Auditory and Vestibular Research 2018. 27(2):.

Comparing the gap in noise test results in patients with type 1 diabetes and normal subjects
Hossein Seraji, Ghassem Mohammadkhani, Ensiyeh Nasliesfahani, Shohreh Jalaie


Background and Aim: Type 1 diabetes (T1D) is a common disorder that can cause various conflicts in the central nervous system (CNS). One of the important abilities of the CNS is the temporal processing. The purpose of this study was to compare the ability of temporal processing in patients with T1D and normal subjects using the gap in noise (GIN) test.
Methods: In this cross-sectional study, 25 T1D patients aged 20 to 30 years old and 25 normal subjects in the same age range were selected through available sampling method and were evaluated by gap in noise test. The level of HbA1c shows how the quality of metabolic control of diabetes has changed over the past 2 to 3 months. The relationship between the approximate threshold (ATh) values and the percent correct answers to the GIN test with HbA1c was investigated.
Results: Both ATh and percent correct responses were significantly different between patients with T1D and normal subjects in both ears and in both sexes (p<0.05). Moreover, the results showed a significant correlation between HbA1c with ATh and the percent correct responses. Also, there was no significant correlation between the duration of the disease with the ATh and the percent correct responses to GIN test.
Conclusion: Patients with TID have a weaker outcome than their normal counterparts during the GIN test. These results may indicate a defect in the ability to temporal processing in these subjects.


Auditory temporal processing; type 1 diabetes; gap in noise test; approximate threshold, percent correct answers

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Jorgensen MB, Buch NH. Studies on the sense of smell and taste in diabetics. Acta Otolaryngol. 1961;53(2-3):539-45. doi: 10.3109/00016486109126521

National Diabetes Data Group. Classification and diagnosis of diabetes mellitus and other categories of glucose intolerance. Diabetes. 1979;28(12):1039-57. doi: 10.2337/diab.28.12.1039

van Belle TL, Coppieters KT, von Herrath MG. Type 1 diabetes: etiology, immunology, and therapeutic strategies. Physiol Rev. 2011;91(1):79-118. doi: 10.1152/physrev.00003.2010

Alvarenga Kde F, Duarte JL, Silva DP, Agostinho-Pesse RS, Negrato CA, Costa OA. Cognitive P300 potential in subjects with diabetes mellitus. Braz J Otorhinolaryngol. 2005;71(2):202-7. doi: S0034-72992005000200014

McCrimmon RJ, Deary IJ, Frier BM. Auditory information processing during acute insulin-induced hypoglycaemia in non-diabetic human subjects. Neuropsychologia. 1997;35(12):1547-53. doi: 10.1016/S0028-3932(97)00080-8

Brismar T, Hyllienmark L, Ekberg K, Johansson BL. Loss of temporal lobe beta power in young adults with type 1 diabetes mellitus. Neuroreport. 2002;13(18):2469-73. doi: 10.1097/01.wnr.0000047688.08940.ab

Strachan MW, Ewing FM, Frier BM, McCrimmon RJ, Deary IJ. Effects of acute hypoglycaemia on auditory information processing in adults with type I diabetes. Diabetologia. 2003;46(1):97-105. doi: 10.1007/s00125-002-0950-2

Musiek FE, Shinn J, Hare C. Plasticity, auditory training, and auditory processing disorders. Semin Hear. 2002;23(4):263-76. doi: 10.1055/s-2002-35862

Shinn JB. Temporal processing and temporal patterning tests. In: Musiek FE, Chermak GD, editors. Handbook of (central) auditory processing disorders: volume 1: auditory neuroscience and diagnosis. 1st ed. San Diego: Plural Publishing Inc; 2007. p. 231-56.

Banai K, Kraus N. Neurobiology of (central) auditory processing disorder and language-based learning disability. In: Musiek FE, Chermak GD, editors. Handbook of (central) auditory processing disorders: volume 1: auditory neuroscience and diagnosis. 1st ed. San Diego: Plural Publishing Inc; 2007. p. 89-116.

Schlauch RS, Nelson P. Puretone evaluation. In: Katz J, Medwetsky L, Burkard R, Hood L, editors. Handbook of clinical audiology. 6th ed. Baltimore: Lippincott Williams & Wilkins; 2009. p. 30-49.

Oldfield RC. The assessment and analysis of han¬dedness: the edinburgh inventory. Neuropsychologia. 1971;9(1):97-113. doi: 10.1016/0028-3932(71)90067-4

Mokhtari H, Rabiei M, Salimi SH. [Psychometric properties of the persian version of adult attention-deficit/hyperactivity disorder self-report scale]. Iranian Journal of Psychiatry and Clinical Psychology. 2015;21(3):244-53. Persian.

Weihing JA, Musiek FE, Shinn JB. The effect of presentation level on the gaps-in-noise (GIN©) test. J Am Acad Audiol. 2007;18(2):141-50. doi: 10.3766/jaaa.18.2.6

Shinn JB, Chermak GD, Musiek FE. GIN (Gaps-In-Noise) performance in the pediatric population. J Am Acad Audiol. 2009;20(4):229-38. doi: 10.3766/jaaa.20.4.3.

Tajik S, Adel Ghahraman M, Tahaie AA, Hajiabolhassan F, Jalilvand Karimi L, Jalaie S. Deficit of auditory temporal processing in children with dyslexia-dysgraphia. Aud Vest Res. 2012;21(4):76-83.

Efron R, Yund EW, Nichols D, Crandall PH. An ear asymmetry for gap detection following anterior temporal lobectomy. Neuropsychologia. 1985;23(1):43-50. doi: 10.1016/0028-3932(85)90042-9

Musen G, Lyoo IK, Sparks CR, Weinger K, Hwang J, Ryan CM, et al. Effects of type 1 diabetes on gray matter density as measured by voxel-based morphometry. Diabetes. 2006;55(2):326-33.

Mishra R, Sanju HK, Kumar P. Auditory temporal resolution in individuals with diabetes mellitus type 2. Int Arch Otorhinolaryngol. 2016;20(4):327-30. doi: 10.1055/s-0035-1571207

Zaidan E, Garcia AP, Tedesco ML, Baran JA. [Performance of normal young adults in two temporal resolution tests]. Pro Fono. 2008;20(1):19-24. Portuguese.

Musiek FE, Shinn JB, Jirsa R, Bamiou DE, Baran JA, Zaida E. GIN (Gaps-In-Noise) test performance in subjects with confirmed central auditory nervous system in volvement. Ear Hear. 2005;26(6):608-18.

Sharifinik M, Tajik S, Mohammadkhani G, Jalaie S. [Comparison of gaps in noise test (gin) in adults with normal and conductive hearing loss]. Journal of Research in Rehabilitation Sciences. 2013;9(4):726-34. Persian.

Valadbeigi A, Weisi F, Rohbakhsh N, Rezaei M, Heidari A, Rasa AR. Central auditory processing and word discrimination in patients with multiple sclerosis. Eur Arch Otorhinolaryngol. 2014;271(11):2891-6. doi: 10.1007/s00405-013-2776-6

Perez AP, Pereira LD. The gap in noise test in 11 and 12-year-old children. Pro Fono. 2010;22(1):7-12.

Balen SA, Bretzke L, Mottecy CM, Liebel G, Boeno MR, Gondim LM. Temporal resolution in children: comparing normal hearing, conductive hearing loss and auditory processing disorder. Braz J Otorhinolaryngol. 2009;75(1):123-9. doi: 10.1016/S1808-8694(15)30843-0

Samelli AG, Schochat E. Study of the right ear advantage on gap detection tests. Braz J Otorhinolaryngol. 2008;74(2):235-40.

Marculino CF, Rabelo CM, Schochat E. Gaps-in-noise test: gap detection thresholds in 9-year-old normal-hearing children. J Soc Bras Fonoaudiol. 2011;23(4):364-7.

Reichard P, Berglund B, Britz A, Cars I, Nilsson BY, Rosenqvist U. Intensified conventional insulin treatment retards the microvascular complications of insulin-dependent diabetes mellitus (IDDM): the stockholm diabetes intervention study (SDIS) after 5 years. J Intern Med. 1991;230(2):101-8. doi: 10.1111/j.1365-2796.1991.tb00415.x

Brismar T, Maurex L, Cooray G, Juntti-Berggren L, Lindström P, Ekberg K, et al. Predictors of cognitive impairment in type 1 diabetes. Psychoneuroendocrinology. 2007;32(8-10):1041-51. doi: 10.1016/j.psyneuen.2007.08.002

Botelho CT, Carvalho SA, Silva IN. Increased pre¬valence of early cochlear damage in young patients with type 1 diabetes detected by distortion product otoacoustic emissions. Int J Audiol. 2014;53(6):402-8. doi: 10.3109/14992027.2013.879341

Teng ZP, Tian R, Xing FL, Tang H, Xu JJ, Zhang BW, et al. An association of type 1 diabetes mellitus with auditory dysfunction: A systematic review and meta-analysis. Laryngoscope. 2017;127(7):1689-97. doi: 10.1002/lary.26346

Oxenham AJ, Bacon SP. Cochlear compression: perceptual measures and implications for normal and impaired hearing. Ear Hear. 2003;24(5):352-66. doi: 10.1097/01.AUD.0000090470.73934.78


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