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15 September 2022
The hunt for hidden hearing loss in humans: From preclinical studies to effective interventions
Joaquin T. Valderrama
1 more and 
David McAlpine
Effect of elevated central gain and brainstem neural transmission time on speech-in-noise intelligibility (Valderrama et al., 2018). This figure shows that when central gain at the level of the midbrain is elevated (high gain), individuals with longer brainstem neural transmission time (measured via the ABR waves I-V interpeak latency) presented worse speech-in-noise hearing performance.

Many individuals experience hearing problems that are hidden under a normal audiogram. This not only impacts on individual sufferers, but also on clinicians who can offer little in the way of support. Animal studies using invasive methodologies have developed solid evidence for a range of pathologies underlying this hidden hearing loss (HHL), including cochlear synaptopathy, auditory nerve demyelination, elevated central gain, and neural mal-adaptation. Despite progress in pre-clinical models, evidence supporting the existence of HHL in humans remains inconclusive, and clinicians lack any non-invasive biomarkers sensitive to HHL, as well as a standardized protocol to manage hearing problems in the absence of elevated hearing thresholds. Here, we review animal models of HHL as well as the ongoing research for tools with which to diagnose and manage hearing difficulties associated with HHL. We also discuss new research opportunities facilitated by recent methodological tools that may overcome a series of barriers that have hampered meaningful progress in diagnosing and treating of HHL.

7,657 views
13 citations

Objective: This study aimed to investigate the epidemiological characteristics of occupational noise-induced hearing loss (NIHL) among manufacturing workers, and to provide evidence for diagnosing and preventing occupational hearing loss caused by complex noise, which is different from Gaussian noise in temporal structure.

Methods: One thousand and fifty manufacturing workers exposed to occupational noise were recruited in a cross-sectional survey. Exposure characteristics and epidemiological distribution of hearing loss and noise exposure metrics (noise energy and kurtosis) were investigated, and the relationship between noise exposure and hearing loss was analyzed. The effects of kurtosis on hearing threshold shift across different frequencies and on NIHL development with exposure duration and noise intensity were also investigated.

Results: Each type of work had specific noise exposure metrics. Noise intensity and kurtosis were independent parameters (r = −0.004, p = 0.885). The prevalence of NIHL and the hearing threshold level had a specific distribution in different types of work. Kurtosis deepened the hearing notch at high frequencies and accelerated the formation of early hearing loss. The effect of exposure duration and noise intensity on the prevalence of high-frequency NIHL (i.e., at 3, 4, 6, and 8 kHz) for manufacturing workers increased with kurtosis in workers with noise exposure duration of less than 10 years and with LAeq.8h between 80 and 90 dB(A). Male (OR = 1.557, 95%CI = 1.141–2.124), age (OR = 1.033, 95%CI = 1.014–1.052), exposure duration (OR = 1.072, 95%CI = 1.038–1.107), kurtosis (OR = 1.002, 95%CI = 1.001–1.003), and noise intensity (LAeq.8h; OR = 1.064, 95%CI = 1.044–1.084) were risk factors for high-frequency NIHL. The speech-frequency NIHL (i.e., at 0.5, 1, and 2 kHz) risk of workers exposed to manufacturing noise was related to age (OR = 1.071, 95%CI = 1.043–1.100). There were no statistically significant associations between speech-frequency NIHL and sex, noise exposure duration, kurtosis, and noise intensity (LAeq.8h).

Conclusion: The high-frequency NIHL prevalence among manufacturing workers is associated with sex, age, exposure duration, noise intensity, and temporal structure of noise, while the speech-frequency NIHL prevalence is associated with age. Kurtosis strengthens the association of noise exposure duration and noise intensity with high-frequency hearing loss. The influence of noise temporal structure should be considered in the diagnosis and early prevention of occupational hearing loss caused by complex noise.

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10 citations
2,683 views
9 citations
6,228 views
17 citations
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16 citations
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Frontiers in Neuroscience

Impact of Acoustic Environments and Noise on Auditory Perception
Edited by Achim Klug, Mary M. Flaherty
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30 June 2025
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