Tone Deafness in Music Does Not Preclude Distributional Learning of Nonnative Tonal Languages in Individuals With Congenital Amusia.

PURPOSE: Previous studies have shown that individuals with congenital amusia exhibit deficient pitch processing across music and language domains. This study investigated whether adult Chinese-speaking listeners with amusia were still able to learn Thai lexical tones based on stimulus frequency of statistical distribution via distributional learning, despite their degraded lexical tone perception. METHOD: Following a pretest-training-posttest design, 21 amusics and 23 typical, musically intact listeners were assigned into bimodal and unimodal distribution conditions. Listeners were asked to discriminate minimal pairs of Thai mid-level tone and falling tone superimposed on variable base syllables and uttered by different speakers. The perceptual accuracy for each test session and improvement from pretest to posttest were collected and analyzed between the two groups using generalized mixed-effects models. RESULTS: When discriminating Thai lexical tones, amusics were less accurate than typical listeners. Nonetheless, similarly to control listeners, perceptual gains from pretest to posttest were observed in bimodally rather than unimodally trained amusics, as evidenced by both trained and nontrained test words. CONCLUSIONS: Amusics are able to learn lexical tones in a second or foreign context of speech. This extends previous research by showing that amusics' distributional learning of linguistic pitch remains largely preserved despite their degraded pitch processing. It is thus likely that manifestations of amusia in speech could not result from their abnormal statistical learning mechanism. This study meanwhile provides a heuristic approach for future studies to apply this paradigm into amusics' treatment to mitigate their pitch-processing disorder.

Distributional learning of musical pitch despite tone deafness in individuals with congenital amusia.

Congenital amusia is an innate and lifelong deficit of music processing. This study investigated whether adult listeners with amusia were still able to learn pitch-related musical chords based on stimulus frequency of statistical distribution, i.e., via distributional learning. Following a pretest-training-posttest design, 18 amusics and 19 typical, musically intact listeners were assigned to bimodal and unimodal conditions that differed in distribution of the stimuli. Participants' task was to discriminate chord minimal pairs, which were transposed to a novel microtonal scale. Accuracy rates for each test session were collected and compared between the two groups using generalized mixed-effects models. Results showed that amusics were less accurate than typical listeners at all comparisons, thus corroborating previous findings. Importantly, amusics-like typical listeners-demonstrated perceptual gains from pretest to posttest in the bimodal condition (but not the unimodal condition). The findings reveal that amusics' distributional learning of music remains largely preserved despite their deficient music processing. Implications of the results for statistical learning and intervention programs to mitigate amusia are discussed.

Individuals with congenital amusia remember music they like.

Music is better recognized when it is liked. Does this association remain evident when music perception and memory are severely impaired, as in congenital amusia? We tested 11 amusic and 11 matched control participants, asking whether liking of a musical excerpt influences subsequent recognition. In an initial exposure phase, participants-unaware that their recognition would be tested subsequently-listened to 24 musical excerpts and judged how much they liked each excerpt. In the test phase that followed, participants rated whether they recognized the previously heard excerpts, which were intermixed with an equal number of foils matched for mode, tempo, and musical genre. As expected, recognition was in general impaired for amusic participants compared with control participants. For both groups, however, recognition was better for excerpts that were liked, and the liking enhancement did not differ between groups. These results contribute to a growing body of research that examines the complex interplay between emotions and cognitive processes. More specifically, they extend previous findings related to amusics' impairments to a new memory paradigm and suggest that (1) amusic individuals are sensitive to an aesthetic and subjective dimension of the music-listening experience, and (2) emotions can support memory processes even in a population with impaired music perception and memory.

Children with amblyaudia show less flexibility in auditory cortical entrainment to periodic non-speech sounds.

OBJECTIVE: We investigated auditory temporal processing in children with amblyaudia (AMB), a subtype of auditory processing disorder (APD), via cortical neural entrainment. DESIGN AND STUDY SAMPLES: Evoked responses were recorded to click-trains at slow vs. fast (8.5 vs. 14.9/s) rates in n = 14 children with AMB and n = 11 age-matched controls. Source and time-frequency analyses (TFA) decomposed EEGs into oscillations (reflecting neural entrainment) stemming from bilateral auditory cortex. RESULTS: Phase-locking strength in AMB depended critically on the speed of auditory stimuli. In contrast to age-matched peers, AMB responses were largely insensitive to rate manipulations. This rate resistance occurred regardless of the ear of presentation and in both cortical hemispheres. CONCLUSIONS: Children with AMB show less rate-related changes in auditory cortical entrainment. In addition to reduced capacity to integrate information between the ears, we identify more rigid tagging of external auditory stimuli. Our neurophysiological findings may account for domain-general temporal processing deficits commonly observed in AMB and related APDs behaviourally. More broadly, our findings may inform communication strategies and future rehabilitation programmes; increasing the rate of stimuli above a normal (slow) speech rate is likely to make stimulus processing more challenging for individuals with AMB/APD.

Subcortical and Cortical Electrophysiological Measures in Children With Speech-in-Noise Deficits Associated With Auditory Processing Disorders.

PURPOSE: The aim of this study was to analyze the subcortical and cortical auditory evoked potentials for speech stimuli in children with speech-in-noise (SIN) deficits associated with auditory processing disorder (APD) without any reading or language deficits. METHOD: The study included 20 children in the age range of 9-13 years. Ten children were recruited to the APD group; they had below-normal scores on the speech-perception-in-noise test and were diagnosed as having APD. The remaining 10 were typically developing (TD) children and were recruited to the TD group. Speech-evoked subcortical (brainstem) and cortical (auditory late latency) responses were recorded and compared across both groups. RESULTS: The results showed a statistically significant reduction in the amplitudes of the subcortical potentials (both for stimulus in quiet and in noise) and the magnitudes of the spectral components (fundamental frequency and the second formant) in children with SIN deficits in the APD group compared to the TD group. In addition, the APD group displayed enhanced amplitudes of the cortical potentials compared to the TD group. CONCLUSION: Children with SIN deficits associated with APD exhibited impaired coding/processing of the auditory information at the level of the brainstem and the auditory cortex. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.21357735.

Long Latency Auditory Evoked Responses in the Identification of Children With Central Auditory Processing Disorders: A Scoping Review.

PURPOSE: The long latency auditory evoked responses (LLAERs), originating in the auditory cortex, are often considered a biomarker for maturity in the central auditory system and may therefore be useful in the evaluation of children with central auditory processing disorder (CAPD). However, the characteristics of the LLAERs elicited in this population have not been widely described, and clinical applications remain unclear. The goal of this scoping review was to investigate if LLAERs can be used to identify children with CAPD. METHOD: A systematic search strategy was used to identify studies that analyzed the latencies and amplitudes of P1, N1, P2, and N2 waveforms of the LLAERs. The online databases, including Embase, Web of Science, MEDLINE, PubMed, ProQuest, and CINAHL, as well as the gray literature were searched for papers published in English and French between January 1980 and May 2021. RESULTS: Seventeen papers met the eligibility criteria and were included in the study. Four papers had pre- and posttraining study designs, and the remaining studies were cross-sectional. Several studies reported significant differences in LLAERs between children with CAPD and their normal-hearing peers, and the results tended toward longer latencies and smaller amplitudes regardless of LLAER waves considered. N1 and/or N2 results were most likely to reveal significant differences between children with CAPD and normal-hearing controls and could potentially be considered a biomarker for CAPD. CONCLUSIONS: It seems that LLAER assessments, especially waves N1 and N2, might assist in better identification of CAPD children. However, considering heterogeneity in the methodology among the included studies, the results should be interpreted with caution. Well-designed studies on children with confirmed CAPD using standard diagnostic and assessment protocols are suggested.

Improvisation is a novel tool to study musicality.

Humans spontaneously invent songs from an early age. Here, we exploit this natural inclination to probe implicit musical knowledge in 33 untrained and poor singers (amusia). Each sang 28 long improvisations as a response to a verbal prompt or a continuation of a melodic stem. To assess the extent to which each improvisation reflects tonality, which has been proposed to be a core organizational principle of musicality and which is present within most music traditions, we developed a new algorithm that compares a sung excerpt to a probability density function representing the tonal hierarchy of Western music. The results show signatures of tonality in both nonmusicians and individuals with congenital amusia, who have notorious difficulty performing musical tasks that require explicit responses and memory. The findings are a proof of concept that improvisation can serve as a novel, even enjoyable method for systematically measuring hidden aspects of musicality across the spectrum of musical ability.

Tonal structures benefit short-term memory for real music: Evidence from non-musicians and individuals with congenital amusia.

Congenital amusia is a neurodevelopmental disorder of music processing, which includes impaired pitch memory, associated to abnormalities in the right fronto-temporal network. Previous research has shown that tonal structures (as defined by the Western musical system) improve short-term memory performance for short tone sequences (in comparison to atonal versions) in non-musician listeners, but the tonal structures only benefited response times in amusic individuals. We here tested the potential benefit of tonal structures for short-term memory with more complex musical material. Congenital amusics and their matched non-musician controls were required to indicate whether two excerpts were the same or different. Results confirmed impaired performance of amusic individuals in this short-term memory task. However, most importantly, both groups of participants showed better memory performance for tonal material than for atonal material. These results revealed that even amusics' impaired short-term memory for pitch shows classical characteristics of short-term memory, that is the mnemonic benefit of structure in the to-be-memorized material. The findings show that amusic individuals have acquired some implicit knowledge of regularities of their culture, allowing for implicit processing of tonal structures, which benefits to memory even for complex material.

The relationship between acoustic and musical pitch processing in adolescents.

Amusia is defined as a difficulty processing the tonal pitch structure of music such that an individual cannot tell the difference between notes that are in-key and out-of-key. A fine-grained pitch discrimination deficit is often observed in people with amusia. It is possible that an intervention, early in development, could mitigate amusia; however, one challenge identifying amusia early in development is that identifying in- and out-of-key notes is a metacognitive task. Given the common co-occurrence of difficulties with pitch discrimination, it would be easier to identify amusia in developing children by using a pitch change detection task. The goal of this study was to explore the behavioural and neurophysiological profiles of adolescents with poor pitch processing (Poor PP) abilities compared with those with normal pitch processing (Normal PP) abilities. Neurophysiologically, the Poor PPs exhibited a similar event-related potential (ERP) profile to adult amusics during both acoustic and musical pitch discrimination tasks. That is, early ERPs (ERAN, MMN) were similar in Poor PPs compared with Normal PPs, whereas late positivities (P300, P600) were absent in Poor PPs, but present in Normal PPs. At the same time, behavioural data revealed a double dissociation between the abilities to detect a pitch deviant in acoustic and musical context, suggesting that about a third of the children would be missed by selecting a fine-grained acoustic pitch discrimination task to identify the presence of amusia in early childhood.

Individuals With Congenital Amusia Show Degraded Speech Perception but Preserved Statistical Learning for Tone Languages.

PURPOSE: Individuals with congenital amusia exhibit degraded speech perception. This study examined whether adult Chinese Mandarin listeners with amusia were still able to extract the statistical regularities of Mandarin speech sounds, despite their degraded speech perception. METHOD: Using the gating paradigm with monosyllabic syllable-tone words, we tested 19 Mandarin-speaking amusics and 19 musically intact controls. Listeners heard increasingly longer fragments of the acoustic signal across eight duration-blocked gates. The stimuli varied in syllable token frequency and syllable-tone co-occurrence probability. The correct syllable-tone word, correct syllable-only, correct tone-only, and correct syllable-incorrect tone responses were compared respectively between the two groups using mixed-effects models. RESULTS: Amusics were less accurate than controls in terms of the correct word, correct syllable-only, and correct tone-only responses. Amusics, however, showed consistent patterns of top-down processing, as indicated by more accurate responses to high-frequency syllables, high-probability tones, and tone errors all in manners similar to those of the control listeners. CONCLUSIONS: Amusics are able to learn syllable and tone statistical regularities from the language input. This extends previous work by showing that amusics can track phonological segment and pitch cues despite their degraded speech perception. The observed speech deficits in amusics are therefore not due to an abnormal statistical learning mechanism. These results support rehabilitation programs aimed at improving amusics' sensitivity to pitch.

Assessment of cochlear electrophysiology in typically developing children and children with auditory processing disorder.

OBJECTIVE: Children with auditory processing disorder (APD) are reported to have abnormal auditory brainstem responses (ABR) but little is understood about their cochlear integrity. Poor cochlear integrity can affect neural responses. In this study, cochlear and auditory brainstem integrity was investigated in children with APD. METHOD: Twenty children with APD, sixteen typically developing children and twenty adults participated in this study. Click evoked electrocochleography (ECochG) and ABRs were recorded from all the participants. Cochlear responses were analyzed using a) latency and amplitude of summating potential; action potential, b) transmission time between summating potential and action potential, c) summating potential/action potential amplitude ratio and d) action potential latency difference to condensation and rarefaction polarity. Amplitude in the ABR components was examined. RESULTS: Children with APD showed similar cochlear function to the typically developing children. There were no significant differences in wave I amplitude between children with APD and typically developing children. However, wave V amplitude was significantly reduced in children with APD compared to typically developing children. CONCLUSION: In the absence of any functional differences in the cochlea, children with APD can show poor amplitude in the later components of the ABR. The ABR anomalies observed in children with APD arise due to poor neural processing, possibly after the first auditory synapse.

Cortical auditory evoked potentials with different acoustic stimuli: Evidence of differences and similarities in coding in auditory processing disorders.

OBJECTIVES: The use of cortical auditory evoked potentials allows for the study of the processing of acoustic signals at the cortical level, an important step in the diagnostic evaluation process, and for the monitoring of the therapeutic process associated with auditory processing disorders (APD). The differences and similarities in the acoustic coding between different types of stimuli in the context of APD remain unknown to this date. METHODS: A total of 37 children aged between 7 and 11 years, with and without APDs (identified based on verbal and non-verbal tests), all with a suitable intelligence quotient with respect to their chronological age, were assessed. Components P1 and N1 were studied using verbal and non-verbal stimuli. RESULTS: The comparison between stimuli in each group revealed that the control group had higher latency and amplitude values for speech stimuli, except for the P1 amplitude, while the group with APDs had different results with respect to the amplitudes of P1 and N1, yielding higher values for speech sounds. The differences between the groups varied according to the type of stimulus: the difference was in amplitude for the verbal stimulus and latency for the non-verbal stimulus. CONCLUSION: The records of components P1 and N1 revealed that the children with APDs performed the coding underlying the detection and identification of acoustic signals, whether verbal and non-verbal, according to a different pattern than the children in the control group.

Role of orff music therapy in improving auditory processing skills in children with intellectual disability.

BACKGROUND: Orff Music Therapy improves auditory processing, language, and cognitive functions in children who have Intellectual Disability (ID). AIMS: In literature, there are no studies from the auditory processing skills reviewing perspective. The current study examined the role of Orff Music Therapy in terms of auditory processing skills of children who have ID. METHOD: Twenty-nine children who have ID were subjected in a 6-week Orff Music Therapy program. RESULTS: The mean musical assessment scores improved after Orff Music Therapy. The total Listening Inventory (TLI) scores before Orff Music Therapy were considered to be risky above the cut-off level for children who have ID. The criterion cutoff scores show if the child's behaviors may indicate a disorder or dysfunction. The TLI scores were reduced after Orff Music Therapy, which means there was an improvement in auditory processing skills. CONCLUSION: Auditory processing skills are essential for children who have ID. If a child who has ID has been identified as having auditory processing disorder (APD), there is a need for a proven therapeutic approach, like Orff Music Therapy. It has been considered that ID and APD can be linked in the same category of neurodevelopmental disorders.

Dichotic listening deficits in amblyaudia are characterized by aberrant neural oscillations in auditory cortex.

OBJECTIVE: Children diagnosed with auditory processing disorder (APD) show deficits in processing complex sounds that are associated with difficulties in higher-order language, learning, cognitive, and communicative functions. Amblyaudia (AMB) is a subcategory of APD characterized by abnormally large ear asymmetries in dichotic listening tasks. METHODS: Here, we examined frequency-specific neural oscillations and functional connectivity via high-density electroencephalography (EEG) in children with and without AMB during passive listening of nonspeech stimuli. RESULTS: Time-frequency maps of these "brain rhythms" revealed stronger phase-locked beta-gamma (~35 Hz) oscillations in AMB participants within bilateral auditory cortex for sounds presented to the right ear, suggesting a hypersynchronization and imbalance of auditory neural activity. Brain-behavior correlations revealed neural asymmetries in cortical responses predicted the larger than normal right-ear advantage seen in participants with AMB. Additionally, we found weaker functional connectivity in the AMB group from right to left auditory cortex, despite their stronger neural responses overall. CONCLUSION: Our results reveal abnormally large auditory sensory encoding and an imbalance in communication between cerebral hemispheres (ipsi- to -contralateral signaling) in AMB. SIGNIFICANCE: These neurophysiological changes might lead to the functionally poorer behavioral capacity to integrate information between the two ears in children with AMB.

Individuals with congenital amusia do not show context-dependent perception of tonal categories.

Perceptual adaptation is an active cognitive process where listeners re-analyse speech categories based on new contexts/situations/talkers. It involves top-down influences from higher cortical levels on lower-level auditory processes. Individuals with congenital amusia have impaired pitch processing with reduced connectivity between frontal and temporal regions. This study examined whether deficits in amusia would lead to impaired perceptual adaptation in lexical tone perception. Thirteen Mandarin-speaking amusics and 13 controls identified the category of target tones on an 8-step continuum ranging from rising to high-level, either in isolation or in a high-/low-pitched context. For tones with no context, amusics exhibited reduced categorical perception than controls. While controls' lexical tone categorization demonstrated a significant context effect due to perceptual adaptation, amusics showed similar categorization patterns across both contexts. These findings suggest that congenital amusia impacts the extraction of context-dependent tonal categories in speech perception, indicating that perceptual adaptation may depend on listeners' perceptual acuity.

Combination of absolute pitch and tone language experience enhances lexical tone perception.

Absolute pitch (AP), a unique ability to name or produce pitch without any reference, is known to be influenced by genetic and cultural factors. AP and tone language experience are both known to promote lexical tone perception. However, the effects of the combination of AP and tone language experience on lexical tone perception are currently not known. In the current study, using behavioral (Categorical Perception) and electrophysiological (Frequency Following Response) measures, we investigated the effect of the combination of AP and tone language experience on lexical tone perception. We found that the Cantonese speakers with AP outperformed the Cantonese speakers without AP on Categorical Perception and Frequency Following Responses of lexical tones, suggesting an additive effect due to the combination of AP and tone language experience. These findings suggest a role of basic sensory pre-attentive auditory processes towards pitch encoding in AP. Further, these findings imply a common mechanism underlying pitch encoding in AP and tone language perception.

Comparison of machine learning models to classify Auditory Brainstem Responses recorded from children with Auditory Processing Disorder.

INTRODUCTION: Auditory brainstem responses (ABRs) offer a unique opportunity to assess the neural integrity of the peripheral auditory nervous system in individuals presenting with listening difficulties. ABRs are typically recorded and analyzed by an audiologist who manually measures the timing and quality of the waveforms. The interpretation of ABRs requires considerable experience and training, and inappropriate interpretation can lead to incorrect judgments about the integrity of the system. Machine learning (ML) techniques may be a suitable approach to automate ABR interpretation and reduce human error. OBJECTIVES: The main objective of this paper was to identify a suitable ML technique to automate the analysis of ABR responses recorded as a part of the electrophysiological testing in the Auditory Processing Disorder clinical test battery. METHODS: ABR responses recorded during routine clinical assessment from 136 children being evaluated for auditory processing difficulties were analyzed using several common ML algorithms: Support Vector Machines (SVM), Random Forests (RF), Decision Trees (DT), Gradient Boosting (GB), Extreme Gradient Boosting (Xgboost), and Neural Networks (NN). A variety of signal feature extraction techniques were used to extract features from the ABR waveforms as inputs to the ML algorithms. Statistical significance testing and confusion matrices were used to identify the most robust model capable of accurately identifying neurological abnormalities present in ABRs. RESULTS: Clinically significant features in the time-frequency representation of the signal were identified. The ML model trained using the Xgboost algorithm was identified as the most robust model with an accuracy of 92% compared to other models. CONCLUSION: The findings of the present study demonstrate that it is possible to develop accurate ML models to automate the process of analyzing ABR waveforms recorded at suprathreshold levels. There is currently no ML-based application to screen children with listening difficulties. Therefore, it is expected that this work will be translated into an evaluation tool that can be used by audiologists in the clinic. Furthermore, this work may aid future researchers in exploring ML paradigms to improve clinical test batteries used by audiologists in achieving accurate diagnoses.

Applicability of the real ear measurement for audiological intervention of tinnitus / Aplicabilidade das medidas da orelha real na intervenção audiológica do zumbido

Abstract Introduction Tinnitus is present in a large part of chronic health complaints, and it is considered a public health problem injurious to the individual's quality of life. Considering the increase of the world population associated with an increase of life expectancy, tinnitus remains a cause for medical concern, since during aging the occurrence of auditory impairments due to the deterioration of the peripheral auditory structures and central impairs the quality of life. Objective The aim of the present study was to analyze the applicability of real ear measurements for audiological intervention of tinnitus through specific evaluation, selection, verification and validation of the hearing aids combined with the sound generator. Methods Forty individuals of both genders with hearing loss and tinnitus complaints were deemed eligible to compose the sample. They were enrolled according to clinical symptoms and submitted to the following procedures: anamnesis and previous complaint history, high frequency audiometry, immittanciometry and acuphenometry with the research of psychoacoustic thresholds of pitch, loudness and minimum masking threshold, sound generator, in addition to the application of the Tinnitus Handicap Inventory and Visual Analog Scale tools. The entire sample was adapted with Siemens hearing aids and a sound generator, participated in a counseling session with support of digital material and evaluated in two situations: Initial Assessment (before the hearing aids and sound generator adaptation) and Final Assessment (6 months, after adaptation). The statistical analyzes were descriptive and inferential, adopted a significance level of 5% and the T-Paired Test and the Spearman Correlation test were performed. Results The results showed that there was a benefit with the use of hearing aids combined with a sound generator from the statistically significant values and strong correlations between the sound generator verification data regarding acuphenometry and the nuisance/severity questionnaires. Regarding the verification of the sound generator, it is important to highlight that the entire sample selected the effective acoustic stimulation based on the comfort levels, which was proved in the present study to be a sufficient intensity for positive prognosis, whereas the users' noises were found below the psychoacoustic thresholds of acuphenometry. Conclusion The present study concluded that the audiological intervention with any level of sound stimulus is enough to obtain a positive prognosis in the medium term. Data that specifies that the verification of sound generator was effective at the real ear measurements are important in the evaluation and intervention of the complaint. In addition, it points out that the greater the tinnitus perception, the greater its severity, and the greater the nuisance, the higher the psychoacoustics thresholds of frequency and the minimum threshold of masking.

Resumo Introdução O zumbido está presente em grande parte das queixas crônicas de saúde, é considerado um problema de saúde pública, prejudicial à qualidade de vida do indivíduo. Considerando o aumento da população mundial associado ao aumento da expectativa de vida, a tendência é que o zumbido permaneça como um motivo de preocupação, uma vez que com a idade a ocorrência de prejuízos auditivos decorrentes da deterioração das estruturas auditivas periféricas e centrais ocasiona grande impacto negativo na qualidade de vida. Objetivo Analisar a aplicabilidade das medidas da orelha real para a intervenção audiológica do zumbido através de avaliação específica, seleção, verificação e validação do aparelho de amplificação sonora individual combinada ao gerador de som. Método Quarenta indivíduos de ambos os sexos com perda auditiva e queixa de zumbido foram considerados elegíveis para compor a amostra. Eles foram atendidos conforme a demanda clínica e submetidos aos seguintes procedimentos: anamnese e história pregressa da queixa, audiometria de alta frequência, imitanciometria e acufenometria com pesquisa dos limiares psicoacústicos de pitch, loudness e limiar mínimo de mascaramento, gerador de som, além da aplicação das ferramentas tinnitus handicap inventory e escala visual analógica. Toda a amostra recebeu aparelho de amplificação sonora individual e gerador de som, ambos da marca Siemens, participaram de uma sessão de aconselhamento com apoio de material digital e foram avaliados em duas situações: Avaliação inicial (antes da adaptação dos aparelhos de amplificação sonora individual e gerador de som) e Avaliação final (6 meses após a adaptação). As análises estatísticas foram descritivas e inferenciais, adotou-se um nível de significância de 5% com a realização do teste t pareado e o teste de correlação de Spearman. Resultados Os resultados mostraram que houve benefício com o uso de aparelho de amplificação sonora individual combinado ao gerador de som com base nos valores estatisticamente significantes e fortes correlações entre os dados da verificação do gerador de som em relação à acufenometria e os questionários de incômodo/gravidade. Em relação à verificação do gerador de som, é importante destacar que toda a amostra selecionou a estimulação acústica efetiva baseada nos níveis de conforto e no presente estudo demonstraram ser de intensidade suficiente para o prognóstico positivo, enquanto que os ruídos dos usuários estavam abaixo dos limiares psicoacústicos da acufenometria. Conclusão A intervenção audiológica com qualquer nível de estímulo sonoro é suficiente para obter um prognóstico positivo em médio prazo. Os dados que demonstram que a verificação do gerador de som foi efetiva nas medidas da orelha real são importantes na avaliação e intervenção da queixa. Além disso, mostram que quanto maior a percepção do zumbido, maior a sua gravidade; e quanto maior o incômodo, maiores os limiares de frequência psicoacústica e o limiar mínimo de mascaramento.

Association between prism adaptation and auditory cues on spatial navigation in individuals with unilateral neglect.

BACKGROUND: Unilateral neglect is common among right-hemispheric stroke individuals and also concerns the auditory modality. Prism adaptation can improve auditory extinction during a dichotic listening task, but its effect during an ecological task has not been studied. OBJECTIVE: The main objective was to evaluate whether lateralized cueing before and after prism adaptation improved virtual spatial navigation of stroke individuals with visual and auditory unilateral neglect. Secondary objectives were to assess spatial memory and obtain a better understanding of the mechanism of the cueing treatment by using an eye-tracker. METHODS: We included 22 stroke individuals with left visual and auditory neglect, 14 individuals without neglect, and 12 healthy controls. After a familiarization task, participants underwent 3 evaluation sessions. Participants were first passively shown a path that they had then to actively reproduce by using a joystick. A path with lateralized beeping sounds indicating direction and a path without any sounds were followed in a randomized order. After prism adaptation, the participants followed a third path with lateralized beeping sounds. The time of navigation and number of trajectory mistakes were recorded. After navigation, spatial memory was assessed. Additionally, an eye-tracker was used during the navigation period. RESULTS: The navigational performance of participants with neglect was significantly better with than without auditory cues, especially after prism adaptation. With auditory cues, participants without neglect reached the navigational performance of healthy controls. The spatial memory of individuals with neglect was significantly lower with auditory cues. Eye-tracking analyses showed that participants with neglect made more saccades and looked longer at the right-square angles in the absence of auditory cues. CONCLUSIONS: This study demonstrates the positive effect of auditory cues in virtual spatial navigation of individuals with visual and auditory neglect and the potentiation of the help of cues after prism adaptation.