Sensitization to masked tones following notched-noise correlates with estimates of cochlear function using distortion product otoacoustic emissions

The stochastic resonance model of auditory perception: A unified explanation of tinnitus development, Zwicker tone illusion, and residual inhibition

Stochastic resonance (SR) has been proposed to play a major role in auditory perception, and to maintain optimal information transmission from the cochlea to the auditory system. By this, the auditory system could adapt to changes of the auditory input at second or even sub-second timescales. In case of reduced auditory input, somatosensory projections to the dorsal cochlear nucleus would be disinhibited in order to improve hearing thresholds by means of SR. As a side effect, the increased somatosensory input corresponding to the observed tinnitus-associated neuronal hyperactivity is then perceived as tinnitus. In addition, the model can also explain transient phantom tone perceptions occurring after ear plugging, or the Zwicker tone illusion. Vice versa, the model predicts that via stimulation with acoustic noise, SR would not be needed to optimize information transmission, and hence somatosensory noise would be tuned down, resulting in a transient vanishing of tinnitus, an effect referred to as residual inhibition.

The Effects of Compensatory Auditory Stimulation and High-Definition Transcranial Direct Current Stimulation (HD-tDCS) on Tinnitus Perception - A Randomized Pilot Study

Background

Tinnitus correlates with elevated hearing thresholds and reduced cochlear compression. We hypothesized that reduced peripheral input leads to elevated neuronal gain resulting in the perception of a phantom sound.

Objective

The purpose of this pilot study was to test whether compensating for this peripheral deficit could reduce the tinnitus percept acutely using customized auditory stimulation. To further enhance the effects of auditory stimulation, this intervention was paired with high-definition transcranial direct current stimulation (HD-tDCS).

Methods

A randomized sham-controlled, single blind study was conducted in a clinical setting on adult participants with chronic tinnitus (n = 14). Compensatory auditory stimulation (CAS) and HD-tDCS were administered either individually or in combination in order to access the effects of both interventions on tinnitus perception. CAS consisted of sound exposure typical to daily living (20-minute sound-track of a TV show), which was adapted with compressive gain to compensate for deficits in each subject's individual audiograms. Minimum masking levels and the visual analog scale were used to assess the strength of the tinnitus percept immediately before and after the treatment intervention.

Results

CAS reduced minimum masking levels, and visual analog scale trended towards improvement. Effects of HD-tDCS could not be resolved with the current sample size.

Conclusions

The results of this pilot study suggest that providing tailored auditory stimulation with frequency-specific gain and compression may alleviate tinnitus in a clinical population. Further experimentation with longer interventions is warranted in order to optimize effect sizes.

On Zwicker tones and musical pitch in the likely absence of phase locking corresponding to the pitch

It was assessed whether Zwicker tones (ZTs) (an auditory afterimage produced by a band-stop noise) have a musical pitch. First (stage I), musically trained subjects adjusted the frequency, level, and decay time of an exponentially decaying diotic sinusoid to sound similar to the ZT they perceived following the presentation of diotic broadband noise, for various band-stop positions. Next (stage II), subjects adjusted a sinusoid in frequency and level so that its pitch was a specified musical interval below that of either a preceding ZT or a preceding sinusoid, and so that it was equally loud. For each subject the reference sinusoid corresponded to their adjusted sinusoid from stage I. Subjects selected appropriate frequency ratios for ZTs, although the standard deviations of the adjustments were larger for the ZTs than for the equally salient sinusoids by a factor of 1.0-2.2. Experiments with monaural stimuli led to similar results, although the pitch of the ZTs could differ for monaural and diotic presentation of the ZT-exciting noise. The results suggest that a weak musical pitch may exist in the absence of phase locking in the auditory nerve to the frequency corresponding to the pitch (or harmonics thereof) at the time of the percept.

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.

Vowel enhancement effects in cochlear-implant users

Auditory enhancement of certain frequencies can occur through prior stimulation of surrounding frequency regions. The underlying neural mechanisms are unknown, but may involve stimulus-driven changes in cochlear gain via the medial olivocochlear complex (MOC) efferents. Cochlear implants (CIs) bypass the cochlea and stimulate the auditory nerve directly. If the MOC plays a critical role in enhancement then CI users should not exhibit this effect. Results using vowel stimuli, with and without preceding sounds designed to enhance formants, provided evidence of auditory enhancement in both normal-hearing listeners and CI users, suggesting that vowel enhancement is not mediated solely by cochlear effects.

Impaired cochlear function correlates with the presence of tinnitus and its estimated spectral profile

The presence of tinnitus often coincides with hearing loss. It has been argued that reduced peripheral input leads to frequency-specific increase in neuronal gains resulting in tinnitus-related hyper-activity. Following this gain-adaptation hypothesis, impaired cochlear function should be predictive of the presence and spectral characteristics of tinnitus. To assess cochlear function, perceptual thresholds and distortion product otoacoustic emissions (DPOAEs) were measured with high frequency resolution for subjects with tinnitus and non-tinnitus control subjects (N = 29 and N = 18) with and without hearing loss. Subjects with tinnitus also provided a 'tinnitus likeness spectrum' by rating the similarity of their tinnitus to tones at various frequencies. On average, subjects with tinnitus had elevated thresholds, reduced DPOAE, and increased slope of the DPOAE input-output function in the range from 4 to 10 kHz. These measures were strongly correlated and were equally predictive of the presence of tinnitus. Subjects with a pronounced edge to their hearing loss profile were very likely to have tinnitus. In the group average, the tinnitus likeness spectrum was correlated with perceptual thresholds (r = 0.98, p < 0.01), confirming previous reports. For 19 of 29 of subjects, perceptual thresholds were correlated with the tinnitus likeness ratings across frequencies and this correlation was significantly improved when low input-level DPOAE were included as an additional variable (r = 0.83 ± 0.09, N = 19). Thus, cochlear function is strongly associated with the tinnitus percept and measures of cochlear function using DPOAEs provide additional diagnostic information over perceptual thresholds alone.

Cochlear efferent innervation and function

PURPOSE OF REVIEW

This review covers topics relevant to olivocochlear-efferent anatomy and function for which there are new findings in papers from 2009 to early 2010.

RECENT FINDINGS

Work within the review period has increased our understanding of medial olivocochlear (MOC) mechanisms in outer hair cells, MOC-reflex tuning, MOC effects on distortion product otoacoustic emissions, the time course of MOC effects, MOC effects in psychophysical tests and on understanding speech, MOC effects in attention and learning, and lateral efferent function in binaural hearing. In addition, there are new insights into efferent molecular mechanisms and their effect on cochlear development.

SUMMARY

Techniques for measuring efferent effects using otoacoustic emissions are now well developed and have promise in clinical applications ranging from predicting which patients are susceptible to acoustic trauma to characterizing relationships between efferent activation and learning disabilities. To realize this promise, studies are needed in which these techniques are applied with high standards.