Department of Speech & Hearing Science, The Ohio State University, Columbus, Ohio, USA.
Independent Statistical Consultant, Columbus, Ohio, USA.
Ear Hear. 2024;45(3):695-709. doi: 10.1097/AUD.0000000000001462. Epub 2024 Jan 17.
Mild traumatic brain injury (TBI) can have persistent effects in the auditory domain (e.g., difficulty listening in noise), despite individuals having normal pure-tone auditory sensitivity. Individuals with a history of mild TBI often perceive hearing difficulty and greater listening effort in complex listening situations. The purpose of the present study was to examine self-perceived hearing difficulty, listening effort, and performance on an auditory processing test battery in adults with a history of mild TBI compared with a control group.
Twenty adults ages 20 to 53 years old participated divided into a mild TBI (n = 10) and control group (n = 10). Perceived hearing difficulties were measured using the Adult Auditory Processing Scale and the Hearing Handicap Inventory for Adults. Listening effort was measured using the National Aeronautics and Space Administration-Task Load Index. Listening effort ratings were obtained at baseline, after each auditory processing test, and at the completion of the test battery. The auditory processing test battery included (1) dichotic word recognition, (2) the 500-Hz masking level difference, (3) the Listening in Spatialized Noise-Sentences test, and (4) the Word Auditory Recognition and Recall Measure (WARRM).
Results indicated that individuals with a history of mild TBI perceived significantly greater degrees of hearing difficulty and listening effort than the control group. There were no significant group differences on two of the auditory processing tasks (dichotic word recognition or Listening in Spatialized Noise-Sentences). The mild TBI group exhibited significantly poorer performance on the 500-Hz MLD and the WARRM, a measure of auditory working memory, than the control group. Greater degrees of self-perceived hearing difficulty were significantly associated with greater listening effort and poorer auditory working memory. Greater listening effort was also significantly associated with poorer auditory working memory.
Results demonstrate that adults with a history of mild TBI may experience subjective hearing difficulty and listening effort when listening in challenging acoustic environments. Poorer auditory working memory on the WARRM task was observed for the adults with mild TBI and was associated with greater hearing difficulty and listening effort. Taken together, the present study suggests that conventional clinical audiometric battery alone may not provide enough information about auditory processing deficits in individuals with a history of mild TBI. The results support the use of a multifaceted battery of auditory processing tasks and subjective measures when evaluating individuals with a history of mild TBI.
轻度创伤性脑损伤（TBI）可能会对听觉领域产生持续影响（例如，在噪声环境中听力困难），尽管个体具有正常的纯音听觉敏感性。有轻度 TBI 病史的个体在复杂听力环境中经常会感到听力困难和更大的听力努力。本研究的目的是比较有轻度 TBI 病史的成年人和对照组在听觉处理测试组中自我感知的听力困难、听力努力和表现。
20 名年龄在 20 至 53 岁的成年人分为轻度 TBI 组（n=10）和对照组（n=10）。使用成人听觉处理量表和成人听觉障碍问卷测量感知听力困难。使用美国国家航空航天局-任务负荷指数测量听力努力。在基线、每次听觉处理测试后和测试结束时获得听力努力评分。听觉处理测试包括（1）双耳分听词识别，（2）500Hz 掩蔽级差，（3）空间化噪声句子测试，和（4）词听觉识别和回忆测试（WARRM）。
结果表明，有轻度 TBI 病史的个体感知到的听力困难和听力努力程度明显大于对照组。在两项听觉处理任务（双耳分听词识别或空间化噪声句子测试）中，两组之间没有显著差异。与对照组相比，轻度 TBI 组在 500Hz MLD 和 WARRM 测试中的表现明显较差，后者是一种听觉工作记忆测试。自我感知听力困难程度越大，听力努力程度和听觉工作记忆能力越差。更大的听力努力程度也与较差的听觉工作记忆能力显著相关。
结果表明，有轻度 TBI 病史的成年人在听挑战性的声音环境时可能会感到主观听力困难和听力努力。在 WARRM 任务中，观察到轻度 TBI 成年人的听觉工作记忆较差，与听力困难和听力努力程度有关。总之，本研究表明，传统的临床听力计测试可能无法提供有关轻度 TBI 病史个体听觉处理缺陷的足够信息。结果支持在评估有轻度 TBI 病史的个体时使用多种听觉处理任务和主观测量方法。
