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Purpose: Hyperacusis (sound sensitivity) is well documented among adults, but little is known about hyperacusis in children. Here, we assess relationships among the presence of hyperacusis, audiometric profiles, and nonauditory factors in a pediatric clinical population. Method: A retrospective review of clinical records from 329 children, ages 2-17 years, was performed to assess the prevalence of hyperacusis and correlations among hearing status, behavioral or communication concerns, and the presence of hyperacusis. Results: In 329 study participants, 18% reported hyperacusis (58% male and 42% female). No significant sex or age differences were found. Hyperacusis was more likely to occur alongside normal hearing or with unilateral hearing loss relative to bilateral hearing loss. Among children with hyperacusis, there was a high prevalence of audiovestibular problems, mental health concerns, speech and language delays, difficulty in school, and behavioral problems. Tinnitus was also found to be comorbid with hyperacusis, but the comorbidity was less than that reported in adults. Conclusions: This study identified common hearing profiles and critical comorbidities in a large clinical cohort of children with hyperacusis. These results demonstrate the urgent need for standardized multidisciplinary assessment and treatment protocols for pediatric hyperacusis. [ABSTRACT FROM AUTHOR]

The article discusses a case study of a 65-year-old man with chronic rhinosinusitis and an elevated lactate level, leading to a diagnosis of type B lactic acidosis secondary to stage IV NK/T-cell lymphoma. The patient's social context, including his migration history from China to the U.S., was considered in the diagnostic process to understand possible exposures and risks. The article emphasizes the importance of integrating social context into clinical reasoning while avoiding premature conclusions based on race or geographic identifiers. The case highlights the need for hospitalists to maintain a high suspicion for type B lactic acidosis in cases of severe and unexplained lactic acidosis, especially when considering occult hematologic malignancies. [Extracted from the article]

Background/Objectives: The aim of the study was to evaluate the prevalence of undiagnosed hearing impairment or central auditory processing disorders in children from I and VIII grades of primary schools in Warsaw. Methods: The participants in the study were 15,659 pupils from classes I and VIII attending primary schools in Warsaw. As part of the study, the hearing threshold for air conduction at frequencies of 0.5–8 kHz was determined, and a test assessing central auditory processing was performed: FPT (Frequency Pattern Test), DDT (Dichotic Digit Test), the Auditory Behaviour Scale (SAB), and an interview questionnaire developed for the program. Results: Abnormal test results were found in 1946 children, of which abnormal hearing screening test results were found in 678 children tested, while reduced central auditory processing results were found in 1268 children. Conclusions: The program implemented draws attention to the fact that tests of central auditory processing are included in the testing protocol. As has been shown, peripheral hearing testing alone is not sufficient to exclude abnormalities concerning the sense of hearing. [ABSTRACT FROM AUTHOR]

During the last decade, there has been a move towards consumer-centric hearing healthcare. This is a direct result of technological advancements (e.g., merger of consumer grade hearing aids with consumer grade earphones creating a wide range of hearing devices) as well as policy changes (e.g., the U.S. Food and Drug Administration creating a new over-the-counter [OTC] hearing aid category). In addition to various direct-to-consumer (DTC) hearing devices available on the market, there are also several validated tools for the self-assessment of auditory function and the detection of ear disease, as well as tools for education about hearing loss, hearing devices, and communication strategies. Further, all can be made easily available to a wide range of people. This perspective provides a framework and identifies tools to improve and maintain optimal auditory wellness across the adult life course. A broadly available and accessible set of tools that can be made available on a digital platform to aid adults in the assessment and as needed, the improvement, of auditory wellness is discussed. [ABSTRACT FROM AUTHOR]

Older adults with normal hearing or with age-related hearing loss face challenges when listening to speech in noisy environments. To better serve individuals with communication difficulties, precision diagnostics are needed to characterize individuals' auditory perceptual and cognitive abilities beyond pure tone thresholds. These abilities can be heterogenous across individuals within the same population. The goal of the present study is to consider the suprathreshold variability and develop characteristic profiles for older adults with normal hearing (ONH) and with hearing loss (OHL). Auditory perceptual and cognitive abilities were tested on ONH (n = 20) and OHL (n = 20) on an abbreviated test battery using portable automated rapid testing. Using cluster analyses, three main profiles were revealed for each group, showing differences in auditory perceptual and cognitive abilities despite similar audiometric thresholds. Analysis of variance showed that ONH profiles differed in spatial release from masking, speech-in-babble testing, cognition, tone-in-noise, and binaural temporal processing abilities. The OHL profiles differed in spatial release from masking, speech-in-babble testing, cognition, and tolerance to background noise performance. Correlation analyses showed significant relationships between auditory and cognitive abilities in both groups. This study showed that auditory perceptual and cognitive deficits can be present to varying degrees in the presence of audiometrically normal hearing and among listeners with similar degrees of hearing loss. The results of this study inform the need for taking individual differences into consideration and developing targeted intervention options beyond pure tone thresholds and speech testing. [ABSTRACT FROM AUTHOR]

Background: Most regular school teachers do not receive formal training in classroom management for students with hearing impairment. Audiologists must understand the teachers' knowledge level in this area to effectively support them. This understanding is essential for the successful integration of students with audiological conditions into the general education system. Aims and Objectives: The current study aimed to determine the level of awareness among regular school teachers in Kerala about various audiological conditions in students and their classroom management. Materials and Methods: To fulfil this aim, questionnaires with 41 questions under five subsections were developed in English and Malayalam. Responses were obtained from 101 participants teaching in 40 schools across 11 districts of Kerala. A qualitative analysis of the obtained data was carried out. Results: The results showed that most participants were knowledgeable about the causes of hearing impairment, hearing tests, and amplification options. They understood the negative effects of hearing impairment on speech–language development and academic performance. However, there was a lack of awareness about different types of hearing aids, assistive devices, and the role of audiologists. Participants were generally familiar with challenges faced by students with hearing impairment, classroom modifications, and teaching strategies. A positive attitude toward accommodating and educating students with hearing impairments in regular schools was observed. Conclusion: The findings provide a perspective into the significant areas that regular school teachers in Kerala are unaware of and must be educated about. The study also highlights the importance of conducting orientation or awareness programs and providing adequate training to regular school teachers. [ABSTRACT FROM AUTHOR]

Objective: Autism spectrum disorder is a lifelong neurodevelopmental condition encompassing complex physical and neurological symptoms, including complex sensory symptoms. This review explores the interface between autism spectrum disorder and paediatric ENT. Methods: Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses ('PRISMA') guideline, a robust literature search and review was conducted by two researchers. Thirty-four papers were filtered into the final review. Results: Published literature clearly demonstrates potential for autism spectrum disorder to present in the form of auditory and other sensory symptoms to ENT surgeons and audiologists who may not fully appreciate this complex condition. Despite this well-documented link, auditory symptoms, auditory processing disorders and hearing loss within autism spectrum disorder remain poorly understood. Conclusion: Improved recognition and understanding of autism spectrum disorder by otolaryngologists could enable more effective diagnostic and management strategies for autistic children who present with auditory and other sensory symptoms. In light of the current 'autism epidemic,' there is an urgent need for further research on this theme. [ABSTRACT FROM AUTHOR]

Purpose: This study tested the hypotheses that (a) motor speech activities are temporally organized around the nuclei into vowel-centric units that hold both stability and flexibility and (b) such temporal organization is impacted by motor speech impairment. Method: Thirteen individuals with amyotrophic lateral sclerosis and 10 healthy controls read a sentence 3 times at each of the following rates: habitual, fast, and slow. Articulatory gestures and phonatory event were assessed in two vowel-centric units, as operationally defined within and across the boundaries of two target words--cat and must--to accommodate common coda omission and coarticulation. Twelve absolute and relative timing measures centering on the nucleus were derived to characterize the temporal organization of each unit. These measures were evaluated in terms of (a) their relations with global duration across rate conditions and (b) between-groups differences for the habitual rate condition. Results: Both vowel-centric units remained stable in relative timing between the articulatory gestures approaching and moving away from the nucleus across rate conditions. Relative timing between the articulatory gestures and phonatory event at smaller temporal granularities varied with global duration, but in different ways for neurologically impaired and healthy speakers. Disease impacts on relative timing were only detected across word boundaries. All absolute timing measures revealed consistent temporal scaling effects and disease-related prolongations. Conclusions: The findings provide preliminary support for vowel-centric temporal organization of motor speech activities. Such temporal organization holds some extent of both stability and flexibility, which may facilitate the parsing of syllabic events during auditory processing, while accommodating task-specific suprasegmental variations. The timing impairments in amyotrophic lateral sclerosis are likely attributed to the disease-imposed dynamic constraints, reducing the entrainment of the related motor speech activities to the underlying linguistic elements. These findings have potential implications in guiding the assessment and management of temporal speech deficits in ALS. [ABSTRACT FROM AUTHOR]

Background: Cohort studies have shown that older adults with hearing impairment as assessed by self-report or behavioral measures are at higher risk of developing dementia many years later. A fine-grained examination of auditory processing holds promise for more effective screening of older adults at risk of cognitive decline. The auditory mismatch negativity (MMN) measure enables one to gain insights into the neurobiological substrate of central auditory processing. We hypothesized that older adults showing compromised indexes of MMN at baseline would exhibit cognitive decline at the one-year follow-up. Methods: We performed cognitive evaluations with the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS; Form A and Form B) in 108 community-dwelling older adults and acquired EEG via the classic passive auditory oddball paradigm at baseline and 12-month follow-up. Results: The results showed that young-old adults with future cognitive decline showed a decrease in MMN peak amplitude, accompanied by a forward-shifting latency, whereas in older adults it showed a delay in MMN latency, and unchanged MMN peak amplitude at midline electrodes (Fz, FCz and Cz). Furthermore, the peak amplitude of the MMN decreases with age in older adults aged 70-80 years rather than 60-70 years or > 80 years. Conclusion: The altered MMN model exists in different aging stages and it's a promising electrophysiological predictor of cognitive decline in older adults. In addition, further research is needed to determine the neural mechanisms and potential implications of the accelerated decline in MMN in older adults. [ABSTRACT FROM AUTHOR]

To evaluate a tablet-based hearing screening game in primary school aged children. To examine the prevalence of middle/outer ear pathology, hearing loss and spatial processing disorder in primary school aged children. The automated hearing test Sound Scouts was used as a screening tool, which measures hearing abnormalities through tests of speech-in-quiet/noise and tone-in-noise. Children who failed the screenings underwent follow up testing with pure tone audiometry, tympanometry, otoscopy, and the Listening in Spatialised Noise-Sentences test. Results of each test were compared to measure efficacy. 1256 children aged 4–13 years from 8 primary schools. 111 children (8.84%) presented with evidence of middle/outer ear pathologies. 21 children (1.67%) had hearing loss in at least one ear. 30 children (2.52%) were diagnosed with spatial processing disorder. False positive rate was 5.01%, indicating that a relatively small proportion of the children who failed the screenings were subsequently shown to have normal auditory function. A game based program testing sound detection and binaural speech processing can be effective in detecting undiagnosed hearing deficits, in large format school-based hearing screenings. Prevalence of hearing abnormalities in Victorian primary school aged children were established, highlighting the value of school hearing screening programs. [ABSTRACT FROM AUTHOR]

Background and Hypothesis Patients with hearing impairment (HI) may experience hearing sounds without external sources, ranging from random meaningless noises (tinnitus) to music and other auditory hallucinations (AHs) with meaningful qualities. To ensure appropriate assessment and management, clinicians need to be aware of these phenomena. However, sensory impairment studies have shown that such clinical awareness is low. Study Design An online survey was conducted investigating awareness of AHs among clinicians and their opinions about these hallucinations. Study Results In total, 125 clinicians (68.8% audiologists; 18.4% Ear-Nose-Throat [ENT] specialists) across 10 countries participated in the survey. The majority (96.8%) was at least slightly aware of AHs in HI. About 69.6% of participants reported encountering patients with AHs less than once every 6 months in their clinic. Awareness was significantly associated with clinicians' belief that patients feel anxious about their hallucinations (β =.018, t (118) = 2.47, P <.01), their belief that clinicians should be more aware of these hallucinations (β =.018, t (118) = 2.60, P <.01), and with confidence of clinicians in their skills to assess them (β =.017, t (118) = 2.63, P <.01). Clinicians felt underequipped to treat AHs (Median = 31; U = 1838; P FDRadj <.01). Conclusions Awareness of AHs among the surveyed clinicians was high. Yet, the low frequency of encounters with hallucinating patients and their belief in music as the most commonly perceived sound suggest unreported cases. Clinicians in this study expressed a lack of confidence regarding the assessment and treatment of AHs and welcome more information. [ABSTRACT FROM AUTHOR]

With an increase in age, peripheral hearing loss and CNS changes occur both structurally and functionally. These changes affect the processes of hearing and listening and auditory data processing. The elderly subjects with normal or near normal auditory sensitivity experience degrees of age-related auditory processing disorder. This study aimed to explore these changes in the elderly population and to compare them with young subjects. In the present study, the dichotic digits test (DDT) was performed to evaluate the binaural auditory processing, and the gap in noise (GIN) detection test was performed to assess the auditory temporal processing function. A significant difference was found in the mean approximate threshold and percent of correct answers of GIN between the old and young subjects (p < 0.05). There was also a significant difference in the mean score of DDT in each ear between the two groups (p < 0.05). The results showed that binaural auditory processing and auditory temporal processing capabilities reduce in the elderly. Early detection of these changes in the elderly and the design of appropriate rehabilitation programs can markedly improve the performance of elderly people. [ABSTRACT FROM AUTHOR]

This pilot case-control study is aimed to estimate 'musical effort' and 'musical pleasantness' in adults normal hearing (NH) and Unilateral Cochlear Implant (UCI) users via neurophysiological indices and a cognitive-behavioural approach. 7 NH and 7 UCI subjects underwent electroencephalographic (EEG) recording with two EEG indices, Approach Withdrawal (AW) and Workload (WI), and behavioural tests conducted during a forced-choice musical emotion recognition task performed in quiet and noise in two emotional conditions. Musical effort in terms of WI did not vary between conditions and groups. Inversely, for AW, statistically significant differences in noisy conditions were observed between groups, indicating a difficulty for the patients in discriminating the musical pleasantness in noise. However, self-reported data suggest the ability of UCI to cognitively evaluate the stimulus in terms of both auditory difficulty and pleasantness. Findings suggest the possible relevance of the Cochlear Implant in supporting the patients' effort in listening to music in noise, allowing a pleasant enjoyment in the quiet condition. Overall, this study appears worthy of interest and paves the way for further investigation by providing data on the neurophysiological perception of music. [ABSTRACT FROM AUTHOR]

Auditory research in developmental dyslexia proposes that deficient auditory processing of speech underlies difficulties with reading and spelling. Focusing predominantly on phonological processing, studies have not yet addressed the role of the speaker-related (indexical) properties of speech that enable the formation of phonological representations. Here, we assess auditory processing of indexical characteristics cueing a speaker's regional dialect and gender to determine whether dyslexia constraints recognition of dialect features and voice gender. Adults and children aged 11-14 years with dyslexia and their age-matched controls responded to 360 unique sentences extracted from spontaneous conversations of 40 speakers. In addition to the original unprocessed speech, there were two focused filtered conditions (using lowpass filtering at 400 Hz and 8-channel noise vocoding) probing listeners' responses to segmental and prosodic cues. Compared with controls, both groups with dyslexia were significantly limited in their abilities to recognize dialect features from either set of cues. The results for gender suggest that their comparatively worse gender recognition in the noise-vocoded condition was possibly related to poor temporal resolution. We propose that the deficient processing of indexical cues by individuals with dyslexia originates in peripheral auditory processes, of which impaired processing of relevant temporal cues in amplitude envelope is a likely candidate. [ABSTRACT FROM AUTHOR]

Cincinnati Auditory Processing Inventory is used to examine difficulties with listening abilities among adolescents and adult groups and to investigate necessary skills for accurate processing of auditory information. This study aimed to develop the Persian version of the University of Cincinnati Auditory Processing Inventory (P-UCAPI) questionnaire. A methodological and cross-sectional study was conducted on 121 adolescents and adults with normal auditory skills in the age range of 13- to 53-year-old in Babol city in Iran. The translation procedure was preceded according to World Health Organization (WHO). Then, item analysis, face validity, test–retest, and internal consistency were calculated. The descriptive statistics of the total score of the P-UCAPI and its subscales (listening and concentrating, understanding speech, following spoken instruction, attention, educational assistance, and other) were measured. In addition, the performance of males and females on this questionnaire was compared. The level of significance was established at (p<.05). A panel including two speech pathologists and one audiologist performed the content validity of the P-UCAPI and reached a consensus on all the items of the questionnaire. To investigate the need for item reduction, a Cronbach's alpha coefficient did not change with removing of each item so, none of the items were eliminated. The mean value and standard deviation of the participants for the total scores of the P-UCAPI were obtained at 53.04 ± 10.77. The mean values and standard deviations of subscales of the P-UCAPI were: listening and concentrating (13.51 ± 4.89), understanding speech (5.77 ± 1.73), following spoken instruction (5.74±.0), attention (8.70 ± 1.24), education assistance (5.68 ± 1.85), and other (13.98 ± 3.84). Males and females had similar performance on P-UCAPI (p-value=.16) and its subscale including listening and concentrating (p-value=.24), understanding speech (p-value=.60), following spoken instruction (p-value=.77), attention (p-value=.96), education assistance (p-value=.71), and other (p-value=.72). The findings of the item analysis revealed that the value of Cronbach's alpha coefficient was not obtained higher than.83 after deleting each item. The value of ICC for test–retest reliability of P-UCAPI was.62 ranging from.38 to.85. For the internal consistency, the value of the alpha coefficient value was (α=.82). P-UCAPI as a translated instrument with satisfactory values for reliability is appropriate to measure the central processing skills of normal adults in Iran. [ABSTRACT FROM AUTHOR]

Aminoglycosides (AG) such as amikacin are commonly used in cystic fibrosis patients with opportunistic pulmonary infections including multi-drug resistant mycobacterium tuberculous and non-tuberculous mycobacterium. Unfortunately, this class of drugs is known to cause peripheral damage to the cochlea leading to hearing loss that can fluctuate and become permanent over time or multiple exposures. However, whether amikacin can lead to central auditory dysfunction like hyperacusis (increased sensitivity to sound) or tinnitus (perception of sound in the absence of acoustic stimulation) is not well-described in the literature. Thus, an animal model needs to be developed that documents these side effects in order to develop therapeutic solutions to reduce AG-induced auditory dysfunction. Here we present pioneer work in mice which demonstrates that amikacin can lead to fluctuating behavioral evidence of hyperacusis and tinnitus as assessed by the acoustic startle reflex. Additionally, electrophysiological assessments of hearing via auditory brainstem response demonstrate increased central activity in the auditory brainstem. These data together suggest that peripheral AG-induced dysfunction can lead to central hyperactivity and possible behavioral manifestations of hyperacusis and tinnitus. Importantly, we demonstrate that ebselen, a novel investigational drug that acts as both an antioxidant and anti-inflammatory, can mitigate AG-induced hyperacusis. [ABSTRACT FROM AUTHOR]

Although posterior cortical atrophy is often regarded as the canonical 'visual dementia', auditory symptoms may also be salient in this disorder. Patients often report particular difficulty hearing in busy environments; however, the core cognitive process-parsing of the auditory environment ('auditory scene analysis')-has been poorly characterized. In this cross-sectional study, we used customized perceptual tasks to assess two generic cognitive operations underpinning auditory scene analysis-sound source segregation and sound event grouping-in a cohort of 21 patients with posterior cortical atrophy, referenced to 15 healthy age-matched individuals and 21 patients with typical Alzheimer's disease. After adjusting for peripheral hearing function and performance on control tasks assessing perceptual and executive response demands, patients with posterior cortical atrophy performed significantly worse on both auditory scene analysis tasks relative to healthy controls and patients with typical Alzheimer's disease (all P < 0.05). Our findings provide further evidence of central auditory dysfunction in posterior cortical atrophy, with implications for our pathophysiological understanding of Alzheimer syndromes as well as clinical diagnosis and management. [ABSTRACT FROM AUTHOR]

Cortical neurodegeneration-induced non-fluent/agrammatic variant of primary progressive aphasia (nfvPPA) is a clinical syndrome characterized by non-fluent speech, such as apraxia of speech or agrammatism. We describe the case of an 80-year-old right-handed woman who exhibited nfvPPA. Atypically, our patient also presented with generalized auditory agnosia. Brain magnetic resonance imaging revealed left-sided predominant atrophy of the bilateral perisylvian area, including the inferior frontal and superior temporal lobes. In a series of auditory tasks assessing generalized auditory agnosia, our patient was unable to accurately identify verbal sounds, environmental sounds, or familiar Japanese songs that she could sing. In the context of recent studies, our study indicates the existence of a clinical syndrome characterized by progressive speech disorder with auditory agnosia. This case report thus provides novel insights into the spectrum of language impairment induced by neurodegenerative disease. [ABSTRACT FROM AUTHOR]

Purpose: Te whare tapa whā represents a Māori view of health and wellness in four dimensions: taha wairua (spiritual health), taha hinengaro (mental health), taha tinana (physical health) and taha whānau (family health). This model of health focuses on indigenous Māori in Aotearoa/New Zealand but has relevance for all people. Speech-language pathologists, including those not familiar with this model, recognise that all four dimensions are needed to support health and wellbeing. Taha wairua includes the importance of culture and heritage to personal identity, an area that speech-language pathology (SLP) recognises as key to clinical competency. Taha hinengaro includes the need to express thoughts and feelings, another area particularly salient to SLP. The other two dimensions taha tinana (physical health) and taha whānau (family health) are arguably more familiar in the day-to-day work of speech-language pathologists. Method: Two broad strands of research are examined within this model of health exploring the challenges faced by vulnerable populations namely: (1) two community based groups (a Choir and a Gavel Club) for people with acquired neurological conditions such as stroke and Parkinson's disease, and (2) diagnosis and management of hearing loss and auditory processing disorder. Result: Community based groups, explored through the CeleBRation Choir and the Gavel Club, highlighted the application of all aspects of te whare tapa whā to the experiences of people with neurological conditions participating in these community therapies. In the area of hearing loss and auditory processing disorder, gaps across all four dimensions of taha wairua, taha hinengaro, taha tinana and taha whānau were identified in the available literature and in examination of clinical provision for participants. Conclusion: Te whare tapa whā provides a framework to consider all the elements that contribute to people living well while experiencing communication challenges within their whānau (extended family). This approach relies on strong partnerships between clinicians, extended family, researchers, communities, organisations and other professionals. Clinicians and researchers are encouraged to consider how their beliefs, practices and impact could improve through consideration of Indigenous health models such as te whare tapa whā. [ABSTRACT FROM AUTHOR]

Mutations in the GJB2 gene are a main cause of autosomal‐recessive nonsyndromic hearing loss (ARNSHL) in many populations. Previous studies have estimated the average frequency of GJB2 mutations to be ∼16% in Iran, but would vary among different ethnic groups. Here, we have taken together and reviewed results from our two previous publications and data from searching other published mutation reports to provide a comprehensive collection of data for GJB2 mutations and HL in central Iran. In all, 332 unrelated families were included and analyzed for the prevalence and type of the GJB2 gene mutations. In total, the frequency of GJB2 mutations was found to be 16% in the central provinces, which is significantly higher than those identified in southern populations of Iran. Also, c.35delG was the most frequent mutation in the related population. The present study suggests that mutations in the GJB2 gene, especially c.35delG, are important causes of HL in central Iran and can be used as a basis of genetic counseling and clinical guidelines in this region. [ABSTRACT FROM AUTHOR]

Purpose: Injury to the dominant left brain hemisphere can lead to specific language deficits such as aphasia, or to the cognitive processes that support language such as attention and working memory. Language is heavily supported through the auditory modality, which is a key area of deficit in acquired language disorders, and recovery of auditory processing is a prerequisite to recovery of other language modalities. A specific auditory processing deficit that has been identified following neurologic injury is dichotic listening. Some researchers have suggested that dichotic listening can be strengthened through the use of a dichotic listening training paradigm, although the impact of this training for adults with neurological injury is unknown. The purpose of this study was to determine whether dichotic listening training improved dichotic listening performance as well as auditory comprehension in individuals with neurological injuries. Method: Five individuals with a history of acquired language deficits who met specific inclusion and exclusion criteria participated in the dichotic listening training for four to six weeks. Dichotic listening and language comprehension skills were evaluated pre- and post-training. Results: Results indicated all participants progressed through a range of dichotic listening tasks during training, and four of the five individuals improved on at least one of the dichotic listening tests post-treatment. All of the participants demonstrated some improvement in auditory processing/comprehension of complex commands. Conclusions: Dichotic listening training has the potential to positively influence dichotic listening and auditory comprehension skills in adults with neurological injury. [ABSTRACT FROM AUTHOR]

Auditory agnosia for environmental sounds (AES) is an example of central auditory dysfunction. It is presumed to be independent of language deficits and in presence of normal hearing. We undertook a detailed neuropsychological assessment including environmental sound naming and recognition in 34 clinically mild Alzheimer's disease (AD) patients and 29 age-matched healthy control subjects. In patients with AD, audiometry was performed to assess the impact on test performance, and in normal controls the Hearing Handicap Inventory for the Elderly - Screening Version to exclude more than mild hearing loss. We adapted a validated environmental sound battery and found near perfect scores in controls. We found that environmental sound agnosia is common in mild AD. We found a statistically significant difference in mean pure tone audiometry in the best ear between patients with and those patients without naming deficits of 11.3 dB (p = 0.010) and of 14.7 dB (p = 0.000) between those with and without recognition deficits. Statistical significance remained after correcting for age, aphasia, Mini-Mental State Examination score, and working memory. Slight and moderate peripheral hearing loss increases the odds ratio of recognition deficits by 13.75 (confidence interval 2.3-81.5) compared to normal hearing patients. We did not find evidence for different forms of AES. This work suggests that an interaction between peripheral hearing loss and AD pathology produces problems with environmental sound recognition. It confirms that the relationship between hearing and dementia is complex but also suggests that interventions to prevent and treat hearing loss could have an effect on AD in its clinical expression. [ABSTRACT FROM AUTHOR]

Background: Hearing impairment may be a modifiable risk factor for dementia. However, it is unclear how hearing associates with pathologies relevant to dementia in preclinical populations.Methods: Data from 368 cognitively healthy individuals born during 1 week in 1946 (age range 69.2-71.9 years), who underwent structural MRI, 18F-florbetapir positron emission tomography, pure tone audiometry and cognitive testing as part of a neuroscience substudy the MRC National Survey of Health and Development were analysed. The aim of the analysis was to investigate whether pure tone audiometry performance predicted a range of cognitive and imaging outcomes relevant to dementia in older adults.Results: There was some evidence that poorer pure tone audiometry performance was associated with lower primary auditory cortex thickness, but no evidence that it predicted in vivo β-amyloid deposition, white matter hyperintensity volume, hippocampal volume or Alzheimer's disease-pattern cortical thickness. A negative association between pure tone audiometry and mini-mental state examination score was observed, but this was no longer evident after excluding a test item assessing repetition of a single phrase.Conclusion: Pure tone audiometry performance did not predict concurrent β-amyloid deposition, small vessel disease or Alzheimer's disease-pattern neurodegeneration, and had limited impact on cognitive function, in healthy adults aged approximately 70 years. [ABSTRACT FROM AUTHOR]

The article presents a study which examined the binaural fusion in children and adults with hearing loss, including those using hearing aids (HA) and cochlear implants (CI). Also discussed are how auditory fusion occurs in adult listeners with typical hearing (TH) and normal central auditory processing, as well as the effects of abnormal binaural fusion on pitch and speech perception.

We report a case in which we quantified the maturation of the central auditory pathway in children with hearing loss and associated disabilities; the audiological intervention was performed using the BAHA softband. The hearing aid was applied according to the international clinical protocols. The presented case reveals the importance of using the P1 CAEP biomarker in clinical practice along with a neuropsychological evaluation to assess the maturation of the central auditory pathways and to objectively quantify the results of auditory rehabilitation in children with hearing loss and associated disabilities. [ABSTRACT FROM AUTHOR]

Objective: To examine the auditory system of Brazilian gasoline station workers using an extensive audiological test battery. Design: This was a cross-sectional study. The audiological evaluation included a questionnaire, pure-tone audiometry, acoustic immittance tests, transient-evoked otoacoustic emissions (TEOAEs), distortion product otoacoustic emissions (DPOAEs), auditory brainstem response (ABR) and P300 auditory-evoked potentials. Study sample: A total of 77 Brazilian gasoline station workers were evaluated, and their results were compared with those of 36 participants who were not exposed to chemicals or noise at work. The gasoline station employees worked in 18 different gas stations, and the noise area measurements from all gas stations revealed time-weighted averages below 85 dBA. Results: Of the 77 gasoline station workers evaluated, 67.5% had audiometric results within the normal range, but 59.7% reported difficulties in communication in noisy places. Gasoline station workers showed significantly poorer results than non-exposed control participants in one or more conditions of each of the audiological tests used, except P300. Conclusions: The results suggest that the gasoline station workers have both peripheral and central auditory dysfunctions that could be partly explained by their exposure to gasoline. [ABSTRACT FROM AUTHOR]

Background: A unilateral hearing loss (UHL) can have a significant functional and social impact on children and adults, affecting their quality of life. In adults, UHL is typically associated with difficulties understanding speech in noise and sound localization, and UHL increases the self-perception of auditory disability for a range of listening situations. Furthermore, despite evidence for the negative effects of reduced unilateral auditory input on the neural encoding of binaural cues, the perceptual consequences of these changes are still not well understood. Purpose: Determine effects of UHL on auditory abilities and speech-evoked cortical auditory evoked potentials (CAEPs). Research Design: CAEPs, sound localization, speech perception in noise and self-perception of auditory abilities (speech, spatial, and qualities hearing scale) were assessed. Study Sample: Thirteen adults with UHL with a range of etiologies, duration of hearing loss, and severity and a control group of eleven binaural listeners with normal hearing. Results: Participants with UHL varied greatly in their ability to localize sound and reported speech recognition and listening effort were the greatest problem. There was a greater effect of right ear than left ear hearing loss on N1 amplitude hemispheric asymmetry and N1 latencies evoked by speech syllables in noise. As duration of hearing loss increased, contralateral dominance (N1 amplitude asymmetry) decreased. N1 amplitudes correlated with speech scores, larger N1 amplitudes were associated with better speech recognition in noise scores. N1 latencies are delayed (in the better ear) and amplitude hemisphere asymmetry differed across UHL participants as function of side of deafness, mainly for right-sided deafness. Conclusion: UHL affects a range of auditory abilities, including speech detection in noise, sound localization, and self-perceived hearing disability. CAEPs elicited by speech sounds are sensitive enough to evidence changes within the auditory cortex due to an UHL. [ABSTRACT FROM AUTHOR]

The integration of multiple sources of sensory input is an automatically occurring process that is key to forming a single coherent percept. This process, known as multisensory integration, is an unconscious one that allows for individuals to make sense of the surrounding environment during ambiguous situations. The most commonly studied form of multisensory integration is the combination of visual and auditory sensory information, such as seen in speech. When forming a coherent percept of speech, a listener can hear the sounds of what is being spoken, while simultaneously processing the visual movement of the speaker's lips. In this way, the input from both visual and auditory modalities is automatically combined. Congenitally deaf individuals are unable to integrate information from the auditory sensory modality, since they are unable to process sound. This hinders their capacity to integrate information, especially in situations of ambiguity, thus demeaning their ability to process incomplete information from multiple sources to form a single accurate percept of the stimuli. This paper explores the impact of hearing aids in the form of cochlear implants in reviving multisensory integration among this population. Through the restoration of input to the auditory sensory modality, it is seen how cochlear implants may play a role in multisensory integration among the congenitally deafened in society. [ABSTRACT FROM AUTHOR]

The primary goal of amplification is to restore audibility without causing discomfort; for someone with severe-to-profound hearing loss, the reduced dynamic range poses unique challenges in hearing-assistive device fitting. These challenges, including physiological limitation, processing difficulties, technology constraints, and other confounding factors, must be considered when selecting, fitting, and counseling for appropriate amplification. Many of the advanced features in hearing aids do not adequately address the unique characteristics of patients with severe-to-profound hearing loss. This review article will attempt to unravel some of the challenges and associated considerations when fitting adults and children with severe-to-profound hearing loss. [ABSTRACT FROM AUTHOR]

Objective: Two modifications of the standardised MUlti Stimulus test with Hidden Reference and Anchor (MUSHRA), namely MUSHRA simple and MUSHRA drag&drop, were implemented and evaluated together with the original test method. The modifications were designed to maximise the accessibility of MUSHRA for elderly and technically non-experienced listeners, who constitute the typical target group in hearing aid evaluation. Design: Three MUSHRA variants were assessed based on subjective and objective measures, e.g. test-retest reliability, discrimination ability, time exposure and overall preference. With each method, participants repeated the task to rate the quality of several hearing aid algorithms four times. Study sample: Fifty listeners grouped into five subject classes were tested, including elderly and technically non-experienced participants with normal and impaired hearing. Normal-hearing, technically experienced students served as controls. Results: Both modifications can be used to obtain compatible rating results. Both were preferred over the classical MUSHRA procedure. Technically experienced listeners performed best with the modification MUSHRA drag&drop. Conclusions: The comprehensive comparison of the MUSHRA variants demonstrates that the intuitive modification MUSHRA drag&drop can be generally recommended. However, considering e.g. specific evaluation demands, we suggest a differentiated and careful application of listening test methods. [ABSTRACT FROM AUTHOR]

Standard audiometric evaluations are not sensitive enough to identify hidden hearing loss (HHL) and/or cochlear synaptopathy (CS). Patients with either of these conditions frequently present with difficulty understanding speech in noise or other complaints such as tinnitus. The purpose of this systematic review is to identify articles in peer-reviewed journals that assessed the sensitivity of audiologic measures for detecting HHL and/or CS, and which showed potential for use in a clinical test battery for these disorders. A reference librarian submitted specific boolean terminology to MEDLINE, Embase, and Web of Science. The authors used a consensus approach with specially designed score sheets for the selection of titles, abstracts, and then articles for inclusion in the systematic review and for quality assessment. Fifteen articles were included in the systematic review. Seven articles involved humans; seven involved animals, and one study used both humans and animals. Results showed that pure-tone audiometry to 20 kHz, otoacoustic emissions, electrocochleography, auditory brainstem response (ABR), electrophysiological tests, speech recognition in noise with and without temporal distortion, interviews, and self-report measures have been used to assess HHL and/or CS. For HHL, ultrahigh-frequency audiometry may help identify persons with sensory hair cell loss that does not show up on standard audiograms. Promising nonbehavioral measures for CS included ABR wave I amplitude, the summating potential-to-action potential ratio, and speech recognition in noise with and without temporal distortion. Self-report questionnaires also may help identify auditory dysfunction in persons with normal hearing. [ABSTRACT FROM AUTHOR]

Auditory hallucinations (AH) are often considered a sign of a psychotic disorder. This is promoted by the DSM-5 category of Other Specified Schizophrenia Spectrum And Other Psychotic Disorder (OSSSOPD), the diagnostic criteria for which are fulfilled with the sole presence of persistent AH, in the absence of any other psychotic symptoms. And yet, persistent AH are not synonymous with having a psychotic disorder, and should therefore not be uncritically treated as such. Many people who seek treatment for persistent AH have no other psychotic symptoms, have preserved realitytesting capacities, and will never develop a schizophrenia spectrum disorder. Instead, hallucinations may be the result of many different causes, including borderline personality disorder, post-traumatic stress disorder (PTSD), hearing loss, sleep disorders or brain lesions, and they may even occur outside the context of any demonstrable pathology. In such cases, the usage of the DSM-5 diagnosis of OSSSOPD would be incorrect, and it may prompt unwarranted treatment with antipsychotic medication. We therefore argue that a DSM-5 diagnosis of Schizophrenia Spectrum Disorder (or any other type of psychotic disorder) characterized by AH should require at least one more symptom listed under the A-criterion (i.e. delusions, disorganized speech, disorganized or catatonic behavior or negative symptoms). Adhering to these more stringent criteria may help to distinguish between individuals with persistent AH which are part of a psychotic disorder, for whom antipsychotic medication may be helpful, and individuals with AH in the absence of such a disorder who may benefit from other approaches (e.g. different pharmacological interventions, improving coping style, trauma-related therapy). [ABSTRACT FROM AUTHOR]

Functional hearing loss (FHL) is a disorder in which there are abnormal values on a hearing test, despite the absence of organic abnormalities in the peripheral and central auditory pathways. Here, we examined the developmental characteristics of FHL and the importance of intervention by analyzing the clinical characteristics of children with this disorder. We retrospectively examined 16 patients assessed under a diagnosis of FHL. After interventions such as psychological counseling by our pediatrics and psychiatry departments, we compared the clinical profiles of patients in which hearing was "improved/normalized" and "unimproved". Fourteen patients visited a pediatrician and two chose not to do so. A discrepancy between the maximum and minimum values of the four index scores was observed in all patients in which WISC-IV (the fourth version of the Wechsler Intelligence Scale for Children) was performed (n = 12). The discrepancy between the verbal comprehension index (VCI) and perceptual reasoning index (PRI) was significantly greater in "unimproved" patients than in "improved/normalized" patients. Hearing improved, or was normalized, after intervention in six of 16 patients. Developmental imbalances were suspected in all 12 children who visited a pediatrician and completed the WISC-IV. Cooperation with pediatricians, psychiatrists, and other health professionals is desirable in supporting patients diagnosed with FHL. [ABSTRACT FROM AUTHOR]

Background: Stroke survivors may suffer from a range of hearing impairments that may restrict their participation in postacute rehabilitation programs. Hearing impairment may have a significant impact on listening, linguistic skills, and overall communication of the affected stroke patient. However, no studies sought to systematically characterize auditory function of stroke patients in detail, to establish the different types of hearing impairments in this cohort of patients. Such information would be clinically useful in understanding and addressing the hearing needs of stroke survivors. Purpose: The present study aimed to characterize and classify the hearing impairments, using a detailed audiological assessment test battery, in order to determine the level of clinical need and inform appropriate rehabilitation for this patient population. Research Design: A case-control study. Study Sample: Forty-two recruited stroke patients who were discharged from a stroke unit and 40 control participants matched for age. Data Collection and Analysis: All participants underwent pure-tone audiometry and immittance measurements including acoustic reflex threshold, transient-evoked otoacoustic emissions, auditory-evoked brainstem response, and a central auditory processing assessment battery, performed in a single session. Hearing impairments were classified as peripheral hearing loss (cochlear and neural type), central auditory processing disorder (CAPD), and as a combination of CAPD and peripheral hearing loss. Results: Overall mean hearing thresholds were not significantly different between the control and stroke groups. The most common type of hearing impairment in stroke patients was the combination type, "peripheral and CAPD," in the 61- to 80-yr-old subgroup (in 55%), and auditory processing deficits in 18- to 60-yr-olds (in 40%), which were both significantly higher than in controls. Conclusions: This is the first study to examine hearing function in detail in stroke patients. Given the importance of hearing for the efficiency of communication, it is essential to identify hearing impairments and differentiate peripheral and central deficits to define an appropriate intervention plan. [ABSTRACT FROM AUTHOR]