Bifenestral surgical and chemical labyrinthectomy, a new effective ablative surgical approach to intractable vertigo in Ménière disease elderly patients / Laberintectomía química y quirúrgica bifenestral, una nueva técnica ablativa eficaz para el vértigo intratable en pacientes ancianos con enfermedad de Ménière

Introduction In this article, the bi-fenestral surgical chemical labyrinthectomy is introduced as a surgical demolition technique for treating resisting incurable forms of Meniere’s disease in patients aged over 70 and/or with low hearing residues refractory to medical treatment. Materials and methods The results on participants fitting the inclusion criteria (n = 16) were reported using anamnesis (frequency of the crisis), Dizziness Handicap Inventory (DHI) and Functional Level Scale (FLS) before and after the intervention. Results Vertigo control was achieved in all patients of this case series. A difference of 57 and 3.67 in mean DHI (from 68 (SD 16.7) to 11 (SD 14)) and FLS (from 4.68 (SD 0.7) to 0.1 (SD 0.3)) scores respectively were seen after an average of 16.28 months. Contextually tinnitus was reported to improve in seven patients (43.75%), aggravate in three (18.75%) and remain unchanged in the remaining six (37.5%). Conclusion Bi-fenestral surgical chemical labyrinthectomy appears a safe, immediate, and effective demolition treatment for vertigo control in a restricted class of patients affected by intractable Meniere disease. (AU)

Introducción En este artículo se presenta la laberintectomía química quirúrgica bifenestral como técnica quirúrgica de demolición para el tratamiento de formas resistentes e incurables de la enfermedad de Meniere en pacientes mayores de 70 años y/o con baja audición refractaria al tratamiento médico. Materiales y métodos Los resultados de los participantes que cumplieron con los criterios de inclusión (n = 16) se informaron mediante anamnesis (frecuencia de las crisis), Dizziness Handicap Inventory (DHI) y Functional Level Scale (FLS) antes y después de la intervención. Resultados Se logró el control del vértigo en todos los pacientes de esta serie de casos. Una diferencia de 57 y 3,67 en las puntuaciones medias de DHI (de 68 (DE 16,7) a 11 (DE 14)) y FLS (de 4,68 (DE 0,7) a 0,1 (DE 0,3)) respectivamente fueron vistos después de un promedio de 16,28 meses. Contextualmente, se informó que el tinnitus mejoró en siete pacientes (43,75%), se agravó en tres (18,75 %) y permaneció sin cambios en los seis restantes (37,5%). Conclusión La laberintectomía química quirúrgica bifenestral parece un tratamiento de demolición seguro, inmediato y efectivo para el control del vértigo en una clase restringida de pacientes afectados por la enfermedad de Meniere intratable. (AU)

Food Insecurity and Hearing Loss Are Interrelated: A Cross-Sectional Population-Based Study.

OBJECTIVES: We aimed to assess whether objectively measured hearing loss and self-perceived hearing handicap in adults are independently associated with food insecurity, and vice versa. DESIGN: Cross-sectional population-based study. POPULATION: 2,500 participants aged 50+ years from the Blue Mountains Hearing Study, with both complete pure-tone audiometry data and information on food security status. MEASUREMENTS: The pure-tone average of frequencies 0.5, 1.0, 2.0 and 4.0 kHz (PTA0.5-4KHz) >25 dB HL in the better ear, established the presence of hearing loss. Self-perceived hearing handicap was assessed by administering the Hearing Handicap Inventory for Elderly Screening (HHIE-S total scores of ≥8 indicates hearing handicap). A 12-item food security survey was administered, comprising statements related to individual and household food situations. RESULTS: Food insecurity was reported by 12.8% of study participants. After adjusting for all potential confounders, any self-perceived hearing handicap significantly increased the likelihood of participants reporting food insecurity by 94% (p<0.0001). Participants reporting any, mild or severe self-perceived hearing handicap had around 2-fold greater odds of experiencing food insecurity. Objectively measured hearing loss did not significantly influence the food security status of study participants. Conversely, food insecurity was significantly associated with both objectively measured hearing loss and self-perceived hearing handicap: multivariate-adjusted OR 1.37 (95% CI 1.01-1.88) and OR 1.83 (95% CI 1.40-2.39), respectively. CONCLUSIONS: Food insecurity was an important social determinant of hearing health among community-dwelling adults. Conversely, participants with a significant self-perceived hearing handicap were more likely to experience food insecurity. These findings add to our understanding of the substantial public health impact of both food insecurity and hearing loss and may highlight areas for future intervention.

Tinnitus and Influencing Comorbidities. / Tinnitus und beeinflussende Komorbiditäten.

Numerous studies show that impairments in chronic tinnitus are closely connected with psychosomatic and other concomitant symptoms. This overview summarizes some of these studies. Beyond hearing loss, individual interactions of medical and psychosocial stress factors as well as resources are of central importance. Tinnitus related distress reflects a large number of intercorrelated, psychosomatic influences - such as personality traits, stress reactivity and depression or anxiety - which can be accompanied by cognitive difficulties and should be conceptualized and assessed within a vulnerability-stress-reaction model. Superordinate factors such as age, gender or education level can increase vulnerability to stress. Therefore, diagnosis and therapy of chronic tinnitus be individualised, multidimensional and interdisciplinary. Multimodal psychosomatic therapy approaches aim to address individually constellated medical, audiological and psychological influences in order to sustainably increase the quality of life of those affected. Counselling in the first contact is also indispensable for diagnosis and therapy.

Association between Subjective Hearing Impairment and Cognitive Status among Korean Elderly.

Background: The goal of this study was to investigate the impact of subjectively assessed hearing impairment on cognitive function in elderly Koreans living in the community. Methods: In the 2020 Survey of Living Conditions and Welfare Needs of Korean Older Persons Survey, 9920 subjects (5949 females; 60%) aged 65 or more years were examined. Using the Korean version of the Mini-Mental Status Examination (MMSE-KC), cognitive function was evaluated. To investigate the relationship between hearing impairment and cognitive status, multiple logistic regression analysis was performed with adjustment for multiple confounding variables (socioeconomic, health behavior, psychological factors, and functional status). There were 2297 participants in the hearing impairment group (23.2%) and 7623 subjects in the no-hearing impairment group. Results: Cognitive impairment was significantly higher in the hearing impairment group (37.2%) compared to the no-hearing impairment group (27.5%). After adjusting for confounders, hearing impairment was significantly associated with an increased risk of cognitive decline (odds ratio [OR] 1.21; 95% confidence interval [CI] 1.08-1.35) compared to no-hearing impairment group. Conclusions: Although a cross-cectional design of this study does not allow a causal reasoning, our findings show a significant association between the hearing loss of older adults and their cognitive impairment. Hearing impairment should be regarded as a risk factor for cognitive disorders.

Intra-operative identification of a temporal bone fracture line during cochlear implant surgery: a case report.

BACKGROUND: Temporal bone fractures are divided into otic capsule sparing and otic capsule involving fractures. In the latter, hearing loss, facial nerve paralysis, cerebrospinal fluid leak and meningitis have been reported to occur. The impact of hearing loss can be devastating, especially when occurring in children, with significant risk to speech development and sound localization. In the event of hearing loss, early rehabilitation is therefore of paramount importance. Identification of an intra-operative fracture line with available images and the outcome of such cases has not been reported. CASE PRESENTATION: We present the case of a 31-month-old male with an otic capsule involving temporal bone fracture, who presented with ipsilateral profound hearing loss. After all required work-up had been performed, he was admitted for a cochlear implant insertion. Per- operatively, a clear fracture line was seen at the round window niche, but a normal insertion was performed despite the anticipated potential ossification at the fracture line. The dreaded complications of cerebrospinal fluid otorrhea or non-auditory stimulation post-implant did not occur. The peculiarity of this case was its rarity, which was demonstrated by clear images that showed the fracture line on preoperative imaging and intraoperatively. CONCLUSION: Cochlear implantation in the presence of a visible fracture line is feasible and the surgical procedure must not be aborted at its discovery. In these cases, post-operative bacterial meningitis can occur and should be treated aggressively with systemic antibiotics to avoid contralateral ossification of the labyrinth due to labyrinthitis.

Interaction of Hearing and Balance. / Interaktion von Hör- und Gleichgewichtssinn.

There is increasingly assumed that, in addition to visual, vestibular and somatosensory afferents, hearing also plays a role in the regulation of balance. It seems that, especially in old age, progressive hearing loss is associated with a decrease in postural control. Several studies investigated this relationship in normal-hearing people, in patients with conventional hearing aids and with implantable hearing systems, as well as in patients with vestibular disorders. Despite the inhomogeneous study situation and lack of evidence, hearing seems to interact with the balance regulation system with potentially stabilizing effect. Furthermore, insights into audiovestibular interaction mechanisms could be achieved, which could possibly be integrated into therapeutic concepts of patients with vestibular disorders. However, further prospective controlled studies are necessary to bring this issue to an evidence-based level.

Evaluation of the Association Between Hearing Aids and Reduced Cognitive Decline in Older Adults with Hearing Impairment.

OBJECTIVE: We investigated whether hearing aids (HAs) for hearing impairment may reduce cognitive decline in older adults. STUDY DESIGN: Retrospective cohort. SETTING: Ambulatory for medical checkup. PATIENTS: Comprised 1,453 older adults aged 65 to 90 years. INTERVENTION: HAs were recommended for hearing impairment with thresholds of ≥40 dB. MAIN OUTCOME MEASURES: The Mini-Mental State Examination (MMSE) and pure-tone audiometry were performed. Over 2 years, multivariate logistic regression analysis was used to assess the effects of sex, age, hearing, HAs, hypertension, diabetes, cerebrovascular disease, smoking, and drinking on MMSE scores. RESULTS: Of 1,453 participants who underwent MMSE, 1,320 who underwent audiometry in the first-year included 99 HA users. Of the 1,320 participants, 858 (89 HA users) were followed longitudinally for 1 year and 672 (66 HA users) for 2 years. In the first-year cross-sectional study, the risk ratios (RRs) for hearing impairment (≥25 dB) when the MMSE scores were ≤23 and ≤27 points were 2.97 (1.40-6.28) and 1.34 (1.01-1.79), respectively. For moderate (40-<70 dB) and moderate to severe (≥40 dB) hearing impairment, the RRs for HA use were 0.30 (0.11-0.86) and 0.50 (0.22-1.13), respectively, when the MMSE scores were ≤23. A 2-year follow-up of participants with moderate hearing impairment yielded hazard ratios for MMSE score decrease of 0.30 (0.11-0.82) after 1 year and 0.16 (0.04-0.64) after 2 years in HA users. CONCLUSIONS: HA use may be associated with reducing MMSE score decrease in older adults with moderate hearing impairment.

Listening with an Ageing Brain - a Cognitive Challenge. / (Zu-)Hören mit alterndem Gehirn ­ eine kognitive Herausforderung.

Hearing impairment has been recently identified as a major modifiable risk factor for cognitive decline in later life and has been becoming of increasing scientific interest. Sensory and cognitive decline are connected by complex bottom-up and top-down processes, a sharp distinction between sensation, perception, and cognition is impossible. This review provides a comprehensive overview on the effects of healthy and pathological aging on auditory as well as cognitive functioning on speech perception and comprehension, as well as specific auditory deficits in the 2 most common neurodegenerative diseases in old age: Alzheimer disease and Parkinson syndrome. Hypotheses linking hearing loss to cognitive decline are discussed, and current knowledge on the effect of hearing rehabilitation on cognitive functioning is presented. This article provides an overview of the complex relationship between hearing and cognition in old age.

Suprathreshold auditory processes in listeners with normal audiograms but extended high-frequency hearing lossa).

Hearing loss in the extended high-frequency (EHF) range (>8 kHz) is widespread among young normal-hearing adults and could have perceptual consequences such as difficulty understanding speech in noise. However, it is unclear how EHF hearing loss might affect basic psychoacoustic processes. The hypothesis that EHF hearing loss is associated with poorer auditory resolution in the standard frequencies was tested. Temporal resolution was characterized by amplitude modulation detection thresholds (AMDTs), and spectral resolution was characterized by frequency change detection thresholds (FCDTs). AMDTs and FCDTs were measured in adults with or without EHF loss but with normal clinical audiograms. AMDTs were measured with 0.5- and 4-kHz carrier frequencies; similarly, FCDTs were measured for 0.5- and 4-kHz base frequencies. AMDTs were significantly higher with the 4 kHz than the 0.5 kHz carrier, but there was no significant effect of EHF loss. There was no significant effect of EHF loss on FCDTs at 0.5 kHz; however, FCDTs were significantly higher at 4 kHz for listeners with than without EHF loss. This suggests that some aspects of auditory resolution in the standard audiometric frequency range may be compromised in listeners with EHF hearing loss despite having a normal audiogram.

[Findings in brainstem auditory evoked potentials in patients under 2 years of age with a history of intraventricular haemorrhage]. / Hallazgos en los potenciales evocados auditivos del tallo cerebral en pacientes menores de 2 años con antecedente de hemorragia intraventricular.

INTRODUCTION: There are few studies that describe the results of auditory pathway assessment in patients with a history of intraventricular haemorrhage (IVH) during the early years of life. Hypoacusis can occur from the earliest stages of IVH. Brainstem auditory evoked potentials (BAEPs) are a useful tool for diagnosing auditory pathway disorders in early childhood. The aim of the present study was to describe the BAEPs findings in patients under 2 years of age with a history of IVH. PATIENTS AND METHODS: We conducted a retrospective observational study in patients under 2 years of age with a history of IVH referred to our hospital for BAEPs over a period of three years. Patients with genetic syndromes associated with hypoacusis were excluded. BAEPs were used to evaluate the presence or absence of any bioelectrical response and latencies of waves I, III and V, as well as of the intervals I-III, III-V and I-V, and also their morphology, amplitude, synchrony and reproducibility. A descriptive analysis was carried out with the calculation of frequencies and percentages. RESULTS: A total of 122 patients were included. Fifty-one per cent of them had a history of Grade I IVH; 42%, Grade II; and 7%, Grades III or IV. A bioelectrical response was obtained in 243 auditory pathways (99.6%). The morphology was found to be altered in 6.2% of the auditory pathways, while amplitudes were decreased in 2.5% of those tested. Latencies for waves I and III were found to be prolonged in 2% and for wave V in 3.6% of patients. The hearing threshold was normal in 64.8%, and 35.2% of cases presented hypoacusis. CONCLUSIONS: The prevalence of hypoacusis was high in the sample analysed. Systematic follow-up using BAEPs is recommended in order to detect and treat problems in the auditory pathway in patients with IVH in a timely manner.

TITLE: Hallazgos en los potenciales evocados auditivos del tallo cerebral en pacientes menores de 2 años con antecedente de hemorragia intraventricular.Introducción. Existen pocos estudios que describan los resultados de la evaluación de la vía auditiva en pacientes con antecedente de hemorragia intraventricular (HIV) durante los primeros años de vida. La hipoacusia puede presentarse desde los grados iniciales de la HIV. Los potenciales evocados auditivos del tallo cerebral (PEATC) son una herramienta útil para diagnosticar alteraciones de la vía auditiva en la infancia temprana. El objetivo del presente estudio fue describir los hallazgos en los PEATC en pacientes menores de 2 años con antecedente de HIV. Pacientes y métodos. Es un estudio observacional retrospectivo realizado en pacientes menores de 2 años con antecedente de HIV enviados a nuestro hospital para la realización de PEATC en un período de tres años. Se excluyó a pacientes con síndromes genéticos asociados a hipoacusia. A través de los PEATC se evaluó la presencia o la ausencia de respuesta bioeléctrica y latencias de las ondas I, III y V, así como de los intervalos I-III, III-V y I-V, además de su morfología, amplitud, sincronía y la replicabilidad. Se realizó un análisis de tipo descriptivo con cálculo de frecuencias y porcentajes. Resultados. Se incluyó a un total de 122 pacientes. El 51% de ellos tenía antecedente de HIV de grado I; el 42%, de grado II; y el 7%, de grados III o IV. La respuesta bioeléctrica se obtuvo en 243 vías auditivas (99,6%). La morfología se encontró alterada en el 6,2% de las vías auditivas, mientras que las amplitudes estuvieron disminuidas en el 2,5% de las evaluadas. Las latencias para las ondas I y III se encontraron prolongadas en el 2%, y, para la onda V, en el 3,6% de los pacientes. El umbral auditivo fue normal en el 64,8%, y el 35,2% de los casos presentó hipoacusia. Conclusiones. La prevalencia de la hipoacusia fue alta en la muestra analizada. Se recomienda realizar el seguimiento mediante PEATC de forma sistemática con la finalidad de detectar y atender oportunamente problemas de la vía auditiva en pacientes con HIV.

[Effectiveness of baloon dilation of Eustachian tube in children with otitis media with effusion]. / Effektivnost' ballonnoi dilatatsii slukhovoi truby u detei s khronicheskim ekssudativnym srednim otitom.

Otitis media with effusion is one of the most common ENT diseases in childhood. Absence of acute symptoms, prevalence of pathology among preschoolers, who often cannot complain on discomfort in the ears and hearing loss, lead to late diagnosis and treatment. Standard surgery is highly effective, but it is not able to help all patients. A new, minimally invasive technique of surgical treatment of otitis media with effusion - balloon dilation of the Eustachian tube provides additional opportunities in solving these problems. OBJECTIVE: To evaluate the effectiveness and possibilities of its increasing in balloon dilation of the auditory tube in children with chronic otitis media with effusion. 34 children with chronic otitis media with effusion were under observation, who underwent 54 operations using a balloon catheter for the auditory tubes. The mismatch between the pressure value and the baloon diameter has been experimentally shown, and therefore a technique for intraoperative control of the effectiveness of the procedure has been developed. The effectiveness of balloon dilation in the study was 30.8-64.3%, depending on the following factors: the stage of otitis media at which the treatment was carried out, the combination of balloon dilation with tympanostomy, the use of intraoperative efficiency control technique. The high safety of the operation and the possibility of its effective implementation in patients with an operated cleft-palate are shown.

Progress made in the efficacy and viability of deep-learning-based noise reduction.

Recent years have brought considerable advances to our ability to increase intelligibility through deep-learning-based noise reduction, especially for hearing-impaired (HI) listeners. In this study, intelligibility improvements resulting from a current algorithm are assessed. These benefits are compared to those resulting from the initial demonstration of deep-learning-based noise reduction for HI listeners ten years ago in Healy, Yoho, Wang, and Wang [(2013). J. Acoust. Soc. Am. 134, 3029-3038]. The stimuli and procedures were broadly similar across studies. However, whereas the initial study involved highly matched training and test conditions, as well as non-causal operation, preventing its ability to operate in the real world, the current attentive recurrent network employed different noise types, talkers, and speech corpora for training versus test, as required for generalization, and it was fully causal, as required for real-time operation. Significant intelligibility benefit was observed in every condition, which averaged 51% points across conditions for HI listeners. Further, benefit was comparable to that obtained in the initial demonstration, despite the considerable additional demands placed on the current algorithm. The retention of large benefit despite the systematic removal of various constraints as required for real-world operation reflects the substantial advances made to deep-learning-based noise reduction.

Large-scale electrophysiology and deep learning reveal distorted neural signal dynamics after hearing loss.

Listeners with hearing loss often struggle to understand speech in noise, even with a hearing aid. To better understand the auditory processing deficits that underlie this problem, we made large-scale brain recordings from gerbils, a common animal model for human hearing, while presenting a large database of speech and noise sounds. We first used manifold learning to identify the neural subspace in which speech is encoded and found that it is low-dimensional and that the dynamics within it are profoundly distorted by hearing loss. We then trained a deep neural network (DNN) to replicate the neural coding of speech with and without hearing loss and analyzed the underlying network dynamics. We found that hearing loss primarily impacts spectral processing, creating nonlinear distortions in cross-frequency interactions that result in a hypersensitivity to background noise that persists even after amplification with a hearing aid. Our results identify a new focus for efforts to design improved hearing aids and demonstrate the power of DNNs as a tool for the study of central brain structures.

Hearing Impairment and Incident Frailty in Later Life: The Health in Men Study (HIMS).

OBJECTIVES: This study is designed to determine if hearing loss is associated with increased risk of frailty in later life. DESIGN: A prospective cohort study. SETTING AND PARTICIPANTS: We retrieved data of a community sample of men aged 70 years and above living in the metropolitan region of Perth, Western Australia. 3,285 participants who were free of frailty at the beginning of the study were followed for up to 17 years. Data were retrieved from the Health in Men Study (HIMS) and the Western Australian Data Linkage System (WADLS). MEASUREMENTS: Hearing loss was defined by self-report or by diagnosis recorded in the WADLS. Incident frailty was assessed using the Hospital Frailty Risk Score (HFRS). RESULTS: A total of 2,348 (71.5%) men developed frailty during follow up. The adjusted hazard ratio was 1.03 (95% CI: 0.95-1.12). The majority of the participants became frail by age 90 regardless of hearing condition. The time point where half of the group become frail was delayed by 14.4 months for men without hearing loss compared with hearing impaired men. CONCLUSIONS: Hearing loss is not associated with incident frailty in men aged 70 years or older when frailty was measured by HFRS. However, this statistically non-significant result could be due to the low sensitivity of study measures. Also, we found a trend that men with hearing loss were more likely to develop frailty compared with their normal-hearing peers, suggesting a potential association between hearing loss and frailty.

Parents of children with hearing loss: Impact and exposure of COVID-19 on mental health.

The aim of this study was to evaluate the impact and exposure of COVID-19 on parent mental health (e.g., depression, anxiety, and post-traumatic stress disorder (PTSD), for parents of children with hearing loss. The survey was distributed via an electronic survey to families subscribed to a pediatric program listserv as part of a university medical center. Fifty-five percent of parents reported elevated symptoms of anxiety, while 16% scored in the clinically significant range for depression. In addition, 20% of parents reported elevated symptoms of PTSD. Liner regressions found that impact of COVID-19 predicted anxiety symptoms, while both impact and exposure predicted depression and PTSD symptoms. In addition, both impact and exposure predicted COVID related parental distress. Exposure and impact of COVID-19 has had negative consequences on parents of children with hearing loss. Although exposure influenced parental mental health, impact uniquely affected depression and PTSD. Results highlight the need for mental health screening, as well implementation of psychological interventions using telehealth or in-person consultations. Future work should focus on post-pandemic challenges, including long-term psychological functioning due to the established relationship between parental mental health and pediatric outcomes.

Prevalence of hearing loss in COVID-19 patients: a systematic review and meta-analysis.

BACKGROUND AND OBJECTIVE: 'Hearing loss' has been reported as a clinical atypical symptom in some COVID-19 patients. We searched and collated the existing literature for a systematic review and meta-analysis to assess the prevalence of hearing loss during the COVID-19 epidemic. METHODS: An exhaustive search of the PubMed, Embase, Web of Science, China National Knowledge Infrastructure and other sources from the inception of the database until 31st December 2022. The Search terms were set to: 'COVID-19', 'SARS-CoV-2', '2019-nCoV', 'hearing impairment', 'hearing loss', 'auditory dysfunction'. The literature data meeting the inclusion criteria were extracted and analyzed. Prevalence was pooled from individual studies using a randomized effects meta-analysis. RESULTS: A total of 22 studies were included in the final analysis, involving 14281 patients with COVID-19 infection, of which 482 patients had varying degrees of hearing loss. Our final meta-analysis demonstrated that the prevalence of hearing loss in COVID-19-positive patients was 8.2% (95%CI 5.0-12.1). Subgroup analysis of age showed that the prevalence of middle-aged and older patients aged 50-60 and over 60 years was 20.6% and 14.8%, respectively, which was significantly higher than that of patients aged 30-40 (4.9%) and 40-50 years (6.0%). CONCLUSION: Hearing loss is one of the clinical symptoms of COVID-19 infection, compared with other diseases, it is less likely to attract the attention of clinical experts or researchers. Raising awareness of this disease can not only enable early diagnosis and treatment of hearing loss, and improve the quality of life of patients, but also enhance our vigilance against virus transmission, which has important clinical and practical significance.

Correlation between grading methods of the cochlear endolymphatic hydrops and hearing loss in meniere's disease using three-dimensional real inversion recovery sequences.

BACKGROUND: The grading of intracochlear endolymphatic hydrops (EH) in Meniere's disease (MD) varies and lacks uniformity. AIMS: To compare the grading consistency and correlation between different grade methods of intracochlear EH and hearing loss. MATERIALS AND METHODS: Thirty-one patients diagnosed with MD underwent gadolinium-enhanced magnetic resonance imaging. Two radiologists graded the cochlea EH according to M1, M2, M3, or M4. We analysed the grading consistency and correlation between the EH degrees and hearing loss. RESULTS: The weighted kappa coefficients for inter-observer and intra-observer agreements for grading using M1 were good, whereas those for M2, M3, and M4 are excellent (all p < 0.001). The cochlear EH degree based on M2 was correlated with the low-to-mid frequencies, high frequencies, full frequencies, and MD clinical stage (all p < 0.05). The degrees based on M1, M3, M4 were only relevant to some of the 4 items. CONCLUSIONS: The grading consistency of M2, M3, M4 is relatively higher than that of M1, and M2 shows the strongest correlation with hearing loss. SIGNIFICANCE: Our results provide a more accurate method for assessing the clinical severity of MD.

Distributional learning of musical pitch despite tone deafness in individuals with congenital amusia.

Congenital amusia is an innate and lifelong deficit of music processing. This study investigated whether adult listeners with amusia were still able to learn pitch-related musical chords based on stimulus frequency of statistical distribution, i.e., via distributional learning. Following a pretest-training-posttest design, 18 amusics and 19 typical, musically intact listeners were assigned to bimodal and unimodal conditions that differed in distribution of the stimuli. Participants' task was to discriminate chord minimal pairs, which were transposed to a novel microtonal scale. Accuracy rates for each test session were collected and compared between the two groups using generalized mixed-effects models. Results showed that amusics were less accurate than typical listeners at all comparisons, thus corroborating previous findings. Importantly, amusics-like typical listeners-demonstrated perceptual gains from pretest to posttest in the bimodal condition (but not the unimodal condition). The findings reveal that amusics' distributional learning of music remains largely preserved despite their deficient music processing. Implications of the results for statistical learning and intervention programs to mitigate amusia are discussed.