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Zelle D, Lorenz L, Thiericke JP, Gummer AW, Dalhoff E. Input-output functions of the nonlinear-distortion component of distortion-product otoacoustic emissions in normal and hearing-impaired human ears. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2017; 141:3203. [PMID: 28599560 PMCID: PMC5426960 DOI: 10.1121/1.4982923] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
Distortion-product otoacoustic emissions (DPOAEs) arise in the cochlea in response to two tones with frequencies f1 and f2 and mainly consist of two components, a nonlinear-distortion and a coherent-reflection component. Wave interference between these components limits the accuracy of DPOAEs when evaluating the function of the cochlea with conventional continuous stimulus tones. Here, DPOAE components are separated in the time domain from DPOAE signals elicited with short stimulus pulses. The extracted nonlinear-distortion components are used to derive estimated distortion-product thresholds (EDPTs) from semi-logarithmic input-output (I/O) functions for 20 normal-hearing and 21 hearing-impaired subjects. I/O functions were measured with frequency-specific stimulus levels at eight frequencies f2 = 1,…, 8 kHz (f2/f1 = 1.2). For comparison, DPOAEs were also elicited with continuous primary tones. Both acquisition paradigms yielded EDPTs, which significantly correlated with behavioral thresholds (p < 0.001) and enabled derivation of estimated hearing thresholds (EHTs) from EDPTs using a linear regression relationship. DPOAE-component separation in the time domain significantly reduced the standard deviation of EHTs compared to that derived from continuous DPOAEs (p < 0.01). In conclusion, using frequency-specific stimulus levels and DPOAE-component separation increases the reliability of DPOAE I/O functions for assessing cochlear function and estimating behavioral thresholds.
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Affiliation(s)
- Dennis Zelle
- Section of Physiological Acoustics and Communication, Department of Otolaryngology, Eberhard-Karls-University Tübingen, Elfriede-Aulhorn-Straße 5, 72076 Tübingen, Germany
| | - Lisa Lorenz
- Section of Physiological Acoustics and Communication, Department of Otolaryngology, Eberhard-Karls-University Tübingen, Elfriede-Aulhorn-Straße 5, 72076 Tübingen, Germany
| | - John P Thiericke
- Section of Physiological Acoustics and Communication, Department of Otolaryngology, Eberhard-Karls-University Tübingen, Elfriede-Aulhorn-Straße 5, 72076 Tübingen, Germany
| | - Anthony W Gummer
- Section of Physiological Acoustics and Communication, Department of Otolaryngology, Eberhard-Karls-University Tübingen, Elfriede-Aulhorn-Straße 5, 72076 Tübingen, Germany
| | - Ernst Dalhoff
- Section of Physiological Acoustics and Communication, Department of Otolaryngology, Eberhard-Karls-University Tübingen, Elfriede-Aulhorn-Straße 5, 72076 Tübingen, Germany
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Le Prell CG, Fulbright A, Spankovich C, Griffiths SK, Lobarinas E, Campbell KCM, Antonelli PJ, Green GE, Guire K, Miller JM. Dietary supplement comprised of β-carotene, vitamin C, vitamin E, and magnesium: failure to prevent music-induced temporary threshold shift. AUDIOLOGY AND NEUROTOLOGY EXTRA 2016; 6:20-39. [PMID: 27990155 DOI: 10.1159/000446600] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
This study examined potential prevention of music-induced temporary threshold shift (TTS) in normal-hearing participants. A dietary supplement composed of β-carotene, vitamins C and E, and magnesium was assessed using a randomized, placebo-controlled, double-blind study design. Dosing began 3 days prior to the music exposure with the final dose consumed approximately 30-min pre-exposure. There were no group differences in post-exposure TTS or music-induced decreases in distortion product otoacoustic emission (DPOAE) amplitude. Transient tinnitus was more likely to be reported by the treatment group, but there were no group differences in perceived loudness or bothersomeness. All subjects were monitored until auditory function returned to pre-exposure levels. Taken together, this supplement had no effect on noise-induced changes in hearing. Recommendations for future clinical trials are discussed.
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Affiliation(s)
- C G Le Prell
- School of Behavioral and Brain Sciences, University of Texas at Dallas, Dallas, Tex
| | - A Fulbright
- Department of Speech, Language, and Hearing Sciences, University of Florida, Gainesville, Fla
| | - C Spankovich
- Department of Otolaryngology and Communicative Sciences, University of Mississippi Medical Center, Jackson, Miss
| | - S K Griffiths
- Department of Speech, Language, and Hearing Sciences, University of Florida, Gainesville, Fla
| | - E Lobarinas
- School of Behavioral and Brain Sciences, University of Texas at Dallas, Dallas, Tex
| | - K C M Campbell
- Department of Surgery, Southern Illinois University School of Medicine, Springfield, Ill
| | - P J Antonelli
- Department of Otolaryngology, University of Florida, Gainesville, Fla
| | - G E Green
- Department of Otolaryngology, University of Michigan, Ann Arbor, Mich
| | - K Guire
- Department of Biostatistics, University of Michigan, Ann Arbor, Mich
| | - J M Miller
- Department of Otolaryngology, University of Michigan, Ann Arbor, Mich
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Spankovich C, Griffiths SK, Lobariñas E, Morgenstein KE, de la Calle S, Ledon V, Guercio D, Le Prell CG. Temporary threshold shift after impulse-noise during video game play: laboratory data. Int J Audiol 2014; 53 Suppl 2:S53-65. [PMID: 24564694 DOI: 10.3109/14992027.2013.865844] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVE Prevention of temporary threshold shift (TTS) after laboratory-based exposure to pure-tones, broadband noise, and narrowband noise signals has been achieved, but prevention of TTS under these experimental conditions may not accurately reflect protection against hearing loss following impulse noise. This study used a controlled laboratory-based TTS paradigm that incorporated impulsive stimuli into the exposure protocol; development of this model could provide a novel platform for assessing proposed therapeutics. DESIGN Participants played a video game that delivered gunfire-like sound through headphones as part of a target practice game. Effects were measured using audiometric threshold evaluations and distortion product otoacoustic emissions (DPOAEs). The sound level and number of impulses presented were sequentially increased throughout the study. STUDY SAMPLE Participants were normal-hearing students at the University of Florida who provided written informed consent prior to participation. RESULTS TTS was not reliably induced by any of the exposure conditions assessed here. However, there was significant individual variability, and a subset of subjects showed TTS under some exposure conditions. CONCLUSIONS A subset of participants demonstrated reliable threshold shifts under some conditions. Additional experiments are needed to better understand and optimize stimulus parameters that influence TTS after simulated impulse noise.
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Affiliation(s)
- C Spankovich
- Department of Speech, Language, and Hearing Sciences, University of Florida , Gainesville , USA
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Digital music exposure reliably induces temporary threshold shift in normal-hearing human subjects. Ear Hear 2013; 33:e44-58. [PMID: 22885407 DOI: 10.1097/aud.0b013e31825f9d89] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
OBJECTIVES One of the challenges for evaluating new otoprotective agents for potential benefit in human populations is the availability of an established clinical paradigm with real-world relevance. These studies were explicitly designed to develop a real-world digital music exposure that reliably induces temporary threshold shift (TTS) in normal-hearing human subjects. DESIGN Thirty-three subjects participated in studies that measured effects of digital music player use on hearing. Subjects selected either rock or pop music, which was then presented at 93 to 95 (n = 10), 98 to 100 (n = 11), or 100 to 102 (n = 12) dBA in-ear exposure level for a period of 4 hr. Audiograms and distortion product otoacoustic emissions (DPOAEs) were measured before and after music exposure. Postmusic tests were initiated 15 min, 1 hr 15 min, 2 hr 15 min, and 3 hr 15 min after the exposure ended. Additional tests were conducted the following day and 1 week later. RESULTS Changes in thresholds after the lowest-level exposure were difficult to distinguish from test-retest variability; however, TTS was reliably detected after higher levels of sound exposure. Changes in audiometric thresholds had a "notch" configuration, with the largest changes observed at 4 kHz (mean = 6.3 ± 3.9 dB; range = 0-14 dB). Recovery was largely complete within the first 4 hr postexposure, and all subjects showed complete recovery of both thresholds and DPOAE measures when tested 1 week postexposure. CONCLUSIONS These data provide insight into the variability of TTS induced by music-player use in a healthy, normal-hearing, young adult population, with music playlist, level, and duration carefully controlled. These data confirm the likelihood of temporary changes in auditory function after digital music-player use. Such data are essential for the development of a human clinical trial protocol that provides a highly powered design for evaluating novel therapeutics in human clinical trials. Care must be taken to fully inform potential subjects in future TTS studies, including protective agent evaluations, that some noise exposures have resulted in neural degeneration in animal models, even when both audiometric thresholds and DPOAE levels returned to pre-exposure values.
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Dalhoff E, Turcanu D, Vetešník A, Gummer AW. Two-source interference as the major reason for auditory-threshold estimation error based on DPOAE input–output functions in normal-hearing subjects. Hear Res 2013; 296:67-82. [DOI: 10.1016/j.heares.2012.12.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2012] [Revised: 11/23/2012] [Accepted: 12/07/2012] [Indexed: 11/16/2022]
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Le Prell CG, Johnson AC, Lindblad AC, Skjönsberg A, Ulfendahl M, Guire K, Green GE, Campbell KCM, Miller JM. Increased vitamin plasma levels in Swedish military personnel treated with nutrients prior to automatic weapon training. Noise Health 2012; 13:432-43. [PMID: 22122960 DOI: 10.4103/1463-1741.90317] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Noise-induced hearing loss (NIHL) is a significant clinical, social, and economic issue. The development of novel therapeutic agents to reduce NIHL will potentially benefit multiple very large noise-exposed populations. Oxidative stress has been identified as a significant contributor to noise-induced sensory cell death and NIHL, and several antioxidant strategies have now been suggested for potential translation to human subjects. One such strategy is a combination of beta-carotene, vitamins C and E, and magnesium, which has shown promise for protection against NIHL in rodent models, and is being evaluated in a series of international human clinical trials using temporary (military gunfire, audio player use) and permanent (stamping factory, military airbase) threshold shift models (NCT00808470). The noise exposures used in the recently completed Swedish military gunfire study described in this report did not, on average, result in measurable changes in auditory function using conventional pure-tone thresholds and distortion product otoacoustic emission (DPOAE) amplitudes as metrics. However, analysis of the plasma samples confirmed significant elevations in the bloodstream 2 hours after oral consumption of active clinical supplies, indicating the dose is realistic. The plasma outcomes are encouraging, but clinical acceptance of any novel therapeutic critically depends on demonstration that the agent reduces noise-induced threshold shift in randomized, placebo-controlled, prospective human clinical trials. Although this noise insult did not induce hearing loss, the trial design and study protocol can be applied to other populations exposed to different noise insults.
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Affiliation(s)
- C G Le Prell
- Department of Speech, Language, and Hearing Sciences, University of Florida, Gainesville, FL, USA
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Thorson MJ, Kopun JG, Neely ST, Tan H, Gorga MP. Reliability of distortion-product otoacoustic emissions and their relation to loudness. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2012; 131:1282-95. [PMID: 22352502 PMCID: PMC3292604 DOI: 10.1121/1.3672654] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/16/2011] [Revised: 11/17/2011] [Accepted: 11/17/2011] [Indexed: 05/25/2023]
Abstract
The reliability of distortion-product otoacoustic emission (DPOAE) measurements and their relation to loudness measurements was examined in 16 normal-hearing subjects and 58 subjects with hearing loss. The level of the distortion product (L(d)) was compared across two sessions and resulted in correlations that exceeded 0.90. The reliability of DPOAEs was less when parameters from nonlinear fits to the input/output (I/O) functions were compared across visits. Next, the relationship between DPOAE I/O parameters and the slope of the low-level portion of the categorical loudness scaling (CLS) function (soft slope) was assessed. Correlations of 0.65, 0.74, and 0.81 at 1, 2, and 4 kHz were observed between CLS soft slope and combined DPOAE parameters. Behavioral threshold had correlations of 0.82, 0.83, and 0.88 at 1, 2, and 4 kHz with CLS soft slope. Combining DPOAEs and behavioral threshold provided little additional information. Lastly, a multivariate approach utilizing the entire DPOAE I/O function was used to predict the CLS rating for each input level (dB SPL). Standard error of the estimate when using this method ranged from 2.4 to 3.0 categorical units (CU), suggesting that DPOAE I/O functions can predict CLS measures within the CU step size used in this study (5).
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Affiliation(s)
- Megan J Thorson
- Boys Town National Research Hospital, 555 North 30th Street, Omaha, Nebraska 68131, USA
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Rodríguez J, Neely ST, Jesteadt W, Tan H, Gorga MP. Comparison of distortion-product otoacoustic emission growth rates and slopes of forward-masked psychometric functions. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2011; 129:864-875. [PMID: 21361444 PMCID: PMC3070994 DOI: 10.1121/1.3523340] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/02/2010] [Revised: 11/09/2010] [Accepted: 11/09/2010] [Indexed: 05/30/2023]
Abstract
Slopes of forward-masked psychometric functions (FM PFs) were compared with distortion-product otoacoustic emission (DPOAE) input/output (I/O) parameters at 1 and 6 kHz to test the hypothesis that these measures provide similar estimates of cochlear compression. Implicit in this hypothesis is the assumption that both DPOAE I/O and FM PF slopes are functionally related to basilar-membrane (BM) response growth. FM PF-slope decreased with signal level, but this effect was reduced or reversed with increasing hearing loss; there was a trend of decreasing psychometric function (PF) slope with increasing frequency, consistent with greater compression at higher frequencies. DPOAE I/O functions at 6 kHz exhibited an increase in the breakpoint of a two-segment slope as a function of hearing loss with a concomitant decrease in the level of the distortion product (L(d)). Results of the comparison between FM PF and DPOAE I/O parameters revealed only a weak correlation, suggesting that one or both of these measures may provide unreliable information about BM compression.
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Affiliation(s)
- Joyce Rodríguez
- Starkey Hearing Research Center, 2150 Shattuck Avenue, Suite 408, Berkeley, California 94704-1345, USA.
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Neely ST, Johnson TA, Kopun J, Dierking DM, Gorga MP. Distortion-product otoacoustic emission input/output characteristics in normal-hearing and hearing-impaired human ears. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2009; 126:728-38. [PMID: 19640039 PMCID: PMC2730716 DOI: 10.1121/1.3158859] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/27/2009] [Revised: 05/15/2009] [Accepted: 05/26/2009] [Indexed: 05/23/2023]
Abstract
Distortion-product otoacoustic emission (DPOAE) input/output (I/O) functions were measured in 322 ears of 176 subjects at as many as 8 f(2) frequencies per ear for a total of 1779 I/O functions. The f(2) frequencies ranged from 0.7 to 8 kHz in half-octave steps. Behavioral thresholds (BTs) at the f(2) frequencies ranged from -5 to 60 dB hearing loss (HL). Both linear-pressure and nonlinear, two-slope functions were fitted to the data. The two-slope function describes I/O compression as output-controlled self-suppression. Most I/O functions (96%) were better fitted by the two-slope method. DPOAE thresholds based on each method were used to predict BTs. Compared to estimates based on linear-pressure functions, individual BTs predicted from DPOAE thresholds based on the two-slope model had lower residual error and accounted for more variance. Another advantage of the two-slope method is that it provides an estimate of response growth rate (RGR) that is not tied to threshold. At all frequencies, the median low-level RGR (across I/O functions of the same f(2) and BT) usually increased as BT increased, while high-level compression decreased. The observed characteristics of DPOAE I/O functions are consistent with the loss of cochlear compression that is typically associated with mild-to-moderate HL.
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Affiliation(s)
- Stephen T Neely
- Boys Town National Research Hospital, 555 North 30th Street, Omaha, NE 68131, USA
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Evaluation of cochlear hearing disorders: normative distortion product otoacoustic emission measurements. Ear Hear 2008; 28:778-92. [PMID: 17982366 DOI: 10.1097/aud.0b013e3181576755] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The overall objective was to begin the investigation, in humans, of distortion product otoacoustic emission measurements, which are intended to be part of a diagnostic protocol being developed. This protocol, designed to distinguish among different cochlear hearing disorders, has been tested to date only through lesion studies in the gerbil (Mills, Ear and Hearing, 27, 508-525, 2006). To be applied successfully to human subjects, it was required that parameters and procedures for emission measurements be found, which resulted in sufficiently small intersubject variability in normal subjects, among other requirements. To attain these objectives, measurements of particular otoacoustic emission responses were made in a reference group of young adults having excellent hearing. DESIGN Twenty young adults (age 18 to 24 yr; 40 ears) comprised the subject group, with equal numbers of men and women. Inclusion criteria included hearing thresholds of 10 dB HL or better in both ears at all frequencies (0.5, 1, 2, 3, 4, 6, and 8 kHz), plus a tympanometric peak response located within +/-30 daPa of ambient pressure in both ears. The otoacoustic emission stimulus consisted of two tones (frequencies f1 and f2) varied in level using 5-dB steps with the lower-frequency stimulus level always 10 dB greater than that of the higher-frequency stimulus. The emission isoresponse threshold was defined to be the stimulus level required to obtain an emission amplitude of -10 dB SPL. Another potential measure was defined to be the emission amplitude at the highest stimulus levels routinely tested. Mean emission amplitudes and thresholds were determined for f2 frequencies equal to audiometric frequencies from 1 to 8 kHz, using two different stimulus frequency ratios, f2/f1=1.21 and 1.28. RESULTS One result of the study was the derivation of reference standards for the emission threshold level, similar to the HL scale for pure-tone thresholds. For use in diagnosis, the optimal measure was found to be the otoacoustic emission threshold for the stimulus frequency ratio f2/f1=1.21 and for f2 frequencies from 1 to 6 kHz. The f2 frequency of 8 kHz seemed less useful because the emission had a relatively high mean threshold. For frequencies 1 to 6 kHz, the variances were adequately small: 95% of the emission thresholds fell within +/-13 dB of the mean at each frequency, a variability only slightly larger than that for the gerbil. Finally, even within the 10-dB HL limit, responses showed a slight trend for increased emission thresholds with increased auditory threshold. Only at 8 kHz was the amount of covariance important, however, with the relationship between emission and auditory thresholds strongest for men. CONCLUSIONS Emission reference standards can be developed by testing a group of young adults with excellent hearing. The diagnostic procedure previously proposed on the basis of gerbil lesion studies may be adapted with relatively little modification for use in human subjects. However, validity of the test and specific numerical results for human subjects remain to be firmly established for the purpose of distinguishing among different cochlear disorders.
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