Although the underlying drivers of tinnitus are still not completely clear, we believe that tinnitus is produced by pathological alterations in the activity of the auditory nerve and the consequent perception of phantom sound. This sound may be produced by the auditory equivalent of pain fibres causing a constant perception of phantom sound rather than pain. There are similarities between the biological processes involved in chronic pain and tinnitus. The chronic pain is produced by activation of HCN2 channels in nerve fibres and we are attempting to treat chronic tinnitus using drugs that have been effective in blocking chronic pain.

This project investigates whether transcranial direct current stimulation (tDCS) can offer relief from tinnitus. Tinnitus is thought to result from high levels of coordinated nerve cell (oscillatory) activity in particular regions of the brain. tDCS is a technique that uses a weak electric current to reduce that activity. The study is the first to record brain activity using magnetoencephalography (MEG) during tDCS in tinnitus participants. This represents an important step-change in this field in terms of objectively measuring what happens during tinnitus treatment. This project is a collaboration between NIHR Nottingham BRC and Sir Peter Mansfield Imaging Centre (SPMIC).

This project is closed to recruitment and is now in follow-up.

There are 12 million people in the UK with long-term hearing loss. Hearing loss isolates people, cutting them off from society. The standard treatment is to amplify quiet sounds using hearing aids, but listening also requires cognition (memory and attention), particularly in noisy and challenging everyday environments. Our research has shown that computer games designed to help people practice listening to speech can improve cognition and listening abilities for people with hearing loss and hearing aid users. These games, termed auditory training, could help patients better understand speech in noise, improving communication, which can improve quality of life.

In the future, we need a large clinical trial to understand all of the benefits of these games to patients. First, we need to find out if the large trial could work, and if so, how best to design it. To do this, we are carrying out a feasibility study. The feasibility study will help ensure any future clinical trial provides high-quality evidence and value for money. We will involve patients in designing the feasibility study, which in turn will make it easier for future patients to take part in the trial.

Large-scale datasets, such as the UK Biobank and the Human Connectome Project, have proved extremely powerful for facilitating research into mechanisms of human health and disease. However, a limitation of existing datasets is that hearing health phenotypes are captured at a rudimentary level, with even basic pure tone audiometry data rarely being available. This severely limits the scope of the questions that can be asked of these datasets from an auditory perspective.

The aim of the BioResource is to extensively phenotype participants using: a battery of tests, to measure hearing ability and ear health; a set of questionnaires to assess health, lifestyle and how hearing conditions affect daily life; and blood/hair samples to measure biomarkers and carry out genotyping. Participants will be followed as they age through periodically repeating tests and questionnaires.

The Nottingham Hearing and Tinnitus BioResource represents our effort to begin leveraging the power of large, open, accessible datasets in a way that could transform how we treat and manage hearing loss and hearing-related conditions in future.

We are planning a feasibility study for the Nottingham Hearing and Tinnitus BioResource. This will evaluate the feasibility of administering a large audiological test battery; to ensure we have the right processes in place to recruit, test, and retain enough participants to make the BioResource viable. We will assess recruitment rates through different recruitment channels, the balance of the participant set recruited (sex, age, hearing conditions), the willingness of people to carry on with a longitudinal study, and the completeness and reliability of the data.

Currently we are: 1) prospectively assessing HCC in people with and without HL, and; 2) investigating associations between HCC and psychological responses, as well as; 3) piloting paediatric work to assess if it's feasible to assess HCC in children.

Noise exposure is the main cause of preventable hearing loss worldwide. Recent results suggest that even moderate noise exposure can cause substantial damage to the cochlear nerve, but it is not currently understood whether this damage extends further up the ascending auditory pathway. We can image the auditory pathway using MRI, including measures of the auditory nerve, and of nerve health and brain volume in the auditory brainstem and auditory cortex. We are conducting a large-scale study, recruiting 200 people, to investigate which of these many MRI measures are the best predictors of symptomatic noise-induced hearing loss.

When we interact with others we sometimes synchronize our behaviours, emotions and even our physiological and brain activity. The synchrony in brain activity might be particularly important in mother-child interactions in that it may facilitate the child’s language and speech development.

This study is recruiting: contact Hilal for more information.

Email Hilal

An online survey study to evaluate the experience and opinions of healthcare professionals dealing with this patient group, and recruitment was launched in May 2022 and data collection will be completed in December 2022. At the same time, a scoping review exploring and collating the auditory and vestibular problems reported in individuals with non-blast-related TBI is ongoing. Findings obtained from these studies will then be used to inform the structure of our clinical project. Our studies will provide clinicians and researchers with a useful framework for advanced research and clinical practice in the diagnosis and treatment of auditory and balance disorders associated with non-blast-related TBI.

By involving healthcare users with experience in SSD treatments, audiologists, ENT surgeons, clinical researchers, and industry representatives; the CROSSSD study gathered international opinions via Delphi surveys and a web-based consensus meeting and found agreement on three measures that should always be reported on in SSD intervention studies. The core outcomes are (1) Spatial orientation, (2) Group conversations in noisy social situations, and (3) Impact on social situations.

If all future SSD intervention studies measure these core outcomes as a minimum, we can more easily compare results of different studies, improve research quality, and enhance clinical decision-making.

Further research is currently underway to help determine ‘how’ these core outcomes should best be measured.

A project to understand the impact of NICE guidance TAG566 (2019) on children with severe or profound hearing loss, by comparing outcomes for children with severe hearing loss using hearing aids and those for children with cochlear implants.

Conventional hearing aid fine-tuning relies on patients recalling and describing sound quality issues to clinicians. However, communication barriers and memory bias may render this practice ineffective. An alternative approach is to let patients adjust hearing aid settings themselves. Self-adjustment methods require mapping parameters to controls that are easily understood and perceptually relevant. This research investigates perceptual and operational aspects of different self-adjustment methods to assess their effects on self-adjustment choices and their effectiveness in hearing aid fine-tuning.

Self-management of long-term conditions was shown to have positive clinical outcomes. However, this is under researched in the case of hearing loss.

This study aims to gain further knowledge on self-management of hearing loss, directly from people with hearing loss and hearing healthcare clinicians. To plan for optimal self-management, it is important to evaluate the extent to which audiology appointments address the elements of self-management that are identified as most important and valuable to the individual with hearing loss. This will allow us to consider the potential form and content of interventions to optimise appointments and promote successful self-management.

How can we process and remix music so it sounds best for those with a hearing loss? The new Cadenza project aims to better define what music personalised for someone with a hearing loss should sound like and exploit the latest in machine learning to create improved music listening experiences. The improvement in music will be achieved by running a series of open competitions, which researchers from around the world will compete in. Competitors will be given music to enhance, through processing and/or remixing. They will be challenged to improve and personalise the music for listeners with hearing losses.

The Universities of Salford, Sheffield, Leeds and Nottingham have been awarded a grant from the Engineering and Physical Sciences Research Council (EPSRC) to investigate adaptations to music for those with a hearing loss. The grant of £1.6 million is a collaborative partnership with industrial partners BBC R&D, Google and Logitech and user engagement via Royal National Institute for the Deaf (RNID).

The Clarity Project is a 5-year UKRI-funded research project involving four UK Universities and associated industrial partners. Our aim is to organise open "challenges" for hearing aid algorithms and to champion novel machine learning approaches to hearing aid speech-in-noise processing. These challenges will focus on speech-in-noise listening, a situation in which hearing aid users report the most dissatisfaction. For each challenge, we will be providing simulation tools, datasets and baseline systems. Our data and code will all be open-sourced, with the aim of lowering barriers that currently prevent speech and audio researchers from considering hearing impairment. Our funding is also allowing us to evaluate challenge submissions by running listening tests with hearing impaired listeners.

To transform hearing care by 2050, we aim to completely re-think the way HAs are designed. Our transformative approach - for the first time - draws on the cognitive principles of normal hearing. Listeners naturally combine information from both their ears and eyes: we use our eyes to help us hear. We will create "multi-modal" aids which not only amplify sounds but contextually use simultaneously collected information from a range of sensors to improve speech intelligibility. For example, a large amount of information about the words said by a person is conveyed in visual information, in the movements of the speaker's lips, hand gestures, and similar. This is ignored by current commercial HAs and could be fed into the speech enhancement process. We can also use wearable sensors (embedded within the HA itself) to estimate listening effort and its impact on the person, and use this to tell whether the speech enhancement process is actually helping or not. Creating these multi-modal "audio-visual" HAs raises many formidable technical challenges which need to be tackled holistically. Making use of lip movements traditionally requires a video camera filming the speaker, which introduces privacy questions. We can overcome some of these questions by encrypting the data as soon as it is collected, and we will pioneer new approaches for processing and understanding the video data while it stays encrypted. We aim to never access the raw video data, but still to use it as a useful source of information. To complement this, we will also investigate methods for remote lip reading without using a video feed, instead exploring the use of radio signals for remote monitoring. 

The socioemotional consequences of hearing loss (and hearing-aid treatment) may play out differently for different people, dependent on their circumstances, personality, and daily activities. In this project we will help to identify individual differences in socioemotional well-being and the best way of measuring them. We will identify if existing measures can accurately and effectively measure the key components, and whether additional interventions could improve socioemotional well-being outcomes for those who need it. This project is the first step in developing understanding and interventions to increase the happiness and comfort of each person with hearing loss based on their individual needs.

The digital intervention aims to provide educational and self-help components to support adults experiencing hyperacusis. A advisory group for the project has been established to help guide the development and evaluation. To ensure acceptability, usability and feasibility of the intervention, interviews, surveys and piloting are being conducted throughout with the intended users (e.g., adults living with hyperacusis and healthcare professionals). 

Using research techniques such as semi-structured interviewing and smartphone based ecological momentary assessment we hope to pave the way for improved clinical assessment and counselling; provide narratives for efforts to promote the uptake of hearing help; identify situations which are especially likely to trigger negative emotions, enabling better targeting of interventions and setting of expectations; identify novel risk factors for the discontinuation of hearing aid use, and thereby inspire work to address those risks.

We have taken an existing measure the York Binaural Hearing Related Quality of Life System (YBHRQL) and adapted the pre-existing domains for use with young people aged 8 to 16 years with a severe or profound hearing loss.  we have used the qualitative pre-test interview approach to put the young people at the heart of our questionnaire adaptation.  A questionnaire can only be as good as the questions it asks.  For these questions to be good they must be both relatable to those completing them and reliable.  We have adapted the existing measure with young people as co-experts.  We are now in the process of validation and scoring.  By developing our questionnaire in this way we have designed it to be a patient reported outcome measure (PROM) which means a health utility value can be calculated from it's score.  This in turn can then be used for health economic calculations of quality and costs associated with care participants receive.  This has been designed to be used in the wider BEARS trial.

Difficulty engaging in conversation is the most often-reported problem of hearing loss, but currently treatment with hearing aids does not adequately fix this. There is a clear and unmet need for understanding why and how older adults with hearing loss experience problems in conversation. With such understanding, better treatments will become possible, improving the social participation of people with hearing loss. In this programme we will develop an in-depth explanation of how miscommunications happen in everyday conversation, and how people behave in response to them.

Conversation is central to humans’ capacity to communicate, maintain relationships, and fulfil requirements of daily living. A person’s capacity for successful spoken conversation relies on both hearing sensitivity and the use of active communication strategies, such as asking for repetitions or moving closer to a talker. This project incorporates active communication strategies into controlled assessment of speech comprehension to quantify the benefit of these strategies and the extent to which taking account of these strategies can improve the prediction of the impact of hearing impairment and amplification on speech understanding.

This is a collaboration with the National Center for Rehabilitative Auditory Research, Portland, Oregon, and the Manchester Biomedical Research Centre. We have scrutinised how the routine nature of the data collection affected its likely quality and structural characteristics, essential insights for anyone using such datasets in research. Using a novel measure of hearing-aid use persistence, we found several factors including prior in-patient care and multimorbidities to be predictive of persistence. We have also addressed the links between dementia and hearing-aid use. We have shown that (a) hearing-aid use reduces dementia risk and (b) dementia reduces hearing-aid use. These are the first quantitative results to demonstrate that cognitive decline leads to device disuse.

A build-up of earwax in the ear canal can cause hearing loss and discomfort and may contribute to infections. Irrigation and microsuction are two earwax removal methods available in the UK. The two methods differ in availability, contraindications, and cost. However, there is a lack of evidence comparing clinical and cost-effectiveness of these techniques.

In preparation for the future clinical trials, we are analysing the content and quality of the earwax removal websites and patients' experiences with each method shared within online forums. We are looking at preference for one method, pre- and post-treatment, outcomes and contraindications and complications.

Therefore, this systematic review and meta-analysis aims to understand the relationship between executive function and self-reported listening and communication difficulties in adults with hearing loss and, where possible, potential covariates of age and pure-tone audiometric thresholds.

Within group conversation, we often need to not only focus on one but monitor multiple talkers at once. That is, we need to engage both selective and distributed attention to not restrict our ability to participate fully. Further, for active engagement in a conversation, the ability to recall words is secondary to the ability to follow the gist of the ongoing conversation(s). To measure the benefits of technology in group conversations, as well as better quantify our conversational capacity, we will develop an outcome based on the Just-Follow Conversation task that can capture the selective and distributed listening required of group conversation.

Therefore, interventions to improve hearing aids use are essential to increase the widespread benefit for those people living with hearing loss. The objective of this Cochrane review is to assess the effectiveness of interventions designed to improve or promote the use of hearing aids in adults with acquired hearing loss fitted with at least one hearing aid. This is an update of a review first published in The Cochrane Library in 2016.

This review aims to address the following questions:

1) Does evidence exist to support improvements in trained and untrained measures of speech perception, cognition, and self-reported communication or quality of life, as a result of individual computer-based or internet-based auditory training in adults with hearing loss (with or without hearing aids or cochlear implants)?

2) Do any improvements in trained or untrained outcomes remain at post-training intervention follow-ups (where measured and reported)?

3) What are the levels of adherence to individual computer-based or internet-based auditory training programs in adults with hearing loss for included studies?

This project aims to explore the successful coping with age-related declines in sensory ability by finding out how combining sensory information from multiple sources may compensate for impairments in hearing and vision. The proposed research will develop researchers' understanding of sensory ability, ageing and memory.

If left untreated, hearing loss leads to difficulties in communication, which can affect daily life. This project aims to identify how individuals' behaviours are linked to their use of hearing technologies and develop an online tool with patients to improve the use of NHS-prescribed hearing aids. Patients will provide feedback on the tool, including how helpful it is for them. This will lead to a future study to examine the feasibility of a multicentre clinical trial to measure the benefits of the tool for NHS patients who receive hearing aids for the first time.

For updates about the Priority Setting Partnership, you can follow @DementiaHearPSP on X/Twitter or visit the JLA website.