Evidence for a bipolar change in distortion product otoacoustic emissions during contralateral acoustic stimulation in humans

Effect of Contralateral Acoustic Stimulation on Temporal Processing Abilities in Individuals with Normal Hearing

The aim of the article was to compare the conditions of silent and contralateral noise on the temporal processing parameters. A total of 40 participants (20 males and 20 females) were enrolled in the study with a mean age of 21.7 years, participants with normal hearing thresholds and no history of middle ear pathology were enrolled for the study. The temporal processing tests such as duration discrimination test, gap detection test, and temporal modulation transfer function tests were carried out in these 40 individuals in the two conditions of silent and contralateral noise using MATLAB. Statistical analysis was carried out using the SPSS version 25.0 were descriptive and inferential statistics were carried out. Data was normally distributed on the Shapiro-Wilk's test of normality due to which a paired t test was carried out to establish the nature of significance between the silent and contralateral noise condition. Results reveal the presence of significant difference (p < 0.01) between the groups for all the parameters of temporal resolution with contralateral noise condition performing better than silent condition for the parameters. There is a positive effect of the efferent auditory pathway on the temporal resolution parameters thus implying that speech perception in noise is improved in the presence of background noise for normal hearing individuals due to this effect.

Evaluating the Function of the Medial Olivocochlear Bundle in Patients With Bilateral Tinnitus

Purpose No study has investigated the effects of contralateral noise (CN) on speech-in-noise perception (SINP) in listeners with tinnitus. The mechanisms underlying the involvement of medial olivocochlear (MOC) reflex with SINP remain to be elucidated. This study aimed to investigate the MOC function in patients with bilateral tinnitus by measuring distortion product otoacoustic emission and SINP. Method Eighteen patients with bilateral tinnitus (one male and 17 females; age: M ± SD = 45.61 ± 10.18 years) and 19 listeners without tinnitus (six males and 13 females; age: M ± SD = 34.11 ± 8.35 years) were recruited for the study. Each subject underwent distortion product otoacoustic emission measurement and the SINP test for both ears. The effects of CN on these two measurements were compared between tinnitus ears (TEs) and no-tinnitus ears (NTEs). Results The presence of CN significantly reduced distortion product (DP) amplitudes and improved SINP for TEs, and the amounts of DP suppression and SINP improvement were similar to those in NTEs. Improvement of SINP was positively correlated with DP suppression at 6185 Hz for NTEs and at 1640 Hz for TEs. Conclusions The results of this study suggest that the amounts of DP suppression and SINP improvement were similar between listeners with and without tinnitus. For both ear groups, the MOC reflex was involved with SINP at specific frequencies. Any clinical test outcomes with regard to the MOC bundle in patients with tinnitus should be interpreted with caution until further studies are conducted.

No effects of attention or visual perceptual load on cochlear function, as measured with stimulus-frequency otoacoustic emissions

The effects of selectively attending to a target stimulus in a background containing distractors can be observed in cortical representations of sound as an attenuation of the representation of distractor stimuli. The locus in the auditory system at which attentional modulations first arise is unknown, but anatomical evidence suggests that cortically driven modulation of neural activity could extend as peripherally as the cochlea itself. Previous studies of selective attention have used otoacoustic emissions to probe cochlear function under varying conditions of attention with mixed results. In the current study, two experiments combined visual and auditory tasks to maximize sustained attention, perceptual load, and cochlear dynamic range in an attempt to improve the likelihood of observing selective attention effects on cochlear responses. Across a total of 45 listeners in the two experiments, no systematic effects of attention or perceptual load were observed on stimulus-frequency otoacoustic emissions. The results revealed significant between-subject variability in the otoacoustic-emission measure of cochlear function that does not depend on listener performance in the behavioral tasks and is not related to movement-generated noise. The findings suggest that attentional modulation of auditory information in humans arises at stages of processing beyond the cochlea.

The Effect of Primary Levels and Frequencies on the Contralateral Suppression of Distortion Product Otoacoustic Emission

BACKGROUND AND OBJECTIVES

Changes in distortion product otoacoustic emission (DPOAE) caused by contralateral suppression (CS) allow the function of the auditory efferent system to be evaluated. Parameters affording maximum CS are preferred in terms of clinical application. Our objective was to evaluate the effects of primary levels and frequencies on DPOAE-mediated CS.

SUBJECTS AND METHODS

Sixteen subjects with normal hearing participated. DPOAEs were recorded with and without contralateral acoustic stimulation; we delivered broadband noise of 65 dB SPL at f2 frequencies between 1,000 Hz and 6,727 Hz, at 8 pt/octave. The L2 was varied between 40 dB SPL and 80 dB SPL in 10-dB steps.

RESULTS

L2 did not significantly affect DPOAE-mediated CS. Higher L2 levels significantly reduced the fine structure depth of both the baseline and suppressed DPOAE datasets. The amount of CS was greatly affected by the f2 frequency; lower and higher frequency ranges afforded significantly stronger suppression than did mid-frequencies within the studied range.

CONCLUSIONS

Our findings suggest that DPOAE CS should be measured over a wide range of frequencies as the amount of CS seems to be highly dependent on f2. The use of a higher L2 level may be optimal when it is sought to evoke strong DPOAE-mediated suppression while simultaneously minimizing DPOAE fine structure. Our findings may assist in optimization of clinical procedures evaluating the integrity of the auditory efferent system.

Current audiological diagnostics

Today's audiological functional diagnostics is based on a variety of hearing tests, whose large number takes account of the variety of malfunctions of a complex sensory organ system and the necessity to examine it in a differentiated manner and at any age of life. The objective is to identify nature and origin of the hearing loss and to quantify its extent as far as necessary to dispose of the information needed to initiate the adequate medical (conservative or operational) treatment or the provision with technical hearing aids or prostheses. Moreover, audiometry provides the basis for the assessment of impairment and handicap as well as for the calculation of the degree of disability. In the present overview, the current state of the method inventory available for practical use is described, starting from basic diagnostics over to complex special techniques. The presentation is systematically grouped in subjective procedures, based on psychoacoustic exploration, and objective methods, based on physical measurements: preliminary hearing tests, pure tone threshold, suprathreshold processing of sound intensity, directional hearing, speech understanding in quiet and in noise, dichotic hearing, tympanogram, acoustic reflex, otoacoustic emissions and auditory evoked potentials. Apart from a few still existing gaps, this method inventory covers the whole spectrum of all clinically relevant functional deficits of the auditory system.

Efferent modulation of pre-neural and neural distortion products

Distortion product otoacoustic emissions (DPOAEs) and distortion product frequency following responses (DPFFRs) are respectively pre-neural and neural measurements associated with cochlear nonlinearity. Because cochlear nonlinearity is putatively linked to outer hair cell electromotility, DPOAEs and DPFFRs may provide complementary measurements of the human medial olivocochlear (MOC) reflex, which directly modulates outer hair cell function. In this study, we first quantified MOC reflex-induced DPOAE inhibition at spectral fine structure peaks in 22 young human adults with normal hearing. The f1 and f2 tone pairs producing the largest DPOAE fine structure peak for each subject were then used to evoke DPFFRs with and without MOC reflex activation to provide a related neural measure of efferent inhibition. We observed significant positive relationships between DPOAE fine structure peak inhibition and inhibition of DPFFR components representing neural phase locking to f2 and 2f1-f2, but not f1. These findings may support previous observations that the MOC reflex inhibits DPOAE sources differentially. That these effects are maintained and represented in the auditory brainstem suggests that the MOC reflex may exert a potent influence on subsequent subcortical neural representation of sound.

Corticofugal Modulation of DPOAEs in Gerbils

Efferent auditory feedback on cochlear hair cells is well studied regarding olivocochlear brainstem mechanisms. Less is known about how the descending corticofugal system may shape efferent feedback and modulate cochlear mechanics. Distortion-product otoacoustic emissions (DPOAEs) are a suitable tool to assess outer hair cell function, as they are by-products of the nonlinear cochlear amplification process. The present project investigates the effects of cortical activity on cubic and quadratic DPOAEs in mongolian gerbils, Meriones unguiculatus, through cortical deactivation using the sodium-channel blocker lidocaine. Contralateral cortical microinjections of lidocaine can lead to either an increase or decrease of median DPOAE levels of up to 10.95 dB. The effects are reversible and comparable at all tested frequencies (0.5-40 kHz). They are not restricted to the preferred frequency of the cortical site of injection. Recovery times are between 20 and 120 min depending on stimulation levels and emission type. When the injection is performed in the ipsilateral hemisphere, DPOAE level shifts are lower in amplitude compared to those after injection in the contralateral hemisphere. No significant changes in DPOAE levels are obtained after saline microinjections. Results indicate that deactivation of auditory cortex activity through lidocaine has a considerable impact on peripheral auditory responses in form of DPOAEs, probably through cortico-olivocochlear pathways.

The medial olivocochlear reflex in children during active listening

OBJECTIVE

To determine if active listening modulates the strength of the medial olivocochlear (MOC) reflex in children.

DESIGN

Click-evoked otoacoustic emissions (CEOAEs) were recorded from the right ear in quiet and in four test conditions: one with contralateral broadband noise (BBN) only, and three with active listening tasks wherein attention was directed to speech embedded in contralateral BBN.

STUDY SAMPLE

Fifteen typically-developing children (ranging in age from 8 to14 years) with normal hearing.

RESULTS

CEOAE levels were reduced in every condition with contralateral acoustic stimulus (CAS) when compared to preceding quiet conditions. There was an additional systematic decrease in CEOAE level with increased listening task difficulty, although this effect was very small. These CEOAE level differences were most apparent in the 8-18 ms region after click onset.

CONCLUSIONS

Active listening may change the strength of the MOC reflex in children, although the effects reported here are very subtle. Further studies are needed to verify that task difficulty modulates the activity of the MOC reflex in children.

Attentional modulation of the inner ear: a combined otoacoustic emission and EEG study

Attending to a single stimulus in a complex multisensory environment requires the ability to select relevant information while ignoring distracting input. The underlying mechanism and involved neuronal levels of this attentional gain control are still a matter of debate. Here, we investigated the influence of intermodal attention on different levels of auditory processing in humans. It is known that the activity of the cochlear amplifier can be modulated by efferent neurons of the medial olivocochlear complex. We used distortion product otoacoustic emission (DPOAE) measurements to monitor cochlear activity during an intermodal cueing paradigm. Simultaneously, central auditory processing was assessed by electroencephalography (EEG) with a steady-state paradigm targeting early cortical responses and analysis of alpha oscillations reflecting higher cognitive control of attentional modulation. We found effects of selective attention at all measured levels of the auditory processing: DPOAE levels differed significantly between periods of visual and auditory attention, showing a reduction during visual attention, but no change during auditory attention. Primary auditory cortex activity, as measured by the auditory steady-state response (ASSR), differed between conditions, with higher ASSRs during auditory than visual attention. Furthermore, the analysis of cortical oscillatory activity revealed increased alpha power over occipitoparietal and frontal regions during auditory compared with visual attention, putatively reflecting suppression of visual processing. In conclusion, this study showed both enhanced processing of attended acoustic stimuli in early sensory cortex and reduced processing of distracting input, both at higher cortical levels and at the most peripheral level of the hearing system, the cochlea.

Effect of tinnitus on distortion product otoacoustic emissions varies with hearing loss

PURPOSE

The aim of this study was to measure the effect of tinnitus, while accounting for the effect of hearing loss and aging, on distortion product otoacoustic emissions (DPOAEs).

METHOD

DPOAEs were measured twice in both ears in 5 groups of participants: young adults with normal hearing, middle-age adults with normal hearing, adults with high-frequency sensorineural hearing loss, age-matched adults with similar hearing loss and tinnitus, and adults with normal hearing and chronic tinnitus.

RESULTS

Multivariate analysis revealed a main effect of hearing loss and age, but no effect of tinnitus, across all 5 groups. Separate tests revealed significant effects of age and tinnitus in the normal-hearing groups and hearing loss in adults with or without tinnitus, but no effect of tinnitus in those with hearing loss.

CONCLUSION

DPOAE levels in the group of adults with hearing loss and tinnitus were diminished, but those in the group with normal hearing and tinnitus were enhanced, relative to DPOAE levels in the controls. Outer hair cell function, as indexed by DPOAEs, exhibits a complex association with tinnitus, and this has implications in the use of DPOAEs as a tool both for testing for tinnitus presence and for creating a model of neural mechanisms underlying tinnitus.

Test/retest repeatability of effect contralateral acoustic stimulation on the magnitudes of distortion product ototacoustic emissions

OBJECTIVES/HYPOTHESIS

Contralateral inhibition of distortion product otoacoustic emissions (DPOAE) has become an important tool to assess the functioning of the medial olivocochlear efferents in humans. However, before this measurement can be applied clinically, the test/retest repeatability needs to be established. Therefore, the current study aimed at evaluating intra- and intersession test/retest repeatability of contralateral inhibition of DPOAE at 2f(1) -f(2) .

STUDY DESIGN

Prospective Test/Retest Reliability Study.

METHODS

Contralateral inhibition of DPOAE magnitudes were measured in the right ear of 24 adult male participants. To assess the intrasession repeatability, measurements were repeated without altering the position of the DPOAE probe (single-probe-fit). To assess intersession reliability, measurements were repeated on 8 different days (multiple-probe-fit). Repeatability of inhibition of DPOAE magnitudes was evaluated by Cronbach's alpha, interclass correlations, standard error of measurement, and its 95% confidence interval and smallest detectable difference.

RESULTS

DPOAE magnitudes were highly stable and repeatable across different recording sessions. However, test/retest reliability coefficients of DPOAE inhibition magnitudes were less than satisfactory for all the frequencies, in both single-probe-fit and multiple-probe-fit modes.

CONCLUSIONS

Results of the present study showed that contralateral inhibition magnitudes of DPOAEs varied considerably, even though DPOAEs magnitudes remained essentially the same across different recording sessions. As reliability is an essential aspect of any clinical procedure, it is suggested that at present contralateral inhibition of DPOAEs should not be used clinically to evaluate the medial efferent system. Laryngoscope, 2012.

Effect of contralateral acoustic stimulation on cochlear tuning measured using stimulus frequency and distortion product OAEs

OBJECTIVE

To study whether a change in cochlear tuning, measured using OAEs, could be detected due to contralateral activation of the efferent system using broadband noise.

DESIGN

Cochlear tuning measures based on SFOAE phase gradients and SFOAE-2TS 'Q' were used to test this hypothesis. SFOAE magnitude and phase gradient were measured using a pure-tone sweep from 1248 to 2496 Hz at 50 dB SPL. 2TS curves of SFOAE were recorded with a suppressor frequency swept from 1120 to 2080 Hz at 50 dB SPL. DPOAE f2-sweep phase gradient was also obtained to allow comparisons with the literature. All three assays were performed across with- and no-CAS conditions.

STUDY SAMPLE

Twenty-two young, normal-hearing adults.

RESULTS

CAS did not produce a statistically significant change in the tuning metric in any of the OAE methods used, despite producing significant reductions in the OAE magnitude.

CONCLUSION

It is unknown whether this insensitivity to CAS is due to an insensitivity of these three measures to cochlear mechanical tuning. The results suggest that any changes in tuning induced by CAS that may occur are small and difficult to detect using the OAE measurement paradigms used here.

Measurement of medial olivocochlear efferent activity in humans: comparison of different distortion product otoacoustic emission-based paradigms

OBJECTIVE

To assess the suitability of contralateral suppression (CS) of distortion product otoacoustic emissions (DPOAEs) for measurement of activity of the medial olivocochlear (MOC) efferents.

BACKGROUND

The MOC efferent system has been shown to be involved in sound discrimination, selective attention to tones, sound localization, and protection of the cochlea against noise. A great variety of paradigms for measurement of MOC activity by CS of OAE (MOC reflex [MOCR]), has been described. An issue of this approach is the dependence of the CS values on stimulus parameters, especially when DPOAE are used.

METHODS

Four different measurement paradigms, which used different combinations of stimulus frequencies and primary tone levels, were applied in 16 human subjects.

RESULTS

Mean absolute values of CS were in the range of 1.2 to 2.6 dB. The use of different stimulus parameters produced not only MOCR values of different size-which was expected-but, in many cases, also different relative classifications of the subjects according to their MOCR strength.

CONCLUSION

The suppression effects on DPOAE demonstrated in this study reflect MOC activity. However, the new conclusion from our data is that CS of DPOAE measurements, as they were used in this study, may not allow for a consistent quantitative classification of human subjects according to their MOCR strength. This finding concerns interpretation of previous studies using CS of DPOAE and analogous future studies. One future approach may lie in the separation of the DPOAE components to distinguish interference phenomena, which complicate interpretation of CS values.

Changes in amplitude and phase of distortion-product otoacoustic emission fine-structure and separated components during efferent activation

Medial olivocochlear (MOC) efferent fibers synapse directly on the outer hair cells (OHCs). Efferent activation evoked by contralateral acoustic stimulation (CAS) will affect OHC amplification and subsequent measures of distortion-product otoacoustic emissions (DPOAEs). The aim of this study was to investigate measures of total and separated DPOAEs during efferent activation. Efferent activation produces both suppression and enhancement of the total DPOAE level. Level enhancements occurred near fine-structure minima and were associated with consistent MOC evoked upward shifts in DPOAE fine-structure frequency. Examination of the phase of the separated components revealed that frequency shifts stemmed from increasing phase leads of the reflection component during CAS, while the generator component phase was nearly invariant. Separation of the two DPOAE components responsible for the fine-structure revealed more consistent reduction of the levels of both components. Using vector subtraction (which takes into account both level and phase) to estimate the changes in the unseparated DPOAE provided consistent evidence of DPOAE suppression. Including phase information provided a more sensitive, valid and consistent estimate of CAS function even if one does not know the position of the DPOAE in the fine-structure.

Impact of three hours of discotheque music on pure-tone thresholds and distortion product otoacoustic emissions

The aim of this study was to investigate whether distortion product otoacoustic emissions (DPOAEs) are a suitable means for detecting changes in outer hair cell (OHC) functionality due to exposure to three hours of discotheque music and whether efferent reflex strength of the medial olivocochlear bundle is able to predict the ear's susceptibility to high-level noise. High-resolution DPOAEs (Δf(2)=47 Hz) were recorded between 3.5 and 4.5 kHz at close-to-threshold primary tone levels. For comparison, high-resolution pure-tone audiometry was conducted in the same frequency range. Efferent reflex strength was measured by means of DPOAEs at a specific frequency with and without contralateral acoustic stimulation. A significant deterioration of more than 10 dB was found for pure-tone thresholds and DPOAE levels indicating that three hours of high-level noise exert a considerable influence on hearing capability and OHC functionality. A significant correlation between shifts in pure-tone threshold and shifts in DPOAE level occurred when removing data with differing calibration across measurements. There was no clear correlation between efferent reflex strength and shifts in pure-tone threshold or shifts in DPOAE level suggesting that the applied measures of efferent reflex strength may not be suitable for quantifying individual vulnerability to noise.

Perceptual learning of non-native speech contrast and functioning of the olivocochlear bundle

The purpose of this study was to investigate the relationship between perceptual learning of non-native speech sounds and strength of feedback in the medial olivocochlear bundle (MOCB). Discrimination abilities of non-native speech sounds (Malayalam) from its native counterparts (Hindi) were monitored during 12 days of training. Contralateral inhibition of otoacoustic emissions were measured on the first and twelfth day of training. Results suggested that training significantly improved reaction time and accuracy of identification of non-native speech sounds. There was a significant positive correlation between the slope (linear) of identification scores and change in distortion product otoacoustic emission inhibition at 3000 Hz. Findings suggest that during perceptual learning feedback from the MOCB may fine tune the brain stem and/or cochlea. However, such a change, isolated to a narrow frequency region, represents a limited effect and needs further exploration to confirm and/or extend any generalization of findings.

Contralateral acoustic stimulation alters the magnitude and phase of distortion product otoacoustic emissions

Activation of medial olivocochlear efferents through contralateral acoustic stimulation (CAS) has been shown to modulate distortion product otoacoustic emission (DPOAE) level in various ways (enhancement, reduction, or no change). The goal of this study was to investigate the effect of a range of CAS levels on DPOAE fine structure. The 2f(1)-f(2) DPOAE was recorded (f(2)/f(1)=1.22, L(1)=55 dB, and L(2)=40 dB) from eight normal-hearing subjects, using both a frequency-sweep paradigm and a fixed frequency paradigm. Contamination due to the middle ear muscle reflex was avoided by monitoring the magnitude and phase of a probe in the test ear and by monitoring DPOAE stimulus levels throughout testing. Results show modulations in both level and frequency of DPOAE fine structure patterns. Frequency shifts observed at DPOAE level minima could explain reports of enhancement in DPOAE level due to efferent activation. CAS affected the magnitude and phase of the DPOAE component from the characteristic frequency region to a greater extent than the component from the overlap region between the stimulus tones. This differential effect explains the occasional enhancement observed in DPOAE level as well as the frequency shift in fine structure patterns.

Contralateral Acoustic Stimulation Modulates Low-Frequency Biasing of DPOAE: Efferent Influence on Cochlear Amplifier Operating State?

The mammalian efferent medial olivocochlear system modulates active amplification of low-level sounds in the cochlea. Changes of the cochlear amplifier can be monitored by distortion product otoacoustic emissions (DPOAEs). The quadratic distortion product f2–f1 is known to be sensitive to changes in the operating point of the amplifier transfer function. We investigated the effect of contralateral acoustic stimulation (CAS), known to elicit efferent activity, on DPOAEs in the gerbil. During CAS, a significant increase of the f2–f1 level occurred already at low contralateral noise levels (20 dB SPL), whereas 2f1–f2 was much less affected. The effect strength depended on the CAS level and as shown in experiments with pure tones on the frequency of the contralateral stimulus. In a second approach, we biased the position of the cochlear partition and thus the cochlear amplifier operating point periodically by a ipsilateral low-frequency tone, which resulted in a phase-related amplitude modulation of f2–f1. This modulation pattern was changed considerably during contralateral noise stimulation, in dependence on the noise level. The experimental results were in good agreement with a simple model of distortion product generation and suggest that the olivocochlear efferents might change the operating state of cochlear amplification.

Considering distortion product otoacoustic emission fine structure in measurements of the medial olivocochlear reflex

In humans, when the medial olivocochlear (MOC) pathway is activated by noise in the opposite ear, changes in distortion product otoacoustic emission (DPOAE) level, i.e., the MOC reflex, can be recorded in the test ear. Recent evidence suggests that DPOAE frequency influences the direction (suppression/enhancement) of the reflex. In this study, DPOAEs were recorded at fine frequency intervals from 500 to 2500 Hz, with and without contralateral acoustic stimulation (CAS) in a group of 15 adults. The MOC reflex was calculated only at DPOAE frequencies corresponding to peaks in the fine structure. Additionally, inverse fast-Fourier transform was conducted to evaluate MOC effects on individual DPOAE components. Results show the following: (1) When considering peaks only, the mean MOC reflex was -2.05 dB and 97% of observations reflected suppression, (2) CAS reduced distortion characteristic frequency component levels more than overlap component levels, and (3) CAS produced an upward shift in fine structure peak frequency. Results indicate that when the MOC reflex is recorded at DPOAE frequencies corresponding to fine structure maxima (i.e., when DPOAE components are constructive and in phase), suppression is reliably observed and level enhancement, which probably reflects component mixing in the ear canal rather than strength of the MOC reflex, is eliminated.

TEOAE suppression in adults with learning disabilities

The presentation of contralateral noise during the recording of transient evoked otoacoustic emissions (TEOAEs) reduces the amplitude of the TEOAE in normally-hearing adults. This is known as TEOAE suppression. The present study investigated TEOAE suppression in 18 adults with learning disabilities (LDs) compared to 18 adults without LDs. TEOAEs were elicited by 60 dB p.e. SPL clicks and were suppressed by the presentation of 60 dB SPL contralateral broadband noise. Suppression was measured as a change in the overall TEOAE response amplitude, and also analysed in 2-ms epochs representing different TEOAE frequency-response bands. A significant interaction was evident between group type and ear tested. Participants in the control group had right ear dominance for the suppression effect, whereas the left ear was found to be dominant for the LD group. These findings suggest a mechanism of the medial olivary cochlear bundle and efferent auditory pathway that differs in those with LD compared to those with typical learning abilities.

Distortion product otoacoustic emission contralateral suppression functions obtained with ramped stimuli

The purpose of this research was to investigate the changes that occur in human distortion product otoacoustic emission (DPOAE) level functions over continuous frequency bands in response to activation of the medial olivocochlear (MOC) efferent system by contralateral broadband noise. DPOAEs were obtained using continuous upward ramps of the lower frequency tone (f(1)) while the higher frequency tone (f(2)) was fixed. These ramps were designed to change the stimulus frequency ratio f(2)/f(1) over a fixed range for each fixed f(2) value of 2, 3, and 4 kHz. Contralateral noise was presented on alternating ramps and the DPOAEs with and without contralateral noise were averaged separately. Stimulus frequency ratios of 1.10 and 1.22, and noise levels of 60 and 50 dB sound pressure level (SPL) were employed. Changes in DPOAE level were generally suppression (a reduction in DPOAE magnitude), but enhancement was also observed. For most participants, changes were evident for much of the frequency ranges tested. Average absolute changes for 60 dB SPL noise were 0.95, 0.81, and 0.42 dB for the wider stimulus frequency ratios and f(2) of 2, 3, and 4 kHz, respectively. For the narrower ratio and 60 dB SPL noise, the changes were larger with average absolute changes of 1.33, 1.09, and 0.87 dB. For the narrower ratio and 50 dB SPL noise, the changes were 1.08, 0.78, and 0.55 dB with f(2) of 2, 3, and 4 kHz, respectively. DPOAE nulls were observed and a common response pattern was a shift of emission morphology to higher frequencies with contralateral acoustic stimulation. The method appears promising for relatively rapid evaluation of the MOC efferent system in humans and offers information complementary to measurement strategies that explore the effects of stimulus level.

Impact of occupational noise on pure-tone threshold and distortion product otoacoustic emissions after one workday

The aim of this study was to investigate whether distortion product otoacoustic emissions (DPOAEs) are a suitable means for detecting small changes in cochlear amplifier functionality due to occupational noise exposure of one workday and whether efferent reflex strength of the medial olivocochlear bundle is able to predict the ear's susceptibility to noise. High-resolution (Deltaf(2)= 47 Hz) DPOAEs were recorded between 3.5 and 4.5 kHz at close-to-threshold primary tone levels. For comparison, pure-tone audiometry was conducted. Efferent reflex strength was measured by means of DPOAEs at a specific frequency with and without contralateral acoustic stimulation. A statistically significant change was found for pure-tone thresholds (DeltaL(ht)=+1.6+/-3.0 dB, n=155) and DPOAE levels (DeltaL(dp)=-1.0+/-2.4 dB, n=646; L(2)=20 dB SPL) in factory workers but not in office workers (DeltaL(ht)=-1.3+/-3.3 dB, n=80; DeltaL(dp)=0.0+/-1.6 dB, n=336) (control group). However, the influence of systematic biases due to, e.g. ear probe calibration or measurement sequence effects, has to be considered. Moreover, there was no significant correlation between efferent reflex strength and shifts in pure-tone thresholds or shifts in DPOAE levels. Thus, the applied measures of efferent reflex strength do not seem to be suitable for predicting temporary changes in hearing capability.

Sources of variability in distortion product otoacoustic emissions

The goal of this study was to determine the extent to which the variability seen in distortion product otoacoustic emissions (DPOAEs), among ears with normal hearing, could be accounted for. Several factors were selected for investigation, including behavioral threshold, differences in middle-ear transmission characteristics either in the forward or the reverse direction, and differences in contributions from the distortion and reflection sources. These variables were assessed after optimizing stimulus parameters for individual ears at each frequency. A multiple-linear regression was performed to identify whether the selected variables, either individually or in combination, explained significant portions of variability in DPOAE responses. Behavioral threshold at the f(2) frequency and behavioral threshold squared at that same frequency explained the largest amount of variability in DPOAE level, compared to the other variables. The combined model explained a small, but significant, amount of variance in DPOAE level at five frequencies. A large amount of residual variability remained, even at frequencies where the model accounted for significant amounts of variance.

Distortion product otoacoustic emission fine structure is responsible for variability of distortion product otoacoustic emission contralateral suppression

Alteration of the distortion product otoacoustic emission (DPOAE) level by a contralateral sound, which is known as DPOAE contralateral suppression, has been attributed to the feedback mechanism of the medial olivocochlear efferents. However, the limited dynamic range and large intra- and intersubject variabilities in the outcome of the measurement restrict its application in assessing the efferent function. In this study, the 2f(1)-f(2) DPgram was measured with a high frequency resolution in six human ears, which exhibits a fine structure with the quasiperiodic appearance of peaks and dips. In the presence of contralateral noise, the DPOAE level increased, decreased, or remained unchanged depending on the frequency. At the peaks, DPOAEs were mostly suppressed with a larger change, while those at the dips had greater variance, with increased occurrence of enhancement or no change. The difference between the peak and dip frequencies in the DPOAE-level change was significant. A switch from suppression to enhancement of the DPOAE level or vice versa with a small change in frequency was noted. These results imply that the DPOAE fine structure is a main source of the variability in DPOAE contralateral suppression measurement. The study suggests that the DPOAE contralateral suppression test would be improved if it is conducted for frequencies at major peaks of the DPOAE fine structure.

Speech-in-noise intelligibility does not correlate with efferent olivocochlear reflex in humans with normal hearing

CONCLUSION

According to the presented data, speech-in-noise intelligibility (SI) does not correlate with olivocochlear efferent activity - as measured by contralateral suppression (CS) of distortion product otoacoustic emissions (DPOAE) in humans with normal auditory threshold.

OBJECTIVES

Literature data indicate a possible role of the medial olivocochlear efferents in speech intelligibility, especially in background noise. The objective of this study was to investigate this relationship.

MATERIALS AND METHODS

SI was evaluated in three independent sessions by determining the ratio speech level/noise level, at which 50% of the words are understood (i.e. speech reception threshold, SRT). Efferent activity was inferred measuring CS of DPOAE, using two different paradigms with extensive variation of stimulus parameters and duplicate measurements.

RESULTS

For optimum measurement of CS, the study was restricted to subjects (n =49) with valid DPOAE down to primary tone levels L1=47/L2 =20 dB SPL. Average SRT was -6.66 dB (-4.50 to -7.65 dB, SD 0.63 dB). CS increased with decreasing primary tone levels, with mean absolute CS values in the range of 0.6-6 dB SPL. Test-retest repeatability was good. Statistical evaluation revealed no significant relationship between SI and CS of DPOAE.

Measurement of the distribution of medial olivocochlear acoustic reflex strengths across normal-hearing individuals via otoacoustic emissions

A clinical test for the strength of the medial olivocochlear reflex (MOCR) might be valuable as a predictor of individuals at risk for acoustic trauma or for explaining why some people have trouble understanding speech in noise. A first step in developing a clinical test for MOCR strength is to determine the range and variation of MOCR strength in a research setting. A measure of MOCR strength near 1 kHz was made across a normal-hearing population (N = 25) by monitoring stimulus-frequency otoacoustic emissions (SFOAEs) while activating the MOCR with 60 dB SPL wideband contralateral noise. Statistically significant MOCR effects were measured in all 25 subjects; but not all SFOAE frequencies tested produced significant effects within the time allotted. To get a metric of MOCR strength, MOCR-induced changes in SFOAEs were normalized by the SFOAE amplitude obtained by two-tone suppression. We found this "normalized MOCR effect" varied across frequency and time within the same subject, sometimes with significant differences between measurements made as little as 40 Hz apart or as little as a few minutes apart. Averaging several single-frequency measures spanning 200 Hz in each subject reduced the frequency- and time-dependent variations enough to produce correlated measures indicative of the true MOCR strength near 1 kHz for each subject. The distribution of MOCR strengths, in terms of SFOAE suppression near 1 kHz, across our normal-hearing subject pool was reasonably approximated by a normal distribution with mean suppression of approximately 35% and standard deviation of approximately 12%. The range of MOCR strengths spanned a factor of 4, suggesting that whatever function the MOCR plays in hearing (e.g., enhancing signal detection in noise, reducing acoustic trauma), different people will have corresponding differences in their abilities to perform that function.

Contralateral suppression of distortion product otoacoustic emissions: effect of the primary frequency in Dpgrams

The amplitude of the 2f1-f2 distortion product otoacoustic emission (DPOAE) can be suppressed by presenting contralateral acoustic stimulation. To test the hypothesis that DPOAE contralateral suppression is influenced by the primary frequency in DPgrams, DPgrams were recorded at resolutions of 1, 8, and 17 pts/octave, in the absence and presence of contralateral broadband noise (BBN). Participants were 20 normal-hearing human adults. In DPgrams with higher frequency resolutions, DPOAE suppression at amplitude peaks in DPgrams (8 pts/octave: Mean = - 0.92 dB, SD = 0.71 for BBN at 60 dB SPL; 17 pts/octave: Mean = - 0.25 to -1.44 dB, SD = 0.51 to 0.86 for BBN at 40 to 70 dB SPL, respectively) was larger than the suppression at the dips in DPgrams (8 pts/octave: Mean = - 0.13 dB, SD = 1.00; 17 pts/octave: Mean = - 0.03 to -0.73 dB, SD = 0.55 to 0.91). A larger intersubject variability in DPOAE contralateral suppression was observed at the dips. The results suggest that measuring DPOAE contralateral suppression at the primary frequencies corresponding to the peaks in DPgrams with higher frequency resolutions may improve the assessment of the efferent system function.

Olivocochlear efferents: anatomy, physiology, function, and the measurement of efferent effects in humans

This review covers the basic anatomy and physiology of the olivocochlear reflexes and the use of otoacoustic emissions (OAEs) in humans to monitor the effects of one group, the medial olivocochlear (MOC) efferents. MOC fibers synapse on outer hair cells (OHCs), and activation of these fibers inhibits basilar membrane responses to low-level sounds. This MOC-induced decrease in the gain of the cochlear amplifier is reflected in changes in OAEs. Any OAE can be used to monitor MOC effects on the cochlear amplifier. Each OAE type has its own advantages and disadvantages. The most straightforward technique for monitoring MOC effects is to elicit MOC activity with an elicitor sound contralateral to the OAE test ear. MOC effects can also be monitored using an ipsilateral elicitor of MOC activity, but the ipsilateral elicitor brings additional problems caused by suppression and cochlear slow intrinsic effects. To measure MOC effects accurately, one must ensure that there are no middle-ear-muscle contractions. Although standard clinical middle-ear-muscle tests are not adequate for this, adequate tests can usually be done with OAE-measuring instruments. An additional complication is that most probe sounds also elicit MOC activity, although this does not prevent the probe from showing MOC effects elicited by contralateral sound. A variety of data indicate that MOC efferents help to reduce acoustic trauma and lessen the masking of transients by background noise; for instance, they aid in speech comprehension in noise. However, much remains to be learned about the role of efferents in auditory function. Monitoring MOC effects in humans using OAEs should continue to provide valuable insights into the role of MOC efferents and may also provide clinical benefits.

Olivocochlear reflex effect on human distortion product otoacoustic emissions is largest at frequencies with distinct fine structure dips

Activity of the medial olivocochlear efferents can be inferred by measuring the change of the level of distortion product otoacoustic emissions (DPOAE) during ipsilateral or contralateral acoustic stimulation, the so-called medial olivocochlear reflex (MOCR). A limitation of this measurement strategy, however, is the distinct variability of MOCR values depending on DPOAE primary tone levels and frequency, which makes selection of the stimulus parameters difficult. The objective of this study was to evaluate the dependence of MOCR values on DPOAE fine structure in humans. MOCR during contralateral acoustic stimulation was measured at frequencies with distinct non-monotonicity ("dip") in the DPOAE fine structure, and in frequencies with flat fine structure. One hundred and twenty one different primary tone level combinations were used (L(1)=50-60dB SPL, L(2)=35-45dB SPL, 1dB steps). The measurement was repeated on another day. The major findings were: (1) Largest MOCR effects can be found in frequencies which exhibit a distinct dip in DPOAE fine structure. (2) Primary tone levels have a critical influence on the magnitude of the MOCR effect. MOCR changes of up to 23dB following a L(1) change of only 1dB were observed. Averages of the maximum MOCR change per 1dB step were in the 3-5dB-range. Both findings can be interpreted in the light of the DPOAE two-generator model [Heitmann, J., Waldmann, B., Schnitzler, H.U., Plinkert, P.K., Zenner, H.P. 1998. Suppression of distortion product otoacoustic emissions (DPOAE) near 2f1-f2 removes DP-gram fine structure - evidence for a secondary generator. Journal of the Acoustical Society of America 103, 1527-1531]. According to the present results we propose, that assessing MOCR specifically at frequencies with a distinct dip in the DPOAE fine structure, in combination with fine variation of the stimulus tone levels, allows for a more targeted search for maximum MOCR effects. Future studies must show if this approach can contribute to the further clarification of the physiological roles of the olivocochlear efferents.

Low-level otoacoustic emissions may predict susceptibility to noise-induced hearing loss

In a longitudinal study with 338 volunteers, audiometric thresholds and otoacoustic emissions were measured before and after 6 months of noise exposure on an aircraft carrier. While the average amplitudes of the otoacoustic emissions decreased significantly, the average audiometric thresholds did not change. Furthermore, there were no significant correlations between changes in audiometric thresholds and changes in otoacoustic emissions. Changes in transient-evoked otoacoustic emissions and distortion-product otoacoustic emissions were moderately correlated. Eighteen ears acquired permanent audiometric threshold shifts. Only one-third of those ears showed significant otoacoustic emission shifts that mirrored their permanent threshold shifts. A Bayesian analysis indicated that permanent threshold shift status following a deployment was predicted by baseline low-level or absent otoacoustic emissions. The best predictor was transient-evoked otoacoustic emission amplitude in the 4-kHz half-octave frequency band, with risk increasing more than sixfold from approximately 3% to 20% as the emission amplitude decreased. It is possible that the otoacoustic emissions indicated noise-induced changes in the inner ear, undetected by audiometric tests. Otoacoustic emissions may therefore be a diagnostic predictor for noise-induced-hearing-loss risk.