral suppression has been applied to study cochlear function and maturation in laboratory animals and humans. Although DPOAE suppression appears to be sensitive to regions of specialized cochlear function and to cochlear immaturity, it is not known whether it reflects permanent cochlear damage, i.e., sensorineural hearing loss (SNHL), in a reliable and systematic manner in humans. Eight school-aged children with mild-moderate SNHL and 20 normal-hearing children served as subjects in this study. DPOAE (2f1-f2) suppression data were collected at four f2 frequencies (1500, 3000, 4000, and 6000 Hz) using moderate-level primary tones. Features of the DPOAE iso-suppression tuning curves and suppression growth were analyzed for both subject groups. Results show that DPOAE suppression tuning curves from hearing-impaired subjects can be reliably recorded. DPOAE suppression tuning curves were generally normal in appearance and shape for six out of eight hearing-impaired subjects but showed subtle abnormalities in at least one feature. There was not one single trend or pattern of abnormality that characterized all hearing-impaired subjects. The most prominent patterns of abnormality included: broadened tuning, elevated tip, and downward shift of tip frequency. The unique patterns of atypical DPOAE suppression in subjects with similar audiograms may suggest different patterns of underlying sensory cell damage. This speculation warrants further investigation.

Suppression tuning in noise-exposed rabbits

Psychophysical, basilar-membrane (BM), and single nerve-fiber tuning curves, as well as suppression of distortion-product otoacoustic emissions (DPOAEs), all give rise to frequency tuning patterns with stereotypical features. Similarities and differences between the behaviors of these tuning functions, both in normal conditions and following various cochlear insults, have been documented. While neural tuning curves (NTCs) and BM tuning curves behave similarly both before and after cochlear insults known to disrupt frequency selectivity, DPOAE suppression tuning curves (STCs) do not necessarily mirror these responses following either administration of ototoxins [Martin et al., J. Acoust. Soc. Am. 104, 972-983 (1998)] or exposure to temporarily damaging noise [Howard et al., J. Acoust. Soc. Am. 111, 285-296 (2002)]. However, changes in STC parameters may be predictive of other changes in cochlear function such as cochlear immaturity in neonatal humans [Abdala, Hear. Res. 121, 125-138 (1998)]. To determine the effects of noise-induced permanent auditory dysfunction on STC parameters, rabbits were exposed to high-level noise that led to permanent reductions in DPOAE level, and comparisons between pre- and postexposure DPOAE levels and STCs were made. Statistical comparisons of pre- and postexposure STC values at CF revealed consistent basal shifts in the frequency region of greatest cochlear damage, whereas thresholds, Q10dB, and tip-to-tail gain values were not reliably altered. Additionally, a large percentage of high-frequency lobes associated with third tone interference phenomena, that were exhibited in some data sets, were dramatically reduced following noise exposure. Thus, previously described areas of DPOAE interference above f2 may also be studied using this type of experimental manipulation [Martin et al., Hear. Res. 136, 105-123 (1999); Mills, J. Acoust. Soc. Am. 107, 2586-2602 (2002)].

Distortion product otoacoustic emission suppression tuning curves in normal-hearing and hearing-impaired human ears

Distortion product otoacoustic emission (DPOAE) suppression measurements were made in 20 subjects with normal hearing and 21 subjects with mild-to-moderate hearing loss. The probe consisted of two primary tones (f2, f1), with f2 held constant at 4 kHz and f2/f1 = 1.22. Primary levels (L1, L2) were set according to the equation L1 = 0.4 L2 + 39 dB [Kummer et al., J. Acoust. Soc. Am. 103, 3431-3444 (1998)], with L2 ranging from 20 to 70 dB SPL (normal-hearing subjects) and 50-70 dB SPL (subjects with hearing loss). Responses elicited by the probe were suppressed by a third tone (f3), varying in frequency from 1 octave below to 1/2 octave above f2. Suppressor level (L3) varied from 5 to 85 dB SPL. Responses in the presence of the suppressor were subtracted from the unsuppressed condition in order to convert the data into decrements (amount of suppression). The slopes of the decrement versus L3 functions were less steep for lower frequency suppressors and more steep for higher frequency suppressors in impaired ears. Suppression tuning curves, constructed by selecting the L3 that resulted in 3 dB of suppression as a function of f3, resulted in tuning curves that were similar in appearance for normal and impaired ears. Although variable, Q10 and Q(ERB) were slightly larger in impaired ears regardless of whether the comparisons were made at equivalent SPL or equivalent sensation levels (SL). Larger tip-to-tail differences were observed in ears with normal hearing when compared at either the same SPL or the same SL, with a much larger effect at similar SL. These results are consistent with the view that subjects with normal hearing and mild-to-moderate hearing loss have similar tuning around a frequency for which the hearing loss exists, but reduced cochlear-amplifier gain.

Transient emission suppression tuning curve attributes in relation to psychoacoustic threshold

Ipsilateral suppression characteristics of transiently evoked otoacoustic emissions (TEOAEs) are described in relation to psychoacoustic threshold at 4000 Hz and the presence or absence of spontaneous otoacoustic emissions in 41 adults with normal hearing. TEOAE amplitudes were measured in response to 4000-Hz tonebursts presented in linear blocks at 40 and 50 dB SPL while puretone suppressors were introduced at a variety of frequencies and levels ipsilateral to and simultaneously with the tonebursts. Suppressors close to the toneburst frequency were most effective in decreasing the amplitude of the TEOAEs, while those more remote in frequency required significantly greater intensity for a similar amount of suppression. Consequently, characteristic tuning curve shapes were obtained. Tuning-curve tip levels were closely associated with the level of the toneburst and tip frequencies occurred at or above the toneburst frequency. Tuning-curve widths (Q10), however, varied significantly across subjects with similar psychoacoustic thresholds in quiet determined by a two-alternative forced-choice method. The results suggest that a portion of that variability may be explained by the presence or absence of spontaneous otoacoustic emissions in an individual ear.

Suppression and enhancement of distortion-product otoacoustic emissions by interference tones above f(2). II. Findings in humans

Distortion-product otoacoustic emission (DPOAE) suppression tuning curves (STCs) can be obtained in a variety of laboratory animals and humans by sweeping the frequencies and levels of a third tone (f(3)) around a set of f(1) and f(2) primaries. In small laboratory animals, it was previously observed that, when the suppressor tone (f(3)) is above f(2), substantial suppression and or enhancement (suppression/enhancement) could be obtained. In the present study, it was of interest to determine if similar suppression/enhancement phenomena could be observed in humans and to what extent this might influence the interpretation of STC results reported in the literature. To this end, STCs were measured for DPOAEs at 2f(1)-f(2) and 2f(2)-f(1) in human subjects at geometric-mean frequencies (GM) of 1, 2, 3, and 4 kHz, and primary-tone equilevels of 80/80 and 75/75 dB SPL and unequal levels of 65/55 dB SPL. Overall, STC parameters were found to be comparable to those reported in the literature. For the 2f(1)-f(2) DPOAE, STC tip frequencies tuned to the region of the primaries, and tip frequencies were slightly influenced by primary-tone level. STC tip thresholds were typically within 10 dB of the level of L(2), and Q(10dB) values ranged from 1.0 to 2.5, which was consistent with the higher-level primaries employed. The 2f(1)-f(2) DPOAE showed consistent regions of suppression that were approximately an octave above the GM for the 1-kHz, 65/55-dB SPL condition. The 2f(2)-f(1) DPOAE tuned to its characteristic place above f(2) and showed reliable enhancement above the STC tip region for the 1-kHz, 75/75-dB SPL primaries. Overall, the results clearly revealed that human ears also display suppression/enhancement phenomena when f(3) reaches frequencies considerably above f(2). If suppression/enhancement phenomena reflect secondary DPOAE sources, then these sources are present in the ear-canal signal from humans as well as small laboratory animals.

Evidence of upward spread of suppression in DPOAE measurements

Measurements of DPOAE level in the presence of a suppressor were used to describe a pattern that is qualitatively similar to population studies in the auditory nerve and to behavioral studies of upward spread of masking. DPOAEs were measured in the presence of a suppressor (f3) fixed at either 2.1 or 4.2 kHz, and set to each of seven levels (L3) from 20 to 80 dB SPL. In the presence of a fixed f3 and L3 combination, f2 was varied from about 1 oct below to at least 1/2 oct above f3, while L2 was set to each of 6 values (20-70 dB SPL). L1 was set according to the equation L1 = 0.4L2 + 39 [Janssen et al., J. Acoust. Soc. Am. 103, 3418-3430 (1998)]. At each L2, L1 combination, DPOAE level was measured in a control condition in which no suppressor was presented. Data were converted into decrements (the amount of suppression, in dB) by subtracting the DPOAE level in the presence of each suppressor from the DPOAE level in the corresponding control condition. Plots of DPOAE decrements as a function of f2 showed maximum suppression when f2 approximately = f3. As L3 increased, the suppressive effect spread more towards higher f2 frequencies, with less spread towards lower frequencies relative to f3. DPOAE decrement versus L3 functions had steeper slopes when f2 > f3, compared to the slopes when f2 < f3. These data are consistent with other findings that have shown that response growth for a characteristic place (CP) or frequency (CF) depends on the relation between CP or CF and driver frequency, with steeper slopes when driver frequency is less than CF and shallower slopes when driver frequency is greater than CF. For a fixed amount of suppression (3 dB), L3 and L2 varied nearly linearly for conditions in which f3 approximately = f2, but grew more rapidly for conditions in which f3 < f2, reflecting the basal spread of excitation to the suppressor. The present data are similar in form to the results observed in population studies from the auditory nerve of lower animals and in behavioral masking studies in humans.

The use of distortion product otoacoustic emission suppression as an estimate of response growth

Distortion product otoacoustic emission (DPOAE) levels in response to primary pairs (f2 = 2 or 4 kHz, L2 ranging from 20 to 60 dB SPL, L1 = 0.4L2 + 39 dB) were measured with and without suppressor tones (f3), which varied from 1 octave below to 1/2 octave above f2, in normal-hearing subjects. Suppressor level (L3) varied from -5 to 85 dB SPL. DPOAE levels were converted into decrements by subtracting the level in the presence of the suppressor from the level in the absence of a suppressor. DPOAE decrement vs L3 functions showed steeper slopes when f3 < f2 and shallower slopes when f3 > f2. This pattern is similar to other measurements of response growth, such as direct measures of basilar-membrane motion, single-unit rate-level functions, suppression of basilar-membrane motion, and discharge-rate suppression from lower animals. As L2 increased, the L3 necessary to maintain 3 dB of suppression increased at a rate of about 1 dB/dB when f3 was approximately equal to f2, but increased more slowly when f3 < f2. Functions relating L3 to L2 in order to maintain a constant 3-dB reduction in DPOAE level were compared for f3 < f2 and for f3 approximately = f2 in order to derive an estimate related to "cochlear-amplifier gain." These results were consistent with the view that "cochlear gain" is greater at lower input levels, decreasing as level increases.

DPOAE suppression tuning: cochlear immaturity in premature neonates or auditory aging in normal-hearing adults?

Previous work has shown that distortion product otoacoustic emission (DPOAE) suppression tuning curves (STCs) recorded from premature neonates are narrower than adult STCs at both low and high frequencies. This has been interpreted to indicate an immaturity in cochlear function prior to term birth. However, an alternative explanation for this finding is that adult DPOAE STCs are broadened and reflect cochlear hair cell loss in normal-hearing adults due to aging, and natural exposure to noise and ototoxins. This alternative hypothesis can be tested by studying suppression tuning in normal-hearing school-aged children. If normal-hearing children, who have not aged significantly or been exposed to noise/ototoxins, have DPOAE suppression tuning similar to adults, the auditory aging hypothesis can be ruled out. However, if children have tuning similar to premature neonates and dissimilar from adults, it implicates aging or other factors intrinsic to the adult cochlea. DPOAE STCs were recorded at 1500, 3000, and 6000 Hz using optimal parameters in normal-hearing children and adults. DPOAE STCs collected previously from premature neonates were used for age comparisons. In general, results indicate that tuning curves from children are comparable to adult STCs and significantly different from neonatal STCS at 1500 and 6000 Hz. Only the growth of suppression was not adultlike in children and only at 6000 Hz. These findings do not strongly support the auditory aging hypothesis as a primary explanation for previously observed neonatal-adult differences in DPOAE suppression tuning. It suggests that these age differences are most likely due to immaturities in the neonatal cochlea. However, nonadultlike suppression growth observed in children at 6000 Hz warrants further attention and may be indicative of subtle alternations in the adult cochlea at high frequencies.