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Detection of 1st- and 2nd-order temporal-envelope cues in a patient with left superior cortical damage.

This psychophysical study explores the extent to which the auditory cortex is necessary for various aspects of temporal-envelope perception, that is, perception of the slow temporal modulations in amplitude known to be crucial for sound identification. The ability to detect 1st- and 2nd-order sinusoidal amplitude modulation (AM) is evaluated in a single patient showing left-hemisphere damage encroaching the primary and secondary auditory cortices. Here, 1st- and 2nd-order AM refer to (1) sinusoidal variation in the amplitude of a 2 kHz pure tone, and (2) sinusoidal variation in the depth of a 64 Hz AM applied to the 2 kHz pure tone, respectively. The results replicate previous findings by showing that damage to the left auditory cortex results in a selective deficit in auditory sensitivity to the lowest 1St-order AM (i.e., 1st-order AM frequencies < 16 Hz). Moreover, a dissociation is apparent between the ability to detect 1st- and 2nd-order temporal-envelope cues. The patient shows poorer than normal ability to detect 2nd-order AM at low frequencies ranging from 4-23 Hz, but normal ability to detect the high (64 Hz) 1st-order AM carrying these 2nd-order modulations. This result indicates that damage to the left primary and secondary auditory cortices affects the ability to detect temporal variations in the local properties of sounds(such as AM depth). It is also consistent with the idea that, as in vision, central nonlinear mechanisms are involved in the computation of such local (or 2nd-order) temporal properties.

Acoustic Stimulation↗

Accuracy of pitch matching for pure tones and for complex tones with overlapping or nonoverlapping harmonics.

The discrimination of the fundamental frequency (fo) of pairs of complex tones with no common harmonics is worse than the discrimination of fo for tones with all harmonics in common. These experiments were conducted to assess whether this effect is a result of pitch shifts between pairs of tones without common harmonics or whether it reflects influences of spectral differences (timbre) on the accuracy of pitch perception. In experiment 1, pitch matches were obtained between sounds drawn from the following types: (1) pure tones (P) with frequencies 100, 200, or 400 Hz; (2) a multiple-component complex tone, designated A, with harmonics 3, 4, 8, 9, 10, 14, 15, and fo = 100, 200, or 400 Hz; (3) A multiple-component complex tone, designated B, with harmonics 5, 6, 7, 11, 12, 13, 16, and with fo = 100, 200 or 400 Hz. The following matches were made; A vs A, B vs B, A vs P, B vs P and P vs P. Pitch shifts were found between the pure tones and the complex tones (A vs P and B vs P), but not between the A and B tones (A vs B). However, the variability of the A vs B matches was significantly greater than that of the A vs A or B vs B matches. Also, the variability of the A vs P and B vs P matches was greater than that for the A vs B matches. In a second experiment, frequency difference limens (DLCs) were measured for the A vs A, B vs B, and A vs B pairs of sounds. The DLCs were larger for the A vs B pair than for A vs A or B vs B. The results suggest that the poor frequency discrimination of tones with no common harmonics does not result from pitch shifts between the tones. Rather, it seems that spectral differences between tones interfere with judgements of their relative pitch.

Adult↗

Effects of stimulus level on the speech perception abilities of children using cochlear implants or digital hearing aids.

OBJECTIVE: The present investigation was designed to provide information to facilitate the decision of whether a child should continue using digital signal processing (DSP) hearing aids with wide dynamic range compression (WDRC) or be recommended for a cochlear implant, based on the unaided pure-tone average (PTA at 500, 1000, and 2000 Hz). DESIGN: Fifty-two children (ages 5 to 15 yr) with unaided PTAs in the moderately severe to profound range, wearing (DSP) hearing aids with (WDRC) or a Nucleus 24, Clarion 1.2, or CII cochlear implant system, participated: 26 with unaided PTAs from 60 to 98 dB HL using DSP hearing aids and 26 with pre-implant unaided PTAs from 93 to 120 dB HL, using cochlear implants. An open-set speech perception test, the Lexical Neighborhood Test (LNT; ), was administered at intensity levels representative of raised (70 dB SPL) and soft (50 dB SPL) speech at two different times approximately 1 mo apart. Minimum audibility of soft sounds was determined for the children with implants and with DSP hearing aids using warble-tone thresholds at octave intervals between 250 and 4000 Hz. RESULT: Regression analyses and significance testing were used to determine the unaided PTA values at which the performance of the DSP Hearing Aid group (DSP HA group) and Cochlear Implant group on the LNT test were statistically different at the 0.05 significance level. For the 70 dB SPL presentation level, the statistically different PTAs were 113 and 97 dB HL at Time 1 and Time 2, respectively, and 96 and 88 dB HL at 50 dB SPL for Time 1 and Time 2, respectively. CONCLUSIONS: The Unaided PTA at which children in the cochlear implant group would be expected to score significantly better than the children in the DSP HA group was lowest (96 and 88 dB HL) for the lower signal level (50 dB SPL). Assuming that LNT scores at 50 dB SPL are representative of long-term hearing of soft incidental speech that is essential for language learning and fluent communication, the children with PTA values greater than the range from 88 to 96 dB HL would be expected to have significantly better LNT scores with a cochlear implant. These results should be further examined with research efforts focusing on early intervention with optimally fitted DSP hearing aids and cochlear implants.

Acoustic Stimulation↗

Speech perception, localization, and lateralization with bilateral cochlear implants.

Five bilateral cochlear implant users were tested for their localization abilities and speech understanding in noise, for both monaural and binaural listening conditions. They also participated in lateralization tasks to assess the impact of variations in interaural time delays (ITDs) and interaural level differences (ILDs) for electrical pulse trains under direct computer control. The localization task used pink noise bursts presented from an eight-loudspeaker array spanning an arc of approximately 108 degrees in front of the listeners at ear level (0-degree elevation). Subjects showed large benefits from bilateral device use compared to either side alone. Typical root-mean-square (rms) averaged errors across all eight loudspeakers in the array were about 10 degrees for bilateral device use and ranged from 20 degrees to 60 degrees using either ear alone. Speech reception thresholds (SRTs) were measured for sentences presented from directly in front of the listeners (0 degrees) in spectrally matching speech-weighted noise at either 0 degrees, +90 degrees or -90 degrees for four subjects out of five tested who could perform the task. For noise to either side, bilateral device use showed a substantial benefit over unilateral device use when noise was ipsilateral to the unilateral device. This was primarily because of monaural head-shadow effects, which resulted in robust SRT improvements (P<0.001) of about 4 to 5 dB when ipsilateral and contralateral noise positions were compared. The additional benefit of using both ears compared to the shadowed ear (i.e., binaural unmasking) was only 1 or 2 dB and less robust (P = 0.04). Results from the lateralization studies showed consistently good sensitivity to ILDs; better than the smallest level adjustment available in the implants (0.17 dB) for some subjects. Sensitivity to ITDs was moderate on the other hand, typically of the order of 100 micros. ITD sensitivity deteriorated rapidly when stimulation rates for unmodulated pulse-trains increased above a few hundred Hz but at 800 pps showed sensitivity comparable to 50-pps pulse-trains when a 50-Hz modulation was applied. In our opinion, these results clearly demonstrate important benefits are available from bilateral implantation, both for localizing sounds (in quiet) and for listening in noise when signal and noise sources are spatially separated. The data do indicate, however, that effects of interaural timing cues are weaker than those from interaural level cues and according to our psychophysical findings rely on the availability of low-rate information below a few hundred Hz.

Adult↗

Comparative study of fixed time versus intensity trade and fixed intensity versus time trade tests in sound lateralization.

OBJECTIVE: In the perception of sound lateralization a sound source exists in the side that the sound reaches an ear earlier in time or louder in intensity than the other ear. It is an imaginary phenomenon where the direction of sound is lateralized by an interaural time difference (ITD) and an interaural intensity difference (IID) of sound by both ears. It is speculated from pathophysiological findings that ITD and IID are processed by different pathways, but it has been not yet proved which of them is predominant in sound lateralization. The time difference can be traded by the intensity difference (fixed time versus intensity trade), and vice versa (fixed intensity versus time trade). In order to investigate predominance in this trade, we measured possible differences in effects by ITD and IID using two opposite trade phenomena of time versus intensity trade and intensity versus time trade. METHODS: The fixed time versus intensity trade test for selected narrow-band noise was investigated in 30 subjects with normal hearing. Using headphones, the subjects were instructed to push the button when the sound bias generated by fixed ITD (4 dB, 6 dB, 8 dB, 10 dB, 12 dB, 14 dB, 16 dB, 18 dB, 20 dB) was traded by gradually increased IID. The plot figure with fixed ITD and required IID to trade was made. It was compared with similar fixed intensity versus time trade test in 12 subjects with normal hearing. The fixed ITD (200-600 micros) was traded by gradually increased IID and the plot figure was made. RESULTS: In fixed time versus intensity trade test, each fixed ITD could be traded with an average of 6 dB of IID. On the other hand, in fixed intensity versus time trade test, ITD required to trade fixed IID increased, in proportion to fixed IID increased. CONCLUSION: It is concluded that predominance exists. In fixed time versus intensity trade test, the uniform amount of IID is required to trade the different ITD. However, in the novel fixed intensity versus time trade test, the phenomenon was in completely different manner that ITD in proportion to the given IID is required to trade.

Acoustic Stimulation↗

Managing disturbing snoring with palatal implants: a pilot study.

OBJECTIVE: To evaluate the safety and efficacy of polyethylene terephthalate implants in the soft palate to modify disturbing snoring. DESIGN: Interventional study, before-after trial. SETTING: Referral center, institutional practice, hospitalized care. PATIENTS: Twelve consecutive patients with disturbing snoring and an apnea-hypopnea index less than 15 per hour and a body mass index of 30 or less were recruited. One patient with no adverse effects was lost to follow-up. Extrusion of implants occurred in 2 patients. Complete data in 9 patients were available for analysis. INTERVENTION: Polyethylene terephthalate implants were inserted in the soft palate. MAIN OUTCOME MEASURES: Safety of the procedure and evaluation of the loudness of snoring by bed partners using a visual analog scale. RESULTS: There were no complications of infection or bleeding. Extrusion of implants occurred in 2 patients with no clinical sequelae. The mean (SD) loudness of snoring at baseline, as assessed by bed partners using a visual analog scale of 0 to 100, was 79 (17.2). This significantly decreased to 48 (20.4) at 3 months (Wilcoxon signed rank test, P =.008). Daytime sleepiness as measured with the Epworth Sleepiness Scale also decreased from an average score of 8.9 at baseline to 5.7 at 3 months (P =.007). There were no significant changes in the apnea-hypopnea index and body mass index from baseline to 3 months' follow-up. CONCLUSIONS: Polyethylene terephthalate implants in the soft palate are safe. Snoring decreased significantly at 3 months after surgery. Polyethylene terephthalate implants in the soft palate should be further explored as a treatment for snoring.

Adult↗

Factors influencing tinnitus loudness and annoyance.

OBJECTIVE: To evaluate the 2 major components of tinnitus severity, loudness and annoyance, and their degree of dependence on characteristics of tinnitus manifestation, history, and etiology. DESIGN: Cross-sectional survey performed during the first months of 2004. SETTING: Nonclinical population. PARTICIPANTS: A total of 4995 members of the German Tinnitus League. MAIN OUTCOME MEASURES: Comprehensive screening questionnaire, including the Klockhoff and Lindblom loudness grading system and the miniversion of the Tinnitus Questionnaire. RESULTS: A moderate correlation of 0.45 was found between tinnitus loudness and annoyance. Both factors were generally higher in men, those older than 50 years, those with binaural and centrally perceived tinnitus, those with increased noise sensitivity, and those who had continuous tinnitus without interruptions. Tinnitus that lasted 12 months or less had a stronger influence on annoyance (odds ratio [OR], 1.96) than on loudness (OR, 0.45), whereas the contrary was found for tinnitus of more than 5 years' duration (ORs, 0.72 and 2.11, respectively). Loudness and annoyance were increased in subjects with coexisting hearing loss, vertigo, and hyperacusis. The impact of hyperacusis on annoyance was clearly stronger than on loudness (ORs, 21.91 vs 9.47). CONCLUSIONS: Several clinical factors of tinnitus influence perceived loudness and annoyance. Both are distinguishable components of tinnitus severity.

Adolescent↗

Auditory dysfunction with facial paralysis.

A series of 58 patients with idiopathic facial paralysis were studied to determine if a concomitant cochlear or eight nerve auditory dysfunction could be identified with traditional audiologic tests. Results indicated that only those patients with a facial nerve lesion, proximal to the stapedius branch, experienced reduced tolerance for loud sounds, reduction of speech discrimination at high-intensity levels, and abnormal loudness growth. Such findings suggest that changes in auditory function, accompanying facial nerve paralysis, are a mechanical effect due to absence of stapedial action. Site of lesion tests in this sample failed to demonstrate eighth nerve dysfunction and, thus, does not support a theory of polyneuropathy that involves the auditory nerve.

Adolescent↗

Multichannel cochlear implants. Channel interactions and processor design.

Multichannel electrical stimulation of the cochlear nerve can generate complex interactions between the individual channels. Two types of channel interactions have been investigated: those that occur when two or more electrode channels are simultaneously stimulated and those that occur when the stimuli from each channel are not temporally coincident. Experiments with three human subjects, implanted with scala tympani electrode arrays, indicate that responses are a strong function of the spacing between the channels, the subject, and the electrode geometry (ie, bipolar or monopolar geometries).

Auditory Threshold↗

Relationships among loudness indexes in cochlear-implant patients.

The purpose of the experiment was to determine if the most-confortable-listening (MCL) levels and loudness-discomfort levels (LDLs) can be predicted from threshold measurements obtained from patients with cochlear implants using direct electrical stimulation. Psychophysical measurements of thresholds, MCLs, and LDLs with 125-Hz and 2000-Hz sinusoids were obtained from 16 patients with cochlear-implants 1 month after the connection of their ineraid processor (an auditory prosthesis). In general, the correlation coefficients among the loudness indexes obtained with a 125-Hz stimulus were similar to those for a 2000-Hz stimulus. Correlations between thresholds and MCLs were moderate, whereas correlations for thresholds and LDLs were fair. Correlations between MCLs and LDLs were high. This suggests that LDLs cannot be predicted from thresholds. On the other hand, these preliminary data suggest that MCLs may be reliably predicted from thresholds or LDLs to set the gain on a cochlear-implant processor.

Adult↗

Characteristics of tinnitus induced by head injury.

OBJECTIVE: To determine if the characteristics of tinnitus produced by head trauma are specific and exclusive when compared with other origins of tinnitus. DESIGN: Retrospective study using clinic test results and data from the Tinnitus Data Registry compiled from questionnaires, interviews, and testing. Tinnitus produced by head injury was compared with tinnitus of mixed origins, including no known origin. SETTING: A tinnitus referral clinic where all patients must see an otologist or an ear, nose, and throat physician prior to attending the clinic. PATIENTS: All patients had severe to moderately severe constant tinnitus and presented with tinnitus as the primary symptom. RESULTS: No exclusive characteristics were found to describe head injury-induced tinnitus. The tinnitus for the group with head injury was statistically significantly (P = .004) louder and occurred with greater incidence of continuing pain in the ears. The group with head injury also had more episodes of dizziness and a more severe form of tinnitus. However, no marked difference was noted in pitch of tinnitus, complexity (number of sounds) of tinnitus, or the minimum masking level. CONCLUSIONS: This retrospective study found that tinnitus induced by head injury was significantly (P = .004) louder than tinnitus induced from other causes but, interestingly, did not require higher levels of masking. The patients with head injury-induced tinnitus more frequently (P = .0003) displayed residual inhibition although the duration of residual inhibition was not different from that of the comparison group. Other symptoms associated with the tinnitus onset were more frequently mentioned by the group with head trauma-induced tinnitus, except for the condition of pressure sensation in the ears. Using a severity questionnaire, the group with head trauma-induced tinnitus rated their tinnitus as being more severe than did the comparison group. However, such things as pitch of the tinnitus, masking level, acceptance of wearable maskers, general hearing level, and complexity of the tinnitus did not distinguish the two groups.

Craniocerebral Trauma↗

Salicylate-induced changes in auditory thresholds of adolescent and adult rats.

Shifts in auditory intensity thresholds after salicylate administration were examined in postweanling and adult pigmented rats at frequencies ranging from 1 to 35 kHz. A total of 132 subjects from both age levels were tested under two-way active avoidance or one-way active avoidance paradigms. Estimated thresholds were inferred from behavioral responses to presentations of descending and ascending series of intensities for each test frequency value. Reliable threshold estimates were found under both avoidance conditioning methods, and compared to controls, subjects at both age levels showed threshold shifts at selective higher frequency values after salicylate injection, and the extent of shifts was related to salicylate dose level.

Acoustic Stimulation↗

Measurement of tinnitus in humans.

Little quantitative measurement of tinnitus was possible before the development of the electric audiometer. Since then many ingenious attempts have been made to simulate the phenomenon. Frequency and masking measurements were described first in 1931 by E. M. Josephson and also by R. L. Wegel, and techniques involving loudness balance, free-field matching and taped sound effects have also been used. More accurate measurement of frequency content can be made by means of music synthesizer. A tinnitus measurement protocol should include assessment of: (1) frequency content; (2) loudness; (3) masking characteristics; and (4) objective measurements. Loudness measurements relate to the annoyance caused by the symptom, which depends, too, on the patient's personality and disposition. Masking characteristics also relate to the loudness of tinnitus and give additional guidance about the suitability of making therapy. They are repeatable and easy to perform. Objective measurements, whether performed with a stethoscope or intrameatal microphone, may reveal vascular bruits or cochlear emissions. We must wait to see how representative are the newer objective measurements of the subjective complaint.

Acoustic Stimulation↗

The effects of rate and forward masking on human adult and newborn auditory evoked brainstem response thresholds.

Several investigators have reported that human newborn auditory brainstem evoked response (ABR) thresholds to clicks are about 10-20 dB higher than human adult thresholds to the same stimuli (Galambos & Hecox, 1978; Shulman-Galambos & Galambos, 1979; Lasky, Rupert, & Waller, 1987). The present study replicated these results, but, in addition, addressed developmental differences in ABR thresholds due to forward masking and changes in stimulus repetition rate. Eight human newborns and seven human adults served as subjects. Newborn ABR thresholds to a 100 microseconds click which followed a 82 db(A) SPL 50 ms broadband forward masker by 10 ms were significantly more elevated relative to their unmasked ABR thresholds than were those of the adults. Relatively loud sounds seem to have a greater effect on the newborn's ability to process subsequently presented soft sounds than they do on adult processing. In contrast, changes in repetition rate of 100 microseconds clicks from 10/s to 50/s had no greater effect on newborn than adult ABR thresholds. At near threshold stimulus levels, rate effects on the ABR are not apparent in newborns nor adults.

Adult↗

Auditory processing skills and phonological representation in dyslexic children.

It is now well-established that there is a causal connection between children's phonological skills and their acquisition of reading and spelling. Here we study low-level auditory processes that may underpin the development of phonological representations in children. Dyslexic and control children were given a battery of phonological tasks, reading and spelling tasks and auditory processing tasks. Potential relations between deficits in dyslexic performance in the auditory processing tasks and phonological awareness were explored. It was found that individual differences in auditory tasks requiring amplitude envelope rise time processing explained significant variance in phonological processing. It is argued that developmentally, amplitude envelope cues may be primary in establishing well-specified phonological representations, as these cues should yield important rhythmic and syllable-level information about speech.

Anomia↗

Is the loudness dependence of auditory evoked potentials modulated by the selective serotonin reuptake inhibitor citalopram in healthy subjects?

The loudness dependence of auditory evoked potentials (LDAEP) has been discussed as a non-invasive in vivo marker of central serotonergic function. Evidence for this has been found in animal studies, but studies in humans provide less consistent results. In this study, the relationship between LDAEP and directly modulated central serotonergic activity in healthy subjects was investigated. In a single-blind cross-over design, the LDAEP of female participants (age: 24.0 +/- 2.3 years) was measured under two conditions: (1) infusion of 20 mg citalopram diluted in 250 ml 0.9% saline and (2) infusion of 250 ml 0.9% saline as placebo. LDAEP was measured at five different time points before, during and up to 60 min after drug/placebo administration and dipole source analysis was performed. The increase of the central serotonin activity in response to citalopram was not accompanied by a significant change of the LDAEP compared to the placebo condition. The result underlines that the acceptance of LDAEP as a marker of central serotonergic function still needs further discussion.

Acoustic Stimulation↗

Medial olivocochlear system and loudness adaptation: differences between musicians and non-musicians.

Simple loudness adaptation and crossed olivocochlear feedback were investigated--through the Tone Decay Test (TDT) and Transiently Evoked Otoacoustic Emission (TEOAE) recording, respectively--in a sample of normal-hearing subjects including both musicians and non-musicians. The results for musicians and non-musicians differed statistically: the musicians showed on average less loudness adaptation and a greater reduction in TEOAE amplitude under contralateral acoustic stimulation, suggesting a stronger medial efferent feedback on the auditory periphery in these subjects. This finding, that not only psychoacoustic performance but also the physiological mechanism is different in musicians, strongly suggests that the latter should, like the former, be influenced by auditory "training" such as music studies. This perspective is discussed in detail in the text, since it raises puzzling questions and outlined promising issues in the field of auditory psychophysiology.

Audiometry, Pure-Tone↗

Differential contribution of frontal and temporal cortices to auditory change detection: fMRI and ERP results.

The present study addresses the functional role of the temporal and frontal lobes in auditory change detection. Prior event-related potential (ERP) research suggested that the mismatch negativity (MMN) reflects the involvement of a temporofrontal network subserving auditory change detection processes and the initiation of an involuntary attention switch. In the present study participants were presented with repetitive spectrally rich sounds. Infrequent changes of either small (10% change), medium (30% change), or large (100% change) magnitude were embedded in the stimulus train. ERPs and fMRI measures were obtained in the same subjects in subsequent sessions. Significant hemodynamic activation in the superior temporal gyri (STG) bilaterally and the opercular part of the right inferior frontal gyrus was observed for large and medium deviants only. ERPs showed that small deviants elicited MMN when presented in silence but not when presented with recorded MR background noise, indicating that small deviants were hardly detected under fMRI conditions. The MR signal change in temporal lobe regions was larger for large than for medium deviants. For the right fronto-opercular cortex the opposite pattern was observed. The strength of the temporal activation correlated with the amplitude of the change-related ERP at around 110 ms from stimulus onset while the frontal activation correlated with the change-related ERP at around 150 ms. These results suggest that the right fronto-opercular cortex is part of the neural network generating the MMN. Three alternative explanations of these findings are discussed.

Adult↗