Neural Regeneration Research ›› 2023, Vol. 18 ›› Issue (9): 1968-1975.doi: 10.4103/1673-5374.361530

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Age-related hearing loss accelerates the decline in fast speech comprehension and the decompensation of cortical network connections

He-Mei Huang1, 2, #, Gui-Sheng Chen1, 2, 3, #, Zhong-Yi Liu4, #, Qing-Lin Meng5, Jia-Hong Li1, 2, Han-Wen Dong1, 2, Yu-Chen Chen6, Fei Zhao7, Xiao-Wu Tang1, 2, Jin-Liang Gao8, Xi-Ming Chen8, Yue-Xin Cai1, 2, 3, *, Yi-Qing Zheng1, 2, 3, *#br#   

  1. 1Department of Otolaryngology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong Province, China; 2Institute of Hearing and Speech-Language Science, Sun Yat-sen University, Guangzhou, Guangdong Province, China; 3Department of Otolaryngology, Shenzhen-Shanwei Central Hospital, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Shanwei, Guangdong Province, China; 4Department of Radiology, Guangdong Provincial Work Injury Rehabilitation Hospital, Guangzhou, Guangdong Province, China; 5Acoustics Lab of School of Physics and Optoelectronics and State Key Laboratory of Subtropical Building Science, South China University of Technology, Guangzhou, Guangdong Province, China; 6Department of Radiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu Province, China; 7Department of Speech and Language Therapy and Hearing Science, Cardiff Metropolitan University, Cardiff, UK; 8Department of Otolaryngology, Shenzhen Baoan Maternal and Child Health Hospital, Shenzhen, Guangdong Province, China
  • Online:2023-09-15 Published:2023-03-06
  • Contact: Yue-Xin Cai, MD, caiyx25@mail.sysu.edu.cn; Yi-Qing Zheng, zhengyiq@mail.sysu.edu.cn.
  • Supported by:
    This work was supported by the National Natural Science Foundation of China, Nos. 82171138 (to YQZ), 82071062 (to YXC), the Natural Science Foundation of Guangdong Province, No. 2021A1515012038 (to YXC), the Fundamental Research Funds for the Central Universities, No. 20ykpy91 (to YXC) and the Sun Yat-Sen Clinical Research Cultivating Program, No. SYS-Q-201903 (to YXC).

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Abstract: Patients with age-related hearing loss face hearing difficulties in daily life. The causes of age-related hearing loss are complex and include changes in peripheral hearing, central processing, and cognitive-related abilities. Furthermore, the factors by which aging relates to hearing loss via changes in auditory processing ability are still unclear. In this cross-sectional study, we evaluated 27 older adults (over 60 years old) with age-related hearing loss, 21 older adults (over 60 years old) with normal hearing, and 30 younger subjects (18–30 years old) with normal hearing. We used the outcome of the upper-threshold test, including the time-compressed threshold and the speech recognition threshold in noisy conditions, as a behavioral indicator of auditory processing ability. We also used electroencephalography to identify presbycusis-related abnormalities in the brain while the participants were in a spontaneous resting state. The time-compressed threshold and speech recognition threshold data indicated significant differences among the groups. In patients with age-related hearing loss, information masking (babble noise) had a greater effect than energy masking (speech-shaped noise) on processing difficulties. In terms of resting-state electroencephalography signals, we observed enhanced frontal lobe (Brodmann’s area, BA11) activation in the older adults with normal hearing compared with the younger participants with normal hearing, and greater activation in the parietal (BA7) and occipital (BA19) lobes in the individuals with age-related hearing loss compared with the younger adults. Our functional connection analysis suggested that compared with younger people, the older adults with normal hearing exhibited enhanced connections among networks, including the default mode network, sensorimotor network, cingulo-opercular network, occipital network, and frontoparietal network. These results suggest that both normal aging and the development of age-related hearing loss have a negative effect on advanced auditory processing capabilities and that hearing loss accelerates the decline in speech comprehension, especially in speech competition situations. Older adults with normal hearing may have increased compensatory attentional resource recruitment represented by the top-down active listening mechanism, while those with age-related hearing loss exhibit decompensation of network connections involving multisensory integration.

Key words: age-related hearing loss, aging, electroencephalography, fast-speech comprehension, functional brain network, functional connectivity, resting-state, sLORETA, source analysis, speech reception threshold