Effects Of Sensorineural Hearing Loss Research Articles

Human auditory ecology: Extending hearing research to the perception of natural soundscapes by humans

A “natural soundscape” refers to the case where the contribution of acoustic events resulting from human activity can be considered as negligeable. As a consequence, natural soundscapes are only composed of biological sounds and geophysical sounds shaped by the specific way sounds propagate within the habitat under study. Within this framework, studying soundscape perception in humans aims at unveiling the relationship between the features of sound mixtures picked up at a given place and time by the peripheral auditory system of a human listener and the characteristics of the auditory percept evoked by these features. We will present a research program based on large and ecologically-valid acoustic databases recorded in protected areas aiming to (i) better understand the mechanisms involved in auditory perception of natural soundscapes; (ii) characterize and explain the effects of sensorineural hearing loss on perception of natural soundscapes; and (iii) assess the extent to which alterations in soundscape perception can be restored back to normal via hearing aids. This programme combines modelling and psychophysical methods to explore our ability to distinguish between habitat, time of day and season, to detect the presence of biological sound sources and to assess levels of biodiversity in the habitat.

Effects of sensorineural hearing loss on formant-frequency discrimination: Measurements and models

This study concerns the effect of hearing loss on discrimination of formant frequencies in vowels. In the response of the healthy ear to a harmonic sound, auditory-nerve (AN) rate functions fluctuate at the fundamental frequency, F0. Responses of inner-hair-cells (IHCs) tuned near spectral peaks are captured (or dominated) by a single harmonic, resulting in lower fluctuation depths than responses of IHCs tuned between spectral peaks. Therefore, the depth of neural fluctuations (NFs) varies along the tonotopic axis and encodes spectral peaks, including formant frequencies of vowels. This NF code is robust across a wide range of sound levels and in background noise. The NF profile is converted into a rate-place representation in the auditory midbrain, wherein neurons are sensitive to low-frequency fluctuations. The NF code is vulnerable to sensorineural hearing loss (SNHL) because capture depends upon saturation of IHCs, and thus the interaction of cochlear gain with IHC transduction. In this study, formant-frequency discrimination limens (DLFFs) were estimated for listeners with normal hearing or mild to moderate SNHL. The F0 was fixed at 100 Hz, and formant peaks were either aligned with harmonic frequencies or placed between harmonics. Formant peak frequencies were 600 and 2000 Hz, in the range of first and second formants of several vowels. The difficulty of the task was varied by changing formant bandwidth to modulate the contrast in the NF profile. Results were compared to predictions from model auditory-nerve and inferior colliculus (IC) neurons, with listeners’ audiograms used to individualize the AN model. Correlations between DLFFs, audiometric thresholds near the formant frequencies, age, and scores on the Quick speech-in-noise test are reported. SNHL had a strong effect on DLFF for the second formant frequency (F2), but relatively small effect on DLFF for the first formant (F1). The IC model appropriately predicted substantial threshold elevations for changes in F2 as a function of SNHL and little effect of SNHL on thresholds for changes in F1.

The effect of sensorineural hearing loss on central auditory processing of signals in noise in older adults.

The study aimed to explore the effect of sensorineural hearing loss on the central auditory processing of signals in noise using cortical auditory evoked potentials (CAEPs) in a cohort of older adults. Three groups of individuals participated in the study. Each group included 33 older adults with normal hearing, those with mild hearing loss and those with moderate hearing loss. N1-P2 peaks of CAEPs by speech stimuli in silent conditions and with varying sound pressure levels of background noise were recorded. CAEP latencies, amplitudes and relative changes in CAEP amplitudes as a function of decreasing signal-to-noise ratios (SNR) in three groups were analyzed using the mixed analysis of variance method. There was a significant main effect of SNR on all CAEP components, as well as significant main effects of hearing status on N1 latencies, amplitudes and relative changes in N1 amplitudes. A significant interaction was found between hearing status and SNR for relative changes in N1 amplitudes. The normal hearing group differed from both the mild and moderate hearing loss groups in terms of relative changes in N1 amplitudes at SNR 10 dB. The results showed decreased amplitudes and increased latencies for N1-P2 response as the SNR of CAEP stimuli was lowered. The degree of reduction in the N1 amplitudes of the older people with normal hearing resulting from the increase in the background noise level was greater than those in their sensorineural hearing-impaired counterparts, providing evidence for decreased central inhibition for individuals with age-related hearing loss.

Wideband Tympanometry in Adults with Severe to Profound Hearing Loss with and without Cochlear Implants

Objectives—Cochlear implantation has been suggested to be associated with an air-bone gap, possibly secondary to increased middle- and inner-ear stiffness. To explore the effect of possible changes in mechanics due to cochlear implantation, we measured wideband tympanometry (WBT) in individuals with normal hearing and individuals with severe to profound sensorineural hearing loss who underwent unilateral or bilateral cochlear implantation. Our goal was to characterize differences in WBT patterns associated with severe to profound sensorineural hearing loss and with cochlear implantation. Design—The study participants were 24 individuals with normal hearing (48 ears) and 17 with cochlear implants, of which 15 were unilaterally implanted and two were implanted bilaterally. All the participants had normal otoscopy. In the implanted group, inner-ear anatomy was normal according to preoperative imaging. All participants underwent pure-tone audiometric assessment, standard tympanometry (226 Hz probe tone), and WBT to a click stimulus (analyzed from 226 to 8000 Hz). WBT was recorded at ambient and peak pressures. To elucidate the effect of sensorineural hearing loss on WBT, we compared normal-hearing ears with impaired non-implanted ears. The impact of cochlear implantation was assessed by comparing the WBT of the implanted and non-implanted ears of the same participants. Moreover, the effect of the ear (right vs. left) and test–retest reproducibility were evaluated. Results—WBT results for right and left ears showed no statistically significant differences in the normal hearing participants. There were no statistical differences shown between repeated measurements of WBT with removal and re-insertion of the probe in any of the groups—the normal ears, the implanted ears, and the non-implanted ears with hearing impairment. Peak compensated admittance (Ytm) in standard tympanometry was normal in 32 out of 34 (94%) ears with sensorineural hearing loss, with one CI user having bilateral negative middle-ear pressure. Compared to normal-hearing ears, ears with severe to profound SNHL, with or without cochlear implantation, showed a significant decrease in absorbance at high frequencies (4000–5000 Hz). Implanted ears, compared both to normal-hearing and contralateral-non-implanted ears, showed a significant decrease in absorbance at low frequencies (400–800 Hz) and an increase in absorbance around 1600 Hz. Conclusions—WBT analysis revealed that the implanted ears showed a significant decrease in absorbance at low frequencies (400–800 Hz) and an increase at 1600 Hz. This finding is likely a result of an increased stiffness due to the implantation surgery and the presence of the implant in the inner ear. In contrast, the specific decrease in absorbance around 4000–5000 Hz in the implanted and non-implanted ears compared to the normal ears is likely either due to aging or the impact of the severe-to-profound SNHL on the input impedance of the cochlea. The structural and functional changes of both the conductive system and the cochlea associated with aging and SNHL may change the wideband acoustic immittance of the ear and these alterations might be correlated with the hearing loss severity. Additional research is needed to determine how much hearing loss and age influence wideband acoustic immittance of the ear.

The effect of sensorineural hearing loss on suprathreshold perception of tonal components in noise.

The present study investigates how sensorineural hearing loss affects the perception of suprathreshold tonal components in noise. Masked threshold, tonality, and loudness of the tonal content are measured for one, two, or four simultaneously presented sinusoids. The levels of the suprathreshold tonal components were chosen relative to the individual masked thresholds. Masked thresholds were significantly higher for the hearing-impaired listeners than for normal-hearing listeners. In general, tonality was the same for hearing-impaired and normal-hearing listeners at the same level above threshold. The same was found for the loudness of the tonal content.

Sensorineural Hearing Loss Affects Functional Connectivity of the Auditory Cortex, Parahippocampal Gyrus and Inferior Prefrontal Gyrus in Tinnitus Patients.

BackgroundTinnitus can interfere with a patient’s speech discrimination, but whether tinnitus itself or the accompanying sensorineural hearing loss (SNHL) causes this interference is still unclear. We analyzed event-related electroencephalograms (EEGs) to observe auditory-related brain function and explore the possible effects of SNHL on auditory processing in tinnitus patients.MethodsSpeech discrimination scores (SDSs) were recorded in 21 healthy control subjects, 24 tinnitus patients, 24 SNHL patients, and 27 patients with both SNHL and tinnitus. EEGs were collected under an oddball paradigm. Then, the mismatch negativity (MMN) amplitude and latency, the clustering coefficient and average path length of the whole network in the tinnitus and SNHL groups were compared with those in the control group. Additionally, we analyzed the intergroup differences in functional connectivity among the primary auditory cortex (AC), parahippocampal gyrus (PHG), and inferior frontal gyrus (IFG).ResultsSNHL patients with or without tinnitus had lower SDSs than the control subjects. Compared with control subjects, tinnitus patients with or without SNHL had decreased MMN amplitudes, and SNHL patients had longer MMN latencies. Tinnitus patients without SNHL had a smaller clustering coefficient and a longer whole-brain average path length than the control subjects. SNHL patients with or without tinnitus had a smaller clustering coefficient and a longer average path length than patients with tinnitus alone. The connectivity strength from the AC to the PHG and IFG was lower on the affected side in tinnitus patients than that in control subjects; the connectivity strength from the PHG to the IFG was also lower on the affected side in tinnitus patients than that in control subjects. However, the connectivity strength from the IFG to the AC was stronger in tinnitus patients than that in the control subjects. In SNHL patients with or without tinnitus, these changes were magnified.ConclusionChanges in auditory processing in tinnitus patients do not influence SDSs. Instead, SNHL might cause the activity of the AC, PHG and IFG to change, resulting in impaired speech recognition in tinnitus patients with SNHL.

Spectral weighting functions for localization of complex sound: Effects of sensorineural hearing loss

When localization cues are distributed across the spectrum of a complex sound, listeners with normal hearing (NH) utilize cues near the 600-800 Hz “ITD dominance region” [Bilsen and Raatgever, Acustica 28, 131–132 (1973)]. Recent work has quantified this pattern using spectral weighting functions (SWFs) [Folkerts and Stecker, ARO 42, 505 (2018)] in NH listeners. However, the salience of the ITD dominance region in listeners with sensorineural hearing loss (SNHL) remains unexamined. Folkerts and Stecker [ARO 45, 171 (2022)] used simulated SNHL in NH listeners to measure impacts of elevated hearing thresholds, loudness recruitment, and reduced high-frequency ITD sensitivity [Steinberg and Gardener, J Acoust. Soc Am 9, 11–23 (1937)] on SWFs. The current study measured SWFs in listeners with bilateral sloping high-frequency SNHL. Direct comparisons to SWFs measured with simulated SNHL test the hypothesis that reduced audibility of high-frequency components shifts the ITD dominance region to lower frequencies (i.e., 400–600 Hz). Individual SWFs measured in listeners with SNHL are compared to their headphone and free field thresholds to assess whether audibility can account for weighting changes. [Work supported by NIH R01-DC016643.]

Age-related changes in event related potentials, steady state responses and temporal processing in the auditory cortex of mice with severe or mild hearing loss

Age-related changes in auditory processing affect the quality of life of older adults with and without hearing loss. To distinguish between the effects of sensorineural hearing loss and aging on cortical processing, the main goal of the present study was to compare cortical responses using the same stimulus paradigms and recording conditions in two strains of mice (C57BL/6J and FVB) that differ in the degree of age-related hearing loss. Electroencephalogram (EEG) recordings were obtained from freely moving young and old mice using epidural screw electrodes. We measured event related potentials (ERP) and 40 Hz auditory steady-state responses (ASSR). We used a novel stimulus, termed the gap-ASSR stimulus, which elicits an ASSR by rapidly presenting short gaps in continuous noise. By varying the gap widths and modulation depths, we probed the limits of temporal processing in young and old mice. Temporal fidelity of ASSR and gap-ASSR responses were measured as phase consistency across trials (inter-trial phase clustering; ITPC). The old C57 mice, which show severe hearing loss, produced larger ERP amplitudes compared to young mice. Despite robust ERPs, the old C57 mice showed significantly diminished ITPC in the ASSR and gap-ASSR responses, even with 100% modulation depth. The FVB mice, which show mild hearing loss with age, generated similar ERP amplitudes and ASSR ITPC across the age groups tested. However, the old FVB mice showed decreased gap-ASSR responses compared to young mice, particularly for modulation depths <100%. The C57 mice data suggest that severe presbycusis leads to increased gain in the auditory cortex, but with reduced temporal fidelity. The FVB mice data suggest that with mild hearing loss, age-related changes in temporal processing become apparent only when tested with more challenging sounds (shorter gaps and shallower modulation).

Sensorineural hearing loss and risk of stroke: a systematic review and meta-analysis

The aim of this systematic review and meta-analysis study was to clarify the effects of sensorineural hearing loss (SNHL) on the incidence of stroke. In line with this, PubMed, Scopus, Web of Science, and ScienceDirect databases were searched using related keywords and MeSH terms from inception to March 1, 2020. Out of the 1961 initial records, eight cohort studies comprising 4,564,202 participants were included, and their qualities were assessed using the Newcastle-Ottawa Scale (NOS). Then, the random-effects model was used to pool HR (95% CI) for risk of stroke; and heterogeneity was presented with I2 index. Subgroup analysis and publication bias tests were performed, and the pooled HR (95% CI) of stroke in SNHL was estimated as 1.31 (1.08, 1.53) for the unadjusted model and 1.33 (1.18, 1.49) for the adjusted model. Subgroup analysis indicates a significantly higher risk of stroke in patients with sudden SNHL (SSNHL) in comparison to age-related HL (ARHL) both in the unadjusted model, [HR = 1.46; 95% CI (1.08, 1.63)] versus [HR = 1.14; 95% CI (0.64, 1.65)], and in the adjusted model, [HR = 1.44; 95% CI (1.15, 1.74)] versus [HR = 1.29; 95% CI (1.24, 1.34)]. Our study showed that patients with SNHL face a higher risk of stroke than those without SNHL. It is necessary to perform hematologic and neurological examinations to help clinicians detect patients who are potentially at risk for stroke.

Effects of cochlear hair cell ablation on spatial learning/memory

Current clinical interest lies in the relationship between hearing loss and cognitive impairment. Previous work demonstrated that noise exposure, a common cause of sensorineural hearing loss (SNHL), leads to cognitive impairments in mice. However, in noise-induced models, it is difficult to distinguish the effects of noise trauma from subsequent SNHL on central processes. Here, we use cochlear hair cell ablation to isolate the effects of SNHL. Cochlear hair cells were conditionally and selectively ablated in mature, transgenic mice where the human diphtheria toxin (DT) receptor was expressed behind the hair-cell specific Pou4f3 promoter. Due to higher Pou4f3 expression in cochlear hair cells than vestibular hair cells, administration of a low dose of DT caused profound SNHL without vestibular dysfunction and had no effect on wild-type (WT) littermates. Spatial learning/memory was assayed using an automated radial 8-arm maze (RAM), where mice were trained to find food rewards over a 14-day period. The number of working memory errors (WME) and reference memory errors (RME) per training day were recorded. All animals were injected with DT during P30–60 and underwent the RAM assay during P90–120. SNHL animals committed more WME and RME than WT animals, demonstrating that isolated SNHL affected cognitive function. Duration of SNHL (60 versus 90 days post DT injection) had no effect on RAM performance. However, younger age of acquired SNHL (DT on P30 versus P60) was associated with fewer WME. This describes the previously undocumented effect of isolated SNHL on cognitive processes that do not directly rely on auditory sensory input.

Effects of Sensorineural Hearing Loss on Cortical Synchronization to Competing Speech during Selective Attention.

When selectively attending to a speech stream in multi-talker scenarios, low-frequency cortical activity is known to synchronize selectively to fluctuations in the attended speech signal. Older listeners with age-related sensorineural hearing loss (presbycusis) often struggle to understand speech in such situations, even when wearing a hearing aid. Yet, it is unclear whether a peripheral hearing loss degrades the attentional modulation of cortical speech tracking. Here, we used psychoacoustics and electroencephalography (EEG) in male and female human listeners to examine potential effects of hearing loss on EEG correlates of speech envelope synchronization in cortex. Behaviorally, older hearing-impaired (HI) listeners showed degraded speech-in-noise recognition and reduced temporal acuity compared with age-matched normal-hearing (NH) controls. During EEG recordings, we used a selective attention task with two spatially separated simultaneous speech streams where NH and HI listeners both showed high speech recognition performance. Low-frequency (<10 Hz) envelope-entrained EEG responses were enhanced in the HI listeners, both for the attended speech, but also for tone sequences modulated at slow rates (4 Hz) during passive listening. Compared with the attended speech, responses to the ignored stream were found to be reduced in both HI and NH listeners, allowing for the attended target to be classified from single-trial EEG data with similar high accuracy in the two groups. However, despite robust attention-modulated speech entrainment, the HI listeners rated the competing speech task to be more difficult. These results suggest that speech-in-noise problems experienced by older HI listeners are not necessarily associated with degraded attentional selection.SIGNIFICANCE STATEMENT People with age-related sensorineural hearing loss often struggle to follow speech in the presence of competing talkers. It is currently unclear whether hearing impairment may impair the ability to use selective attention to suppress distracting speech in situations when the distractor is well segregated from the target. Here, we report amplified envelope-entrained cortical EEG responses to attended speech and to simple tones modulated at speech rates (4 Hz) in listeners with age-related hearing loss. Critically, despite increased self-reported listening difficulties, cortical synchronization to speech mixtures was robustly modulated by selective attention in listeners with hearing loss. This allowed the attended talker to be classified from single-trial EEG responses with high accuracy in both older hearing-impaired listeners and age-matched normal-hearing controls.

Effect of sensorineural hearing loss on neurocognitive and adaptive functioning in survivors of pediatric embryonal brain tumor.

Survivors of pediatric embryonal brain tumors (BT) are at high risk for sensorineural hearing loss (SNHL) associated with neurocognitive decline. However, previous studies have not assessed the relationship between SNHL and adaptive functioning. We examined neurocognitive and adaptive functioning in patients with and without SNHL. Participants included 36 patients treated for an embryonal BT with craniospinal irradiation (CSI) and cisplatin chemotherapy who were assessed 6.7years post-treatment on average. The impact of SNHL on neurocognitive performance and parent-rated adaptive functioning was assessed in univariate and multivariate analyses. There were 17 cases with SNHL (mean age at evaluation = 14.4) and 19 cases with NH (mean age at evaluation = 13.8). After accounting for age at diagnosis and additional covariates in multivariable analyses, SNHL was associated with worse overall intellectual functioning (p = 0.027) and perceptual reasoning (p = 0.016) performance. There was no effect of SNHL on adaptive functioning in multivariable models. Age at diagnosis and sex were associated with performance on neurocognitive measures. SNHL in pediatric embryonal BT is associated with increased risk for neurocognitive deficits in conjunction with other demographic and treatment-related factors.

Development of a Test Battery for Evaluating Speech Perception in Complex Listening Environments: Effects of Sensorineural Hearing Loss.

To evaluate the speech-in-noise performance of listeners with different levels of hearing loss in a variety of complex listening environments. The quick speech-in-noise (QuickSIN)-based test battery was used to measure the speech recognition performance of listeners with different levels of hearing loss. Subjective estimates of speech reception thresholds (SRTs) corresponding to 100% and 0% speech intelligibility, respectively, were obtained using a method of adjustment before objective measurement of the actual SRT corresponding to 50% speech intelligibility in every listening condition. Of the seven alternative listening conditions, two conditions, one involving time-compressed, reverberant speech (TC+Rev), and the other (N0Sπ) having in-phase noise masker (N0) and out-of-phase target (Sπ), were found to be substantially more sensitive to the effect of hearing loss than the standard QuickSIN test. The performance in these two conditions also correlated with self-reported difficulties in attention/concentration during speech communication and in localizing the sound source, respectively. Hearing thresholds could account for about 50% or less variance in SRTs in any listening condition. Subjectively estimated SRTs (SRTs corresponding to 0% and 100% speech intelligibility) were highly correlated with the objective SRT measurements (SRT corresponding to 50% speech intelligibility). A test battery that includes the TC+Rev and the N0Sπ conditions would be useful in identifying individuals with hearing loss with speech-in-noise deficits in everyday communication.

The effect of sensorineural hearing loss and tinnitus on speech recognition over air and bone conduction military communications headsets

Military personnel are at risk for hearing loss due to noise exposure during deployment (USACHPPM, 2008). Despite mandated use of hearing protection, hearing loss and tinnitus are prevalent due to reluctance to use hearing protection. Bone conduction headsets can offer good speech intelligibility for normal hearing (NH) listeners while allowing the ears to remain open in quiet environments and the use of hearing protection when needed. Those who suffer from tinnitus, the experience of perceiving a sound not produced by an external source, often show degraded speech recognition; however, it is unclear whether this is a result of decreased hearing sensitivity or increased distractibility (Moon et al., 2015). It has been suggested that the vibratory stimulation of a bone conduction headset might ameliorate the effects of tinnitus on speech perception; however, there is currently no research to support or refute this claim (Hoare et al., 2014). Speech recognition of words presented over air conduction and bone conduction headsets was measured for three groups of listeners: NH, sensorineural hearing impaired, and/or tinnitus sufferers. Three levels of speech-to-noise (SNR = 0, −6, −12 dB) were created by embedding speech items in pink noise. Better speech recognition performance was observed with the bone conduction headset regardless of hearing profile, and speech intelligibility was a function of SNR. Discussion will include study limitations and the implications of these findings for those serving in the military.

A mismatch negativity study in Mandarin-speaking children with sensorineural hearing loss

Objectivea) To examine the effects of sensorineural hearing loss on the discriminability of linguistic and non-linguistic stimuli at the cortical level, and b) to examine whether the cortical responses differ based on the chronological age at intervention, the degree of hearing loss, or the acoustic stimulation mode in children with severe and profound hearing loss. MethodsMismatch negativity (MMN) responses were collected from 43 children with severe and profound bilateral sensorineural hearing loss, and 20 children with normal hearing (age: 3–6 years). In the non-verbal stimulation condition, pure tones with frequencies of 1 kHz and 1.1 kHz were used as the standard and the deviant respectively. In the verbal stimulation condition, the Chinese mandarin tokens/ba2/and/ba4/were used as the standard and the deviant respectively. Latency and amplitude of the MMN responses were collected and analyzed. ResultsOverall, children with hearing loss showed longer latencies and lower amplitudes of the MMN responses to both non-verbal and verbal stimulations. The latency of the verbal/ba2/–/ba4/pair was longer than that of the nonverbal 1 kHz–1.1 kHz pair in both groups of children. ConclusionsChildren with hearing loss, especially those who received intervention after 2 years of age, showed substantial weakness in the neural responses to lexical tones and pure tones. Thus, the chronological age when the children receive hearing intervention may have an impact on the effectiveness of discriminating between verbal and non-verbal signals.

A Method for Assessing Auditory Spatial Analysis in Reverberant Multitalker Environments.

Deficits in spatial hearing can have a negative impact on listeners' ability to orient in their environment and follow conversations in noisy backgrounds and may exacerbate the experience of hearing loss as a handicap. However, there are no good tools available for reliably capturing the spatial hearing abilities of listeners in complex acoustic environments containing multiple sounds of interest. The purpose of this study was to explore a new method to measure auditory spatial analysis in a reverberant multitalker scenario. This study was a descriptive case control study. Ten listeners with normal hearing (NH) aged 20-31 yr and 16 listeners with hearing impairment (HI) aged 52-85 yr participated in the study. The latter group had symmetrical sensorineural hearing losses with a four-frequency average hearing loss of 29.7 dB HL. A large reverberant room was simulated using a loudspeaker array in an anechoic chamber. In this simulated room, 96 scenes comprising between one and six concurrent talkers at different locations were generated. Listeners were presented with 45-sec samples of each scene, and were required to count, locate, and identify the gender of all talkers, using a graphical user interface on an iPad. Performance was evaluated in terms of correctly counting the sources and accuracy in localizing their direction. Listeners with NH were able to reliably analyze scenes with up to four simultaneous talkers, while most listeners with hearing loss demonstrated errors even with two talkers at a time. Localization performance decreased in both groups with increasing number of talkers and was significantly poorer in listeners with HI. Overall performance was significantly correlated with hearing loss. This new method appears to be useful for estimating spatial abilities in realistic multitalker scenes. The method is sensitive to the number of sources in the scene, and to effects of sensorineural hearing loss. Further work will be needed to compare this method to more traditional single-source localization tests.

Speech Coding in the Midbrain: Effects of Sensorineural Hearing Loss.

In response to voiced speech sounds, auditory-nerve (AN) fibres phase-lock to harmonics near best frequency (BF) and to the fundamental frequency (F0) of voiced sounds. Due to nonlinearities in the healthy ear, phase-locking in each frequency channel is dominated either by a single harmonic, for channels tuned near formants, or by F0, for channels between formants. The alternating dominance of these factors sets up a robust pattern of F0-synchronized rate across best frequency (BF). This profile of a temporally coded measure is transformed into a mean rate profile in the midbrain (inferior colliculus, IC), where neurons are sensitive to low-frequency fluctuations. In the impaired ear, the F0-synchronized rate profile is affected by several factors: Reduced synchrony capture decreases the dominance of a single harmonic near BF on the response. Elevated thresholds also reduce the effect of rate saturation, resulting in increased F0-synchrony. Wider peripheral tuning results in a wider-band envelope with reduced F0 amplitude. In general, sensorineural hearing loss reduces the contrast in AN F0-synchronized rates across BF. Computational models for AN and IC neurons illustrate how hearing loss would affect the F0-synchronized rate profiles set up in response to voiced speech sounds.

Modeling the Effects of Sensorineural Hearing Loss on Sound Localization in the Median Plane.

Listeners use monaural spectral cues to localize sound sources in sagittal planes (along the up-down and front-back directions). How sensorineural hearing loss affects the salience of monaural spectral cues is unclear. To simulate the effects of outer-hair-cell (OHC) dysfunction and the contribution of different auditory-nerve fiber types on localization performance, we incorporated a nonlinear model of the auditory periphery into a model of sagittal-plane sound localization for normal-hearing listeners. The localization model was first evaluated in its ability to predict the effects of spectral cue modifications for normal-hearing listeners. Then, we used it to simulate various degrees of OHC dysfunction applied to different types of auditory-nerve fibers. Predicted localization performance was hardly affected by mild OHC dysfunction but was strongly degraded in conditions involving severe and complete OHC dysfunction. These predictions resemble the usually observed degradation in localization performance induced by sensorineural hearing loss. Predicted localization performance was best when preserving fibers with medium spontaneous rates, which is particularly important in view of noise-induced hearing loss associated with degeneration of this fiber type. On average across listeners, predicted localization performance was strongly related to level discrimination sensitivity of auditory-nerve fibers, indicating an essential role of this coding property for localization accuracy in sagittal planes.

Informational Masking in Normal-Hearing and Hearing-Impaired Listeners Measured in a Nonspeech Pattern Identification Task.

Individuals with sensorineural hearing loss (SNHL) often experience more difficulty with listening in multisource environments than do normal-hearing (NH) listeners. While the peripheral effects of sensorineural hearing loss certainly contribute to this difficulty, differences in central processing of auditory information may also contribute. To explore this issue, it is important to account for peripheral differences between NH and these hearing-impaired (HI) listeners so that central effects in multisource listening can be examined. In the present study, NH and HI listeners performed a tonal pattern identification task at two distant center frequencies (CFs), 850 and 3500 Hz. In an attempt to control for differences in the peripheral representations of the stimuli, the patterns were presented at the same sensation level (15 dB SL), and the frequency deviation of the tones comprising the patterns was adjusted to obtain equal quiet pattern identification performance across all listeners at both CFs. Tonal sequences were then presented at both CFs simultaneously (informational masking conditions), and listeners were asked either to selectively attend to a source (CF) or to divide attention between CFs and identify the pattern at a CF designated after each trial. There were large differences between groups in the frequency deviations necessary to perform the pattern identification task. After compensating for these differences, there were small differences between NH and HI listeners in the informational masking conditions. HI listeners showed slightly greater performance asymmetry between the low and high CFs than did NH listeners, possibly due to central differences in frequency weighting between groups.

Effect of Sensorineural Hearing Loss on Neurocognitive Functioning in Pediatric Brain Tumor Survivors.

Intensified therapy with platinum-based regimens for pediatric brain tumors has dramatically increased the number of pediatric brain tumor survivors (PBTS) but frequently causes permanent sensorineural hearing loss (SNHL). Although neurocognitive decline in PBTS is known to be associated with radiation therapy (RT), SNHL represents a potential additional contributor whose long-term impact has yet to be fully determined. The neurocognitive impact of significant SNHL (Chang scale ≥ 2b) in PBTS was assessed through a retrospective cohort study of audiograms and neurocognitive testing. Scores for neurocognitive domains and subtest task performance were analyzed to identify specific strengths and weakness for PBTS with SNHL. In a cohort of PBTS (n = 58) treated with platinum therapy, significant SNHL was identified in more than half (55%, n = 32/58), of which the majority required hearing aids (72%, 23/32). RT exposure was approximately evenly divided between those with and without SNHL. PBTS were 6.7 ± 0.6 and 11.3 ± 0.7 years old at diagnosis and neurocognitive testing, respectively. In multivariate analyses adjusted for RT dose, SNHL was independently associated with deficits in intelligence, executive function, and verbal reasoning skills. Subtests revealed PBTS with SNHL to have poor learning efficiency but intact memory and information acquisition. SNHL in PBTS increases the risk for severe therapy-related intellectual and neurocognitive deficits. Additional prospective investigation in malignant brain tumors is necessary to validate these findings through integration of audiology and neurocognitive assessments and to identify appropriate strategies for neurocognitive screening and rehabilitation specific to PBTS with and without SNHL.