Leigh-Paffenroth Elizabeth D, Elangovan Saravanan
James H. Quillen VA Medical Center, Mountain Home, TN, USA.
J Am Acad Audiol. 2011 Jul-Aug;22(7):393-404. doi: 10.3766/jaaa.22.7.2.
Hearing loss and age interfere with the auditory system's ability to process temporal changes in the acoustic signal. A key unresolved question is whether high-frequency sensorineural hearing loss (HFSNHL) affects temporal processing in the low-frequency region where hearing loss is minimal or nonexistent. A second unresolved question is whether changes in hearing occur in middle-aged subjects in the absence of HFSNHL.
The purpose of this study was twofold: (1) to examine the influence of HFSNHL and aging on the auditory temporal processing abilities of low-frequency auditory channels with normal hearing sensitivity and (2) to examine the relations among gap detection measures, self-assessment reports of understanding speech, and functional measures of speech perception in middle-aged individuals with and without HFSNHL.
The subject groups were matched for either age (middle age) or pure-tone sensitivity (with or without hearing loss) to study the effects of age and HFSNHL on behavioral and functional measures of temporal processing and word recognition performance. These effects were analyzed by individual repeated-measures analyses of variance. Post hoc analyses were performed for each significant main effect and interaction. The relationships among the measures were analyzed with Pearson correlations.
Eleven normal-hearing young adults (YNH), eight normal-hearing middle-aged adults (MANH), and nine middle-aged adults with HFSNHL were recruited for this study. Normal hearing sensitivity was defined as pure-tone thresholds ≤25 dB HL for octave frequencies from 250 to 8000 Hz. HFSNHL was defined as pure-tone thresholds ≤25 dB HL from 250 to 2000 Hz and ≥35 dB HL from 3000 to 8000 Hz.
Gap detection thresholds (GDTs) were measured under within-channel and between-channel conditions with the stimulus spectrum limited to regions of normal hearing sensitivity for the HFSNHL group (i.e., <2000 Hz). Self-perceived hearing problems were measured by a questionnaire (Abbreviated Profile of Hearing Aid Benefit), and word recognition performance was assessed under four conditions: quiet and babble, with and without low-pass filtering (cutoff frequency = 2000 Hz).
The effects of HFSNHL and age were found for gap detection, self-perceived hearing problems, and word recognition in noise. The presence of HFSNHL significantly increased GDTs for stimuli presented in regions of normal pure-tone sensitivity. In addition, middle-aged subjects with normal hearing sensitivity reported significantly more problems hearing in background noise than the young normal-hearing subjects. Significant relationships between self-report measures of hearing ability in background noise and word recognition in babble were found.
The conclusions from the present study are twofold: (1) HFSNHL may have an off-channel impact on auditory temporal processing, and (2) presenescent changes in the auditory system of MANH subjects increased self-perceived problems hearing in background noise and decreased functional performance in background noise compared with YNH subjects.
听力损失和年龄会干扰听觉系统处理声信号中时间变化的能力。一个关键的未解决问题是,高频感音神经性听力损失(HFSNHL)是否会影响听力损失最小或不存在的低频区域的时间处理。另一个未解决的问题是,在没有HFSNHL的中年受试者中是否会发生听力变化。
本研究的目的有两个:(1)研究HFSNHL和衰老对听力敏感度正常的低频听觉通道的听觉时间处理能力的影响;(2)研究有和没有HFSNHL的中年个体的间隙检测指标、言语理解自我评估报告和言语感知功能指标之间的关系。
根据年龄(中年)或纯音敏感度(有或没有听力损失)对受试者组进行匹配,以研究年龄和HFSNHL对时间处理和单词识别表现的行为和功能指标的影响。通过个体重复测量方差分析对这些影响进行分析。对每个显著的主效应和交互作用进行事后分析。用Pearson相关性分析指标之间的关系。
本研究招募了11名听力正常的年轻成年人(YNH)、8名听力正常的中年成年人(MANH)和9名患有HFSNHL的中年成年人。正常听力敏感度定义为250至8000 Hz倍频程频率的纯音阈值≤25 dB HL。HFSNHL定义为250至2000 Hz的纯音阈值≤25 dB HL,3000至8000 Hz的纯音阈值≥35 dB HL。
在通道内和通道间条件下测量间隙检测阈值(GDT),刺激频谱限于HFSNHL组听力正常敏感度的区域(即<2000 Hz)。通过问卷(助听器效益简表)测量自我感知的听力问题,并在四种条件下评估单词识别表现:安静和嘈杂环境,有和没有低通滤波(截止频率 = 2000 Hz)。
发现HFSNHL和年龄对间隙检测、自我感知的听力问题和噪声中的单词识别有影响。HFSNHL的存在显著增加了纯音敏感度正常区域呈现的刺激的GDT。此外,听力敏感度正常的中年受试者报告在背景噪声中听力的问题比听力正常的年轻受试者显著更多。发现背景噪声中听力能力的自我报告指标与嘈杂环境中单词识别之间存在显著关系。
本研究的结论有两个:(1)HFSNHL可能对听觉时间处理有通道外影响;(2)与YNH受试者相比,MANH受试者听觉系统的衰老前变化增加了在背景噪声中自我感知的听力问题,并降低了背景噪声中的功能表现。