Bureš Zbyněk, Profant Oliver, Svobodová Veronika, Tóthová Diana, Vencovský Václav, Syka Josef
Department of Auditory Neuroscience, Institute of Experimental Medicine of the Czech Academy of Sciences, Prague, Czechia.
Department of Technical Studies, College of Polytechnics, Jihlava, Czechia.
Front Aging Neurosci. 2019 Aug 21;11:219. doi: 10.3389/fnagi.2019.00219. eCollection 2019.
Deteriorated speech comprehension is a common manifestation of the age-related decline of auditory functions (presbycusis). It could be assumed that when presbycusis is accompanied by tinnitus, general hearing functions, and particularly comprehension of speech in quiet and speech in noise (SIN), will be significantly affected. In this study, speech comprehension ability and other parameters of auditory function were assessed in elderly subjects with (T, = 25) and without (NT, = 26) tinnitus, aiming for examination of both peripheral and central auditory processing. Apart from high-frequency audiograms in quiet and in background noise, speech recognition thresholds in silence or in competitive babble noise, and the ability to understand temporally gated speech (GS), we measured also sensitivity to frequency modulation (FM) and interaural delay, gap detection thresholds (GDT), or the difference limens of intensity. The results show that in elderly participants matched by age (mean ages around 68 years), cognitive status (median MoCA scores around 27), and hearing thresholds [median pure-tone averages (PTA) around 16 dB hearing loss (HL)], tinnitus has little influence on speech comprehension. The tinnitus patients also show similar GDT, sensitivity to interaural intensity difference, and sensitivity to FM as the NT subjects. Despite these similarities, nevertheless, significant differences in auditory processing have been found in the tinnitus participants: a worse ability to detect tones in noise, a higher sensitivity to intensity changes, and a higher sensitivity to interaural time differences. Additional correlation analyses further revealed that speech comprehension in the T subjects is dependent on the sensitivity to temporal modulation and interaural time delay (ITD), while these correlations are weak and non-significant in the NT subjects. Therefore, despite similarities in average speech comprehension and several other parameters of auditory function, elderly people with tinnitus exhibit different auditory processing, particularly at a suprathreshold level. The results also suggest that speech comprehension ability of elderly tinnitus patients relies more on temporal features of the sound stimuli, especially under difficult conditions, compared to elderly people without tinnitus.
言语理解能力下降是听觉功能与年龄相关衰退（老年性聋）的常见表现。可以推测，当老年性聋伴有耳鸣时，总体听力功能，尤其是安静环境下的言语理解能力以及噪声环境下的言语理解能力（言语噪声测试）将受到显著影响。在本研究中，对患有耳鸣（T组，n = 25）和未患耳鸣（NT组，n = 26）的老年受试者的言语理解能力及其他听觉功能参数进行了评估，旨在检查外周和中枢听觉处理情况。除了安静和背景噪声环境下的高频听力图、安静或竞争性嘈杂噪声环境下的言语识别阈值以及理解时间门控言语（GS）的能力外，我们还测量了频率调制（FM）敏感度、双耳延迟、间隙检测阈值（GDT）或强度差异阈。结果表明，在年龄匹配（平均年龄约68岁）、认知状态（蒙特利尔认知评估量表中位数得分约27）和听力阈值[纯音平均听阈中位数（PTA）约16 dB听力损失（HL）]的老年参与者中，耳鸣对言语理解影响不大。耳鸣患者在GDT、双耳强度差异敏感度和FM敏感度方面也与NT组受试者相似。尽管存在这些相似之处，但在耳鸣参与者中仍发现了听觉处理方面的显著差异：在噪声中检测音调的能力较差、对强度变化更敏感以及对双耳时间差异更敏感。进一步的相关性分析表明，T组受试者的言语理解能力取决于对时间调制和双耳时间延迟（ITD）的敏感度，而在NT组受试者中，这些相关性较弱且无统计学意义。因此，尽管在平均言语理解能力和其他一些听觉功能参数方面存在相似之处，但患有耳鸣的老年人表现出不同的听觉处理方式，尤其是在阈上水平。结果还表明，与未患耳鸣的老年人相比，老年耳鸣患者的言语理解能力在困难条件下更依赖于声音刺激的时间特征。
