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Biomedical subjects

J Jerger

Publications and source records attributed to J Jerger.

At least 37 records · Page 2Linked to original sources
PubMed1997

Factor analytic structure of auditory impairment in elderly persons.

The audiometric and self-assessed handicap data of 180 elderly persons with presbyacusic-type hearing impairment were submitted to principal components analysis in order to study the factor structure underlying auditory processing. Audiometric data included pure-tone threshold sensitivity, speech understanding scores for monosyllabic words without competition, synthetic sentences within competition, and dichotic synthetic sentence identification. The Hearing Handicap Inventory for the Elderly (HHIE) was used to quantify self-assessed handicap both by the subjects and by their significant others. Six factors emerged from the analysis: (1) low-frequency sensitivity loss, (2) high-frequency sensitivity loss, (3) general speech understanding ability, (4) self-assessed handicap, (5) the central processing of left ear input, and (6) the central processing of right ear input. Five conclusions are highlighted: (1) degree of hearing sensitivity loss, which determines speech audibility, remains a key concept in understanding the speech understanding problems of elderly persons; (2) low-frequency and high-frequency sensitivity loss emerge as separate factors; (3) a factor of general speech understanding ability, not strongly related to audibility, is confirmed; (4) the central processing of right and left ear verbal inputs emerge as separate factors; and (5) perceived auditory handicap emerges as a separate factor, apparently not strongly related to either audibility, general speech understanding, or the central processing of verbal input.

Acoustic Impedance Tests↗
PubMed1997

Comparison of performance with frequency transposition hearing aids and conventional hearing aids.

Four experienced hearing aid users were evaluated using a frequency transposition (TranSonic) hearing system. Following a trial period, the Abbreviated Profile of Hearing Aid Performance (APHAB) and a variety of speech audiometric measures were used to compare the frequency transposition fitting with each subject's conventional hearing aids. A single-subject study design with a series of repeated measures permitted statistical analysis of differences in performance with the various amplification strategies. Two of the four subjects demonstrated statistically significant benefit with the frequency transposition device. Results show the efficacy of frequency transposition in improving speech understanding and quality of life in some individuals with severe-to-profound hearing loss. Overall, results suggest the need for evaluating the benefit of frequency transposition on an individual basis.

Adult↗
PubMed1996

Monitoring of cisplatin ototoxicity by distortion-product otoacoustic emissions.

Cisplatin is one of the most commonly used chemotherapeutic agents. However, ototoxicity, in particular, damage to the outer hair cells of the cochlea, is one of its major side effects. Otoacoustic emissions are acoustical signals that originate from the contractile activity of the outer hair cells. They are transmitted from the cochlea to the external ear canal via the middle ear apparatus. Testing is quick, painless, objective, and non-invasive. Distortion-product otoacoustic emissions (DPOAEs) are one of the evoked types of otoacoustic emissions. They are quite sensitive to any insult to the outer hair cells, even before damage is manifested in pure tone audiometry (PTA). A patient, who was on cisplatin chemotherapy due to prostate cancer, was monitored periodically for ototoxicity using DPOAEs and PTA. DPOAEs were found to detect ototoxicity one course of chemotherapy earlier than PTA during cisplatin chemotherapy. The clinical application and sensitivity of DPOAEs in monitoring ototoxicity were discussed.

Acoustic Stimulation↗
PubMed1996

Comparison of conventional amplification and an assistive listening device in elderly persons.

OBJECTIVE: To assess the impact of personal amplification systems on quality of life of elderly persons and to compare conventional hearing aid with assistive listening device. DESIGN: Audiologic, neuropsychologic, and quality-of-life measures were prospectively administered to 180 elderly, hearing-impaired persons before and after randomized 6 wk trials of four treatment conditions-a no-amplification condition and three different types of amplification: 1) conventional hearing aid, 2) assistive listening device, and 3) a combination of the two systems. All subjects volunteered to participate in a study comparing different amplification systems and were paid for their participation. RESULTS: Both self-perceived handicap and speech understanding were improved significantly by all three amplification systems. There were no significant group differences between new users and previous users of amplification in self-assessed handicap after amplification use. Anecdotally, subjects preferred the sound quality of the assistive listening device, but an overwhelming majority (97.3%) still chose the conventional aid for use in daily living. CONCLUSIONS: Results affirm the significant impact of amplification on the quality of life of elderly persons. The strong preference for the conventional hearing aid in everyday use undoubtedly reflects the fact that elderly users usually are not willing to endure the difficulties associated with the use of remote-microphone systems.

Adult↗
PubMed1996

Hearing aid use, central auditory disorder, and hearing handicap in elderly persons.

We compared self-reported handicap (Hearing Handicap Inventory for the Elderly, HHIE) scores before and after a 6-week period of hearing aid use in subjects drawn from a pool of 115 elderly persons with hearing impairment. Study patients (PTs) were divided into two categories according to whether scores on a dichotic listening test (Dichotic Sentence Identification Test, DSI) were normal or abnormal. In a subgroup of 63 persons who had not previously used amplification, subjects in the two DSI categories showed equivalent average HHIE scores. After 6 weeks of first-time hearing aid use, there was a significant improvement in average HHIE scores, but only in the DSI-normal category. In the subgroup with dichotic deficits (DSI-abnormal group), average HHIE scores did not change significantly after hearing aid use. In a subgroup of 89 PTs, we compared the self-assessed HHIE scores of the PTs with the HHIE scores rated by their significant others (SOs). In both DSI categories, the average handicap, as judged by the subject's SO, was significantly greater than the handicap as judged by the PT. In addition, both ratings reflected significant improvement after hearing aid use. It was the case, however, that improvement consequent on amplification was significantly smaller for subjects in the DSI-abnormal category. Finally, we show, in the entire pool of 115 PTs, that the effect of practice on the HHIE score is not sufficient to explain the improvement after amplification. Results affirm both the positive value of amplification and the negative impact of central auditory deficit as they affect the HHIE scores of the elderly hearing-impaired person.

Aged↗
PubMed1995

Quantifying improvement with amplification.

We employed a nonparametric measure, the randomization test, to evaluate, statistically, a variety of speech understanding measures used to quantify the efficacy of different intervention strategies in five clinical patients. The flexibility of the approach was demonstrated by comparing monaural with binaural amplification, a conventional aid with an assistive listening device, and a cochlear implant alone versus a cochlear implant supplemented by visual cues. The randomization test allows statistical analysis of differences in performance at the level of the individual subject. This approach may be useful in addressing accountability when recommending a specific intervention strategy for a particular hearing-impaired individual.

Adolescent↗
PubMed1995

Comparison of crossed and uncrossed acoustic reflex latencies.

OBJECTIVE: To compare morphologies of crossed and uncrossed acoustic reflex waveforms. DESIGN: Subjects were 12 young adults with normal hearing. A signal-averaging technique was used to compare onset and offset latencies of crossed and uncrossed acoustic reflex waveforms when maximum amplitudes were matched. RESULTS: Onset latency was similar for the two modes, but offset latency was significantly longer for the crossed reflex. Further, in individual subjects the difference between crossed and uncrossed offset latencies was inversely proportional to maximum reflex amplitude. CONCLUSION: Results emphasize the complex interaction between amplitude and latency characteristics of acoustic reflex waveform.

Acoustic Impedance Tests↗
PubMed1995

Dichotic listening, event-related potentials, and interhemispheric transfer in the elderly.

OBJECTIVE: To determine the basis for the large, age-related asymmetries in dichotic listening performance scores reported by Jerger et al. (1994). DESIGN: Behavioral and electrophysiologic responses to dichotic listening tasks in both verbal and nonverbal paradigms were obtain in four groups of subjects: young adults with normal hearing, elderly persons with presbyacusis, elderly persons with presbyacusis and marked dichotic deficits, and patients with lesions of the corpus callosum. RESULTS: In comparison with the young group the two elderly groups showed an increasing left-ear deficit on the verbal task, and an increasing right-ear deficit on the nonverbal paradigm. The pattern of results obtained in the elderly persons with marked dichotic deficits was similar to the pattern of results in the group with callosal lesions. CONCLUSIONS: With age, there may be a significant loss of efficiency of interhemispheric transfer of auditory information through the corpus callosum. Such age-related deficit might have important implications for the effective use of binaural information by elderly person.

Adolescent↗
PubMed1995

Hearing impairment in older adults: new concepts.

OBJECTIVE: To review present information about the epidemiology, etiologies, pathogenesis, evaluation, and quality of life aspects of hearing loss and to present an approach to rehabilitation for hearing loss in older adults. DESIGN: A survey of recent findings on the problem of hearing loss in older adults, efficacy of intervention with amplification, and new developments in intervention strategies. CONCLUSIONS: The complex nature of hearing problems in older adults involves changes in the auditory periphery as well as in the central mechanisms for processing sound input. These changes affect the social and emotional impact of the hearing disorder. The importance of understanding the many implications of hearing loss on quality of life is emphasized. Both older adults and immediate family members need information and advice about the consequences of age-related hearing loss. The physician has a key role in helping them to overcome negative attitudes toward a hearing handicap. For most older persons, hearing aids alleviate many of the handicaps of hearing impairment. For some older persons who do not benefit adequately from conventional hearing aids, assistive listening devices may be helpful. Many old persons and their relatives are reluctant to confront the reality of hearing handicap and try to hide the fact that they need sound amplification. One important future direction is to foster acceptance of hearing loss and to support the more open use of amplification systems.

Aged↗
PubMed1995

Improving the efficiency of speech audiometry: computer-based approach.

Speech audiometric measures were carried out on 981 patients using a computer-based system that permitted a comparison between two modes of signal presentation, manual and automatic. The manual mode, designed to simulate the pace of live-voice testing, allowed the presentation of speech signals at a rate dictated by the patient's response. The automatic mode, designed to simulate tape-player testing, fixed the interstimulus interval. A comparison of elapsed time for the completion of word recognition testing with phonetically balanced (PB) word lists showed that use of the manual mode resulted in increased efficiency. Testing time was reduced by an average of 22 percent. These results suggest that the clinical efficiency of speech audiometric testing can be enhanced by using a computer-based manual approach. The combination of digitally recorded speech stimuli with a computer-based manual approach may provide a useful compromise between the efficiency of live-voice testing and the signal consistency of magnetic-tape or compact-disc recordings.

Adolescent↗
PubMed1994

Effects of age and gender on dichotic sentence identification.

There is converging evidence that aging causes a progressive decline in the central processing of speech and that this decline is greater for left-ear than for right-ear input. In the present paper we investigated, by means of a dichotic sentence identification paradigm, some parameters of the "left-ear effect." We analyzed the clinical records of 356 individuals, 203 males and 153 females, to whom the Dichotic Sentence Identification (DSI) Test had been administered as part of routine audiometric assessment. Subjects ranged in age from 9 to 91 yr. The DSI test was always carried out in two modes: free report (FR) and directed report (DR). In the FR mode the subject reported what was heard in both ears. In the DR mode the subject reported only what was heard in one precued ear. In half of the trials the right ear was precued, in the other half the left ear was precued. Findings confirm a progressively larger right-ear advantage, or left-ear deficit, with increasing age. We document this effect in both the FR and DR modes, then demonstrate that the effects cannot be attributed to interaural asymmetries in threshold sensitivity. Comparison of male and female data suggest a gender difference in the effect of age on the left-ear deficit. Males show a larger effect then females in both modes of test administration. Finally, we propose a model of dichotic listening performance that attempts to explain ear asymmetry as the linear combination of an auditory/structural component and a task-related/cognitive component. We then show how these hypothetical components change with age in the present sample.

Adolescent↗
PubMed1994

Efficacy of the cued-listening task in the evaluation of binaural hearing aids.

To evaluate the efficacy of the cued-listening task (CLT) in the evaluation of binaural hearing aid performance, we tested 10 experienced binaural hearing aid users. Subjects listened for a speech target embedded in continuous discourse from either the right or left directions while simultaneously suppressing similar continuous discourse from the other direction. The task was carried out in the presence of multitalker babble from an overhead source. The target-to-babble ratio was always 0 dB. Testing was carried out in four conditions: (1) unaided; (2) aided in right ear; (3) aided in left ear; and (4) aided binaurally. Results showed that neither condition of monaural amplification was significantly better than the unaided condition. Under binaural amplification, however, there was a significant improvement in target recognition. Furthermore, this enhancement in performance was significantly greater when targets came from the right side than when they came from the left side.

Aged↗
PubMed1993

Developmental trends in the interaction between auditory and linguistic processing.

The developmental course of multidimensional speech processing was examined in 80 children between 3 and 6 years of age and in 60 adults between 20 and 86 years of age. Processing interactions were assessed with a speeded classification task (Garner, 1974a), which required the subjects to attend selectively to the voice dimension while ignoring the linguistic dimension, and vice versa. The children and adults exhibited both similarities and differences in the patterns of processing dependencies. For all ages, performance for each dimension was slower in the presence of variation in the irrelevant dimension; irrelevant variation in the voice dimension disrupted performance more than irrelevant variation in the linguistic dimension. Trends in the degree of interference, on the other hand, showed significant differences between dimensions as a function of age. Whereas the degree of interference for the voice-dimension-relevant did not show significant age-related change, the degree of interference for the word-dimension-relevant declined significantly with age in a linear as well as a quadratic manner. A major age-related change in the relation between dimensions was that word processing, relative to voice-gender processing, required significantly more time in the children than in the adults. Overall, the developmental course characterizing multidimensional speech processing evidenced more pronounced change when the linguistic dimension, rather than the voice dimension, was relevant.

Adult↗