Central Auditory System Research Articles

Strategies of hearing aids fitting for improving speech recognition in noisy environments

To assess speech recognition in users of mono- and binaural hearing aids (HA) with dynamic environment control system (DECS). 25 HA users with symmetrical bilateral moderate to severe sensorineural hearing loss and 10 individuals with normal hearing underwent speech audiometry in a free sound field by listening to an adaptive Russian matrix sentence test with a background noise. The testing was conducted for hearing impaired patients with one and two HA. The Speech Recognition Thresholds in noise (SRTN) using HA with DESC and using HA without DESC were compared. The dichotic digits test and the rapidly alternating speech perception test were performed to evaluate the central auditory system function. The SRTN in normal hearing listeners was -16.4±1.9 dB SNR. In the case of monaural using HA without DESC the SRTN was -2.5±4.4 dB SNR, using HA with DESC it was -5.8±4.0 dB SNR; in the case of using binaural HAs it was -6.3±3.8 dB SNR and -9.9±3.1 dB SNR accordingly. HAs with Dynamic Environment Control System are highly effective for speech perception in noisy environments. Binaural HA use is more effective than monaural HA use regardless of HA model. Speech recognition in noisy environments in cases of binaural HA use correlates significantly with results of tests assessing the central auditory system function.

Group II Metabotropic Glutamate Receptors Modulate Sound Evoked and Spontaneous Activity in the Mouse Inferior Colliculus.

Little is known about the functions of Group II metabotropic glutamate receptors (mGluRs2/3) in the inferior colliculus (IC), a midbrain structure that is a major integration region of the central auditory system. We investigated how these receptors modulate sound-evoked and spontaneous firing in the mouse IC in vivo. We first performed immunostaining and tested hearing thresholds to validate vesicular GABA transporter (VGAT)-ChR2 transgenic mice on a mixed CBA/CaJ x C57BL/6J genetic background. Transgenic animals allowed for optogenetic cell-type identification. Extracellular single neuron recordings were obtained before and after pharmacological mGluR2/3 activation. We observed increased sound-evoked firing, as assessed by the rate-level functions (RLFs), in a subset of both GABAergic and non-GABAergic IC neurons following mGluR2/3 pharmacological activation. These neurons also displayed elevated spontaneous excitability and were distributed throughout the IC area tested, suggesting a widespread mGluR2/3 distribution in the mouse IC.

Experimental study of potential adverse effects on the auditory system of rabbits exposed to short-term GSM-1800 radiation

Purpose The effects of the electromagnetic (EM) radiation emitted by a mobile phone on the central auditory system of rabbits are investigated in this paper. Auditory brainstem response (ABR) measurements were performed before and after short-term exposure to EM radiation. Materials and methods Excitation was provided by a GSM-1800 emitter placed in contact with the (randomly selected) ear of the anesthetized rabbit/subject. The latency of waves I, II, III, IV, V and the interpeak latencies I-III, I-V, III-V were recorded, for both ears, before (baseline recordings) and after 1, 15, 30, 45 and 60 minutes of exposure to the EM radiation. The repeated measures one-way analysis of variance (ANOVA) followed by the post hoc Tukey test for pairwise comparisons was performed in order to decide about the significance of the results. Results The statistical tests indicated that, as regards the ear ipsilateral to the radiating module, the mean latencies of waves I, II, III, IV, V, I-III, I-IV after 60 min exposure, the mean latencies of waves I, III, IV, V, I-III, I-IV after 45 min exposure and the mean latencies of waves I, III, IV, V, I-IV after 30 min exposure, were significantly prolonged compared to the corresponding baseline values. Statistically significant differences were also found for certain peak and interpeak latencies for 60 min exposure as compared with the corresponding results for 1 min and 15 min exposure. No statistically significant delay was observed for the latencies before and after the exposure, for the ear contralateral to the radiation source. Conclusions Although we found that more than 30 min exposure to GSM-1800 radiation resulted in prolongation of certain ABR components of rabbits, further investigation may be needed into the potential adverse effects on the auditory pathways.

Effect of Kv3 channel modulators on auditory temporal resolution in aged Fischer 344 rats

AUT00063 and AUT00202 are novel pharmaceutical modulators of the Kv3 subfamily of voltage-gated K+ channels. Kv3.1 channels, which control fast firing of many central auditory neurons, have been shown to decline with age and this may contribute to age-related deficits in central auditory processing. In the present study, the effects of the two novel compounds that specifically modulate Kv3 channels on auditory temporal processing were examined in aged (19-25-month-old) and young-adult (3-5 month-old) Fischer 344 rats (F344) using a behavioral gap-prepulse inhibition (gap-PPI) paradigm. The acoustic startle response (ASR) and its inhibition induced by a gap in noise were measured before and after drug administration. Hearing thresholds in tested rats were evaluated by the auditory brainstem response (ABR). Aged F344 rats had significantly higher ABR thresholds, lower amplitudes of ASR, and weaker gap-PPI compared with young-adult rats. No influence of AUT00063 and AUT00202 administration was observed on ABR hearing thresholds in rats of both age groups. AUT00063 and AUT00202 had suppressive effect on ASR of F344 rats that was more pronounced with AUT00063. The degree of suppression depended on the dose and age of the rats. Both compounds significantly improved the gap-PPI performance in gap detection tests in aged rats. These results indicate that AUT00063 and AUT00202 may influence intrinsic firing properties of neurons in the central auditory system of aged animals and have the potential to treat aged-related hearing disorders.

The effects of music on working memory among older adults: Literature review

Older adults demonstrate a decline in working memory which in turn leads to a reduction of cognitive skills. Therefore, perform optimal approach of working memory remediation is important to well-being for older adults. This paper aims to review the effects of music on working memory among older adults as well as the role of working memory in the central auditory system. Articles included in this review were identified through a search of the databases PubMed, Scopus, and Google Scholar using the search terms music, working memory, aging and central auditory processing disorder. The literature search was restricted to the years 1981 to 2020 and articles published in the English language. Central auditory processing skills such as speech-in-noise perception impaired mostly among older adults. Early diagnose of central auditory processing disorder and perform the music therapy is very important in older adults.

OCENA AUDIOLOGICZNA URAZOWEGO USZKODZENIA MÓZGU – STUDIUM PRZYPADKU

BackgroundTraumatic brain injury (TBI) is a pathology frequently causing mortality or serious sequelae. About 20% of individuals with TBI will have some degree of auditory alteration. The aim of the present study was to use behavioural and electrophysiological assessments to analyse the hearing of a patient with TBI.Case reportA young male adult who had suffered severe TBI caused by a motorcycle accident was evaluated. The patient underwent a peripheral hearing evaluation and electrophysiological assessment. Pure tone audiometry revealed profound sensorineural hearing loss in the left ear and normal hearing in the right. In the electrophysiological assessment, an ABR click test showed the presence of a response in the right ear at 80 dB HL but no response in the left ear at 90 dB HL. Evaluation of the Middle Latency Response revealed the presence of both an electrode effect (C3) and an ear effect (A1). The P300 wave showed an event-related potential within normal limits in the right ear and no responses in the left.ConclusionsThe present case study verifies the importance of assessing the peripheral and central auditory nervous system in cases of patients with a history of TBI. It reinforces the need for diagnosis and audiological monitoring of these patients.

Auditory event-related potentials and mismatch negativity in children with hearing loss using hearing aids or cochlear implants – A three-year follow-up study

ObjectivesThe primary aim was to examine how event-related potentials (ERPs) and mismatch negativity (MMN) change and develop over time among children with hearing loss (HL) using hearing aids (HAs) or cochlear implants (CIs). Children with normal hearing (NH) were tested as a reference group. MethodsThis three-year follow-up study included 13 children with sensorineural HL (SNHL); 7 children using bilateral HAs and 6 children using CIs; and 10 children with NH as a reference group. ERPs were recorded at baseline and after three years. At time for the original study the children were approximately 5–8 years old and at the follow-up study 8–11 years old. ERP recordings and data processing were identical in both sessions. A standard stimulus alternated with five different deviants (gap, intensity, pitch, location and duration), presented in a pseudorandom sequence, thus following the multi-feature paradigm, Optimum-1. MMN was calculated from the average ERP of each deviant minus the standard stimuli. Repeated measures ANOVA was used for the statistical analyses and the results were based on samples within a specific time interval; 80–224 ms. ResultsThere was a statistically significant difference in the obligatory responses between the NH and HA groups at baseline, but this difference disappeared after three years in our follow-up study. The children with HA also showed a significant difference in mean ERP at baseline compared to follow-up, and significant differences between the deviants at follow-up but not at baseline. This suggests an improvement over time among the children with HAs. On the other hand, the children with CIs did not differ from the NH children at baseline, but after three years their mean ERP was significantly lower compared to both the children with HA and NH, indicating a reduced development of the central auditory system in this age span among the children with CIs. Regarding MMN, there was an interaction between the duration deviant and time for the children with HA, also indicating a possible improvement over time among the HA children. ConclusionsThis three-year follow-up study shows neurophysiological differences between children with HL and children with NH. The results suggest a delay in the central auditory processing among the HA children compared to children with NH, but a possible catch-up, over time, and this potential may be worth to be utilized. Regarding the CI children, similar improvement in this age span is missing, meaning there are differences between the subgroups of children with HL, i.e. the children with HAs vs. CIs. The results highlight the importance of distinguishing between subgroups of children with HL in further research.

Auditory fear conditioning alters neural gain in the cochlear nucleus: a wireless neural recording study in freely behaving rats.

Anxiety disorders involve distorted perception of the world including increased saliency of stress-associated cues. However, plasticity in the initial sensory regions of the brain following a fearful experience has never been examined. The cochlear nucleus (CN) is the first station in the central auditory system, with heterogeneous collections of neurons that not only project to but also receive projections from cortico-limbic regions, suggesting a potential for experience-dependent plasticity. Using wireless neural recordings in freely behaving rats, we demonstrate for the first time that neural gain in the CN is significantly altered by fear conditioning to auditory sequences. Specifically, the ventral subnuclei significantly increased firing rate to the conditioned tone sequence, while the dorsal subnuclei significantly decreased firing rate during the conditioning session overall. These findings suggest subregion-specific changes in the balance of inhibition and excitation in the CN as a result of conditioning experience. Heart rate was measured as the conditioned response (CR), which showed that while pre-conditioned stimulus (CS) responding did not change across baseline and conditioning sessions, significant changes in heart rate were observed to the tone sequence followed by shock. Heart-rate findings support acquisition of conditioned fear. Taken together, the present study presents first evidence for potential experience-dependent changes in auditory perception that involve novel plasticity within the first site of processing auditory information in the brain.

Expression pattern of cochlear microRNAs in the mammalian auditory hindbrain

The auditory system comprises the auditory periphery, engaged in sound transduction and the central auditory system, implicated in auditory information processing and perception. Recently, evidence mounted that the mammalian peripheral and central auditory systems share a number of genes critical for proper development and function. This bears implication for auditory rehabilitation and evolution of the auditory system. To analyze to which extent microRNAs (miRNAs) belong to genes shared between both systems, we characterize the expression pattern of 12 cochlea-abundant miRNAs in the central auditory system. Quantitative real-time PCR (qRT-PCR) demonstrated expression of all 12 genes in the cochlea, the auditory hindbrain and the non-auditory prefrontal cortex (PFC) at embryonic stage (E)16 and postnatal stages (P)0 and P30. Eleven of them showed differences in expression between tissues and nine between the developmental time points. Hierarchical cluster analysis revealed that the temporal expression pattern in the auditory hindbrain was more similar to the PFC than to the cochlea. Spatiotemporal expression analysis by RNA in situ hybridization demonstrated widespread expression throughout the cochlear nucleus complex (CNC) and the superior olivary complex (SOC) during postnatal development. Altogether, our data indicate that miRNAs represent a relevant class of genetic factors functioning across the auditory system. Given the importance of gene regulatory network (GRN) components for development, physiology and evolution, the 12 miRNAs provide promising entry points to gain insights into their molecular underpinnings in the auditory system.

Auditory and Visual System White Matter Is Differentially Impacted by Normative Aging in Macaques.

Deficits in auditory and visual processing are commonly encountered by older individuals. In addition to the relatively well described age-associated pathologies that reduce sensory processing at the level of the cochlea and eye, multiple changes occur along the ascending auditory and visual pathways that further reduce sensory function in each domain. One fundamental question that remains to be directly addressed is whether the structure and function of the central auditory and visual systems follow similar trajectories across the lifespan or sustain the impacts of brain aging independently. The present study used diffusion magnetic resonance imaging and electrophysiological assessments of auditory and visual system function in adult and aged macaques to better understand how age-related changes in white matter connectivity at multiple levels of each sensory system might impact auditory and visual function. In particular, the fractional anisotropy (FA) of auditory and visual system thalamocortical and interhemispheric corticocortical connections was estimated using probabilistic tractography analyses. Sensory processing and sensory system FA were both reduced in older animals compared with younger adults. Corticocortical FA was significantly reduced only in white matter of the auditory system of aged monkeys, while thalamocortical FA was lower only in visual system white matter of the same animals. Importantly, these structural alterations were significantly associated with sensory function within each domain. Together, these results indicate that age-associated deficits in auditory and visual processing emerge in part from microstructural alterations to specific sensory white matter tracts, and not from general differences in white matter condition across the aging brain.SIGNIFICANCE STATEMENT Age-associated deficits in sensory processing arise from structural and functional alterations to both peripheral sensory organs and central brain regions. It remains unclear whether different sensory systems undergo similar or distinct trajectories in function across the lifespan. To provide novel insights into this question, this study combines electrophysiological assessments of auditory and visual function with diffusion MRI in aged macaques. The results suggest that age-related sensory processing deficits in part result from factors that impact the condition of specific white matter tracts, and not from general decreases in connectivity between sensory brain regions. Such anatomic specificity argues for a framework aimed at understanding vulnerabilities with relatively local influence and brain region specificity.

Noise Induced Hearing Loss and Tinnitus-New Research Developments and Remaining Gaps in Disease Assessment, Treatment, and Prevention.

Long-term noise exposure often results in noise induced hearing loss (NIHL). Tinnitus, the generation of phantom sounds, can also result from noise exposure, although understanding of its underlying mechanisms are limited. Recent studies, however, are shedding light on the neural processes involved in NIHL and tinnitus, leading to potential new and innovative treatments. This review focuses on the assessment of NIHL, available treatments, and development of new pharmacologic and non-pharmacologic treatments based on recent studies of central auditory plasticity and adaptive changes in hearing. We discuss the mechanisms and maladaptive plasticity of NIHL, neuronal aspects of tinnitus triggers, and mechanisms such as tinnitus-associated neural changes at the cochlear nucleus underlying the generation of tinnitus after noise-induced deafferentation. We include observations from recent studies, including our own studies on associated risks and emerging treatments for tinnitus. Increasing knowledge of neural plasticity and adaptive changes in the central auditory system suggest that NIHL is preventable and transient abnormalities may be reversable, although ongoing research in assessment and early detection of hearing difficulties is still urgently needed. Since no treatment can yet reverse noise-related damage completely, preventative strategies and increased awareness of hearing health are essential.

Enhanced loudness perception in ears with reduced peripheral function: A remote psychoacoustic investigation

Central gain models of hyperacusis propose that a loss of afferent input drives over-amplification of sound-evoked activity in the central auditory system, leading to enhanced loudness perception. We conducted a remote study aimed at quantifying variation in loudness perception as a function of peripheral auditory status [i.e., summating potential (SP)/action potential (AP) ratio]. To control for the contributions of age and other individual differences, twelve adults with normal hearing and strongly asymmetric SP/AP ratios between ears were recruited from a prior study. Participants completed a battery of self-directed psychoacoustic tests at home using calibrated headphones and tablet computers running custom software. Loudness perception was assessed at a variety of frequencies in each ear using standard clinical assessments [e.g., loudness discomfort levels (LDLs), dynamic range] and more fine-grained assessments of loudness growth as a function of stimulus intensity. While traditional measures of LDL and dynamic range varied widely both within and between subjects, ears with evidence of possible cochlear synaptopathy (high SP/AP ratios) demonstrated elevated loudness perception for intensities in-between threshold and LDL. Detailed assessments of loudness growth across sensation levels may be more sensitive to variation in underlying peripheral neural status than traditional, single-point clinical measures of loudness discomfort.

Using auditory electrophysiology testing to define the high frequencies across non-human mammal species

While the human's frequency range of audibility has been well documented at 20–20 000 Hz, the audible frequency ranges vary considerably from species to species. As such, that which constitutes the “high-frequency” range is quite different in mice, rats, guinea pigs, gerbils, chinchillas, and cats. These mammalian species have been frequently used in anatomical and physiological investigations of the peripheral and central auditory nervous systems. Much of what we know about the physiology of the auditory system is based upon on these animal species, yet many of their auditory systems operate in a much different frequency range from the human's. We will discuss the use of auditory electrophysiology to define the high-frequency ranges across several different mammal species, and then transition to a comparison of their high-frequency ranges to that of the human. Further, we will discuss the implications of trying to extrapolate insight into human auditory physiology from animal species whose high-frequency ranges are quite different from our own.

Age-Related Hearing Loss in C57BL/6J Mice Is Associated with Mitophagy Impairment in the Central Auditory System.

Aging is associated with functional and morphological changes in the sensory organs, including the auditory system. Mitophagy, a process that regulates the turnover of dysfunctional mitochondria, is impaired with aging. This study aimed to investigate the effect of aging on mitophagy in the central auditory system using an age-related hearing loss mouse model. C57BL/6J mice were divided into the following four groups based on age: 1-, 6-, 12-, and 18-month groups. The hearing ability was evaluated by measuring the auditory brainstem response (ABR) thresholds. The mitochondrial DNA damage level and the expression of mitophagy-related genes, and proteins were investigated by real-time polymerase chain reaction and Western blot analyses. The colocalization of mitophagosomes and lysosomes in the mouse auditory cortex and inferior colliculus was analyzed by immunofluorescence analysis. The expression of genes involved in mitophagy, such as PINK1, Parkin, and BNIP3 in the mouse auditory cortex and inferior colliculus, was investigated by immunohistochemical staining. The ABR threshold increased with aging. In addition to the mitochondrial DNA integrity, the mRNA levels of PINK1, Parkin, NIX, and BNIP3, as well as the protein levels of PINK1, Parkin, BNIP3, COX4, LC3B, mitochondrial oxidative phosphorylation (OXPHOS) subunits I–IV in the mouse auditory cortex significantly decreased with aging. The immunofluorescence analysis revealed that the colocalization of mitophagosomes and lysosomes in the mouse auditory cortex and inferior colliculus decreased with aging. The immunohistochemical analysis revealed that the expression of PINK1, Parkin, and BNIP3 decreased in the mouse auditory cortex and inferior colliculus with aging. These findings indicate that aging-associated impaired mitophagy may contribute to the cellular changes observed in an aged central auditory system, which result in age-related hearing loss. Thus, the induction of mitophagy can be a potential therapeutic strategy for age-related hearing loss.

Longitudinal Decline on the Dichotic Digits Test

Purpose The dichotic digits test (DDT) is commonly administered in clinical and research settings, but it is not well understood how performance changes in aging. The purpose of this study is to determine the 5-year change on the free recall task and right ear advantage (REA) in a population-based cohort and factors associated with change. Method Participants in the population-based Epidemiology of Hearing Loss Study, who completed the DDT during the fourth (2009-2010) and fifth (2013-2016) examination periods were included (n = 865, M age = 72.8 years at baseline). Free recall DDT was administered using 25 sets of triple-digit pairs presented at 70 dB HL. The REA was calculated by subtracting the score in the left ear from the score in the right ear. Results In 5 years, most participants (62.4%) declined on free recall performance (mean decline = 3.0% [4.5 digits], p < .01). In age-sex-adjusted models, higher baseline scores, hearing impairment, and lower education were significantly associated with increased risk of decline. An REA at baseline (76.8%) and follow-up (77.9%) was common. Half of participants (50.6%) had a 5-year REA widening (M = 1.9% [1.4 digits], p = .01). Older age, but not hearing impairment, was associated with increased risk of REA widening. Conclusions The 5-year decline on free recall recognition performance was not associated with age but was associated with hearing impairment, whereas the 5-year widening of REA was associated with age but not hearing impairment. These results indicate that the REA may be a more sensitive measure of aging of the central auditory system than free recall performance.

Comparative Assessment of Spatial and Temporal Resolutions in the Localization of an Approaching and Receding Broadband Noise Source in Healthy Subjects and Patients with First-degree Symmetric Sensorineural Hearing Loss

Comparative assessment of the spatial and temporal resolutions of hearing for stationary and moving sound images was performed in free field for 12 normally hearing listeners and 12 patients with symmetric sensorineural hearing loss of the first degree. It has been shown that the spatial resolution in patients with hearing loss is not changed during localization of stationary sound images, while the temporal and spatial thresholds of a moving sound source localization vary. In different patients, they may coincide with the data obtained for the group of normally hearing subjects or may be several times higher. One of the reasons for this variability may be temporal auditory analysis impairment. A correlation of the characteristics of moving sound images localization revealed in patients with hearing loss indicates different degrees of central auditory system impairment in patients with similar tonal audiograms.

Specific loss of neural sensitivity to interaural time difference of unmodulated noise stimuli following noise-induced hearing loss.

Sensorineural hearing loss (SNHL) causes an overall deficit in binaural hearing, including the abilities to localize sound sources, discriminate interaural time and level differences (ITDs and ILDs, respectively), and utilize binaural cues to aid signal detection and comprehension in noisy environments. Few studies have examined the effect of SNHL on binaural coding in the central auditory system, and those that have focused on age-related hearing loss. We induced hearing loss in male and female Dutch-belted rabbits via noise overexposure and compared unanesthetized single-unit responses of their inferior colliculi [hearing loss (HL) neurons] with those of unexposed rabbits. Sound-level thresholds of HL neurons to diotic noise were elevated by 75 dB, on average. Sensitivity of firing rates of HL neurons to the azimuth of a broadband noise stimulus was reduced, on average, but was confounded by differences in sound level with respect to detection threshold between groups. We independently manipulated ITD and ILD in virtual acoustic space and found directional sensitivity in binaurally sensitive HL neurons was entirely due to ILD sensitivity and no different than that for unexposed rabbits. However, ITD sensitivity was completely absent in binaurally sensitive HL neurons for noise stimuli both in virtual acoustic space and with ITDs extending to ±3 ms. HL neurons also had weaker spike-timing precision and slightly increased spontaneous rates. Overall, ILD sensitivity was uncompromised, whereas ITD sensitivity was completely lost, implying a specific inability to use information in the timing or correlation of acoustic noise waveforms between the two ears following severe SNHL.NEW & NOTEWORTHY Sensorineural hearing loss compromises perceptual abilities that arise from hearing with two ears, yet its effects on binaural aspects of neural responses are largely unknown. We found that, following severe hearing loss because of acoustic trauma, auditory midbrain neurons specifically lost the ability to encode time differences between the arrival of a broadband noise stimulus to the two ears, whereas the encoding of sound level differences between the two ears remained uncompromised.

Perceptual and Electrophysiological Correlates of Fixed Versus Moving Sound Source Lateralization.

Purpose The aims of the study were (a) to evaluate the effects of systematically varied factors of stimulus duration, interaural-level difference (ILD), and direction on perceptual and electrophysiological metrics of lateralization for fixed versus moving targets and (b) to evaluate the hemispheric activity underlying perception of fixed versus moving auditory targets. Method Twelve normal-hearing, young adult listeners were evaluated using perceptual and P300 tests of lateralization. Both perceptual and P300 tests utilized stimuli that varied for type (fixed and moving), direction (right and left), duration (100 and 500 ms), and magnitude of ILD (9 and 18 dB). Listeners provided laterality judgments and stimulus-type discrimination (fixed vs. moving) judgments for all combinations of acoustic factors. During P300 recordings, listeners discriminated between left- versus right-directed targets, as the other acoustic parameters were varied. Results ILD magnitude and stimulus type had statistically significant effects on laterality ratings, with larger magnitude ILDs and fixed type resulting in greater lateralization. Discriminability between fixed versus moving targets was dependent on stimulus duration and ILD magnitude. ILD magnitude was a significant predictor of P300 amplitude. There was a statistically significant inverse relationship between the perceived velocity of targets and P300 latency. Lateralized targets evoked contralateral hemispheric P300 activity. Moreover, a right-hemisphere enhancement was observed for fixed-type lateralized deviant stimuli. Conclusions Perceptual and P300 findings indicate that lateralization of auditory movement is highly dependent on temporal integration. Both the behavioral and physiological findings of this study suggest that moving auditory targets with ecologically valid velocities are processed by the central auditory nervous system within a window of temporal integration that is greater than that for fixed auditory targets. Furthermore, these findings lend support for a left hemispatial perceptual bias and right hemispheric dominance for spatial listening.

Prematurity and the Auditory System: Considerations for Audiologists

Prematurity and the Auditory System: Considerations for Audiologists

The effects of a temporal processing-based auditory training program on the auditory skills of elderly users of hearing aids: a study protocol for a randomized clinical trial

Background: One of the most important effects of age-related declines in neural processing speed is the impairment of temporal resolution, which leads to difficulty hearing in noisy environments. Since the central auditory system is highly plastic, by designing and implementing a temporal processing-based auditory training program, we can help the elderly improve their listening skills and speech understanding in noisy environments. Methods: In the first phase of this research, based on the theoretical framework of temporal processing, an auditory training solution was developed as a software program. In the second phase, which will be described in the present study, the effects of the designed program on the listening skills of the elderly users of hearing aids (age: 60-75 years) will be studied in the control and intervention groups. In the intervention group, the auditory training program will be implemented for three months (36 sessions), and the results of central tests (GIN, DPT, QuickSIN) and the electrophysiological speech-ABR test will be compared in both groups before, immediately and one month after the intervention. Discussion: Since temporal processing is not sufficient in auditory training programs for the elderly with hearing impairments, implementation of a temporal processing-based auditory training program can reduce hearing problems in noisy environments among elderly users of hearing aids. Trial registration: This study was registered as a clinical trial in the Iranian Registry of Clinical Trials ( IRCT20190921044838N1) on December 25, 2019.