Auditory Test Research Articles

Hearing Loss and Cognitive Decline in the Aging Population: Emerging Perspectives in Audiology.

In this perspective article, the author explores the connections between hearing loss, central auditory processing, and cognitive decline, offering insights into the complex dynamics at play. Drawing upon a range of studies, the relationship between age-related central auditory processing disorders and Alzheimer's disease is discussed, with the aim of enhancing our understanding of these interconnected conditions. Highlighting the evolving significance of audiologists in the dual management of cognitive health and hearing impairments, the author focuses on their role in identifying early signs of cognitive impairment and evaluates various cognitive screening tools used in this context. The discussion extends to adaptations of hearing assessments for older adults, especially those diagnosed with dementia, and highlights the significance of objective auditory electrophysiological tests. These tests are presented as vital in assessing the influence of aging and Alzheimer's disease on auditory processing capabilities and to signal cognitive dysfunction. The article underscores the critical role of audiologists in addressing the challenges faced by the aging population. The perspective calls for further research to improve diagnostic and therapeutic strategies in audiology, and emphasizes the need for a multidisciplinary approach in tackling the nexus of hearing loss, auditory processing, and cognitive decline.

Development of Persian Monosyllabic and Disyllabic Words for Auditory Test of Adults and Evaluation of Their Face Validity Using Psychometric Function

Background and Aim: The utilization of speech materials in audiological assessments has faced challenges due to a lack of standardization and insufficient consideration of acoustic factors. This study aimed to develop a set of psychometrically validated monosyllabic and disyllabic words in Persian for use in auditory tests. Methods: This cross-sectional study involved collecting the most frequently used one- and two-syllable words from Persian dictionaries. A panel of experts evaluated the selected words using a 4-point Likert scale. Based on their recommendations, 382 monosyllabic words and 150 disyllabic words met the established criteria. Male and female talkers recorded these words, which were then presented in a random order to 30 young adults with normal hearing (aged 18–30 years). The presentation intensity levels ranged from 0 to 48 dB HL with 8 dB increments. Logistic regression was used to determine the psychometric properties of the words. Results: As the intensity level increased, the percentage of word recognition scores also increased, reaching 100% at an intensity level of 48 dB HL. For Persian monosyllabic words, the mean psychometric slope was 0.29 %/dB for male talkers and 0.25 %/dB for female talkers. The corresponding slopes for Persian disyllabic words were 0.23 %/dB and 0.21 %/dB, respectively. Conclusion: This study successfully developed 382 monosyllabic words and 150 disyllabic words in Persian with comparable psychometric properties. These words can be utilized in auditory tests for Iranian adults. Keywords: Monosyllabic words; disyllabic words; psychometric‏ ‏function; logistic regression; Persian speech materials

Is It Possible to Use the Speech-Evoked Auditory Brainstem Response Test During Sleep as It Is Used During Wakefulness?

Background and Aim: It is important to know how much are the auditory electrophysi- ological tests affected by sleep and wakefulness to be employed in different situations. This problem is more important for the speech-evoked Auditory Brainstem Response (speech- ABR) test that is affected by higher-level processing. This study aimed to compare the results of the speech-ABR test between wakefulness and sleep states. Methods: Sixteen young male adults (aged 20–28 years) with normal hearing participated in this study. The speech-ABR to the /da/ syllable was recorded during wakefulness and sleep. Electroencephalography (EEG) and behavioral tests (eyes position, body movements, etc.) were monitored during the test time to confirm the sleep state. Results: The speech-ABR test parameters showed significant changes during sleep compared to wakefulness (latencies of waves V and A were longer and the amplitudes of waves V and A, the slope of V-A complex, and the spectral magnitude of F1 were lower). However, the spectral magnitude of higher frequencies was not significantly different. In addition, no significant statistical difference was observed in speech-ABR parameters between right and left ears. Conclusion: Although the speech-ABR originates from brainstem centers, unlike conventional click-evoked ABR, it is affected by sleep as it is affected by the higher-level auditory processing functions. Although, further studies are needed. However, our study opens the way for many applied auditory studies about the possibility to use speech-ABR for auditory processing assessments in sleep state of different population groups, such as neonates. Keywords: Auditory brainstem response; speech acoustics; sleep; electroencephalography

Influence of Speech Rate on Auditory Recognition in Cochlear Implant Users

Introduction: This study aimed to verify the influence of speech stimulus presentation and speed on auditory recognition in cochlear implant (CI) users with poorer performance. Methods: The cross-sectional observational study applied auditory speech perception tests to fifteen adults, using three different ways of presenting the stimulus, in the absence of competitive noise: monitored live voice (MLV); recorded speech at typical speed (RSTS); recorded speech at slow speed (RSSS). The scores were assessed using the Percent Sentence Recognition Index (PSRI). The data were inferentially analysed using the Friedman and Wilcoxon tests with a 95% confidence interval and 5% significance level (p < 0.05). Results: The mean age was 41.1 years, the mean duration of CI use was 11.4 years, and the mean hearing threshold was 29.7 ± 5.9 dBHL. Test performance, as determined by the PSRI, was MLV = 42.4 ± 17.9%; RSTS = 20.3 ± 14.3%; RSSS = 40.6 ± 20.7%. There was a significant difference identified for RSTS compared to MLV and RSSS. Conclusion: The way the stimulus is presented and the speed at which it is presented enable greater auditory speech recognition in CI users, thus favouring comprehension when the tests are applied in the MLV and RSSS modalities.

Sustained Effectiveness and Safety Over Time of Teriflunomide in Chinese Patients with Relapsing Multiple Sclerosis in the Greater Bay Area of China: Insights from Real-World Data.

The real-world data on the medium- to long-term effectiveness and safety of teriflunomide in Chinese patients with relapsing multiple sclerosis (MS) is limited. Therefore, this study aims to assess the treatment outcomes of teriflunomide in Chinese patients with MS over a medium- to long-term period. This cohort study was carried out in three tertiary hospitals and regional MS centers located in the Greater Bay Area of China. We obtained the historical clinical data of patients who underwent teriflunomide treatment for at least 6months. The primary objective was to evaluate the proportion of patients achieving no evidence of disease activity (NEDA)-3 status, which is characterized by the absence of relapses, confirmed disability worsening, and new or enlarging MRI lesions, over time. Secondary objectives included assessing the proportion of patients meeting each NEDA-3 criterion, changes in motor and cognitive function, as well as the incidence of adverse events and treatment discontinuations. A total of 160 patients with MS were enrolled, including 125 patients treated with teriflunomide for at least 1year (≥ 1-year completers) and 71 patients treated for at least 2years (≥ 2-year completers). A total of 85.63% of the overall population achieved clinical NEDA-3 status at 6months of teriflunomide treatment, and 71.20% of ≥ 1-year completers achieved NEDA-3 status at 12months of teriflunomide treatment. The median timed 25-foot walk test (T25FW), nine-hole peg test (9-HPT), and paced auditory serial addition test (PASAT) results were relatively stable before and after treatment. Medium- to long-term MS disease activity, as indicated by NEDA-3 status, is well controlled in patients treated with continuous teriflunomide treatment in real-world settings.

The influence of depression and anxiety on cognition in people with multiple sclerosis: a cross-sectional analysis.

There are conflicting findings about the relationships between depression, anxiety, and cognitive dysfunction in people with multiple sclerosis (MS), and a paucity of research has examined the cumulative influence on cognition of depression plus anxiety. This study aimed to determine whether elevated symptoms of depression and anxiety alone or in combination are associated with worse cognition in people with MS. In this cross-sectional analysis, people with MS consecutively seen at a tertiary neuropsychiatry clinic completed the Hospital Anxiety and Depression Scale for symptoms of depression (HADS-D) and anxiety (HADS-A), and the Minimal Assessment of Cognitive Function in MS for cognitive indices. Accounting for covariates, regression models predicted cognitive indices from scores for HADS-D, HADS-A, and the interaction. Of 831 people with MS, 72% were female, mean age was 43.2years, and median Expanded Disability Status Scale score was 2.0. Depressive symptoms were independently predictive of lower verbal fluency (Controlled Oral Word Association Test, p < 0.01), verbal learning (California Verbal Learning Test-II (CVLT-II) total learning, p = 0.02), verbal delayed recall (CVLT-II delayed recall, p < 0.01), and processing speed (Symbol Digit Modalities Test, p < 0.01; three-second Paced Auditory Serial Addition Test (PASAT), p = 0.05; two-second PASAT, p = 0.01). Anxiety in people with depression predicted decreased visuospatial function (Judgment of Line Orientation, p = 0.05), verbal learning (p < 0.01), verbal delayed recall (p < 0.01), visuospatial recall (Brief Visuospatial Memory Test-Revised, p = 0.02), and executive function (Delis-Kaplan Executive Function System, p < 0.01). Anxiety alone was not independently predictive of cognition. In conclusion, depression, especially with comorbid anxiety, is associated with cognitive dysfunction in people with MS.

Intranasal dexmedetomidine for sedation in ABR testing in children: No pain, big gain!

ObjectivesObtaining perfect immobility or sleep in children undergoing ABR auditory brainstem response) testing can be challenging. We examined the effectiveness and safety of intranasal dexmedetomidine for sedation of children undergoing ABR testing. Material and methodsWe included prospectively all patients aged from 1 to 15 years for whom sedation for ABR testing was required, between July 2018 and November 2021. We administered an initial dose of 2.5 μg/kg intranasal dexmedetomidine with a repeat dose of 1 μg/kg if needed 30 min later. Collected data included success rate of sedation, sedation onset and recovery times and incidence of side effects. ResultsABR testing was undertaken successfully in 57 of the 59 patients, giving a total success rate of 96,6 %. (95 % confidence interval 88.5 %–99.1 %). The median time to onset of sleep was 32 ± 18.3 min. The median duration of sedation recovery time was 48 ± 24.7 min. We recorded the adverse effects. Thirty-one patients experienced bradycardia and 28 patients experienced hypotension, all of which resolved without intervention. ConclusionIntranasal dexmedetomidine is an effective, safe, simple of use and noninvasive method for sedation in children. It could have a major role in auditory brainstem response testing, specially in the case of non-cooperative children. Registration number of the trialNCT03530371.

Comprehensive analysis of two hotspot codons in the TUBB4B gene and associated phenotypes

Our purpose was to elucidate the genotype and ophthalmological and audiological phenotype in TUBB4B-associated inherited retinal dystrophy (IRD) and sensorineural hearing loss (SNHL), and to model the effects of all possible amino acid substitutions at the hotspot codons Arg390 and Arg391. Six patients from five families with heterozygous missense variants in TUBB4B were included in this observational study. Ophthalmological testing included best-corrected visual acuity, fundus examination, optical coherence tomography, fundus autofluorescence imaging, and full-field electroretinography (ERG). Audiological examination included pure-tone and speech audiometry in adult patients and auditory brainstem response testing in a child. Genetic testing was performed by disease gene panel analysis based on genome sequencing. The molecular consequences of the substitutions of residues 390 and 391 on TUBB4B and its interaction with α-tubulin were predicted in silico on its three-dimensional structure obtained by homology modelling. Two independent patients had amino acid exchanges at position 391 (p.(Arg391His) or p.(Arg391Cys)) of the TUBB4B protein. Both had a distinct IRD phenotype with peripheral round yellowish lesions with pigmented spots and mild or moderate SNHL, respectively. Yet the phenotype was milder with a sectorial pattern of bone spicules in one patient, likely due to a genetically confirmed mosaicism for p.(Arg391His). Three patients were heterozygous for an amino acid exchange at position 390 (p.(Arg390Gln) or p.(Arg390Trp)) and presented with another distinct retinal phenotype with well demarcated pericentral retinitis pigmentosa. All showed SNHL ranging from mild to severe. One additional patient showed a variant distinct from codon 390 or 391 (p.(Tyr310His)), and presented with congenital profound hearing loss and reduced responses in ERG. Variants at codon positions 390 and 391 were predicted to decrease the structural stability of TUBB4B and its complex with α-tubulin, as well as the complex affinity. In conclusion, the twofold larger reduction in heterodimer affinity exhibited by Arg391 substitutions suggested an association with the more severe retinal phenotype, compared to the substitution at Arg390.

Increased [18F]Fluorodeoxyglucose Uptake in the Left Pallidum in Military Veterans with Blast-Related Mild Traumatic Brain Injury: Potential as an Imaging Biomarker and Mediation with Executive Dysfunction and Cognitive Impairment.

Blast-related mild traumatic brain injury (blast-mTBI) can result in a spectrum of persistent symptoms leading to substantial functional impairment and reduced quality of life. Clinical evaluation and discernment from other conditions common to military service can be challenging and subject to patient recall bias and the limitations of available assessment measures. The need for objective biomarkers to facilitate accurate diagnosis, not just for symptom management and rehabilitation but for prognostication and disability compensation purposes is clear. Toward this end, we compared regional brain [18F]fluorodeoxyglucose-positron emission tomography ([18F]FDG-PET) intensity-scaled uptake measurements and motor, neuropsychological, and behavioral assessments in 79 combat Veterans with retrospectively recalled blast-mTBI with 41 control participants having no lifetime history of TBI. Using an agnostic and unbiased approach, we found significantly increased left pallidum [18F]FDG-uptake in Veterans with blast-mTBI versus control participants, p < 0.0001; q = 3.29 × 10-9 [Cohen's d, 1.38, 95% confidence interval (0.96, 1.79)]. The degree of left pallidum [18F]FDG-uptake correlated with the number of self-reported blast-mTBIs, r2 = 0.22; p < 0.0001. Greater [18F]FDG-uptake in the left pallidum provided excellent discrimination between Veterans with blast-mTBI and controls, with a receiver operator characteristic area under the curve of 0.859 (p < 0.0001) and likelihood ratio of 21.19 (threshold:SUVR ≥ 0.895). Deficits in executive function assessed using the Behavior Rating Inventory of Executive Function-Adult Global Executive Composite T-score were identified in Veterans with blast-mTBI compared with controls, p < 0.0001. Regression-based mediation analyses determined that in Veterans with blast-mTBI, increased [18F]FDG-uptake in the left pallidum-mediated executive function impairments, adjusted causal mediation estimate p = 0.021; total effect estimate, p = 0.039. Measures of working and prospective memory (Auditory Consonant Trigrams test and Memory for Intentions Test, respectively) were negatively correlated with left pallidum [18F]FDG-uptake, p < 0.0001, with mTBI as a covariate. Increased left pallidum [18F]FDG-uptake in Veterans with blast-mTBI compared with controls did not covary with dominant handedness or with motor activity assessed using the Unified Parkinson's Disease Rating Scale. Localized increased [18F]FDG-uptake in the left pallidum may reflect a compensatory response to functional deficits following blast-mTBI. Limited imaging resolution does not allow us to distinguish subregions of the pallidum; however, the significant correlation of our data with behavioral but not motor outcomes suggests involvement of the ventral pallidum, which is known to regulate motivation, behavior, and emotions through basal ganglia-thalamo-cortical circuits. Increased [18F]FDG-uptake in the left pallidum in blast-mTBI versus control participants was consistently identified using two different PET scanners, supporting the generalizability of this finding. Although confirmation of our results by single-subject-to-cohort analyses will be required before clinical deployment, this study provides proof of concept that [18F]FDG-PET bears promise as a readily available noninvasive biomarker for blast-mTBI. Further, our findings support a causative relationship between executive dysfunction and increased [18F]FDG-uptake in the left pallidum.

Auditory processing disorder: an online survey of hearing healthcare professionals’ knowledge and practices

Objective To investigate (1) the current level of awareness and knowledge on Auditory Processing Disorder (APD) among Audiologists and other hearing healthcare professionals; (2) current practices in screening, diagnosis, and management of APD in children and adults across the UK; (3) professional’s acceptance of APD assessment and diagnosis. Design An online survey was disseminated through the British Academy of Audiology and ENT UK. Study sample A total of 191 hearing healthcare professionals responded to the survey. Results Overall, while 63% of the respondents considered themselves to be adequately informed about APD, only 4% viewed themselves as very informed on the topic. Fewer than half of the respondents report screening (31%), diagnosing (14%), or managing (36%) cases of APD. For screening APD, professionals most commonly use auditory processing tests in adults and take case histories in children, whereas routine audiological procedures are the primary method for diagnosing APD in both adults and children. Although modifying the listening environment is a widely recommended management strategy for APD, half of the respondents indicated that a diagnosis of APD has no implications for patient management. Conclusions There is a critical need to promote APD-related training to ensure they can provide appropriate referrals and management.

The relationship between event-related potential components and suicide risk in major depressive disorder

BackgroundSuicide is a serious global issue, with major depressive disorder (MDD) being a significant risk factor for suicidal thoughts and behaviors. There is an urgent need to determine whether event-related potential components (ERPs) could be used as an indicator to assess suicidal risk. MethodsFrom 2020 to 2023, 258 participants in total were recruited into the study. All participants were divided into four groups: MDD patients at high (n = 66), moderate (n = 66), and low risk (n = 56) of suicide, and healthy controls (HCs)(n = 70). Each participant provided socio-demographic information and underwent evaluations using clinical psychological scales such as 7-item Generalized Anxiety Disorder (GAD-7), Health Questionnaire-9 items (PHQ-9), and Nurses' Global Assessment of Suicide Risk (NGASR). The auditory brainstem response test and ERP examination were performed for all subjects. ResultsOur study found that the amplitude of P2–P3 and N2–P3 was significantly reduced in MDD patients at moderate and high risk of suicide, and these were negatively correlated with NGASR total score (all P < 0.05). Point B latency was positively correlated with NGASR total score (P < 0.05). Patients with MDD patients at low risk for suicide had a lower A-B amplitude compared to HCs (P < 0.05). No differences were found in MMN or P50 components between the four groups (all P > 0.05). ConclusionsMDD patients at higher risk of suicide exhibited severe impairment of cognitive function. ERP indices, such as the amplitude of P2–P3 and N2–P3, could be associated with the risk of suicide in MDD patients.

Is there a bilingual advantage in auditory attention among children? A systematic review and meta-analysis of standardized auditory attention tests.

A wealth of research has investigated the associations between bilingualism and cognition, especially in regards to executive function. Some developmental studies reveal different cognitive profiles between monolinguals and bilinguals in visual or audio-visual attention tasks, which might stem from their attention allocation differences. Yet, whether such distinction exists in the auditory domain alone is unknown. In this study, we compared differences in auditory attention, measured by standardized tests, between monolingual and bilingual children. A comprehensive literature search was conducted in three electronic databases: OVID Medline, OVID PsycInfo, and EBSCO CINAHL. Twenty studies using standardized tests to assess auditory attention in monolingual and bilingual participants aged less than 18 years were identified. We assessed the quality of these studies using a scoring tool for evaluating primary research. For statistical analysis, we pooled the effect size in a random-effects meta-analytic model, where between-study heterogeneity was quantified using the I2 statistic. No substantial publication bias was observed based on the funnel plot. Further, meta-regression modelling suggests that test measure (accuracy vs. response times) significantly affected the studies' effect sizes whereas other factors (e.g., participant age, stimulus type) did not. Specifically, studies reporting accuracy observed marginally greater accuracy in bilinguals (g = 0.10), whereas those reporting response times indicated faster latency in monolinguals (g = -0.34). There was little difference between monolingual and bilingual children's performance on standardized auditory attention tests. We also found that studies tend to include a wide variety of bilingual children but report limited language background information of the participants. This, unfortunately, limits the potential theoretical contributions of the reviewed studies. Recommendations to improve the quality of future research are discussed.

Central Auditory Processing Deficit in Children Diagnosed with Autism Spectrum Disorder

Purpose: The study aims to check the presence of auditory processing deficit in children diagnosed with autism spectrum disorder.Methods: A total of 10 subjects within the age range of 6-10 years diagnosed with autism spectrum disorder were recruited for the study. Buffalo model questionnaire (child form) for CAPD was given to the parents of the children with autism and scores were noted. Auditory cognition which is a sub category of auditory processing was assessed for each subject with the help of Angel sound software version 5.08.03 by Emily Shannon Fu Foundation. Forward digit test was done and the auditory memory of the participant was checked. The result obtained from the subjective perception of parents and objective evaluation was compared and the correlation was checked.Results: The questionnaire given to the parents had different subsections and questions included in the category of memory revealed poor scores. Similarly, the scores obtained for forward digit test was reduced for the children diagnosed with autistic spectrum disorder when compared to the normative given by the software. The children were able to memorize maximum of only 3 digits.Conclusions: It can be concluded that there is a relation between and subjective perception of parents of children with autism and objective evaluation of auditory processing. In our study, the scores for auditory cognition test are reduced for children with autism. Autistic people with auditory processing disorders can hear, but they have difficulty understanding what they hear. Auditory processing disorder is a crucial pathology of the autistic disorder.

Central auditory functions in post-COVID-19 adults; a case control study

BackgroundThis study aimed to evaluate the central auditory abilities in post-coronavirus disease 2019 (COVID-19) adults by using Central Auditory Tests (CATs). This study included a complaining group (GI), a non-complaining group (GII), and a control healthy group (GIII). All subjects were evaluated using CATsResultsResults demonstrated statistically significant differences across groups as regards Speech Perception in Noise Test (SPIN), Duration Pattern Sequence Test (DPT), Gap in Noise Test (GIN), and Memory Test (ANOVA, p-value ≤ 0.05). The post-hoc test revealed that, except for recognition memory, both study groups showed statistically significant differences from the control group. Also, significant differences were detected between both GI and GII groups regarding SPIN−10 signal-to-noise ratio (S/N), DPT, GIN threshold, memory for content, and memory for sequenceConclusionsCOVID-19 led to central auditory processing disorders (c)APD.

An Interdisciplinary Protocol for Ventriculoperitoneal Shunt Patient Selection in Normal Pressure Hydrocephalus

BackgroundNormal pressure hydrocephalus (NPH) can be treated with ventriculoperitoneal shunt (VPS) placement, but no broadly implemented indication for VPS exists. MethodsOur protocol consists of physical therapy and occupational therapy practitioners administering validated tests of gait, balance, and cognition before and after lumbar drain (LD) placement. Specific tests include: Timed “Up & Go”, Tinetti Gait and Balance Assessment, Berg Balance Scale, Mini Mental Status Exam, Trail Making Test Part B, and the Rey Auditory and Visual Learning Test. Minimal clinically important difference values for each test were determined from literature review. A retrospective review of patients treated under this protocol was performed. The primary outcomes were candidacy for VPS based on the protocol and patient-reported symptomatic improvement after VPS placement. Results48/75 (64%) patients received VPS. 43/48 (89.6%) of those shunted reported improved symptoms at 6 week follow up. However, 10/22 (45.5%) reported worsening symptoms at 1 year follow up. The mean Tinetti score significantly increased after LD in patients who improved with VPS compared to the no shunt group (4.27 vs -0.48, p<0.001). 6/33 (18%) patients with post-op imaging had a subdural fluid collection identified and 3/49 (6%) had other complications, including 1 seizure, 1 intracerebral hemorrhage, and 1 stroke. ConclusionsStandardized assessment of gait, balance, and cognition before and after temporary CSF diversion identifies patients with NPH likely to benefit from VPS placement with a low complication rate. One year after VPS, approximately half of patients had symptoms recur.

The impact of ankle–foot orthoses on mobility of dual-task walking in stroke patients? A cross-sectional two-factor factorial design clinical trial

ABSTRACT To assess the impact of ankle-foot orthoses (AFOs) on mobility and gait during dual-task walking in post-stroke survivors. In this cross-sectional, factorial design trial, stroke survivors performed four randomized tasks: (1) dual-task walking with AFOs, (2) single-task walking with AFOs, (3) dual-task walking without AFOs, and (4) single-task walking without AFOs. Primary outcome was the Timed Up and Go (TUG) test, with secondary outcomes including gait metrics, Tinetti scores, and auditory N-back tests. In the results, 48 subjects (38 males and 10 females; 19-65 years) completed the trial. Patients had a greater TUG score with AFOs compared with non-AFOs conditions (95% CI: 7.22–14.41, P < 0.001) in single-task and dual-task conditions. Secondary outcomes showed marked enhancement with AFOs during dual-task walking, with significant interaction effects in gait metrics, balance, and cognitive function (P < 0.05). Although not statistically significant, dual-task effects of TUG and walking speed were more pronounced during dual-task walking. In conclusion, AFOs enhance mobility and gait during both single and dual-task walking in post-stroke survivors.

Examining the utility of near infrared light as pre-exposure therapy to mitigate temporary noise-induced hearing loss in humans.

This study sought to determine the effect of Occupational Safety and Health Administration (OSHA) compliant noise on auditory health and assess whether pre-noise near infrared (NIR) light therapy can mitigate the effects of noise exposure. Over four visits, participants (n = 30, NCT#: 03834714) with normal hearing completed baseline hearing health assessments followed by exposure to open ear, continuous pink noise at 94 dBA for 15 min. Immediately thereafter, post-noise hearing tests at 3000, 4000, and 6000 Hz and distortion product otoacoustic emissions (DPOAEs) were conducted along with the Modified Rhyme Test (MRT), Masking Level Difference Test (MLD), and Fixed Level Frequency Tests (FLFT) [collectively referred to as the Central and Peripheral Auditory Test Battery (CPATB)] to acquire baseline noise sensitivity profiles. Participants were then randomized to either Active or Sham NIR light therapy for 30 min binaurally to conclude Visit 1. Visit 2 (≥24 and ≤ 48 h from Visit 1) began with an additional 30-min session of Active NIR light therapy or Sham followed by repeat CPATB testing and noise exposure. Post-noise testing was again conducted immediately after noise exposure to assess the effect of NIR light therapy. The remaining visits were conducted following ≥2 weeks of noise rest in a cross-over design (i.e., those who had received Active NIR light therapy in Visits 1 and 2 received Sham therapy in Visits 3 and 4). Recovery hearing tests and DPOAEs were completed at the end of each visit. Participants experienced temporary threshold shifts (TTS) immediately following noise exposure, with a mean shift of 6.79 dB HL (±6.25), 10.61 dB HL (±6.89), and 7.30 dB HL (±7.25) at 3000, 4000, and 6000 Hz, respectively, though all thresholds returned to baseline at 3000, 4000, and 6000 Hz within 75 min of noise exposure. Paradoxically, Active NIR light therapy threshold shifts were statistically higher than Sham therapy at 3000 Hz (p = 0.04), but no other differences were observed at the other frequencies tested. An age sub-analysis demonstrated that TTS among younger adults were generally larger in the Sham therapy group versus Active therapy, though this was not statistically different. There were no differences in CPATB test results across Active or Sham groups. Finally, we observed no changes in auditory function or central processing following noise exposure, suggestive of healthy and resilient inner ears. In this study, locally administered NIR prior to noise exposure did not induce a significant protective effect in mitigating noise-induced TTS. Further exploration is needed to implement effective dosage and administration for this promising otoprotective therapy.

Predicting Matrix Test Effectiveness for Evaluating Auditory Performance in Noise Using Pure-Tone Audiometry and Speech Recognition in Quiet in Cochlear Implant Recipients

Introduction: Auditory performance in noise of cochlear implant recipients can be assessed with the adaptive Matrix test (MT); however, when the speech-to-noise ratio (SNR) exceeds 15 dB, the background noise has any negative impact on the speech recognition. Here, we aim to evaluate the predictive power of aided pure-tone audiometry and speech recognition in quiet and establish cut-off values for both tests that indicate whether auditory performance in noise can be assessed using the Matrix sentence test in a diffuse noise environment. Methods: Here, we assessed the power of pure-tone audiometry and speech recognition in quiet to predict the response to the MT. Ninety-eight cochlear implant recipients were assessed using different sound processors from Advanced Bionics (n = 56) and CochlearTM (n = 42). Auditory tests were performed at least 1 year after cochlear implantation or upgrading the sound processor to ensure the best benefit of the implant. Auditory assessment of the implanted ear in free-field conditions included: pure-tone average (PTA), speech discrimination score (SDS) in quiet at 65 dB, and speech recognition threshold (SRT) in noise that is the SNR at which the patient can correctly recognize 50% of the words using the MT in a diffuse sound field. Results: The SRT in noise was determined in 60 patients (61%) and undetermined in 38 (39%) using the MT. When cut-off values for PTA <36 dB and SDS >41% were used separately, they were able to predict a positive response to the MT in 83% of recipients; using both cut-off values together, the predictive value reached 92%. Discussion: As the pure-tone audiometry is standardized universally and the speech recognition in quiet could vary depending on the language used; we propose that the MT should be performed in recipients with PTA <36 dB, and in recipients with PTA >36 dB, a list of Matrix sentences at a fixed SNR should be presented to determine the percentage of words understood. This approach should enable clinicians to obtain information about auditory performance in noise whenever possible.

Temporal processing abilities in normal hearing individuals with tinnitus: a systematic review

PurposeTinnitus, characterized by the perception of auditory phantoms, is prevalent worldwide and can lead to a range of hearing-related issues. Understanding its influence on temporal processing helps to delineate the auditory manifestations of tinnitus. This systematic review aimed to identify the patterns of temporal processing difficulties in individuals with tinnitus and normal hearing abilities. Furthermore, this review evaluates the potential of specific measurement techniques as tools for diagnosing temporal processing deficits in tinnitus.MethodsA comprehensive search was conducted in multiple international databases, followed by rigorous screening of the titles, abstracts, and full-length content. The inclusion and exclusion criteria were formulated using the Population, intervention, compression, Outcome, and Study design (PICOS) format, and the study bias was determined. After excluding irrelevant articles, nine studies were selected for the analysis.ResultsOver 50% of the selected studies demonstrated a significant impact on temporal processing in individuals with tinnitus, especially with gap detection test (GDT) and gaps in noise (GIN) tests, indicating of the deficits in peripheral temporal process in tinnitus individuals with normal hearing. However, the other central auditory tests showed no major changes.ConclusionsThe findings from this review underscore the importance of understanding temporal processing impairments in tinnitus and hold promise for enhancing the diagnostic accuracy and treatment outcomes, ultimately improving the lives of those affected by tinnitus. This review highlights the potential of the GDT and GIN tests as sensitive tools for assessing temporal processing deficits in the peripheral auditory system, which in turn can manifest as central changes in temporal processing.Systematic review registrationhttp://www.crd.york.ac.uk/PROSPERO/display_record.asp?ID=CRD42021287194, Prospero [CRD42021287194].

The effects of acute normobaric hypoxia on standing balance while dual-tasking with and without visual input.

To investigate the influence of acute normobaric hypoxia on standing balance under single and dual-task conditions, both with and without visual input. 20 participants (7 female, 20-31years old) stood on a force plate for 16, 90-s trials across four balance conditions: single-task (quiet stance) or dual-task (auditory Stroop test), with eyes open or closed. Trials were divided into four oxygen conditions where the fraction of inspired oxygen (FIO2) was manipulated (normoxia: 0.21 and normobaric hypoxia: 0.16, 0.145 and 0.13 FIO2) to simulate altitudes of 1100, 3,400, 4300, and 5200m. Participants breathed each FIO2 for ~ 3min before testing, which lasted an additional 7-8min per oxygen condition. Cardiorespiratory measures included heart rate, peripheral blood oxygen saturation, and pressure of end tidal (PET) CO2 and O2. Center of pressure measures included total path length, 95% ellipse area, and anteroposterior and mediolateral velocity. Auditory Stroop test performance was measured as response accuracy and latency. Significant decreases in oxygen saturation and PETO2, and increased heart rate were observed between normoxia and normobaric hypoxia (P < 0.0001). Total path length was higher at 0.13 compared to 0.21 FIO2 for the eyes closed no Stoop test condition (P = 0.0197). No other significant differences were observed. These findings suggest that acute normobaric hypoxia has a minimal impact on standing balance and does not influence auditory Stroop test or dual-task performance. Further investigation with longer exposure is required to understand the impact and time course of normobaric hypoxia on standing balance.