The relationship and interdependence of auditory thresholds, proposed behavioural measures of hidden hearing loss, and physiological measures of auditory function.
Aryn M Kamerer, Sara E Harris, Chris S Wichman and 2 others
PMID 39180321WHAT IT FOUND
After accounting for hearing thresholds, tests of outer hair cell and auditory nerve function did not predict thresholds in noise, frequency modulation detection, or speech recognition in 224 adults.
These behavioral tests are not useful proxies for hidden cochlear or neural damage.
Key findings
01After accounting for hearing thresholds, physiological measures did not predict the behavioral auditory measures tested.
02Hearing thresholds explained a large share of the behavioral scores, including 36% of thresholds in noise at 1.5 kHz, 60% at 4 kHz, and 40% of word recognition in quiet.
03Word recognition showed ceiling effects in quiet, noise, and time-compressed speech.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The sample was not drawn from the general population; it was deliberately assembled with similar numbers of people with normal hearing and hearing loss, so the results may not apply to a typical clinic. The method for removing hearing threshold effects depends on this sample, so the same person could receive a different threshold-independent score in another sample. The behavioral tests had poor-to-moderate reliability, which makes it harder to detect true relationships. The study did not test several other physiological measures that may be more relevant to hidden hearing loss, such as electrocochleography, ABR wave I curvature, envelope-following response, high-rate ABR, or middle ear muscle reflex. Word recognition had ceiling effects in quiet, noise, and time-compressed speech.
Declared interests
The authors declare no conflicts of interest.
The easy way to misread this
Do not conclude that normal audiograms plus difficulty with speech in noise prove hidden inner hair cell or auditory nerve damage. In this study, once hearing threshold effects were removed, thresholds in noise, frequency-modulation detection, and speech recognition scores were not predicted by distortion-product otoacoustic emissions, auditory brainstem response wave amplitudes, or the frequency-following response.