Description of a new low-cost and open-source audiometer and its validation with normal-hearing listeners: The Aupiometer.

Hearing loss is a major public health problem. In 2050, it could affect 2.5 billion people. It has therefore become necessary to prevent and diagnose them as early and as widely as possible. However, the costs of clinical equipment dedicated to the functional exploration of hearing remain high and hamper their distribution, while the technologies used are relatively basic. For example, the gold-standard pure-tone audiometry (PTA) essentially consists of emitting pure sounds. In addition, clinical audiometers are generally limited to PTA or few audiological tests, while hearing loss induce multiple functional deficits. Here, we present the Aupiometer, a low-cost audiometer implemented on a modular open-source system based on Raspberry Pi, and which integrates the entire technical framework necessary to carry out audiological measurements. Several hearing tests are already implemented (e.g. PTA, speech audiometry, questionnaires), while the clinical validity of the Aupiometer was verified on a panel of participants (N = 16) for an automated test of standard and extended high-frequency PTA, from 0.125 to 16 kHz, in comparison with a clinical audiometer. For this comparison between the two devices and over this wide frequency range, the difference is evaluated as less than ±10 dB for a 90% confidence interval, of the same order of magnitude as on test-retest differences on a single device. The interest of this device also extends to academic research as it should encourage the prototyping of innovative hearing tests by the community, in order to better understand the diversity of hearing problems in the population.

French version of the coordinate response measure corpus and its validation on a speech-on-speech task.

Since its creation, the coordinate response measure (CRM) corpus has been applied in hundreds of studies to explore the mechanisms of informational masking in multi-talker situations, but also in speech-in-noise or auditory attentional tasks. Here, we present its French version, with equivalent content to the original version in English. Furthermore, an evaluation of speech-on-speech intelligibility in French shows informational masking with similar result patterns to the original data in English. This validation of the French CRM corpus allows to propose the use of the CRM for intelligibility tests in French, and for comparisons with a foreign language under masking conditions.

Predictors of Speech-in-Noise Understanding in a Population of Occupationally Noise-Exposed Individuals.

Understanding speech in noise is particularly difficult for individuals occupationally exposed to noise due to a mix of noise-induced auditory lesions and the energetic masking of speech signals. For years, the monitoring of conventional audiometric thresholds has been the usual method to check and preserve auditory function. Recently, suprathreshold deficits, notably, difficulties in understanding speech in noise, has pointed out the need for new monitoring tools. The present study aims to identify the most important variables that predict speech in noise understanding in order to suggest a new method of hearing status monitoring. Physiological (distortion products of otoacoustic emissions, electrocochleography) and behavioral (amplitude and frequency modulation detection thresholds, conventional and extended high-frequency audiometric thresholds) variables were collected in a population of individuals presenting a relatively homogeneous occupational noise exposure. Those variables were used as predictors in a statistical model (random forest) to predict the scores of three different speech-in-noise tests and a self-report of speech-in-noise ability. The extended high-frequency threshold appears to be the best predictor and therefore an interesting candidate for a new way of monitoring noise-exposed professionals.

Long-Term Hearing Loss after Acute Acoustic Trauma in the French Military: A Retrospective Study.

INTRODUCTION: Acute acoustic trauma (AAT) is characterized by cochlea-vestibular signs following intense noise exposure, often caused by impulse noise. French military faces a high risk of AAT because of the use of weapons with peak sound levels exceeding 150 dB. Hearing loss (HL) resulting from AAT can have a significant impact on quality of life and operational capacity. The aim of this study was to assess the prevalence of long-term hearing impairment after AAT. MATERIALS AND METHODS: The study involved a retrospective review of computer-based patient records from four military medical centers in Northeast France between January 2016 and December 2021. The inclusion criteria required the presence of cochlea-vestibular signs following impulse acoustic exposure and the absence of other causes. Sociodemographic and clinical data were collected, including audiometric data before and after exposure. The primary end point was the presence of a threshold elevation greater than 10 dB between reference and late audiograms. RESULTS: A total of 419 patients were included in the analysis, with a majority of males (n = 419; 84.7%) and a mean age of 23.6 yrs. The most common causative agent was the 5.56-mm assault rifle (n = 327; 78.0%). Tinnitus was the most frequent symptom (n = 366; 87.4%), followed by hypoacusis (n = 147; 35.1%) and earache (n = 89; 21.2%). The initial audiograms showed no HL in 31.0% of cases, while the mean deficit across all frequencies was 15.4 dB. All patients received corticosteroid therapy, with a mean duration of 6.0 d. Late audiograms conducted at an average interval of 448.0 d after AAT revealed a prevalence of long-term HL exceeding 20%. Higher doses of corticosteroid therapy (>1 mg/kg) were associated with a reduced frequency of long-term HL. CONCLUSIONS: This study highlights the prevalence of long-term hearing impairment after AAT in the French military. The findings emphasize the importance of preventive measures, including proper use of hearing protection devices, and the need for timely diagnosis and treatment. Further research is warranted to explore gender susceptibility to AAT and evaluate the impact of different weapons on AAT characteristics. The study also underscores the potential benefits of higher doses of corticosteroid therapy in reducing the risk of long-term hearing impairment. Overall, the findings contribute to a better understanding of AAT and can inform strategies for its prevention and management in military settings.

Cocktail party training induces increased speech intelligibility and decreased cortical activity in bilateral inferior frontal gyri. A functional near-infrared study.

The human brain networks responsible for selectively listening to a voice amid other talkers remain to be clarified. The present study aimed to investigate relationships between cortical activity and performance in a speech-in-speech task, before (Experiment I) and after training-induced improvements (Experiment II). In Experiment I, 74 participants performed a speech-in-speech task while their cortical activity was measured using a functional near infrared spectroscopy (fNIRS) device. One target talker and one masker talker were simultaneously presented at three different target-to-masker ratios (TMRs): adverse, intermediate and favorable. Behavioral results show that performance may increase monotonically with TMR in some participants and failed to decrease, or even improved, in the adverse-TMR condition for others. On the neural level, an extensive brain network including the frontal (left prefrontal cortex, right dorsolateral prefrontal cortex and bilateral inferior frontal gyri) and temporal (bilateral auditory cortex) regions was more solicited by the intermediate condition than the two others. Additionally, bilateral frontal gyri and left auditory cortex activities were found to be positively correlated with behavioral performance in the adverse-TMR condition. In Experiment II, 27 participants, whose performance was the poorest in the adverse-TMR condition of Experiment I, were trained to improve performance in that condition. Results show significant performance improvements along with decreased activity in bilateral inferior frontal gyri, the right dorsolateral prefrontal cortex, the left inferior parietal cortex and the right auditory cortex in the adverse-TMR condition after training. Arguably, lower neural activity reflects higher efficiency in processing masker inhibition after speech-in-speech training. As speech-in-noise tasks also imply frontal and temporal regions, we suggest that regardless of the type of masking (speech or noise) the complexity of the task will prompt the implication of a similar brain network. Furthermore, the initial significant cognitive recruitment will be reduced following a training leading to an economy of cognitive resources.

How to detect and track chronic neurologic sequelae of COVID-19? Use of auditory brainstem responses and neuroimaging for long-term patient follow-up.

This review intends to provide an overview of the current knowledge on neurologic sequelae of COVID-19 and their possible etiology, and, based on available data, proposes possible improvements in current medical care procedures. We conducted a thorough review of the scientific literature on neurologic manifestations of COVID-19, the neuroinvasive propensity of known coronaviruses (CoV) and their possible effects on brain structural and functional integrity. It appears that around one third of COVID-19 patients admitted to intensive care units (ICU) for respiratory difficulties exhibit neurologic symptoms. This may be due to progressive brain damage and dysfunction triggered by severe hypoxia and hypoxemia, heightened inflammation and SARS-CoV-2 dissemination into brain parenchyma, as suggested by current reports and analyses of previous CoV outbreaks. Viral invasion of the brain may particularly target and alter brainstem and thalamic functions and, consequently, result in sensorimotor dysfunctions and psychiatric disorders. Moreover, data collected from other structurally homologous CoV suggest that SARS-CoV-2 infection may lead to brain cell degeneration and demyelination similar to multiple sclerosis (MS). Hence, current evidence warrants further evaluation and long-term follow-up of possible neurologic sequelae in COVID-19 patients. It may be particularly relevant to evaluate brainstem integrity in recovered patients, as it is suspected that this cerebral area may particularly be dysfunctional following SARS-CoV-2 infection. Because CoV infection can potentially lead to chronic neuroinflammation and progressive demyelination, neuroimaging features and signs of MS may also be evaluated in the long term in recovered COVID-19 patients.

Development of a French version of the Modified Rhyme Test.

A reproducible method to measure the intelligibility of communication systems is required to assess their efficiency. The current study seeks to develop a French version of the Modified Rhyme Test (MRT) [(House, Williams, Heker, and Kryter (1965). J. Acoust. Soc. Am. 37, 158-66], an intelligibility test composed of 50 six-word lists, originally developed for military applications and now widely used. An evaluation of the authors' French MRT was carried out, reproducing the original experimental conditions used by House and colleagues. Very similar results were found between the original MRT and the French MRT, validating the latter for further use and dissemination.

The Spatial Release of Cognitive Load in Cocktail Party Is Determined by the Relative Levels of the Talkers.

In a multi-talker situation, spatial separation between talkers reduces cognitive processing load: this is the "spatial release of cognitive load". The present study investigated the role played by the relative levels of the talkers on this spatial release of cognitive load. During the experiment, participants had to report the speech emitted by a target talker in the presence of a concurrent masker talker. The spatial separation (0° and 120° angular distance in azimuth) and the relative levels of the talkers (adverse, intermediate, and favorable target-to-masker ratio) were manipulated. The cognitive load was assessed with a prefrontal functional near-infrared spectroscopy. Data from 14 young normal-hearing listeners revealed that the target-to-masker ratio had a direct impact on the spatial release of cognitive load. Spatial separation significantly reduced the prefrontal activity only for the intermediate target-to-masker ratio and had no effect on prefrontal activity for the favorable and the adverse target-to-masker ratios. Therefore, the relative levels of the talkers might be a key point to determine the spatial release of cognitive load and more specifically the prefrontal activity induced by spatial cues in multi-talker situations.

Corrigendum: Perceptual factors contribute more than acoustical factors to sound localization abilities with virtual sources.

[This corrects the article on p. 451 in vol. 8, PMID: 25688182.].

Perceptual factors contribute more than acoustical factors to sound localization abilities with virtual sources.

Human sound localization abilities rely on binaural and spectral cues. Spectral cues arise from interactions between the sound wave and the listener's body (head-related transfer function, HRTF). Large individual differences were reported in localization abilities, even in young normal-hearing adults. Several studies have attempted to determine whether localization abilities depend mostly on acoustical cues or on perceptual processes involved in the analysis of these cues. These studies have yielded inconsistent findings, which could result from methodological issues. In this study, we measured sound localization performance with normal and modified acoustical cues (i.e., with individual and non-individual HRTFs, respectively) in 20 naïve listeners. Test conditions were chosen to address most methodological issues from past studies. Procedural training was provided prior to sound localization tests. The results showed no direct relationship between behavioral results and an acoustical metrics (spectral-shape prominence of individual HRTFs). Despite uncertainties due to technical issues with the normalization of the HRTFs, large acoustical differences between individual and non-individual HRTFs appeared to be needed to produce behavioral effects. A subset of 15 listeners then trained in the sound localization task with individual HRTFs. Training included either visual correct-answer feedback (for the test group) or no feedback (for the control group), and was assumed to elicit perceptual learning for the test group only. Few listeners from the control group, but most listeners from the test group, showed significant training-induced learning. For the test group, learning was related to pre-training performance (i.e., the poorer the pre-training performance, the greater the learning amount) and was retained after 1 month. The results are interpreted as being in favor of a larger contribution of perceptual factors than of acoustical factors to sound localization abilities with virtual sources.

Sound localization in noise and sensitivity to spectral shape.

Individual differences exist in sound localization performance even for normal-hearing listeners. Some of these differences might be related to acoustical differences in localization cues carried by the head related transfer functions (HRTF). Recent data suggest that individual differences in sound localization performance could also have a perceptual origin. The localization of an auditory target in the up/down and front/back dimensions requires the analysis of the spectral shape of the stimulus. In the present study, we investigated the role of an acoustic factor, the prominence of the spectral shape ("spectral strength") and the role of a perceptual factor, the listener's sensitivity to spectral shape, in individual differences observed in sound localization performance. Spectral strength was computed as the spectral distance between the magnitude spectrum of the HRTFs and a flat spectrum. Sensitivity to spectral shape was evaluated using spectral-modulation thresholds measured with a broadband (0.2-12.8 kHz) or high-frequency (4-16 kHz) carrier and for different spectral modulation frequencies (below 1 cycle/octave, between 1 and 2 cycles/octave, above 2 cycles/octave). Data obtained from 19 young normal-hearing listeners showed that low thresholds for spectral modulation frequency below 1 cycle/octave with a high-frequency carrier were associated with better sound localization performance. No correlation was found between sound localization performance and the spectral strength of the HRTFs. These results suggest that differences in perceptual ability, rather than acoustical differences, contribute to individual differences in sound localization performance in noise.

Auditory efferents facilitate sound localization in noise in humans.

The mammalian auditory system contains descending neural pathways, some of which project onto the cochlea via the medial olivocochlear (MOC) system. The function of this efferent auditory system is not entirely clear. Behavioral studies in animals with olivocochlear (OC) lesions suggest that the MOC serves to facilitate sound localization in noise. In the current work, noise-induced OC activity (the OC reflex) and sound-localization performance in noise were measured in normal-hearing humans. Consistent with earlier studies, both measures were found to vary substantially across individuals. Importantly, significant correlations were observed between OC-reflex strength and the effect of noise on sound-localization performance; the stronger the OC reflex, the less marked the effect of noise. These results suggest that MOC activation by noise helps to counteract the detrimental effects of background noise on neural representations of direction-dependent spectral features, which are especially important for accurate localization in the up/down and front/back dimensions.