Trends in Hearing最新文献

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.

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.

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 prospective study investigated the potential benefits of deactivating the second most apical electrode to improve access to lower-frequency pitch and first formant information to help improve speech and music outcomes with a cochlear implant. Twenty-one adults (30 ears) with cochlear implants completed an A-B-A-B study to compare the participant's clinical map with all electrodes active (A) and their clinical map with the second most apical electrode deactivated (B). Test measures included pitch discrimination, speech understanding in noise, and subjective musical sound quality and enjoyment ratings. This study also investigated the impact of participant demographic and electrode placement factors on the degree of benefit derived from the experimental map (B). There was no significant difference between the two conditions on any measure at the group level. However, individual participants demonstrated improvements in pitch discrimination (33.3%), speech perception in noise (43.3%), musical sound quality (50.0%), and musical enjoyment (40.0%). Musical sound quality and enjoyment ratings were strongly correlated, and speech perception correlated with musical enjoyment but not sound quality. Electrodes outside scala tympani, smaller electrode-to-modiolus distances, and certain device manufacturers (Cochlear and MED-EL) predicted greater benefit from deactivating the second-most apical electrode. Certain adult cochlear implant users may benefit from selective apical electrode deactivation, depending on their demographic and electrode placement profile. Clinicians could consider deactivating the second most apical electrode with patients, who report poor musical sound quality or those who have disengaged from music since receiving their CI to assess potential benefits individually.

Individuals with tinnitus hear sounds that are not present in the external environment. Whereas hearing difficulties at frequencies near those matching the tinnitus pitch are a common complaint for individuals with tinnitus, it is unclear to what extent the internal tinnitus sounds interfere with the detection of external sounds. We therefore studied whether pure-tone detection at the estimated frequency corresponding to the tinnitus pitch (f_tp) was affected by confusion with the tinnitus percept. Signs of confusion would be a high false alarm rate or a shallower slope of the psychometric function for tone detection at f_tp. We selected participants with symmetric, tonal tinnitus, who were able to estimate its pitch consistently (n = 18). Another 18 participants matched for high-frequency hearing loss, age, and sex, but without tinnitus, served as the control group. For both groups, we measured the psychometric function for detecting long-duration tones, maximizing the likelihood for confusion with an external sound. We observed that false alarm rates for tinnitus participants were not higher for test tones at f_tp, nor were they higher than for the control group without tinnitus. Similar results were obtained for the slopes of the psychometric functions. Apparently, individuals with tinnitus are well able to discriminate between their own tinnitus and comparable external sounds. Our results indicate that (tonal) tinnitus does not interfere with the detection of soft sounds at the tinnitus pitch-matched frequency.

This study compared the behavioral minimum audible angle (MAA) and the electrophysiological acoustic change complex (ACC) elicited by an azimuthal shift in sound location. To examine age effects, 63 participants with normal or near-normal hearing were divided into three age groups (Young, Mid-Aged, and Older). The stimuli were narrow bands of noise centered at 500 Hz to facilitate reliance on primarily binaural temporal cues. Putative spatial location was manipulated by means of head-related transfer functions under headphones. MAA results showed that performance was dependent on the reference location, with performance becoming poorer as the reference location shifted away from midline. The Young group had smaller MAAs than the Older group, and performance of the Mid-Age group was intermediate. Measurement of the ACC was restricted to shifts away from midline, and results showed no ACC for shifts of 4.5° and 9° but present ACCs for shifts of 13.5°, 18°, and 36°. The robustness of the ACC, as measured with the intertrial phase coherence metric, grew with increasing azimuthal shift. For shifts of 13.5° and 18°, Young participants had more robust ACCs than Older participants. Although age-related deficits were found in both the MAA and in the robustness of the ACC, no associations were observed at the individual level between MAA and ACC measures. Further work is necessary to evaluate the ACC elicited by shifts from off-midline reference locations before a firm conclusion can be reached that the ACC is not a viable objective proxy for the MAA.

The effect of complex acoustic environments (CAEs), typically comprising target and interfering sound sources as well as room reflections, on the speech reception of hearing-impaired (HI) listeners has been examined in several studies. However, only little is known about audio quality perception of HI listeners in such CAEs. Thus, this study assessed detection thresholds and suprathreshold audio quality ratings of listeners with very mild and moderate hearing loss (HL) for several distortions applied to speech and pink noise: nonlinear saturation, spectral ripples, level differences, and spatial position offsets. The stimuli were presented in acoustical scenes that differ in their complexity by manipulating room size in conjunction with reverberation time, and the number and spatial position of interfering sound sources. The strongest differences between listeners with very mild and moderate HL were observed in the presence of interfering sounds. In such situations, listeners with moderate HL had consistently higher distortion detection thresholds than listeners with very mild HL. Moreover, they rated audio quality lower for the masked than for the unmasked distorted targets, indicating difficulties in separating the target from the maskers. Significant correlations were found between the listeners' pure tone average (PTA) and distortion detection thresholds in situations with maskers. Thus, PTAs seem to be a suitable predictor for distortion thresholds of HI listeners in CAEs. The effect of reverberation strongly depended on the target (speech or pink noise) and the type of distortions.

The discrepancy between the hearing aid benefit estimated in standard audiological tests, like speech audiometry, and the perceived benefit in daily life has led to interest in methods better reflecting real-world performance. In contrast to audiological tests, everyday communication commonly takes place in enclosed spaces with acoustic reflections and multiple sound sources, including sounds from adjoining rooms through open doors. This study investigates speech recognition thresholds (SRTs) with a sentence test in a laboratory environment resembling an average German living room with an adjacent kitchen. Additionally, acoustic simulations of the environment were presented in a large-scale (86) and small-scale (4) loudspeaker array, with the latter feasible for a clinical context. Measurements with normal-hearing and hearing-impaired listeners were conducted using different spatial target positions and a fixed masker position. One of the target positions was within the adjacent kitchen without line-of-sight to the sound source, representing a challenging acoustic configuration. Hearing-impaired listeners performed the measurements with and without their hearing aids. SRTs were compared between different presentation settings and to those measured in standard free-field audiological spatial configurations (S0N0, S0N90). An auditory model was employed for further analysis. Results show that SRTs in the simulated living room environment with 86 and 4 loudspeakers matched the real environment, even for aided listeners, indicating that virtual acoustics representations can reflect real-world listening performance. When signal-to-noise ratios were normalized, the measured hearing aid benefit did not differ significantly between the standard audiological spatial configuration S0N90 and any spatial configuration in the living room environment.

The study set out to acquire validation data for Arabic versions of the Digits-in-Noise (DIN) test, measured using browser-based software suitable for home hearing screening. DIN and pure-tone audiometric (PTA) thresholds were obtained from a sample of 155 Arabic-speaking participants, varying widely in age and in degree and type of hearing loss. DIN thresholds were measured using both diotic and antiphasic stimuli, with the goal of determining whether antiphasic testing provides superior prediction of poorer-ear hearing loss. A comprehensive study protocol was publicly pre-registered via the Open Science Framework. Both types of DIN threshold correlate with poorer-ear PTA thresholds after controlling for age, but the correlation is significantly stronger for antiphasic than diotic stimuli. Antiphasic DIN thresholds increase more steeply than diotic DIN thresholds as poorer-ear PTA thresholds increase, and are superior binary classifiers of hearing loss. Combined with previous results based on DIN data measured in participants' homes, the present findings suggest that the browser-based Arabic DIN test may be effective in remote hearing screening, when combined with antiphasic digit presentation.

Problems with own-voice sounds are common in hearing aid users. As auditory feedback is used to regulate the voice, it is possible that hearing aid use affects phonation. The aim of this paper is to compare hearing aid users' perception of their own voice with and without hearing aids and any effect on phonation. Eighty-five first-time and 85 experienced hearing aid users together with a control group of 70 completed evaluations of their own recorded and live voice in addition to two external voices. The participants' voice recordings were used for acoustic analysis. The results showed moderate to severe own-voice problems (OVP) in 17.6% of first-time users and 18.8% of experienced users. Hearing condition was a significant predictor of the perception of pitch in external voices and of monotony, lower naturalness, and lower pleasantness in their own live voice. The groups with hearing impairment had a higher mean fundamental frequency (f0) than the control group. Hearing aids decreased the speaking sound pressure level by 2 dB on average. Moreover, acoustic analysis shows a complex relationship between hearing impairment, hearing aids, and phonation and an immediate decrease in speech level when using hearing aids. Our findings support previous literature regarding auditory feedback and voice regulation. The results should motivate clinicians in hearing and voice care to routinely take hearing functions into account when assessing voice problems.