Auditory Electrophysiological and Perceptual Measures in Student Musicians with High Sound Exposure

A scoping review of the prevalence of musicians' hearing loss

Introduction

Hearing loss is the most commonly recognized occupational disease in Germany. Musicians are also affected, as playing classical music can expose them to high or very high sound volumes. With this scoping review, we aimed to assess the prevalence of noise-induced hearing loss among professional musicians and evaluate its characteristics.

Methods

The databases such as MEDLINE, Embase, Cochrane Library, and Google Scholar were searched using the terms (hearing loss OR hearing impairment OR hearing difficulties OR acoustic trauma) AND (musician) on 14 August 2023 and 2 January 2025. Only original studies with audiometric examination results were included.

Results

A total of 79 studies were retrieved for descriptive analysis. The median number of participants was 52 (IQR 30-109). The majority of the retrieved studies included participants with at least 5 years of experience as practicing musicians. The proportion of men was significantly higher than that of women, with the medianmen portion of 69% (IQR 53-83%). Students were a common study population, indicating that the data on older and retired musicians were either rare or missing. As a result, the lifetime prevalence of hearing loss in musicians could not be determined. The data analysis showed an increased risk of hearing loss >15-20 dB in the frequency range of 4,000-6,000 Hz among participants in the classical genre group. Studies with participants having normal hearing were also found within that genre. Rock, pop, and jazz musicians had an increased risk of hearing loss >20 dB in the frequency range of 3,000-8,000 Hz. The data for military and marching band music and traditional music genres were limited. The retrieved studies indicated a higher risk of hearing loss >20 dB in the frequency range of 4,000-6,000 Hz. A total of 17 studies adjusted the audiogram results for age, 2 did not, and 59 had no report. Data extraction yielded a prevalence of notch configurations in 20-50% of the classical musicians, with hearing loss affecting 5-70% of them. Up to 40% of rock, pop, and jazz musicians showed notch configurations, with 20-60% experiencing hearing loss.

Conclusion

Overall, a definitive assessment of the prevalence of musicians' hearing loss cannot be drawn from the available data. Prospective, longitudinal studies with reliable sample sizes and representative populations are essential. A multicenter study would also be valuable.

Vestibulocochlear system and quality of life in musicians: a study on the effects of auditory exposure

PURPOSE

To evaluate and compare the effects of sound exposure on the vestibulocochlear system and the quality of life among musicians.

METHODS

Fifty-six individuals participated, including 28 musicians and 28 non-musicians, aged 18 to 45 years, of both genders. Participants underwent medical history assessment, basic audiological evaluation, vestibular evoked myogenic potential (VEMP), and exclusively, WHOQOL-Bref questionnaire.

RESULTS

Professional and enthusiast musicians participated, showing increased auditory thresholds at 3 and 4 kHz frequencies and considerably satisfactory quality of life. There was significance in cervical VEMP latencies and the latency of the P15 wave in the left ocular VEMP of the study group compared to the control group. VEMP demonstrated larger waves bilaterally in men compared to women.

CONCLUSION

It was concluded that sound exposure, within tolerance limits in terms of time and intensity, was capable of providing auditory, vestibular, and quality of life benefits for musicians.

Effects of high-intensity chronic noise on spatial memory in male versus female rats

The detrimental effects of high-intensity noise on the auditory system and emotional status, including the induction of anxiety, are well documented. Preclinical as well as epidemiological and clinical studies have solidly established differential responses between males and females to various stressful stimuli, including high-intensity white noise (HIWN). However, whether chronic exposure to noise affects cognitive functions and whether this effect is sex dependent has not been adequately addressed. In this study, we used two cognitive test paradigms, such as the Morris water maze (MWM) and the multi-branch maze (MBM), to test the effect of chronic HIWN on indices of spatial learning and memory in both male and female Wistar rats. Our findings indicate that daily (1 h) exposure to 100 dB of noise for 30 consecutive days induces different task-dependent responses in male versus female rats. For example, in the acquisition phase of MWM, female rats exposed to noise outperformed their male counterparts at twice the speed. Similarly, in the MBM test, noise-exposed female rats outperformed the male rats in reaching the nest box. It is clear from these studies that noise impairs cognitive functions twice as negatively in male rats as in female rats. Thus, sex-related differences in spatial learning and memory in response to HIWN must be taken into consideration when investigating the neurobiological components and/or treatment modalities.

Effects of age and noise exposure history on auditory nerve response amplitudes: A systematic review, study, and meta-analysis

Auditory nerve (AN) function has been hypothesized to deteriorate with age and noise exposure. Here, we perform a systematic review of published studies and find that the evidence for age-related deficits in AN function is largely consistent across the literature, but there are inconsistent findings among studies of noise exposure history. Further, evidence from animal studies suggests that the greatest deficits in AN response amplitudes are found in noise-exposed aged mice, but a test of the interaction between effects of age and noise exposure on AN function has not been conducted in humans. We report a study of our own examining differences in the response amplitude of the compound action potential N1 (CAP N1) between younger and older adults with and without a self-reported history of noise exposure in a large sample of human participants (63 younger adults 18-30 years of age, 103 older adults 50-86 years of age). CAP N1 response amplitudes were smaller in older than younger adults. Noise exposure history did not appear to predict CAP N1 response amplitudes, nor did the effect of noise exposure history interact with age. We then incorporated our results into two meta-analyses of published studies of age and noise exposure history effects on AN response amplitudes in neurotypical human samples. The meta-analyses found that age effects across studies are robust (r = -0.407), but noise exposure effects are weak (r = -0.152). We conclude that noise exposure effects may be highly variable depending on sample characteristics, study design, and statistical approach, and researchers should be cautious when interpreting results. The underlying pathology of age-related and noise-induced changes in AN function are difficult to determine in living humans, creating a need for longitudinal studies of changes in AN function across the lifespan and histological examination of the AN from temporal bones collected post-mortem.

Effects of Age and Noise Exposure History on Auditory Nerve Response Amplitudes: A Systematic Review, Study, and Meta-Analysis

Auditory nerve (AN) function has been hypothesized to deteriorate with age and noise exposure. Here, we perform a systematic review of published studies and find that the evidence for age-related deficits in AN function is largely consistent across the literature, but there are inconsistent findings among studies of noise exposure history. Further, evidence from animal studies suggests that the greatest deficits in AN response amplitudes are found in noise-exposed aged mice, but a test of the interaction between effects of age and noise exposure on AN function has not been conducted in humans. We report a study of our own examining differences in the response amplitude of the compound action potential N1 (CAP N1) between younger and older adults with and without a self-reported history of noise exposure in a large sample of human participants (63 younger adults 18-30 years of age, 103 older adults 50-86 years of age). CAP N1 response amplitudes were smaller in older than younger adults. Noise exposure history did not appear to predict CAP N1 response amplitudes, nor did the effect of noise exposure history interact with age. We then incorporated our results into two meta-analyses of published studies of age and noise exposure history effects on AN response amplitudes in neurotypical human samples. The meta-analyses found that age effects across studies are robust (r=-0.407), but noise-exposure effects are weak (r=-0.152). We conclude that noise-exposure effects may be highly variable depending on sample characteristics, study design, and statistical approach, and researchers should be cautious when interpreting results. The underlying pathology of age-related and noise-induced changes in AN function are difficult to determine in living humans, creating a need for longitudinal studies of changes in AN function across the lifespan and histological examination of the AN from temporal bones collected post-mortem.