Auditory difficulties in blast-exposed Veterans with clinically normal hearing

Saunders, Gabrielle H.; Frederick, Melissa T.; Arnold, Michelle; Silverman, Shien Pei C.; Chisolm, Theresa H.; Myers, Paula J.

doi:10.1682/jrrd.2014.11.0275

Cited by 81 publications

(117 citation statements)

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(68 reference statements)

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“…Common among post-concussive symptoms are auditory complaints, which may be present and untreated in a majority of cases (Oleksiak et al, 2012), but data remain scarce for civilian populations who lack the auditory comorbidities associated with military service. The impairments that have been found in people with auditory complaints after blast and non-blast injuries include auditory processing deficits that may be associated with elevated pure-tone thresholds (Lew et al, 2007; Oleksiak et al, 2012; Gallun et al, 2012; Saunders et al, 2015). …”

Section: Discussionmentioning

confidence: 99%

“…By comparing this group to a matched group of listeners with no history of neurological insult spanning an equivalent range of age and pure-tone thresholds, any additional deficit resulting from TBI beyond age and pure-tone thresholds could be demonstrated. The number of abnormal test results for listeners in the TBI group is often reported in studies that include a battery of auditory tests (Nölle et al, 2004; Bergemalm and Lyxell, 2005; Turgeon et al, 2011; Gallun et al, 2012; Saunders et al, 2015). In this study the number of listeners with abnormal results were computed based on normative data when available, and based on YNH group data otherwise.…”

Section: Methodsmentioning

confidence: 99%

“…The exact nature of auditory complaints is a source of discussion, but a number of studies report deficits in auditory function persisting even in the absence of auditory threshold elevation (Cockrell and Gregory, 1992; Nölle et al, 2004; Musiek et al, 2004; Bergemalm and Lyxell, 2005; Flood et al, 2005; Turgeon et al, 2011; Oleksiak et al, 2012; Gallun et al, 2012; Saunders et al, 2015). It is unclear whether those deficits were due to peripheral auditory, central auditory, or non-auditory cognitive factors.…”

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confidence: 99%

“…It is unclear whether those deficits were due to peripheral auditory, central auditory, or non-auditory cognitive factors. For example, abnormal results on tests of dichotic listening (e.g., Turgeon et al, 2011; Gallun et al, 2012; Saunders et al, 2015) can result from corpus callosum damage (Musiek et al, 2004) that is not auditory-specific. While the auditory literature presents impaired performance on complex speech tasks as evidence for auditory processing disorder, the neuropsychology literature uses deficits on complex speech tasks as evidence of various cognitive impairments.…”

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confidence: 99%

“…A final issue of interest is the growing body of data suggesting a link between MTBI and auditory processing deficits among individuals who experienced MTBI as a result of military combat, predominantly blast exposure (Gallun et al, 2012; Oleksiak et al, 2012; Saunders et al, 2015). A majority of those individuals also experienced acoustic trauma and a high level of long-term noise exposure.…”

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confidence: 99%

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Auditory and Cognitive Factors Associated with Speech-in-Noise Complaints following Mild Traumatic Brain Injury

2017

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Background Auditory complaints following mild traumatic brain injury are common, but few studies have addressed the role of auditory temporal processing in speech recognition complaints. Purpose In this study, deficits understanding speech in a background of speech noise following MTBI were evaluated with the goal of comparing the relative contributions of auditory and non-auditory factors. Research Design A matched-groups design was used in which a group of listeners with a history of MTBI were compared to a group matched in age and pure-tone thresholds, as well as a control group of young listeners with normal hearing. Study Sample Thirty-three listeners participated in the study, including thirteen in the MTBI group (mean age 46.7 years), eleven in the Matched group (mean age 49 years), and nine in the YNH group (mean age 20.8 years). Data Collection and Analysis Speech-in-noise deficits were evaluated using subjective measures as well as monaural word (WIN) and sentence (QuickSIN) tasks, and a binaural spatial release task. Performance on these measures was compared to psychophysical tasks evaluating monaural and binaural temporal fine structure tasks and spectral resolution. Cognitive measures of attention, processing speed, and working memory were evaluated as a possible difference between MTBI and Matched groups contributing to speech-in-noise deficits. Results A high proportion of listeners in the MTBI group reported difficulty understanding speech in noise (84%) compared to the Matched group (9.1%), and listeners who reported difficulty were more likely to have abnormal results on objective measures of speech in noise. No significant group differences were found between the MTBI and Matched listeners on any of the measures reported, but the number of abnormal tests differed across groups. Regression analysis revealed that a combination of auditory and auditory processing factors contributed to monaural speech-in-noise scores, but the benefit of spatial separation was related to a combination of working memory and peripheral auditory factors across all listeners in the study. Conclusions The results of this study are consistent with previous findings that a subset of listeners with MTBI have objective auditory deficits. Speech-in-noise performance was related to a combination of auditory and non-auditory factors, confirming the important role of audiology in MTBI rehabilitation. Further research is needed to evaluate the prevalence and causal relationship of auditory deficits following MTBI.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Auditory and Cognitive Factors Associated with Speech-in-Noise Complaints following Mild Traumatic Brain Injury

2017

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Analysis of Early Biomarkers Associated With Noise-Induced Hearing Loss Among Shipyard Workers

et al. 2021

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IMPORTANCE It is important to determine what frequencies and auditory perceptual measures are the most sensitive early indicators of noise-induced hearing impairment.OBJECTIVES To examine whether hearing loss among shipyard workers increases more rapidly at extended high frequencies than at clinical frequencies and whether subtle auditory processing deficits are present in those with extensive noise exposure but little or no hearing loss. DESIGN, SETTING, AND PARTICIPANTSThis cross-sectional study collected audiometric data (0.25-16 kHz), survey questionnaires, and noise exposure levels from 7890 shipyard workers in a Shanghai shipyard from 2015 to 2019. Worsening hearing loss was evaluated in the group with hearing loss. Speech processing and temporal processing were evaluated in 610 participants with noise exposure and clinically normal hearing to identify early biomarkers of noise-induced hearing impairment. Data analysis was conducted from November to December 2020. MAIN OUTCOMES AND MEASURES Linear regression was performed to model the increase in hearing loss as function of cumulative noise exposure and compared with a group who were monitored longitudinally for 4 years. Auditory processing tests included speech-in-noise tests, competing sentence tests, dichotic listening tests, and gap detection threshold tests and were compared with a control group without history of noise exposure. RESULTS Of the 5539 participants (median [interquartile range (IQR)] age, 41.0 [34.0-47.0] years;3861 [86.6%] men) included in the cross-sectional analysis, 4459 (80.5%) were hearing loss positive and 1080 (19.5%) were hearing loss negative. In younger participants (ie, Յ40 years), the maximum rate of increase in hearing loss was 0.40 (95% CI, 0.39-0.42) dB per A-weighted dB-year (dB/dBAyear) at 12.5 kHz, higher than the growth rates of 0.36 (95% CI, 0.35-0.36) dB/dBA-year at 4 kHz, 0.32 (95% CI, 0.31-0.33) dB/dBA-year at 10 kHz, 0.31 (95% CI, 0.30-0.31) dB/dBA-year at 6 kHz, 0.27 (95% CI, 0.26-0.27) dB/dBA-year at 3 kHz, and 0.27 (95% CI, 0.27-0.28) dB/dBA-year at 8 kHz. In the 4-year longitudinal analysis of hearing loss among 403 participants, the mean (SD) annual deterioration in hearing was 2.70 (2.98) dB/y at 12.5 kHz, almost twice as that observed at lower frequencies (eg, at 3kHz: 1.18 [2.15] dB/y). The auditory processing scores of participants with clinically normal hearing and a history of noise exposure were significantly lower than those of control participants (eg, median [IQR] score on speech-in-noise test, noise-exposed group 1 vs

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Patient‐reported auditory handicap measures following mild traumatic brain injury

et al. 2019

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Objectives/Hypothesis Few studies have specifically addressed auditory complaints in patients with nonblast mild traumatic brain injury (mTBI). Herein, we aimed to investigate auditory symptoms in patients following mTBI using patient‐reported outcome measures. Study Design Retrospective analysis of prospectively collected data in a tertiary‐care hospital. Methods The patients included those with mTBI (cases) and those without mTBI (controls). Individuals (≥18 years old) with and without mTBI were screened. Exclusion criteria included history of otologic disorders, blast injury, or occupational noise exposure. Primary outcomes included the Hearing Handicap Inventory for Adults (HHIA), Tinnitus Handicap Inventory (THI), and Hyperacusis Questionnaire (HQ). Secondary outcomes included subjective auditory complaints. Results From September 2017 to September 2018, 52 patients with mTBI and 55 controls met inclusion and exclusion criteria. The mean time between mTBI and survey intake was 70.6 months. The mean age and gender were 51.5 years old and 73% female in the mTBI group, and 46.1 years old and 56.3% female in the control group (P = .112 and P = .105, respectively). Patients with mTBI reported hyperacusis (67.3% of all mTBI patients), hearing loss (61.5%), and tinnitus (61.5%), compared to 8.3%, 12.7%, and 16.4%, respectively, for control subjects (P < .0001). The mean HHIA score in the mTBI group was 38.3 versus 8.5 in controls (P = .002). The mean THI score was 27.4 in the mTBI group and 3.1 in controls (P < .0001). The mean HQ score was 26.5 in mTBI group and 7.3 in controls (P = .001). Conclusions Auditory symptoms and associated handicap were common in patients with nonblast mTBI compared to age‐matched controls. Findings have implications for the pathophysiology and management of symptoms in this patient population. Level of Evidence 3 Laryngoscope, 130:761–767, 2020

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Auditory difficulties in blast-exposed Veterans with clinically normal hearing

Cited by 81 publications

References 50 publications

Auditory and Cognitive Factors Associated with Speech-in-Noise Complaints following Mild Traumatic Brain Injury

Auditory and Cognitive Factors Associated with Speech-in-Noise Complaints following Mild Traumatic Brain Injury

Analysis of Early Biomarkers Associated With Noise-Induced Hearing Loss Among Shipyard Workers

Patient‐reported auditory handicap measures following mild traumatic brain injury

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