title: The use of psychophysical tuning curves to explore dead regions in the cochlea.
abstract: OBJECTIVE
  "Dead regions" are regions in the cochlea with no functioning inner hair cells (IHCs) and/or neurons. Amplification (using a hearing aid) over a frequency range corresponding to a dead region may not be beneficial and may even impair speech intelligibility. The objective of this article is to illustrate the use of psychophysical tuning curves (PTCs) as a tool for investigating dead regions and to illustrate the variety of audiogram configurations that can be associated with dead regions. We explore the influence of signal level and signal frequency to test the hypothesis that the frequency at the tip of the tuning curve defines the boundary of the dead region.
  
  
  METHODS
  PTCs were measured for five subjects with sensorineural hearing loss who were suspected of having dead regions. One had a relatively "flat" loss, one had a mild mid-frequency loss and three had high-frequency losses, varying in severity from 70 dB to more than 120 dB. For each PTC, the level and frequency of the sinusoidal signal were fixed, and the level of a narrowband noise masker needed just to mask the signal was determined as a function of the masker frequency. When the signal falls in a frequency region that is not "dead," the signal is detected via IHCs with characteristic frequencies (CFs) at or close to the signal frequency. In such a case, the tip of the PTC (the masker frequency at which the masker level is lowest) lies at or close to the signal frequency. When a dead region is present, the signal is detected via IHCs with CFs different from that of the signal frequency. In such a case, the tip of the PTC is shifted away from the signal frequency.
  
  
  RESULTS
  PTCs with frequency-shifted tips (indicative of dead regions) were found for all subjects. The frequencies at the tips sometimes decreased slightly with increasing signal level. For the subject with a relatively flat loss, PTCs with tips close to 3000 Hz were obtained for signal frequencies of 400, 1000 and 1500 Hz. A PTC with a tip at 5000 Hz was found for a signal frequency of 6000 Hz. These results suggest that this subject had an "island" of surviving IHCs and neurons with CFs ranging from 3000 to 5000 Hz, with extensive dead regions on either side. For the subject with a mid-frequency loss, the pattern of results suggested a mid-frequency dead region. For the subjects with high-frequency loss, the results suggested the presence of high-frequency dead regions, in one case starting at a frequency where absolute thresholds were only slightly higher than normal.
  
  
  CONCLUSIONS
  PTCs can be used to detect and delimit dead regions. Often, the frequency at the tip of the PTC can be used to define approximately one boundary of the dead region. However, the detection of beats can affect the shape of the PTC around the tip when the signal frequency lies just inside the dead region. The level of the signal can also have some effect on the frequency at the tip of the PTC. Very low signal levels can lead to variable results. Dead regions can start at frequencies where absolute thresholds are near normal.
authors.affiliation: Department of Experimental Psychology, University of Cambridge, UK.
authors.forename: B C
authors.initials: BC
authors.lastname: Moore
authors.forename: J I
authors.initials: JI
authors.lastname: Alcántara
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001309:Auditory Threshold / Q000502:physiology; D003051:Cochlea / Q000503:physiopathology*; D004867:Equipment Design; D018072:Hair Cells, Auditory, Outer / Q000503:physiopathology; D006316:Hearing Loss, High-Frequency / Q000175:diagnosis* / Q000503:physiopathology*; D006319:Hearing Loss, Sensorineural / Q000175:diagnosis* / Q000503:physiopathology*; D006801:Humans; D008875:Middle Aged; D017084:Otoacoustic Emissions, Spontaneous / Q000502:physiology; D010470:Perceptual Masking / Q000502:physiology; D011601:Psychophysics / Q000295:instrumentation / Q000379:methods; D012720:Severity of Illness Index