Evoked Potentials Reveal Noise Exposure-Related Central Auditory Changes Despite Normal Audiograms

• Published in: American journal of audiology Vol. 29; no. 2; pp. 152 - 164
• Main Authors: Bramhall, Naomi F, Niemczak, Christopher E, Kampel, Sean D, Billings, Curtis J, McMillan, Garnett P
• Format: Journal Article
• Language: English
• Published: United States American Speech-Language-Hearing Association 01.06.2020
• Subjects: Adult; Aging; Amplitude (Acoustics); Analysis; Animals; Audiology; Audiometry, Pure-Tone; Auditory Diseases, Central - physiopathology; Auditory Pathways - physiopathology; Auditory perception; Auditory processing disorders; Auditory system; Auditory Tests; Case-Control Studies; Cochlea; Evoked Potentials, Auditory - physiology; Evoked Potentials, Auditory, Brain Stem - physiology; Evoked responses; Female; Firearms; Hair Cells, Auditory, Inner; Hearing disorders; Hearing protection; Humans; Hyperactivity; Male; Military service; Noise; Noise control; Noise, Occupational; Otoacoustic Emissions, Spontaneous - physiology; Perceptual Impairments; Reaction time; Speech; Speech perception; Synapses; Tinnitus; Tinnitus - physiopathology; Veterans; Weapons; Young Adult; Afghanistan; Iraq
• ISSN: 1059-0889; 1558-9137
• DOI: 10.1044/2019_AJA-19-00060

Purpose Complaints of auditory perceptual deficits, such as tinnitus and difficulty understanding speech in background noise, among individuals with clinically normal audiograms present a perplexing problem for audiologists. One potential explanation for these "hidden" auditory deficits is loss of the synaptic connections between the inner hair cells and their afferent auditory nerve fiber targets, a condition that has been termed . In animal models, cochlear synaptopathy can occur due to aging or exposure to noise or ototoxic drugs and is associated with reduced auditory brainstem response (ABR) wave I amplitudes. Decreased ABR wave I amplitudes have been demonstrated among young military Veterans and non-Veterans with a history of firearm use, suggesting that humans may also experience noise-induced synaptopathy. However, the downstream consequences of synaptopathy are unclear. Method To investigate how noise-induced reductions in wave I amplitude impact the central auditory system, the ABR, the middle latency response (MLR), and the late latency response (LLR) were measured in 65 young Veterans and non-Veterans with normal audiograms. Results In response to a click stimulus, the MLR was weaker for Veterans compared to non-Veterans, but the LLR was not reduced. In addition, low ABR wave I amplitudes were associated with a reduced MLR, but with an increased LLR. Notably, Veterans reporting tinnitus showed the largest mean LLRs. Conclusions These findings indicate that decreased peripheral auditory input leads to compensatory gain in the central auditory system, even among individuals with normal audiograms, and may impact auditory perception. This pattern of reduced MLR, but not LLR, was observed among Veterans even after statistical adjustment for sex and distortion product otoacoustic emission differences, suggesting that synaptic loss plays a role in the observed central gain. Supplemental Material https://doi.org/10.23641/asha.11977854.