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Trends in Hearing

SAGE Publications

Preprints posted in the last 30 days, ranked by how well they match Trends in Hearing's content profile, based on 15 papers previously published here. The average preprint has a 0.01% match score for this journal, so anything above that is already an above-average fit.

1
Context effects in pitch discrimination reflect response bias not sensory bias

Dirks, C. E.; Guest, D. R.; Oxenham, A.

2026-07-03 neuroscience 10.64898/2026.07.02.735981 medRxiv
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Context effects are ubiquitous across sensory systems and reflect a general encoding principle for both simple and complex stimuli. One simple context effect, contraction bias, manifests in two-interval perception tasks as a bias of the perceived magnitude of the first stimulus toward the center of the overall magnitude range. The underlying cause of contraction bias is unclear. One explanation is that a listeners magnitude estimate of the first stimulus is combined with a perceptual anchor, usually the mean stimulus magnitude, biasing it toward the anchor (sensory model). An alternative explanation is that a listeners response criterion shifts, based on the magnitude of the stimulus pair, relative to the mean magnitude of the stimuli range (decision model). Two pitch-discrimination experiments were performed to test these hypotheses in the auditory domain. The first was a forced-choice discrimination task, where listeners were asked to identify the higher or lower tone in a pair. The second was a same-different task where listeners indicated whether or not the two tones in a pair differed in frequency. Contraction bias was observed in the higher-lower discrimination task, even after extensive perceptual training with feedback. In contrast, no contraction bias was observed in the same-different task. Computational models of the sensory and decision hypotheses were fit to data from both experiments. The sensory model captured the pattern of results the higher-lower experiment but erroneously predicted a contraction bias in the same-different task. The decision model produced similar predictions to the sensory model in the higher-lower task but correctly predicted no contraction bias in the same-different task, and produced lower prediction errors and more stable parameter estimates in both paradigms. Overall, the results suggest that the underlying nature of the contraction bias may reflect decision, rather than sensory, biases based on the context.

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Automated auditory brainstem response peak estimation using a convolutional neural net

Marrone, J. P.; Ziliak, M. C.; Bartlett, E. L.

2026-07-06 neuroscience 10.64898/2026.06.30.735643 medRxiv
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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.

3
Neural Tracking of Speech Envelope as an Index of Spatial Release from Masking

Galeano-Otalvaro, J.-D.; Dieudonne, B.; Francart, T.; Wouters, J.

2026-07-02 neuroscience 10.64898/2026.06.29.734758 medRxiv
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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.

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Tune Out: A randomised controlled trial to investigate the impact of an online program on tinnitus severity, handicap, and psychological symptoms in adults with tinnitus.

Laird, E. C.; Gosbell, D.; Dall'Est, A.; Malicka, A.

2026-07-08 otolaryngology 10.64898/2026.07.05.26357341 medRxiv
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Objective: To evaluate the efficacy, engagement, and usability of Tune Out, an unguided, self-paced online tinnitus management program, for reducing tinnitus severity in adults with tinnitus. Design: A two-arm, parallel-group randomised controlled trial was conducted with Australian adults reporting diagnosed or self-reported tinnitus. Participants were randomised to immediate access to Tune Out or a waitlist control group. Outcomes were assessed at baseline, 6 weeks, and 12 weeks. The primary outcome was tinnitus severity measured using the Tinnitus Functional Index (TFI). Secondary outcomes included tinnitus handicap, psychological symptoms, program engagement, self-efficacy, and usability. Results: Eighty-eight participants were randomised: 43 to the intervention group and 45 to the waitlist control group. The primary outcome analysis included 63 participants at 12 weeks. A significant Group x Time interaction was observed for TFI total score, indicating greater reductions in tinnitus severity over time in the intervention group compared with waitlist control, F(2, 102.57) = 5.95, p = .004, partial 2= .104. Significant effects were also observed for tinnitus handicap, F(2, 106.76) = 4.12, p = .019, partial 2 = .072. Effects on psychological symptoms were less consistent, although anxiety showed a significant Group x Time interaction, F(2, 116.85) = 3.63, p = .030, partial 2 = .059. At 12 weeks, 23.1% of intervention participants achieved a clinically meaningful reduction in tinnitus severity compared with 5.4% of controls. Program use was highly variable, with a median use of 1.10 hours, and 25.6% of intervention participants recording no use. Usability ratings were favourable among respondents, with a mean System Usability Scale score of 73.13. Conclusions: Tune Out demonstrated preliminary efficacy for reducing tinnitus severity and tinnitus handicap compared with waitlist control. Effects on broader psychological symptoms were less consistent. Although usability was rated positively, low and variable engagement highlights the need for strategies to support uptake and sustained use in unguided digital tinnitus interventions.

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Within-electrode temporal envelope processing predicts multi-channel speech outcomes across cochlear implant pulse rates

Azadpour, M.; Neukam, J.; Capach, N.; Svirsky, M.

2026-06-29 neuroscience 10.64898/2026.06.24.734273 medRxiv
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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.

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Articulatory timing and form support distinct neural benefits during audiovisual speech

Nidiffer, A.; O'Sullivan, A.; Lalor, E. C.

2026-07-15 neuroscience 10.64898/2026.07.14.738583 medRxiv
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In noisy environments, visible speech articulations improve listening comprehension. The benefit derives from several sources, including articulatory timing and shape. Recent research has shown that visual cortex encodes a categorical representation of articulatory features and that visual speech can benefit both acoustic and phonetic feature processing separately. The present study advances the hypothesis that the shape of the articulators specifically influences the categorization of auditory speech in terms of its phonetic features. We tested this by linearly modeling electroencephalographic responses to natural, continuous speech (in noise) in terms of the acoustic and articulatory features of the speech. We compared the performance of these models in conditions where the speech was accompanied by a natural video of the speaker with their mouth visible, and a video where their mouth was covered by a dynamic ellipse obscuring articulatory shape but preserving dynamics. The dynamic mask reduced comprehension, neural processing of phonetic features, the associated multisensory benefits, and indices of visual-only linguistic processing over occipital scalp. Our findings support substantial visual involvement in speech comprehension, derived largely from the shape of the articulators. They also corroborate several proposals involving audiovisual speech processing hierarchy and the nature of the information contained in visible speech. HighlightsO_LIVisual speech provides at least two forms of information to enhance acoustic speech processing: redundant temporal dynamics and complementary articulatory information C_LIO_LICovering the mouth with a dynamic mask preserves horizontal and vertical lip movement information, but largely removes articulatory detail C_LIO_LIVisual speech with a mask preserves some general multisensory benefits but removes visual linguistic information and its ability to enhance auditory processing at the level of phonetic features. C_LI

7
Physiological limits of localized hypothermia in the human cochlea: The role of vascular heat transport

McCorkendale, B.; Rodriguez, R.; Fink, R.; Moore, M.; Romero, S.; Esmailie, F.

2026-07-15 bioengineering 10.64898/2026.07.14.738525 medRxiv
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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.

8
Revisiting Analog Electrical Stimulation with Current Focusing in a Guinea Pig Model of Cochlear Implants.

Adenis, V.; Bartholomew, R. A.; Lee, J.-I.; Jung, A.; Brown, M. C.; Fried, S. I.; Lee, D. J.; Arenberg, J. G.

2026-07-08 neuroscience 10.64898/2026.07.02.735566 medRxiv
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Modern cochlear implants (CIs) use pulsatile stimulation to restore hearing for individuals with severe hearing loss. CIs provide robust speech recognition in quiet but poorly represent temporal fine structure (TFS), needed for challenging listening situations. Analog stimulation preserves the acoustic waveform and may better encode TFS, yet it has not been evaluated combined with modern current-focusing strategies. We compared neural responses in the inferior colliculus (IC) evoked by CI stimuli consisting of 100 pulses/s biphasic pulse trains and 100 cycles/s sinusoidal analog stimulation with monopolar, bipolar, and tripolar electrode configurations in urethane-anesthetized guinea pigs. Following cochlear implantation, multiunit activity was recorded from the tonotopic axis of the central nucleus of the IC using 16-channel silicon probes. Detection thresholds, spread of excitation, vector strength, sustained response percentage, and temporal response properties were quantified. Analog stimulation consistently evoked significantly lower activation thresholds than pulsatile stimulation while maintaining comparable or sometimes narrower spatial selectivity across stimulation modes. In contrast, analog stimulation generated lower vector strength, larger tonic response components, and a pronounced level-dependent polarity effect. At low stimulus levels, responses were dominated by the cathodic phase of the sinusoidal waveform, whereas increasing stimulus level responses were elicited by both phases, producing synchronization at twice the stimulus frequency. These findings demonstrate that stimulation waveform strongly influences temporal coding while having relatively little effect on the spatial distribution of neural activation. These results provide a physiological basis for reexamining analog stimulation as an alternative strategy for cochlear implant sound coding.

9
Perceptual consistency in phoneme categorization is driven by neural consistency and predicts improved speech-in-noise performance

Rizzi, R.; Stirn, J. R.; Eisenhut, Z.; Bidelman, G. M.

2026-07-03 neuroscience 10.64898/2026.07.02.736174 medRxiv
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Listeners discretize the speech signal by assigning sounds to phonetic categories, though there is variability in how individuals accomplish categorization. Having more consistent categorization of sounds may be advantageous for understanding speech-in-noise (SIN). Though, it is unclear how different levels of neural processing in the auditory system reflect these perceptual differences. We recorded brainstem frequency-following responses (FFRs) and cortical event-related potentials (ERPs) while listeners actively labeled vowels along an acoustic-phonetic continuum using a visual analog scale. We computed intertrial consistency of neural responses to index the stability of listeners' neural speech representations across stimulus presentations. We also assessed how faithfully midbrain and cortical responses represented stimulus acoustics using representational dissimilarity matrices (RDMs) computed across all token pairs. Neural RDMs were then compared with acoustic and phonetic category RDMs to assess whether FFRs and ERPs carried gradient vs. categorical information of the speech signal. We found greater behavioral consistency during phoneme labeling was correlated with improved SIN scores. Neurally, we found greater cortical or subcortical consistency predicted greater behavioral consistency. RDMs revealed subcortical responses retained more acoustic details, while cortical responses more closely reflected abstract phoneme categories. Our findings reveal important benefits of perceptual consistency to other domains of speech perception. We find perceptual consistency is driven by more consistent encoding of speech at either a cortical or subcortical level. More consistent sensory processing could provide a more stable readout of the speech signal to higher cortical brain areas which could confer advantages to later perceptual processes downstream.

10
The Listening Effort Profile of Eye Movements: Easy, Difficult, and Impossible Speech Comprehension

Herrmann, B.; Fink, L. K.; Pandey, P. R.; Johnsrude, I.; Ryan, J. D.

2026-07-03 neuroscience 10.64898/2026.06.30.735702 medRxiv
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Speech comprehension in noisy environments often requires cognitive effort, but listeners may disengage when comprehension becomes impossible. Eye movements have recently emerged as a promising new measure of listening effort, but it remains unclear whether eye movements are sensitive to the full effort profile across easy, difficult, and impossible speech comprehension. Across four experiments, participants listened to sentences at easy, difficult, and impossible levels of multi-talker background babble while pupil size and eye movements were recorded. Pupil size generally followed the expected inverted u-shaped effort profile: low for easy speech, maximal for difficult but still intelligible speech and lower again for impossible speech, although this pattern partly reflected sustained, condition-specific differences and not only sentence-evoked responses. Gaze dispersion - measuring the spread of eye movements - decreased with high temporal selectivity during difficult relative to easy and impossible speech, indicating reduced eye movements during active, effortful listening. However, gaze dispersion was also lower, but less temporally selective, during impossible compared to easy listening, especially in non-baseline-corrected analyses, suggesting that reduced eye movements do not index listening effort uniquely. Instead, eye movements appear to reflect both attentional engagement during difficult listening and disengagement or inward attention when meaningful listening is no longer possible. These findings indicate that pupil size and eye movements provide complementary indices of listening-related cognition, and highlight the integration of listening, cognition, and motor systems.

11
Sonification of Elephant Infrasound

Bozdogan, A.; Aarts, R. M.

2026-07-08 bioengineering 10.64898/2026.07.07.736953 medRxiv
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Elephants and other large mammals produce low-frequency vocalizations extending well below the 20 Hz lower limit of human hearing, a regime known as infrasound. These rumbles serve vital social and reproductive functions over distances of several kilometers, yet they are inaudible to human observers and cannot be reproduced by conventional small loudspeakers. We present a complete signal-processing pipeline that renders sub-20 Hz elephant rumbles perceptible through a small loudspeaker by exploiting the missing-fundamental psychoacoustic effect. Butterworth bandpass filters isolate the infrasonic content; a full-wave integrator nonlinear device (NLD) generates the harmonic series required for virtual pitch perception; and a hysteresis-comparator fundamental-frequency estimator normalizes the NLD output. The pipeline was validated on African elephant field recordings and deployed on a credit-card-sized, low-cost single-board computer with an infrasound microphone and a small Bluetooth loudspeaker, demonstrating live operation in the field. The processed output shows a 10 dB to 15 dB elevation in the loudspeakers efficient band during call segments compared with background. The system enables zoo visitors and wildlife observers to perceive elephant rumbles in real time, opening new avenues for behavioral studies and public engagement with animal communication.

12
Speech clarity shapes auditory attention and visual-signal coupling during multimodal sentence comprehension

Husta, C.; Seijdel, N.; Drijvers, L.

2026-07-14 neuroscience 10.64898/2026.07.13.738151 medRxiv
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Face-to-face communication requires listeners to attend, integrate, and weigh multiple communicative signals, including auditory speech, mouth movements, and co-speech gestures. The contribution of these signals may depend on the reliability of auditory input and the informativeness of the available signals. We utilized rapid invisible frequency tagging (RIFT) with EEG to examine how participants attend to and integrate these different signals in clear and adverse listening conditions. Participants watched videos of an actress producing clear or noise-vocoded sentences. Auditory speech was amplitude-modulated at 58Hz, while the luminance of the gesture and mouth regions was frequency-tagged at 63Hz and 65Hz. Degraded speech elicited stronger responses at the auditory tagged frequency, suggesting increased attentional gain to the auditory signal when listening was challenging. In contrast, clear speech elicited stronger responses at the gesture tagged frequency and a stronger 2Hz intermodulation response (65-63Hz), reflecting enhanced nonlinear coupling between mouth movements and gestures. Finally, in degraded speech, the informativeness of mouth movement, but not gesture, was associated with intermodulation strength, suggesting that the informativeness of mouth movements plays a greater role in multisensory interaction when listening is challenging. Our findings demonstrate that both signal reliability and informativeness shape multisensory integration during spoken language comprehension.

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Older adults show overexaggerated and larger noise-related degradation in their neural tracking of speech

MacLean, J.; Bidelman, G.

2026-07-03 neuroscience 10.64898/2026.07.03.736364 medRxiv
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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.

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Effect of tempo on newborns' neural processing of auditory rhythm: Emergence of sensitivity to metrical structure

Edalati, M.; Psaris, M.; Gallard, A.; Foulon, A.; Wallois, F.; Tillmann, B.; Trainor, L.; Moghimi, S.

2026-07-08 neuroscience 10.64898/2026.07.07.736947 medRxiv
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Rhythm perception ability underpins music and language processing, and its developmental origins trace back to the earliest periods of life. While most rhythm patterns contain a variety of inter-onset intervals, listeners typically extract a steady underlying beat periodicity, as well as beat grouping periodicities (groups of two or three beats will be at frequencies 1/2 or 1/3, respectively, of that of the primary beat), forming a metrical hierarchy. While the developing brain can track auditory rhythm before birth, a previous study found that neural sensitivity to faster beat-related periodicities emerges early in third trimester of gestation, whereas encoding of slower metrical structure periodicities only appears closer to term birth. However, as rhythm patterns were only presented at one tempo, neural sensitivity to metrical structure could not be disentangled from sensitivity to tempo during early development. Thus, here we presented auditory rhythmic sequences at two different tempi and used high-resolution electroencephalography to measure neural sensitivity to their encoding in full-term newborns and young adults. Adults demonstrated a similar sensitivity to metrical structure across tempi, with greatest response at the duple metrical frequency regardless of tempo. Newborn neural responses, by contrast, were tempo-dependent, displaying markedly different response patterns across beat and meter frequencies at the different tempi. Together, these results reveal that tempo and metrical structure interact in shaping how the neonatal brain encodes auditory rhythm, suggesting that early neural processing may be constrained in its ability to track slower periodicities, and highlighting a developmental shift in the relative contributions of tempo and metrical structure to rhythmic processing.

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Motor signals modulate cortical but not subcortical processing of self-initiated sounds

Raiff, L.; Butler, G.; McFarlane, K.; Chandrasekaran, B.; Sitek, K. R.

2026-07-11 neuroscience 10.64898/2026.07.10.737812 medRxiv
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When we produce sounds ourselves, the brain modulates the auditory neural response through an efference copy mechanism, allowing us to distinguish between self-initiated and externally generated auditory inputs. However, the precise level of the auditory pathway at which this attenuation occurs remains unclear. While evidence from animal models suggests that early auditory processing of self-generated sounds may be modulated by corticofugal signaling, localized cortical modulation would preserve the high-fidelity subcortical sound encoding while allowing flexible, context-dependent processing at higher levels. To probe potential motor influences in the early auditory system, we collected scalp-recorded frequency following responses (FFRs) from 33 normal-hearing adults during active (self-initiated) and passive (externally presented) listening conditions using a 170 ms speech stimulus. Data were collected with a vertical montage that emphasizes subcortical generators of the FFR. We observed no significant differences in the FFR between active and passive conditions in spectral power, response amplitude, pitch tracking, onset latency, or phase consistency. In contrast, cortical event-related potentials showed motor-induced suppression (MIS): reduced early peak amplitudes in the active condition after correcting for motor signals, increased phase consistency prior to auditory feedback, and more precise phase consistency at sound offset. In addition to indicating FFRs can be collected during a wider range of behavioral tasks without substantial motor contamination, our observation of the canonical MIS in cortical signals but not in FFRs suggests that MIS of self-initiated sounds primarily affects later stages of auditory processing rather than the early encoding reflected in the FFR.

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Differential Recovery Trajectories of Emergency Otolaryngologic Conditions across the COVID-19 Pandemic: A Six-year Longitudinal Study from an Urban Emergency Center

Ogawa, M.

2026-06-23 otolaryngology 10.64898/2026.06.20.26356151 medRxiv
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Objective: The COVID-19 pandemic markedly altered social activity patterns, healthcare utilization, and the epidemiology of infectious diseases. However, its long-term impact on emergency otolaryngologic conditions remains incompletely understood. This study investigated long-term trends in emergency otolaryngologic conditions before, during, and after the COVID-19 pandemic using comprehensive data from a large urban emergency clinic in Osaka, Japan. Methods: All new otolaryngologic outpatients who visited the Chuo Emergency Medical Clinic (CEMC) in Osaka City between 2019 and 2024were retrospectively analyzed. Annual trends in absolute numbers and relative proportions of emergency otolaryngologic conditions were examined by anatomical region and disease category, using 2019 as the pre-pandemic baseline. Results: A total of 99,324 new otolaryngologic outpatients were analyzed. Overall emergency visits declined sharply to approximately half of baseline in 2020, followed by a gradual but incomplete recovery toward pre-pandemic levels by 2024. Most anatomical categories declined to 45-61% of baseline in 2020 and exhibited gradual yet incomplete recovery through 2023; in stark contrast, laryngeal conditions diverged sharply, surging beyond pre-pandemic levels after 2022. Acute infectious otorhinolaryngologic diseases fell to 23-50% of baseline in 2020 and showed variable recovery (69-103%) by 2024. Notably, laryngitis exceeded the baseline, reaching 132% in 2023, whereas epiglottic edema exhibited only a transient increase approaching the baseline in 2021. Non-infectious emergency conditions generally showed only a marginal decrease in 2020 and remained relatively stable throughout the study period, except for sudden sensorineural hearing loss (SSNHL), which dropped sharply to 39% of the baseline in 2020 and remained persistently reduced through 2024. Traumatic emergencies declined variably to 53-81% of the baseline in 2020, followed by an incomplete recovery, reaching only 55-69% by 2024. Conclusion: Emergency otolaryngologic conditions demonstrated heterogeneous recovery trajectories following the COVID-19 pandemic. While most infectious and traumatic conditions gradually but incompletely normalized, laryngeal conditions showed a distinct post-pandemic surge, and SSNHL remained persistently suppressed. These findings reveal heterogeneous, condition-specific recovery trajectories that reflect both genuine shifts in community pathogen burden, true traumatic incidence, and persistent alterations in healthcare-seeking behaviors, insights essential for resource allocation during future public health emergencies.

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Effects of Tempo, Dynamics, and String on Physical Exposure in Professional Violinists

Fan, X.; Mathiassen, S. E.; Johansson, P. J.; Jackson, J. A.; Nyman, T.

2026-07-03 bioengineering 10.64898/2026.06.29.735269 medRxiv
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This study examined how tempo, dynamics, and string influence upper-extremity physical exposure in professional violinists and how exposure variability is distributed among musical characteristics, between-subject differences, and residual variability. Twelve violinists performed seven standardized scales while bilateral upper-arm and wrist kinematics and shoulder and forearm muscle activity were recorded. Linear mixed-effects models showed that faster tempo increased right upper-arm velocity and bilateral forearm activity while reducing right upper-arm and wrist ranges of motion. Louder dynamics increased bilateral forearm and right trapezius activity and right-wrist ranges of motion. Higher-posture strings increased right upper-arm elevation and right shoulder muscle activity. Variance analysis identified exposures predominantly related to musical characteristics, jointly related to musical characteristics and between-subject differences, predominantly related to between-subject differences, or mainly unexplained. These findings support future exposure prediction from musical characteristics and targeted prevention through repertoire-based workload management, structured recovery, and individualized technique-focused strategies.

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Connexin 30 mutation rescues high-frequency hearing, reduces gap junctional coupling and alters potassium currents in cochlear Deiters cells

Simoes, P.; Lukashkina, V. A.; Lukashkin, A. N.; Levic, S.; Russell, I. J.

2026-07-09 neuroscience 10.64898/2026.07.04.736514 medRxiv
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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.

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Presynaptic mitochondria calcium uniporter promotes auditory temporal processing during sustained high-rate activity

Li, G.; Xie, R.

2026-06-25 neuroscience 10.64898/2026.06.21.733581 medRxiv
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Mitochondrial calcium uniporter (MCU) uptakes calcium into mitochondria to maintain intracellular calcium homeostasis, malfunction of which has been implicated in altered neuronal signaling and disease. Its role in synaptic transmission remains understudied, especially in intact neural circuits. We investigated MCU function at the auditory nerve endbulb of Held synapse and postsynaptic bushy neurons in the cochlear nucleus, using age-matched control and MCU knockout (KO) mice of either sex. Whole-cell voltage- and current-clamp recordings were acquired from acute brain slices to examine synaptic transmission and postsynaptic responses. We found that basal synaptic properties at the endbulb of Held were unchanged in MCU KO mice, whereas synaptic transmission during sustained high-rate activity was significantly altered with a shift toward increased asynchronous release. Similarly, MCU deficiency did not change the intrinsic membrane properties of postsynaptic bushy neurons, but significantly reduced the temporal precision of auditory nerve evoked spikes trains at high rates. These results demonstrate that MCU is largely dispensable under low-rate activity, presumably because its activation requires relatively high calcium concentrations. In contrast, during sustained high-rate activity, MCU becomes an important regulator of synaptic function by reducing asynchronous neurotransmitter release under elevated intracellular calcium. Particularly in the auditory system, where neurons routinely fire at high rates, MCU promotes temporal processing and thereby plays a key role in supporting auditory function. It suggests that impaired MCU function under pathological conditions may be an important mechanism underlying central auditory processing deficits, and consequently contributes to hearing loss

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Modeling human echolocation using a Kalman filter

Krasovskaya, S.; Coughlan, J. M.; Teng, S.

2026-07-07 neuroscience 10.64898/2026.07.01.735693 medRxiv
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Some blind individuals use echolocation, a skill that allows them to better navigate their environment using echoes from self-generated mouth clicks reflected off surrounding surfaces. Echolocation involves a complex interplay of sensory accumulation, information processing, dynamic prediction, motor planning and execution in real-time. Computational modeling offers a valuable approach to understanding the cognitive and neural mechanisms underlying echolocation performance, in particular the temporal dynamics of the process. We present a computational model of human echolocation behavior based on a Kalman filter, where we treat the echolocator as an active sensor that maintains an internal belief about the target's location and continuously refines it via echo feedback. The model, based on observations of echolocation in blind human experts, simulates the use of mouth clicks and returning echoes to localize and orient toward a target under varying conditions. In the experiment, the target is placed at a random azimuth in the frontal plane. An echolocator aims a series of mouth clicks in various directions and infers the target azimuth using acoustic information received from the click echoes. The system integrates three major components: (1) a simulation of echoacoustic interaural time differences (ITD) to estimate the relative head-target angle; (2) a Kalman filter that processes these ITDs to iteratively update probabilistic beliefs about target location and associated uncertainty; and (3) a motor control system that modulates head movements with the current belief state. The Kalman filter serves as a representation of the internal state of the observer, where its beliefs drive the direction of head rotation, and its uncertainty estimates drive head velocity adjustments. Model performance demonstrates that simple predictive computational approaches can reproduce key aspects of echo-guided sensorimotor learning, providing a framework that may be leveraged to develop biologically plausible models, advance understanding of best practices, and potentially improve intervention strategies.