Acquired amusia after a right middle cerebral artery infarction - a case study.

A 62-year-old musician-MM-developed amusia after a right middle-cerebral-artery infarction. Initially, MM showed melodic deficits while discriminating pitch-related differences in melodies, musical memory problems, and impaired sensitivity to tonal structures, but normal pitch discrimination and spectral resolution thresholds, and normal cognitive and language abilities. His rhythmic processing was intact when pitch variations were removed. After 3 months, MM showed a large improvement in his sensitivity to tonality, but persistent melodic deficits and a decline in perceiving the metric structure of rhythmic sequences. We also found visual cues aided melodic processing, which is novel and beneficial for future rehabilitation practice.

Relationship Between Cognitive Abilities and Basic Auditory Processing in Young Adults.

PURPOSE: The diagnosis of auditory processing disorder (APD) is controversial particularly due to the influence of higher order factors of language and cognition on the diagnostic APD testing. As a result, there might be a need for testing for other domains (e.g., cognition) along with conducting the diagnostic APD testing to rule out the influence of other domains. In order to make recommendations on whether cognitive testing is needed along with the auditory processing testing, as a starting point, the current study was conducted to examine the relationship between cognitive abilities and basic auditory processing in young adults. METHOD: A total of 38 young adults with normal audiometric thresholds between 250 and 8000 Hz participated in this study. They were tested on their executive function, language, processing speed, working memory, and episodic memory components of cognitive testing and tests for temporal fine structure and spectrotemporal sensitivity for auditory processing testing. RESULTS: No significant correlation was found between the cognitive tests and the tests for basic auditory processing in young adults. CONCLUSIONS: These findings present contrast to the existing findings in children and older adults where a stronger correlation between cognitive abilities and auditory processing has been found. The current findings suggest that testing for cognitive abilities may not be needed when testing for basic auditory processing in young adults.

Multisensory perceptual distortion including auditory distortions in Alice in Wonderland syndrome: a case report.

Alice in Wonderland syndrome (AIWS) is a rare perceptual disorder characterized mainly by perceptual distortions of visual objects and one's own body. While there are many case reports of visual and somatosensory distortions associated with AIWS, little is known about auditory distortion. Therefore, we present the case of a 22-year-old right-handed woman who described having auditory as well as visual and somatosensory distortion experiences and a family history of AIWS. The subject reported experiencing multisensory perceptual distortions, where she sees other people's faces as larger and hears their voices as louder at the same time. This particular case suggests that auditory distortion - which contributes to constructing the perception of the surrounding space and the body - may also be characterized as a perceptual symptom of AIWS.

Electrophysiological Evidence of Auditory and Cognitive Processing Deficits in Parkinson Disease.

BACKGROUND: Parkinson's disease (PD) patients are at increased risk for central auditory processing (CAP) deficits and cognitive dysfunction. However, behavioral assessments of CAP and cognitive processing used in a previous study by our research team found few significant differences in performance between early-stage PD patients and age-matched control subjects. The objective of this study is to use auditory event-related potentials (AERPs) to compare CAP and cognitive functions in a population of PD patients with a group of age-matched control subjects. METHODS: AERPs in response to tonal and speech stimuli were recorded from 35 adults who had a medical diagnosis of PD (23 males and 12 females; mean age = 66.9 ± s.d.11.2 years), and 35 age-matched control subjects who did not have PD or any other neurological disorders (31 males and 4 females; mean age = 65.4 ± s.d.12.3 years). Auditory stimuli included pure tones (500 and 1000 Hz) to elicit the P300 response and a dichotic digits paradigm to elicit the N200 processing negativity. RESULTS: Compared to control subjects, PD patients exhibited significantly longer latencies of P300 and N200 components and smaller amplitude N200 components. Latency and amplitude of the N200 component were significantly correlated with participants' age. N200 amplitude was correlated with results from the Rey Auditory Verbal Learning Test (RAVLT) of cognitive ability. Latency of the P300 and amplitude of the N200 components were significantly correlated with results from the Spatial Release From Masking (SRM) behavioral CAP assessment. CONCLUSIONS: AERP assessments used in this study appear to be sensitive indicators of CAP and cognitive deficits exhibited by early-stage PD patients. While few significant differences in performance on behavioral CAP and cognitive tests were previously observed between this population of PD patients and age-matched control subjects, N200 and P300 components recorded in the present study revealed impaired neural processing by the PD group.

Dichotic listening deficits in amblyaudia are characterized by aberrant neural oscillations in auditory cortex.

OBJECTIVE: Children diagnosed with auditory processing disorder (APD) show deficits in processing complex sounds that are associated with difficulties in higher-order language, learning, cognitive, and communicative functions. Amblyaudia (AMB) is a subcategory of APD characterized by abnormally large ear asymmetries in dichotic listening tasks. METHODS: Here, we examined frequency-specific neural oscillations and functional connectivity via high-density electroencephalography (EEG) in children with and without AMB during passive listening of nonspeech stimuli. RESULTS: Time-frequency maps of these "brain rhythms" revealed stronger phase-locked beta-gamma (~35 Hz) oscillations in AMB participants within bilateral auditory cortex for sounds presented to the right ear, suggesting a hypersynchronization and imbalance of auditory neural activity. Brain-behavior correlations revealed neural asymmetries in cortical responses predicted the larger than normal right-ear advantage seen in participants with AMB. Additionally, we found weaker functional connectivity in the AMB group from right to left auditory cortex, despite their stronger neural responses overall. CONCLUSION: Our results reveal abnormally large auditory sensory encoding and an imbalance in communication between cerebral hemispheres (ipsi- to -contralateral signaling) in AMB. SIGNIFICANCE: These neurophysiological changes might lead to the functionally poorer behavioral capacity to integrate information between the two ears in children with AMB.

Dissociation of tone merger and congenital amusia in Hong Kong Cantonese.

While the issue of individual variation has been widely studied in second language learning or processing, it is less well understood how perceptual and musical aptitude differences can explain individual variation in native speech processing. In the current study, we make use of tone merger in Hong Kong Cantonese, an ongoing sound change that concerns the merging of tones in perception, production or both in a portion of native speakers, to examine the possible relationship between tone merger and musical and pitch abilities. Although a previous study has reported the occurrence of tone merger independently of musical training, it has not been investigated before whether tone-merging individuals, especially those merging tones in perception, would have inferior musical perception and fine-grained pitch sensitivities, given the close relationship of speech and music. To this end, we tested three groups of tone-merging individuals with various tone perception and production profiles on musical perception and pitch threshold tasks, in comparison to a group of Cantonese speakers with congenital amusia, and another group of controls without tone merger or amusia. Additionally, the amusics were compared with tone-merging individuals on the details of their tone discrimination and production profiles. The results showed a clear dissociation of tone merger and amusia, with the tone-merging individuals exhibiting intact musical and pitch abilities; on the other hand, the amusics demonstrated widespread difficulties in tone discrimination yet intact tone production, in contrast to the highly selective confusion of a specific tone pair in production or discrimination in tone-merging individuals. These findings provide the first evidence that tone merger and amusia are distinct from each other, and further suggest that the cause of tone merger may lie elsewhere rather than being driven by musical or pitch deficits. We also discussed issues arising from the current findings regarding the neural mechanisms of tone merger and amusia.

Aberrant auditory system and its developmental implications for autism.

Most infants who are later diagnosed with autism show delayed speech and language and/or atypical language profile. There is a large body of research on abnormal speech and language in children with autism. However, auditory development has been relatively under-investigated in autism research, despite its inextricable relationship with language development and despite researchers' ability to detect abnormalities in brain development and behavior in early infancy. In this review, we synthesize research on auditory processing in the prenatal period through infancy and childhood in typically developing children, children at high risk for autism, and children diagnosed with autism. We conclude that there are clear neurobiological and behavioral links between abnormal auditory development and the deficits in social communication seen in autism. We then offer perspectives on the need for a systematic characterization of early auditory development in autism, and identified questions to be addressed in future research on the development of autism.

Congenital amusia and academic performance among Colombian university students.

BACKGROUND: Congenital amusia is a rare neurogenetic and neuropsychological condition which hinders the ability to recognize variations in all aspects of a musical piece. Although previous studies have determined the prevalence of congenital amusia in the general population, few have studied its presence among university students. Findings regarding the association between this condition and academic performance are equivocal, although evidence suggests that musical training improves scholastic achievement. METHODS: We conducted a cross-sectional study on a sample of 383 university students, all pursuing health-related degrees, comparing their class rank with their performance on the BRAMS Online Test for amusia. RESULTS: We found a prevalence of 0.52% for pitch-based amusia. When applying the Off-Scale test failure criterion for the definition of amusia in our sample, we found a prevalence of 4.4%. Logistic models showed an increase in risk of poor academic performance (lowest quartile) in subjects who failed the off-scale test (Odds Ratio: 7.14 95% CI 2.59-19.6) and who met any of the described definitions of amusia (Odds Ratio: 4.89 95% CI 2.24-10.7). CONCLUSIONS: Both musical training and self-report of musical ability significantly affected test results. Although musical education shows some effect over academic performance, further studies are required to determine if this is due to differential effects in subjects with and without amusia.

The impact of vocal tuning in the perceptual auditory judgment of normal and deviated voice qualities. / O impacto da afinação vocal na análise perceptivo-auditiva de vozes normais e alteradas.

PURPOSE: To evaluate the ability that in tune and out of tune individuals have to identify normal and deviated voice qualities and to compare it with their performance in auditory processing tests and perceptual judgment. METHOD: The study investigated 15 in tune and 15 out of tune individuals. Participants were matched for age and sex, were amateur choir singers, had normal hearing thresholds and normal vocal quality. All individuals underwent Pitch-matching scanning to be classified as in or out of tune. Next, they performed the Pitch Pattern Sequence (PPS) and the Duration Pattern Sequence (DPS) tests and the perceptual judgment of 36 voices plus 20% of repetition for reliability analysis. RESULTS: The out of tune individuals had worse performance in the PPS and DPS for both ears (p=0.002 RE; p=0.001 LE; p=0.009 DPS); no difference was observed in the perceptual judgment and the reliability (p=0.153). However, participants with normal PPS and DPS had better performance in the perceptual judgment and better reliability (p=0.033). Thus, individuals with disorders in temporal auditory processing skills have greater difficulty in the perceptual judgment and have lower intra-rater reliability, despite being in or out of tune. CONCLUSION: It can be observed that voice tone is not required to guarantee good perceptual judgment. However, temporal patterns and intra-rater reliability are essential to perceptually assess normal and altered voice qualities. Therefore, auditory training should be included in programs that aim to develop voice perceptual judgment abilities.

Altered functional connectivity during speech perception in congenital amusia.

Individuals with congenital amusia have a lifelong history of unreliable pitch processing. Accordingly, they downweight pitch cues during speech perception and instead rely on other dimensions such as duration. We investigated the neural basis for this strategy. During fMRI, individuals with amusia (N = 15) and controls (N = 15) read sentences where a comma indicated a grammatical phrase boundary. They then heard two sentences spoken that differed only in pitch and/or duration cues and selected the best match for the written sentence. Prominent reductions in functional connectivity were detected in the amusia group between left prefrontal language-related regions and right hemisphere pitch-related regions, which reflected the between-group differences in cue weights in the same groups of listeners. Connectivity differences between these regions were not present during a control task. Our results indicate that the reliability of perceptual dimensions is linked with functional connectivity between frontal and perceptual regions and suggest a compensatory mechanism.

Spoken language is colored by fluctuations in pitch and rhythm. Rather than speaking in a flat monotone, we allow our sentences to rise and fall. We vary the length of syllables, drawing out some, and shortening others. These fluctuations, known as prosody, add emotion to speech and denote punctuation. In written language, we use a comma or a period to signal a boundary between phrases. In speech, we use changes in pitch ­ how deep or sharp a voice sounds ­ or in the length of syllables. Having more than one type of cue that can signal emotion or transitions between sentences has a number of advantages. It means that people can understand each other even when factors such as background noise obscure one set of cues. It also means that people with impaired sound perception can still understand speech. Those with a condition called congenital amusia, for example, struggle to perceive pitch, but they can compensate for this difficulty by placing greater emphasis on other aspects of speech. Jasmin et al. showed how the brain achieves this by comparing the brain activities of people with and without amusia. Participants were asked to read sentences on a screen where a comma indicated a boundary between two phrases. They then heard two spoken sentences, and had to choose the one that matched the written sentence. The spoken sentences used changes in pitch and/or syllable duration to signal the position of the comma. This provided listeners with the information needed to distinguish between "after John runs the race, ..." and "after John runs, the race...", for example. When two brain regions communicate, they tend to increase their activity at around the same time. The brain regions are then said to show functional connectivity. Jasmin et al. found that compared to healthy volunteers, people with amusia showed less functional connectivity between left hemisphere brain regions that process language and right hemisphere regions that process pitch. In other words, because pitch is a less reliable source of information for people with amusia, they recruit pitch-related brain regions less when processing speech. These results add to our understanding of how brains compensate for impaired perception. This may be useful for understanding the neural basis of compensation in other clinical conditions. It could also help us design bespoke hearing aids or other communication devices, such as computer programs that convert text into speech. Such programs could tailor the pitch and rhythm characteristics of the speech they produce to suit the perception of individual users.

Remediating spatial processing disorder in Aboriginal and Torres Strait Islander children.

OBJECTIVE: Australian Aboriginal and Torres Strait Islander children are much more likely than non-Indigenous children to experience early onset, chronic otitis media and associated hearing loss. This can result in the child developing spatial processing disorder (SPD). The aim of this study was to assess the efficacy of Sound Storm auditory training in remediating SPD in Aboriginal and Torres Strait Islander children at a regional school in Queensland, Australia. METHOD: Fifteen Aboriginal and Torres Strait Islander children (males = 8, females = 7, age range = 6-13 years, mean = 8 years; 6 months) with SPD were tested on audiometry, the Listening in Spatialized Noise - Sentences Test (LiSN-S), and Listening in Spatialized Noise - Universal Test (LiSN-U). Teachers completed the Listening Inventory for Education - Revised Teacher Questionnaire (LIFE-R) and Auditory Processing Domains Questionnaire (APDQ). These measures were taken pre- and post-training with Sound Storm. RESULTS: Children's Sound Storm noise-to-signal ratio improved significantly and was positively correlated with the number of games they played. Eight of the nine children who completed at least 40% of the training were retested on the LiSN-S, LiSN-U, LIFE-R, and APDQ post-training. SPD was remediated in seven children according to the LiSN-S. All five children who were retested on the LiSN-U post-training showed spatial advantage scores within the normal range. Questionnaire results were mixed with only some children showing improved scores on the LIFE-R and APDQ. CONCLUSIONS: Sound Storm auditory training can be used in school with Aboriginal and Torres Strait Islander children to remediate SPD, however, it has its challenges. Maintaining the child's motivation to complete the training can be difficult. Additionally, the impacts of school holidays, events, and absences must be managed, as well as the impacts of the program on the child's school day.

Amusia congénita y sus efectos en habilidades no musicales / Congenital amusia and its effects on non-musical skills

INTRODUCCIÓN: La amusia congénita es una condición específica en la que el individuo afectado es incapaz de reconocer variaciones tonales en las piezas musicales. Esto no puede explicarse por una lesión encefálica previa, una pérdida auditiva, un déficit cognitivo, un trastorno socioafectivo o una falta de estimulación ambiental. Actualmente se estima una prevalencia del 1,5% de la población mundial, con un importante componente genético entre los afectados. Se ha descrito que en las personas con amusia puede haber afectación de ciertas habilidades cognitivas en el campo emocional, espacial y del lenguaje. OBJETIVO: Revisar la bibliografía donde se describen los efectos en las habilidades no musicales que pueden coexistir en individuos con amusia congénita. DESARROLLO: Varios estudios de neuroimagen han permitido observar cambios morfológicos y funcionales en el lóbulo temporal, así como en las conexiones de la sustancia blanca entre el giro temporal superior y el giro frontal inferior. Partiendo de estas regiones afectadas, podría existir un déficit en habilidades cognitivas relacionadas con áreas adyacentes. CONCLUSIONES: La amusia congénita se ha relacionado con un pobre desempeño en diferentes habilidades cognitivas no musicales, como el procesamiento visuoespacial, el procesamiento del lenguaje, alteraciones de la lectura, el reconocimiento de rostros y aspectos emocionales

INTRODUCTION: Congenital amusia is a specific condition in which the individual is unable to recognise tonal variations in a piece of musical. This cannot be explained by a previous brain injury, hearing loss, cognitive deficit, socio-affective disorder or lack of environmental stimulation. The current estimated prevalence is 1.5% of the world population, with a significant genetic component among those who suffer from it. It has been claimed that certain cognitive abilities in the emotional, spatial and language fields may be affected in people with amusia. AIM: To review the literature describing the effects on non-musical skills that may coexist in individuals with congenital amusia. DEVELOPMENT: Several neuroimaging studies have observed morphological and functional changes in the temporal lobe, as well as in the white matter connections between the superior temporal gyrus and the inferior frontal gyrus. From these affected regions, there may be a deficit in cognitive skills related to adjacent areas. CONCLUSIONS: Congenital amusia has been associated with poor performance in different non-musical cognitive skills, such as visuospatial processing, language processing, reading difficulties, face recognition and emotional aspects

Impact of hearing loss on the performance of auditory processing measured by questionnaires in Korean adolescents.

Increasing use of personal listening devices has been accompanied by increase in the prevalence of hearing loss (HL) among youth in Korea, as in other countries. Auditory processing disorder (APD) is one of the main factors affecting academic achievement at school. This study aimed to investigate the prevalence of HL in students attending general middle- and high schools and compare the findings with the APD survey results. From June 1 to December 31, 2016, Korean adolescents (n = 2,791) in the first years of middle- and high school underwent audiometric testing and otologic examination and completed questionnaires on APD. The survey was sponsored by the Korean Society of Otolaryngology-Head and Neck Surgery and the Korean Otology Society. The prevalence of speech-frequency hearing loss (SFHL) and high-frequency hearing loss (HFHL) in the poorer ear was 11.6% and 10.3%, respectively, among Korean adolescents. We analysed data from the Scale of Auditory Behaviors, Fisher's Auditory Problems Checklist, and KNISE-Auditory Behavioral Checklist and compared these with the results of hearing tests. We observed positive correlations among the APD questionnaire results and mean hearing levels. This study suggested that hearing loss, especially bilateral high-frequency hearing loss, may affect central auditory processing.

Auditory processing, co-morbidities, and parental report of sleep disturbance in children with auditory processing disorder (APD).

OBJECTIVES: To evaluate the prevalence of sleep disturbance and its relationship with auditory processing (AP) and co-morbidities in children diagnosed with auditory processing disorder (APD). METHODS: Data from 109 children (Males = 59, Females = 50) with mean non-verbal intelligence quotient (NVIQ) of 89.44 (SD:18.16), aged between 6 and 16 years (mean: 10 years 7 months; SD: 2 years 9 months) with a diagnosis of APD were analysed. Participants performed ≤1.33 SD below the mean in two or more out of five SCAN-3 diagnostic APD tests that included 'Filtered Words' (FW), 'Auditory Figure Ground 0 dB' (AFG0), 'Competing Words-Directed Ear' (CW-DE), 'Competing Sentences' (CS) and 'Time Compressed Sentences' (TCS). Concern about sleep in addition to other symptoms and medical history were documented from structured parental history sheet which forms part of the routine APD assessment. Language impairment (LI), attention-deficit-hyperactivity-disorder (ADHD) and oppositional defiant disorder (ODD), and anxiety were evaluated using the 'Children's Communication Checklist-2' (CCC-2), 'Swanson Nolan and Pelham rating scale' (SNAP-IV) and 'Anxiety Scale for Children-Autism Spectrum Disorder' (ASC-ASD) respectively. RESULTS: Sixty children had sleep disturbance, a prevalence of 55% (95% CI 45.2%-64.6%). The two groups of APD children, with (n = 49) and without sleep (n = 60) disturbance, did not vary in their auditory processing abilities. The sleep disturbed group had significant issues with pragmatic language impairment, hyperactivity/impulsivity, oppositional defiant symptoms and anxiety compared to the group without sleep disturbance when they were analysed separately. After the variables were considered in step wise fashion in binary logistic regression analyses, only pragmatic language impairment and anxiety predicted sleep disturbance (p < .01). CONCLUSION: In APD the prevalence of sleep disturbance is high, justifying screening within a transdisciplinary APD assessment protocol. Sleep disturbance in APD is predicted by pragmatic language impairment and anxiety, but not by ADHD symptoms or ODD.

Abnormal development of auditory responses in the inferior colliculus of a mouse model of Fragile X Syndrome.

Sensory processing abnormalities are frequently associated with autism spectrum disorders, but the underlying mechanisms are unclear. Here we studied auditory processing in a mouse model of Fragile X Syndrome (FXS), a leading known genetic cause of autism and intellectual disability. Both humans with FXS and the Fragile X mental retardation gene (Fmr1) knockout (KO) mouse model show auditory hypersensitivity, with the latter showing a strong propensity for audiogenic seizures (AGS) early in development. Because midbrain abnormalities cause AGS, we investigated whether the inferior colliculus (IC) of the Fmr1 KO mice shows abnormal auditory processing compared with wild-type (WT) controls at specific developmental time points. Using antibodies against neural activity marker c-Fos, we found increased density of c-Fos+ neurons in the IC, but not auditory cortex, of Fmr1 KO mice at P21 and P34 following sound presentation. In vivo single-unit recordings showed that IC neurons of Fmr1 KO mice are hyperresponsive to tone bursts and amplitude-modulated tones during development and show broader frequency tuning curves. There were no differences in rate-level responses or phase locking to amplitude-modulated tones in IC neurons between genotypes. Taken together, these data provide evidence for the development of auditory hyperresponsiveness in the IC of Fmr1 KO mice. Although most human and mouse work in autism and sensory processing has centered on the forebrain, our new findings, along with recent work on the lower brainstem, suggest that abnormal subcortical responses may underlie auditory hypersensitivity in autism spectrum disorders.NEW & NOTEWORTHY Autism spectrum disorders (ASD) are commonly associated with sensory sensitivity issues, but the underlying mechanisms are unclear. This study presents novel evidence for neural correlates of auditory hypersensitivity in the developing inferior colliculus (IC) in Fmr1 knockout (KO) mouse, a mouse model of Fragile X Syndrome (FXS), a leading genetic cause of ASD. Responses begin to show genotype differences between postnatal days 14 and 21, suggesting an early developmental treatment window.

Multi-level evidence of an allelic hierarchy of USH2A variants in hearing, auditory processing and speech/language outcomes.

Language development builds upon a complex network of interacting subservient systems. It therefore follows that variations in, and subclinical disruptions of, these systems may have secondary effects on emergent language. In this paper, we consider the relationship between genetic variants, hearing, auditory processing and language development. We employ whole genome sequencing in a discovery family to target association and gene x environment interaction analyses in two large population cohorts; the Avon Longitudinal Study of Parents and Children (ALSPAC) and UK10K. These investigations indicate that USH2A variants are associated with altered low-frequency sound perception which, in turn, increases the risk of developmental language disorder. We further show that Ush2a heterozygote mice have low-level hearing impairments, persistent higher-order acoustic processing deficits and altered vocalizations. These findings provide new insights into the complexity of genetic mechanisms serving language development and disorders and the relationships between developmental auditory and neural systems.

Paradoxical and labile medial olivocochlear functioning as a potential marker of auditory processing disorder in a child with learning disabilities.

INTRODUCTION: The medial olivocochlear system (MOCS) is composed of fibres projecting directly onto outer hair cells and plays a role in improving the signal-to-noise ratio. The MOCS can be evaluated by measuring suppression of the otoacoustic emissions evoked by contralateral acoustic stimulation. Dyslexic children present an increased probability of auditory processing disorder (APD). These children may present paradoxical MOCS dysfunction. CASE REPORT: We report the case of a dyslexic child with APD, who was severely disabled in a noisy environment. Audiometric tests were normal, and the central auditory assessment showed labile MOCS functioning that was not only ineffective, but also potentially deleterious, possibly accounting for this child's hearing impairment in a noisy environment. DISCUSSION: This case illustrates the importance of audiological assessment and objective investigation of MOCS function in children with a learning disability, especially with hearing difficulties in the presence of noise, in whom auditory training can be beneficial.

Applicability of the real ear measurement for audiological intervention of tinnitus / Aplicabilidade das medidas da orelha real na intervenção audiológica do zumbido

Abstract Introduction Tinnitus is present in a large part of chronic health complaints, and it is considered a public health problem injurious to the individual's quality of life. Considering the increase of the world population associated with an increase of life expectancy, tinnitus remains a cause for medical concern, since during aging the occurrence of auditory impairments due to the deterioration of the peripheral auditory structures and central impairs the quality of life. Objective The aim of the present study was to analyze the applicability of real ear measurements for audiological intervention of tinnitus through specific evaluation, selection, verification and validation of the hearing aids combined with the sound generator. Methods Forty individuals of both genders with hearing loss and tinnitus complaints were deemed eligible to compose the sample. They were enrolled according to clinical symptoms and submitted to the following procedures: anamnesis and previous complaint history, high frequency audiometry, immittanciometry and acuphenometry with the research of psychoacoustic thresholds of pitch, loudness and minimum masking threshold, sound generator, in addition to the application of the Tinnitus Handicap Inventory and Visual Analog Scale tools. The entire sample was adapted with Siemens hearing aids and a sound generator, participated in a counseling session with support of digital material and evaluated in two situations: Initial Assessment (before the hearing aids and sound generator adaptation) and Final Assessment (6 months, after adaptation). The statistical analyzes were descriptive and inferential, adopted a significance level of 5% and the T-Paired Test and the Spearman Correlation test were performed. Results The results showed that there was a benefit with the use of hearing aids combined with a sound generator from the statistically significant values and strong correlations between the sound generator verification data regarding acuphenometry and the nuisance/severity questionnaires. Regarding the verification of the sound generator, it is important to highlight that the entire sample selected the effective acoustic stimulation based on the comfort levels, which was proved in the present study to be a sufficient intensity for positive prognosis, whereas the users' noises were found below the psychoacoustic thresholds of acuphenometry. Conclusion The present study concluded that the audiological intervention with any level of sound stimulus is enough to obtain a positive prognosis in the medium term. Data that specifies that the verification of sound generator was effective at the real ear measurements are important in the evaluation and intervention of the complaint. In addition, it points out that the greater the tinnitus perception, the greater its severity, and the greater the nuisance, the higher the psychoacoustics thresholds of frequency and the minimum threshold of masking.

Resumo Introdução O zumbido está presente em grande parte das queixas crônicas de saúde, é considerado um problema de saúde pública, prejudicial à qualidade de vida do indivíduo. Considerando o aumento da população mundial associado ao aumento da expectativa de vida, a tendência é que o zumbido permaneça como um motivo de preocupação, uma vez que com a idade a ocorrência de prejuízos auditivos decorrentes da deterioração das estruturas auditivas periféricas e centrais ocasiona grande impacto negativo na qualidade de vida. Objetivo Analisar a aplicabilidade das medidas da orelha real para a intervenção audiológica do zumbido através de avaliação específica, seleção, verificação e validação do aparelho de amplificação sonora individual combinada ao gerador de som. Método Quarenta indivíduos de ambos os sexos com perda auditiva e queixa de zumbido foram considerados elegíveis para compor a amostra. Eles foram atendidos conforme a demanda clínica e submetidos aos seguintes procedimentos: anamnese e história pregressa da queixa, audiometria de alta frequência, imitanciometria e acufenometria com pesquisa dos limiares psicoacústicos de pitch, loudness e limiar mínimo de mascaramento, gerador de som, além da aplicação das ferramentas tinnitus handicap inventory e escala visual analógica. Toda a amostra recebeu aparelho de amplificação sonora individual e gerador de som, ambos da marca Siemens, participaram de uma sessão de aconselhamento com apoio de material digital e foram avaliados em duas situações: Avaliação inicial (antes da adaptação dos aparelhos de amplificação sonora individual e gerador de som) e Avaliação final (6 meses após a adaptação). As análises estatísticas foram descritivas e inferenciais, adotou-se um nível de significância de 5% com a realização do teste t pareado e o teste de correlação de Spearman. Resultados Os resultados mostraram que houve benefício com o uso de aparelho de amplificação sonora individual combinado ao gerador de som com base nos valores estatisticamente significantes e fortes correlações entre os dados da verificação do gerador de som em relação à acufenometria e os questionários de incômodo/gravidade. Em relação à verificação do gerador de som, é importante destacar que toda a amostra selecionou a estimulação acústica efetiva baseada nos níveis de conforto e no presente estudo demonstraram ser de intensidade suficiente para o prognóstico positivo, enquanto que os ruídos dos usuários estavam abaixo dos limiares psicoacústicos da acufenometria. Conclusão A intervenção audiológica com qualquer nível de estímulo sonoro é suficiente para obter um prognóstico positivo em médio prazo. Os dados que demonstram que a verificação do gerador de som foi efetiva nas medidas da orelha real são importantes na avaliação e intervenção da queixa. Além disso, mostram que quanto maior a percepção do zumbido, maior a sua gravidade; e quanto maior o incômodo, maiores os limiares de frequência psicoacústica e o limiar mínimo de mascaramento.

Binaural interaction component of the auditory brainstem response in children with autism spectrum disorder.

INTRODUCTION: There is ample evidence that auditory dysfunction is a common feature of autism spectrum disorder (ASD). Binaural interaction component (BIC) manifests binaural interaction and is valid and proven response which reflects ongoing binaural processing. OBJECTIVES: To investigate the differences in binaural interaction component of auditory brainstem response (ABR-BIC) between children with autism spectrum disorder (ASD) and normal peers and to correlate between ABR-BIC amplitudes and the acquired communication skills in ASD children. METHODS: ASD was diagnosed according to the criteria of 5th edition of diagnostic and statistical manual of mental disorders (DSM-V) and all children with ASD underwent test of acquired communication skills (TACS). Click evoked ABRs were elicited by left monaural, right monaural and binaural stimulation at intensity of 65 dBnHL in all participants. ABR-BIC was then calculated as the difference between the binaurally evoked ABR waveform and a predicted binaural waveform created by algebraically summing the left and right monaurally evoked ABRs. The difference in amplitudes that gives rise to ABR-BIC is at IV-VI waves. RESULTS: ABR-BIC amplitudes were demonstrated to be significantly reduced in the ASD group compared to the control group. There was significant positive correlation between ABR-BIC amplitude and the language and social scores in TACS. CONCLUSION: This study provided an objective evidence of binaural processing disorder in children with ASD.

Spectro-temporal modulation detection and its relation to speech perception in children with auditory processing disorder.

OBJECTIVES: Poor speech perception in noise is one of the most common complaints reported for children with auditory processing disorder (APD). APD is defined as a deficit in perceptual processing of acoustic information in the auditory system in which decreased spectro-temporal resolution may also contribute. Since the recognition of spoken message in the context of other sounds, is based on the processing of auditory spectro-temporal modulations, the assessment of spectro-temporal modulations sensitivity can evaluate the listener's ability to retrieve and integrate speech segments covered by noise. Therefore, the purpose of this study was to examine spectro-temporal modulation (STM) detection and its relation to speech perception in children with APD and to compare the results with aged-matched normally developed children. METHODS: 35 children with APD and 32 normal hearing children (8-12 years old) were enrolled. In order to examine STM detection performance, six different STM stimulus conditions were employed using three different temporal modulation rates (4, 12 and 32 Hz) and two different spectral modulation densities (0.5 and 2.0 cycles/octave). Initially, the STM detection thresholds at these six STM stimulus conditions were measured in both groups and the results were compared. Thereafter, the relation between STM detection thresholds and speech perception tests, including consonant-vowel in noise and word in noise tests were assessed. RESULTS: The STM sensitivity was poorer than normal for APD children at all STM stimulus conditions. Children with APD displayed significantly poorer STM detection thresholds than those of normally developed children (p < 0.05). Significant correlations were found between STM detection thresholds and speech perception in noise in both groups (p < 0.05). CONCLUSION: The results suggest that the altered encoding of spectro-temporal acoustic cues in the auditory nervous system may be one of the underlying factors of reduced STM detection performance in children with APD. The present study may suggest that poor ability to extract STM cues in children with APD, can be an underlying factor for their listening problems in noise and poor speech perception in challenging situations.