Aging in binaural hearing begins in mid-life: evidence from cortical auditory-evoked responses to changes in interaural phase

The Rapid Decline in Interaural-Time-Difference Sensitivity for Pure Tones Can Be Explained by Peripheral Filtering

PURPOSE

The interaural time difference (ITD) is a primary horizontal-plane sound localization cue computed in the auditory brainstem. ITDs are accessible in the temporal fine structure of pure tones with a frequency of no higher than about 1400 Hz. How listeners' ITD sensitivity transitions from very best sensitivity near 700 Hz to impossible to detect within 1 octave currently lacks a fully compelling physiological explanation. Here, it was hypothesized that the rapid decline in ITD sensitivity is dictated not by a central neural limitation but by initial peripheral sound encoding, specifically, the low-frequency (apical) portion of the cochlear excitation pattern produced by a pure tone.

METHODS

ITD sensitivity was measured in 16 normal-hearing listeners as a joint function of frequency (900-1500 Hz) and level (10-50 dB sensation level).

RESULTS

Performance decreased with increasing frequency and decreasing sound level. The slope of performance decline was 90 dB/octave, consistent with the low-frequency slope of the cochlear excitation pattern.

CONCLUSION

Fine-structure ITD sensitivity near 1400 Hz may be conveyed primarily by "off-frequency" activation of neurons tuned to lower frequencies near 700 Hz. Physiologically, this could be realized by having neurons sensitive to fine-structure ITD up to only about 700 Hz. A more extreme model would have only a single narrow channel near 700 Hz that conveys fine-structure ITDs. Such a model is a major simplification and departure from the classic formulation of the binaural display, which consists of a matrix of neurons tuned to a wide range of relevant frequencies and ITDs.

Central Auditory Changes Associated with Age-related Hearing Loss

Objective. This study aimed to investigate age-related changes in cortical auditory evoked potentials (CAEPs) while considering three crucial factors: aging, high-frequency hearing loss and sensation level of the CAEP stimulus. Method. The electrophysiological and audiometric data of 71 elderly participants were analyzed using multiple regression analysis to investigate the association of CAEPs with the factors of aging, high-frequency hearing loss and sensation level of the CAEP test stimulus. Results. Aging was significantly associated with prolonged N1 and P2 latencies and reduced P2 amplitude. Elevated thresholds related to the sensation level of the CAEP stimulus were significantly associated with increased N1 and P2 amplitudes and decreased N1 latency. A significant relationship was detected between high-frequency hearing thresholds and the shortening of P2 latencies and the reduction of P2 amplitudes. Conclusion. The results of this study highlight the complex interplay of aging, high-frequency hearing loss and the sensation level of the CAEP stimulus on CAEP components in elderly people. These factors should be considered in future research using CAEPs to enhance overall understanding of auditory processing in the aging population.

Objective measure of binaural processing: Acoustic change complex in response to interaural phase differences

Combining cochlear implants with binaural acoustic hearing via preserved hearing in the implanted ear(s) is commonly referred to as combined electric and acoustic stimulation (EAS). EAS fittings can provide patients with significant benefit for speech recognition in complex noise, perceived listening difficulty, and horizontal-plane localization as compared to traditional bimodal hearing conditions with contralateral and monaural acoustic hearing. However, EAS benefit varies across patients and the degree of benefit is not reliably related to the underlying audiogram. Previous research has indicated that EAS benefit for speech recognition in complex listening scenarios and localization is significantly correlated with the patients' binaural cue sensitivity, namely interaural time differences (ITD). In the context of pure tones, interaural phase differences (IPD) and ITD can be understood as two perspectives on the same phenomenon. Through simple mathematical conversion, one can be transformed into the other, illustrating their inherent interrelation for spatial hearing abilities. However, assessing binaural cue sensitivity is not part of a clinical assessment battery as psychophysical tasks are time consuming, require training to achieve performance asymptote, and specialized programming and software all of which render this clinically unfeasible. In this study, we investigated the possibility of using an objective measure of binaural cue sensitivity by the acoustic change complex (ACC) via imposition of an IPD of varying degrees at stimulus midpoint. Ten adult listeners with normal hearing were assessed on tasks of behavioral and objective binaural cue sensitivity for carrier frequencies of 250 and 1000 Hz. Results suggest that 1) ACC amplitude increases with IPD; 2) ACC-based IPD sensitivity for 250 Hz is significantly correlated with behavioral ITD sensitivity; 3) Participants were more sensitive to IPDs at 250 Hz as compared to 1000 Hz. Thus, this objective measure of IPD sensitivity may hold clinical application for pre- and post-operative assessment for individuals meeting candidacy indications for cochlear implantation with low-frequency acoustic hearing preservation as this relatively quick and objective measure may provide clinicians with information identifying patients most likely to derive benefit from EAS technology.

Rate dependent neural responses of interaural-time-difference cues in fine-structure and envelope

Advancements in cochlear implants (CIs) have led to a significant increase in bilateral CI users, especially among children. Yet, most bilateral CI users do not fully achieve the intended binaural benefit due to potential limitations in signal processing and/or surgical implant positioning. One crucial auditory cue that normal hearing (NH) listeners can benefit from is the interaural time difference (ITD), i.e., the time difference between the arrival of a sound at two ears. The ITD sensitivity is thought to be heavily relying on the effective utilization of temporal fine structure (very rapid oscillations in sound). Unfortunately, most current CIs do not transmit such true fine structure. Nevertheless, bilateral CI users have demonstrated sensitivity to ITD cues delivered through envelope or interaural pulse time differences, i.e., the time gap between the pulses delivered to the two implants. However, their ITD sensitivity is significantly poorer compared to NH individuals, and it further degrades at higher CI stimulation rates, especially when the rate exceeds 300 pulse per second. The overall purpose of this research thread is to improve spatial hearing abilities in bilateral CI users. This study aims to develop electroencephalography (EEG) paradigms that can be used with clinical settings to assess and optimize the delivery of ITD cues, which are crucial for spatial hearing in everyday life. The research objective of this article was to determine the effect of CI stimulation pulse rate on the ITD sensitivity, and to characterize the rate-dependent degradation in ITD perception using EEG measures. To develop protocols for bilateral CI studies, EEG responses were obtained from NH listeners using sinusoidal-amplitude-modulated (SAM) tones and filtered clicks with changes in either fine structure ITD (ITDFS) or envelope ITD (ITDENV). Multiple EEG responses were analyzed, which included the subcortical auditory steady-state responses (ASSRs) and cortical auditory evoked potentials (CAEPs) elicited by stimuli onset, offset, and changes. Results indicated that acoustic change complex (ACC) responses elicited by ITDENV changes were significantly smaller or absent compared to those elicited by ITDFS changes. The ACC morphologies evoked by ITDFS changes were similar to onset and offset CAEPs, although the peak latencies were longest for ACC responses and shortest for offset CAEPs. The high-frequency stimuli clearly elicited subcortical ASSRs, but smaller than those evoked by lower carrier frequency SAM tones. The 40-Hz ASSRs decreased with increasing carrier frequencies. Filtered clicks elicited larger ASSRs compared to high-frequency SAM tones, with the order being 40 > 160 > 80> 320 Hz ASSR for both stimulus types. Wavelet analysis revealed a clear interaction between detectable transient CAEPs and 40-Hz ASSRs in the time-frequency domain for SAM tones with a low carrier frequency.

Age-Related Deficits in Binaural Hearing: Contribution of Peripheral and Central Effects

Pure-tone audiograms often poorly predict elderly humans' ability to communicate in everyday complex acoustic scenes. Binaural processing is crucial for discriminating sound sources in such complex acoustic scenes. The compromised perception of communication signals presented above hearing threshold has been linked to both peripheral and central age-related changes in the auditory system. Investigating young and old Mongolian gerbils of both sexes, an established model for human hearing, we demonstrate age-related supra-threshold deficits in binaural hearing using behavioral, electrophysiological, anatomical, and imaging methods. Binaural processing ability was measured as the binaural masking level difference (BMLD), an established measure in human psychophysics. We tested gerbils behaviorally with "virtual headphones," recorded single-unit responses in the auditory midbrain and evaluated gross midbrain and cortical responses using positron emission tomography (PET) imaging. Furthermore, we obtained additional measures of auditory function based on auditory brainstem responses, auditory-nerve synapse counts, and evidence for central inhibitory processing revealed by PET. BMLD deteriorates already in middle-aged animals having normal audiometric thresholds and is even worse in old animals with hearing loss. The magnitude of auditory brainstem response measures related to auditory-nerve function and binaural processing in the auditory brainstem also deteriorate. Furthermore, central GABAergic inhibition is affected by age. Because the number of synapses in the apical turn of the inner ear was not reduced in middle-aged animals, we conclude that peripheral synaptopathy contributes little to binaural processing deficits. Exploratory analyses suggest increased hearing thresholds, altered binaural processing in the brainstem and changed central GABAergic inhibition as potential contributors.

Age-related differences in auditory spatial processing revealed by acoustic change complex

Objectives

The auditory spatial processing abilities mature throughout childhood and degenerate in older adults. This study aimed to compare the differences in onset cortical auditory evoked potentials (CAEPs) and location-evoked acoustic change complex (ACC) responses among children, adults, and the elderly and to investigate the impact of aging and development on ACC responses.

Design

One hundred and seventeen people were recruited in the study, including 57 typically-developed children, 30 adults, and 30 elderlies. The onset-CAEP evoked by white noise and ACC by sequential changes in azimuths were recorded. Latencies and amplitudes as a function of azimuths were analyzed using the analysis of variance, Pearson correlation analysis, and multiple linear regression model.

Results

The ACC N1'-P2' amplitudes and latencies in adults, P1'-N1' amplitudes in children, and N1' amplitudes and latencies in the elderly were correlated with angles of shifts. The N1'-P2' and P2' amplitudes decreased in the elderly compared to adults. In Children, the ACC P1'-N1' responses gradually differentiated into the P1'-N1'-P2' complex. Multiple regression analysis showed that N1'-P2' amplitudes (R2 = 0.33) and P2' latencies (R2 = 0.18) were the two most variable predictors in adults, while in the elderly, N1' latencies (R2 = 0.26) explained most variances. Although the amplitudes of onset-CAEP differed at some angles, it could not predict angle changes as effectively as ACC responses.

Conclusion

The location-evoked ACC responses varied among children, adults, and the elderly. The N1'-P2' amplitudes and P2' latencies in adults and N1' latencies in the elderly explained most variances of changes in spatial position. The differentiation of the N1' waveform was observed in children. Further research should be conducted across all age groups, along with behavioral assessments, to confirm the relationship between aging and immaturity in objective ACC responses and poorer subjective spatial performance.

Significance

ACCs evoked by location changes were assessed in adults, children, and the elderly to explore the impact of aging and development on these differences.

Cortical sensory gating and reactions to dynamic speech-in-noise in older normal-hearing and hearing-impaired adults

OBJECTIVE

To examine whether cortical sensory gating predicts how older adults with and without hearing loss perform the Tracking of Noise Tolerance (TNT) test.

DESIGN

Single-blind mixed design. TNT performance was defined by average tolerated noise relative to speech levels (TNTAve) and by an average range of noise levels over a two-minute trial (excursion). Sensory gating of P1-N1-P2 components was measured using pairs of 1 kHz tone pips.

STUDY SAMPLE

Twenty-three normal-hearing (NH) and 16 hearing-impaired (HI) older adults with a moderate-to-severe degree of sensorineural hearing loss.

RESULTS

NH listeners tolerated significantly more noise than HI listeners, but the two groups did not differ in their excursion. Both NH and HI listeners exhibited significant gating of P1 amplitudes and N1P2 peak-to-peak amplitudes with no difference in gating magnitudes between listener groups. Sensory gating magnitudes of P1 and N1P2 did not predict TNTAve scores, but N1P2 gating negatively predicted excursion after accounting for listener age and hearing thresholds.

CONCLUSIONS

Listeners' reactivity to a roving noise (excursion), but not their average noise tolerance (TNTAve), was predicted by sensory gating at N1P2 generators. These results suggest that temporal aspects of speech-in-noise processing may be affected by declines in the central inhibition of older adults.

The rapid decline in interaural-time-difference sensitivity for pure tones can be explained by peripheral filtering

Purpose

The interaural time difference (ITD) is a primary horizontal-plane sound localization cue computed in the auditory brainstem. ITDs are accessible in the temporal fine structure of pure tones with a frequency of no higher than about 1400 Hz. Explaining how listeners' ITD sensitivity transitions from very best sensitivity near 700 Hz to impossible to detect within 1 octave currently lacks a fully compelling physiological explanation. Here, it was hypothesized that the rapid decline in ITD sensitivity is dictated not by a central neural limitation but by initial peripheral sound encoding, specifically, the low-frequency (apical) edge of the cochlear excitation pattern produced by a pure tone.

Methods

ITD sensitivity was measured in 16 normal-hearing listeners as a joint function of frequency (900-1500 Hz) and level (10-50 dB sensation level).

Results

Performance decreased with increasing frequency and decreasing sound level. The slope of performance decline was 90 dB/octave, consistent with the low-frequency slope of the cochlear excitation pattern.

Conclusion

Fine-structure ITD sensitivity near 1400 Hz may be conveyed primarily by "off-frequency" activation of neurons tuned to lower frequencies near 700 Hz. Physiologically, this could be realized by having neurons sensitive to fine-structure ITD up to only about 700 Hz. A more extreme model would have only a single narrow channel near 700 Hz that conveys fine-structure ITDs. Such a model is a major simplification and departure from the classic formulation of the binaural display, which consists of a matrix of neurons tuned to a wide range of relevant frequencies and ITDs.

Impact of processing-latency induced interaural delay and level discrepancy on sensitivity to interaural level differences in cochlear implant users

PURPOSE

This study investigated whether an interaural delay, e.g. caused by the processing latency of a hearing device, can affect sensitivity to interaural level differences (ILDs) in normal hearing subjects or cochlear implant (CI) users with contralateral normal hearing (SSD-CI).

METHODS

Sensitivity to ILD was measured in 10 SSD-CI subjects and in 24 normal hearing subjects. The stimulus was a noise burst presented via headphones and via a direct cable connection (CI). ILD sensitivity was measured for different interaural delays in the range induced by hearing devices. ILD sensitivity was correlated with results obtained in a sound localization task using seven loudspeakers in the frontal horizontal plane.

RESULTS

In the normal hearing subjects the sensitivity to interaural level differences deteriorated significantly with increasing interaural delays. In the CI group, no significant effect of interaural delays on ILD sensitivity was found. The NH subjects were significantly more sensitive to ILDs. The mean localization error in the CI group was 10.8° higher than in the normal hearing group. No correlation between sound localization ability and ILD sensitivity was found.

CONCLUSION

Interaural delays influence the perception of ILDs. For normal hearing subjects a significant decrement in sensitivity to ILD was measured. The effect could not be confirmed in the tested SSD-CI group, probably due to a small subject group with large variations. The temporal matching of the two sides may be beneficial for ILD processing and thus sound localization for CI patients. However, further studies are needed for verification.

Effects of cochlear implantation on cognitive decline in older adults: A systematic review and meta-analysis

Background

Hearing loss has been reported as the most significant modifiable risk factor for dementia, but it is still unknown whether auditory rehabilitation can practically prevent cognitive decline. We aim to systematically analyze the longitudinal effects of auditory rehabilitation via cochlear implants (CIs).

Methods

In this systematic review and meta-analysis, we searched relevant literature published from January 1, 2000 to April 30, 2022, using electronic databases, and selected studies in which CIs were performed mainly on older adults and follow-up assessments were conducted in both domains: speech perception and cognitive function. A random-effects meta-analysis was conducted for each domain and for each timepoint comparison (pre-CI vs. six months post-CI; six months post-CI vs. 12 months post-CI; pre-CI vs. 12 months post-CI), and heterogeneity was assessed using Cochran's Q test.

Findings

Of the 1918 retrieved articles, 20 research papers (648 CI subjects) were included. The results demonstrated that speech perception was rapidly enhanced after CI, whereas cognitive function had different speeds of improvement for different subtypes: executive function steadily improved significantly up to 12 months post-CI (g = 0.281, p < 0.001; g = 0.115, p = 0.003; g = 0.260, p < 0.001 in the order of timepoint comparison); verbal memory was significantly enhanced at six months post-CI and was maintained until 12 months post-CI (g = 0.296, p = 0.002; g = 0.095, p = 0.427; g = 0.401, p < 0.001); non-verbal memory showed no considerable progress at six months post-CI, but significant improvement at 12 months post-CI (g = -0.053, p = 0.723; g = 0.112, p = 0.089; g = 0.214, p = 0.023).

Interpretation

The outcomes demonstrate that auditory rehabilitation via CIs could have a long-term positive impact on cognitive abilities. Given that older adults' cognitive abilities are on the trajectory of progressive decline with age, these results highlight the need to increase the adoption of CIs among this population.

Effects of Maturation and Chronological Aging on Auditory Spatial Processing: A Cross-Sectional Study Across Life Span

OBJECTIVE

The primary aim of the research was to document spatial acuity changes across the life span using a battery of psychoacoustical and perceptual tests. The secondary aim was to identify the optimal metric for measuring spatial processing changes across the life span (ages 10-70 years).

DESIGN AND STUDY SAMPLE

A cross-sectional study comprising 115 participants with clinically normal hearing was conducted. Purposive sampling was adopted to recruit participants in the study, who were divided into six groups based on their chronological age.

METHOD

Temporal, intensity, spectral, and composite correlates of spatial acuity were assessed using psychoacoustic measures and perceptual questionnaires. The temporal (interaural time difference [ITD]) and intensity correlates (interaural level difference [ILD]) of spatial perception were obtained using a MATLAB (v 2020a), whereas the composite correlate (virtual auditory space identification scores [VASIs]) and perceptual ratings of spatial processing were measured using Paradigm software and speech spatial and qualities in Kannada (SSQ-K).

RESULTS

Results across all tests (multivariate analyses variance: 6 age groups × 4 tests, followed by post hoc tests) consistently demonstrate poor ITD and ILD thresholds and overall lower spatial accuracy (VASI, SSQ-K) with increasing age. Discriminant function analyses (DFAs) revealed that VASI had a higher predictive power in capturing age-related changes in auditory spatial processing. The group segregation on spatial performance in DFA became evident after 50 years.

CONCLUSION

This study provides evidence of gradual change in all three correlates of spatial processing, with statistically demonstrable deficits appearing from fourth decade of life on VASI and fifth decade of life on binaural processing.

Age-Related Changes in Interaural-Level-Difference-Based Across-Frequency Binaural Interference

Low-frequency interaural time differences and high-frequency interaural level differences (ILDs) are used to localize sounds in the horizontal plane. Older listeners appear to be worse at horizontal-plane sound localization to compared younger listeners, but little is understood about age-related changes to across-frequency binaural processing. This study investigated if the frequency dependence of across-frequency ILD processing is altered for older compared to younger listeners, which was done by using an across-frequency binaural interference task (when the interaural difference sensitivity for a target sound is decreased by a spectrally remote interfering sound with zero interaural differences). It was hypothesized that as listeners experience advancing age and age-related high-frequency hearing loss (i.e., presbycusis), they will demonstrate worse binaural performance and experience more across-channel binaural interference (because of age-related temporal processing deficits), and will increasingly be affected by interferers at lower frequencies (because of age-related hearing loss) when compared to younger listeners. There were 11 older (>65 yrs) and 20 younger (<30 yrs) listeners with normal to near-normal audiometric thresholds up to 2 kHz. They were tested using a left-right ILD lateralization discrimination task. Single-tone ILD discrimination thresholds and across-frequency binaural interference were measured at 0.5, 1, 2, 4, and 8 kHz. ILD thresholds and interference were about twice as large for older compared to younger listeners. Interferers ≤1 kHz produced 2-3 times as much across-frequency binaural interference for older compared to younger listeners. Hearing thresholds were significant predictors of single-tone ILD thresholds; in addition, both target and interferer hearing thresholds were significant predictors of binaural interference. The results suggest a reweighting of binaural information that occurs with advancing age and age-related high-frequency hearing loss. This evidence of plasticity may help explain some of the age-related changes in spatial-hearing abilities.

Musical Training and Its Association With Age-Related Changes in Binaural, Temporal, and Spatial Processing

OBJECTIVE

This article aimed to assess the relationship between musical training and age-related changes in binaural, temporal, and spatial processing abilities.

DESIGN

A standard group comparison study was conducted involving both musicians and nonmusicians. The effect of musical training was assessed using a battery of psychoacoustical tests (interaural time and level difference thresholds: ITD & ILD, binaural gap detection threshold, and virtual auditory space identification test) and subjective ratings (Spatial-Hearing subsection of Speech, Spatial, and Quality of Hearing scale in Kannada).

STUDY SAMPLE

A total of 60 participants, between 41 and 70 years, were divided into three groups of 20 each, based on their age (41-50, 51-60, and 61-70 years). Each of these three groups was subdivided into two, one comprising 10 musicians (vocalists practicing South-Indian classical music) and the other comprising 10 nonmusicians.

RESULTS

Multivariate analyses of variance revealed that musicians performed significantly better (p < .001) than nonmusicians in all the tests. Analyses of variance showed that whereas age had no effect (p > .05) on performance in any of the tests in musicians, age affected the performance of nonmusicians significantly in terms of ITD (p = .02) and ILD (p = .01) thresholds.

CONCLUSION

Musical training appears to have the potential to slow down age-related decline in binaural, temporal, and spatial processing.

The electrophysiological masking level difference: effects of age and mediation of hearing and cognition

OBJECTIVE

Evaluate the conceptual framework that age effects on the electrophysiological binaural masking level difference (MLD) are partially mediated by age-related hearing loss and/or global cognitive function via mediation analysis.

DESIGN

Participants underwent a series of audiometric tests. The MLD was measured via cortical auditory evoked potentials using a speech stimulus (/ɑ/) in speech-weighted background noise. We used mediation analyses to determine the total effect, natural direct effects, and natural indirect effects, which are displayed as regression coefficients ([95% CI]; p value).

STUDY SAMPLE

Twenty-eight individuals aged 19-87 years (mean [SD]: 53.3 [25.2]), recruited from the community.

RESULTS

Older age had a significant total effect on the MLD (-0.69 [95% CI: -0.96, -0.45]; p < 0.01). Neither pure tone average (-0.11 [95% CI: -0.43, 0.24; p = 0.54] nor global cognitive function (-0.02 [95% CI: -0.13, 0.02]; p = 0.55) mediated the relationship of age and the MLD and effect sizes were small. Results were insensitive to use of alternative hearing measures or inclusion of interaction terms.

CONCLUSIONS

The electrophysiological MLD may be an age-sensitive measure of binaural temporal processing that is minimally affected by age-related hearing loss and global cognitive function.

Large group differences in binaural sensitivity are represented in preattentive responses from auditory cortex

Correlated sounds presented to two ears are perceived as compact and centrally lateralized, whereas decorrelation between ears leads to intracranial image widening. Though most listeners have fine resolution for perceptual changes in interaural correlation (IAC), some investigators have reported large variability in IAC thresholds, and some normal-hearing listeners even exhibit seemingly debilitating IAC thresholds. It is unknown whether or not this variability across individuals and outlier manifestations are a product of task difficulty, poor training, or a neural deficit in the binaural auditory system. The purpose of this study was first to identify listeners with normal and abnormal IAC resolution, second to evaluate the neural responses elicited by IAC changes, and third to use a well-established model of binaural processing to determine a potential explanation for observed individual variability. Nineteen subjects were enrolled in the study, eight of whom were identified as poor performers in the IAC-threshold task. Global scalp responses (N1 and P2 amplitudes of an auditory change complex) in the individuals with poor IAC behavioral thresholds were significantly smaller than for listeners with better IAC resolution. Source-localized evoked responses confirmed this group effect in multiple subdivisions of the auditory cortex, including Heschl's gyrus, planum temporale, and the temporal sulcus. In combination with binaural modeling results, this study provides objective electrophysiological evidence of a binaural processing deficit linked to internal noise, that corresponds to very poor IAC thresholds in listeners that otherwise have normal audiometric profiles and lack spatial hearing complaints.NEW & NOTEWORTHY Group differences in the perception of interaural correlation (IAC) were observed in human adults with normal audiometric sensitivity. These differences were reflected in cortical-evoked activity measured via electroencephalography (EEG). For some participants, weak representation of the binaural cue at the cortical level in preattentive N1-P2 cortical responses may be indicative of a potential processing deficit. Such a deficit may be related to a poorly understood condition known as hidden hearing loss.

Cortical Processing of Binaural Cues as Shown by EEG Responses to Random-Chord Stereograms

Spatial hearing facilitates the perceptual organization of complex soundscapes into accurate mental representations of sound sources in the environment. Yet, the role of binaural cues in auditory scene analysis (ASA) has received relatively little attention in recent neuroscientific studies employing novel, spectro-temporally complex stimuli. This may be because a stimulation paradigm that provides binaurally derived grouping cues of sufficient spectro-temporal complexity has not yet been established for neuroscientific ASA experiments. Random-chord stereograms (RCS) are a class of auditory stimuli that exploit spectro-temporal variations in the interaural envelope correlation of noise-like sounds with interaurally coherent fine structure; they evoke salient auditory percepts that emerge only under binaural listening. Here, our aim was to assess the usability of the RCS paradigm for indexing binaural processing in the human brain. To this end, we recorded EEG responses to RCS stimuli from 12 normal-hearing subjects. The stimuli consisted of an initial 3-s noise segment with interaurally uncorrelated envelopes, followed by another 3-s segment, where envelope correlation was modulated periodically according to the RCS paradigm. Modulations were applied either across the entire stimulus bandwidth (wideband stimuli) or in temporally shifting frequency bands (ripple stimulus). Event-related potentials and inter-trial phase coherence analyses of the EEG responses showed that the introduction of the 3- or 5-Hz wideband modulations produced a prominent change-onset complex and ongoing synchronized responses to the RCS modulations. In contrast, the ripple stimulus elicited a change-onset response but no response to ongoing RCS modulation. Frequency-domain analyses revealed increased spectral power at the fundamental frequency and the first harmonic of wideband RCS modulations. RCS stimulation yields robust EEG measures of binaurally driven auditory reorganization and has potential to provide a flexible stimulation paradigm suitable for isolating binaural effects in ASA experiments.

Comparison of two cortical measures of binaural hearing acuity

OBJECTIVE

Multiple studies have demonstrated binaural hearing deficits in the aging and those with hearing loss. Consequently, there is great interest in developing efficient clinical tests of binaural hearing acuity to improve diagnostic assessments and to assist clinicians when fitting binaural hearing aids and/or cochlear implants.

DESIGN

Two cortical measures of interaural phase difference sensitivity, the acoustic change complex (ACC) and interaural phase modulation following response (IPM-FR), were compared on three metrics using five different stimulus interaural phase differences (IPDs; 0°, ±22.5°, ±45°, ±67.5° and ±90°). These metrics were scalp topography, time-to-detect, and input-output characteristics.

STUDY SAMPLE

Ten young, normal-hearing listeners.

RESULTS

Scalp topography qualitatively differed between ACC and IPM-FR. The IPM-FR demonstrated better time-to-detect performance on smaller (±22.5° and ±45°) but not larger (67.5°, and ±90°) IPDs. Input-output characteristics of each response were similar.

CONCLUSIONS

The IPM-FR may be a faster and more efficient tool for assessing neural sensitivity to subtle IPD changes. However, the ACC may be useful for research or clinical questions concerned with the topographic representation of binaural cues.

Selective auditory attention modulates cortical responses to sound location change in younger and older adults

The present study measured scalp potentials in response to low-frequency, narrowband noise bursts changing location in the front, azimuthal plane. At question was whether selective auditory attention has a modulatory effect on the cortical encoding of spatial change and whether older listeners with normal-hearing thresholds would show depressed cortical representation for spatial changes relative to younger listeners. Young and older normal-hearing listeners were instructed to either passively listen to the stimulus presentation or actively attend to a single location (either 30° left or right of midline) and detect when a noise stream moved to the attended location. Prominent peaks of the electroencephalographic scalp waveforms were compared across groups, locations, and attention conditions. In addition, an opponent-channel model of spatial coding was performed to capture the effect of attention on spatial-change tuning. Younger listeners showed not only larger responses overall but a greater dynamic range in their response to location changes. Results suggest that younger listeners were acquiring and encoding key spatial cues at early cortical processing areas. On the other hand, each group exhibited modulatory effects of attention to spatial-change tuning, indicating that both younger and older listeners selectively attend to space in a manner that amplifies the available signal.NEW & NOTEWORTHY In complex acoustic scenes, listeners take advantage of spatial cues to selectively attend to sounds that are deemed immediately relevant. At the neural level, selective attention amplifies electrical responses to spatial changes. We tested whether older and younger listeners have comparable modulatory effects of attention to stimuli moving in the free field. Results indicate that although older listeners do have depressed overall responses, selective attention enhances spatial-change tuning in younger and older listeners alike.

Impaired Binaural Hearing in Adults: A Selected Review of the Literature

Despite over 100 years of study, there are still many fundamental questions about binaural hearing that remain unanswered, including how impairments of binaural function are related to the mechanisms of binaural hearing. This review focuses on a number of studies that are fundamental to understanding what is known about the effects of peripheral hearing loss, aging, traumatic brain injury, strokes, brain tumors, and multiple sclerosis (MS) on binaural function. The literature reviewed makes clear that while each of these conditions has the potential to impair the binaural system, the specific abilities of a given patient cannot be known without performing multiple behavioral and/or neurophysiological measurements of binaural sensitivity. Future work in this area has the potential to bring awareness of binaural dysfunction to patients and clinicians as well as a deeper understanding of the mechanisms of binaural hearing, but it will require the integration of clinical research with animal and computational modeling approaches.

Neural Generators Underlying Temporal Envelope Processing Show Altered Responses and Hemispheric Asymmetry Across Age

Speech understanding problems are highly prevalent in the aging population, even when hearing sensitivity is clinically normal. These difficulties are attributed to changes in central temporal processing with age and can potentially be captured by age-related changes in neural generators. The aim of this study is to investigate age-related changes in a wide range of neural generators during temporal processing in middle-aged and older persons with normal audiometric thresholds. A minimum-norm imaging technique is employed to reconstruct cortical and subcortical neural generators of temporal processing for different acoustic modulations. The results indicate that for relatively slow modulations (<50 Hz), the response strength of neural sources is higher in older adults than in younger ones, while the phase-locking does not change. For faster modulations (80 Hz), both the response strength and the phase-locking of neural sources are reduced in older adults compared to younger ones. These age-related changes in temporal envelope processing of slow and fast acoustic modulations are possibly due to loss of functional inhibition, which is accompanied by aging. Both cortical (primary and non-primary) and subcortical neural generators demonstrate similar age-related changes in response strength and phase-locking. Hemispheric asymmetry is also altered in older adults compared to younger ones. Alterations depend on the modulation frequency and side of stimulation. The current findings at source level could have important implications for the understanding of age-related changes in auditory temporal processing and for developing advanced rehabilitation strategies to address speech understanding difficulties in the aging population.

Effects of age on psychophysical measures of auditory temporal processing and speech reception at low and high levels

•

We found little evidence of greater age-related hearing declines at high sound levels.

•

There are age-related temporal-processing declines independent of hearing loss.

•

No evidence of age-related speech-reception deficits independent of hearing loss.

Age-related cochlear synaptopathy (CS) has been shown to occur in rodents with minimal noise exposure, and has been hypothesized to play a crucial role in age-related hearing declines in humans. It is not known to what extent age-related CS occurs in humans, and how it affects the coding of supra-threshold sounds and speech in noise. Because in rodents CS affects mainly low- and medium-spontaneous rate (L/M-SR) auditory-nerve fibers with rate-level functions covering medium-high levels, it should lead to greater deficits in the processing of sounds at high than at low stimulus levels. In this cross-sectional study the performance of 102 listeners across the age range (34 young, 34 middle-aged, 34 older) was assessed in a set of psychophysical temporal processing and speech reception in noise tests at both low, and high stimulus levels. Mixed-effect multiple regression models were used to estimate the effects of age while partialing out effects of audiometric thresholds, lifetime noise exposure, cognitive abilities (assessed with additional tests), and musical experience. Age was independently associated with performance deficits on several tests. However, only for one out of 13 tests were age effects credibly larger at the high compared to the low stimulus level. Overall these results do not provide much evidence that age-related CS, to the extent to which it may occur in humans according to the rodent model of greater L/M-SR synaptic loss, has substantial effects on psychophysical measures of auditory temporal processing or on speech reception in noise.

Age-Related Deficits in Electrophysiological and Behavioral Measures of Binaural Temporal Processing

Binaural processing, particularly the processing of interaural phase differences, is important for sound localization and speech understanding in background noise. Age has been shown to impact the neural encoding and perception of these binaural temporal cues even in individuals with clinically normal hearing sensitivity. This work used a new electrophysiological response, called the interaural phase modulation-following response (IPM-FR), to examine the effects of age on the neural encoding of interaural phase difference cues. Relationships between neural recordings and performance on several behavioral measures of binaural processing were used to determine whether the IPM-FR is predictive of interaural phase difference sensitivity and functional speech understanding deficits. Behavioral binaural frequency modulation detection thresholds were measured to assess sensitivity to interaural phase differences while spatial release-from-masking thresholds were used to assess speech understanding abilities in spatialized noise. Thirty adults between the ages of 35 to 74 years with normal low-frequency hearing thresholds were used in this study. Data showed that older participants had weaker neural responses to the interaural phase difference cue and were less able to take advantage of binaural cues for speech understanding compared to younger participants. Results also showed that the IPM-FR was predictive of performance on the binaural frequency modulation detection task, but not on the spatial release-from-masking task after accounting the effects of age. These results confirm previous work that showed that the IPM-FR reflects age-related declines in binaural temporal processing and provide further evidence that this response may represent a useful objective tool for assessing binaural function. However, further research is needed to understand how the IPM-FR is related to speech understanding abilities.

Sensitivity to interaural time differences and localization accuracy in cochlear implant users with combined electric-acoustic stimulation

OBJECTIVES

In this study, localization accuracy and sensitivity to acoustic interaural time differences (ITDs) in subjects using cochlear implants with combined electric-acoustic stimulation (EAS) were assessed and compared with the results of a normal hearing control group.

METHODS

Eight CI users with EAS (2 bilaterally implanted, 6 unilaterally implanted) and symmetric binaural acoustic hearing and 24 normal hearing subjects participated in the study. The first experiment determined mean localization error (MLE) for different angles of sound incidence between ± 60° (frontal and dorsal presentation). The stimuli were either low-pass, high-pass or broadband noise bursts. In a second experiment, just noticeable differences (JND) of ITDs were measured for pure tones of 125 Hz, 250 Hz and 500 Hz (headphone presentation).

RESULTS

Experiment 1: MLE of EAS subjects was 8.5°, 14.3° and 14.7°, (low-, high-pass and broadband stimuli respectively). In the control group, MLE was 1.8° (broadband stimuli). In the differentiation between sound incidence from front and back, EAS subjects performed on chance level. Experiment 2: The JND-ITDs were 88.7 μs for 125 Hz, 48.8 μs for 250 Hz and 52.9 μs for 500 Hz (EAS subjects). Compared to the control group, JND-ITD for 125 Hz was on the same level of performance. No statistically significant correlation was found between MLE and JND-ITD in the EAS cohort.

CONCLUSIONS

Near to normal ITD sensitivity in the lower frequency acoustic hearing was demonstrated in a cohort of EAS users. However, in an acoustic localization task, the majority of the subjects did not reached the level of accuracy of normal hearing. Presumably, signal processing time delay differences between devices used on both sides are deteriorating the transfer of precise binaural timing cues.

The Impact of Speech Recognition Testing on State Anxiety in Young, Middle-Age, and Older Adults

Purpose This study assessed state anxiety as a function of speech recognition testing using three clinical measures of speech in noise and one clinical measure of dichotic speech recognition. Method Thirty young adults, 30 middle-age adults, and 25 older adults participated. State anxiety was measured pre- and post-speech recognition testing using the State-Trait Anxiety Inventory. Speech recognition was measured with the Revised Speech Perception in Noise Test, the Quick Speech-in-Noise Test, the Words-in-Noise Test, and the Dichotic Digits Test (DDT). Results Speech recognition performance was as expected: Older adults performed significantly poorer on all measures as compared to the young adults and significantly poorer on the Revised Speech Perception in Noise Test, the Quick Speech-in-Noise Test, and the Words-in-Noise Test as compared to the middle-age adults. On average, State-Trait Anxiety Inventory scores increased posttesting, with the middle-age adults exhibiting significantly greater increases in state anxiety as compared to the young and older adults. Increases in state anxiety were significantly greater for the DDT relative to the speech-in-noise tests for the middle-age adults only. Poorer DDT recognition performance was associated with higher levels of state anxiety. Conclusions Increases in state anxiety were observed after speech-in-noise and dichotic listening testing for all groups, with significant increases seen for the young and middle-age adults. Although the exact mechanisms could not be determined, multiple factors likely influenced the observed increases in state anxiety, including task difficulty, individual proficiency, and age.

Effects of hearing loss and age on the binaural processing of temporal envelope and temporal fine structure information

Within the cochlea, broadband sounds like speech and music are filtered into a series of narrowband signals, each with a relatively slowly varying envelope (ENV) imposed on a rapidly oscillating carrier (the temporal fine structure, TFS). Information about ENV is conveyed by the timing and short-term rate of action potentials in the auditory nerve while information about TFS is conveyed by synchronization of action potentials to a specific phase of the waveform in the cochlea (phase locking). This paper describes the effects of age and hearing loss on the binaural processing of ENV and TFS information, i.e. on the processing of differences in ENV and TFS at the two ears. The binaural processing of TFS information is adversely affected by both hearing loss and increasing age. The binaural processing of ENV information deteriorates somewhat with increasing age but is only slightly affected by hearing loss. The reduced TFS processing abilities found for older/hearing-impaired subjects may partially account for the difficulties that such subjects experience in complex listening situations when the target speech and interfering sounds come from different directions in space.

Reversal of Age-Related Changes in Cortical Sound-Azimuth Selectivity with Training

The compromised abilities to understand speech and localize sounds are two hallmark deficits in aged individuals. Earlier studies have shown that age-related deficits in cortical neural timing, which is clearly associated with speech perception, can be partially reversed with auditory training. However, whether training can reverse aged-related cortical changes in the domain of spatial processing has never been studied. In this study, we examined cortical spatial processing in ~21-month-old rats that were trained on a sound-azimuth discrimination task. We found that animals that experienced 1 month of training displayed sharper cortical sound-azimuth tuning when compared to the age-matched untrained controls. This training-induced remodeling in spatial tuning was paralleled by increases of cortical parvalbumin-labeled inhibitory interneurons. However, no measurable changes in cortical spatial processing were recorded in age-matched animals that were passively exposed to training sounds with no task demands. These results that demonstrate the effects of training on cortical spatial domain processing in the rodent model further support the notion that age-related changes in central neural process are, due to their plastic nature, reversible. Moreover, the results offer the encouraging possibility that behavioral training might be used to attenuate declines in auditory perception, which are commonly observed in older individuals.

Sensitivity to Interaural Phase in Older Hearing-Impaired Listeners Correlates With Nonauditory Trail Making Scores and With a Spatial Auditory Task of Unrelated Peripheral Origin

Interaural phase difference (IPD) discrimination upper frequency limits and just-noticeable differences (JNDs), interaural level difference (ILD) JNDs, and diotic intensity JNDs were measured for 20 older hearing-impaired listeners with matched moderate sloping to severe sensorineural hearing losses. The JNDs were measured using tone stimuli at 500 Hz. In addition to these auditory tests, the participants completed a cognitive test (Trail Making Test). Significant performance improvements in IPD discrimination were observed across test sessions. Strong correlations were found between IPD and ILD discrimination performance. Very strong correlations were observed between IPD discrimination and Trail Making performance as well as strong correlations between ILD discrimination and Trail Making performance. These relationships indicate that interindividual variability in IPD discrimination performance did not exclusively reflect deficits specific to any auditory processing, including early auditory processing of temporal information. The observed relationships between spatial audition and cognition may instead be attributable to a modality-general spatial processing deficit and/or individual differences in global processing speed.

Auditory Evoked Responses in Older Adults With Normal Hearing, Untreated, and Treated Age-Related Hearing Loss

OBJECTIVES

The goal of this study was to identify the effects of auditory deprivation (age-related hearing loss) and auditory stimulation (history of hearing aid use) on the neural registration of sound across two stimulus presentation conditions: (1) equal sound pressure level and (2) equal sensation level.

DESIGN

We used a between-groups design, involving three groups of 14 older adults (n = 42; 62 to 84 years): (1) clinically defined normal hearing (≤25 dB from 250 to 8000 Hz, bilaterally), (2) bilateral mild-moderate/moderately severe sensorineural hearing loss who have never used hearing aids, and (3) bilateral mild-moderate/moderately severe sensorineural hearing loss who have worn bilateral hearing aids for at least the past 2 years.

RESULTS

There were significant delays in the auditory P1-N1-P2 complex in older adults with hearing loss compared with their normal hearing peers when using equal sound pressure levels for all participants. However, when the degree and configuration of hearing loss were accounted for through the presentation of equal sensation level stimuli, no latency delays were observed. These results suggest that stimulus audibility modulates P1-N1-P2 morphology and should be controlled for when defining deprivation and stimulus-related neuroplasticity in people with hearing loss. Moreover, a history of auditory stimulation, in the form of hearing aid use, does not appreciably alter the neural registration of unaided auditory evoked brain activity when quantified by the P1-N1-P2.

CONCLUSIONS

When comparing auditory cortical responses in older adults with and without hearing loss, stimulus audibility, and not hearing loss-related neurophysiological changes, results in delayed response latency for those with age-related hearing loss. Future studies should carefully consider stimulus presentation levels when drawing conclusions about deprivation- and stimulation-related neuroplasticity. Additionally, auditory stimulation, in the form of a history of hearing aid use, does not significantly affect the neural registration of sound when quantified using the P1-N1-P2-evoked response.

Effects of Directional Microphone and Noise Reduction on Subcortical and Cortical Auditory-Evoked Potentials in Older Listeners With Hearing Loss

OBJECTIVES

Understanding how signal processing influences neural activity in the brain with hearing loss is relevant to the design and evaluation of features intended to alleviate speech-in-noise deficits faced by many hearing aid wearers. Here, we examine whether hearing aid processing schemes that are designed to improve speech-in-noise intelligibility (i.e., directional microphone and noise reduction) also improve electrophysiological indices of speech processing in older listeners with hearing loss.

DESIGN

The study followed a double-blind within-subjects design. A sample of 19 older adults (8 females; mean age = 73.6 years, range = 56-86 years; 17 experienced hearing aid users) with a moderate to severe sensorineural hearing impairment participated in the experiment. Auditory-evoked potentials associated with processing in cortex (P1-N1-P2) and subcortex (frequency-following response) were measured over the course of two 2-hour visits. Listeners were presented with sequences of the consonant-vowel syllable /da/ in continuous speech-shaped noise at signal to noise ratios (SNRs) of 0, +5, and +10 dB. Speech and noise stimuli were pre-recorded using a Knowles Electronics Manikin for Acoustic Research (KEMAR) head and torso simulator outfitted with hearing aids programmed for each listener's loss. The study aid programs were set according to 4 conditions: (1) omnidirectional microphone, (2) omnidirectional microphone with noise reduction, (3) directional microphone, and (4) directional microphone with noise reduction. For each hearing aid condition, speech was presented from a loudspeaker located at 1 m directly in front of KEMAR (i.e., 0° in the azimuth) at 75 dB SPL and noise was presented from a matching loudspeaker located at 1 m directly behind KEMAR (i.e., 180° in the azimuth). Recorded stimulus sequences were normalized for speech level across conditions and presented to listeners over electromagnetically shielded ER-2 ear-insert transducers. Presentation levels were calibrated to match the output of listeners' study aids.

RESULTS

Cortical components from listeners with hearing loss were enhanced with improving SNR and with use of a directional microphone and noise reduction. On the other hand, subcortical components did not show sensitivity to SNR or microphone mode but did show enhanced encoding of temporal fine structure of speech for conditions where noise reduction was enabled.

CONCLUSIONS

These results suggest that auditory-evoked potentials may be useful in evaluating the benefit of different noise-mitigating hearing aid features.

Bottom-up and top-down neural signatures of disordered multi-talker speech perception in adults with normal hearing

In social settings, speech waveforms from nearby speakers mix together in our ear canals. Normally, the brain unmixes the attended speech stream from the chorus of background speakers using a combination of fast temporal processing and cognitive active listening mechanisms. Of >100,000 patient records,~10% of adults visited our clinic because of reduced hearing, only to learn that their hearing was clinically normal and should not cause communication difficulties. We found that multi-talker speech intelligibility thresholds varied widely in normal hearing adults, but could be predicted from neural phase-locking to frequency modulation (FM) cues measured with ear canal EEG recordings. Combining neural temporal fine structure processing, pupil-indexed listening effort, and behavioral FM thresholds accounted for 78% of the variability in multi-talker speech intelligibility. The disordered bottom-up and top-down markers of poor multi-talker speech perception identified here could inform the design of next-generation clinical tests for hidden hearing disorders.

Predicting Speech Perception in Older Listeners with Sensorineural Hearing Loss Using Automatic Speech Recognition

The objective of this study was to provide proof of concept that the speech intelligibility in quiet of unaided older hearing-impaired (OHI) listeners can be predicted by automatic speech recognition (ASR). Twenty-four OHI listeners completed three speech-identification tasks using speech materials of varying linguistic complexity and predictability (i.e., logatoms, words, and sentences). An ASR system was first trained on different speech materials and then used to recognize the same speech stimuli presented to the listeners but processed to mimic some of the perceptual consequences of age-related hearing loss experienced by each of the listeners: the elevation of hearing thresholds (by linear filtering), the loss of frequency selectivity (by spectrally smearing), and loudness recruitment (by raising the amplitude envelope to a power). Independently of the size of the lexicon used in the ASR system, strong to very strong correlations were observed between human and machine intelligibility scores. However, large root-mean-square errors (RMSEs) were observed for all conditions. The simulation of frequency selectivity loss had a negative impact on the strength of the correlation and the RMSE. Highest correlations and smallest RMSEs were found for logatoms, suggesting that the prediction system reflects mostly the functioning of the peripheral part of the auditory system. In the case of sentences, the prediction of human intelligibility was significantly improved by taking into account cognitive performance. This study demonstrates for the first time that ASR, even when trained on intact independent speech material, can be used to estimate trends in speech intelligibility of OHI listeners.

Designing Supportive Soundscapes for Nursing Home Residents with Dementia

Sound and its resulting soundscape is a major appraisal component of the living environment. Where environmental sounds (e.g., outdoor traffic sounds) are often perceived as negative, a soundscape (e.g., containing natural sounds) can also have a positive effect on health and well-being. This supportive effect of a soundscape is getting increasing attention for use in practice. This paper addresses the design of a supportive sonic environment for persons with dementia in nursing homes. Starting from a review of key mechanisms related to sonic perception, cognitive deficits and related behavior, a framework is derived for the composition of a sonic environment for persons with dementia. The proposed framework is centered around using acoustic stimuli for influencing mood, stimulating the feeling of safety and triggering a response in a person. These stimuli are intended to be deployed as added sounds in a nursing home to improve the well-being and behavior of the residents.

Supra-threshold perception and neural representation of tones presented in noise in conditions of masking release

The neural representation and perceptual salience of tonal signals presented in different noise maskers were investigated. The properties of the maskers and signals were varied such that they produced different amounts of either monaural masking release, binaural masking release, or a combination of both. The signals were then presented at different levels above their corresponding masked thresholds and auditory evoked potentials (AEPs) were measured. It was found that, independent of the masking condition, the amplitude of the P2 component of the AEP was similar for the same stimulus levels above masked threshold, suggesting that both monaural and binaural effects of masking release were represented at the level of the auditory pathway where P2 is generated. The perceptual salience of the signal was evaluated at equal levels above masked threshold using a rating task. In contrast to the electrophysiological findings, the subjective ratings of the perceptual signal salience were less consistent with the signal level above masked threshold and varied strongly across listeners and masking conditions. Overall, the results from the present study suggest that the P2 amplitude of the AEP represents an objective indicator of the audibility of a target signal in the presence of complex acoustic maskers.

Discrimination of the phase of amplitude modulation applied to different carriers: Effects of modulation rate and modulation depth for young and older subjects

The discrimination of amplitude modulation (AM) from frequency modulation (FM) of a 1000-Hz carrier, with equally detectable AM and FM, is better for a 2-Hz than for a 10-Hz modulation rate. This might reflect greater sensitivity to temporal fine structure for low than for high rates. Alternatively, AM-FM discrimination may depend on comparing fluctuations in excitation level on the two sides of the excitation pattern, which are in phase for AM and out of phase for FM. Discrimination of the relative phase of fluctuations might worsen with increasing rate, which could account for the effect of rate on AM-FM discrimination. To test this, discrimination of the phase of AM applied to two sinusoidal carriers was assessed, with a band of noise between the two carriers to prevent use of within-channel cues. Young and older subjects with normal hearing were tested. Performance was almost constant for AM rates from 2 to 10 Hz, but worsened at 20 Hz. Performance was near chance for AM depths near the detection threshold. The results suggest that the superior AM-FM discrimination at 2 Hz cannot be explained in terms of comparison of the phase of fluctuations on the two sides of the excitation pattern.

Effects of Musical Training and Hearing Loss on Fundamental Frequency Discrimination and Temporal Fine Structure Processing: Psychophysics and Modeling

Several studies have shown that musical training leads to improved fundamental frequency (F0) discrimination for young listeners with normal hearing (NH). It is unclear whether a comparable effect of musical training occurs for listeners whose sensory encoding of F0 is degraded. To address this question, the effect of musical training was investigated for three groups of listeners (young NH, older NH, and older listeners with hearing impairment, HI). In a first experiment, F0 discrimination was investigated using complex tones that differed in harmonic content and phase configuration (sine, positive, or negative Schroeder). Musical training was associated with significantly better F0 discrimination of complex tones containing low-numbered harmonics for all groups of listeners. Part of this effect was caused by the fact that musicians were more robust than non-musicians to harmonic roving. Despite the benefit relative to their non-musicians counterparts, the older musicians, with or without HI, performed worse than the young musicians. In a second experiment, binaural sensitivity to temporal fine structure (TFS) cues was assessed for the same listeners by estimating the highest frequency at which an interaural phase difference was perceived. Performance was better for musicians for all groups of listeners and the use of TFS cues was degraded for the two older groups of listeners. These findings suggest that musical training is associated with an enhancement of both TFS cues encoding and F0 discrimination in young and older listeners with or without HI, although the musicians' benefit decreased with increasing hearing loss. Additionally, models of the auditory periphery and midbrain were used to examine the effect of HI on F0 encoding. The model predictions reflected the worsening in F0 discrimination with increasing HI and accounted for up to 80 % of the variance in the data.

Listening Difficulties in Children With Fetal Alcohol Spectrum Disorders: More Than a Problem of Audibility

Purpose Data from standardized caregiver questionnaires indicate that children with fetal alcohol spectrum disorders (FASDs) frequently exhibit atypical auditory behaviors, including reduced responsivity to spoken stimuli. Another body of evidence suggests that prenatal alcohol exposure may result in auditory dysfunction involving loss of audibility (i.e., hearing loss) and/or impaired processing of clearly audible, "suprathreshold" sounds necessary for sound-in-noise listening. Yet, the nexus between atypical auditory behavior and underlying auditory dysfunction in children with FASDs remains largely unexplored. Method To investigate atypical auditory behaviors in FASDs and explore their potential physiological bases, we examined clinical data from 325 children diagnosed with FASDs at the University of Washington using the FASD 4-Digit Diagnostic Code. Atypical behaviors reported on the "auditory filtering" domain of the Short Sensory Profile were assessed to document their prevalence across FASD diagnoses and explore their relationship to reported hearing loss and/or central nervous system measures of cognition, attention, and language function that may indicate suprathreshold processing deficits. Results Atypical auditory behavior was reported among 80% of children with FASDs, a prevalence that did not vary by FASD diagnostic severity or hearing status but was positively correlated with attention-deficit/hyperactivity disorder. In contrast, hearing loss was documented in the clinical records of 40% of children with fetal alcohol syndrome (FAS; a diagnosis on the fetal alcohol spectrum characterized by central nervous system dysfunction, facial dysmorphia, and growth deficiency), 16-fold more prevalent than for those with less severe FASDs (2.4%). Reported hearing loss was significantly associated with physical features characteristic of FAS. Conclusion Children with FAS but not other FASDs may be at a particular risk for hearing loss. However, listening difficulties in the absence of hearing loss-presumably related to suprathreshold processing deficits-are prevalent across the entire fetal alcohol spectrum. The nature and impact of both listening difficulties and hearing loss in FASDs warrant further investigation.

Cortical Correlates of Binaural Temporal Processing Deficits in Older Adults

OBJECTIVES

This study was designed to evaluate binaural temporal processing in young and older adults using a binaural masking level difference (BMLD) paradigm. Using behavioral and electrophysiological measures within the same listeners, a series of stimulus manipulations was used to evaluate the relative contribution of binaural temporal fine-structure and temporal envelope cues. We evaluated the hypotheses that age-related declines in the BMLD task would be more strongly associated with temporal fine-structure than envelope cues and that age-related declines in behavioral measures would be correlated with cortical auditory evoked potential (CAEP) measures.

DESIGN

Thirty adults participated in the study, including 10 young normal-hearing, 10 older normal-hearing, and 10 older hearing-impaired adults with bilaterally symmetric, mild-to-moderate sensorineural hearing loss. Behavioral and CAEP thresholds were measured for diotic (So) and dichotic (Sπ) tonal signals presented in continuous diotic (No) narrowband noise (50-Hz wide) maskers. Temporal envelope cues were manipulated by using two different narrowband maskers; Gaussian noise (GN) with robust envelope fluctuations and low-noise noise (LNN) with minimal envelope fluctuations. The potential to use temporal fine-structure cues was controlled by varying the signal frequency (500 or 4000 Hz), thereby relying on the natural decline in phase-locking with increasing frequency.

RESULTS

Behavioral and CAEP thresholds were similar across groups for diotic conditions, while the masking release in dichotic conditions was larger for younger than for older participants. Across all participants, BMLDs were larger for GN than LNN and for 500-Hz than for 4000-Hz conditions, where envelope and fine-structure cues were most salient, respectively. Specific age-related differences were demonstrated for 500-Hz dichotic conditions in GN and LNN, reflecting reduced binaural temporal fine-structure coding. No significant age effects were observed for 4000-Hz dichotic conditions, consistent with similar use of binaural temporal envelope cues across age in these conditions. For all groups, thresholds and derived BMLD values obtained using the behavioral and CAEP methods were strongly correlated, supporting the notion that CAEP measures may be useful as an objective index of age-related changes in binaural temporal processing.

CONCLUSIONS

These results demonstrate an age-related decline in the processing of binaural temporal fine-structure cues with preserved temporal envelope coding that was similar with and without mild-to-moderate peripheral hearing loss. Such age-related changes can be reliably indexed by both behavioral and CAEP measures in young and older adults.

Electrophysiological and Behavioral Evidence of Reduced Binaural Temporal Processing in the Aging and Hearing Impaired Human Auditory System

A person’s ability to process temporal fine structure information is indispensable for speech understanding. As speech understanding typically deteriorates throughout adult life, this study aimed to disentangle age and hearing impairment (HI)-related changes in binaural temporal processing. This was achieved by examining neural and behavioral processing of interaural phase differences (IPDs). Neural IPD processing was studied electrophysiologically through steady-state activity in the electroencephalogram evoked by periodic changes in IPDs over time, embedded in the temporal fine structure of acoustic stimulation. In addition, behavioral IPD discrimination thresholds were determined for the same stimuli. To disentangle potential effects of age from those of HI, both measures were applied to six participant groups: young, middle-aged, and older persons, with either normal hearing or sensorineural HI. All participants passed a cognitive screening, and stimulus audibility was controlled for in participants with HI. The results demonstrated that HI changes neural processing of binaural temporal information for all age-groups included in this study. These outcomes were revealed, superimposed on age-related changes that emerge between young adulthood and middle age. Poorer neural outcomes were also associated with poorer behavioral performance, even though the behavioral IPD discrimination thresholds were affected by age rather than by HI. The neural outcomes of this study are the first to evidence and disentangle the dual load of age and HI on binaural temporal processing. These results could be a valuable first step toward future research on rehabilitation.

Functional Age-Related Changes Within the Human Auditory System Studied by Audiometric Examination

Age related hearing loss (presbycusis) is one of the most common sensory deficits in the aging population. The main subjective ailment in the elderly is the deterioration of speech understanding, especially in a noisy environment, which cannot solely be explained by increased hearing thresholds. The examination methods used in presbycusis are primarily focused on the peripheral pathologies (e.g., hearing sensitivity measured by hearing thresholds), with only a limited capacity to detect the central lesion. In our study, auditory tests focused on central auditory abilities were used in addition to classical examination tests, with the aim to compare auditory abilities between an elderly group (elderly, mean age 70.4 years) and young controls (young, mean age 24.4 years) with clinically normal auditory thresholds, and to clarify the interactions between peripheral and central auditory impairments. Despite the fact that the elderly were selected to show natural age-related deterioration of hearing (auditory thresholds did not exceed 20 dB HL for main speech frequencies) and with clinically normal speech reception thresholds (SRTs), the detailed examination of their auditory functions revealed deteriorated processing of temporal parameters [gap detection threshold (GDT), interaural time difference (ITD) detection] which was partially responsible for the altered perception of distorted speech (speech in babble noise, gated speech). An analysis of interactions between peripheral and central auditory abilities, showed a stronger influence of peripheral function than temporal processing ability on speech perception in silence in the elderly with normal cognitive function. However, in a more natural environment mimicked by the addition of background noise, the role of temporal processing increased rapidly.

The Association Between the Processing of Binaural Temporal-Fine-Structure Information and Audiometric Threshold and Age: A Meta-Analysis

The ability to process binaural temporal fine structure (TFS) information, which influences the perception of speech in spatially distributed soundscapes, declines with increasing hearing loss and age. Because of the relatively small sample sizes used in previous studies, and the population-unrepresentative distribution of hearing loss and ages within study samples, it has been difficult to determine the relative and combined contributions of hearing loss and age. The aim of this study was to survey published and unpublished studies that assessed binaural TFS sensitivity using the TFS-low frequency (LF) test. Results from 19 studies were collated, yielding sample sizes of 147 to 648, depending on the test frequency. At least for the test frequency of 500 Hz, there were at least 67 listeners in each of four adult age groups and the distribution of audiometric thresholds at the test frequency within each group was similar to that for the population as a whole. Binaural TFS sensitivity declined with increasing age across the adult lifespan and with increasing hearing loss in old adulthood. For all test frequencies, both audiometric threshold and age were significantly negatively correlated with TFS-LF sensitivity (r ranging from −0.19 to −0.64) but the correlation was always significantly higher for age than for audiometric threshold. Regression analyses showed that the standardized regression coefficient was greater for age than for audiometric threshold, and that there was a significant interaction; the effect of increasing age among older listeners was greater when the hearing loss was ≥30 dB than when it was < 30 dB.

Effects of Age and Hearing Loss on the Discrimination of Amplitude and Frequency Modulation for 2- and 10-Hz Rates

Detection of frequency modulation (FM) with rate = 10 Hz may depend on conversion of FM to amplitude modulation (AM) in the cochlea, while detection of 2-Hz FM may depend on the use of temporal fine structure (TFS) information. TFS processing may worsen with greater age and hearing loss while AM processing probably does not. A two-stage experiment was conducted to test these ideas while controlling for the effects of detection efficiency. Stage 1 measured psychometric functions for the detection of AM alone and FM alone imposed on a 1-kHz carrier, using 2- and 10-Hz rates. Stage 2 assessed the discrimination of AM from FM at the same modulation rate when the detectability of the AM alone and FM alone was equated. Discrimination was better for the 2-Hz than for the 10-Hz rate for all young normal-hearing subjects and for some older subjects with normal hearing at 1 kHz. Other older subjects with normal hearing showed no clear difference in AM-FM discrimination for the 2- and 10-Hz rates, as was the case for most older hearing-impaired subjects. The results suggest that the ability to use TFS cues is reduced for some older people and most hearing-impaired people.

How aging impacts the encoding of binaural cues and the perception of auditory space

Over the years, the effect of aging on auditory function has been investigated in animal models and humans in an effort to characterize age-related changes in both perception and physiology. Here, we review how aging may impact neural encoding and processing of binaural and spatial cues in human listeners with a focus on recent work by the authors as well as others. Age-related declines in monaural temporal processing, as estimated from measures of gap detection and temporal fine structure discrimination, have been associated with poorer performance on binaural tasks that require precise temporal processing. In lateralization and localization tasks, as well as in the detection of signals in noise, marked age-related changes have been demonstrated in both behavioral and electrophysiological measures and have been attributed to declines in neural synchrony and reduced central inhibition with advancing age. Evidence for such mechanisms, however, are influenced by the task (passive vs. attending) and the stimulus paradigm (e.g., static vs. continuous with dynamic change). That is, cortical auditory evoked potentials (CAEP) measured in response to static interaural time differences (ITDs) are larger in older versus younger listeners, consistent with reduced inhibition, while continuous stimuli with dynamic ITD changes lead to smaller responses in older compared to younger adults, suggestive of poorer neural synchrony. Additionally, the distribution of cortical activity is broader and less asymmetric in older than younger adults, consistent with the hemispheric asymmetry reduction in older adults model of cognitive aging. When older listeners attend to selected target locations in the free field, their CAEP components (N1, P2, P3) are again consistently smaller relative to younger listeners, and the reduced asymmetry in the distribution of cortical activity is maintained. As this research matures, proper neural biomarkers for changes in spatial hearing can provide objective evidence of impairment and targets for remediation. Future research should focus on the development and evaluation of effective approaches for remediating these spatial processing deficits associated with aging and hearing loss.

Auditory cortex responses to interaural time differences in the envelope of low-frequency sound, recorded with MEG in young and older listeners

Interaural time and intensity differences (ITD and IID) are important cues in binaural hearing and allow for sound localization, improving speech understanding in noise and reverberation, and integrating sound sources in the auditory scene. Whereas previous research showed that the upper-frequency limit for ITD detection in the fine structure of sound declines in aging, the processing of envelope ITD in low-frequency amplitude modulated (AM) sound and the related brain responses are less understood. This study investigated the cortical processing of envelope ITD and compared the results with previous findings about the fine-structure ITD. In two experiments, participants listened to 40-Hz AM tones containing sudden changes in the envelope ITD. Multiple MEG responses were analyzed, including the auditory evoked N1 responses, elicited both by sound onsets and ITD changes, and 40-Hz responses, elicited by the AM. The first experiment with healthy young adults revealed a substantial decline in the magnitudes of the ITD change N1 response, and the 40-Hz phase resets at higher carrier frequencies, suggesting a similar frequency characteristic as observed for fine structure ITD. The amplitude of the 40-Hz ASSR declined only gradually with increasing carrier frequency, and it was excluded as a confounding factor in the decline in the ITD response. Larger responses to outward ITD changes than inward changes, here first reported for envelope ITD, were another characteristics that were similar to fine-structure ITD. A second experiment with groups of young and older listeners examined the effects of aging and concurrent noise on the cortical envelope ITD responses. One important research question was, whether binaural cues are accessible in noise. Behavioural tests showed an age-related hearing loss in the older group and decreased performance in envelope ITD detection and speech-in-noise (SIN) understanding. Binaural hearing and SIN performance were correlated with one other, but not with hearing loss. The frequency limit for envelope ITD was reduced in older listeners similarly as previously found for fine structure ITD, and older listeners were more susceptible to concurrent multi-talker noise. The similarities between responses to envelope ITD and to fine structure ITD suggest that a common cortical code exists for the envelope and fine structure ITD. The dependency on the carrier frequency suggests that envelope ITD processing at the subcortical level requires stimulus phase locking, which might be reduced in aging.

The effects of aging on auditory cortical function

Age-related hearing loss is a prominent deficit, afflicting approximately half of the geriatric population. In many cases, the person may have no deficits in detecting sounds, but nonetheless suffers from a reduced ability to understand speech, particularly in a noisy environment. While rodent models have shown that there are a variety of age-related changes throughout the auditory neuraxis, far fewer studies have investigated the effects at the cortical level. Here I review recent evidence from a non-human primate model of age-related hearing loss at the level of the core (primary auditory cortex, A1) and belt (caudolateral field, CL) in young and aged animals with normal detection thresholds. The findings are that there is an increase in both the spontaneous and driven activity, an increase in spatial tuning, and a reduction in the temporal fidelity of the response in aged animals. These results are consistent with an age-related imbalance of excitation and inhibition in the auditory cortex. These spatial and temporal processing deficits could underlie the major complaint of geriatrics, that it is difficult to understand speech in noise.

Robust Neuronal Discrimination in Primary Auditory Cortex Despite Degradations of Spectro-temporal Acoustic Details: Comparison Between Guinea Pigs with Normal Hearing and Mild Age-Related Hearing Loss

This study investigated to which extent the primary auditory cortex of young normal-hearing and mild hearing-impaired aged animals is able to maintain invariant representation of critical temporal-modulation features when sounds are submitted to degradations of fine spectro-temporal acoustic details. This was achieved by recording ensemble of cortical responses to conspecific vocalizations in guinea pigs with either normal hearing or mild age-related sensorineural hearing loss. The vocalizations were degraded using a tone vocoder. The neuronal responses and their discrimination capacities (estimated by mutual information) were analyzed at single recording and population levels. For normal-hearing animals, the neuronal responses decreased as a function of the number of the vocoder frequency bands, so did their discriminative capacities at the single recording level. However, small neuronal populations were found to be robust to the degradations induced by the vocoder. Similar robustness was obtained when broadband noise was added to exacerbate further the spectro-temporal distortions produced by the vocoder. A comparable pattern of robustness to degradations in fine spectro-temporal details was found for hearing-impaired animals. However, the latter showed an overall decrease in neuronal discrimination capacities between vocalizations in noisy conditions. Consistent with previous studies, these results demonstrate that the primary auditory cortex maintains robust neural representation of temporal envelope features for communication sounds under a large range of spectro-temporal degradations.

Effects of age on sensitivity to interaural time differences in envelope and fine structure, individually and in combination

Sensitivity to interaural time differences (ITDs) in envelope and temporal fine structure (TFS) of amplitude-modulated (AM) tones was assessed for young and older subjects, all with clinically normal hearing at the carrier frequencies of 250 and 500 Hz. Some subjects had hearing loss at higher frequencies. In experiment 1, thresholds for detecting changes in ITD were measured when the ITD was present in the TFS alone (ITD_TFS), the envelope alone (ITD_ENV), or both (ITD_TFS/ENV). Thresholds tended to be higher for the older than for the young subjects. ITD_ENV thresholds were much higher than ITD_TFS thresholds, while ITD_TFS/ENV thresholds were similar to ITD_TFS thresholds. ITD_TFS thresholds were lower than ITD thresholds obtained with an unmodulated pure tone, indicating that uninformative AM can improve ITD_TFS discrimination. In experiment 2, equally detectable values of ITD_TFS and ITD_ENV were combined so as to give consistent or inconsistent lateralization. There were large individual differences, but several subjects gave scores that were much higher than would be expected from the optimal combination of independent sources of information, even for the inconsistent condition. It is suggested that ITD_TFS and ITD_ENV cues are processed partly independently, but that both cues influence lateralization judgments, even when one cue is uninformative.

Age-Related Changes in Binaural Interaction at Brainstem Level

OBJECTIVES

Age-related hearing loss hampers the ability to understand speech in adverse listening conditions. This is attributed to a complex interaction of changes in the peripheral and central auditory system. One aspect that may deteriorate across the lifespan is binaural interaction. The present study investigates binaural interaction at the level of the auditory brainstem. It is hypothesized that brainstem binaural interaction deteriorates with advancing age.

DESIGN

Forty-two subjects of various age participated in the study. Auditory brainstem responses (ABRs) were recorded using clicks and 500 Hz tone-bursts. ABRs were elicited by monaural right, monaural left, and binaural stimulation. Binaural interaction was investigated in two ways. First, grand averages of the binaural interaction component were computed for each age group. Second, wave V characteristics of the binaural ABR were compared with those of the summed left and right ABRs.

RESULTS

Binaural interaction in the click ABR was demonstrated by shorter latencies and smaller amplitudes in the binaural compared with the summed monaural responses. For 500 Hz tone-burst ABR, no latency differences were found. However, amplitudes were significantly smaller in the binaural than summed monaural condition. An age-effect was found for 500 Hz tone-burst, but not for click ABR.

CONCLUSIONS

Brainstem binaural interaction seems to decline with age. Interestingly, these changes seem to be stimulus-dependent.