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Graterón E, Scaglione T, Airen S, Goncalves S, Ceballos SA, Baguley D, Chiossone JA. Transient decrease in sound tolerance levels following hearing deprivation in normal-hearing subjects. J Otol 2022; 17:232-238. [PMID: 36249923 PMCID: PMC9547106 DOI: 10.1016/j.joto.2022.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 08/30/2022] [Accepted: 09/04/2022] [Indexed: 11/19/2022] Open
Affiliation(s)
- Eleazar Graterón
- Fundación Venezolana de Otología, Clinical Research Group, Venezuela
| | - Tricia Scaglione
- University of Miami, Department of Otolaryngology, USA
- Corresponding author. 8100 SW 10th Ave, Crossroads Business Park Bldg 3, Floor 3, Plantation, FL, 33322, USA.
| | - Shriya Airen
- University of Miami, Department of Otolaryngology, USA
| | | | - Sinay A. Ceballos
- Fundación Venezolana de Otología, Clinical Research Group, Venezuela
| | | | - Juan A. Chiossone
- Fundación Venezolana de Otología, Clinical Research Group, Venezuela
- University of Miami, Department of Otolaryngology, USA
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Liu X, Li L, Chen GD, Salvi R. How low must you go? Effects of low-level noise on cochlear neural response. Hear Res 2020; 392:107980. [DOI: 10.1016/j.heares.2020.107980] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Revised: 04/17/2020] [Accepted: 04/21/2020] [Indexed: 10/24/2022]
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Aazh H, Moore BCJ. Factors related to uncomfortable loudness levels for patients seen in a tinnitus and hyperacusis clinic. Int J Audiol 2017. [PMID: 28622055 DOI: 10.1080/14992027.2017.1335888] [Citation(s) in RCA: 58] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
OBJECTIVES The aims were as follows: (1) to explore patterns of uncomfortable loudness levels (ULLs) across frequency and their associated factors for patients with tinnitus and hyperacusis, and (2) to re-evaluate the criteria for diagnosing hyperacusis based on ULLs and scores for the Hyperacusis Questionnaire (HQ). DESIGN This was a retrospective cross-sectional study. STUDY SAMPLE 573 consecutive patients for whom ULLs had been measured were included. RESULTS A good correspondence between the diagnosis of hyperacusis based on the across-frequency average ULL for the ear with the lowest ULLs (ULLmin) and hyperacusis handicap based on HQ scores was obtained with cut-off values of ULLmin ≤77 dB HL and HQ score ≥ 22. A regression model showed significant relationships between ULLmin and the score on the HQ and age. The mean HQ score for patients with a large interaural asymmetry in ULLs was significantly higher than for the remainder. Hyperacusis handicap was associated with strong across-frequency variations in ULLs. CONCLUSIONS Appropriate cut-off values for diagnosing hyperacusis are ULLmin ≤77 dB HL and HQ score ≥22. Large interaural asymmetry and large across-frequency variations in ULLs are associated with higher HQ scores.
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Affiliation(s)
- Hashir Aazh
- a Audiology Department , Royal Surrey County Hospital NHS Foundation Trust , Guildford , UK and
| | - Brian C J Moore
- b Department of Experimental Psychology , University of Cambridge , Cambridge , UK
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Abstract
A structured counseling protocol is described that, when combined with low-level broadband sound therapy from bilateral sound generators, offers audiologists a new tool for facilitating the expansion of the auditory dynamic range (DR) for loudness. The protocol and its content are specifically designed to address and treat problems that impact hearing-impaired persons who, due to their reduced DRs, may be limited in the use and benefit of amplified sound from hearing aids. The reduced DRs may result from elevated audiometric thresholds and/or reduced sound tolerance as documented by lower-than-normal loudness discomfort levels (LDLs). Accordingly, the counseling protocol is appropriate for challenging and difficult-to-fit persons with sensorineural hearing losses who experience loudness recruitment or hyperacusis. Positive treatment outcomes for individuals with the former and latter conditions are highlighted in this issue by incremental shifts (improvements) in LDL and/or categorical loudness judgments, associated reduced complaints of sound intolerance, and functional improvements in daily communication, speech understanding, and quality of life leading to improved hearing aid benefit, satisfaction, and aided sound quality, posttreatment.
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Affiliation(s)
- Susan L Gold
- Retired; formerly affiliated with the University of Maryland Tinnitus and Hyperacusis Center, Baltimore, Maryland
| | - Craig Formby
- Department of Communicative Disorders, University of Alabama, Tuscaloosa, Alabama
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Formby C, Payne J, Yang X, Wu D, Parton JM. Repeated Measurement of Absolute and Relative Judgments of Loudness: Clinical Relevance for Prescriptive Fitting of Aided Target Gains for soft, Comfortable, and Loud, But Ok Sound Levels. Semin Hear 2017; 38:26-52. [PMID: 28286363 DOI: 10.1055/s-0037-1598064] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
This study was undertaken with the purpose of streamlining clinical measures of loudness growth to facilitate and enhance prescriptive fitting of nonlinear hearing aids. Repeated measures of loudness at 500 and 3,000 Hz were obtained bilaterally at monthly intervals over a 6-month period from three groups of young adult listeners. All volunteers had normal audiometric hearing sensitivity and middle ear function, and all denied problems related to sound tolerance. Group 1 performed judgments of soft and loud, but OK for presentation of ascending sound levels. We defined these judgments operationally as absolute judgments of loudness. Group 2 initially performed loudness judgments across a continuum of seven loudness categories ranging from judgments of very soft to uncomfortably loud for presentation of ascending sound levels per the Contour Test of Loudness; we defined these judgments as relative judgments of loudness. In the same session, they then performed the absolute judgments for soft and loud, but OK sound levels. Group 3 performed the same set of loudness judgments as did group 2, but the task order was reversed such that they performed the absolute judgments initially within each test session followed by the relative judgments. The key findings from this study were as follows: (1) Within group, the absolute and relative tasks yielded clinically similar judgments for soft and for loud, but OK sound levels. These judgments were largely independent of task order, ear, frequency, or trial order within a given session. (2) Loudness judgments increased, on average, by ∼3 dB between the first and last test session, which is consistent with the commonly reported acclimatization effect reported for incremental changes in loudness discomfort levels as a consequence of chronic bilateral hearing aid use. (3) Measured and predicted comfortable judgments of loudness were in good agreement for the individual listener and for groups of listeners. These comfortable judgments bisect the measured levels judged for soft and for loud, but OK sounds. (4) Loudness judgments within the same loudness category varied across listeners within group by as much as 50 to 60 dB. Such large variation in judgments of loudness is problematic, especially because hearing-impaired listeners are known to exhibit similarly large ranges of intersubject response variation and, yet, poplar prescriptive fitting strategies continue to use average rather than individual loudness data to fit nonlinear hearing aids. The primary conclusions drawn from these findings are that reliable absolute judgments of soft and loud, but OK are clinically practical and economical to measure and, from these judgments, good estimates of comfortable loudness can also be predicted for individuals or for groups of listeners. Such loudness data, as measured as described in this report, offer promise for streamlining and enhancing prescriptive fitting of nonlinear hearing aids to target gain settings for soft (audible), comfortable, and loud, but OK (tolerable) sound inputs for the individual listener.
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Affiliation(s)
- Craig Formby
- Department of Communicative Disorders, University of Alabama, Tuscaloosa, Alabama
| | - JoAnne Payne
- Department of Communicative Disorders, University of Alabama, Tuscaloosa, Alabama
| | - Xin Yang
- Statistics Research and Consulting Lab, Department of Information Systems, Statistics, and Management Science, Culverhouse College of Commerce, University of Alabama, Tuscaloosa, Alabama
| | - Delphanie Wu
- Department of Communicative Disorders, University of Alabama, Tuscaloosa, Alabama
| | - Jason M Parton
- Statistics Research and Consulting Lab, Department of Information Systems, Statistics, and Management Science, Culverhouse College of Commerce, University of Alabama, Tuscaloosa, Alabama
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Formby C, Korczak P, Sherlock LP, Hawley ML, Gold S. Auditory Brainstem and Middle Latency Responses Measured Pre- and Posttreatment for Hyperacusic Hearing-Impaired Persons Successfully Treated to Improve Sound Tolerance and to Expand the Dynamic Range for Loudness: Case Evidence. Semin Hear 2017; 38:71-93. [PMID: 28286365 DOI: 10.1055/s-0037-1598066] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
In this report of three cases, we consider electrophysiologic measures from three hyperacusic hearing-impaired individuals who, prior to treatment to expand their dynamic ranges for loudness, were problematic hearing aid candidates because of their diminished sound tolerance and reduced dynamic ranges. Two of these individuals were treated with structured counseling combined with low-level broadband sound therapy from bilateral sound generators and the third case received structured counseling in combination with a short-acting placebo sound therapy. Each individual was highly responsive to his or her assigned treatment as revealed by expansion of the dynamic range by at least 20 dB at one or more frequencies posttreatment. Of specific interest in this report are their latency and amplitude measures taken from tone burst-evoked auditory brainstem response (ABR) and cortically derived middle latency response (MLR) recordings, measured as a function of increasing loudness at 500 and 2,000 Hz pre- and posttreatment. The resulting ABR and MLR latency and amplitude measures for each case are considered here in terms of pre- and posttreatment predictions. The respective pre- and posttreatment predictions anticipated larger pretreatment response amplitudes and shorter pretreatment response latencies relative to typical normal control values and smaller normative-like posttreatment response amplitudes and longer posttreatment response latencies relative to the corresponding pretreatment values for each individual. From these results and predictions, we conjecture about the neural origins of the hyperacusis conditions (i.e., brainstem versus cortical) and the neuronal sites responsive to treatment. The only consistent finding in support of the pre- and posttreatment predictions and, thus, the strongest index of hyperacusis and positive treatment-related effects was measured for MLR latency responses for wave Pa at 2,000 Hz. Other response indices, including ABR wave V latency and wave V-V' amplitude and MLR wave Na-Pa amplitude for 500 and 2,000 Hz, appear either ambiguous across and/or within these individuals. Notwithstanding significant challenges for interpreting these findings, including associated confounding effects of their sensorineural hearing losses and differences in the presentation levels of the toneburst stimuli used to collect these measures for each individual, our limited analyses of three cases suggest measures of MLR wave Pa latency at 2,000 Hz (reflecting cortical contributions) may be a promising objective indicator of hyperacusis and dynamic range expansion treatment effects.
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Affiliation(s)
- Craig Formby
- Department of Communicative Disorders, University of Alabama, Tuscaloosa, Alabama
| | - Peggy Korczak
- Department of Audiology, Speech Language Pathology, and Deaf Studies, Towson University, Towson, Maryland
| | - LaGuinn P Sherlock
- Army Hearing Division, United State Army Public Health Center (Provisional), Aberdeen Proving Ground, Aberdeen, Maryland; National Military Audiology and Speech Pathology Center, Walter Reed National Military Medical Center, Bethesda, Maryland
| | - Monica L Hawley
- Department of Otolaryngology-HNS, University of Iowa, Iowa City, Iowa
| | - Susan Gold
- University of Maryland Tinnitus and Hyperacusis Center (retired), Columbia, Maryland
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Pienkowski M, Tyler RS, Roncancio ER, Jun HJ, Brozoski T, Dauman N, Coelho CB, Andersson G, Keiner AJ, Cacace AT, Martin N, Moore BCJ. A review of hyperacusis and future directions: part II. Measurement, mechanisms, and treatment. Am J Audiol 2014; 23:420-36. [PMID: 25478787 DOI: 10.1044/2014_aja-13-0037] [Citation(s) in RCA: 73] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2013] [Accepted: 02/21/2014] [Indexed: 12/24/2022] Open
Abstract
PURPOSE Hyperacusis can be extremely debilitating, and at present, there is no cure. In this detailed review of the field, we consolidate present knowledge in the hope of facilitating future research. METHOD We review and reference the literature on hyperacusis and related areas. This is the 2nd of a 2-part review. RESULTS Hyperacusis encompasses a wide range of reactions to sounds, which can be grouped into the categories of excessive loudness, annoyance, fear, and pain. Reasonable approaches to assessing the different forms of hyperacusis are emerging, including brain-imaging studies. Researchers are only beginning to understand the many mechanisms at play, and valid animal models are still evolving. There are many counseling and sound-therapy approaches that some patients find helpful, but well-controlled studies are needed to measure their long-term efficacy and to test new approaches. CONCLUSIONS Hyperacusis can make life difficult in this increasingly noisy world, forcing sufferers to dramatically alter their work and social habits. We believe this is an opportune time to explore approaches to better understand and treat hyperacusis.
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Affiliation(s)
| | | | | | | | - Tom Brozoski
- Southern Illinois University School of Medicine, Springfield
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Fournier P, Schönwiesner M, Hébert S. Loudness modulation after transient and permanent hearing loss: implications for tinnitus and hyperacusis. Neuroscience 2014; 283:64-77. [PMID: 25135356 DOI: 10.1016/j.neuroscience.2014.08.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2014] [Revised: 08/06/2014] [Accepted: 08/07/2014] [Indexed: 11/19/2022]
Abstract
Loudness is the primary perceptual correlate of sound intensity. The relationship between sound intensity and loudness is not fixed, and can be modified by short-term sound deprivation or stimulation. Deprivation increases sound sensitivity, whereas stimulation decreases it. We review the effects of short-term auditory deprivation and stimulation on the auditory central nervous system of humans and animals, and we extend the discussion to permanent auditory deprivation (hearing loss) and auditory pathologies of loudness perception. Although there is sufficient evidence to conclude that loudness can be modulated in normal hearing listeners by temporary sound deprivation and stimulation, evidence is scanter for the hearing-impaired listeners. In addition, cortical effects of sound deprivation and stimulation in humans, which may correlate with loudness coding, are still largely unknown and should be the target of future research.
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Affiliation(s)
- P Fournier
- School of Speech Pathology and Audiology, Université de Montréal, Montréal, Québec, Canada; International Laboratory for Research on Brain, Music, and Sound (BRAMS), Université de Montréal, Montréal, Québec, Canada; Centre de recherche de l'Institut Universitaire de Gériatrie de Montréal (CRIUGM), Montréal, Québec, Canada
| | - M Schönwiesner
- International Laboratory for Research on Brain, Music, and Sound (BRAMS), Université de Montréal, Montréal, Québec, Canada; Department of Psychology, Université de Montréal, Montréal, Québec, Canada
| | - S Hébert
- School of Speech Pathology and Audiology, Université de Montréal, Montréal, Québec, Canada; International Laboratory for Research on Brain, Music, and Sound (BRAMS), Université de Montréal, Montréal, Québec, Canada; Centre de recherche de l'Institut Universitaire de Gériatrie de Montréal (CRIUGM), Montréal, Québec, Canada.
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Munro KJ, Merrett JF. Brainstem plasticity and modified loudness following short-term use of hearing aids. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2013; 133:343-349. [PMID: 23297907 DOI: 10.1121/1.4770234] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Previous research has shown that the threshold of the middle ear acoustic reflex is modified in adult listeners following 1 week of continuous monaural sensory deprivation [Munro and Blount, J. Acoust. Soc. Am. 126, 568-571 (2009)]. The results of the present study provide evidence of plasticity in the brainstem of adult listeners following monaural auditory stimulation. Acoustic reflexes were obtained at a higher sound pressure level in the ear that had been fitted with a low-gain hearing aid for 5 days. These changes are in the opposite direction to those reported after sensory deprivation and are consistent with a gain control mechanism mediated by a process within the brainstem. Stimuli were reported as less loud after hearing aid use but the relationship with changes to the acoustic reflex threshold was not statistically significant.
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Affiliation(s)
- Kevin J Munro
- School of Psychological Sciences, University of Manchester, Manchester M13 9PL, United Kingdom.
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Noreña AJ. Stimulating the Auditory System to Treat Tinnitus: From Alleviating the Symptoms to Addressing the Causes. SPRINGER HANDBOOK OF AUDITORY RESEARCH 2012. [DOI: 10.1007/978-1-4614-3728-4_10] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
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Noreña AJ. An integrative model of tinnitus based on a central gain controlling neural sensitivity. Neurosci Biobehav Rev 2011; 35:1089-109. [PMID: 21094182 DOI: 10.1016/j.neubiorev.2010.11.003] [Citation(s) in RCA: 285] [Impact Index Per Article: 21.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2010] [Revised: 10/20/2010] [Accepted: 11/12/2010] [Indexed: 02/03/2023]
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