| 1. |
- Andersson, Gerhard, et al.
(author)
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Tinnitus Distress, Anxiety, Depression, and Hearing Problems among Cochlear Implant Patients with Tinnitus
- 2009
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In: JOURNAL OF THE AMERICAN ACADEMY OF AUDIOLOGY. - : Georg Thieme Verlag KG. - 1050-0545 .- 2157-3107. ; 20:5, s. 315-319
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Journal article (peer-reviewed)abstract
- Background: While several studies have investigated the presence and annoyance of tinnitus in cochlear implant (CI) recipients, few studies have probed the handicap experienced in association with tinnitus in this population. Purpose: The aim of this study was to use validated self-report measures in a consecutive sample of Cl patients who reported tinnitus in order to determine the extent of tinnitus handicap. Research Design: In a retrospective design, a total of 151 patients (80% response rate) responded to a postal questionnaire, and of these, 111 (74%) reported that they currently experienced tinnitus and were asked to complete the full questionnaire. Sampling was performed at a point of a mean 2.9 years postsurgery (SD = 1.8 years). Three established self-report questionnaires were included measuring tinnitus handicap (Tinnitus Handicap Inventory [THI]) hearing problems (Gothenburg Profile), and finally, a measure of anxiety and depression (Hospital Anxiety and Depression Scale). We analyzed the data by means of Pearson product moment correlations, Mests, ANOVAs, and chi-square. Results: Data from the validated questionnaires showed relatively low levels of tinnitus distress, moderate levels of hearing problems, and low scores on the anxiety and depression scales. Using the criteria proposed for the THI (which was completed by 107 patients), 35% (N = 38) had a score indicating "no handicap," 30% (N = 32) "mild handicap" 18% (N = 19) "moderate handicap", and 17% (N = 18) "severe handicap." Thus 37 individuals from the total series of 151 reported moderate to severe tinnitus handicap (24.5%). Tinnitus distress was associated with increased hearing problems, anxiety, and depression. Conclusion: Tinnitus can be a significant problem following Cl, but that the experienced distress is often moderate. However, a quarter of Cl recipients do demonstrate moderate/severe tinnitus handicap, and thus are candidates for tinnitus specific therapy. The level of tinnitus handicap is associated with hearing problems and psychological distress.
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| 2. |
- Banh, Jessica, et al.
(author)
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Age Affects Responses on the Speech, Spatial, and Qualities of Hearing Scale (SSQ) by Adults with Minimal Audiometric Loss
- 2012
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In: JOURNAL OF THE AMERICAN ACADEMY OF AUDIOLOGY. - : American Academy of Audiology. - 1050-0545 .- 2157-3107. ; 23:2, s. 81-91
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Journal article (peer-reviewed)abstract
- Background: Age-related declines in auditory and cognitive processing may contribute to the difficulties with listening in noise that are often reported by older adults. Such difficulties are reported even by those who have relatively good audiograms that could be considered "normal" for their age (ISO 7029-2000 [ISO, 2000]). The Speech, Spatial, and Qualities of Hearing Scale (SSQ; Gatehouse and Noble, 2004) is a questionnaire developed to measure a listeners self-reported ability to hear in a variety of everyday situations, such as those that are challenging for older adults, and it can provide insights into the possible contributions of auditory and cognitive factors to their listening difficulties. The SSQ has been shown to be a sensitive and reliable questionnaire to detect benefits associated with the use of different hearing technologies and potentially other forms of intervention. Establishing how age-matched listeners with audiograms "normal" for their age rate the items on the SSQ could enable an extension of its use in audiological assessment and in setting rehabilitative goals. less thanbrgreater than less thanbrgreater thanPurpose: The main purpose of this study was to investigate how younger and older adults who passed audiometric screening and who had thresholds considered to be "normal" for their age responded on the SSQ. It was also of interest to compare these results to those reported previously for older listeners with hearing loss in an attempt to tease out the relative effects of age and hearing loss. less thanbrgreater than less thanbrgreater thanStudy Sample: The SSQ was administered to 48 younger (mean age = 19 yr; SD = 1.0) and 48 older (mean age = 70 yr, SD = 4.1) adults with clinically normal audiometric thresholds below 4 kHz. The younger adults were recruited through an introductory psychology course, and the older adults were volunteers from the local community. less thanbrgreater than less thanbrgreater thanData Collection and Analysis: Both age groups completed the SSQ. The differences between the groups were analyzed. Correlations were used to compare the pattern of results across items for the two age groups in the present study and to assess the relationship between SSQ scores and objective measures of hearing. Comparisons were also made to published results for older adults with hearing loss. less thanbrgreater than less thanbrgreater thanResults: The pattern of reported difficulty across items was similar for both age groups, but younger adults had significantly higher scores than older adults on 42 of the 46 items. On average, younger adults scored 8.8 (SD = 0.6) out of 10 and older adults scored 7.7 (SD = 1.2) out of 10. By comparison, scores of 5.5 (SD = 1.9) have been reported for older adults (mean age = 71 yr, SD = 8.1) with moderate hearing loss (Gatehouse and Noble, 2004). less thanbrgreater than less thanbrgreater thanConclusions: By establishing the best scores that could reasonably be expected from younger and older adults with "normal" hearing thresholds, these results provide clinicians with information that should assist them in setting realistic targets for interventions for adults of different ages.
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| 3. |
- Beukes, Eldre W., et al.
(author)
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Internet-Based Intervention for Tinnitus: Outcome of a Single-Group Open Trial
- 2017
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In: Journal of american academy of audiology. - : AMER ACAD AUDIOLOGY. - 1050-0545 .- 2157-3107. ; 28:4, s. 340-351
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Journal article (peer-reviewed)abstract
- Background: Managing chronic tinnitus is challenging, and innovative ways to address the resulting health-care burden are required. Internet-based cognitive behavioral therapy (iCBT) for tinnitus shows promise as a cost-effective treatment option. The feasibility and effectiveness of iCBT in the United Kingdom are yet to be explored. Furthermore, it is not known if iCBT can be supported by an audiologist rather than a psychologist. Purpose: This study aimed to determine the feasibility of guided iCBT using audiological support on tinnitus distress and tinnitus-related comorbidities. Furthermore, it aimed to establish the feasibility of iCBT for tinnitus distress in the United Kingdom, by determining recruitment, attrition, and compliance rates. Finally, it aimed to identify which aspects of the protocol require refinement for subsequent clinical trials. Research Design: A single-group open trial design was implemented. This study would serve as a prerequisite study, to identify barriers, before undertaking effectiveness trials. Study Sample: Participants consisted of 37 adults (18 males, 19 females), with an age range of between 50 and 59 yr. The mean preintervention tinnitus severity rating was 56.15 (standard deviation = 18.35), which is categorized as "severe tinnitus" as measured by the Tinnitus Functional Index (TFI). Five participants withdrew during the study, and 29 of the remaining participants completed the postintervention questionnaire. Intervention: The guided iCBT intervention ran over an eight-week period and consisted of 16 obligatory modules and five optional modules. The intervention was designed to be interactive, interesting, and stimulating. A key element was the provision of support from an audiologist throughout the program. Data Collection and Analysis: Online questionnaires were used throughout the study. These were administered at baseline and postintervention to determine attrition and compliance rates and to facilitate sample size estimates for further clinical trials. Outcome measures for tinnitus severity, hearing handicap, insomnia, cognitive functioning, hyperacusis, anxiety, depression, and life satisfaction were used to investigate the effects of iCBT with audiological support. In addition, a weekly questionnaire was incorporated to monitor change in tinnitus distress while undertaking the intervention. Results: Feasibility was established using an audiologist to support this guided iCBT intervention, as a significant change postintervention was found for tinnitus severity, as measured by the TFI and the Tinnitus Handicap Inventory, Screening version. The attrition rate was 22% and compliance was variable. Although these results were based on a small sample, they provide encouraging evidence for the feasibility of delivering iCBT treatment for tinnitus symptoms with audiology support in the United Kingdom. Conclusions: An Internet-based intervention of tinnitus appears to be feasible in the United Kingdom when using audiological support. Randomized controlled trials to further investigate the effectiveness of iCBT for tinnitus in the United Kingdom are required.
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| 4. |
- Björsne, Andreas, 1984, et al.
(author)
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When Can Stable AutoNRT Thresholds be Expected? A Clinical Implication When Fitting Young Children.
- 2020
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In: Journal of the American Academy of Audiology. - : Georg Thieme Verlag KG. - 2157-3107 .- 1050-0545. ; 31:1, s. 69-75
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Journal article (peer-reviewed)abstract
- Objective measurements are important for programming cochlear implants in young children and other individuals who cannot participate in behavioral measurements. AutoNRT, the automatic method used to record responses from the auditory nerve in the Cochlear Ltd., implant system, is often used as a basis for estimating the threshold level and comfort level (C-level) for these patients. However, it has not been sufficiently established if AutoNRT measurements remain consistent over time.This study aimed to determine if/when AutoNRT thresholds stabilize.The study design was a longitudinal prospective study.AutoNRT thresholds were obtained from 52 young children and 80 adults. All subjects received the same implant (CI24RE Contour Advance).AutoNRT thresholds were measured on all intracochlear electrodes during the surgery and at the initial activation. During the following year, children were measured at 1, 3, 6, and 12 months, and adults were measured at 6 and 12 months. The results were analyzed based on mean values, correlation, and absolute mean differences.There were large variations for all electrodes between the intraoperative and postoperative AutoNRT thresholds of both children and adults. For children, the thresholds were considered to be stable from 1 month. The correlations obtained between the last two measurements, 6 and 12 months, for both children and adults were generally high for all electrodes.The present results demonstrate the importance of repeating the AutoNRT measurement postoperatively, at about 1 month after initial activation, to obtain reliable and stable thresholds for estimating the T- and C-level profiles.
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| 5. |
- Brännström, Jonas, et al.
(author)
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Acceptance of Background Noise, Working Memory Capacity, and Auditory Evoked Potentials in Subjects with Normal Hearing
- 2012
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In: Journal of the American Academy of Audiology. - : Georg Thieme Verlag KG. - 2157-3107 .- 1050-0545. ; 23:7, s. 542-552
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Journal article (peer-reviewed)abstract
- Background: The acceptable noise level (ANL) test is a method for quantifying the amount of background noise that subjects accept when listening to speech. Large variations in ANL have been seen between normal-hearing subjects and between studies of normal-hearing subjects, but few explanatory variables have been identified. Purpose: To explore a possible relationship between a Swedish version of the ANL test, working memory capacity (WMC), and auditory evoked potentials (AEPs). Research Design: ANL, WMC, and AEP were tested in a counterbalanced order across subjects. Study Sample: Twenty-one normal-hearing subjects participated in the study (14 females and 7 males; aged 20-39 yr with an average of 25.7 yr). Data Collection and Analysis: Reported data consists of age, pure-tone average (PTA), most comfortable level (MCL), background noise level (BNL), ANL (i.e., MCL-BNL), AEP latencies, AEP amplitudes, and WMC. Spearman's rank correlation coefficient was calculated between the collected variables to investigate associations. A principal component analysis (PCA) with Varimax rotation was conducted on the collected variables to explore underlying factors and estimate interactions between the tested variables. Subjects were also pooled into two groups depending on their results on the WMC test, one group with a score lower than the average and one with a score higher than the average. Comparisons between these two groups were made using the Mann-Whitney U-test with Bonferroni correction for multiple comparisons. Results: A negative association was found between ANL and WMC but not between AEP and ANL or WMC. Furthermore, ANL is derived from MCL and BNL, and a significant positive association was found between BNL and WMC. However, no significant associations were seen between AEP latencies and amplitudes and the demographic variables, MCL, and BNL. The PCA identified two underlying factors: One that contained MCL, BNL, ANL, and WMC and another that contained latency for wave Na and amplitudes for waves V and Na-Pa. Using the variables in the first factor, the findings were further explored by pooling the subjects into two groups according to their WMC (WMClow, and WMChigh). It was found that the WMClow had significantly poorer BNL than the WMChigh. Conclusions: The findings suggest that there is a strong relationship between BNL and WMC, while the association between MCL, ANL, and WMC seems less clear-cut.
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| 6. |
- Brännström, Jonas, et al.
(author)
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Clinical Application and Psychometric Properties of a Swedish Translation of the Abbreviated Profile of Hearing Aid Benefit
- 2020
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In: Journal of the American Academy of Audiology. - : Georg Thieme Verlag KG. - 2157-3107 .- 1050-0545. ; 31:9, s. 656-665
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Journal article (peer-reviewed)abstract
- BACKGROUND: The impact of hearing loss on the individual and his/her everyday life can be assessed using questionnaires with the purpose to improve rehabilitation quality. The Abbreviated Profile of Hearing Aid Benefit (APHAB) can be used to evaluate disability in everyday life associated with hearing loss. Previous studies have examined APHAB outcomes in sensorineural hearing loss and we do not know whether the type of hearing loss influence questionnaire outcomes.PURPOSE: The purpose was to evaluate the psychometric properties of a Swedish translation of the APHAB and the influence of demographic variables on the outcome in a clinical sample.RESEARCH DESIGN: A descriptive, cross-sectional study in a clinical sample.STUDY SAMPLE: Forty-eight participants with no hearing aid experience seeking audiological rehabilitation for the first time. These participants represented different degrees of hearing loss and three types of hearing loss: monaural mixed, binaural mixed, and binaural sensorineural hearing loss.DATA COLLECTION AND ANALYSIS: Pure-tone audiometry was conducted and the participants completed the unaided APHAB during their first appointment at the clinic. Psychometric properties of the questionnaire were examined and the influence of age, gender, type of hearing loss, and degree of hearing loss on APHAB scores were studied.RESULTS: The psychometric properties indicate high test-retest reliability but there seems to be some potential issues with the properties of the reverberation (RV) subscale. The items from the RV subscale failed to load as a separate component and the internal consistency of the subscale improved by removing four items (items 1, 9, 11, and 16). With few exceptions, APHAB scores were not influenced by age, gender, or type of hearing loss. APHAB scores were generally influenced by degree of hearing loss in both the best and the worst ear.CONCLUSION: This Swedish version of the APHAB can be additionally improved by addressing the inconsistencies found in the RV subscale by rephrasing or removing some items. The degree of hearing loss has some influence on questionnaire outcomes but not age, gender, and type of hearing loss.
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| 7. |
- Brännström, Jonas, et al.
(author)
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Hearing aid fitting outcome: clinical application and psychometric properties of a Swedish translation of the international outcome inventory for hearing aids (IOI-HA).
- 2010
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In: Journal of the American Academy of Audiology. - : Georg Thieme Verlag KG. - 2157-3107 .- 1050-0545. ; 21:8, s. 512-521
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Journal article (peer-reviewed)abstract
- BACKGROUND: The International Outcome Inventory for Hearing Aids (IOI-HA) is a seven-item hearing-specific questionnaire. It was developed with the purpose of evaluating the efficacy of hearing aid rehabilitation. Few psychometric properties have been presented for a Swedish translation of the IOI-HA. Furthermore, previous studies have examined the IOI-HA in mainly sensorineural hearing losses, and we do not know how the type of hearing loss affects the outcome. PURPOSE: To evaluate the hearing aid fitting outcome measured in a clinical setting using a Swedish translation of the International Outcome Inventory for Hearing Aids (IOI-HA), to determine the psychometric properties of the translation, and to examine how a number of demographic variables such as type of hearing loss affect the outcome. RESEARCH DESIGN: A descriptive and correlational study in a retrospective sample. STUDY SAMPLE: Two hundred and twenty-four (107 females and 117 males; ages 27-94 yr with an average of 66.1 yr) first-time hearing aid users. INTERVENTION: Mostly digital hearing aids (97.8%) were fitted monaurally (60%) or binaurally (40%) between 2007 and 2009. DATA COLLECTION AND ANALYSIS: The subjects were mailed the IOI-HA questionnaire six months after their final appointment, and the completed questionnaire was returned by mail to the clinic. The psychometric properties were evaluated and compared to previous studies using the IOI-HA. The associations between the outcome scores and a number of demographic variables (age, gender, degree of hearing loss, type of hearing loss, number of hearing aids, and type of hearing aids) were examined. Based on the pure tone audiograms, the subjects were divided into three groups; those with conductive hearing losses, sensorineural hearing losses, and mixed hearing losses. For these groups, the differences in outcome measured as IOI-HA were examined. RESULTS: The psychometric properties of the present translation of the IOI-HA showed resemblance in many aspects to previous reports. Furthermore, the type of hearing loss seems to affect the IOI-HA outcome. Hearing loss increases with increasing age, and hearing aid use increases with increasing degree of hearing loss. Subjects with sensorineural hearing losses show significantly poorer scores on items concerning introspective aspects of the outcome in comparison to subjects with mixed hearing losses and subjects with conductive hearing losses. Monaurally fitted subjects tend to report lower scores on average, but monaural or binaural hearing aid fitting do not significantly affect the subjective outcome. CONCLUSIONS: The psychometric properties of the present Swedish translation of the IOI-HA show resemblance in many aspects to previous reports, but the differences observed could be due to differences in the study populations. Overall, the demographic variables examined could not be used as predictors for the hearing aid fitting outcome, and more reliable predictors need to be identified.
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| 8. |
- Brännström, Jonas, et al.
(author)
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Prediction of IOI-HA Scores Using Speech Reception Thresholds and Speech Discrimination Scores in Quiet.
- 2014
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In: Journal of the American Academy of Audiology. - : Georg Thieme Verlag KG. - 2157-3107 .- 1050-0545. ; 25:2, s. 154-163
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Journal article (peer-reviewed)abstract
- Background: Outcome measures can be used to improve the quality of the rehabilitation by identifying and understanding which variables influence the outcome. This information can be used to improve outcomes for clients. In clinical practice, pure-tone audiometry, speech reception thresholds (SRTs), and speech discrimination scores (SDSs) in quiet or in noise are common assessments made prior to hearing aid (HA) fittings. It is not known whether SRT and SDS in quiet relate to HA outcome measured with the International Outcome Inventory for Hearing Aids (IOI-HA). Purpose: The aim of the present study was to investigate the relationship between pure-tone average (PTA), SRT, and SDS in quiet and IOI-HA in both first-time and experienced HA users. Research Design: SRT and SDS were measured in a sample of HA users who also responded to the IOI-HA. Study Sample: Fifty-eight Danish-speaking adult HA users. Data Collection and Analysis: The psychometric properties were evaluated and compared to previous studies using the IOI-HA. The associations and differences between the outcome scores and a number of descriptive variables (age, gender, fitted monaurally/binaurally with HA, first-time/experienced HA users, years of HA use, time since last HA fitting, best ear PTA, best ear SRT, or best ear SDS) were examined. A multiple forward stepwise regression analysis was conducted using scores on the separate IOI-HA items, the global score, and scores on the introspection and interaction subscales as dependent variables to examine whether the descriptive variables could predict these outcome measures. Results: Scores on single IOI-HA items, the global score, and scores on the introspection (items 1, 2, 4, and 7) and interaction (items 3, 5, and 6) subscales closely resemble those previously reported. Multiple regression analysis showed that the best ear SDS predicts about 18-19% of the outcome on items 3 and 5 separately, and about 16% on the interaction subscale (sum of items 3, 5, and 6) Conclusions: The best ears SDS explains some of the variance displayed in the IOI-HA global score and the interaction subscale. The relation between SDS and IOI-HA suggests that a poor unaided SDS might in itself be a limiting factor for the HA rehabilitation efficacy and hence the IOI-HA outcome. The clinician could use this information to align the user's HA expectations to what is within possible reach.
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| 9. |
- Brännström, K. Jonas, et al.
(author)
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Increasing cognitive interference modulates the amplitude of the auditory brainstem response
- 2018
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In: Journal of the American Academy of Audiology. - : Georg Thieme Verlag KG. - 1050-0545 .- 2157-3107. ; 29:6, s. 512-519
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Journal article (peer-reviewed)abstract
- Background: Despite the presence of efferent neural pathways from the cortex to brainstem, evidence for cognitive inhibition and sensory gating on the auditory brainstem has been mixed. Some previous studies have suggested auditory brainstem responses (ABR) can be affected by cognitive load whereas others have not. Purpose: The present study explores if the ABR recorded from adults with normal hearing was affected by increased cognitive load involving cognitive interference. Research Design: Within-subject repeated measures. Study Sample: Twenty young adults with normal hearing (ten females and ten males, aged 21–26 yr). Data Collection and Analysis: ABRs were collected with and without cognitive load (a visual Stroop task). Two measures of cognitive interference, that is, the ability to suppress task-irrelevant input, were derived from the performance on the Stroop task. Results: No main effect of cognitive load on ABR wave V amplitudes was found. Participants with higher cognitive interference showed increased response times and larger decreases in ABR wave V amplitudes from the no cognitive load to cognitive load conditions. Conclusions: The present study showed that ABR wave V amplitudes did not change with increased overall cognitive load (cognitive load with and without cognitive interference), but ABR amplitude was related to cognitive interference. Increased cognitive load in the form of increased cognitive interference could trigger cognitive inhibition and/or sensory gating to suppress the processing of task-irrelevant information at the level of the brainstem. This suppression could present as reduced ABR wave V amplitudes.
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| 10. |
- Brännström, K. Jonas, et al.
(author)
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Reading comprehension in quiet and in noise : Effects on immediate and delayed recall in relation to tinnitus and high-frequency hearing thresholds
- 2018
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In: Journal of the American Academy of Audiology. - : Georg Thieme Verlag KG. - 1050-0545 .- 2157-3107. ; 29:6, s. 503-511
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Journal article (peer-reviewed)abstract
- Background: A common complaint by people with tinnitus is that they experience that the tinnitus causes attention and concentration problems. Previous studies have examined how tinnitus influences cognitive performance on short and intensive cognitive tasks but without proper control of hearing status. Purpose: To examine the impact tinnitus and high-frequency hearing thresholds have on reading comprehension in quiet and in background noise. Research Design: A between-group design with matched control participants. Study Sample: One group of participants with tinnitus (n 5 20) and an age and gender matched control group without tinnitus (n 5 20) participated. Both groups had normal hearing thresholds (20 dB HL at frequencies 0.125 to 8 kHz). Data Collection and Analysis: Measurements were made assessing hearing thresholds and immediate and delayed recall using a reading comprehension test in quiet and in noise. All participants completed the Swedish version of the Hospital Anxiety and Depression Scale, and participants with tinnitus also completed the Tinnitus Questionnaire. Results: The groups did not differ in immediate nor delayed recall. Accounting for the effect of age, a significant positive correlation was found between best ear high-frequency pure tone average (HF-PTA; 10000, 12500, and 14000 Hz) and the difference score between immediate and delayed recall in noise. Conclusions: Tinnitus seems to have no effect on immediate and delayed recall in quiet or in background noise when hearing status is controlled for. The detrimental effect of background noise on the processes utilized for efficient encoding into long-term memory is larger in participants with better HF-PTA. More specifically, when reading in noise, participants with better HF-PTA seem to recall less information than participants with poorer HF-PTA.
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