Speech intelligibility and its relation to auditory temporal processing in Czech and Swiss German subjects with and without tinnitus.

PURPOSE: Previous studies have shown that levels for 50% speech intelligibility in quiet and in noise differ for different languages. Here, we aimed to find out whether these differences may relate to different auditory processing of temporal sound features in different languages, and to determine the influence of tinnitus on speech comprehension in different languages. METHODS: We measured speech intelligibility under various conditions (words in quiet, sentences in babble noise, interrupted sentences) along with tone detection thresholds in quiet [PTA] and in noise [PTAnoise], gap detection thresholds [GDT], and detection thresholds for frequency modulation [FMT], and compared them between Czech and Swiss subjects matched in mean age and PTA. RESULTS: The Swiss subjects exhibited higher speech reception thresholds in quiet, higher threshold speech-to-noise ratio, and shallower slope of performance-intensity function for the words in quiet. Importantly, the intelligibility of temporally gated speech was similar in the Czech and Swiss subjects. The PTAnoise, GDT, and FMT were similar in the two groups. The Czech subjects exhibited correlations of the speech tests with GDT and FMT, which was not the case in the Swiss group. Qualitatively, the results of comparisons between the Swiss and Czech populations were not influenced by presence of subjective tinnitus. CONCLUSION: The results support the notion of language-specific differences in speech comprehension which persists also in tinnitus subjects, and indicates different associations with the elementary measures of auditory temporal processing.

Limiar Diferencial de mascaramento e potencial evocado auditivo de tronco encefálico em adultos normo-ouvintes com zumbido / Masking Level Difference and Auditory Brainstem ResponseIn Normal Hearing Adults With Tinnitus / Umbral de enmascaramiento diferencial y potencial evocado auditivo del tronco encefálico en adultos con audición normal y tinnitus

Introdução: O zumbido é uma ilusão auditiva consciente, uma sensação sonora não relacionada com uma fonte externa de estimulação. Objetivos: Caracterizar a Acufenometria, Limiar Diferencial de Mascaramento, o questionário de qualidade de vida Inventário de Desvantagem do Zumbido e Potencial Auditivo de Tronco Encefálico em adultos normo-ouvintes com zumbido, com a finalidade de comparar seus achados. Método: Vinte indivíduos do sexo feminino e masculino, entre 20 e 60 anos de idade, normo-ouvintes com queixa de zumbido, foram submetidos ao Acufenometria, Limiar Diferencial de Mascaramento, Inventário de Desvantagem do Zumbido e Potencial Evocado Auditivo de Tronco Encefálico. Resultados: AAcufenometriarevelou que o pitch médio foi de 4,3 KHz à orelha direita e 4,6 KHz à orelha esquerda. O loudness médio foi de 21,7 dBNS à orelha direita e 23,5 dBNS à orelha esquerda. O Limiar Diferencial de Mascaramento médio mostrou-se alterado. O Inventário de Desvantagem do Zumbido médio correspondeu à classificação de grau leve. O Potencial Evocado Auditivo de Tronco Encefálico apresentou parâmetros dentro da normalidade bilateralmente. Conclusão: Constatou-se que adultos normo-ouvintes com queixa de zumbido apresentam zumbido de pitch agudo bilateral com discreto impacto na qualidade de vida, condução adequada das vias auditivas até o tronco encefálico e comprometimento na identificação de sons na presença de ruído, demonstrando que o zumbido pode ter repercussões nas habilidades auditivas centrais. (AU)

Introduction: Tinnitus is a conscious auditory illusion, a sound perception unrelated to any external stimulus source. Objectives: To characterize the Acuphenometry, Masking Level Difference, the quality of life questionnaire Tinnitus Handicap Inventory and Auditory Brainstem Response in normal hearing adults with tinnitus, with the purpose of comparing the findings. Method: Twenty female and male individuals, between 20 and 60 years of age, normal hearing with complaints of tinnitus, underwent Acuphenometry, Masking Level Difference, Tinnitus Handicap Inventory and Auditory Brainstem Response. Results: The Acuphenometry showed the average pitch was 4.3 KHz to the right ear and 4.6 KHz to the left ear. The average loudness was 21.7 dBSL to the right ear and 23.5 dBs to the left ear. The average Masking Level Difference was altered. The average Tinnitus Handicap Inventory corresponded to the classification of mild grade. Auditory Brainstem Response showed parameters within normal range bilaterally. Conclusion: It was found that normal hearing adults with tinnitus complaints have bilateral acute pitch tinnitus with a slight impact on quality of life, appropriate conduction of auditory pathways to the brainstem and impaired identification of sounds in the presence of noise, demonstrating that tinnitus can have repercussions on central auditory skills. (AU)

Introducción: El tinnitus es una ilusión auditiva consciente, una sensación de sonido no relacionada con una fuente externa de estimulación. Objetivos: Caracterizar la coincidencia de tono y volumen, el umbral de enmascaramiento diferencial, el inventario de minusvalía para acúfenos y el potencial auditivo del tronco encefálico en adultos normoyentes con acúfenos, con el fin de comparar sus hallazgos. Método:Veinte sujetos masculinos y femeninos, con edades entre 20 y 60 años, audición normal con tinnitus, fueron sometidos a acúfenos, Umbral de Enmascaramiento Diferencial, Inventario de Desventajas de Tinnitus y Potenciales Evocados Auditivos del Tronco Encefalico. Resultados: La combinación de tono y volumen reveló que el tono promedio era de 4,3 KHz en el oído derecho y de 4,6 KHz en el oído izquierdo. Mientras que el volumen medio fue de 21,7 dBNS para el oído derecho y de 23,5 dBNS para el oído izquierdo. Se modificó el umbral diferencial de enmascaramiento promedio. El Inventario de Desventajas de Tinnitus promedio correspondió a la clasificación de grado leve. El Potenciales Evocados Auditivos del Tronco Encefalico presentó parámetros dentro del rango normal bilateralmente. Conclusión:Se encontró que los adultos normooyentes con quejas de tinnitus presentan tinnitus de tono alto bilateral con leve impacto en la calidad de vida, conducción adecuada de las vías auditivas al tronco encefálico y deterioro en la identificación de sonidos en presencia de ruido, demostrando que Tinnitus puede tener repercusiones en las habilidades auditivas centrales. (AU)

The German hearing in noise test with a female talker: development and comparison with German male speech test.

PURPOSE: The aim of the study was to develop the German Hearing in Noise Test (HINT) with female speaker by fulfilling the recommendations by International Collegium of Rehabilitative Audiology (ICRA) for using a female speaker to create new multilingual speech tests and to determine norms and to compare these norms with German male speech tests-the male speakers HINT and the Oldenburg Sentence Test (OLSA). METHODS: The HINT with a female speaker consists of the same speech material as the male speaking HINT. After recording the speech material, 10 normal hearing subjects were included to determine the performance-intensity function (PI function). 24 subjects were part of the measurements to determine the norms and compare them with the norms of male HINT and OLSA. Comparably, adaptive, open-set methods under headphones (HINT) and sound field (OLSA) were used. RESULTS: Acoustic phonetic analysis demonstrated significant difference in mean fundamental frequency, its range and mean speaking rate between both HINT speakers. The calculated norms by three of the tested four conditions of the HINT with a female speaker are not significantly different from the norms with a male speaker. No significant effect of the speaker's gender of the first HINT measurement and no significant correlation between the threshold results of the HINT and the OLSA were determined. CONCLUSIONS: The Norms for German HINT with a female speaker are comparable to the norms of the HINT with a male speaker. The speech intelligibility score of the HINT does not depend on the speakers' gender despite significant difference of acoustic-phonetic parameters between the female and male HINT speaker's voice. Instead, the speech intelligibility rating must be seen as a function of the used speech material.

Effect of interaural electrode insertion depth difference and independent band selection on sentence recognition in noise and spatial release from masking in simulated bilateral cochlear implant listening.

PURPOSE: Inter-aural insertion depth difference (IEDD) in bilateral cochlear implant (BiCI) with continuous interleaved sampling (CIS) processing is known to reduce the recognition of speech in noise and spatial release from masking (SRM). However, the independent channel selection in the 'n-of-m' sound coding strategy might have a different effect on speech recognition and SRM when compared to the effects of IEDD in CIS-based findings. This study aimed to investigate the effect of bilateral 'n-of-m' processing strategy and interaural electrode insertion depth difference on speech recognition in noise and SRM under conditions that simulated bilateral cochlear implant listening. METHODS: Five young adults with normal hearing sensitivity participated in the study. The target sentences were spatially filtered to originate from 0° and the masker was spatially filtered at 0°, 15°, 37.5°, and 90° using the Oldenburg head-related transfer function database for behind the ear microphone. A 22-channel sine wave vocoder processing based on 'n-of-m' processing was applied to the spatialized target-masker mixture, in each ear. The perceptual experiment involved a test of speech recognition in noise under one co-located condition (target and masker at 0°) and three spatially separated conditions (target at 0°, masker at 15°, 37.5°, or 90° to the right ear). RESULTS: The results were analyzed using a three-way repeated measure analysis of variance (ANOVA). The effect of interaural insertion depth difference (F (2,8) = 3.145, p = 0.098, ɳ2 = 0.007) and spatial separation between target and masker (F (3,12) = 1.239, p = 0.339, ɳ2 = 0.004) on speech recognition in noise was not significant. CONCLUSIONS: Speech recognition in noise and SRM were not affected by IEDD ≤ 3 mm. Bilateral 'n-of-m' processing resulted in reduced speech recognition in noise and SRM.

Prediction of tinnitus masking benefit within a case series using a spiking neural network model.

Masking has been widely used as a tinnitus therapy, with large individual differences in its effectiveness. The basis of this variation is unknown. We examined individual tinnitus and psychological responses to three masking types, energetic masking (bilateral broadband static or rain noise [BBN]), informational masking (BBN with a notch at tinnitus pitch and 3-dimensional cues) and a masker combining both effects (BBN with spatial cues). Eleven participants with chronic tinnitus were followed for 12 months, each person used each masking approach for 3 months with a 1 month washout-baseline. The Tinnitus Functional Index (TFI), Tinnitus Rating Scales, Positive and Negative Affect Scale and Depression Anxiety Stress Scales, were measured every month of treatment. Electroencephalography (EEG) and psychoacoustic assessment was undertaken at baseline and following 3 months of each masking sound. The computational modeling of EEG data was based on the framework of brain-inspired Spiking Neural Network (SNN) architecture called NeuCube, designed for this study for mapping, learning, visualizing and classifying of brain activity patterns. EEG was related to clinically significant change in the TFI using the SNN model. The SNN framework was able to predict sound therapy responders (93% accuracy) from non-responders (100% accuracy) using baseline EEG recordings. The combination of energetic and informational masking was an effective treatment sound in more individuals than the other sounds used. Although the findings are promising, they are preliminary and require confirmation in independent and larger samples.

[Tinnitus - current trends and prospects]. / Sub''ektivnyi ushnoi shum: sovremennye tendentsii i perspektivy.

Tinnitus is described as the perception of any sound or noise in the absence of real acoustic stimulation. Numerous investigations have been tried for this potentially debilitating, heterogeneous symptom. The authors overview the current concepts of the management of the suffering tinnitus patients. The review contains modern views on the mechanisms of generation, etiology and pathogenesis of tinnitus. Classifications for practical management of patients are presented. The review of medical and physical methods of therapy and rehabilitation of a tinnitus patients given. The review includes the most clinically reliable and common methods of treatment and rehabilitation.

O uso do mascaramento contralateral na pesquisa do potencial evocado auditivo de tronco encefálico por condução aérea: revisão sistemática / Use of contralateral masking in air-conduction auditory brainstem response: systematic review

RESUMO Objetivos analisar criticamente a necessidade do uso do mascaramento contralateral na pesquisa do potencial evocado auditivo de tronco encefálico (PEATE) por condução aérea, na perda auditiva sensorioneural unilateral ou bilateral assimétrica, por meio de uma revisão sistemática da literatura. Estratégia de pesquisa foram consultadas as bases de dados eletrônicas PubMed/MEDLINE, LILACS, ADOLEC, IBECS, SciELO, Web of Science, Scopus e Embase, bem como os anais do Encontro Internacional de Audiologia e do Congresso Brasileiro de Fonoaudiologia, além das bases de instituições com pós-graduação em Fonoaudiologia, utilizando os descritores Evoked Potentials, Auditory, Brain Stem, Perceptual Masking e Hearing Loss, Sensorineural. Critérios de seleção foram selecionados os estudos com níveis de evidência de 1 a 5, publicados em português, inglês ou espanhol, até janeiro de 2018. Os artigos deveriam abordar a necessidade do uso do mascaramento contralateral na pesquisa do PEATE por condução aérea, em indivíduos com perda auditiva sensorioneural unilateral ou bilateral assimétrica. Resultados foram encontrados 334 estudos, sendo que oito artigos contemplaram os critérios preestabelecidos. Os estudos incluídos foram controversos quanto ao uso do mascaramento contralateral. Conclusão não existe um consenso quanto à necessidade do uso do mascaramento contralateral no PEATE por condução aérea, em indivíduos com perda auditiva sensorioneural unilateral. No entanto, a maioria dos estudos direcionou para a sua utilização na pesquisa do PEATE com estímulo clique em indivíduos com perda auditiva sensorioneural unilateral de graus severo e profundo.

ABSTRACT Purpose Critically analyze the need to use contralateral masking in the measurement of Auditory Brainstem Response (ABR) by air conduction on unilateral or bilateral asymmetric sensorineural hearing loss by means of a systematic literature review. Research strategies A search was conducted at the PubMed/MEDLINE, LILACS, ADOLEC, IBECS, SciELO, Web of Science, Scopus and Embase electronic databases, proceedings of the International Meeting of Audiology and the Brazilian Congress of Speech-language Pathology and Audiology, and bases of institutions with Graduate Studies Programs in Speech-language Pathology and Audiology, using the following descriptors: Evoked Potentials, Auditory, Brainstem, Perceptual Masking, Hearing Loss, and Sensorineural. Selection criteria Studies with levels of evidence from 1 to 5 published in Portuguese, English or Spanish until January 2018 were selected. The articles should address the need to use contralateral masking in the measurement of air-conduction ABR in individuals with unilateral or bilateral asymmetric sensorineural hearing loss. Results A total of 334 studies were found, and eight of them met the pre-established criteria. The studies included in the review were controversial as to the need for contralateral masking. Conclusion There is no consensus on the need to use contralateral masking in the measurement of ABR by air conduction in individuals with unilateral sensorineural hearing loss; however, most studies report the use of contralateral masking in the measurement of ABR with click stimulus in individuals with severe and profound unilateral sensorineural hearing loss.

Improving the soundscape quality of urban areas exposed to aircraft noise by adding moving water and vegetation.

Research shows that the sight of trees and the sound of moving water improve the soundscape quality of outdoor spaces exposed to road traffic noise. Effects are attributed to non-energetic masking, visual attentional distortion, and congruence between sight and hearing. However, there is no literature on such effects for aircraft noise. Aircraft noise varies from other traffic sources, i.e., in terms temporal variability, duration, and spectral composition, complicating the application of findings without further research. In a virtual reality experiment reported in this article, participants were asked to rate scenarios with different sound levels of flyovers, urban typologies, vegetation, and/ or water features. The results showed a significant improvement of the soundscape quality when (1) vegetation and (2) moving water were present, and especially when (3) vegetation and moving water were presented simultaneously, especially for residential areas in terms of the relative change. Moving water also reduced the saliency of aircraft flyovers significantly, changing the constellation of fore- and background sounds. Moving water raised the perceived audibility of the most dominant sound source too, which could be attributed to non-energetic masking effects. The findings of this study indicate that soundscape strategies can complement noise abatement in areas prone to aircraft noise.

Benefits of upgrading to the Nucleus® 6 sound processor for a wider clinical population.

OBJECTIVES: To determine whether a large clinical group of cochlear implant (CI) recipients demonstrated a difference in sentence recognition in noise when using their pre-upgrade sound processor compared to when using the Nucleus 6 processor, and to examine the impact of the following factors: implant type, sound processor type, age, or onset of hearing loss. METHODS: A file review of 154 CI recipients (aged 7-92 years old) who requested an upgrade to the Nucleus 6 sound processor at the Cochlear Care Centre Melbourne was conducted. 105 recipients had complete data collected according to the protocol. A repeated measures, single subject design was used. Performance of CI recipients was compared with their pre-upgrade sound processor versus the Nucleus 6 processor using the Australian Sentence Test in Noise. RESULTS: Group performance of CI recipients improved by 4.7 dB with the Nucleus 6 compared with the pre-upgrade sound processor. The benefit was not affected by pre-upgrade sound processor type or implant type (including older implant types and sound processors), age or onset of hearing loss (pre-lingual versus post-lingual). CONCLUSION: This study confirmed that a clinical group of CI recipients obtained a significant benefit when upgrading to the Nucleus 6 sound processor.

Task interference and distraction efficacy in patients with fibromyalgia: an experimental investigation.

Pain has the capacity to interfere with daily tasks. Although task interference by pain is largely unintentional, it can be controlled to a certain extent. Such top-down control over pain has been believed to be reduced in patients with fibromyalgia (FM). In this study, we investigated task interference and distraction efficacy in patients with FM and a matched healthy control group. Forty-nine patients with FM and 49 healthy volunteers performed as quickly as possible (1) a visual localization task in the presence of nonpainful vibrating or painful electric somatic stimuli, and (2) a somatosensory localization task (using nonpainful or painful stimuli). Participants reported on their experience of the somatic stimuli on some of the trials during both localisation tasks. Results indicated that pain interferes with performance of the visual task, in both patients with FM and healthy individuals. Furthermore, participants experienced the pain stimulus as less intense when directing attention away from the pain than when focusing on the pain. Overall, task performance of patients with FM was slower compared with the task performance in the healthy control group. In contrast to our hypotheses, patients with FM and healthy volunteers did not differ in the magnitude of the interference effect and distraction efficacy. In conclusion, current study provides support for contemporary theories claiming that attention modulates the experience of pain and vice versa. However, no evidence was found for an altered attentional processing of pain in patients with FM. Furthermore, results indicate that task interference and distraction efficacy are not just 2 sides of the same coin.

EEG measures of brain activity reveal that smoking-related images capture the attention of smokers outside of awareness.

The capture of attention by substance-related stimuli in dependent users is a major factor in the maintenance and/or cessation of substance use. The present study examined the automaticity of this process in smokers, as well as the effects of craving. Event-related potential (ERP) measures of spatial-attention allocation (N2pc) and extended target processing (SPCN) were isolated during an object-substitution masking (OSM) task that disrupted the perceptual visibility of smoking-related and office-related targets. Each participant completed two experimental sessions: one in which they were deprived of nicotine for a period of several hours prior to the session (craving), and one before which they were allowed to smoke (non-craving). Results were consistent with an account of automatic attentional capture by smoking-related images outside of awareness, with masked trials yielding a selective enhancement of the attention-sensitive N2pc in response to these images, but in the absence of a corresponding behavioral enhancement on those trials. Finally, the manipulation of craving appeared to increase the overall task demand, yielding an enhancement of the SPCN component across target type and masking conditions. Together, these results suggest that smoking-related visual stimuli in the environment can capture the attention of smokers outside of awareness, in what seems to be an automatic process.

Efeito da idade no processamento auditivo temporal: benefício da modulação do mascaramento e efeito do pós-mascaramento / Age effects in temporal auditory processing: modulation masking release and forward masking effect

RESUMO Objetivo Investigar o efeito da idade no benefício da modulação do ruído mascarante (masking release) e no pós-mascaramento ( forward masking). Métodos Participaram da pesquisa jovens (média de idade de 18 anos e quatro meses) e idosos (média de idade de 64 anos e três meses) falantes nativos do Português Brasileiro e com audição normal. Mediante uso de sentenças da versão brasileira do Hearing in Noise Test, determinou-se, para ambos os grupos, limiares de reconhecimento em presença de ruído estável e em presença de ruído modulado em amplitude (10 Hz). Para a pesquisa do pós-macaramento, foram determinados limiares auditivos em intervalos de tempo de 4, 16, 64 e 128 milissegundos, após a interrupção do ruído. Para avaliar a normalidade dos resultados obtidos, foi aplicado o teste de Shapiro-Wilk. Nas variáveis em que a normalidade foi indicada, aplicou-se o teste t de Student para amostras independentes e nos casos em que a normalidade não foi encontrada, aplicou-se o teste de Mann-Whitney. Foi considerado o nível de significância de 5% Resultados Observou-se o benefício da modulação do mascaramento nos dois grupos. Porém, esse benefício foi menor para o grupo dos idosos (p-valor < 0,001). Na investigação do pós-mascaramento, houve diferença significativa entre os grupos, na média de limiares em 128 milissegundos, após a cessação do ruído (p-valor = 0,006). Conclusão O estudo mostra efeito da idade no benefício de modulação do ruído mascarante e no pós-mascaramento.

ABSTRACT Purpose The purpose of this study was to investigate the age-related effects of modulation masking release and forward masking. Methods Ten younger (mean age of 18.4) and ten older (mean age of 64.3) adults participated in the study. All participants were native speakers of Brazilian Portuguese with normal hearing. Sentences of the Brazilian version of the Hearing in Noise Test were used to obtain speech recognition thresholds in the presence of steady-state noise and amplitude-modulated noise (10 Hz). To investigate forward masking, auditory thresholds were determined at time intervals of 4, 16, 64, and 128 ms after noise interruption. The Shapiro-Wilk test was applied to evaluate the normality of the results. In the variables in which normality was indicated, the Student's t-test was applied for the independent samples, and the Mann-Whitney test was applied in cases where normality was not found. A significance level of 5% was adopted for all statistical analyses. Results Modulation masking release was present in both groups; however, it was significantly smaller in the elderly group. As for forward masking investigation, higher thresholds were obtained after noise interruption, and improved as the time interval between noise and stimulus presentation increased. Forward masking was higher in the elderly group, whit higher thresholds for the time interval of 128 ms. Conclusion An age-related effect was identified on modulation masking release and forward masking.

Masking Level Difference em escolares: análises ambientais / Masking Level Difference in schoolchildren: environmental analysis

RESUMO Objetivo Pesquisar a habilidade auditiva de atenção seletiva na população escolar e identificar valores de referência para a faixa etária de sete a dez anos por meio do teste Masking Level Difference, além de identificar se a escolaridade dos pais, bem como a renda familiar, pode influenciar os resultados do teste. Método Participaram do estudo 31 escolares que se encaixaram nos critérios de elegibilidade da pesquisa, sendo 20 do gênero feminino e 11 do gênero masculino. Realizou-se anamnese para questionamento da renda familiar e escolaridade dos pais do escolar, inspeção visual do meato acústico externo, audiometria tonal liminar, logoaudiometria, medidas de imitância acústica, teste Dicótico de Dígitos e teste Masking Level Difference. Resultados A idade média dos indivíduos foi de 8,67 anos. Não foi observada diferença entre os gêneros e entre as idades avaliadas, no desempenho do MLD. Não houve relação entre a escolaridade dos pais e a renda mensal média com o desempenho das crianças no MLD. A média do MLD foi de 7,65 dB, com desvio padrão de 2,51 dB. Conclusão O Masking Level Difference em escolares de sete a dez anos é de 7,65 dB e independe do gênero, do nível de escolaridade dos pais ou da renda mensal média da família do escolar.

ABSTRACT Purpose To investigate the auditory ability of selective attention in the school population and to identify reference values to the age group from seven to ten years old through the Masking Level Difference Test, and to identify if the parents' schooling, as well as the family income can influence the test results. Methods Thirty-one schoolchildren who match the eligibility criteria attended the study, being 20 female and 11 male. An anamnesis was conducted to question the familiar income and the schooling of the children´s parents; we also performed visual inspection of the External Acoustic Meatus, Pure Tone Audiometry, Speech Audiometry, Acoustic Immittance Measures, Dichotic Digits Test and Masking Level Difference test. Results The mean age of the individuals was 8.67 years. There were no observed differences between genders and between the evaluated ages in the MLD performance. There was no relation between the parents' schooling and the average monthly income with the performance of the children in MLD Test. The MLD mean was 7.65 dB and standard deviation of 2.51 dB. Conclusion The Masking Level Difference in schoolchildren from seven to ten years old is 7.65 dB and is independent of the gender, parents' schooling and the average monthly income of the schoolchild.

Logistic regression analysis of factors influencing the effectiveness of intensive sound masking therapy in patients with tinnitus.

OBJECTIVES: To investigate factors influencing the effectiveness of intensive sound masking therapy on tinnitus using logistic regression analysis. DESIGN: The study used a retrospective cross-section analysis. PARTICIPANTS: 102 patients with tinnitus were recruited at the Sun Yat-sen Memorial Hospital of Sun Yat-sen University, China. INTERVENTION: Intensive sound masking therapy was used as an intervention approach for patients with tinnitus. PRIMARY AND SECONDARY OUTCOME MEASURES: Participants underwent audiological investigations and tinnitus pitch and loudness matching measurements, followed by intensive sound masking therapy. The Tinnitus Handicap Inventory (THI) was used as the outcome measure pre and post treatment. Multivariate logistic regression was performed to investigate the association of demographic and audiological factors with effective therapy. RESULTS: According to the THI score changes pre and post sound masking intervention, 51 participants were categorised into an effective group, the remaining 51 participants were placed in a non-effective group. Those in the effective group were significantly younger than those in the non-effective group (P=0.012). Significantly more participants had flat audiogram configurations in the effective group (P=0.04). Multivariable logistic regression analysis showed that age (OR=0.96, 95% CI 0.93 to 0.99, P=0.007), audiometric configuration (P=0.027) and THI score pre treatment (OR=1.04, 95% CI 1.02 to 1.07, P<0.001) were significantly associated with therapeutic effectiveness. Further analysis showed that patients with flat audiometric configurations were 5.45 times more likely to respond to intervention than those with high-frequency steeply sloping audiograms (OR=5.45, 95% CI 1.67 to 17.86, P=0.005). CONCLUSION: Audiometric configuration, age and THI scores appear to be predictive of the effectiveness of sound masking treatment. Gender, tinnitus characteristics and hearing threshold measures do not seem to be related to treatment effectiveness. A further randomised control study is needed to provide evidence of the effectiveness of prognostic factors in tinnitus interventions.

Normal behavioral responses to light and darkness and the pupillary light reflex are dependent upon the olivary pretectal nucleus in the diurnal Nile grass rat.

The olivary pretectal nucleus (OPT) is a midbrain structure that receives reciprocal bilateral retinal projections, is involved in the pupillary light reflex, and connects reciprocally with the intergeniculate leaflet (IGL), a retinorecipient brain region that mediates behavioral responses to light pulses (i.e., masking) in diurnal Nile grass rats. Here, we lesioned the OPT and evaluated behavioral responses in grass rats to various lighting conditions, as well as their anxiety-like responses to light exposure. While control grass rats remained diurnal, grass rats with OPT lesions exhibited a more night-active pattern under 12h:12h light-dark (LD) conditions. However, when placed in constant darkness, OPT-lesioned grass rats became more active during their subjective day, suggesting that an exaggerated masking response to light may be responsible for the effect of OPT lesions on locomotor activity in LD. To test this hypothesis, we presented dark and light pulses to controls and grass rats with OPT lesions; controls increased their activity in response to light, whereas those with OPT lesions significantly increased activity in response to darkness. Further, when placed in a 7-h ultradian LD cycle, animals with OPT lesions were more active during darkness than controls. OPT lesions also abolished the pupillary light reflex, but did not affect anxiety-like behaviors. Finally, in animals with OPT lesions, light did not induce Fos expression in the ventrolateral geniculate nucleus, as it did in controls. Altogether, these results suggest that masking responses to light and darkness are dependent upon nuclei within the subcortical visual shell in grass rats.

Quantification of masking risk in screening mammography with volumetric breast density maps.

PURPOSE: Fibroglandular tissue may mask breast cancers, thereby reducing the sensitivity of mammography. Here, we investigate methods for identification of women at high risk of a masked tumor, who could benefit from additional imaging. METHODS: The last negative screening mammograms of 111 women with interval cancer (IC) within 12 months after the examination and 1110 selected normal screening exams from women without cancer were used. From the mammograms, volumetric breast density maps were computed, which provide the dense tissue thickness for each pixel location. With these maps, three measurements were derived: (1) percent dense volume (PDV), (2) percent area where dense tissue thickness exceeds 1 cm (PDA), and (3) dense tissue masking model (DTMM). Breast density was scored by a breast radiologist using BI-RADS. Women with heterogeneously and extremely dense breasts were considered at high masking risk. For each masking measure, mammograms were divided into a high- and low-risk category such that the same proportion of the controls is at high masking risk as with BI-RADS. RESULTS: Of the women with IC, 66.1, 71.9, 69.2, and 63.0% were categorized to be at high masking risk with PDV, PDA, DTMM, and BI-RADS, respectively, against 38.5% of the controls. The proportion of IC at high masking risk is statistically significantly different between BI-RADS and PDA (p-value 0.022). Differences between BI-RADS and PDV, or BI-RADS and DTMM, are not statistically significant. CONCLUSION: Measures based on density maps, and in particular PDA, are promising tools to identify women at high risk for a masked cancer.

What's she doing in the kitchen? Context helps when actions are hard to recognize.

Specific spatial environments are often indicative of where certain actions may take place: In kitchens we prepare food, and in bathrooms we engage in personal hygiene, but not vice versa. In action recognition, contextual cues may constrain an observer's expectations toward actions that are more strongly associated with a particular context than others. Such cues should become particularly helpful when the action itself is difficult to recognize. However, to date only easily identifiable actions were investigated, and the effects of context on recognition were rather interfering than facilitatory. To test whether context also facilitates action recognition, we measured recognition performance of hardly identifiable actions that took place in compatible, incompatible, and neutral contextual settings. Action information was degraded by pixelizing the area of the object manipulation while the room in which the action took place remained fully visible. We found significantly higher accuracy for actions that took place in compatible compared to incompatible and neutral settings, indicating facilitation. Additionally, action recognition was slower in incompatible settings than in compatible and neutral settings, indicating interference. Together, our findings demonstrate that contextual information is effectively exploited during action observation, in particular when visual information about the action itself is sparse. Differential effects on speed and accuracy suggest that contexts modulate action recognition at different levels of processing. Our findings emphasize the importance of contextual information in comprehensive, ecologically valid models of action recognition.

Treatment of Tinnitus: A Scoping Review.

BACKGROUND: Tinnitus is a perception of an auditory sensation without the presence of an external sound. It has devastating impact on the quality of life and psychosocial aspect of the sufferer. Mechanisms of tinnitus not clear; however, its management include counselling, hearing aids, tinnitus masking, relaxation therapy, cognitive behaviour therapy and tinnitus retraining therapy. OBJECTIVE: To conduct a scoping review to explore the role of counselling, hearing aids, tinnitus masking, relaxation therapy, cognitive-behavioural therapy and tinnitus retraining therapy in India. To also provide an overview of efficacy of these approaches in tinnitus management. RESEARCH DESIGN: Scoping review. STUDY SAMPLE: Experimental studies, follow-up assessments, and reviews assessing tinnitus treatment approaches were identified as a result of an electronic database met search. RESULTS: The evidence suggests that all tinnitus management programs have their unique benefits in the treatment of tinnitus. Given the confounding variables that include length of therapy, tinnitus severity and subject population, the overall level of evidence is equivocal. Nonetheless, the efficacy of CBT appears reasonably established and combined approach (masking + counselling + attention diversion) appears to be most promising for audiologists for future tinnitus management. A common ground of therapeutic elements was established and evidence was found to be robust enough to guide clinical practice. CONCLUSION: The use of more robust methodology with well-defined control groups, as well as randomization of clinical trials in future studies would increase the quality of evidence in the study of tinnitus management. CLINICAL RECOMMENDATION: Combined therapies (masking + counselling + attention diversion) appear more appropriate in the treatment of tinnitus as the evidence is not sufficient to support a specific treatment method.

Effects of Tinnitus Retraining Therapy with Different Colours of Sound.

BACKGROUND: In Tinnitus Retraining Therapy (TRT) sound stimulation is conventionally performed with low-level broadband sound generators; since the patient has to receive it for many hours in a day, it is important that the sound is tolerable and agreeable to the patient. A clinical trial was undertaken to evaluate the effect of different colour sound generators on tinnitus. The colour of a sound refers to the power spectrum of the signal. The sound generators used in this study provide the option to choose the preferred or most acceptable sound among white, red and pink noise. METHODS AND FINDINGS: Changes in Tinnitus Handicap Inventory and Numeric Rating Scales were measured in 20 patients after 3 and 6 months following the fitting of ear-level multi-colour sound generators. The outcomes were compared to a similar group of 20 participants receiving the same management except through conventional white noise sound generators. Significant improvements were obtained in both groups following 3 and 6 months after fitting. No significant difference was found between the two groups using one or the other type of sound. Two thirds of the patient preferred white noise, making it the most appealing amongst the options. The rest of the patients indicated red noise as the preferred sound given that it reminded them of soothing noises like shower or rainfall. No one chose pink noise. CONCLUSIONS: TRT with different colour sound generators is effective in reducing the discomfort caused by tinnitus in normal hearing patients. Enabling the patients to choose their preferred sound after short trial periods achieved higher patient satisfaction. This practice could help tailor individualized treatment for each patient.

Enmascaramiento clínico: una revisión de la literatura / Clinical masking: a literature review

Son diversos los métodos planteados para aplicar enmascaramiento, de esta forma es necesario revisar la literatura en búsqueda de consenso. Se revisaron críticamente los métodos utilizados y recomendados por la literatura y sociedades internacionales, en torno a la aplicación de enmascaramiento. Se consultó entre agosto y noviembre de 2015 en PUBMED, SciELO y Google Scholar por estudios acerca de métodos de enmascaramiento utilizados en audiometría. También se revisaron las guías de organizaciones internacionales y lo publicado en libros relacionados con el área de audiología. El método de "La Meseta" es el más referenciado, siendo modificado posteriormente. Existen variaciones en criterios de atenuación interaural, necesidad de enmascaramiento, enmascaramiento inicial, incrementos para obtener la meseta y niveles del efecto de oclusión. Se concluye que la literatura muestra diferencias al momento de decidir cuándo enmascarar y cómo hacerlo. No obstante, se puede establecer criterios comunes en relación a los niveles de atenuación interaural, cuándo enmascarar, valores de efecto de oclusión y metodología. El método de "La Meseta" sigue siendo el más recomendado. La modificación realizada por Yacullo es la más referenciada y recomendada en la literatura actual.

Adequate use of masking is key in the correct diagnosis of hearing loss. Various methods are suggested regarding the application of clinical masking, hence the need to review literature in order to reach a consensus. To critically review the specialized literature and international societies' recommendations regarding clinical masking. From August to November 2015, PUBMED, SciELO and Google Scholar articles on clinical masking methods used in tonal audiometries were consulted, as well as international organization guidelines, and literature in the area of Audiology. Hood's plateau method, later revised, received the most references. The modified versions consider the number of increments needed to determine the true threshold, and the occlusion effect. Optimized methods show the variations regarding interaural attenuation, need for masking, initial masking level, increments to reach "The Plateau", and the occlusion effect. Literature shows differences regarding when and how to use masking; however, common criteria can be established with reference to the levels of interaural attenuation, when to use masking, occlusion effect values and methodology. The plateau method proposed by Hood is still the most recommended. Yacullo's optimization is currently the one with the most references and recommendations in specialized literature.