Training-induced changes in the processing of sound in patients with sensorineural hearing loss and its impact on quality of life

点击翻译按钮获取中文摘要

Context and rationale: Hearing loss affects over 10 million people in the UK, with older individuals being at greater risk. The negative effects of hearing loss are far reaching, and include social isolation, depression and increased risk of dementia. The social and economic costs are therefore significant.The most common cause of hearing loss in the UK is changes in the inner ear, known as presbyacusis, with the most commonly reported difficulty being conversations with others, particularly in background noise such as restaurants. This complaint has two components: first, levels of sound are reduced and second, individuals struggle differentiating between sounds spaced close together. The latter ability is known as temporal processing of sounds. Given the rapid transitions of speech, this skill is vital for understanding even the simple utterances but is essential in noisy envionments. Treatment options are primarily hearing aids which, despite technological advances, still have limitations in these environments.Recently, there have been encouraging reports of training individuals with hearing impairment on temporal processing tasks. However, to what extent this improvement transfers to speech perception improvements in the "real world", and thereby alleviates the negative social impact of hearing loss, remains unclear. We propose a training study on temporal processing with the following aims:(1) characterise the consequences of hearing impairment in a wider context beyond traditional pure-tone testing (e.g. by using speech in noise tests, detailed anatomical scans and quality of life measures).(2) examine the benefits of auditory training on the perception of speech and mental well-being.(3) predict who benefits from training based on the combination of test results before training and magnitude of improvement on these tests after training. Methodology: We will recruit participants with mild/moderate hearing loss (<60 years of age to minimise confounds from, e.g. cognitive decline). Participants (n=50) will be randomly assigned to one of two online training programmes for several weeks hosted by Posit Science (Brain Fitness). One group will take part in the auditory programme, consisting of a variety of enjoyable tasks aimed at improving temporal processing speeds, and another group will take part in a visual training programme, as an active control condition. This particular training programme is proposed as it has previously led to encouraging results and adherence to the programme can be followed online by the researcher. Participants will be assessed on a range of psychophysical and qualitative measures before and after training.