Unitron announced the introduction of Blu, an innovative new platform designed to keep up with the complexity of everyday life.
The new Blu platform helps “provide next-generation sound performance” according to the company. Powered by the new Sonova PRISMTM (Processing Real-Time Intelligent Sound Management) chip and Unitron’s new signal processing system, Integra OS, Blu delivers an “adaptable, personalized, and freeing hearing experience like never before.” Integra OS helps “optimize the listening experience to each client’s specific situation from highly complex to very quiet.”
“It is hard to know what experiences we may encounter throughout the day,” said Nicola McLaughlin, director of hearing instruments business at Unitron. “With our new Blu platform clients are provided with our most advanced sound performance and will be ready for life’s unexpected moments knowing their hearing aids will keep up with their unique lifestyle.”
With Blu and the Remote Plus app, clients can temporarily “boost clarity and comfort within the automatic program,” the company says. For special circumstances they can select from up to six optional, pre-set programs which they can further adjust to enhance speech, reduce noise, or focus the microphones to meet their lifestyle needs.
Compatible with Bluetooth products, Blu “helps allow wearers to interact seamlessly with their favorite devices.” With new tap control, Blu wearers can access virtual assistants, accept and end calls, as well as pause and play media while connected simultaneously to two Bluetooth devices, all with a double-tap to the side of the ear. In total, clients can pair up to eight devices, including both Android and Apple phones, tablets, and other Bluetooth devices.
“Our world is increasingly rooted in technology-based solutions. As more of us move to a remote work model, the amount of devices we are connected to throughout the day is growing,” said Sandra Fulton, vice president of group marketing at Unitron. “As our clients’ lifestyles evolve, so must Unitron’s products, and Blu seamlessly allows our customers to immerse themselves in all aspects of life with full confidence in their hearing aid compatibility.”
The new Moxi Blu family has been redesigned for “additional wearing comfort and ease of use,” and includes two lithium-ion rechargeable models. With Unitron’s Remote Plus app, clients can help maximize their hearing experience with in-app reminders and contextual how-to’s designed to “seamlessly familiarize clients to the new technology.” A no-commitment trial period with all Moxi Blu hearing instruments also ensure clients have peace of mind while selecting the right device for their needs.
“Confidence in not only the product, but in one’s ability to embrace life’s spontaneity and take in every experience from one moment to the next is vital,” said Fulton. “Unitron is proud to provide innovations that fit seamlessly into our clients’ lives.”
The new Moxi Blu hearing aids will be able to order/ship on May 4, 2021. For more information on the Blu platform, please visit: www.unitron.com/blu.
Source: Unitron
Image: Unitron
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By Laura Winther Balling, PhD, Oliver Townend, BSc, and Dana Helmink, AuD
Sound quality plays a key feature for overall hearing aid satisfaction as well as in everyday moments of real-life hearing. A large international survey of hearing aid users confirms the importance of sound quality, showing higher satisfaction with the WIDEX MOMENT™ hearing aids for overall sound quality, for specific situations of real-life use and for hearing aid users’ ability to participate in daily life.
As one of the major global hearing aid manufacturers, Widex has a long history of focusing on sound quality, designing all signal processing with the aim of achieving the best and most natural sound quality possible. For example, True Input Technology, with a linear transfer function up to 113 dB SPL and a linear input dynamic range of 108 dB SPL, was groundbreaking when launched,1 as was Variable Speed Compression, which offers the benefits of both slow and fast-acting compression.2
Most recently, WIDEX MOMENT™ launched with the focus on sound quality expressed in two main features:
TruAcoustics™ is an intelligent algorithm by which the acoustics in the individual ear canal is integrated in the parameter settings of the hearing aid, so the output at the eardrum is exactly right for the individual ear canal with the specific earware choice.3
Widex PureSound™ drastically reduces hearing aid delay and eliminates the delay-based distortions which are characteristic of other digital hearing aids.4
Innovations like these improve the sound quality in clearly audible ways and result in sound quality preferences in studies, such as the one reported by Balling et al.4 However, it is also an important assumption of the Widex design philosophy that good sound is not an isolated quality but a means to achieving higher hearing aid satisfaction across many situations in real life. With this broader view of sound quality, it is arguably the most important parameter for hearing aid satisfaction, along with speech understanding (especially in noise).
For these reasons, the survey reported below focused on satisfaction with sound quality in itself, as well as the experience in diverse situations of real-life hearing with Widex MOMENT hearing aid.
Survey Method
Our survey included 101 experienced hearing aid users recruited at local hearing clinics in 7 countries (US, Canada, China, Germany, France, Portugal, UK). They all wore the MOMENT mRIC R D rechargeable hearing aids and rated their satisfaction with them in comparison to their own existing hearing aids, which were from all major brands. Respondents were 60% male with a median age of 66 years (range 18-88). Close to half (45%) were work active, and they had a median of 6 years’ hearing aid experience (range 1-59 years).
Respondents fell into two groups: 39 of them had mild-to-moderate hearing losses going from 40 dBHL at low frequencies to 70 dBHL at high and had as their primary program PureSound™, which is particularly suitable for open fits and milder losses. The other 62 respondents had hearing losses up to 80 dB HL across frequencies (the mRIC M-receiver fitting range) and were fitted with the Universal program as their primary program. The MOMENT hearing aids were fitted with the ear tip recommended in the Compass GPS fitting software.
The survey used a cross-over design where respondents started a 7-week survey period by rating their satisfaction with their own existing hearing aids before being fitted with the MOMENT hearing aids and wearing them for 3 weeks. After 3 weeks, they rated their satisfaction with the MOMENT devices, before switching back to their own hearing aids, wearing those for 2 weeks and rating them at Week 6. For the final 2 weeks of the survey, respondents wore MOMENT and filled in a final set of questions about those at Week 7. This resulted in two ratings for own hearing aids (at Weeks 0 and 5) and two for MOMENT (at Weeks 3 and 7).
The questionnaires were filled in online using SMART-TRIAL software, using a format inspired by the MarkeTrak surveys,5 where respondents rate their satisfaction with their hearing aids on a 7-point scale ranging from “Very dissatisfied” (a rating of 1) to ‘Very satisfied’ (a rating of 7). Following the MarkeTrak approach, respondents who gave ratings in the top-3 satisfaction categories may be classified together as being “satisfied.” We asked questions about satisfaction both in general and in specific real-life situations.
The responses show that people are reasonably satisfied with their own hearing aids at the beginning of the survey period, but once they try the MOMENT hearing aids, their ratings of their own hearing aids in many cases become significantly lower. This in itself is evidence in favor of the MOMENT devices. However, the more interesting direct comparison is between the ratings of own hearing aids in Week 5 and MOMENT in Week 7, where respondents have had the most time to form an opinion about the new hearing aids.
We also estimated the age of the respondents’ own hearing aids based on the launch date of the device. Interestingly, we found no significant effects of this variable, indicating that the MOMENT advantages that we observe throughout are not simply explained by the contrast between older own hearing aids and new MOMENT devices, but by a genuine preference for the MOMENT sound.
Unless otherwise indicated, statistical testing of results was done using mixed-effects models that take into account the crucial fact that we have multiple responses per person. The significance levels for the relevant contrasts between own and MOMENT hearing aids are all below 0.0001, which means that potential concerns about repeated testing are unfounded.
Sound Quality Across Situations
As we would expect given the Widex design focus, the responses show a solid sound quality advantage for the MOMENT hearing aids, with significantly higher satisfaction for MOMENT than for own hearing aids (p < 0.0001). Looking at the average ratings plotted in the left panel of Figure 1, there is a 1-point advantage for MOMENT, with the average rating “Satisfied” for MOMENT and “Somewhat satisfied” for own hearing aids. Examining the distribution of answers in the right panel of Figure 1, we see many more “Very satisfied” and “Satisfied” MOMENT users. In total, considering the top-3 satisfaction categories, 91% of respondents are satisfied with the MOMENT sound quality.
Figure 1. Ratings of satisfaction with sound quality. The left panel shows mean ratings of satisfaction with sound quality as filled circles, with the whiskers representing ±1 standard deviation (SD) around the mean. The right plot shows ratings of own hearing aids in Week 5 and of MOMENT hearing aids in Week 7 of the survey.
An intriguing question is which aspects of sound and hearing aid use influence these high-satisfaction sound quality ratings. This is a complex issue that this survey cannot fully address, but it is informative to look at which other questions are correlated with sound quality satisfaction. In Table 1, such correlations are listed for the ratings of MOMENT at the end of the survey period. They are all strong correlations ranging between 0.522 to 0.698, and although there is some variation between individual situations, the correlations are all highly significant and of similar size. These correlations do not, of course, indicate causation but do suggest that sound quality plays a similar role across different situations.
Table 1. Spearman Rho correlations between sound quality satisfaction and satisfaction in specific situations for WIDEX MOMENT. (Notations: *** indicates significance at the p<0.001 level; a) Speech-in-noise situations; b) Outdoor situations; c) Listening through devices.
Another way of assessing the impact of sound quality on everyday satisfaction with hearing aids is analyzing the average satisfaction across the specific situations listed in Table 1 (excepting satisfaction with soft and loud sounds, which are not specific situations). A regression model shows that satisfaction with sound quality is a highly significant predictor of mean satisfaction across situations, accounting for more than 50% of the variance in satisfaction across situations (R2 = 0.51).
Sound Quality and Naturalness
In addition to the different listening situations, Table 1 also lists respondents’ agreement with the statement “I find that the sound is natural with the MOMENT hearing aids” on a 7-point scale. This shows one of the highest correlations with sound quality satisfaction, which means that those hearing aid wearers who are highly satisfied with the sound quality also perceive the sound as more natural.
In addition, naturalness ratings show a very similar pattern across weeks to sound quality satisfaction, as illustrated in Figure 2. Again, we see approximately a 1-point difference between the ratings of own and MOMENT hearing aids, and many more who “Agree” or “Strongly agree” that the sound of MOMENT is natural.
Figure 2. Ratings of naturalness of sound, with the left panel showing mean ratings per week and the right panel showing ratings for own hearing aids in Week 5 and for MOMENT in Week 7.
Satisfaction in Everyday Situations
As seen in Table 1, the survey included questions on a wide range of everyday situations. In Figure 3, these are grouped into four different more general categories, showing the distribution of ratings in Week 5 (own hearing aids) and Week 7 (MOMENT hearing aids).
Figure 3. Histograms showing distribution of ratings in Weeks 5 (own hearing aids) and 7 (MOMENT hearing aids).
The top-left panel shows the satisfaction with conversations in quiet, assessed by a single question. Level of satisfaction is generally high, as we would expect for this relatively easy listening environment. However, although the baseline is already high, the MOMENT ratings are still higher, with the most frequent response being “Very satisfied” and the difference to own hearing aids being highly significant (p < 0.0001).
Speech-in-noise ratings are shown in the top-right panel, based on a mean across questions on satisfaction in restaurants and with conversations in noise and during transport. These tend to be difficult situations for hearing aid users, which is also clear if we compare the general level of satisfaction with speech in quiet. This makes the significant advantage for MOMENT (p < 0.0001) all the more noteworthy: the most frequent mean rating for these questions is clearly in the “Satisfied” category for MOMENT, whereas ratings for own hearing aids are more spread out, with “Somewhat dissatisfied” as the most frequent. If we compare the own-vs-MOMENT hearing aid ratings per respondent, five times as many respondents are more satisfied with the MOMENT hearing aids compared with their own: 74% of respondents are more satisfied with MOMENT, 12% more satisfied with their own, and the remaining 14% give the same ratings to both.
The bottom left panel illustrates mean ratings in outdoor situations, again with a markedly differently distribution of ratings for own and MOMENT hearing aids (p < 0.0001). Part of the explanation for the MOMENT advantage could be that respondents experience the sound of MOMENT as more natural, something that is likely to play a larger role outdoors.
The final panel of Figure 3 represents the frequent listening situations where sound comes from a device, with TV likely being the most frequent for most people, but also telephone and music. As for conversations in quiet, the general level of satisfaction is higher here than for more difficult listening situations, but the MOMENT advantage remains, with a significant difference to own hearing aids (p < 0.0001). Collectively, the four types of situations illustrated in Figure 3 give a comprehensive view of the everyday lives of hearing aid users, and across all these situations MOMENT shows a solid advantage.
Participation in Daily Life
A common problem for people with hearing loss, reported both scientifically6,7 and by hearing aid users and their relatives to HCPs all over the world, is the difficulty of participating in everyday life. Therefore, the survey included a question inspired by the International Outcome Inventory for Hearing Aids (IOI-HA)8: “How satisfied are you with your ability to participate effortlessly in everyday life with [your own hearing aids/the WIDEX MOMENT hearing aids]?” The ratings for this question are shown in Figure 4, where both plots illustrate a similar 1-point MOMENT advantage that was also seen previously (p < 0.0001). An interesting statistic is how many people are satisfied (in the top-3 categories) with their ability to participate in everyday life; this number is 69% for own hearing aids but 90% for MOMENT. Conversely, only 6% of respondents indicate dissatisfaction with participation when wearing MOMENT, while the corresponding number is 20% for own hearing aids, in spite of the fact that the MOMENT devices are new to the respondents and they cannot be expected to be completely habituated to them yet.
Figure 4. Ratings of ability to participate in everyday life, with the left panel showing mean ratings per week and the right panel showing ratings for own hearing aids in Week 5 and for MOMENT in Week 7.
Overall Satisfaction
Finally, a question about overall satisfaction examines how all these different elements of real-life hearing come together in the respondents’ entire experience of wearing the MOMENT hearing aids, compared with their own. The responses to this question were tested in the same way as previous results, showing significantly higher ratings (p < 0.0001) for MOMENT than own hearing aids. The left panel in Figure 5 is a particularly clear example that respondents’ ratings of their own hearing aids change when they have tried MOMENT, as evidenced by the lower ratings in Week 5 compared to Week 0. More generally, Figure 5 confirms the MOMENT advantage that has also been clear in the more detailed questions, with the most frequent overall response to the MOMENT hearing aids being “Very satisfied.”
Figure 5. Ratings of overall satisfaction, with the left panel showing mean ratings per week and the right panel showing ratings for own hearing aids in Week 5 and for MOMENT in Week 7.
The Importance of Sound Quality in Real Life Hearing Aid Use
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Oticon Launches Oticon More at 2021 OticonNext Event
Oticon announced that over 5,000 hearing care professionals registered to join the company for its 2021 OticonNext “Discover More” Conference, the company’s “biggest ever launch event for a new product.” The live, virtual knowledge-sharing experience introduced participants to Oticon More, “the world’s first hearing aid with an on-board deep neural network.” This new hearing aid is said to build on Oticon’s “proven BrainHearing approach to deliver a full and precisely balanced sound scene that makes it easier for the brain to perform optimally.” Oticon President Gary Rosenblum and Oticon staff experts showed conference participants how Oticon More represents a “fundamentally new approach” to signal processing.
“Through the OticonNext Conference, we aimed to equip practitioners with the knowledge and tools they need to continue to bring life-changing technology to patients,” said Rosenblum. “Over the past decade, Oticon has pioneered new standards and advanced its portfolio of hearing solutions dramatically. From our newest addition, Oticon More, to our innovative power and pediatric solutions, we continue to offer hearing care professionals and their patients one of the industry’s most comprehensive portfolios of hearing technology.”
Rosenblum shared recent honors for the new hearing solution with conference participants. On January 11, the Consumer Electronics Association named Oticon More an honoree in the CES 2021 Innovation Awards in the Health & Wellness and Wearable Technologies categories. This is the fifth consecutive year that Oticon, Inc has been recognized by the international awards program that annually selects the best of the best in consumer electronics. The most recent awards bring to an even dozen the number of times Oticon has been honored by the CES InnovationAwards program.
Inspiration, Innovation, and Practice Support
Keynote speaker Dan Buettner, author of The Blue Zones: Lessons for Living Longer from the People Who’ve Lived the Longest, provided guidance on how technology like Oticon More contributes to health and long life by enabling patients to maintain vital connections to people and the world. A panel discussion addressed questions from the online audience on Oticon More’s technology innovations, including the new Polaris platform. Following the conference, hearing care professionals were invited to explore The Zone exhibit hall to learn more about the variety of clinical and business support available through Oticon and the company’s business partners.
Interactive Webisodes Continue Knowledge Sharing
The conference’s interactive virtual format extends beyond the launch event with a series of post-conference educational webisodes that build on the knowledge gained at OticonNext. The live interactive sessions take a deeper dive into the audiology of Oticon More and the new research that shows the brain needs access to all sounds—not just speech—in order to work in a natural way. Scheduled for February and March, the five webisodes each last approximately one hour and require prior registration.
Learn more about Oticon More and the entire portfolio of Oticon hearing solutions with BrainHearing technology at: www.Oticon.com/More.
Available at the Honiton hearing centre near Exeter Devon
Source: Oticon
Images: Oticon
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Zoom Charges Monthly Fee for Closed Captioning During Pandemic, ‘WBFO’ Reports
The challenges for hearing impaired people working remotely and utilizing video conferencing services during the coronavirus pandemic can make communication difficult. According to an article on the WBFO/NPR website, hearing advocate and Living With Hearing Loss founder Shari Eberts recently wrote an open letter—that turned into a petition with 58,000 signatures—asking video conferencing companies to remove the paywall from their captioning services.
According to the article, both Google and Microsoft have complied, but Zoom is still charging a $200 monthly fee for users to be able to access closed captioning.
Issues with video conferencing that include poor audio and/or sound quality as well as spotty internet connection, can make lip reading difficult. Even when using workarounds like speaker mode to be able to see a larger version of the person they’re speaking with and/or headphones to improve sound quality, a person’s lips can be out of sync with their words, Eberts says in the article. Closed captions could improve communication in these situations, she says.
“It’s hard for us to want to jump in or to share our thoughts because we’re not sure what’s been said. And obviously, there’s a lot of trepidation about looking silly or repeating something that someone just said,” Eberts is quoted in the article as saying.
To read the article in its entirety, please click here.
Source: WBFO
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‘BMJ’ Publishes ‘First Reported UK Case’ of Sudden Hearing Loss Linked to COVID-19
Although uncommon, sudden permanent hearing loss seems to be linked to COVID-19 infection in some people, warn doctors, reporting the first UK case in the journal BMJ Case Reports. An article summarising the results appears on the EurekAlert website.
Awareness of this possible side effect is important, because a prompt course of steroid treatment can reverse this disabling condition, they emphasize.
Sudden hearing loss is frequently seen by ear, nose, and throat specialists, with around 5-160 cases per 100,000 people reported every year. It’s not clear what the causes are, but the condition can follow a viral infection, such as flu, herpes, or cytomegalovirus.
Despite plenty of published research on sudden onset hearing loss, only a handful of other cases associated with COVID-19 have been reported, and none in the UK—until now.
The doctors describe a case of a 45-year-old man with asthma who was referred to the ear, nose, and throat department at their hospital after suddenly experiencing hearing loss in one ear while being treated for COVID-19 infection as an inpatient.
He had been admitted to hospital with COVID-19 symptoms which had been going on for 10 days. He was transferred to intensive care as he was struggling to breathe.
He was put on a ventilator for 30 days and developed other complications as a result. He was treated with remdesivir, intravenous steroids, and a blood transfusion after which he started to get better.
But a week after the breathing tube was removed and he left intensive care, he noticed ringing (tinnitus) in his left ear followed by sudden hearing loss in that ear.
He had not lost his hearing or had ear problems before. And apart from asthma, he was otherwise fit and well.
Examination of his ear canals revealed that he had no blockages or inflammation. But a hearing test showed that he had substantially lost his hearing in the left ear. He was treated with steroid tablets and injections after which his hearing partially recovered.
He tested negative for other potential causes, including rheumatoid arthritis, flu, and HIV, prompting his doctors to conclude that his hearing loss was associated with COVID-19 infection.
“Despite the considerable literature on COVID-19 and the various symptoms associated with the virus, there is a lack of discussion on the relationship between COVID-19 and hearing,” say the report authors. “Hearing loss and tinnitus are symptoms that have been seen in patients with both COVID-19 and influenza virus, but have not been highlighted.”
The first case of hearing loss mentioning COVID-19 alone was reported in April this year.
SARS-CoV-2, the virus responsible for COVID-19, is thought to lock on to a particular type of cell lining the lungs. And the virus has also recently been found in similar cells lining the middle ear, explain the report authors. SARS-CoV-2 also generates an inflammatory response and an increase in the chemicals that have been linked to hearing loss.
“This is the first reported case of sensorineural hearing loss following COVID-19 infection in the UK,” write the report authors. “Given the widespread presence of the virus in the population and the significant morbidity of hearing loss, it is important to investigate this further.”
They add: “This is especially true given the need to promptly identify and treat the hearing loss and the current difficulty in accessing medical services.”
Doctors should ask patients in intensive care about hearing loss and refer them for urgent treatment, they advise.
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Hearing Speech Requires Quiet—In More Ways than One
A very interesting paper by:
Kim Krieger, Research Writer, University of Connecticut
Perceiving speech requires quieting certain types of brain cells, report a team of researchers from UConn Health and University of Rochester in an upcoming issue of the Journal of Neurophysiology. Their research reveals a previously unknown population of brain cells, and opens up a new way of understanding how the brain hears, according to an article on theUConn Today website.
Your brain is never silent. Brain cells, known as neurons, constantly chatter. When a neuron gets excited, it fires up and chatters louder. Following the analogy further, a neuron at maximum excitement could be said to shout. When a friend says your name, your ears signal cells in the middle of the brain. Those cells are attuned to something called the amplitude modulation frequency. That’s the frequency at which the amplitude, or volume, of the sound changes over time.
Amplitude modulation is very important to human speech. It carries a lot of the meaning. If the amplitude modulation patterns are muffled, speech becomes much harder to understand. Researchers have known there are groups of neurons keenly attuned to specific frequency ranges of amplitude modulation; such a group of neurons might focus on sounds with amplitude modulation frequencies around 32 Hertz (Hz), or 64 Hz, or 128 Hz, or some other frequencies within the range of human hearing. But many previous studies of the brain had shown that populations of neurons exposed to specific amplitude modulated sounds would get excited in seemingly disorganised patterns. The responses could seem like a raucous jumble, not the organized and predictable patterns you would expect if the theory, of specific neurons attuned to specific amplitude modulation frequencies, was the whole story.
UConn Health neuroscientists Duck O. Kim and Shigeyuki Kuwada passionately wanted to figure out the real story. Kuwada had made many contributions to science’s understanding of binaural (two-eared) hearing, beginning in the 1970s. Binaural hearing is essential to how we localise where a sound is coming from. Kuwada (or Shig, as his colleagues called him) and Kim, both professors in the School of Medicine, began collaborating in 2005 on how neural processing of amplitude modulation influences the way we recognise speech. They had a lot of experience studying individual neurons in the brain, and, together with Laurel Carney at the University of Rochester, they came up with an ambitious plan: they would systematically probe how every single neuron in a specific part of the brain reacted to a certain sound when that sound was amplitude modulated, and when it was not. They studied isolated single-neuron responses of 105 neurons in the inferior colliculus (a part of the brainstem) and 30 neurons in the medial geniculate body (a part of the thalamus) of rabbits. The study took them two hours a day, every day, over a period of years to get the data they needed.
While they were writing up their results, Shig became ill with cancer. But still he persisted in the research. And after years of painstaking measurement, all three of the researchers were amazed at the results of their analysis: there was a hitherto unknown population of neurons that did the exact opposite of what the conventional wisdom predicted. Instead of getting excited when they heard certain amplitude modulated frequencies, they quieted down. The more the sound was amplitude modulated in a specific modulation frequency, the quieter they got.
It was particularly intriguing because the visual system of the brain has long been understood to operate in a similar way. One population of visual neurons (called the “ON” neurons) gets excited by certain visual stimuli while, at the same time, another population of neurons (called the “OFF” neurons) gets suppressed.
Last year, when Shig was dying, Kim made him a promise.
“In the final days of Shig, I indicated to him and his family that I will put my full effort toward having our joint research results published. I feel relieved now that it is accomplished,” Kim says. The new findings could be particularly helpful for people who have lost their ability to hear and understand spoken words. If they can be offered therapy with an implant that stimulates brain cells directly, it could try to match the natural behavior of the hearing brain.
“It should not excite every neuron; it should try to match how the brain responds to sounds, with some neurons excited and others suppressed,” Kim says.
The research was funding by the National Institutes of Health.
Original Paper: Kim DO, Carney LH, Kuwada S. Amplitude modulation transfer functions reveal opposing populations within both the inferior colliculus and medial geniculate body. Journal of Neurophysiology. 2020. DOI: https://doi.org/10.1152/jn.00279.2020.
Researchers Explain Link Between Hearing Loss & Dementia
Hearing loss has been shown to be linked to dementia in epidemiological studies and may be responsible for a tenth of the 47 million cases worldwide.
Now, published in the journal Neuron, a team at Newcastle University provide a new theory to explain how a disorder of the ear can lead to Alzheimer’s disease—a concept never looked at before. An article summarising the results of the research appears on the University’s website.
It is hoped that this new understanding may be a significant step towards advancing research into Alzheimer’s disease and how to prevent the illness for future generations.
Key Considerations
Newcastle experts considered three key aspects; a common underlying cause for hearing loss and dementia; lack of sound-related input leading to brain shrinking; and cognitive impairment resulting in people having to engage more brain resources to compensate for hearing loss, which then become unavailable for other tasks.
The team propose a new angle which focuses on the memory centers deep in the temporal lobe. Their recent work indicates that this part of the brain, typically associated with long-term memory for places and events, is also involved in short-term storage and manipulation of auditory information.
They consider explanations for how changes in brain activity due to hearing loss might directly promote the presence of abnormal proteins that cause Alzheimer’s disease, therefore triggering the disease.
Professor Tim Griffiths, from Newcastle University’s Faculty of Medical Sciences, said: “The challenge has been to explain how a disorder of the ear can lead to a degenerative problem in the brain.
“We suggest a new theory based on how we use what is generally considered to be the memory system in the brain when we have difficulty listening in real-world environments.”
Collaborative Research
Work on mechanisms for difficult listening is a central theme for the research group, including members in Newcastle, UCL, and Iowa University, that has been supported by a Medical Research Council program grant.
Dr Will Sedley, from Newcastle University’s Faculty of Medical Sciences, said: “This memory system engaged in difficult listening is the most common site for the onset of Alzheimer’s disease.
“We propose that altered activity in the memory system caused by hearing loss and the Alzheimer’s disease process trigger each other. Researchers now need to examine this mechanism in models of the pathological process to test if this new theory is right.”
The experts developed the theory of this important link with hearing loss by bringing together findings from a variety of human studies and animal models. Future work will continue to look at this area.
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University of Auckland to Study Chatbot Technology for Potential Tinnitus Therapy
Chatbot technology that offers therapy for tinnitus sufferers via a mobile device such as a smartphone will be trialed at the University of Auckland, according to an announcement on the school’s website.
Potential Tinnitus Therapy
Researchers are recruiting participants for the “Tinnibot” study which is aimed at helping those who suffer from a hearing disorder that affects around one in ten New Zealanders and more than 700 million people worldwide.
Tinnitus is usually experienced as a ringing in the ears but sufferers report a range of noises including buzzing, clicking, and even the sound of cicadas. Severity varies: sounds can be continuous or intermittent but the condition is linked to serious mental health effects including depression, anxiety, and insomnia. Currently there is no cure.
But as online technologies and devices such as smartphones change the way health care is delivered, Dr Fabrice Bardy from the University of Auckland’s School of Psychology says it has created new opportunities to treat tinnitus and to study which treatments work best.
Dr Fabrice Bardy
Tinnibot is a chatbot program which uses Cognitive Behavioural Therapy (CBT), proven to be effective in the treatment of tinnitus but usually only available through one-on-one sessions which can be expensive and involve long wait times.
The chatbot’s software interface delivers CBT designed for an individual’s needs directly to their mobile, conducting an automated and interactive text conversation designed to help people regulate their thoughts by focusing on positive thoughts and challenging negative ones.
The interface incorporates a sound therapy library which has proved to be effective tinnitus therapy, particularly for those who have trouble sleeping. It works by using noise at just the right volume to drown out the sounds tinnitus can produce.
Dr Bardy describes Tinnibot to be like having a tinnitus expert in your pocket.
“This chatbot interface is the first one designed specifically for the treatment of tinnitus, a tool that offers direct therapy and support which is convenient and affordable,” he said. “It will help people better understand their condition and to manage symptoms, give them a sense of being in control, and a confidence boost because that’s an important part of successful treatment.”
Participants in the research will be split into two cohorts with one using Tinnibot only and the other using Tinnibot as well as video counseling with a psychologist. The aim is to see which treatment is more effective.
Honiton hearing near Exeter
If you have been bothered with tinnitus for over three months and if you are interested in participating in the study, contact Dr Bardy for more information.
Apple Takes Another Step Toward Hearing Aid Functionality
On Monday, June 22, Apple introduced its latest operating system, iOS14, which includes —among many new features—a substantial move towards its AirPod Pros becoming a hearing-aid-like device. Almost buried as an afterthought at the bottom of Apple’s IOS New Features Preview are identical entries in the “Airpods” and “Accessibility” sections that say:
Headphone Accommodations
This new accessibility feature is designed to amplify soft sounds and adjust certain frequencies for an individual’s hearing, to help music, movies, phone calls, and podcasts sound more crisp and clear.Headphone Accommodations also supports Transparency mode on AirPods Pro, making quiet voices more audible and tuning the sounds of your environment to your hearing needs.
Hmmm…sounds a lot like a basic description of wide dynamic frequency compression (WDRC) or AGC, doesn’t it? Abram Bailey of Hearing Tracker, who broke the news yesterday, stated “This is the extremely exciting part, as it indicates that AirPods can now essentially be used to provide typical hearing aid functionality; applying personalised amplification to make it easier to hear those around you.” Bailey went on to show how the headphone accommodations use a custom audio setup with a listening test that generates an “audiogram” from the Apple Health app that “seems to indicate that the AirPods Pro will be capable of providing a very fine-tuned custom amplification experience, based on the audiogram (pitch-by-pitch hearing abilities) unique to the user.”
It should be acknowledged that Apple has for many years been developing hearing-aid-related features, including Live Listen for hearing aids and cochlear implants in 2014 (and later for AirPods and the Earpods), in addition to speech audiometry and speech-in-noise packages for developers, noise warning apps for its WatchOS, and more. The company sold more than 60 million Airpods in 2019, compared to about 15 million hearing aids worldwide for the entire hearing industry (4.2 million units in the US). Apple’s Wearables, Home and Accessories division had the most significant year-on-year growth for the company last year, with its sales increasing 41% thanks to the Airpod and Apple Watch, and the tech-giant owns an enviable 36.5% of the wearables market, according to CompareCamp. Mind you, this includes the “hearables” market that Nick Hunn predicted earlier this year will reach $80 billion a year by 2025.
As Paul Dybala, PhD, AuD, of AudiologyDesign points out in a recent LinkedIn post about Apple and its threat to the hearing industry, “If none of this impresses you, buy a pair of AirPod Pros and turn on the Active Noise Cancelling feature. Then change them over to Transparency Mode and listen further. Once you wipe your jaw off the floor, continue reading. Take your time, I’ll wait…” However, he then goes on to point out that hearing loss is widely viewed as a healthcare problem that should be addressed by a hearing healthcare professional, as shown in a 2017 survey by a study he did with colleague Brande Plotnick at Healthy Hearing.
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As a side-note, I’ve personally tried several of the products and hearing tests available in some of the better PSAPs. As one example, Alango Technology’s BeHear app did an impressive job of replicating an audiogram of my own mild sloping hearing loss and tailoring the sound to suit my preferences. The idea of an app doing this also reminded me of a September 2018 Hearing Reviewarticle by James Jerger, PhD, who—after describing three basic forms of automated audiometry—wrote:
“The most important issue is to catch up with the rest of the automated world…In spite of the many examples of successful automated systems summarised above, I suspect that there will be little further progress in the actual clinical use of automated audiometry of any variety until clinicians become part of the solution. It goes back to their initial educational experience. If the only procedure they learn as students is the manual Hughson-Westlake method on a conventional audiometer, it is unlikely that they will be easily diverted from that familiar path, sophisticated technology notwithstanding. PhD and AuD students—in addition to practicing clinicians—need to understand that automated audiometry can be carried out by less credentialed personnel, resulting in time and cost savings in a clinical setting. It is apparent this testing is moving into the digital/consumer realm [with the link going to Apple’s WDDC 2018 video that includes a demonstration of speech audiometry].
The point is professional hearing healthcare is so much more than automated tests and apps. As Dr Dybala notes in his article, it’s about assessing an often-complex medical problem and applying all of the tools available to tailor an individual solution that works for the patient in all kinds of listening situations, including (and especially) noise. However, as shown by Apple and others, the world of hearables with their automated testing and applied amplification should help millions of consumers make their first moves toward professional hearing care.
https://honiton-hearing.co.uk/wp-content/uploads/2020/06/Apple-earpods.jpg14001400adminhttps://honitonnew.leecurran.co.uk/wp-content/uploads/2018/03/honitonhearinglogo.pngadmin2020-06-30 18:09:002020-06-30 18:11:33Apple Takes Another Step Toward Hearing Aid Functionality
Treatment of Ménière’s Disease and Vertigo with Intranasal Betahistine
Auris Medical Holding AG, a Swiss-based clinical-stage public company (NASDAQ: EARS) dedicated to developing therapeutics in otolaryngology, has announced it will develop betahistine dihydrochloride in a spray formulation (with the product name AM-125) for the intranasal treatment of Ménière’s disease and vestibular vertigo. This represents the third clinical-stage development program to Auris Medical’s pipeline, and an expansion by the company into the field of vestibular disorders. Auris is also developing a drug for idiopathic sudden sensorineural hearing loss (ISSNHL, sudden hearing loss) and acute inner ear tinnitus.
“We are excited to add AM-125 to our development pipeline as it addresses important unmet medical needs in vestibular disorders and serves as a strategic fit with our existing projects,” said Auris Medical’s Founder, Chairman and CEO Thomas Meyer in a press statement. “While oral betahistine has been a mainstay treatment for Ménière’s disease and vestibular vertigo for many years and in many countries around the world, we expect the novel approach of intranasal delivery to offer significant additional benefits in terms of efficacy and tolerability.”
Auris Medical reports that it has entered into an agreement with Otifex Therapeutics Pty Ltd to purchase various assets related to intranasal betahistine, including preclinical and clinical data, as well as certain intellectual property rights. In a Phase 1 trial conducted by Otifex, intranasal betahistine showed good tolerance and a significantly higher bioavailability than reported for oral betahistine administration. Auris Medical plans to initiate a second Phase 1 trial in 2017.
“As our treatment options for vestibular disorders are currently very limited in the United States, I am pleased to see that betahistine will be developed as a treatment for patients here who are suffering from Ménière’s disease or vestibular vertigo,” said Lawrence R. Lustig, MD, Chair, Department of Otolaryngology at Columbia University Medical Center in the press release. “The compound has an established track record for safety, and the clinical experience suggests that it may help control or ease vertigo attacks in Ménière’s disease. It will be exciting to have a new treatment for this disabling condition.”
According to Auris Medical, Betahistine is a small molecule drug that acts as a partial histamine H1-receptor agonist and a H3-receptor antagonist. The compound has demonstrated increased cochlear, vestibular, and cerebral blood flow, vestibular compensation, and the ability to inhibit neuronal firing in the vestibular nuclei.
Oral betahistine is approved for the treatment of Ménière’s disease and vestibular vertigo in more than 80 countries worldwide, and has been reportedly prescribed more than 130 million patients. However, betahistine has not been approved for marketing in the United States for the past few decades.
The brand Serc (betahistine) was approved by the FDA in the early 1970s as vestibular suppressant for Ménière’s disease, but that approval was withdrawn after about 5 years. Primarily, the drug has had issues surrounding its clinical trials and subsequent proof of efficacy. Even though studies have shown betahistine effective against vertigo attacks, most of these studies have been criticized for design flaws. The Cochrane Library concluded in 2001 that “Most trials suggested a reduction of vertigo with betahistine and some suggested a reduction in tinnitus but all these effects may have been caused by bias in the methods. One trial with good methods showed no effect of betahistine on tinnitus compared with placebo in 35 patients. None of the trials showed any effect of betahistine on hearing loss. No serious adverse effects were found with betahistine.”
Update on Auris Medical Tinnitus Trials
Auris Medical also announced last week that it has resumed patient enrollment in the TACTT3 Phase 3 trial of Keyzilen® (AM-101) in acute and post-acute inner ear tinnitus. According to Reuters, the company experienced a set-back in August when the drug missed the main goals of a late-stage study by failing to meet the two co-primary effectiveness goals of statistically significant changes in tinnitus loudness and tinnitus burden compared to a placebo.
“Following the swift approval by regulatory agencies and ethics committees, we are pleased to resume enrollment under the amended protocol in the TACTT3 Phase 3 clinical trial of Keyzilen,” said Meyer. “We have applied key learnings from the TACTT2 trial that we believe substantially strengthen TACTT3’s probability of success, and we look forward to top-line results in early 2018.”
TACTT3, which is being conducted in Europe, is a randomized, double-blind, placebo-controlled Phase 3 trial in inner ear tinnitus following traumatic cochlear injury or otitis media. The trial previously enrolled more than 300 patients during the acute tinnitus stage (Stratum A) and approximately 330 patients during the post-acute tinnitus stage (Stratum B). As previously announced, the TACTT3 protocol was amended based on analysis of the TACTT2 Phase 3 trial outcomes. The amended protocol elevates the Tinnitus Functional Index score from a key secondary endpoint to an alternate primary efficacy endpoint, includes certain patient subgroups in confirmatory statistical testing, and increases the trial size with the enrollment of an additional 60 patients in each of Stratum A and B.
https://honiton-hearing.co.uk/wp-content/uploads/2020/06/Honiton-hearing-Treatment-of-Ménière’s-Disease-and-Vertigo-with-Intranasal-Betahistine-.jpg528620adminhttps://honitonnew.leecurran.co.uk/wp-content/uploads/2018/03/honitonhearinglogo.pngadmin2020-06-22 11:54:132021-07-04 14:58:35Treatment of Ménière’s Disease and Vertigo with Intranasal Betahistine
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