Normal Hearing Individuals Research Articles

SHIMP Findings in Individuals Using Personal Listening Devices.

Listening to PLD at higher volume levels are known to cause subtle pre-clinical damage to the auditory system and vestibular end organs. Exposure to PLDs may also cause vestibular dysfunction much before the cochlear dysfunction. SHIMP is a newly described tool to assess the vestibulo-ocular reflex (VOR) gain suppression. With the premise that prolonged exposure to PLDs at high volume levels may cause vestibular dysfunction, and SHIMP being an early detector of vestibular dysfunction, the study was undertaken. The study aimed to describe the SHIMP test findings in normal hearing individuals with and without prolonged exposure to PLDs at > 60% of volume. A cross sectional comparative study was carried out on 128 participants with and without history of PLD exposure. Participants within the age range of 15-24years and history of PLD usage at < 60% volume for < 1year and at > 60% volume for > 1year were recruited for the study. Output dBSPLs delivered by PLDs were measured using microphone in the ear method. Further, SHIMP was administered to assess the vestibular function. The dBSPL levels used by the participants of both the groups were within the DRC used for occupational noise exposure. Likewise, no statistically significant difference was observed between the two groups. Participants using PLDs with dBSPLs within the DRC may not be at a crucial risk. However, one must use precautionary measures to prevent any subclinical or long-lasting damage to the inner ear.

Music Perception and Music-Related Quality of Life in Adult Cochlear Implant Users: Exploring the Need for Music Rehabilitation.

Cochlear implant (CI) users face difficulties in accurately perceiving basic musical elements such as pitch, melody, and timbre. Music significantly affects the quality of life (QoL) of CI users. Individually and culturally influenced music perception exceeds psychophysical measures in capturing the subjective music enjoyment of CI users. Understanding the music perception, enjoyment, and habits of CI users is crucial for approaches to improve music-related QoL (MuRQoL). Therefore, this study aims to investigate music perception skills, experiences, and participation in music activities in a large group of adult CI users, and to understand the importance of these factors and their impact on QoL of CI users. This study included 214 CI recipients with diverse auditory experiences who were aged between 18 and 65 years and were unilateral, bimodal, or bilateral users for at least 1 year and 193 normal hearing (NH) controls. All participants completed the information forms and the MuRQoL questionnaire. To assess the impact of music on QoL and identify personalized rehabilitation needs, the scores for each question in both parts of the questionnaire were intersected on a matrix. Data were presented in detail for the CI group and compared between CI and NH groups. A statistically significant difference was found between the matched CI and NH groups in favor of the NH group in terms of music perception and music engagement. Participants who received music education at any point in their lives had significantly higher MuRQoL questionnaire scores. There was no significant relationship found between the duration of auditory rehabilitation, pre-CI hearing aid usage, music listening modality, and MuRQoL questionnaire scores. Unilateral CI users had significantly lower scores in music perception and music engagement subsections compared with bimodal and bilateral CI users. Also, it was found that music had a strong negative impact on QoL in 67/214 of the CI users. Although CI users scored significantly lower than NH individuals on the first part of the questionnaire, which asked about musical skills, enjoyment, and participation in musical activities, findings suggest that CI users value music and music enjoyment just as much. The study reveals the influence of factors such as education level, age, music education, type of hearing loss and auditory rehabilitation on music perception, music enjoyment, and participation in music activities through self-report. The results indicate that for many CI users, music has a strong negative impact on QoL, highlighting the need for personalized music interventions, the inclusion of self-report questionnaires, and music perception tests in clinical evaluations.

Cognitive Changes Up to 4 Years After Cochlear Implantation in Older Adults: A Prospective Longitudinal Study Using the RBANS-H.

Hearing loss is a worldwide health problem that currently affects around 20% of the world's population. Untreated hearing loss can have a significant impact on daily life, it can cause social isolation, loneliness, frustration, and higher anxiety and depression rates. Furthermore, older adults with hearing impairment have a higher risk for accelerated cognitive decline compared with normal-hearing individuals. Previous research indicated a positive effect of cochlear implantation on Health-related Quality of life (HRQoL) and cognitive functioning 1 year after cochlear implantation. The aim of this study was to evaluate the long-term effect of cochlear implantation on cognition and HRQoL in older adults with severe-to-profound hearing loss. All included subjects were 55 years or older with postlingual, bilateral, severe-to-profound hearing loss, and received a unilateral cochlear implant. Cognition was evaluated using the Repeatable Battery for the Assessment of Neuropsychological Status for Hearing Impaired Individuals (RBANS-H), and HRQoL was evaluated using the following five questionnaires: Nijmegen Cochlear Implant Questionnaire (NCIQ); Hearing Implant Sound Quality Index (HISQUI); Speech, Spatial, and Qualities of Hearing Scale (SSQ12); Hospital Anxiety and Depression scale (HADS); and Type D questionnaire (DS14). Individuals were evaluated preoperatively, and annually up to 4 years after CI activation. After cochlear implantation an improvement in hearing, cognition, and HRQoL was observed. When comparing preoperative and 12 months postoperative results a significant improvement was observed in the total RBANS-H score (mean [SD], 92.78 [±15.08] versus 98.35 [±14.18], p < 0.001) and the subdomain scores for "Immediate Memory" (94.13 [±18.75] versus 105.39 [±19.98], p = 0.005), "Attention" (86.17 [±19.02] versus 91.57 [±15.35], p = 0.048), and "Delayed memory" (97.91 [±14.51] versus 103.83 [±14.714], p = 0.017). When comparing preoperative results with 4 years postoperative results, a significant improvement was observed in "Immediate Memory" (94.13 [±18.75] versus 101.91 [±16.09], p = 0.020) and a significant decline was observed in "Visuospatial Memory" (97.04 [±17.47] versus 87.26 [±13.41], p = 0.013). Compared with the preoperative results, no significant improvement was observed in the total RBANS-H score 4 years after implantation. A significant improvement was observed for the HRQoL questionnaires, that is, NCIQ, HISQUI19, SSQ12, HADS, and DS14, 1 year after cochlear implantation. When comparing preoperative results with 4-year postoperative results, significant improvement was observed for the NCIQ and DS14 social inhibition scores. Long-term results of the SSQ12 and HISQUI19 were lacking. Unilateral cochlear implantation in an adult population with bilateral severe-to-profound sensorineural hearing loss has a positive effect on cognitive functioning and HRQoL 1 year after activation. This positive effect on cognitive functioning was no longer observed 4 years after cochlear implantation. Further research is needed to explain individual variation in the evolution of cognitive functioning.

Development and evaluation of a novel user-operated slider-based audiometry method.

To evaluate a novel user-operated audiometry method allowing users full control in determining their pure-tone hearing thresholds. Comparative study. Participants were recruited from a hearing clinic after undergoing manual audiometry (six frequencies). They then performed test-retests of a new test (slider audiometry, eight frequencies) and completed the System Usability Scale questionnaire. 37 adult participants, including 30 hearing-impaired and seven normal-hearing individuals. Mean (SD) threshold differences for octave frequencies between 250 to 2000 Hz between manual and slider audiometry ranged from -7.8 (6.6) to -5.7 (6.5) dB and were significant. For 4000 and 8000 Hz mean differences were -0.3 (8.4) and 0.0 (9.7) dB and insignificant. Standard deviations ranged from 6.5 to 9.7 dB across six tested frequencies. Slider test-retest mean threshold differences ranged from -1.4 (4.7) to 0.3 (6.0) dB across eight tested frequencies, with standard deviations ranging from 4.1 to 8.5 dB. The average usability score for the slider audiometry was 88.3. When compared to manual audiometry, the slider audiometry demonstrated validity at 4000 and 8000 Hz but found significantly lower thresholds for octave frequencies between 250 to 2000 Hz. Test-retests of the new method revealed small mean differences and acceptable SDs.

ICF-based hearing and functioning assessment: validation and research outcomes of utilizing the HEAR-COMMAND tool for patients with mild to moderately severe hearing loss and individuals with normal hearing.

Current clinical assessments for Hearing Loss (HL) are often limited to controlled laboratory settings in which a narrow spectrum of hearing difficulties can be assessed. A majority of the daily life challenges caused by HL cannot be measured in clinical methodologies. To screen the individuals' needs and limitations, a questionnaire named the HEAR-COMMAND tool was developed and qualitatively validated through an international collaboration, aligning with the World Health Organization's International Classification of Functioning, Disability, and Health Framework (ICF) Core Sets for Hearing Loss. The tool empowers healthcare professionals (HCPs) to integrate the ICF framework into patient assessments and patient-reported outcomes (PRO) in clinical and non-clinical settings. The aim is to provide a general foundation and starting point for future applications in various areas including ENT and hearing acoustics. The outcome can be employed to define and support rehabilitation in an evidence-based manner. This article presents the validation and research outcomes of using the tool for individuals with mild to moderately severe HL in contrast to normal-hearing individuals. Using a cross-sectional multicenter study, the tool was distributed among 215 participants in Germany, the USA, and Egypt, filled in German, English, or Arabic. Three outcome scores and the corresponding disability degree were defined: hearing-related, non-hearing-related, and speech-perception scores. The content and construct validation were conducted, and the tool's internal consistency was assessed. The extracted constructs included "Auditory processing functionality", "Sound quality compatibility", "Listening and communication functionality", "Interpersonal interaction functionality and infrastructure accessibility", "Social determinants and infrastructure compatibility", "Other sensory integration functionality", and "Cognitive functionality". Regarding content validity, it was demonstrated that normal-hearing participants differed significantly from individuals with HL in the hearing-related and speech-perception scores. The reliability assessment showed a high internal consistency (Cronbach's alpha = 0.9). The outcome demonstrated the HEAR-COMMAND tool's high content and construct validity. The tool can effectively represent the patient's perspective of HL and hearing-related functioning and enhance the effectiveness of the treatment plans and rehabilitation. The broad range of targeted concepts provides a unique overview of daily life hearing difficulties and their impact on the patient's functioning and quality of life.

Benefit of Modulated Masking in hearing according to age

ObjectiveTo analyze the Benefit of Modulated Masking (BMM) on hearing in young, adult and elderly normal-hearing individuals. MethodsThe sample included 60 normal-hearing individuals aged 18–75 years who underwent behavioral assessment (sentence recognition test in the presence of steady and modulated noise) and electrophysiological assessment (cortical Auditory Evoked Potential) to investigate BMM. The results were analyzed comparatively using the paired t-test and ANOVA for repeated measures, followed by the Bonferroni post-hoc test (p-value < 0.05). ResultsA decrease in latencies and an increase in amplitudes of cortical components (P1-N1-P2) was observed due to noise modulation in all age groups. Modulated noise generated better auditory threshold responses (electrophysiological and behavioral), compared to steady noise. The elderly presented a higher threshold in both hearing domains, compared to the other participants, as well as a lower BMM magnitude. ConclusionIt was possible to conclude that the modulated noise generated less interference in the magnitude of the neural response (smaller latencies) and in the neural processing time (larger amplitudes) for the speech stimulus in all participants. The higher auditory thresholds (electrophysiological and behavioral) and the lower BMM magnitude observed in the elderly group, even in the face of noise modulation, suggest a lower temporal auditory performance in this population, and may indicate a deficit in the temporal resolution capacity, associated with the process of aging. Level of evidence3.

Interaction of sensory processing and balance in adult cochlear implant users.

The aim of this study was to evaluate the sensory processing skills, quality of life and balance performance in adult cochlear implant users. A sample of 40 individuals was studied in two groups; 20 normal hearing individuals (37.84 ± 15.39 years old) and 20 cochlear implant users (35.58 ± 11.22 year old). Balance performance was assessed by Computerized Dynamic Posturography. The Adolescent/Adult Sensory Profile completed by the individual was used to assess sensory processing skills. Finally, quality of life was assessed with the Short Form-36. Among the different sensory processing parameters in the adolescent/adult sensory profile, a significant difference was found between the two groups in the parameters of low registration, sensory sensitivity and sensory avoidance (p < .05). Visual, vestibular and composite scores were found to be lower in cochlear implant users by Computerised Dynamic Posturography assessment (p < .05). When assessing quality of life, emotional well-being and social functioning parameters were found to be lower in cochlear implant users (p < .05). Factors such as the inability to reach sufficient auditory stimuli due to hearing loss and the occurrence of vestibular problems after cochlear implant surgery limit the quantity and quality of sensory stimuli from the environment. Individuals with cochlear implants may prefer to live isolated from society because they cannot adequately process incoming sensory stimuli due to hearing/balance problems, and this may negatively affect the quality of life of individuals. Our findings revealed the necessity of multisensory assessment and therapy protocols when rehabilitating individuals with cochlear implants.

Examining the psychometric properties of the Columbia Speech Quality Instrument in cochlear implant users

ObjectiveAlthough speech recognition among cochlear implant (CI) users improved over the past few decades, many still report poor speech quality. Currently, there is no validated tool to measure speech quality. The objective was to examine whether a previously validated speech quality tool is applicable in the CI population using psychometric analysis.DesignCross-sectional psychometric analysis of the Columbia Speech Quality Instrument (CSQI; previously validated in normal-hearing individuals; consists of 2 original and 7 manipulated speech clips designed to accentuate selected speech characteristics) was performed in adult English-speaking CI recipients (N = 36). Subjects rated each clip using a visual analog scale (VAS) on 14 characteristics: cartoonish/not-cartoonish, clear/unclear, like/dislike, breathy/not-breathy, smooth/rough, echo-y/not-echo-y, tinny/bassy, soothing/not-soothing, natural/unnatural, mechanical/not-mechanical, hoarse/smooth, pleasant/unpleasant, male/female, and speech-like/not-speech-like. Main outcome measures included validity, reliability, and factor structure.ResultsContent validity was previously confirmed during instrument design. Construct validity by item-item correlation analysis demonstrated correlation of 12/14 items with ≥1 other retained item (r ≥ 0.35, Spearman). Reliability was confirmed by internal consistency; factor analysis using two subsets selected by Scree plot and factor loading ≥0.4 demonstrated Cronbach alpha coefficients of 0.89 and 0.74 for factors 1 and 2, respectively. Tinny/bassy and male/female were the only characteristics that did not pass construct validity or internal consistency.ConclusionsThe CSQI has strong psychometric properties in the CI population; however, our findings support removal of tinny/bass and male/female characteristics from the final instrument prior to implementation in the CI population. The CSQI can be utilized in cochlear implantees to investigate effects of changes in speech processing strategies and postoperative outcomes with different devices.

Normoacusia y discriminación verbal en entornos sonoros reales

IntroductionHuman beings are constantly exposed to complex acoustic environments every day, which even pose challenges for individuals with normal hearing. Speech perception relies not only on fixed elements within the acoustic wave but is also influenced by various factors. These factors include speech intensity, environmental noise, the presence of other speakers, individual specific characteristics, spatial separatios of sound sources, ambient reverberation, and audiovisual cues. The objective of this study is twofold: to determine the auditory capacity of normal hearing individuals to discriminate spoken words in real-life acoustic conditions and perform a phonetic analysis of misunderstood spoken words. Materials and methodsThis is a descriptive observational cross-sectional study involving 20 normal hearing individuals. Verbal audiometry was conducted in an open-field environment, with sounds masked by simulated real-word acoustic environment at various sound intensity levels. To enhance sound emission, 2D visual images related to the sounds were displayed on a television. We analyzed the percentage of correct answers and performed a phonetic analysis of misunderstood spanish bisyllabic words in each environment. Results14 women (70%) and 6 men (30%), with an average age of 26±5,4 years and a mean airway hearing threshold in the right ear of 10,56±3,52dB SPL and in the left ear of 10,12±2,49dB SPL. The percentage of verbal discrimination in the ‘Ocean’ sound environment was 97,2±5,04%, ‘Restaurant’ was 94±4,58%, and ‘Traffic’ was 86,2±9,94% (p=0,000). Regarding the phonetic analysis, the allophones that exhibited statistically significant differences were as follows: [o] (p=0,002) within the group of vocalic phonemes, [n] (p=0,000) of voiced nasal consonants, [ɾ] (p=0,0016) of voiced fricatives, [b] (p=0,000) and [g] (p=0,045) of voiced stops. ConclusionsThe dynamic properties of the acoustic environment can impact the ability of a normal hearing individual to extract information from a voice signal. Our study demonstrates that this ability decreases when the voice signal is masked by one or more simultaneous interfering voices, as observed in a ‘Restaurant’ environment, and when it is masked by a continuous and intense noise environment such as ‘Traffic’. Regarding the phonetic analysis, when the sound environment was composed of continuous-low frequency noise, we found that nasal consonants were particularly challenging to identify. Furthermore, in situations with distracting verbal signals, vowels and vibrating consonants exhibited the worst intelligibility.

Normal hearing and verbal discrimination in real sounds environments

IntroductionHuman beings are constantly exposed to complex acoustic environments every day, which even pose challenges for individuals with normal hearing. Speech perception relies not only on fixed elements within the acoustic wave but is also influenced by various factors. These factors include speech intensity, environmental noise, the presence of other speakers, individual specific characteristics, spatial separatios of sound sources, ambient reverberation, and audiovisual cues. The objective of this study is twofold: to determine the auditory capacity of normal hearing individuals to discriminate spoken words in real-life acoustic conditions and perform a phonetic analysis of misunderstood spoken words. Materials and methodsThis is a descriptive observational cross-sectional study involving 20 normal hearing individuals. Verbal audiometry was conducted in an open-field environment, with sounds masked by simulated real-word acoustic environment at various sound intensity levels. To enhance sound emission, 2D visual images related to the sounds were displayed on a television. We analyzed the percentage of correct answers and performed a phonetic analysis of misunderstood Spanish bisyllabic words in each environment. Results14 women (70%) and 6 men (30%), with an average age of 26 ± 5,4 years and a mean airway hearing threshold in the right ear of 10,56 ± 3,52 dB SPL and in the left ear of 10,12 ± 2,49 dB SPL. The percentage of verbal discrimination in the “Ocean” sound environment was 97,2 ± 5,04%, “Restaurant” was 94 ± 4,58%, and “Traffic” was 86,2 ± 9,94% (p = 0,000). Regarding the phonetic analysis, the allophones that exhibited statistically significant differences were as follows: [o] (p = 0,002) within the group of vocalic phonemes, [n] (p = 0,000) of voiced nasal consonants, [r] (p = 0,0016) of voiced fricatives, [b] (p = 0,000) and [g] (p = 0,045) of voiced stops. ConclusionThe dynamic properties of the acoustic environment can impact the ability of a normal hearing individual to extract information from a voice signal. Our study demonstrates that this ability decreases when the voice signal is masked by one or more simultaneous interfering voices, as observed in a “Restaurant” environment, and when it is masked by a continuous and intense noise environment such as “Traffic”. Regarding the phonetic analysis, when the sound environment was composed of continuous-low frequency noise, we found that nasal consonants were particularly challenging to identify. Furthermore in situations with distracting verbal signals, vowels and vibrating consonants exhibited the worst intelligibility.

Spanish translation and validation of the Music-Related Quality of Life Questionnaire (MuRQoL) in postlingually deaf cochlear implant users

PurposeThe aim of this study was to translate and validate the “Music-Related Quality of Life Questionnaire” into Spanish (sMuRQoL) and assess its convergent validity and discriminative capacity by comparing its scores with the outcomes of the musical perception test Meludia.MethodsThe sMuRQoL was completed by 129 patients: 55 cochlear implant (CI) users and 74 normal hearing (NH) individuals. Conducted in this study were an exploratory factor analysis, an evaluation of internal consistency, an assessment of score stability through test–retest reliability, a comparison of sMuRQoL scores between CI users and NH individuals and an examination of potential evidence of convergent validity and discriminative capacity of sMuRQoL in relation to other tools. This involved the comparison of the questionnaire scores with the Meludia outcomes.ResultsThe sMuRQoL demonstrated a two-dimensional structure. All the dimensions displayed high internal consistency (α = 0.879–0.945) and score stability (ICC = 0.890–0.942). There were significant differences in the Frequency test between NH and CI users (d = 1.19–1.45). There’s evidence of convergent validity between the scores of the Frequency test and the results of Meludia (r = 0.242–0.645). Additionally, the Frequency test demonstrate a good discriminative capacity to identify patients with poorer musical perception.ConclusionsThe sMuRQoL is a reliable questionnaire, with adequate evidence of validity based on internal structure. This study provides an accessible, cost-effective, and quick-to-administer instrument in Spanish, optimizing available healthcare resources and bringing us closer to the patient needs.

Rate dependent neural responses of interaural-time-difference cues in fine-structure and envelope.

Advancements in cochlear implants (CIs) have led to a significant increase in bilateral CI users, especially among children. Yet, most bilateral CI users do not fully achieve the intended binaural benefit due to potential limitations in signal processing and/or surgical implant positioning. One crucial auditory cue that normal hearing (NH) listeners can benefit from is the interaural time difference (ITD), i.e., the time difference between the arrival of a sound at two ears. The ITD sensitivity is thought to be heavily relying on the effective utilization of temporal fine structure (very rapid oscillations in sound). Unfortunately, most current CIs do not transmit such true fine structure. Nevertheless, bilateral CI users have demonstrated sensitivity to ITD cues delivered through envelope or interaural pulse time differences, i.e., the time gap between the pulses delivered to the two implants. However, their ITD sensitivity is significantly poorer compared to NH individuals, and it further degrades at higher CI stimulation rates, especially when the rate exceeds 300 pulse per second. The overall purpose of this research thread is to improve spatial hearing abilities in bilateral CI users. This study aims to develop electroencephalography (EEG) paradigms that can be used with clinical settings to assess and optimize the delivery of ITD cues, which are crucial for spatial hearing in everyday life. The research objective of this article was to determine the effect of CI stimulation pulse rate on the ITD sensitivity, and to characterize the rate-dependent degradation in ITD perception using EEG measures. To develop protocols for bilateral CI studies, EEG responses were obtained from NH listeners using sinusoidal-amplitude-modulated (SAM) tones and filtered clicks with changes in either fine structure ITD (ITDFS) or envelope ITD (ITDENV). Multiple EEG responses were analyzed, which included the subcortical auditory steady-state responses (ASSRs) and cortical auditory evoked potentials (CAEPs) elicited by stimuli onset, offset, and changes. Results indicated that acoustic change complex (ACC) responses elicited by ITDENV changes were significantly smaller or absent compared to those elicited by ITDFS changes. The ACC morphologies evoked by ITDFS changes were similar to onset and offset CAEPs, although the peak latencies were longest for ACC responses and shortest for offset CAEPs. The high-frequency stimuli clearly elicited subcortical ASSRs, but smaller than those evoked by lower carrier frequency SAM tones. The 40-Hz ASSRs decreased with increasing carrier frequencies. Filtered clicks elicited larger ASSRs compared to high-frequency SAM tones, with the order being 40 > 160 > 80> 320 Hz ASSR for both stimulus types. Wavelet analysis revealed a clear interaction between detectable transient CAEPs and 40-Hz ASSRs in the time-frequency domain for SAM tones with a low carrier frequency.

Effect of Modulated Masking on Cortical Auditory Evoked Potential in Normal Hearing Individuals: A Systematic Review and Meta-analysis.

Introduction The study of electrophysiological auditory measures with different types of masking makes it possible to understand temporal processing skills and the processes involved in speech recognition in noise situations. The use of modulated masking in cortical measures of hearing enables the obtainment of analysis parameters of the masking release and its impact on neural auditory processing. Objective To investigate the behavior of cortical auditory evoked potentials (CAEPs) with modulated masking in the normal hearing population. Data synthesis A total of 2,159 articles were identified in the initial search; of these, 12 were selected for full reading. After excluding studies that did not meet the eligibility criteria, six articles were included in the present systematic review. The results show that the type of masking has an influence on cortical auditory behavior, indicating a different effect on neural posture rergarding CAEP responses. Modulated noise as masking in the CAEP record generated statistically higher and earlier responses compared with non-modulated/steady noise, evidenced by the results obtained in the meta-analysis with subgroup analysis. These responses may indicate an influence of the type of noise in the neural auditory coding. Conclusion Better responses were observed in modulated masking in terms of the behavior of CAEPs. Decreased latency and increased amplitude of cortical measurements with the use of modulated noise indicate a lower masking effect of this noise in cortical auditory processing, evidencing the masking release phenomenon.

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

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

Reference Data for a Quick Speech-in-Noise Hearing Test in the French Language

Introduction: Difficulty in understanding speech in noise is the most common complaint of people with hearing impairment. Thus, there is a need for tests of speech-in-noise ability in clinical settings, which have to be evaluated for each language. Here, a reference dataset is presented for a quick speech-in-noise test in the French language (Vocale Rapide dans le Bruit, VRB; Leclercq, Renard, & Vincent, 2018). Methods: A large cohort (N = 641) was tested in a nationwide multicentric study. The cohort comprised normal-hearing individuals and individuals with a broad range of symmetrical hearing losses. Short everyday sentences embedded in babble noise were presented over a spatial array of loudspeakers. Speech level was kept constant, while noise level was progressively increased over a range of signal-to-noise ratios. The signal-to-noise ratio for which 50% of keywords could be correctly reported (speech reception threshold, SRT) was derived from psychometric functions. Other audiometric measures were collected for the cohort, such as audiograms and speech-in-quiet performance. Results: The VRB test was both sensitive and reliable, as shown by the steep slope of the psychometric functions and by the high test-retest consistency across sentence lists. Correlation analyses showed that pure tone averages derived from the audiograms explained 74% of the SRT variance over the whole cohort, but only 29% for individuals with clinically normal audiograms. SRTs were then compared to recent guidelines from the French Society of Audiology [Eur Ann Otorhinolaryngol Head Neck Dis. 2022;139(1):21–7]. Among individuals who would not have qualified for hearing aid prescription based on their audiogram or speech intelligibility in quiet, 18.4% were now eligible as they displayed SRTs in noise impaired by 3 dB or more. For individuals with borderline audiograms, between 20 dB HL and 30 dB HL, the prevalence of impaired SRTs increased to 71.4%. Finally, even though five lists are recommended for clinical use, a minute-long screening using only one VRB list detected 98.6% of impaired SRTs. Conclusion: The reference data suggest that VRB testing can be used to identify individuals with speech-in-noise impairment.

Multimodal sensorimotor investigation of audio-visual integration in cochlear implant users

Rhythm is an omnipresent element of many daily activities. Numerous studies in cognitive sciences have highlighted that humans exhibit greater precision in synchronizing their movements with auditory rhythmic stimuli compared to visual ones. Deaf individuals were shown to excel in synchronizing with visual cues, surpassing those with normal hearing (NH). Furthermore, it was demonstrated that cochlear implant (CI) users were able to move in time to the beat of music, although not as well as NH controls. This study aims to investigate whether CI users retain a visual synchronization advantage from their pre-implant deafness, while maintaining auditory synchronization skills comparable to those of NH individuals, or if the neural reorganization post-implantation negates the visual synchronization advantage acquired pre-implantation. Specifically, we assessed both unimodal and multimodal auditory and visual abilities in CI users compared to NH controls using a standard sensorimotor synchronization paradigm. Results revealed that CI users exhibit comparable auditory rhythmic synchronization abilities to NH individuals, which is consistent with existing research, while not displaying a superior ability in synchronizing with visual rhythms, likely due to neural reorganization following implantation. This shift in audio-visual integration among CI users suggests that the post-implant reorganization of their auditory cortex might hinder the effective integration of temporal auditory input from the implant with visual information.

Vestibular evoked myogenic potential (VEMP) test-retest reliability in adults.

The technique of measuring ocular vestibular evoked myogenic potentials (oVEMP) in response to Mini-shaker vibration is relatively new, there is a limited normative data to define the presence or absence of a response in the literature. To determine the test-retest reliability of cervical and ocular VEMPs (cVEMP and oVEMP, respectively) to air-conducted sound (ACS) and bone-conducted vibration (BCV) stimulation and to determine normative ranges for the responses. Twenty normal-hearing individuals (40 ears) and 20 hearing impaired volunteers with normal balance function (40 ears) were examined in this study. ACS cVEMP and BCV oVEMP (using a Mini-shaker) were recorded from both groups to assess the test-retest reliability and to collect normative VEMP data for P1/N1 latencies and amplitudes from 20 normal hearing individuals. To test reliability, VEMP recordings were repeated within the same session. The test-retest reliability for all the cVEMP parameters showed excellent reliability whereas oVEMP parameters showed between fair and excellent reliability depending on the parameter tested. Normative data for VEMP P1/N1 latencies and amplitudes were established. Normative data and test-retest reliability for BCV oVEMP using the Mini-shaker at 100 Hz were established in our study for the first time in the literature. Responses appear reliable.

A Comparison of Montreal Cognitive Assessment Scores among Individuals with Normal Hearing and Cochlear Implants.

The Montreal Cognitive Assessment (MoCA) is a cognitive screening tool that has 4 of 10 test items heavily dependent on auditory input, potentially leaving hearing-impaired (HI) individuals at a disadvantage. Previous work found that HI individuals scored lower than normal-hearing (NH) individuals on the MoCA, potentially attributed to the degraded auditory signals negatively impacting the ability to commit auditory information to memory. However, there is no research comparing how cochlear implant (CI) recipients perform on the MoCA relative to NH and HI individuals. This study aimed to (1) examine the effect of implementing three different hearing-adjusted scoring methods for a group of age-matched CI recipients and NH individuals, (2) determine if there is a difference between the two groups in overall scores and hearing-adjusted scores, and (3) compare scores across our CI and NH data to the published HI data for all scoring methods. We hypothesized that (1) scores for CI recipients would improve with implementation of the hearing-adjusted scoring methods over the original method, (2) CI recipients would score lower than NH participants for both original and adjusted scoring methods, and (3) the difference in scores between NH and CI listeners for both adjusted and unadjusted scores would be greater than that reported in the literature between NH and HI individuals due to the greater severity of hearing loss and relatively poor spectral resolution of CIs. A total of 94 adults with CIs and 105 adults with NH were initially enrolled. After age-matching the two groups and excluding those who self-identified as NH but failed a hearing screening, a total of 75 CI participants (mean age 61.2 y) and 74 NH participants (mean age 58.8 y) were administered the MoCA. Scores were compared between the NH and CI groups, as well as to published HI data, using the original MoCA scoring method and three alternative scoring methods that excluded various auditory-dependent test items. MoCA scores improved for all groups when two of the three alternative scoring methods were used, with no significant interaction between scoring method and group. Scores for CI recipients were significantly poorer than those for age-matched NH participants for all scoring methods. CI recipients scored better than the published data for HI individuals; however, the HI group was not age matched to the CI and NH groups. MoCA scores are only partly affected by the potentially greater cognitive processing required to interpret degraded auditory signals. Even with the removal of the auditory-dependent items, CI recipients still did not perform as well as the age-matched NH group. Importantly, removing auditory-dependent items significantly and fundamentally alters the test, thereby reducing its sensitivity. This has important limitations for administration and interpretation of the MoCA for people with hearing loss.

Effect of Head Position on Distortion Product Otoacoustic Emissions

Abstract Objectives The study aimed to explore the impact of various head positions on the distortion product otoacoustic emissions (DPOAE) amplitudes, identifying the specific DPOAE frequencies showing the effect was also of interest. Materials and Methods DPOAEs were recorded from the right ears of 50 normal-hearing individuals in six head positions, supine, and five sitting positions (head erect, roll left, roll right, pitch backward, and pitch forward). DPOAEs were averaged and measured for their overall and frequency-specific amplitudes at 1 kHz, 1.5 kHz, 2 kHz, 3 kHz, 4 kHz, 6 kHz, and 8 kHz. Statistical Analysis To investigate the statistical significance of the observed mean differences, the data was tested using repeated measures of analysis of variance (ANOVA) following the Shapiro–Wilk normality test. The pair-wise comparison was tested using the Bonferroni post-hoc test and one-sided Bayesian paired sample t-test. Results The results of ANOVA revealed a significant main effect of head posture only at 1 kHz. The Bonferroni post-hoc test and one-sided Bayesian paired sample t-test results showed significantly higher DPOAE amplitude in the head erect compared to the supine position. There were no significant differences between other pairs of head postures. Conclusion Head posture is a trivial influencing factor of DPOAEs and hence, does not require consideration in interpreting DPOAEs.

Intracranial electrophysiology of spectrally degraded speech in the human cortex.

Cochlear implants (CIs) are the treatment of choice for severe to profound hearing loss. Variability in CI outcomes remains despite advances in technology and is attributed in part to differences in cortical processing. Studying these differences in CI users is technically challenging. Spectrally degraded stimuli presented to normal-hearing individuals approximate input to the central auditory system in CI users. This study used intracranial electroencephalography (iEEG) to investigate cortical processing of spectrally degraded speech. Participants were adult neurosurgical epilepsy patients. Stimuli were utterances /aba/ and /ada/, spectrally degraded using a noise vocoder (1-4 bands) or presented without vocoding. The stimuli were presented in a two-alternative forced choice task. Cortical activity was recorded using depth and subdural iEEG electrodes. Electrode coverage included auditory core in posteromedial Heschl's gyrus (HGPM), superior temporal gyrus (STG), ventral and dorsal auditory-related areas, and prefrontal and sensorimotor cortex. Analysis focused on high gamma (70-150 Hz) power augmentation and alpha (8-14 Hz) suppression. Chance task performance occurred with 1-2 spectral bands and was near-ceiling for clear stimuli. Performance was variable with 3-4 bands, permitting identification of good and poor performers. There was no relationship between task performance and participants demographic, audiometric, neuropsychological, or clinical profiles. Several response patterns were identified based on magnitude and differences between stimulus conditions. HGPM responded strongly to all stimuli. A preference for clear speech emerged within non-core auditory cortex. Good performers typically had strong responses to all stimuli along the dorsal stream, including posterior STG, supramarginal, and precentral gyrus; a minority of sites in STG and supramarginal gyrus had a preference for vocoded stimuli. In poor performers, responses were typically restricted to clear speech. Alpha suppression was more pronounced in good performers. In contrast, poor performers exhibited a greater involvement of posterior middle temporal gyrus when listening to clear speech. Responses to noise-vocoded speech provide insights into potential factors underlying CI outcome variability. The results emphasize differences in the balance of neural processing along the dorsal and ventral stream between good and poor performers, identify specific cortical regions that may have diagnostic and prognostic utility, and suggest potential targets for neuromodulation-based CI rehabilitation strategies.