A Clinically Viable Medial Olivocochlear Reflex Assay Using Transient-Evoked Otoacoustic Emissions.

OBJECTIVES: The contralateral medial olivocochlear reflex (MOCR) strength may indicate various auditory conditions in humans, but a clinically viable assay and equipment are needed for quick, accurate, and reliable measurements. The first experiment compared an earlier version of the assay, which used a nonlinear-mode chirp stimulus, with a new assay using a linear-mode click stimulus, designed to give reliable MOCR measurements in most normal-hearing ears. The second experiment extended the improved assay on a purpose-built binaural hardware platform that used forward-pressure level (FPL) calibration for both the stimulus and the contralateral MOCR elicitor. DESIGN: Transient-evoked otoacoustic emission (TEOAE) tests were measured with and without a 60-dB SPL MOCR-evoking contralateral broadband noise. The normalized MOCR strength (MOCR%) was derived from the TEOAE responses for each trial pair using the complex pressure difference weighted by the TEOAE magnitude. Experiment 1 compared MOCR% within-subject and across-day using two TEOAE stimuli: nonlinear-mode chirps (50 dB SPL, bandpass 1-5 kHz, 14 ms window delayed by 2 ms) and linear-mode clicks (50 dB SPL, bandpass 0.5-2.5 kHz, 13 ms window delayed by 5 ms). TEOAE responses were analyzed in the 0.5 to 2.5 kHz band. Thirty adult participants with normal hearing (30 ears) completed the study. The TEOAE stimulus was calibrated in situ using spectral flattening, and the contralateral noise was calibrated in a coupler. Twelve TEOAE trial pairs were collected for each participant and condition. Experiment 2 used a purpose-built binaural system. The TEOAE stimuli were linear-mode clicks (50 dB SPL, bandpass 1-3 kHz, 13 ms window delayed by 5 ms), analyzed in the 1 to 3 kHz band over ~12 trial pairs. After a probe refit, an additional trial pair was collected for the two early-stopping signal-to-noise ratio criteria (15 and 20 dB). They were evaluated for single-trial reliability and test time. Nineteen adult participants with normal hearing (38 ears) completed the study. The TEOAE clicks and contralateral elicitor noise were calibrated in situ using FPL and delivered with automated timing. RESULTS: MOCR% for linear-mode clicks was distinguishable from measurement variability in 98% to 100% of participants' ears (both experiments), compared with only 73% for the nonlinear-mode chirp (experiment 1). MOCR detectability was assessed using the MOCR% across-subject/within-subject variance ratio. The ratio in experiment 1 for linear-mode clicks was higher (8.0) than for nonlinear-mode chirps (6.4). The ratio for linear-mode clicks (8.9) in experiment 2 was slightly higher than for the comparable linear-mode stimulus (8.0) in experiment 1. TEOAEs showed excellent reliability with high signal-to-noise ratios in both experiments, but reliability was higher for linear-mode clicks than nonlinear-mode chirps. MOCR reliability for the two stimuli was comparable. The FPL pressure response retest reliability derived from the SPL at the microphone was higher than the SPL retest reliability across 0.4 to 8 kHz. Stable results required 2 to 3 trial pairs for the linear-mode click (experiments 1 and 2) and three for the nonlinear-mode chirp (experiment 1), taking around 2 min on average. CONCLUSIONS: The linear-mode click assay produced measurable, reliable, and stable TEOAE and MOCR results on both hardware platforms in around 2 min per ear. The stimulus design and response window ensured that any stimulus artifact in linear mode was unlikely to confound the results. The refined assay is ready to produce high-quality data quickly for clinical and field studies to develop population norms, recognize diagnostic patterns, and determine risk profiles.

Deep Learning Models for Predicting Hearing Thresholds Based on Swept-Tone Stimulus-Frequency Otoacoustic Emissions.

OBJECTIVES: This study aims to develop deep learning (DL) models for the quantitative prediction of hearing thresholds based on stimulus-frequency otoacoustic emissions (SFOAEs) evoked by swept tones. DESIGN: A total of 174 ears with normal hearing and 388 ears with sensorineural hearing loss were studied. SFOAEs in the 0.3 to 4.3 kHz frequency range were recorded using linearly swept tones at a rate of 2 Hz/msec, with stimulus level changing from 40 to 60 dB SPL in 10 dB steps. Four DL models were used to predict hearing thresholds at octave frequencies from 0.5 to 4 kHz. The models-a conventional convolutional neural network (CNN), a hybrid CNN-k-nearest neighbor (KNN), a hybrid CNN-support vector machine (SVM), and a hybrid CNN-random forest (RF)-were individually built for each frequency. The input to the DL models was the measured raw SFOAE amplitude spectra and their corresponding signal to noise ratio spectra. All DL models shared a CNN-based feature self-extractor. They differed in that the conventional CNN utilized a fully connected layer to make the final regression decision, whereas the hybrid CNN-KNN, CNN-SVM, and CNN-RF models were designed by replacing the last fully connected layer of CNN model with a traditional machine learning (ML) regressor, that is, KNN, SVM, and RF, respectively. The model performance was evaluated using mean absolute error and SE averaged over 20 repetitions of 5 × 5 fold nested cross-validation. The performance of the proposed DL models was compared with two types of traditional ML models. RESULTS: The proposed SFOAE-based DL models resulted in an optimal mean absolute error of 5.98, 5.22, 5.51, and 6.06 dB at 0.5, 1, 2, and 4 kHz, respectively, superior to that obtained by the traditional ML models. The produced SEs were 8.55, 7.27, 7.58, and 7.95 dB at 0.5, 1, 2, and 4 kHz, respectively. All the DL models outperformed any of the traditional ML models. CONCLUSIONS: The proposed swept-tone SFOAE-based DL models were capable of quantitatively predicting hearing thresholds with satisfactory performance. With DL techniques, the underlying relationship between SFOAEs and hearing thresholds at disparate frequencies was explored and captured, potentially improving the diagnostic value of SFOAEs.

Speech Perception in Noise and Medial Olivocochlear Reflex: Effects of Age, Speech Stimulus, and Response-Related Variables.

PURPOSE: The role of the medial olivocochlear system in speech perception in noise has been debated over the years, with studies showing mixed results. One possible reason for this could be the dependence of this relationship on the parameters used in assessing the speech perception ability (age, stimulus, and response-related variables). METHODS: The current study assessed the influence of the type of speech stimuli (monosyllables, words, and sentences), the signal-to-noise ratio (+5, 0, -5, and -10 dB), the metric used to quantify the speech perception ability (percent-correct, SNR-50, and slope of the psychometric function) and age (young vs old) on the relationship between medial olivocochlear reflex (quantified by contralateral inhibition of transient evoked otoacoustic emissions) and speech perception in noise. RESULTS: A linear mixed-effects model revealed no significant contributions of the medial olivocochlear reflex to speech perception in noise. CONCLUSION: The results suggest that there was no evidence of any modulatory influence of the indirectly measured medial olivocochlear reflex strength on speech perception in noise.

The effects of broadband elicitor duration on a psychoacoustic measure of cochlear gain reduction.

Physiological and psychoacoustic studies of the medial olivocochlear reflex (MOCR) in humans have often relied on long duration elicitors (>100 ms). This is largely due to previous research using otoacoustic emissions (OAEs) that found multiple MOCR time constants, including time constants in the 100s of milliseconds, when elicited by broadband noise. However, the effect of the duration of a broadband noise elicitor on similar psychoacoustic tasks is currently unknown. The current study measured the effects of ipsilateral broadband noise elicitor duration on psychoacoustic gain reduction estimated from a forward-masking paradigm. Analysis showed that both masker type and elicitor duration were significant main effects, but no interaction was found. Gain reduction time constants were ∼46 ms for the masker present condition and ∼78 ms for the masker absent condition (ranging from ∼29 to 172 ms), both similar to the fast time constants reported in the OAE literature (70-100 ms). Maximum gain reduction was seen for elicitor durations of ∼200 ms. This is longer than the 50-ms duration which was found to produce maximum gain reduction with a tonal on-frequency elicitor. Future studies of gain reduction may use 150-200 ms broadband elicitors to maximally or near-maximally stimulate the MOCR.

Using Stapes Velocity to Estimate the Efficacy of Mechanical Stimulation of the Round Window With an Active Middle Ear Implant.

OBJECTIVE: To test a method to measure the efficacy of active middle ear implants when coupled to the round window. METHODS: Data previously published in Koka et al. ( Hear Res 2010;263:128-137) were used in this study. Simultaneous measurements of cochlear microphonics (CM) and stapes velocity in response to both acoustic stimulation (forward direction) and round window (RW) stimulation (reverse direction) with an active middle ear implant (AMEI) were made in seven ears in five chinchillas. For each stimulus frequency, the amplitude of the CM was measured separately as a function of intensity (dB SPL or dB mV). Equivalent vibrational input to the cochlea was determined by equating the acoustic and AMEI-generated CM amplitudes for a given intensity. In the condition of equivalent CM amplitude between acoustic and RW stimulation-generated output, we assume that the same vibrational input to the cochlea was present regardless of the route of stimulation. RESULTS: The measured stapes velocities for equivalent CM output from the two types of input were not significantly different for low and medium frequencies (0.25-4 kHz); however, the velocities for AMEI-RW drive were significantly lower for higher frequencies (4-14 kHz). Thus, for RM stimulation with an AMEI, stapes velocities can underestimate the mechanical input to the cochlea by ~20 dB for frequencies greater than ~4 kHz. CONCLUSIONS: This study confirms that stapes velocity (with the assumption of equivalent stapes velocity for forward and reverse stimulation) cannot be used as a proxy for effective input to the cochlea when it is stimulated in the reverse direction. Future research on application of intraoperative electrophysiological measurements during surgery (CM, compound action potential, or auditory brainstem response) for estimating efficacy and optimizing device coupling and performance is warranted.

Medial Olivocochlear Reflex Strength in Ears With Low-to-Moderate Annual Noise Exposure.

PURPOSE: Studies in lower mammals demonstrate enhancement of the medial olivocochlear reflex (MOCR) following noise exposure. A similar effect may occur in humans, and there is some evidence of an individual's acoustic history affecting the MOCR. The current work evaluates the relationship between an individual's annual noise exposure history and their MOCR strength. Given the potential role of the MOCR as a biological hearing protector, it is important to identify factors associated with MOCR strength. METHOD: Data were collected from 98 normal-hearing young adults. Annual noise exposure history was estimated using the Noise Exposure Questionnaire. MOCR strength was assayed using click-evoked otoacoustic emissions (CEOAEs) measured with and without noise presented to the contralateral ear. MOCR metrics included the MOCR-induced otoacoustic emission (OAE) magnitude shift and phase shift. A CEOAE signal-to-noise ratio (SNR) of at least 12 dB was required for estimation of the MOCR metrics. Linear regression was applied to evaluate the relationship between MOCR metrics and annual noise exposure. RESULTS: Annual noise exposure was not a statistically significant predictor of the MOCR-induced CEOAE magnitude shift. However, annual noise exposure was a statistically significant predictor of the MOCR-induced CEOAE phase shift-the MOCR-induced phase shift decreased with increasing noise exposure. Additionally, annual noise exposure was a statistically significant predictor of OAE level. CONCLUSIONS: Findings contrast with recent work that suggests MOCR strength increases with annual noise exposure. Compared with previous work, data for this study were collected using more stringent SNR criteria, which is expected to increase the precision of the MOCR metrics. Additionally, data were collected for a larger subject population with a wider range of noise exposures. Whether findings generalize to other exposure durations and levels is unknown and requires future study.

The middle ear muscle reflex: Current and future role in assessing noise-induced cochlear damage.

The middle ear muscle reflex (MEMR) in humans is a bilateral contraction of the middle ear stapedial muscle in response to moderate-to-high intensity acoustic stimuli. Clinically, MEMR thresholds have been used for differential diagnosis of otopathologies for decades. More recently, changes in MEMR amplitude or threshold have been proposed as an assessment for noise-induced synaptopathy, a subclinical form of cochlear damage characterized by suprathreshold hearing problems that occur as a function of inner hair cell (IHC) synaptic loss, including hearing-in-noise deficits, tinnitus, and hyperacusis. In animal models, changes in wideband MEMR immittance have been correlated with noise-induced synaptopathy; however, studies in humans have shown more varied results. The discrepancies observed across studies could reflect the heterogeneity of synaptopathy in humans more than the effects of parametric differences or relative sensitivity of the measurement. Whereas the etiology and degree of synaptopathy can be carefully controlled in animal models, synaptopathy in humans likely stems from multiple etiologies and thus can vary greatly across the population. Here, we explore the evolving research evidence of the MEMR response in relation to subclinical noise-induced cochlear damage and the MEMR as an early correlate of suprathreshold deficits.

Assessing Medial Olivocochlear Reflex Strengths via Auditory Brainstem Response: Measurement and Variability in Normal-Hearing Individuals.

PURPOSE: Optimal measurement settings to measure the medial olivocochlear reflex (MOCR) in humans have not yet been defined. The purpose of this study was to advance the representation of the MOCR in auditory brainstem response (ABR) as an addition to the current diagnostic portfolio. PARTICIPANTS AND METHOD: Twelve female and 14 male normal-hearing adults participated in the study. Potential effects of a contralateral acoustic stimulus (CAS) on amplitude changes were investigated by recording ABR waveform profiles on the left side at click intensities of 50/60/70 dB nHL with and without CAS (60 dB SPL). Secondly, to detect potential chronological order influences, measurement settings were rearranged on the right side and measurements were repeated. Additionally, ABR thresholds were recorded with and without a CAS in 10 patients. RESULTS: When the effect of contralateral suppression was analyzed on the basis of amplitude changes, there was a change under administration of the CAS signal that was statistically significant. Interestingly, the order of recordings affected the degree of amplitude change. In three out of 10 patients, reproducible suppression effects on ABR thresholds were detectable upon CAS presentation. CONCLUSIONS: To our knowledge, this is the largest study dealing with the recording of the MOCR elicited by a contralateral noise via ABR in normal-hearing individuals. Effects of MOCR are measurable via amplitude changes upon CAS administration. Chronological orders influence the impact of this effect on amplitude changes. Optimal measurement settings have not yet been defined. However, experiments such as this study may help to further improve measurements, and thus advance the representation of the MOC reflex in ABR as an addition to the current diagnostic portfolio.

Inter-Subject Variability in the Dependence of Medial-Olivocochlear Reflex Strength on Noise Bandwidth.

OBJECTIVES: The objective of the study was to quantify inter-subject variability in the dependence of the medial-olivocochlear reflex (MOCR) on noise bandwidth. Of specific interest was whether inter-subject variability in MOCR dependence on bandwidth explained variability in the MOCR response elicited by wideband noise. DESIGN: Thirty-two young adults with normal hearing participated in the study. Click-evoked otoacoustic emissions were measured in the ipsilateral ear with and without noise presented in the contralateral ear. Presentation of contralateral noise served to activate the MOCR. The MOCR was activated using five different noise stimuli with bandwidths ranging from 1- to 5-octaves wide (center frequency of 2 kHz; bandwidth incremented in 1-octave steps). Noise spectral levels (19.6 dB SPL/Hz) were held constant across all bandwidths. MOCR metrics included the normalized-percent change in the otoacoustic emission (OAE), the MOCR-induced OAE magnitude shift, and the MOCR-induced OAE phase shift. Linear mixed-effect models were fit to model the dependence of MOCR-induced OAE magnitude and phase changes on noise bandwidth. The use of a mixed-effect modeling approach allowed for the estimation of subject-specific model parameters that capture on- and off-frequency contributions to the MOCR effects. Regression analysis was performed to evaluate the predictive capacity of subject-specific model parameters on the MOCR response elicited by wideband noise. RESULTS: All OAE-based MOCR metrics increased as the noise bandwidth increased from 1- to 5-octaves wide. The dependence of MOCR-induced OAE magnitude and phase shifts on activator bandwidth was well approximated using a linear model with intercept and slope terms. On average, MOCR-induced magnitude and phase shifts increased at a rate of 0.3 dB/octave and 0.01 cycles/octave, respectively, as bandwidth extended beyond the predicted region of OAE generation. A statistically significant random effect of subject was found for both the intercept and slope parameter of each model. Subject-specific slope estimates were statistically significant predictors of a repeated measure of the wideband MOCR response. A higher slope was predictive of larger wideband MOCR effects. CONCLUSIONS: MOCR-induced changes to the OAE are greatest when the MOCR is elicited using wideband noise. Variability in the process of spectral integration within the MOCR pathway appears to explain, in part, inter-subject variability in OAE-based estimates of the MOCR response elicited by wideband noise.

Lack of correlation between medial olivocochlear reflex strength and sentence recognition in noise.

OBJECTIVE: The medial olivocochlear (MOC) reflex provides unmasking of sounds in noise, but its contribution to speech-in-noise perception remains unclear due to conflicting results. This study determined associations between MOC reflex strength and sentence recognition in noise in individuals with normal hearing. DESIGN: MOC reflex strength was assessed using contralateral inhibition of transient-evoked otoacoustic emissions (TEOAEs). Scores on the AzBio sentence task were quantified at three signal-to-noise ratios (SNRs). Additionally, slope and threshold of the psychometric function were computed. Associations between MOC reflex strength and speech-in-noise outcomes were assessed using Spearman rank correlations. STUDY SAMPLE: Nineteen young adults with normal hearing participated, with data from 17 individuals (mean age = 21.8 years) included in the analysis. RESULTS: Contralateral noise significantly decreased the amplitude of TEOAEs. A range of contralateral inhibition values was exhibited across participants. Scores increased significantly with increasing SNR. Contrary to hypotheses, there were no significant correlations between MOC reflex strength and score, nor were there any significant correlations between MOC reflex strength and measures of the psychometric function. CONCLUSIONS: Results found no significant monotonic relationship between MOC reflex strength and sentence recognition in noise. Future work is needed to determine the functional role of the MOC reflex.

Visual attention does not affect the reliability of otoacoustic emission or medial olivocochlear reflex.

This study investigated whether visual attention affects the reliability (i.e., repeatability) of transiently evoked otoacoustic emission (TEOAE) magnitudes or of medial olivocochlear reflex (MOCR) estimates. TEOAEs were measured during three visual attentional conditions: control (subject were seated with eyes closed); passive (subjects looked at a pattern of squares on a computer screen); and active (subjects silently counted an occasionally inverted pattern). To estimate reliability, the whole recording session was repeated the next day. The results showed that visual attention does not significantly affect TEOAE or MOCR magnitudes-or their reliability. It is therefore possible to employ visual stimuli (e.g., watching a silent movie) during TEOAE experiments, a procedure sometimes used during testing to prevent subjects from falling asleep or to keep children still and quiet.

The purinergic receptors 2X3 on spiral ganglion neurons enhance the medial olivocochlear reflex in mice after long-term moderate noise exposure.

Our purpose was to study the expression of purinergic receptors 2X2 (P2X2) and purinergic receptors 2X3 (P2X3) in spiral ganglion neurons (SGNs), the afferent nerves of medial olivocochlear (MOC) reflex, after long-term moderate noise exposure, and its relationship with the enhancement of MOC reflex. Mice were exposed a moderate broadband noise for 4 weeks consecutively. Then mouse hearing functions, including threshold auditory brainstem responses, distortion-product otoacoustic emissions, and MOC reflex, were evaluated and the expression of P2X2 and P2X3 on SGNs were assessed by cochlear immunofluorescence. AF-353 was injected before each noise exposure. Four weeks later, mice were also tested for hearing functions and expression of P2X2 and P2X3 on SGNs. The long-term moderate noise strengthened MOC reflex, and AF-353 reduced it in mice and P2X3 expression on SGNs increased after long-term moderate noise exposure, and AF-353 can downregulate it. The P2X3 on SGNs of mice increased after long-term moderate noise exposure, and the upregulation of it mediated the enhancement of MOC reflex.

Evaluation of the efferent auditory system in COVID-19 adult patients.

BACKGROUND: The short- and long-term effects of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection on the medial olivocochlear reflex and outer hair cells in the cochlea remain largely unclear. AIMS: The aim of this study was to investigate the efferent auditory system effects in adult patients with COVID-19. MATERIALS AND METHODS: The study included 18-50 years old 44 volunteers: 26 individuals (52 ears) with COVID-19 in the study group and 18 healthy individuals (36 ears) in the control group. Otolaryngological examination, immitancemetric evaluation, distortion product otoacoustic emission (DPOAE), contralateral acoustic stimulation with DPOAE, audiometric evaluation, and high frequency audiometric evaluation were performed in all individuals participating in the study. RESULTS: In our study, patients with COVID-19 had significantly lower DPOAE results with or without broadband noise at only 6 kHz frequency and contralateral suppression results at all frequencies compared to healthy individuals. A statistically significant difference was found between the study and control groups according to whether the participants had a response in the high frequency audiometry at 12 and 16 kHz frequencies. CONCLUSIONS: COVID-19 affects many systems in the body. As a result of the findings obtained in the present study, it is shown that the auditory efferent system may also be affected.

Intracochlear pressure as an objective measure for perceived loudness with bone conduction implants.

BACKGROUND: The generally accepted method to assess the functionality of novel bone conduction implants in a preclinical stage is to experimentally measure the vibratory response of the cochlear promontory. Yet, bone conduction of sound is a complex propagation phenomenon, depending on both frequency and amplitude, involving different conduction pathways. OBJECTIVES: The aim of this study is to validate the use of intracochlear sound pressure (ICP) as an objective indicator for perceived loudness for bone conduction stimulation. It is investigated whether a correlation exists between intracochlear sound pressure measurements in cadaveric temporal bones and clinically obtained results using the outcome of a loudness balancing experiment. METHODS: Ten normal hearing subjects were asked to balance the perceived loudness between air conducted (AC) sound and bone conducted (BC) sound by changing the AC stimulus. Mean balanced thresholds were calculated and used as stimulation levels in a cadaver trial (N = 4) where intracochlear sound pressure was measured during AC and BC stimulation to assess the correlation with the measured clinical data. The intracochlear pressure was measured at the relatively low stimulation amplitude of 80 dBHL using a lock-in amplification technique. RESULTS: Applying AC and BC stimulation at equal perceived loudness on cadaveric heads yield a similar differential intracochlear pressure, with differences between AC and BC falling within the range of variability of normal hearing test subjects. CONCLUSION: Comparing the perceived loudness at 80 dB HL for both AC and BC validates intracochlear pressure as an objective indicator of the cochlear drive. The measurement setup is more time-intensive than measuring the vibratory response of the cochlear promontory, yet it provides direct information on the level of the cochlear scalae.

Standardization of the TEOAE Contralateral Suppression Test in Terms of Stimulus Intensity and Contralateral Noise Duration in Individuals with Normal Hearing.

BACKGROUND: A standard method and parameter study were performed for the contralateral suppression test. PURPOSE: Our study aimed to determine the contralateral transient-evoked otoacoustic emission (TEOAE) suppression test method and stimulus-noise parameters that have a standard procedure and will enable the efferent system to be easily evaluated in clinics. RESEARCH DESIGN: This study was conducted in two parts with two different groups of participants as a within-subjects design. In the first part, the signal-to-noise ratio at which maximum suppression obtained was investigated with 29 participants. In the second part, the optimal contralateral noise presentation method (in terms of noise-time or noise-sweep) was examined with 21 participants. STUDY SAMPLE: In the first part 29 young adults aged between 18 and 32 (23.03 ± 2.84), 20 females and 9 males, and in the second part 21 young adults aged between 19 and 34 years (mean age: 23.71 ± 3.48 years), 16 females and 5 males, participated in the second part. All participants had normal hearing. DATA COLLECTION AND ANALYSIS: To obtain maximum OAE suppression, different parameters were tested with the Otodynamics ILO292-II OAE device at both parts of the study in a double-walled audiometric test booths. Multirepeated analysis of variance, pairwise comparison, Friedman test, and Wilcoxon signed-rank tests were used for statistical analysis. RESULTS: In the first part, maximum suppression was achieved at 65 dB peSPL (decibel peak-equivalent sound pressure level) TEOAE stimulus and 65 dB SPL broadband noise. In the second part, maximum suppression was obtained in noise-time method with 30 seconds "duration." CONCLUSIONS: To provide standardization in clinics, it can be recommended that the contralateral suppression of OAEs was measured at 65 dB peSPL TEOAE stimulus and 65 dB SPL broadband noise in the linear stimulation mode with Otodynamics ILO 292-II double-probe OAE device. To obtain maximum suppression, the noise-time method with 30 seconds duration can be used.

Evaluating auditory brainstem response to a level-dependent chirp designed based on derived-band latencies.

The best cochlear-neural delay model for designing a chirp that can produce the largest auditory brainstem response (ABR) has not been established. This study comprised two experiments. Experiment I aimed to estimate the delay model by measuring derived-band ABR latencies at different levels. The results demonstrated that, as the level decreased, the delay between the center frequencies of 0.7 and 5.7 kHz increased. The aim of experiment II was to compare ABRs generated by three stimuli: (1) a level-dependent derived-band (DB)-Chirp, designed based on the model in experiment I; (2) a level-dependent level specific (LS)-Chirp from Kristensen and Elberling [(2012). J. Am. Acad. Audiol. 23, 712-721]; and (3) a click. The results demonstrated that the DB-Chirp produced significantly larger wave V than the LS-Chirp at 45 dB normal hearing level (nHL); however, no differences were observed at other levels. The wave I generated by the DB-Chirp and LS-Chirp were significantly larger than those evoked by the click at 45 and 60 dB nHL and at 30 and 45 dB nHL, respectively; however, at all levels, no differences between these two chirps were observed. The DB-Chirp may be a valuable stimulus for producing ABRs for clinical applications such as assessing cochlear synaptopathy and estimating hearing sensitivity.

Expectations of the timing and intensity of a stimulus propagate to the auditory periphery through the medial olivocochlear reflex.

Expectations concerning the timing of a stimulus enhance attention at the time at which the event occurs, which confers significant sensory and behavioral benefits. Herein, we show that temporal expectations modulate even the sensory transduction in the auditory periphery via the descending pathway. We measured the medial olivocochlear reflex (MOCR), a sound-activated efferent feedback that controls outer hair cell motility and optimizes the dynamic range of the sensory system. MOCR was noninvasively assessed using otoacoustic emissions. We found that the MOCR was enhanced by a visual cue presented at a fixed interval before a sound but was unaffected if the interval was changing between trials. The MOCR was also observed to be stronger when the learned timing expectation matched with the timing of the sound but remained unvaried when these two factors did not match. This implies that the MOCR can be voluntarily controlled in a stimulus- and goal-directed manner. Moreover, we found that the MOCR was enhanced by the expectation of a strong but not a weak, sound intensity. This asymmetrical enhancement could facilitate antimasking and noise protective effects without disrupting the detection of faint signals. Therefore, the descending pathway conveys temporal and intensity expectations to modulate auditory processing.

The effect of coffee on contralateral suppression of transient evoked otoacoustic emissions.

Background: Coffee is a popular non-alcoholic beverage consumed by humans across the world. It contains caffeine, which is a type of stimulant of the central nervous system. In the auditory system, it has a positive effect on auditory brainstem response and perception of speech in noise. Further, caffeine has an inhibitory effect in the cochlea, but studies have rarely investigated its effect on otoacoustic emissions (OAEs) in humans. OAEs are low-intensity sounds produced by the cochlea, which could be recorded in the ear canal. The present study was carried out to investigate the effect of coffee on transient evoked otoacoustic emission (TEOAE) and contralateral suppression of TEOAE. Method: A total of 52 young adults participated in the study. A cross-over study design was used for the present investigation. The TEOAE and contralateral suppression of TEOAE were recorded before and after consumption of coffee and milk. The contralateral suppression of TEOAE was measured by presenting white noise to the contralateral ear at 40, 50, and 60 dB sound pressure level (SPL). Results: The mean amplitude of TEOAE before and after consumption of coffee was similar in both ears. Further, the mean contralateral suppression of TEOAE was slightly larger after consumption of coffee in both ears. However, the mean difference was not significant in both the ears. Conclusions: Based on the findings of present study, coffee has no significant effect on the amplitude of TEOAE and contralateral suppression of TEOAE.

Understanding degraded speech leads to perceptual gating of a brainstem reflex in human listeners.

The ability to navigate "cocktail party" situations by focusing on sounds of interest over irrelevant, background sounds is often considered in terms of cortical mechanisms. However, subcortical circuits such as the pathway underlying the medial olivocochlear (MOC) reflex modulate the activity of the inner ear itself, supporting the extraction of salient features from auditory scene prior to any cortical processing. To understand the contribution of auditory subcortical nuclei and the cochlea in complex listening tasks, we made physiological recordings along the auditory pathway while listeners engaged in detecting non(sense) words in lists of words. Both naturally spoken and intrinsically noisy, vocoded speech-filtering that mimics processing by a cochlear implant (CI)-significantly activated the MOC reflex, but this was not the case for speech in background noise, which more engaged midbrain and cortical resources. A model of the initial stages of auditory processing reproduced specific effects of each form of speech degradation, providing a rationale for goal-directed gating of the MOC reflex based on enhancing the representation of the energy envelope of the acoustic waveform. Our data reveal the coexistence of 2 strategies in the auditory system that may facilitate speech understanding in situations where the signal is either intrinsically degraded or masked by extrinsic acoustic energy. Whereas intrinsically degraded streams recruit the MOC reflex to improve representation of speech cues peripherally, extrinsically masked streams rely more on higher auditory centres to denoise signals.