Journal of the American Academy of Audiology最新文献

Background:  Falls are a significant health care concern for older adults in the United States. Audiologists are health care providers who are experts in hearing and vestibular dysfunctions, two areas known to be risk factors for falls. It is not known whether audiology patients consider audiology services to be related to falls or whether they consider audiologists to be a viable resource related to fall-related health care.

Purpose:  The purpose of this study was to investigate whether audiology patients consider (1) hearing, dizziness, and balance difficulties as risk factors for falls, and (2) audiologists as health care providers who can address fall risk, assessment, and prevention.

Research design:  This was a cross-sectional survey study.

Study sample:  In total, 78 community-dwelling audiology patients aged 60 years or older were included in the study.

Intervention:  Not applicable DATA COLLECTION AND ANALYSIS:  To reach a broad group of participants, online surveys (Qualtrics) and paper-and-pencil surveys (at the university clinic) were used. The analysis included descriptive statistics and independent-samples t-tests.

Results:  Nearly half of participants (48.7%) fell within the preceding year, and almost three-quarters (72.4%) felt falls were an important health care concern for them. Fewer than half (43.4%) considered hearing loss to be a fall risk factor, compared to dizziness (92.2%) and balance problems (97.3%). Slightly over half (53.3%) agreed that audiologists can address falls, fall risk, and prevention. However, only 39.5% would discuss falls with their audiologist, compared to 57.9% for dizziness and balance concerns and 90.5% for hearing concerns. No significant differences were found between participants who reported a recent fall and those who did not.

Conclusions:  Targeted patient education regarding the audiology scope of practice as it pertains to fall risk and prevention may be warranted, particularly if hearing loss is a modifiable fall risk factor which can be addressed through seeking audiologic services.

Background:  We previously reported the results of exploratory factor analysis (EFA) of the Hyperacusis Impact Questionnaire (HIQ), the Sound Sensitivity Symptoms Questionnaire (SSSD), and the Screening for Anxiety and Depression in Tinnitus (SAD-T). Confirmatory factor analysis (CFA) is necessary to confirm the latent constructs determined using EFA. CFA should use different samples but with similar characteristics to those used for EFA.

Purpose:  The aim was to use CFA to confirm latent constructs derived using EFA of the HIQ, SSSQ, and SAD-T. We further evaluated the psychometric properties of parent versions of these questionnaires (indicated by -P), which are intended for use with children.

Research design:  This was a retrospective cross-sectional study.

Study sample:  Data for 323 consecutive adults and 49 children who attended a Tinnitus and Hyperacusis Therapy Clinic in the United Kingdom within a 6-month period were included.

Data collection and analysis:  Data were collected retrospectively from the records of patients held at the Audiology Department. CFA with the weighted least-squares mean and variance-adjusted estimator was applied to assess the previously proposed factor structures of the HIQ, SSSQ, and SAD-T. The internal consistency of the scales was assessed via Cronbach's α (α). The items of the HIQ, SSSQ, and SAD-T were tested for measurement invariance regarding age and gender using the multiple indicator multiple cause (MIMIC) model.

Results:  All questionnaires showed good to excellent internal consistency, with α = 0.93 for the HIQ, 0.87 for the SSSQ, and 0.91 for the SAD-T. The parent versions showed acceptable to good internal consistency, with α = 0.88 for the HIQ-P, 0.71 for the SSSQ-P, and 0.86 for the SAD-T-P. CFA showed that the HIQ, SSSQ, and SAD-T were all one-factor questionnaires and the factors generally were similar to those obtained for the EFA. The MIMIC model showed that all three questionnaires can be considered as measurement invariant, with scores similar across genders and ages.

Conclusion: The HIQ, SSSQ, and SAD-T are internally consistent one-factor questionnaires that can be used in clinical and research settings to assess the impact of hyperacusis, the severity of sound sensitivity symptoms, and to screen for anxiety and depression symptoms. Future studies should further explore the psychometric properties of the parent versions of the HIQ, SSSQ, and SAD-T.

Background:  Hidden hearing loss (HHL) is a newly described condition that has been associated with hearing thresholds within normal limits and poorer speech-in-noise (SIN) performance. Furthermore, HHL has been associated with an elevated or absent middle ear muscle reflex (MEMR). One of the leading factors causing HHL is exposure to noise, specifically in patients who experience temporary threshold shift. This study investigated the SIN performance and MEMR in individuals at risk for noise exposure. Additionally, this study investigated the auditory nerve response measured to different stimulation rates in order to evaluate the auditory nerve adaptation and potentially identify neural loss in individuals at risk for noise exposure.

Research design:  Twenty-one young-adult participants (11 low-risk and 10 high-risk) were recruited to participate in the study. Participants were divided into a low-risk and high-risk group based on their noise exposure history and if they have experienced any signs of temporary threshold shift following noise exposure. SIN testing, distortion product otoacoustic emissions (DPOAEs), MEMR, hearing thresholds, and electrocochleography (ECochG) were measured. Experimental protocol included measuring MEMR, word recognition scores in quiet and in noise (0 dB signal-to-noise ratio), and ECochG recordings at three rates (9.1, 37.1, and 71.1 clicks/seconds).

Data analysis:  Descriptive statistics are provided for the different variables. Contingency tables were used to investigate the frequency of measuring normal MEMR between both groups. We also investigated the audiometric threshold, DPOAEs amplitude, and SIN results between groups using independent samples t-tests. Lastly, we investigated the effect of stimulation rate on the summating potential (SP) and action potential (AP) between groups using repeated measures analysis of variance with mixed effects.

Results:  No significant differences in hearing thresholds or DPOAEs amplitude at any tested frequency between both groups. Significantly larger number of participants in the high-risk group have abnormal MEMR compared with the low-risk group. Significantly poorer performance on SIN, smaller AP amplitude, and greater SP/AP amplitude ratio in the high-risk group. Furthermore, the AP amplitude adapted differently for the high-risk group with increasing stimulation rate compared with the low-risk group.

Conclusions:  The results of this study show that HHL is associated with poorer SIN performance and abnormal MEMR. Additionally, the significant reduction in AP amplitude and the degree of AP amplitude adaptation with change in stimulus rate might indicate loss of neural output in individuals with a history of noise exposure.

Background:  Williams syndrome (WS) is a genetic, multisystemic, neurodevelopmental disorder, in which studies have demonstrated the presence of auditory deficits such as conductive and sensorineural hearing loss, cochlear weakness, and subclinical signs of hearing impairment. However, few studies have assessed this population's central auditory system.

Purpose:  To analyze long-latency auditory evoked potential (LLAEP) in adults with WS and compare them with those obtained from neurotypical individuals with no hearing complaints.

Research design:  A cross-sectional observational study with subjects who were submitted to LLAEP assessment with the oddball paradigm and tone-burst stimuli.

Study sample:  A total of 30 individuals of both sexes, aged 18 to 37 years-15 had WS and comprised the study group (SG) and 15 did not have either the syndrome or hearing complaints and comprised the control group (CG); they were matched for sex and age.

Results:  The LLAEP analysis showed larger P1-N1 and P2-N2 amplitudes but smaller N2-P3 amplitude in SG, which also had delayed latencies in all components compared with CG.

Conclusion:  Adults with WS had increased neuronal response in identifying stimulus characteristics, attentional difficulties in auditory tasks, and deficits in auditory information processing speed.

Background:  In literature, the cognitive performance results of normal hearing individuals with tinnitus are inconsistent. It also differs in the control of other factors that may affect cognition.

Purpose:  This study aimed to determine the differences in attention and memory performance between normal hearing individuals with chronic subjective tinnitus and age-sex-education-matched healthy controls.

Study sample:  Normal hearing individuals with subjective chronic tinnitus between 18 and 55 years of age, who have normal cognitive abilities (tinnitus group, n = 30) and age-sex-matched normal hearing individuals without tinnitus who have normal cognitive abilities (control group, n = 30) were included in this study.

Data collection:  The Montreal Cognitive Assessment Test measured participants' general cognitive screening, and depressive symptoms were measured by Beck Depression Inventory (BDI). Tinnitus Handicap Inventory was used to determine the tinnitus handicap levels. Attention performance was evaluated with Stroop Test-TBAG Form, and short-term and working memory performances were evaluated with the Wechsler Adult Intelligence Scale-Revised (WAIS-R)-Digit Span Test.

Results:  The tinnitus and control groups' depressive symptom scores were similar concerning the BDI (p = 0.90). There was no statistically significant difference between both groups according to the completion time of the five sections of the Stroop Test, the number of errors and corrections of the Stroop 5 test, and the (WAIS-R)-Digit Span Test scores (p > 0.05).

Conclusion:  In our study, the Stroop Test and Digit Span Test performances of individuals with tinnitus and normal hearing were similar to the control group. Despite previous studies claiming an effect of tinnitus on cognition, our contrary findings are discussed in the light of other demographic, audiological, and psychological measurement variables, especially hearing loss.

Background:  Recently, we developed a hearing-related lifestyle questionnaire (HEARLI-Q), which asks respondents to rate their hearing aid (HA) satisfaction in 23 everyday listening situations. It is unknown how HA satisfaction on the retrospective HEARLI-Q scale compares with HA satisfaction measured on the same scale implemented in Ecological Momentary Assessment (EMA).

Purpose:  To learn how retrospective (HEARLI-Q) and in situ (EMA) assessments can complement each other.

Research design:  An observational study.

Study sample:  Twenty-one experienced HA users.

Data collection and analysis:  The participants first filled out the HEARLI-Q questionnaire, followed by a 1-week EMA trial using their own HAs. HA satisfaction ratings were compared between the two questionnaires and the underlying drivers of discrepancies in HA satisfaction ratings were evaluated.

Results:  HA satisfaction ratings were significantly higher in EMA for speech communication with one or several people. Hearing difficulty in these situations was rated higher in HEARLI-Q than in EMA, but occurrence of those difficult listening situations was also rated to be lower. When comparing only the situations that occur on daily or weekly basis, the two questionnaires had similar HA satisfaction ratings.

Conclusions:  Lower occurrence of difficult listening situations seems to be the key driver of discrepancies in HA satisfaction ratings between EMA and HEARLI-Q. The advantage of EMA is that it provides insight into an individual's day-to-day life and is not prone to memory bias. HEARLI-Q, on the other hand, can capture situations that occur infrequently or are inconvenient to report in the moment. Administering HEARLI-Q and EMA in combination could give a more holistic view of HA satisfaction.

Background:  Misophonia is a decreased tolerance of certain sounds related to eating noises, lip smacking, sniffing, breathing, clicking sounds, and tapping. While several validated self-report misophonia questionnaires exist, none focus solely on the impact of misophonia on the patient's life. Additionally, there are no available validated pediatric self-report measures of misophonia. Therefore, a tool was needed to assess the impact of misophonia on both adult and pediatric patients.

Purpose:  To evaluate the psychometric properties of the 8-item Misophonia Impact Questionnaire (MIQ).

Research design:  This was a retrospective cross-sectional study.

Study sample:  Patients who attended the Tinnitus and Hyperacusis Therapy Specialist Clinic in the United Kingdom seeking help for tinnitus, hyperacusis, and/or misophonia (n = 256). A subsample of children aged 16 years or younger (n = 15) was included for preliminary analyses of a version of the MIQ to be filled in by a parent (MIQ-P).

Data collection and analysis:  Data were collected retrospectively from the records of patients held at the audiology department. These included demographic data, audiological measures, and self-report questionnaires taken as part of routine care. Descriptive statistics and psychometric analyses were conducted. The MIQ was analyzed for item difficulty, factor structure, reliability, and construct validity.

Results:  Confirmatory factor analysis revealed that a one-factor model for the MIQ gave an excellent fit and its estimated reliability was excellent, with Cronbach's α = 0.94. The total MIQ scores were highly correlated with scores for the Hyperacusis Impact Questionnaire and Sound Sensitivity Symptoms Questionnaire. MIQ scores were not significantly correlated with scores for the Tinnitus Impact Questionnaire or average hearing thresholds. Preliminary data from the subsample indicated excellent internal consistency for the MIQ-P, with Cronbach's α = 0.92.

Conclusions:  The MIQ is a promising questionnaire for assessing the impact of misophonia. Future studies should focus on establishing test/retest reliability, identifying clinically significant change in MIQ scores, defining the severity of misophonia impact categories, and further exploring the psychometric properties of the MIQ-P.

Background:  The Claus Elberling Chirp (CE-Chirp) stimulus used in the auditory brainstem responses (ABRs) was developed to compensate for the cochlear wave delay. As a version of broadband CE-Chirp stimulus, the use of level-specific (LS) CE-Chirp stimuli, which are created with varying delay models suitable for the intensity levels at which the sound is transmitted, is becoming increasingly common.

Purpose:  The aim of this study was to compare click ABRs with LS CE-Chirp ABR thresholds in adults with sensorineural hearing loss.

Research design:  The research is a cross-sectional, analytical research.

Study sample:  Twenty-two adult patients (n = 44 ears) with bilateral sensorineural hearing loss were included in the study.

Data collection and analysis:  Pure-tone audiometry, click ABR, and LS CE-Chirp ABR tests were performed on adult (13 males and 9 females; 42.86 ± 14.50 years) patients with bilateral sensorineural hearing loss. Click ABR and LS CE-Chirp ABR thresholds were compared in terms of proximity to behavioral hearing thresholds of 2 kHz, 4 kHz, and 2 to 4 kHz averages.

Results:  Both types of ABR stimuli were able to identify with total hearing loss (n = 6). A significant difference was found between LS CE-Chirp ABR thresholds (53.81 ± 20.28 decibel normal hearing level [dB nHL]) and click ABR thresholds (58.81 ± 19.11 dB nHL) in the other ears (n = 38) with hearing loss (p = 0.00). When both ears were evaluated together and the right and left ears were evaluated separately, no difference was found between LS CE-Chirp ABR thresholds and 4 kHz hearing thresholds (p = 0.66, 0.80, and 0.69, respectively).

Conclusion:  In adults with hearing loss, the LS CE-Chirp provides ABR thresholds closer to the behavioral hearing thresholds at 2 and 4 kHz compared with the click stimulus. Notably, there was no difference between LS CE-Chirp ABR thresholds and the 4 kHz behavioral hearing thresholds. We concluded that the LS CE-Chirp can be used effectively in the estimation of behavioral hearing thresholds in adults with hearing loss.

Background:  Cervical vestibular-evoked myogenic potentials (cVEMPs) and masseter vestibular-evoked myogenic potentials (mVEMPs) are considered to have a common saccular origin. While a few studies have examined both vestibular-evoked myogenic potentials (VEMPs) in individuals with brainstem disorders as part of a test battery, the relation between these two potentials has rarely been the subject of discussion.

Purpose:  The present study explored the relation between mVEMPs and cVEMPs using electromyography (EMG)-scaled parameters in normal-hearing young adults.

Research design:  Within-subject study design.

Study sample:  Twenty young adults between 18 and 39 years of age (11 males, 9 females) participated in the study.

Data collection and analysis:  cVEMP and mVEMP were performed on all the participants at 95 dBnHL with 500 Hz tone burst stimuli. Various VEMP parameters were evaluated including P13 and N23 peak latencies, the amplitude of the P13-N23 complex, and the Interaural Amplitude Asymmetry Ratio in EMG-scaled and unscaled conditions.

Results:  All participants exhibited a 100% response rate for cVEMP and mVEMP responses. There were no significant ears and gender effect for both cVEMP and mVEMP. No correlation was found between cVEMP and mVEMP. There was no significant difference found between P1 and N1 latency values of cVEMP and mVEMP; however, a significant variation was observed for peak-to-peak amplitude both in EMG-scaled and unscaled conditions between cVEMP and mVEMP.

Conclusions:  Minimal to no association between any parameters of cVEMPs and mVEMPs suggests no significant relationship between these two VEMPs.

Background:  Cases of self-reported hearing difficulty despite no traditionally measured hearing loss (pure tone audiometric thresholds ≤ 25 dB HL from 250 Hz through 8000 Hz) have risen with the return of Veterans from recent conflicts in Operation Enduring Freedom, Operation Iraqi Freedom, and Operation New Dawn. Auditory outcomes improved despite low compliance among those receiving treatment. Medical chart data appeared more comprehensive for Veterans with, rather than without, auditory complaints. One possibility is that self-reported hearing problems are associated with a subset of these comorbidities, the treatment of which improved auditory outcomes.

Purpose:  This study examined the relationships between Veterans' self-reported auditory problems and other diagnosed medical conditions.

Research design:  A retrospective chart review was used.

Study sample:  Participants were 286 Veterans, aged 21 to 52 years with pure-tone audiometric thresholds ≤ 25 dB HL at all measured frequencies in both ears. Veterans were dichotomized into a group with either self-reported hearing complaints (n = 143) or an age-matched control group with no auditory complaints (n = 143).

Data collection and analysis:  A query of the Computerized Patient Record System was performed with the date range restricted to 2009 to 2018. Metrics of self-perceived hearing handicap, auditory processing disorder testing, and hearing aid use were collected. All diagnoses and related symptoms were recorded. A best subsets regression with principled model selection was performed to investigate the role of these comorbidities on self-perceived hearing loss.

Results:  The self-report group had 16 comorbidities that were classified as prevalent, having occurred in ≥33.3% of the group, compared with the age-matched control group, which had 2 comorbidities. The number of diagnosed medical conditions was associated with self-perceived hearing impairment. Specifically, posttraumatic stress disorder (PTSD) and related symptom clusters constituted the largest group of comorbidities that were significantly associated with self-reported hearing problems.

Conclusions:  The significant association between PTSD and self-perceived hearing impairment warrants investigations on whether treatment of PTSD would reduce perceived hearing handicap severity. Further, PTSD assessments could be useful for audiologists to identify potential candidates for auditory complaints without measured hearing loss.