Journal of the American Academy of Audiology最新文献

Background:  Saccadometry is an advanced ocular motor test battery that allows for the functional evaluation of the varied brain regions and circuits involved in the generation of fast, purposeful, and accurate saccadic eye movements. The test battery is composed of prosaccade (PS) and antisaccade (AS) tests that progressively increase cognitive demand. Existing saccadometry protocols qualitatively describe trends across the lifespan, but have not been widely adopted by clinicians.

Purpose:  The aims of this study are to design an efficient and simplified clinical saccadometry protocol using video oculography (VOG) equipment and establish associated evaluative standards across the lifespan.

Study sample:  Data were reported on 273 adults ages 18 to 69 years.

Results:  Evaluative data on four measures: directional error rate (DE), latency (Lat), peak velocity (Vel), and accuracy (Acc) during PS and AS measurements were provided. Age-group differences were found in Lat (p < 0.01) and Vel (p = 0.04) during PS and age-group differences were found in DE (p = 0.04), Lat (p < 0.01) and Vel (p < 0.01) during AS. Gender differences were found in DE (p = 0.01) and Lat (p < 0.01) during AS.

Conclusions:  This study established a standardized and time-efficient protocol with evaluative standards for individuals ages 18 to 69 years old to enable the use of saccadometry as an objective measure in the clinic. Saccadometry allows clinicians to look beyond the traditional saccade test and evaluate complex oculomotor and cognitive functions that will better help clinicians differentiate between peripheral and central diagnoses.

Background:  The introduction of over-the-counter hearing aids (HA) has resulted in a new hearing-health-care pathway.

Purpose:  The aim of this study was to assess if individuals could navigate four steps in a direct-to-consumer (DTC) HA delivery model, which include self-identification of hearing difficulties and risk for ear disease, self-selection of device, self-fitting and programming of device, and self-management.

Research design:  Fifty-two participants self-reported their degree of hearing loss and risk for ear disease. Participants were provided with three preselected DTC-HA Web sites and asked to select a device. Using the manufacturer's instructions, they then self-fit and programmed the device they chose. Participants' HA use and handling skills were evaluated using the Practical HA Skills Test-Revised (PHAST-R) and the Measure of Audiologic Rehabilitation Self-efficacy for Hearing Aids (MARS-HA). Real-ear verification was completed to determine how closely they programmed their device to NAL-NL2 targets. Agreement between self-reported degree of hearing loss and ear disease was determined from an audiological and ear disease risk assessment, respectively.

Results:  Seventy-five percent of participants reported that their perceived hearing loss was in the mild-to-moderate range. Ninety-three percent of participants who were identified to be at risk for ear disease did not self-report being at risk. PHAST-R scores ranged from 45 to 100% and were significantly impacted by manufacturer instructions. Only 24% of fittings were within the accepted tolerances for prescriptive targets.

Conclusions:  No participant was able to successfully navigate all four steps in the proposed DTC-HA model. Participants with hearing thresholds ≤ 25 dB HL and participants who were identified as being at risk for ear disease, but did not self-report the risk, both said they would purchase a DTC-HA as a treatment option. Manufacturer instructional materials can impact setup and programming of a DTC device. DTC models of hearing-health care may require additional consumer support.

Background:  Tinnitus, hyperacusis, and difficulties listening in background noise may be associated with the loss of auditory nerve fibers known as the condition of cochlear synaptopathy. Multiple research-based tests of auditory function have been developed to identify the potential for synaptopathy in animals and humans, including assessment of the middle-ear muscle reflex (MEMR). Despite these research-based tests, there is no verified method for measuring or identifying the potential for cochlear synaptopathy using standard audiologic equipment.

Purpose:  The goal of this study was to determine if commonly used audiometric equipment could be configured in a way that approximated the test methods used in the research environment, making it a viable tool in the assessment of patients who present with symptoms consistent with cochlear synaptopathy (tinnitus, hyperacusis, speech-in-noise difficulties).

Methods:  Laboratory-based and clinically based measures of MEMR strength-as estimated from changes in probe pressure/admittance in response to contralateral noise-were compared for 20 subjects. MEMR strength estimated from laboratory equipment increased with increasing intensity of the contralateral noise elicitor.

Results and conclusions:  A moderate positive correlation was found between laboratory- and clinically based measures of MEMR strength. This correlation supports the hypothesis that commonly used clinical equipment can be employed to assess the potential for cochlear synaptopathy in patients who present with the associated symptoms.

Objective:  The aim of this study was to assess whether the age of patients and severity and configuration of hearing loss would impact on the correlations between auditory brainstem response (ABR) and auditory steady-state response (ASSR) results.

Methods:  ASSR and ABR test results of 806 ears were evaluated retrospectively.

Results:  The ASSR thresholds correlated significantly with click ABR (c-ABR) thresholds (p < 0.01), especially at 2 to 4 kHz. The correlations were significant in all age groups and severities and configurations of hearing loss (p < 0.01).

Conclusions:  Since c-ABR responses help detect hearing thresholds between 2 and 4 kHz and ASSRs help detect hearing thresholds between 0.5 and 4 kHz, these tests should be complementary when low frequencies are also involved in hearing loss. Otherwise, the outcomes of ABR and ASSR tests seem comparable independent of age of the patients and configuration and severity of hearing loss.

Background:  Irrelevant sound or speech effect affects an individual's serial recall task of visual and auditory presentations. Cartoon soundscape mimics irrelevant sound effects. A constant and repeated exposure to cartoons in early childhood should influence children's auditory learning or recall performance.

Purpose:  To investigate the effects of cartoons' soundscape irrelevant sound effects on young children's auditory processing and working memory skills.

Research design:  A cross-sectional study was used to observe the influence of the cartoon soundscape irrelevant sound effects on children.

Study sample:  Sixty young children having hearing thresholds within 15 dB HL, in the age range 5 to 6 years, exposed to cartoons (Indian plus non-Indian) were considered for the study.

Data collection and analysis:  Pitch pattern test (PPT), duration pattern test (DPT), and Corsi block working memory apparatus were applied to the participants exposed to cartoons. The data obtained were compared statistically in terms of the groups' performances.

Results:  There was a significant difference in PPT (p = 0.023) and DPT (p = 0.001) between the exposed and nonexposed groups. In contrast, there was no significant difference between the two groups in Corsi block working memory (p > 0.05).

Conclusion:  Cartoon soundscape irrelevant sound or speech affects young children's auditory processing skills. The visual-spatial recall follows a different developmental pattern in young children without recoding to phonological aspects. It is predicted that our study findings might help determine the ill effects of cartoons on the auditory and language development process.

Background:  The masking-level difference (MLD) can be measured via voluntary behavioral responses (voluntary behavioral MLD [vMLD]) and/or via electrophysiological cortical auditory evoked potentials (CAEPs; electrophysiological MLD [eMLD]). It may be possible to enhance the ecologic validity of the MLD by using nonsense-syllable speech stimuli.

Purpose:  The aim of this study is to determine the feasibility of measuring both the vMLD and eMLD with speech stimuli. The study also investigates whether certain nonsense-syllable stimuli (/α/, /dα/, /di/, /tα/, /wα/) may be more useful than others in measuring both the vMLD and eMLD.

Research design:  This is a descriptive feasibility pilot study.

Study sample:  Seventeen young adults (age range 19-26 years; 15 women) with hearing thresholds of 0.25-8.0 kHz ≤ 25 dB HL, bilaterally, were recruited.

Data collection and analysis:  Behavioral and electrophysiological MLDs were measured with similar methods. The MLD was defined as SoNo - SπNo thresholds. Stimuli were natural-sounding nonsense syllables (/α/, /dα/, /di/, /tα/, /wα/), which were presented in 65 dB HL continuous speech-weighted noise. The eMLD was measured with the CAEP P2. Group means, standard deviations, and distributions were presented. The feasibility of using nonsense syllables was evaluated by considering whether measurable vMLDs and eMLDs were produced. Useful nonsense syllables produced vMLDs and eMLDs with (1) comparatively large mean magnitudes, (2) few negligible MLDs, and (3) distributions with adequate spread and few extreme values.

Results:  The stimuli /α/ (6.0 [1.9]) and /wα/ (7.5 [1.3]) produced vMLDs with the highest average magnitudes, with no vMLDs of 0 dB and with adequate spread. The stimulus /α/ produced eMLDs with the highest average magnitude (9.6 [2.8]), no eMLDs of 0 dB and adequate spread, whereas the stimulus /wα/ produced eMLDs with an adequate magnitude (6.9 [3.9]), no MLDs of 0 dB, but with a right-skewed distribution and an extreme value. The other stimuli produced vMLDs with low mean magnitudes and several vMLDs of 0 dB.

Conclusion:  These pilot data support the feasibility of using nonsense syllables to record vMLDs and eMLDs. The stimulus /α/ appeared most useful for both behavioral and electrophysiological modalities. Differences in MLDs across modalities may be attributed to low-level audibility of some high-frequency components of the stimuli.

Background:  Individual cardiovascular disease (CVD) risk factors (RFs) have been associated with hearing loss (HL). The relationship to aggregate risk is poorly understood and has not been explored in the Hispanic/Latino population.

Purpose:  The aim of this study was to characterize the association between aggregate CVD RF burden and hearing among Hispanics/Latinos.

Research design:  Cross-sectional examination.

Study sample:  Participants (18-74 years; n = 12,766) in the Hispanic Community Health Study/Study of Latinos.

Data collection and analysis:  Thresholds (0.5-8 kHz) were obtained, and HL was defined dichotomously as pure-tone average (PTA_{0.5,1, 2,4}) > 25 dB HL. Optimal CVD risk burden was defined as follows: systolic blood pressure (SBP) < 120 mm Hg and diastolic blood pressure (DBP) < 80 mm Hg; total cholesterol < 180 mg/dL; nonsmoking; and no diabetes. Major CVD RFs were diabetes, currently smoking, SBP >160 or DBP > 100 mm Hg (or antihypertensives), and total cholesterol > 240 mg/dL (or statins). Thresholds were estimated by age (18-44 and ≥45 years) and sex using linear regression. The association between CVD risk burden and HL was assessed using multivariable logistic regression. Models were adjusted for age, sex, Hispanic/Latino background, center, education, income, alcohol use, body mass index, and noise exposure.

Results:  In the target population, 53.03% were female and 18.81% and 8.52% had all RFs optimal and ≥2 major RFs, respectively. Elevated BP (SBP 120-139 mm Hg or DBP 80-89 mm Hg) was associated with HL in females < 45 years (odds ratio [OR], 2.18; 95% confidence interval [CI], 1.14-4.16). Diabetes (OR, 1.37; 95% CI, 1.01-1.84) and tobacco smoking (OR, 1.44; 95% CI, 1.03-2.01) were associated with HL in females ≥ 45 years. The odds of HL were higher for females ≥ 45 years with ≥2 RFs versus those with all RFs optimal (OR, 1.99; 95% CI, 1.12-3.53). Elevated BP (SBP 140-159 mm Hg or DBP 90-99 mm Hg), but not aggregate risk burden, was associated with HL in males ≥ 45 years (OR, 1.49; 95% CI, 1.02-2.19). No relationships with major CVD RFs were significant in males < 45 years.

Conclusions:  HL is associated with elevated BP in females < 45 years, with diabetes and hypertension in males ≥ 45 years, and with diabetes, smoking, and having ≥2 major CVD RFs in females ≥ 45 years. Future studies are needed to examine if these factors are associated with incident HL.

Background:  The condition of persistent postural perceptual dizziness (PPPD) is a common chronic vestibular disorder that is thought to be due to a central vestibular maladaptation. The condition is frequently encountered in those with a history of migraine, anxiety, or panic attacks. Many cases of PPPD are preceded by vestibular disorders, with vestibular migraine thought to precede at least 20% of cases.

Purpose:  Those with a history of migraine have been shown to have difficulties with sensory integration, habituation, and intolerance to stimuli. This often leads to discomfort associated with some vestibular test procedures, specifically caloric irrigations. At this time there has been little investigation into any prolonged symptoms associated with undergoing vestibular test procedures in this population.

Conclusions:  We pose a case report of a patient with a history of migraine that developed new-onset PPPD following caloric irrigations.