Listening to speech-in-noise with hearing aids: Do the self-reported outcomes reflect the behavioral speech perception task performance?

BACKGROUND: The aim of this study is to examine the relationship between behavioral speech-in-noise listening tasks and self-reported speech-in-noise outcomes of hearing aid user adult listeners. METHOD: To measure the self-reported outcomes of hearing, the Hearing Handicap Inventory for Adults [HHI-A], Speech, Spatial and Qualities of Hearing Scale (SSQ) and Amsterdam Inventory for Auditory Disability and Handicap were employed. To screen the cognitive abilities, Montreal Cognitive Assessment (MoCA) tool was used. Turkish matrix sentence test (TMST) was used for speech-in-noise test. Eighteen adult hearing aid users (mean age of 36.6 years) were participated. CONCLUSIONS: Results showed that some self-reported listening-in-noise outcomes are correlated with lab-based measurements of speech-in-noise test scores but not with the aided speech intelligibility thresholds. Given the present limitations of relying solely on self-report measures, it is important to complement them with objective measures to ensure a comprehensive evaluation.

Subcortical auditory system in tinnitus with normal hearing: insights from electrophysiological perspective.

PURPOSE: The mechanism of tinnitus remains poorly understood; however, studies have underscored the significance of the subcortical auditory system in tinnitus perception. In this study, our aim was to investigate the subcortical auditory system using electrophysiological measurements in individuals with tinnitus and normal hearing. Additionally, we aimed to assess speech-in-noise (SiN) perception to determine whether individuals with tinnitus exhibit SiN deficits despite having normal-hearing thresholds. METHODS: A total 42 normal-hearing participants, including 22 individuals with chronic subjective tinnitus and 20 normal individuals, participated in the study. We recorded auditory brainstem response (ABR) and speech-evoked frequency following response (sFFR) from the participants. SiN perception was also assessed using the Matrix test. RESULTS: Our results revealed a significant prolongation of the O peak, which encodes sound offset in sFFR, for the tinnitus group (p < 0.01). The greater non-stimulus-evoked activity was also found in individuals with tinnitus (p < 0.01). In ABR, the tinnitus group showed reduced wave I amplitude and prolonged absolute wave I, III, and V latencies (p ≤ 0.02). Our findings suggested that individuals with tinnitus had poorer SiN perception compared to normal participants (p < 0.05). CONCLUSION: The deficit in encoding sound offset may indicate an impaired inhibitory mechanism in tinnitus. The greater non-stimulus-evoked activity observed in the tinnitus group suggests increased neural noise at the subcortical level. Additionally, individuals with tinnitus may experience speech-in-noise deficits despite having a normal audiogram. Taken together, these findings suggest that the lack of inhibition and increased neural noise may be associated with tinnitus perception.

The mismatch negativity responses of individuals with tinnitus with normal extended high-frequency hearing-is it possible to use mismatch negativity in the evaluation of tinnitus?

OBJECTIVE: This study uses the multi-feature paradigm to compare the MMN responses of individuals with normal hearing thresholds, including the high frequencies with and without tinnitus. METHODS: Sixteen subjects with chronic subjective idiopathic tinnitus and twenty matched healthy controls were included in the study. Participants with hearing thresholds (0.125-16 kHz) less than 20 dB HL and MoCA test scores above 21 were included in the study. MMN responses and topographical maps of the responses resulting from the multi-feature MMN paradigm were recorded from 22 surface scalp electrodes. Amplitude and latency parameters of the MMN responses of five different deviants, consisting of frequency, intensity, duration, location, and silent gap, were compared between the two groups. RESULTS: The amplitudes of MMN responses were lower in the tinnitus group than in the control group at Fz electrode for all deviant types. At the same time, there was no difference between the groups for MMN latencies and, no correlation was found between THI and MMN. CONCLUSION: According to our results, the MMN might indicate a possible impairment in pre-attentive and automatic central auditory processing for chronic tinnitus patients. Since MMN responses in the tinnitus group differ from those of healthy individuals, it might be used as a reference for evaluating the central auditory pathways of tinnitus patients.

Auditory brainstem response in unilateral tinnitus patients: does symmetrical hearing thresholds and within-subject comparison affect responses?

OBJECTIVE: In recent studies, cochlear synaptopathy has been suggested as a potential pathophysiology mechanism for tinnitus, which occurs in individuals with normal hearing thresholds. Auditory Brainstem Response (ABR) is a noninvasive method frequently used in the literature to evaluate cochlear synaptopathy in tinnitus patients. However, possible factors such as high-frequency pure-tone hearing thresholds, age, gender, and head characteristics that may affect ABR were not considered sufficiently in previous studies. Therefore, the present study aims to evaluate tinnitus ears and non-tinnitus ears with ABR in unilateral chronic tinnitus patients with symmetrical hearing. METHODS: Twenty unilateral chronic tinnitus patients having normal pure-tone average with symmetrical hearing thresholds was included in the study. Subjects were evaluated with 0.25-16 kHz pure-tone audiometry, Tinnitus Handicap Inventory (THI) and ABR were administered. All ears were evaluated monaurally using click stimuli at 80 dB nHL, alternating polarity (21.1 rate/s, 2000 sweeps). RESULTS: Wave I amplitude of the ABR and the ratio of III/I, V/I, and V/III wave amplitudes from tinnitus ears was higher than non-tinnitus ears. At the same time, there was a positive correlation between THI and V-I and V-III interpeak latency range, and a negative correlation between V/III wave amplitude ratio. CONCLUSION: ABR can be used as an evaluation method to provide evidence that the neural organizations of individuals with chronic tinnitus differ in certain regions in their auditory pathways. The correlation between THI and ABR findings suggests that there may be a connection between tinnitus distress and the neural organization of the auditory system.

Development of speech intelligibility in geriatric individuals with hearing loss.

BACKGROUND: In our study, we aimed to evaluate the hearing aid benefit and speech intelligibility with hearing aids using objective and subjective measurements, according to the type of hearing loss in elderly individuals who used different types of hearing aids. METHODS: The objective and subjective findings from a total of 47 elderly individuals between the ages of 60 and 84, who used regular hearing aids for at least six months, and who were diagnosed with different types and degrees of hearing loss were evaluated by scanning them retrospectively. RESULTS: : In our study, the Adaptive Turkish matrix sentence test (ATMST) was carried out with binaural headphones, and a statistically significant difference was observed between the ATMST scores of individuals with symmetrical hearing loss. A significant difference was found between the ATMST score averages for individuals with symmetrical hearing loss (S0 N90 and S0 N270) and asymmetric hearing loss (S0 N0 and S0 N270) in the free area. A significant difference was found between abbreviated profile of hearing aid benefit satisfaction questionnaires before and after hearing aid use in all groups. DISCUSSION: The Turkish matrix sentence test (TMST) in noise can be used routinely in clinics in order to evaluate the possible hearing loss from the daily environment and the hearing aid effectiveness.

Evaluation of auditory temporal processing in patients fitted with bone-anchored hearing aids.

PURPOSE: The present study aimed to identify temporal processing abilities in users of bone-anchored hearing aid (BAHA). METHODS: Seventeen subjects with BAHA (SWB) users and 29 subjects with normal-hearing were compared using the frequency pattern test, duration pattern test, and speech-in-noise test. Besides behavioral temporal processing tests, a multi-feature mismatch negativity (MMN) test was performed in BAHA users to assess the accuracy of objective auditory discrimination at the cortical level, irrespective of the subjects' attention or behavioral task. RESULTS: The results of the multi-feature MMN test showed that BAHA users could perceive differences in frequency, duration, intensity. However, no response was elicited regarding localization of stimulus and gaps within tones. Word recognition performance in noise was significantly poorer compared with normal hearing groups. All age groups showed no differences in terms of temporal processing abilities except 30-39 years duration pattern ability weaker in SWB group. CONCLUSION: The present study was the first to indicate that the use of unilateral BAHA has no effect on the localization of auditory stimuli at the cortical level according to electrophysiological test. Although Baha users have near-normal levels of hearing thresholds and temporal ordering abilities with their devices, since they benefit from the unilateral device, they still have some difficulties in resolution, recognizing and distinguishing the spatial aspects of speech, especially in multiple and noisy listening environments.

Listening handicap in tinnitus patients with normal extended high frequencies from the perspective of the autonomic nervous system-Effort or fatigue?

OBJECTIVE: In previous studies, the results regarding the presence of listening effort or fatigue in tinnitus patients were inconsistent. The reason for this inconsistency could be that extended high frequencies, which can cause listening handicap, were not within normal limits. Therefore, this study aimed to evaluate the listening skills in tinnitus patients by matching the normal hearing thresholds at all frequencies, including the extended high frequency. METHODS: Eighteen chronic tinnitus patients and thirty matched healthy controls having normal pure-tone average with symmetrical hearing thresholds was included. Subjects were evaluated with 0.125-20 kHz pure-tone audiometry, Montreal cognitive assessment test (MoCA), Tinnitus Handicap Inventory (THI), Matrix Test, Pupillometry. RESULTS: Pupil dilatation in the 'coding' phase of the sentence presented in tinnitus patients was less than in the control group (p < 0.05). There was no difference between the groups for Matrix test scores (p > 0.05) Also, there was no statistically significant correlation between THI and Pupillometry components nor between MoCA (p > 0.05). CONCLUSION: Even though tinnitus patients had normal hearing in the range of 0.125-20 kHz, their autonomic nervous system responses during listening differed from healthy subjects. This difference was interpreted for potential listening fatigue in tinnitus patients.

Reliability and Validity of the Turkish Version of the Vanderbilt Fatigue Scale for Adults.

PURPOSE: Listening-related fatigue (LRF) is a prominent topic of research interest. The purpose of this study is to investigate the reliability and validity of the Turkish version of the 40-item Vanderbilt Fatigue Scale for Adults (TR-VFS-A-40). METHOD: This study included 317 adults with no hearing loss and 260 adults with hearing loss in the study group, totaling 577 adults aged 18-75 years. While 31 adults in the study group did not use any hearing technology, there were 96 hearing aid users and 123 cochlear implant (CI) users. A subset of 80 CI users completed the TR-VFS-A-40 a second time, 2 weeks later, to assess test-retest reliability. Intraclass correlation coefficients were used to assess test-retest reliability. Cronbach's alpha was used to evaluate internal consistency. To examine construct validity, a confirmatory factor analysis (CFA) was performed. For concurrent validity analysis, the Checklist Individual Strength (CIS) and TR-VFS-A-40 scores were analyzed using the Spearman correlation test. RESULTS: Cronbach's alpha values were excellent for the total scale of .987 and the cognitive, emotional, physical, and social subscales (.953, .954, .955, and .946, respectively). Analyses of concurrent validity revealed strong and significant correlations between CIS and TR-VFS-A-40 scores, indicating a good concurrent validity. The CFA determined that the construct validity of the TR-VFS-A-40 was satisfactory. CONCLUSION: The TR-VFS-A-40 is a valid and reliable measure of LRF. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.25457752.

Subcortical Auditory Processing and Speech Perception in Noise Among Individuals With and Without Extended High-Frequency Hearing Loss.

PURPOSE: The significance of extended high-frequency (EHF) hearing (> 8 kHz) is not well understood so far. In this study, we aimed to understand the relationship between EHF hearing loss (EHFHL) and speech perception in noise (SPIN) and the associated physiological signatures using the speech-evoked frequency-following response (sFFR). METHOD: Sixteen young adults with EHFHL and 16 age- and sex-matched individuals with normal hearing participated in the study. SPIN performance in right speech-right noise, left speech-left noise, and binaural listening conditions was evaluated using the Turkish Matrix Test. Additionally, subcortical auditory processing was assessed by recording sFFRs elicited by 40-ms /da/ stimuli. RESULTS: Individuals with EHFHL demonstrated poorer SPIN performances in all listening conditions (p < .01). Longer latencies were observed in the V (onset) and O (offset) peaks in these individuals (p ≤ .01). However, only the V/A peak amplitude was found to be significantly reduced in individuals with EHFHL (p < .01). CONCLUSIONS: Our findings highlight the importance of EHF hearing and suggest that EHF hearing should be considered among the key elements in SPIN. Individuals with EHFHL show a tendency toward weaker subcortical auditory processing, which likely contributes to their poorer SPIN performance. Thus, routine assessment of EHF hearing should be implemented in clinical settings, alongside the evaluation of standard audiometric frequencies (0.25-8 kHz).

The role of suprathreshold auditory processing abilities in children with specific learning disorder.

OBJECTIVE: To assess the suprathreshold auditory processing and speech recognition abilities in noise in children with specific learning disorder (SLD). METHODS: A group of twenty-five children diagnosed with SLD and a control group of twenty-five neuro-typical children were included in the study. All the participants were between 6-11 years old. To evaluate suprathreshold auditory processing abilities, the participants were given the Temporal Fine Structure (TFS) Sensitivity Test and the Temporal Envelope (TE) Sensitivity Test, as well as the Consonant Identification Test, was administered to evaluate speech recognition ability in noise. In addition, the Wechsler Intelligence Scale for Children - Fourth Edition (WISC-IV) intelligence test was applied to children with SLD, and the relationship between WISC-IV intelligence test scores in different skills and suprathreshold auditory processing and speech recognition abilities in noise was investigated. RESULTS: Significant differences were found between children diagnosed with SLD and neuro-typical children in terms of suprathreshold auditory processing tasks and speech recognition in noise. Additionally, no correlation was found between suprathreshold auditory processing tasks, speech recognition in noise, and intelligence tests. CONCLUSION: Suprathreshold auditory processing and speech recognition abilities in noise were found to be affected in children with SLD. A holistic evaluation including a multidisciplinary approach that includes suprathreshold auditory processing abilities is required for children diagnosed with SLD.

Functional and structural evaluation of hearing in acromegaly.

CONTEXT: The impact of acromegaly on the auditory system remains unknown. OBJECTIVE: This study aimed to examine audiological symptoms and the structure and function of the auditory system in patients with acromegaly. DESIGN/SETTING AND PATIENTS: The study included 44 patients with acromegaly. Pure tone audiometry, speech audiometry, tympanometry, otoacoustic emissions testing, computerized tomography of the temporal bone and magnetic resonance imaging of the ear were performed in all patients. The study also included 36 age- and sex-matched healthy controls. The patients with acromegaly were divided into three subgroups, as follows: controlled disease (n=13); partially controlled disease (n=16); uncontrolled disease (n = 15). RESULTS: In all, 43% of the patients with acromegaly had hearing loss, and 20% had had an episode of otitis in at least one ear. Median pure tone average (PTA) in the patients with acromegaly was 12.5 dB (range: 2-72 dB), vs 8.3 dB (range: 0-20 dB) in the control group (P < 0.001). PTA did not differ significantly between the three patient subgroups. Audiometric tests showed various degrees of hearing loss in at least one ear in 21 patients (48%). Conductive, sensorineural and mixed type hearing loss in at least one ear was noted in 9%, 30% and 18% of the patients, respectively. Auditory imaging showed that 50% of the patients had temporomandibular joint degeneration (TMJD). CONCLUSIONS: Hearing loss is quite common in patients with acromegaly. Contrary to common belief, in this study, conductive hearing loss did not occur more frequently than other types. Based on PTA findings in the controls and patients with acromegaly, acromegaly caused hearing loss, but the level of disease activity had no effect on hearing. Middle ear pressure problems might be caused by increased perilymph because of growth hormone (GH)-related volume overload.

Gender Effects on Binaural Speech Auditory Brainstem Response.

BACKGROUND: The speech auditory brainstem response is a tool that provides direct information on how speech sound is temporally and spectrally coded by the auditory brainstem. Speech auditory brainstem response is influenced by many variables, but the effect of gender is unclear, particularly in the binaural recording. Studies on speech auditory brainstem response evoked by binaural stimulation are limited, but gender studies are even more limited and contradictory. This study aimed at examining the effect of gender on speech auditory brainstem response in adults. METHODS: Time- and frequency-domain analyses of speech auditory brainstem response recordings of 30 healthy participants (15 women and 15 men) aged 18-35 years with normal hearing and no musical education were obtained. For each adult, speech auditory brainstem response was recorded with the syllable /da/ presented binaurally. Peaks of time (V, A, C, D, E, F, and O) and frequency (fundamental frequency, first formant frequency, and high frequency) domains of speech auditory brainstem response were compared between men and women. RESULTS: V, A, and F peak latencies of women were significantly shorter than those of men (P< .05). However, no difference was found in the peak amplitude of the time (P > .05) or frequency domain between women and men (P > .05). CONCLUSION: Gender differences in binaural speech auditory brainstem response are significant in adults, particularly in the time domain. When speech stimuli are used for auditory brainstem responses, normative data specific to gender are required. Preliminary normative data from this study could serve as a reference for future studies on binaural speech auditory brainstem response among Turkish adults.

Cochlear synaptopathy causes loudness perception impairment without hearing loss.

Purpose: In this study, the development of a quantitative measurement method to predict long-term auditory adaptation through the stimuli that have been modulated according to different short-term modulation types was aimed to form a psychoacoustic test battery. It might be used in the evaluation process of individuals with hidden hearing loss. Methods: The individuals participating in our study were separated into two groups: high-risk group (n = 39) and low-risk group (n = 30) according to the noise-exposure score. To all participants, auditory brainstem response (ABR), dichotically digit test, Turkish matrix sentence test, otoacoustic emissions test, amplitude modulation detection test, and loudness adaptation test were applied. Stimuli, used in loudness adaptation tests, were provided in three different experiment pairs (experiment 1-2, experiment 3-4, and experiment 5-6). Results: The amplitude of wave I of ABR increased as the intensity level increased in the low-risk group, whereas the amplitude reduced as the intensity level increased in the high-risk group (P < 0.05). When different carrier frequency stimuli were used in amplitude modulation detection test, we found that loudness adaptation was highest at 1 kHz carrier frequency with background noise (P < 0.05). Conclusion: We observed that individuals assumed having hidden hearing loss had high adaptation scores. It was thought that this result might be related to auditory nerve fibers with low spontaneous rate and thus distortion in temporal coding skills might lead to abnormal loudness adaptation, especially with contralateral noise.

Multi-feature mismatch negativity: How can reliable data be recorded in a short time?

OBJECTIVE: The aim of the study was to conduct multi-feature mismatch negativity (MMN) implementations and identify via a test-retest study the reliability of MMN responses obtained through a 5-stimulus version of the MMN paradigm. It was also aimed to identify a reliable MMN recording number by comparing the MMN responses obtained under conditions of ten and four recordings conditions while making the recording time shorter. METHODS: Twenty-one healthy volunteers, aged between 18 and 36 years, were included in the study. A 5-stimulus version of the multi-feature MMN paradigm was presented to participants. Ten recordings were obtained for each participant under both test and retest conditions. The MATLAB program was utilized in the evaluation of MMN amplitude and latency. The Fz was chosen for the statistical analysis. Four of the ten recordings were chosen at random, and statistical analyses were performed again for those four recordings. RESULTS: There was no statistically significant difference in amplitudes obtained from test and retest conditions with ten recordings. With four recordings, for frequency, intensity, duration, and gap deviants, there were no statistically significant differences between amplitudes obtained under test and retest conditions. However, there was a statistically significant difference between amplitudes of the location deviant. No statistically significant difference was observed among latencies under test-retest conditions with both ten and four recordings. CONCLUSIONS: These findings demonstrate that MMN amplitudes could be used reliably as short-time evaluations with four recordings, but more recordings are required for MMN latencies. In terms of practicality, four recordings are more advantageous and comfortable for both clinicians and patients in MMN practice. SIGNIFICANCE: When behavioral tests are required, MMN is regarded as an objective test that can be used reliably for adults, children, and infants who cannot be evaluated using behavioral methods. It is concluded that conditions with four recordings aremore advantageous and comfortable for both clinicians and patients in MMN practice.

Evaluation of temporal and suprasegmental auditory processing in patients with unilateral hearing loss.

OBJECTIVES: To determine the temporal order, resolution, and perception of prosody skills in Single-Sided Deafness (SSD) compared to an age- and sex-matched normal hearing group's same side ear and both ears. METHODS: This was a Case-Control study including 30 subjects with SSD, and age- and sex-matched 30 subjects with bilateral normal hearing (total of 60 subjects- mean age: 38.7 ± 11.6 years). The Montreal Cognitive Assessment (MoCA), Frequency Pattern Test (FPT), Duration Pattern Test (DPT), Random Gap Detection Test (RGDT), Evaluation of Motor Response Time and Emotional Prosody Assessment were performed on the clinically normal ear in the SSD group, the same side ear in the normal hearing group, and both ears of the normal hearing group (the SSD, MNH, and BNH groups, respectively). RESULTS: Individuals with SSD had worse results in DPT (p < .001), gap detection at 0.5 kHz (p < .001), gap detection at 4 kHz (p < .001), and composite score (p < .001) than the BNH group. For reaction time measurements, the SSD group had slower performance scores than the BNH group for DPT (p < .001) and FPT (p < .001). CONCLUSIONS: Poor temporal processing ability and reduced reaction times may help explain the difficulties in those with SSD in performing daily living activities such as speech understanding in noise and requires more processing efforts. However, there were no significant differences between the groups in frequency pattern performance and emotional prosody skills, supporting the claim that fundamental frequency is one of the most important measures of perception in emotional prosody. We demonstrated that unilateral hearing is adequate to analyze frequency patterns to aid in prosody perception. Analysis of reaction times in temporal processing and emotional prosody could provide different perspectives of auditory processing. Slower reaction time of SSD should be considered for habilitation purposes.

Audiological findings in Noonan syndrome.

OBJECTIVES: The aim of this study was to evaluate audiologic properties of patients with Noonan syndrome and compare these findings with those of unaffected peers. METHODS: The study included 17 children with Noonan syndrome and 20 typically developing children without Noonan syndrome. Pure tone and speech audiometry, immitancemetric measurement, otoacoustic emissions measurement and auditory brainstem response tests were applied to all (n = 37) children. RESULTS: Hearing thresholds of children with Noonan syndrome were higher (poorer) than those observed unaffected peers, while the hearing sensitivity of the both groups were normal limits (p = 0.013 for right, p = 0.031 for left ear). Transient evoked otoacoustic emissions amplitudes of the children with Noonan syndrome were lower than the children without Noonan syndrome (p = 0.005 for right, p = 0.002 for left ear). Middle ear pressures and auditory brainstem response values were within normal limits and there was no difference between the two groups (p > 0.05). CONCLUSION: General benefit of the present study is to characterize the audiologic findings of children with Noonan syndrome, which is beneficial in clinics evaluating children with Noonan syndrome.

The role of the medial olivocochlear system in the complaints of understanding speech in noisy environments by individuals with normal hearing.

OBJECTIVE: The aim of our study is to investigate the relationship between the complaint of speech understanding in noisy environments and the findings of contralateral suppression of transient evoked otoacoustic emissions and speech recognition in noise test methods in individuals with normal hearing. METHODS: Sixty-nine subjects between 18 and 53 years of age with normal hearing participated in the present study. The subjects were assigned to one of two groups, reported difficulty understanding speech in noise or no reported difficulty understanding speech in noise. After hearing and immitancemetric evaluation, contralateral suppression of transient evoked otoacoustic emissions and speech recognition in noise tests were administered to both groups. Suppression was calculated in half-octave frequency bands centered at 1.0, 1.5, 2.0, 3.0 and 4.0kHz. RESULTS: We found out that the speech recognition in noise scores and contralateral suppression values were lower in subjects with the complaint of speech understanding in noise than those who do not have such complaints. CONCLUSIONS: We concluded that the complaint of speech understanding in noise may be related to the medial efferent system dysfunction, so central auditory nervous system.

Evaluation of hearing and speech-language in preschool children: how important, why we should perform?

The aim of the study was to present the hearing and speech-language findings of preschool children. The children in this study were aged 3-5 years. Sixtyseven of 239 children (28.0%) had been referred to a physician because of possible middle ear problems, and 25 of the 67 children had slight and mild conduction type hearing loss with air-bone gaps. One of 239 children had profound sensorineural hearing loss. Speech-language problems were found in 70 of 239 children (29.3%). Necessary attention should be paid to the evaluation of hearing and speech-language skills in preschool-aged children to avoid delayed detection and to give these children the opportunity for timely intervention for hearing and speech-language problems.