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Behavioral and Electrophysiologic Binaural Processing in Persons with Symmetric Hearing Loss

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Binaural hearing improves our ability to understand speech and to localize sounds. Hearing loss can interfere with binaural cues, and despite the success of amplification, ∼25% of people with bilateral hearing loss fit with two hearing aids choose to wear only one (e.g., Brooks and Bulmer, 1981). One explanation is reduced binaural processing, which occurs when the signal presented to one ear interferes with the perception of the signal presented to the other ear (e.g., Jerger et al, 1993). Typical clinical measures, however, are insensitive to binaural processing deficits.


The purpose of this study was to determine the extent to which behavioral measures of binaural performance were related to electrophysiological measures of binaural processing in subjects with symmetrical pure-tone sensitivity.

Research Design:

The relationship between middle latency responses (MLRs) and behavioral performance on binaural listening tasks was assessed by Spearman's rho correlation analyses. Separate repeated measures analyses of variance (RMANOVAs) were performed for MLR latency and MLR amplitude.

Study Sample:

Nineteen subjects were recruited for the present study based on a clinical presentation of symmetrical pure-tone sensitivity with asymmetrical performance on a word-recognition in noise test. This subpopulation of patients included both subjects with and subjects without hearing loss.

Data Collection and Analysis:

Monaural and binaural auditory processing was measured behaviorally and electrophysiologically in right-handed subjects. The behavioral tests included the Words-in-Noise test (WIN), the dichotic digits test (DDT), and the 500 Hz masking level difference (MLD). Electrophysiologic responses were measured by the binaural interaction component (BIC) of the MLR. The electrophysiological responses were analyzed to examine the effects of peak (Na, Pa, and Nb) and condition (monaural left, monaural right, binaural, and BIC) on MLR amplitude and latency.


Significant correlations were found among electrophysiological measures of binaural hearing and behavioral tests of binaural hearing. A strong correlation between the MLD and the binaural Na-Pa amplitude was found (r = .816).


The behavioral and electrophysiological measures used in the present study clearly showed evidence of reduced binaural processing in ∼10 of the subjects in the present study who had symmetrical pure-tone sensitivity. These results underscore the importance of understanding binaural auditory processing and how these measures may or may not identify functional auditory problems.
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Keywords: Auditory evoked potentials; binaural processing; hearing loss; speech perception

Document Type: Research Article

Affiliations: James H. Quillen VA Medical Center, Mountain Home, Tennessee

Publication date: March 1, 2011

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