Making Sense of Sound

Rush College of Health Sciences

In most auditory testing, the emphasis is on accuracy in speech recognition, since speech is our primary means of communication. But myriad sounds beyond language are key to our understanding of the world around us.

“A car honking, a baby crying, a fire alarm — recognizing these sounds can be important to our safety,” explained Valeriy Shafiro, Ph.D. “And there are also lots of nonlinguistic environmental sounds we enjoy listening to: the sound of the ocean, the wind in the trees when we walk in the woods.” Shafiro, an associate professor of communication disorders and principal investigator in the Rush Auditory Research Laboratory, conducts research in hearing and speech perception that focuses on finding new ways to diagnose auditory deficits and improve communication abilities in adults. These new diagnostic techniques have the potential to improve the quality of life of a variety of audiology patients — even well beyond the groups Shafiro is currently studying.

Addressing a rehab deficit 

Much of Shafiro’s lab’s past work, which has been funded by the National Institutes of Health (NIH), the American Speech-Language-Hearing Foundation (ASHFoundation) and the Hearing Health Foundation, formerly known as the Deafness Research Foundation, has assessed the ability of people with cochlear implants to recognize a variety of nonspeech sounds — a particularly useful means of auditory assessment in a large, urban medical center that treats many non-English speakers.

A recent study tested listeners’ ability to recognize those sounds with or without the contextual clues present in everyday life. For example, an ambiguous sound can be perceived as a burning fuse when preceded by the sound of a match being struck and followed by the sound of an explosion, but it may be perceived as bacon frying when surrounded by other kitchen sounds.

Credit: Rush University

Credit: Rush University

“Compared with people with normal hearing, people with cochlear implants show some pretty clear deficits in identifying environmental sounds as well as speech,” Shafiro said. “Research from several labs, including ours, shows the possibility for cochlear implant users to improve if they work on it. But there are few readily available opportunities for these patients to obtain rehabilitation, for reasons including travel difficulties, health care reimbursements and scope of practice.”

Shafiro is now evaluating the usefulness of Internet-based environmental sound and speech training for people who rely on cochlear implants in daily life. “A Randomized Controlled Trial to Evaluate the Benefits of an Internet-Based Auditory Training Program for Cochlear Implant Patients,” a two-year grant from the ASHFoundation, aims to help fill the rehabilitation deficit for adults who receive cochlear implants.

“With Internet access now widely available, patients can do the auditory exercises online, at their own pace and without having to travel,” Shafiro said. When completed, the study will give him and his colleagues a deeper understanding of the benefits and challenges of computerized auditory training.

Hearing-dementia link

Measuring listeners’ recognition of nonlinguistic sounds was also a component of a recent study from the Rush Auditory Research Laboratory in collaboration with the Rush Alzheimer’s Disease Center.

“Hearing, Speech and Episodic Memory in Older African-American and White Adults,” funded with a grant from the NIH, examined a topic of wide current interest: the relationship between aging, hearing loss and cognitive deficits. As Baby Boomers age, research like this has major implications for the health and well-being of older adults. “Some recent research has reported that people with a greater rate of age-related hearing loss also have a greater rate of cognitive decline,” Shafiro explained.

“Typical tests of working memory are based on retaining words or numbers, but we wanted to explore this further by measuring both nonspeech and speech perception.” 

Using tests previously designed by Stanley Sheft, senior researcher at the Rush Auditory Research Laboratory and principal investigator on the study, the team measured the ability of a cohort of community-dwelling older adults without known dementia to discriminate brief nonlinguistic sound patterns.

The addition of nonlinguistic sounds produced somewhat different results than those yielded by previous research. Although other studies have associated speech perception with cognitive performance, the Rush study did not find this correlation when measuring hearing thresholds or the ability to recognize speech in noise.

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However, “We found a relationship between working memory and the ability to discriminate brief auditory patterns,” said Shafiro, who hopes to revisit the study cohort in the future to see whether the tests may be predictive of the trajectory of cognitive decline.

This article was repurposed with permission from Rush University Medical Center, and originally appeared in the Rush College of Health Sciences magazine Impact. Valeriy Shafiro, Ph.D., is a 2008 Emerging Research Grants recipient.

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I Would Love to Hear the Conversation

By Joe Mussomeli

Music is another language that calls to my brother, Alex. Though he was born with hearing loss, he experiences music as more than just sounds, as something more beautiful. He sets his daily activities—painting, doing homework, or reading—to the melodies of either classical or popular music. 

Music for Alex, and for many others with hearing loss, is both a blessing and a curse. Sometimes loud music volumes, especially in crowded spaces, can be a distraction for him. This recently became apparent at dinner in a restaurant with our parents. At first, he appreciated everything about the restaurant: the delicious smells, the cheerful faces, and the lively music.  We talked amongst ourselves until problems arose for Alex. Alex struggles to hear what others say under ordinary circumstances, but in a loud restaurant, conversation is virtually impossible for him. 

Restaurants serve and are staffed by so many people in close quarters, all of whom are immersed in their own simultaneous conversations. Music creates another layer of sound on top of these many voices. In this environment, Alex is only able to hear a tornado of noises, all scrambled together, that do not make any sense to him. 

That evening at the restaurant, Alex desperately tried to make sense of what we were saying, but couldn’t. The noise was too loud and too much to bare. We tried to accommodate Alex by repeating our words or speaking closer to him. Unfortunately, as the evening went on, the restaurant got more crowded and the noises, including the music, grew louder.

Eventually, Alex couldn’t manage the noise anymore, so we left. When we got home, Alex sat in his room for hours before I eventually entered to ask if he was okay. He was unhappily replaying the experience in his head. He told me, “I was lost in a storm of noise, unable to find my way out.” 

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I just sat there for a moment, unsure of how to respond, but I knew I had to say something. So, I asked Alex what he was going to do about his problem. Would he find a solution or simply refuse to go to another restaurant ever again? The choice was up to him. With that, Alex reflected, and eventually, an idea came to him: The Mini-Mic. 

The Mini-Mic is an assistive device Alex had previously used at school whenever he needed to hear others more clearly in crowded, noisy spaces. When someone speaks directly into the mic, the audio feeds into Alex’s hearing aid and cochlear implant. The mic had worked well in the classroom, so Alex figured that it could work successfully in a restaurant, too. After this realization, Alex was determined to give the restaurant another try.  

Nothing had changed at the restaurant, but Alex had. The crowded restaurant buzzed with loud chatter and music. Alex was not discouraged. As soon as we were seated, my mom placed the Mini-Mic on the table. Alex connected his implant and hearing aid to it, and then, he could hear everything. Just like everyone else, Alex was able to enjoy a meal and conversation at the same time. He was able to dine with us, talk with us, and laugh with us. And he was able to enjoy the music, playing vibrantly in the background.

Joe Mussomeli is an 11th-grade student who lives in Westport, CT. His younger brother, Alex, has been featured in Hearing Health magazine and is a participant in HHF’s “Faces of Hearing Loss” campaign.

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Hazardous Noise Can Affect More Than Your Hearing

By Strom & Associates

Each year, hazardous noise causes about 22 million workers in America to suffer a hearing loss on the job, and that hearing loss can affect everything from the quality of life to income potential and the ability to work. Understanding the far-reaching implications of permanent, irreversible hearing loss is critical for workers to protect their health and mental well-being.

Risk of Hearing Loss in the Workplace

Noise is one of the most misunderstood workplace hazards. The risk of hearing loss due to workplace exposure is significant. If the noise in a workplace is higher than 85 decibels average over eight hours, permanent hearing loss can occur. Even the noise from a carpenter’s shop or a farming operation can reach this threshold daily.

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Hearing Loss Affects Mental Health

People who have untreated hearing loss report a number of mental health issues. They may feel angry or irritable, and often they feel lonely because they are not able to interact with other people easily. This can cause them to avoid social situations. Untreated hearing loss can cause stress, fatigue, and undue tension. Some people with this condition also suffer from depression.

Hearing Loss Affects Income Potential

Hearing loss suffered on the job can also impact a worker’s overall income potential. When a worker cannot hear, he or she may not be able to do a job to the fullest. Reduced job performance can make it difficult to get promotions or raises. It can also lower the individual’s earning power because certain jobs require a full use of hearing to perform safely.

Additional Effects of Hearing Loss

In addition to income potential and mental health concerns, hearing loss can impact an individual’s overall quality of life. This is difficult to measure, but the National Institute of Occupational Safety and Health estimates hearing loss takes away 2.5 healthy years from workers exposed to work noises. Also, hearing loss can impair an individual’s memory and ability to learn new tasks.

The effects of hearing loss reach far beyond the ears. When workers are aware of the long-term and far-reaching impacts of hearing loss, the importance of using protective equipment may become more evident even if the sounds do not seem overly loud in the workplace.

This article was republished with permission from Strom & Associates, a Chicago-based personal injury law firm. For more, see https://stromlawyers.com.

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Moving Beyond Wnt and Notch Pathways for Hair Cell Regeneration

By Christopher Geissler, Ph.D.

There are several active human clinical trials evaluating the safety of inner ear hair cell regeneration therapies, but these therapies’ target mechanisms may be insufficient to stimulate hair cell growth in the adult mammalian cochlea. These approaches rely on the canonical Wnt and Notch signaling pathways and the Atoh1 molecule, which is necessary for hair cell regeneration and is regulated by these pathways. 

However, a report published in Molecular Therapy in May 2019 by Anshula Samarajeewa, Bonnie E. Jacques, Ph.D., and Alain Dabdoub, Ph.D., a member of Hearing Health Foundation (HHF)’s Hearing Restoration Project (HRP) consortium, notes that there has been very limited success thus far in regenerating hair cells in adult mammalian cochlea using these signaling pathways. This likely means, the authors write, that researchers will need combined approaches that also use epigenome-editing techniques to address changes to the genetic material and activity that occurs with age. 

Both the Wnt and Notch pathways play a role in determining how inner ear cells develop into specific types of cells and multiply, and they are also important in the development of the cochlea as a whole. Activating Wnt pathways and inhibiting Notch pathways can turn supporting cells into hair cells in fetuses and newborn mammals, making these key targets for hair cell regeneration. But both become much less effective as the body ages. Manipulating these pathways in adult animals has led to some success in regenerating hair cells, but these new hair cells tend not to develop fully, do not form necessary connections with auditory neurons, or even survive.  

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This lack of success is not because these pathways no longer exist in adults; researchers have found that they are still functional. This suggests that there are epigenetic changes that occur as a result of aging to make the adult cochlea less receptive to regeneration. Targeting epigenetic enzymes in addition to the Wnt and Notch signaling pathways may therefore prove more successful, but researchers still need to determine which part of the chromosome to target. This process would involve gene-editing techniques like CRISPR. This type of epigenome editing has slowed hearing loss in newborn mice, but it has yet to be tried in adult mice. If successful, this technique has the potential to treat hereditary and acquired forms of hearing loss.

HRP consortium member Alain Dabdoub, Ph.D., is a senior scientist, biological sciences at Sunnybrook Research Institute, University of Toronto. For more, see hhf.org/hrp.

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Outsmarting the Most Common Military Injury: How One Veteran Is Helping Future Generations

By Imani Rodriguez

After 26 years of military service, Hearing Health Foundation (HHF) Board Chair Col. John Dillard (U.S. Army, Ret.) lives with tinnitus and noise-induced hearing loss. Tinnitus is one of the most prevalent war injuries among American veterans—and hearing loss is equally common—and Dillard is dedicated to improving the lives of millions through the advancement of tinnitus research that will lead to more reliable treatments and, eventually, permanent relief through cures. Tinnitus is the perception of ringing or buzzing in the ears without an external sound source.

In addition to supporting the advancement of more viable treatments and cures for tinnitus through HHF’s groundbreaking research, Dillard is a U.S. Department of Defense consumer reviewer for the Peer Review Medical Research Program (PRMRP), part of the U.S. government’s Congressionally Directed Medical Research Programs. 

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Dillard is actively serving as a tinnitus consumer reviewer for the fourth consecutive year after again meeting qualifications through a rigorous application process. As a senior lecturer for systems acquisition management at the Naval Postgraduate School in Monterey, California, he is well connected with members of the military community, many who also live with tinnitus. He is a valuable contributor to discussions about tinnitus with scientists and the general public alike.

As a tinnitus consumer reviewer for the PRMRP, Dillard is responsible for evaluating and scoring tinnitus research proposals based on their potential for scientific and clinical impact. His academic experience as a military researcher has allowed him to assist with the critical thinking and reasoning aspects of each proposal. And from his own military experience, Dillard is keenly aware of how vital this research is for those returning from combat.

Tinnitus is a chronic condition without an existing reliable treatment, although certain products on the market claim otherwise. “There are no nutritional, pharmacological, surgical, deep brain or transdermal electrical stimulation, sound, transcranial magnetic, or other therapies proven efficacious for tinnitus,” Dillard says. “There are many treatments marketed to the naive consumer or patient/sufferer, but none of them are truly effective. Most folks who know me understand my extreme cautions against what I consider ‘snake oil’ treatments. People should spend no money on these products.”

Dillard says one exception using sound therapy is Tinnitus Retraining Therapy (TRT), currently considered the gold standard in coping with—but not eliminating or curing—disruptive levels of tinnitus. “I have personally benefited from TRT,” he says. TRT involves wearing ear-level devices that work to deliver masking noise to the brain, with or without hearing amplification; the therapy can typically be incorporated into hearing aids. 

Dillard is confident progress will continue to be made by both HHF and the Department of Defense. “We know now that tinnitus is more of a ‘brain problem’ that usually starts from damage to the ear in the form of noise-induced hearing loss,” he says. 

“We need to help the brain heal itself and correct what is actually an auditory ‘hallucination’ of hyperactive neuronal activity. It’s a very resilient, maladaptive feedback loop that works much like learned pain,” Dillard adds “We also hope for various pharmacological approaches being tried that can help tamp down this hyperactivity. I’m hopeful that we will see progress on treating tinnitus in our lifetimes.”

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Col. John Dillard (U.S. Army, Ret.) was appointed Chair of Hearing Health Foundation’s Board of Directors July 1, 2019, after joining the Board in February 2018. He wrote about his experience in the military and how it affected his hearing as the Fall 2017 Hearing Health cover story. HHF marketing and communications intern Imani Rodriguez studied communications and public relations at Rutgers University. 

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United by Hearing Loss in Rochester, NY

By Lauren McGrath

Hearing Health Foundation (HHF) proudly attended the 40th annual Hearing Loss Association of America (HLAA) convention last week in Rochester, NY. Rochester, fittingly, is the U.S. city with the highest per capita deaf population and a vibrant hub for hearing loss accessibility.

HHF CEO Timothy Higdon and Director of Marketing and Communications Lauren McGrath were present at the city’s Joseph A. Floreano Riverside Convention Center to speak with thousands of individuals about the significance of hearing loss research and education.

The conference began with a keynote speech from psychotherapist and author Rebecca Alexander, who lives with Usher syndrome and has partnered with HHF Board member Sophia Boccard to raise awareness of the condition. Alexander cited her cochlear implants as a vital tool hat “helped her reconnect with life.” She also reminded the audience of the importance of requesting assistance. “Why are we so averse to asking people for help?” she inquired, reminding her listeners that no one can read our minds when we face difficulties with hearing, vision, or balance.

CEO Timothy Higdon and Director of Marketing & Communications Lauren McGrath at HHF’s booth in the exhibit hall.

CEO Timothy Higdon and Director of Marketing & Communications Lauren McGrath at HHF’s booth in the exhibit hall.

Chief of the Laboratory of Molecular Genetics at the National Institute on Deafness and Other Communication Disorders, Thomas Friedman, Ph.D., who was funded by HHF’s Emerging Research Grants (ERG) program in 1994 and 1995, introduced the conference’s research symposium on genetics and hearing loss. There are 142 genes known to be associated with deafness, and animal models (mice, zebrafish, and fruit flies) are essential to providing such evidence. 

Zheng-Yi Chen, Ph.D. (Mass. Eye and Ear; 1994 ERG), Patricia White, Ph.D. (University of Rochester School of Medicine; 1999 and 2001 ERG), and Hela Azaiez, Ph.D. (University of Iowa), provided supplementary insights about genetic hearing loss and the possibilities for treatment. Further research updates about hereditary deafness will be available in the Summer 2019 issue of Hearing Health in late July. 

In the exhibit hall, HHF had the opportunity to speak to individuals with hearing loss interested to learn about new advances in research, including exactly how a chicken is connected to potential cures for hearing loss and tinnitus. At neighboring booths, HHF met with representatives from like-minded nonprofit organizations and hearing loss technology providers.

Beyond the exhibit hall, guests participated in workshops focused on self-efficacy, hearing devices, assistive technology, health insurance, and safe travel, among other topics.

The convention buzzed with curiosity, knowledge and compassion. As always, HHF is grateful to HLAA for uniting many of the nation’s most dedicated hearing loss advocates in a valuable three-day experience.

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Bodybuilding Against All Odds

By Mersal Faizi

Meet Elizabeth “Elizzy” Galvan, a 40-year-old professional bodybuilder from Fargo, North Dakota, who doesn’t fit the stereotypical presentation of someone in her chosen sport. She is deaf, lives with Usher syndrome, and has one arm—all so-called limitations that make her success exceptionally inspirational.

Galvan lost her right arm at age 3 in an accident with an old-fashioned washing machine. The same year, she developed a bilateral hearing loss as a result of an illness and was fitted with hearing aids.

Photo Credit: Michael Kehoe

Photo Credit: Michael Kehoe

Galvan’s parents chose to enroll her in North Dakota School for the Deaf at age 3, where she learned to communicate with American Sign Language (ASL). Decades later, this remains her preferred mode of communication. She also uses notes, speech-to-text, and body language when her conversational partner does not know ASL.

During a routine vision screening test in school at age 16, Galvan was diagnosed with Usher syndrome, the most common genetic disorder causing progressive hearing and losses. The diagnosis was unexpected because Galvan does not have a known family connection to Usher syndrome. “This explained why I would always bump into things and lose my balance,” Galvan said.

Galvan’s father required she wear her hearing aids while she was in school. Though the devices improved her hearing, Galvan says she disliked them greatly because she found pride in her deafness and didn't want to change who she was. With the freedom to make her own decisions at 18, Galvan stopped wearing her hearing aids.

As an adult, Galvan learned how to function comfortably with the help of a friend and Usher advocate. Galvan’s friend recommended she ask someone to tap her shoulder when there is a step in front of her, and to use hand gestures close to her face to signal to her that others are present. These methods became necessary when her vision began to worsen and she was mistaken for being rude when bumping into people unknowingly.

In 2015, Galvan underwent a major back surgery that left her weaker than she was before. Through her own research, she discovered bodybuilding would help her regain strength. After just one bodybuilding session at the gym, Galvan felt energized and ready to improve herself mentally and physically. “My conditions don’t limit me, but motivate me to become stronger,” Galvan says.

Galvan exercises independently in facilities that fit her needs. Before joining or using a new gym, she carefully evaluates the space and equipment to make sure it’s well-lit and spacious.  She wants to make sure it's safe to work out in without further injuring herself.

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Still fairly new to bodybuilding, Galvan has already won awards in the sport. She has earned  second, third, and fourth place trophies in competitions and received an award for inspiring others from the National Physique Committee, the largest amateur bodybuilding organization in the U.S. Galvan will participatie in her third bodybuilding competition in October 2019.

Galvan considers her bodybuilding journey her way of showing people she is capable of defeating the odds. “Disabilities don’t prevent us from doing anything,” she says, “they just make us do things differently.”

Former marketing & communications intern Mersal Faizi studies corporate communications at Baruch College.

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2019-2020 Emerging Research Grantees Announced

By Christopher Geissler, Ph.D.

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Hearing Health Foundation (HHF) is proud to announce the recipients of Emerging Research Grants (ERG) for the upcoming year (July 1, 2019 — June 30, 2020). Following a rigorous review process, our Scientific Review Committee and Council of Scientific Trustees, comprised of senior expert scientists and physicians from across the US, have chosen fourteen especially meritorious projects to fund, covering a broad range of hearing and balance science. We are pleased to be able to support the work of these promising researchers and look forward to learning about the advances they will undoubtedly make in the coming year and beyond.

This year’s ERG recipients are:

Dunia Abdul-Aziz, M.D.
Massachusetts Eye and Ear
Project: Targeting epigenetics to restore hair cells

Pierre Apostolides, Ph.D.
Regents of the University of Michigan
Project: Novel mechanisms of cortical neuromodulation

Michael Dent, Ph.D.
University at Buffalo
Project: Noise-induced tinnitus in mice
Generously funded by The Les Paul Foundation

Vijayalakshmi Easwar, Ph.D.
University of Wisconsin Madison
Project: Neural correlates of amplified speech in children with sensorineural hearing loss
Generously funded by The Children’s Hearing Institute

Kristi Hendrickson, Ph.D.
University of Iowa
Project: Neural correlates of semantic structure in children who are hard of hearing
Generously funded by General Grand Chapter Royal Arch Masons

Hao Luo, Ph.D.
Wayne State University
Cochlear electrical stimulation induced tinnitus suppression and related neural activity change in the rat's inferior colliculus
Generously funded by General Grand Chapter Royal Arch Masons

Kristy Lawton, Ph.D.
Washington State University Vancouver
Project: Characterizing noise-induced synaptic loss in the zebrafish lateral line
Generously funded by General Grand Chapter Royal Arch Masons

Anat Lubetzky, P.T., Ph.D.
New York University
Project: A balancing act in hearing and vestibular loss: assessing auditory contribution to multisensory integration for postural control in an immersive virtual environment

David Martinelli, Ph.D.
University of Connecticut Health Center
Project: Creation and validation of a novel genetically-induced animal model for hyperacusis
Generously funded by Hyperacusis Research

Jameson Mattingly, M.D.
The Ohio State University
Project: Differentiating Ménière's disease and vestibular migraine using audiometry and vestibular threshold measurements

Vijaya Prakash Krishnan Muthaiah, P.T., Ph.D.
University at Buffalo
Project: Potential of inhibition of Poly ADP Ribose Polymerase as a therapeutic approach in blast induced cochlear and brain injury.
Generously funded by General Grand Chapter Royal Arch Masons

William “Jason” Riggs, Au.D.
The Ohio State University
Project: electrophysiological characteristics in children with auditory neuropathy spectrum disorder
Generously funded by General Grand Chapter Royal Arch Masons

Gail Seigel, Ph.D.
The Research Foundation of SUNY on behalf of the University at Buffalo
Project: Targeting microglial activation in hyperacusis

Victor Wong, Ph.D.
Burke Medical Research Institute
Project: Targeting tubulin acetylation in spiral ganglion neurons for the treatment of hearing loss

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Very High-Frequency Hearing Loss and Tinnitus: Is There a Link?

By Julia Campbell, Au.D., Ph.D.

Tinnitus is theorized to possibly arise from decreased central inhibition related to cochlear damage, or hearing loss. A reduction in inhibition function would allow signals that are normally suppressed to be perceived, resulting in tinnitus. However, many individuals with clinically typical hearing also present with tinnitus.

In our earlier study, results indicated that despite an apparently intact peripheral auditory system, inhibitory function was atypical and significantly related to tinnitus severity among a population reporting mild tinnitus. With central inhibition lowered, signals that are typically dampened are able to be perceived, potentially resulting in tinnitus. Our paper also showed the utility of measuring central inhibition through cortical auditory evoked potentials (CAEPs), which are electrical responses in the brain that reveal levels of central inhibition.

Given the prior study’s results, we thought it is possible that hearing loss within extended high-frequency thresholds (10, 12.5, and 16 kilohertz), which are not typically assessed in the clinic, may negatively impact inhibitory function and subsequent gating measures.

For our follow-up research, published in the American Journal of Audiology on April 22, 2019, we examined the role of both extended high-frequency thresholds and sensory gating dysfunction, a measure of central inhibition abnormality, in typical-hearing adults with and without tinnitus. Results suggest that extended high-frequency thresholds do not correlate with CAEP amplitude gating indices—in other words, high-frequency hearing loss was not associated with decreased central inhibition.

CAEP gating waveforms in A) a typical-hearing subject without tinnitus and B) a typical-hearing subject with tinnitus. The solid line represents the CAEP response to the first stimulus (S1) in a tonal pair, and the dashed the CAEP response to the second stimulus (S2) in a tonal pair. Typical gating is observed when CAEP S2 amplitude is lower compared with CAEP S1 amplitude (A). Atypical gating occurs when CAEP S2 amplitude is equal to or larger than CAEP S1 amplitude (B).

CAEP gating waveforms in A) a typical-hearing subject without tinnitus and B) a typical-hearing subject with tinnitus. The solid line represents the CAEP response to the first stimulus (S1) in a tonal pair, and the dashed the CAEP response to the second stimulus (S2) in a tonal pair. Typical gating is observed when CAEP S2 amplitude is lower compared with CAEP S1 amplitude (A). Atypical gating occurs when CAEP S2 amplitude is equal to or larger than CAEP S1 amplitude (B).

However, we found an unexpected relationship in the tinnitus group: Those with better (lower) thresholds also presented with worse tinnitus. We believe this finding may be due to typical-hearing adults with better high-frequency hearing to be more aware of internal auditory signals, and thus perceive tinnitus. However, further research is needed to investigate this hypothesis.

In addition, atypical gating performance was observed in adults with a Tinnitus Handicap Inventory score over 6, which may demonstrate that tinnitus severity must reach a certain point in order for central gating deficits to be observed, or vice versa. A hierarchical multiple regression showed both extended high-frequency thresholds and atypical gating function to account for a significant 49 percent of tinnitus severity.

Therefore, auditory gating appears to be a useful objective measure for tinnitus severity, at least in adults with clinically typical hearing. It also appears that the testing of extended high-frequency thresholds is warranted in this population, to be used in combination with CAEP amplitude gating indices. Our laboratory is now conducting studies investigating the utility of auditory gating as a clinical tool for the objective assessment of tinnitus severity in adults with hearing loss.

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2016 Emerging Research Grants scientist Julia Campbell, Au.D., Ph.D., CCC-A, FAAA, received the Les Paul Foundation Award for Tinnitus Research. She is an assistant professor in communication sciences and disorders in the Central Sensory Processes Laboratory at the University of Texas at Austin. If you are interested in participating in this research, email julia.campbell@austin.utexas.edu.

Empower groundbreaking research toward better treatments and cures for hearing loss and tinnitus. If you are able, please make a contribution today.

 
 
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Have Loop, Will Travel

By Stephen O. Frazier

I'm 80 years old with a hearing loss. What I've learned through my travels is that I need more than just my hearing aids.

In New York City not long ago, I expected to have a problem when I approached the fare booth to buy a subway pass. I knew the roar of trains constantly passing through makes it difficult for someone with typical hearing to communicate, let alone someone like me with a severe hearing loss.

National Association of the Deaf via hearingloop.org

National Association of the Deaf via hearingloop.org

But when I noticed a sign for hearing loops, a blue symbol with an ear and a “T,” I turned off my hearing aids’ mics and turned on their telecoils. To my surprise and delight, I heard quite clearly the attendant’s voice, just as a train was passing through underneath.   

Telecoils, or T-coils, are tiny coils of wire in my hearing aids that receive sound from the electromagnetic signal from a hearing loop. A hearing loop, in turn, is a wire that surrounds a defined area and is connected to a sound source such as a public address system. It emits a signal that carries the sound from its electronic source to the T-coils in my hearing aids, which are already optimized for my hearing ability. It’s as simple as flipping a switch to gain access to sound in any looped setting.

Beyond New York City, hearing loops are available around the country in auditoriums, train stations, airports, places of worship, theaters, and more. For a full and growing list, see time2loopamerica.com and aldlocator.com.

The technology also works with devices called neck loops—personal loops that replace the headsets used in assistive listening situations (such as a museum audio guide, in-flight entertainment, or a live theater production) and send sound to the telecoils of hearing aids.

Travelers with hearing loss should look for the international hearing loop symbol, which is usually blue in the U.S. but may be maroon or green or some other color abroad. If you aren’t sure whether your hearing aid has T-coils, talk to your hearing healthcare provider. Keep in mind the smallest-size hearing aids sometimes do not come with telecoils.

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Here are some of my other travel tips, as a lifelong travel enthusiast:

  • If you have a Pocket Talker or some other personal sound amplifier, take it along with a neck loop to hear over cabin noise in flight.  

  • Download a speech-to-text app like Live Caption or InnoCaption to your cell phone to let you read what's said to you by others.

  • Download a captioned phone app such as the one from Hamilton CapTel so you will have captioned phone access during your trip, for both placing and receiving calls.

  • Pack extra hearing aid batteries and, if you have one, an extra hearing aid for the trip.  

  • If your hearing aids are rechargeable, be sure to take the charger and put it in your carry-on in case your checked luggage doesn't arrive with you.

  • Take a pen and notepad with you to communicate with ticket/gate agents in case you can't hear them over the noise in the airport.

  • Download the SoundPrint app for its Quiet List that identifies restaurants and bars in several U.S. cities, including popular destination New York City, that are less noisy than others and more conducive to conversation.

  • Print your ticket and boarding pass at home, or send it to your phone.

  • If available, take a seat near the information counter at the gate and alert the attendant to your hearing loss. Request that you be notified of any emergency or other announcements. Often the agent will add you to the group allowed to preboard.

  • As you board the aircraft, alert the flight attendant(s) to your hearing loss so they will know to pay attention to your communication needs, and read the safety instructions in the pocket in front of you—you will probably have difficulty understanding the oral version offered by the flight crew.

  • Once you reach your destination, if staying in a hotel, alert the desk clerk to your hearing difficulty so staff can be instructed to personally inform you of any emergency, e.g., fire alarms. If you feel you need it, ask for an Americans with Disabilities Act (ADA) deaf/hard-of-hearing kit from the hotel; they are required to have them available.  These kits include such items as a door knock sensor, telephone handset amplifier, telephone ringer signaler, visual/audio smoke detector, and a special alarm clock. Not all hotels are in compliance with the ADA so check ahead on the availability of a kit.

  • And most of all, relax and enjoy your travels!

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Stephen O. Frazier is a hearing loss support specialist, the former Hearing Loss Association of America (HLAA) chapter coordinator for New Mexico, and director of Loop New Mexico. He serves on the national HLAA Hearing Loop Steering Committee and on the New Mexico Speech-Language Pathology, Audiology, and Hearing Aid Dispensing Practices Board. To learn more about loops, see hearingloop.org.

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