What's That Noise?

By Laura Friedman

In honor of World Tinnitus Day April 18, Hearing Health Foundation (HHF) wants to draw attention to the effects and challenges associated with tinnitus.

The U.S. Centers for Disease Control estimates some 15% of Americans—about 50 million people—have experienced tinnitus. Roughly 20 million people struggle with chronic tinnitus, while 2 million have extreme and debilitating cases. It is also a top war wound among active U.S. military personnel and veterans.

Tinnitus is defined as the perception of sound when there is no external, acoustic source. Individuals with tinnitus may describe the noise as buzzing, hissing, whistling, swooshing, or clicking. Roughly 90 percent of tinnitus cases occur with an underlying hearing loss.

Tinnitus can be either intermittent or chronic. People who experience intermittent tinnitus occasionally hear sounds in their ears that can last from minutes to hours after being exposed to excessively loud noises. An example would be someone sitting near the fence of a NASCAR race without wearing hearing protection. People with chronic tinnitus, on the other hand, often experience noise more frequently, which can last for more than three months.

The impact of tinnitus on everyday life differs from person to person. Researchers found that most people with chronic tinnitus are not too bothered by it. Many of these people prefer to only see a doctor for assurance that their tinnitus is not an indication of a serious disease or impending deafness. People who were bothered by their tinnitus reported that it was annoying, invasive, upsetting, and distracting in daily life. In a small tinnitus self-help group, some members frequently describe having problems sleeping, understanding speech, poor concentration, inability to relax, and depression.

People with age-related hearing loss, or presbycusis, may also experience a ringing, hissing, or roaring sound in the ears. Presbycusis progresses over time and is generally more severe in men than in women and the risk increases with age, as shown in epidemiological surveys.

Although there is no cure for tinnitus, there are available treatments that can minimize tinnitus symptoms. Tinnitus Activities Treatment (TAT), cognitive behavioral therapy (CBT), and Tinnitus Retraining Therapy (TRT) are sound therapies that can lessen the effects of tinnitus, often times very helpful in combination with counseling. Furthermore, by using hearing protection and noise reduction technologies, and by avoiding excessive noise, many people can prevent significant hearing problems.

Taking care of your hearing should always be part of keeping healthy overall. If you suspect a hearing loss or tinnitus, HHF recommends getting your hearing checked. If you do have a hearing loss or tinnitus, talk with your hearing healthcare professional about available treatments. For more information, visit hhf.org/tinnitus or email us at info@hhf.org.

Laura Friedman is the Communications and Programs Manager of Hearing Health Foundation.

Cortical Alpha Oscillations Predict Speech Intelligibility

By Andrew Dimitrijevic, Ph.D.

Hearing Health Foundation Emerging Research Grants recipient Andrew Dimitrijevic, Ph.D., and colleagues recently published “Cortical Alpha Oscillations Predict Speech Intelligibility” in the journal Frontiers in Human Neuroscience.

The scientists measured brain activity that originates from the cortex, known as alpha rhythms. Previous research has linked these rhythms to sensory processes involving working memory and attention, two crucial tasks for listening to speech in noise. However, no previous research has studied alpha rhythms directly during a clinical speech in noise perception task. The purpose of this study was to measure alpha rhythms during attentive listening in a commonly used speech-in-noise task, known as digits-in-nose (DiN), to better understand the neural processes associated with speech hearing in noise.

Fourteen typical-hearing young adult subjects performed the DiN test while wearing electrode caps to measure alpha rhythms. All subjects completed the task in active and passive listening conditions. The active condition mimicked attentive listening and asked the subject to repeat the digits heard in varying levels of background noise. In the passive condition, the subjects were instructed to ignore the digits and watch a movie of their choice, with captions and no audio.

Two key findings emerged from this study in regards to the influence of attention, individual variability, and predictability of correct recall.

First, the authors concluded that the active condition produced alpha rhythms, while passive listening yielded no such activity. Selective auditory attention can therefore be indexed through this measurement. This result also illustrates that these alpha rhythms arise from neural processes associated with selective attention, rather than from the physical characteristics of sound. To the authors’ knowledge, these differences between passive and active conditions have not previously been reported.

Secondly, all participants showed similar brain activation that predicted when one was going to make a mistake on the DiN task. Specifically, a greater magnitude in one particular aspect of alpha rhythms was found to correlate with comprehension; a larger magnitude on correct trials was observed relative to incorrect trials. This finding was consistent throughout the study and has great potential for clinical use.

Dimitrijevic and his colleagues’ novel findings propel the field’s understanding of the neural activity related to speech-in-noise tasks. It informs the assessment of clinical populations with speech in noise deficits, such as those with auditory neuropathy spectrum disorder or central auditory processing disorder (CAPD).

Future research will attempt to use this alpha rhythms paradigm in typically developing children and those with CAPD. Ultimately, the scientists hope to develop a clinical tool to better assess listening in a more real-world situation, such as in the presence of background noise, to augment traditional audiological testing.

Andrew Dimitrijevic, Ph.D., is a 2015 Emerging Research Grantee and General Grand Chapter Royal Arch Masons International award recipient. Hearing Health Foundation would like to thank the Royal Arch Masons for their generous contributions to Emerging Research Grants scientists working in the area of central auditory processing disorders (CAPD). We appreciate their ongoing commitment to funding CAPD research.

We need your help supporting innovative hearing and balance science. Please make a contribution today.

Understanding Auditory Processing Disorder

 By Frankie Huang

April 4 is Auditory Processing Disorder Awareness Day and the Hearing Health Foundation is highlighting the effects and challenges associated with living with APD.

Auditory processing disorder (APD), also known as central auditory processing disorder (CAPD), is an auditory deficit affecting how the central nervous system interprets verbal information. Those living with APD show impairments in sound localization, specifically their ability to isolate a sound source in social environments.

Approximately 5% of school-age children have APD. Children with APD often are uncertain about what they hear and have difficulty listening in loud background noises as well as understanding rapid speech. Often distracted, they can struggle to keep up with conversations which impedes their ability to read, spell, and follow oral directions.

Researchers found a correlation between working memory capacity, which is the ability to retain and manipulate information, and speech development. They found that working memory capacity was significantly lower in children with APD and may be the cause of their inability to separate and group incoming information and, in turn, lead to poor speech perception in noisy environments.

Other researchers found that peripheral hearing loss may affect performance in certain APD tests in older adults. Older adults with mild to moderate hearing loss did significantly poorer on tests that require recalling words, identifying high and low tone patterns, and repeating short sentences.

Although APD can be difficult to diagnose, there are telltale signs: poor auditory memory, difficulty identifying sounds, and a delayed response to verbal requests and instructions. APD is sometimes misdiagnosed as ADD/ADHD or dyslexia, so if you suspect you or a loved one may have APD, it is advised that they go through an individual comprehensive assessment with an audiologist for a more accurate diagnosis.

It is important to understand that research is still needed to understand auditory processing disorders, accurate methodologies for diagnosis, and the best interventions for each child or adult. Even though there are available strategies to treat children with APD, researchers are hard at work finding alternative treatments that will improve the lives of those suffering from APD.

Learn about Hearing Health Foundation’s 2016 Emerging Research Grants recipients who are conducting research to improve the lives of those affected by APD. These grantees are General Grand Chapter Royal Arch Masons International award recipients and we are grateful to the Masons for their ongoing support.

John Brigande provides commentary: Hearing in the mouse of Usher

Oregon Health & Science University

The March issue of Nature Biotechnology brings together a set of articles that provide an overview of promising RNA-based therapies and the challenges of clinical validation and commercialization. In his News and Views essay, “Hearing in the mouse of Usher,” John V. Brigande, Ph.D., provides commentary on two studies in the issue that report important progress in research on gene therapy for the inner ear.

One in eight people in the United States aged 12 years or older has hearing loss in both ears. That figure suggests that, if you don’t have hearing loss, you likely know someone who does. Worldwide, hearing loss profoundly interferes with life tasks like learning and interpersonal communication for an estimated 32 million children and 328 million adults worldwide. Inherited genetic mutations cause about 50 percent of these cases.

The challenge in developing gene therapy for the inner ear isn’t a lack of known genes associated with hearing loss, but a lack of vectors to deliver DNA into cells. Brigande, associate professor of otolaryngology and cell, developmental, and cancer biology at the OHSU School of Medicine, provides perspective on companion studies that demonstrate adeno-associated viral vectors as a potent gene transfer agent for cochlear cell targets.

The first study demonstrates safe and efficient gene transfer to hair cells of the mouse inner ear using a synthetic adeno-associated viral vector that promises to be a powerful starting point for developing appropriate vectors for use in the human inner ear. The second study demonstrates that a single neonatal treatment with this viral vector successfully delivers a healthy gene to the inner ear to achieve unprecedented recovery of hearing and balance in a mouse model of a disease called Usher syndrome. Individuals with Usher syndrome type 1c are born deaf and with profound balance issues and experience vision loss by early adolescence. The research teams were led by scientists from the Harvard School of Medicine.

Brigande sees these new studies as potentially spurring investment and kickstarting the development of new approaches to correct a diverse set of deafness genes. 

Hearing Restoration Project consortium member John V. Brigande, Ph.D., is a developmental neurobiologist at the Oregon Hearing Research Center. He also teaches in the Neuroscience Graduate Program and in the Program in Molecular and Cellular Biology at the Oregon Health & Science University. This blog was reposted with the permission of Oregon Health & Science University.

High-Tech Hope for the Hard of Hearing

"In 2011, the Hearing Health Foundation based in New York, created the Hearing Restoration Project, a consortium of fourteen scientists who agreed to work together toward that goal, partly with funding from the foundation. One of the originators of the project, Edwin Rubel, who was a co-discoverer of hair-cell regrowth in chickens, told me, “It’s potentially the best thing that ever happened, because it really does bring together a lot of different kinds of expertise.”

Hearing Health Foundation's work toward finding better therapies and cures for hearing loss and tinnitus was featured in the April 3, 2017 Issue of T High-Tech Hope for the Hard of Hearing he New Yorker Magazine. Read the article here.

Our 2016 Annual Report Is Now Available!

By Frankie Huang

Hearing Health Foundation (HHF) is happy to announce that its 2016 annual report is now available. The report is an in-depth review of our activities, events, and achievements for fiscal year 2016. We are very proud of top marks from top charity-rating agencies and even more proud our audited financial statements.

We are fortunate to have such generous supporters who raised funds to further HHF’s mission of prevention, education, and research. Check out our supporters' creative and unique fundraisers; if you feel inspired and would like to organize an event of your own, please contact us at development@hhf.org.

In 2016, the Hearing Restoration Project (HRP) has made significant strides, bringing us closer to finding a cure for hearing loss and tinnitus. Here are just two of the HRP’s discoveries:

• Successfully disrupted gene expression in the adult mouse cochlea, including capturing high-quality images—necessary for testing genes in regeneration.
   

• Confirmed that the “DTR mouse” is an excellent platform for studying ways to stimulate hair cell regeneration in the mammalian inner ear.

HHF awarded nine Emerging Research Grants (ERGs) to early-career scientists who are pursuing projects in the areas of Central Auditory Processing Disorder (CAPD), Hyperacusis, Ménière's disease, Stria, and Tinnitus. Through ERG, we hope to uncover better treatment options and deeper understanding of these disorders.

Last but certainly not least, we want to express our gratitude and appreciation for our many donors; because of their support, we were able to continue with our important work. To see your name on our next donors’ list, we gladly welcome and appreciate your gift in any amount made by Sept. 30, 2017.

Urgent Call to Action: Proposed Cuts to Hearing Research

By Nadine Dehgan, Elizabeth Keithley, Ph.D., and Peter Barr-Gillespie, Ph.D.

Hearing Health Foundation (HHF) is deeply concerned to learn the Trump administration has proposed an 18% cut to the budget for the National Institutes of Health (NIH).

Such a cut would be devastating for all medical research - including hearing research. As an advocate for the millions of Americans who have hearing loss we are especially troubled.

A drastic decrease to the funding of hearing research would disrupt the efforts of the many hearing researchers who dedicate their lives to finding cures and treatments for hearing loss, tinnitus and balance disorders.

HHF and the NIH are partners in funding research. HHF’s two research programs—the Emerging Research Grants and the Hearing Restoration Project—both rely on NIH support. HHF's funding alone cannot support these labs.

Private funding of hearing research is dwarfed by NIH support, and these proposed cuts could harm the research program of each and every hearing research lab, including those supported by the HHF.

As people with hearing loss, parents of those with hearing loss, children of those with hearing loss and as the leadership of the Hearing Health Foundation we ask your support. Financial support is always needed and welcome - but in this case we are specifically asking for you to contact your representatives to let them know that you oppose cuts to the NIH (and in fact support increases to the NIH’s budget).

If you are passionate about funding the research that will lead to cures for hearing loss and balance disorders, now is the time to act.

Please join us in contacting your Senators and House Representative's offices today.

With our sincere thanks,
Nadine Dehgan | CEO of HHF
Elizabeth Keithley | Chair of the Board
Peter Barr-Gillespie | HRP Scientific Director

Low Income at Disproportionate Risk for Hearing Loss

By Morgan Leppla

Hearing loss affects people of every age, race, and socioeconomic level. However, there are circumstances that put different people in danger of acquiring it. While some causes of hearing loss are avoidable or controllable, others are are not easily escaped. Low income people are much more likely to suffer from hearing loss than those who earn higher salaries, witnessed in both children and adults.

There are a number of reasons for this disproportional risk. Access to regular and preventative health care can be scarce so the prevalence of health problems tends to be higher overall, including that of hearing loss. Middle ear infections are more common, as is lead poisoning and malnutrition. Such detriments affect physical as well as mental development in children, and impact socio-emotional and academic performance. This disparity is heightened within underfunded school systems where sufficient accommodations for all disabilities, including hearing loss, may not be available.  

Low income caretakers of children experience additional external burdens due to a host of factors, such as long work schedules, literacy level, and language proficiency. These factors also make it difficult for caretakers to advocate on behalf of their children, or possibly notice their children’s developmental delays as a result of potential hearing loss.

Low income individuals who have emigrated from developing nations are also more likely to have already experienced some degree of permanent hearing damage. They are also often ushered into low-paying jobs that can include occupational workplace hazards like dangerously loud noises or exposure to chemicals.

People of color have  a higher risk for acquiring hearing loss. While non-Hispanic Whites still constitute the largest single group of Americans living in poverty, ethnic minority groups are overrepresented (27.4 percent African-American; 28.4 percent American Indian and Alaskan Native; 26.6 percent Hispanic, and 12.1 percent Asian and Pacific Islander compared with 9.9 percent non-Hispanic White). 

Lastly, men of all races, in low income jobs that may include physical labor, are even more at risk than other men. (If you didn’t already know, men are more likely than women to have a hearing loss, regardless of income levels).

Preventing hearing loss requires effort communicating with groups that are more at risk. If we are to end hearing loss as an epidemic, it makes sense to promote and extend hearing health care to populations who could use it most.

Under Normal Circumstances

By Morgan Leppla

March is Disability Awareness Month. In honor of this important awareness month, Hearing Health Foundation is raising awareness and celebrating all of our different abilities and doing our part to reduce the stigma of living with hearing loss and its associated disorders.

Whether we like it or not, people compare themselves to others. Maybe contemporary culture brings it out in us, or perhaps that impulse is rooted in Darwinism ideology of survival of the fittest, reminding us of competitive advantages. Who is taller, more intelligent, faster?

Possibly, it also has to do with how we conceptualize normalcy. In the mid-1800s, Belgian statistician Adolphe Quetelet introduced the idea of “l’homme moyen” (average man) when he realized that human traits are distributed over a bell curve. So the average man would have the mean of all human traits in a single abstract person.

“Normal” entered English vocabulary in 1840 and has since been used to describe bodies and behavior. However, before society focused on the “the norm” it concerned itself with “the ideal.” Take the most coveted parts of bodies and traits that exist and combine them, and that would be the ideal person.

So why is this distinction meaningful? Because every living person is non-ideal, since by definition it cannot exist in one person, whereas people (bodies and traits) can be “normal.” On the contrary, normalcy is attainable on an individual level. And society’s reactive effect to the creation of normal humans was the production of their dichotomous counterparts: the extremes or deviants at the tail ends of the bell curve, the abnormal.

However, a collision of the normal and the ideal occurred when English statistician Francis Galton decided to rank human traits, created quartiles on an intelligence bell curve, and ordered them one to four. One was lowest intelligence and least desirable while four was highest intelligence and most desirable. He reoriented the human ideal using the norm. And now, I would say, it is “normal” to want to be the smartest, most athletic, most attractive, etc.?

The latter half of the 19th century employed pseudo-empirical justifications for describing how bodies should be in fairly clear terms. And to focus on distribution of differences warps the way society approaches normalcy as a concept. It allows us to draw lines where perhaps they ought not exist.

Thus we arrive at the construction of disability. Anyone who does not physically look like others or does not act like others is perceived as deviant or abnormal because they are at the wrong end of the bell curve. Beyond the initial construction of the human normal, barriers that are literal, educational, communicational, and attitudinal further maintain “disability” since nonexistent or poor accommodations along with stigma exacerbate “disabling” differences.

Hearing Health Foundation is encouraging everyone to think about how “norms” have molded our preferences and attitudes and whether that translates to treating people differently. Life may be more arbitrary than you think, and more can be going on than what meets the eye.

HHF is committed to spreading awareness of hearing loss and its associated disorders as well as reducing the stigma attached to them. If you’d like to share your story and experiences with our community, please email us at info@hhf.org.

Make a Sound Investment

By Frankie Huang

In honor of World Hearing Day, which takes place on March 3 every year, Hearing Health Foundation is joining forces with the World Health Organization (WHO) to draw attention to the economic impact of hearing loss and the importance of treating hearing loss.

Did you know the economic cost for unaddressed hearing loss is estimated to be $750 billion globally? In the U.S. individuals with untreated severe to profound hearing loss are expected to cost society $270,000 each over the course of their lifetimes. Most of these costs are due to reduced productivity in the workplace, although the use of special education resources among children and other social services are also factors.

Lifetime earnings for those with untreated hearing loss average 50 to 70% less than their typical-hearing peers in the U.S., and has been shown to negatively impact household income up to $12,000 per year, on average, depending on the degree of hearing loss, according to the Better Hearing Institute. This is largely due to having fewer opportunities for promotions, reduced job performance, and decreased earning power.

Beyond economic losses, untreated hearing loss can significantly impact a person’s quality of life. Researchers have found that individuals with untreated hearing loss are more likely to develop depression, anxiety, and feelings of inadequacy. They may also avoid or withdraw from social situations. Left undetected in children, hearing loss can negatively impact speech and language acquisition, academic achievement, and social and emotional development.

Prevention, screening for early identification, early intervention, and rehabilitation through hearing devices are among the strategies that mitigate hearing loss and its consequences. Those who treat their hearing loss with hearing aids and/or cochlear implants show improvement in social, emotional, and psychological well-being. Interventions can significantly decrease isolation, increase self-esteem, and lead to better employment opportunities and earnings—all of which will benefit society as a whole.

For World Hearing Day 2017, the WHO has joined forces with Mimi Hearing Technologies. To raise awareness of hearing loss, Mimi hopes to have 1 million people test their hearing. To do this, they are offering the Hearing Test app on iOS free for everyone. If you suspect you or a loved one may have hearing loss, this is a great opportunity to test your hearing with Mimi’s Hearing Test, which is an initial online assessment. The results may require a follow-up appointment with a hearing health professional. However, by detecting signs of hearing loss early on the benefits of treating hearing loss far outweigh the consequences if left untreated.