Hearing Subjects Research Articles

Accuracy of self- and proxy-rated hearing among older adults with and without cognitive impairment.

Hearing loss is highly prevalent among older adults with cognitive impairment and may exacerbate neuropsychiatric symptoms and affect interactions with others. Although audiometry is the gold standard for measuring hearing, it is not always used in research or clinical settings focused on the care of individuals with cognitive impairment. Subjective assessments of hearing, both self- and proxy-rated, are widespread but may not adequately capture the presence of hearing loss as compared to audiometry. This study investigates the concordance between subjective and objective hearing assessments among older adults with and without cognitive impairment and evaluates factors associated with concordance. Participants were a subset of the Atherosclerosis Risk in Communities Neurocognitive Study (ARIC-NCS), a prospective cohort study representing four US communities with adjudicated cognitive diagnoses and audiometric data, totaling 3326 self-rated and 520 proxy-rated hearing assessments. Sensitivity and specificity were calculated, and multivariable logistic regression estimated the magnitude of the association between the concordance of hearing assessments and variables of interest. Sensitivity and specificity for self-rated hearing status were 71.2% and 85.9% among cognitively normal older adults, 61.1% and 84.9% among persons with MCI, and 52.6% and 81.2% among persons with dementia, respectively. For proxy-rated hearing, sensitivity and specificity were 65.7% and 83.3% for persons with MCI and 73.3% and 60.3% for persons with dementia, respectively. Female sex was positively associated with concordance for self-rated hearing assessments. The low sensitivity of self- and proxy-rated hearing assessments compared to audiometry suggests that hearing loss among older adults with cognitive impairment may go underreported and unaddressed in subjective assessments. Clinicians and researchers should recognize the limitations of using self- and proxy-rated hearing assessments as measures of hearing status and incorporate objective audiometric evaluation whenever possible.

The First Real-World Experience with Betibeglogene Autotemcel (beti-cel) Gene Therapy Treatment for Transfusion-Dependent β-Thalassemia (TDT)

BackgroundBeti-cel ex vivo gene therapy integrates a modified HBB gene into hematopoietic stem cells of patients with TDT, aiming to enable lifelong, stable production of functional adult hemoglobin (Hb). The efficacy and safety of the treatment have been demonstrated in a total of 63 patients treated across 4 clinical trials (HGB-204,-HGB-205, HGB-207, and HGB-212). Here, we present the first patient who received beti-cel outside of the clinical trial setting, a 14-year-old male with a β 0/β + (IVS-1-6) genotype.MethodsFollowing hematopoietic stem cell collection via granulocyte-colony stimulating factor plus plerixafor mobilization and apheresis, CD34+ cells were transduced with the BB305 lentiviral vector encoding HbA T87Q. The patient received hypertransfusion before mobilization and conditioning, maintaining a pre-transfusion Hb level of >11 g/dL. Six days prior to beti-cel infusion, single-agent busulfan myeloablation was initiated (16 single doses at 0.8 mg/kg body weight; 3.2 mg/kg/24 h) with concomitant clonazepam (see Table for treatment timeline). Ursodeoxycholic acid therapy was continued as hepatic veno-occlusive disease (VOD) prophylaxis through inpatient treatment.ResultsThe patient was diagnosed with TDT at the age of 2 years in his home country and has been treated in Germany since the age of 9. Regular transfusion therapy was initiated soon after diagnosis (Table). Aged 9, the patient was started on desferasirox for iron elimination therapy. His annualized red blood cell (RBC) transfusion volume was 174 ml/kg in 2018 and 185 ml/kg in 2019, maintaining his pre-transfusion Hb at or above 9 g/dl. No HLA-related donor was available for allogeneic transplant.At informed consent, the patient was 13 years old and met the eligibility criteria for beti-cel treatment as outlined in the summary of product characteristics (SmPC). The patient was physically fit, with a 90% Lansky score and regular participation in school sports, but reported physical limitations when running extensively. The patient underwent a thorough assessment before admission (Table), which did not reveal any remarkable abnormalities except TDT-related splenomegaly and signs of slight iron overload (liver iron content, 2.0 mg/g dry weight [normal range, 0.17-1.8]).On 11/Feb/2021, the patient was infused with 5.1 × 10 6 CD34+ cells/kg. The patient received 4 RBC and 8 platelet transfusions following infusion until Day 13 and 27, respectively (Table). Neutrophil and platelet engraftment occurred on day 27 post beti-cel infusion. The patient was discharged from inpatient treatment the same day, in excellent general condition, with 90% Lansky score, Hb of 8.2 g/dl, a reticulocyte count of 9.3%, a total white cell count of 1.55/nl, a neutrophil count of 0.75/nl, and a platelet count of 24/nl.At last follow-up (+100 days), the patient felt well and exhibited normal exercise tolerance. He has received neither red blood cell nor platelet transfusions or chelation therapy since discharge. Total Hb was 11.8 g/dl (Table). Granulocytes and lymphocytes had recovered to normal levels. The patient showed continued, albeit slowly improving, thrombocytopenia (platelet count, 31/nl [29/nl at +60 days]), consistent with previous observations after beti-cel therapy.Myeloablation and beti-cel infusion were tolerated well. Adverse events post infusion were febrile neutropenia, elevated C-reactive protein levels, pruritus, gingivitis, mild mucositis, and vertigo, consistent with the SmPC. At +23 and +26 days, the patient experienced transient subjective hearing loss (quickly resolved). No VOD events occurred.ConclusionsThis is the first real-world patient with TDT treated with beti-cel therapy. The treatment regimen had a tolerability profile consistent with that of mobilization, apheresis, and busulfan myeloablation, matching clinical trial observations. Following treatment, this 14-year-old patient reached a total Hb of 11.8 g/dL at +100 days without requirement of red cell transfusions and continues to exhibit prolonged but slowly improving and asymptomatic thrombocytopenia. [Display omitted] DisclosuresSchmitt: TolerogenixX Ltd: Current Employment; Therakos/Mallinckrodt: Research Funding; Hexal: Other: Travel grant; Jazz Pharmaceuticals: Other: Travel grant. Schmitt: Bluebird Bio: Other: Travel grants; Novartis: Other: Travel grants, Research Funding; TolerogenixX: Current holder of individual stocks in a privately-held company; Apogenix: Research Funding; MSD: Membership on an entity's Board of Directors or advisory committees; Hexal: Other: Travel grants, Research Funding; Kite Gilead: Other: Travel grants. Kulozik: Novartis: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; Sanofi: Consultancy, Honoraria; BioMedX: Consultancy, Honoraria; Celgene: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; bluebird bio, Inc.: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Speakers Bureau.

Personality captures dissociations of subjective versus objective hearing in noise.

Acoustic noise is pervasive in human environments. Some individuals are more tolerant to noise than others. We demonstrate the explanatory potential of Big-5 personality traits neuroticism (being emotionally unstable) and extraversion (being enthusiastic, outgoing) on subjective self-report and objective psycho-acoustic metrics of hearing in noise in two samples (total N = 1103). Under statistical control for demographics and in agreement with pre-registered hypotheses, lower neuroticism and higher extraversion independently explained superior self-reported noise resistance, speech-hearing ability and acceptable background noise levels. Surprisingly, objective speech-in-noise recognition instead increased with higher levels of neuroticism. In turn, the bias in subjectively overrating one's own hearing in noise decreases with higher neuroticism but increases with higher extraversion. Of benefit to currently underspecified frameworks of hearing in noise and tailored audiological treatments, these results show that personality explains inter-individual differences in coping with acoustic noise, which is a ubiquitous source of distraction and a health hazard.

Infrafloccular approach effectively prevents hearing complication in microvascular decompression surgery for hemifacial spasm

Objective The infrafloccular approach in microvascular decompression (MVD) surgery for hemifacial spasm (HFS) was investigated for the prevention of hearing complications. Methods Retrospective analysis of 136 patients who underwent MVD for HFS in 2019. The infrafloccular approach for MVD was adopted to resolve the symptom and protect hearing function. Postoperative hearing function was evaluated subjectively and objectively within 30 postoperative days, and later mainly subjectively. Postoperative condition of mastoid air cells based on the CT scan of the following day was also recorded. Results No final postoperative subjective hearing impairment was found in all patients. Mastoid air cells were opened in 105 patients, and subjective hearing impairment was recorded in 57 patients within 30 postoperative days, but all improved later. Increases in thresholds of greater than 10 dB in air conduction were observed in 28 patients, including 26 of transient conductive hearing loss (increases in the threshold of less than or equal to 10 dB). The other 2 patients with increases in the threshold of greater than 10 dB in both air and bone conduction had improvement confirmed by later audiometry. Conclusions Infrafloccular approach in MVD for HFS provides a good hearing outcome. Inclusion of postoperative hearing conditions in the later period is ideal for a precise hearing evaluation.

Peripheral Hearing Loss and Its Association with Cognition among Ethnic Chinese Older Adults

Introduction: Many studies on hearing loss (HL) and cognition are limited by subjective hearing assessments and verbally administered cognition tests, the majority of the document findings in Western populations. This study aimed to assess the association of HL with cognitive impairment among ethnic Chinese Singaporean older adults using visually presented cognitive tests. Methods: The hearing of community-dwelling older adults was assessed using pure tone audiometry. Cognitive function was assessed using the Computerized Cambridge Cognitive Test Battery (CANTAB). Multiple regression analyses examined the association between hearing and cognitive function, adjusted for age, education, and gender. Results: HL (pure-tone average [PTA] of thresholds at 0.5, 1, 2, and 4 kHz in the better ear, BE4PTA) was associated with reduced performance in delayed matching and multitasking tasks (β = −0.25, p = 0.019, and β = 0.02, p = 0.023, respectively). Moderate to severe HL was associated with reduced performance in delayed matching and verbal recall memory tasks (β = −10.6, p = 0.019, and β = −0.28, p = 0.042). High-frequency HL was associated with reduced performance in the spatial working memory task (β = 0.004, p = 0.022). All-frequency HL was associated with reduced performance in spatial working memory and multitasking (β = 0.01, p = 0.040, and β = 0.02, p = 0.048). Conclusion: Similar to Western populations, HL among tonal language-speaking ethnic Chinese was associated with worse performance in tasks requiring working memory and executive function.

A Longitudinal Analysis of the Cognitive Function and Related Factors in Older Adults Using a Multilevel Growth Model

Objectives: The purpose of this study is to examine changes in the cognitive function of the elderly over time and to identify factors affecting the cognitive decline by dividing them into multidimensional factors such as socio-demographic factors, physical and mental health factors, hearing factors, and social contact factors.Methods: This study used the Korean Longitudinal Study of Aging (KLoSA). A multilevel growth model analysis was conducted on 992 elderly people aged 60 or older who had been measured repeatedly seven times from 2006 to 2018.Results: First, the results showed that the cognitive function of the elderly decreased linearly over the years. Second, the initial status of cognitive function decreased as the age increased and as education level and economic condition decreased. The change rate of the cognitive function increased as education level increased. Third, at each time point, depression level had a negative effect on cognitive function, and subjective hearing condition had a negative effect on cognitive function. These influences decreased over time.Conclusion: The lower the education level, the higher the depression level; and the worse the subjective hearing condition, the more likely the elderly are to experience cognitive decline. Because the impact on cognitive function is large in the early stages of depression and hearing loss, it is necessary to detect them early and to make appropriate intervention to prevent cognitive decline.

Prepulse inhibition predicts subjective hearing in rats

Auditory studies in animals benefit from quick and accurate audiometry. The auditory brainstem response (ABR) and prepulse inhibition (PPI) have been widely used for hearing assessment in animals, but how well these assessments predict subjective audiometry still remains unclear. Human studies suggest that subjective audiometry is consistent with the ABR-based audiogram, not with the PPI-based audiogram, likely due to top-down processing in the cortex that inhibits PPI. Here, we challenged this view in Wistar rats, as rodents exhibit less complexity of cortical activities and thereby less influence of the cerebral cortex on PPI compared to humans. To test our hypothesis, we investigated whether subjective audiometry correlates with ABR- or PPI-based audiograms across the range of audible frequencies in Wistar rats. The subjective audiogram was obtained through pure-tone audiometry based on operant conditioning. Our results demonstrated that both the ABR-based and PPI-based audiograms significantly correlated to the subjective audiogram. We also found that ASR strength was information-rich, and adequate interpolation of this data offered accurate audiometry. Thus, unlike in humans, PPI could be used to predict subjective audibility in rats.

Self-determination and Physical Functioning as Mediators of the Association between Self-reported Sensory Impairments and Happiness among Older Adults

ABSTRACT Introduction The prevalence of vision and hearing impairments increases through age. This development is individually associated with physical functioning difficulties, self-determination issues, and lower levels of happiness. Method This study examined how self-reported sensory impairments relate to happiness with physical autonomy and social engagement as mediators using structural equation modelling. Using the nationally representative 2017 Survey of Older Persons in Thailand, the analytic sample size was 34,195 with an age range of 60-103 years and a mean age of 69.6 years. Results A negative association between subjective vision impairment and happiness was observed through the mediation of limitations in physical functioning and community activity. Subjective hearing impairment was observed to lack association with happiness taking into account all the mediating factors. Conclusion 4The care needs of older adults in Thailand where the ageing of the population progresses could then differ depending on their health and well-being status.

Normalización de los Potenciales Evocados Auditivos del Tronco Cerebral I: Resultados en una muestra de adultos normoyentes

Este artículo es el primero de una serie de estudios que tienen por objeto describir las características de los Potenciales Evocados Auditivos del Tronco Cerebral (PEATC) tanto en sujetos normoyentes como hipoacúsicos. En la interpretación de estos registros electrofisiológicos es necesario conocer los valores de normalidad de la latencia y amplitud de los principales componentes y su relación con la distintas intensidades así como los valores de los intervalos interondas y las posibles diferencias interaurales. Estos valores de normalidad varían en función de múltiples factores como el sexo, la edad, los parámetros de estimulación y de registro o las condiciones en las cuales se llevan a cabo los PEATC. En este primer trabajo se describen los valores de normalidad de latencia de los componentes de los PEATC utilizando para ello los parámetros de estimulación y de registro propios de nuestro laboratorio en una muestra de sujetos adultos normoyentes.

Los potenciales evocados auditivos de estado estable a múltiples frecuencias y su valor en la evaluación objetiva de la audición

Uno de los principales objetivos en la realización de un examen electroaudiométrico es la obtención de una evaluación frecuencia específico de los umbrales de audibilidad. En las últimas décadas han sido propuestas múltiples técnicas basadas en el registro de los Potenciales Evocados Auditivos (PEA). Los mismos no son afectados por la sedación ni el sueño y pueden ser detectados a intensidades de estimulación muy cercanas al umbral de audibilidad. Las ventajas antes mencionadas lo han convertido en una útil herramienta para la evaluación objetiva de la audición. No obstante, esta técnica tiene ciertas limitaciones desde el punto de vista electroaudiométrico, debido principalmente a la falta de frecuencia especificada de dicha respuesta.
 Los Potenciales Evocados Auditivos de Estado Estable (PEAee) por estímulos tonales aislados y a frecuencias de estimulación entre 75 y 110 Hz han sido propuestos como una alternativa valida para la realización de una audiometría frecuencia especifica. Este tipo de respuesta representa la descarga sincrónica de las neuronas del tronco cerebral, las cuales siguen la frecuencia de modulación del estimulo que les da origen.
 Múltiples han sido los autores que en los últimos años y usando este tipo de respuesta han obtenido estimaciones confiables del umbral de audibilidad tonal, tanto en niños y adultos sanos como en sujetos hipoacúsicos. Esta técnica tiene múltiples ventajas sobre los PEA transitorios en la determinación de umbrales específicos en frecuencia: 1) Dado la periodicidad de la respuesta esta puede ser representada en el dominio de la frecuencia, minimizando por ende la complejidad de su medición, 2) El estimulo acústico empleado es mas especifico en frecuencia, 3) Debido a las propiedades de rectificación de la coclea la respuesta provocada por un tono modulado en amplitud es representada como un pico espectral a la frecuencia de modulación, 4) Estos picos espectrales pueden ser detectados usando diferentes estadígrafos en el dominio de la frecuencia.
 A pesar de las ventajas anteriormente descritas, la obtención de un audiograma completo mediante el uso de los PEAee provocados por estímulos tonales aislados puede requerir un gran consumo de tiempo. Más recientemente ha sido propuesta una variante optimizada de los PEAee entre 75 y 110 Hz con el empleo simultaneo de múltiples tonos modulados en amplitud. Dado el hecho que cada tono portador es modulado con una frecuencia diferente, múltiples tonos pueden ser entonces sumados, formando un tono complejo compuesto por múltiples tonos modulados en amplitud. Usando entonces como estimulo, una mezcla compuesta por tonos de 500, 1000, 2000 y 4000 Hz podemos activar y evaluar simultáneamente estas cuatro regiones de frecuencia de la cóclea. Por otra parte, estos estímulos complejos pueden ser presentados binauralmente, evaluando ambos oídos simultáneamente.
 Los PEAee provocados por múltiples tonos modulados en amplitud han sido empleados con alentadores resultados en la determinación objetiva de los umbrales de audibilidad en niños y adultos, pacientes hipoacúsicos y en la detección temprana de defectos auditivos. El presente artículo resume algunos conceptos básicos, así como sus aplicaciones clínicas.

Prevalence and influencing factors of hearing status for workers with different subjective perception of hearing in Wuhan City from 2017 to 2019

Objective To investigate the hearing status and influencing factors of hearing among people with different subjective perception of hearing in Wuhan City from 2017 to 2019. Methods A cross-sectional survey was conducted to select some automobile manufacturing workers who underwent physical examination in Wuhan Prevention and Treatment Center for Occupational Disease from Jan 2017 to Dec 2019 as the research subjects. Questionnaire survey and pure tone threshold test were conducted. After excluding individuals with missing information, a total of 15 594 individuals were finally included for analysis and research. Logistic regression analysis was used to explore the influencing factors of hearing status for workers with different subjective perception of hearing. Results Among the 15 594 male workers in automobile manufacturing industry, the proportion of subjective feeling of hearing for good, general and poor was 45.86% (7 152/15 594), 51.75% (8 070/15 594) and 2.39% (372/15 594), respectively. In terms of speech frequency, the proportion of hearing loss of the workers with good subjective hearing was 3.45%. In terms of high frequency, the proportion of hearing loss of workers with good subjective hearing was 18.47%. Age≥40 (OR=4.53, 95% CI=3.34-6.14, P Conclusion Some people with good subjective perception of hearing still have hearing loss, and risk factors of hearing loss among people with different subjective perception of hearing are different.

Late Breaking Abstracts

Late Breaking Abstracts

Clinical, oculographic and vestibular test characteristics of Ménière's disease.

Seventy Ménière's disease (MD) patients with spontaneous vertigo (100%), unilateral aural fullness (57.1%), tinnitus (78.6%), and subjective hearing loss (75.7%) self-recorded nystagmus during their episodes of vertigo using portable video oculography goggles. All demonstrated ictal spontaneous nystagmus, horizontal in 94.3% (n = 66) and vertical in 5.7% (n = 4), with a mean slow-phase velocity (SPV) of 42.8 ± 31.1°/s (range 5.3-160.1). Direction reversal of spontaneous horizontal nystagmus was captured in 58.6%, within the same episode in 34.3%, and over different days in 24.3%. In 18.6%, we observed ipsiversive then contraversive nystagmus, and in 12.9% contraversive to ipsiversive direction reversal. Ictal nystagmus SPV (42.8 ± 31.1°/s) was significantly faster than interictal (1.4 ± 3.1°/s, p < 0.001, CI 34.277-48.776). Compared to age-matched healthy controls, interictal video head impulse test gains in MD ears were significantly lower, cumulative and first saccade (S1) amplitudes were significantly larger, and S1 peak velocities were significantly faster (p = 0.038/0.019/0.008/ < 0.001, CI 0.002-0.071/0.130-1.444/0.138-0.909/14.614-41.506). Audiometry showed asymmetrically increased thresholds in 100% of MD ears (n = 70). Significant caloric, air-conducted (AC) cervical vestibular-evoked myogenic potential (VEMP), and AC ocular VEMP asymmetries were found in 61.4, 37.9, and 44.4% of patients (MD ear reduced). Transtympanic electrocochleography tested in 36 ears (23 patients) showed 81.8% of MD ears had a positive result for hydrops (either a summating potential at 1/2kHz < - 6µV, or an SP/AP ratio > 40%). Using ictal nystagmus findings of SPV > 12°/s, and a caloric canal paresis > 25%, we correctly separated a diagnosis MD from Vestibular Migraine with a sensitivity and specificity of 95.7% and 85.1% (CI 0.89-0.97).

Prognostic factors in non-organic hearing loss in children

Objective Exploring factors that predict a favourable clinical outcome in non-organic hearing loss (NOHL) in children. NOHL is defined as a subjective hearing loss without correlation in objective measures. Design Retrospective analysis of all childrens’ data with the diagnosis NOHL seen between 2005 and 2017 at a tertiary referral centre. Study sample Sixty-seven children (44 female, 23 male; mean age 11.26 years) were included. Statistical analyses included descriptive statistics, logistic regression, correlations, and Mann–Whitney U tests. Results A quarter of the children (17/67) had been provided previously with hearing aids without objective sensorineural hearing loss. Having been provided with hearing aids before the first visit to our clinic lowered the chance of normal hearing at the final visit by 76%. The prescription of hearing aids was significantly more likely in girls. Children provided with hearing aids were significantly older than those without and the time span between the first occurrence of the NOHL and first presentation at our department was longer than in children not provided with hearing aids. Conclusions In cases of NOHL, hearing aid prescription is not indicated and significantly lowers a child’s chance of full recovery and, thus, should not be prescribed unless NOHL is ruled out.

Auditory processing in normally hearing individuals with and without tinnitus: assessment with four psychoacoustic tests

PurposeIn most cases, tinnitus co-exists with hearing loss, suggesting that poorer speech understanding is simply due to a lack of acoustic information reaching the central nervous system (CNS). However, it also happens that patients with tinnitus who have normal hearing also report problems with speech understanding, and it is possible to suppose that tinnitus is to blame for difficulties in perceptual processing of auditory information. The purpose of the study was to evaluate the auditory processing abilities of normally hearing subjects with and without tinnitus.MethodsThe study group comprised 97 adults, 54 of whom had normal hearing and chronic tinnitus (the study group) and 43 who had normal hearing and no tinnitus (the control group). The audiological assessment comprised pure-tone audiometry and high-frequency pure-tone audiometry, impedance audiometry, and distortion product oto-acoustic emission assessment. To evaluate possible auditory processing deficits, the Frequency Pattern Test (FPT), Duration Pattern Test (DPT), Dichotic Listening Test (DLT), and Gap Detection Threshold (GDT) tests were performed.ResultsThe tinnitus subjects had significantly lower scores than the controls in the gap detection test (p < 0.01) and in the dichotic listening test (p < 0.001), but only for the right ear. The results for both groups were similar in the temporal ordering tests (FPT and DPT). Right-ear advantage (REA) was found for the controls, but not for the tinnitus subjects.ConclusionIn normally hearing patients, the presence of tinnitus may be accompanied with auditory processing difficulties.

Subjective hearing sensation of process variations at a milling machine. How reliable will chatter marks be detected?

Intuition enables experienced machine operators to detect production errors and to identify their specific sources. A prominent example in machining are chatter marks caused by machining vibrations. The operator's assessment, if the process runs stable or not, is not exclusively based on technical parameters such as rotation frequency, tool diameter, or the number of teeth. Because the human ear is a powerful feature extraction and classification device, this study investigates to what degree the hearing sensation influences the operators decision making. A steel machining process with a design of experiments (DOE)-based variation of process parameters was conducted on a milling machine. Microphone and acceleration sensors recorded machining vibrations and machine operators documented their hearing sensation via survey sheet. In order to obtain the optimal dataset for calculating various psychoacoustic characteristics, a principle component analysis was conducted. The subsequent correlation analysis of all sensor data and the operator information suggest that psychoacoustic characteristics such as tonality and loudness are very good indicators of the process quality perceived by the operator. The results support the application of psychoacoustic technology for machine and process monitoring.

A Longitudinal Exploration of Self-Reported Hearing Loss, Tinnitus, and Posttraumatic Stress Disorder Treatment Outcomes in Australian Veterans.

Tinnitus, hearing loss, and posttraumatic stress disorder (PTSD) are common conditions among veterans. Shared underlying symptoms, such as hypervigilance and heightened sense of threat, may interfere with talk-based psychological treatments. The aim was to investigate the prevalence and risk factors for self-reported tinnitus and hearing loss among Australian treatment-seeking veterans, as well as links with PTSD symptoms and quality of life (QOL) after treatment. Australian veterans participating in hospital-based PTSD treatment (n = 523) completed self-report measures of subjective hearing impairment, service-related factors, PTSD symptoms, and QOL at treatment intake and discharge, as well as 3- and 9-month follow-ups. Univariate analyses of covariance modeled symptom change over time. More than half of veterans on PTSD treatment self-reported doctor-diagnosed hearing loss or tinnitus, whereas 43% reported both. However, 75% reported subjective mild to moderate hearing impairment, and only 1% reported severe impairment. Service-related factors, such as longer length of service and exposure to explosions, were risk factors for having any hearing condition. After controlling for intake scores, there were no significant differences on PTSD or QOL outcomes over time between those with and without hearing conditions. Although self-reported tinnitus and hearing loss are prevalent among veterans, those with severe hearing impairments are unlikely to be represented in this context. There is a need for psychological treatments that are accessible to patients with severe hearing impairments, which should be examined routinely among military members accessing psychological treatments.

Tinnitus and Subjective Hearing Loss are More Common in Migraine: A Cross-Sectional NHANES Analysis.

To investigate whether migraine is independently associated with tinnitus and subjective hearing loss (HL) in a large national database. The de-identified 1999 to 2004 National Health and Nutrition Examination Survey database was retrospectively queried for subjects aged 18 to 65. HL and tinnitus were subjectively reported by subjects. A total of 12,962 subjects (52.9% female) with a mean age of 38.1 ± 14.6 years were included. This consisted of 2,657 (20.5%), 2,344 (18.1%), and 2,582 (19.9%) subjects who had migraine, subjective-HL, and tinnitus, respectively. In patients with tinnitus or subjective-HL, migraine was reported in 35.6% and 24.5%, respectively. Migraineurs were more likely to have subjective-HL (25.0% vs. 16.6%, p < 0.001) and tinnitus (34.6% vs. 16.9%, p < 0.001) compared to the nonmigraineurs. This corresponded to migraine having an odds ratio of 1.5 (95% confidence interval [CI] 1.3-1.7, p < 0.001) and 2.2 (95% CI 2.0-2.4, p < 0.001) for subjective-HL and tinnitus, respectively. After adjusting for confounders, subjective-HL (odds ratio [OR] = 1.2, 95% CI 1.1-1.4, p = 0.003), tinnitus (OR = 2.1, 95% CI 1.9-2.3, p < 0.001), and neck pain (OR = 4.0, 95% CI 3.6-4.5, p < 0.001) were more common in migraineurs. Among migraineurs, a higher proportion of those with tinnitus also had subjective-HL compared to those without tinnitus (40.0% vs. 15.3%, p < 0.001), and a higher proportion of those with subjective-HL also had tinnitus compared to those without HL (58.1% vs. 27.3%, p < 0.001). This study suggests an independent association between migraine with subjective-HL and tinnitus. Otologic migraine, which is the effects of migraine on the ear, may be partly responsible for the link between HL, tinnitus, neck pain, and migraine.

Development of SC-10: A psychometrically equivalent Singapore Mandarin disyllabic word list for clinical speech audiometry use.

ObjectiveThe aim of this study is to develop and evaluate a set of psychometrically equivalent disyllabic wordlist (SC-10) in Singapore Mandarin for clinical use.Study designA preliminary set of 1000 words were obtained from a dictionary of frequently used words by Singapore students. Ten native judges rate the familiarity level of each word. This is followed by a face-to-face public survey to rank the shortlisted word set from most to least familiar. The final 108 disyllabic words were recorded by a native female talker. 20 normal hearing subjects were used to obtain the percentage of correct word recognition at 24 intensity levels (−10 dB HL to 26 dB HL in 2 dB increment). Psychometric function slopes were calculated for each word. 100 words were eventually chosen and assigned into ten 10-word lists based on a psychometric balancing protocol. Minor digital adjustments were made to the intensity of each wordlist to improve their auditory homogeneity.The developed SC-10 wordlists were validated by a separate group of 25 normal hearing subjects. Test-retest reliability was carried out on 20 out of 25 participants at the selected intensity levels (SRT-5, SRT, SRT+5).ResultsThe calculated regression slopes in the psychometric functions for the ten lists are between 8.0 and 9.8%/dB. Single factor ANOVA analysis showed no significant difference in both the mean intensity required to obtain 50% recognition score (f = 0.109, df = 9, p = 0.999) and the slopes of the psychometric functions (f = 0.078, df = 9, p = 0.999) between the ten word lists. List validation on 25 normal hearing participants (PTA = 11.0 dB HL, SD = 4.3) showed a mean speech recognition threshold (SRT) of 9.3 dB HL (SD = 3.5)and regression slope of 8.395%/dB. Quadratic regression analysis showed a positive correlation (r2 = 0.923) between presentation level and word recognition score (WRS). The difference between PTA and SRT of each subject all fall within the clinically acceptable difference of 10 dB HL. Test-retest reliability, carried out on 20 subjects at three levels (SRT-5, SRT, and SRT+5 dB), showed no significance difference between word recognition score when the same participant is tested again at the same intensity level using a different wordlist.ConclusionAll in all, it shows that the SC-10 speech materials are valid for clinical use for Mandarin speech audiometry in Singapore.

Speech audiometry in noise: SNR Loss per age-group in normal hearing subjects

ObjectivesThe present study aimed to determine normal SNR values per age group for the 50% speech reception threshold in noise (SNR Loss) on the VRB (Vocale Rapide dans le Bruit: rapid speech in noise) test. Material and MethodsTwo hundred patients underwent pure-tone threshold and VRB speech-in-noise audiometry. Six ages groups were distinguished: 20–30, 30–40, 40–50, 50–60, 60–70 and>70 years. All subjects had normal hearing for age according to ISO 7029. SNR Loss was measured according to age group. ResultsMean SNR Loss ranged from −0.37dB in the youngest age group (20–30 years) to +6.84dB in the oldest (>70 years). Range and interquartile range increased with age: 3.66 and 1.49dB respectively for 20–30 year-olds; 6 and 3.5dB for>70 year-olds. Linear regression between SNR Loss and age showed a coefficient R2 of 0.83. ConclusionThe present study reports SNR Loss values per age group in normal-hearing subjects (ISO 7029), confirming that SNR Loss increases with age. Scatter also increased with age, suggesting that other age-related factors combine with inner-ear aging to impair hearing in noise.