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Journal of Clinical Medicine Apr 2020Auditory neuropathy spectrum disorder (ANSD) refers to a range of hearing impairments characterized by deteriorated speech perception, despite relatively preserved... (Review)
Review
Auditory neuropathy spectrum disorder (ANSD) refers to a range of hearing impairments characterized by deteriorated speech perception, despite relatively preserved pure-tone detection thresholds. Affected individuals usually present with abnormal auditory brainstem responses (ABRs), but normal otoacoustic emissions (OAEs). These electrophysiological characteristics have led to the hypothesis that ANSD may be caused by various dysfunctions at the cochlear inner hair cell (IHC) and spiral ganglion neuron (SGN) levels, while the activity of outer hair cells (OHCs) is preserved, resulting in discrepancies between pure-tone and speech comprehension thresholds. The exact prevalence of ANSD remains unknown; clinical findings show a large variability among subjects with hearing impairment ranging from mild to profound hearing loss. A wide range of prenatal and postnatal etiologies have been proposed. The study of genetics and of the implicated sites of lesion correlated with clinical findings have also led to a better understanding of the molecular mechanisms underlying the various forms of ANSD, and may guide clinicians in better screening, assessment and treatment of ANSD patients. Besides OAEs and ABRs, audiological assessment includes stapedial reflex measurements, supraliminal psychoacoustic tests, electrocochleography (ECochG), auditory steady-state responses (ASSRs) and cortical auditory evoked potentials (CAEPs). Hearing aids are indicated in the treatment of ANSD with mild to moderate hearing loss, whereas cochlear implantation is the first choice of treatment in case of profound hearing loss, especially in case of IHC presynaptic disorders, or in case of poor auditory outcomes with conventional hearing aids.
PubMed: 32290039
DOI: 10.3390/jcm9041074 -
The Journal of the Acoustical Society... Dec 2022This paper reviews methods and considerations for measuring tinnitus in clinical trials designed to evaluate treatment options using investigational medicinal products.... (Review)
Review
This paper reviews methods and considerations for measuring tinnitus in clinical trials designed to evaluate treatment options using investigational medicinal products. Tests applied in tinnitus-related research and clinical practice have their own measurement purposes, advantages, and limitations. If the characteristics of each test method are well understood, the test can be effectively used in clinical trials. For the accuracy of clinical trial results, it is necessary to use a test tool with verified validity, reliability, and sensitivity. If a test tool that is likely to have high variability in the same individual is required in the clinical trial, strategies to increase the reliability of the test, such as repeat measurements, may also be needed. In addition, a test tool that meets the purpose of the clinical trial should be selected. For example, the tinnitus questionnaire is appropriate to assess reactions to tinnitus, and measurements of tinnitus loudness or pitch are appropriate to evaluate the psychoacoustic characteristics of tinnitus. In conclusion, the use of validated test tools that meet the purpose of the trial will help with the accuracy of the clinical trial results.
Topics: Humans; Tinnitus; Reproducibility of Results; Psychoacoustics; Surveys and Questionnaires; Pharmaceutical Preparations
PubMed: 36586833
DOI: 10.1121/10.0014699 -
Otology & Neurotology : Official... Feb 2021Tinnitus loudness is a subjective measure, and it does not directly reflect either tinnitus severity or the impact on daily life. Nevertheless, loud tinnitus may be the...
INTRODUCTION
Tinnitus loudness is a subjective measure, and it does not directly reflect either tinnitus severity or the impact on daily life. Nevertheless, loud tinnitus may be the most frequent clinical complaint of tinnitus patients. Factors contributing to the loudness of the phantom sound have rarely been studied. We evaluated both matched and self-rated loudness in a large sample of patients with tinnitus and analyzed the influencing factors among demographic, hearing, and tinnitus characteristics.
METHODS
Two hundred ninety-nine patients with chronic tinnitus were enrolled. We evaluated the matched loudness, minimal masking level (MML), and visual analog scale (VAS) loudness. Stepwise multiple regression analyses were performed for each loudness measure using independent variables of age, sex, time since tinnitus onset, tinnitus laterality, pure-tone average, tinnitus pitch, tinnitus handicap inventory (THI) score, VAS annoyance, disturbance and daily tinnitus duration, and depression score. We calculated bivariate correlations between each loudness measure and all independent variables.
RESULTS
The psychoacoustic loudness measures (matched loudness and MML) were highly correlated and were affected by the hearing deficit and tinnitus pitch (Pearson r > 0.5 for pure tone averages, and r > 0.3 for tinnitus pitch for both variables, p < 0.05), whereas the subjective measurement (VAS loudness) exhibited little to no correlation with the other two measures and was related to psycho-emotional factors such as the THI score, VAS variables, and depression (Pearson r > 0.6 for VAS annoyance, r > 0.4 for VAS daily duration and disturbance and THI score, r > 0.3 for the depression score, p < 0.05).
CONCLUSION
The matched tinnitus loudness and MML values were influenced principally by the extent of hearing loss and related factors, suggesting that rehabilitation using hearing aids could help reduce perception of tinnitus loudness. A psycho-emotional approach might more effectively lessen self-perceived loudness.
Topics: Hearing Aids; Hearing Loss; Humans; Psychoacoustics; Tinnitus; Visual Analog Scale
PubMed: 33165158
DOI: 10.1097/MAO.0000000000002932 -
Cerebellum (London, England) Aug 2021
Topics: Auditory Perceptual Disorders; Friedreich Ataxia; Humans; Trinucleotide Repeats
PubMed: 33599953
DOI: 10.1007/s12311-021-01238-7 -
Otolaryngologic Clinics of North America Aug 2020Tinnitus is commonly referred to as "ringing in the ears." Epidemiologic studies highlight challenges associated with clinical determination of tinnitus and... (Review)
Review
Tinnitus is commonly referred to as "ringing in the ears." Epidemiologic studies highlight challenges associated with clinical determination of tinnitus and ascertainment of its etiology, functional effects, temporal characteristics, psychoacoustic parameters, and risk factors. Because no standards exist for capturing these factors as measures, direct comparison of data between studies is not possible. This report suggests terminology and definitions to promote standardization, with a brief overview of findings from selected population-based epidemiologic studies. Tinnitus-specific data are presented from the Noise Outcomes in Servicemembers Epidemiology study. Further epidemiologic studies are needed to develop tinnitus treatment and a cure for this chronic condition.
Topics: Hearing Loss; Humans; Noise; Ototoxicity; Psychoacoustics; Risk Factors; Tinnitus
PubMed: 32362561
DOI: 10.1016/j.otc.2020.03.002 -
The European Journal of Neuroscience Mar 2020Several behavioural studies in humans have shown that listening to sounds with two ears that is binaural hearing, provides the human auditory system with extra... (Review)
Review
Several behavioural studies in humans have shown that listening to sounds with two ears that is binaural hearing, provides the human auditory system with extra information on the sound source that is not available when sounds are only perceived through one ear that is monaurally. Binaural processing involves the analysis of phase and level differences between the two ear signals. As monaural cochlea processing (in each ear) precedes the neural stages responsible for binaural processing properties it is reasonable to assume that properties of the cochlea may also be observed in binaural processing. A main characteristic of cochlea processing is its frequency selectivity. In psychoacoustics, there is an ongoing discussion on the frequency selectivity of the binaural auditory system. While some psychoacoustic experiments seem to indicate poorer frequency selectivity of the binaural system than that of the monaural processing others seem to indicate the same frequency selectivity for monaural and binaural processing. This study provides an overview of these seemingly controversial results and the different explanations that were provided to account for the different results.
Topics: Auditory Perception; Hearing; Humans; Psychoacoustics
PubMed: 29359360
DOI: 10.1111/ejn.13837 -
Hearing Research Jun 2022The role of the mammalian auditory olivocochlear efferent system in hearing has long been the subject of debate. Its ability to protect against damaging noise exposure... (Review)
Review
The role of the mammalian auditory olivocochlear efferent system in hearing has long been the subject of debate. Its ability to protect against damaging noise exposure is clear, but whether or not this is the primary function of a system that evolved in the absence of industrial noise remains controversial. Here we review the behavioral consequences of olivocochlear activation and diminished olivocochlear function. Attempts to demonstrate a role for hearing in noise have yielded conflicting results in both animal and human studies. A role in selective attention to sounds in the presence of distractors, or attention to visual stimuli in the presence of competing auditory stimuli, has been established in animal models, but again behavioral studies in humans remain equivocal. Auditory processing deficits occur in models of congenital olivocochlear dysfunction, but these deficits likely reflect abnormal central auditory development rather than direct effects of olivocochlear feedback. Additional proposed roles in age-related hearing loss, tinnitus, hyperacusis, and binaural or spatial hearing, are intriguing, but require additional study. These behavioral studies almost exclusively focus on medial olivocochlear effects, and many relied on lesioning techniques that can have unspecific effects. The consequences of lateral olivocochlear and of corticofugal pathway activation for perception remain unknown. As new tools for targeted manipulation of olivocochlear neurons emerge, there is potential for a transformation of our understanding of the role of the olivocochlear system in behavior across species.
Topics: Acoustic Stimulation; Animals; Auditory Perception; Cochlea; Efferent Pathways; Hearing; Hyperacusis; Mammals; Noise; Olivary Nucleus
PubMed: 33674070
DOI: 10.1016/j.heares.2021.108207 -
Journal of Integrative Bioinformatics Sep 2022Tinnitus is an annoying ringing in the ears, in varying shades and intensities. Tinnitus can affect a person's overall health and social well-being (e.g., sleep... (Review)
Review
Tinnitus is an annoying ringing in the ears, in varying shades and intensities. Tinnitus can affect a person's overall health and social well-being (e.g., sleep problems, trouble concentrating, anxiety, depression and inability to work). The diagnostic procedure of tinnitus usually consists of three steps: an audiological examination, psychoacoustic measurement, and a disability evaluation. All steps are performed by physicians, who use specialised hardware/software and administer questionnaires. This paper presents a system, to be used by patients, for the diagnosis and self-management of tinnitus. The system is made up of an app and a device. The app is responsible for executing - through the device - a part of the required audiological and psychoacoustic examinations, as well as administering questionnaires that evaluate disability. The paper reviews the quality of the automated audiometric reporting and the user experience provided by the app. Descriptive and inferential statistics were used to support the findings. The results show that automated reporting is comparable with that of physicians and that user experience was improved by re-designing and re-developing the acufenometry of the app. As for the user experience, two experts in Human-Computer Interaction evaluated the first version of the app: their agreement was good (Cohen's = 0.639) and the average rating of the app was 1.43/2. Also patients evaluated the app in its initial version: the satisfactory tasks (audiometry and questionnaires) were rated as 4.31/5 and 4.65/5. The unsatisfactory task (acufenometry) was improved and the average rating increased from 2.86/5 to 3.96/5 ( = 0.0005). Finally, the general usability of the app was increased from the initial value of 73.6/100 to 85.4/100 ( = 0.0003). The strengths of the project are twofold. Firstly, the automated reporting feature, which - to the best of our knowledge - is the first attempt in this area. Secondly, the overall app usability, which was evaluated and improved during its development. In summary, the conclusion drawn from the conducted project is that the system works as expected, and despite some weaknesses, also the replication of the device would not be expensive, and it can be used in different scenarios.
Topics: Humans; Mobile Applications; Self-Management; Surveys and Questionnaires; Tinnitus
PubMed: 36039680
DOI: 10.1515/jib-2022-0004 -
European Journal of Neurology Oct 2020Hidden hearing loss has been reported in patients with Charcot-Marie-Tooth (CMT) disease; however, the auditory-processing deficits have not been widely explored. We...
BACKGROUND AND PURPOSE
Hidden hearing loss has been reported in patients with Charcot-Marie-Tooth (CMT) disease; however, the auditory-processing deficits have not been widely explored. We investigated the psychoacoustic and neurophysiological aspects of auditory processing in patients with CMT disease type 1A (CMT1A) and type 2A (CMT2A).
METHODS
A total of 43 patients with CMT1A and 15 patients with CMT2A were prospectively enrolled. All patients with CMT disease had normal sound-detection ability by using pure-tone audiometry. Spectral-ripple discrimination, temporal modulation detection and auditory frequency-following response were compared between CMT1A, CMT2A and control groups.
RESULTS
Although all participants had normal audiograms, patients with CMT disease had difficulty understanding speech in noise. The psychoacoustic auditory processing was somewhat different depending on the underlying pathophysiology of CMT disease. Patients with CMT1A had degraded auditory temporal and spectral processing. Patients with CMT2A had no reduced spectral resolution, but they showed further reduced temporal resolution than the patients with CMT1A. The amplitudes of the frequency-following response were reduced in patients with CMT1A and CMT2A, but the neural timing remained relatively intact.
CONCLUSIONS
When we first assessed the neural representation to speech at the brainstem level, the grand average brainstem responses were reduced in both patients with CMT1A and CMT2A compared with healthy controls. As the psychoacoustic aspects of auditory dysfunctions in CMT1A and CMT2A were somewhat different, it is necessary to consider future auditory rehabilitation methods based on their pathophysiology.
Topics: Auditory Perception; Charcot-Marie-Tooth Disease; Humans; Neurophysiology; Psychoacoustics
PubMed: 32478888
DOI: 10.1111/ene.14370 -
The Journal of the Acoustical Society... Aug 2023Web-based testing is an appealing option for expanding psychoacoustics research outside laboratory environments due to its simple logistics. For example, research...
Web-based testing is an appealing option for expanding psychoacoustics research outside laboratory environments due to its simple logistics. For example, research participants partake in listening tasks using their own computer and audio hardware and can participate in a comfortable environment of their choice at their own pace. However, it is unknown how deviations from conventional in-lab testing affect data quality, particularly in binaural hearing tasks that traditionally require highly precise audio presentation. Here, we used an online platform to replicate two published in-lab experiments: lateralization to interaural time and level differences (ITD and ILD, experiment I) and dichotic and contralateral unmasking of speech (experiment II) in normal-hearing (NH) young adults. Lateralization data collected online were strikingly similar to in-lab results. Likewise, the amount of unmasking measured online and in-lab differed by less than 1 dB, although online participants demonstrated higher speech reception thresholds overall than those tested in-lab by up to ∼7 dB. Results from online participants who completed a hearing screening versus those who self-reported NH did not differ significantly. We conclude that web-based psychoacoustics testing is a viable option for assessing binaural hearing abilities among young NH adults and discuss important considerations for online study design.
Topics: Young Adult; Humans; Psychoacoustics; Speech Perception; Hearing; Auditory Perception; Internet
PubMed: 37556566
DOI: 10.1121/10.0020567