Potential objective measures to assess the presence of hidden hearing loss in young adults with long-term exposure to loud music

Several objective measures for identifying individuals with “hidden hearing loss” (HHL), have been proposed based on cochlear synaptopathy and the resulting central changes in neural gain. While the loss of high-threshold auditory nerve fibres may result in weaker middle-ear muscle reflexes (MEMR) in HHL sufferers, binaural processing is likely disproportionately and deleteriously impacted by central gain changes in the same group of individuals. In this study, two groups of young adults (<35 years old) with normal audiometric thresholds were recruited, one of which consisted of students from a music conservatory who co-reported tinnitus and listening-in-noise difficulties, likely as a result of HHL. Participants completed a set of questionnaires as well as undergoing both multi-frequency MEMR testing (four ipsilateral elicitors), and an electrophysiological measure of IPD processing known as the ‘Interaural Phase Modulation-Following-Response(“IPM-FR”) (evoked using two IPD transitions using a clinical setup). Results show that the ‘HHL/Tinnitus’ group presents lower scores on the Speech, Spatial and Qualities of Hearing Scale questionnaire, less steep MEMR growth functions, and smaller IPM-FRs compared to the ‘control’ group. This suggests that both objective measures could be clinically useful to identify populations with HHL.