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Schirmer J, Wolpert S, Dapper K, Rühle M, Wertz J, Wouters M, Eldh T, Bader K, Singer W, Gaudrain E, Başkent D, Verhulst S, Braun C, Rüttiger L, Munk MHJ, Dalhoff E, Knipper M. Neural Adaptation at Stimulus Onset and Speed of Neural Processing as Critical Contributors to Speech Comprehension Independent of Hearing Threshold or Age. J Clin Med 2024; 13:2725. [PMID: 38731254 PMCID: PMC11084258 DOI: 10.3390/jcm13092725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Revised: 04/24/2024] [Accepted: 04/26/2024] [Indexed: 05/13/2024] Open
Abstract
Background: It is assumed that speech comprehension deficits in background noise are caused by age-related or acquired hearing loss. Methods: We examined young, middle-aged, and older individuals with and without hearing threshold loss using pure-tone (PT) audiometry, short-pulsed distortion-product otoacoustic emissions (pDPOAEs), auditory brainstem responses (ABRs), auditory steady-state responses (ASSRs), speech comprehension (OLSA), and syllable discrimination in quiet and noise. Results: A noticeable decline of hearing sensitivity in extended high-frequency regions and its influence on low-frequency-induced ABRs was striking. When testing for differences in OLSA thresholds normalized for PT thresholds (PTTs), marked differences in speech comprehension ability exist not only in noise, but also in quiet, and they exist throughout the whole age range investigated. Listeners with poor speech comprehension in quiet exhibited a relatively lower pDPOAE and, thus, cochlear amplifier performance independent of PTT, smaller and delayed ABRs, and lower performance in vowel-phoneme discrimination below phase-locking limits (/o/-/u/). When OLSA was tested in noise, listeners with poor speech comprehension independent of PTT had larger pDPOAEs and, thus, cochlear amplifier performance, larger ASSR amplitudes, and higher uncomfortable loudness levels, all linked with lower performance of vowel-phoneme discrimination above the phase-locking limit (/i/-/y/). Conslusions: This study indicates that listening in noise in humans has a sizable disadvantage in envelope coding when basilar-membrane compression is compromised. Clearly, and in contrast to previous assumptions, both good and poor speech comprehension can exist independently of differences in PTTs and age, a phenomenon that urgently requires improved techniques to diagnose sound processing at stimulus onset in the clinical routine.
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Affiliation(s)
- Jakob Schirmer
- Department of Otolaryngology, Head and Neck Surgery, University of Tübingen, Elfriede-Aulhorn-Str. 5, 72076 Tübingen, Germany; (J.S.); (S.W.); (K.D.); (M.R.); (J.W.); (T.E.); (K.B.); (W.S.); (L.R.)
| | - Stephan Wolpert
- Department of Otolaryngology, Head and Neck Surgery, University of Tübingen, Elfriede-Aulhorn-Str. 5, 72076 Tübingen, Germany; (J.S.); (S.W.); (K.D.); (M.R.); (J.W.); (T.E.); (K.B.); (W.S.); (L.R.)
| | - Konrad Dapper
- Department of Otolaryngology, Head and Neck Surgery, University of Tübingen, Elfriede-Aulhorn-Str. 5, 72076 Tübingen, Germany; (J.S.); (S.W.); (K.D.); (M.R.); (J.W.); (T.E.); (K.B.); (W.S.); (L.R.)
- Department of Biology, Technical University Darmstadt, 64287 Darmstadt, Germany
| | - Moritz Rühle
- Department of Otolaryngology, Head and Neck Surgery, University of Tübingen, Elfriede-Aulhorn-Str. 5, 72076 Tübingen, Germany; (J.S.); (S.W.); (K.D.); (M.R.); (J.W.); (T.E.); (K.B.); (W.S.); (L.R.)
| | - Jakob Wertz
- Department of Otolaryngology, Head and Neck Surgery, University of Tübingen, Elfriede-Aulhorn-Str. 5, 72076 Tübingen, Germany; (J.S.); (S.W.); (K.D.); (M.R.); (J.W.); (T.E.); (K.B.); (W.S.); (L.R.)
| | - Marjoleen Wouters
- Department of Information Technology, Ghent University, Technologiepark 126, 9052 Zwijnaarde, Belgium; (M.W.); (S.V.)
| | - Therese Eldh
- Department of Otolaryngology, Head and Neck Surgery, University of Tübingen, Elfriede-Aulhorn-Str. 5, 72076 Tübingen, Germany; (J.S.); (S.W.); (K.D.); (M.R.); (J.W.); (T.E.); (K.B.); (W.S.); (L.R.)
| | - Katharina Bader
- Department of Otolaryngology, Head and Neck Surgery, University of Tübingen, Elfriede-Aulhorn-Str. 5, 72076 Tübingen, Germany; (J.S.); (S.W.); (K.D.); (M.R.); (J.W.); (T.E.); (K.B.); (W.S.); (L.R.)
| | - Wibke Singer
- Department of Otolaryngology, Head and Neck Surgery, University of Tübingen, Elfriede-Aulhorn-Str. 5, 72076 Tübingen, Germany; (J.S.); (S.W.); (K.D.); (M.R.); (J.W.); (T.E.); (K.B.); (W.S.); (L.R.)
| | - Etienne Gaudrain
- Lyon Neuroscience Research Center, Centre National de la Recherche Scientifique UMR5292, Inserm U1028, Université Lyon 1, Centre Hospitalier Le Vinatier-Bâtiment 462–Neurocampus, 95 Boulevard Pinel, 69675 Bron CEDEX, France;
- Department of Otorhinolaryngology, University Medical Center Groningen (UMCG), Hanzeplein 1, BB21, 9700 RB Groningen, The Netherlands;
| | - Deniz Başkent
- Department of Otorhinolaryngology, University Medical Center Groningen (UMCG), Hanzeplein 1, BB21, 9700 RB Groningen, The Netherlands;
| | - Sarah Verhulst
- Department of Information Technology, Ghent University, Technologiepark 126, 9052 Zwijnaarde, Belgium; (M.W.); (S.V.)
| | - Christoph Braun
- Magnetoencephalography-Centre and Hertie Institute for Clinical Brain Research, University of Tübingen, Otfried-Müller-Straße 27, 72076 Tübingen, Germany;
- Center for Mind and Brain Research, University of Trento, Palazzo Fedrigotti-corso Bettini 31, 38068 Rovereto, Italy
| | - Lukas Rüttiger
- Department of Otolaryngology, Head and Neck Surgery, University of Tübingen, Elfriede-Aulhorn-Str. 5, 72076 Tübingen, Germany; (J.S.); (S.W.); (K.D.); (M.R.); (J.W.); (T.E.); (K.B.); (W.S.); (L.R.)
| | - Matthias H. J. Munk
- Department of Biology, Technical University Darmstadt, 64287 Darmstadt, Germany
- Department of Psychiatry & Psychotherapy, University of Tübingen, Calwerstraße 14, 72076 Tübingen, Germany
| | - Ernst Dalhoff
- Department of Otolaryngology, Head and Neck Surgery, University of Tübingen, Elfriede-Aulhorn-Str. 5, 72076 Tübingen, Germany; (J.S.); (S.W.); (K.D.); (M.R.); (J.W.); (T.E.); (K.B.); (W.S.); (L.R.)
| | - Marlies Knipper
- Department of Otolaryngology, Head and Neck Surgery, University of Tübingen, Elfriede-Aulhorn-Str. 5, 72076 Tübingen, Germany; (J.S.); (S.W.); (K.D.); (M.R.); (J.W.); (T.E.); (K.B.); (W.S.); (L.R.)
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Wertz J, Rüttiger L, Bender B, Klose U, Stark RS, Dapper K, Saemisch J, Braun C, Singer W, Dalhoff E, Bader K, Wolpert SM, Knipper M, Munk MHJ. Differential cortical activation patterns: pioneering sub-classification of tinnitus with and without hyperacusis by combining audiometry, gamma oscillations, and hemodynamics. Front Neurosci 2024; 17:1232446. [PMID: 38239827 PMCID: PMC10794389 DOI: 10.3389/fnins.2023.1232446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 10/16/2023] [Indexed: 01/22/2024] Open
Abstract
The ongoing controversies about the neural basis of tinnitus, whether linked with central neural gain or not, may hamper efforts to develop therapies. We asked to what extent measurable audiometric characteristics of tinnitus without (T) or with co-occurrence of hyperacusis (TH) are distinguishable on the level of cortical responses. To accomplish this, electroencephalography (EEG) and concurrent functional near-infrared spectroscopy (fNIRS) were measured while patients performed an attentionally demanding auditory discrimination task using stimuli within the individual tinnitus frequency (fTin) and a reference frequency (fRef). Resting-state-fMRI-based functional connectivity (rs-fMRI-bfc) in ascending auditory nuclei (AAN), the primary auditory cortex (AC-I), and four other regions relevant for directing attention or regulating distress in temporal, parietal, and prefrontal cortex was compiled and compared to EEG and concurrent fNIRS activity in the same brain areas. We observed no group differences in pure-tone audiometry (PTA) between 10 and 16 kHz. However, the PTA threshold around the tinnitus pitch was positively correlated with the self-rated tinnitus loudness and also correlated with distress in T-groups, while TH experienced their tinnitus loudness at minimal loudness levels already with maximal suffering scores. The T-group exhibited prolonged auditory brain stem (ABR) wave I latency and reduced ABR wave V amplitudes (indicating reduced neural synchrony in the brainstem), which were associated with lower rs-fMRI-bfc between AAN and the AC-I, as observed in previous studies. In T-subjects, these features were linked with elevated spontaneous and reduced evoked gamma oscillations and with reduced deoxygenated hemoglobin (deoxy-Hb) concentrations in response to stimulation with lower frequencies in temporal cortex (Brodmann area (BA) 41, 42, 22), implying less synchronous auditory responses during active auditory discrimination of reference frequencies. In contrast, in the TH-group gamma oscillations and hemodynamic responses in temporoparietal regions were reversed during active discrimination of tinnitus frequencies. Our findings suggest that T and TH differ in auditory discrimination and memory-dependent directed attention during active discrimination at either tinnitus or reference frequencies, offering a test paradigm that may allow for more precise sub-classification of tinnitus and future improved treatment approaches.
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Affiliation(s)
- Jakob Wertz
- Department of Otolaryngology, Head and Neck Surgery, Tübingen Hearing Research Centre, University of Tübingen, Tübingen, Germany
| | - Lukas Rüttiger
- Department of Otolaryngology, Head and Neck Surgery, Tübingen Hearing Research Centre, University of Tübingen, Tübingen, Germany
| | - Benjamin Bender
- Department of Diagnostic and Interventional Neuroradiology, University of Tübingen, Tübingen, Germany
| | - Uwe Klose
- Department of Diagnostic and Interventional Neuroradiology, University of Tübingen, Tübingen, Germany
| | - Robert S. Stark
- Department of Psychiatry and Psychotherapy, University of Tübingen, Tübingen, Germany
| | - Konrad Dapper
- Department of Otolaryngology, Head and Neck Surgery, Tübingen Hearing Research Centre, University of Tübingen, Tübingen, Germany
- Department of Biology, Technical University Darmstadt, Darmstadt, Germany
| | - Jörg Saemisch
- Department of Otolaryngology, Head and Neck Surgery, Tübingen Hearing Research Centre, University of Tübingen, Tübingen, Germany
| | | | - Wibke Singer
- Department of Otolaryngology, Head and Neck Surgery, Tübingen Hearing Research Centre, University of Tübingen, Tübingen, Germany
| | - Ernst Dalhoff
- Section of Physiological Acoustics and Communication, Department of Otolaryngology, Head and Neck Surgery, University of Tübingen, Tübingen, Germany
| | - Katharina Bader
- Section of Physiological Acoustics and Communication, Department of Otolaryngology, Head and Neck Surgery, University of Tübingen, Tübingen, Germany
| | - Stephan M. Wolpert
- Department of Otolaryngology, Head and Neck Surgery, Tübingen Hearing Research Centre, University of Tübingen, Tübingen, Germany
| | - Marlies Knipper
- Department of Otolaryngology, Head and Neck Surgery, Tübingen Hearing Research Centre, University of Tübingen, Tübingen, Germany
| | - Matthias H. J. Munk
- Department of Psychiatry and Psychotherapy, University of Tübingen, Tübingen, Germany
- Department of Biology, Technical University Darmstadt, Darmstadt, Germany
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Bader K, Dierkes L, Braun LH, Gummer AW, Dalhoff E, Zelle D. Test-retest reliability of distortion-product thresholds compared to behavioral auditory thresholds. Hear Res 2021; 406:108232. [PMID: 33984603 DOI: 10.1016/j.heares.2021.108232] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 03/15/2021] [Accepted: 03/24/2021] [Indexed: 10/21/2022]
Abstract
When referred to baseline measures, serial monitoring of pure-tone behavioral thresholds and distortion-product otoacoustic emissions (DPOAEs) can be used to detect the progression of cochlear damage. Semi-logarithmic DPOAE input-output (I/O) functions enable the computation of estimated distortion-product thresholds (EDPTs) by means of linear regression, a metric that provides a quantitative estimate of hearing loss due to cochlear-amplifier degradation. DPOAE wave interference and a suboptimal choice of stimulus levels limit the accuracy of EDPTs. This work identifies the test-retest reliability of EDPTs derived from short-pulse DPOAE level maps (EDPTLM), a method that circumvents limitations associated with both wave interference and suboptimal choice of stimulus levels. The test-retest reliability was compared to that of EDPTs derived from semi-logarithmic I/O functions (EDPTI/O) and that of behavioral thresholds acquired with pure-tone audiometry (PTA) and modified Békésy tracking audiometry (TA) to provide a foundation for identifying and interpreting significant threshold shifts. The DPOAE-based auditory thresholds (EDPTLM and EDPTI/O) and behavioral thresholds (PTA and TA) were recorded seven times within three months at 14 frequencies with f2 = 1-14 kHz in 20 ears from ten subjects with normal hearing (4PTA0.5-4kHz < 20 dB HL). To obtain EDPTLM, short-pulse DPOAEs were recorded using 21 L1,L2 pairs. Reconstruction of DPOAE growth behavior as a function of L1 and L2 using nonlinear curve fitting enabled the derivation of EDPTLM for each frequency. Test-retest reliability was determined using three different approaches: 1) centered thresholds, 2) average threshold differences, and 3) average absolute threshold differences, between each possible test session (N = 21). Test-retest reliability based on centered thresholds and average threshold differences showed no statistically significant difference between EDPTLM, EDPTI/O, PTA, and TA for the pooled analysis incorporating all stimulus frequencies. Average absolute threshold differences presented small but significant differences in test-retest reliability with median values of 3.00 dB for PTA, 3.20 dB for TA, 3.34 dB for EDPTLM, and 3.51 dB for EDPTI/O. A considerable frequency dependence of test-retest reliability was found; namely, the highest test-retest reliability was for EDPTLM at f2 = 11 - 14 kHz. Otherwise, at lower frequencies, the highest test-retest reliability was for TA at f2 =1 - 2 kHz. Overall, the test-retest reliability of EDPTLM was better than that of EDPTI/O and was similar to that for behavioral thresholds. Hence, deriving EDPTLM from individual level maps is a promising and sensitive method for objectively monitoring the state of the cochlea. Furthermore, the detection of an equidirectional threshold change at a single frequency in both EDPTLM and TA might allow reducing the threshold shift as indication of a follow-up examination from the clinical standard of 10 dB down to 5 dB. This stricter indicator might be beneficial when monitoring cochlear damage, for example ototoxicity, in the presence of (remnant) cochlear amplification at baseline.
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Affiliation(s)
- Katharina Bader
- Department of Otolaryngology, Head and Neck Surgery, Eberhard-Karls-University Tübingen, Elfriede-Aulhorn-Straße 5, 72076 Tübingen, Germany
| | - Linda Dierkes
- Department of Otolaryngology, Head and Neck Surgery, Eberhard-Karls-University Tübingen, Elfriede-Aulhorn-Straße 5, 72076 Tübingen, Germany
| | - Lore Helene Braun
- Department of Radiooncology, Eberhard-Karls-University Tübingen, Hoppe-Seyler-Straße 3, 72076 Tübingen, Germany; Current address: Department of Radiooncology, Marienhospital Stuttgart, Böheimstraße 37, 70199 Stuttgart, Germany
| | - Anthony W Gummer
- Section of Physiological Acoustics and Communication, Department of Otolaryngology, Eberhard-Karls-University Tübingen, Elfriede-Aulhorn-Straße 5, 72076 Tübingen, Germany
| | - Ernst Dalhoff
- Section of Physiological Acoustics and Communication, Department of Otolaryngology, Eberhard-Karls-University Tübingen, Elfriede-Aulhorn-Straße 5, 72076 Tübingen, Germany
| | - Dennis Zelle
- Section of Physiological Acoustics and Communication, Department of Otolaryngology, Eberhard-Karls-University Tübingen, Elfriede-Aulhorn-Straße 5, 72076 Tübingen, Germany; Current address: Redwave Medical GmbH, Hans-Knöll-Str. 6, 07745 Jena, Germany
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Marcrum SC, Höfle E, Picou EM, Steffens T, Kummer P, Kwok P. A clinical comparison of DPOAE fine structure reduction methods. Int J Audiol 2020; 60:191-201. [PMID: 32985942 DOI: 10.1080/14992027.2020.1822552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To evaluate two real-time methods for reducing distortion product otoacoustic emission (DPOAE) fine structure in terms of DPOAE amplitude and fine structure depth. DESIGN A prospective, repeated-measures design was used to assess DPOAE characteristics in response to a conventional stimulation method (Conv.), as well as for methods implementing either a generic suppressor tone (Supp.) or frequency modulation of the f2 primary tone (FM). STUDY SAMPLE Eighty-three young adults (58 females) between the ages of 20 and 34 years with normal hearing completed testing for this study. RESULTS Use of the Conv. and FM methods resulted in consistently higher DPOAE levels relative to the Supp. method, with average advantages of 6 and 5 dB, respectively. For all methods, increased fine structure depth was observed for stimulation with lower level (25-45 dB SPL) and lower frequency (1000-3000 Hz) primary tones. Finally, use of the Supp. and FM methods resulted in significantly decreased fine structure depth relative to the Conv. method. CONCLUSION Through frequency modulation of the f2 primary tone, it was possible to reduce the depth of fine structure across a clinically meaningful range of stimulation levels and frequencies without concomitant reduction in DPOAE amplitude.
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Affiliation(s)
- Steven C Marcrum
- Department of Otolaryngology, University Hospital Regensburg, Regensburg, Germany
| | - Eva Höfle
- Department of Otolaryngology, University Hospital Regensburg, Regensburg, Germany
| | - Erin M Picou
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Thomas Steffens
- Department of Otolaryngology, University Hospital Regensburg, Regensburg, Germany
| | - Peter Kummer
- Section Phoniatrics and Pediatric Audiology, Department of Otolaryngology, University Hospital Regensburg, Regensburg, Germany
| | - Pingling Kwok
- Department of Otolaryngology, University Hospital Regensburg, Regensburg, Germany
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Zelle D, Bader K, Dierkes L, Gummer AW, Dalhoff E. Derivation of input-output functions from distortion-product otoacoustic emission level maps. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2020; 147:3169. [PMID: 32486784 DOI: 10.1121/10.0001142] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Accepted: 04/07/2020] [Indexed: 06/11/2023]
Abstract
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, fDP=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.
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Affiliation(s)
- Dennis Zelle
- Section of Physiological Acoustics and Communication, Department of Otolaryngology, Eberhard-Karls-University Tübingen, Elfriede-Aulhorn-Straße 5, 72076 Tübingen, Germany
| | - Katharina Bader
- Department of Otolaryngology, Head and Neck Surgery, Eberhard-Karls-University Tübingen, Elfriede-Aulhorn- Straße 5, 72076 Tübingen, Germany
| | - Linda Dierkes
- Department of Otolaryngology, Head and Neck Surgery, Eberhard-Karls-University Tübingen, Elfriede-Aulhorn- Straße 5, 72076 Tübingen, Germany
| | - Anthony W Gummer
- Section of Physiological Acoustics and Communication, Department of Otolaryngology, Eberhard-Karls-University Tübingen, Elfriede-Aulhorn-Straße 5, 72076 Tübingen, Germany
| | - Ernst Dalhoff
- Section of Physiological Acoustics and Communication, Department of Otolaryngology, Eberhard-Karls-University Tübingen, Elfriede-Aulhorn-Straße 5, 72076 Tübingen, Germany
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Vencovský V, Zelle D, Dalhoff E, Gummer AW, Vetešník A. The influence of distributed source regions in the formation of the nonlinear distortion component of cubic distortion-product otoacoustic emissions. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2019; 145:2909. [PMID: 31153314 DOI: 10.1121/1.5100611] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/09/2018] [Accepted: 04/16/2019] [Indexed: 06/09/2023]
Abstract
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.
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Affiliation(s)
- Václav Vencovský
- Department of Radioelectronics, Czech Technical University in Prague, Technická 2, 166 27 Prague 6, Czech Republic
| | - Dennis Zelle
- Section of Physiological Acoustics and Communication, Department of Otolaryngology, Eberhard-Karls-University Tübingen, Elfriede-Aulhorn-Strasse 5, 72076 Tübingen, Germany
| | - Ernst Dalhoff
- Section of Physiological Acoustics and Communication, Department of Otolaryngology, Eberhard-Karls-University Tübingen, Elfriede-Aulhorn-Strasse 5, 72076 Tübingen, Germany
| | - Anthony W Gummer
- Section of Physiological Acoustics and Communication, Department of Otolaryngology, Eberhard-Karls-University Tübingen, Elfriede-Aulhorn-Strasse 5, 72076 Tübingen, Germany
| | - Aleš Vetešník
- Department of Nuclear Chemistry, Czech Technical University in Prague, Břehová 7, 115 19 Prague, Czech Republic
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Zelle D, Dalhoff E, Gummer AW. Objective audiometry with DPOAEs : New findings for generation mechanisms and clinical applications. HNO 2019; 65:122-129. [PMID: 28470484 PMCID: PMC5554278 DOI: 10.1007/s00106-016-0267-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Background Distortion product otoacoustic emissions (DPOAEs) and transient-evoked otoacoustic emissions (TEOAEs) are sound waves generated as byproducts of the cochlear amplifier. These are measurable in the auditory canal and represent an objective method for diagnosing functional disorders of the inner ear. Conventional DPOAE and TEOAE methods permit detection of hearing impairment, but with less than desirable accuracy. Objective By accounting for DPOAE generation mechanisms, the aim is to improve the accuracy of inner-ear diagnosis. Methods DPOAEs consist of two components, which emerge at different positions along the cochlea and which may cause artifacts due to mutual interference. Here, the two components are separated in the time domain using short stimulus pulses. Optimized stimulus levels facilitate the acquisition of DPOAEs with maximum amplitudes. DPOAE and Békésy audiograms were recorded from 41 subjects in a clinically relevant frequency range of 1.5–6 kHz. Results The short stimulus pulses allowed artifact-free measurement of DPOAEs. Semilogarithmic input–output functions yielded estimated distortion product thresholds, which were significantly correlated with the subjectively acquired Békésy thresholds. In addition, they allowed detection of hearing impairment from 20 dB HL, with 95% sensitivity and only a 5% false-positive rate. This accuracy was achieved with a measurement time of about 1–2 min per frequency. Conclusion Compared to conventional DPOAE and TEOAE methods, separation of DPOAE components using short-pulse DPOAEs in combination with optimized stimulus parameters considerably enhances the accuracy of DPOAEs for diagnosing impairment of the cochlear amplifier.
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Affiliation(s)
- D Zelle
- Section of Physiological Acoustics and Communication, Department of Otolaryngology, University of Tübingen, Elfriede-Aulhorn-Str. 5, 72076, Tübingen, Germany
| | - E Dalhoff
- Section of Physiological Acoustics and Communication, Department of Otolaryngology, University of Tübingen, Elfriede-Aulhorn-Str. 5, 72076, Tübingen, Germany
| | - A W Gummer
- Section of Physiological Acoustics and Communication, Department of Otolaryngology, University of Tübingen, Elfriede-Aulhorn-Str. 5, 72076, Tübingen, Germany.
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Zelle D, Dalhoff E, Gummer AW. Comparison of time-domain source-separation techniques for short-pulse distortion-product otoacoustic emissions. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2017; 142:EL544. [PMID: 29289117 DOI: 10.1121/1.5016466] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
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.
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Affiliation(s)
- Dennis Zelle
- Section of Physiological Acoustics and Communication, Department of Otolaryngology, Eberhard-Karls-University Tübingen, Elfriede-Aulhorn-Strasse 5, 72076 Tübingen, Germany , ,
| | - Ernst Dalhoff
- Section of Physiological Acoustics and Communication, Department of Otolaryngology, Eberhard-Karls-University Tübingen, Elfriede-Aulhorn-Strasse 5, 72076 Tübingen, Germany , ,
| | - Anthony W Gummer
- Section of Physiological Acoustics and Communication, Department of Otolaryngology, Eberhard-Karls-University Tübingen, Elfriede-Aulhorn-Strasse 5, 72076 Tübingen, Germany , ,
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Zelle D, Lorenz L, Thiericke JP, Gummer AW, Dalhoff E. Input-output functions of the nonlinear-distortion component of distortion-product otoacoustic emissions in normal and hearing-impaired human ears. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2017; 141:3203. [PMID: 28599560 PMCID: PMC5426960 DOI: 10.1121/1.4982923] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
Distortion-product otoacoustic emissions (DPOAEs) arise in the cochlea in response to two tones with frequencies f1 and f2 and mainly consist of two components, a nonlinear-distortion and a coherent-reflection component. Wave interference between these components limits the accuracy of DPOAEs when evaluating the function of the cochlea with conventional continuous stimulus tones. Here, DPOAE components are separated in the time domain from DPOAE signals elicited with short stimulus pulses. The extracted nonlinear-distortion components are used to derive estimated distortion-product thresholds (EDPTs) from semi-logarithmic input-output (I/O) functions for 20 normal-hearing and 21 hearing-impaired subjects. I/O functions were measured with frequency-specific stimulus levels at eight frequencies f2 = 1,…, 8 kHz (f2/f1 = 1.2). For comparison, DPOAEs were also elicited with continuous primary tones. Both acquisition paradigms yielded EDPTs, which significantly correlated with behavioral thresholds (p < 0.001) and enabled derivation of estimated hearing thresholds (EHTs) from EDPTs using a linear regression relationship. DPOAE-component separation in the time domain significantly reduced the standard deviation of EHTs compared to that derived from continuous DPOAEs (p < 0.01). In conclusion, using frequency-specific stimulus levels and DPOAE-component separation increases the reliability of DPOAE I/O functions for assessing cochlear function and estimating behavioral thresholds.
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Affiliation(s)
- Dennis Zelle
- Section of Physiological Acoustics and Communication, Department of Otolaryngology, Eberhard-Karls-University Tübingen, Elfriede-Aulhorn-Straße 5, 72076 Tübingen, Germany
| | - Lisa Lorenz
- Section of Physiological Acoustics and Communication, Department of Otolaryngology, Eberhard-Karls-University Tübingen, Elfriede-Aulhorn-Straße 5, 72076 Tübingen, Germany
| | - John P Thiericke
- Section of Physiological Acoustics and Communication, Department of Otolaryngology, Eberhard-Karls-University Tübingen, Elfriede-Aulhorn-Straße 5, 72076 Tübingen, Germany
| | - Anthony W Gummer
- Section of Physiological Acoustics and Communication, Department of Otolaryngology, Eberhard-Karls-University Tübingen, Elfriede-Aulhorn-Straße 5, 72076 Tübingen, Germany
| | - Ernst Dalhoff
- Section of Physiological Acoustics and Communication, Department of Otolaryngology, Eberhard-Karls-University Tübingen, Elfriede-Aulhorn-Straße 5, 72076 Tübingen, Germany
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Zelle D, Thiericke JP, Dalhoff E, Gummer AW. Level dependence of the nonlinear-distortion component of distortion-product otoacoustic emissions in humans. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2015; 138:3475-90. [PMID: 26723305 DOI: 10.1121/1.4936860] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
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.
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Affiliation(s)
- Dennis Zelle
- Section of Physiological Acoustics and Communication, Department of Otolaryngology, Eberhard-Karls-University Tübingen, Tübingen, Germany
| | - John P Thiericke
- Section of Physiological Acoustics and Communication, Department of Otolaryngology, Eberhard-Karls-University Tübingen, Tübingen, Germany
| | - Ernst Dalhoff
- Section of Physiological Acoustics and Communication, Department of Otolaryngology, Eberhard-Karls-University Tübingen, Tübingen, Germany
| | - Anthony W Gummer
- Section of Physiological Acoustics and Communication, Department of Otolaryngology, Eberhard-Karls-University Tübingen, Tübingen, Germany
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