Spectrally specific temporal analyses of spike-train responses to complex sounds: A unifying framework.

Significant scientific and translational questions remain in auditory neuroscience surrounding the neural correlates of perception. Relating perceptual and neural data collected from humans can be useful; however, human-based neural data are typically limited to evoked far-field responses, which lack anatomical and physiological specificity. Laboratory-controlled preclinical animal models offer the advantage of comparing single-unit and evoked responses from the same animals. This ability provides opportunities to develop invaluable insight into proper interpretations of evoked responses, which benefits both basic-science studies of neural mechanisms and translational applications, e.g., diagnostic development. However, these comparisons have been limited by a disconnect between the types of spectrotemporal analyses used with single-unit spike trains and evoked responses, which results because these response types are fundamentally different (point-process versus continuous-valued signals) even though the responses themselves are related. Here, we describe a unifying framework to study temporal coding of complex sounds that allows spike-train and evoked-response data to be analyzed and compared using the same advanced signal-processing techniques. The framework uses a set of peristimulus-time histograms computed from single-unit spike trains in response to polarity-alternating stimuli to allow advanced spectral analyses of both slow (envelope) and rapid (temporal fine structure) response components. Demonstrated benefits include: (1) novel spectrally specific temporal-coding measures that are less confounded by distortions due to hair-cell transduction, synaptic rectification, and neural stochasticity compared to previous metrics, e.g., the correlogram peak-height, (2) spectrally specific analyses of spike-train modulation coding (magnitude and phase), which can be directly compared to modern perceptually based models of speech intelligibility (e.g., that depend on modulation filter banks), and (3) superior spectral resolution in analyzing the neural representation of nonstationary sounds, such as speech and music. This unifying framework significantly expands the potential of preclinical animal models to advance our understanding of the physiological correlates of perceptual deficits in real-world listening following sensorineural hearing loss.

Computer-assisted reading intervention for children with hearing impairment using cochlear implants: Effects on auditory event-related potentials and mismatch negativity.

OBJECTIVES: The primary aim was to find out whether a computer-assisted reading intervention program with a phonic approach can affect event-related (ERPs) and mismatch negativity (MMN) in hearing impaired (HI) children using cochlear implants (CIs). METHODS: This study involved a test group of 15 HI children with CIs and a control group of 14 normal hearing (NH) children. The children were 4 years and 10 months to 8 years and 1 month old. ERPs were recorded immediately before and after 4 weeks of training with a computer-assisted reading intervention, GraphoGame. A multi-feature paradigm, Optimum-1, was used, i.e. a standard stimulus alternated with five different deviants: gap intensity, pitch, location and duration. MMN was calculated from the mean amplitude ERP of each deviant minus the standard stimulus response in a specific time interval, 80 - 224 ms. Repeated measures ANOVA was used for the statistical analysis. RESULTS: The results did not show any significant changes with the computerassisted training in the ERPs and MMNs among the HI children with CIs. The presence of both MMN and a positive mismatch response (pMMR), which might reflect an immaturity, complicates interpreting the results in this age group. Individually, there was a mix of MMNs and pMMRs among all participants, pre and post training, and the change of each deviant after intervention was not predictable. CONCLUSIONS: There are no significant changes in ERP or MMN after intervention, however lack of significances must be interpreted with caution. Besides the presence of both MMNs and pMMRs, only modest changes are to be expected on an individual basis and small samples hinder making statistical conclusions regarding the training's effects. The study contributes to some more descriptive pieces of ERPs and MMNs among the HI children with CIs. The issues of MMN and pMMR are highlighted.

Hearing and Quality-of-Life Outcomes After Cochlear Implantation in Adult Hearing Aid Users 65 Years or Older: A Secondary Analysis of a Nonrandomized Clinical Trial.

Importance: Hearing loss, especially moderate to severe forms, has the potential to negatively affect an individual's physical, social, emotional, and cognitive well-being. Moreover, having ineffective binaural hearing increases difficulty understanding speech in noise and leads to a greater degree of social isolation and loneliness and a reduced quality of life (QoL). Objective: To explore the audiometric and holistic effects of cochlear implantation in a group of adults 65 years or older compared with an optimized bilateral hearing aid condition. Design, Setting, and Participants: This ad hoc secondary analysis of a prospective, single-subject, repeated-measures nonrandomized clinical trial included 13 cochlear implantation centers across the United States. Participants 65 years or older with postlingual bilateral moderate-to-profound sensorineural hearing loss with aided Consonant-Vowel Nucleus-Consonant (CNC) word scores in quiet of 40% or less in the ear to undergo implantation and 50% or less in the contralateral ear were included in the analysis. Baseline QoL testing was performed after 1 month of optimized bilateral hearing aid use. Participants were enrolled from February 20, 2017, to May 3, 2018, and follow-up was completed December 21, 2018. Data were analyzed from March 25, 2019, to March 31, 2020. Interventions: Unilateral implantation with a slim, modiolar cochlear implant device. Hearing aid use in the contralateral ear was required through the 6-month primary end-point interval. Main Outcomes and Measures: The primary objective was to evaluate speech perception before and 6 months after activation of a new cochlear implant. Secondary objectives were QoL metrics in the everyday listening condition before and 6 months after implantation. Results: Seventy participants (51 men [73%]) with a median age of 74 (range, 65-91) years were included in the analysis. No major adverse events occurred. Mixed-model analysis with estimated marginal means and 95% CIs compared preimplantation baseline performance with 6-month postimplantation performance. A clinically important improvement in CNC words was shown in the bimodal condition, with a mean difference of 37.2% (95% CI, 32.0%-42.4%), and in the unilateral (cochlear implant only) condition, with a mean difference of 44.1% (95% CI, 39.0%-49.2%). A clinically important improvement in noise (AzBio sentences signal-to-noise ratio of +10 dB) was also shown, with a mean difference of 21.6% (95% CI, 15.7%-27.5%) in the bimodal condition and 24.5% (95% CI, 18.3%-30.7%) in the unilateral condition. The Health Utilities Index Mark 3 multiple-attribute score improved by 0.186 (95% CI, 0.136-0.234); the Speech, Spatial, and Qualities of Hearing Scale total score improved by 2.58 (95% CI, 2.18-2.99); and a novel Device Use Questionnaire reported 94% of participants were satisfied with overall hearing in the everyday listening condition. Conclusions and Relevance: This subgroup analysis of patients 65 years or older enrolled in a within-subject clinical trial of cochlear implantation demonstrated clinically meaningful audiometric and QoL benefit with an acceptable risk profile. These findings suggest that cochlear implantation in older adults may facilitate the concept of healthy aging. Trial Registration: ClinicalTrials.gov Identifier: NCT03007472.

The derived-band envelope following response and its sensitivity to sensorineural hearing deficits.

The envelope following response (EFR) has been proposed as a non-invasive marker of synaptopathy in animal models. However, its amplitude is affected by the spread of basilar-membrane excitation and other coexisting sensorineural hearing deficits. This study aims to (i) improve frequency specificity of the EFR by introducing a derived-band EFR (DBEFR) technique and (ii) investigate the effect of lifetime noise exposure, age and outer-hair-cell (OHC) damage on DBEFR magnitudes. Additionally, we adopt a modelling approach to validate the frequency-specificity of the DBEFR and test how different aspects of sensorineural hearing loss affect peripheral generators. The combined analysis of simulations and experimental data proposes that the DBEFRs extracted from the [2-6]-kHz frequency band is a sensitive and frequency-specific measure of synaptopathy in humans. Individual variability in DBEFR magnitudes among listeners with normal audiograms was explained by their self-reported amount of experienced lifetime noise-exposure and corresponded to amplitude variability predicted by synaptopathy. Older listeners consistently had reduced DBEFR magnitudes in comparison to young normal-hearing listeners, in correspondence to how age-induced synaptopathy affects EFRs and compromises temporal envelope encoding. To a lesser degree, OHC damage was also seen to affect the DBEFR magnitude, hence the DBEFR metric should ideally be combined with a sensitive marker of OHC damage to offer a differential diagnosis of synaptopathy in listeners with impaired audiograms.

Binaural cue sensitivity in cochlear implant recipients with acoustic hearing preservation.

Bilateral acoustic hearing in cochlear implant (CI) recipients with hearing preservation may allow access to binaural cues. Sensitivity to acoustic binaural cues has been shown in some listeners combining electric and acoustic stimulation (EAS), yet remains poorly understood and may be subject to limitations imposed by the electrical stimulation and/or amplification asymmetries. The purpose of this study was to investigate the effect of stimulus level, frequency-dependent gain, and the addition of unilateral electrical stimulation on sensitivity to low-frequency binaural cues. Thresholds were measured for interaural time and level differences (ITD and ILD) carried by a low-frequency, bandpass noise (100-800 Hz). 16 adult CI EAS listeners (mean age = 50.2 years) each participated in three listening conditions: acoustic hearing only at 90 dB SPL, acoustic hearing only at 60 dB SPL with frequency-dependent gain, and acoustic hearing plus unilateral CI at 60 dB SPL with frequency-dependent gain applied to the acoustic channels only. Results revealed thresholds within the ecologically relevant ITD and/or ILD range for most EAS listeners. No significant effects of presentation level, frequency-dependent gain, or the addition of unilateral electrical stimulation on the resultant thresholds for ITDs or ILDs were observed at the group level. Correlational analyses related ITD and ILD thresholds to the degree of EAS benefit (i.e., advantage of acoustic hearing in the implanted ear) for speech recognition in diffuse noise. There was a significant relationship between EAS benefit and ITD thresholds, but no statistically significant relationship between EAS benefit and ILD thresholds. In summary, the results of this study are not consistent with our previous data obtained with simulated EAS in normal-hearing listeners, which showed significant binaural interference by a unilateral electrical "distractor" (Van Ginkel et al., 2019). The difference between studies suggests that chronic exposure to unilateral electrical stimulation combined with bilateral acoustic stimulation may reduce interference effects, perhaps because listeners adapt to the presence of the constant but binaurally incongruous CI stimulus. These results are consistent with past studies that demonstrated no interference in spatial hearing tasks due to the addition of a unilateral CI in adult EAS listeners.

Effects of Sensorineural Hearing Loss on Cortical Synchronization to Competing Speech during Selective Attention.

When selectively attending to a speech stream in multi-talker scenarios, low-frequency cortical activity is known to synchronize selectively to fluctuations in the attended speech signal. Older listeners with age-related sensorineural hearing loss (presbycusis) often struggle to understand speech in such situations, even when wearing a hearing aid. Yet, it is unclear whether a peripheral hearing loss degrades the attentional modulation of cortical speech tracking. Here, we used psychoacoustics and electroencephalography (EEG) in male and female human listeners to examine potential effects of hearing loss on EEG correlates of speech envelope synchronization in cortex. Behaviorally, older hearing-impaired (HI) listeners showed degraded speech-in-noise recognition and reduced temporal acuity compared with age-matched normal-hearing (NH) controls. During EEG recordings, we used a selective attention task with two spatially separated simultaneous speech streams where NH and HI listeners both showed high speech recognition performance. Low-frequency (<10 Hz) envelope-entrained EEG responses were enhanced in the HI listeners, both for the attended speech, but also for tone sequences modulated at slow rates (4 Hz) during passive listening. Compared with the attended speech, responses to the ignored stream were found to be reduced in both HI and NH listeners, allowing for the attended target to be classified from single-trial EEG data with similar high accuracy in the two groups. However, despite robust attention-modulated speech entrainment, the HI listeners rated the competing speech task to be more difficult. These results suggest that speech-in-noise problems experienced by older HI listeners are not necessarily associated with degraded attentional selection.SIGNIFICANCE STATEMENT People with age-related sensorineural hearing loss often struggle to follow speech in the presence of competing talkers. It is currently unclear whether hearing impairment may impair the ability to use selective attention to suppress distracting speech in situations when the distractor is well segregated from the target. Here, we report amplified envelope-entrained cortical EEG responses to attended speech and to simple tones modulated at speech rates (4 Hz) in listeners with age-related hearing loss. Critically, despite increased self-reported listening difficulties, cortical synchronization to speech mixtures was robustly modulated by selective attention in listeners with hearing loss. This allowed the attended talker to be classified from single-trial EEG responses with high accuracy in both older hearing-impaired listeners and age-matched normal-hearing controls.

Narrow-band ripple glide direction discrimination and its relationship to frequency selectivity estimated using psychophysical tuning curves.

The highest spectral ripple density at which the discrimination of ripple glide direction was possible (STRtdir task) was assessed for one-octave wide (narrowband) stimuli with center frequencies of 500, 1000, 2000, and 4000 Hz and for a broadband stimulus. A pink noise lowpass filtered at the lower edge frequency of the rippled-noise stimuli was used to mask possible combination ripples. The relationship between thresholds measured using the STRtdir task and estimates of the sharpness of tuning (Q10) derived from fast psychophysical tuning curves was assessed for subjects with normal hearing (NH) and cochlear hearing loss (CHL). The STRtdir thresholds for the narrowband stimuli were highly correlated with Q10 values for the same center frequency, supporting the idea that STRtdir thresholds for the narrowband stimuli provide a good measure of frequency resolution. Both the STRtdir thresholds and the Q10 values were lower (worse) for the subjects with CHL than for the subjects with NH. For both the NH and CHL subjects, mean STRtdir thresholds for the broadband stimulus were not significantly higher (better) than for the narrowband stimuli, suggesting little or no ability to combine information across center frequencies.

Contributions to Speech-Cue Weighting in Older Adults With Impaired Hearing.

Purpose In a previous paper (Souza, Wright, Blackburn, Tatman, & Gallun, 2015), we explored the extent to which individuals with sensorineural hearing loss used different cues for speech identification when multiple cues were available. Specifically, some listeners placed the greatest weight on spectral cues (spectral shape and/or formant transition), whereas others relied on the temporal envelope. In the current study, we aimed to determine whether listeners who relied on temporal envelope did so because they were unable to discriminate the formant information at a level sufficient to use it for identification and the extent to which a brief discrimination test could predict cue weighting patterns. Method Participants were 30 older adults with bilateral sensorineural hearing loss. The first task was to label synthetic speech tokens based on the combined percept of temporal envelope rise time and formant transitions. An individual profile was derived from linear discriminant analysis of the identification responses. The second task was to discriminate differences in either temporal envelope rise time or formant transitions. The third task was to discriminate spectrotemporal modulation in a nonspeech stimulus. Results All listeners were able to discriminate temporal envelope rise time at levels sufficient for the identification task. There was wide variability in the ability to discriminate formant transitions, and that ability predicted approximately one third of the variance in the identification task. There was no relationship between performance in the identification task and either amount of hearing loss or ability to discriminate nonspeech spectrotemporal modulation. Conclusions The data suggest that listeners who rely to a greater extent on temporal cues lack the ability to discriminate fine-grained spectral information. The fact that the amount of hearing loss was not associated with the cue profile underscores the need to characterize individual abilities in a more nuanced way than can be captured by the pure-tone audiogram.

Applicability of subcortical EEG metrics of synaptopathy to older listeners with impaired audiograms.

Emerging evidence suggests that cochlear synaptopathy is a common feature of sensorineural hearing loss, but it is not known to what extent electrophysiological metrics targeting synaptopathy in animals can be applied to people, such as those with impaired audiograms. This study investigates the applicability of subcortical electrophysiological measures associated with synaptopathy, i.e., auditory brainstem responses (ABRs) and envelope following responses (EFRs), to older participants with high-frequency sloping audiograms. The outcomes of this study are important for the development of reliable and sensitive synaptopathy diagnostics in people with normal or impaired outer-hair-cell function. Click-ABRs at different sound pressure levels and EFRs to amplitude-modulated stimuli were recorded, as well as relative EFR and ABR metrics which reduce the influence of individual factors such as head size and noise floor level on the measures. Most tested metrics showed significant differences between the groups and did not always follow the trends expected from synaptopathy. Age was not a reliable predictor for the electrophysiological metrics in the older hearing-impaired group or young normal-hearing control group. This study contributes to a better understanding of how electrophysiological synaptopathy metrics differ in ears with healthy and impaired audiograms, which is an important first step towards unravelling the perceptual consequences of synaptopathy.

Cochlear implantation under local anesthesia: a possible alternative for elderly patients.

INTRODUCTION: As average life-expectancy increases, a sufficient hearing rehabilitation for elderly patients with severe-to-profound sensorineural hearing loss becomes more important. Cochlear implantation is a relatively safe surgical procedure also for elderly patients, the higher risk is caused by general anesthesia. We report on four patients who underwent cochlear implantation under local anesthesia. METHODS: After detailed preoperative examinations (audiological tests, imaging, genetic tests, evaluation of motivation and compliance of the patient), four patient with severe-to-profound hearing loss were selected for cochlear implantation under local anesthesia. For the electrode insertion, we used the posterior suprameatal approach technique. Pre- and postoperative pure tone audiometry and speech-perception tests were conducted to prove the success of the procedure. RESULTS: The mentioned technique was applied; the average length of the operation was 52 min. The intraoperative measurements showed normal impedance and normal neuronal response telemetry, all the patients had sound experience during the intraoperative examination of the engineer. No complications were observed. The postoperative audiological tests showed a significant increase in the hearing perception. CONCLUSION: Cochlear implantation under local anesthesia is a safe and fast procedure for elderly patients. The intraoperative sound experience can give an extra motivation in the postoperative rehabilitation. Our results prove that by carefully selected elderly patients cochlear implantation can assure a significant increase in speech perception. We can establish that the new posterior suprameatal approach technique combined with local anesthesia presents a viable future option for those patients who were inoperable beforehand because of high risks of general anesthesia.

Categorization of sentence recognition for older adults under noisy and time-altered conditions.

PURPOSE: While evaluating the speech recognition ability of older adults, the present study aimed to analyze their error types in parts of speech and find error patterns under various conditions of background noise level and speed of speech. METHODS: Twenty older adults with normal hearing for their age (NHiA) and 20 older adults with sensorineural hearing loss (SNHL) participated. Their cognitive function was screened as within the normal range (mini-mental state examination scores >25). The SNHL listeners were divided into high performers (SNHL-H; n=12) and low performers (SNHL-L; n=8), based on their achieving word recognition scores above or below 70%, respectively. A sentence recognition test was conducted at four levels of signal-to-noise ratio (SNR; eg, no noise, +6, +3, 0 dB) and four conditions of time alteration (eg, 30% and 15% of compression and expansion) at the most comfortable level for each participant. RESULTS: As expected, the three groups showed that the error percentage increased in sentence recognition as either the SNR decreased or the speech rate became faster. Interestingly, a larger performance difference was found between the SNHL-H and SNHL-L groups in the condition of time alteration than in that of background noise. Among the parts of speech, nouns presented the highest error scores for all participants regardless of degree of listening difficulty. The noun errors of the three groups mainly consisted of no response and fail patterns, but substitution and omission were identified as the third pattern of noun error for background noise and fast speech, respectively. CONCLUSION: Deterioration of speech recognition from the hearing threshold and supra-threshold auditory processing was seen in the elderly in difficult listening environments such as background noise and time alteration. Although different group performance ran across the eight experimental conditions, the robustness of noun errors and the error patterns were very similar, which might be extended to a possible clinical application of aural rehabilitation for the elderly population.

A "Buildup" of Speech Intelligibility in Listeners With Normal Hearing and Hearing Loss.

The perception of simple auditory mixtures is known to evolve over time. For instance, a common example of this is the "buildup" of stream segregation that is observed for sequences of tones alternating in pitch. Yet very little is known about how the perception of more complicated auditory scenes, such as multitalker mixtures, changes over time. Previous data are consistent with the idea that the ability to segregate a target talker from competing sounds improves rapidly when stable cues are available, which leads to improvements in speech intelligibility. This study examined the time course of this buildup in listeners with normal and impaired hearing. Five simultaneous sequences of digits, varying in length from three to six digits, were presented from five locations in the horizontal plane. A synchronized visual cue at one location indicated which sequence was the target on each trial. We observed a buildup in digit identification performance, driven primarily by reductions in confusions between the target and the maskers, that occurred over the course of three to four digits. Performance tended to be poorer in listeners with hearing loss; however, there was only weak evidence that the buildup was diminished or slowed in this group.

Reliability and Repeatability of the Speech Cue Profile.

Purpose: Researchers have long noted speech recognition variability that is not explained by the pure-tone audiogram. Previous work (Souza, Wright, Blackburn, Tatman, & Gallun, 2015) demonstrated that a small number of listeners with sensorineural hearing loss utilized different types of acoustic cues to identify speechlike stimuli, specifically the extent to which the participant relied upon spectral (or temporal) information for identification. Consistent with recent calls for data rigor and reproducibility, the primary aims of this study were to replicate the pattern of cue use in a larger cohort and to verify stability of the cue profiles over time. Method: Cue-use profiles were measured for adults with sensorineural hearing loss using a syllable identification task consisting of synthetic speechlike stimuli in which spectral and temporal dimensions were manipulated along continua. For the first set, a static spectral shape varied from alveolar to palatal, and a temporal envelope rise time varied from affricate to fricative. For the second set, formant transitions varied from labial to alveolar and a temporal envelope rise time varied from approximant to stop. A discriminant feature analysis was used to determine to what degree spectral and temporal information contributed to stimulus identification. A subset of participants completed a 2nd visit using the same stimuli and procedures. Results: When spectral information was static, most participants were more influenced by spectral than by temporal information. When spectral information was dynamic, participants demonstrated a balanced distribution of cue-use patterns, with nearly equal numbers of individuals influenced by spectral or temporal cues. Individual cue profile was repeatable over a period of several months. Conclusion: In combination with previously published data, these results indicate that listeners with sensorineural hearing loss are influenced by different cues to identify speechlike sounds and that those patterns are stable over time.

The use of self-report measures to examine changes in perception in response to fittings using different signal processing parameters.

Clinicians have long used self-report methods to assess hearing aid benefit. However, there are fewer data as to whether self-report instruments can be used to compare differences between signal processing settings. This study examined how self-perceived performance varied as a function of modifications in signal processing using two self-report measures. Data were collected as part of a double-blind randomised crossover clinical trial. Participants were fit with two fittings: mild processing (slow time constants, disabled frequency lowering) and strong processing (fast time constants, frequency lowering enabled). The speech, spatial, and qualities of hearing (SSQ) questionnaire and the Effectiveness of Auditory Rehabilitation (EAR) questionnaire were collected at multiple time points. Older adults with sensorineural hearing loss who had not used hearing aids within the previous year participated (49 older adults were consented; 40 were included in the final data analyses). Findings show that listeners report a difference in perceived performance when hearing aid features are modified. Both self-report measures were able to capture this change in perceived performance. Self-report measures provide a tool for capturing changes in perceived performance when hearing aid processing features are modified and may enhance provision of an evidence-based hearing aid fitting.

A pilot study: Considering spirituality in an inclusive model of practice in clinical audiology.

BACKGROUND:  A patient-orientated approach in medical clinical practice is emerging where patients and practitioners are considering and including the spiritual, emotional and psychosocial aspects of the individual. This practice is an important change in health care, specifically in the field of audiology as a holistic view of the patient now alters the perspective on the management of individuals with hearing impairments. Objectives: This article explored the experiences of a participant who reported supernatural healing of his sensorineural hearing loss (SNHL). Hence, this study focuses on the consideration of spirituality in the inclusive model of care. Method: An exploratory, qualitative narrative inquiry was used to obtain data from a single pilot case study of a 27-year-old man who reported healing of his permanent profound hearing loss. Results: Four themes were identified within the narrative obtained: prayer and faith, deaf culture, identity and purpose. The participant stated that he believed that he was partially healed to fulfil his purpose in life. The partial healing allowed him to belong to the deaf community and the hearing world simultaneously. Conclusion: South Africans live in a diverse society where most people accept spirituality as part of their search for meaning in life. Health care for individuals should therefore consider the person as a holistic being more than a medical entity. The exploration of narratives of individuals who report supernatural healing of a SNHL will assist health care practitioners and audiologists in managing individuals in an inclusive manner. This pilot study thus has implications for policy and practice in health care contexts.

Impact of SNR, masker type and noise reduction processing on sentence recognition performance and listening effort as indicated by the pupil dilation response.

Recent studies have shown that activating the noise reduction scheme in hearing aids results in a smaller peak pupil dilation (PPD), indicating reduced listening effort, at 50% and 95% correct sentence recognition with a 4-talker masker. The objective of this study was to measure the effect of the noise reduction scheme (on or off) on PPD and sentence recognition across a wide range of signal-to-noise ratios (SNRs) from +16 dB to -12 dB and two masker types (4-talker and stationary noise). Relatively low PPDs were observed at very low (-12 dB) and very high (+16 dB to +8 dB) SNRs presumably due to 'giving up' and 'easy listening', respectively. The maximum PPD was observed with SNRs at approximately 50% correct sentence recognition. Sentence recognition with both masker types was significantly improved by the noise reduction scheme, which corresponds to the shift in performance from SNR function at approximately 5 dB toward a lower SNR. This intelligibility effect was accompanied by a corresponding effect on the PPD, shifting the peak by approximately 4 dB toward a lower SNR. In addition, with the 4-talker masker, when the noise reduction scheme was active, the PPD was smaller overall than that when the scheme was inactive. We conclude that with the 4-talker masker, noise reduction scheme processing provides a listening effort benefit in addition to any effect associated with improved intelligibility. Thus, the effect of the noise reduction scheme on listening effort incorporates more than can be explained by intelligibility alone, emphasizing the potential importance of measuring listening effort in addition to traditional speech reception measures.

Age-related defects in short-term plasticity are reversed by acetyl-L-carnitine at the mouse calyx of Held.

Hearing acuity and sound localization are affected by aging and may contribute to cognitive dementias. Although loss of sensorineural conduction is well documented to occur with age, little is known regarding short-term synaptic plasticity in central auditory nuclei. Age-related changes in synaptic transmission properties were evaluated at the mouse calyx of Held, a sign-inverting relay synapse in the circuit for sound localization, in juvenile adults (1 month old) and late middle-aged (18-21 months old) mice. Synaptic timing and short-term plasticity were severely disrupted in older mice. Surprisingly, acetyl-l-carnitine (ALCAR), an anti-inflammatory agent that facilitates mitochondrial function, fully reversed synaptic transmission delays and defects in short-term plasticity in aged mice to reflect transmission similar to that seen in juvenile adults. These findings support ALCAR supplementation as an adjuvant to improve short-term plasticity and potentially central nervous system performance in animals compromised by age and/or neurodegenerative disease.

Effects of cochlear synaptopathy on middle-ear muscle reflexes in unanesthetized mice.

Cochlear synaptopathy, i.e. the loss of auditory-nerve connections with cochlear hair cells, is seen in aging, noise damage, and other types of acquired sensorineural hearing loss. Because the subset of auditory-nerve fibers with high thresholds and low spontaneous rates (SRs) is disproportionately affected, audiometric thresholds are relatively insensitive to this primary neural degeneration. Although suprathreshold amplitudes of wave I of the auditory brainstem response (ABR) are attenuated in synaptopathic mice, there is not yet a robust diagnostic in humans. The middle-ear muscle reflex (MEMR) might be a sensitive metric (Valero et al., 2016), because low-SR fibers may be important drivers of the MEMR (Liberman and Kiang, 1984; Kobler et al., 1992). Here, to test the hypothesis that narrowband reflex elicitors can identify synaptopathic cochlear regions, we measured reflex growth functions in unanesthetized mice with varying degrees of noise-induced synaptopathy and in unexposed controls. To separate effects of the MEMR from those of the medial olivocochlear reflex, the other sound-evoked cochlear feedback loop, we used a mutant mouse strain with deletion of the acetylcholine receptor required for olivocochlear function. We demonstrate that the MEMR is normal when activated from non-synaptopathic cochlear regions, is greatly weakened in synaptopathic regions, and is a more sensitive indicator of moderate synaptopathy than the suprathreshold amplitude of ABR wave I.

Auditory enhancement under simultaneous masking in normal-hearing and hearing-impaired listeners.

Auditory enhancement, where a target sound within a masker is rendered more audible by the prior presentation of the masker alone, may play an important role in auditory perception under variable everyday acoustic conditions. Cochlear hearing loss may reduce enhancement effects, potentially contributing to the difficulties experienced by hearing-impaired (HI) individuals in noisy and reverberant environments. However, it remains unknown whether, and by how much, enhancement under simultaneous masking is reduced in HI listeners. Enhancement of a pure tone under simultaneous masking with a multi-tone masker was measured in HI listeners and age-matched normal-hearing (NH) listeners as function of the spectral notch width of the masker, using stimuli at equal sensation levels as well as at equal sound pressure levels, but with the stimuli presented in noise to the NH listeners to maintain the equal sensation level between listener groups. The results showed that HI listeners exhibited some enhancement in all conditions. However, even when conditions were made as comparable as possible, in terms of effective spectral notch width and presentation level, the enhancement effect in HI listeners under simultaneous masking was reduced relative to that observed in NH listeners.

Binaural model-based dynamic-range compression.

OBJECTIVE: Binaural cues such as interaural level differences (ILDs) are used to organise auditory perception and to segregate sound sources in complex acoustical environments. In bilaterally fitted hearing aids, dynamic-range compression operating independently at each ear potentially alters these ILDs, thus distorting binaural perception and sound source segregation. DESIGN: A binaurally-linked model-based fast-acting dynamic compression algorithm designed to approximate the normal-hearing basilar membrane (BM) input-output function in hearing-impaired listeners is suggested. A multi-center evaluation in comparison with an alternative binaural and two bilateral fittings was performed to assess the effect of binaural synchronisation on (a) speech intelligibility and (b) perceived quality in realistic conditions. STUDY SAMPLE: 30 and 12 hearing impaired (HI) listeners were aided individually with the algorithms for both experimental parts, respectively. RESULTS: A small preference towards the proposed model-based algorithm in the direct quality comparison was found. However, no benefit of binaural-synchronisation regarding speech intelligibility was found, suggesting a dominant role of the better ear in all experimental conditions. CONCLUSION: The suggested binaural synchronisation of compression algorithms showed a limited effect on the tested outcome measures, however, linking could be situationally beneficial to preserve a natural binaural perception of the acoustical environment.