Biomedical subjects

A Q Summerfield

Publications and source records attributed to A Q Summerfield.

At least 19 recordsLinked to original sources

PubMed2001

Prevalence of permanent childhood hearing impairment in the United Kingdom and implications for universal neonatal hearing screening: questionnaire based ascertainment study.

OBJECTIVE: To estimate the prevalence of confirmed permanent childhood hearing impairment and its profile across age and degree of impairment in the United Kingdom. DESIGN: Retrospective total ascertainment through sources in the health and education sectors by postal questionnaire. SETTING: Hospital based otology and audiology departments, community health clinics, education services for hearing impaired children. PARTICIPANTS: Children born from 1980 to 1995, resident in United Kingdom in 1998, with severe permanent childhood hearing impairment (hearing level in the better ear >40 dB averaged over 0.5, 1, 2, and 4 kHz). MAIN OUTCOME MEASURES: Numbers of cases with date of birth and severity of impairment converted to prevalences for each annual birth cohort (cases/1000 live births) and adjusted for under ascertainment. RESULTS: 26 000 notifications ascertained 17 160 individual children. Prevalence rose from 0.91 (95% confidence interval 0.85 to 0.98) for 3 year olds to 1.65 (1.62 to 1.68) for children aged 9-16 years. Adjustment for under ascertainment increased estimates to 1.07 (1.03 to 1.12) and 2.05 (2.02 to 2.08). Comparison with previous studies showed that prevalence increases with age, rather than declining with year of birth. CONCLUSIONS: Prevalence of confirmed permanent childhood hearing impairment increases until the age of 9 years to a level higher than previously estimated. Relative to current yields of universal neonatal hearing screening in the United Kingdom, which are close to 1/1000 live births, 50-90% more children are diagnosed with permanent childhood hearing impairment by the age of 9 years. Paediatric audiology services must have the capacity to achieve early identification and confirmation of these additional cases.

Adolescent↗

PubMed2001

Functionally equivalent ages and hearing levels of children with cochlear implants measured with pre-recorded stimuli.

Three groups of children undertook an interactive computer-based closed-set test of the ability to identify pre-recorded spoken words presented acoustically. The test was completed by 31/39 children with profound hearing loss who had used the Nucleus Spectra-22 cochlear-implant system for at least one year (Group A); by 30 children with normal hearing (Group B); and by 22 children with severe-profound hearing loss who used acoustic hearing aids (Group C). Among the implanted children, those who were younger when implanted and who had used their devices for longer produced higher scores (multiple-r = 0.68). Logistic regression functions were fitted to the data from Group B to describe the relationship between performance and age, and to the data from Group C to describe the relationships between performance and average hearing level (AHL) and aided threshold. By use of the regression equations, the performance of each implanted child was converted into a functionally equivalent (FE) age, an FE AHL and an FE aided threshold. Despite high variability leading to wide confidence intervals, these transformations showed that: (1) mean FE age (3.4 years) lagged mean chronological age (7.4 years), but some implanted children performed within the range expected for children with normal hearing of the same age; (2) mean FE AHL was 94 dB compared with a mean pre-implant AHL of 117 dB; (3) mean FE aided threshold was 45 dB(A) compared with a mean pre-implant aided threshold of 99 dB(A). These results confirm that implantation of appropriate candidates leads to functionally better hearing than would be expected with acoustic hearing aids. The results also demonstrate that many implanted children can participate in interactive tests with pre-recorded speech, thus providing robust data for comparison with future performance.

Adult↗

PubMed2001

Functional magnetic resonance imaging measurements of sound-level encoding in the absence of background scanner noise.

Effects of sound level on auditory cortical activation are seen in neuroimaging data. However, factors such as the cortical response to the intense ambient scanner noise and to the bandwidth of the acoustic stimuli will both confound precise quantification and interpretation of such sound-level effects. The present study used temporally "sparse" imaging to reduce effects of scanner noise. To achieve control for stimulus bandwidth, three schemes were compared for sound-level matching across bandwidth: component level, root-mean-square power and loudness. The calculation of the loudness match was based on the model reported by Moore and Glasberg [Acta Acust. 82, 335-345 (1996)]. Ten normally hearing volunteers were scanned using functional magnetic resonance imaging (tMRI) while listening to a 300-Hz tone presented at six different sound levels between 66 and 91 dB SPL and a harmonic-complex tone (F0= 186 Hz) presented at 65 and 85 dB SPL. This range of sound levels encompassed all three bases of sound-level matching. Activation in the superior temporal gyrus, induced by each of the eight tone conditions relative to a quiet baseline condition, was quantified as to extent and magnitude. Sound level had a small, but significant, effect on the extent of activation for the pure tone, but not for the harmonic-complex tone, while it had a significant effect on the response magnitude for both types of stimulus. Response magnitude increased linearly as a function of sound level for the full range of levels for the pure tone. The harmonic-complex tone produced greater activation than the pure tone, irrespective of the matching scheme for sound level, indicating that bandwidth had a greater effect on the pattern of auditory activation than sound level. Nevertheless, when the data were collapsed across stimulus class, extent and magnitude were significantly correlated with the loudness scale (measured in phons), but not with the intensity scale (measured in SPL). We therefore recommend the loudness formula as the most appropriate basis of matching sound level to control for loudness effects when cortical responses to other stimulus attributes, such as stimulus class, are the principal concern.

Adult↗

PubMed2001

Active control of the volume acquisition noise in functional magnetic resonance imaging: method and psychoacoustical evaluation.

Functional magnetic resonance imaging (fMRI) provides a noninvasive tool for observing correlates of neural activity in the brain while a subject listens to sound. However, intense acoustic noise is generated in the process of capturing MR images. This noise stimulates the auditory nervous system, limiting the dynamic range available for displaying stimulus-driven activity. The noise is potentially damaging to hearing and is distracting for the subject. In an active noise control (ANC) system, a reference sample of a noise is processed to form a sound which adds destructively with the noise at the listener's ear. We describe an implementation of ANC in the electromagnetically hostile and physically compact MRI scanning environment. First, a prototype system was evaluated psychoacoustically in the laboratory, using the electrical drive to a noise-generating loudspeaker as the reference. This system produced 10-20 dB of subjective noise-reduction between 250 Hz and 1 kHz, and smaller amounts at higher frequencies. The system was modified to operate in a real MR scanner where the reference was obtained by recording the acoustic scanner noise. Objective reduction by 30-40 dB of the most intense component in scanner noises was realized between 500 Hz and 3500 Hz, and subjective reduction of 12 dB and 5 dB in tests at frequencies of 600 Hz and at 1.9 kHz, respectively. Although the benefit of ANC is limited by transmission paths to the cochlea other than air-conduction routes from the auditory meatus, ANC achieves worthwhile attenuation even in the frequency range of maximum bone conduction (1.5-2 kHz). ANC should, therefore, be generally useful during auditory fMRI.

Auditory Perception↗

PubMed2000

Time-course of the auditory BOLD response to scanner noise.

It is a concern for auditory fMRI studies that acoustic noise generated by the scanner produces an auditory response that can confound stimulus-induced activation. To establish how to minimize this problem, the present study mapped the time-course of the auditory response to a burst of acoustic scanner noise by employing a single-event method. Recorded bursts of scanner noise were interspersed with clustered-volume acquisitions at a range of stimulus-to-imaging delays to map the response with a temporal resolution of 1 sec. There were strong responses (1.5% signal change) to scanner noise in primary and secondary auditory cortex. In both cortical areas, the mean response rose to a peak by 4-5 sec after stimulus onset and decayed after a further 5-8 sec. The time course indicates that noise contamination in auditory fMRI can be substantially reduced by using a 9-12-sec repetition time, thus maximizing the dynamic range available for displaying the response to acoustical stimuli of interest.

Adult↗

PubMed2000

Sound-level measurements and calculations of safe noise dosage during EPI at 3 T.

This paper describes systematic methods for measuring and controlling sound levels within a magnetic resonance scanner. The methods are illustrated by application to the acoustic noise generated by a 3 T scanner during echoplanar imaging (EPI). Across five measurement sessions, sound pressure levels at the center of the head gradient coil ranged from 122 to 131 dB SPL [123 to 132 dB(A)]. For protection against damaging noise exposure, UK and US industrial guidelines stipulate that the maximum permitted daily noise dosage is equivalent to 90 dB(A) for 8 hours, where noise dosage is a function of the level of an acoustic signal and the length of exposure to it. Without hearing protection, this equivalent level would be exceeded by less than 5 seconds of exposure to the measured levels of scanner acoustic noise. These findings highlight the importance of noise reduction and hearing protection for those exposed to the acoustic noise generated during EPI.

Auditory Threshold↗

PubMed2000

Integration of monaural and binaural evidence of vowel formants.

The intelligibility of speech is sustained at lower signal-to-noise ratios when the speech has a different interaural configuration from the noise. This paper argues that the advantage arises in part because listeners combine evidence of the spectrum of speech in the across-frequency profile of interaural decorrelation with evidence in the across-frequency profile of intensity. To support the argument, three experiments examined the ability of listeners to integrate and segregate evidence of vowel formants in these two profiles. In experiment 1, listeners achieved accurate identification of the members of a small set of vowels whose first formant was defined by a peak in one profile and whose second formant was defined by a peak in the other profile. This result demonstrates that integration is possible. Experiment 2 demonstrated that integration is not mandatory, insofar as listeners could report the identity of a vowel defined entirely in one profile despite the presence of a competing vowel in the other profile. The presence of the competing vowel reduced accuracy of identification, however, showing that segregation was incomplete. Experiment 3 demonstrated that segregation of the binaural vowel, in particular, can be increased by the introduction of an onset asynchrony between the competing vowels. The results of experiments 2 and 3 show that the intrinsic cues for segregation of the profiles are relatively weak. Overall, the results are compatible with the argument that listeners can integrate evidence of spectral peaks from the two profiles.

Adult↗

PubMed2000

The lateralization of simple dichotic pitches.

A "simple" dichotic pitch arises when a single narrow band possesses a different interaural configuration from a surrounding broadband noise whose interaural configuration is uniform and correlated. Such pitches were created by interaurally decorrelating a narrow band (experiment 1) or by giving a narrow band a different interaural time difference from the noise (experiment 2). Using an adaptive forced-choice procedure, listeners adjusted the interaural intensity difference of "pointers" to match their lateralization to that of the dichotic pitches. The primary determinants of lateralization were the interaural configuration of the broadband noise (experiment 1), the center frequency of the narrow band (experiment 1), and its interaural configuration (experiment 2). The ability of two computational models to predict these results was evaluated. A version of the central-spectrum model [J. Raatgever and F. A. Bilsen, J. Acoust. Soc. Am. 80, 429-441 (1986)] incorporating realistic frequency selectivity accounted for the main results of experiment 1 but not experiment 2. A new "reconstruction-comparison" model accounted for the main results of both experiments. To accommodate the variables shown to influence lateralization, this model segregates evidence of the dichotic pitch from the noise, reconstructs the cross-correlogram of the noise, and compares it with the cross-correlogram of the original stimulus.

Auditory Perception↗

PubMed2000

Lip-reading ability and patterns of cortical activation studied using fMRI.

Lip-reading is a complex cognitive skill with large individual differences in performance. The basis of these individual differences remains poorly understood. Functional magnetic resonance imaging (fMRI) techniques allows brain activation accompanying complex cognitive activities to be studied noninvasively. In the present paper, fMRI was used to study the patterns of cortical activation that occur during the silent lip-reading of connected speech and to investigate whether there are detectable differences in activation between subjects with widely differing lip-reading abilities. From a cohort of 26 volunteers, nine subjects who fell into three distinct lip-reading ability groups were selected. Brain activation was measured in two conditions: an experimental condition where subjects attempted to lip-read sentences; and a baseline condition where subjects passively viewed a static image of a talker's face. Relative to the baseline condition, lip-reading induced activation in several cortical areas, including the auditory cortices, despite the lack of an auditory component to the task. In comparison to the better two groups of lip-readers, subjects in the poorest group displayed significantly less activation in superior and middle temporal gyrus, but not inferior temporal gyrus. These preliminary results justify more extensive investigations of the cortical basis of individual differences in lip-reading.

Adult↗

PubMed2000

Modulation and task effects in auditory processing measured using fMRI.

Active listening has been reported to elicit a different sensory response from passive listening and is generally observed as an increase in the magnitude of activation. Sensory activation differences may therefore be masked by the effect of attention. The present study measured activation induced by static and modulated tones, while controlling attention by using target-discrimination and passive listening tasks. The factorial design enabled us to determine whether the stimulus-induced activation in auditory cortex was independent of the information-processing demands of the task. Contrasted against a silent baseline, listening to the tones induced widespread activation in the temporal cortex, including Heschl's gyrus (HG), planum temporale, superior temporal gyrus (STG), and superior temporal sulcus. No additional auditory areas were recruited in the response to modulated tones compared to static tones, but there was an increase in the response in the STG, anterior to HG. Relative to passive listening, the active task increased the response in the STG, posterior to HG. The active task also recruited regions in the frontal and parietal cortex and subcortical areas. These findings indicate that preferential responses to the changing spectro-temporal properties of the stimuli and to the target-discrimination task involve distinct, non-overlapping areas of the secondary auditory cortex. Thus, in the present study, differences in sensory activation were not masked by the effects of attention.

Acoustic Stimulation↗

PubMed1999

Paediatric cochlear implantation and health-technology assessment.

Cochlear implants are provided to children on the basis of the hypothesis that short-term outcomes in auditory receptive skills will translate via a cascade of medium-term outcomes into greater social independence and quality of life. The medium-term outcomes include: (i) enhanced engagement and integration in primary education, leading to greater scholastic achievement; (ii) enhanced social versatility and robustness, permitting a successful transition to secondary education; and (iii) enhanced educational qualifications, allowing greater opportunities in further education and employment. A sufficient number of children have used implants for long enough for it to be feasible to establish whether the first two medium-term outcomes are being achieved and, if so, at what cost in the provision of health care and education. The first part of this paper discusses alternative research designs that could address these issues. Although a prospective randomised controlled trial would provide the most powerful evidence for or against the hypothesis, it is implausible that adequate compliance with randomisation to treatments could be sustained to give such a study sufficient power. The most powerful realisable design would be a large-scale cross-sectional comparison of implanted children and matched groups of their non-implanted peers. The second part of the paper describes the results of a speculative cost-benefit analysis that seeks to identify the cost to society of providing implants to children. The analysis is based on measured costs of health care, but on estimates of costs and cost-savings in other domains. It indicates that paediatric implantation could be cost-neutral in the UK, provided that implantation saved pound sterling 3000/year in the cost of education, pound sterling 1000/year in other domains, and permitted an increase in personal income of 25% of the national median household income. These savings might be realised if implantation permitted sufficient facility in spoken language to allow every implanted child to enter mainstream education.

Child↗

PubMed1999

"Sparse" temporal sampling in auditory fMRI.

The use of functional magnetic resonance imaging (fMRI) to explore central auditory function may be compromised by the intense bursts of stray acoustic noise produced by the scanner whenever the magnetic resonance signal is read out. We present results evaluating the use of one method to reduce the effect of the scanner noise: "sparse" temporal sampling. Using this technique, single volumes of brain images are acquired at the end of stimulus and baseline conditions. To optimize detection of the activation, images are taken near to the maxima and minima of the hemodynamic response during the experimental cycle. Thus, the effective auditory stimulus for the activation is not masked by the scanner noise. In experiment 1, the course of the hemodynamic response to auditory stimulation was mapped during continuous task performance. The mean peak of the response was at 10.5 sec after stimulus onset, with little further change until stimulus offset. In experiment 2, sparse imaging was used to acquire activation images. Despite the fewer samples with sparse imaging, this method successfully delimited broadly the same regions of activation as conventional continuous imaging. However, the mean percentage MR signal change within the region of interest was greater using sparse imaging. Auditory experiments that use continuous imaging methods may measure activation that is a result of an interaction between the stimulus and task factors (e.g., attentive effort) induced by the intense background noise. We suggest that sparse imaging is advantageous in auditory experiments as it ensures that the obtained activation depends on the stimulus alone.

Acoustic Stimulation↗

PubMed1999

A binaural analog of gap detection.

The temporal resolution of the binaural auditory system was measured using a binaural analog of gap detection. A binaural "gap" was defined as a burst of interaurally uncorrelated noise (Nu) placed between two bursts of interaurally correlated noise (N0). The Nu burst creates a dip in the output of a binaural temporal window integrating interaural correlation, analogous to the dip created by a silent gap in the output of a monaural temporal window integrating intensity. The equivalent rectangular duration (ERD) of the binaural window was used as an index of binaural temporal resolution. In order to derive the ERD, both the shortest-detectable binaural gap and the jnd for a reduction in interaural correlation from unity were measured. In experiment 1, binaural-gap thresholds were measured using narrow-band noise carriers as a function of center frequency from 250 to 2000 Hz (fixed 100-Hz bandwidth) and a function of lower-cutoff frequency from 100 to 400 Hz (fixed 500-Hz upper-cutoff frequency). Binaural-gap thresholds (1) increased significantly with increasing frequency in both tasks, and (2) at frequencies below 500 Hz, were shorter than corresponding silent-gap thresholds measured with the same N0 noises. In experiment 2, interaural-correlation jnd's were measured for the same conditions. The jnd's also increased significantly with increasing frequency. The results were analyzed using a temporal window integrating the output of a computational model of binaural processing. The ERD of the window varied widely across listeners, with a mean value of 140 ms, and did not significantly depend on frequency. This duration is about an order of magnitude longer than the ERD of the monaural temporal window and is, therefore, consistent with "binaural sluggishness."

Auditory Perception↗

PubMed1998

Dichotic pitches as illusions of binaural unmasking. I. Huggins' pitch and the "binaural edge pitch".

The two most salient dichotic pitches, the Huggins pitch (HP) and the binaural edge pitch (BEP), are produced by applying interaural phase transitions of 360 and 180 degrees, respectively, to a broadband noise. This paper examines accounts of these pitches, concentrating on a "central activity pattern" (CAP) model and a "modified equalization-cancellation" (mE-C) model. The CAP model proposes that a dichotic pitch is heard at frequency f when an individual across-frequency scan in an interaural cross-correlation matrix contains a sharp peak at f. The mE-C model proposes that a dichotic pitch is heard when a plot of interaural decorrelation against frequency contains a peak at f. The predictions of the models diverge for the BEP at very narrow transition bandwidths: the mE-C model predicts that salience is sustained, while the CAP model predicts that salience declines and that the dominant percept is of the in-phase segment of the noise. Experiment 1 showed that the salience of the BEP was sustained at the narrowest bandwidths that could be generated (0.5% of the transition frequency). Experiment 2 confirmed that the pitch of a BEP produced by a 0.5% transition bandwidth was close to the frequency of the transition band. Experiment 3 showed that pairs of simultaneous narrow 180-degree transitions, whose frequencies corresponded to vowel formants, were perceived as the intended vowels. Moreover, the same vowels were perceived whether the in-phase portion of the noise lay between the two transition frequencies or on either side of them. In contrast, different patterns of identification responses were made to diotic band-pass and band-stop noises whose cutoff frequencies corresponded to the same formants. Thus, the vowel-identification responses made to the dichotic stimuli were not based on hearing the in-phase portions of the noise as formants. These results are not predicted by the CAP model but are consistent with the mE-C model. It is argued that the mE-C model provides a more coherent and parsimonious account of many aspects of the HP and the BEP than do alternative models.

Dichotic Listening Tests↗

PubMed1998

Dichotic pitches as illusions of binaural unmasking. II. The Fourcin pitch and the dichotic repetition pitch.

The predictions of three models are compared with respect to existing experimental data on the perception of the Fourcin pitch (FP) and the dichotic repetition pitch (DRP). Each model generates a central spectrum (CS), which is examined for peaks at frequencies consistent with the perceived pitches. A modified equalization-cancellation (mE-C) model of binaural unmasking [Culling and Summerfield, J. Acoust. Soc. Am. 98, 785-797 (1995)] generates a CS which reflects the degree of interaural decorrelation present in each frequency channel. This model accounts for the perceived frequencies of FPs, but produces no output for DRP stimuli. A restricted equalization-cancellation (rE-C) model [Bilsen and Goldstein, J. Acoust. Soc. Am. 55, 292-296 (1974)] sums the time-varying excitation in corresponding frequency channels, without equalization, to form a CS. A central activity pattern (CAP) model [Raatgever and Bilsen, J. Acoust. Soc. Am. 80, 429-441 (1986)] generates a CS by scanning an interaural cross-correlation matrix across frequency. The rE-C and CAP models yield inaccurate predictions of the perceived frequencies of FPs, but predict the occurrence of the DRP and its correct pitch. The complementary predictions of the mE-C model compared to the rE-C and CAP models, together with the evidence that the FP is clearly audible for the majority of listeners, while the DRP is faintly heard by a minority of listeners, suggest that the mE-C model provides the best available account of the FP, and that the DRP is produced by a separate mechanism.

Dichotic Listening Tests↗

PubMed1997

Cost-effectiveness considerations in pediatric cochlear implantation.

OBJECTIVE: To summarizes the results of cost-utility analyses of pediatric cochlear implantation (CI) in the United Kingdom. METHOD: Analysis is based on the direct costs of medical and rehabilitative management and also on emerging evidence that implantation leads to a shift in educational placements in favor of mainstreaming with support. RESULT: The resulting cost-utility ratio falls on the margin of the range considered acceptable within the British health-care system. The analysis also suggests that pediatric CI could be acceptably cost-effective. CONCLUSION: The next step should be to measure the costs of alternative educational settings directly.

Adult↗

PubMed1996

Cochlear implantation: relationships with research on auditory deprivation and acclimatization.

This paper reviews research on cochlear implantation relevant to deprivation and acclimatization with acoustical hearing aids. The term "deprivation" is used in its everyday sense to refer to the bilateral absence of acoustic stimulation. Results are reviewed from several sources, with detailed evidence presented from three groups of postlingually deafened adult patients and one group of prelingually deafened child patients, all implanted at the University of Iowa. Outcomes from implantation reveal consistent effects of deprivation, evidenced by significant negative correlations between accuracy of speech perception and the duration of profound/total deafness before implantation. Outcomes also show acclimatization in the form of significant improvements in performance over time after implantation. For adult patients, the level of performance measured shortly after implantation on average is about half the level measured eventually. Individually, 80% of the adult patients implanted in Iowa show significant performance improvements with time. On average, performance reached asymptote after 30 to 40 mo of implant use, although individual differences in the rate and amount of improvement are large. Absolute accuracy of speech perception with implants by adults is believed to be related to preoperative measures in three domains: 1) the number and physiological responsiveness of auditory ganglion cells and nerve fibers, indexed by measures of hearing sensitivity, duration of deafness, and age; 2) the responsiveness of the central nervous system, indexed by measures of cognitive and linguistic ability, and possibly also by age and duration of deafness; and 3) the motivation to learn to use the implant. Preliminary analyses suggest that the measures in the first domain are more strongly associated with the immediate benefit from implantation than with the subsequent improvement in performance over time.

Adolescent↗

PubMed1996

Adult auditory learning and training.

We describe a theoretical framework that distinguishes stimulus, procedural, and task aspects of learning, and we suggest that this framework may allow an improved understanding of acclimatization and late-onset auditory deprivation. We review the literature on learning after sensorineural hearing loss and after the provision of amplification. We then examine the possibility of using training to improve the speech-understanding skills of listeners with sensorineural hearing loss after provision of amplification. Here, we concentrate on techniques recently demonstrated to encourage the acquisition of non-native phonetic contrasts in second-language learners. We argue that there are three general principles associated with auditory learning and training: 1) the more complex the task, the longer the learning period required; 2) the greater the similarity between training and test tasks, the greater the transfer of training; and 3a) the more familiar the stimulus materials, the faster the subsequent learning. When training for speech identification in everyday life, maximizing the opportunity for the listener to cope with the acoustic variability found in natural speech, both within and between talkers, is important. We, therefore, argue that the third principle should be extended: 3b) the more the training set exemplifies the acoustic variability found within and between talkers, the greater the transfer to open-set speech identification in everyday life. Throughout the review, we show that individual differences in learning are observed in the rate of acquisition and in the level of asymptotic performance. We argue that it is possible to postulate modulators of learning that may account for some of these individual differences. Possible candidates for influential modulators are: 1) the history of hearing impairment--the longer the history, the longer the time taken to improve performance and, possibly, the lower the asymptotic level of performance; 2) the severity and pattern of hearing loss; 3) the degree of asymmetry in the hearing loss and its effect on the binaural organization of the hearing system; and 4) the level of patient adaptability and cognitive abilities, such as attentional control and short-term memory span.

Cognition↗