Journal of the American Academy of Audiology最新文献

Background:  In the United Kingdom, audiologist-delivered cognitive behavioral therapy (CBT) is a key intervention to alleviate the distress caused by tinnitus and its comorbid hyperacusis. However, the availability of face-to-face CBT is limited, and such therapy involves significant costs. CBT provided via the internet provides a potential solution to improve access to CBT for tinnitus.

Purpose:  The aim was to perform a preliminary assessment of the effect of a specific program of nonguided internet-based CBT for tinnitus, denoted iCBT(T), in alleviating the problems caused by tinnitus alone or tinnitus combined with hyperacusis.

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

Study sample:  The data for 28 people with tinnitus who completed the iCBT(T) program and answered a series of questions about their tinnitus and hearing status were included in the study. Twelve patients also reported having hyperacusis (including five also with misophonia).

Data collection and analysis:  The iCBT(T) program has seven self-help modules. Anonymous data were collected retrospectively from patients' answers to the questions in the iCBT(T) initial and final assessment modules. Questionnaires administered within the iCBT(T) program were: 4C Tinnitus Management Questionnaire (4C), Screening for Anxiety and Depression in Tinnitus (SAD-T), and the CBT Effectiveness Questionnaire (CBT-EQ).

Results:  Responses to the 4C showed a significant improvement from pre- to posttreatment, with a medium effect size. The mean improvement was similar for those with and without hyperacusis. Responses to the SAD-T questionnaire also showed a significant improvement from pre- to posttreatment with a medium effect size. The improvement was significantly greater for participants with tinnitus alone than for participants who also had hyperacusis. For both the 4C and the SAD-T, the improvements were not significantly related to age or gender. Participants' views of the effectiveness of the iCBT(T) program were assessed using the CBT-EQ. The mean score was 50 out of a maximum of 80, indicating moderately high effectiveness. CBT-EQ scores did not differ for those with and without hyperacusis.

Conclusion:  Based on this preliminary analysis, the iCBT(T) program showed promising results in improving the ability to manage tinnitus and decreasing symptoms of anxiety and depression. Future studies with larger samples and control group(s) are required to further assess various aspects of this program.

Background:  Working memory, a short-term memory component, is a multicomponent system that manages attention and short-term memory in speech perception in challenging listening conditions. These challenging conditions cause listening effort that can be objectively evaluated by pupillometry. Studies show that auditory working memory is more developed in musicians for complex auditory tasks.

Purpose:  This study aims to compare the listening effort and short-term memory in noise between musicians and nonmusicians.

Research design:  An experimental research design was adopted for the study.

Study sample:  The study was conducted on 22 musicians and 20 nonmusicians between the ages of 20 and 45.

Data collection and analysis:  Participants' effort analysis was measured with pupillometry; performance analysis was measured with short-term memory score by listening to the 15 word lists of Verbal Memory Processes Test. Participants are tested under three conditions: quiet, +15 signal-to-noise ratio (SNR), and +5 SNR.

Results:  While nonmusicians showed significantly higher short-term memory score (STMS) than musicians in the quiet condition, musicians' STMS were significantly higher in both noise conditions (+15 SNR and +5 SNR). The nonmusician's percentage of pupil growth averages were higher than the musicians for three conditions.

Conclusion:  As a result, musicians had better memory performance in noise and less effort in the listening task according to lower pupil growth. This study objectively evaluated the differences between participants' listening efforts by pupillometry. It is also observed that the SNR and music training affect memory performance.

Background:  Hyperacusis can be defined as an intolerance of certain everyday sounds, which are perceived as too loud or uncomfortable and which cause significant distress and impairment in the individual's day-to-day activities. Misophonia is defined as a high magnitude of emotional and behavioral reaction to certain sounds produced by human beings, such as eating sounds and breathing sounds. Several psychometric instruments have been developed to assess symptoms and the impact of hyperacusis and misophonia; however, to the authors' knowledge, no study has evaluated and compared the methodological quality of the studies on psychometric properties of the existing instruments.

Purpose:  This article systematically reviews the research studies assessing the psychometric properties of the instruments used for hyperacusis and misophonia and assesses the quality and appropriateness of the methodologies used.

Research design:  Systematic review.

Data collection and analysis:  A systematic literature search was performed using five electronic literature databases (PubMed, Scopus, PsycINFO, Google Scholar, and Web of Science). Studies were included if they were written in English and reported information about the psychometric properties of instruments measuring hyperacusis or misophonia symptoms or their impact. The quality of the studies and that of the psychometric instruments were evaluated using the consensus-based standards for the selection of health-measurement instruments (COSMIN) tool.

Results:  The title and abstracts of 916 articles were screened and 39 articles were selected for full-text evaluation, with 14 articles meeting the inclusion criteria. From these 14 articles, 8 different instruments (5 for hyperacusis and 3 for misophonia) were identified and reviewed comprising: (1) Hyperacusis Questionnaire (HQ), (2) Inventory of Hyperacusis Symptoms, (3) questionnaire on hypersensitivity to sound, (4) Hyperacusis Handicap Questionnaire, (5) short HQ, (6) Amsterdam Misophonia Scale, (7) MisoQuest, and (8) the Misophonia Questionnaire.

Conclusion:  None of the papers reviewed reported all the information required to meet the COSMIN standards. The studies' methodological quality varied between "very good" and "inadequate" depending on their grade on the COSMIN tool. There is a need for further research on the psychometric properties of the instruments included in this review.

Background:  Vestibular migraine (VM) is one of the common causes of episodic dizziness, but it is underdiagnosed and poorly understood. Previous research suggests that otolith reflex pathway performance is often impaired in this patient group, leading to altered perception of roll plane stimuli. Clinically, this perception can be measured with subjective visual vertical (SVV) testing.

Purpose:  The aim of this study is to compare static SVV performance (absolute mean SVV tilt, variance) in a cohort of patients diagnosed with VM to results obtained from clinically derived normative data.

Study design:  Retrospective case review.

Study sample:  Ninety-four consecutive patients between 18 and 65 years of age diagnosed with VM were included in this comparison to clinically derived normative data.

Data collection and analysis:  Retrospective chart review was completed. Demographic data, symptom report, and vestibular laboratory results were documented. SVV performance was documented in terms of absolute mean SVV tilt and response variance.

Results:  Abnormal mean SVV tilt was described in 54% (n = 51) of patients with VM. Including abnormal response variance increased those identified with abnormal presentation to 67% (n = 63). Laboratory findings were insignificant for semicircular canal function, but of those with abnormal ocular vestibular myogenic potential results (n = 30), 77% (n = 23) demonstrated both abnormal SVV and utriculo-ocular reflex performance. There were no associations noted for SVV performance and demographic or other self-report variables.

Conclusion:  Absolute mean SVV tilt and response variance are often abnormal in patients diagnosed with VM. These findings support theories suggesting atypical intralabyrinthine integration within the vestibular nuclei and cerebellar nodular pathways.

Background:  Binaural hearing is of utmost importance for communicating in noisy surroundings and localizing the direction of sound. Unilateral hearing loss (UHL) affects the quality of life in both childhood and adulthood, speech development, and academic achievements. Sound amplification using air-conducting hearing aids (HAs) is a common option for hearing rehabilitation of UHL. The processing time of digital HAs can significantly delay the acoustic stimulation in 3 to 10 milliseconds, which is far longer than the maximal natural interaural time difference (ITD) of 750 microseconds. This can further impair spatial localization in these patients.

Purpose:  We sought to assess whether HA effects on ITD and interaural level difference (ILD) impair localization among subjects with unilateral conductive hearing loss (UCHL).

Research design:  "Normal"-hearing participants underwent localization testing in different free field settings.

Study sample:  Ten volunteers with "normal"-hearing thresholds participated.

Intervention:  Repeated assessments were compared between "normal" (binaural) hearing, UCHL induced by insertion of an inactivated HA to the ear canal (conductive HL), and amplification with a HA.

Results:  In UCHL mode, with HA switched-off, localization was significantly impaired compared to "normal" hearing (NH; η²= 0.151). Localization error was more pronounced when sound was presented from the front and from the side of the occluded ear. When switched-on, amplification with HAs significantly improved localization for all participants compared to UCHL. Better localization with HAs was seen in high frequencies compared to low frequencies (η²= 0.08, 0.03). Even with HAs, localization did not reach that of NH (η²= 0.034).

Conclusion:  Mild UCHL caused localization to deteriorate. HAs significantly improved sound localization, albeit the delay caused by the device processing time. Most of the improvements were seen in high-frequency sounds, representing a beneficial effect of amplification on ILD. Our results have potential clinical value in situations of mild CHL, for instance, otitis media with effusion.

Background:  Cochlear implants (CIs) improve spoken language skills as well as social and academic performance in children with severe and profound sensorineural hearing loss.

Purpose:  We compare the social skills, academic competence, and problem behaviors in children with CIs and their typical-hearing peers and investigate the relationship between language skills and social skills, academic competence, and problem behaviors in children with CIs.

Research design:  Thirty-two children with CIs were divided into two groups according to implantation age: early (n = 17) and late-implanted group (n = 15). The control group was formed by the inclusion of five same-sex classmates of each implanted child selected by the teachers of the children with CIs. Thus, 160 typical-hearing children were included in the control group.

Study sample:  Thirty-two children with CIs and 160 typical-hearing children participated in this study.

Data collection and analysis:  Primary school teachers rated the children's social skills, academic competence, and problem behaviors using the Social Skills Rating System (SSRS). The language skills of the children with CIs were assessed with the Turkish Expressive and Receptive Language Test (TIFALDI).

Results:  A statistically significant difference was found between the SSRS scores of the study and control groups, which was mostly due to lower social skills, and academic competence, and higher problem behavior ratings in the late-implanted group. In the study group, there was a statistically significant correlation between TIFALDI and SSRS scores.

Conclusion:  Early cochlear implantation provides advantages in social skills and vocabulary for children with profound congenital hearing loss. Late-implanted children need special support in different developmental areas despite attending mainstream education.

Background:  Mal de Debarquement Syndrome (MdDS) has a stereotypical presentation of symptoms including continuous rocking/swaying sensations described as feeling like one is "still on the boat," following travel, especially on water vessels. MdDS is even more notorious for the duration of symptoms that can persist months or years, and historically this condition has escaped effective treatments.

Purpose:  This case study presents a case of classic MdDS that was effectively treated in an Audiology-Vestibular clinic. Treatment consisted of three, relatively short-lived vestibular rehabilitation sessions using the "Roll Readaptation" technique that has previously been reported in Neurology journals.

Study sample:  The study sample includes a 48-year-old female with a history of MdDS following two separate ocean cruises. She underwent vestibular evaluation and was treated with a treatment paradigm aimed to readapt the central vestibular system and vestibular-ocular reflex.

Results:  This report focuses on a brief review of current symptomology and diagnostic criteria of MdDS, underlying pathophysiology and application of a relatively new treatment technique in an audiology clinic. This patient was shown full-field, omni-directional optokinetic (OPK) stimulus while rolling her head rhythmically for up to 4 minutes at a time. After three treatment sessions, the patient had a significant reduction in subjective symptoms and returned to full-time work. She had previously been off work for nearly 3 months.

Conclusion:  Individuals with MdDS suffer large daily and work life disruptions due to the persistent nature of symptoms, and their physical manifestations. In addition, they have historically had minimal treatment options. This case demonstrates that audiologists with proper equipment may have the potential to readily offer treatment for a previously "untreatable" condition.

Background:  Studies examining face processing among individuals with congenital deafness show inconsistent results that are often accounted for by sign language skill. However, working memory for faces as an aspect of face processing has not yet been examined in congenital deafness.

Purpose:  To explore working memory for faces among individuals with congenital deafness who are skilled in sign language.

Research design:  A quasi-experimental study of individuals with congenital deafness and a control group.

Study sample:  Sixteen individuals with congenital deafness who are skilled in sign language and 18 participants with intact hearing, matched for age, and education.

Intervention:  The participants performed two conditions of the N-back test in ascending difficulty (i.e., 1-back and 2-back).

Data collection and analysis:  Levene's and Shapiro-Wilk tests were used to assess group homoscedasticity and normality, respectively. A two-way repeated measures analysis of variance was applied to compare the groups in response time and accuracy of the N-back test, as well as Pearson correlation between response time and accuracy, and sign language skill duration.

Results:  The congenital deafness group performed better than controls, as was found in the response time but not in the accuracy variables. However, an interaction effect showed that this pattern was significant for the 1-back but not for the 2-back condition in the response time but not the accuracy. Further, there was a marginal effect in response time but a significant one in accuracy showing the 2-back was performed worse than the 1-back. No significant correlation was found between response time and accuracy, and sign language skill duration.

Conclusion:  Face processing advantage associated with congenital deafness is dependent on cognitive load, but sign language duration does not affect this trend. In addition, response time and accuracy are not equally sensitive to performance differences in the N-back test.

Background:  Listening effort is primarily reflective of real-world performance. Therefore, it is crucial to evaluate the listening effort to predict the performance of hearing aid (HA) users in their daily lives.

Purpose:  This study aimed to investigate the relationship between listening effort, daily HA use time, and HA satisfaction.

Research design:  This is a cross-sectional study.

Study sample:  Thirty-three bilateral behind-the-ear HA users (17 females and 16 males) between 19 and 37 years were participated. All participants had bilateral, symmetric, moderate sensorineural hearing loss and at least 6 months of experience using HAs. The pure-tone average thresholds (PTA) of the participants' left and right ears were 55.34 ± 4.38 and 54.85 ± 5.05, respectively.

Data collection and analysis:  First, daily HA use times of the last 30 days were derived from data logging. Second, participants were asked to fill in the Satisfaction with Amplification in Daily Life Scale questionnaire (SADL). Lastly, participants performed the dual-task paradigm to evaluate listening effort. The dual-task paradigm consisted of a primary speech recognition task that included three different individualized signal-to-noise ratio (SNR) conditions, that is, SNR100, SNR80, and SNR50, which the participant could understand 100, 80, and 50% of the speech, respectively. The secondary task was a visual reaction time task that required participants to press the key in response to a visual probe (an image of a white or red rectangle). Multiple linear regression analyses were used to model the effect of factors (daily HA use time and HA satisfaction) on reaction times (RT) of each three individualized SNR sessions.

Results:  Mean daily HA use time of the participants was 5.72 ± 4.14 hours. Mean RTs of SNR50, SNR80, and SNR100 conditions were 1,050.61 ± 286.49, 893.33 ± 274.79, and 815.45 ± 233.22 ms, respectively. Multiple linear regression analyses showed that daily HA use time and HA satisfaction are significantly related to listening effort in all SNR conditions. For SNR80 condition; F (2,30) = 47.699, p < 0.001, with an adjusted R ² of 0.745.

Conclusion:  As far as we know, this study is the first to demonstrate a strong link between listening effort, daily HA use time, and HA satisfaction. Evaluating listening effort following the HA fitting session may provide preliminary information about the treatment success of HA.

Background:  Audiological manifestations of patients with PLA2G6-associated neurodegeneration are limited.

Objective:  To analyze the audiological findings in a cohort of 13 children with infantile neuroaxonal dystrophy (INAD).

Method:  Patients underwent a battery of audiological tests including tympanometry, distortion product otoacoustic emissions, impedance audiometry, and Brainstem Auditory Evoked Potentials (BAEPs).

Results:  Audiological studies of 13 children indicated sensorineural hearing loss in six children and auditory neuropathy spectrum disorder in four children.

Conclusion:  This study may extend the auditory findings for INAD. Additional studies on quality of life and cognitive-brain degeneration related to this disease are required before making appropriate recommendations for aural rehabilitation.