Implications of blast exposure for central auditory function: A review

Gallun, Frederick J.; Lewis, Martyn; Folmer, Robert L.; Diedesch, Anna C.; Kubli, Lina R.; McDermott, Daniel; Walden, Therese C.; Fausti, Stephen A.; Lew, Henry L.; Leek, Marjorie R.

doi:10.1682/jrrd.2010.09.0166

Cited by 67 publications

(52 citation statements)

References 67 publications

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“…Discussions with clinical audiologists and OIF/OEF/OND Veterans Service Office personnel suggest that a common complaint voiced by blast-exposed Veterans is an inability to understand speech in noisy environments, even when peripheral hearing is within normal or near-normal limits. Such complaints are consistent with damage to neural networks responsible for higher-order auditory processing [2].…”

Section: Introductionsupporting

confidence: 66%

Performance on tests of central auditory processing by individuals exposed to high-intensity blasts

Gallun

Diedesch

Kubli

et al. 2012

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Abstract-Thirty-six blast-exposed patients and twenty-nine non-blast-exposed control subjects were tested on a battery of behavioral and electrophysiological tests that have been shown to be sensitive to central auditory processing deficits. Abnormal performance among the blast-exposed patients was assessed with reference to normative values established as the mean performance on each test by the control subjects plus or minus two standard deviations. Blast-exposed patients performed abnormally at rates significantly above that which would occur by chance on three of the behavioral tests of central auditory processing: the Gaps-In-Noise, Masking Level Difference, and Staggered Spondaic Words tests. The proportion of blast-exposed patients performing abnormally on a speech-in-noise test (Quick Speech-In-Noise) was also significantly above that expected by chance. These results suggest that, for some patients, blast exposure may lead to difficulties with hearing in complex auditory environments, even when peripheral hearing sensitivity is near normal limits.Key words: audiometric evaluation, auditory dysfunction, auditory processing disorder, blast, central auditory processing, evoked potential, hearing loss, rehabilitation, traumatic brain injury, Veterans. INTRODUCTION The recent conflicts in Afghanistan and

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Section: Introductionsupporting

confidence: 66%

Performance on tests of central auditory processing by individuals exposed to high-intensity blasts

Gallun

Diedesch

Kubli

et al. 2012

JRRD

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101

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“…Previous reports have described the ways in which blast exposure could [4] and does [3] cause changes in the ability of listeners to perform on tests of central auditory processing measured within a year of blast exposure. Tasks upon which blast-exposed participants were most likely to perform poorly included those relying upon temporal pattern perception, auditory temporal resolution, binaural processing, and dichotic listening.…”

Section: Introductionmentioning

confidence: 99%

Chronic effects of exposure to high-intensity blasts: Results on tests of central auditory processing

et al. 2016

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Abstract-Patients who have recently experienced highintensity blasts are more likely to perform abnormally on tests developed to be sensitive to deficits of central auditory processing than were age-and hearing-matched individuals without blast exposures. Here, a group of 59 participants was recruited, 30 of whom were exposed to high-intensity blasts between 4 and 11 yr prior to testing and did not participate in the previous study, along with 29 controls similar in age and hearing thresholds to the blast group. All were tested on a set of behavioral tests that were used in the previous study. Abnormal performance was measured with reference both to published normative data and to the average performance of the control group. Members of the blast-exposed group were again found to be significantly more likely to perform in the abnormal range than were the members of the control group. Because the patients in this study were tested a minimum of 4 yr after blast exposure, these results suggest that for some of those exposed, problems processing auditory information may be a chronic effect of blast exposure even in the absence of significant peripheral hearing loss.

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“…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%

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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Implications of blast exposure for central auditory function: A review

Cited by 67 publications

References 67 publications

Performance on tests of central auditory processing by individuals exposed to high-intensity blasts

Performance on tests of central auditory processing by individuals exposed to high-intensity blasts

Chronic effects of exposure to high-intensity blasts: Results on tests of central auditory processing

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

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