NIHR Nottingham Hearing Biomedical Research Unit

Nottingham, United Kingdom

NIHR Nottingham Hearing Biomedical Research Unit

Nottingham, United Kingdom
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Holmes E.,University of York | Kitterick P.T.,NIHR Nottingham Hearing Biomedical Research Unit | Summerfield A.Q.,University of York
Hearing Research | Year: 2017

Restoring normal hearing requires knowledge of how peripheral and central auditory processes are affected by hearing loss. Previous research has focussed primarily on peripheral changes following sensorineural hearing loss, whereas consequences for central auditory processing have received less attention. We examined the ability of hearing-impaired children to direct auditory attention to a voice of interest (based on the talker's spatial location or gender) in the presence of a common form of background noise: the voices of competing talkers (i.e. during multi-talker, or “Cocktail Party” listening). We measured brain activity using electro-encephalography (EEG) when children prepared to direct attention to the spatial location or gender of an upcoming target talker who spoke in a mixture of three talkers. Compared to normally-hearing children, hearing-impaired children showed significantly less evidence of preparatory brain activity when required to direct spatial attention. This finding is consistent with the idea that hearing-impaired children have a reduced ability to prepare spatial attention for an upcoming talker. Moreover, preparatory brain activity was not restored when hearing-impaired children listened with their acoustic hearing aids. An implication of these findings is that steps to improve auditory attention alongside acoustic hearing aids may be required to improve the ability of hearing-impaired children to understand speech in the presence of competing talkers. © 2017 Elsevier B.V.


Stacey P.C.,Nottingham Trent University | Kitterick P.T.,NIHR Nottingham Hearing Biomedical Research Unit | Morris S.D.,University of Nottingham | Sumner C.J.,University of Nottingham
Hearing Research | Year: 2016

Understanding what is said in demanding listening situations is assisted greatly by looking at the face of a talker. Previous studies have observed that normal-hearing listeners can benefit from this visual information when a talker's voice is presented in background noise. These benefits have also been observed in quiet listening conditions in cochlear-implant users, whose device does not convey the informative temporal fine structure cues in speech, and when normal-hearing individuals listen to speech processed to remove these informative temporal fine structure cues. The current study (1) characterised the benefits of visual information when listening in background noise; and (2) used sine-wave vocoding to compare the size of the visual benefit when speech is presented with or without informative temporal fine structure. The accuracy with which normal-hearing individuals reported words in spoken sentences was assessed across three experiments. The availability of visual information and informative temporal fine structure cues was varied within and across the experiments. The results showed that visual benefit was observed using open- and closed-set tests of speech perception. The size of the benefit increased when informative temporal fine structure cues were removed. This finding suggests that visual information may play an important role in the ability of cochlear-implant users to understand speech in many everyday situations. Models of audio-visual integration were able to account for the additional benefit of visual information when speech was degraded and suggested that auditory and visual information was being integrated in a similar way in all conditions. The modelling results were consistent with the notion that audio-visual benefit is derived from the optimal combination of auditory and visual sensory cues. © 2016 Elsevier B.V.


Fackrell K.,NIHR Nottingham Hearing Biomedical Research Unit | Fackrell K.,University of Nottingham | Hall D.A.,NIHR Nottingham Hearing Biomedical Research Unit | Hall D.A.,University of Nottingham | And 3 more authors.
Hearing Research | Year: 2016

Objectives: Questionnaires are essential for measuring tinnitus severity and intervention-related change but there is no standard instrument used routinely in research settings. Most tinnitus questionnaires are optimised for measuring severity but not change. However, the Tinnitus Functional Index (TFI) claims to be optimised for both. It has not however been fully validated for research purposes. Here we evaluate the relevant psychometric properties of the TFI, specifically the questionnaire factor structure, reproducibility, validity and responsiveness guided by quality criteria for the measurement properties of health-related questionnaires. Methods: The study involved a retrospective analysis of data collected for 294 members of the general public who participated in a randomised controlled trial of a novel tinnitus device (ClinicalTrials.gov Identifier: NCT01541969). Participants completed up to eight commonly used assessment questionnaires including the TFI, Tinnitus Handicap Inventory (THI), Tinnitus Handicap Questionnaire (THQ), a Visual Analogue Scale of loudness (VAS-Loudness), Percentage Annoyance question, the Beck's Depression Inventory (BDI), Beck's Anxiety Inventory (BAI), and the World Health Organisation Quality of Life-Bref (WHOQOL-BREF). A series of analyses assessed the study objectives. Forty four participants completed the TFI at a second visit (within 7-21 days and before receiving any intervention) providing data for reproducibility assessments. Results: The 8-factor structure was not fully confirmed for this general (non-clinical) population. Whilst it was acceptable standalone subscale, the 'auditory' factor showed poor loading with the higher order factor 'functional impact of tinnitus'. Reproducibility assessments for the overall TFI indicate high internal consistency (α = 0.80) and extremely high reliability (ICC: 0.91), whilst agreement was borderline acceptable (93%). Construct validity was demonstrated by high correlations between scores on the TFI and THI (r = 0.82) and THQ (r = 0.82), moderate correlations with VAS-L (r = 0.46), PR-A (r = 0.58), BDI (r = 0.57), BAI (r = 0.39) and WHOQOL (r = -0.48). Floor effects were observed for more than 50% of the items. A smallest detectable change score of 22.4 is proposed for the TFI global score. Conclusion: Even though the proposed 8-factor structure was not fully confirmed for this population, the TFI appears to cover multiple symptom domains, and to measure the construct of tinnitus with an excellent reliability in distinguishing between patients. While the TFI may discriminate those whose tinnitus is not a problem, floor effects in many items means it is less appropriate as a measure of change in this subgroup. Further investigation is needed to determine whether these effects are relevant in other populations. © 2015 The Authors.


Holmes E.,University of York | Kitterick P.T.,NIHR Nottingham Hearing Biomedical Research Unit | Kitterick P.T.,University of Nottingham | Summerfield A.Q.,University of York
Hearing Research | Year: 2016

Selective attention is critical for successful speech perception because speech is often encountered in the presence of other sounds, including the voices of competing talkers. Faced with the need to attend selectively, listeners perceive speech more accurately when they know characteristics of upcoming talkers before they begin to speak. However, the neural processes that underlie the preparation of selective attention for voices are not fully understood. The current experiments used electroencephalography (EEG) to investigate the time course of brain activity during preparation for an upcoming talker in young adults aged 18-27 years with normal hearing (Experiments 1 and 2) and in typically-developing children aged 7-13 years (Experiment 3). Participants reported key words spoken by a target talker when an opposite-gender distractor talker spoke simultaneously. The two talkers were presented from different spatial locations (±30° azimuth). Before the talkers began to speak, a visual cue indicated either the location (left/right) or the gender (male/female) of the target talker. Adults evoked preparatory EEG activity that started shortly after (<50 ms) the visual cue was presented and was sustained until the talkers began to speak. The location cue evoked similar preparatory activity in Experiments 1 and 2 with different samples of participants. The gender cue did not evoke preparatory activity when it predicted gender only (Experiment 1) but did evoke preparatory activity when it predicted the identity of a specific talker with greater certainty (Experiment 2). Location cues evoked significant preparatory EEG activity in children but gender cues did not. The results provide converging evidence that listeners evoke consistent preparatory brain activity for selecting a talker by their location (regardless of their gender or identity), but not by their gender alone. © 2016 Elsevier B.V.


McCormack A.,NIHR Nottingham Hearing Biomedical Research Unit | McCormack A.,University of Nottingham | Edmondson-Jones M.,NIHR Nottingham Hearing Biomedical Research Unit | Edmondson-Jones M.,University of Nottingham | And 7 more authors.
Journal of Psychosomatic Research | Year: 2014

Background: Previous research has suggested that a substantial proportion of the population are severely affected by tinnitus, however recent population data are lacking. Furthermore, there is growing evidence that the perception of severity is closely related to personality factors such as neuroticism. Objective: In a subset (N. = 172,621) of a large population sample of >. 500,000 adults aged 40 to 69. years, (from the UK Biobank dataset) we calculated the prevalence of tinnitus and that which is perceived as bothersome, and examined the association between tinnitus and a putative predisposing personality factor, neuroticism. Method: Participants were recruited through National Health Service registers and aimed to be inclusive and as representative of the UK population as possible. The assessment included subjective questions concerning hearing and tinnitus. Neuroticism was self-rated on 13 questions from the Eysenck Personality Inventory. Associations between neuroticism and tinnitus were tested with logistic regression analyses. Results: Prevalence of tinnitus was significantly higher for males, and increased with age, doubling between the youngest and oldest age groups (males 13% and 26%; females 9% and 19% respectively). Of those with tinnitus, females were more likely to report bothersome tinnitus. Neuroticism was associated with current tinnitus and bothersome tinnitus, with the items: 'loneliness', 'mood swings', 'worrier/anxious' and 'miserableness', as the strongest associations of bothersome tinnitus. Conclusions: Neuroticism was identified as a novel association with tinnitus. Individuals with tinnitus and higher levels of neuroticism are more likely to experience bothersome tinnitus, possibly as a reflection of greater sensitivity to intrusive experiences. © 2013 The Authors.


Qureishi A.,Northampton General Hospital | Lee Y.,NIHR Nottingham Hearing Biomedical Research Unit | Belfield K.,University of Nottingham | Birchall J.P.,University of Nottingham | Daniel M.,NIHR Nottingham Hearing Biomedical Research Unit
Infection and Drug Resistance | Year: 2014

Acute otitis media and otitis media with effusion are common childhood disorders, a source of significant morbidity, and a leading cause of antibiotic prescription in primary health care. Although effective treatments are available, some shortcomings remain, and thus better treatments would be welcome. Recent discoveries within the field of otitis media research relating to its etiology and pathogenesis have led to further investigation aimed at developing novel treatments. This article provides a review of the latest evidence relating to the understanding of acute otitis media and otitis media with effusion, current treatment strategies, their limitations, new areas of research, and novel strategies for treatment. © 2014 Qureishi et al.


McCormack A.,University of Nottingham | McCormack A.,NIHR Nottingham Hearing Biomedical Research Unit | Shorter G.W.,University of Ulster | Griffiths M.D.,Nottingham Trent University
International Journal of Mental Health and Addiction | Year: 2013

Internet gambling participation is rapidly increasing, however little is known about potential links between internet gambling and problem gambling. This study examined the predictors of online problem gambling and whether these differed from established predictors of offline problem gambling. Data were obtained online in response to posts on 32 international gambling websites (n = 1,119). Potential correlates included demographic questions, gambling activities, frequency of gambling, and reasons for gambling online. Multinomial logistic regression revealed that compared to non-problem gamblers, online problem gamblers were more likely to be male, smoke cigarettes, gamble alone, have a disability, lie about their age online, gamble online for more than 4 h at a time, engage in two or more online gambling activities regularly, gamble after a near miss, and drink alcohol while gambling online. Therefore, characteristics predictive of offline problem gambling are similar to those predicting online problem gambling. As a result online gambling could potentially be problematic for those individuals who have problems with gambling more generally. © 2013 Springer Science+Business Media New York.


Hoare D.,NIHR Nottingham Hearing Biomedical Research Unit | Hoare D.,University of Nottingham | Adjamian P.,University of Nottingham | Sereda M.,NIHR Nottingham Hearing Biomedical Research Unit | And 3 more authors.
Noise and Health | Year: 2013

The past decade has seen an escalating enthusiasm to comprehend chronic tinnitus from the perspective of both scientific understanding and clinical management. At the same time, there is a significant interest and commercial investment in providing targeted and individualized approaches to care, which incorporate novel sound-based technologies, with standard audiological and psychological strategies. Commercially produced sound-based devices for the tinnitus market include Co-ordinated Reset Neuromodulation ® , Neuromonics © , Serenade ® , and Widex ® Zen. Additionally, experimental interventions such as those based on frequency-discrimination training are of current interest. Many of these interventions overtly claim to target the underlying neurological causes of tinnitus. Here, we briefly summarize current perspectives on the pathophysiology of tinnitus and evaluate claims made by the device supporters from a critical point of view. We provide an opinion on how future research in the field of individualized sound-based interventions might best provide a reliable evidence-base in this growing area of translational medicine.


Henshaw H.,NIHR Nottingham Hearing Biomedical Research Unit | Ferguson M.A.,NIHR Nottingham Hearing Biomedical Research Unit
PLoS ONE | Year: 2013

Background:Auditory training involves active listening to auditory stimuli and aims to improve performance in auditory tasks. As such, auditory training is a potential intervention for the management of people with hearing loss.Objective:This systematic review (PROSPERO 2011: CRD42011001406) evaluated the published evidence-base for the efficacy of individual computer-based auditory training to improve speech intelligibility, cognition and communication abilities in adults with hearing loss, with or without hearing aids or cochlear implants.Methods:A systematic search of eight databases and key journals identified 229 articles published since 1996, 13 of which met the inclusion criteria. Data were independently extracted and reviewed by the two authors. Study quality was assessed using ten pre-defined scientific and intervention-specific measures.Results:Auditory training resulted in improved performance for trained tasks in 9/10 articles that reported on-task outcomes. Although significant generalisation of learning was shown to untrained measures of speech intelligibility (11/13 articles), cognition (1/1 articles) and self-reported hearing abilities (1/2 articles), improvements were small and not robust. Where reported, compliance with computer-based auditory training was high, and retention of learning was shown at post-training follow-ups. Published evidence was of very-low to moderate study quality.Conclusions:Our findings demonstrate that published evidence for the efficacy of individual computer-based auditory training for adults with hearing loss is not robust and therefore cannot be reliably used to guide intervention at this time. We identify a need for high-quality evidence to further examine the efficacy of computer-based auditory training for people with hearing loss. © 2013 Henshaw, Ferguson.


Pierzycki R.H.,University of Nottingham | Pierzycki R.H.,NIHR Nottingham Hearing Biomedical Research Unit | Seeber B.U.,University of Nottingham | Seeber B.U.,TU Munich
JARO - Journal of the Association for Research in Otolaryngology | Year: 2014

Comodulation masking release (CMR) is an improvement in the detection threshold of a masked signal that occurs when the masker envelopes are correlated across frequency (i.e., comodulation). CMR can be observed when flanking bands (FBs) of noise co-modulated with an on-frequency band (OFB) noise masker are added at remote frequencies (CMR1), or when co-modulated envelopes are used instead of anti-modulated envelopes (OFB and FB envelopes out of phase, CMR2). For FBs widely separated from the OFB, this process is assumed to rely mostly on across-channel comparison of temporal envelopes. Since cochlear implants (CIs) rely predominantly on the transmission of envelope cues, we investigated if CMR can be observed in electric hearing. We stimulated the auditory nerve of eight CI users with trains of modulated electric pulses presented on an OFB electrode alone, or together with pulse trains on one or two FB electrodes. Participants had to detect signal-induced changes in the envelope of an electric pulse train masker presented on the OFB electrode. Envelopes on FB electrodes were either co-modulated or anti-modulated with the envelope of the OFB masker. We observed CMR1 in one of the eight CI users. However, significant CMR2 was observed in most CI users. Reducing amplitude-modulation rate from 20 to 8 Hz, reducing envelopes' randomness or increasing electrode separation did not generally improve CMR1, but increased the prevalence of CMR2. The present results suggest that comodulation of envelopes can aid signal detection in electric hearing. © 2014 The Author(s).

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