A new efficient and safe music exposure paradigm (Iliadou et al., 2024)

Purpose: The purpose of this study was to develop a time-efficient music exposure and testing paradigm that safely creates temporary cochlear dysfunction that could be used in future temporary threshold shift (TTS) studies.Method: A 30-min audio compilation of pop rock music tracks was created. Adult volunteers with normal hearing were then exposed to this music material monaurally through headphones for 30 min at 97 dBA or 15 min at 100 dBA. Levels were measured from the ear of a manikin and are considered to provide an equivalent daily noise dose based on a 3-dB exchange. We assessed the changes in their hearing, by means of distortion product otoacoustic emission (DPOAE) testing, and standard and extended high-frequency pure-tone audiometry before and after exposure. There were 17 volunteers in total. In the first trial, eight volunteers (four females; Mdnage = 31 years [interquartile range, IQR = 4.25]) were included. Although TTS was observed in all eight participants for at least one frequency, a large variation in affected frequencies was observed. To address this issue, the audio material was further remastered to adjust levels across the different frequency bands. Fourteen adults (nine newly recruited and five from the first trial; seven females; Mdnage = 31 years [IQR = 5]) were exposed to the new material.Results: All but two of 17 participants presented clinically significant TTS or decrease in DPOAE amplitude in at least one frequency. Statistically significant average TTS of 7.43 dB was observed at 6 kHz. There were statistically significant average DPOAE amplitude shifts of −2.55 dB at 4 kHz, −4.97 dB at 6 kHz, and −3.14 dB at 8 kHz. No participant presented permanent threshold shift.Conclusions: A monaural music paradigm was developed and shown to induce statistically significant TTS and DPOAE amplitude shifts, without evidence of permanent loss. This realistic and time-efficient paradigm may be considered a viable option for experimental studies of temporary music-induced hearing loss.Supplemental Material S1. TTS per frequency for the 17 participants of the pilot study.Supplemental Material S2. Ultimate PTA threshold shift per frequency for the first part of the experimental study.Supplemental Material S3. Ultimate PTA threshold shift per frequency for the second part of the experimental study.Supplemental Material S4. Distortion product otoacoustic emission data for Trials 1 and 2.Iliadou, E., Pastiadis, K., Dimitriadis, D., Plack, C. J., & Bibas, A. (2024). Development and validation of an efficient and safe loud music exposure paradigm. Journal of Speech, Language, and Hearing Research, 67(2), 668–679. https://doi.org/10.1044/2023_JSLHR-23-00332

研究目的：本研究旨在开发一种省时的音乐暴露与测试范式，该范式可安全诱导暂时性耳蜗功能障碍，可应用于未来的暂时性听阈偏移（Temporary Threshold Shift, TTS）相关研究。
方法：本研究首先制作了一段时长30分钟的流行摇滚音乐音频合集。随后招募听力正常的成年志愿者，通过头戴式耳机单耳暴露于该音频素材，暴露参数为97 dBA下暴露30分钟，或100 dBA下暴露15分钟。暴露声级通过仿真人头模型的耳部测得，基于3dB交换率计算，该声级可等效为日常噪声暴露剂量。我们分别于暴露前后，通过畸变产物耳声发射（Distortion Product Otoacoustic Emission, DPOAE）测试、标准及扩展高频纯音测听，评估受试者的听力变化情况。本研究共纳入17名志愿者：首次试验中纳入8名志愿者（4名女性；中位数年龄为31岁，四分位距（Interquartile Range, IQR）=4.25）。尽管8名受试者在至少一个频率上均出现了暂时性听阈偏移，但受影响的频率存在较大差异。为解决该问题，研究团队对音频素材进行了重新母带处理，以调整不同频带的声级。随后共有14名成年人（9名新招募者，5名来自首次试验；7名女性；中位数年龄为31岁，四分位距IQR=5）暴露于优化后的音频素材。
结果：17名受试者中除2名外，均在至少一个频率上出现具有临床意义的暂时性听阈偏移或畸变产物耳声发射幅值下降。在6 kHz频率处观测到具有统计学意义的平均暂时性听阈偏移7.43 dB。各频率处的平均畸变产物耳声发射幅值变化分别为：4 kHz处-2.55 dB、6 kHz处-4.97 dB、8 kHz处-3.14 dB。所有受试者均未出现永久性听阈偏移。
结论：本研究开发的单耳音乐暴露范式可诱导具有统计学意义的暂时性听阈偏移及畸变产物耳声发射幅值变化，且未观测到永久性听力损失的迹象。该范式兼具真实性与时效性，可作为暂时性音乐性听力损失实验研究的可行方案。
补充材料S1：预试验17名受试者各频率的暂时性听阈偏移数据。
补充材料S2：试验第一阶段受试者各频率的最终纯音测听（Pure Tone Audiometry, PTA）听阈偏移数据。
补充材料S3：试验第二阶段受试者各频率的最终纯音测听听阈偏移数据。
补充材料S4：两次试验的畸变产物耳声发射数据。
参考文献：Iliadou, E., Pastiadis, K., Dimitriadis, D., Plack, C. J., & Bibas, A. (2024). 高效安全的大声音乐暴露范式的开发与验证. 《言语、语言与听力研究杂志》, 67(2), 668–679. https://doi.org/10.1044/2023_JSLHR-23-00332