Synthetic Sentence Identification Research Articles

Effectiveness of Television Streaming on Hearing Aid User Performance and Satisfaction in Quiet and in Noise.

The purpose of this study was to determine the effectiveness of television (TV) streaming on hearing aid user performance and satisfaction in quiet and in noise. Twenty experienced hearing aid users were evaluated in quiet and in noise (5 dB SNR) under three hearing aid conditions: hearing aids, streaming with hearing aid microphones attenuated by 6 dB, and streaming with hearing aid microphones muted. The audiovisual Connected Speech Test served as the signal, and the ipsilateral competing message from the Synthetic Sentence Identification-Ipsilateral Competing Message (SSI-ICM) served as the noise. Measures of speech understanding, satisfaction with sound quality and clarity, and preference were obtained. Speech understanding was significantly better in quiet than in noise, and streaming improved performance in noise when the hearing aid microphones were muted. Sound quality satisfaction was significantly better in quiet than in noise but was not impacted significantly by the hearing aid settings. Speech clarity satisfaction was significantly better in quiet than in noise, and streaming improved satisfaction in noise when the hearing aid microphones were muted. More participants preferred streaming with the microphones muted in quiet, in noise, and overall; however, results did not reach statistical significance. Hearing aid users did not benefit from TV streaming with the microphones attenuated or muted when listening in quiet. TV streaming was more beneficial to hearing aid users when listening in noise with the microphones muted. Hearing aid users should be counseled on the impact of the hearing aid microphone settings when using a TV streamer, particularly in noise.

Liver Fibrosis and Hearing Loss in an Older Mediterranean Population: Results from the Salus in Apulia Study.

Aging is the main negative prognostic factor for various chronic diseases, such as liver fibrosis, and clinical disorders such as hearing loss. This study aimed to investigate the association between age-related hearing loss (ARHL) and age-related central auditory processing disorder (CAPD), and the risk for liver fibrosis in a cross-sectional study on an aging population. Liver fibrosis risk was judged on the fibrosis-4 (FIB-4) score. Peripheral ARHL was evaluated with pure tone audiometry using a calibrated audiometer. The pure tone average (PTA), calculated as a threshold ≤ 40 dB (HL) in the better ear, was measured at the frequencies 0.5-4 kHz. For age-related CAPD assessment, we employed the Synthetic Sentence Identification with an Ipsilateral Competitive Message test (SSI-ICM). General linear Logistic regression models were used to estimate the association. The increase in the PTA 0.5-2 kHz (coefficient: 0.02, SE: 0.01, CI 95%: 0.01 to 0.03) was directly associated with a higher risk of liver fibrosis (FIB-4 ≥ 2.67). Moreover, the reduction in SSI (coefficient: -0.02, SE: 0.01, CI 95%: -0.03 to -0.01) was inversely associated with FIB-4 values < 2.67. Our results show an association between liver fibrosis and both ARHL and CAPD, linked by the typical consequence of aging. We also assume a role of inflammatory responses and oxidative stress.

Mild Traumatic Brain Injury: Long-Term Follow-Up of Central Auditory Processing After Auditory Training.

Background and ObjectivesEven a mild traumatic brain injury can impair the peripheral and central parts of the auditory system. The objective was to compare the performance of individuals with mild traumatic brain injury in behavioral and electrophysiological central auditory tests before and after formal auditory training, and to verify the stability of these measures over time. Subjects and MethodsTen 16- to 64-year-old individuals diagnosed with mild traumatic brain injury underwent behavioral and electrophysiological assessment of the central auditory processing in three stages: before, right after, and six months after formal auditory training. ResultsStatistically significant differences were observed for speech by white noise, synthetic sentence identification, sound localization, verbal sequential memory, and duration pattern tests in the assessment six months after formal auditory training. No statistically significant differences were observed between the P300 assessments, either with tone-burst or speech stimulus, in N2 and P3 latencies, and P3 amplitude. ConclusionsThe results of the behavioral assessment of the central auditory processing improved, while the P300 remained stable with both stimuli, six months after completing formal auditory training. This demonstrates that auditory training has long-term benefits for people with mild traumatic brain injury.

Dietary Habits and Nutrient Intakes Are Associated to Age-Related Central Auditory Processing Disorder in a Cohort From Southern Italy.

ObjectivesCentral auditory processing disorder (CAPD) commonly occurs in older age. However, few studies of a possible link between age-related CAPD and diet in an older population have been conducted. The objective of the present study was to investigate the relationship between eating habits and age-related CAPD in a population >65 years, using cross-sectional and retrospective data obtained in the same population-based study about 12 years ago.MethodsWe selected 734 participants (403 men) from a large population-based study. For age-related CAPD assessment, we used the Synthetic Sentence Identification with Ipsilateral Competitive Message test. Dietary habits were assessed by a Food Frequency Questionnaire. Associations between age-related CAPD and food groups/macro-and micronutrients were explored using adjusted logistic regression models.ResultsAge-related CAPD subjects consumed more dairy (111 vs. 98 g/d), olives and vegetable oil (63 vs. 52 g/d) and spirits (2 vs.1 g/d), and less fruits (536 vs. 651 g/d) in the cross-sectional analysis. Age-related CAPD subjects had a lower intake of potassium, vitamin C, and a higher fat intake. Further analyses identified dietary fiber as being inversely related to age-related CAPD.DiscussionThe present study provided evidence that the dietary hypotheses proposed for explaining the development of cognitive disorders in older age might also hold for age-related CAPD. Further data from other large and prospective population-based studies are needed for confirming these findings.

Predicting Hearing Aid Satisfaction in Adults: A Systematic Review of Speech-in-noise Tests and Other Behavioral Measures.

Adults with hearing loss report a wide range of hearing aid satisfaction that does not significantly correlate to degree of hearing loss. It is not clear which auditory behavioral factors do contribute to hearing aid satisfaction. While poor speech understanding in noise is known to contribute to dissatisfaction, there are many categories of this type of assessment. The purpose of this systematic review is to answer the question, "Are behavioral pre-fitting measures using speech and nonspeech materials related to hearing aid satisfaction among adults?" Six electronic databases were searched to find peer-reviewed studies published before June 2020. The included studies reported on the relationship between auditory behavioral measures and hearing aid satisfaction alone or globally with other outcome domains among adults with hearing loss. Six types of behavioral prefitting measures were evaluated: speech recognition in quiet (% correct), speech recognition in noise (% correct), reception thresholds for speech-in-noise, speech-based subjective ratings, dichotic speech tests, and tests using nonspeech material. Each relevant study was independently reviewed by two reviewers. Methodological quality was evaluated in each included study using the American Speech-Language-Hearing Association's level of evidence ratings. There were 1342 articles identified in the systematic review process. After duplicates were removed and specific inclusion criteria were applied, 21 studies were included. All studies included had a 0 to 4 methodological quality rating indicating weak to moderate internal validity. The tests that showed potential for clinical application due to significant correlations with satisfaction were the QuickSIN, the synthetic sentence identification, the hearing in noise test, and the acceptable noise level test. Audibility, as measured by degree of hearing loss, was not significantly correlated to hearing aid satisfaction in the 13 studies that reported on this measure. Based on this review, results indicated that speech-in-noise tests had the highest associations to hearing aid satisfaction, suggesting a greater role for assessment of speech-in-noise perception in auditory rehabilitation. This is an important finding for clinical practice, given that audibility was not a significant factor in predicting satisfaction. Overall, the results from this review show a need for well-designed, high-quality, prospective studies assessing the predictive value of prefitting measures on hearing aid satisfaction with current hearing aid models.

Association Between Central and Peripheral Age-Related Hearing Loss and Different Frailty Phenotypes in an Older Population in Southern Italy

The association between age-related hearing loss (ARHL) and physical or cognitive frailty has been poorly explored. These associations could define new perspectives for delaying frailty-related processes in older age. To examine whether peripheral ARHL and age-related central auditory processing disorder (CAPD) are independently associated with physical or cognitive frailty. This cross-sectional study analyzed registry data from December 31, 2014, on 1929 older (≥65 years) participants of the Salus in Apulia Study (Southern Italy) who underwent audiologic, physical, and neuropsychological assessment. Data analysis was performed from December 12, 2019, to January 4, 2020. Prevalence of peripheral ARHL in older individuals with physical and/or cognitive frailty and those without frailty assessed using the Fried criteria (physical) and the Mini-Mental State Examination (cognitive). Multivariable logistic regression models were used to assess associations of audiologic variables with frailty phenotype. Data from 1929 participants (mean [SD] age, 73.6 [6.3] years; 974 male [50.5%]) were eligible for the analyses. The prevalence of peripheral ARHL was higher in the physical frailty group (96 [26.6%]) than in the nonfrail group (329 [21.0%]) (difference, 5.61 percentage points; 95% CI, 0.63-10.59 percentage points) and in the cognitive frailty group (40 [38.8%]) than in the nonfrail group (385 [21.1%]) (difference, 17.75 percentage points; 95% CI, 8.2-27.3 percentage points). Age-related CAPD was more prevalent in the physical frailty group (62 [17.2%]) than in the nonfrail group (219 [14.0%]) (difference, 3.21 percentage points; 95% CI, -1.04 to 7.46 percentage points) and in the cognitive frailty group (28 [27.2%]) than in the nonfrail group (253 [13.9%]) (difference, 13.33 percentage points; 95% CI, 4.10-22.21 percentage points). In the multivariable models, age-related CAPD was associated with cognitive frailty in the fully adjusted model (odds ratio [OR], 1.889; 95% CI, 1.094-3.311). There was also an inverse association between the unitary increase in Synthetic Sentence Identification With the Ipsilateral Competitive Message scores, indicating a lower likelihood of this disorder, and cognitive frailty (OR, 0.989; 95% CI, 0.988-0.999). Peripheral ARHL was associated with cognitive frailty only in the partially adjusted model (OR, 1.725; 95% CI, 1.008-2.937). In this cross-sectional study of 1929 participants, age-related CAPD was independently associated with cognitive frailty. Whether the management of ARHL may help prevent the development of different frailty phenotypes or improve their clinical consequences should be addressed in longitudinal studies and, eventually, well-designed randomized clinical trials.

The peripheral hearing and central auditory processing skills of individuals with subjective memory complaints

AbstractBackgroundWith no cure or effective treatment currently in sight, it is critical to identify those factors that may prevent or delay cognitive decline and dementia in older adults, it is important to focus on potentially modifiable risk factors. Untreated hearing loss contributes up to about 9% of the modifiable risk factors in mid‐life (Livingston et al., 2017).MethodA total of 95 participants were recruited from the larger Western Australia Memory Study and were classified as SMCs (N = 61; 20 males and 41 females, mean age 71.47 + 7.19 years) and non‐SMCs (N = 34; 10 males, 24 females, mean age 68.85 + 7.70 years). All participants completed a peripheral hearing assessment, a CAP assessment battery (Dichotic Digits, Duration Pattern Test, Dichotic Sentence Identification, Synthetic Sentence Identification with Ipsilateral Competing Message and the Quick‐Speech‐in‐Noise) and a cognitive screening assessment.ResultThe SMCs group performed significantly poorer than the control group on Synthetic Sentence Identification with Ipsilateral Competing Message ‐10dB and ‐20 dB Signal to Noise Ratio conditions. No significant differences were found between the two groups on the peripheral hearing threshold measurements.ConclusionThe results suggest that individuals with SMCs perform poorly in CAP assessments in comparison to the controls. The poor CAP in SMC individuals may result in a greater cost to their finite pool of cognitive resources. The CAP results provide yet another biomarker that supports the hypothesis that SMCs may be a primary indication on neuropathological changes in the brain affecting various functions. Longitudinal follow up of individuals with SMCs and decreased CAP abilities should inform whether this group is at higher risk of developing dementia as compared to non‐SMCs and to those SMC individuals without CAP difficulties.

Retinal Vascular Density on Optical Coherence Tomography Angiography and Age-Related Central and Peripheral Hearing Loss in a Southern Italian Older Population.

Age-related hearing loss (ARHL) and retinal vessel changes have both been associated to neurodegeneration/dementia, suggesting a possible link between these 2 conditions in older age. We aimed to determine whether superficial and deep vascular density (SVD and DVD) of the capillary plexi of macular vasculature can be associated with peripheral ARHL and age-related central auditory central processing (CAPD). We analyzed data on 886 older participants (65 years+, age range: 65-92 years) in the cross-sectional population-based Salus in Apulia Study. Optical coherence tomography angiography was used to measure SVD and DVD of the capillary plexi of the macula at the 3-mm circle area centered on the fovea (whole retina), the parafoveal quadrant, and foveal quadrant. Disabling peripheral ARHL was defined as >40 dB hearing level of pure tone average on the frequencies from 0.5, 1, 2, and 4 KHz in the better ear, and age-related CAPD as <50% at the Synthetic Sentence Identification with Ipsilateral Competitive Message test in at least one ear. DVD at the whole retina and at the parafoveal quadrant were inversely associated only with age-related CAPD (odds ratio [OR]: 0.93, 95% confidence interval [CI]: 0.88-0.96 and OR: 0.94, 95 CI: 0.90-0.99, respectively). No further associations with peripheral ARHL were evident. Retinal vasculature is associated with central auditory processing pathology, possibly playing an important role in early detection and intervention. The association of retinal vascular density with age-related CAPD may bring us a further step forward in understanding the biological mechanisms underlying the links between neurodegeneration/dementia and ARHL.

The Peripheral Hearing and Central Auditory Processing Skills of Individuals With Subjective Memory Complaints

PurposeThis study examined the central auditory processing (CAP) assessment results of adults between 45 and 85 years of age with probable pre-clinical Alzheimer’s disease – i.e., individuals with subjective memory complaints (SMCs) as compared to those who were not reporting significant levels of memory complaints (non-SMCs). It was hypothesized that the SMC group would perform significantly poorer on tests of central auditory skills compared to participants with non-SMCs (control group).MethodsA total of 95 participants were recruited from the larger Western Australia Memory Study and were classified as SMCs (N = 61; 20 males and 41 females, mean age 71.47 ±7.18 years) and non-SMCs (N = 34; 10 males, 24 females, mean age 68.85 ±7.69 years). All participants completed a peripheral hearing assessment, a CAP assessment battery including Dichotic Digits, Duration Pattern Test, Dichotic Sentence Identification, Synthetic Sentence Identification with Ipsilateral Competing Message (SSI-ICM) and the Quick-Speech-in-Noise, and a cognitive screening assessment.ResultsThe SMCs group performed significantly poorer than the control group on SSI-ICM −10 and −20 dB signal-to-noise conditions. No significant differences were found between the two groups on the peripheral hearing threshold measurements and other CAP assessments.ConclusionsThe results suggest that individuals with SMCs perform poorly on specific CAP assessments in comparison to the controls. The poor CAP in SMC individuals may result in a higher cost to their finite pool of cognitive resources. The CAP results provide yet another biomarker that supports the hypothesis that SMCs may be a primary indication of neuropathological changes in the brain. Longitudinal follow up of individuals with SMCs, and decreased CAP abilities should inform whether this group is at higher risk of developing dementia as compared to non-SMCs and those SMC individuals without CAP difficulties.

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

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

Age-Related Central Auditory Processing Disorder, MCI, and Dementia in an Older Population of Southern Italy.

We explored the associations of age-related central auditory processing disorder (CAPD) with mild cognitive impairment (MCI) and dementia in an older population-based cohort in Apulia, Southern Italy (GreatAGE Study). Cross-sectional data from a population-based study. Castellana Grotte, Bari, Italy. Between 2013 and 2018, MCI, dementia, age-related CAPD (no disabling hearing loss and <50% score on the SSI-ICM test [Synthetic Sentence Identification-Ipsilateral Competing Message]), neurologic and neuropsychological examinations, and serum metabolic biomarkers assays were investigated on 1647 healthy volunteers aged >65 years. The prevalences of age-related CAPD, MCI, and dementia were 14.15%, 15.79%, and 3.58%, respectively. Among the subjects with MCI and dementia, 19.61% and 42.37% had age-related CAPD. In the regressive models, age-related CAPD was associated with MCI (odds ratio, 1.50; 95% CI, 1.01-2.21) and dementia (odds ratio, 2.23; 95% CI, 1.12-4.42). Global cognition scores were positively associated with increasing SSI-ICM scores in linear models. All models were adjusted for demographics and metabolic serum biomarkers. The tight association of age-related CAPD with MCI and dementia suggests the involvement of central auditory pathways in neurodegeneration, but it is not clear which is the real direction of this association. However, CAPD is a possible diagnostic marker of cognitive dysfunction in older patients.

Voice Quality and Auditory Processing in Subjects with and Without Musical Experience

The relationship between voice and auditory processing is complex and has aroused increasing scientific interest in the last decades. Little is known about the relationship between voice quality and auditory processing in individuals with and without musical experience. To assess voice quality and auditory processing in subjects with and without musical experience. Total 120 individuals were split into three groups: GS = singers (N = 47), GI = instrumentalists (N = 43), and NM = nonmusicians (N = 30); group GS was subdivided into GS = 20 singers only and GSI = 27 singers and instrumentalists at the same time. Subjects were undertaken vocal assessment by means of Perceptual Assessment of voice recording followed by self-assessment of a potential voice problem using the Brazilian validated version of the Voice Symptom Scale (VoiSS) (Escala de Sintomas Vocais - ESV). The central auditory processing was carried out following such temporal processing tests: Frequency Pattern Test (FPT), Random Gap Detection Test (RGDT), and auditory-perceptual analysis of distorted speech as indicated: Synthetic Sentence Identification (SSI) test, with Ipsilateral Competing Message. GSI reported a higher number of voice symptoms compared to the other groups for the VoiSS. Throughout the groups, most individuals did not present voice disorders and, when presented, were mild. Subgroup GSI showed the best auditory abilities of temporal ordering for the FPT-Humming and FPT-Verbal, whereas NM had the worst performance. Negligible correlation strength alone was found between the different central auditory processing tests, the overall degree of vocal deviation in the auditory-perceptual analysis of voice quality, and the total score of the Voice Symptom Scale protocol. The voice quality of musicians and nonmusicians was correlated with their auditory processing; although with negligible strength. It was verified that singers-instrumentalist reported more voice symptoms compared to the other groups. Despite the large variation throughout the groups concerning auditory processing, musicians, especially singers-instrumentalists, have shown better auditory abilities of temporal ordering, suggesting that musical training and experience may account for such performance.

Otitis Media: Long-Term Effect on Central Auditory Nervous System.

Objectives To analyze the central auditory nervous system function through behavioral and electrophysiological tests in children with a history of otitis media and subsequent bilateral tubes placement surgery. Methods The participants were divided into two groups between eight and 14 years old: control group (CG) consisted of 40 children with no history of otitis media; experimental group (EG) consisted of 50 children with documented history of otitis media and undertook a surgery for bilateral tubes placement. All children completed audiological evaluation (audiometry, speech audiometry, and immittance audiometry), behavioral evaluation (tests: dichotic digits, synthetic sentence identification with ipsilateral competing message, gaps-in-noise, frequency pattern), and electrophysiological evaluation (Auditory Brainstem Response, ABR, Frequency Following Response, FFR (verbal), and Long Latency Auditory Evoked Potential, LLAEP). Results The EG group showed significantly poorer performance (p<0.001) than the CG for all auditory abilities studied. The results revealed significant latency delays and reduced amplitude (p<0.05) of waves III and V for ABR; significant latency delay was seen of potentials P2, N2, and P300 for LLAEP; significant latency delays and reduced amplitude (p<0.05) were observed for FFR in children with a history of otitis media. Conclusion The results demonstrate negative effect of otitis media in the auditory abilities and electrophysiological measures in children with a history of otitis media.

Central auditory processing findings in a group of cognitively impaired individuals

Introduction: Prevalence of central auditory processing disorders (CAPD) increases with age. Central auditory dysfunction is also more prevalent in older people with mild memory impairment compared with cognitively normal older people. These findings suggest that CAPD could be a marker of subtle cognitive dysfunction. A logical question is whether tests of CAPD have a potential role in evaluation of possible cognitive decline in elderly people with hearing complaints. This question has direct clinical relevance because tests for CAPD are widely available, easy to administer in a short time.Methods: Fifty-one patient having cognitive impairment (diagnosed according Diagnostic and Statistical Manual of Mental disorders, fifth edition 2013 (DSM-V) comprise the study group. The control group includes twenty age and gender matched individuals. A detailed neuropsychological assessment of both groups with tests from various cognitive domains (Visuospatial functions, executive function, short-term memory and verbal episodic memory). Behavioural central auditory tests included the Arabic versions of speech in noise test (SPIN) and/or synthetic sentence identification (SSI) test according to education of patient, the dichotic digits test (DDT), The auditory fusion test (AFT) and auditory memory tests.Results: There was a statistically significant difference between both groups in the behavioural central auditory tests.Conclusions: The relation of some measures of auditory processing to deficits in cognitive function might enable the early identification of cognitive decline with such measures in the older population. Aging can contribute to changes in central auditory processing (CAP) in the elderly especially in Speech understanding in background noise, Dichotic listening and Temporal Processing.

Correlation between cognitive functions and central auditory processing in adolescents with non-cholesteatomatous chronic otitis media.

Auditory deprivation associated with early otitis media with effusion has been considered a risk factor for central auditory processing (CAP), as well as for the development of a number of cognitive functions.Objective:To study the neuropsychological functions of attention, working memory and executive function in adolescents with and without non-cholesteatomatous chronic otitis media (NCCOM) and analyze their interrelationships with the behavioral evaluation of CAP.Methods:Sixty-eight adolescents were recruited, 34 were diagnosed with NCCOM (study group - SG), and 34 had no otological history (control group - CG). The Neupsilin Brief Neuropsychological Assessment Instrument was used. CAP was assessed by: Masking Level Difference, Synthetic Sentence Identification, Random Gap Detection Test, Duration Pattern Sequence Test and Dichotic Digits Test.Results:The results of Neupsilin showed lower scores in the study group when compared to the control group on the following tests: digit sequence repetition, ascending digit ordering, auditory sentence span, and phonemic verbal fluency. An association was found between central auditory processing tests and Neupsilin subtests.Conclusion:The effects of NCCOM on attention, memory and executive function related to central auditory processing disorder in adolescents seem to be enhanced by the severity of the disease.

Auditory Processing of Older Adults With Probable Mild Cognitive Impairment.

Studies suggest that deficits in auditory processing predict cognitive decline and dementia, but those studies included limited measures of auditory processing. The purpose of this study was to compare older adults with and without probable mild cognitive impairment (MCI) across two domains of auditory processing (auditory performance in competing acoustic signals and temporal aspects of audition). The Montreal Cognitive Assessment (Nasreddine et al., 2005) was used to classify participants as with or without probable MCI. In this cross-sectional study, participants (n = 79) completed 4 measures of auditory processing: Synthetic Sentence Identification with Ipsilateral Competing Message (Gates, Beiser, Rees, D'Agostino, & Wolf, 2002), Dichotic Sentence Identification (Fifer, Jerger, Berlin, Tobey, & Campbell, 1983), Adaptive Tests of Temporal Resolution (ATTR; Lister & Roberts, 2006; across-channel and within-channel subtests), and time-compressed speech (Wilson, 1993; Wilson, Preece, Salamon, Sperry, & Bornstein, 1994). Audiometry was also conducted. Those with probable MCI had significantly poorer performance than those without MCI on Synthetic Sentence Identification with Ipsilateral Competing Message, Dichotic Sentence Identification, and the ATTR within-channel subtest. No group differences were found for time-compressed speech, ATTR across-channel, or audiometric measures. Older adults with cognitive impairment not only have difficulty with competing acoustic signals but may also show poor temporal processing. The profile of auditory processing deficits among older adults with cognitive impairment may include multiple domains.

Hearing loss as a risk factor for dementia: A systematic review.

ObjectivesTo review evidence of hearing loss as a risk factor for dementia. Data Sources: PubMed Review methods: A systematic review was conducted using the PubMed database using the search terms (hearing loss OR presbycusis) AND (dementia OR cognitive decline). Initially, 488 articles were obtained. Only those studies evaluating an association between hearing loss and incident dementia or cognitive decline were included in the analysis. This resulted in 17 articles which were thoroughly evaluated with consideration for study design, method for determining hearing loss and cognitive status, relevant covariates and confounding factors, and key findings.ResultsAll of the 17 articles meeting inclusion criteria indicate that hearing loss is associated with dementia or cognitive decline. The methods used among the studies for ascertaining hearing loss and dementia were notably varied. For hearing loss, peripheral auditory function was tested far more than central auditory function. For peripheral audition, pure tone audiometry was the most commonly reported method for defining hearing loss. Only a few studies measured central auditory function by using the Synthetic Sentence Identification with Ipsilateral Competing Message test (SSI‐ICM) and the Staggered Spondaic Word Test (SSW). Dementia was most often defined using the Mini Mental State Exam (MMSE). However, many studies used extensive batteries of tests to define cognitive status, often including a neuropsychologist. Confounding variables such as cardiovascular risk factors were measured in 17 studies and family history of dementia was only evaluated in 1 study. Overall, the methods used by studies to ascertain hearing loss, cognitive status and other variables are valid, making their evaluation appear reliable.ConclusionWhile each of the studies included in this study utilized slightly different methods for evaluating participants, each of them demonstrated that hearing loss is associated with higher incidence of dementia in older adults.Level of EvidenceLevel V, systematic review.

The role of the cerebellum in auditory processing using the SSI test

AbstractThe Synthetic Sentence Identification (SSI) test assesses central auditory pathways by measuring auditory and visual sensitivity and testing selective attention. Cerebellum activation in auditory attention and sensorial activity modulation have already been described. Assessing patients with cerebellar lesions alone using the SSI test can confirm the role of the cerebellum in auditory processing. AimTo evaluate the role of the cerebellum in auditory processing in individuals with normal hearing and in those with chronic cerebellum lesions, using the SSI test. Materials and MethodsCross-sectional cohort study. A study group comprising 18 patients with chronic cerebellar lesion and a control group of 20 healthy individuals were assessed. The SSI test was applied in an Ipsilateral Competitive Message (ICM) and Contralateral Competitive Message (CCM) modes. To compare the results between groups, we used the chi-square test for qualitative variables. ResultsA statistically significant difference was found between the study and control groups using the ICM mode of the SSI test (p=0.035), but not in the CCM mode (p=0.083). ConclusionThe results on the SSI confirmed cerebellar participation in auditory processing in individuals with chronic cerebellar lesions and in those with normal hearing assessed in this study.

Effects of auditory training in individuals with high-frequency hearing loss

OBJECTIVE:To determine the effects of a formal auditory training program on the behavioral, electrophysiological and subjective aspects of auditory function in individuals with bilateral high-frequency hearing loss.METHOD:A prospective study of seven individuals aged 46 to 57 years with symmetric, moderate high-frequency hearing loss ranging from 3 to 8 kHz was conducted. Evaluations of auditory processing (sound location, verbal and non-verbal sequential memory tests, the speech-in-noise test, the staggered spondaic word test, synthetic sentence identification with competitive ipsilateral and contralateral competitive messages, random gap detection and the standard duration test), auditory brainstem response and long-latency potentials and the administration of the Abbreviated Profile of Hearing Aid Benefit questionnaire were performed in a sound booth before and immediately after formal auditory training.RESULTS:All of the participants demonstrated abnormal pre-training long-latency characteristics (abnormal latency or absence of the P3 component) and these abnormal characteristics were maintained in six of the seven individuals at the post-training evaluation. No significant differences were found between ears in the quantitative analysis of auditory brainstem responses or long-latency potentials. However, the subjects demonstrated improvements on all behavioral tests. For the questionnaire, the difference on the background noise subscale achieved statistical significance.CONCLUSION:Auditory training in adults with high-frequency hearing loss led to improvements in figure-background hearing skills for verbal sounds, temporal ordination and resolution, and communication in noisy environments. Electrophysiological changes were also observed because, after the training, some long latency components that were absent pre-training were observed during the re-evaluation.

Central auditory functions in elderly individuals

AbstractElderly individuals often have more difficulty in understanding speech than younger adults, particularly in noisy environments. Three models that attempt to explain this are as follows: (a) deterioration in peripheral hearing; (b) structural changes to the central auditory system; and (c) changes in normal cognitive processes. The aim of this study was to assess the central auditory functions in an elderly population and compare them with those of an adult population. Participants and methods The study group included 60 elderly individuals; they were older than 60 years of age and were divided into two subgroups: the first subgroup A included 24 elderly individuals with normal peripheral hearing and the second subgroup B included 36 elderly individuals with presbycusis with a mild degree of hearing loss. The control group included 30 individuals ranging in age from 18 to 30 years. Both the study and the control group were subjected to an otological examination, immittancemetry, pure tone audiometry, speech audiometry, and central auditory processing assessment using the following selected few behavioral central auditory tests: synthetic sentence identification test with ipsilateral competing message (SSI-ICM), dichotic digits test (DDT), auditory fusion test-revised (AFT-R), and pitch pattern sequences test (PPT). Results There were elevated hearing thresholds at mostly all frequencies with statistically significant differences on comparing both study subgroups A and B with the control group. On using SSI-ICM, in the competition ratio (−15 dB), there were statistically significantly low scores in subgroups A and B compared with the control group. Results of DDT showed statistically significantly low scores on comparing the results between the left ear and the right ear in both subgroups A and B. There was a statistically significant elevated gap threshold for tonal stimuli in the AFT-R test on comparing both subgroups A and B with the control group. The results of PPT showed that subgroup B obtained a statistically significantly lower score compared with the control group. There was a statistically significant negative correlation between age and the results of SSI-ICM in the competition ratio 0 dB when presented to the left ear, DDT, and PPT. There was a statistically significant positive correlation between age and the results of AFT-R when presented at 4000 Hz. Conclusion Age-related changes to auditory processing will occur in most adults 60 years of age and older that may or may not be concomitant with peripheral hearing loss. Aging decreases the capacity of digit recognition and also increases interaural asymmetries. Many older listeners show reduced temporal resolution even when potential influences of hearing loss are absent. Temporal ordering abilities decrease with age. Recommendation It is important to include central auditory tests in the audiologic assessment protocol of the elderly. The utilization of these tests in assessment of the elderly enables us to improve the quality of therapeutic-rehabilitative interventions.