Dichotic Sentence Identification Test Research Articles

DOES HEARING LOSS MODERATE THE RELATIONSHIP BETWEEN COGNITION AND DEPRESSION?

Abstract Hearing loss, depression, and cognitive impairment are common, co-occurring conditions experienced by older adults, but the nature of the relationship among these conditions remains unclear. Both depression and hearing loss have been identified as risk factors for dementia, but for different stages of life (e.g., Singh-Manoux et al., 2017; Livingston et al., 2020). Hearing loss is described as the strongest modifiable risk factor in mid-life, and depression is second only to smoking as the strongest modifiable risk factor in late-life (Livingston et al., 2020). The association between hearing loss and depression is well documented in the literature (e.g., Lawrence et al., 2015). It is possible that hearing loss, as an earlier risk factor, moderates the relationship between depression and cognition. Therefore, as part of an ongoing longitudinal study of early indicators of cognitive decline, we examined the moderating effect of two measures of hearing (pure-tone hearing threshold average, Dichotic Sentence Identification test) on the relationship between depression (Geriatric Depression Scale) and cognition (Montreal Cognitive Assessment, Digit Symbol Substitution test) for a group of 65 older adults (mean age 74). Although none of the hearing or cognitive measures were significant predictors of depression scores on their own, there was a significant negative interaction between the Montreal Cognitive Assessment and pure-tone hearing threshold average, p = 0.048. These results may be interpreted to suggest that individuals with higher (poorer) hearing thresholds show a decrease in depression as their cognitive scores improve, whereas individuals with lower (better) hearing thresholds show the opposite pattern.

Association of Performance on Dichotic Auditory Tests With Risk for Incident Dementia and Alzheimer Dementia

Age-related hearing difficulties can include problems with signal audibility and central auditory processing. Studies have demonstrated associations between audibility and dementia risk. To our knowledge, limited data exist to determine whether audibility, central processing, or both drive these associations. To determine the associations between signal sensitivity, central auditory processing, and dementia and Alzheimer dementia (AD) risk. This follow-up observational study of a sample from the prospective Adult Changes in Thought study of dementia risk was conducted at Kaiser Permanente Washington, a western Washington health care delivery system, and included 280 volunteer participants without dementia who were evaluated from October 2003 to February 2006 with follow-up through September 2018. Analyses began in 2019 and continued through 2021. Hearing tests included pure tone signal audibility, a monaural word recognition test, and 2 dichotic tests: the Dichotic Sentence Identification (DSI) test and the Dichotic Digits test (DDT). Cognition was assessed biennially with the Cognitive Abilities Screening Instrument (range, 1-100; higher scores are better), and scores of less than 86 prompted clinical and neuropsychological evaluations. All data were reviewed at multidisciplinary consensus conferences, and standardized criteria were used to define incident cases of dementia and probable or possible AD. Cox proportional hazard models were used to determine associations with hearing test performance. A total of 280 participants (177 women [63%]; mean [SD] age, 79.5 [5.2] years). As of September 2018, there were 2196 person-years of follow-up (mean, 7.8 years) and 89 incident cases of dementia (66 not previously analyzed), of which 84 (94.4%) were AD (63 not previously analyzed). Compared with people with DSI scores of more than 80, the dementia adjusted hazard ratio (aHR) for DSI scores of less than 50 was 4.18 (95% CI, 2.37-7.38; P < .001); for a DSI score of 50 to 80, it was 1.82 (95% CI, 1.10-3.04; P = .02). Compared with people with DDT scores of more than 80, the dementia aHR for DDT scores of less than 50 was 2.66 (95% CI, 1.31-5.42; P = .01); for a DDT score of 50 to 80, it was 2.40 (95% CI, 1.45-3.98; P = .001). The AD results were similar. Pure tone averages were weakly and insignificantly associated with dementia and AD, and associations were null when controlling for DSI scores. In this cohort study, abnormal central auditory processing as measured by dichotic tests was independently associated with dementia and AD risk.

Left Ear Hearing Predicts Functional Activity in the Brains of Patients with Alzheimer's Disease Dementia.

To determine whether central speech processing ability, as measured by hearing in noise, differs between right and left ears in adults with Alzheimer's disease related dementia (AD) as well as whether differences in central speech processing ability correlate with an fMRI-based measurement of global functional brain connectivity. This prospective study was carried out at a tertiary referral center. Patients with an AD diagnosis and pure tone averages 40 dB HL or better were included. They were examined using resting-state fMRI and underwent central audiometric testing using the Dichotic Sentence Identification Test (DSI), the Dichotic Digits Test (DD), and the Synthetic Sentence Identification Test (SS), which test hearing in noise. DSI scores were correlated with resting-state fMRI connectivity between 361 distinct gray matter brain regions of interest (ROIs). Average global connectivity was calculated as mean functional connectivity between an ROI and the other 360 regions, a quantitative marker representing overall functional connectivity in the brain. Sixteen subjects had adequate fMRI and hearing data. The average age was 71.5 years old (±6.0). The average DSI score for the left ear was 40% (±34%) compared to 90% (±10%) in the right ear (P < .001). No difference between ears was noted on the DD. SS does not differentiate between ears, but worsening scores were noted with increasing background noise. Of the fMRI ROIs, 269 of the 361 had multiple comparison corrected significant correlations between global connectivity and DSI of the left ear (P = .004, r = .673), and all 269 showed higher functional connectivity for individuals with higher left DSI score. No correlations between DSI of the right ear and functional connectivity were found. Correlation was noted between left sided DSI and functional connectivity in patients with AD. Auditory input from the left ear was more susceptible to impairment, suggesting that side-specific auditory input may influence central auditory processing.

Mismatch Negativity Occurrence with Verbal and Nonverbal Stimuli in Normal-Hearing Adults.

Introduction The mismatch negativity (MMN) is a long-latency auditory evoked potential related to a passive elicited auditory event. Objective To verify the occurrence of MMN with different stimuli, to describe reference values in normal-hearing adults with verbal and nonverbal stimuli and to compare them with each other, besides analyzing the latency, area, and amplitude regarding gender and between the ears. Method Normal-hearing individuals, aged between 18 and 59 years old, participated in the study. As inclusion criterion in the study, all of them underwent tone threshold audiometry, logoaudiometry, tympanometry, and the Dichotic Sentence Identification (DSI) test, and later the MMN with 4 different stimuli, being 2 verbal (da/ta and ba/di) and 2 nonverbal stimuli (750/1,000Hz and 750/4,000Hz), which are considered stimuli with low and high contrast. Results A total of 90 individuals composed the sample, being 39 males and 51 females, with an average age of 26.9 years old. In the analysis of the latency, amplitude, and area of the four stimuli between the ears, they were not considered statistically different. There was a significant difference between all of the stimuli in terms of latency, amplitude and area, with the highest latency found in da/ta, and the greatest amplitude and area in ba/di. Regarding gender, there was only difference in the latency of the da/ta stimulus. Conclusion The da/ta and 750/1,000Hz stimuli elicited the most MMN in the population of normal-hearing adults. Among the genders, there was difference only regarding the latency of the verbal stimulus da/ta, and there was no difference between the ears.

Mismatch Negativity Elicited by Verbal and Nonverbal Stimuli: Comparison with Potential N1.

Introduction Mismatch negativity (MMN) is a long latency auditory evoked potential, represented by a negative wave, generated after the potential N1 and visualized in a resulting wave. Objective To identify the time of occurrence of MMN after N1, elicited with verbal and nonverbal stimuli. Methods Ninety individuals aged between 18 and 56 years old participated in the study, 39 of whom were male and 51 female, with normal auditory thresholds, at least 8 years of schooling, and who did not present auditory processing complaints. All of them underwent audiologic anamnesis, visual inspection of external auditory meatus, pure tone audiometry, speech audiometry, acoustic immittance measures and the dichotic sentence identification test as a screening for alterations in auditory processing, a requirement to participate in the sample. The MMN was applied with two different stimuli, with these being da/ta (verbal) and 750 Hz and 1,000 Hz (nonverbal). Results There was a statistically significant difference between the latency values of the N1 potential and the MMN with the two stimuli, as well as between the MMN with verbal and nonverbal stimuli, and the latency of the MMN elicited with da/ta being greater than that elicited with 750 Hz and 1,000 Hz, which facilitated its visualization. Conclusion The time of occurrence of MMN after the N1 elicited with verbal stimuli was 100.4 ms and with nonverbal stimuli 85.5 ms. Thus, the marking of the MMN with verbal stimuli proved to be more distant from N1 compared with the nonverbal stimuli.

Evaluation of selective attention in patients with misophonia

IntroductionMisophonia is characterized by the aversion to very selective sounds, which evoke a strong emotional reaction. It has been inferred that misophonia, as well as tinnitus, is associated with hyperconnectivity between auditory and limbic systems. Individuals with bothersome tinnitus may have selective attention impairment, but it has not been demonstrated in case of misophonia yet. ObjectiveTo characterize a sample of misophonic subjects and compare it with two control groups, one with tinnitus individuals (without misophonia) and the other with asymptomatic individuals (without misophonia and without tinnitus), regarding the selective attention. MethodsWe evaluated 40 normal-hearing participants: 10 with misophonia, 10 with tinnitus (without misophonia) and 20 without tinnitus and without misophonia. In order to evaluate the selective attention, the dichotic sentence identification test was applied in three situations: firstly, the Brazilian Portuguese test was applied. Then, the same test was applied, combined with two competitive sounds: chewing sound (representing a sound that commonly triggers misophonia), and white noise (representing a common type of tinnitus which causes discomfort to patients). ResultsThe dichotic sentence identification test with chewing sound, showed that the average of correct responses differed between misophonia and without tinnitus and without misophonia (p=0.027) and between misophonia and tinnitus (without misophonia) (p=0.002), in both cases lower in misophonia. Both, the dichotic sentence identification test alone, and with white noise, failed to show differences in the average of correct responses among the three groups (p≥0.452). ConclusionThe misophonia participants presented a lower percentage of correct responses in the dichotic sentence identification test with chewing sound; suggesting that individuals with misophonia may have selective attention impairment when they are exposed to sounds that trigger this condition.

Influence of the educational status on the Dichotic Sentence Identification test in Brazilian Portuguese.

To compare the performance of the Dichotic Sentence Identification (DSI) test in the Brazilian Portuguese version, considering: the right and left ears and the educational status in normal-hearing individuals. This investigation assessed 200 individuals who are normal listeners and right-handed and were divided into seven groups according to the years of schooling. All the participants underwent basic audiologic evaluation and behavioral auditory processing assessment (sound localization test, memory test for verbal and nonverbal sounds in sequence, dichotic digits test, and DSI). The evaluated individuals revealed an average educational status of 13.1 years and results within normal limits in the selected tests for the audiologic and auditory processing assessments. Regarding the DSI test, the educational status showed a dependent relationship with the percentages of correct answers in each stage of the test and the evaluated ear. There was a statistically significant positive correlation between the educational status and the percentage of correct answers for all the stages of the DSI test in both the ears. There was also an effect of the educational level on the results obtained in each condition of the DSI test, with the exception of directed attention to the right ear. Comparing the performance considering the variables studied in the DSI test, we concluded that there is an advantage of the right ear and that, the better the educational level, the better the performance of the individuals.

Benchmarks for the Dichotic Sentence Identification test in Brazilian Portuguese for ear and age

IntroductionDichotic listening tests should be used in local languages and adapted for the population. ObjectiveStandardize the Brazilian Portuguese version of the Dichotic Sentence Identification test in normal listeners, comparing the performance for age and ear. MethodsThis prospective study included 200 normal listeners divided into four groups according to age: 13–19 years (GI), 20–29 years (GII), 30–39 years (GIII), and 40–49 years (GIV). The Dichotic Sentence Identification was applied in four stages: training, binaural integration and directed sound from right and left. ResultsBetter results for the right ear were observed in the stages of binaural integration in all assessed groups. There was a negative correlation between age and percentage of correct responses in both ears for free report and training. The worst performance in all stages of the test was observed for the age group 40–49 years old. ConclusionsReference values for the Brazilian Portuguese version of the Dichotic Sentence Identification test in normal listeners aged 13–49 years were established according to age, ear, and test stage; they should be used as benchmarks when evaluating individuals with these characteristics.

Central Auditory Dysfunction in Older Persons With Memory Impairment or Alzheimer Dementia

To assess the effect of memory impairment on central auditory function. Case-control study. The Virginia Merrill Bloedel Hearing Research Center, Seattle, Washington. The study cohort of 313 volunteers from a dementia surveillance research program comprised 3 groups: (1) controls without memory loss (n = 232); (2) memory-impaired participants with mild memory impairment but without dementia (n = 64); and (3) memory-impaired participants with a dementia diagnosis (n = 17). Behavioral central auditory tests were the Synthetic Sentence Identification with Ipsilateral Competing Message test, the Dichotic Sentence Identification test, and the Dichotic Digits Test. Memory impairment was indicated by a total score on the Cognitive Ability Screening Instrument of 86 or less, or a total score of 90 or less with a memory subscale score of 10 or less. The mean score on each central auditory test worsened significantly across the 3 memory groups even after adjustment for age and peripheral hearing status (P<.05); it was poorest in the dementia group and moderately reduced in the memory-impaired group compared with the control group. Heterogeneity of results was noted in all 3 groups. Central auditory function was affected by even mild memory impairment. The Dichotic Sentence Identification test in the free report mode was the most sensitive test for the presence of memory impairment. We recommend that central auditory testing be considered in the evaluation of older persons with hearing complaints as part of a comprehensive, individualized program to assist their needs in both the aural rehabilitative and the cognitive domains.

Dichotic listening tests in the assessment of auditory processing disorders

In the clinical audiological application of dichotic listening tests to assess interaural asymmetry, does mode of administration influence results and their interpretation? This paper reviews the various ways in which dichotic listening tests have been administered, considers the possible extra-auditory confounds that may influence each one, then presents data on 172 elderly persons to whom the Dichotic Sentence Identification (DSI) Test was administered in both divided and directed-attention modes. There were three outcome patterns. In 19% of the total cohort, DSI scores were within normal limits on both ears under both modes of administration (Pattern I). In 58% of participants the DSI score was abnormal on one ear (almost always the left ear) in the divided-attention mode but no abnormality on either ear in the directed attention mode (Pattern II). In 23% of the cohort there was an equivalent unilateral deficit under both modes of administration (Pattern III). Pattern II suggests a primarily cognitive ...

Cross-Sectional Study of Differences in Speech Understanding Between Users and Nonusers of Estrogen Replacement Therapy

The purpose of this study was to examine whether women who use estrogen replacement therapy (ERT) differ from women not using ERT on several measures of speech understanding. Participants (n = 38, 60 to 74 years) completed a battery of tests including pure-tone audiometry, the Dichotic Sentence Identification (DSI) test, a test of auditory-only and auditory-visual sentence recognition, and a measure of speech understanding in reverberation. In general, women who used ERT were better able to understand distorted speech than were nonusers of ERT.

The Development of Two Speech Based Tests of Central Auditory Function for Australian Use

The Synthetic Sentence Identification (SSI) test and Dichotic Sentence Identification (DSI) test are chiefly used to assess central auditory function. These tests are reportedly more tolerant of hearing loss than other measures and used together, provide analogous but differing measures of central auditory function which can be administered within an acceptable time frame. The purpose of this study was to generate and evaluate an Australian version of the DSI test and the SSI test. The test materials were trialed on younger and older normal hearing adults whose first language was Australian English. Results show near perfect performance for young adults using comfortable listening levels while older adults showed greater variability in performance. In addition, there was decreasing performance with age on both test measures for the left ear. These results were compared with those reported for the original SSI and DSI tests and similar outcomes were found.

Reliability of two measures of speech recognition in elderly people.

The revised Speech Perception in Noise (SPIN) test and the Dichotic Sentence Identification (DSI) test have been used to help evaluate speech-recognition capabilities in elderly people. We evaluated the test-retest reliability of these measures for 17 subjects aged 63-82 years. The DSI and revised SPIN tests were administered at 65, 75, and 85 dB SPL, with a total of three presentations at each level. Reliability was assessed using a repeated-measures analysis of variance and 95% critical differences for each test. Results raise serious questions about the use of these tests for diagnostic determinations or assessment of speech-recognition ability in elderly people.

Development of a dichotic sentence identification test for hearing-impaired adults.

Third-order synthetic sentences were aligned to make them suitable for dichotic presentation. These dichotic sentence materials were then administered to 14 normal listeners and 48 hearing-impaired subjects to determine the influence of peripheral hearing loss on test performance. Results suggest that the Dichotic Sentence Identification test is resistant to the influence of peripheral hearing loss until the pure-tone average of 500, 1000, and 2000 Hz exceeds approximately 50 dB. Beyond this level, degree of peripheral hearing loss limits its value for detecting central auditory disorder. Data are also provided on six persons with either confirmed or suspected lesions involving retrocochlear structures.