Changes In Loudness Research Articles

The Effects of Diegetic and Nondiegetic Music on Viewers’ Interpretations of a Film Scene

Previous studies have shown that pairing a film excerpt with different musical soundtracks can change the audience’s interpretation of the scene. This study examined the effects of mixing the same piece of music at different levels of loudness in a film soundtrack to suggest diegeticmusic (“source music,” presented as if arising from within the fictional world of the film characters) or to suggest nondiegetic music (a “dramatic score” accompanying the scene but not originating from within the fictional world). Adjusting the level of loudness significantly altered viewers’ perceptions of many elements that are fundamental to the storyline, including inferences about the relationship, intentions, and emotions of the film characters, their romantic interest toward each other, and the overall perceived tension of the scene. Surprisingly, varying the loudness (and resulting timbre) of the same piece of music produced greater differences in viewers’ interpretations of the film scene and characters than switching to a different music track. This finding is of theoretical and practical interest as changes in loudness and timbre are among the primary post-production modifications sound editors make to differentiate “source music” from “dramatic score” in motion pictures, and the effects on viewers have rarely been empirically investigated.

The natural history of subjective tinnitus in adults: A systematic review and meta-analysis of no-intervention periods in controlled trials.

Tinnitus is a prevalent condition, but little has been published regarding the natural history of the condition. One technique for evaluating the long-term progression of the disease is to examine what happens to participants in the no-intervention control arm of a clinical trial. The aim of this study was to examine no-intervention or waiting-list data reported in trials, in which participants on the active arm received any form of tinnitus intervention. CINAHL, PsychINFO, EMBASE, ASSIA, PubMed, Web of Science, Science Direct, EBSCO Host, and Cochrane. Inclusion criteria followed the PICOS principles: Participants, adults with tinnitus; Intervention, none; Control, any intervention for alleviating tinnitus; Outcomes, a measure assessing tinnitus symptoms using a multi-item patient-reported tinnitus questionnaire. Secondary outcome measures included multi-item patient-reported questionnaires of mood and health-related quality of life and measures that quantified change in tinnitus loudness; Study design, randomized controlled trials or observational studies utilizing a no-intervention or waiting-list control group. Data were extracted and standardized mean difference was calculated for each study to enable meta-analysis. The evidence strongly favored a statistically significant decrease in the impact of tinnitus over time, though there was significant heterogeneity and clinical significance cannot be interpreted. Outcome data regarding secondary measures did not demonstrate any clinically significant change. Participants allocated to the no-intervention or waiting-list control arm of clinical trials for a tinnitus intervention show a small but significant improvement in self-reported measures of tinnitus with time; the clinical significance of this finding is unknown. There is, however, considerable variation across individuals. These findings support previous work and can cautiously be used when counseling patients. Laryngoscope, 128:217-227, 2018.

Stimulus Pauses and Perturbations Differentially Delay or Promote the Segregation of Auditory Objects: Psychoacoustics and Modeling.

Segregating distinct sound sources is fundamental for auditory perception, as in the cocktail party problem. In a process called the build-up of stream segregation, distinct sound sources that are perceptually integrated initially can be segregated into separate streams after several seconds. Previous research concluded that abrupt changes in the incoming sounds during build-up—for example, a step change in location, loudness or timing—reset the percept to integrated. Following this reset, the multisecond build-up process begins again. Neurophysiological recordings in auditory cortex (A1) show fast (subsecond) adaptation, but unified mechanistic explanations for the bias toward integration, multisecond build-up and resets remain elusive. Combining psychoacoustics and modeling, we show that initial unadapted A1 responses bias integration, that the slowness of build-up arises naturally from competition downstream, and that recovery of adaptation can explain resets. An early bias toward integrated perceptual interpretations arising from primary cortical stages that encode low-level features and feed into competition downstream could also explain similar phenomena in vision. Further, we report a previously overlooked class of perturbations that promote segregation rather than integration. Our results challenge current understanding for perturbation effects on the emergence of sound source segregation, leading to a new hypothesis for differential processing downstream of A1. Transient perturbations can momentarily redirect A1 responses as input to downstream competition units that favor segregation.

Testing the shared spatial representation of magnitude of auditory and visual intensity.

The largely automatic mapping observed between space and sensory magnitudes suggests representation by a single system across domains. Using stimulus response compatibility tasks, the study confirms that a relative, auditory magnitude such as loudness shows a spatial compatibility effect similar to those evidenced for visual sensory domains but only with comparison tasks and for vertically oriented responses. No effect is seen when participants track changes in amplitude or when responses are oriented vertically. In a bimodal context, the study tested whether the spatial mapping of magnitude in 1 sensory modality (loudness) interacts with the spatial representation of magnitude in another sense (luminance). Observed interactions across modalities suggest overlap of magnitude representation across distinct sensory domains, whereas the absence of an effect for dynamic changes in loudness suggests that it is useful for decisions to act on 1 of several objects rather than for tracking magnitude changes in 1 object. (PsycINFO Database Record

Using acoustic reflex threshold, auditory brainstem response and loudness judgments to investigate changes in neural gain following acute unilateral deprivation in normal hearing adults

Unilateral auditory deprivation induces a reduction in the acoustic reflex threshold (ART) and an increase in loudness. These findings have been interpreted as a compensatory change in neural gain, governed by changes in excitatory and inhibitory neural inputs. There is also evidence to suggest that changes in neural gain can be measured using the auditory brainstem response (ABR). The present study extended Munro et al. (2014) [J. Acoust. Soc. Am. 135, 315–322] by investigating changes after 4 days of unilateral earplug use to: (i) ART, (ii) ABR and (iii) loudness. Because changes may occur during the post-deprivation test session (day 4), ART measurements were taken 1 h and 2 h post-earplug removal. There was a significant reduction in ART in the treatment ear immediately after the removal of the earplug, which is consistent with a compensatory increase in neural gain. A novel finding was the significant return of ARTs to baseline within 2 h of earplug removal. A second novel finding was a significant decrease in the mean amplitude of ABR wave V in the treatment ear, but a significant increase in the control ear, both after 4 days of deprivation. These changes in the ABR are in the opposite direction to those predicted. We were unable to replicate the change in loudness reported in previous deprivation studies; however, the short period of earplug use may have contributed to this null finding.

Zinc supplementation for tinnitus.

Tinnitus is the perception of sound without external acoustic stimuli. Patients with severe tinnitus may have physical and psychological complaints and their tinnitus can cause deterioration in their quality of life. At present no specific therapy for tinnitus has been found to be satisfactory in all patients. In recent decades, a number of reports have suggested that oral zinc supplementation may be effective in the management of tinnitus. Since zinc has a role in cochlear physiology and in the synapses of the auditory system, there is a plausible mechanism of action for this treatment. To evaluate the effectiveness and safety of oral zinc supplementation in the management of patients with tinnitus. The Cochrane ENT Information Specialist searched the ENT Trials Register; Central Register of Controlled Trials (CENTRAL 2016, Issue 6); PubMed; EMBASE; CINAHL; Web of Science; ClinicalTrials.gov; ICTRP and additional sources for published and unpublished trials. The date of the search was 14 July 2016. Randomised controlled trials comparing zinc supplementation versus placebo in adults (18 years and over) with tinnitus. We used the standard methodological procedures recommended by Cochrane. Our primary outcome measures were improvement in tinnitus severity and disability, measured by a validated tinnitus-specific questionnaire, and adverse effects. Secondary outcomes were quality of life, change in socioeconomic impact associated with work, change in anxiety and depression disorders, change in psychoacoustic parameters, change in tinnitus loudness, change in overall severity of tinnitus and change in thresholds on pure tone audiometry. We used GRADE to assess the quality of the evidence for each outcome; this is indicated in italics. We included three trials involving a total of 209 participants. The studies were at moderate to high risk of bias. All included studies had differences in participant selection criteria, length of follow-up and outcome measurement, precluding a meta-analysis. The participants were all adults over 18 years with subjective tinnitus, but one study conducted in 2013 (n = 109) included only elderly patients. Improvement in tinnitus severity and disabilityOnly the study in elderly patients used a validated instrument (Tinnitus Handicap Questionnaire) for this primary outcome. The authors of this cross-over study did not report the results of the two phases separately and found no significant differences in the proportion of patients reporting tinnitus improvement at four months of follow-up: 5% (5/93) versus 2% (2/94) in the zinc and placebo groups, respectively (risk ratio (RR) 2.53, 95% confidence interval (CI) 0.50 to 12.70; very low-quality evidence).None of the included studies reported any significant adverse effects. Secondary outcomesFor the secondary outcome change in tinnitus loudness, one study reported no significant difference between the zinc and placebo groups after eight weeks: mean difference in tinnitus loudness -9.71 dB (95% CI -25.53 to 6.11; very low-quality evidence). Another study also measured tinnitus loudness but used a 0- to 100-point scale. The authors of this second study reported no significant difference between the zinc and placebo groups after four months: mean difference in tinnitus loudness rating scores 0.50 (95% CI -5.08 to 6.08; very low-quality evidence).Two studies used unvalidated instruments to assess tinnitus severity. One (with 50 participants) reported the severity of tinnitus using a non-validated scale (0 to 7 points) and found no significant difference in subjective tinnitus scores between the zinc and placebo groups at the end of eight weeks of follow-up (mean difference (MD) -1.41, 95% CI -2.97 to 0.15; very low-quality evidence). A third trial (n = 50) also evaluated the improvement of tinnitus using a non-validated instrument (a 0 to 10 scale: 10 = severe and unbearable tinnitus). In this study, after eight weeks there was no difference in the proportion of patients with improvement in their tinnitus, 8.7% (2/23) treated with zinc versus 8% (2/25) of those who received a placebo (RR 1.09, 95% CI 0.17 to 7.10, very low-quality evidence).None of the included studies reported any of our other secondary outcomes (quality of life, change in socioeconomic impact associated with work, change in anxiety and depression disorders, change in psychoacoustic parameters or change in thresholds on pure tone audiometry). We found no evidence that the use of oral zinc supplementation improves symptoms in adults with tinnitus.

Early age noise exposure increases loudness perception - A novel animal model of hyperacusis

The neural mechanisms that give rise to hyperacusis, a reduction in loudness tolerance, are largely unknown. Some reports suggest that hyperacusis is linked to childhood hearing loss. However, the evidence for this is largely circumstantial. In order to rigorously test this hypothesis, we studied loudness changes in rats caused by intense noise exposure (12 kHz narrow band noise, 115 dB SPL, 4 h) at postnatal 16 days. Rats without noise exposure were used as controls. The exposed noise group (n = 7) showed a mean 40–50 dB hearing loss compared to the control group (n = 8) at high frequencies (>= 8 kHz) and less hearing loss at lower frequencies. Loudness was evaluated using sound reaction time and loudness response functions in an operant conditioning-based behavioral task using narrow-band noise (40–110 dB SPL, centered at 2, 4 and 12 kHz). Interestingly, the sound reaction time of the noise group was significantly shorter than the control group at supra-threshold levels. The average reaction time was less than 100 ms in the noise group at 100 dB SPL, which was three times shorter than the control group. Our results indicate that early noise-induced hearing loss leads to a significant increase of loudness, a behavior indicative of hyperacusis. Our results are consistent with clinical reports suggesting that hearing loss at an early age is a significant risk factor for hyperacusis.

No change in the acoustic reflex threshold and auditory brainstem response following short-term acoustic stimulation in normal hearing adults.

Unilateral auditory deprivation or stimulation can induce changes in loudness and modify the sound level required to elicit the acoustic reflex. This has been explained in terms of a change in neural response, or gain, for a given sound level. However, it is unclear if these changes are driven by the asymmetry in auditory input or if they will also occur following bilateral changes in auditory input. The present study used a cross-over trial of unilateral and bilateral amplification to investigate changes in the acoustic reflex thresholds (ARTs) and the auditory brainstem response (ABR) in normal hearing listeners. Each treatment lasted 7 days and there was a 7-day washout period between the treatments. There was no significant change in the ART or ABR with either treatment. This null finding may have occurred because the amplification was insufficient to induce experience-related changes to the ABR and ART. Based on the null findings from the present study, and evidence of a change in ART in previous unilateral hearing aid use in normal hearing listeners, the threshold to trigger adaptive changes appears to be around 5 days of amplification with real ear insertion gain greater than 13-17 dB.

Moving Music

We examined how children (5- and 8-year-olds) associate changes in musical parameters with bodily motion, using movement and verbal tasks. In Task 1, participants moved to short musical stimuli involving bidirectional changes in pitch, loudness, or tempo. In Task 2, participants selected motion features appropriate to the same stimuli (forced-choice verbal task). In Task 1 the distribution of movement features significantly varied for different musical parameters: pitch change associated most strongly with vertical motion, loudness change with muscular energy and vertical motion, and tempo change with speed and muscular energy. In both tasks and for both ages, directions of change in motion and musical parameters correlated, e.g., increase in loudness was associated with increasing speed, increasing muscular energy, and spatial rise. The effect of pitch direction was mediated by temporal order, suggesting that overall pitch contour, rather than local direction only, affects bodily motion. Age affected responses to pitch direction, rather than loudness or tempo change. Results suggest that children consistently correlate musical and movement features through both verbal and motion responses, presenting an intricate web of auditory-motor-cognitive mappings.

Auditory navigation with a tubular acoustic model for interactive distance cues and personalized head-related transfer functions

This paper presents a novel spatial auditory display that combines a virtual environment based on a Digital Waveguide Mesh (DWM) model of a small tubular shape with a binaural rendering system with personalized head-related transfer functions (HRTFs) allowing interactive selection of absolute 3D spatial cues of direction as well as egocentric distance. The tube metaphor in particular minimizes loudness changes with distance, providing mainly direct-to-reverberant and spectral cues. The proposed display was assessed through a target-reaching task where participants explore a 2D virtual map with a pen tablet and hit a sound source (the target) using auditory information only; subjective time to hit and traveled distance were analyzed for three experiments. The first one aimed at assessing the proposed HRTF selection method for personalization and dimensionality of the reaching task, with particular attention to elevation perception; we showed that most subjects performed better when they had to reach a vertically unbounded (2D) rather then an elevated (3D) target. The second experiment analyzed interaction between the tube metaphor and HRTF showing a dominant effect of DWM model over binaural rendering. In the last experiment, participants using absolute distance cues from the tube model performed comparably well to when they could rely on more robust, although relative, intensity cues. These results suggest that participants made proficient use of both binaural and reverberation cues during the task, displayed as part of a coherent 3D sound model, in spite of the known complexity of use of both such cues. HRTF personalization was beneficial for participants who were able to perceive vertical dimension of a virtual sound. Further work is needed to add full physical consistency to the proposed auditory display.

Morphometric Differences of Vocal Tract Articulators in Different Loudness Conditions in Singing.

IntroductionDynamic MRI analysis of phonation has gathered interest in voice and speech physiology. However, there are limited data addressing the extent to which articulation is dependent on loudness.Material and Methods12 professional singer subjects of different voice classifications were analysed concerning the vocal tract profiles recorded with dynamic real-time MRI with 25fps in different pitch and loudness conditions. The subjects were asked to sing ascending scales on the vowel /a/ in three loudness conditions (comfortable = mf, very soft = pp, very loud = ff, respectively). Furthermore, fundamental frequency and sound pressure level were analysed from the simultaneously recorded optical audio signal after noise cancellation.ResultsThe data show articulatory differences with respect to changes of both pitch and loudness. Here, lip opening and pharynx width were increased. While the vertical larynx position was rising with pitch it was lower for greater loudness. Especially, the lip opening and pharynx width were more strongly correlated with the sound pressure level than with pitch.ConclusionFor the vowel /a/ loudness has an effect on articulation during singing which should be considered when articulatory vocal tract data are interpreted.

The Moderating Effect of Frequent Singing on Voice Aging

The effects of aging on voice production are well documented, including changes in loudness, pitch, and voice quality. However, one important and clinically relevant question that remains concerns the possibility that the aging of voice can be prevented or at least delayed through noninvasive methods. Indeed, discovering natural means to preserve the integrity of the human voice throughout aging could have a major impact on the quality of life of elderly adults. The objective of this study was therefore to examine the potentially positive effect of singing on voice production. To this aim, a group of 72 healthy nonsmoking adults (20-93 years old) was recruited and separated into three groups based on their singing habits. Several voice parameters were assessed (fundamental frequency [f0] mean, f0 standard deviation [SD], f0 minimum and f0 maximum, mean amplitude and amplitude SD, jitter, shimmer, and harmonic-to-noise ratio) during the sustained production of vowel /a/. Other parameters were assessed during standardized reading passage (speaking f0, speaking f0 SD). As was expected, age effects were found on most acoustic parameters with significant sex differences. Importantly, moderation analyses revealed that frequent singing moderates the effect of aging on most acoustic parameters. Specifically, in frequent singers, there was no decrease in the stability of pitch and amplitude with age, suggesting that the voice of frequent singers remains more stable in aging than the voice of non-singers, and more generally, providing empirical evidence for a positive effect of singing on voice in aging.

Effects of auditory enhancement on the loudness of masker and target components

Auditory enhancement refers to the observation that the salience of one spectral region (the “signal”) of a broadband sound can be enhanced and can “pop out” from the remainder of the sound (the “masker”) if it is preceded by the broadband sound without the signal. The present study investigated auditory enhancement as an effective change in loudness, to determine whether it reflects a change in the loudness of the signal, the masker, or both. In the first experiment, the 500-ms precursor, an inharmonic complex with logarithmically spaced components, was followed after a 50-ms gap by the 100-ms signal or masker alone, the loudness of which was compared with that of the same signal or masker presented 2 s later. In the second experiment, the loudness of the signal embedded in the masker was assessed with and without a precursor using the same method, as was the loudness of the entire signal-plus-masker complex. The results suggest that the precursor does not affect the loudness of the signal or the masker alone, but enhances the loudness of the signal in the presence of the masker, while leaving the loudness of the surrounding masker unaffected. The results are consistent with an explanation based on “adaptation of inhibition” [Viemeister and Bacon (1982). J. Acoust. Soc. Am. 71, 1502–1507].

The Effect of a Vocal Loading Task on Vocal Function Before and After 24 Hours of Thickened Liquid Use

Objective: To determine the effect of a vocal loading task on vocal function before and after 24 hours of thickened liquid use. Methods: Seven healthy adults, ages 19 to 52 years of age, were recruited as participants. Baseline data regarding daily food/liquid intake and urine specific gravity levels (USG) as a marker of hydration were obtained. Participants then completed a vocal loading task, which consisted of 3 × 10 repetitions of a sustained vowel task at 65 dB to 75 dB SPL. Voice recordings and subjective ratings of vocal fatigue and muscle soreness were obtained prior to and following the vocal loading task for both the pre-thickened liquid and post-thickened liquid experimental session. The voice samples were analyzed for changes in fundamental frequency, loudness, and perturbation measures. Results: There was a significant main effect of vocal loading on vocal loudness as well as subjective ratings of vocal fatigue and muscle soreness; all parameters were higher post-vocal loading. There was also a significant main effect of thickened liquid use on jitter, as jitter levels were substantially lower post-thickened liquids. Conclusion: The objective and subjective changes reported by the participants’ post-vocal loading are consistent with prior reports concerning normal adaptive responses to greater vocal demands and increased muscular effort. A brief period of thickened liquids does not appear to affect vocal function.

The Effects of Acoustic Intensity, Spectrum, and Duration on Global Loudness Change

The Effects of Acoustic Intensity, Spectrum, and Duration on Global Loudness Change

Repetitive transcranial magnetic stimulation induces oscillatory power changes in chronic tinnitus.

Chronic tinnitus is associated with neuroplastic changes in auditory and non-auditory cortical areas. About 10 years ago, repetitive transcranial magnetic stimulation (rTMS) of auditory and prefrontal cortex was introduced as potential treatment for tinnitus. The resulting changes in tinnitus loudness are interpreted in the context of rTMS induced activity changes (neuroplasticity). Here, we investigate the effect of single rTMS sessions on oscillatory power to probe the capacity of rTMS to interfere with tinnitus-specific cortical plasticity. We measured 20 patients with bilateral chronic tinnitus and 20 healthy controls comparable for age, sex, handedness, and hearing level with a 63-channel electroencephalography (EEG) system. Educational level, intelligence, depressivity and hyperacusis were controlled for by analysis of covariance. Different rTMS protocols were tested: Left and right temporal and left and right prefrontal cortices were each stimulated with 200 pulses at 1 Hz and with an intensity of 60% stimulator output. Stimulation of central parietal cortex with 6-fold reduced intensity (inverted passive-cooled coil) served as sham condition. Before and after each rTMS protocol 5 min of resting state EEG were recorded. The order of rTMS protocols was randomized over two sessions with 1 week interval in between. Analyses on electrode level showed that people with and without tinnitus differed in their response to left temporal and right frontal stimulation. In tinnitus patients left temporal rTMS decreased frontal theta and delta and increased beta2 power, whereas right frontal rTMS decreased right temporal beta3 and gamma power. No changes or increases were observed in the control group. Only non-systematic changes in tinnitus loudness were induced by single sessions of rTMS. This is the first study to show tinnitus-related alterations of neuroplasticity that were specific to stimulation site and oscillatory frequency. The observed effects can be interpreted within the thalamocortical dysrhythmia model assuming that slow waves represent processes of deafferentiation and that high frequencies might be indicators for tinnitus loudness. Moreover our findings confirm the role of the left temporal and the right frontal areas as relevant hubs in tinnitus related neuronal network. Our results underscore the value of combined TMS-EEG measurements for investigating disease related changes in neuroplasticity.

The effects of stereo disparity on the behavioural and electrophysiological correlates of perception of audio–visual motion in depth

Motion is represented by low-level signals, such as size-expansion in vision or loudness changes in the auditory modality. The visual and auditory signals from the same object or event may be integrated and facilitate detection. We explored behavioural and electrophysiological correlates of congruent and incongruent audio–visual depth motion in conditions where auditory level changes, visual expansion, and visual disparity cues were manipulated. In Experiment 1 participants discriminated auditory motion direction whilst viewing looming or receding, 2D or 3D, visual stimuli. Responses were faster and more accurate for congruent than for incongruent audio–visual cues, and the congruency effect (i.e., difference between incongruent and congruent conditions) was larger for visual 3D cues compared to 2D cues. In Experiment 2, event-related potentials (ERPs) were collected during presentation of the 2D and 3D, looming and receding, audio–visual stimuli, while participants detected an infrequent deviant sound. Our main finding was that audio–visual congruity was affected by retinal disparity at an early processing stage (135–160ms) over occipito-parietal scalp. Topographic analyses suggested that similar brain networks were activated for the 2D and 3D congruity effects, but that cortical responses were stronger in the 3D condition. Differences between congruent and incongruent conditions were observed between 140–200ms, 220–280ms, and 350–500ms after stimulus onset.

Response: A commentary on: "Neural overlap in processing music and speech".

Response: A commentary on: "Neural overlap in processing music and speech".

Intensity, Duration, and Location of High-Definition Transcranial Direct Current Stimulation for Tinnitus Relief

Background and Objective. Tinnitus is the perception of a phantom sound. The aim of this study was to compare current intensity (center anode 1 mA and 2 mA), duration (10 minutes and 20 minutes), and location (left temporoparietal area [LTA] and dorsolateral prefrontal cortex [DLPFC]) using 4 × 1 high-definition transcranial direct current stimulation (HD-tDCS) for tinnitus reduction. Methods. Twenty-seven participants with chronic tinnitus (>2 years) and mean age of 53.5 years underwent 2 sessions of HD-tDCS of the LTA and DLPFC in a randomized order with a 1 week gap between site of stimulation. During each session, a combination of 4 different settings were used in increasing dose (1 mA, 10 minutes; 1 mA, 20 minutes; 2 mA, 10 minutes; and 2 mA, 20 minutes). The impact of different settings on tinnitus loudness and annoyance was documented. Results. Twenty-one participants (77.78%) reported a minimum of 1 point reduction on tinnitus loudness or annoyance scales. There were significant changes in loudness and annoyance for duration of stimulation, F(1, 26) = 10.08, P < .005, and current intensity, F(1, 26) = 14.24, P = .001. There was no interaction between the location, intensity, and duration of stimulation. Higher intensity (2 mA) and longer duration (20 minutes) of stimulation were more effective. Conclusions. A current intensity of 2 mA for 20-minute duration was the most effective setting used for tinnitus relief. The stimulation of the LTA and DLPFC were equally effective for suppressing tinnitus loudness and annoyance.

Stapedectomy Effects on Tinnitus: Relationship of Change in Loudness to Change in Severity.

To relate poststapedectomy change in tinnitus loudness to change in tinnitus severity. Prospective, within-subjects. A single otology and neurotology subspecialty referral practice. Forty-nine subjects undergoing stapedectomy completed the study between January 2012 and October 2013. Tinnitus instruments, audiometric data, and demographic information were collected prior to and 1 and 6 months after surgery. Tinnitus loudness was assessed using an 11-point (0 = none; 5 = conversation level; 10 = jet engine) visual analog scale, and severity was measured using the validated Tinnitus Functional Index. The relationship between change in tinnitus loudness and change in tinnitus severity was evaluated using linear regression and receiver operating characteristic (ROC) analyses. A linear regression model of change in tinnitus loudness averaged for both ears on a visual analog scale (ΔVASavg) versus change in Tinnitus Functional Index score (ΔTFI) showed a strong correlation (ΔTFI = 9.35 ×ΔVASavg; R = 0.64; P < .001). An ROC analysis identified ΔVASavg between 1.5 and 2.0 as the optimal threshold for predicting a clinically significant change in tinnitus severity (ΔTFI ≥ 13), with sensitivity and specificity of approximately 0.62 and a positive predictive value (PPV) of 0.64. For poststapedectomy patients, a VAS loudness change by 1.5 to 2.0 points averaged for both ears in bilateral tinnitus or ~3 points in unilateral tinnitus has a PPV ~0.64 for a clinically significant change in tinnitus severity.