Relación entre hiperacusia y desorden del procesamiento auditivo central: Una revisión de la literatura / Relationship between hyperacusis and auditory processing disorder: a literature review

Resumen La hiperacusia corresponde a la excesiva sensibilidad auditiva o intolerancia a ciertos sonidos cotidianos que para la mayoría de las personas parecerían habituales. Considerando los mecanismos fisiológicos involucrados en el origen de la hiperacusia, es lógico pensar que su presencia podría afectar algunas habilidades del procesamiento auditivo central, sin embargo, la evidencia en torno al tema es escasa y no existe actualmente una revisión de la literatura que agrupe las investigaciones sobre esta temática. Por ello, el presente estudio pretende identificar y analizar la evidencia científica disponible sobre la relación entre hiperacusia y desorden del procesamiento auditivo central. Se realizó una revisión de la literatura guiada por protocolo PRISMA en las bases de datos Proquest, Ebsco, Pubmed, ScienceDirect, Cochrane Library y Scielo de acuerdo con términos claves. Fueron incluidos artículos originales de investigación, revisiones sistemáticas y metaanálisis, publicados desde el año 2010, realizados en animales y humanos, escritos en idiomas inglés, español y portugués. Se encontraron 323 estudios relacionados con los términos claves utilizados, de los cuales 13 cumplieron con los criterios de inclusión y fueron analizados. Se puede concluir que la evidencia científica en torno al tema es escasa e incipiente. Estructuras de la vía auditiva central como núcleos cocleares, lemnisco lateral, colículos inferiores, cuerpo geniculado medial y corteza auditiva primaria estarían relacionadas con la hiperacusia, así como también habilidades de procesamiento auditivo de figura/fondo, ordenación temporal y transferencia interhemisférica se verían afectadas.

Abstract Hyperacusis has been defined as the excessive auditory sensitivity or intolerance to certain everyday sounds that seem common for most people. Considering the underlying physiological mechanisms of hyperacusis, it is reasonable to think that it could affect some abilities involved in the central auditory processing. However, there is lack of evidence about this topic, and there is no literature review that gathers all the existing research. Therefore, the current study intends to identify and analyze the available scientific evidence regarding the relationship between hyperacusis and central auditory processing disorder. The review of the literature followed the PRISMA protocol, using key words in Proquest, Ebsco, Pubmed, ScienceDirect, Cochrane Library and Scielo databases. Original research articles, systematic reviews and meta-analyses of studies made with human and animals that have been published since 2010 in English, Spanish and Portuguese were included. Among them, 323 studies were related to the key terms, out of which 13 met the inclusion criteria and were analyzed. It is possible to conclude that there is little and incipient scientific evidence on the topic. Structures of the central auditory pathway such as cochlear nuclei, lateral lemniscus, inferior colliculi, medial geniculate body and primary auditory cortex seem to be related to hyperacusis; auditory processing skills such as figure/ground discrimination, temporal ordering and interhemispheric transfer appear to be affected as well.

Comparison of Relative Loudness Judgment in Children using Listening Devices with Typically Developing Children

Abstract Introduction Loudness perception is considered important for the perception of emotions, relative distance and stress patterns. However, certain digital hearing devices worn by those with hearing impairment may affect their loudness perception. This could happen in devices that have compression circuits to make loud sounds soft and soft sounds loud. These devices could hamper children from gaining knowledge about loudness of acoustical signals. Objective To compare relative loudness judgment of children using listening devices with age-matched typically developing children. Methods The relative loudness judgment of sounds created by day-to-day objects were evaluated on 60 children (20 normal-hearing, 20 hearing aid users, & 20 cochlear implant users), utilizing a standard group comparison design. Using a two-alternate forced-choice technique, the children were required to select picturized sound sources that were louder. Results The majority of the participants obtained good scores and poorer scores were mainly obtained by children using cochlear implants. The cochlear implant users obtained significantly lower scores than the normal-hearing participants. However, the scores were not significantly different between the normal-hearing children and the hearing aid users as well as between the two groups with hearing impairment. Conclusion Thus, despite loudness being altered by listening devices, children using non-linear hearing aids or cochlear implants are able to develop relative loudness judgment for acoustic stimuli. However, loudness growth for electrical stimuli needs to be studied.

Influência da retroalimentação auditiva nos parâmetros acústicos vocais de indivíduos sem queixas vocais / Influence of auditory feedback in the vocal acoustic parameters of individuals without vocal complaints

RESUMO Introdução: A qualidade da emissão vocal é dependente da integridade do mecanismo de retroalimentação auditiva. A presença de eventuais falhas nesse mecanismo está relacionada à indução do abuso e/ ou mau uso vocal e, por conseguinte, do surgimento de quadros de disfonia. Objetivo: Avaliar a influência da retroalimentação auditiva na intensidade e na frequência da voz, em indivíduos sem queixas vocais. Métodos: Participaram da pesquisa 40 sujeitos do gênero feminino, sem queixas vocais e com limiares auditivos dentro dos padrões de normalidade. As participantes foram submetidas a uma avaliação auditiva, composta por audiometria tonal liminar, imitanciometria e por uma avaliação acústica vocal dos parâmetros de intensidade e frequência, realizada em três momentos: antes, durante e após a exposição ao ruído branco. Resultados: Houve diferença significativa na relação das médias obtidas na intensidade e entre o limiar dos reflexos acústicos contralaterais e as frequências vocais, nos três momentos da avaliação acústica. Conclusão: Os achados sugerem que a retroalimentação auditiva interfere no controle da intensidade e frequência vocal.

ABSTRACT Introduction: The quality of the vocal emission is dependent on the integrity of the auditory feedback mechanism of the presence of eventual failures is related to the induction of abuse and / or vocal misuse, and therefore of the surgeon of dysphonia. Purpose: To evaluate the influence of auditory feedback in voice intensity and frequency in individuals with no vocal complaints. Methods: Participants were 40 female subjects without vocal and auditory thresholds within normal standards complaints. Participants underwent an auditory evaluation composed of pure tone audiometry, tympanometry and a vocal acoustic assessment of intensity and frequency parameters, carried out in three stages: before, during and after exposure to white noise. Results: There was significant difference in the average of the ratio obtained in intensity and between the threshold of contralateral acoustic reflexes and vocal frequencies in the three moments of acoustic evaluation. Conclusion: Thus, the findings suggest that auditory feedback interferes with the control of the intensity and vocal frequency.

Estimation of spectral oscillatory power of resting-state EEG in subjective tinnitus / 中国耳鼻咽喉头颈外科

OBJECTIVE To explor e the characteristics of spectral oscillatory power of resting-state electroencephalography(EEG) in subjective tinnitus patients and to lay the foundation for study of central mechanism of tinnitus.METHODS 31 subjects(15 subjects with subjective tinnitus and 16 age matching healthy subjects) underwent a 128-channel resting-state EEG analyses. After a series of preprocessing, data were segmented into 8 frequency bands, including δ(0.5～3.5 Hz), θ(4～7.5 Hz), α1(8～10 Hz), α2(10～12 Hz), β1(13～18 Hz), β2(18.5～21 Hz), β3(21.5～30 Hz) and γ(30.5～44 Hz). The group differences of spectral power were analyzed by independent t test. Correlation between spectral power of each frequency band and tinnitus subjective symptoms were also analyzed. RESULTS Significant higher spectral power of the α1, β and γ bandwere found in the left and right temporal areas of tinnitus group compared with that of normal group.Tinnitus subjects also had higher spectral powerof the δ and θ band in temporo-parietal areas than that of the normal group. There was no significant difference of spectral power in other frequency bands. Moreover, signif icant positive cor relation were found between tinnitus loudness and spectralpower of right anterior lateral(R=0.66, P =0.007) and right anterior medial(R=0.58, P =0.031) areas. CONCLUSION Tinnitus subjects have higher spectral oscillatory power on right and left temporal lobe and temporo-parietal area. A positive correlation exsit between tinnitus loudness andspectral power of right anterior lateral and medial areas in tinnitus subjects, whichindicate that central reorganizationexsit in tinnitus reorganization andγ band maybe considered as a possible biomarkerforthe tinnitus subjective symptom.

Análise das modificações vocais de repórteres na situação de ruído / Analysis of reporters' vocal changes in the presence of noise

OBJETIVO: Verificar e comparar a ocorrência das modificações vocais de repórteres e não-repórteres na presença de ruído mascarante. MÉTODOS:Participaram 46 sujeitos, sendo 23 repórteres e 23 não-repórteres (grupo controle), todos com audição normal. Os participantes deveriam ler um trecho de uma matéria de telejornal em três situações de escuta: sem ruído mascarante, com ruído de 50 dB, e com ruído de 90 dB. As narrações foram gravadas e submetidas à avaliação perceptivo-auditiva (realizada por uma fonoaudióloga especialista em voz) e análise acústica (medidas extraídas por meio do Software Voxmetria - CTS Informática). RESULTADOS: Com 50 dB de mascaramento, houve maior aumento nos parâmetros pitch (82,6%), loudness (91,3%) e tensão (82,6%) no grupo controle, quando este foi comparado ao grupo dos repórteres. O mesmo ocorreu com ruído de 90 dB para os parâmetros pitch (95,7%), loudness (100%) e tensão (91,3%). CONCLUSÃO: As consequências negativas do efeito Lombard ocorrem em ambos os grupos, porém, pelas respostas apresentadas, os repórteres demonstram conseguir inibir parcialmente o impacto negativo das situações de ruído, por provável estabilidade da emissão profissional e ativação de outras vias de monitoramento.

PURPOSE: To investigate and compare the occurrence of vocal changes in the presence of masking noise between reporters and other professionals. METHODS: Participants were 46 subjects with normal hearing, 23 reporters (study group) and 23 non-reporters (control group). Participants read an excerpt from a TV news broadcast in three listening situations: without masking noise, with 50 dB white noise, and with 90 dB white noise. The narrations were recorded and then submitted to auditory-perceptual and acoustic analyses. The auditory-perceptual analysis was performed by a speech-language pathologist specialized in voice. The acoustic analysis used the software Voxmetria (CTS Informática) to perform the acoustic measurements. RESULTS: In the situation with 50 dB masking noise, individuals in the control group had higher increase of the following parameters, when compared to the group of reporters: pitch (82.6%), loudness (91.3%), and strain (82.6%). The same occurred in the situation with 90 dB masking noise for the same parameters: pitch (95.7%), loudness (100%) and strain (91.3%). CONCLUSION: The negative consequences of the Lombard effect occur in both groups; however, reporters showed the ability to partially inhibit the negative impact of noise situations, probably due to the stability of the professional speech production and activation of other feedback pathways.

Desempenho de adultos jovens normais em dois testes de resolução temporal / Performance of normal young adults in two temporal resolution tests

TEMA: o processamento auditivo temporal se refere a percepção de um evento sonoro ou de uma alteração no mesmo, dentro de um intervalo definido de tempo e é considerado uma habilidade fundamental na percepção auditiva de sons verbais e não verbais, na percepção de música, ritmo e pontuação e na discriminação de pitch, de duração e de fonemas. OBJETIVO: realizar um estudo comparativo do desempenho de adultos jovens normais nos testes de resolução temporal, Random Gap Detection Test (RGDT) e Gaps-in-Noise (GIN) e analisar diferenças entre esses dois métodos de avaliação. MÉTODO: 25 universitários, 11 homens e 14 mulheres, com audição normal e sem histórico de alterações educacionais, neurológicas e/ou linguagem, foram submetidos ao RGDT e ao GIN, a 40dB NS. RESULTADO: observou-se diferença estatisticamente significante entre os sexos sendo que as mulheres apresentaram pior desempenho nos dois testes. No estudo comparativo dos resultados do RGDT e GIN, observaram-se diferenças significativas no desempenho da amostra. De maneira geral, os limiares de detecção de gap no teste GIN foram melhores do que os limiares obtidos no RGDT. CONCLUSÃO: o sexo masculino teve melhor desempenho tanto no teste RGDT quanto no GIN, quando comparado ao feminino. Além disso, não houve diferença significante nas repostas do GIN nas orelhas direita e esquerda. Os sujeitos deste estudo tiveram melhor desempenho no teste GIN, quando comparado ao RGDT, tanto no sexo masculino quanto no feminino. Portanto, o teste GIN apresentou vantagens sobre o RGDT não apenas quanto à sua validade e sensibilidade, mas também com relação a sua aplicação e correção dos resultados.

BACKGROUND: temporal auditory processing is defined as the perception of sound or of sound alteration within a restricted time interval and is considered a fundamental ability for the auditory perception of verbal and non verbal sounds, for the perception of music, rhythm, periodicity and in the discrimination of pitch, duration and of phonemes. AIM: to compare the performance of normal Brazilian adults in two temporal resolution tests: the Gaps-in-Noise Test (GIN) and the Random Gap Detection Test (RGDT), and to analyze potential differences of performance in these two tests. METHOD: twenty-five college students with normal hearing (11 males and 14 females) and no history of educational, neurological and/or language problems, underwent the GIN and RGDT at 40dB SL. RESULTS: statistically significant gender effects for both tests were found, with female participants showing poorer performance on both temporal processing tests. In addition, a comparative analysis of the results obtained in the GIN and RGDT revealed significant differences in the threshold measures derived for these two tests. In general, significantly better gap detection thresholds were observed for both male and female participants on the GIN test when compared to the results obtained for the RGDT. CONCLUSION: male participants presented better performances on both RGDT and GIN, when compared to the females. There were no differences in performance between right and left ears on the GIN test. Participants of the present investigation, males and females, performed better on the GIN when compared to the RGDT. The GIN presented advantages over the RGDT, not only in terms of clinical validity and sensibility, but also in terms of application and scoring.