A new active bone-conduction implant: surgical experiences and audiological outcomes in patients with bilateral congenital microtia.

PURPOSE: First-generation bone bridges (BBs) have demonstrated favorable safety and audiological benefits in patients with conductive hearing loss. However, studies on the effects of second-generation BBs are limited, especially among children. In this study, we aimed to explore the surgical and audiological effects of second-generation BBs in patients with bilateral congenital microtia. METHODS: This single-center prospective study included nine Mandarin-speaking patients with bilateral microtia. All the patients underwent BCI Generation 602 (BCI602; MED-EL, Innsbruck, Austria) implant surgery between September 2021 and June 2023. Audiological and sound localization tests were performed under unaided and BB-aided conditions. RESULTS: The transmastoid and retrosigmoid sinus approaches were implemented in three and six patients, respectively. No patient underwent preoperative planning, lifts were unnecessary, and no sigmoid sinus or dural compression occurred. The mean function gain at 0.5-4.0 kHz was 28.06 ± 4.55-dB HL. The word recognition scores improved significantly in quiet under the BB aided condition. Signal-to-noise ratio reduction by 10.56 ± 2.30 dB improved the speech reception threshold in noise. Patients fitted with a unilateral BB demonstrated inferior sound source localization after the initial activation. CONCLUSIONS: Second-generation BBs are safe and effective for patients with bilateral congenital microtia and may be suitable for children with mastoid hypoplasia without preoperative three-dimensional reconstruction.

Features of the speech processing network in post- and prelingually deaf cochlear implant users.

The onset of hearing loss can lead to altered brain structure and functions. However, hearing restoration may also result in distinct cortical reorganization. A differential pattern of functional remodeling was observed between post- and prelingual cochlear implant users, but it remains unclear how these speech processing networks are reorganized after cochlear implantation. To explore the impact of language acquisition and hearing restoration on speech perception in cochlear implant users, we conducted assessments of brain activation, functional connectivity, and graph theory-based analysis using functional near-infrared spectroscopy. We examined the effects of speech-in-noise stimuli on three groups: postlingual cochlear implant users (n = 12), prelingual cochlear implant users (n = 10), and age-matched individuals with hearing controls (HC) (n = 22). The activation of auditory-related areas in cochlear implant users showed a lower response compared with the HC group. Wernicke's area and Broca's area demonstrated differences network attributes in speech processing networks in post- and prelingual cochlear implant users. In addition, cochlear implant users maintain a high efficiency of the speech processing network to process speech information. Taken together, our results characterize the speech processing networks, in varying noise environments, in post- and prelingual cochlear implant users and provide new insights for theories of how implantation modes impact remodeling of the speech processing functional networks.

Effects of Age on the Auditory Cortex During Speech Perception in Noise: Evidence From Functional Near-Infrared Spectroscopy.

OBJECTIVES: Age-related speech perception difficulties may be related to a decline in central auditory processing abilities, particularly in noisy or challenging environments. However, how the activation patterns related to speech stimulation in different noise situations change with normal aging has yet to be elucidated. In this study, we aimed to investigate the effects of noisy environments and aging on patterns of auditory cortical activation. DESIGN: We analyzed the functional near-infrared spectroscopy signals of 20 young adults, 21 middle-aged adults, and 21 elderly adults, and evaluated their cortical response patterns to speech stimuli under five different signal to noise ratios (SNRs). In addition, we analyzed the behavior score, activation intensity, oxyhemoglobin variability, and dominant hemisphere, to investigate the effects of aging and noisy environments on auditory cortical activation. RESULTS: Activation intensity and oxyhemoglobin variability both showed a decreasing trend with aging at an SNR of 0 dB; we also identified a strong correlation between activation intensity and age under this condition. However, we observed an inconsistent activation pattern when the SNR was 5 dB. Furthermore, our analysis revealed that the left hemisphere may be more susceptible to aging than the right hemisphere. Activation in the right hemisphere was more evident in older adults than in the left hemisphere; in contrast, younger adults showed leftward lateralization. CONCLUSIONS: Our analysis showed that with aging, auditory cortical regions gradually become inflexible in noisy environments. Furthermore, changes in cortical activation patterns with aging may be related to SNR conditions, and that understandable speech with a low SNR ratio but still understandable may induce the highest level of activation. We also found that the left hemisphere was more affected by aging than the right hemisphere in speech perception tasks; the left-sided dominance observed in younger individuals gradually shifted to the right hemisphere with aging.

Aging effects on dual-route speech processing networks during speech perception in noise.

Healthy aging leads to complex changes in the functional network of speech processing in a noisy environment. The dual-route neural architecture has been applied to the study of speech processing. Although evidence suggests that senescent increases activity in the brain regions across the dorsal and ventral stream regions to offset reduced periphery, the regulatory mechanism of dual-route functional networks underlying such compensation remains largely unknown. Here, by utilizing functional near-infrared spectroscopy (fNIRS), we investigated the compensatory mechanism of the dual-route functional connectivity, and its relationship with healthy aging by using a speech perception task at varying signal-to-noise ratios (SNR) in healthy individuals (young adults, middle-aged adults, and older adults). Results showed that the speech perception scores showed a significant age-related decrease with the reduction of the SNR. The analysis results of dual-route speech processing networks showed that the functional connection of Wernicke's area and homolog Wernicke's area were age-related increases. Further to clarify the age-related characteristics of the dual-route speech processing networks, graph-theoretical network analysis revealed an age-related increase in the efficiency of the networks, and the age-related differences in nodal characteristics were found both in Wernicke's area and homolog Wernicke's area under noise environment. Thus, Wernicke's area might be a key network hub to maintain efficient information transfer across the speech process network with healthy aging. Moreover, older adults would recruit more resources from the homologous Wernicke's area in a noisy environment. The recruitment of the homolog of Wernicke's area might provide a means of compensation for older adults for decoding speech in an adverse listening environment. Together, our results characterized dual-route speech processing networks at varying noise environments and provided new insight for the compensatory theories of how aging modulates the dual-route speech processing functional networks.

Abnormal white and gray matter functional connectivity is associated with cognitive dysfunction in presbycusis.

Presbycusis is characterized by high-frequency hearing loss and is closely associated with cognitive decline. Previous studies have observed functional reorganization of gray matter in presbycusis, but the information transmission between gray matter and white matter remains ill-defined. Using resting-state functional magnetic resonance imaging, we investigated differences in functional connectivity (GM-GM, WM-WM, and GM-WM) between 60 patients with presbycusis and 57 healthy controls. Subsequently, we examined the correlation between these connectivity differences with high-frequency hearing loss as well as cognitive impairment. Our results revealed significant alterations in functional connectivity involving the body of the corpus callosum, posterior limbs of the internal capsule, retrolenticular region of the internal capsule, and the gray matter regions in presbycusis. Notably, disrupted functional connectivity was observed between the body of the corpus callosum and ventral anterior cingulate cortex in presbycusis, which was associated with impaired attention. Additionally, enhanced functional connectivity was found in presbycusis between the internal capsule and the ventral auditory processing stream, which was related to impaired cognition in multiple domains. These two patterns of altered functional connectivity between gray matter and white matter may involve both bottom-up and top-down regulation of cognitive function. These findings provide novel insights into understanding cognitive compensation and resource redistribution mechanisms in presbycusis.

Analysis of audiological outcomes of children referred from a universal newborn hearing screening program over 9 years in Beijing, China.

Universal newborn hearing screening (UNHS) and audiological diagnosis are crucial for children with congenital hearing loss (HL). The objective of this study was to analyze hearing screening techniques, audiological outcomes and risk factors among children referred from a UNHS program in Beijing. A retrospective analysis was performed in children who were referred to our hospital after failing UNHS during a 9-year period. A series of audiological diagnostic tests were administered to each case, to confirm and determine the type and degree of HL. Risk factors for HL were collected. Of 1839 cases, 53.0% were referred after only transient evoked otoacoustic emission (TEOAE) testing, 46.1% were screened by a combination of TEOAE and automatic auditory brainstem response (AABR) testing, and 1.0% were referred after only AABR testing. HL was confirmed in 55.7% of cases. Ears with screening results that led to referral experienced a more severe degree of HL than those with results that passed. Risk factors for HL were identified in 113 (6.1%) cases. The main risk factors included craniofacial anomalies (2.7%), length of stay in the neonatal intensive care unit longer than 5 days (2.4%) and birth weight less than 1500 g (0.8%). The statistical data showed that age (P < 0.001) and risk factors, including craniofacial anomalies (P < 0.001) and low birth weight (P = 0.048), were associated with the presence of HL. This study suggested that hearing screening plays an important role in the early detection of HL and that children with risk factors should be closely monitored.

The longitudinal relationship between hearing loss and cognitive decline in tonal language-speaking older adults in China.

Introduction: Previous longitudinal studies indicate that hearing loss and cognitive impairment are associated in non-tonal language-speaking older adults. This study aimed to investigate whether there is a longitudinal association between hearing loss and cognitive decline in older adults who speak a tonal language. Methods: Chinese-speaking older adults aged 60 years and above were recruited for baseline and 12 month follow-up measurements. All participants completed a pure tone audiometric hearing test, Hearing Impaired-Montreal Cognitive Assessment Test (HI-MoCA), and a Computerized Neuropsychological Test Battery (CANTAB). The De Jong Gierveld Loneliness Scale was used to measure loneliness, and the 21-item Depression Anxiety Stress Scale (DASS-21) was used to measure aspects of mental health. Associations between baseline hearing loss and various cognitive, mental and psychosocial measures were evaluated using logistic regression. Results: A total of 71 (29.6%) of the participants had normal hearing, 70 (29.2%) had mild hearing loss, and 99 (41.2%) had moderate or severe hearing loss at baseline, based on mean hearing thresholds in the better ear. After adjusting for demographic and other factors, baseline moderate/severe audiometric hearing loss was associated with an increased risk of cognitive impairment at follow-up (OR: 2.20, 95% CI: 1.06, 4.50). When pure-tone average (PTA) was modeled continuously, an average difference of 0.24 in HI-MoCA scores for every 10 dB increase in BE4FA existed, and an average difference of 0.07 in the change of HI-MoCA scores in a 12 month period. Discussion: The results revealed a significant longitudinal relationship between age-related hearing loss and cognitive decline in this cohort of tonal language-speaking older adults. Steps should also be taken to incorporate hearing assessment and cognitive screening in clinical protocols for older adults 60 years and above in both hearing and memory clinics.

Optimized concurrent hearing and genetic screening in Beijing, China: A cross-sectional study.

Concurrent screening has been proven to provide a comprehensive approach for management of congenital deafness and prevention of ototoxicity. The SLC26A4 gene is associated with late-onset hearing loss and is of great clinical concern. For much earlier detection of newborns with deafness-causing mutations in the SLC26A4 gene, the Beijing Municipal Government launched a chip for optimized genetic screening of 15 variants of 4 genes causing deafness based on a chip to screen for 9 variants of 4 genes, and 6 variants of the SLC26A4 gene have now been added. To ascertain the advantage of a screening chip including 15 variants of 4 genes, the trends in concurrent hearing and genetic screening were analyzed in 2019 and 2020. Subjects were 76,460 newborns who underwent concurrent hearing and genetic screening at 24 maternal and child care centers in Beijing from January 2019 to December 2020. Hearing screening was conducted using transiently evoked otoacoustic emissions (TEOAEs), distortion product otoacoustic emissions (DPOAE), or the automated auditory brainstem response (AABR). Dried blood spots were collected for genetic testing and 15 variants of 4 genes, namely GJB2, SLC26A4, mtDNA 12S rRNA, and GJB3, were screened for using a DNA microarray platform. The initial referral rate for hearing screening decreased from 3.60% (1,502/41,690) in 2019 to 3.23% (1,124/34,770) in 2020, and the total referral rate for hearing screening dropped form 0.57% (236/41,690) in 2019 to 0.54% (187/34,770) in 2020, indicating the reduced false positive rate of newborn hearing screening and policies to prevent hearing loss conducted by the Beijing Municipal Government have had a significant effect. Positivity according to genetic screening was similar in 2019 (4.970%, 2,072/41,690) and 2020 (4.863%,1,691/34,770), and the most frequent mutant alleles were c.235 del C in the GJB2 gene, followed by c.919-2 A > G in the SLC26A4 gene, and c.299 del AT in the GJB2 gene. In this cohort study, 71.43% (5/7) of newborns with 2 variants of the SLC26A4 gene were screened for newly added mutations, and 28.57% (2/7) of newborns with 2 variants of the SLC26A4 gene passed hearing screening, suggesting that a screening chip including 15 variants of 4 genes was superior at early detection of hearing loss, and especially in early identification of newborns with deafness-causing mutations in the SLC26A4 gene. These findings have clinical significance.

The Relationship of Age-Related Hearing Loss with Cognitive Decline and Dementia in a Sinitic Language-Speaking Adult Population: A Systematic Review and Meta-Analysis.

Background and Objectives: Substantial evidence supports the association between untreated hearing loss, cognitive decline, and dementia in the non-tonal language-speaking population. Whether a similar association between hearing loss and cognitive decline and dementia exists in Sinitic tonal language-speaking people is yet to be elucidated. We aimed to systematically review the current evidence on the association between hearing loss and cognitive impairment/decline, and dementia in older adults who speak a Sinitic tonal language. Research Design and Methods: This systematic review considered peer-reviewed articles that employed objective or subjective hearing measurement and cognitive function, cognitive impairment, or diagnosis of dementia. All articles written in English and Chinese and published before March 2022 were included. Databases including Embase, MEDLINE, Web of Science, PsycINFO and Google Scholar, SinoMed, and CBM were utilized using MeSH terms and keywords. Results: Thirty-five articles met our inclusion criteria. Of these, 29 unique studies with an estimated 372,154 participants were included in the meta-analyses. Among all included studies, the effect size of cognitive function with hearing loss, the regression coefficient was -0.26 (95% confidence interval [CI], -0.45 to -0.07). Among cross-sectional and cohort studies, a significant association was found between hearing loss and cognitive impairment and dementia, with odds ratios of 1.85 (95% CI, 1.59-2.17) and 1.89 (95% CI, 1.50-2.38), respectively. Discussion and Implications: Most of the studies included in this systematic review observed a significant association between hearing loss and cognitive impairment and dementia. There was no significant difference to the findings in non-tonal language populations.

[Analysis of clinical audiological characteristics in 868 children referred from maternal and child institutions].

Objective:To investigate the clinical audiological characteristics of children referred from maternal and child institutions and analyze the high risk factors of hearing loss, so as to provide scientific basis for further improvement of children's ear and hearing care. Methods:The subjects of this study were 868 children who were referred by maternal and child institutions in Beijing to the otology outpatient of Beijing Tongren Hospital, Capital Medical University for hearing diagnosis. All subjects underwent acoustic immittance, auditory brainstem response, distortion products otoacoustic emission and other audiological tests. Children were divided into groups according to the age of diagnosis: 0-<3 months group（242 cases）, 3-<6 months group（328 cases）, 6-<12 months group（180 cases）, ≥12 months group（118 cases）, the results of hearing diagnosis, hearing loss degree and types, the relationship between high risk factors and hearing loss in each group were compared and analyzed. Results:The age of diagnosis of 868 children was（7.13±8.29） months. 488 cases with hearing loss accounted for 56.22% and 380 cases with normal hearing accounted for 43.78%. Proportion of different degree of hearing loss of 792 ears from high to low was as follows: mild, 366 ears（46.21%）; moderate, 214 ears（27.02%）; severe, 151 ears（19.07%）; profound, 61 ears（7.70%）. There were statistically significant differences in the proportion of different hearing loss degree among 0-<3 months group, 3-<6 months group, 6-<12 months group and ≥12 months group（P<0.001）. Pairwise comparison between groups showed that the proportion of mild hearing loss of 0-<3 months group was higher than that in the other three groups（P<0.05）, there was no significant difference of moderate hearing loss among all groups（P>0.05）, the proportion of severe hearing loss of ≥12 months group was higher than that of 0-<3 months group（P<0.05）. The proportion of profound hearing loss with 0-<3 months group was lower than the other three groups（P<0.05）. In 792 ears with hearing loss, sensorineural hearing loss accounted for 67.42%, conductive hearing loss accounted for 20.71% and mixed hearing loss accounted for 11.87%. Among 98 cases with high risk factors for hearing loss, 58 cases（59.18%） were diagnosed with hearing loss. The incidence of hearing loss with high risk factors ranked from high to low was: craniofacial malformation（93.75%）, family history/congenital genetic syndrome（61.11%）, neonatal intensive care unit（NICU） hospitalization（46.43%） and others（20.00%）. Conclusion:Referrals from maternal and child institutions play an important role in the early detection of children with mild to moderate sensorineural hearing loss. Children with craniofacial malformation, family history/congenital genetic syndrome, hospitalization history of NICU and other high risk factors have a high incidence of hearing loss and should be attached with great importance.

Features of beta-gamma phase-amplitude coupling in cochlear implant users derived from EEG.

Cochlear implants (CIs) allow patients with severe to profound hearing loss to gain or regain their sense of hearing. However, the objective assessment of auditory rehabilitation in CI users remains a challenge. In particular, the utility of phase-amplitude coupling (PAC) for evaluating postoperative rehabilitation of CI users remains unknown. In the present study, we conducted an oddball paradigm with stimuli varying in sample speech syllables and collected electroencephalography (EEG) signals for 10 CI users at the time the implant was activated and 180 days after activation. Twelve normal-hearing subjects served as controls. We explored the oscillatory properties of the neural response to syllable incongruence and the cross-frequency coupling between multiple frequencies in CI users. We found that beta-gamma coupling appeared to be enhanced in CI users compared with normal controls and this difference gradually disappeared with increasing implantation time. The present results suggest that predictively encoded auditory pathways are gradually restored in CI users. In addition, the PAC feature in unilateral CI users was found to be lateralized in the auditory cortex, which was consistent with previous studies of auditory-evoked cortical activity. Therefore, PAC may be a reference biomarker for the rehabilitation of speech discrimination in CI users.

Comparisons of air-conduction hearing thresholds between manual and automated methods in a commercial audiometer.

Objective: To investigate the correlation of air-conduction thresholds between automated audiometry in a non-isolated environment and manual audiometry in participants with normal hearing and different degrees of hearing loss. Methods: Eighty-three participants aged 11-88 years old underwent automated pure-tone audiometry in a non-acoustically isolated environment, and the results were compared with those of manual pure-tone audiometry performed in a standard acoustically isolated booth, with the order of testing randomised. Six frequencies of 250, 500, 1,000, 2000, 4,000 and 8,000 Hz were tested. Results: All 166 ears were completed and 996 valid hearing threshold data were obtained, with 28 data exceeding the 95% confidence interval in the Bland-Altman plot, accounting for 2.81% of all data. The means and standard deviations of the differences for the six frequencies from 250 to 8,000 Hz were, respectively, 0.63 ± 5.31, 0.69 ± 4.50, 0.45 ± 4.99, 0.3 ± 6.2, -0.15 ± 4.8, and 0.21 ± 4.97 dB. The correlation coefficients of the two test results for normal hearing, mild, moderate, severe and above hearing loss groups were 0.95, 0.92, 0.97, and 0.96, respectively. The correlation coefficient of the automated and manual audiometry thresholds for the age groups under 40 years, 40-60 years, and 60 years above, were 0.98, 0.97 and 0.97, respectively, with all being statistically significant (p < 0.01). The response time of the three age groups were 791 ± 181 ms, 900 ± 190 ms and 1,063 ± 332 ms, respectively, and there was a significant difference between the groups under 40 years and over 60 years. Conclusion: There was good consistency between automated pure-tone audiometry in a non-acoustically isolated environment and manual pure-tone audiometry in participants with different hearing levels and different age groups.

The impact of untreated hearing loss on depression, anxiety, stress, and loneliness in tonal language-speaking older adults in China.

Background: Age-related hearing loss, mental health conditions, and loneliness commonly affect older adults. This study aimed to determine whether untreated hearing loss is independently associated with depression, anxiety, stress, and loneliness in tonal language-speaking older adults in China. Study design: Observational, cross-sectional study. Methods: 293 older adults (111 males, M = 70.33 ± 4.90 years; 182 females, M = 69.02 ± 4.08 years) were recruited. All participants completed a pure tone audiometric hearing assessment, and provided information on living arrangements, marital status, leisure activities, tobacco and alcohol use, and medical history. The Mandarin version of the De Jong Gierveld Loneliness Scale was used to measure loneliness, and the Mandarin version of the 21-item Depression Anxiety Stress Scale (DASS-21) was used to assess a range of symptoms common to depression, stress, and anxiety of the participants. The analysis focused on determining the predictors of depression, anxiety, and stress, and the predictors of measures of loneliness. Results: Multiple stepwise regression analyses revealed that the emotional loneliness (ß = 0.303, p < 0.001) and living status (ß = 0.110, p = 0.048) significantly predicted DASS depression scores; emotional loneliness (ß = 0.276, p < 0.001) and a history of vascular disease (ß = 0.148, p = 0.009) were significantly related to DASS anxiety scores; emotional loneliness (ß = 0.341, p < 0.001) and a history of vascular disease (ß = 0.129, p = 0.019) significantly predicted DASS stress scores. Furthermore, multiple stepwise regression analyses showed that DASS stress scores (ß = 0.333, p < 0.001), education years (ß = -0.126, p = 0.020), marriage status (ß = 0.122, p = 0.024), and a history of vascular disease (ß = 0.111, p = 0.044) significantly predicted emotional loneliness; four-frequency average hearing loss (ß = 0.149, p = 0.010) and DASS stress scores (ß = 0.123, p = 0.034) significantly predicted social loneliness scale; and four-frequency average hearing loss (ß = 0.167, p = 0.003) and DASS stress scores (ß = 0.279, p < 0.001) also significantly predicted overall loneliness. There were no significant associations with high-frequency hearing loss. Conclusion: This study revealed that loneliness has a significant relationship both with hearing loss and aspects of mental health in an older adult Mandarin-speaking population. However, mental health was not significantly associated with hearing loss in this population.

Clinical comparison of two automated audiometry procedures.

Objective: Automated pure-tone audiometry has been shown to provide similar hearing threshold estimates to conventional audiometry, but lower correlations were reported at high and low frequencies in audiometric tests than those of manual tests, while the correlations were better in the middle frequencies. In this paper, we used the same equipment and different test procedures for automated testing, and compared the results with manual test results. Design: One hundred subjects aged 18-36 years were randomly divided into two groups to perform air-conduction pure-tone audiometry (0.25, 0.5, 1, 2, 4, 8 kHz) using the ascending and shortened ascending protocols built-in to the automated audiometer, respectively. Recorded testing time, the total number of responses and the subject's preference tests were compared with those of manual tests. Results: Significant difference was found at 250 Hz regarding the distribution of the absolute difference between the two automated and the manual thresholds. The testing time spend in the ascending method (9.8 ± 1.4 min, mean ± SD) was significantly longer than in the shorted ascending method (5.8 ± 0.9 min). The total numbers of responses of the ascending method (90.5 ± 10.8 times) and shorted ascending method (62.0 ± 11.4 times) were significantly different. Finally, no significant difference was found in preferences between automated and manual procedures. Conclusion: The shorted ascending method can save lots of testing time. The difference between the two automated thresholds at 250 Hz is caused by the different test procedures, and the difference at 8,000 Hz between the automated test and the manual test can be due to the transducer types and allowable differences in calibration.

ENT characteristics and therapeutic results in multisystemic disorders of mitochondrial encephalomyopathy.

Here we report the evaluation of the frequency of subjective and objective otolaryngologic findings and therapeutic results in 32 patients with mitochondrial encephalomyopathy (MEM) from September 2001 to June 2021. Our analysis included studying the patients' family histories, the clinical manifestations of MEM, and the therapeutic effects of treatments. The patients' ages ranged from 2 to 77 years, with a median age of 12.3 years. We found that MEM ENT symptoms were characterized by hearing loss, dysphagia, and facial weakness. Most cases of sensorineural hearing loss were bilateral symmetrical progressive or sudden deafness since adolescence, which were often underestimated. Associated neuromuscular symptoms required mtDNA testing. Dysphagia and facial weakness occurred preferentially in middle-aged patients, and muscle biopsies were advised. Distortion product otoacoustic emissions and auditory brainstem responsetesting were more sensitive and reliable than pure tone averages for objective monitoring of pathogenesis. Administration of the mitochondrial synthase complex benefited patients with acute episodes. If patients did not fully recover and exhibitedresidual language deficits, hearing aids or cochlear implants were recommended. Counsel was given regarding synthetical treatments for facial weakness, endoscopic circopharyngealmyotomy for dysphagia, and surgical correction of ptosis. This study demonstrates that increased awareness of these symptoms is important to address appropriate interventions and avoid complications such as ablepsia, aphasia, social isolation, malnutrition, aspiration pneumonia, and heart failure in the setting of MEM.

Aging Affects Subcortical Pitch Information Encoding Differently in Humans With Different Language Backgrounds.

Aging and language background have been shown to affect pitch information encoding at the subcortical level. To study the individual and compounded effects on subcortical pitch information encoding, Frequency Following Responses were recorded from subjects across various ages and language backgrounds. Differences were found in pitch information encoding strength and accuracy among the groups, indicating that language experience and aging affect accuracy and magnitude of pitch information encoding ability at the subcortical level. Moreover, stronger effects of aging were seen in the magnitude of phase-locking in the native language speaker groups, while language background appears to have more impact on the accuracy of pitch tracking in older adult groups.

Relationship of age-related hearing loss with cognitive decline and dementia in Sinitic tonal language-speaking populations: protocol for a systematic review and meta-analysis.

INTRODUCTION: Existing research on the potential association between age-related hearing loss (ARHL) and cognitive decline and dementia in tonal language-speaking populations is limited and inconsistent. There is psychophysiological evidence suggesting a tonal language background may be linked to enhanced general cognitive functions. We aim to systematically review the current evidence on the association between hearing loss and cognitive impairment/decline and dementia in older adults who speak a Sinitic tonal language, the most commonly spoken tonal language. METHODS AND ANALYSIS: This systematic review will consider peer-reviewed articles that employ objective or subjective hearing measurement and cognitive impairment or diagnosis of dementia. All relevant research publications in English or Chinese and published up to March 2022 will be considered for inclusion. Embase, MEDLINE, Web of Science, PsycINFO Google Scholar, SinoMed and Chinese Biomedical Database will be used, using both medical subject heading terms and keywords. The quality of evidence of an association between ARHL and cognitive impairment and/or dementia will be evaluated by the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system. A random-effects meta-analysis will be carried out with the Comprehensive Meta-Analysis software. ETHICS AND DISSEMINATION: Ethical approval will not be required for this systematic review. The results will be disseminated through peer-reviewed publications and conferences. PROSPERO REGISTRATION NUMBER: CRD42021235310.

The Relationship Between Hearing Loss and Cognitive Impairment in a Chinese Elderly Population: The Baseline Analysis.

Objectives: The objective of the study was to investigate the association between untreated age-related hearing loss and cognitive impairment in Mandarin-speaking older adults living in China. Methods: Older adults (293; 111 males, M = 70.33 ± 4.90 years; 182 females, M = 69.02 ± 4.08 years) were recruited. All participants completed a pure tone audiometric hearing assessment, Hearing Impairment-Montreal Cognitive Assessment Test (HI-MoCA), and a computerized neuropsychology test battery (CANTAB). The Mandarin version of the De Jong Gierveld Loneliness Scale was used to measure the loneliness, and the Mandarin version of the 21-item Depression Anxiety Stress Scale (DASS-21) was used to measure the current severity of a range of symptoms common to depression, stress, and anxiety of the participants. Results: A multiple stepwise regression analysis showed that the average of four mid-frequency thresholds in the better ear was related to CANTAB Paired Associates Learning (ß = 0.20, p = 0.002), and the global cognitive function score (HI-MoCA) (ß = -0.25, p < 0.001). The average of three high frequencies in the better ear was significantly associated with CANTAB Delayed Matching to Sample (ß = -0.16, p = 0.008), and Spatial Working Memory (ß = 0.17, p = 0.003). Conclusion: The results revealed a significant relationship between age-related hearing loss and cognitive impairment in Mandarin-speaking older adults. These research outcomes have clinical implications specifically for hearing health care professionals in China and other populations that speak a tonal language, especially when providing hearing rehabilitation.

[Mitochondrial encephalomyopathy involves ophthalmology otorhinolaryngology neurology and their clinical features].

Objective:This study aimed to provide better understanding of the otolaryngologic features, combined with ophthalmologic and neurologic characteristics in mitochondrial encephalomyopathy（MEM）, and to help ENT and auditory practitioner making correct diagnosis as well. Methods:Twenty-eight patients with MEM were enrolled between September 2001 and January 2020. Information about family histories and clinical symptoms was retrospectively analyzed. All patients underwent otorhinolaryngological, ophthalmological and neurological examinations, including: pure-tone audiometry, acoustic immittance（AI）, distortion-product otoacoustic emissions（DPOAE）, auditory brainstem response（ABR）, cochlear micropotential（CM）, speech discrimination score（SDS）, electroneurography（ENoG）, computed tomography（CT） of the temporal bone and cranial magnetic resonance weighted imaging scan（MRI）, muscle biopsy and mtDNA gene testing. Results:ENT subjective manifestations were present in 15 cases （53.6%） with sensorineural hearing loss（SNHL）, 4（14.3%） with tinnitus, 4（14.3%） with facial weakness, 3（10.7%） with dysphagia, 1（3.6%） with auditory agnosia. Ophthalmological and neurological symptoms included ptosis in 16 cases （57.1%）, exercise intolerance in 16（57.1%）, optic atrophy in 15（53.6%）, muscular atrophy in 6（21.4%）, and stroke-like episodes in 5（17.9%）. The results of objective examinations were as follows: DPOAE were not elicited in 18（64.3%） cases, ABR abnormalities in 18（64.3%） cases, hearing threshold shift in 15（53.6%） cases, AI normal and CM was not detected in all cases, SDS decreased in 6（21.4%） cases, facial ENoG abnormalities in 4（14.3%） cases, laryngeal ENoG abnormalities in 3（10.7%） cases, EMG abnormalities in 6（21.4%） cases, and ECG abnormalities in 8（28.6%） cases. Temporal CT were normal, but cranial MRI abnormalities were found in 19 cases（67.9%）, including central nerve demyelination, white matter hyperintensities, generalized cerebellar and cerebral atrophy, multiple cortical/subcortical infarct-like lesions, basal ganglia calcification. Conclusion:Multisystemic syndromes in MEM can present as a variety of otolaryngological, ophthalmological and neurological abnormalities, such as ptosis, audio-visual disturbance, exercise intolerance and stroke-like episodes etc. SNHL, tinnitus, auditory agnosia, facial weakness and dysphagia were ENT specific manifestations. SNHL in MEM is bilateral symmetrical progressive or of sudden onset since teenage. mtDNA testing may be helpful for adolescent patient whose SNHL was associated with neuromuscular symptoms. Muscle biopsy should be considered when middle-aged patients developed facial weakness and dysphagia. DPOAE and ABR are the optimal objective audiometric tests to monitor the progression of MEM associated with SNHL.

Effects of Wireless Remote Microphone on Speech Recognition in Noise for Hearing Aid Users in China.

Objective: This study was aimed at evaluating improvements in speech-in-noise recognition ability as measured by signal-to-noise ratio (SNR) with the use of wireless remote microphone technology. These microphones transmit digital signals via radio frequency directly to hearing aids and may be a valuable assistive listening device for the hearing-impaired population of Mandarin speakers in China. Methods: Twenty-three adults (aged 19-80 years old) and fourteen children (aged 8-17 years old) with bilateral sensorineural hearing loss were recruited. The Mandarin Hearing in Noise Test was used to test speech recognition ability in adult subjects, and the Mandarin Hearing in Noise Test for Children was used for children. The subjects' perceived SNR was measured using sentence recognition ability at three different listening distances of 1.5, 3, and 6 m. At each distance, SNR was obtained under three device settings: hearing aid microphone alone, wireless remote microphone alone, and hearing aid microphone and wireless remote microphone simultaneously. Results: At each test distance, for both adult and pediatric groups, speech-in-noise recognition thresholds were significantly lower with the use of the wireless remote microphone in comparison with the hearing aid microphones alone (P < 0.05), indicating better SNR performance with the wireless remote microphone. Moreover, when the wireless remote microphone was used, test distance had no effect on speech-in-noise recognition for either adults or children. Conclusion: Wireless remote microphone technology can significantly improve speech recognition performance in challenging listening environments for Mandarin speaking hearing aid users in China.