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JAMA Network Open Mar 2023Despite normal audiometry, adults living with HIV have lower distortion product otoacoustic emissions (DPOAEs) compared with HIV-negative controls, but the degree of...
IMPORTANCE
Despite normal audiometry, adults living with HIV have lower distortion product otoacoustic emissions (DPOAEs) compared with HIV-negative controls, but the degree of these differences in children living with HIV is unknown. If subclinical auditory deficits are present, results could affect developmental outcomes in children living with HIV (CLWH).
OBJECTIVE
To compare DPOAEs and auditory brainstem responses (ABR) between 2 age- and sex-matched groups of younger children with normal audiometry, 1 infected with HIV and the other uninfected.
DESIGN, SETTING, AND PARTICIPANTS
Cohort study in an infectious disease center in Dar es Salaam, Tanzania. Participants included 340 Tanzanian children aged 3 to 9 years with clinically normal hearing, type A tympanograms bilaterally, and air-conduction thresholds of 20 dB HL or less from 0.5 to 8 kHz. Participants in the cohort repeated testing approximately every 6 months (approximately 2.2 sessions per participant) for a total of 744 total observations. Data were analyzed from March 2020 to January 2022.
MAIN OUTCOMES AND MEASURES
DPOAE amplitudes from 1.5 to 8 kHz using an f2 to f1 ratio of 1.2 and L1/L2 values of 65/55 dB sound pressure level and click-evoked ABR using a slow (21.1/s) and fast (61.1/s) click rate.
RESULTS
A total of 141 CLWH (70 female participants [49.3%]; mean [SD] age, 7.24 [1.67] years) and 199 HIV-negative individuals (99 female participants [49.7%]; mean [SD] age, 7.26 [1.44] years) participated in the study. The groups did not differ significantly in age, static immittance, or air-conduction thresholds. HIV status was independently associated with approximately 1.4 dB (95% CI, -3.28 to 0.30 dB) to 3.8 dB (95% CI, 6.03 to -1.99 dB) lower DPOAE amplitudes at 6 and 8 kHz bilaterally and 0.28 μV (95% CI, 0.01 to 0.33 μV) lower ABR wave V amplitudes in the right ear.
CONCLUSIONS AND RELEVANCE
Consistent with previous findings in young adults, CLWH had slightly, but reliably, lower DPOAEs and ABR wave V amplitudes than HIV-negative controls. The magnitude of these differences was small, but results suggest an early and consistent association between HIV infection or treatment and outer hair cell and auditory brainstem responses in children as young as 3 years. These subclinical changes suggest tracking both auditory function and development outcomes in CLWH is warranted.
Topics: Young Adult; Humans; Child; Female; Otoacoustic Emissions, Spontaneous; Tanzania; HIV Infections; Cohort Studies; Audiometry, Pure-Tone; Auditory Threshold; Hearing
PubMed: 36920392
DOI: 10.1001/jamanetworkopen.2023.3061 -
Neuroscience May 2019The effects of traumatic noise-exposure and deafening on auditory system function have received a great deal of attention. However, lower levels of noise as well as... (Review)
Review
The effects of traumatic noise-exposure and deafening on auditory system function have received a great deal of attention. However, lower levels of noise as well as temporary conductive hearing loss also have consequences on auditory physiology and hearing. Here we review how abnormal acoustic experience at early ages affects the ascending and descending auditory pathways, as well as hearing behavior.
Topics: Animals; Auditory Pathways; Auditory Threshold; Hearing; Hearing Loss, Conductive; Hearing Loss, Noise-Induced; Humans; Noise
PubMed: 30685543
DOI: 10.1016/j.neuroscience.2019.01.020 -
PloS One 2023Infrasounds are signals with frequencies below the classical audio-frequency range, i.e., below 20 Hz. Several previous studies have shown that infrasound is audible as...
Infrasounds are signals with frequencies below the classical audio-frequency range, i.e., below 20 Hz. Several previous studies have shown that infrasound is audible as well, provided that the sound level is high enough. Hence, the sound pressure levels at threshold are much higher than those in the classical audio-frequency range. The present study investigates how the duration and the shape of the temporal envelope affect thresholds of infrasound stimuli in quiet. Two envelope types were considered: one where the duration of the steady state was varied (plateau bursts) and one where the number of consecutive onset-offset bursts was varied (multiple bursts). Stimuli were presented monaurally to human listeners by means of a low-distortion sound reproduction system. For both envelope types, thresholds decrease with increasing duration, a phenomenon often referred to as temporal integration. At the same duration, thresholds for plateau-burst stimuli are typically lower than those for multiple-burst stimuli. The data are well described by a slightly modified version of a model that was previously developed to account for temporal integration in the classical audio-frequency range. The results suggest similar mechanisms underlying the detection of stimuli with frequencies in the infrasound and in the classical audio-frequency range. Since the model accounts for the effect of duration and, more generally, the shape of the envelope, it can be used to enhance the comparability of existing and future datasets of thresholds for infrasounds with different temporal stimulus parameters.
Topics: Humans; Sound; Auditory Threshold
PubMed: 37523364
DOI: 10.1371/journal.pone.0289216 -
American Journal of Audiology Mar 2021Purpose Auditory threshold estimation using the auditory brainstem response or auditory steady state response is limited in some populations (e.g., individuals with...
Purpose Auditory threshold estimation using the auditory brainstem response or auditory steady state response is limited in some populations (e.g., individuals with auditory neuropathy spectrum disorder [ANSD] or those who have difficulty remaining still during testing and cannot tolerate general anesthetic). However, cortical auditory evoked potentials (CAEPs) can be recorded in many such patients and have been employed in threshold approximation. Thus, we studied CAEP estimates of auditory thresholds in participants with normal hearing, sensorineural hearing loss, and ANSD. Method We recorded CAEPs at varying intensity levels to speech (i.e., /ba/) and tones (i.e., 1 kHz) to estimate auditory thresholds in normal-hearing adults ( = 10) and children ( = 10) and case studies of children with sensorineural hearing loss and ANSD. Results Results showed a pattern of CAEP amplitude decrease and latency increase as stimulus intensities declined until waveform components disappeared near auditory threshold levels. Overall, CAEP thresholds were within 10 dB HL of behavioral thresholds for both stimuli. Conclusions The above findings suggest that CAEPs may be clinically useful in estimating auditory threshold in populations for whom such a method does not currently exist. Physiologic threshold estimation in difficult-to-test clinical populations could lead to earlier intervention and improved outcomes.
Topics: Adult; Auditory Threshold; Child; Evoked Potentials, Auditory; Hearing; Hearing Loss, Central; Hearing Loss, Sensorineural; Humans
PubMed: 33264574
DOI: 10.1044/2020_AJA-20-00062 -
Scientific Reports Sep 2021Auditory studies in animals benefit from quick and accurate audiometry. The auditory brainstem response (ABR) and prepulse inhibition (PPI) have been widely used for...
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.
Topics: Acoustic Stimulation; Animals; Audiometry, Pure-Tone; Auditory Threshold; Evoked Potentials, Auditory, Brain Stem; Feasibility Studies; Hearing; Male; Models, Animal; Prepulse Inhibition; Rats; Rats, Wistar; Species Specificity
PubMed: 34556706
DOI: 10.1038/s41598-021-98167-6 -
American Journal of Audiology Oct 2021Purpose Distortion product otoacoustic emissions (DPOAEs) and audiometric thresholds have been used to account for the impacts of subclinical outer hair cell (OHC)...
Purpose Distortion product otoacoustic emissions (DPOAEs) and audiometric thresholds have been used to account for the impacts of subclinical outer hair cell (OHC) dysfunction on auditory perception and measures of auditory physiology. However, the relationship between DPOAEs and the audiogram is unclear. This study investigated this relationship by determining how well DPOAE levels can predict the audiogram among individuals with clinically normal hearing. Additionally, the impacts of age, noise exposure, and the perception of tinnitus on the ability of DPOAE levels to predict the audiogram were evaluated. Method Suprathreshold DPOAE levels from 1 to 10 kHz and pure-tone thresholds from 0.25 to 16 kHz were measured in 366 ears from 194 young adults (19-35 years old) with clinically normal audiograms and middle ear function. The measured DPOAE levels at all frequencies were used to predict pure-tone thresholds at each frequency. Participants were grouped by age, self-reported noise exposure/Veteran status, and self-report of tinnitus. Results Including DPOAE levels in the pure-tone threshold prediction model improved threshold predictions at all frequencies from 0.25 to 16 kHz compared with a model based only on sample mean pure-tone thresholds, but these improvements were modest. DPOAE levels for frequencies of 4 and 5 kHz were particularly influential in predicting pure-tone thresholds above 4 kHz. However, prediction accuracy varied based on participant characteristics. On average, predicted pure-tone thresholds were better than measured thresholds among Veterans, individuals with tinnitus, and the oldest age group. Conclusions These results indicate a complex relationship between DPOAE levels and the audiogram. Underestimation of pure-tone thresholds for some groups suggests that additional factors other than OHC damage may impact thresholds among individuals within these categories. These findings suggest that DPOAE levels and pure-tone thresholds may differ in terms of how well they reflect subclinical OHC dysfunction. Supplemental Material https://doi.org/10.23641/asha.13564745.
Topics: Adult; Audiometry, Pure-Tone; Auditory Threshold; Humans; Otoacoustic Emissions, Spontaneous; Tinnitus; Young Adult
PubMed: 33465327
DOI: 10.1044/2020_AJA-20-00056 -
The Journal of the Acoustical Society... Oct 2021The relationship between sound duration and detection threshold has long been thought to reflect temporal integration. Reports of species differences in this...
The relationship between sound duration and detection threshold has long been thought to reflect temporal integration. Reports of species differences in this relationship are equivocal: some meta-analyses report no species differences, whereas others report substantial differences, particularly between humans and their close phylogenetic relatives, macaques. This renders translational work in macaques problematic. To reevaluate this difference, tone detection performance was measured in macaques using a go/no-go reaction time (RT) task at various tone durations and in the presence of broadband noise (BBN). Detection thresholds, RTs, and the dynamic range (DR) of the psychometric function decreased as the tone duration increased. The threshold by duration trends suggest macaques integrate at a similar rate to humans. The RT trends also resemble human data and are the first reported in animals. Whereas the BBN did not affect how the threshold or RT changed with the duration, it substantially reduced the DR at short durations. A probabilistic Poisson model replicated the effects of duration on threshold and DR and required integration from multiple simulated auditory nerve fibers to explain the performance at shorter durations. These data suggest that, contrary to previous studies, macaques are uniquely well-suited to model human temporal integration and form the baseline for future neurophysiological studies.
Topics: Animals; Auditory Threshold; Benchmarking; Humans; Macaca; Phylogeny; Sound
PubMed: 34717465
DOI: 10.1121/10.0006658 -
Trends in Hearing 2019The frequency-specific tone-evoked auditory brainstem response (ABR) is an indispensable tool in both the audiology clinic and research laboratory. Most frequently, the...
The frequency-specific tone-evoked auditory brainstem response (ABR) is an indispensable tool in both the audiology clinic and research laboratory. Most frequently, the toneburst ABR is used to estimate hearing thresholds in infants, toddlers, and other patients for whom behavioral testing is not feasible. Therefore, results of the ABR exam form the basis for decisions regarding interventions and hearing habilitation with implications extending far into the child's future. Currently, responses are elicited by periodic sequences of toneburst stimuli presented serially to one ear at a time, which take a long time to measure multiple frequencies and intensities, and provide incomplete information if the infant wakes up early. Here, we describe a new method, the parallel ABR (pABR), which uses randomly timed toneburst stimuli to simultaneously acquire ABR waveforms to five frequencies in both ears. Here, we describe the pABR and quantify its effectiveness in addressing the greatest drawback of current methods: test duration. We show that in adults with normal hearing the pABR yields high-quality waveforms over a range of intensities, with similar morphology to the standard ABR in a fraction of the recording time. Furthermore, longer latencies and smaller amplitudes for low frequencies at a high intensity evoked by the pABR versus serial ABR suggest that responses may have better place specificity due to the masking provided by the other simultaneous toneburst sequences. Thus, the pABR has substantial potential for facilitating faster accumulation of more diagnostic information that is important for timely identification and treatment of hearing loss.
Topics: Adult; Auditory Threshold; Evoked Potentials, Auditory, Brain Stem; Female; Hearing; Hearing Loss; Hearing Tests; Humans; Male; Time Factors
PubMed: 31516096
DOI: 10.1177/2331216519871395 -
Trends in Hearing Dec 2015Users of bilateral cochlear implants (CIs) show above-chance performance in localizing the source of a sound in the azimuthal (horizontal) plane; although localization... (Review)
Review
Users of bilateral cochlear implants (CIs) show above-chance performance in localizing the source of a sound in the azimuthal (horizontal) plane; although localization errors are far worse than for normal-hearing listeners, they are considerably better than for CI listeners with only one implant. In most previous studies, subjects had access to interaural level differences and to interaural time differences conveyed in the temporal envelope. Here, we present a binaural model that predicts the azimuthal direction of sound arrival from a two-channel input signal as it is received at the left and right CI processor. The model includes a replication of a clinical speech-coding strategy, a model of the electrode-nerve interface and binaural brainstem neurons, and three different prediction stages that are trained to map the neural response rate to an azimuthal angle. The model is trained and tested with various noise and speech stimuli created by means of virtual acoustics. Localization error patterns of the model match experimental data and are explicable largely in terms of the nonmonotonic relationship between interaural level difference and azimuthal angle.
Topics: Acoustic Stimulation; Auditory Perception; Auditory Threshold; Cochlear Implantation; Cochlear Implants; Deafness; Female; Humans; Male; Sound Localization
PubMed: 26631106
DOI: 10.1177/2331216515616378 -
Journal of Speech, Language, and... Oct 2019Purpose Spectral modulation detection is an increasingly common assay of suprathreshold auditory perception and has been correlated with speech perception performance.... (Randomized Controlled Trial)
Randomized Controlled Trial
Purpose Spectral modulation detection is an increasingly common assay of suprathreshold auditory perception and has been correlated with speech perception performance. Here, the potential effects of stimulus duration and stimulus presentation level on spectral modulation detection were investigated. Method Spectral modulation detection thresholds were measured as a function of modulation frequency in young, normal-hearing listeners. The standard stimulus was a bandpass noise, and signal stimuli were created by superimposing sinusoidal spectral modulation on the bandpass noise carrier. The modulation was sinusoidal on a log frequency axis and a log (dB) amplitude scale with a random starting phase (0-2π radians). In 1 experiment, stimulus durations were 50, 100, 200, or 400 ms (at fixed level 81 dB SPL). In a 2nd experiment, stimuli were presented at sensation levels of 10, 20, 30, 40, and 60 dB SL (fixed at a duration of 400 ms). Results Spectral modulation detection thresholds were similarly low for the 400- and 200-ms durations, increased slightly for the 100-ms duration, and increased markedly for the 50-ms duration. Thresholds were lowest for 40 dB SL; increased slightly for 20, 30, and 60 dB SL; and markedly higher for the 10-dB SL condition. Conclusions The increase in thresholds for the shortest durations and lowest sensational levels is consistent with previous investigations of auditory spectral profile analysis. The effects of presentation level and stimulus duration are important considerations in the context of understanding potential relationships between the perception of spectral cues and speech perception, when designing investigations and interpreting data related to spectral envelope perception, and in the context of models of auditory perception. As examples, 2 simple models based on auditory nerve output that have been used to explain spectrotemporal modulation in previous investigations produced an output inconsistent with the present results. Plain language summary Intensity variations across audio frequency lead to spectral shapes that are essential and sometimes signature features of various sounds in the environment, including speech. Here, we show how laboratory measures of spectral shape perception depend on presentation level and stimulus duration.
Topics: Acoustic Stimulation; Adult; Auditory Perception; Auditory Threshold; Female; Healthy Volunteers; Hearing; Humans; Male; Noise; Speech Perception; Time Factors; Young Adult
PubMed: 31638883
DOI: 10.1044/2019_JSLHR-H-18-0449