Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 2.946
Filtrar
1.
Hear Res ; 452: 109105, 2024 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-39216335

RESUMO

Cochlear implant (CI) users experience diminished music enjoyment due to the technical limitations of the CI. Nonetheless, behavioral studies have reported that rhythmic features are well-transmitted through the CI. Still, the gradual improvement of rhythm perception after the CI switch-on has not yet been determined using neurophysiological measures. To fill this gap, we here reanalyzed the electroencephalographic responses of participants from two previous mismatch negativity studies. These studies included eight recently implanted CI users measured twice, within the first six weeks after CI switch-on and approximately three months later; thirteen experienced CI users with a median experience of 7 years; and fourteen normally hearing (NH) controls. All participants listened to a repetitive four-tone pattern (known in music as Alberti bass) for 35 min. Applying frequency tagging, we aimed to estimate the neural activity synchronized to the periodicities of the Alberti bass. We hypothesized that longer experience with the CI would be reflected in stronger frequency-tagged neural responses approaching the responses of NH controls. We found an increase in the frequency-tagged amplitudes after only 3 months of CI use. This increase in neural synchronization may reflect an early adaptation to the CI stimulation. Moreover, the frequency-tagged amplitudes of experienced CI users were significantly greater than those of recently implanted CI users, but still smaller than those of NH controls. The frequency-tagged neural responses did not just reflect spectrotemporal changes in the stimuli (i.e., intensity or spectral content fluctuating over time), but also showed non-linear transformations that seemed to enhance relevant periodicities of the Alberti bass. Our findings provide neurophysiological evidence indicating a gradual adaptation to the CI, which is noticeable already after three months, resulting in close to NH brain processing of spectrotemporal features of musical rhythms after extended CI use.


Assuntos
Estimulação Acústica , Implante Coclear , Implantes Cocleares , Eletroencefalografia , Música , Humanos , Feminino , Masculino , Pessoa de Meia-Idade , Adulto , Implante Coclear/instrumentação , Fatores de Tempo , Estudos de Casos e Controles , Potenciais Evocados Auditivos , Pessoas com Deficiência Auditiva/psicologia , Pessoas com Deficiência Auditiva/reabilitação , Idoso , Percepção Auditiva , Adaptação Fisiológica , Percepção da Altura Sonora
2.
Trends Hear ; 28: 23312165241263485, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39099537

RESUMO

Older adults with normal hearing or with age-related hearing loss face challenges when listening to speech in noisy environments. To better serve individuals with communication difficulties, precision diagnostics are needed to characterize individuals' auditory perceptual and cognitive abilities beyond pure tone thresholds. These abilities can be heterogenous across individuals within the same population. The goal of the present study is to consider the suprathreshold variability and develop characteristic profiles for older adults with normal hearing (ONH) and with hearing loss (OHL). Auditory perceptual and cognitive abilities were tested on ONH (n = 20) and OHL (n = 20) on an abbreviated test battery using portable automated rapid testing. Using cluster analyses, three main profiles were revealed for each group, showing differences in auditory perceptual and cognitive abilities despite similar audiometric thresholds. Analysis of variance showed that ONH profiles differed in spatial release from masking, speech-in-babble testing, cognition, tone-in-noise, and binaural temporal processing abilities. The OHL profiles differed in spatial release from masking, speech-in-babble testing, cognition, and tolerance to background noise performance. Correlation analyses showed significant relationships between auditory and cognitive abilities in both groups. This study showed that auditory perceptual and cognitive deficits can be present to varying degrees in the presence of audiometrically normal hearing and among listeners with similar degrees of hearing loss. The results of this study inform the need for taking individual differences into consideration and developing targeted intervention options beyond pure tone thresholds and speech testing.


Assuntos
Audiometria de Tons Puros , Limiar Auditivo , Cognição , Ruído , Mascaramento Perceptivo , Percepção da Fala , Humanos , Masculino , Cognição/fisiologia , Feminino , Idoso , Limiar Auditivo/fisiologia , Percepção da Fala/fisiologia , Pessoa de Meia-Idade , Ruído/efeitos adversos , Estimulação Acústica , Percepção Auditiva/fisiologia , Idoso de 80 Anos ou mais , Audição/fisiologia , Fatores Etários , Estudos de Casos e Controles , Presbiacusia/diagnóstico , Presbiacusia/fisiopatologia , Valor Preditivo dos Testes , Audiologia/métodos , Individualidade , Pessoas com Deficiência Auditiva/psicologia , Análise por Conglomerados , Audiometria da Fala/métodos
3.
Trends Hear ; 28: 23312165241273393, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39113646

RESUMO

Hearing loss is common among Veterans, and extensive hearing care resources are prioritized within the Veterans Administration (VA). Severe hearing loss poses unique communication challenges with speech understanding that may not be overcome with amplification. We analyzed data from the VA Audiometric Repository between 2005 and 2017 and the relationship between hearing loss severity with speech recognition scores. We hypothesized that a significant subset of Veterans with severe or worse hearing loss would have poor unaided speech perception outcomes even with adequate audibility. Sociodemographic characteristics and comorbidities were compiled using electronic medical records as was self-report measures of hearing disability. We identified a cohort of 137,500 unique Veterans with 232,789 audiograms demonstrating bilateral severe or worse hearing loss (four-frequency PTA > 70 dB HL). The median (IQR; range) age of Veterans at their first audiogram with severe or worse hearing loss was 81 years (74 to 87; 21-90+), and a majority were male (136,087 [99%]) and non-Hispanic white (107,798 [78.4%]). Among those with bilateral severe or worse hearing loss, 41,901 (30.5%) also had poor speech recognition scores (<50% words), with greater hearing loss severity correlating with worse speech perception. We observed variability in speech perception abilities in those with moderate-severe and greater levels of hearing loss who may derive limited benefit from amplification. Veterans with communication challenges may warrant alternative approaches and treatment strategies such as cochlear implants to support communication needs.


Assuntos
Perda Auditiva , Índice de Gravidade de Doença , Percepção da Fala , Humanos , Masculino , Feminino , Idoso , Pessoa de Meia-Idade , Prevalência , Idoso de 80 Anos ou mais , Estados Unidos/epidemiologia , Adulto , Perda Auditiva/epidemiologia , Perda Auditiva/diagnóstico , Veteranos , Adulto Jovem , Limiar Auditivo , Saúde dos Veteranos , United States Department of Veterans Affairs , Pessoas com Deficiência Auditiva/psicologia , Auxiliares de Audição
4.
BMJ Open ; 14(8): e089118, 2024 Aug 08.
Artigo em Inglês | MEDLINE | ID: mdl-39122403

RESUMO

INTRODUCTION: Children who are deaf or hard-of-hearing (DHH) are at risk for speech and language delay. Language outcomes are worse in DHH children from lower socioeconomic backgrounds, due in part to disparities in access to specialised speech-language therapy. Teletherapy may help improve access to this specialised care and close this language gap. Inclusion of diverse DHH children in prospective randomised clinical trials has been challenging but is necessary to address disparities and pursue hearing health equity. Stakeholder input regarding decisions on study design elements, including comparator groups, masking, assessments and compensation, is necessary to design inclusive studies. We have designed an inclusive, equitable comparativeness effectiveness trial to address disparities in paediatric hearing health. The specific aims of the study are to determine the effect of access to and utilisation of speech-language teletherapy in addressing language disparities in low-income children who are DHH. METHODS AND ANALYSIS: After stakeholder input and pilot data collection, we designed a randomised clinical trial and concurrent longitudinal cohort trial to be conducted at four tertiary children's hospitals in the USA. Participants will include 210 DHH children aged 0-27 months. 140 of these children will be from lower income households, who will be randomised 1:1 to receive usual care versus usual care plus access to supplemental speech-language teletherapy. 70 children from higher income households will be simultaneously recruited as a comparison cohort. Primary outcome measure will be the Preschool Language Scales Auditory Comprehension subscale standard score, with additional speech, language, hearing and quality of life validated measures as secondary outcomes. ETHICS AND DISSEMINATION: This study was approved by the Institutional Review Boards of the participating sites: the University of California, San Francisco (19-28356), Rady Children's Hospital (804651) and Seattle Children's Hospital (STUDY00003750). Parents of enrolled children will provide written informed consent for their child's participation. Professional and parent stakeholder groups that have been involved throughout the study design will facilitate dissemination and implementation of study findings via publication and through national and regional organisations. TRIAL REGISTRATION NUMBER: NCT04928209.


Assuntos
Surdez , Humanos , Pré-Escolar , Lactente , Pessoas com Deficiência Auditiva , Recém-Nascido , Transtornos do Desenvolvimento da Linguagem/terapia , Disparidades em Assistência à Saúde , Ensaios Clínicos Controlados Aleatórios como Assunto , Feminino , Fonoterapia/métodos , Estudos Multicêntricos como Assunto , Terapia da Linguagem/métodos , Masculino , Estudos Prospectivos , Projetos de Pesquisa , Acessibilidade aos Serviços de Saúde , Qualidade de Vida
5.
Trends Hear ; 28: 23312165241273342, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39150412

RESUMO

During the last decade, there has been a move towards consumer-centric hearing healthcare. This is a direct result of technological advancements (e.g., merger of consumer grade hearing aids with consumer grade earphones creating a wide range of hearing devices) as well as policy changes (e.g., the U.S. Food and Drug Administration creating a new over-the-counter [OTC] hearing aid category). In addition to various direct-to-consumer (DTC) hearing devices available on the market, there are also several validated tools for the self-assessment of auditory function and the detection of ear disease, as well as tools for education about hearing loss, hearing devices, and communication strategies. Further, all can be made easily available to a wide range of people. This perspective provides a framework and identifies tools to improve and maintain optimal auditory wellness across the adult life course. A broadly available and accessible set of tools that can be made available on a digital platform to aid adults in the assessment and as needed, the improvement, of auditory wellness is discussed.


Assuntos
Auxiliares de Audição , Perda Auditiva , Humanos , Perda Auditiva/diagnóstico , Perda Auditiva/reabilitação , Perda Auditiva/fisiopatologia , Perda Auditiva/terapia , Audição , Pessoas com Deficiência Auditiva/reabilitação , Pessoas com Deficiência Auditiva/psicologia , Correção de Deficiência Auditiva/instrumentação , Percepção Auditiva , Conhecimentos, Atitudes e Prática em Saúde , Educação de Pacientes como Assunto
6.
Codas ; 36(5): e20230239, 2024.
Artigo em Português, Inglês | MEDLINE | ID: mdl-39109753

RESUMO

PURPOSE: To associate maternal anxiety with sociodemographic factors, breastfeeding practices, oral habits, and the child's entry into daycare among deaf and hearing (non-deaf) mothers. METHODS: This retrospective comparative cross-sectional study included 116 mothers (29 deaf and 87 hearing) of children aged between two and five years. Deaf mothers belonged to a reference center in the city, while hearing mothers were contacted in public daycares where their children were enrolled. Mothers underwent interviews covering socio-economic factors and child development-related aspects. Additionally, they completed the Brazilian Beck Anxiety Inventory, adapted for both deaf and hearing individuals, serving as instruments to assess anxiety. The Kolmogorov-Smirnov normality test, Kruskal Wallis test, Mann-Whitney test, and Poisson Regression were employed for statistical analyses (p<0.05). RESULTS: Deaf mothers exhibited anxiety scores one and a half times higher than hearing mothers. Moreover, mothers of children with thumb-sucking habits showed higher anxiety scores, while mothers whose children started attending daycare as infants demonstrated lower anxiety scores compared to mothers of children without such habits and who did not attend daycare. CONCLUSION: Deaf mothers displayed higher anxiety levels when compared to hearing mothers. Children's behaviors, such as thumb-sucking habits, and early enrollment in daycare during the first year of life influenced maternal anxiety.


OBJETIVO: Associar a ansiedade materna aos fatores sociodemográficos, pratica de aleitamento, hábitos bucais e ingresso da criança em creche entre mulheres surdas e ouvintes. MÉTODO: Participaram deste estudo transversal retrospectivo comparativo, 116 mães (29 surdas e 87 ouvintes) de crianças na faixa etária entre dois e cinco anos. As mães surdas pertenciam a um centro de referência da cidade e as mães ouvintes foram contatadas em creches públicas, onde seus filhos estavam matriculados. As mães foram submetidas a entrevista sobre fatores socioeconômicos e relacionados ao desenvolvimento dos filhos, além de realizarem o preenchimento do Inventário Brasileiro de Ansiedade de Beck, nas versões para surdos e ouvintes, que foram instrumentos usados para avaliar a ansiedade. O teste de normalidade de Kolmogorov-Smirnov, os testes de Kruskal Wallis, Mann-Whitney e Regressão de Poisson foram utilizados para análises estatísticas (p <0,05). RESULTADOS: Mães surdas apresentaram escore de ansiedade uma vez e meia maior que mães ouvintes. Além disso, mães de crianças com hábito de sucção de dedo apresentaram maior escore de ansiedade e mães cujos filhos começaram a frequentar a creche ainda bebês apresentaram menor escore de ansiedade, quando comparados a crianças sem o hábito e que não frequentavam a creche. CONCLUSÃO: Mães surdas apresentaram maior ansiedade quando comparadas às ouvintes. Comportamento dos filhos com hábitos de sucção de dedo e o ingresso em creches no primeiro ano de vida influenciaram a ansiedade materna.


Assuntos
Ansiedade , Surdez , Mães , Fatores Socioeconômicos , Humanos , Estudos Transversais , Mães/psicologia , Feminino , Estudos Retrospectivos , Pré-Escolar , Adulto , Surdez/psicologia , Brasil , Aleitamento Materno/psicologia , Pessoas com Deficiência Auditiva/psicologia , Masculino , Adulto Jovem , Creches
7.
Sensors (Basel) ; 24(16)2024 Aug 19.
Artigo em Inglês | MEDLINE | ID: mdl-39205045

RESUMO

Sign language is undoubtedly a common way of communication among deaf and non-verbal people. But it is not common among hearing people to use sign language to express feelings or share information in everyday life. Therefore, a significant communication gap exists between deaf and hearing individuals, despite both groups experiencing similar emotions and sentiments. In this paper, we developed a convolutional neural network-squeeze excitation network to predict the sign language signs and developed a smartphone application to provide access to the ML model to use it. The SE block provides attention to the channel of the image, thus improving the performance of the model. On the other hand, the smartphone application brings the ML model close to people so that everyone can benefit from it. In addition, we used the Shapley additive explanation to interpret the black box nature of the ML model and understand the models working from within. Using our ML model, we achieved an accuracy of 99.86% on the KU-BdSL dataset. The SHAP analysis shows that the model primarily relies on hand-related visual cues to predict sign language signs, aligning with human communication patterns.


Assuntos
Surdez , Aprendizado de Máquina , Língua de Sinais , Humanos , Surdez/fisiopatologia , Redes Neurais de Computação , Smartphone , Pessoas com Deficiência Auditiva/psicologia
8.
Trends Hear ; 28: 23312165241273346, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39195628

RESUMO

There is broad consensus that listening effort is an important outcome for measuring hearing performance. However, there remains debate on the best ways to measure listening effort. This study sought to measure neural correlates of listening effort using functional near-infrared spectroscopy (fNIRS) in experienced adult hearing aid users. The study evaluated impacts of amplification and signal-to-noise ratio (SNR) on cerebral blood oxygenation, with the expectation that easier listening conditions would be associated with less oxygenation in the prefrontal cortex. Thirty experienced adult hearing aid users repeated sentence-final words from low-context Revised Speech Perception in Noise Test sentences. Participants repeated words at a hard SNR (individual SNR-50) or easy SNR (individual SNR-50 + 10 dB), while wearing hearing aids fit to prescriptive targets or without wearing hearing aids. In addition to assessing listening accuracy and subjective listening effort, prefrontal blood oxygenation was measured using fNIRS. As expected, easier listening conditions (i.e., easy SNR, with hearing aids) led to better listening accuracy, lower subjective listening effort, and lower oxygenation across the entire prefrontal cortex compared to harder listening conditions. Listening accuracy and subjective listening effort were also significant predictors of oxygenation.


Assuntos
Auxiliares de Audição , Espectroscopia de Luz Próxima ao Infravermelho , Percepção da Fala , Humanos , Masculino , Feminino , Percepção da Fala/fisiologia , Idoso , Pessoa de Meia-Idade , Razão Sinal-Ruído , Estimulação Acústica/métodos , Córtex Pré-Frontal/fisiologia , Pessoas com Deficiência Auditiva/psicologia , Pessoas com Deficiência Auditiva/reabilitação , Ruído/efeitos adversos , Correção de Deficiência Auditiva/instrumentação , Correção de Deficiência Auditiva/métodos , Adulto , Idoso de 80 Anos ou mais , Audição/fisiologia , Circulação Cerebrovascular/fisiologia , Limiar Auditivo/fisiologia , Inteligibilidade da Fala/fisiologia
13.
Trends Hear ; 28: 23312165241271340, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39215517

RESUMO

Timing cues such as interaural time differences (ITDs) and temporal pitch are pivotal for sound localization and source segregation, but their perception is degraded in cochlear-implant (CI) listeners as compared to normal-hearing listeners. In multi-electrode stimulation, intra-aural channel interactions between electrodes are assumed to be an important factor limiting access to those cues. The monaural asynchrony of stimulation timing across electrodes is assumed to mediate the amount of these interactions. This study investigated the effect of the monaural temporal electrode asynchrony (mTEA) between two electrodes, applied similarly in both ears, on ITD-based left/right discrimination sensitivity in five CI listeners, using pulse trains with 100 pulses per second and per electrode. Forward-masked spatial tuning curves were measured at both ears to find electrode separations evoking controlled degrees of across-electrode masking. For electrode separations smaller than 3 mm, results showed an effect of mTEA. Patterns were u/v-shaped, consistent with an explanation in terms of the effective pulse rate that appears to be subject to the well-known rate limitation in electric hearing. For separations larger than 7 mm, no mTEA effects were observed. A comparison to monaural rate-pitch discrimination in a separate set of listeners and in a matched setup showed no systematic differences between percepts. Overall, an important role of the mTEA in both binaural and monaural dual-electrode stimulation is consistent with a monaural pulse-rate limitation whose effect is mediated by channel interactions. Future CI stimulation strategies aiming at improved timing-cue encoding should minimize the stimulation delay between nearby electrodes that need to be stimulated successively.


Assuntos
Estimulação Acústica , Implante Coclear , Implantes Cocleares , Sinais (Psicologia) , Localização de Som , Humanos , Pessoa de Meia-Idade , Masculino , Feminino , Localização de Som/fisiologia , Idoso , Implante Coclear/instrumentação , Mascaramento Perceptivo/fisiologia , Fatores de Tempo , Pessoas com Deficiência Auditiva/reabilitação , Pessoas com Deficiência Auditiva/psicologia , Adulto , Estimulação Elétrica , Discriminação da Altura Tonal/fisiologia , Limiar Auditivo/fisiologia
14.
J Commun Disord ; 111: 106458, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39208681

RESUMO

INTRODUCTION: Vocabulary knowledge is an essential element in language development. There is evidence of significant differences in vocabulary knowledge between deaf children and hearing peers of the same age. These differences put deaf students at a disadvantage when compared to their hearing counterparts. The aim of this study was to investigate whether certain types of words characterise the lexical difficulties of deaf students. Our starting point is that this knowledge is needed to design interventions that are adapted to the particular needs of these students for their lexical development. METHODS: We evaluated the lexical comprehension of 90 Spanish students. The sample comprised 45 hearing students and 45 students with severe or profound hearing loss. Both groups were attending the later years of primary school (8 to -12-year-olds). They were tested using the Spanish Peabody Picture Vocabulary Test-III. The performance of both groups was statistically compared using percentiles and standard scores as well as a selected set of words from the test. RESULTS: No significant differences between hearing and deaf groups were found by age, sex, and sociocultural level. Significant differences were found between groups in their percentile and standard scores. There were no significant differences in performance between the two groups on only five of the 25 words with the highest error rate in the deaf group. The qualitative analysis of the remaining 20 words that were especially challenging for deaf students reveals results of interest which could help guide interventions. CONCLUSIONS: The results indicate the need for lexical intervention for deaf students in the final years of primary school. The specialised support service for deaf learners should approach the intervention by targeting a specific type of vocabulary, making the semantic relationships between these words more transparent and promoting a deeper understanding of them.


Assuntos
Surdez , Pessoas com Deficiência Auditiva , Vocabulário , Humanos , Masculino , Feminino , Criança , Surdez/psicologia , Pessoas com Deficiência Auditiva/psicologia , Estudantes/psicologia , Compreensão , Desenvolvimento da Linguagem , Testes de Linguagem , Espanha
15.
Trends Hear ; 28: 23312165241265199, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39095047

RESUMO

Participation in complex listening situations such as group conversations in noisy environments sets high demands on the auditory system and on cognitive processing. Reports of hearing-impaired people indicate that strenuous listening situations occurring throughout the day lead to feelings of fatigue at the end of the day. The aim of the present study was to develop a suitable test sequence to evoke and measure listening effort (LE) and listening-related fatigue (LRF), and, to evaluate the influence of hearing aid use on both dimensions in mild to moderately hearing-impaired participants. The chosen approach aims to reconstruct a representative acoustic day (Time Compressed Acoustic Day [TCAD]) by means of an eight-part hearing-test sequence with a total duration of approximately 2½ h. For this purpose, the hearing test sequence combined four different listening tasks with five different acoustic scenarios and was presented to the 20 test subjects using virtual acoustics in an open field measurement in aided and unaided conditions. Besides subjective ratings of LE and LRF, behavioral measures (response accuracy, reaction times), and an attention test (d2-R) were performed prior to and after the TCAD. Furthermore, stress hormones were evaluated by taking salivary samples. Subjective ratings of LRF increased throughout the test sequence. This effect was observed to be higher when testing unaided. In three of the eight listening tests, the aided condition led to significantly faster reaction times/response accuracies than in the unaided condition. In the d2-R test, an interaction in processing speed between time (pre- vs. post-TCAD) and provision (unaided vs. aided) was found suggesting an influence of hearing aid provision on LRF. A comparison of the averaged subjective ratings at the beginning and end of the TCAD shows a significant increase in LRF for both conditions. At the end of the TCAD, subjective fatigue was significantly lower when wearing hearing aids. The analysis of stress hormones did not reveal significant effects.


Assuntos
Estimulação Acústica , Auxiliares de Audição , Ruído , Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Ruído/efeitos adversos , Correção de Deficiência Auditiva/instrumentação , Correção de Deficiência Auditiva/métodos , Atenção , Pessoas com Deficiência Auditiva/psicologia , Pessoas com Deficiência Auditiva/reabilitação , Adulto , Fadiga Auditiva , Fatores de Tempo , Tempo de Reação , Realidade Virtual , Percepção Auditiva/fisiologia , Fadiga , Perda Auditiva/psicologia , Perda Auditiva/reabilitação , Perda Auditiva/fisiopatologia , Perda Auditiva/diagnóstico , Percepção da Fala/fisiologia , Saliva/metabolismo , Saliva/química , Audição , Limiar Auditivo
16.
J Commun Disord ; 111: 106454, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39142008

RESUMO

This study explores the narrative skills of deaf and hearing children within the context of Arabic diglossia, a linguistic environment characterised by significant differences between spoken dialects and formal written language. Using Stein and Glenn's (1979) and Bruner's (1991) frameworks, the research analyses the narrative constructions of 13 hearing and 13 deaf children in Kuwait. The findings reveal that hearing children, benefiting from consistent exposure to spoken and formal Arabic, produced more coherent and detailed narratives compared to deaf children. Hearing participants also demonstrated greater vocabulary diversity. Age-related improvements in narrative skills were more pronounced among hearing children, while the impact of sign language exposure on narrative abilities was significant among deaf children. The study underscores the critical role of early language exposure and educational support in fostering narrative development, particularly in a diglossic context. These findings highlight the need for specialised educational strategies to support the unique narrative development needs of deaf children.


Assuntos
Surdez , Narração , Humanos , Criança , Masculino , Feminino , Surdez/psicologia , Kuweit , Língua de Sinais , Pré-Escolar , Idioma , Vocabulário , Pessoas com Deficiência Auditiva/psicologia
17.
Hear Res ; 451: 109096, 2024 Sep 15.
Artigo em Inglês | MEDLINE | ID: mdl-39116708

RESUMO

Congenital or early-onset unilateral hearing loss (UHL) can disrupt the normal development of the auditory system. In extreme cases of UHL (i.e., single sided deafness), consistent cochlear implant use during sensitive periods resulted in cortical reorganization that partially reversed the detrimental effects of unilateral sensory deprivation. There is a gap in knowledge, however, regarding cortical plasticity i.e. the brain's capacity to adapt, reorganize, and develop binaural pathways in milder degrees of UHL rehabilitated by a hearing aid (HA). The current study was set to investigate early-stage cortical processing and electrophysiological manifestations of binaural processing by means of cortical auditory evoked potentials (CAEPs) to speech sounds, in children with moderate to severe-to-profound UHL using a HA. Fourteen children with UHL (CHwUHL), 6-14 years old consistently using a HA for 3.5 (±2.3) years participated in the study. CAEPs were elicited to the speech sounds /m/, /g/, and /t/ in three listening conditions: monaural [Normal hearing (NH), HA], and bilateral [BI (NH + HA)]. Results indicated age-appropriate CAEP morphology in the NH and BI listening conditions in all children. In the HA listening condition: (1) CAEPs showed similar morphology to that found in the NH listening condition, however, the mature morphology observed in older children in the NH listening condition was not evident; (2) P1 was elicited in all but two children with severe-to-profound hearing loss, to at least one speech stimuli, indicating effective audibility; (3) A significant mismatch in timing and synchrony between the NH and HA ear was found; (4) P1 was sensitive to the acoustic features of the eliciting stimulus and to the amplification characteristics of the HA. Finally, a cortical binaural interaction component (BIC) was derived in most children. In conclusion, the current study provides first-time evidence for cortical plasticity and partial reversal of the detrimental effects of moderate to severe-to-profound UHL rehabilitated by a HA. The derivation of a cortical biomarker of binaural processing implies that functional binaural pathways can develop when sufficient auditory input is provided to the affected ear. CAEPs may thus serve as a clinical tool for assessing, monitoring, and managing CHwUHL using a HA.


Assuntos
Estimulação Acústica , Córtex Auditivo , Vias Auditivas , Potenciais Evocados Auditivos , Auxiliares de Audição , Perda Auditiva Unilateral , Plasticidade Neuronal , Percepção da Fala , Humanos , Criança , Masculino , Feminino , Córtex Auditivo/fisiopatologia , Perda Auditiva Unilateral/fisiopatologia , Perda Auditiva Unilateral/reabilitação , Adolescente , Vias Auditivas/fisiopatologia , Pessoas com Deficiência Auditiva/reabilitação , Pessoas com Deficiência Auditiva/psicologia , Correção de Deficiência Auditiva , Eletroencefalografia , Fatores Etários , Biomarcadores , Audição
18.
Hear Res ; 451: 109090, 2024 Sep 15.
Artigo em Inglês | MEDLINE | ID: mdl-39047579

RESUMO

OBJECTIVE: The acoustic change complex (ACC) is a cortical auditory evoked potential (CAEP) and can be elicited by a change in an otherwise continuous sound. The ACC has been highlighted as a promising tool in the assessment of sound and speech discrimination capacity, and particularly for difficult-to-test populations such as infants with hearing loss, due to the objective nature of ACC measurements. Indeed, there is a pressing need to develop further means to accurately and thoroughly establish the hearing status of children with hearing loss, to help guide hearing interventions in a timely manner. Despite the potential of the ACC method, ACC measurements remain relatively rare in a standard clinical settings. The objective of this study was to perform an up-to-date systematic review on ACC measurements in children, to provide greater clarity and consensus on the possible methodologies, applications, and performance of this technique, and to facilitate its uptake in relevant clinical settings. DESIGN: Original peer-reviewed articles conducting ACC measurements in children (< 18 years). Data were extracted and summarised for: (1) participant characteristics; (2) ACC methods and auditory stimuli; (3) information related to the performance of the ACC technique; (4) ACC measurement outcomes, advantages, and challenges. The systematic review was conducted using PRISMA guidelines for reporting and the methodological quality of included articles was assessed. RESULTS: A total of 28 studies were identified (9 infant studies). Review results show that ACC responses can be measured in infants (from < 3 months), and there is evidence of age-dependency, including increased robustness of the ACC response with increasing childhood age. Clinical applications include the measurement of the neural capacity for speech and non-speech sound discrimination in children with hearing loss, auditory neuropathy spectrum disorder (ANSD) and central auditory processing disorder (CAPD). Additionally, ACCs can be recorded in children with hearing aids, auditory brainstem implants, and cochlear implants, and ACC results may guide hearing intervention/rehabilitation strategies. The review identified that the time taken to perform ACC measurements was often lengthy; the development of more efficient ACC test procedures for children would be beneficial. Comparisons between objective ACC measurements and behavioural measures of sound discrimination showed significant correlations for some, but not all, included studies. CONCLUSIONS: ACC measurements of the neural capacity to discriminate between speech and non-speech sounds are feasible in infants and children, and a wide range of possible clinical applications exist, although more time-efficient procedures would be advantageous for clinical uptake. A consideration of age and maturational effects is recommended, and further research is required to investigate the relationship between objective ACC measures and behavioural measures of sound and speech perception for effective clinical implementation.


Assuntos
Estimulação Acústica , Percepção Auditiva , Potenciais Evocados Auditivos , Adolescente , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Fatores Etários , Córtex Auditivo/fisiologia , Córtex Auditivo/fisiopatologia , Vias Auditivas/fisiopatologia , Vias Auditivas/fisiologia , Audição , Perda Auditiva/fisiopatologia , Perda Auditiva/diagnóstico , Perda Auditiva/reabilitação , Pessoas com Deficiência Auditiva/psicologia , Pessoas com Deficiência Auditiva/reabilitação , Valor Preditivo dos Testes , Reprodutibilidade dos Testes , Testes de Discriminação da Fala
19.
Hear Res ; 451: 109074, 2024 Sep 15.
Artigo em Inglês | MEDLINE | ID: mdl-39018768

RESUMO

Many children with profound hearing loss have received cochlear implants (CI) to help restore some sense of hearing. There is, however, limited research on long-term neurocognitive outcomes in young adults who have grown up hearing through a CI. This study compared the cognitive outcomes of early-implanted (n = 20) and late-implanted (n = 21) young adult CI users, and typically hearing (TH) controls (n=56), all of whom were enrolled in college. Cognitive fluidity, nonverbal intelligence, and American Sign Language (ASL) comprehension were assessed, revealing no significant differences in cognition and nonverbal intelligence between the early and late-implanted groups. However, there was a difference in ASL comprehension, with the late-implanted group having significantly higher ASL comprehension. Although young adult CI users showed significantly lower scores in a working memory and processing speed task than TH age-matched controls, there were no significant differences in tasks involving executive function shifting, inhibitory control, and episodic memory between young adult CI and young adult TH participants. In an exploratory analysis of a subset of CI participants (n = 17) in whom we were able to examine crossmodal plasticity, we saw greater evidence of crossmodal recruitment from the visual system in late-implanted compared with early-implanted CI young adults. However, cortical visual evoked potential latency biomarkers of crossmodal plasticity were not correlated with cognitive measures or ASL comprehension. The results suggest that in the late-implanted CI users, early access to sign language may have served as a scaffold for appropriate cognitive development, while in the early-implanted group early access to oral language benefited cognitive development. Furthermore, our results suggest that the persistence of crossmodal neuroplasticity into adulthood does not necessarily impact cognitive development. In conclusion, early access to language - spoken or signed - may be important for cognitive development, with no observable effect of crossmodal plasticity on cognitive outcomes.


Assuntos
Implante Coclear , Implantes Cocleares , Cognição , Compreensão , Plasticidade Neuronal , Pessoas com Deficiência Auditiva , Humanos , Masculino , Adulto Jovem , Feminino , Implante Coclear/instrumentação , Pessoas com Deficiência Auditiva/psicologia , Pessoas com Deficiência Auditiva/reabilitação , Adulto , Estudos de Casos e Controles , Adolescente , Fatores de Tempo , Fatores Etários , Testes Neuropsicológicos , Memória de Curto Prazo , Função Executiva , Resultado do Tratamento , Audição , Correção de Deficiência Auditiva/instrumentação
20.
Hear Res ; 451: 109088, 2024 Sep 15.
Artigo em Inglês | MEDLINE | ID: mdl-39032483

RESUMO

Combining a cochlear implant with contralateral acoustic hearing typically enhances speech understanding, although this improvement varies among CI users and can lead to an interference effect. This variability may be associated with the effectiveness of the integration between electric and acoustic stimulation, which might be affected by the temporal mismatch between the two listening sides. Finding methods to compensate for the temporal mismatch might contribute to the optimal adjustment of bimodal devices and to improve hearing in CI users with contralateral acoustic hearing. The current study investigates cortical auditory evoked potentials (CAEPs) in normal hearing listeners (NH) and CI users with contralateral acoustic hearing. In NH, the amplitude of the N1 peak and the maximum phase locking value (PLV) were analyzed under monaural, binaural, and binaural temporally mismatched conditions. In CI users, CAEPs were measured when listening with CI only (CIS_only), acoustically only (AS_only) and with both sides together (CIS+AS). When listening with CIS+AS, various interaural delays were introduced between the electric and acoustic stimuli. In NH listeners, interaural temporal mismatch resulted in decreased N1 amplitude and PLV. Moreover, PLV is suggested as a more sensitive measure to investigate the integration of information between the two listening sides. CI users showed varied N1 latencies between the AS_only and CIS_only listening conditions, with increased N1 amplitude when the temporal mismatch was compensated. A tendency towards increased PLV was also observed, however, to a lesser extent than in NH listeners, suggesting a limited integration between electric and acoustic stimulation. This work highlights the potential of CAEPs measurement to investigate cortical processing of the information between two listening sides in NH and bimodal CI users.


Assuntos
Estimulação Acústica , Córtex Auditivo , Implante Coclear , Implantes Cocleares , Estimulação Elétrica , Potenciais Evocados Auditivos , Pessoas com Deficiência Auditiva , Percepção da Fala , Humanos , Feminino , Masculino , Adulto , Pessoa de Meia-Idade , Idoso , Implante Coclear/instrumentação , Córtex Auditivo/fisiopatologia , Adulto Jovem , Fatores de Tempo , Pessoas com Deficiência Auditiva/psicologia , Pessoas com Deficiência Auditiva/reabilitação , Tempo de Reação , Estudos de Casos e Controles , Audição , Eletroencefalografia , Limiar Auditivo , Percepção Auditiva
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA