The Interaural Time Difference for High-Pass Filtered Noise and Its Relationship With Brainstem Dysfunction and Disability in Multiple Sclerosis.

PURPOSE: Just noticeable difference for interaural time difference (JND-ITD) is a sensitive test to detect silent lesions and neural asynchrony along the auditory pathways among individuals with multiple sclerosis (MS), but it has not been studied with brainstem functional system scores (BFSS) and expanded disability status scale (EDSS). The study aims to assess the usefulness of JND-ITD thresholds in individuals with MS and relate to brainstem magnetic resonance imaging (MRI) lesions, BFSS, and disability (EDSS). METHOD: Standard group comparison design was adapted to compare the JND-ITD thresholds between individuals with MS (n = 45) and age and gender-matched healthy participants (n = 45). All participants underwent case history, neurological examination including BFSS and EDSS scoring, MRI brain imaging, minimental state examination, routine audiological evaluation, and ITD testing for high-pass filtered noise stimuli. RESULTS: Of the 36 MS participants with abnormal JND-ITD thresholds, 22 (48.9%) participants could not identify maximum JND-ITD values (1,280 µs) in the ITD task. Abnormal JND-ITDs thresholds (139-1,280 µs) were obtained in 14 (31.11%) participants with MS. The JND-ITD thresholds were significantly different between the healthy and MS group. No significant association was found between the presence of ITD abnormality with the presence of brainstem lesions (MRI) and brainstem dysfunction (BFSS). Also, this study did not find any relationship between JND-ITD thresholds with disability (EDSS). CONCLUSIONS: This study supports the findings that JND-ITD for high-pass filtered noise is a sensitive test to detect lesions along the auditory system. Even though JND-ITD thresholds did not relate with BFSS and EDSS scores, JND-ITD abnormalities can be of great value in identifying lesions along the auditory system, especially in the early stages of MS, when clinical neurological examination does not show any signs of brainstem dysfunction, disability, and MRI without any lesions in the brain.

Assessment of auditory perception abilities using temporal envelope and fine structure processing in children with self-limited epilepsy with centrotemporal spikes.

OBJECTIVES: Children with self-limited epilepsy with centrotemporal spikes (SeLECTS) exhibit difficulty processing spoken messages without hearing loss. The temporal envelope and fine structure processing abilities are the fundamental aspects of the normal listening process. There is limited literature on the temporal envelope and fine structure processing in children with SeLECTS. We evaluated the temporal envelope and fine structure processing in children with SeLECTS. DESIGN: The study included 35 children with SeLECTS and 50 typically developing children (TDC). The temporal envelope processing was measured using the temporal modulation transfer function (TMTF) and temporal fine structure using the temporal fine structure low-frequency (TFS LF) test. The TMTF was measured for the modulation rates 4, 8, 16, 32, 64 and 128 Hz. The TFS LF was done for 250, 500 and 750 Hz. RESULTS: The difference in modulation detection thresholds at 4 Hz was not found to be significant, whereas there was a significant difference in modulation detection thresholds observed for all the other modulation frequencies (p < 0.05) between the children with SeLECTS and TDC. The thresholds at 250, 500 and 750 Hz were higher (poorer) for children with SeLECTS than the TDC and was significant (p < 0.05). CONCLUSIONS: The TMTF and TFS LF tests were of practical use in evaluating temporal envelope and fine structure processing abilities in children with SeLECTS. The results suggest that children with SeLECTS have a poor temporal envelope and fine structure processing compared to the TDC.

Effect of Listening Biographies on Frequency Following Response Responses of Vocalists, Violinists, and Non-Musicians to Indian Carnatic Music Stimuli.

BACKGROUND AND OBJECTIVES: The current study investigates pitch coding using frequency following response (FFR) among vocalists, violinists, and non-musicians for Indian Carnatic transition music stimuli and assesses whether their listening biographies strengthen their F0 neural encoding for these stimuli. Subjects and. METHODS: Three participant groups in the age range of 18-45 years were included in the study. The first group of participants consisted of 20 trained Carnatic vocalists, the second group consisted of 13 trained violinists, and the third group consisted of 22 non-musicians. The stimuli consisted of three Indian Carnatic raga notes (/S-R2-G3/), which was sung by a trained vocalist and played by a trained violinist. For the purposes of this study, the two transitions between the notes T1=/S-R2/ and T2=/R2-G3/ were analyzed, and FFRs were recorded binaurally at 80 dB SPL using neuroscan equipment. RESULTS: Overall average responses of the participants were generated. To assess the participants' pitch tracking to the Carnatic music stimuli, stimulus to response correlation (CC), pitch strength (PS), and pitch error (PE) were measured. Results revealed that both the vocalists and violinists had better CC and PS values with lower PE values, as compared to non-musicians, for both vocal and violin T1 and T2 transition stimuli. Between the musician groups, the vocalists were found to perform superiorly to the violinists for both vocal and violin T1 and T2 transition stimuli. CONCLUSIONS: Listening biographies strengthened F0 neural coding, with respect to the vocalists for vocal stimulus at the brainstem level. The violinists, on the other hand, did not show such preference.

Enhancement of Processing Capabilities of Hippocampus Lobe: A P300 Based Event Related Potential Study.

BACKGROUND AND OBJECTIVES: The influence of music training on different areas of the brain has been extensively researched, but the underlying neurobehavioral mechanisms remain unknown. In the present study, the effects of training for more than three years in Carnatic music (an Indian form of music) on the discrimination ability of different areas of the brain were tested using P300 analysis at three electrode placement sites. Subjects and. METHODS: A total of 27 individuals, including 13 singers aged 16-30 years (mean±standard deviation, 23±3.2 years) and 14 non-singers aged 16-30 years (mean age, 24±2.9 years), participated in this study. The singers had 3-5 years of formal training experience in Carnatic music. Cortical activities in areas corresponding to attention, discrimination, and memory were tested using P300 analysis, and the tests were performed using the Intelligent Hearing System. RESULTS: The mean P300 amplitude of the singers at the Fz electrode placement site (5.64±1.81) was significantly higher than that of the non-singers (3.85±1.60; t(25)=3.3, p<0.05). The amplitude at the Cz electrode placement site in singers (5.90±2.18) was significantly higher than that in non-singers (3.46±1.40; t(25)=3.3, p<0.05). The amplitude at the Pz electrode placement site in singers (4.94±1.89) was significantly higher than that in non-singers (3.57±1.50; t(25)=3.3, p<0.05). Among singers, the mean P300 amplitude was significantly higher in the Cz site than the other placement sites, and among non-singers, the mean P300 amplitude was significantly higher in the Fz site than the other placement sites, i.e., music training facilitated enhancement of the P300 amplitude at the Cz site. CONCLUSIONS: The findings of this study suggest that more than three years of training in Carnatic singing can enhance neural coding to discriminate subtle differences, leading to enhanced discrimination abilities of the brain, mainly in the generation site corresponding to Cz electrode placement.

Effectiveness of Brainstem Auditory Evoked Potentials Scoring in Evaluating Brainstem Dysfunction and Disability Among Individuals With Multiple Sclerosis.

Purpose The brainstem dysfunction in multiple sclerosis (MS) often causes significant functional impairment leading to disability. This study aims to explore modified brainstem auditory evoked potential (BAEP) scores based on the pattern of BAEP abnormalities and relate with brainstem symptoms, brainstem functional system scores (BFSS), brainstem lesions, and disability. Method Forty-five participants with relapsing-remitting MS and 45 age- and gender-matched healthy controls underwent case history assessment, otoscopic examination, pure-tone audiometry, and BAEP testing. Also, neurological examination (Expanded Disability Status Scale, FSS scales) and magnetic resonance imaging were carried out on MS participants. Patterns of BAEP abnormalities were categorized and converted to BAEP scores. Results Out of 45 participants' brainstem symptoms, BFSS > 1, brainstem lesions (magnetic resonance imaging), and BAEP abnormalities were observed in 75.6%, 42.2%, 62.2%, and 55.56% of participants, respectively. Waves V and III abnormalities were more common among MS participants and showed a significant difference from the control group in the Mann-Whitney U test. Chi-square test did not show a significant association of BAEP abnormalities with brainstem symptoms and lesions but showed significant association with BFSS. The mean and standard deviation of BAEP scores in MS participants were 1.73 + 2.37. All healthy controls showed BAEP scores of 0. BAEP scores in MS participants showed significant correlation with BFSS scores and predict Expanded Disability Status Scale scores. Conclusion BAEP scores based on the pattern of BAEP abnormality can be a valid and useful measure in evaluating brainstem functions and predicting disability in MS.

Social representation of hearing aids among people with hearing loss: an exploratory study.

OBJECTIVE: The aim of the current study was to examine the social representation (SR) of hearing aids in people with hearing loss (PHL) in India, the Republic of Korea (ROK), the United Kingdom (UK), and the United States of America (US). DESIGN: The study used a cross-sectional survey design. The data collected by using a free association task were analysed qualitatively (i.e. content analysis) and quantitatively (i.e. chi-square analysis, similarities analysis, prototypical analysis). STUDY SAMPLE: 424 participants with hearing loss. RESULTS: The most commonly reported categories across all countries were "beneficial," "cost and time," and "appearance and design." Approximately 50% of the associations reported were negative. There were variations in terms of the categories that were predominant in the SR of each country. "Others actions and attitude" category was predominantly reported by PHL in India. "Disturbance" and "dissatisfaction" of hearing aids and the "repairs and maintenance of hearing aids" categories were mainly reported from the ROK and the US, respectively. CONCLUSIONS: The current results highlight the main aspects that PHL report spontaneously when they think about hearing aids. The findings will help to further inform public health campaigns and will contribute to develop culturally appropriate media materials regarding hearing aids.

Evaluation of auditory spectral resolution abilities in children with benign epilepsy with centrotemporal spikes using spectral temporally modulated ripple test.

PURPOSE: Spectral resolution is imperative for complex listening tasks such as understanding speech in the presence of background noise and has a significant role in children, particularly classroom learning. The present study evaluated the auditory spectral resolution abilities of children with Benign epilepsy with centrotemporal spikes (BECTS). METHOD: This cross-sectional study conducted from August 2017 to March 2020 recruited 23 children with clinical and electrographic features consistent with BECTS as cases. Fifteen age and sex matched typically developing children (TDC) were taken as controls. Spectral resolution abilities were evaluated using the recently developed Spectral temporally modulated Ripple test (SMRT). RESULTS: The mean age of the cases was 10.63 ±â€¯1.91 years with a slight male preponderance (69%). The mean (±SD) SMRT thresholds in the cases and controls were 5.90 (±1.91) and 7.21 (±1.03) respectively. The auditory spectral resolution threshold measured by SMRT in children with BECTS was observed to be significantly lower when compared to the controls (p of 0.021). CONCLUSION: Children with BECTS have a lower spectral resolution threshold by SMRT.

Assessment of the psychometric properties of the AQoL-4D questionnaire in Kannada language for use with adults with hearing loss.

OBJECTIVE: This study aimed to validate the translated (Kannada language) version of the Assessment of Quality of Life-4 Dimensions (AQoL-4D) questionnaire for use in Kannada speaking adults with hearing loss. DESIGN: The study involved a cross-sectional survey design. The original (English) and the translated versions of the AQoL-4D questionnaire along with two other questionnaires, that is, the Hearing Handicap Questionnaire and the Participation Scale were self-administered by the study participants. The Kannada AQoL-4D was filled in twice by roughly 50% of the study sample in two sessions that were 15 d apart. STUDY SAMPLE: In total, 103 Kannada-English biliterate adults with hearing loss participated in the study. RESULTS: Overall analysis involved testing the factor structure and various psychometric properties including the internal consistency, discriminant validity, convergent validity and possible floor/ceiling effects. The factor analysis indicated a four-factor structure, and the overall results showed acceptable psychometric properties of the scores of the full scale. However, poor internal consistency was obtained for three out of the four subscales extracted from the questionnaire. CONCLUSION: Based on the internal consistency of the subscales, we recommend using either the full scale or only the first subscale in Kannada speaking adults with hearing loss.

The Participation Scale: psychometric properties of a South Indian translation with hearing-impaired respondents.

AIMS: The Participation Scale (P-Scale) is a widely used generic self-report measure designed to assess an individual's participation restriction consequent to any disease condition. The present study aimed to evaluate the validity and reliability of a south Indian (Kannada language) version of the P-Scale for use with adults with hearing loss. This study is a part of an ongoing research program on the assessment of outcomes of hearing health rehabilitation with hearing aids involving Indian client groups. METHODS: One hundred and three adults with hearing loss completed the original English and the newly translated-adapted Kannada P-Scale questionnaire. Nearly half of the participants completed repeat testing of the Kannada version 15 days after the initial assessment. Along with the P-Scale, Kannada versions of the Hearing Handicap Questionnaire (HHQ) and the Assessment of Quality of Life - 4 Dimensions Questionnaire (AQoL-4D) were also administered. Based on predefined quality criteria, five different psychometric properties of the P-Scale were evaluated, together with an analysis of the Kannada P-Scale's factor structure. The psychometric properties assessed included internal consistency, test-retest reliability, convergent validity, discriminant validity, and floor-ceiling effects. RESULTS: Principal component analysis indicated a four-factor complex structure, which explained 69.78% of the variance in the Kannada P-Scale. High internal consistency (Cronbach's alpha = 0.90) and test-retest reliability (internal consistency coefficient >0.90) were obtained. Comparisons with the HHQ (ρ = 0.52) and AQoL-4 D (ρ = 0.76) indicated good convergent validity. Discriminant validity among the P-Scale questions was acceptable (inter-item correlation <0.60). Floor and ceiling effects were not evident in the Kannada P-Scale. CONCLUSIONS: The psychometric characteristics of the Kannada P-scale were found to be sufficient for use with the participant group (literate, Kannada-speaking adults with hearing loss) who were assessed in this study. Further research is required to determine generalizability of the Kannada P-Scale among other Kannada-speaking communities. Implications for Rehabilitation The Kannada version of the Participation Scale (P-Scale) can be validly used with Kannada speaking adults with hearing loss. The Kannada P-Scale can be used for clinical/research purposes to assess outcome (specifically, change in participation restriction) before, during, and after the hearing rehabilitation process. However, education and socioeconomic status may have an effect of the Kannada P-Scale results and these factors need to be further investigated prior to wider clinical use.

Social Representation of "Loud Music" in Young Adults: A Cross-Cultural Study.

BACKGROUND: Exposure to recreational noise, particularly music exposure, is considered one of the biggest public health hazards of our time. Some important influencing factors such as socioeconomic status, educational background, and cross-cultural perspectives have previously been found to be associated with attitudes toward loud music and the use of hearing protection. Although culture seems to play an important role, there is relatively little known about how it influences perceptions regarding loud music exposure in young adults. PURPOSE: The present study was aimed to explore cross-cultural perceptions of and reactions to loud music in young adults (18-25 yr) using the theory of social representations. RESEARCH DESIGN: The study used a cross-sectional survey design. STUDY SAMPLE: The study sample included young adults (n = 534) from five different countries (India, Iran, Portugal, the United States, and the United Kingdom) who were recruited using convenience sampling. DATA COLLECTION AND ANALYSIS: Data were collected using a questionnaire. Data were analyzed using a content analysis, co-occurrence analysis, and also χ² analysis. RESULTS: Fairly equal numbers of positive and negative connotations (∼40%) were noted in all countries. However, the χ² analysis showed significant differences between the countries (most positive connotations were found in India and Iran, whereas the most negative connotations were found in the United Kingdom and Portugal) regarding the informants' perception of loud music. The co-occurrence analysis results generally indicate that the category "negative emotions and actions" occurred most frequently, immediately followed by the category "positive emotions and actions." The other most frequently occurring categories included "acoustics," "physical aliment," "location," and "ear and hearing problems." These six categories formed the central nodes of the social representation of loud music exposure in the global index. Although some similarities and differences were noted among the social representations toward loud music among countries, it is noteworthy that more similarities than differences were noted among countries. CONCLUSIONS: The study results suggest that "loud music" is perceived to have both positive and negative aspects within society and culture. We suggest that the health promotion strategies should focus on changing societal norms and regulations to be more effective in decreasing the noise- and/or music-induced auditory symptoms among young adults.

Social representation of "music" in young adults: a cross-cultural study.

OBJECTIVE: This study was aimed to explore perceptions of and reactions to music in young adults (18-25 years) using the theory of social representations (TSR). DESIGN: The study used a cross-sectional survey design and included participants from India, Iran, Portugal, USA and UK. Data were analysed using various qualitative and quantitative methods. STUDY SAMPLE: The study sample included 534 young adults. RESULTS: The Chi-square analysis showed significant differences between the countries regarding the informants' perception of music. The most positive connotations about music were found in the responses obtained from Iranian participants (82.2%), followed by Portuguese participants (80.6%), while the most negative connotations about music were found in the responses obtained from Indian participants (18.2%), followed by Iranian participants (7.3%). The participants' responses fell into 19 main categories based on their meaning; however, not all categories were found in all five countries. The co-occurrence analysis results generally indicate that the category "positive emotions or actions" was the most frequent category occurring in all five countries. CONCLUSIONS: The results indicate that music is generally considered to bring positive emotions for people within these societies, although a small percentage of responses indicate some negative consequences of music.

Psychometric properties of the hearing handicap questionnaire: a Kannada (South-Indian) translation.

OBJECTIVE: To assess the psychometric properties of the Hearing Handicap Questionnaire (HHQ) in Kannada (a South-Indian language) among adults with hearing loss. DESIGN: The study involved a cross-sectional survey design. Participants provided demographic details and completed the Kannada and English (original) version of the HHQ questionnaire. To evaluate test-retest reliability, ∼50% of the participants completed the Kannada version for the second time after 15 days. STUDY SAMPLE: The sample comprised 103 adults with hearing loss recruited from local audiology clinics. RESULTS: Exploratory factor analysis indicated a one-factor structure, which explained 71% of the variance in Kannada-HHQ scores. The internal consistency measured with Cronbach's alpha was 0.96. The test-retest reliability correlations of the Kannada version with the English and with the same Kannada version re-administered after 15 days were 0.96 and 0.91, respectively. Convergent validity of the scale was confirmed by significant correlations with the Participation Scale and the Assessment of Quality of Life scales. Discriminant validity was found to be low as all the Kannada-HHQ questions were highly correlated with each other (r> 0.60). No floor and ceiling effects were identified. CONCLUSIONS: The psychometric properties of the Kannada-HHQ scale are considered to be adequate for clinical or research use.

Translation and Adaptation of Five English Language Self-Report Health Measures to South Indian Kannada Language.

The objective of this study was to translate and adapt five English self-report health measures to a South Indian language Kannada. Currently, no systematically developed questionnaires assessing hearing rehabilitation outcomes are available for clinical or research use in Kannada. The questionnaires included for translation and adaptation were the hearing handicap questionnaire, the international outcome inventory - hearing aids, the self-assessment of communication, the participation scale, and the assessment of quality of life - 4 dimensions. The questionnaires were translated and adapted using the American Association of Orthopedic Surgeons (AAOS) guidelines. The five stages followed in the study included: i) forward translation; ii) common translation synthesis; iii) backward translation; iv) expert committee review; v) pre-final testing. In this paper, in addition to a description of the process, we also highlight practical issues faced while adopting the procedure with an aim to help readers better understand the intricacies involved in such processes. This can be helpful to researchers and clinicians who are keen to adapt standard self-report questionnaires from other languages to their native language.

Social representation of "hearing loss": cross-cultural exploratory study in India, Iran, Portugal, and the UK.

BACKGROUND: Hearing loss is one of the most common chronic conditions in older adults. In audiology literature, several studies have examined the attitudes and behavior of people with hearing loss; however, not much is known about the manner in which society in general views and perceives hearing loss. This exploratory study was aimed at understanding the social representation of hearing loss (among the general public) in the countries of India, Iran, Portugal, and the UK. We also compared these social representations. MATERIALS AND METHODS: The study involved a cross-sectional design, and participants were recruited using the snowball sampling method. A total of 404 people from four countries participated in the study. Data were collected using a free-association task where participants were asked to produce up to five words or phrases that came to mind while thinking about hearing loss. In addition, they were also asked to indicate if each word they presented had positive, neutral, or negative associations in their view. Data were analyzed using various qualitative and quantitative methods. RESULTS: The most frequently occurring categories were: assessment and management; causes of hearing loss; communication difficulties; disability; hearing ability or disability; hearing instruments; negative mental state; the attitudes of others; and sound and acoustics of the environment. Some categories were reported with similar frequency in most countries (eg, causes of hearing loss, communication difficulties, and negative mental state), whereas others differed among countries. Participants in India reported significantly more positive and fewer negative associations when compared to participants from Iran, Portugal, and the UK. However, there was no statistical difference among neutral responses reported among these countries. Also, more differences were noted among these countries than similarities. CONCLUSION: These findings provide useful insights into the public perception of hearing loss that may prove useful in public education and counseling.

Social representation of hearing aids: cross-cultural study in India, Iran, Portugal, and the United Kingdom.

BACKGROUND: The current study was aimed at understanding the social representation of hearing aids in India, Iran, Portugal, and the United Kingdom. We also compared these results to explore the cross-cultural differences and similarities among these countries. METHODS: The study involved a cross-sectional design, and the data were collected from four different countries using the snowball sampling method. Data were analyzed using a content analysis to identify the most-similar categories of responses reported, a co-occurrences analysis to see which of these categories are reported commonly, and a chi-square analysis to study if there was any association between positive, neutral, and negative connotations among participants in different countries. RESULTS: The current study revealed four different social representations of hearing aids from India, Iran, Portugal, and the United Kingdom, and also a global index. CONCLUSION: The study results provide very useful insights into how hearing aids are represented in the society. These findings may have important implications for public education and also for manufacturers from the viewpoint of designing and marketing hearing aids in different countries.

Exploring the influence of culture on hearing help-seeking and hearing-aid uptake.

OBJECTIVE: The purpose of this paper was to highlight the importance of cultural influence in understanding hearing-help seeking and hearing-aid uptake. DESIGN: Information on audiological services in different countries and 'theories related to cross-culture' is presented, followed by a general discussion. STUDY SAMPLE: Twenty-seven relevant literature reviews on hearing impairment, cross-cultural studies, and the health psychology model and others as secondary resources. RESULTS: Despite the adverse consequences of hearing impairment and the significant potential benefits of audiological rehabilitation, only a small number of those with hearing impairment seek professional help and take up appropriate rehabilitation. Therefore, hearing help-seeking and hearing-aid uptake has recently become the hot topic for clinicians and researchers. Previous research has identified many contributing factors for hearing help-seeking with self-reported hearing disability being one of the main factors. Although significant differences in help-seeking and hearing-aid adoption rates have been reported across countries in population studies, limited literature on the influence of cross-cultural factors in this area calls for an immediate need for research. CONCLUSIONS: This paper highlights the importance of psychological models and cross-cultural research in the area of hearing help-seeking and hearing-aid uptake, and consequently some directions for future research are proposed.

Audiologists' preferences for patient-centredness: a cross-sectional questionnaire study of cross-cultural differences and similarities among professionals in Portugal, India and Iran.

OBJECTIVE: Patient-centredness has become an important aspect of health service delivery; however, there are a limited number of studies that focus on this concept in the domain of hearing healthcare. The objective of this study was to examine and compare audiologists' preferences for patient-centredness in Portugal, India and Iran. DESIGN: The study used a cross-sectional survey design with audiologists recruited from three different countries. PARTICIPANTS: A total of 191 fully-completed responses were included in the analysis (55 from Portugal, 78 from India and 58 from Iran). MAIN OUTCOME MEASURE: The Patient-Practitioner Orientation Scale (PPOS). RESULTS: PPOS mean scores suggest that audiologists have a preference for patient-centredness (ie, mean of 3.6 in a 5-point scale). However, marked differences were observed between specific PPOS items suggesting these preferences vary across clinical situations. A significant level of difference (p<0.001) was found between audiologists' preferences for patient-centredness in three countries. Audiologists in Portugal had a greater preference for patient-centredness when compared to audiologists in India and Iran, although no significant differences were found in terms of age and duration of experience among these sample populations. CONCLUSIONS: There are differences and similarities in audiologists' preferences for patient-centredness among countries. These findings may have implications for the training of professionals and also for clinical practice in terms of optimising hearing healthcare across countries.