Hearing Research

The middle ear muscle reflex (MEMR) and medial olivocochlear reflex (MOCR) are increasingly studied for their role in suprathreshold auditory processing. However, recording these reflexes in humans is potentially complicated by age-related (sub)clinical hearing loss and co-activation. This study investigates (1) the influence of age-related (sub)clinical hearing loss, (2) methodological differences between conventional and wideband MEMR techniques, and (3) how MEMR activation contaminates MOCR recordings. Three test groups were included: young normal-hearing adults, middle-aged normal-hearing adults, and middle-aged adults with audiometric hearing loss. Cochlear status and neural encoding was assessed using distortion-product otoacoustic emissions (DPOAEs) and envelope following responses (EFRs). MEMR recordings were compared using conventional tonal stimuli and wideband stimuli. MOCR was recorded at elicitor levels of 60 and 75 dB to evaluate MEMR co-activation. MEMR was related to age, suggesting sensitivity to subclinical cochlear damage. Wideband stimuli were beneficial as elicitor (noise vs. tone), while changing the probe stimuli added no significant benefit (click vs. tone). MOCR strength did not correlate with age-related subclinical hearing, suggesting that MOCR measurements may reflect efferent function relatively independently of afferent sensorineural status in audiometric normal hearing subjects. However, reliable recordings were challenging in participants with audiometric hearing loss due to poor OAE baselines. MEMR co-activation was detectable in the click response and could alter MOCR-induced suppression. These findings suggest that, in cases of normal hearing thresholds, MEMR amplitude may be a marker of subclinical cochlear damage and MOCR measurements may more specifically reflect efferent function. Clinical measurements can be improved using broadband stimuli, accounting for outer-hair-cell damage, and defining criteria for reflex co-activation.

Aging and noise over-exposure lead to complex mixtures of cochlear degradation that impair the structure and function of outer hair cells, inner hair cells (IHCs), and the cochlear nerve. However, IHC damage and cochlear synaptopathy (CS) remain pathologies "hidden" from the audiogram. This study aimed to identify and differentiate the physiological signatures of these two distinct pathologies using promising non-invasive assays: Envelope Following Responses (EFRs), Auditory Brainstem Response (ABRs), Wideband middle-ear reflexes (WB-MEMRs), and Distortion Product Otoacoustic Emissions (DPOAEs). We utilized chinchilla models of carboplatin-induced (CA) IHC damage (N = 4) and temporary threshold shift (TTS) noise-induced CS (N = 4) to compare the physiological signatures of each pathology. While both groups showed unchanged ABR thresholds two weeks after exposure, EFRs, ABR Wave V/I ratios, and MEMRs showed distinct effects of exposure. Despite non-elevated ABR-derived audiometric thresholds after exposure, both CA and TTS exposure resulted in severe in EFR "peakiness", particularly for sharp, short-duty-cycle stimuli and significant elevations in ABR Wave V/I ratios. However, these findings were less-pronounced in the TTS-exposed animals. WB-MEMR amplitudes were decreased with elevated thresholds in both groups; this effect was more pronounced in the TTS group. Opposite trends in DPOAE amplitudes indicated that while both IHC damage and CS result in similar suprathreshold temporal coding deficits, effects on outer-hair-cell integrity and auditory efferent physiology may differ between the two pathologies. Future work and novel diagnostics should aim to distinguish these specific cochlear pathologies in clinical populations, or at the very least consider their overlap. HighlightsO_LIA multi-metric diagnostic approach was used with chinchilla models of inner-hair-cell (IHC) damage and cochlear synaptopathy (CS). C_LIO_LIIHC damage and synaptopathy both cause suprathreshold deficits "hidden" from the audiogram. C_LIO_LIIHC damage results in more severe temporal envelope coding degradation than does synaptopathy. C_LIO_LIA combination of EFR "peakiness", ABR Wave V/I ratio, and Wideband Middle Ear Muscle Reflex (WB-MEMR) appear to be useful measures for profiling IHC damage and CS. C_LI

Acoustic cues such as pitch and spatial location allow listeners to attend to a target speaker and ignore competing talkers, aiding speech recognition in background noise. Diminished ability to utilize acoustic cues for speech stream segregation may thus contribute to older adults' challenges hearing in noise. Adults aged 18-74 completed a speech-in-speech identification task with three conditions containing 1) only pitch cues (fundamental frequency), 2) only spatial cues (interaural time differences; ITDs), and 3) both pitch and spatial cues for segregating a target talker from competing talkers. Hearing thresholds at standard and extended high frequencies (EHFs), auditory brainstem responses (ABRs), and digit span scores were acquired to examine the influence of sensory and cognitive factors on use of each acoustic cue for speech-in-speech recognition. Significant differences were observed between cue condition scores indicating that use of the available cue(s) drove performance. ABR metrics were not a significant predictor but digit span scores significantly predicted scores on all three cue conditions. Working memory abilities therefore set a baseline for participants' speech-in-speech recognition regardless of the acoustic content. Hearing thresholds at standard frequencies significantly predicted scores on the Pitch condition. EHF hearing thresholds better predicted Spatial and Both Cue condition performance, suggesting that EHF thresholds represent auditory processing important for coding ITDs. Age group analysis revealed that older adults (aged 40+) performed significantly more poorly on all cue conditions of the speech-in-speech recognition task relative to younger adults. Age-related changes in auditory sensory processing may therefore impair older adults' speech-in-noise perception by reducing their ability to use acoustic cues for segregating target and competing speech.

The human auditory system decomposes complex sounds into distinct components via a collection of processing steps. Knowing whether Spiral Ganglion Cells (SGCs) play an active role in the decoding of complex sounds can facilitate the development of Cochlear Implant (Cl) coding strategies and clinical assessment tools. Early animal studies reported SGCs being similar across different characteristic frequencies (CFs). In this study, human electrically evoked compound action potentials (eCAPs) were analysed to probe the relationship between the reciprocal of CF and the duration of the eCAP. A significant relationship could indicate that SGCs may not simply be passive cables. eCAP datasets from 6 published studies (175 Cl users, 1243 recordings) were analysed and their peaks were automatically labelled. The nlp2 latency was derived for each recording as a proxy of the action potential duration. The CF of each recording was estimated by mapping the average insertion angle of the electrode to the human SGC map. A weak but statistically significant relationship was observed between the n1p2 latency and the reciprocal of CF (random-effects model with random intercepts for subject, r = 0.09, p = 0.024, n= 450) supporting the hypothesis that lower CF is associated with slower repolarisation (longer n1p2 latency) in human spiral ganglion cells.

Since young adults hear sounds up to 20 kHz, the loss of extended high-frequency hearing (EHF; above 8 kHz) is a hallmark of age-related hearing loss, often progressing from early lifetime. However, this deficit frequently goes undetected because routine clinical hearing tests and most hearing aids are currently limited mostly up to 8 kHz. EHF hearing has been linked to deficits in speech perception in noise and to self-reported hearing. However, it remains elusive how EHF hearing influences speech intelligibility. Here we recorded neuromagnetic brain responses using magnetoencephalography (MEG) within a frequency-tagging speech paradigm designed to probe hierarchical levels of attention and memory-dependent speech processing and recognition. Auditory evoked cortical magnetic field (AEF) responses were significantly reduced in both left and right brain hemispheres in individuals with impaired EHF hearing compared to those subjects with rather preserved EHF hearing. A gradual reinforcement of left-hemispheric AEF seen over age was not observed in young adults (19-29 y) with preserved EHF hearing. This was linked to stronger auditory brainstem responses (ABR), reflecting better neural synchronized auditory responses at stimulus onset. The reinforced left hemispheric dominance in young adults with impaired EHF hearing, in contrast, was linked to lower ABRs. Our findings suggest that sound energy above 8 kHz contributes through its impact on stimulus-onset synchrony to phase locking of oscillations in the auditory cortex to intelligible speech. Together, the results highlight the need to reconsider the neglect of EHF hearing in both audiological assessment and hearing aid design. SignificanceWe show here that deficits in extended high-frequency (EHF) hearing, up to now neglected in routine clinical audiometry and hearing aid technology, lead to reduced cortical evoked auditory field (AEF) response amplitudes to attended and unattended speech, even at a young age. A gradual increase in reinforced left-hemispheric AEF responses during attended speech does not occur in young people with good EHF hearing; this is linked to better synchronization of neural responses at the onset of sound. This suggests a crucial role of sounds containing energy above 8kHz in minimizing the need for cognitive resources during active listening. Collectively, our results challenge current clinical practices and underscore the need to incorporate EHF hearing into audiological assessment and hearing aid design.

Chronic tinnitus is a common condition with few effective treatments and no cure. Though inconsistent results across MRI studies of tinnitus have slowed mechanistic insight, converging evidence across animal and human studies clearly implicate auditory-system dysfunction. This paper presents a systematic, retrospective assessment of auditory-network function in chronic tinnitus across multiple fMRI datasets. Auditory network nodes were newly defined in this effort, including novel nodes in cerebellum previously linked with somatotopic representations of articulators (lobules VI, VIIIa). Auditory-network connectivity in cerebellum and superior olivary complex was reduced in chronic tinnitus, perhaps explaining the recent success of trigeminal stimulation in improving tinnitus. Auditory-network strength was also reduced, corroborating some recent studies and perhaps reflecting increased spontaneous neuronal activity reported in animal models. Together, these results suggest auditory-network dysconnectivity as a tinnitus biomarker, and that efferent cochlear pathways related to head-centric interoception may play a mechanistic role.

Tinnitus is commonly associated with hearing loss, yet it can also occur in individuals with clinically normal audiometric thresholds. This dissociation has led to the hypothesis that hidden sensorineural hearing loss underlies tinnitus in audiometrically normal-hearing individuals. However, identifying such subclinical deficits non-invasively is challenging because audiometric measures are influenced by age-related changes and interactions among sensorineural processes. In this study, we disentangled the contributions of tinnitus, age, and hearing status to sensorineural encoding and speech perception. We included 113 participants, divided into age- and hearing-status-matched groups with and without tinnitus, and assessed them using otoacoustic emissions, auditory evoked potentials, auditory reflex measurements, and behavioral tasks of speech perception. This design enabled a rigorous evaluation of whether hidden sensorineural deficits underlie tinnitus. Age and hearing status had substantial effects on objective measures of sensorineural function, whereas tinnitus-related effects were subtle and age specific. Young adults with tinnitus and normal audiometric thresholds exhibited enhanced auditory brainstem responses, elevated envelope following responses, and better vowel discrimination. In contrast, middle-aged adults with tinnitus showed no such enhancements and demonstrated poorer speech-in-noise performance. Correlation analyses revealed a tinnitus-related shift toward greater reliance on central auditory processing, compared with the predominantly peripheral associations observed in controls. The middle ear muscle reflex was unaffected by tinnitus but was correlated with hyperacusis-related parameters. Together, these findings suggest distinct tinnitus-related auditory profiles across the lifespan: neural enhancement and improved vowel discrimination in young adults, versus degraded sensorineural encoding and reduced speech intelligibility in middle-aged adults. Significance StatementTinnitus affects a significant portion of the population, yet its underlying origins are still unclear. While hearing loss is a common cause, individuals with tinnitus may also have normal hearing thresholds. This suggests that subtle sensorineural damage may also play a role. This study critically investigates tinnitus-, age-, and hearing-related sensorineural encoding using non-invasive electrophysiological measures, auditory reflexes, and speech perception tasks in carefully matched participant groups. The study reveals distinct tinnitus-related auditory profiles throughout the lifespan; including enhanced sensorineural processing in young adults and degraded encoding with impaired speech perception in middle-aged adults. These findings provide critical insight into the mechanisms underlying tinnitus and offer objective markers for future research on tinnitus diagnosis and treatment

ObjectivesObjective and ecologically valid measures of speech processing can complement conventional audiologic assessments. Phoneme-related potentials (PRPs), derived by averaging listeners electroencephalography (EEG) responses time-locked to phonemes in continuous speech, have emerged as a promising approach for capturing cortical processing of speech in naturalistic listening conditions. Importantly, PRPs reveal speech perception challenges even when conventional audiograms are clinically normal, positioning them as a promising neural marker for suprathreshold listening difficulties that standard audiometry often misses. As a critical step toward clinical translation, this study examined the extent to which PRP-derived measures remain stable across real-world contexts relevant to clinical implementation, including monaural versus binaural presentation, stimulus intensity level, and repeated testing sessions. The study also assessed cortical tracking of lower-level speech acoustics to determine whether the PRP findings could be attributed to acoustic processing. DesignEEG was recorded from 18 young adults with normal hearing as they listened to audiobook speech presented monaurally or binaurally at 60 or 75 dB across two sessions separated by approximately one week. Neural differentiation of phoneme manner-of-articulation classes (vowels, nasals/approximants, fricatives, and stops) in PRPs was quantified using two measures: an F-statistic reflecting between-manner relative to within-manner variability, and classification accuracy from a machine-learning model trained to predict manner class from PRPs. Temporal response function modeling assessed neural tracking of continuous acoustic envelope and onset features of the audiobook speech. ResultsNeither PRP-derived measure of manner differentiation showed significant effects of session, presentation modality, intensity level, or their interactions. Intraclass correlation analyses further indicated moderate-to-good reliability across all three factors. In contrast, neural tracking of the acoustic envelope and acoustic onsets was stronger under binaural than monaural presentation, with binaural presentation eliciting more pronounced cortical responses to the envelope. ConclusionsPRP-derived measures remained relatively stable across modest procedural variations that are common in clinical testing contexts, positioning PRPs as a potent objective index of naturalistic speech processing. This stability may reflect cortical processing of abstract, linguistically relevant speech categories and suggest that PRPs provide complementary information beyond audiologic assessments of peripheral auditory functions and EEG measures that primarily capture lower-level acoustic processing.

The early-onset, high-frequency hearing loss phenotype of CD-1 mice is rescued by the A88V mutation of the connexin 30 gap-junctional protein, despite a reduced endocochlear potential (EP), which drives cochlear hair cell receptor potentials. The mutation enables organ of Corti (OoC) extracellular receptor potentials to be similar in size to those of sensitive-hearing CBA/J mice, presumably through increased OoC resistance, despite smaller intracellular outer hair cell (OHC) receptor potentials. Low-frequency hearing in CD-1Cx30A88V/A88V mice is impaired, compared with those of CBA/J and wild-type CD-1 mice. To investigate the cellular basis of OoC resistance increase and EP decrease, we made in situ electrophysiological measurements from Deiters cells (DCs) in the OoC of homozygous CD-1Cx30A88V/A88V mice. DCs contribute to the OHC cytoskeletal scaffold and cochlear K+ recycling, and are interconnected by syncytial junctions comprising connexins 30 and 26. Measurements from CD-1Cx30A88V/A88V mice were compared with those from wild-type CD-1 mice, with sensitive hearing below 12 kHz, and from the CBA/J strain. Syncytial junctional-coupling between DCs of CD-1Cx30A88V/A88V mice was weaker, input resistance greater, potassium current expression was modified, and voltage-sensitive activation was shifted to more negative values compared to those of CD-1 and CBA/J mice. Inactivating potassium currents dominate in DCs of CBA/J and CD-1Cx30A88V/A88V mice with excellent high-frequency hearing, and sustained currents dominate in DCs of CD-1 mice with early-onset hearing loss. These findings are discussed in relation to maintenance of OoC electrochemistry, rescue of early-onset hearing loss, impaired low-frequency hearing in CD-1Cx30A88V/A88V mice, and the basis of high-frequency hearing.

ObjectivesOutcomes following cochlear implantation vary substantially across adult recipients, and the cognitive and perceptual factors contributing to this variability are not fully understood. This poses a challenge for developing strategies to improve cochlear implant outcomes, as such approaches require a clearer understanding of the mechanisms underlying individual listening difficulties. In this study, we investigated auditory cognitive measures in cochlear implant (CI) users to further elucidate the origins of this variability. DesignThirty-seven adult cochlear implant users completed measures of auditory cognition, comprising auditory working memory (AWM) and sound segregation ability, measured using an auditory figure-ground task (AFG), as well as measures of peripheral temporal and spectral processing, comprising the temporal modulation detection threshold (TMDT) and spectral ripple discrimination threshold (SRDT). Speech perception outcomes were assessed using word-in-noise (WIN) and sentence-in-noise (SIN) tasks. Separate multiple linear regression models evaluated the unique contribution of the auditory cognition measures to WIN and SIN performance, after accounting for the peripheral measures. ResultsBoth regression models explained a substantial proportion of variance in speech-in-noise outcomes (WIN: adjusted R{superscript 2} = 0.55; SIN: adjusted R{superscript 2}=0.57, both p < 0.001). For WIN performance, AFG and AWM were significant predictors. A similar pattern was found for SIN performance, where lower AWM ability and poorer AFG segregation were linked to poorer sentence listening in noise. No significant effects of spectral ripple discrimination or temporal modulation detection were observed in either model, even though both were significantly correlated with WIN performance. ConclusionsThese findings indicate that auditory working memory and sound segregation ability are robust predictors of speech-in-noise outcomes in adult cochlear implant users, across both word- and sentence-level measures. Together, the results may help explain why speech-in-noise outcomes remain highly variable among CI users, even when basic sensory encoding abilities are taken into account. Incorporating measures of auditory working memory and fundamental sound segregation may therefore improve outcome prediction and help in developing more individualised rehabilitation strategies.

PurposeMild therapeutic hypothermia (MTH) preserves cochlear function in animal models and is now entering early-phase human trials for hearing preservation. However, the extent to which the human cochlea can actually be cooled, and the mechanisms underlying MTH, remain unclear, in part because blood perfusion is expected to oppose localized cooling. In this study we evaluated the impact of blood flow on human cochlear temperature exposed to the MTH device using a combined experimental and computational approach. MethodsTemperature measurements were obtained from a human cadaver skull exposed to a commercial MTH device. These data were used to validate a three-dimensional bioheat transfer model incorporating realistic skull anatomy. The validated model was subsequently extended to include physiological blood perfusion in the internal carotid artery; a major heat source located near the cochlea. Finally, the in silico model was further expanded to incorporate the surrounding skin and brain tissues. ResultsIncorporating blood flow in internal carotid artery substantially altered predicted cochlear temperature distributions, highlighting the importance of localized vascular heat transport in the human cochlea during MTH. Although cochlear cooling was attenuated in the presence of perfusion, the therapeutic effects of MTH may not depend solely on the magnitude of local intracochlear temperature reduction. Additional mechanisms, such as reduced facial surface temperature, may also contribute to its efficacy. ConclusionThe validated in silico model provides a physiologically realistic framework for evaluating human cochlear thermal responses, investigating MTH mechanisms, and optimizing temperature-based strategies for hearing preservation.

Pure tone audiometry (PTA) remains the clinical standard for evaluating hearing ability, yet individuals with similar audiometric profiles often exhibit substantial variability in their capacity to understand speech in everyday listening environments. Growing evidence suggests this variance is related to contributions from cognitive ability and auditory processing that standard threshold measures do not capture. To investigate how PTA, cognitive factors, and demographics such as age jointly predict real-world speech perception, 116 veteran adults 20-70 years old spanning a range of normal to moderate sensorineural hearing losses completed a spatial auditory attention task. Target color words were embedded within naturalistic short-story narratives presented under two conditions: a mono-talker speech-in-quiet (SIQ) condition and a dual-talker speech-in-noise (SIN) condition with a spatially separated competing narrative. Behavioral performance was quantified via color word hit accuracy, reaction time, and comprehension question accuracy. Participants also completed pure tone audiometry, the Montreal Cognitive Assessment (MoCA), and the Speech, Spatial and Qualities of Hearing Scale (SSQ12). Mixed-effects regression models were used to evaluate the contributions of PTA, age, cognitive ability, and self-reported hearing difficulty (SSQ12) to task performance across conditions. Results demonstrate a complex interplay between age, PTA, MoCA, and/or listening condition (SIQ vs. SIN) in predicting identification accuracy, reaction time, and comprehension. Age and condition significantly predicted hit accuracy and reaction time, with older participants showing improved accuracy in quiet but declining accuracy and slower responses in noise. PTA did not emerge as a significant main effect predictor but interacted with cognitive ability and condition to modulate performance, in some cases exhibiting a paradoxical inverse relationship with accuracy dependent on MoCA score. MoCA scores significantly predicted comprehension across conditions, and SIN hit accuracy was positively correlated with SSQ12 scores, validating the task against participants real-world listening experiences. These findings highlight the importance of incorporating cognitive screening and ecologically valid speech perception tasks into audiological assessment to better identify individuals at risk for functional hearing impairment in complex listening environments.

Mammalian hearing depends on the active amplification of sound-evoked waves as they travel along the basilar membrane within the cochlea. This amplification is mediated by the outer hair cells (OHCs), which generate force to enhance the vibrations of the surrounding structures. While OHCs at a given location only amplify basilar membrane motion for a narrow frequency range, recent measurements show that the amplification of motions deeper within the organ of Corti is much more broadband. However, the extent to which this broadband amplification influences the motions that are most relevant to inner hair cell stimulation - i.e., at the organs apical surface - remains uncertain. Here, optical coherence tomography was used to demonstrate that OHCs nonlinearly amplify the motions near the top of the organ of Corti, including at the reticular lamina and tectorial membrane, over a wide frequency range in the mouse cochlear apex. Responses at all frequencies were physiologically vulnerable and grew compressively with stimulus level. Low-frequency responses also exhibited non-monotonic features that were due to interference between amplified motion and the underlying traveling wave. The data suggest that broadband amplification of motions at the top of the organ of Corti likely explains certain phenomena observed in auditory nerve responses.

Background: Speech-in-noise (SIN) perception is a difficult everyday listening task that becomes more difficult with age. Neural tracking of target speech is associated with successful speech perception in clean and noise-degraded listening environments. How aging impacts neural tracking of speech and relates to behavioral decrements in older adults' SIN perception remains unclear. To address these questions, we measured neural speech tracking during a continuous SIN perception task in younger and older adults via multichannel EEG. Method: Participants (n=83) monitored a continuous stream of syllables (~4.5 Hz) presented in quiet and noise conditions during EEG recordings. We assessed neural phase-locking value (PLV) to the acoustic speech envelope to investigate interactions between aging, hearing loss, and stimulus noise on neural synchronization to speech. Results: Compared to younger adults, older adults demonstrated less behavioral sensitivity to noise effects than young adults and had higher overall PLV to target speech. Older adults also showed greater noise-related degradations in neural speech processing relative to younger listeners. Age remained a strong predictor of behavioral responses to speech even after controlling for hearing loss. Covarying for hearing loss removed most age-related effects on neural PLV. Conclusion: Older adults demonstrate overexaggerated neural tracking to ongoing speech presented in quiet and greater noise-related reductions in neurobehavioral speech processing than young adults. Our results support the decline-compensation hypothesis, corroborate unusually large speech envelope encoding in older listeners, and suggest more robust neural synchronization to the speech signal is not always perceptually advantageous.

Auditory brainstem responses (ABRs) are a core part of objective functional evaluations of hearing sensitivity and subcortical auditory transmission. Manual assessments of ABR waveforms are still a primary means by which thresholds and peak amplitudes and latencies are measured, which is time-consuming and prone to user variability. Automated methods have offered promising alternatives for ABR classification, but they have sometimes been limited in accuracy or robustness. Here, we developed and tested a supervised convolutional neural network (CNN) based ABR peak classifier that works across sound levels and sound frequencies that can be run quickly on a personal computer using single or dual-channel ABR inputs. For ABR peaks I, III, IV, and V, the classifier achieved over 95% accuracy. High accuracy was maintained even after noise-exposure causing temporary or permanent threshold shifts, and over 90% of peaks were within 0.041 ms (1 sample) of the manually identified peak. Only a few hundred samples were needed to train the network, making it widely amenable to smaller data studies or where the number of subjects or sessions may be low.

Intrinsic lateral olivocochlear (iLOC) neurons provide vital brainstem efferent feedback to the cochlea in order to modulate hearing sensitivity through synapses onto type-I spiral ganglion neurons. During ageing or mutations affecting hair cell transduction in mice, efferent neurons rewire to form direct axo-somatic synapses onto inner hair cells (IHCs), recapitulating a synaptic configuration typically only restricted to the immature cochlea. Whether this rewiring reflects a compensatory mechanism or some form of attempted repair, or how iLOC biophysics change throughout ageing and this rewiring process, is not known. We utilised whole-cell patch-clamp electrophysiology to investigate iLOC activity and their underlying biophysics across the wild-type mouse lifespan. We show that iLOC neurons undergo a progressive increase in excitability with post-natal development and ageing, producing more spikes for a given stimulus. This intrinsic excitability shift was driven by the developmental decline in the A-type Kv4 mediated potassium current and increase in Kv2 mediated current. In ageing animals, and distinct from post-natal development, further increased firing rates were supported by an increased size of the fast-activating Kv3 current. Spontaneous bursting activity remained present in ageing iLOC neurons, and no reversion to an immature biophysics profile was evident. Interestingly, despite robustly eliciting efferent rewiring of IHCs, an accelerated ageing-like re-innervation genetic model did not recreate the biophysical changes in the iLOC neurons that reflected the ageing system. This work reveals distinct processes occurring within the iLOC feedback system, and shows that age-related enhancements of SGN resting activity are not triggered by deficits in IHC transduction.

PurposeThis research sought to develop a low-cognitive-load speech-in-noise test based on consonant confusions with the potential for assessing hearing-aid benefit. MethodsVowel-consonant-vowel (VCV) stimuli with added speech-shaped noise were presented as a closed-set consonant identification task. Initially, consonant-confusion matrices were used to select, from a larger set of consonants and vowel contexts, a set of ten consonants and associated signal-to-noise ratios (SNR) that were sensitive to hearing loss. The sensitivity of the qVCV test to hearing loss was validated by comparing predicted pure-tone average (PTA) hearing thresholds with their audiometric PTA. Clinical viability of the qVCV test was assessed by comparisons to the QuickSIN test. Hearing-aid benefit was assessed by comparing test scores in unaided and aided conditions. ResultsThe consonants most sensitive to hearing loss were /b d g t k v z s [esh] n/ in the vowel context /[a]/. A cross-validated prediction of PTA had a mean-absolute error of 5.7 dB. The repeatability of qVCV at 50 trials was equivalent to the QuickSIN average of two lists. Hearing-aid benefit was quantified as a decibel reduction in hearing loss. ConclusionsqVCV and QuickSIN performed similarly when test times are equated. The advantages of qVCV include lower cognitive demand, fewer learning effects, and automated scoring. PTA predicted by qVCV which greatly exceeds audiometric PTA may indicate either cognitive deficits or cochlear neural degeneration. The qVCV quantification of hearing-aid benefit may have clinical value.

Understanding speech in noisy environments relies strongly on binaural cues such as interaural time differences (ITDs) and interaural level differences (ILDs), which support spatial hearing and the segregation of competing sound sources. When these cues are degraded, listeners experience substantial difficulty in complex acoustic environments. Behavioural measures of binaural benefit, such as binaural masking level differences (BMLDs), binaural intelligibility level differences (BILDs), and spatial release from masking (SRM), are well established in normal-hearing (NH) listeners, but they require an active behavioural response. Neural speech tracking using electroencephalography (EEG) has emerged as a promising approach for quantifying neural processing of continuous speech, yet its sensitivity to spatial hearing cues remains insufficiently characterised. In this study, we investigated the neural correlates of spatial release from masking in NH listeners using EEG-based neural speech tracking. Nineteen participants listened to continuous Dutch speech stories presented with masking noise under two spatial configurations, collocated (S0N0) and spatially separated (S0N90), across multiple signal-to-noise ratios (SNRs). Neural tracking of the speech envelope was quantified using both envelope reconstruction and temporal response function (TRF) analyses. Spatial separation enhanced neural tracking of the target speech envelope, particularly at challenging SNRs where behavioural SRM was also observed. TRF analysis further revealed condition-dependent morphologies, including increased amplitudes and decreased latencies of late cortical components consistent with spatial unmasking effects. These neural differences were most pronounced at low SNRs, where spatial cues provide the greatest perceptual benefit. Together, these findings demonstrate that neural speech tracking captures cortical signatures of spatial unmasking and closely reflects behavioural improvements in speech understanding. Establishing these relationships in NH listeners supports the development of objective neural measures for evaluating binaural benefit in difficult-to-test populations.

Cochlear implants (CIs) restore hearing by stimulating auditory neurons to encode amplitude envelopes across frequency bands, providing essential cues for speech recognition. This study investigated how stimulation pulse rate constrains temporal envelope processing and speech cue perception in ten post-lingually deaf CI users by evaluating amplitude modulation (AM) detection thresholds and consonant identification performance across pulse rates. The effects of pulse rate on temporal processing and speech perception were examined using both standard clinical multi-channel strategies and single-channel strategies designed to isolate within-channel envelope representations. Results revealed a significant decline in AM detection and consonant recognition performance at the lowest tested pulse rate of 125 pulses per second (pps), consistent with perceptual constraints on temporal processing at low carrier rates, rather than inadequate envelope sampling. At the highest pulse rate of 4000pps, a non-significant reduction in AM detection was observed which may be consistent with previously reported reductions in amplitude discrimination at high pulse rates. Consonant recognition performance remained stable across clinically relevant pulse rates (250-2000pps), though listener-specific pulse rate effects were observed. Notably, significant correlations were found between single-channel and multi-channel performance in AM detection and consonant recognition tasks. These findings support an important contribution of within-electrode temporal envelope processing to multi-channel speech perception and highlight the clinical relevance of individual variability in pulse rate effects.

Aminoglycoside (AG) antibiotic safety is limited by ototoxicity, the mitigation of which is vital considering bacterial resistance mediated erosion of our antibiotic arsenal. Previously, we observed tectorial membrane (TM) sequestration of Ca2+. We hypothesized that the TM sequesters other cations, including the AG gentamicin. We proposed to test the effect of TM genetic ablation on ototoxicity and TM-AG sequestration. After intraperitoneal AG-furosemide, TM-lacking Tecta{Delta}ENT/{Delta}ENT mice showed limited outer hair cell loss, unlike wildtype littermates. Spectroscopy measurements of gentamicin-Texas red (GTTR) were made in isolated wildtype and TectaY1870C TMs and guinea pig cochleae following direct or intraperitoneal GTTR administration. TM-GTTR sequestration was observed in all cases, while negatively correlated with TectaY1870C zygosity. In summary, we discovered a novel TM component in the AG ototoxicity pathway. Intact TM structure is necessary for sequestration, and the TM modulates AG ototoxicity. TM-GTTR sequestration following systemic injection indicates that this phenomenon occurs during AG therapy. Single sentence summaryOtotoxic aminoglycosides collect inside the acellular tectorial membrane of the inner ear, likely due to electrostatic interactions, and the structural status of that membrane modulates the toxic effect of those aminoglycosides on sensory hair cells.