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In the AS task, performance was worse when noise was added and when digit categories changed. In the WMST, digit recall accuracy was worse in noise, but reaction times (RTs) were not affected. Conclusions: The results of this experiment show that accuracy and RT performance on auditory cognitive tasks generally worsens in background noise, even when intelligibility remains high. This suggests that background noise increases WM load and the decline in performance can be interpreted as an increase in listening effort. The specific integration of attentional control in these tasks, especially the AS task, may 1) have increased the sensitivity over traditional WM tasks and 2) allow for the ability to differentiate between peripheral and central mechanisms.

An emerging body of literature is demonstrating a significant relationship between cognition and listening performance. Noise has been shown to be detrimental to maintaining focus of attention in cognitive tasks. Noise characteristics, for a given SNR, may have differing impacts on these tasks. Fourteen normal-hearing individuals participated in an experiment designed to examine the effects of different background noises on auditory cognitive tasks while still maintaining a high-level of intelligibility (90%). Three tasks were used: a working memory span task, an attention-switching task, and a language comprehension task. The first two tasks were completed in quiet and three different types of modulated background noise, and the language comprehension task was performed in quiet and one modulated noise. Performance in both the working memory span task and attention- switching task were correlated significantly with language comprehension, suggesting that the cognitive resources tapped by these tasks are similar to those required for a complex activity such as comprehending language. Also, all three noise types had a significant effect on performance, which supports the notion that the noises used in the experiment imposed an increase in cognitive load which may impair an individual’s ability to thrive in these situations.

ImportanceAnimal models have shown altered dorsal cochlear nucleus circuitry in animals that develop tinnitus; however, precise treatment using bisensory (auditory and somatosensory) stimuli can reverse altered neural patterns and lessen tinnitus.ObjectiveTo confirm and extend the findings of a pilot study, which suggested an increased efficacy of bisensory stimulation, to a clinical trial with a greater duration and greater number of participants.Design, Setting, and ParticipantsThis double-blind, crossover, single-center randomized clinical trial was conducted from March 2019, with a 3-month follow-up per participant ending in July 2022. Eligible adults were recruited from the University of Michigan Health System in Ann Arbor, Michigan. Eligibility criteria included bothersome tinnitus (Tinnitus Functional Index [TFI] score, ≥17 points), somatic tinnitus, normal to moderate hearing loss, and no other tinnitus treatments in the 6 months prior to the trial. Included participants were randomized to either treatment group 1, which received active (bisensory) treatment, or group 2, which received the control (auditory-only) treatment. Results were analyzed using intent-to-treat (ITT) and per protocol (PP) populations.InterventionPrecisely timed bisensory (combined auditory and somatosensory) treatment was delivered through a portable, custom, take-home device that was provided to each participant for daily, at-home treatments. Group 1 participants received 30 minutes per day of the bisensory treatment for 6 weeks, followed by a 6-week washout phase, and then 30 minutes per day of the auditory-only treatment followed by a second 6-week washout phase. Group 2 participants received the auditory-only treatment first, followed by a washout phase, and then the bisensory treatment followed by a second washout phase.Main Outcomes and MeasuresPrimary end points were changes in TFI score and tinnitus loudness level from baseline through week 6 and week 12.ResultsOf 337 screened individuals, 99 (mean [SD] age, 47 [12.7] years; 59 males [60%]; 85 with non-Hispanic White [86%] race and ethnicity) were enrolled into the study and randomized to treatment group 1 (n = 49) or group 2 (n = 50). The active but not the control treatment resulted in clinically significant decreases in TFI scores at week 6 of phase 1 (ITT population: –12.0 [95% CI, –16.9 to –7.9] points; P < .001; PP population: –13.2 [95% CI, –16.0 to –10.5] points; P < .001). Decreases in tinnitus loudness level were greater than 6 dB sensation level (SL; >half as loud) at week 6 for the bisensory treatment group, with little effect for the auditory-only treatment control group at week 6 of phase 1 (ITT population: –5.8 [95% CI, –9.5 to –2.2] dB; P = .08; PP population: –7.2 [95% CI, –11.4 to –3.1] dB; P = .03), and up to 11 dB SL at week 12 of phase 2 (ITT population: –10.9 [95% CI, –15.2 to –6.5] dB; P = .001; PP population: –14.1 [95% CI, –18.4 to –9.8] dB; P < .001). Decreased tinnitus loudness level and TFI scores extended into the washout phase, indicating a prolonged treatment effect.Conclusions and RelevanceThis trial found that precisely timed bisensory treatment using stimuli and timing developed in a validated animal model was effective for adults with somatic tinnitus. Prolonged reduction in tinnitus symptoms can result from using an extended treatment duration.Trial RegistrationClinicalTrials.gov Identifier: NCT03621735

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Inclusion of a single, adjacent, high- or low-frequency decrement improved increment detection but not to the same extent as when decrements flanked both sides.

The Stroop task (Stroop, 1935) has been used extensively in cognitive psychology research for the study of selective attention and processing speed and accuracy. A recent experiment in our lab used an auditory-spatial Stroop task where participants were required to determine the spatial location of congruent and incongruent directional words. Results of that experiment showed that incongruent trials had a significant effect on performance, but only in the vertical plane. Special load theory (Park, Kim, & Chun, 2007) states that distractibility is a function of the relationship between working memory (WM) load and the targets/distractors of the task. The auditory-spatial Stroop task was modified by using WM loads intended to interfere specifically with the semantic or spatial aspects of the task. Given that targets in the task are the spatial locations of the words, special load theory predicts that a spatial WM load results in decreased performance (increased interference) while a verbal WM load predicts increased performance (decreased interference). Data presented will illuminate whether spatial or verbal WM load has a greater impact on performance in an auditory-spatial Stroop task.