Effects of hearing loss on heart rate variability and skin conductance measured during sentence recognition in noise

Autonomic Nervous System Responses to Hearing-Related Demand and Evaluative Threat

PURPOSE

This paper consists of 2 parts. The purpose of Part 1 was to review the potential influence of internal (person-related) factors on listening effort. The purpose of Part 2 was to present, in support of Part 1, preliminary data illustrating the interactive effects of an external factor (task demand) and an internal factor (evaluative threat) on autonomic nervous system measures.

METHOD

For Part 1, we provided a brief narrative review of motivation and stress as modulators of listening effort. For Part 2, we described preliminary data from a study using a repeated-measures (2 × 2) design involving manipulations of task demand (high, low) and evaluative threat (high, low). The low-demand task consisted of repetition of sentences from a narrative. The high-demand task consisted of answering questions about the narrative, requiring both comprehension and recall. During the high evaluative threat condition, participants were filmed and told that their video recordings would be evaluated by a panel of experts. During the low evaluative threat condition, no filming occurred; participants were instructed to "do your best." Skin conductance (sympathetic nervous system activity) and heart rate variability (HRV, parasympathetic activity) were measured during the listening tasks. The HRV measure was the root mean square of successive differences of adjacent interbeat intervals. Twelve adults with hearing loss participated.

RESULTS

Skin conductance increased and HRV decreased relative to baseline (no task) for all listening conditions. Skin conductance increased significantly with an increase in evaluative threat, but only for the more demanding task. There was no significant change in HRV in response to increasing evaluative threat or task demand.

CONCLUSIONS

Listening effort may be influenced by factors other than task difficulty, as reviewed in Part 1. This idea is supported by the preliminary data indicating that the sympathetic nervous system response to task demand is modulated by social evaluative threat. More work is needed to determine the relative contributions of motivation and emotional stress on physiological responses during listening tasks.

Subjective Listening Effort and Electrodermal Activity in Listening Situations with Reverberation and Noise

Disturbing factors like reverberation or ambient noise can impair speech recognition and raise the listening effort needed for successful communication in daily life. Situations with high listening effort are thought to result in increased stress for the listener. The aim of this study was to explore possible measures to determine listening effort in situations with varying background noise and reverberation. For this purpose, subjective ratings of listening effort, speech recognition, and stress level, together with the electrodermal activity as a measure of the autonomic stress reaction, were investigated. It was expected that the electrodermal activity would show different stress levels in different acoustic situations and might serve as an alternative to subjective ratings. Ten young normal-hearing and 17 elderly hearing-impaired subjects listened to sentences from the Oldenburg sentence test either with stationary background noise or with reverberation. Four listening situations were generated, an easy and a hard one for each of the two disturbing factors, which were related to each other by the Speech Transmission Index. The easy situation resulted in 100% and the hard situation resulted in 30 to 80% speech recognition. The results of the subjective ratings showed significant differences between the easy and the hard listening situations in both subject groups. Two methods of analyzing the electrodermal activity values revealed similar, but nonsignificant trends. Significant correlations between subjective ratings and physiological electrodermal activity data were observed for normal-hearing subjects in the noise situation.

Age-Related Differences in Lexical Access Relate to Speech Recognition in Noise

Vocabulary size has been suggested as a useful measure of “verbal abilities” that correlates with speech recognition scores. Knowing more words is linked to better speech recognition. How vocabulary knowledge translates to general speech recognition mechanisms, how these mechanisms relate to offline speech recognition scores, and how they may be modulated by acoustical distortion or age, is less clear. Age-related differences in linguistic measures may predict age-related differences in speech recognition in noise performance. We hypothesized that speech recognition performance can be predicted by the efficiency of lexical access, which refers to the speed with which a given word can be searched and accessed relative to the size of the mental lexicon. We tested speech recognition in a clinical German sentence-in-noise test at two signal-to-noise ratios (SNRs), in 22 younger (18–35 years) and 22 older (60–78 years) listeners with normal hearing. We also assessed receptive vocabulary, lexical access time, verbal working memory, and hearing thresholds as measures of individual differences. Age group, SNR level, vocabulary size, and lexical access time were significant predictors of individual speech recognition scores, but working memory and hearing threshold were not. Interestingly, longer accessing times were correlated with better speech recognition scores. Hierarchical regression models for each subset of age group and SNR showed very similar patterns: the combination of vocabulary size and lexical access time contributed most to speech recognition performance; only for the younger group at the better SNR (yielding about 85% correct speech recognition) did vocabulary size alone predict performance. Our data suggest that successful speech recognition in noise is mainly modulated by the efficiency of lexical access. This suggests that older adults’ poorer performance in the speech recognition task may have arisen from reduced efficiency in lexical access; with an average vocabulary size similar to that of younger adults, they were still slower in lexical access.

Monitoring Alpha Oscillations and Pupil Dilation across a Performance-Intensity Function

Listening to degraded speech can be challenging and requires a continuous investment of cognitive resources, which is more challenging for those with hearing loss. However, while alpha power (8-12 Hz) and pupil dilation have been suggested as objective correlates of listening effort, it is not clear whether they assess the same cognitive processes involved, or other sensory and/or neurophysiological mechanisms that are associated with the task. Therefore, the aim of this study is to compare alpha power and pupil dilation during a sentence recognition task in 15 randomized levels of noise (-7 to +7 dB SNR) using highly intelligible (16 channel vocoded) and moderately intelligible (6 channel vocoded) speech. Twenty young normal-hearing adults participated in the study, however, due to extraneous noise, data from only 16 (10 females, 6 males; aged 19-28 years) was used in the Electroencephalography (EEG) analysis and 10 in the pupil analysis. Behavioral testing of perceived effort and speech performance was assessed at 3 fixed SNRs per participant and was comparable to sentence recognition performance assessed in the physiological test session for both 16- and 6-channel vocoded sentences. Results showed a significant interaction between channel vocoding for both the alpha power and the pupil size changes. While both measures significantly decreased with more positive SNRs for the 16-channel vocoding, this was not observed with the 6-channel vocoding. The results of this study suggest that these measures may encode different processes involved in speech perception, which show similar trends for highly intelligible speech, but diverge for more spectrally degraded speech. The results to date suggest that these objective correlates of listening effort, and the cognitive processes involved in listening effort, are not yet sufficiently well understood to be used within a clinical setting.

Parasympathetic Nervous System Dysfunction, as Identified by Pupil Light Reflex, and Its Possible Connection to Hearing Impairment

CONTEXT

Although the pupil light reflex has been widely used as a clinical diagnostic tool for autonomic nervous system dysfunction, there is no systematic review available to summarize the evidence that the pupil light reflex is a sensitive method to detect parasympathetic dysfunction. Meanwhile, the relationship between parasympathetic functioning and hearing impairment is relatively unknown.

OBJECTIVES

To 1) review the evidence for the pupil light reflex being a sensitive method to evaluate parasympathetic dysfunction, 2) review the evidence relating hearing impairment and parasympathetic activity and 3) seek evidence of possible connections between hearing impairment and the pupil light reflex.

METHODS

Literature searches were performed in five electronic databases. All selected articles were categorized into three sections: pupil light reflex and parasympathetic dysfunction, hearing impairment and parasympathetic activity, pupil light reflex and hearing impairment.

RESULTS

Thirty-eight articles were included in this review. Among them, 36 articles addressed the pupil light reflex and parasympathetic dysfunction. We summarized the information in these data according to different types of parasympathetic-related diseases. Most of the studies showed a difference on at least one pupil light reflex parameter between patients and healthy controls. Two articles discussed the relationship between hearing impairment and parasympathetic activity. Both studies reported a reduced parasympathetic activity in the hearing impaired groups. The searches identified no results for pupil light reflex and hearing impairment.

DISCUSSION AND CONCLUSIONS

As the first systematic review of the evidence, our findings suggest that the pupil light reflex is a sensitive tool to assess the presence of parasympathetic dysfunction. Maximum constriction velocity and relative constriction amplitude appear to be the most sensitive parameters. There are only two studies investigating the relationship between parasympathetic activity and hearing impairment, hence further research is needed. The pupil light reflex could be a candidate measurement tool to achieve this goal.

Autonomic Nervous System Responses During Perception of Masked Speech may Reflect Constructs other than Subjective Listening Effort

Typically, understanding speech seems effortless and automatic. However, a variety of factors may, independently or interactively, make listening more effortful. Physiological measures may help to distinguish between the application of different cognitive mechanisms whose operation is perceived as effortful. In the present study, physiological and behavioral measures associated with task demand were collected along with behavioral measures of performance while participants listened to and repeated sentences. The goal was to measure psychophysiological reactivity associated with three degraded listening conditions, each of which differed in terms of the source of the difficulty (distortion, energetic masking, and informational masking), and therefore were expected to engage different cognitive mechanisms. These conditions were chosen to be matched for overall performance (keywords correct), and were compared to listening to unmasked speech produced by a natural voice. The three degraded conditions were: (1) Unmasked speech produced by a computer speech synthesizer, (2) Speech produced by a natural voice and masked byspeech-shaped noise and (3) Speech produced by a natural voice and masked by two-talker babble. Masked conditions were both presented at a -8 dB signal to noise ratio (SNR), a level shown in previous research to result in comparable levels of performance for these stimuli and maskers. Performance was measured in terms of proportion of key words identified correctly, and task demand or effort was quantified subjectively by self-report. Measures of psychophysiological reactivity included electrodermal (skin conductance) response frequency and amplitude, blood pulse amplitude and pulse rate. Results suggest that the two masked conditions evoked stronger psychophysiological reactivity than did the two unmasked conditions even when behavioral measures of listening performance and listeners’ subjective perception of task demand were comparable across the three degraded conditions.

Comparison of Psychophysiological and Dual-Task Measures of Listening Effort

PURPOSE

We wished to make a comparison of psychophysiological measures of listening effort with subjective and dual-task measures of listening effort for a diotic-dichotic-digits and a sentences-in-noise task.

METHOD

Three groups of young adults (18-38 years old) with normal hearing participated in three experiments: two psychophysiological studies for two different listening tasks and a dual-task measure for a sentences-in-noise task. Psychophysiological variables included skin conductance, heart-rate variability, and heart rate; the dual-task measure was a letter-identification task. Heart-rate variability was quantified with the difference from baseline for the normalized standard deviation of R to R.

RESULTS

Heart-rate variability differences from baseline were greater for increased task complexity and for poorer signal-to-noise ratios (SNRs). The dual-task measure of listening effort also increased for sentences presented at a +5 dB SNR compared with a +15 dB SNR. Skin conductance was elevated for greater task complexity only, and similar across noise conditions. None of these measures were significantly correlated with subjective measures of listening effort.

CONCLUSIONS

Heart-rate variability appears to be a robust psychophysiological indicator of listening effort, sensitive to both task complexity and SNR. This sensitivity to SNR was similar to a dual-task measure of listening effort.

Mental workload estimations in unilateral deafened children

Despite of technological innovations, noisy environments still constitute a challenging and stressful situation for words recognition by hearing impaired subjects. The evaluation of the mental workload imposed by the noisy environments for the recognition of the words in prelingually deaf children is then of paramount importance since it could affect the speed of the learning process during scholar period.The aim of the present study was to investigate different electroencephalographic (EEG) power spectral density (PSD) components (in theta 4-8 Hz - and alpha - 8-12 Hz - frequency bands) to estimate the mental workload index in different noise conditions during a word recognition task in prelingually deaf children, a population not yet investigated in relation to the workload index during auditory tasks. A pilot study involving a small group of prelingually deaf children was then subjected to EEG recordings during an auditory task composed by a listening and a successive recognition of words with different noise conditions. Results showed that in the pre-word listening phase frontal EEG PSD in theta band and the ratio of the frontal EEG PSD in theta band and the parietal EEG PSD in alpha band (workload index; IWL) reported highest values in the most demanding noise condition. In addition, in the phase preceding the word forced-choice task the highest parietal EEG PSD in alpha band and IWL values were reported at the presumably simplest condition (noise emitted in correspondence of the subject's deaf ear). These results could suggest the prominence of EEG PSD theta component activity in the pre-word listening phase. In addition, a more challenging noise situation in the pre-choice phase would be so "over-demanding" to fail to enhance both the alpha power and the IWL in comparison to the already demanding "simple" condition.