From Healthy Hearing to Healthy Living: A Holistic Approach.

The negative consequences of hearing loss go beyond difficulties with communication, having been identified as a major risk factor for injury and illness, social isolation, depression, overall quality of life, and mortality. Hearing loss affects the individual, their families and social network, the broader healthcare system, and the economy. Recognizing that there are multifactorial considerations associated with understanding and mitigating the consequences of hearing loss, great benefit is gained by taking an interdisciplinary, interprofessional, holistic approach to studying hearing loss in research and in developing holistic clinical strategies targeted at prevention, diagnosis, treatment, and social policy. Within the framework of this supplement focused on the role of ecological validity in hearing-related research and application, this article provides a general commentary on how ecological validity can be considered with a holistic perspective in mind. First, we consider how a holistic approach can be applied within clinical practice, how it can be applied to laboratory-based research to increase ecological validity, and how it can be applied to professional training and education within both research and clinical domains. Second, we discuss the associations between hearing loss and dementia as an example of how these holistic principles can be applied. The main goal of highlighting these approaches and principles is to motivate a change in the narrative about hearing loss from a focus in research and application on promoting healthy hearing, to a focus on living well.

Demonstrating the potential for dynamic auditory stimulation to contribute to motion sickness.

Auditory cues can create the illusion of self-motion (vection) in the absence of visual or physical stimulation. The present study aimed to determine whether auditory cues alone can also elicit motion sickness and how auditory cues contribute to motion sickness when added to visual motion stimuli. Twenty participants were seated in front of a curved projection display and were exposed to a virtual scene that constantly rotated around the participant's vertical axis. The virtual scene contained either visual-only, auditory-only, or a combination of corresponding visual and auditory cues. All participants performed all three conditions in a counterbalanced order. Participants tilted their heads alternately towards the right or left shoulder in all conditions during stimulus exposure in order to create pseudo-Coriolis effects and to maximize the likelihood for motion sickness. Measurements of motion sickness (onset, severity), vection (latency, strength, duration), and postural steadiness (center of pressure) were recorded. Results showed that adding auditory cues to the visual stimuli did not, on average, affect motion sickness and postural steadiness, but it did reduce vection onset times and increased vection strength compared to pure visual or pure auditory stimulation. Eighteen of the 20 participants reported at least slight motion sickness in the two conditions including visual stimuli. More interestingly, six participants also reported slight motion sickness during pure auditory stimulation and two of the six participants stopped the pure auditory test session due to motion sickness. The present study is the first to demonstrate that motion sickness may be caused by pure auditory stimulation, which we refer to as "auditorily induced motion sickness".

Combined effects of auditory and visual cues on the perception of vection.

Vection is the illusion of self-motion in the absence of real physical movement. The aim of the present study was to analyze how multisensory inputs (visual and auditory) contribute to the perception of vection. Participants were seated in a stationary position in front of a large, curved projection display and were exposed to a virtual scene that constantly rotated around the yaw-axis, simulating a 360° rotation. The virtual scene contained either only visual, only auditory, or a combination of visual and auditory cues. Additionally, simulated rotation speed (90°/s vs. 60°/s) and the number of sound sources (1 vs. 3) were varied for all three stimulus conditions. All participants were exposed to every condition in a randomized order. Data specific to vection latency, vection strength, the severity of motion sickness (MS), and postural steadiness were collected. Results revealed reduced vection onset latencies and increased vection strength when auditory cues were added to the visual stimuli, whereas MS and postural steadiness were not affected by the presence of auditory cues. Half of the participants reported experiencing auditorily induced vection, although the sensation was rather weak and less robust than visually induced vection. Results demonstrate that the combination of visual and auditory cues can enhance the sensation of vection.

Neural mechanisms for the effect of prior knowledge on audiovisual integration.

Converging evidence indicates that prior knowledge plays an important role in multisensory integration. However, the neural mechanisms underlying the processes with which prior knowledge is integrated with current sensory information remains unknown. In this study, we measured event-related potentials (ERPs) while manipulating prior knowledge using a novel visual letter recognition task in which auditory information was always presented simultaneously. The color of the letters was assigned to a particular probability of being associated with audiovisual congruency (e.g., green=high probability (HP) and blue=low probability (LP)). Results demonstrate that this prior began affecting reaction times to the congruent audiovisual stimuli at about the 900th trial. Consequently, the ERP data was analyzed in two phases: the "early phase" (trial 900). The effects of prior knowledge were revealed through difference waveforms generated by subtracting the ERPs for the congruent audiovisual stimuli in the LP condition from those in the HP condition. A frontal-central probability effect (90-120 ms) was observed in the early phase. A right parietal-occipital probability effect (40-96 ms) and a frontal-central probability effect (170-200 ms) were observed in the late phase. The results suggest that during the initial acquisition of the knowledge about the probability of congruency, the brain assigned more attention to audiovisual stimuli for the LP condition. Following the acquisition of this prior knowledge, it was then used during early stages of visual processing and modulated the activity of multisensory cortical areas.

Imagined self-motion differs from perceived self-motion: evidence from a novel continuous pointing method.

BACKGROUND: The extent to which actual movements and imagined movements maintain a shared internal representation has been a matter of much scientific debate. Of the studies examining such questions, few have directly compared actual full-body movements to imagined movements through space. Here we used a novel continuous pointing method to a) provide a more detailed characterization of self-motion perception during actual walking and b) compare the pattern of responding during actual walking to that which occurs during imagined walking. METHODOLOGY/PRINCIPAL FINDINGS: This continuous pointing method requires participants to view a target and continuously point towards it as they walk, or imagine walking past it along a straight, forward trajectory. By measuring changes in the pointing direction of the arm, we were able to determine participants' perceived/imagined location at each moment during the trajectory and, hence, perceived/imagined self-velocity during the entire movement. The specific pattern of pointing behaviour that was revealed during sighted walking was also observed during blind walking. Specifically, a peak in arm azimuth velocity was observed upon target passage and a strong correlation was observed between arm azimuth velocity and pointing elevation. Importantly, this characteristic pattern of pointing was not consistently observed during imagined self-motion. CONCLUSIONS/SIGNIFICANCE: Overall, the spatial updating processes that occur during actual self-motion were not evidenced during imagined movement. Because of the rich description of self-motion perception afforded by continuous pointing, this method is expected to have significant implications for several research areas, including those related to motor imagery and spatial cognition and to applied fields for which mental practice techniques are common (e.g. rehabilitation and athletics).