# UNDERSTANDING SUPRATHRESHOLD HEARING DEFICITS

> **NIH NIH R01** · FATHER FLANAGAN'S BOYS' HOME · 2021 · $406,542

## Abstract

PROJECT SUMMARY/ABSTRACT
 Sensorineural hearing loss (SNHL) can occur as a result of dysfunction of outer hair cells, inner hair cells,
auditory-nerve fibers or synapses. However, standard clinical techniques are limited in their ability to
differentiate these dysfunctions because they focus on threshold elevation and thus provide insufficient
information about suprathreshold auditory dysfunction, which has greater ecological validity than threshold
elevation. SNHL that does not elevate thresholds, and therefore would be missed by standard clinical
techniques, is sometimes referred to as “hidden hearing loss” (HHL). Recent animal studies suggest that
noise-induced synaptopathy may underlie HHL and may be the cause of suprathreshold hearing deficits, such
as difficulty understanding speech in noise. However, there is limited research to support the diagnosis of HHL
in humans beyond reports that some individuals have suprathreshold hearing deficits that cannot be predicted
from their audiograms. Understanding HHL in humans will require the use of measurements of auditory
function that are specific to the location of the dysfunction in the auditory pathway, including the specific group
of auditory-nerve fibers (low vs. high spontaneous-rate fibers) underlying the dysfunction. The long-term goals
of this research program are to improve our understanding of suprathreshold hearing deficits and to develop
intervention strategies that ameliorate these deficits. The immediate goal of this proposal is to establish a
theoretical framework for the development of diagnostic methods for HHL in humans. Unfortunately, a “gold
standard” does not exist because synaptopathy cannot be directly observed in humans. Consequently, our
approach is to develop a statistical model of HHL that describes the relationship and interdependence between
specific behavioral and physiological measures of auditory function that are thought to be indicative of HHL
and measures that reflect the functional integrity of sites along the auditory pathway. The goal will be achieved
by pursuing three aims: (1) Develop a statistical model of HHL for individuals with normal hearing, (2) Develop
a statistical model of HHL for individuals with clinical hearing loss caused by noise exposure, and (3) Validate a
predictive model of HHL and demonstrate its relation to speech understanding in noise. We will establish a
functional definition of HHL as a component of the variability in measures impacted by HHL that is not due to
audiometric threshold. We will then create a statistical model that relates this estimate of HHL to measures that
reflect sites of dysfunction along the auditory pathway. Through the aims, we will test the hypothesis that HHL
accounts for some of the variability in suprathreshold measures of auditory function. The proposed research
will lead to evidence-based models of suprathreshold auditory dysfunction that are capable of predicting
hearing deficits, provide further insights ...

## Key facts

- **NIH application ID:** 10242166
- **Project number:** 5R01DC016348-05
- **Recipient organization:** FATHER FLANAGAN'S BOYS' HOME
- **Principal Investigator:** Stephen T Neely
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $406,542
- **Award type:** 5
- **Project period:** 2017-09-21 → 2023-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10242166

## Citation

> US National Institutes of Health, RePORTER application 10242166, UNDERSTANDING SUPRATHRESHOLD HEARING DEFICITS (5R01DC016348-05). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10242166. Licensed CC0.

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