The objective of this prospective study was to report on the prevalence of hearing impairment in the neonatal unit population. From 15 February 2000 to 15 March 2000 and from 15 February 2001 to 15 May 2001, 401 neonates were screened using transient evoked otoacoustic emissions (TEOAE) followed by second-stage screening of those infants who failed the initial test. Eight (2 per cent) infants failed one ear and 23 (5.74 per cent) infants failed both ears, adding up to 7.74 per cent planned for second-stage screening. Five out of 22 infants who came for the follow up failed the screening, resulting in a prevalence of hearing impairment of 1 per cent (95 per cent confidence interval [95% CI]: 0.0-2.0). Craniofacial malformations, very low birth weight, ototoxic medication, stigmata/syndromes associated with hearing loss and hyperbilirubinaemia at the level of exchange tranfusion were identified to be independent significant risk factors for hearing impairment, while poor Apgar scores and mechanical ventilation of more than five days were not. In conclusion, hearing screening in high-risk neonates revealed a total of 1 per cent with hearing loss. The changes in the risk profile indicate improved perinatal handling in a neonatal population at risk for hearing disorders.
The objective of this study was to investigate the degree to which Auditory Steady State Response (ASSR) thresholds correlate with behavioral thresholds in two groups of adult subjects, one with normal hearing and the other with sensorineural hearing impairment. When the relationship between ASSR and behavioral thresholds were analyzed separately according to different groups of subjects, significant correlations were only found for the hearing impaired group. The mean differences between the actual and the predicted thresholds derived from linear regression analysis for that group of subjects were found to be 5 dB (SD = 4), 3 dB (SD = 3), 4 dB (SD = 3) and 4 dB (SD = 4) with correlation coefficients of 0.80, 0.88, 0.91 and 0.97 for the 500, 1000, 2000 and 4000 Hz carrier frequencies, respectively. When the relationship between ASSR and behavioral thresholds were analyzed using data from both groups of subjects, correlation coefficients were found to be higher across carrier frequencies of 500 to 4000 Hz (r ³ 0.96) with mean differences between the actual and the predicted thresholds of 6 dB (SD = 3), 4 dB (SD = 3), 4 dB (SD = 3) and 6 dB (SD = 3) for the hearing impaired group and 11dB (SD = 7), 8 dB (SD = 8), 8 dB (SD = 6) and 10 dB (SD = 7) for the normal hearing group. However, it was observed that the range of differences between the actual and the predicted thresholds were quite large reaching 34 dB for the 500 and 4000 Hz carrier frequencies. This suggests that in clinical setting, ASSR cannot predict the presence or absence of a hearing loss accurately. In general, it can be concluded that ASSR allow for an accurate prediction of behavioral thresholds within ± 10 dB in subjects with hearing impairment. However, ASSR cannot accurately predict hearing thresholds in normally hearing individuals.
Key words: auditory steady-state response threshold, behavioral threshold, adult, normal hearing, hearing impairment
Single and double dichotic digit tests in Malay language were developed and standardized as an initial attempt to incorporate tests of auditory processing within the scope of audiology practice in Malaysia. Normative data under free recall, directed right-ear first, and directed left-ear first listening conditions were determined using 120 Malay children between the ages of 6 and 11 years old with normal hearing and normal academic performance. Test-retest reliability was assessed in 15 of the study subjects. In general, the double dichotic digit test produced greater differences in scores between age groups, and a greater right-ear advantage than the single dichotic digit test. In addition, the double dichotic digit test also had higher test-retest reliability. These findings suggest the double dichotic digit test is more clinically applicable.
We performed a study to determine if cerumen in the ear canal causes significant hearing loss and to ascertain if there is any correlation between the amount of cerumen and the degree of hearing loss. Our study was conducted on 109 ears in 80 patients. The results indicated that impacted cerumen does cause a significant degree of conductive hearing loss. We found no significant correlation between the length of the cerumen plug and the severity of hearing loss. Nor did we find any significant correlation between the presence of impacted cerumen and variables such as age, sex, ethnicity, or affected side.
This study investigated the effect of intensity on pitch in electric hearing and its relationship to the speech perception ability of cochlear implantees. Subjects were 13 adult users of the Nucleus 22 cochlear implant system, using either the Spectra22 or ESPrit22 speech processor and the SPEAK speech processing strategy. A multidimensional scaling technique was employed. Speech perception was measured using sentences and vowels. All measurements were performed in a soundfield condition, and subjects wore their own speech processors with their normally used settings. Results showed a significant correlation between the degree of deviation of the subjects' stimulus spaces from the "ideal" space and subjects' performance with the sentences, but not with the vowels. A significant correlation was found between subjects' response variability in performing the multidimensional scaling task and their speech perception measures, suggesting that spectral smearing or underlying cognitive abilities might affect implantees' speech perception performance.
Transient-evoked otoacoustic emission (TEOAE) is a well-established screening tool for universal newborn hearing screening. The aims of this study are to measure the effects of background noise on recording of TEOAE and the duration required to complete the test at various noise levels. This study is a prospective study from June 2006 until May 2007. The study population were newborns from postnatal wards who were delivered at term pregnancy. Newborns who were more than 8-h old and passed a hearing screening testing using screening auditory brainstem response (SABRe) were further tested with TEOAE in four different test environments [isolation room in the ward during non-peak hour (E1), isolation room in the ward during peak hour (E2), maternal bedside in the ward during non-peak hour (E3) and maternal bedside in the ward during peak hour (E4)]. This study showed that test environment significantly influenced the time required to complete testing in both ears with F [534.23] = 0.945; P < 0.001 on the right ear and F [636.54] = 0.954; P < 0.001 on the left. Our study revealed that TEOAE testing was efficient in defining the presence of normal hearing in our postnatal wards at maternal bedside during non-peak hour with a specificity of 96.8%. Our study concludes that background noise levels for acceptable and accurate TEOAE recording in newborns should not exceed 65 dB A. In addition, when using TEOAE assessment in noisy environments, the time taken to obtain accurate results will greatly increase.
Reflex epilepsy is usually induced by external stimulation, photosensitive epilepsy being the most common. Epilepsy induced by auditory stimulation is rarely studied. There are no currently published magnetoencephalographic (MEG) studies demonstrating the initiation of epileptic neuronal discharges by repeated auditory stimulations in temporal lobe epilepsy (TLE) patients. We retrospectively studied one TLE patient who underwent a MEG study to localize her epileptic focus. Auditory, somatosensory, visual and motor evoked potential studies were performed during the MEG recording. A single dipole method calculated equivalent current dipoles to localize the epileptic source. The least-squares minimization method was used to obtain the optimal solution with goodness-of-fit of greater than 80%. Periodic lateralized epileptiform discharges (PLEDs) were recorded in the temporal region when repeated auditory stimulations were done. We postulated that neuronal cortical suppression occurred during repeated stimulations which provoked epileptiform discharges (PLEDs) without any physical symptoms or aura. It was concluded that repeated stimulations could facilitate epileptiform discharges in focal area/areas in certain subjects.
In two experiments, we investigated age-related changes in how prosodic pitch accents affect memory. Participants listened to recorded discourses that contained two contrasts between pairs of items (e.g., one story contrasted British scientists with French scientists and Malaysia with Indonesia). The end of each discourse referred to one item from each pair; these references received a pitch accent that either denoted contrast (L + H* in the ToBI system) or did not (H*). A contrastive accent on a particular pair improved later recognition memory equally for young and older adults. However, older adults showed decreased memory if the other pair received a contrastive accent (Experiment 1). Young adults with low working memory performance also showed this penalty (Experiment 2). These results suggest that pitch accents guide processing resources to important information for both older and younger adults but diminish memory for less important information in groups with reduced resources, including older adults.
This fMRI study is about modelling the effective connectivity between Heschl's gyrus (HG) and the superior temporal gyrus (STG) in human primary auditory cortices. MATERIALS #ENTITYSTARTX00026;
The nature of culture-specific startles syndromes such as "Latah" in Indonesia and Malaysia is ill understood. Hypotheses concerning their origin include sociocultural behavior, psychiatric disorders, and neurological syndromes. The various disorders show striking similarities despite occurring in diverse cultural settings and genetically distant populations. They are characterized clinically by exaggerated startle responses and involuntary vocalizations, echolalia, and echopraxia. Quantifying startle reflexes may help define Latah within the 3 groups of startle syndromes: (1) hyperekplexia, (2) startle-induced disorders, and (3) neuropsychiatric startle syndromes. Twelve female Latah patients (mean age, 44.6 years; SD, 7.7 years) and 12 age-, sex- and socioeconomically matched controls (mean age, 42.3 year; SD, 8.0) were studied using structured history taking and neurological examination including provocation of vocalizations, echolalia, and echopraxia. We quantified auditory startle reflexes with electromyographic activity of 6 left-sided muscles following 104-dB tones. We defined 2 phases for the startle response: a short latency motor startle reflex initiated in the lower brain stem <100/120 ms) and a later, second phase more influenced by psychological factors (the "orienting reflex," 100/120-1000 ms after the stimulus). Early as well as late motor startle responses were significantly increased in patients compared with controls (P ≤ .05). Following their startle response, Latah patients showed stereotyped responses including vocalizations and echo phenomena. Startle responses were increased, but clinically these proved insignificant compared with the stereotyped behavioral responses following the startle response. This study supports the classification of Latah as a "neuropsychiatric startle syndrome."
A phenomenological model of the auditory periphery in cats was previously developed by Zilany and colleagues [J. Acoust. Soc. Am. 126, 2390-2412 (2009)] to examine the detailed transformation of acoustic signals into the auditory-nerve representation. In this paper, a few issues arising from the responses of the previous version have been addressed. The parameters of the synapse model have been readjusted to better simulate reported physiological discharge rates at saturation for higher characteristic frequencies [Liberman, J. Acoust. Soc. Am. 63, 442-455 (1978)]. This modification also corrects the responses of higher-characteristic frequency (CF) model fibers to low-frequency tones that were erroneously much higher than the responses of low-CF model fibers in the previous version. In addition, an analytical method has been implemented to compute the mean discharge rate and variance from the model's synapse output that takes into account the effects of absolute refractoriness.
Deficits in the ability to process emotions characterize several neuropsychiatric disorders and are traits of Parkinson's disease (PD), and there is need for a method of quantifying emotion, which is currently performed by clinical diagnosis. Electroencephalogram (EEG) signals, being an activity of central nervous system (CNS), can reflect the underlying true emotional state of a person. This study applied machine-learning algorithms to categorize EEG emotional states in PD patients that would classify six basic emotions (happiness and sadness, fear, anger, surprise and disgust) in comparison with healthy controls (HC). Emotional EEG data were recorded from 20 PD patients and 20 healthy age-, education level- and sex-matched controls using multimodal (audio-visual) stimuli. The use of nonlinear features motivated by the higher-order spectra (HOS) has been reported to be a promising approach to classify the emotional states. In this work, we made the comparative study of the performance of k-nearest neighbor (kNN) and support vector machine (SVM) classifiers using the features derived from HOS and from the power spectrum. Analysis of variance (ANOVA) showed that power spectrum and HOS based features were statistically significant among the six emotional states (p < 0.0001). Classification results shows that using the selected HOS based features instead of power spectrum based features provided comparatively better accuracy for all the six classes with an overall accuracy of 70.10% ± 2.83% and 77.29% ± 1.73% for PD patients and HC in beta (13-30 Hz) band using SVM classifier. Besides, PD patients achieved less accuracy in the processing of negative emotions (sadness, fear, anger and disgust) than in processing of positive emotions (happiness, surprise) compared with HC. These results demonstrate the effectiveness of applying machine learning techniques to the classification of emotional states in PD patients in a user independent manner using EEG signals. The accuracy of the system can be improved by investigating the other HOS based features. This study might lead to a practical system for noninvasive assessment of the emotional impairments associated with neurological disorders.
In addition to classic motor signs and symptoms, individuals with Parkinson's disease (PD) are characterized by emotional deficits. Ongoing brain activity can be recorded by electroencephalograph (EEG) to discover the links between emotional states and brain activity. This study utilized machine-learning algorithms to categorize emotional states in PD patients compared with healthy controls (HC) using EEG. Twenty non-demented PD patients and 20 healthy age-, gender-, and education level-matched controls viewed happiness, sadness, fear, anger, surprise, and disgust emotional stimuli while fourteen-channel EEG was being recorded. Multimodal stimulus (combination of audio and visual) was used to evoke the emotions. To classify the EEG-based emotional states and visualize the changes of emotional states over time, this paper compares four kinds of EEG features for emotional state classification and proposes an approach to track the trajectory of emotion changes with manifold learning. From the experimental results using our EEG data set, we found that (a) bispectrum feature is superior to other three kinds of features, namely power spectrum, wavelet packet and nonlinear dynamical analysis; (b) higher frequency bands (alpha, beta and gamma) play a more important role in emotion activities than lower frequency bands (delta and theta) in both groups and; (c) the trajectory of emotion changes can be visualized by reducing subject-independent features with manifold learning. This provides a promising way of implementing visualization of patient's emotional state in real time and leads to a practical system for noninvasive assessment of the emotional impairments associated with neurological disorders.
Event-related potentials (ERPs) may provide a non-invasive index of brain function for a range of clinical applications. However, as a lab-based technique, ERPs are limited by technical challenges that prevent full integration into clinical settings.
Schroeder-phase masking complexes have been used in many psychophysical experiments to examine the phase curvature of cochlear filtering at characteristic frequencies, and other aspects of cochlear nonlinearity. In a normal nonlinear cochlea, changing the "scalar factor" of the Schroeder-phase masker from -1 through 0 to +1 results in a marked difference in the measured masked thresholds, whereas this difference is reduced in ears with damaged outer hair cells. Despite the valuable information it may give, one disadvantage of the Schroeder-phase masking procedure is the length of the test - using the conventional three-alternative forced-choice technique to measure a masking function takes around 45 min for one combination of probe frequency and intensity. As an alternative, we have developed a fast method of recording these functions which uses a Békésy tracking procedure. Testing at 500 Hz in normal hearing participants, we demonstrate that our fast method: i) shows good agreement with the conventional method; ii) shows high test-retest reliability; and iii) shortens the testing time to 8 min.
For estimating behavioral hearing thresholds, auditory steady state response (ASSR) can be reliably evoked by stimuli at low and high modulation frequencies (MFs). In this regard, little is known regarding ASSR thresholds evoked by stimuli at different MFs in female and male participants. In fact, recent data suggest that 40-Hz ASSR is influenced by estrogen level in females. Hence, the aim of the present study was to determine the effect of gender and MF on ASSR thresholds in young adults. Twenty-eight normally hearing participants (14 males and 14 females) were enrolled in this study. For each subject, ASSR thresholds were recorded with narrow-band chirps at 500, 1,000, 2,000, and 4,000 Hz carrier frequencies (CFs) and at 40 and 90 Hz MFs. Two-way mixed ANOVA (with gender and MF as the factors) revealed no significant interaction effect between factors at all CFs (p > 0.05). The gender effect was only significant at 500 Hz CF (p < 0.05). At 500 and 1,000 Hz CFs, mean ASSR thresholds were significantly lower at 40 Hz MF than at 90 Hz MF (p < 0.05). Interestingly, at 2,000 and 4,000 Hz CFs, mean ASSR thresholds were significantly lower at 90 Hz MF than at 40 Hz MF (p < 0.05). The lower ASSR thresholds in females might be due to hormonal influence. When recording ASSR thresholds at low MF, we suggest the use of gender-specific normative data so that more valid comparisons can be made, particularly at 500 Hz CF.
The purpose of this study was to determine the effects of noise type, signal-to-noise ratio (SNR), age, and hearing status on cortical auditory evoked potentials (CAEPs) to speech sounds. This helps to explain the hearing-in-noise difficulties often seen in the aging and hearing impaired population. Continuous, modulated, and babble noise types were presented at varying SNRs to 30 individuals divided into three groups according to age and hearing status. Significant main effects of noise type, SNR, and group were found. Interaction effects revealed that the SNR effect varies as a function of noise type and is most systematic for continuous noise. Effects of age and hearing loss were limited to CAEP latency and were differentially modulated by energetic and informational-like masking. It is clear that the spectrotemporal characteristics of signals and noises play an important role in determining the morphology of neural responses. Participant factors such as age and hearing status, also play an important role in determining the brain's response to complex auditory stimuli and contribute to the ability to listen in noise.