Manchester Centre for Audiology and Deafness (ManCAD) / Research / Assessment and diagnosis

Assessment and diagnosis

Current projects

Understanding the consequences of recreational noise exposure

Funder:

Medical Research Council (MRC)

Staff involved:

Chris Plack, Kevin Munro, Karolina Kluk, Rebecca Millman, Garreth Prendergast, Hannah Guest, Sue Francis (University of Nottingham), Rebecca Dewey (University of Nottingham)

Project overview:

Current understanding of the impact of noise exposure on human hearing is poor, due to a combination of compromised study design and insensitive tests. We will use a unique range of sensitive tests, well beyond standard clinical measures. Most have never been evaluated in a longitudinal design.

Our study will determine, for the first time, the true extent of damage caused by early noise exposure, and the risk factors involved. We will also use advanced neuroimaging to measure directly, for the first time, the structural neural changes caused by noise damage in humans.

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Early biomarkers of healthy ageing and Alzheimer’s disease

Funder:

Deafness support network

Staff involved:

Jenna Littlejohn, Chris Plack, David Moore

Project overview:

During the long pre-clinical pathogenesis of Alzheimer’s disease, the most common cause of dementia, we hypothesise that multiple stages of the auditory system are under stress from the effects of neurodegeneration.

By recruiting people at the prodromal stage of Alzheimer’s disease, our proposal aims to identify whether objective auditory temporal coding measures are associated with the Alzheimer’s disease disease process, and may provide auditory biomarkers for Alzheimer’s disease which help to map progression of the disease.

This would also help to understand further the relationship between Alzheimer’s disease and hearing impairment, by providing a potential mechanism linking the two.

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The effects on auditory function of radiotherapy and chemotherapy treatments for head and neck tumours (EARAD)

Funder:

Marston Scholarship, BRC Advanced Radiotherapy and Hearing Health themes.

Staff involved:

Chris Plack, Catharine West, Kevin Munro, Hannah Guest, Marianne Aznar, Lip Wai Lee

Project overview:

The EARAD project is designed to evaluate the effects of radiotherapy and combined chemoradiotherapy treatments (CCRTs), both known to cause damage to the cochlea and auditory brainstem (ototoxicity).

The overall aim is to provide data that will define the amount of radiotherapy needed to damage individual substructures of the auditory pathway so that a better balance can be made between ototoxic hearing loss and tumour control during radiotherapy for head and neck cancer.

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Listening effort: Quantifying an important dimension of hearing disability and treatment benefit

Funder:

Manchester NIHR BRC in Hearing Health.

Staff involved:

Peter Carolan, Rebecca Millman, Antje Heinrich and Kevin Munro

Project overview:

Listening effort is the mental effort required to achieve success in listening goals. We all experience listening effort to some extent. You might have noticed that you have to put extra effort into listening under challenging conditions, for example, when listening in high levels of background noise or when you’re listening to someone with an unfamiliar accent.

The amount of listening effort used during listening is influenced by a combination of listening demands, cognitive resources and the motivation to use those cognitive resources. This project aims to quantify the effects of listening demands and motivation on both objective and subjective measures of listening effort.

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Personalised hearing-aid fitting using suprathreshold tests

Funder:

Wellcome Trust Projects for Translation

Staff involved:

Josef Schlittenlacher, Karolina Kluk, Michael Stone, Emanuele Perugia

Project overview:

The project aims to develop and implement a new hearing aid fitting formula through online hearing tests. Online hearing tests required a reasonable test duration and the calibration of the equipment. Suprathreshold tests based on the machine learning algorithm can alleviate these problems.

Our notched-noise test uses Gaussian Processes to optimise stimulus parameters and to maintain a probabilistic estimate of the auditory-filter shapes. The new formula using auditory-filter shapes will lead to better sound quality for all hearing-aid users, and provide considerably higher speech intelligibility than the current standard.

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The effects of female sex hormones on auditory function and tinnitus

Funder:

Saudi Royal Embassy (PhD Studentship)

Staff involved:

Nada Aloufi, Karolina Kluk, Antje Heinrich, Kay Marshall

Project overview:

The sex differences in auditory function are well-documented in the literature, however, the cause of such differences is not clear. Women tend to have better hearing sensitivity than age-matched men (Boothalingam et al., 2018) and these differences may be due to female sex hormones (oestrogen and progesterone).

These hormones are found in both genders, however, women have higher levels than men and have more female-hormone receptors in the inner ear (He and Ren, 2018). In this project, we are investigating the effect of female sex hormones on auditory function.

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Behavioural audiometry measures in babies: Innovation, novelty, and optimisation (BAMBINO)

BAMBINO logoFunder:

William Demant Foundation

Staff involved:

Anisa Visram, Iain Jackson, Michael Stone, Tim Cootes, Kevin Munro

Project overview:

The BAMBINO study works with families and children under two years to improve hearing tests for babies. Our goal is to increase the amount of information audiologists obtain during hearing assessment by making tests more fun and engaging, and by exploring new ways of measuring whether or not babies respond to sounds.

Our work examines how sounds and images that are meaningful to children, like the theme from a favourite TV show, can increase engagement during hearing tests, and how machine learning can help to interpret subtle changes in babies’ faces and behaviour in response to sounds.

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Insight into auditory processing provided by non-standard stimuli

Staff involved:

Garreth Prendergast

Project overview:

The majority of studies investigating auditory processing either use natural sounds, such as speech, or very simple well-controlled sounds where only a few parameters change. Previous work has demonstrated in both humans and animals, the specific characteristics of these simple sounds are important and that using slightly different, but still very simple sounds, can provide additional insights into our understanding of the auditory system.

It may be that much of our understanding of auditory processing comes from sounds which are too simple, and too artificial to faithfully capture the nature of neural coding performed by the system. The aim of this study is to establish if such nonstandard stimuli can provide a comparable insight into human sub-cortical processing.

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Benchmarking performance of remote microphone technologies used with hearing aids

Funder:

National Deaf Children’s Society

Staff involved:

Michael Stone, Helen Chilton, Helen Glyde, Harvey Dillon, Keith Wilbraham, Helen Whiston, Melanie Lough

Project overview:

Remote microphones enable hearing aid users to hear a remote talker as if they were standing next to them. There is an expanding range of technologies employed to perform this function.

Many of these technologies are cheaper than for those traditionally used in the education sector. We are exploring what makes for acceptable performance for a remote microphone system in an education setting, so that cost is not the driving factor in selection.

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A low-cost hearing aid for low/middle income countries

Funder:

UK Research and Innovation (UKRI)

Staff involved:

Michael Stone, Melanie Lough, Helen Whiston. A sub-contract from the University of Warwick.

Project overview:

The miniaturisation of hearing aids is achieved by using custom-designed signal processing on silicon chips. These chips are therefore expensive. A new, low-power, very cheap, general-purpose chip can be programmed to perform the hearing aid function and so drive the cost down.

We are advising on the audiological aspects of design, fitting and assessing of the hearing aids in a field trial in Nepal.

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Persistent auditory consequences of COVID-19: A Manchester research study (PACCMan)

Funders:

PACCMan logoThe Royal National Institute for Deaf People, The Dowager Countess Eleanor Peel Trust, and the University of Manchester COVID-19 Research Appeal Fund

Staff involved:

Kevin Munro, Chris Plack, Hannah Guest, Anisa Visram, Iain Jackson

Project overview:

A substantial minority of patients hospitalised for COVID-19 experience persistent auditory symptoms following recovery from the acute phase of the illness. PACCMan aims to determine the prevalence, location, and severity of COVID-19-related auditory disorders, as well as any associations with potential risk markers (lifestyle, co-morbidities, and critical care interventions).

Our custom-built hearing-assessment van will visit COVID-19 patients – and patients hospitalised for other illnesses – at their homes. The two groups will be compared on a wide range of state-of-the-art auditory measures, testing for enduring effects of COVID-19 throughout the auditory pathway.

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Integrated objective testing using decision tree

Funder:

Manchester NIHR BRC in Hearing Health

Staff involved:

Emanuele Perugia, Karolina Kluk

Project overview:

The project aims to develop an objective and automated audiological test-battery, critical for fast and reliable diagnosis of hearing disorders in infants and children, and adults with special needs.

A decision tree will allow multiple audiological tests to be conducted in an intelligent, logical order, where the results of one test will determine the type and parameters of the next test performed.

The error propagation within the decision tree is being assessed. The decision tree is based on a mix of data modelling and measurements taken noninvasively from the brain’s response to sound.

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Hearing health information from primary care data: how to capture hearing aid uptake?

Funder:

National Institute for Health Research (NIHR)

Staff involved:

Kevin Munro and Piers Dawes on behalf of the trial management team and BRC partners

Project overview:

Our long-term plan is to develop an online hearing check with a support package that avoids regular visits to NHS clinics.

Before we can compare our online package with usual care, we need to find a reliable way of measuring who gets a hearing aid. The aim is to develop measures of hearing aid uptake using GP data.

The project is funded by a programme development grant from the National Institute for Health Research and involves a collaboration between the three NIHR Biomedical Research centres with a hearing research theme (Manchester, Nottingham and University College London Hospital).

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Investigating chronic symptoms, balance function, motor development and health-related quality of life in children and adolescents with vestibular dysfunction

Funder:

The Ewing Foundation

Staff involved:

Samantha Lear, Karolina Kluk, Antje Heinrich

Project overview:

There is a very limited evidence and few certainties about outcomes in children and adolescents with vestibular dysfunction. In particular there is a shortage of evidence about the impact on quality of life and psychological wellbeing in children and adolescents with vestibular dysfunction.

The planned study will follow up children and young people who have been identified with vestibular dysfunction at Sheffield Children’s Hospital. The primary objective of the study is to examine the long term vestibular-related outcomes and quality of life measures reported by children and young people with vestibular dysfunction and their families/carers.

We will also examine whether objectively measured balance function in this group does correct itself and whether the objective measures of balance function correlate with subjective reports of balance function in this group.

This study aims to identify biomarkers of poor outcomes, such as which types of vestibular abnormality (e.g. total bilateral hypofunction vs unilateral vestibular dysfunction vs central abnormality) are associated with poorer outcomes.

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