Electrocochleographic frequency-following responses as a potential marker of age-related cochlear neural degeneration.

Auditory nerve (AN) fibers that innervate inner hair cells in the cochlea degenerate with advancing age. It has been proposed that age-related reductions in brainstem frequency-following responses (FFR) to the carrier of low-frequency, high-intensity pure tones may partially reflect this neural loss in the cochlea (Märcher-Rørsted et al., 2022). If the loss of AN fibers is the primary factor contributing to age-related changes in the brainstem FFR, then the FFR could serve as an indicator of cochlear neural degeneration. In this study, we employed electrocochleography (ECochG) to investigate the effects of age on frequency-following neurophonic potentials, i.e., neural responses phase-locked to the carrier frequency of the tone stimulus. We compared these findings to the brainstem-generated FFRs obtained simultaneously using the same stimulation. We conducted recordings in young and older individuals with normal hearing. Responses to pure tones (250 ms, 516 and 1086 Hz, 85 dB SPL) and clicks were recorded using both ECochG at the tympanic membrane and traditional scalp electroencephalographic (EEG) recordings of the FFR. Distortion product otoacoustic emissions (DPOAE) were also collected. In the ECochG recordings, sustained AN neurophonic (ANN) responses to tonal stimulation, as well as the click-evoked compound action potential (CAP) of the AN, were significantly reduced in the older listeners compared to young controls, despite normal audiometric thresholds. In the EEG recordings, brainstem FFRs to the same tone stimulation were also diminished in the older participants. Unlike the reduced AN CAP response, the transient-evoked wave-V remained unaffected. These findings could indicate that a decreased number of AN fibers contributes to the response in the older participants. The results suggest that the scalp-recorded FFR, as opposed to the clinical standard wave-V of the auditory brainstem response, may serve as a more reliable indicator of age-related cochlear neural degeneration.

Disentangling the effects of hearing loss and age on amplitude modulation frequency selectivity.

The processing and perception of amplitude modulation (AM) in the auditory system reflect a frequency-selective process, often described as a modulation filterbank. Previous studies on perceptual AM masking reported similar results for older listeners with hearing impairment (HI listeners) and young listeners with normal hearing (NH listeners), suggesting no effects of age or hearing loss on AM frequency selectivity. However, recent evidence has shown that age, independently of hearing loss, adversely affects AM frequency selectivity. Hence, this study aimed to disentangle the effects of hearing loss and age. A simultaneous AM masking paradigm was employed, using a sinusoidal carrier at 2.8 kHz, narrowband noise modulation maskers, and target modulation frequencies of 4, 16, 64, and 128 Hz. The results obtained from young (n = 3, 24-30 years of age) and older (n = 10, 63-77 years of age) HI listeners were compared to previously obtained data from young and older NH listeners. Notably, the HI listeners generally exhibited lower (unmasked) AM detection thresholds and greater AM frequency selectivity than their NH counterparts in both age groups. Overall, the results suggest that age negatively affects AM frequency selectivity for both NH and HI listeners, whereas hearing loss improves AM detection and AM selectivity, likely due to the loss of peripheral compression.

Predicting early auditory evoked potentials using a computational model of auditory-nerve processing.

Non-invasive electrophysiological measures, such as auditory evoked potentials (AEPs), play a crucial role in diagnosing auditory pathology. However, the relationship between AEP morphology and cochlear degeneration remains complex and not well understood. Dau [J. Acoust. Soc. Am. 113, 936-950 (2003)] proposed a computational framework for modeling AEPs that utilized a nonlinear auditory-nerve (AN) model followed by a linear unitary response function. While the model captured some important features of the measured AEPs, it also exhibited several discrepancies in response patterns compared to the actual measurements. In this study, an enhanced AEP modeling framework is presented, incorporating an improved AN model, and the conclusions from the original study were reevaluated. Simulation results with transient and sustained stimuli demonstrated accurate auditory brainstem responses (ABRs) and frequency-following responses (FFRs) as a function of stimulation level, although wave-V latencies remained too short, similar to the original study. When compared to physiological responses in animals, the revised model framework showed a more accurate balance between the contributions of auditory-nerve fibers (ANFs) at on- and off-frequency regions to the predicted FFRs. These findings emphasize the importance of cochlear processing in brainstem potentials. This framework may provide a valuable tool for assessing human AN models and simulating AEPs for various subtypes of peripheral pathologies, offering opportunities for research and clinical applications.

The effect of auditory training on listening effort in hearing-aid users: insights from a pupillometry study.

OBJECTIVE: The study investigated how auditory training affects effort exerted by hearing-impaired listeners in speech-in-noise task. DESIGN: Pupillometry was used to characterise listening effort during a hearing in noise test (HINT) before and after phoneme-in-noise identification training. Half of the study participants completed the training, while the other half formed an active control group. STUDY SAMPLE: Twenty 63-to-79 years old experienced hearing-aid users. RESULTS: Higher peak pupil dilations (PPDs) were obtained at the end of the study compared to the beginning in both groups of the participants. The analysis of pupil dilation in an extended time window revealed, however, that the magnitude of pupillary response increased more in the training than in the control group. The effect of training on effort was observed in pupil responses even when no improvement in HINT was found. CONCLUSION: The results demonstrate that using a listening effort metric adds additional insights into the effectiveness of auditory training compared to the situation when only speech-in-noise performance is considered. Trends observed in pupil responses suggested increased effort-both after the training and the placebo intervention-most likely reflecting the effect of the individual's motivation.

Effect of sound therapy on whole scalp oscillatory brain activity and distress in chronic tinnitus patients.

Introduction: Sound therapy is a common tinnitus treatment, where the tinnitus percept is either fully or partially masked by an external sound. Some tinnitus patients experience a decrease in tinnitus related distress after the use of sound therapy. Differences in the neural response to sound therapy may form a basis for classifying tinnitus patients. Methods: In this study, the long-term (2 months) effects of sound therapy on the oscillatory brain activity and tinnitus related distress were investigated in chronic tinnitus patients. Baseline oscillatory activity in the group of tinnitus participants was also compared to a matched control group. Results: No differences were found in the oscillatory activity when comparing the tinnitus group to the control group. Differences were found for the frequency range between 27.5 and 41.5 Hz corresponding to high beta and gamma power when comparing the tinnitus group before and after the use of sound therapy. Furthermore, a reduction of the tinnitus-related distress was found after the long-term use of sound therapy. However, there was no correlation between the changes in the oscillatory activity and the reductions of the tinnitus-related distress. Discussion: Overall, the lack of correlation between the changes in tinnitus-related distress and changes in power activity hampers the interpretability of the findings and undermines the utility of using oscillatory activity as a biomarker for the effect of sound therapy treatment.

The Effects of Noise and Simulated Conductive Hearing Loss on Physiological Response Measures During Interactive Conversations.

PURPOSE: The purpose of this work was to study the effects of background noise and hearing attenuation associated with earplugs on three physiological measures, assumed to be markers of effort investment and arousal, during interactive communication. METHOD: Twelve pairs of older people (average age of 63.2 years) with age-adjusted normal hearing took part in a face-to-face communication to solve a Diapix task. Communication was held in different levels of babble noise (0, 60, and 70 dBA) and with two levels of hearing attenuation (0 and 25 dB) in quiet. The physiological measures obtained included pupil size, heart rate variability, and skin conductance. In addition, subjective ratings of perceived communication success, frustration, and effort were obtained. RESULTS: Ratings of perceived success, frustration, and effort confirmed that communication was more difficult in noise and with approximately 25-dB hearing attenuation and suggested that the implemented levels of noise and hearing attenuation resulted in comparable communication difficulties. Background noise at 70 dBA and hearing attenuation both led to an initial increase in pupil size (associated with effort), but only the effect of the background noise was sustained throughout the conversation. The 25-dB hearing attenuation led to a significant decrease of the high-frequency power of heart rate variability and a significant increase of skin conductance level, measured as the average z value of the electrodermal activity amplitude. CONCLUSION: This study demonstrated that several physiological measures appear to be viable indicators of changing communication conditions, with pupillometry and cardiovascular as well as electrodermal measures potentially being markers of communication difficulty.

A Data-driven Distance Metric for Evaluating the effects of Dynamic Range Compression in Adverse Conditions.

Dynamic range compression is a crucial component in hearing aids, aiming to restore audibility for hearing-impaired listeners. However, determining suitable compression parameters, such as the time constants for the level estimation stage, remains a topic of debate, as the perceptual benefit of different parameter configurations varies depending on the acoustic conditions. In this study, a data-driven distance metric based on physical metrics was developed to evaluate and compare the performance of various compression systems. This analysis encompassed fast-acting and slow-acting compression, as well as a "scene-aware" compression that dynamically adjusted the release time constant based on the presence of the target. A reference system called "source-independent compression" was also considered, which had access to individual speech and noise signals. Multiple physical metrics were employed to assess the effects of these different compression systems under diverse acoustic conditions, including varying levels of interfering noise and degrees of room reverberation. Factor analysis was applied to derive a concise set of interpretable features representing the impact of compression, expressed as linear combinations of carefully selected objective metrics. The reduced dimensional representation enabled the use of the Manhattan distance to measure the similarity between the compression systems. Results demonstrated that the scene-aware compressor generally exhibited a smaller distance to the reference system compared to both the fast-acting and slow-acting compressors. This finding suggests that an adaptive compression system holds potential benefits across a range of acoustic conditions.

The Role of Average Fundamental Frequency Difference on the Intelligibility of Real-Life Competing Sentences.

PURPOSE: The average fundamental frequency separation (∆fo) between two competing voices has been shown to provide an important cue for target-speech intelligibility. However, some of the previous investigations used speech materials with linguistic properties and fo characteristics that may not be typical of realistic acoustic scenarios. This study investigated to what extent the effect of ∆fo generalizes to more real-life speech. METHODS: Real-life sentences and a well-controlled method for manipulating the acoustic stimuli were employed. Fifteen young normal-hearing native Danish listeners were tested in a two-competing-voices sentence recognition task at several target-to-masker ratios (TMRs) and ∆fos. RESULTS: Compared to previous studies that addressed the same experimental scenario with less realistic speech materials, the present results showed only a moderate effect of ∆fo at negative TMRs and a negligible effect at positive TMRs. An analysis of the employed stimuli showed that a large ∆fo effect on the target speech intelligibility is only observed when the competing sentences have highly synchronous fo trajectories, which is typical of the artificial speech materials employed in previous studies. CONCLUSION: Overall, the present results suggest a relatively small effect of ∆fo on the intelligibility of real-life speech, as compared to previously employed artificial speech, in two-competing-sentences conditions.

Age-related reduction of amplitude modulation frequency selectivity.

The perception of amplitude modulations (AMs) has been characterized by a frequency-selective process in the temporal envelope domain and simulated in computational auditory processing and perception models using a modulation filterbank. Such AM frequency-selective processing has been argued to be critical for the perception of complex sounds, including speech. This study aimed at investigating the effects of age on behavioral AM frequency selectivity in young (n = 11, 22-29 years) versus older (n = 10, 57-77 years) listeners with normal hearing, using a simultaneous AM masking paradigm with a sinusoidal carrier (2.8 kHz), target modulation frequencies of 4, 16, 64, and 128 Hz, and narrowband-noise modulation maskers. A reduction of AM frequency selectivity by a factor of up to 2 was found in the older listeners. While the observed AM selectivity co-varied with the unmasked AM detection sensitivity, the age-related broadening of the masked threshold patterns remained stable even when AM sensitivity was similar across groups for an extended stimulus duration. The results from the present study might provide a valuable basis for further investigations exploring the effects of age and reduced AM frequency selectivity on complex sound perception as well as the interaction of age and hearing impairment on AM processing and perception.

The effect of phoneme-based auditory training on speech intelligibility in hearing-aid users.

OBJECTIVE: Hearing loss commonly causes difficulties in understanding speech in the presence of background noise. The benefits of hearing-aids in terms of speech intelligibility in challenging listening scenarios remain limited. The present study investigated if phoneme-in-noise discrimination training improves phoneme identification and sentence intelligibility in noise in hearing-aid users. DESIGN: Two groups of participants received either a two-week training program or a control intervention. Three phoneme categories were trained: onset consonants (C1), vowels (V) and post-vowel consonants (C2) in C1-V-C2-/i/ logatomes from the Danish nonsense word corpus (DANOK). Phoneme identification test and hearing in noise test (HINT) were administered before and after the respective interventions and, for the training group only, after three months. STUDY SAMPLE: Twenty 63-to-79 years old individuals with a mild-to-moderate sensorineural hearing loss and at least one year of experience using hearing-aids. RESULTS: The training provided an improvement in phoneme identification scores for vowels and post-vowel consonants, which was retained over three months. No significant performance improvement in HINT was found. CONCLUSION: The study demonstrates that the training induced a robust refinement of auditory perception at a phoneme level but provides no evidence for the generalisation to an untrained sentence intelligibility task.

Toward a clinically viable spectro-temporal modulation test for predicting supra-threshold speech reception in hearing-impaired listeners.

The ability of hearing-impaired listeners to detect spectro-temporal modulation (STM) has been shown to correlate with individual listeners' speech reception performance. However, the STM detection tests used in previous studies were overly challenging especially for elderly listeners with moderate-to-severe hearing loss. Furthermore, the speech tests considered as a reference were not optimized to yield ecologically valid outcomes that represent real-life speech reception deficits. The present study investigated an STM detection measurement paradigm with individualized audibility compensation, focusing on its clinical viability and relevance as a real-life supra-threshold speech intelligibility predictor. STM thresholds were measured in 13 elderly hearing-impaired native Danish listeners using four previously established (noise-carrier based) and two novel complex-tone carrier based STM stimulus variants. Speech reception thresholds (SRTs) were measured (i) in a realistic spatial speech-on-speech set up and (ii) using co-located stationary noise, both with individualized amplification. In contrast with previous related studies, the proposed measurement paradigm yielded robust STM thresholds for all listeners and conditions. The STM thresholds were positively correlated with the SRTs, whereby significant correlations were found for the realistic speech-test condition but not for the stationary-noise condition. Three STM stimulus variants (one noise-carrier based and two complex-tone based) yielded significant predictions of SRTs, accounting for up to 53% of the SRT variance. The results of the study could form the basis for a clinically viable STM test for quantifying supra-threshold speech reception deficits in aided hearing-impaired listeners.

Baseline pupil size encodes task-related information and modulates the task-evoked response in a speech-in-noise task.

Pupillometry data are commonly reported relative to a baseline value recorded in a controlled pre-task condition. In this study, the influence of the experimental design and the preparatory processing related to task difficulty on the baseline pupil size was investigated during a speech intelligibility in noise paradigm. Furthermore, the relationship between the baseline pupil size and the temporal dynamics of the pupil response was assessed. The analysis revealed strong effects of block presentation order, within-block sentence order and task difficulty on the baseline values. An interaction between signal-to-noise ratio and block order was found, indicating that baseline values reflect listener expectations arising from the order in which the different blocks were presented. Furthermore, the baseline pupil size was found to affect the slope, delay and curvature of the pupillary response as well as the peak pupil dilation. This suggests that baseline correction might be sufficient when reporting pupillometry results in terms of mean pupil dilation only, but not when a more complex characterization of the temporal dynamics of the response is considered. By clarifying which factors affect baseline pupil size and how baseline values interact with the task-evoked response, the results from the present study can contribute to a better interpretation of the pupillary response as a marker of cognitive processing.

A comparative study of eight human auditory models of monaural processing.

A number of auditory models have been developed using diverging approaches, either physiological or perceptual, but they share comparable stages of signal processing, as they are inspired by the same constitutive parts of the auditory system. We compare eight monaural models that are openly accessible in the Auditory Modelling Toolbox. We discuss the considerations required to make the model outputs comparable to each other, as well as the results for the following model processing stages or their equivalents: Outer and middle ear, cochlear filter bank, inner hair cell, auditory nerve synapse, cochlear nucleus, and inferior colliculus. The discussion includes a list of recommendations for future applications of auditory models.

Towards Auditory Profile-Based Hearing-Aid Fittings: BEAR Rationale and Clinical Implementation.

(1) Background: To improve hearing-aid rehabilitation, the Danish 'Better hEAring Rehabilitation' (BEAR) project recently developed methods for individual hearing loss characterization and hearing-aid fitting. Four auditory profiles differing in terms of audiometric hearing loss and supra-threshold hearing abilities were identified. To enable auditory profile-based hearing-aid treatment, a fitting rationale leveraging differences in gain prescription and signal-to-noise (SNR) improvement was developed. This report describes the translation of this rationale to clinical devices supplied by three industrial partners. (2) Methods: Regarding the SNR improvement, advanced feature settings were proposed and verified based on free-field measurements made with an acoustic mannikin fitted with the different hearing aids. Regarding the gain prescription, a clinically feasible fitting tool and procedure based on real-ear gain adjustments were developed. (3) Results: Analyses of the collected real-ear gain and SNR improvement data confirmed the feasibility of the clinical implementation. Differences between the auditory profile-based fitting strategy and a current 'best practice' procedure based on the NAL-NL2 fitting rule were verified and are discussed in terms of limitations and future perspectives. (4) Conclusion: Based on a joint effort from academic and industrial partners, the BEAR fitting rationale was transferred to commercially available hearing aids.

The Short and Long-Term Effect of Sound Therapy on Visual Attention in Chronic Tinnitus Patients.

Sound therapy is one of the most common tinnitus treatments that can be used either to mask or to shift attention away from the tinnitus percept. However, the actual benefit of sound therapy and the mechanisms leading to the benefits remain limited. The objective of this study was to investigate the short-term (15 min) and long-term (2 months) effects of sound therapy on visual attention in chronic tinnitus patients. Visual attention was evaluated with the behavioral Attention Network Task, while the tinnitus-related distress was evaluated with the Tinnitus Handicap Inventory (THI) to quantify the effect of sound therapy. The study included 20 participants with chronic and bothersome tinnitus (>6 months, THI > 18) and 20 matched control participants. All participants took part in a first session consisting of a baseline condition, a short-term sound therapy condition and a silent control condition. The tinnitus participants also took part in a second session that evaluated the long-term effect of the therapy. A reduction in the tinnitus-related distress was found after the long-term use of sound therapy. Furthermore, a reduction in the differential index of the executive control (EC) attention network, indicating improved attention, was found after long-term use of sound therapy in the sound condition but not in the silent control condition. In contrast to earlier research, no differences were found between the tinnitus group and the control group for the baseline measurement of the EC attention network. Overall, the results suggest that there is no link between the visual attention networks and the sound therapy's effect on tinnitus-related distress.

Speech intelligibility prediction based on modulation frequency-selective processing.

Speech intelligibility models can provide insights regarding the auditory processes involved in human speech perception and communication. One successful approach to modelling speech intelligibility has been based on the analysis of the amplitude modulations present in speech as well as competing interferers. This review covers speech intelligibility models that include a modulation-frequency selective processing stage i.e., a modulation filterbank, as part of their front end. The speech-based envelope power spectrum model [sEPSM, Jørgensen and Dau (2011). J. Acoust. Soc. Am. 130(3), 1475-1487], several variants of the sEPSM including modifications with respect to temporal resolution, spectro-temporal processing and binaural processing, as well as the speech-based computational auditory signal processing and perception model [sCASP; Relaño-Iborra et al. (2019). J. Acoust. Soc. Am. 146(5), 3306-3317], which is based on an established auditory signal detection and masking model, are discussed. The key processing stages of these models for the prediction of speech intelligibility across a variety of acoustic conditions are addressed in relation to competing modeling approaches. The strengths and weaknesses of the modulation-based analysis are outlined and perspectives presented, particularly in connection with the challenge of predicting the consequences of individual hearing loss on speech intelligibility.

Modulation transfer functions for audiovisual speech.

Temporal synchrony between facial motion and acoustic modulations is a hallmark feature of audiovisual speech. The moving face and mouth during natural speech is known to be correlated with low-frequency acoustic envelope fluctuations (below 10 Hz), but the precise rates at which envelope information is synchronized with motion in different parts of the face are less clear. Here, we used regularized canonical correlation analysis (rCCA) to learn speech envelope filters whose outputs correlate with motion in different parts of the speakers face. We leveraged recent advances in video-based 3D facial landmark estimation allowing us to examine statistical envelope-face correlations across a large number of speakers (∼4000). Specifically, rCCA was used to learn modulation transfer functions (MTFs) for the speech envelope that significantly predict correlation with facial motion across different speakers. The AV analysis revealed bandpass speech envelope filters at distinct temporal scales. A first set of MTFs showed peaks around 3-4 Hz and were correlated with mouth movements. A second set of MTFs captured envelope fluctuations in the 1-2 Hz range correlated with more global face and head motion. These two distinctive timescales emerged only as a property of natural AV speech statistics across many speakers. A similar analysis of fewer speakers performing a controlled speech task highlighted only the well-known temporal modulations around 4 Hz correlated with orofacial motion. The different bandpass ranges of AV correlation align notably with the average rates at which syllables (3-4 Hz) and phrases (1-2 Hz) are produced in natural speech. Whereas periodicities at the syllable rate are evident in the envelope spectrum of the speech signal itself, slower 1-2 Hz regularities thus only become prominent when considering crossmodal signal statistics. This may indicate a motor origin of temporal regularities at the timescales of syllables and phrases in natural speech.

Broadband Amplification as Tinnitus Treatment.

This study investigated the effect of broadband amplification (125 Hz to 10 kHz) as tinnitus treatment for participants with high-frequency hearing loss and compared these effects with an active placebo condition using band-limited amplification (125 Hz to 3-4 kHz). A double-blinded crossover study. Twenty-three participants with high-frequency (≥3 kHz) hearing loss and chronic tinnitus were included in the study, and 17 completed the full treatment protocol. Two different hearing aid treatments were provided for 3 months each: Broadband amplification provided gain in the frequency range from 125 Hz to 10 kHz and band-limited amplification only provided gain in the low-frequency range (≤3-4 kHz). The effect of the two treatments on tinnitus distress was evaluated with the Tinnitus Handicap Inventory (THI) and the Tinnitus Functional Index (TFI) questionnaires. The effect of the treatment on tinnitus loudness was evaluated with a visual analog scale (VAS) for loudness and a psychoacoustic loudness measure. Furthermore, the tinnitus annoyance was evaluated with a VAS for annoyance. The tinnitus pitch was evaluated based on the tinnitus likeness spectrum. A statistically significant difference was found between the two treatment groups (broadband vs. band-limited amplification) for the treatment-related change in THI and TFI with respect to the baseline. Furthermore, a statistically significant difference was found between the two treatment conditions for the annoyance measure. Regarding the loudness measure, no statistically significant differences were found between the treatments, although there was a trend towards a lower VAS-based loudness measure resulting from the broadband amplification. No changes were observed in the tinnitus pitch between the different conditions. Overall, the results from the present study suggest that tinnitus patients with high-frequency hearing loss can experience a decrease in tinnitus-related distress and annoyance from high-frequency amplification.

The effect of hearing aid dynamic range compression on speech intelligibility in a realistic virtual sound environment.

Measures of "aided" speech intelligibility (SI) for listeners wearing hearing aids (HAs) are commonly obtained using rather artificial acoustic stimuli and spatial configurations compared to those encountered in everyday complex listening scenarios. In the present study, the effect of hearing aid dynamic range compression (DRC) on SI was investigated in simulated real-world acoustic conditions. A spatialized version of the Danish Hearing In Noise Test was employed inside a loudspeaker-based virtual sound environment to present spatialized target speech in background noise consisting of either spatial recordings of two real-world sound scenarios or quadraphonic, artificial speech-shaped noise (SSN). Unaided performance was compared with results obtained with a basic HA simulator employing fast-acting DRC. Speech reception thresholds (SRTs) with and without DRC were found to be significantly higher in the conditions with real-world background noise than in the condition with artificial SSN. Improvements in SRTs caused by the HA were only significant in conditions with real-world background noise and were related to differences in the output signal-to-noise ratio of the HA signal processing between the real-world versus artificial conditions. The results may be valuable for the design, development, and evaluation of HA signal processing strategies in realistic, but controlled, acoustic settings.

Corrigendum: Auditory tests for characterizing hearing deficits in listeners with various hearing abilities: The BEAR test battery.

[This corrects the article DOI: 10.3389/fnins.2021.724007.].