Experimental confirmation of the two-source interference model for the fine structure of distortion product otoacoustic emissions

Reliable Long-Term Serial Evaluation of Cochlear Function Using Pulsed Distortion-Product Otoacoustic Emissions: Analyzing Levels and Pressure Time Courses

OBJECTIVES

To date, there is no international standard on how to use distortion-product otoacoustic emissions (DPOAEs) in serial measurements to accurately detect changes in the function of the cochlear amplifier due, for example, to ototoxic therapies, occupational noise, or the development of regenerative therapies. The use of clinically established standard DPOAE protocols for serial monitoring programs appears to be hampered by multiple factors, including probe placement and calibration effects, signal-processing complexities associated with multiple sites of emission generation as well as suboptimal selection of stimulus parameters.

DESIGN

Pulsed DPOAEs were measured seven times within 3 months for f2 = 1 to 14 kHz and L2 = 25 to 80 dB SPL in 20 ears of 10 healthy participants with normal hearing (mean age = 32.1 ± 9.7 years). L1 values were computed from individual optimal-path parameters derived from the corresponding individual DPOAE level map in the first test session. Three different DPOAE metrics for evaluating the functional state of the cochlear amplifier were investigated with respect to their test-retest reliability: (1) the interference-free, nonlinear-distortion component level ( LOD ), (2) the time course of the DPOAE-envelope levels, LDP ( t ), and (3) the squared, zero-lag correlation coefficient ( ) between the time courses of the DPOAE-envelope pressures, pDP ( t ), measured in two sessions. The latter two metrics include the two main DPOAE components and their state of interference.

RESULTS

Collated over all sessions and frequencies, the median absolute difference for LOD was 1.93 dB and for LDP ( t ) was 2.52 dB; the median of was 0.988. For the low ( f2 = 1 to 3 kHz), mid ( f2 = 4 to 9 kHz), and high ( f2 = 10 to 14 kHz) frequency ranges, the test-retest reliability of LOD increased with increasing signal to noise ratio (SNR).

CONCLUSIONS

On the basis of the knowledge gained from this study on the test-retest reliability of pulsed DPOAE signals and the current literature, we propose a DPOAE protocol for future serial monitoring applications that takes into account the following factors: (1) separation of DPOAE components, (2) use of individually optimal stimulus parameters, (3) SNR of at least 15 dB, (4) accurate pressure calibration, (5) consideration of frequency- and level-dependent test-retest reliabilities and corresponding reference ranges, and (6) stimulus levels L2 that are as low as possible with sufficient SNR to capture the nonlinear functional state of the cochlear amplifier operating at its highest gain.

Exploring the Influence of Extended High-Frequency Hearing on Cochlear Functioning at Lower Frequencies

PURPOSE

Diminished basal cochlear function, as indicated by elevated hearing thresholds in the extended high frequencies (EHFs), has been associated with lower levels of click-evoked and distortion-product otoacoustic emissions measured at lower frequencies. However, stimulus-frequency otoacoustic emissions (SFOAEs) at low-probe levels are reflection-source emissions that do not share the same generation mechanism as distortion-source emissions. The primary objective of the present study was to examine the influence of hearing thresholds in the EHFs on SFOAEs measured at lower frequencies.

METHOD

SFOAEs were recorded from both ears in 45 individuals with normal hearing thresholds in the conventional audiometric frequencies (0.25-8 kHz). Hearing thresholds were also measured at EHFs (10, 12.5, and 16 kHz). SFOAE magnitudes and signal-to-noise ratios (SNRs) were averaged across 1, 2, and 4 kHz probe frequencies and also averaged for high-probe frequencies (2 and 4 kHz).

RESULTS

SFOAE magnitudes and SNRs were significantly higher for ears with better EHF hearing relative to poorer EHF hearing, categorized based on the median split. In addition, hearing in the EHFs significantly contributed to the variance in all SFOAE measures, except for the high-frequency SFOAE magnitudes model. However, hearing thresholds at the probe frequencies did not significantly contribute to the variance in SFOAEs.

CONCLUSIONS

The study findings suggest that alterations in the basal cochlea, as revealed by EHF hearing thresholds, could be associated with diminished cochlear functioning in relatively apical regions, shown by SFOAEs at lower frequencies, in individuals with normal audiograms. These findings underscore the significance of considering EHF thresholds in audiological evaluations, as alterations in these frequencies may reflect broader cochlear health status.

Optimal Scale-Invariant Wavelet Representation and Filtering of Human Otoacoustic Emissions

Otoacoustic emissions (OAEs) are generated in the cochlea and recorded in the ear canal either as a time domain waveform or as a collection of complex responses to tones in the frequency domain (Probst et al. J Account Soc Am 89:2027-2067, 1991). They are typically represented either in their original acquisition domain or in its Fourier-conjugated domain. Round-trip excursions to the conjugated domain are often used to perform filtering operations in the computationally simplest way, exploiting the convolution theorem. OAE signals consist of the superposition of backward waves generated in different cochlear regions by different generation mechanisms, over a wide frequency range. The cochlear scaling symmetry (cochlear physics is the same at all frequency scales), which approximately holds in the human cochlea, leaves its fingerprints in the mathematical properties of OAE signals. According to a generally accepted taxonomy (Sher and Guinan Jr, J Acoust Soc Am 105:782-798, 1999), OAEs are generated either by wave-fixed sources, moving with frequency according with the cochlear scaling (as in nonlinear distortion) or by place-fixed sources (as in coherent reflection by roughness). If scaling symmetry holds, the two generation mechanisms yield OAEs with different phase gradient delay: almost null for wave-fixed sources, and long (and scaling as 1/f) for place-fixed sources. Thus, the most effective representation of OAE signals is often that respecting the cochlear scale-invariance, such as the time-frequency domain representation provided by the wavelet transform. In the time-frequency domain, the elaborate spectra or waveforms yielded by the superposition of OAE components from different generation mechanisms assume a much clearer 2-D pattern, with each component localized in a specific and predictable region. The wavelet representation of OAE signals is optimal both for visualization purposes and for designing filters that effectively separate different OAE components, improving both the specificity and the sensitivity of OAE-based applications. Indeed, different OAE components have different physiological meanings, and filtering dramatically improves the signal-to-noise ratio.

Descriptive Characterization of High-Frequency Distortion Product Otoacoustic Emission Source Components in Children

PURPOSE

Distortion product otoacoustic emissions (DPOAEs) provide an objective assessment of cochlear function and are used for serial ototoxicity monitoring in pediatric cancer patients. DPOAEs are modeled as having distortion (near f2) and reflection (near 2f1-f2) component sources, and developmental changes are observed in these components' relative strengths in infants compared with adults. However, little is known about source component strengths in childhood or at extended high frequencies (EHFs; > 8 kHz). Thus, the purpose of this study was to describe the effects of age and stimulus frequency on DPOAE components in children.

METHOD

DPOAEs were collected with varied frequency ratios (f2/f1 = 1.1-1.25) for a wide range of frequencies (2-16 kHz) in 39 younger (3-6 years) and 41 older (10-12 years) children with constant levels (L1/L2) of 65/50 dB SPL. A depth-compensated simulator sound pressure level method of calibration was employed. A time waveform representation of the results across various ratios was created to estimate peak pressures and latencies of each DPOAE component.

RESULTS

Estimated peak pressures of DPOAE components revealed the greatest differences in DPOAE sources between children occurring at the highest frequencies tested, where the peak pressure of both components was largest for younger compared with older children. Latency differences between the children were only noted at higher frequencies for the distortion component.

CONCLUSIONS

These results suggest that DPOAE levels decrease with age and reflection emissions are vulnerable to cochlear change. This work guides optimization of protocols for pediatric ototoxicity monitoring, whereby including EHF otoacoustic emissions is clearly warranted and choosing to isolate DPOAE sources may prove beneficial.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.23669214.

The Effect of Stimuli Level on Distortion Product Otoacoustic Emission in Normal Hearing Adults

The goal of this study is to compare three of the most commonly used primary-level relation paradigms (i.e., Scissors, Boys Town 'Optimal', and Equal-Level) in generation of distortion product otoacoustic emissions (DPOAEs) in normal hearing adults. The generator and reflection components were extracted from DPOAEs in each paradigm. The generator and reflection component levels and input/output (I/O) functions were compared across paradigms and primary-tone levels. The results showed a different I/O function growth behavior across frequency and levels among paradigms. The Optimal paradigm showed a systematic change in the generator and reflection component levels and I/O slopes across primary levels among subjects. Moreover, the levels and slopes in the Optimal paradigm were more distinct across levels with less variations across frequency leading to a systematic change in the DPOAE fine structure across levels. The I/O functions were found to be more sensitive to the selected paradigm; especially the I/O function for the reflection component. The I/O functions of the reflection components showed large variability across frequencies due to different frequency shifts in their microstructure depending on the paradigm. The findings of this study suggested the Optimal paradigm as the proper primary-level relation to study cochlear amplification/compression. The findings of this study shows that care needs to be taken in comparing the findings of different studies that generated DPOAEs with a different level-relation paradigm.

Usefulness of phase gradients of otoacoustic emissions in auditory health screening: An exploration with swept tones

Otoacoustic emissions (OAEs) are low-level sounds generated by the cochlea and widely used as a noninvasive tool to inspect cochlear impairments. However, only the amplitude information of OAE signals is used in current clinical tests, while the OAE phase containing important information about cochlear functions is commonly discarded, due to the insufficient frequency-resolution of existing OAE tests. In this study, swept tones with time-varying frequencies were used to measure stimulus frequency OAEs (SFOAEs) in human subjects, so that high-resolution phase spectra that are not available in existing OAE tests could be obtained and analyzed. The results showed that the phase of swept-tone SFOAEs demonstrated steep gradients as the frequency increased in human subjects with normal hearing. The steep phase gradients were sensitive to auditory functional abnormality caused by cochlear damage and stimulus artifacts introduced by system distortions. At low stimulus levels, the group delays derived from the phase gradients decreased from around 8.5 to 3 ms as the frequency increased from 1 to 10 kHz for subjects with normal hearing, and the pattern of group-delay versus frequency function showed significant difference for subjects with hearing loss. By using the swept-tone technology, the study suggests that the OAE phase gradients could provide highly sensitive information about the cochlear functions and therefore should be integrated into the conventional methods to improve the reliability of auditory health screening.

An additional source of distortion-product otoacoustic emissions from perturbation of nonlinear force by reflection from inhomogeneities

The basilar membrane in the cochlea can be modeled as an array of fluid coupled segments driven by stapes vibration and by the undamping nonlinear force simulating cochlear amplification. If stimulated with two tones, the model generates additional tones due to nonlinear distortion. These distortion products (DPs) can be transmitted into the ear canal and produce distortion-product otoacoustic emissions (DPOAEs) known to be generated in the healthy ear of various vertebrates. This study presents a solution for DPs in a two-dimensional nonlinear cochlear model with cochlear roughness-small irregularities in the impedance along the basilar membrane, which may produce additional DPs due to coherent reflection. The solution allows for decomposition of various sources of DPs in the model. In addition to the already described nonlinear-distortion and coherent-reflection mechanisms of DP generation, this study identifies a long-latency DPOAE component due to perturbation of nonlinear force. DP wavelets that are coherently reflected due to impedance irregularities travel toward the stapes across the primary generation region of DPs and there evoke perturbation of the nonlinear undamping force. The ensuing DP wavelets have opposite phase to the wavelets arising from coherent reflection, which results in partial cancellation of the coherent-reflection DP wavelets.

Optimizing distortion product otoacoustic emission recordings in normal-hearing ears by adopting cochlear place-specific stimuli

Distortion product otoacoustic emissions (DPOAEs) provide a window into active cochlear processes and have become a popular clinical and research tool. DPOAEs are commonly recorded using stimulus with fixed presentation levels and frequency ratio irrespective of the test frequency. However, this is inconsistent with the changing mechanical properties of the cochlear partition from the base to the apex that lend specific frequency-dependent spatial properties to the cochlear traveling wave. Therefore, the frequency and level characteristics between the stimulus tones should also need to be adjusted as a function of frequency to maintain optimal interaction between them. The goal of this investigation was to establish a frequency-specific measurement protocol guided by local cochlear mechanics. A broad stimulus parameter space extending up to 20 kHz was explored in a group of normal-hearing individuals. The stimulus frequency ratio yielding the largest 2f₁-f₂ DPOAE level changed as a function of frequency and stimulus level. Specifically, for a constant stimulus level, the frequency ratio producing the largest DPOAE level decreased with increasing frequency. Similarly, at a given f₂ frequency, the stimulus frequency ratio producing the largest DPOAE level became wider as stimulus level increased. These results confirm and strengthen our current understanding of DPOAE generation in the normally functioning cochlea and expand our understanding to previously unexamined higher frequencies. These data support the use of frequency- and level-specific stimulus frequency ratios to maximize DPOAE generation.

Joint Profile Characteristics of Long-Latency Transient Evoked and Distortion Otoacoustic Emissions

PURPOSE

In clinical practice, otoacoustic emissions (OAEs) are interpreted as either "present" or "absent." However, OAEs have the potential to inform about etiology and severity of hearing loss if analyzed in other dimensions. A proposed method uses the nonlinear component of the distortion product OAEs together with stimulus frequency OAEs to construct a joint reflection-distortion profile. The objective of the current study is to determine if joint reflection-distortion profiles can be created using long-latency (LL) components of transient evoked OAEs (TEOAEs) as the reflection-type emission.

METHOD

LL TEOAEs and the nonlinear distortion OAEs were measured from adult ears. Individual input-output (I/O) functions were created, and OAE level was normalized by dividing by the stimulus level yielding individual gain functions. Peak strength, compression threshold, and OAE level at compression threshold were derived from individual gain functions to create joint reflection-distortion profiles.

RESULTS

TEOAEs with a poststimulus window starting at 6 ms had I/O functions with compression characteristics similar to LL TEOAE components. The model fit the LL gain functions, which had R ² > .93, significantly better than the nonlinear distortion OAE gain functions, which had R ² = .596-.99. Interquartile ranges for joint reflection-distortion profiles were larger for compression threshold and OAE level at compression threshold but smaller for peak strength than those previously published.

CONCLUSIONS

The gain function fits LL TEOAEs well. Joint reflection-distortion profiles are a promising method that could enhance diagnosis of hearing loss, and use of the LL TEOAE in the profile for peak strength may be important because of narrow interquartile ranges.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.20323593.

The influence of self-reported noise exposure on 2ƒ1-ƒ2 distortion product otoacoustic emission level, fine structure, and components in a normal-hearing population

Distortion product otoacoustic emissions (DPOAEs) offer an outcome measure to consider for clinical detection and monitoring outer hair cell dysfunction as a result of noise exposure. This investigation detailed DPOAE characteristics and behavioral hearing thresholds up to 20 kHz to identify promising metrics for early detection of cochlear dysfunction. In a sample of normal-hearing individuals with and without self-reported noise exposure, the DPOAE and hearing threshold measures, as assessed by two questions, were examined. The effects on various auditory measures in individuals aged 10-65 years old with clinically normal/near-normal hearing through 4 kHz were evaluated. Individuals reporting occupational noise exposures (n = 84) and recreational noise exposures (n = 46) were compared to age-matched nonexposed individuals. The hearing thresholds and DPOAE level, fine structure, and component characteristics for the full frequency bandwidth were examined. The data suggest that the DPOAE levels measured using a range of stimulus levels hold clinical utility while fine structure characteristics offer limited use. Under carefully calibrated conditions, the extension to frequencies beyond 8 kHz in combination with various stimulus levels holds clinical utility. Moreover, this work supports the potential utility of the distortion product place component level for revealing differences in cochlear function due to self-reported, casual noise exposure that are not observable in behavioral hearing thresholds.

Distortion Product Otoacoustic Emission Component Behavior as a Function of Primary Frequency Ratio and Primary Level

OBJECTIVES

Distortion product otoacoustic emissions (DPOAEs) are composed of distortion and reflection components. Much is known about the influence of the stimulus frequency ratio (f 2 /f 1 ) on the overall/composite DPOAE level. However, the influence of f 2 /f 1 on individual DPOAE components is not as well examined. The goals of this pilot study were to systematically evaluate the effects of f 2 /f 1 on DPOAE components in clinically normal-hearing young adult ears. To extend the limited reports in the literature, this examination was carried out over an extended frequency range using two stimulus-level combinations.

DESIGN

DPOAEs were recorded from seven normal-hearing, young adult ears for f 2 frequencies between 0.75 and 16 kHz over a range of f 2 /f 1 using two stimulus-level combinations. The distortion (DPOAE D ) and reflection (DPOAE R ) components were separated using an inverse fast Fourier transform algorithm. Optimal ratios for the composite DPOAE and DPOAE components were determined from smoothed versions of level versus ratio functions in each case.

RESULTS

The optimal ratio for the composite DPOAE level increased with stimulus level and decreased as a function of frequency above 1 kHz. The optimal ratios for the DPOAE components followed a similar trend, decreasing with increasing frequency. The optimal ratio for DPOAE D was generally higher than that for DPOAE R . The overall level for DPOAE D was greater than that of DPOAE R , both decreasing with increasing frequency. DPOAE R , but not DPOAE D , became unrecordable above the noise floor at the higher frequencies.

CONCLUSIONS

DPOAE components behave similarly but not identically as a function of f 2 /f 1 . The ear canal DPOAE is generally dominated by DPOAE D . The behavior of DPOAE D as a function of f 2 /f 1 is entirely consistent with known properties of cochlear mechanics. The behavior of DPOAE R is more variable across ears, perhaps reflective of the increased number of parameters that influence its final form. Attempting to use an f 2 /f 1 that would allow a greater bias of the ear canal DPOAE toward one component or the other does not appear to be practical.

Distortion Product Otoacoustic Emission (DPOAE) Growth in Aging Ears with Clinically Normal Behavioral Thresholds

Age-related hearing loss (ARHL) is a devastating public health issue. To successfully address ARHL using existing and future treatments, it is imperative to detect the earliest signs of age-related auditory decline and understand the mechanisms driving it. Here, we explore early signs of age-related auditory decline by characterizing cochlear function in 199 ears aged 10-65 years, all of which had clinically defined normal hearing (i.e., behavioral thresholds ≤ 25 dB HL from .25 to 8 kHz bilaterally) and no history of noise exposure. We characterized cochlear function by measuring behavioral thresholds in two paradigms (traditional audiometric thresholds from .25 to 8 kHz and Békésy tracking thresholds from .125 to 20 kHz) and distortion product otoacoustic emission (DPOAE) growth functions at f₂ = 2, 4, and 8 kHz. Behavioral thresholds through a standard clinical frequency range (up to 8 kHz) showed statistically, but not clinically, significant declines across increasing decades of life. In contrast, DPOAE growth measured in the same frequency range showed clear declines as early 30 years of age, particularly across moderate stimulus levels (L₂ = 25-45 dB SPL). These substantial declines in DPOAE growth were not fully explained by differences in behavioral thresholds measured in the same frequency region. Additionally, high-frequency Békésy tracking thresholds above ~11.2 kHz showed frank declines with increasing age. Collectively, these results suggest that early age-related cochlear decline (1) begins as early as the third or fourth decade of life, (2) is greatest in the cochlear base but apparent through the length of the cochlear partition, (3) cannot be detected fully by traditional clinical measures, and (4) is likely due to a complex mix of etiologies.

Weakened Cochlear Nonlinearity During Human Aging and Perceptual Correlates

OBJECTIVE

As humans age, compressive nonlinearity-a hallmark of healthy cochlear function-changes. The nonlinear distortion-component of the distortion product otoacoustic emission (DPOAE) provides a noninvasive gauge of cochlear nonlinearity. Earlier published work has suggested that weakened nonlinearity begins in middle age; the current work extends this investigation into the eight decade of life using advanced DPOAE data collection and analysis methods as well as multiple metrics of nonlinearity, including a test of loudness scaling.

DESIGN

The 2f1-f2 DPOAE was recorded in 20 young adults, 25 middle-aged adults and 32 older adults from f2 = 0.78 to 9.4 kHz with primary tones (f2/f1 = 1.22) swept upward at a rate of 0.5 octave/sec. Only frequencies with audiometric thresholds ≤20 dB HL were included in the analysis and to the extent possible, ears were audiometrically matched to eliminate hearing threshold as a contributing factor to the observed age effects. Input/output functions were generated for the separated distortion-component of the DPOAE to probe compressive nonlinearity of the cochlea, and ipsilateral suppression of the DPOAE was conducted to probe two-tone suppression. To investigate the perceptual effects of weakening nonlinearity on loudness perception, the same subjects performed categorical loudness scaling. Age effects on both DPOAE and loudness scaling variables were assessed, and correlations were conducted between key OAE and perceptual metrics.

RESULTS

Age × Frequency ANOVAs revealed that the compression knee of the DPOAE I/O function occurred at higher stimulus levels in both groups of older adults compared to young adults, suggesting an expanded linear range with aging; also, the compressive slope (growth beyond the knee point) was steeper in older-adults compared to young adults. These results were most notable at high frequencies. ANOVAs including age and auditory threshold as factors confirmed that the age effect observed was independent of threshold. Additionally, in smaller subsets of subjects with audiometrically matched data, these same trends persisted, further ruling out hearing threshold as an influential factor. The growth of DPOAE ipsilateral suppression was shallower near 4 kHz in middle-aged and older adults compared to young adults and elevated suppression thresholds were observed. Results of categorical loudness scaling showed steeper growth of loudness for older adults and, at fixed sensation levels (dB SL), the older-adult group rated tones as louder than did their young-adult counterparts, suggesting abnormal loudness growth and perception. Several correlations between the compression knee of the DPOAE I/O function and key metrics of loudness scaling were significant and accounted for up to one-third of the variance.

CONCLUSIONS

Results indicate that the aging cochlea begins to show weakened nonlinearity in middle age and it progressively weakens further into senescence. The perceptual impact of weakened nonlinearity during aging is manifested as abnormal loudness judgments; that is, in older-adult ears, a tone considered comfortable or medium in young-adult ears can be considered loud. The biophysical origin of this weakened nonlinearity is not known. It is hypothesized to reflect aging-related damage to, or loss of, outer hair cells and their stereocilia. More work is warranted to better define the perceptual impact of a linearized cochlear response in older adults and to consider how this deficit might impact the fitting of hearing aids and other intervention strategies.

Examining the Factors that Contribute to Non-Monotonic Growth of the [Formula: see text] Otoacoustic Emission in Humans

Cubic distortion product otoacoustic emission input-output functions in humans show a complex pattern of growth. To further investigate the growth of the [Formula: see text] otoacoustic emission, magnitude and phase input-output functions were obtained from human subjects using a range of stimulus levels, frequencies, and frequency ratios. Three factors related to cochlear nonlinearity may produce non-monotonic input-output functions: a two-component interaction, an operating point shift, and two-tone suppression. To complement data interpretation, a local model of distortion product otoacoustic emission generation was fit to the magnitude spectrum of the averaged ear canal sound pressure recording to quantify operating point shift. Results obtained are consistent with non-monotonic growth occurring primarily as a result of two-tone suppression and/or a two-component interaction. These two mechanisms are expected to operate at different stimulus levels, with different signature magnitude and phase patterns, and are unlikely to overlap in producing non-monotonic growth. An operating point shift was suggested in three cases. These results support multiple factors contributing to the complexity of growth of the [Formula: see text] otoacoustic emission in humans and highlight the importance of looking at phase in addition to magnitude when interpreting distortion product otoacoustic emission growth.

Otoacoustic Emissions Evoked by the Time-Varying Harmonic Structure of Speech

The human auditory system is exceptional at comprehending an individual speaker even in complex acoustic environments. Because the inner ear, or cochlea, possesses an active mechanism that can be controlled by subsequent neural processing centers through descending nerve fibers, it may already contribute to speech processing. The cochlear activity can be assessed by recording otoacoustic emissions (OAEs), but employing these emissions to assess speech processing in the cochlea is obstructed by the complexity of natural speech. Here, we develop a novel methodology to measure OAEs that are related to the time-varying harmonic structure of speech [speech-distortion-product OAEs (DPOAEs)]. We then employ the method to investigate the effect of selective attention on the speech-DPOAEs. We provide tentative evidence that the speech-DPOAEs are larger when the corresponding speech signal is attended than when it is ignored. Our development of speech-DPOAEs opens up a path to further investigations of the contribution of the cochlea to the processing of complex real-world signals.

Cochlear tuning estimates from level ratio functions of distortion product otoacoustic emissions

Objective: Distortion product otoacoustic emission (DPOAE) levels plotted as a function of stimulus frequency ratio demonstrate a bandpass shape. This bandpass shape is narrower at higher frequencies compared to lower frequencies and thus has been thought to be related to cochlear mechanical tuning.Design: However, the frequency- and level-dependence of these functions above 8 kHz is largely unknown. Furthermore, how tuning estimates from these functions are related to behavioural tuning is not fully understood.Study Sample: From experiment 1, we report DPOAE level ratio functions (LRF) from seven normal-hearing, young-adults for f₂ = 0.75-16 kHz and two stimulus levels of 62/52 and 52/37 dB FPL. We found that LRFs became narrower as a function of increasing frequency and decreasing level.Results: Tuning estimates from these functions increased as expected from 1-8 kHz. In experiment 2, we compared tuning estimates from DPOAE LRF to behavioural tuning in 24 normal-hearing, young adults for 1 and 4 kHz and found that behavioural tuning generally predicted DPOAE LRF estimated tuning.Conclusions: Our findings suggest that DPOAE LRFs generally reflect the tuning profile consistent with basilar membrane, neural, and behavioural tuning. However, further investigations are warranted to fully determine the use of DPOAE LRF as a clinical measure of cochlear tuning.

Correlation and Reliability of Behavioral and Otoacoustic-Emission Estimates of Contralateral Medial Olivocochlear Reflex Strength in Humans

The roles of the medial olivocochlear reflex (MOCR) in human hearing have been widely investigated but remain controversial. We reason that this may be because the effects of MOCR activation on cochlear mechanical responses can be assessed only indirectly in healthy humans, and the different methods used to assess those effects possibly yield different and/or unreliable estimates. One aim of this study was to investigate the correlation between three methods often employed to assess the strength of MOCR activation by contralateral acoustic stimulation (CAS). We measured tone detection thresholds (N = 28), click-evoked otoacoustic emission (CEOAE) input/output (I/O) curves (N = 18), and distortion-product otoacoustic emission (DPOAE) I/O curves (N = 18) for various test frequencies in the presence and the absence of CAS (broadband noise of 60 dB SPL). As expected, CAS worsened tone detection thresholds, suppressed CEOAEs and DPOAEs, and horizontally shifted CEOAE and DPOAE I/O curves to higher levels. However, the CAS effect on tone detection thresholds was not correlated with the horizontal shift of CEOAE or DPOAE I/O curves, and the CAS-induced CEOAE suppression was not correlated with DPOAE suppression. Only the horizontal shifts of CEOAE and DPOAE I/O functions were correlated with each other at 1.5, 2, and 3 kHz. A second aim was to investigate which of the methods is more reliable. The test–retest variability of the CAS effect was high overall but smallest for tone detection thresholds and CEOAEs, suggesting that their use should be prioritized over the use of DPOAEs. Many factors not related with the MOCR, including the limited parametric space studied, the low resolution of the I/O curves, and the reduced numbers of observations due to data exclusion likely contributed to the weak correlations and the large test–retest variability noted. These findings can help us understand the inconsistencies among past studies and improve our understanding of the functional significance of the MOCR.

Estimating Hearing Thresholds From Stimulus-Frequency Otoacoustic Emissions

It is of clinical interest to estimate pure-tone thresholds from potentially available objective measures, such as stimulus-frequency otoacoustic emissions (SFOAEs). SFOAEs can determine hearing status (normal hearing vs. hearing loss), but few studies have explored their further potential in predicting audiometric thresholds. The current study investigates the ability of SFOAEs to predict hearing thresholds at octave frequencies from 0.5 to 8 kHz. SFOAE input/output functions and pure-tone thresholds were measured from 230 ears with normal hearing and 737 ears with sensorineural hearing loss. Two methods were used to predict hearing thresholds. Method 1 is a linear regression model; Method 2 proposed in this study is a back propagation (BP) network predictor built on the bases of a BP neural network and principal component analysis. In addition, a BP network classifier was built to identify hearing status. Both Methods 1 and 2 were able to predict hearing thresholds from 0.5 to 8 kHz, but Method 2 achieved better performance than Method 1. The BP network classifiers achieved excellent performance in determining the presence or absence of hearing loss at all test frequencies. The results show that SFOAEs are not only able to identify hearing status with great accuracy at all test frequencies but, more importantly, can predict hearing thresholds at octave frequencies from 0.5 to 8 kHz, with best performance at 0.5 to 4 kHz. The BP network predictor is a potential tool for quantitatively predicting hearing thresholds, at least at 0.5 to 4 kHz.

The role of efferents in human auditory development: efferent inhibition predicts frequency discrimination in noise for children

The descending corticofugal fibers originate from the auditory cortex and exert control on the periphery via the olivocochlear efferents. Medial efferents are thought to enhance the discriminability of transient sounds in background noise. In addition, the observation of deleterious long-term effects of efferent sectioning on the response properties of auditory nerve fibers in neonatal cats supports an efferent-mediated control of normal development. However, the role of the efferent system in human hearing remains unclear. The objective of the present study was to test the hypothesis that the medial efferents are involved in the development of frequency discrimination in noise. The hypothesis was examined with a combined behavioral and physiological approach. Frequency discrimination in noise and efferent inhibition were measured in 5- to 12-yr-old children (n = 127) and young adults (n = 37). Medial efferent strength was noninvasively assayed with a rigorous otoacoustic emission protocol. Results revealed an age-mediated relationship between efferent inhibition and frequency discrimination in noise. Efferent inhibition strongly predicted frequency discrimination in noise for younger children (5-9 yr). However, for older children (>9 yr) and adults, efferent inhibition was not related to frequency discrimination in noise. These findings support the role of efferents in the development of hearing-in-noise in humans; specifically, younger children compared with older children and adults are relatively more dependent on efferent inhibition for extracting relevant cues in noise. Additionally, the present findings caution against postulating an oversimplified relationship between efferent inhibition and measures of auditory perception in humans.NEW & NOTEWORTHY Despite several decades of research, the functional role of medial olivocochlear efferents in humans remains controversial and is thought to be insignificant. Here it is shown that medial efferent inhibition strongly predicts frequency discrimination in noise for younger children but not for older children and adults. Young children are relatively more dependent on the efferent system for listening-in-noise. This study highlights the role of the efferent system in hearing-in-noise during childhood development.

Derivation of input-output functions from distortion-product otoacoustic emission level maps

Distortion-product otoacoustic emissions (DPOAEs) emerge from the cochlea when elicited with two tones of frequencies f₁ and f₂. DPOAEs mainly consist of two components, a nonlinear-distortion and a coherent-reflection component. Input-output (I/O) functions of DPOAE pressure at the cubic difference frequency, f_DP=2f₁-f₂, enable the computation of estimated distortion-product thresholds (EDPTs), offering a noninvasive approach to estimate auditory thresholds. However, wave interference between the DPOAE components and suboptimal stimulus-level pairs reduces the accuracy of EDPTs. Here, the amplitude P of the nonlinear-distortion component is extracted from short-pulse DPOAE time signals. DPOAE level maps representing the growth behavior of P in L₁,L₂ space are recorded for 21 stimulus-level pairs and 14 frequencies with f₂=1 to 14 kHz (f₂/f₁=1.2) from 20 ears. Reproducing DPOAE growth behavior using a least-squares fit approach enables the derivation of ridge-based I/O functions from model level maps. Objective evaluation criteria assess the fit results and provide EDPTs, which correlate significantly with auditory thresholds (p < 0.001). In conclusion, I/O functions derived from model level maps provide EDPTs with high precision but without the need of predefined optimal stimulus-level pairs.

The Medial Olivocochlear Reflex Is Unlikely to Play a Role in Listening Difficulties in Children

The medial olivocochlear reflex (MOCR) has been implicated in several auditory processes. The putative role of the MOCR in improving speech perception in noise is particularly relevant for children who complain of listening difficulties (LiD). The hypothesis that the MOCR may be impaired in individuals with LiD or auditory processing disorder has led to several investigations but without consensus. In two related studies, we compared the MOCR functioning of children with LiD and typically developing (TD) children in the same age range (7-17 years). In Study 1, we investigated ipsilateral, contralateral, and bilateral MOCR using forward-masked click-evoked otoacoustic emissions (CEOAEs; n = 17 TD, 17 LiD). In Study 2, we employed three OAE types: CEOAEs (n = 16 TD, 21 LiD), stimulus frequency OAEs (n = 21 TD, 30 LiD), and distortion product OAEs (n = 17 TD, 22 LiD) in a contralateral noise paradigm. Results from both studies suggest that the MOCR functioning is not significantly different between the two groups. Some likely reasons for differences in findings among published studies could stem from the lack of strict data quality measures (e.g., high signal-to-noise ratio, control for the middle ear muscle reflex) that were enforced in the present study. The inherent variability of the MOCR, the subpar reliability of current MOCR methods, and the heterogeneity in auditory processing deficits that underlie auditory processing disorder make detecting clinically relevant differences in MOCR function impractical using current methods.

Observations of Distortion Product Otoacoustic Emission Components in Adults With Hearing Loss

OBJECTIVES

Distortion product otoacoustic emissions (DPOAEs) measured in the ear canal are composed of OAEs generated by at least two mechanisms coming from different places in the cochlea. Otoacoustic emission (OAE) models hypothesize that reduction of cochlear gain will differentially impact the components. The purpose of the current experiment was to provide preliminary data about DPOAE components in adults with hearing loss in relation to OAE models and explore whether evaluation of the relative amplitudes of generator and reflection components can enhance identification of hearing loss.

DESIGN

DPOAEs were measured from 45 adult ears; 21 had normal hearing (≤15 dB HL) and 24 with mild-to-severe sensorineural hearing loss (>15 dB HL). The higher frequency primary (f2) was swept logarithmically between 1500 and 6000 Hz, and f2/f1 was 1.22. The two equal-level primaries varied from 55 to 75 dB SPL in 5 dB steps. The swept primary procedure permitted the measurement of the amplitude and phase of the DPOAE fine structure and the extraction of the two major components (generator and reflection) by varying the predicted delays of the analysis windows.

RESULTS

DPOAE fine structure was reduced or absent in ears with hearing loss. DPOAE generator and reflection components were lower in ears with hearing loss than those with normal hearing, especially for the reflection component. Significant correlations were found between the generator component and hearing threshold but not between reflection levels and hearing threshold. Most ears with normal hearing had both components, but only a small number of ears with hearing loss had both components.

CONCLUSIONS

The reflection component is not recordable or low in level in ears with hearing loss, explaining the reduced or absent DPOAE fine structure. DPOAE generator components are also lower in level in ears with hearing loss than in ears without hearing loss. In ears that had both measurable generator and reflection components, the relationship between the two did not depend on the presence or absence of hearing loss. Because reflection components are not measurable in many ears with hearing thresholds >15 dB HL, stimuli that evoke other types of reflection emissions, such as stimulus-frequency or long-latency transient-evoked emissions, should be explored in conjunction with DPOAE generator components.

Otoacoustic emissions in neonates exposed to smoke during pregnancy

Introduction

The toxic substances present in cigarette smoke can damage cochlea hair cells. This effect has been investigated by measuring otoacoustic emissions.

Objective

To investigate the impact of stimuli on otoacoustic emissions, comparing neonates with and without exposure to cigarette smoke during pregnancy.

Methods

Transient-evoked otoacoustic emissions, evoked by a click stimulus, and distortion product otoacoustic emissions, evoked by two tones tests were conducted in both ears, using an Interacoustic TITAN device. The study included 105 neonates divided into two groups: a study group, comprising 47 neonates exposed to smoke during pregnancy; and a control group comprized of 58 neonates who were not exposed. All participants had normal neonatal hearing screening.

Results

No statistical differences in distortion product otoacoustic emissions response levels were found between the groups. In the transient-evoked otoacoustic emissions tests lower response levels were observed in the study group than the control group in frequency band analysis of the right ear, with statistically significant differences in signals and signal-noise ratio (except at 1 kHz).

Conclusion

The impact of smoking exposure could be analyzed through transient-evoked otoacoustic emissions in neonates. The group effect of smoke exposure during pregnancy was evidenced by a reduction in transient-evoked otoacoustic emissions levels. This same effect was not observed for the analyses performed on distortion product otoacoustic emissions levels.

Cochlear Mechanisms and Otoacoustic Emission Test Performance

OBJECTIVES

This study aims to determine the impact of controlling cochlear-source mechanism on the accuracy with which auditory status is identified using otoacoustic emissions (OAEs) in two groups of subjects with normal hearing (NH) and subjects with mild to moderate hearing loss.

DESIGN

Data were collected from 212 subjects with NH and with mild to moderate hearing loss who fell into two categories based on a distortion product OAE (DPOAE) screening protocol: the uncertain-identification group (where errors were likely) and the certain-identification group (where errors were unlikely). DPOAE fine-structure patterns were recorded at intervals surrounding f2 = 1, 2 and 4 kHz (f2/f1 ratio = 1.22), with L2 = 35, 45, and 55 dB SPL (L1/L2 ratio = 10 dB). The discrete cosine transform was used to smooth fine structure, limiting the source contribution to the distortion source only. Reflection-source OAEs were also recorded using amplitude-modulated stimulus frequency OAEs (AM-SFOAE). Area under the relative operating characteristic (AROC) curve was used to quantify test accuracy when the source contribution was controlled versus the condition where both sources contribute. Additionally, failure rate, fixed at 5% for NH ears, as a function of behavioral-threshold category was evaluated.

RESULTS

When data for the entire subject group were examined, reducing the reflection-source contribution to the DPOAE did not result in better test performance than the best control condition at any frequency tested. When the subjects with NH were restricted to those with confirmed fine structure, AROC analyses indicated that reducing the reflection-source contribution resulted in several small increases in the accuracy (2%-5%) with which auditory status was identified relative to the best control condition. This improvement was observed for the lowest stimulus levels (i.e., L2 = 35 or 45 dB SPL). In this subset of subjects, distortion-source DPOAEs resulted in more accurate identification of mild hearing loss for a fixed false-positive rate of 5% in NH ears at lower L2's, conditions with poor accuracy in the larger group of subjects. The impact of controlling the source contribution on the identification of moderate losses was less clear in the reduced subject group, with some conditions where the distortion-source DPOAE was more accurate than the control condition and other conditions where there was no change. There was no evidence that reflection-source AM-SFOAEs more accurately identified ears with hearing loss when compared to any of the DPOAE conditions in either the large or reduced group of subjects.

CONCLUSION

While improvements in test accuracy were observed for some subjects and some conditions (e.g., mild hearing losses and low stimulus levels in the reduced subset of subjects), these results suggest that restricting cochlear source contribution by "smoothing" DPOAE fine structure is not expected to improve DPOAE test accuracy in a general population of subjects. Likewise, recording reflection-source OAEs using the AM-SFOAE technique would not be expected to more accurately identify hearing status compared to mixed- or single-source DPOAEs.

Emerging Distortion Product Otoacoustic Emission Techniques to Identify Preclinical Warning Signs of Basal Cochlear Dysfunction Due to Ototoxicity

Hundreds of medications commonly prescribed for anticancer treatments and some infections are known to cause hearing damage, referred to as ototoxicity. Preventing or minimizing ototoxicity is critical in order to preserve quality of life for patients receiving treatment and to reduce the societal burden of hearing loss. Current clinical evaluations are restricted to a limited frequency range (≤8 kHz); however, this approach does not permit the earliest detection of ototoxicity, most likely to be observed at the highest frequencies (9–20 kHz). Distortion product otoacoustic emissions (DPOAEs) offer a noninvasive, objective approach to monitor cochlear health in those unable to respond via conventional methods. The current report analyzes different DPOAE paradigms used in patients undergoing chemotherapy treatments with various platinum derivatives. Individualized serial monitoring protocols were completed at the highest frequencies with measurable DPOAEs. This allowed the exploration of potential clinical translation opportunities for further quantification of the earliest signs of underlying cochlear damage, which may go undetected with conventional methods. Clinical practice has the potential to be enhanced by emerging DPOAE applications, including targeted monitoring protocols and high-frequency stimuli to assess cochlear function, especially at the highest frequencies, and advanced calibration techniques to ensure the stability of serial measurements.

The influence of distributed source regions in the formation of the nonlinear distortion component of cubic distortion-product otoacoustic emissions

Distortion product otoacoustic emissions (DPOAEs) are evoked by two stimulus tones with frequency f₁ and f₂ of ratio f₂/f₁  in the range between approximately 1.05 and 1.4. This study theoretically and experimentally analyzes the cubic 2f₁-f₂ DPOAE for different stimulus levels of one of the tones while the other is constant. Simulations for f₂/f₁ of 1.2 and moderate stimulus levels (30-70 dB sound pressure level) indicate that cubic distortion products are generated along a relatively large length of the basilar membrane, the extent of which increases with stimulus level. However, apical from the place of maximum nonlinear force, the wavelets generated by these distributed sources mutually cancel. Therefore, although the spatial extent of the primary DPOAE sources broadens with increasing stimulus level (up to 1.5 oct), the basilar-membrane region contributing to the DPOAE signal is relatively narrow (0.6 oct) and level independent. The observed dependence of DPOAE amplitude on stimulus level can be well-approximated by a point source at the basilar-membrane place where the largest distortion product (maximum of the nonlinear force) is generated. Onset and offset of the DPOAE signal may contain amplitude overshoots (complexities), which are in most cases asymmetrical. Two-tone suppression was identified as the main cause of these onset and offset complexities. DPOAE measurements in two normal-hearing subjects support the level dependence of the steady-state DPOAE amplitude and the asymmetry in the onset and offset responses predicted by the theoretical analysis.

Optimizing Clinical Interpretation of Distortion Product Otoacoustic Emissions in Infants

OBJECTIVES

The purpose of this study was to analyze distortion product otoacoustic emission (DPOAE) level and signal to noise ratio in a group of infants from birth to 4 months of age to optimize prediction of hearing status. DPOAEs from infants with normal hearing (NH) and hearing loss (HL) were used to predict the presence of conductive HL (CHL), sensorineural HL (SNHL), and mixed HL (MHL). Wideband ambient absorbance was also measured and compared among the HL types.

DESIGN

This is a prospective, longitudinal study of 279 infants with verified NH and HL, including conductive, sensorineural, and mixed types that were enrolled from a well-baby nursery and two neonatal intensive care units in Cincinnati, Ohio. At approximately 1 month of age, DPOAEs (1-8 kHz), wideband absorbance (0.25-8 kHz), and air and bone conduction diagnostic tone burst auditory brainstem response (0.5-4 kHz) thresholds were measured. Hearing status was verified at approximately 9 months of age with visual reinforcement audiometry (0.5-4 kHz). Auditory brainstem response air conduction thresholds were used to assign infants to an NH or HL group, and the efficacy of DPOAE data to classify ears as NH or HL was analyzed using receiver operating characteristic (ROC) curves. Two summary statistics of the ROC curve were calculated: the area under the ROC curve and the point of symmetry on the curve at which the sensitivity and specificity were equal. DPOAE level and signal to noise ratio cutoff values were defined at each frequency as the symmetry point on their respective ROC curve, and DPOAE results were combined across frequency in a multifrequency analysis to predict the presence of HL.

RESULTS

Single-frequency test performance of DPOAEs was best at mid to high frequencies (3-8 kHz) with intermediate performance at 1.5 and 2 kHz and chance performance at 1 kHz. Infants with a conductive component to their HL (CHL and MHL combined) displayed significantly lower ambient absorbance values than the NH group. No differences in ambient absorbance were found between the NH and SNHL groups. Multifrequency analysis resulted in the best prediction of HL for the SNHL/MHL group with poorer sensitivity values when infants with CHL were included.

CONCLUSIONS

Clinical interpretation of DPOAEs in infants can be improved by using age-appropriate normative ranges and optimized cutoff values. DPOAE interpretation is most predictive at higher F2 test frequencies in young infants (2-8 kHz) due to poor test performance at 1 to 1.5 kHz. Multifrequency rules can be used to improve sensitivity while balancing specificity. Last, a sensitive middle ear measure such as wideband absorbance should be included in the test battery to assess possibility of a conductive component to the HL.

Investigation of the 2f1-f2 and 2f2-f1 distortion product otoacoustic emissions using a computational model of the gerbil ear

In this work, a three-dimensional computational model of the gerbil ear is used to investigate the generation of the 2f₁-f₂ and 2f₂-f₁ distortion product otoacoustic emissions (DPOAEs). In order to predict both the distortion and reflection sources, cochlear roughness is modeled by introducing random inhomogeneities in the outer hair cell properties. The model was used to simulate the generation of DPOAEs in response to a two-tone stimulus for various primary stimulus levels and frequency ratios. As in published experiments, the 2f₁-f₂ DPOAEs are mostly dominated by the distortion component while the 2f₂-f₁ DPOAEs are dominated by the reflection component; furthermore, the influence of the levels and frequency ratio of the primaries are consistent with measurements. Analysis of the intracochlear response shows that the distortion component has the highest magnitude at all longitudinal locations for the 2f₁-f₂ distortion product (DP) while the distortion component only dominates close to the DP best place in the case of the 2f₂-f₁ DP. Decomposition of the intracochlear DPs into forward and reverse waves demonstrates that the 2f₁-f₂ DP generates reverse waves for both the distortion and reflection components; however, a reverse wave is only generated for the reflection component in the case of the 2f₂-f₁ DP. As in experiments in the gerbil, the group delay of the reflection component of the DPOAE is between 1× and 2× the forward group delay, which is consistent with the propagation of DP towards the stapes as slow reverse waves.

Efferent-induced alterations in distortion and reflection otoacoustic emissions in children

The medial olivocochlear efferent fibers control outer hair cell responses and inhibit the cochlear-amplifier gain. Measuring efferent function is both theoretically and clinically relevant. In humans, medial efferent inhibition can be assayed via otoacoustic emissions (OAEs). OAEs arise by two fundamentally different mechanisms-nonlinear distortion and coherent reflection. Distortion and reflection emissions are typically applied in isolation for studying the efferent inhibition. Such an approach inadvertently assumes that efferent-induced shifts in distortion and reflection emissions provide redundant information. In this study, efferent-induced shifts in distortion and reflection emissions (click-evoked and stimulus frequency OAEs) were measured in the same subjects-5- to 10-yr-old children. Consistent with the OAE generation theory, efferent-induced shifts in distortion and reflection emissions did not correlate, whereas the two reflection emission shifts correlated. This suggests that using either OAE types provides fragmented information on efferent inhibition and highlights the need to use both distortion and reflection emissions for describing efferent effects.

Changes in the Compressive Nonlinearity of the Cochlea During Early Aging: Estimates From Distortion OAE Input/Output Functions

OBJECTIVES

The level-dependent growth of distortion product otoacoustic emissions (DPOAEs) provides an indirect metric of cochlear compressive nonlinearity. Recent evidence suggests that aging reduces nonlinear distortion emissions more than those associated with linear reflection. Therefore, in this study, we generate input/output (I/O) functions from the isolated distortion component of the DPOAE to probe the effects of early aging on the compressive nonlinearity of the cochlea.

DESIGN

Thirty adults whose ages ranged from 18 to 64 years participated in this study, forming a continuum of young to middle-age subjects. When necessary for analyses, subjects were divided into a young-adult group with a mean age of 21 years, and a middle-aged group with a mean age of 52 years. All young-adult subjects and 11 of the middle-aged subjects had normal hearing; 4 middle-aged ears had slight audiometric threshold elevation at mid-to-high frequencies. DPOAEs (2f1 - f2) were recorded using primary tones swept upward in frequency from 0.5 to 8 kHz, and varied from 25 to 80 dB sound pressure level. The nonlinear distortion component of the total DPOAE was separated and used to create I/O functions at one-half octave intervals from 1.3 to 7.4 kHz. Four features of OAE compression were extracted from a fit to these functions: compression threshold, range of compression, compression slope, and low-level growth. These values were compared between age groups and correlational analyses were conducted between OAE compression threshold and age with audiometric threshold controlled.

RESULTS

Older ears had reduced DPOAE amplitude compared with young-adult ears. The OAE compression threshold was elevated at test frequencies above 2 kHz in the middle-aged subjects by 19 dB (35 versus 54 dB SPL), thereby reducing the compression range. In addition, middle-aged ears showed steeper amplitude growth beyond the compression threshold. Audiometric threshold was initially found to be a confound in establishing the relationship between compression and age; however, statistical analyses allowed us to control its variance. Correlations performed while controlling for age differences in high-frequency audiometric thresholds showed significant relationships between the DPOAE I/O compression threshold and age: Older subjects tended to have elevated compression thresholds compared with younger subjects and an extended range of monotonic growth.

CONCLUSIONS

Cochlear manifestations of nonlinearity, such as the DPOAE, weaken during early aging, and DPOAE I/O functions become linearized. Commensurate changes in high-frequency audiometric thresholds are not sufficient to fully explain these changes. The results suggest that age-related changes in compressive nonlinearity could produce a reduced dynamic range of hearing, and contribute to perceptual difficulties in older listeners.

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.

Comparison of time-domain source-separation techniques for short-pulse distortion-product otoacoustic emissions

Distortion-product otoacoustic emissions (DPOAEs) are presumed to consist mainly of two components, a nonlinear-distortion component and a coherent-reflection component. Wave interference between these two components reduces the accuracy of DPOAEs when used to evaluate cochlear function. Here, short tone pulses are utilized to record DPOAE signals in normal-hearing subjects. DPOAE components are extracted from recordings at discrete frequencies using two different techniques in the time domain. The extracted DPOAE components are compared to recordings obtained with conventional, continuous primary tones.

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.

Rippling pattern of distortion product otoacoustic emissions evoked by high-frequency primaries in guinea pigs

The origin of ripples in distortion product otoacoustic emission (DPOAE) amplitude which appear at specific DPOAE frequencies during f₁ tone sweeps using fixed high frequency f₂ (>20 kHz) in guinea pigs is investigated. The peaks of the ripples, or local DPOAE amplitude maxima, are separated by approximately half octave intervals and are accompanied by phase oscillations. The local maxima appear at the same frequencies in DPOAEs of different order and velocity responses of the stapes and do not shift with increasing levels of the primaries. A suppressor tone had little effect on the frequencies of the maxima, but partially suppressed DPOAE amplitude when it was placed close to the f₂ frequencies. These findings agree with earlier observations that the maxima occur at the same DPOAE frequencies, which are independent of the f₂ and the primary ratio, and thus are likely to be associated with DPOAE propagation mechanisms. Furthermore, the separation of the local maxima by approximately half an octave may suggest that the maxima are due to interference of the travelling waves along the basilar membrane at the frequency of the DPOAE. It is suggested that the rippling pattern appears because of interaction between DPOAE reverse travelling waves with standing waves formed in the cochlea.

Towards a joint reflection-distortion otoacoustic emission profile: Results in normal and impaired ears

Otoacoustic emissions (OAEs) provide salient information about cochlear function and dysfunction. Two broad classes of emissions, linear reflection and nonlinear distortion, arise via distinct cochlear processes and hence, appear to provide independent information about cochlear health and hearing. Considered in combination, these two OAE types may characterize sensory hearing loss most effectively. In this study, the level-dependent growth of stimulus-frequency OAEs (a reflection-type emission) and distortion-product OAEs (a distortion-type emission) were measured in ten normal-hearing ears and eight ears with slight-to-moderate sensorineural hearing loss. Metrics of OAE strength and compression were derived from OAE input/output functions and then considered in a combined fashion. Results indicate that SFOAEs and DPOAEs differ significantly in their strength and compression features. When SFOAE and DPOAE metrics are displayed together on a two-dimensional plot, relatively well-defined data clusters describe their normative relationship. In hearing-impaired ears, this relationship is disrupted but not in a uniform way across ears; ears with similar audiograms showed differently altered joint-OAE profiles. Hearing loss sometimes affected only one OAE or one more than the other. Results suggest a joint-OAE profile is promising and warrants study in a large group of subjects with sensory hearing loss of varied etiologies.

Input-output functions of the nonlinear-distortion component of distortion-product otoacoustic emissions in normal and hearing-impaired human ears

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.

Isolating spectral cues in amplitude and quasi-frequency modulation discrimination by reducing stimulus duration

This study investigated the psychophysical effects of distortion products in a listening task traditionally used to estimate the bandwidth of phase sensitivity. For a 2000 Hz carrier, estimates of modulation depth necessary to discriminate amplitude modulated (AM) tones and quasi-frequency modulated (QFM) were measured in a two interval forced choice task as a function modulation frequency. Temporal modulation transfer functions were often non-monotonic at modulation frequencies above 300 Hz. This was likely to be due to a spectral cue arising from the interaction of auditory distortion products and the lower sideband of the stimulus complex. When the stimulus duration was decreased from 200 ms to 20 ms, thresholds for low-frequency modulators rose to near-chance levels, whereas thresholds in the region of non-monotonicities were less affected. The decrease in stimulus duration appears to hinder the listener's ability to use temporal cues in order to discriminate between AM and QFM, whereas spectral information derived from distortion product cues appears more resilient.

Distortion-Product Otoacoustic Emission Measured Below 300 Hz in Normal-Hearing Human Subjects

Physiological noise levels in the human ear canal often exceed naturally low levels of otoacoustic emissions (OAEs) near the threshold of hearing. Low-frequency noise, and electronic filtering to cope with it, has effectively limited the study of OAE to frequencies above about 500 Hz. Presently, a custom-built low-frequency acoustic probe was put to use in 21 normal-hearing human subjects (of 34 recruited). Distortion-product otoacoustic emission (DPOAE) was measured in the enclosed ear canal volume as the response to two simultaneously presented tones with frequencies f ₁ and f ₂. The stimulus-frequency ratio f ₂/f ₁ was varied systematically to find the "optimal" ratio evoking the largest level at 2 f ₁-f ₂ frequencies 87.9, 176, and 264 Hz. No reference data exist in this frequency region. Results show that DPOAE exists down to at least 87.9 Hz, maintaining the bell-shaped dependence on the f ₂/f ₁ ratio known from higher frequencies. Toward low frequencies, however, the bell broadens and the optimal ratio increases proportionally to the bandwidth of an auditory filter as defined by the equivalent rectangular bandwidth. The DPOAE phase rotates monotonously as a function of the stimulus ratio, and its slope trend supports the notion of a lack of scaling symmetry in the apex of the cochlea.

Estimation of Round-Trip Outer-Middle Ear Gain Using DPOAEs

The reported research introduces a noninvasive approach to estimate round-trip outer-middle ear pressure gain using distortion product otoacoustic emissions (DPOAEs). Our ability to hear depends primarily on sound waves traveling through the outer and middle ear toward the inner ear. The role of the outer and middle ear in sound transmission is particularly important for otoacoustic emissions (OAEs), which are sound signals generated in a healthy cochlea and recorded by a sensitive microphone placed in the ear canal. OAEs are used to evaluate the health and function of the cochlea; however, they are also affected by outer and middle ear characteristics. To better assess cochlear health using OAEs, it is critical to quantify the effect of the outer and middle ear on sound transmission. DPOAEs were obtained in two conditions: (i) two-tone and (ii) three-tone. In the two-tone condition, DPOAEs were generated by presenting two primary tones in the ear canal. In the three-tone condition, DPOAEs at the same frequencies (as in the two-tone condition) were generated by the interaction of the lower frequency primary tone in the two-tone condition with a distortion product generated by the interaction of two other external tones. Considering how the primary tones and DPOAEs of the aforementioned conditions were affected by the forward and reverse outer-middle ear transmission, an estimate of the round-trip outer-middle ear pressure gain was obtained. The round-trip outer-middle ear gain estimates ranged from -39 to -17 dB between 1 and 3.3 kHz.

Individual Differences in Behavioural Decision Weights Related to Irregularities in Cochlear Mechanics

An unexpected finding of previous psychophysical studies is that listeners show highly replicable, individualistic patterns of decision weights on frequencies affecting their performance in spectral discrimination tasks--what has been referred to as individual listening styles. We, like many other researchers, have attributed these listening styles to peculiarities in how listeners attend to sounds, but we now believe they partially reflect irregularities in cochlear micromechanics modifying what listeners hear. The most striking evidence for cochlear irregularities is the presence of low-level spontaneous otoacoustic emissions (SOAEs) measured in the ear canal and the systematic variation in stimulus frequency otoacoustic emissions (SFOAEs), both of which result from back-propagation of waves in the cochlea. SOAEs and SFOAEs vary greatly across individual ears and have been shown to affect behavioural thresholds, behavioural frequency selectivity and judged loudness for tones. The present paper reports pilot data providing evidence that SOAEs and SFOAEs are also predictive of the relative decision weight listeners give to a pair of tones in a level discrimination task. In one condition the frequency of one tone was selected to be near that of an SOAE and the frequency of the other was selected to be in a frequency region for which there was no detectable SOAE. In a second condition the frequency of one tone was selected to correspond to an SFOAE maximum, the frequency of the other tone, an SFOAE minimum. In both conditions a statistically significant correlation was found between the average relative decision weight on the two tones and the difference in OAE levels.

Distortion product otoacoustic emission generation mechanisms and their dependence on stimulus level and primary frequency ratio

In this study, a systematic analysis of the dependence on stimulus level and primary frequency ratio r of the different components of human distortion product otoacoustic emissions has been performed, to check the validity of theoretical models of their generation, as regards the localization of the sources and the relative weight of distortion and reflection generation mechanisms. 2f1 - f2 and 2f2 - f1 distortion product otoacoustic emissions of 12 normal hearing ears from six human subjects have been measured at four different levels, in the range [35, 65] dB sound pressure level, at eight different ratios, in the range [1.1, 1.45]. Time-frequency filtering was used to separate distortion and reflection components. Numerical simulations have also been performed using an active nonlinear cochlear model. Both in the experiment and in the simulations, the behavior of the 2f1 - f2 distortion and reflection components was in agreement with previous measurements and with the predictions of the two-source model. The 2f2 - f1 response showed a rotating-phase component only, whose behavior was in general agreement with that predicted for a component generated and reflected within a region basal to the characteristic place of frequency 2f2 - f1, although alternative interpretations, which are also discussed, cannot be ruled out.

Level dependence of the nonlinear-distortion component of distortion-product otoacoustic emissions in humans

Distortion-product otoacoustic emissions (DPOAEs) emerge when presenting two primary tones with different frequencies f1 and f2 to the cochlea and are commonly used in diagnosis and research to evaluate the functional state of the cochlea. Optimal primary-tone stimulus levels accounting for the different level dependencies of the traveling-wave amplitudes of the two primary tones near the f2-tonotopic place on the basilar membrane are often used to maximize DPOAE amplitudes. However, parameters defining the optimal levels can be affected by wave interference between the nonlinear-distortion and coherent-reflection components of the DPOAE. Here, the components were separated in the time domain using a pulsed stimulus paradigm and optimal levels determined. Based on the amplitude dependence of the nonlinear-distortion components on primary-tone stimulus levels, level parameters yielding maximum DPOAE amplitudes were derived for six normal-hearing adults and compared to data recorded with continuous two-tone stimulation. The level parameters resulting from analysis of the nonlinear-distortion components show dependence on stimulus frequency and small standard deviations. DPOAE input/output functions derived for optimal levels exhibit larger slopes, wider dynamic range and less variability across subjects than those derived for conventional stimulus and analysis conditions, potentially increasing their reliability and sensitivity for assessing cochlea function.

Optimizing swept-tone protocols for recording distortion-product otoacoustic emissions in adults and newborns

Distortion-product otoacoustic emissions (DPOAEs), which are routinely used in the audiology clinic and research laboratory, are conventionally recorded with discrete tones presented sequentially across frequency. However, a more efficient technique sweeps tones smoothly across frequency and applies a least-squares-fitting (LSF) procedure to compute estimates of otoacoustic emission phase and amplitude. In this study, the optimal parameters (i.e., sweep rate and duration of the LSF analysis window) required to record and analyze swept-tone DPOAEs were tested and defined in 15 adults and 10 newborns. Results indicate that optimal recording of swept-tone DPOAEs requires use of an appropriate analysis bandwidth, defined as the range of frequencies included in each least squares fit model. To achieve this, the rate at which the tones are swept and the length of the LSF analysis window must be carefully considered and changed in concert. Additionally, the optimal analysis bandwidth must be adjusted to accommodate frequency-dependent latency shifts in the reflection-component of the DPOAE. Parametric guidelines established here are equally applicable to adults and newborns. However, elevated noise during newborn swept-tone DPOAE recordings warrants protocol adaptations to improve signal-to-noise ratio and response quality.

Frequency-change in DPOAE evoked by 1 s/octave sweeping primaries in newborns and adults

Distortion product otoacoustic emissions (DPOAE) in newborns and adults were evoked by sweeping primaries up and down in frequency at 1 s/octave. Sweeping up and down in frequency resulted in changes in the amplitude vs. frequency functions of the composite DPOAE and its two major components. In addition, DPOAE component phases differed slightly between the up- and down-swept conditions. The changes in amplitude vs. frequency functions were quantified using a covariate correlation technique, yielding single-valued estimates of the magnitude of the frequency changes. Separate analyses were performed for the entire DPOAE frequency range and split into low and high frequency ranges. There were consistent changes in newborn and adult composite DPOAEs and reflection components, but not generator components. Adults had significant frequency changes in the composite DPOAE for all frequency ranges and in the reflection component for the entire frequency range. Newborns had significant frequency change in the reflection component for all frequency ranges. Differences in frequency change between adults and newborns may stem from developmental changes in cochlear processing. Alignment of the component phase differences between the up- and down-swept conditions resulted in elimination of frequency-change in reconstructed composite DPOAEs.

Stability of the medial olivocochlear reflex as measured by distortion product otoacoustic emissions

PURPOSE

The purpose of this study was to assess the repeatability of a fine-resolution, distortion product otoacoustic emission (DPOAE)-based assay of the medial olivocochlear (MOC) reflex in normal-hearing adults.

METHOD

Data were collected during 36 test sessions from 4 normal-hearing adults to assess short-term stability and 5 normal-hearing adults to assess long-term stability. DPOAE level and phase measurements were recorded with and without contralateral acoustic stimulation. MOC reflex indices were computed by (a) noting contralateral acoustic stimulation-induced changes in DPOAE level (both absolute and normalized) at fine-structure peaks, (b) recording the effect as a vector difference, and (c) separating DPOAE components and considering a component-specific metric.

RESULTS

Analyses indicated good repeatability of all indices of the MOC reflex in most frequency ranges. Short- and long-term repeatability were generally comparable. Indices normalized to a subject's own baseline fared best, showing strong short- and long-term stability across all frequency intervals.

CONCLUSIONS

These results suggest that fine-resolution DPOAE-based measures of the MOC reflex measured at strategic frequencies are stable, and natural variance from day-to-day or week-to-week durations is small enough to detect between-group differences and possibly to monitor intervention-related success. However, this is an empirical question that must be directly tested to confirm its utility.

Otoacoustic-emission-based medial-olivocochlear reflex assays for humans

Otoacoustic emission (OAE) tests of the medial-olivocochlear reflex (MOCR) in humans were assessed for viability as clinical assays. Two reflection-source OAEs [TEOAEs: transient-evoked otoacoustic emissions evoked by a 47 dB sound pressure level (SPL) chirp; and discrete-tone SFOAEs: stimulus-frequency otoacoustic emissions evoked by 40 dB SPL tones, and assessed with a 60 dB SPL suppressor] were compared in 27 normal-hearing adults. The MOCR elicitor was a 60 dB SPL contralateral broadband noise. An estimate of MOCR strength, MOCR%, was defined as the vector difference between OAEs measured with and without the elicitor, normalized by OAE magnitude (without elicitor). An MOCR was reliably detected in most ears. Within subjects, MOCR strength was correlated across frequency bands and across OAE type. The ratio of across-subject variability to within-subject variability ranged from 2 to 15, with wideband TEOAEs and averaged SFOAEs giving the highest ratios. MOCR strength in individual ears was reliably classified into low, normal, and high groups. SFOAEs using 1.5 to 2 kHz tones and TEOAEs in the 0.5 to 2.5 kHz band gave the best statistical results. TEOAEs had more clinical advantages. Both assays could be made faster for clinical applications, such as screening for individual susceptibility to acoustic trauma in a hearing-conservation program.

Medial efferent mechanisms in children with auditory processing disorders

Auditory processing disorder (APD) affects about 2–5% of children. However, the nature of this disorder is poorly understood. Children with APD typically have difficulties in complex listening situations. One mechanism thought to aid in listening-in-noise is the medial olivocochlear (MOC) inhibition. The purpose of this review was to critically analyze the published data on MOC inhibition in children with APD to determine whether the MOC efferents are involved in these individuals. The otoacoustic emission (OAE) methods used to assay MOC reflex were examined in the context of the current understanding of OAE generation mechanisms. Relevant literature suggests critical differences in the study population and OAE methods. Variables currently known to influence MOC reflex measurements, for example, middle-ear muscle reflexes or OAE signal-to-noise ratio, were not controlled in most studies. The use of potentially weaker OAE methods and the remarkable heterogeneity across studies does not allow for a definite conclusion whether or not the MOC reflex is altered in children with APD. Further carefully designed studies are needed to confirm the involvement of MOC efferents in APD. Knowledge of efferent functioning in children with APD would be mechanistically and clinically beneficial.

The effect of stimulus bandwidth on the nonlinear-derived tone-burst-evoked otoacoustic emission

Intermodulation distortion has been hypothesized as a mechanism contributing to the generation of short-latency (SL) components in the transient-evoked otoacoustic emission (TEOAE). Presumably, nonlinear interactions between the frequency components within the evoking stimulus induce cochlear distortion products, which mix in the cochlea and ear canal with reflected energy from each stimulus-frequency's tonotopic place. The mixing of these different components is evidenced in the bandpass-filtered emission waveform as a series of different latency peaks. The current study tested the hypothesis that intermodulation distortion, induced within the spectral bandwidth of the evoking stimulus, is the primary mechanism through which the SL components are generated. The nonlinear-derived tone-burst-evoked OAE (TBOAEnl) was evoked using 2-kHz tone bursts with durations of 3, 6, 12, and 24 cycles. As tone burst duration doubled, the spectral bandwidth was halved. It was hypothesized that contributions to the TBOAEnl from SL components would decrease as tone burst duration increased and spectral bandwidth decreased, if the SL components were generated through intermodulation distortion. Despite differences in spectral bandwidth between the evoking stimuli, the latencies and magnitudes of the different latency components between the 3- and 6-cycle TBOAEnl were comparable. The 12- and 24-cycle TBOAEnl envelopes were characteristic of destructive phase interactions between different latency components overlapping in time. The different latency components in the 3- and 6-cycle TBOAEnl introduced a characteristic level dependency to TBOAEnl magnitude and latency when analyzed across a broad time window spanning the different components. A similar dependency described the 12- and 24-cycle TBOAEnl input/output and latency-intensity functions, suggesting that the SL components evident in the shorter-duration TBOAEnl equally contributed to the longer-duration TBOAEnl, despite reductions in spectral bandwidth. The similarity between the different TBOAEnl suggests that they share a common generation mechanism and casts doubt on intermodulation distortion as the generation mechanism of SL TEOAE components in humans.