Speech Comprehension Difficulties in Chronic Tinnitus and Its Relation to Hyperacusis

Vielsmeier, Veronika; Kreuzer, Peter; Haubner, Frank; Steffens, Thomas; Semmler, Philipp R. O.; Kleinjung, Tobias; Schlee, Winfried; Langguth, Berthold; Schecklmann, Martin

doi:10.3389/fnagi.2016.00293

Cited by 30 publications

(19 citation statements)

References 37 publications

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“…In animal studies, central hyperactivity has been associated with tinnitus, reduced sound tolerance, and loudness recruitment ( Attias et al, 2005 ; Cai et al, 2009 ; Middleton et al, 2011 ; Heeringa and van Dijk, 2014 ; Kalappa et al, 2014 ). Tinnitus and reduced sound tolerance are associated with impaired speech comprehension in noise ( Vielsmeier et al, 2016 ) and can cause difficulty using amplification devices ( Lindley et al, 2001 ; Formby et al, 2008 ). Hyperactivity in central auditory pathways could affect other aspects of perception such as spectral contrast perception and temporal processing ( Møller, 1972 ; Blackburn and Sachs, 1990 ; Young et al, 1992 ; Doucet et al, 1999 ; McGinley and Oertel, 2006 ; Chen et al, 2016 ).…”

Section: Discussionmentioning

confidence: 99%

Central Compensation in Auditory Brainstem after Damaging Noise Exposure

Schrode

Muniak

Kim

et al. 2018

eNeuro

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Noise exposure is one of the most common causes of hearing loss and peripheral damage to the auditory system. A growing literature suggests that the auditory system can compensate for peripheral loss through increased central neural activity. The current study sought to investigate the link between noise exposure, increases in central gain, synaptic reorganization, and auditory function. All axons of the auditory nerve project to the cochlear nucleus, making it a requisite nucleus for sound detection. As the first synapse in the central auditory system, the cochlear nucleus is well positioned to respond plastically to loss of peripheral input. To investigate noise-induced compensation in the central auditory system, we measured auditory brainstem responses (ABRs) and auditory perception and collected tissue from mice exposed to broadband noise. Noise-exposed mice showed elevated ABR thresholds, reduced ABR wave 1 amplitudes, and spiral ganglion neuron loss. Despite peripheral damage, noise-exposed mice were hyperreactive to loud sounds and showed nearly normal behavioral sound detection thresholds. Ratios of late ABR peaks (2–4) relative to the first ABR peak indicated that brainstem pathways were hyperactive in noise-exposed mice, while anatomical analysis indicated there was an imbalance between expression of excitatory and inhibitory proteins in the ventral cochlear nucleus. The results of the current study suggest that a reorganization of excitation and inhibition in the ventral cochlear nucleus may drive hyperactivity in the central auditory system. This increase in central gain can compensate for peripheral loss to restore some aspects of auditory function.

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Section: Discussionmentioning

confidence: 99%

Central Compensation in Auditory Brainstem after Damaging Noise Exposure

Schrode

Muniak

Kim

et al. 2018

eNeuro

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“…While tinnitus and hyperacusis do not always overlap clinically, the findings by Hébert et al (ibid) support the relevance of identifying a sub-group of patients for whom specific treatments may be beneficial (Dauman and Bouscau-Faure, 2005 ; Schecklmann et al, 2014 ). Vielsmeier and co-authors reported recently that more than 70% of patients with tinnitus ( n = 351) experienced difficulties understanding speech (Vielsmeier et al, 2016 ). While these difficulties were a concern for 40% of the patients when no specific circumstance was considered, 80% acknowledged that speech understanding was a problem in a cocktail party situation, with multiple sources of noise.…”

Section: Introductionmentioning

confidence: 99%

Exploring Tinnitus-Induced Disablement by Persistent Frustration in Aging Individuals: A Grounded Theory Study

Dauman

Erlandsson

Dauman

2017

Front. Aging Neurosci.

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Background: Qualitative research can help to improve the management of patients, meet their expectations and assist physicians in alleviating their suffering. The perception of moment-to-moment variability in tinnitus annoyance is an emerging field of exploration. This study sought to enlighten variability in tinnitus-induced disablement using a qualitative approach.Methods: Twelve participants (six females, six males, aged 51–79) were recruited via the French Tinnitus Association Journal for participation in recorded semi-structured interviews. Each participant had three interviews lasting 1 h, the sessions being separated one from the other by 2 weeks. Following recommendations of Charmaz (2014), the second and third interviews were aimed at gathering rich data, by enhancing the participants' reflexivity in the circumstances of distress caused by tinnitus. After transcription, the data (n = 36 interviews) were analyzed using the approach to Grounded Theory proposed by Strauss and Corbin (1998).Results: Tinnitus as persistent frustration emerged as being the core category uniting all the other categories of the study. Hence, the core category accounted for the broader scope in participants' experience of chronic tinnitus. It is suggested that tinnitus-induced disablement varied according to the degree of frustration felt by the participants in not being able to achieve their goals. The implications of this were analyzed using the following categories: “Losing body ownership,” “Lacking perspectives,” and “Persevering through difficulties.” Based on these findings, we draw a substantive theory of tinnitus tolerance that promotes an active, disciplined and individualized approach to tinnitus-induced disablement. The model distinguishes pathways from sustained suffering to reduced annoyance (i.e., emerging tolerance). It accounts for difficulties that the participants experienced with a perceived unchanged annoyance over time. Furthermore, this model identifies a set of new attitudes toward oneself and others that tinnitus tolerance would entail.Conclusion: The subjective experience of frustration enlightens tinnitus-induced disablement, offering new perspectives for long-term self-management. Modulation of frustration, rather than moderation of tinnitus interference, is suggested as a new approach to the clinical management of tinnitus-related distress.

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“…Nevertheless, some clinical tests, such as those related to speech understanding, may be helpful in characterizing the impact of tinnitus even in those with normal hearing sensitivity. For instance, tinnitus patients report hearing and speech comprehension difficulties (Tyler and Baker 1983;Tyler et al 2014), with such difficulties increasing in adverse listening environments (Vielsmeier et al 2016). As summarized in Table 1, studies focusing on speech recognition ability in noise have demonstrated that tinnitus patients performed poorly on this task, even when they reported having normal hearing sensitivity.…”

Section: Introductionmentioning

confidence: 99%

Right-Ear Advantage for Speech-in-Noise Recognition in Patients with Nonlateralized Tinnitus and Normal Hearing Sensitivity

Tai

Husain

2017

JARO

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Despite having normal hearing sensitivity, patients with chronic tinnitus may experience more difficulty recognizing speech in adverse listening conditions as compared to controls. However, the association between the characteristics of tinnitus (severity and loudness) and speech recognition remains unclear. In this study, the Quick Speech-in-Noise test (QuickSIN) was conducted monaurally on 14 patients with bilateral tinnitus and 14 age- and hearing-matched adults to determine the relation between tinnitus characteristics and speech understanding. Further, Tinnitus Handicap Inventory (THI), tinnitus loudness magnitude estimation, and loudness matching were obtained to better characterize the perceptual and psychological aspects of tinnitus. The patients reported low THI scores, with most participants in the slight handicap category. Significant between-group differences in speech-in-noise performance were only found at the 5-dB signal-to-noise ratio (SNR) condition. The tinnitus group performed significantly worse in the left ear than in the right ear, even though bilateral tinnitus percept and symmetrical thresholds were reported in all patients. This between-ear difference is likely influenced by a right-ear advantage for speech sounds, as factors related to testing order and fatigue were ruled out. Additionally, significant correlations found between SNR loss in the left ear and tinnitus loudness matching suggest that perceptual factors related to tinnitus had an effect on speech-in-noise performance, pointing to a possible interaction between peripheral and cognitive factors in chronic tinnitus. Further studies, that take into account both hearing and cognitive abilities of patients, are needed to better parse out the effect of tinnitus in the absence of hearing impairment.

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Speech Comprehension Difficulties in Chronic Tinnitus and Its Relation to Hyperacusis

Cited by 30 publications

References 37 publications

Central Compensation in Auditory Brainstem after Damaging Noise Exposure

Central Compensation in Auditory Brainstem after Damaging Noise Exposure

Exploring Tinnitus-Induced Disablement by Persistent Frustration in Aging Individuals: A Grounded Theory Study

Right-Ear Advantage for Speech-in-Noise Recognition in Patients with Nonlateralized Tinnitus and Normal Hearing Sensitivity

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