Trends in Hearing最新文献

We describe the development and validation of a self-administered online hearing test, which screens for hearing loss and provides an estimated audiogram. The hearing test computes test results from age, self-reported hearing abilities, and self-assessed pure-tone thresholds. It relies on regression, Bayesian and binary classification, leveraging probabilistic effects of age as well as interfrequency and interaural relationships in audiograms. The test was devised based on development data, collected prospectively in an online experiment from a purposive convenience sample of 251 adult American, Australian, Canadian, and Swiss participants, 58% of whom had hearing loss. Later, we externally validated the hearing test. Validation data were collected prospectively from a representative sample of 156 adult Belgian participants, 15% of whom had hearing loss. Participants completed the hearing test and audiometric assessments at home. The results for the primary screening outcome showed that the hearing test screened for mild hearing losses with a sensitivity of 0.83 [95%-confidence interval (CI): 0.65, 0.96], specificity of 0.94 [CI: 0.89, 0.98], positive predictive value of 0.70 [CI: 0.57, 0.87], and negative predictive value of 0.97 [CI: 0.94, 0.99]. Results for the secondary audiogram estimation outcome showed mean differences between estimated and gold standard hearing thresholds ranging from 2.1 to 12.4 dB, with an average standard deviation of the differences of 14.8 dB. In conclusion, the hearing test performed comparably to state-of-the-art hearing screeners. This test, therefore, is a validated alternative to existing screening tools, and, additionally, it provides an estimated audiogram.

While hearing aids are beneficial in compensating for hearing loss and suppressing ambient noise, they may also introduce an unwanted processing burden to the listener's sensory and cognitive system. To investigate such adverse side effects, hearing aids may be set to a 'transparent mode', aiming to replicate natural hearing through the open ear as best as possible. Such transparent hearing aids have previously been demonstrated to exhibit a small but significant disadvantage in speech intelligibility, with less conclusive effects on self-rated listening effort. Here we aimed to reproduce these findings and expand them with neurophysiological measures of invested listening effort, including parietal alpha power and pupil size. Invested listening effort was measured across five task difficulties, ranging from nearly impossible to easy, with normal-hearing participants in both aided and unaided conditions. Results well reproduced a hearing aid disadvantage for speech intelligibility and subjective listening effort ratings. As to be expected, pupil size and parietal alpha power followed an inverted u-shape, peaking at moderate task difficulties (around SRT50). However, the transparent hearing aid increased pupil size and parietal alpha power at medium task demand (between SRT20 and SRT80). These neurophysiological effects were larger than those observed in speech intelligibility and subjective listening effort, respectively. The results gain plausibility by yielding a substantial association of individual pupil size and individual parietal alpha power. In sum, our findings suggest that key neurophysiological measures of invested listening effort are sensitive to the individual additional burden on speech intelligibility that hearing aid processing can introduce.

Cochlear implant (CI) users are usually poor at using timing information to detect changes in either pitch or sound location. This deficit occurs even for listeners with good speech perception and even when the speech processor is bypassed to present simple, idealized stimuli to one or more electrodes. The present article presents seven expert opinion pieces on the likely neural bases for these limitations, the extent to which they are modifiable by sensory experience and training, and the most promising ways to overcome them in future. The article combines insights from physiology and psychophysics in cochlear-implanted humans and animals, highlights areas of agreement and controversy, and proposes new experiments that could resolve areas of disagreement.

The combination of directional microphones (DIR) and spectral noise reduction (NR) is a common technique in hearing aid signal processing, for improving speech intelligibility in spatial acoustic scenarios. The benefit from DIR + NR varies considerably across individuals, which impedes prescribing the optimal strength of such processing during hearing aid fitting. The goal of this study was to investigate the correlation of four audiological factors with the benefit of speech reception thresholds (SRTs) from DIR + NR: the closedness of the acoustic coupling in the ear canal, audible contrast thresholds test (ACT™), the audiogram, and age. As part of a larger field study, 123 experienced hearing aid users in two centers in Germany and Japan were fitted bilaterally with the same hearing aids. SRTs were obtained with and without strong DIR + NR in a spatial speech-in-noise scenario before and after the field trials. Closedness of acoustic coupling was found to have the strongest correlation with SRT benefit from DIR + NR (most likely dominated by DIR rather than NR processing), followed by audible contrast thresholds (ACT) and the audiogram, both with the same significantly weaker correlation. Age was not correlated with the benefit from DIR + NR. The results suggest fitting hearing aid users irrespective of age with as-closed-as-possible acoustic coupling to maximize the benefit of DIR + NR. Furthermore, the closedness of acoustic coupling in combination with ACT or the audiogram may serve audiologists in predicting individual speech intelligibility benefits from strong DIR + NR for better guidance to set its strength during hearing aid fitting.

Speech-on-speech masking is a common and challenging situation in everyday verbal communication. The ability to segregate competing auditory streams is a necessary requirement for focusing attention on the target speech. The Visual World Paradigm (VWP) provides insight into speech processing by capturing gaze fixations on visually presented icons that reflect the speech signal. This study aimed to propose a new VWP to examine the time course of speech segregation when competing sentences are presented and to collect pupil size data as a measure of listening effort. Twelve young normal-hearing participants were presented with competing matrix sentences (structure "name-verb-numeral-adjective-object") diotically via headphones at four target-to-masker ratios (TMRs), corresponding to intermediate to near perfect speech recognition. The VWP visually presented the number and object words from both the target and masker sentences. Participants were instructed to gaze at the corresponding words of the target sentence without providing verbal responses. The gaze fixations consistently reflected the different TMRs for both number and object words. The slopes of the fixation curves were steeper, and the proportion of target fixations increased with higher TMRs, suggesting more efficient segregation under more favorable conditions. Temporal analysis of pupil data using Bayesian paired sample t-tests showed a corresponding reduction in pupil dilation with increasing TMR, indicating reduced listening effort. The results support the conclusion that the proposed VWP and the captured eye movements and pupil dilation are suitable for objective assessment of sentence-based speech-on-speech segregation and the corresponding listening effort.

Many of our conversations occur in nonideal situations, from the hum of a car to the babble of a cocktail party. Additionally, in conversation, listeners are often required to switch their attention between multiple talkers, which places demands on both auditory and cognitive processes. Speech understanding in such situations appears to be particularly demanding for older adults with hearing impairment. This study examined the effects of age and hearing ability on performance in an online speech recall task. Two target sentences, spoken by the same talker or different talkers, were presented one after the other, analogous to a conversational turn switch. The first target sentence was presented in quiet, and the second target sentence was presented alongside either a noise masker (steady-state speech-shaped noise) or a speech masker (another nontarget sentence). Relative to when the target talker remained the same between sentences, listeners were less accurate at recalling information in the second target sentence when the target talker changed, particularly when the target talker for sentence one became the masker for sentence two. Listeners with poorer speech-in-noise reception thresholds were less accurate in both noise- and speech-masked trials and made more masker confusions in speech-masked trials. Furthermore, an interaction revealed that listeners with poorer speech reception thresholds had particular difficulty when the target talker remained the same. Our study replicates previous research regarding the costs of switching nonspatial attention, extending these findings to older adults with a range of hearing abilities.

Subjective ratings of communication function reflect both auditory sensitivity and the situational, social, and emotional consequences of communication difficulties. Listeners interact with people and their environment differently, have various ways of handling stressful situations, and have diverse communication needs. Therefore, understanding the relationship between auditory and mental health factors is crucial for the holistic diagnosis and treatment of communication difficulty, particularly as mental health and communication function may have bidirectional effects. The goal of this study was to evaluate the degree to which social anxiety and negative affect (encompassing generalized anxiety, depression, and anger) contributed to subjective communication function (hearing handicap) in adult listeners. A cross-sectional online survey was administered via REDCap. Primary measures were brief assessments of social anxiety, negative affect, and subjective communication function measures. Participants were 628 adults (408 women, 220 men), ages 19 to 87 years (mean = 43) living in the United States. Results indicated that individuals reporting higher social anxiety and higher negative affect also reported poorer communication function. Multiple linear regression analysis revealed that both negative affect and social anxiety were significant and unique predictors of subjective communication function. Social anxiety and negative affect both significantly, and uniquely, contribute to how much someone feels a hearing loss impacts their daily communication function. Further examination of social anxiety and negative affect in older adults with hearing loss may help researchers and clinicians understand the complex interactions between mental health and sensory function during everyday communication, in this rapidly growing clinical population.

Under- and overamplification of sound is a common problem in hearing aid fitting. This paper describes the implementation of two new variants of the hearing in noise test for quantifying aided hearing at the lower and upper ends of the range of everyday-life sound levels. We present results from experiments carried out with 30 adult hearing aid users to determine the respective test-retest reliabilities. Participants completed a test battery consisting of the standard Danish hearing in noise test, a variant targeting the lower threshold of audibility and a variant targeting the limit of loudness discomfort. The participants completed the test battery twice for reliability analysis. The results revealed a significant difference between test and retest for both the hearing in noise test and the two hearing in noise test variants. However, the effect sizes for the differences were all very small. A calculation of Pearson correlation coefficients showed that both the hearing in noise test and the two new hearing in noise test variants had significant and strong correlations between test and retest. The within-subject standard deviations were determined to be 0.8 dB for hearing in noise test, 0.9 dB for lower-end test, and 2.2 dB for upper-end test. The findings demonstrate that both the lower-end test and upper-end test have high test-retest reliabilities, and thus can provide consistent and reliable results.

The present work quantifies the Lombard effect across native speakers of Mandarin Chinese using the Matrix sentence test, which is optimized for precisely assessing speech recognition thresholds (SRTs) in noise. Specifically, we studied the effects of speaker gender, fundamental frequency (F0), formant frequencies (F1 and F2), the duration and rate of voiced segments, and frequency-specific energy redistribution characterized by alpha ratio and speech-weighted signal-to-noise ratio (swSNR) on the recognition of Mandarin in plain and Lombard speech. The Mandarin Chinese matrix test was recorded with plain and Lombard speech from 11 native-Mandarin speakers. SRTs in stationary noise were measured with native-Mandarin, normal-hearing listeners. Results showed that on average, Mandarin Lombard speech was more intelligible than Mandarin plain speech for both female and male speakers, and the Mandarin Lombard gain of female speakers was larger than that of males. In addition, various acoustic analyses involving all speakers showed that (a) only swSNR was significantly correlated with the SRT of the Mandarin plain speech; (b) most acoustic measures were significantly correlated with the SRT of the Mandarin Lombard speech; and (c) alpha ratio and swSNR were significantly correlated with the SRT Lombard gain. In addition, a gender effect was found in the correlational analysis between acoustic parameters and SRT as well as Lombard gain in SRT. The findings highlight the impact of increased high-frequency energy on the observed Lombard gain in Mandarin speech, whereas the changes in individual acoustic parameters (e.g., F0 and F1) appear to play only a minor role.

This nationwide retrospective cohort study examines the association between adults with hearing loss (HL) and subsequent injury risk. Utilizing data from the Taiwan National Health Insurance Research Database (2000-2017), the study included 19,480 patients with HL and 77,920 matched controls. Over an average follow-up of 9.08 years, 18.30% of the 97,400 subjects sustained subsequent all-cause injuries. The injury incidence was significantly higher in the HL group compared to the control group (24.04% vs. 16.86%, p < .001). After adjusting for demographics and comorbidities, the adjusted hazard ratio (aHR) for injury in the HL cohort was 2.35 (95% CI: 2.22-2.49). Kaplan-Meier analysis showed significant differences in injury-free survival between the HL and control groups (log-rank test, p < .001). The increased risk was consistent across age groups (18-64 and ≥65 years), with the HL group showing a higher risk of unintentional injuries (aHR: 2.62; 95% CI: 2.45-2.80), including falls (aHR: 2.83; 95% CI: 2.52-3.17) and traffic-related injuries (aHR: 2.38; 95% CI: 2.07-2.74). These findings highlight an independent association between HL and increased injury risk, underscoring the need for healthcare providers to counsel adult HL patients on preventive measures.