For decades, we have presumed the death of hair cells and spiral ganglion neurons are the main cause of hearing loss and difficulties understanding speech in noise, but new findings suggest synapse loss may be the key contributor. Specifically, recent preclinical studies suggest that the synapses between inner hair cells and spiral ganglion neurons with low spontaneous rates and high thresholds are the most vulnerable subcellular structures, with respect to insults during aging and noise exposure. This cochlear synaptopathy can be "hidden" because this synaptic loss can occur without permanent hearing threshold shifts. This new discovery of synaptic loss opens doors to new research directions. Here, we review a number of recent studies and make suggestions in two critical future research directions. First, based on solid evidence of cochlear synaptopathy in animal models, it is time to apply molecular approaches to identify the underlying molecular mechanisms; improved understanding is necessary for developing rational, effective therapies against this cochlear synaptopathy. Second, in human studies, the data supporting cochlear synaptopathy are indirect although rapid progress has been made. To fully identify changes in function that are directly related this hidden synaptic damage, we argue that a battery of tests including both electrophysiological and behavior tests should be combined for diagnosis of "hidden hearing loss" in clinical studies. This new approach may provide a direct link between cochlear synaptopathy and perceptual difficulties.

Thirty "new" lists of monosyllabic words were created at the University of Melbourne and recorded by Australian and American English speakers. These new lists and the ten original CNC lists (Peterson and Lehiste, 1962) were used during the feasibility study of the Nucleus Research Platform 8 Cochlear Implant System (Holden et al, 2004). Performance was similar across original and new lists for six implanted Australian subjects; for four implanted U.S. subjects, mean performance was 23 percentage points lower with the new than with the original lists. To evaluate differences between original and new lists for the American English recording, 22 CI recipients were administered all 40 CNC lists (30 new and 10 original lists). The overall mean word score for the new lists was significantly lower (22.3 percentage points) than for the original lists. Acoustic analysis revealed that decreased performance was most likely due to reduced amplitudes of certain initial and final consonants. The new CNC lists can be used as more difficult test material for clinical research.

The specification of vowel formant bandwidths for speech synthesis has been inconsistent in the past, perhaps due to the difficulty of measuring formant bandwidths in natural speech and the possible perceptual insignificance of formant bandwidths on the intelligibility of synthetic speech. Here, regression equations are presented for the estimation of formant bandwidths based on measurements from natural speech which is based only on formant center frequency and independent of other formant values. Current usage, as well as comparison with another well-known estimation algorithm suggests that the new procedure should be quite acceptable for some types of speech synthesis.

Studies of thresholds for discrimination of formant frequency variation in synthetic vowel sounds have been predominantly limited to variations in a single formant. Here, differences limens (DLs) are presented for multiformant variations expressed in measures of delta F and as distances in the auditory-perceptual space (APS) proposed by J. D. Miller [J. Acoust. Soc. Am. 85, 2114-2134 (1989)]. DLs for four subjects were estimated along 102 synthetic vowel continua representing five patterns of formant variation [(1) single variation in F1; (2) single variation in F2; (3) parallel simultaneous variation in F1 and F2; (4) opposing simultaneous variation in F1 and F2; and parallel simultaneous variation in F1, F2, and F3] and 17 within- or between-category vowel sounds. Minimal uncertainty methodology was employed utilizing an adaptive up-down procedure with a cued, two-interval forced-choice (2IFC) task. The results of this experiment reflect smaller DLs for both single- and multiple-formant changes than have been found in the past and also suggest that discrimination of parallel multiformant variation is significantly better than opposing multiformant or single-formant variation.

Two speech processor programs (MAPs) differing only in electrode frequency boundary assignments were created for each of eight Nucleus 24 Cochlear Implant recipients. The default MAPs used typical frequency boundaries, and the experimental MAPs reassigned one additional electrode to vowel formant regions. Four objective speech tests and a questionnaire were used to evaluate speech recognition with the two MAPs. Results for the closed-set vowel test and the formant discrimination test showed small but significant improvement in scores with the experimental MAP. Differences for the Consonant-Vowel Nucleus-Consonant word test and closed-set consonant test were nonsignificant. Feature analysis revealed no significant differences in information transmission. Seven of the eight subjects preferred the experimental MAP, reporting louder, crisper, and clearer sound. The results suggest that Nucleus 24 recipients should be given an opportunity to compare a MAP that assigns more electrodes in vowel formant regions with the default MAP to determine which provides the most benefit in everyday life.