Effects of sensorineural hearing loss on formant-frequency discrimination: Measurements and models.

This study concerns the effect of hearing loss on discrimination of formant frequencies in vowels. In the response of the healthy ear to a harmonic sound, auditory-nerve (AN) rate functions fluctuate at the fundamental frequency, F0. Responses of inner-hair-cells (IHCs) tuned near spectral peaks are captured (or dominated) by a single harmonic, resulting in lower fluctuation depths than responses of IHCs tuned between spectral peaks. Therefore, the depth of neural fluctuations (NFs) varies along the tonotopic axis and encodes spectral peaks, including formant frequencies of vowels. This NF code is robust across a wide range of sound levels and in background noise. The NF profile is converted into a rate-place representation in the auditory midbrain, wherein neurons are sensitive to low-frequency fluctuations. The NF code is vulnerable to sensorineural hearing loss (SNHL) because capture depends upon saturation of IHCs, and thus the interaction of cochlear gain with IHC transduction. In this study, formant-frequency discrimination limens (DLFFs) were estimated for listeners with normal hearing or mild to moderate SNHL. The F0 was fixed at 100 Hz, and formant peaks were either aligned with harmonic frequencies or placed between harmonics. Formant peak frequencies were 600 and 2000 Hz, in the range of first and second formants of several vowels. The difficulty of the task was varied by changing formant bandwidth to modulate the contrast in the NF profile. Results were compared to predictions from model auditory-nerve and inferior colliculus (IC) neurons, with listeners' audiograms used to individualize the AN model. Correlations between DLFFs, audiometric thresholds near the formant frequencies, age, and scores on the Quick speech-in-noise test are reported. SNHL had a strong effect on DLFF for the second formant frequency (F2), but relatively small effect on DLFF for the first formant (F1). The IC model appropriately predicted substantial threshold elevations for changes in F2 as a function of SNHL and little effect of SNHL on thresholds for changes in F1.

Sensorineural Hearing Loss Diminishes Use of Temporal Envelope Cues: Evidence From Roving-Level Tone-in-Noise Detection.

OBJECTIVES: The objective of our study is to understand how listeners with and without sensorineural hearing loss (SNHL) use energy and temporal envelope cues to detect tones in noise. Previous studies of low-frequency tone-in-noise detection have shown that when energy cues are made less reliable using a roving-level paradigm, thresholds of listeners with normal hearing (NH) are only slightly increased. This result is consistent with studies demonstrating the importance of temporal envelope cues for masked detection. In contrast, roving-level detection thresholds are more elevated in listeners with SNHL at the test frequency, suggesting stronger weighting of energy cues. The present study extended these tests to a wide range of frequencies and stimulus levels. The authors hypothesized that individual listeners with SNHL use energy and temporal envelope cues differently for masked detection at different frequencies and levels, depending on the degree of hearing loss. DESIGN: Twelve listeners with mild to moderate SNHL and 12 NH listeners participated. Tone-in-noise detection thresholds at 0.5, 1, 2, and 4 kHz in 1/3 octave bands of simultaneously gated Gaussian noise were obtained using a novel, two-part tracking paradigm. A track refers to the sequence of trials in an adaptive test procedure; the signal to noise ratio was the tracked variable. Each part of the track consisted of a two-alternative, two-interval, forced-choice procedure. The initial portion of the track estimated detection threshold using a fixed masker level. When the track continued, stimulus levels were randomly varied over a 20-dB rove range (±10 dB with respect to mean masker level), and a second threshold was estimated. Rove effect (RE) was defined as the difference between thresholds for the fixed- and roving-level tests. The size of the RE indicated how strongly a listener weighted energy-based cues for masked detection. Participants were tested at one to three masker levels per frequency, depending on audibility. RESULTS: Across all stimulus frequencies and levels, NH listeners had small REs (≈1 dB), whereas listeners with SNHL typically had larger REs. Some listeners with SNHL had larger REs at higher frequencies, where pure-tone audiometric thresholds were typically elevated. RE did not vary significantly with masker level for either group. Increased RE for the SNHL group was consistent with simulations in which energy cues were more heavily weighted than envelope cues. CONCLUSIONS: Tone-in-noise detection thresholds in NH listeners were typically elevated only slightly by the roving-level paradigm at any frequency or level tested, consistent with the primary use of level-independent cues, such as temporal envelope cues that are conveyed by fluctuations in neural responses. In comparison, thresholds of listeners with SNHL were more affected by the roving-level paradigm, suggesting stronger weighting of energy cues. For listeners with SNHL, the largest RE was observed at 4000 Hz, for which pure-tone audiometric thresholds were most elevated. Specifically, RE size at 4000 Hz was significantly correlated with higher pure-tone audiometric thresholds at the same frequency, after controlling for the effect of age. Future studies will explore strategies for restoring or enhancing neural fluctuation cues that may lead to improved hearing in noise for listeners with SNHL.

Hearing function in patients living with HIV/AIDS.

OBJECTIVES: During the earlier years of the HIV/AIDS epidemic, initial reports described sensorineural hearing loss in up to 49% of individuals with HIV/AIDS. During those years, patients commonly progressed to advanced stages of HIV disease and frequently had neurological complications. However, the abnormalities on pure-tone audiometry and brainstem-evoked responses outlined in small studies were not always consistently correlated with advanced stages of HIV/AIDS. Moreover, these studies could not exclude the confounding effect of concurrent opportunistic infections and syphilis. Additional reports also have indicated that some antiretroviral medications may be ototoxic; thus, it has been difficult to make conclusions regarding the cause of changes in hearing function in HIV-infected patients. More recently, accelerated aging has been suggested as a potential explanation for the disproportionate increase in complications of aging described in many HIV-infected patients; hence, accelerated aging-associated hearing loss may also be playing a role in these patients. DESIGN: We conducted a large cross-sectional analysis of hearing function in over 300 patients with HIV-1 infection and in 137 HIV-uninfected controls. HIV-infected participants and HIV-uninfected controls underwent a 2-hr battery of hearing tests including the Hearing Handicap Inventory, standard audiometric pure-tone air and bone conduction testing, tympanometric testing, and speech reception and discrimination testing. RESULTS: Three-way analysis of variance (ANOVA) and logistic regression analysis of 278 eligible HIV-infected subjects stratified by disease stage in early HIV disease (n = 127) and late HIV disease (n = 148) and 120 eligible HIV-uninfected controls revealed no statistically significant differences among the three study groups in either overall 4-frequency pure-tone average (4-PTA) or hearing loss prevalence in either ear. Three-way ANOVA showed significant differences in word recognition scores in the right ear among groups, a significant group effect on tympanogram static admittance in both ears and a significant group effect on tympanic gradient in the right ear. There was significantly larger admittance and gradient in controls as compared to the HIV-infected group at late stage of disease. Hearing loss in the HIV-infected groups was associated with increased age and was similar to that described in the literature for the general population. Three-way ANOVA analysis also indicated significantly greater pure-tone thresholds (worse hearing) at low frequencies in HIV patients in the late stage of disease compared with HIV-uninfected controls. This difference was also found by semi-parametric mixed effects models. CONCLUSIONS: Despite reports of "premature" or "accelerated" aging in HIV-infected subjects, we found no evidence of hearing loss occurring at an earlier age in HIV-infected patients compared to HIV-uninfected controls. Similar to what is described in the general population, the probability of hearing loss increased with age in the HIV-infected subjects and was more common in patients over 60 years of age. Interestingly, HIV-infected subjects had worse hearing at lower frequencies and have significant differences in tympanometry compared to HIV-uninfected controls; these findings deserve further study.

Neural correlates of age-related declines in frequency selectivity in the auditory midbrain.

Reduced frequency selectivity is associated with an age-related decline in speech recognition in background noise and reverberant environments. To elucidate neural correlates of age-related alteration in frequency selectivity, the present study examined frequency response areas (FRAs) of multi-unit clusters in the inferior colliculus of young, middle-aged, and old CBA/CaJ mice. The FRAs in middle-aged and old mice were found to be broader and more asymmetric in shape. In addition to a decrease of closed/complex FRAs in both middle age and old groups, there was a transient decrease in V-shaped FRAs and a concomitant increase in multipeak FRAs in middle age. Intensity coding was also affected by age, as observed in an increase of monotonic responses in middle-aged and old mice. While a decline in low-level activity began in middle age, reduced driven rates at suprathreshold levels occurred later in old age. Collectively, these results support the view that aging alters frequency selectivity by widening excitatory FRAs and that these changes begin to appear in middle age.