Speech recognition in noise as a function of the number of spectral channels: comparison of acoustic hearing and cochlear implants

The importance of temporal-fine structure to perceive time-compressed speech with and without the restoration of the syllabic rhythm

Intelligibility of time-compressed (TC) speech decreases with increasing speech rate. However, intelligibility can be restored by 'repackaging' the TC speech by inserting silences between the syllables so that the original 'rhythm' is restored. Although restoration of the speech rhythm affects solely the temporal envelope, it is unclear to which extent repackaging also affects the perception of the temporal-fine structure (TFS). Here we investigate to which extent TFS contributes to the perception of TC and repackaged TC speech in quiet. Intelligibility of TC sentences with a speech rate of 15.6 syllables per second (sps) and the repackaged sentences, by adding 100 ms of silence between the syllables of the TC speech (i.e., a speech rate of 6.1 sps), was assessed for three TFS conditions: the original TFS and the TFS conveyed by an 8- and 16-channel noise vocoder. An overall positive effect on intelligibility of both the repackaging process and of the amount of TFS available to the listener was observed. Furthermore, the benefit associated with the repackaging TC speech depended on the amount of TFS available. The results show TFS contributes significantly to the perception of fast speech even when the overall rhythm/envelope of TC speech is restored.

Relationship between electrode position and temporal modulation sensitivity in cochlear implant users: Are close electrodes always better?

Temporal modulation sensitivity has been studied extensively for cochlear implant (CI) users due to its strong correlation to speech recognition outcomes. Previous studies reported that temporal modulation detection thresholds (MDTs) vary across the tonotopic axis and attributed this variation to patchy neural survival. However, correlates of neural health identified in animal models depend on electrode position in humans. Nonetheless, the relationship between MDT and electrode location has not been explored. We tested 13 ears for the effect of distance on modulation sensitivity, specifically targeting the question of whether electrodes closer to the modiolus are universally beneficial. Participants in this study were postlingually deafened and users of Cochlear Nucleus CIs. The distance of each electrode from the medial wall (MW) of the cochlea and mid-modiolar axis (MMA) was measured from scans obtained using computerized tomography (CT) imaging. The distance measures were correlated with slopes of spatial tuning curves measured on selected electrodes to investigate if electrode position accounts, at least in part, for the width of neural excitation. In accordance with previous findings, electrode position explained 24% of the variance in slopes of the spatial tuning curves. All functioning electrodes were also measured for MDTs. Five ears showed a positive correlation between MDTs and at least one distance measure across the array; 6 ears showed negative correlations and the remaining two ears showed no relationship. The ears showing positive MDT-distance correlations, thus benefiting from electrodes being close to the neural elements, were those who performed better on the two speech recognition measures, i.e., speech reception thresholds (SRTs) and recognition of the AzBio sentences. These results could suggest that ears able to take advantage of the proximal placement of electrodes are likely to have better speech recognition outcomes. Previous histological studies of humans demonstrated that speech recognition is correlated with spiral ganglion cell counts. Alternatively, ears with good speech recognition outcomes may have good overall neural health, which is a precondition for close electrodes to produce spatially confined neural excitation patterns that facilitate modulation sensitivity. These findings suggest that the methods to reduce channel interaction, e.g., perimodiolar electrode array or current focusing, may only be beneficial for a subgroup of CI users. Additionally, it suggests that estimating neural survival preoperatively is important for choosing the most appropriate electrode array type (perimodiolar vs. lateral wall) for optimal implant function.

Noise-Vocoded Sentence Recognition and the Use of Context in Older and Younger Adult Listeners

PURPOSE

When listening to speech under adverse conditions, older adults, even with "age-normal" hearing, face challenges that may lead to poorer speech recognition than their younger peers. Older listeners generally demonstrate poorer suprathreshold auditory processing along with aging-related declines in neurocognitive functioning that may impair their ability to compensate using "top-down" cognitive-linguistic functions. This study explored top-down processing in older and younger adult listeners, specifically the use of semantic context during noise-vocoded sentence recognition.

METHOD

Eighty-four adults with age-normal hearing (45 young normal-hearing [YNH] and 39 older normal-hearing [ONH] adults) participated. Participants were tested for recognition accuracy for two sets of noise-vocoded sentence materials: one that was semantically meaningful and the other that was syntactically appropriate but semantically anomalous. Participants were also tested for hearing ability and for neurocognitive functioning to assess working memory capacity, speed of lexical access, inhibitory control, and nonverbal fluid reasoning, as well as vocabulary knowledge.

RESULTS

The ONH and YNH listeners made use of semantic context to a similar extent. Nonverbal reasoning predicted recognition of both meaningful and anomalous sentences, whereas pure-tone average contributed additionally to anomalous sentence recognition. None of the hearing, neurocognitive, or language measures significantly predicted the amount of context gain, computed as the difference score between meaningful and anomalous sentence recognition. However, exploratory cluster analyses demonstrated four listener profiles and suggested that individuals may vary in the strategies used to recognize speech under adverse listening conditions.

CONCLUSIONS

Older and younger listeners made use of sentence context to similar degrees. Nonverbal reasoning was found to be a contributor to noise-vocoded sentence recognition. However, different listeners may approach the problem of recognizing meaningful speech under adverse conditions using different strategies based on their hearing, neurocognitive, and language profiles. These findings provide support for the complexity of bottom-up and top-down interactions during speech recognition under adverse listening conditions.

Electrical Field Interactions during Adjacent Electrode Stimulations: eABR Evaluation in Cochlear Implant Users

The present study investigates how electrically evoked Auditory Brainstem Responses (eABRs) can be used to measure local channel interactions along cochlear implant (CI) electrode arrays. eABRs were recorded from 16 experienced CI patients in response to electrical pulse trains delivered using three stimulation configurations: (1) single electrode stimulations (E11 or E13); (2) simultaneous stimulation from two electrodes separated by one (E_n and E_n+2, E11 and E13); and (3) stimulations from three consecutive electrodes (E11, E12, and E13). Stimulation level was kept constant at 70% electrical dynamic range (EDR) on the two flanking electrodes (E11 and E13) and was varied from 0 to 100% EDR on the middle electrode (E12). We hypothesized that increasing the middle electrode stimulation level would cause increasing local electrical interactions, reflected in characteristics of the evoked compound eABR. Results show that group averaged eABR wave III and V latency and amplitude were reduced when stimulation level at the middle electrode was increased, in particular when stimulation level on E12 reached 40, 70, and 100% EDR. Compound eABRs can provide a detailed individual quantification of electrical interactions occurring at specific electrodes along the CI electrode array. This approach allows a fine determination of interactions at the single electrode level potentially informing audiological decisions regarding mapping of CI systems.

Musical Emotion Categorization with Vocoders of Varying Temporal and Spectral Content

While previous research investigating music emotion perception of cochlear implant (CI) users observed that temporal cues informing tempo largely convey emotional arousal (relaxing/stimulating), it remains unclear how other properties of the temporal content may contribute to the transmission of arousal features. Moreover, while detailed spectral information related to pitch and harmony in music - often not well perceived by CI users- reportedly conveys emotional valence (positive, negative), it remains unclear how the quality of spectral content contributes to valence perception. Therefore, the current study used vocoders to vary temporal and spectral content of music and tested music emotion categorization (joy, fear, serenity, sadness) in 23 normal-hearing participants. Vocoders were varied with two carriers (sinewave or noise; primarily modulating temporal information), and two filter orders (low or high; primarily modulating spectral information). Results indicated that emotion categorization was above-chance in vocoded excerpts but poorer than in a non-vocoded control condition. Among vocoded conditions, better temporal content (sinewave carriers) improved emotion categorization with a large effect while better spectral content (high filter order) improved it with a small effect. Arousal features were comparably transmitted in non-vocoded and vocoded conditions, indicating that lower temporal content successfully conveyed emotional arousal. Valence feature transmission steeply declined in vocoded conditions, revealing that valence perception was difficult for both lower and higher spectral content. The reliance on arousal information for emotion categorization of vocoded music suggests that efforts to refine temporal cues in the CI user signal may immediately benefit their music emotion perception.

The 100 Most-Cited Manuscripts in Hearing Implants: A Bibliometrics Analysis

The aim of the study was to characterise the most frequently cited articles on the topic of hearing implants. A systematic search was carried out using the Thomson Reuters Web of Science Core Collection database. Eligibility criteria restricted the results to primary studies and reviews published from 1970 to 2022 in English dealing primarily with hearing implants. Data including the authors, year of publication, journal, country of origin, number of citations and average number of citations per year were extracted, as well as the impact factors and five-year impact factor of journals publishing the articles. The top 100 papers were published across 23 journals and were cited 23,139 times. The most-cited and influential article describes the first use of the continuous interleaved sampling (CIS) strategy utilised in all modern cochlear implants. More than half of the studies on the list were produced by authors from the United States, and the Ear and Hearing journal had both the greatest number of articles and the greatest number of total citations. To conclude, this research serves as a guide to the most influential articles on the topic of hearing implants, although bibliometric analyses mainly focus on citations. The most-cited article was an influential description of CIS.

Strategic Pauses Relieve Listeners from the Effort of Listening to Fast Speech: Data Limited and Resource Limited Processes in Narrative Recall by Adult Users of Cochlear Implants

Speech that has been artificially accelerated through time compression produces a notable deficit in recall of the speech content. This is especially so for adults with cochlear implants (CI). At the perceptual level, this deficit may be due to the sharply degraded CI signal, combined with the reduced richness of compressed speech. At the cognitive level, the rapidity of time-compressed speech can deprive the listener of the ordinarily available processing time present when speech is delivered at a normal speech rate. Two experiments are reported. Experiment 1 was conducted with 27 normal-hearing young adults as a proof-of-concept demonstration that restoring lost processing time by inserting silent pauses at linguistically salient points within a time-compressed narrative ("time-restoration") returns recall accuracy to a level approximating that for a normal speech rate. Noise vocoder conditions with 10 and 6 channels reduced the effectiveness of time-restoration. Pupil dilation indicated that additional effort was expended by participants while attempting to process the time-compressed narratives, with the effortful demand on resources reduced with time restoration. In Experiment 2, 15 adult CI users tested with the same (unvocoded) materials showed a similar pattern of behavioral and pupillary responses, but with the notable exception that meaningful recovery of recall accuracy with time-restoration was limited to a subgroup of CI users identified by better working memory spans, and better word and sentence recognition scores. Results are discussed in terms of sensory-cognitive interactions in data-limited and resource-limited processes among adult users of cochlear implants.

SpeedCAP: An Efficient Method for Estimating Neural Activation Patterns Using Electrically Evoked Compound Action-Potentials in Cochlear Implant Users

OBJECTIVES

Electrically evoked compound action-potentials (ECAPs) can be recorded using the electrodes in a cochlear implant (CI) and represent the synchronous responses of the electrically stimulated auditory nerve. ECAPs can be obtained using a forward-masking method that measures the neural response to a probe and masker electrode separately and in combination. The panoramic ECAP (PECAP) analyses measured ECAPs obtained using multiple combinations of masker and probe electrodes and uses a nonlinear optimization algorithm to estimate current spread from each electrode and neural health along the cochlea. However, the measurement of ECAPs from multiple combinations of electrodes is too time consuming for use in clinics. Here, we propose and evaluate SpeedCAP, a speedy method for obtaining the PECAP measurements that minimizes recording time by exploiting redundancies between multiple ECAP measures.

DESIGN

In the first study, 11 users of Cochlear Ltd. CIs took part. ECAPs were recorded using the forward-masking artifact-cancelation technique at the most comfortable loudness level (MCL) for every combination of masker and probe electrodes for all active electrodes in the users' MAPs, as per the standard PECAP recording paradigm. The same current levels and recording parameters were then used to collect ECAPs in the same users with the SpeedCAP method. The ECAP amplitudes were then compared between the two conditions, as were the corresponding estimates of neural health and current spread calculated using the PECAP method previously described by Garcia et al. The second study measured SpeedCAP intraoperatively in 8 CI patients and with all maskers and probes presented at the same current level to assess feasibility. ECAPs for the subset of conditions where the masker and probe were presented on the same electrode were compared with those obtained using the slower approach leveraged by the standard clinical software.

RESULTS

Data collection time was reduced from ≈45 to ≈8 minutes. There were no significant differences between normalized root mean squared error (RMSE) repeatability metrics for post-operative PECAP and SpeedCAP data, nor for the RMSEs calculated between PECAP and SpeedCAP data. The comparison achieved 80% power to detect effect sizes down to 8.2% RMSE. When between-participant differences were removed, both the neural-health (r = 0.73) and current-spread (r = 0.65) estimates were significantly correlated (p < 0.0001, df = 218) between SpeedCAP and PECAP conditions across all electrodes, and showed RMSE errors of 12.7 ± 4.7% and 16.8 ± 8.8%, respectively (with the ± margins representing 95% confidence intervals). Valid ECAPs were obtained in all patients in the second study, demonstrating intraoperative feasibility of SpeedCAP. No significant differences in RMSEs were detectable between post- and intra-operative ECAP measurements, with the comparison achieving 80% power to detect effect sizes down to 13.3% RMSE.

CONCLUSIONS

The improved efficiency of SpeedCAP provides time savings facilitating multi-electrode ECAP recordings in routine clinical practice. SpeedCAP data collection is sufficiently quick to record intraoperatively, and adds no more than 8.2% error to the ECAP amplitudes. Such measurements could thereafter be submitted to models such as PECAP to provide patient-specific patterns of neural activation to inform programming of clinical MAPs and identify causes of poor performance at the electrode-nerve interface of CI users. The speed and accuracy of these measurements also opens up a wide range of additional research questions to be addressed.

Strength of Attentional Modulation on Cortical Auditory Evoked Responses Correlates with Speech-in-Noise Performance in Bimodal Cochlear Implant Users

Auditory selective attention is a crucial top-down cognitive mechanism for understanding speech in noise. Cochlear implant (CI) users display great variability in speech-in-noise performance that is not easily explained by peripheral auditory profile or demographic factors. Thus, it is imperative to understand if auditory cognitive processes such as selective attention explain such variability. The presented study directly addressed this question by quantifying attentional modulation of cortical auditory responses during an attention task and comparing its individual differences with speech-in-noise performance. In our attention experiment, participants with CI were given a pre-stimulus visual cue that directed their attention to either of two speech streams and were asked to select a deviant syllable in the target stream. The two speech streams consisted of the female voice saying "Up" five times every 800 ms and the male voice saying "Down" four times every 1 s. The onset of each syllable elicited distinct event-related potentials (ERPs). At each syllable onset, the difference in the amplitudes of ERPs between the two attentional conditions (attended - ignored) was computed. This ERP amplitude difference served as a proxy for attentional modulation strength. Our group-level analysis showed that the amplitude of ERPs was greater when the syllable was attended than ignored, exhibiting that attention modulated cortical auditory responses. Moreover, the strength of attentional modulation showed a significant correlation with speech-in-noise performance. These results suggest that the attentional modulation of cortical auditory responses may provide a neural marker for predicting CI users' success in clinical tests of speech-in-noise listening.

Activation region overlap visualization for image-guided cochlear implant programming

Objective. The cochlear implant is a neural prosthesis designed to directly stimulate auditory nerve fibers to induce the sensation of hearing in those experiencing severe-to-profound hearing loss. After surgical implantation, audiologists program the implant's external processor with settings intended to produce optimal hearing outcomes. The likelihood of achieving optimal outcomes increases when audiologists have access to tools that objectively present information related to the patient's own anatomy and surgical outcomes. This includes visualizations like the one presented here, termed the activation region overlap image, which is designed to decrease subjectivity when determining amounts of overlapping stimulation between implant electrodes.Approach. This visualization uses estimates of electric field strength to indicate spread of neural excitation due to each electrode. Unlike prior visualizations, this method explicitly defines regions of nerves receiving substantial stimulation from each electrode to help clinicians assess the presence of significant overlapping stimulation. A multi-reviewer study compared this and an existing technique on the consistency, efficiency, and optimality of plans generated from each method. Statistical significance was evaluated using the two-sided Wilcoxon rank sum test.Main results. The study showed statistically significant improvements in consistency (p < 10-12), efficiency (p < 10-15), and optimality (p < 10-5) when generating plans using the proposed method versus the existing method.Significance. This visualization addresses subjectivity in assessing overlapping stimulation between implant electrodes, which currently relies on reviewer estimates. The results of the evaluation indicate the provision of such objective information during programming sessions would likely benefit clinicians in making programming decisions.

The recognition of time-compressed speech as a function of age in listeners with cochlear implants or normal hearing

Speech recognition is diminished when a listener has an auditory temporal processing deficit. Such deficits occur in listeners over 65 years old with normal hearing (NH) and with age-related hearing loss, but their source is still unclear. These deficits may be especially apparent when speech occurs at a rapid rate and when a listener is mostly reliant on temporal information to recognize speech, such as when listening with a cochlear implant (CI) or to vocoded speech (a CI simulation). Assessment of the auditory temporal processing abilities of adults with CIs across a wide range of ages should better reveal central or cognitive sources of age-related deficits with rapid speech because CI stimulation bypasses much of the cochlear encoding that is affected by age-related peripheral hearing loss. This study used time-compressed speech at four different degrees of time compression (0, 20, 40, and 60%) to challenge the auditory temporal processing abilities of younger, middle-aged, and older listeners with CIs or with NH. Listeners with NH were presented vocoded speech at four degrees of spectral resolution (unprocessed, 16, 8, and 4 channels). Results showed an interaction between age and degree of time compression. The reduction in speech recognition associated with faster rates of speech was greater for older adults than younger adults. The performance of the middle-aged listeners was more similar to that of the older listeners than to that of the younger listeners, especially at higher degrees of time compression. A measure of cognitive processing speed did not predict the effects of time compression. These results suggest that central auditory changes related to the aging process are at least partially responsible for the auditory temporal processing deficits seen in older listeners, rather than solely peripheral age-related changes.

Reconsidering commonly used stimuli in speech perception experiments

This paper examines some commonly used stimuli in speech perception experiments and raises questions about their use, or about the interpretations of previous results. The takeaway messages are: 1) the Hillenbrand vowels represent a particular dialect rather than a gold standard, and English vowels contain spectral dynamics that have been largely underappreciated, 2) the /ɑ/ context is very common but not clearly superior as a context for testing consonant perception, 3) /ɑ/ is particularly problematic when testing voice-onset-time perception because it introduces strong confounds in the formant transitions, 4) /dɑ/ is grossly overrepresented in neurophysiological studies and yet is insufficient as a generalized proxy for "speech perception," and 5) digit tests and matrix sentences including the coordinate response measure are systematically insensitive to important patterns in speech perception. Each of these stimulus sets and concepts is described with careful attention to their unique value and also cases where they might be misunderstood or over-interpreted.

Speech recognition as a function of the number of channels for pediatric cochlear implant recipients

This study investigated the number of channels required for asymptotic speech recognition for ten pediatric cochlear implant (CI) recipients with precurved electrode arrays. Programs with 4-22 active electrodes were used to assess word and sentence recognition in noise. Children demonstrated significant performance gains up to 12 electrodes for continuous interleaved sampling (CIS) and up to 22 channels with 16 maxima. These data are consistent with the latest adult CI studies demonstrating that modern CI recipients have access to more than 8 independent channels and that both adults and children exhibit performance gains up to 22 channels.

Lexical Access Changes Based on Listener Needs: Real-Time Word Recognition in Continuous Speech in Cochlear Implant Users

OBJECTIVES

A key challenge in word recognition is the temporary ambiguity created by the fact that speech unfolds over time. In normal hearing (NH) listeners, this temporary ambiguity is resolved through incremental processing and competition among lexical candidates. Post-lingually deafened cochlear implant (CI) users show similar incremental processing and competition but with slight delays. However, even brief delays could lead to drastic changes when compounded across multiple words in a phrase. This study asks whether words presented in non-informative continuous speech (a carrier phrase) are processed differently than in isolation and whether NH listeners and CI users exhibit different effects of a carrier phrase.

DESIGN

In a Visual World Paradigm experiment, listeners heard words either in isolation or in non-informative carrier phrases (e.g., "click on the…" ). Listeners selected the picture corresponding to the target word from among four items including the target word (e.g., mustard ), a cohort competitor (e.g., mustache ), a rhyme competitor (e.g., custard ), and an unrelated item (e.g., penguin ). Eye movements were tracked as an index of the relative activation of each lexical candidate as competition unfolds over the course of word recognition. Participants included 21 post-lingually deafened cochlear implant users and 21 NH controls. A replication experiment presented in the Supplemental Digital Content, http://links.lww.com/EANDH/A999 included an additional 22 post-lingually deafened CI users and 18 NH controls.

RESULTS

Both CI users and the NH controls were accurate at recognizing the words both in continuous speech and in isolation. The time course of lexical activation (indexed by the fixations) differed substantially between groups. CI users were delayed in fixating the target relative to NH controls. Additionally, CI users showed less competition from cohorts than NH controls (even as previous studies have often report increased competition). However, CI users took longer to suppress the cohort and suppressed it less fully than the NH controls. For both CI users and NH controls, embedding words in carrier phrases led to more immediacy in lexical access as observed by increases in cohort competition relative to when words were presented in isolation. However, CI users were not differentially affected by the carriers.

CONCLUSIONS

Unlike prior work, CI users appeared to exhibit "wait-and-see" profile, in which lexical access is delayed minimizing early competition. However, CI users simultaneously sustained competitor activation late in the trial, possibly to preserve flexibility. This hybrid profile has not been observed previously. When target words are heard in continuous speech, both CI users and NH controls more heavily weight early information. However, CI users (but not NH listeners) also commit less fully to the target, potentially keeping options open if they need to recover from a misperception. This mix of patterns reflects a lexical system that is extremely flexible and adapts to fit the needs of a listener.

Effects of Temporal Envelope Cutoff Frequency, Number of Channels, and Carrier Type on Brainstem Neural Representation of Pitch in Vocoded Speech

PURPOSE

The objective of this study was to determine if and how the subcortical neural representation of pitch cues in listeners with normal hearing is affected by systematic manipulation of vocoder parameters.

METHOD

This study assessed the effects of temporal envelope cutoff frequency (50 and 500 Hz), number of channels (1-32), and carrier type (sine-wave and noise-band) on brainstem neural representation of fundamental frequency (f _o) in frequency-following responses (FFRs) to vocoded vowels of 15 young adult listeners with normal hearing.

RESULTS

Results showed that FFR f _o strength (quantified as absolute f _o magnitude divided by noise floor [NF] magnitude) significantly improved with 500-Hz vs. 50-Hz temporal envelopes for all channel numbers and both carriers except the 1-channel noise-band vocoder. FFR f _o strength with 500-Hz temporal envelopes significantly improved when the channel number increased from 1 to 2, but it either declined (sine-wave vocoders) or saturated (noise-band vocoders) when the channel number increased from 4 to 32. FFR f _o strength with 50-Hz temporal envelopes was similarly small for both carriers with all channel numbers, except for a significant improvement with the 16-channel sine-wave vocoder. With 500-Hz temporal envelopes, FFR f _o strength was significantly greater for sine-wave vocoders than for noise-band vocoders with channel numbers 1-8; no significant differences were seen with 16 and 32 channels. With 50-Hz temporal envelopes, the carrier effect was only observed with 16 channels. In contrast, there was no significant carrier effect for the absolute f _o magnitude. Compared to sine-wave vocoders, noise-band vocoders had a higher NF and thus lower relative FFR f _o strength.

CONCLUSIONS

It is important to normalize the f _o magnitude relative to the NF when analyzing the FFRs to vocoded speech. The physiological findings reported here may result from the availability of f _o-related temporal periodicity and spectral sidelobes in vocoded signals and should be considered when selecting vocoder parameters and interpreting results in future physiological studies. In general, the dependence of brainstem neural phase-locking strength to f _o on vocoder parameters may confound the comparison of pitch-related behavioral results across different vocoder designs.

Evaluation of phase-locking to parameterized speech envelopes

Humans rely on the temporal processing ability of the auditory system to perceive speech during everyday communication. The temporal envelope of speech is essential for speech perception, particularly envelope modulations below 20 Hz. In the literature, the neural representation of this speech envelope is usually investigated by recording neural phase-locked responses to speech stimuli. However, these phase-locked responses are not only associated with envelope modulation processing, but also with processing of linguistic information at a higher-order level when speech is comprehended. It is thus difficult to disentangle the responses into components from the acoustic envelope itself and the linguistic structures in speech (such as words, phrases and sentences). Another way to investigate neural modulation processing is to use sinusoidal amplitude-modulated stimuli at different modulation frequencies to obtain the temporal modulation transfer function. However, these transfer functions are considerably variable across modulation frequencies and individual listeners. To tackle the issues of both speech and sinusoidal amplitude-modulated stimuli, the recently introduced Temporal Speech Envelope Tracking (TEMPEST) framework proposed the use of stimuli with a distribution of envelope modulations. The framework aims to assess the brain's capability to process temporal envelopes in different frequency bands using stimuli with speech-like envelope modulations. In this study, we provide a proof-of-concept of the framework using stimuli with modulation frequency bands around the syllable and phoneme rate in natural speech. We evaluated whether the evoked phase-locked neural activity correlates with the speech-weighted modulation transfer function measured using sinusoidal amplitude-modulated stimuli in normal-hearing listeners. Since many studies on modulation processing employ different metrics and comparing their results is difficult, we included different power- and phase-based metrics and investigate how these metrics relate to each other. Results reveal a strong correspondence across listeners between the neural activity evoked by the speech-like stimuli and the activity evoked by the sinusoidal amplitude-modulated stimuli. Furthermore, strong correspondence was also apparent between each metric, facilitating comparisons between studies using different metrics. These findings indicate the potential of the TEMPEST framework to efficiently assess the neural capability to process temporal envelope modulations within a frequency band that is important for speech perception.

Frequency Mapping of a Precurved Electrode Array in the Internal Auditory Canal for a Pediatric Cochlear Implant Recipient

OBJECTIVES

Review the effectiveness of an alternative mapping procedure of a precurved electrode array in the internal auditory canal (IAC).

DESIGN

A 7-year-old bilateral cochlear implant (CI) recipient of precurved arrays transferred to the study site and demonstrated no speech recognition with the left CI. Imaging revealed bilateral incomplete partition type III malformations. For the left CI, four contacts were observed in the basal cochlear turn and 18 contacts were coiled in the IAC. The family decided against revision surgery. Pitch ranking was completed to map the contacts in the IAC that were perceptually discrete and tonotopically organized.

RESULTS

For the left CI, PB-K word recognition improved from no recognition to 32% after 1 month and to 52% after 3 months. In the bilateral CI condition, performance improved from 56 to 72% after 1 month and 80% after 3 months.

CONCLUSION

A precurved array in the IAC creates difficult management decisions. Direct stimulation of the auditory nerve resulted in better monaural and bilateral speech recognition, likely due to better spectral representation of the speech signal. Individualizing the map using imaging and behavioral findings may improve performance for malpositioned arrays when revision surgery is not pursued.

Development and Characterization of a Micromagnetic Alternative to Cochlear Implant Electrode Arrays

To stimulate the auditory nerve, cochlear implants directly inject electrical current into surrounding tissue via an implanted electrode array. While many cochlear implant users achieve strong speech perception scores, there remains significant variability. Since cochlear implant electrode arrays are surrounded by a conductive fluid, perilymph, a spread of excitation occurs. The functionality of the cochlea is spatially dependent, and a wider area of excitation negatively affects the hearing of the user. Importantly, magnetic fields are unaffected by the material properties of biological components. To utilize the electromagnetic properties of the human ear, a microcoil array was developed. The microcoils are 4-turn solenoids with a 250-μm turn radius and a 31.75-μm wire radius, coated with Parylene-C. The efficient design was implemented to accelerate testing. The obtained results describe stimulation capabilities. Functionality was validated using a frequency response analyzer to measure how the generated electromagnetic power radiates in space. 99.8% power loss was observed over a 100-μm separation between a pair of identical microcoils. Obtained through finite-element modeling, the microcoils can be driven by a 60 mA, 5 kHz, sinusoidal input for 10 minutes before predicted inflammation. Rattay's activating function was calculated to evaluate the magnetic stimulation effect of external fields on target neurons. Combined with the frequency response analysis, magnitude and spatial effects of the generated potential is established. As a result, each microcoil requires a 400-μm-wide area for each independent stimulation channel, which is 84% narrower than a commercial cochlear array channel, thereby suggesting greater spatial selectivity.

Influence of the spread of electric field on neural excitation in cochlear implant users: Transimpedance and spread of excitation measurements

Channel interactions caused by spread of the intracochlear electric field and, thus, the spread of neural excitation constrain frequency selectivity and speech recognition in cochlear implant (CI) users. Studying the influence of the spread of electric field (SEF) on the spread of excitation (SOE) can help us better understand the electrical-neural interface. The primary aim of this study was to examine the influence of the SEF on the SOE. In 38 Nucleus (Cochlear Ltd. Sydney, Australia) CI recipients, we assessed the spatial SEF by measuring the voltage drop (transimpedance) and the SOE through neural responses (electrically evoked compound action potentials [eCAPs]) along the electrode array. Transimpedance was recorded using the monopolar (MP2) mode as the stimulation and recording mode. Biphasic square-wave pulses with an amplitude of 110 CL and duration of 37 µs were used for stimulation. SOE was measured at the probe active electrodes E5, E13, and E18. The stimulation amplitudes were set individually to the thresholds of the neural response telemetry (T-NRT), which were measured by the AutoNRT protocol. The transimpedance half-widths were between 0.00 electrodes and 8.55 electrodes. The SOE half-widths reached values between 0.54 electrodes and 5.70 electrodes. Considering individual transimpedance and SOE half-widths, the SEF and SOE showed a significant positive correlation only at electrode E13. Furthermore, this study shows a significant negative correlation of the SEF and SOE in consideration of mean half-widths.

Model-based prediction of optogenetic sound encoding in the human cochlea by future optical cochlear implants

When hearing fails, electrical cochlear implants (eCIs) partially restore hearing by direct stimulation of spiral ganglion neurons (SGNs). As light can be better confined in space than electrical current, optical CIs (oCIs) provide more spectral information promising a fundamental improvement of hearing restoration by cochlear implants. Here, we turned to computer modelling for predicting the outcome of optogenetic hearing restoration by future oCIs in humans. We combined three-dimensional reconstruction of the human cochlea with ray-tracing simulation of emission from LED or laser-coupled waveguide emitters of the oCI. Irradiance was read out at the somata of SGNs. The irradiance values reached with waveguides were about 14 times higher than with LEDs, at the same radiant flux of the emitter. Moreover, waveguides outperformed LEDs regarding spectral selectivity. oCIs with either emitter type showed greater spectral selectivity when compared to eCI. In addition, modeling the effects of the source-to-SGN distance, orientation of the sources and impact of scar tissue further informs the development of optogenetic hearing restoration.

Effect of stimulation parameters on sequential current-steered stimuli in cochlear implants

Manipulation of cochlear implant (CI) place pitch was carried out with current steering by stimulating two CI electrodes sequentially. The objective was to investigate whether shifts in activated neural populations could be achieved to produce salient pitch differences and to determine which stimulation parameters would be more effective in steering of current. These were the pulse rate and pulse width of electrical stimuli and the distance between the two current-steering electrodes. Nine CI users participated, and ten ears were tested. The pattern of pitch changes was not consistent across listeners, but the data suggest that individualized selection of stimulation parameters may be used to effect place pitch changes with sequential current steering. Individual analyses showed that pulse width generally had little influence on the effectiveness of current steering with sequential stimuli, while more salient place pitch shifts were often achieved at wider electrode spacing or when the stimulation pulse rate was the same as that indicated on the clinical MAP (the set of stimulation parameters) of the listener. Results imply that current steering may be used in CIs that allow only sequential stimulation to achieve place pitch manipulation.

Speech recognition as a function of the number of channels for Mid-Scala electrode array recipients

This study investigated the number of channels needed for maximum speech understanding and sound quality in 15 adult cochlear implant (CI) recipients with Advanced Bionics (AB) Mid-Scala electrode arrays completely within scala tympani. In experiment I, CI programs used a continuous interleaved sampling (CIS)-based strategy and 4-16 active electrodes. In experiment II, CI programs used an n-of-m strategy featuring 16 active electrodes with either 8- or 12-maxima. Speech understanding and sound quality measures were assessed. For CIS programs, participants demonstrated performance gains using up to 4-10 electrodes on speech measures and sound quality ratings. For n-of-m programs, there was no significant effect of maxima, suggesting 8-maxima is sufficient for this sample's maximum performance and sound quality. These results are largely consistent with previous studies using straight electrode arrays [e.g., Fishman, Shannon, and Slattery (1997). J. Speech Lang. Hear. Res. 40, 1201-1215; Friesen, Shannon, Baskent, and Wang (2001). J. Acoust. Soc. Am. 110, 1150-1163; Shannon, Cruz, and Galvin (2011). Audiol. Neurotol. 16, 113-123; Berg, Noble, Dawant, Dwyer, Labadie, and Gifford (2020). J. Acoust. Soc. Am. 147, 3646-3656] and in contrast with recent studies looking at cochlear precurved electrode arrays [e.g., Croghan, Duran, and Smith (2017). J. Acoust. Soc. Am. 142, EL537-EL543; Berg, Noble, Dawant, Dwuer, Labadie, and Gifford (2019b). J. Acoust. Soc. Am. 145, 1556-1564], which found continuous improvements up to 16 independent channels. These findings suggest that Mid-Scala electrode array recipients demonstrate similar channel independence to straight electrode arrays rather than other manufacturer's precurved electrode arrays.

Side-of-Implantation Effect on Functional Asymmetry in the Auditory Cortex of Single-Sided Deaf Cochlear-Implant Users

Cochlear implants (CIs) allow to restore the hearing function in profoundly deaf individuals. Due to the degradation of the stimulus by CI signal processing, implanted individuals with single-sided deafness (SSD) have the specific challenge that the input highly differs between their ears. The present study compared normal-hearing (NH) listeners (N = 10) and left- and right-ear implanted SSD CI users (N = 10 left, N = 9 right), to evaluate cortical speech processing between CI- and NH-ears and to explore for side-of-implantation effects. The participants performed a two-deviant oddball task, separately with the left and the right ear. Auditory event-related potentials (ERPs) in response to syllables were compared between proficient and non-proficient CI users, as well as between CI and NH ears. The effect of the side of implantation was analysed on the sensor and the source level. CI proficiency could be distinguished based on the ERP amplitudes of the N1 and the P3b. Moreover, syllable processing via the CI ear, when compared to the NH ear, resulted in attenuated and delayed ERPs. In addition, the left-ear implanted SSD CI users revealed an enhanced functional asymmetry in the auditory cortex than right-ear implanted SSD CI users, regardless of whether the syllables were perceived via the CI or the NH ear. Our findings reveal that speech-discrimination proficiency in SSD CI users can be assessed by N1 and P3b ERPs. The results contribute to a better understanding of the rehabilitation success in SSD CI users by showing that cortical speech processing in SSD CI users is affected by CI-related stimulus degradation and experience-related functional changes in the auditory cortex.

The P300 Auditory Event-Related Potential May Predict Segregation of Competing Speech by Bimodal Cochlear Implant Listeners

Compared to normal-hearing (NH) listeners, cochlear implant (CI) listeners have greater difficulty segregating competing speech. Neurophysiological studies have largely investigated the neural foundations for CI listeners' speech recognition in quiet, mainly using the P300 component of event-related potentials (ERPs). P300 is closely related to cognitive processes involving auditory discrimination, selective attention, and working memory. Different from speech perception in quiet, little is known about the neurophysiological foundations for segregation of competing speech by CI listeners. In this study, ERPs were measured for a 1 vs. 2 kHz contrast in 11 Mandarin-speaking bimodal CI listeners and 11 NH listeners. Speech reception thresholds (SRTs) for a male target talker were measured in steady noise or with a male or female masker. Results showed that P300 amplitudes were significantly larger and latencies were significantly shorter for the NH than for the CI group. Similarly, SRTs were significantly better for the NH than for the CI group. Across all participants, P300 amplitude was significantly correlated with SRTs in steady noise (r = -0.65, p = 0.001) and with the competing male (r = -0.62, p = 0.002) and female maskers (r = -0.60, p = 0.003). Within the CI group, there was a significant correlation between P300 amplitude and SRTs with the male masker (r = -0.78, p = 0.005), which produced the most informational masking. The results suggest that P300 amplitude may be a clinically useful neural correlate of central auditory processing capabilities (e.g., susceptibility to informational masking) in bimodal CI patients.

Differential weighting of temporal envelope cues from the low-frequency region for Mandarin sentence recognition in noise

BACKGROUND

Temporal envelope cues are conveyed by cochlear implants (CIs) to hearing loss patients to restore hearing. Although CIs could enable users to communicate in clear listening environments, noisy environments still pose a problem. To improve speech-processing strategies used in Chinese CIs, we explored the relative contributions made by the temporal envelope in various frequency regions, as relevant to Mandarin sentence recognition in noise.

METHODS

Original speech material from the Mandarin version of the Hearing in Noise Test (MHINT) was mixed with speech-shaped noise (SSN), sinusoidally amplitude-modulated speech-shaped noise (SAM SSN), and sinusoidally amplitude-modulated (SAM) white noise (4 Hz) at a + 5 dB signal-to-noise ratio, respectively. Envelope information of the noise-corrupted speech material was extracted from 30 contiguous bands that were allocated to five frequency regions. The intelligibility of the noise-corrupted speech material (temporal cues from one or two regions were removed) was measured to estimate the relative weights of temporal envelope cues from the five frequency regions.

RESULTS

In SSN, the mean weights of Regions 1-5 were 0.34, 0.19, 0.20, 0.16, and 0.11, respectively; in SAM SSN, the mean weights of Regions 1-5 were 0.34, 0.17, 0.24, 0.14, and 0.11, respectively; and in SAM white noise, the mean weights of Regions 1-5 were 0.46, 0.24, 0.22, 0.06, and 0.02, respectively.

CONCLUSIONS

The results suggest that the temporal envelope in the low-frequency region transmits the greatest amount of information in terms of Mandarin sentence recognition for three types of noise, which differed from the perception strategy employed in clear listening environments.

Effect of Place-Based Versus Default Mapping Procedures on Masked Speech Recognition: Simulations of Cochlear Implant Alone and Electric-Acoustic Stimulation

PURPOSE

Cochlear implant (CI) recipients demonstrate variable speech recognition when listening with a CI-alone or electric-acoustic stimulation (EAS) device, which may be due in part to electric frequency-to-place mismatches created by the default mapping procedures. Performance may be improved if the filter frequencies are aligned with the cochlear place frequencies, known as place-based mapping. Performance with default maps versus an experimental place-based map was compared for participants with normal hearing when listening to CI-alone or EAS simulations to observe potential outcomes prior to initiating an investigation with CI recipients.

METHOD

A noise vocoder simulated CI-alone and EAS devices, mapped with default or place-based procedures. The simulations were based on an actual 24-mm electrode array recipient, whose insertion angles for each electrode contact were used to estimate the respective cochlear place frequency. The default maps used the filter frequencies assigned by the clinical software. The filter frequencies for the place-based maps aligned with the cochlear place frequencies for individual contacts in the low- to mid-frequency cochlear region. For the EAS simulations, low-frequency acoustic information was filtered to simulate aided low-frequency audibility. Performance was evaluated for the AzBio sentences presented in a 10-talker masker at +5 dB signal-to-noise ratio (SNR), +10 dB SNR, and asymptote.

RESULTS

Performance was better with the place-based maps as compared with the default maps for both CI-alone and EAS simulations. For instance, median performance at +10 dB SNR for the CI-alone simulation was 57% correct for the place-based map and 20% for the default map. For the EAS simulation, those values were 59% and 37% correct. Adding acoustic low-frequency information resulted in a similar benefit for both maps.

CONCLUSIONS

Reducing frequency-to-place mismatches, such as with the experimental place-based mapping procedure, produces a greater benefit in speech recognition than maximizing bandwidth for CI-alone and EAS simulations. Ongoing work is evaluating the initial and long-term performance benefits in CI-alone and EAS users.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.19529053.

Magnetic stimulation allows focal activation of the mouse cochlea

Cochlear implants (CIs) provide sound and speech sensations for patients with severe to profound hearing loss by electrically stimulating the auditory nerve. While most CI users achieve some degree of open set word recognition under quiet conditions, hearing that utilizes complex neural coding (e.g., appreciating music) has proved elusive, probably because of the inability of CIs to create narrow regions of spectral activation. Several novel approaches have recently shown promise for improving spatial selectivity, but substantial design differences from conventional CIs will necessitate much additional safety and efficacy testing before clinical viability is established. Outside the cochlea, magnetic stimulation from small coils (micro-coils) has been shown to confine activation more narrowly than that from conventional microelectrodes, raising the possibility that coil-based stimulation of the cochlea could improve the spectral resolution of CIs. To explore this, we delivered magnetic stimulation from micro-coils to multiple locations of the cochlea and measured the spread of activation utilizing a multielectrode array inserted into the inferior colliculus; responses to magnetic stimulation were compared to analogous experiments with conventional microelectrodes as well as to responses when presenting auditory monotones. Encouragingly, the extent of activation with micro-coils was ~60% narrower compared to electric stimulation and largely similar to the spread arising from acoustic stimulation. The dynamic range of coils was more than three times larger than that of electrodes, further supporting a smaller spread of activation. While much additional testing is required, these results support the notion that magnetic micro-coil CIs can produce a larger number of independent spectral channels and may therefore improve auditory outcomes. Further, because coil-based devices are structurally similar to existing CIs, fewer impediments to clinical translational are likely to arise.

Degraded and computer-generated speech processing in a bonobo

The human auditory system is capable of processing human speech even in situations when it has been heavily degraded, such as during noise-vocoding, when frequency domain-based cues to phonetic content are strongly reduced. This has contributed to arguments that speech processing is highly specialized and likely a de novo evolved trait in humans. Previous comparative research has demonstrated that a language competent chimpanzee was also capable of recognizing degraded speech, and therefore that the mechanisms underlying speech processing may not be uniquely human. However, to form a robust reconstruction of the evolutionary origins of speech processing, additional data from other closely related ape species is needed. Specifically, such data can help disentangle whether these capabilities evolved independently in humans and chimpanzees, or if they were inherited from our last common ancestor. Here we provide evidence of processing of highly varied (degraded and computer-generated) speech in a language competent bonobo, Kanzi. We took advantage of Kanzi's existing proficiency with touchscreens and his ability to report his understanding of human speech through interacting with arbitrary symbols called lexigrams. Specifically, we asked Kanzi to recognise both human (natural) and computer-generated forms of 40 highly familiar words that had been degraded (noise-vocoded and sinusoidal forms) using a match-to-sample paradigm. Results suggest that-apart from noise-vocoded computer-generated speech-Kanzi recognised both natural and computer-generated voices that had been degraded, at rates significantly above chance. Kanzi performed better with all forms of natural voice speech compared to computer-generated speech. This work provides additional support for the hypothesis that the processing apparatus necessary to deal with highly variable speech, including for the first time in nonhuman animals, computer-generated speech, may be at least as old as the last common ancestor we share with bonobos and chimpanzees.

Impacts of signal processing factors on perceptual restoration in cochlear-implant users

Cochlear-implant (CI) users have previously demonstrated perceptual restoration, or successful repair of noise-interrupted speech, using the interrupted sentences paradigm [Bhargava, Gaudrain, and Başkent (2014). "Top-down restoration of speech in cochlear-implant users," Hear. Res. 309, 113-123]. The perceptual restoration effect was defined experimentally as higher speech understanding scores with noise-burst interrupted sentences compared to silent-gap interrupted sentences. For the perceptual restoration illusion to occur, it is often necessary for the masking or interrupting noise bursts to have a higher intensity than the adjacent speech signal to be perceived as a plausible masker. Thus, signal processing factors like noise reduction algorithms and automatic gain control could have a negative impact on speech repair in this population. Surprisingly, evidence that participants with cochlear implants experienced the perceptual restoration illusion was not observed across the two planned experiments. A separate experiment, which aimed to provide a close replication of previous work on perceptual restoration in CI users, also found no consistent evidence of perceptual restoration, contrasting the original study's previously reported findings. Typical speech repair of interrupted sentences was not observed in the present work's sample of CI users, and signal-processing factors did not appear to affect speech repair.

Emerging therapies for human hearing loss

INTRODUCTION

More than 5% of the world's population have a disabling hearing loss which can be managed by hearing aids or implanted electrical devices. However, outcomes are highly variable, and the sound perceived by recipients is far from perfect. Sparked by the discovery of progenitor cells in the cochlea and rapid progress in drug delivery to the cochlea, biological and pharmaceutical therapies are currently in development to improve the function of the cochlear implant or eliminate the need for it altogether.

AREAS COVERED

This review highlights progress in emerging regenerative strategies to restore hearing and adjunct therapies to augment the cochlear implant. Novel approaches include the reprogramming of progenitor cells to restore the sensory hair cell population in the cochlea, gene therapy and gene editing to treat hereditary and acquired hearing loss. A detailed review of optogenetics is also presented as a technique that could enable optical stimulation of the spiral ganglion neurons, replacing or complementing electrical stimulation.

EXPERT OPINION

Increasing evidence of substantial reversal of hearing loss in animal models, alongside rapid advances in delivery strategies to the cochlea and learnings from clinical trials will amalgamate into a biological or pharmaceutical therapy to replace or complement the cochlear implant.

Medical-Grade Silicone Rubber-Hydrogel-Composites for Modiolar Hugging Cochlear Implants

The gold standard for the partial restoration of sensorineural hearing loss is cochlear implant surgery, which restores patients’ speech comprehension. The remaining limitations, e.g., music perception, are partly due to a gap between cochlear implant electrodes and the auditory nerve cells in the modiolus of the inner ear. Reducing this gap will most likely lead to improved cochlear implant performance. To achieve this, a bending or curling mechanism in the electrode array is discussed. We propose a silicone rubber–hydrogel actuator where the hydrogel forms a percolating network in the dorsal silicone rubber compartment of the electrode array to exert bending forces at low volume swelling ratios. A material study of suitable polymers (medical-grade PDMS and hydrogels), including parametrized bending curvature measurements, is presented. The curvature radii measured meet the anatomical needs for positioning electrodes very closely to the modiolus. Besides stage-one biocompatibility according to ISO 10993-5, we also developed and validated a simplified mathematical model for designing hydrogel-actuated CI with modiolar hugging functionality.

Age-Related Changes in Voice Emotion Recognition by Postlingually Deafened Listeners With Cochlear Implants

OBJECTIVES

Identification of emotional prosody in speech declines with age in normally hearing (NH) adults. Cochlear implant (CI) users have deficits in the perception of prosody, but the effects of age on vocal emotion recognition by adult postlingually deaf CI users are not known. The objective of the present study was to examine age-related changes in CI users' and NH listeners' emotion recognition.

DESIGN

Participants included 18 CI users (29.6 to 74.5 years) and 43 NH adults (25.8 to 74.8 years). Participants listened to emotion-neutral sentences spoken by a male and female talker in five emotions (happy, sad, scared, angry, neutral). NH adults heard them in four conditions: unprocessed (full spectrum) speech, 16-channel, 8-channel, and 4-channel noise-band vocoded speech. The adult CI users only listened to unprocessed (full spectrum) speech. Sensitivity (d') to emotions and Reaction Times were obtained using a single-interval, five-alternative, forced-choice paradigm.

RESULTS

For NH participants, results indicated age-related declines in Accuracy and d', and age-related increases in Reaction Time in all conditions. Results indicated an overall deficit, as well as age-related declines in overall d' for CI users, but Reaction Times were elevated compared with NH listeners and did not show age-related changes. Analysis of Accuracy scores (hit rates) were generally consistent with d' data.

CONCLUSIONS

Both CI users and NH listeners showed age-related deficits in emotion identification. The CI users' overall deficit in emotion perception, and their slower response times, suggest impaired social communication which may in turn impact overall well-being, particularly so for older CI users, as lower vocal emotion recognition scores have been associated with poorer subjective quality of life in CI patients.

Lexical Effects on the Perceived Clarity of Noise-Vocoded Speech in Younger and Older Listeners

When listening to degraded speech, such as speech delivered by a cochlear implant (CI), listeners make use of top-down linguistic knowledge to facilitate speech recognition. Lexical knowledge supports speech recognition and enhances the perceived clarity of speech. Yet, the extent to which lexical knowledge can be used to effectively compensate for degraded input may depend on the degree of degradation and the listener's age. The current study investigated lexical effects in the compensation for speech that was degraded via noise-vocoding in younger and older listeners. In an online experiment, younger and older normal-hearing (NH) listeners rated the clarity of noise-vocoded sentences on a scale from 1 ("very unclear") to 7 ("completely clear"). Lexical information was provided by matching text primes and the lexical content of the target utterance. Half of the sentences were preceded by a matching text prime, while half were preceded by a non-matching prime. Each sentence also consisted of three key words of high or low lexical frequency and neighborhood density. Sentences were processed to simulate CI hearing, using an eight-channel noise vocoder with varying filter slopes. Results showed that lexical information impacted the perceived clarity of noise-vocoded speech. Noise-vocoded speech was perceived as clearer when preceded by a matching prime, and when sentences included key words with high lexical frequency and low neighborhood density. However, the strength of the lexical effects depended on the level of degradation. Matching text primes had a greater impact for speech with poorer spectral resolution, but lexical content had a smaller impact for speech with poorer spectral resolution. Finally, lexical information appeared to benefit both younger and older listeners. Findings demonstrate that lexical knowledge can be employed by younger and older listeners in cognitive compensation during the processing of noise-vocoded speech. However, lexical content may not be as reliable when the signal is highly degraded. Clinical implications are that for adult CI users, lexical knowledge might be used to compensate for the degraded speech signal, regardless of age, but some CI users may be hindered by a relatively poor signal.

Distinct multisensory perceptual processes guide enhanced auditory recognition memory in older cochlear implant users

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Congruent audio-visual encoding enhances later auditory processing in the elderly.

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CI users benefit from additional congruent visual information, similar to controls.

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CI users show distinct neurophysiological processes, compared to controls.

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CI users show an earlier modulation of event-related topographies, compared to controls.

In naturalistic situations, sounds are often perceived in conjunction with matching visual impressions. For example, we see and hear the neighbor’s dog barking in the garden. Still, there is a good chance that we recognize the neighbor’s dog even when we only hear it barking, but do not see it behind the fence. Previous studies with normal-hearing (NH) listeners have shown that the audio-visual presentation of a perceptual object (like an animal) increases the probability to recognize this object later on, even if the repeated presentation of this object occurs in a purely auditory condition. In patients with a cochlear implant (CI), however, the electrical hearing of sounds is impoverished, and the ability to recognize perceptual objects in auditory conditions is significantly limited. It is currently not well understood whether CI users – as NH listeners – show a multisensory facilitation for auditory recognition. The present study used event-related potentials (ERPs) and a continuous recognition paradigm with auditory and audio-visual stimuli to test the prediction that CI users show a benefit from audio-visual perception. Indeed, the congruent audio-visual context resulted in an improved recognition ability of objects in an auditory-only condition, both in the NH listeners and the CI users. The ERPs revealed a group-specific pattern of voltage topographies and correlations between these ERP maps and the auditory recognition ability, indicating a different processing of congruent audio-visual stimuli in CI users when compared to NH listeners. Taken together, our results point to distinct cortical processing of naturalistic audio-visual objects in CI users and NH listeners, which however allows both groups to improve the recognition ability of these objects in a purely auditory context. Our findings are of relevance for future clinical research since audio-visual perception might also improve the auditory rehabilitation after cochlear implantation.

Stimulus context affects the phonemic categorization of temporally based word contrasts in adult cochlear-implant users

Cochlear-implant (CI) users rely heavily on temporal envelope cues for speech understanding. This study examined whether their sensitivity to temporal cues in word segments is affected when the words are preceded by non-informative carrier sentences. Thirteen adult CI users performed phonemic categorization tasks that present primarily temporally based word contrasts: Buy-Pie contrast with word-initial stop of varying voice-onset time (VOT), and Dish-Ditch contrast with varying silent intervals preceding the word-final fricative. These words were presented in isolation or were preceded by carrier stimuli including a sentence, a sentence-envelope-modulated noise, or an unmodulated speech-shaped noise. While participants were able to categorize both word contrasts, stimulus context effects were observed primarily for the Buy-Pie contrast, such that participants reported more "Buy" responses for words with longer VOTs in conditions with carrier stimuli than in isolation. The two non-speech carrier stimuli yielded similar or even greater context effects than sentences. The context effects disappeared when target words were delayed from the carrier stimuli for ≥75 ms. These results suggest that stimulus contexts affect auditory temporal processing in CI users but the context effects appear to be cue-specific. The context effects may be governed by general auditory processes, not those specific to speech processing.

Listening to Music Through Hearing Aids: Potential Lessons for Cochlear Implants

Some of the problems experienced by users of hearing aids (HAs) when listening to music are relevant to cochlear implants (CIs). One problem is related to the high peak levels (up to 120 dB SPL) that occur in live music. Some HAs and CIs overload at such levels, because of the limited dynamic range of the microphones and analogue-to-digital converters (ADCs), leading to perceived distortion. Potential solutions are to use 24-bit ADCs or to include an adjustable gain between the microphones and the ADCs. A related problem is how to squeeze the wide dynamic range of music into the limited dynamic range of the user, which can be only 6-20 dB for CI users. In HAs, this is usually done via multi-channel amplitude compression (automatic gain control, AGC). In CIs, a single-channel front-end AGC is applied to the broadband input signal or a control signal derived from a running average of the broadband signal level is used to control the mapping of the channel envelope magnitude to an electrical signal. This introduces several problems: (1) an intense narrowband signal (e.g. a strong bass sound) reduces the level for all frequency components, making some parts of the music harder to hear; (2) the AGC introduces cross-modulation effects that can make a steady sound (e.g. sustained strings or a sung note) appear to fluctuate in level. Potential solutions are to use several frequency channels to create slowly varying gain-control signals and to use slow-acting (or dual time-constant) AGC rather than fast-acting AGC.

Audibility emphasis of low-level sounds improves consonant identification while preserving vowel identification for cochlear implant users

Consonant perception is challenging for listeners with hearing loss, and transmission of speech over communication channels further deteriorates the acoustics of consonants. Part of the challenge arises from the short-term low energy spectro-temporal profile of consonants (for example, relative to vowels). We hypothesized that an audibility enhancement approach aimed at boosting the energy of low-level sounds would improve identification of consonants without diminishing vowel identification. We tested this hypothesis with 11 cochlear implant users, who completed an online listening experiment remotely using the media device and implant settings that they most commonly use when making video calls. Loudness growth and detection thresholds were measured for pure tone stimuli to characterize the relative loudness of test conditions. Consonant and vowel identification were measured in quiet and in speech-shaped noise for progressively difficult signal-to-noise ratios (+12, +6, 0, -6 dB SNR). These conditions were tested with and without an audibility-emphasis algorithm designed to enhance consonant identification at the source. The results show that the algorithm improves consonant identification in noise for cochlear implant users without diminishing vowel identification. We conclude that low-level emphasis of audio can improve speech recognition for cochlear implant users in the case of video calls or other telecommunications where the target speech can be preprocessed separately from environmental noise.

Children's syntactic parsing and sentence comprehension with a degraded auditory signal

During sentence comprehension, young children anticipate syntactic structures using early-arriving words and have difficulties revising incorrect predictions using late-arriving words. However, nearly all work to date has focused on syntactic parsing in idealized speech environments, and little is known about how children's strategies for predicting and revising meanings are affected by signal degradation. This study compares comprehension of active and passive sentences in natural and vocoded speech. In a word-interpretation task, 5-year-olds inferred the meanings of novel words in sentences that (1) encouraged agent-first predictions (e.g., The blicket is eating the seal implies The blicket is the agent), (2) required revising predictions (e.g., The blicket is eaten by the seal implies The blicket is the theme), or (3) weakened predictions by placing familiar nouns in sentence-initial position (e.g., The seal is eating/eaten by the blicket). When novel words promoted agent-first predictions, children misinterpreted passives as actives, and errors increased with vocoded compared to natural speech. However, when familiar words were sentence-initial that weakened agent-first predictions, children accurately interpreted passives, with no signal-degradation effects. This demonstrates that signal quality interacts with interpretive processes during sentence comprehension, and the impacts of speech degradation are greatest when late-arriving information conflicts with predictions.

Listening Effort in Cochlear Implant Users: The Effect of Speech Intelligibility, Noise Reduction Processing, and Working Memory Capacity on the Pupil Dilation Response

PURPOSE

This study aimed to evaluate the effect of speech recognition performance, working memory capacity (WMC), and a noise reduction algorithm (NRA) on listening effort as measured with pupillometry in cochlear implant (CI) users while listening to speech in noise.

METHOD

Speech recognition and pupil responses (peak dilation, peak latency, and release of dilation) were measured during a speech recognition task at three speech-to-noise ratios (SNRs) with an NRA in both on and off conditions. WMC was measured with a reading span task. Twenty experienced CI users participated in this study.

RESULTS

With increasing SNR and speech recognition performance, (a) the peak pupil dilation decreased by only a small amount, (b) the peak latency decreased, and (c) the release of dilation after the sentences increased. The NRA had no effect on speech recognition in noise or on the peak or latency values of the pupil response but caused less release of dilation after the end of the sentences. A lower reading span score was associated with higher peak pupil dilation but was not associated with peak latency, release of dilation, or speech recognition in noise.

CONCLUSIONS

In CI users, speech perception is effortful, even at higher speech recognition scores and high SNRs, indicating that CI users are in a chronic state of increased effort in communication situations. The application of a clinically used NRA did not improve speech perception, nor did it reduce listening effort. Participants with a relatively low WMC exerted relatively more listening effort but did not have better speech reception thresholds in noise.

A Phenomenological Model Reproducing Temporal Response Characteristics of an Electrically Stimulated Auditory Nerve Fiber

The ability of cochlear implants (CIs) to restore hearing to profoundly deaf people is based on direct electrical stimulation of the auditory nerve fibers (ANFs). Still, CI users do not achieve as good hearing outcomes as their normal-hearing peers. The development and optimization of CI stimulation strategies to reduce that gap could benefit from computational models that can predict responses evoked by different stimulation patterns, particularly temporal responses for coding of temporal fine structure information. To that end, we present the sequential biphasic leaky integrate-and-fire (S-BLIF) model for the ANF response to various pulse shapes and temporal sequences. The phenomenological S-BLIF model is adapted from the earlier BLIF model that can reproduce neurophysiological single-fiber cat ANF data from single-pulse stimulations. It was extended with elements that simulate refractoriness, facilitation, accommodation and long-term adaptation by affecting the threshold value of the model momentarily after supra- and subthreshold stimulation. Evaluation of the model demonstrated that it can reproduce neurophysiological data from single neuron recordings involving temporal phenomena related to inter-pulse interactions. Specifically, data for refractoriness, facilitation, accommodation and spike-rate adaptation can be reproduced. In addition, the model can account for effects of pulse rate on the synchrony between the pulsatile input and the spike-train output. Consequently, the model offers a versatile tool for testing new coding strategies for, e.g., temporal fine structure using pseudo-monophasic pulses, and for estimating the status of the electrode-neuron interface in the CI user's cochlea.

The Impact of Neurocognitive Skills on Recognition of Spectrally Degraded Sentences

BACKGROUND

 Recent models theorize that neurocognitive resources are deployed differently during speech recognition depending on task demands, such as the severity of degradation of the signal or modality (auditory vs. audiovisual [AV]). This concept is particularly relevant to the adult cochlear implant (CI) population, considering the large amount of variability among CI users in their spectro-temporal processing abilities. However, disentangling the effects of individual differences in spectro-temporal processing and neurocognitive skills on speech recognition in clinical populations of adult CI users is challenging. Thus, this study investigated the relationship between neurocognitive functions and recognition of spectrally degraded speech in a group of young adult normal-hearing (NH) listeners.

PURPOSE

 The aim of this study was to manipulate the degree of spectral degradation and modality of speech presented to young adult NH listeners to determine whether deployment of neurocognitive skills would be affected.

RESEARCH DESIGN

 Correlational study design.

STUDY SAMPLE

 Twenty-one NH college students.

DATA COLLECTION AND ANALYSIS

 Participants listened to sentences in three spectral-degradation conditions: no degradation (clear sentences); moderate degradation (8-channel noise-vocoded); and high degradation (4-channel noise-vocoded). Thirty sentences were presented in an auditory-only (A-only) modality and an AV fashion. Visual assessments from The National Institute of Health Toolbox Cognitive Battery were completed to evaluate working memory, inhibition-concentration, cognitive flexibility, and processing speed. Analyses of variance compared speech recognition performance among spectral degradation condition and modality. Bivariate correlation analyses were performed among speech recognition performance and the neurocognitive skills in the various test conditions.

RESULTS

 Main effects on sentence recognition were found for degree of degradation (p = < 0.001) and modality (p = < 0.001). Inhibition-concentration skills moderately correlated (r = 0.45, p = 0.02) with recognition scores for sentences that were moderately degraded in the A-only condition. No correlations were found among neurocognitive scores and AV speech recognition scores.

CONCLUSIONS

 Inhibition-concentration skills are deployed differentially during sentence recognition, depending on the level of signal degradation. Additional studies will be required to study these relations in actual clinical populations such as adult CI users.

Adults with cochlear implants can use prosody to determine the clausal structure of spoken sentences

Speech prosody, including pitch contour, word stress, pauses, and vowel lengthening, can aid the detection of the clausal structure of a multi-clause sentence and this, in turn, can help listeners determine the meaning. However, for cochlear implant (CI) users, the reduced acoustic richness of the signal raises the question of whether CI users may have difficulty using sentence prosody to detect syntactic clause boundaries within sentences or whether this ability is rescued by the redundancy of the prosodic features that normally co-occur at clause boundaries. Twenty-two CI users, ranging in age from 19 to 77 years old, recalled three types of sentences: sentences in which the prosodic pattern was appropriate to the location of a clause boundary within the sentence (congruent prosody), sentences with reduced prosodic information, or sentences in which the location of the clause boundary and the prosodic marking of a clause boundary were placed in conflict. The results showed the presence of congruent prosody to be associated with superior sentence recall and a reduced processing effort as indexed by the pupil dilation. The individual differences in a standard test of word recognition (consonant-nucleus-consonant score) were related to the recall accuracy as well as the processing effort. The outcomes are discussed in terms of the redundancy of the prosodic features, which normally accompany a clause boundary and processing effort.

Valid Acoustic Models of Cochlear Implants: One Size Does Not Fit All

HYPOTHESIS

This study tests the hypothesis that it is possible to find tone or noise vocoders that sound similar and result in similar speech perception scores to a cochlear implant (CI). This would validate the use of such vocoders as acoustic models of CIs. We further hypothesize that those valid acoustic models will require a personalized amount of frequency mismatch between input filters and output tones or noise bands.

BACKGROUND

Noise or tone vocoders have been used as acoustic models of CIs in hundreds of publications but have never been convincingly validated.

METHODS

Acoustic models were evaluated by single-sided deaf CI users who compared what they heard with the CI in one ear to what they heard with the acoustic model in the other ear. We evaluated frequency-matched models (both all-channel and 6-channel models, both tone and noise vocoders) as well as self-selected models that included an individualized level of frequency mismatch.

RESULTS

Self-selected acoustic models resulted in similar levels of speech perception and similar perceptual quality as the CI. These models also matched the CI in terms of perceived intelligibility, harshness, and pleasantness.

CONCLUSION

Valid acoustic models of CIs exist, but they are different from the models most widely used in the literature. Individual amounts of frequency mismatch may be required to optimize the validity of the model. This may be related to the basalward frequency mismatch experienced by postlingually deaf patients after cochlear implantation.

Auditory Brainstem Responses Predict Behavioral Deficits in Rats with Varying Levels of Noise-Induced Hearing Loss

Intense noise exposure is a leading cause of hearing loss, which results in degraded speech sound discrimination ability, particularly in noisy environments. The development of an animal model of speech discrimination deficits due to noise induced hearing loss (NIHL) would enable testing of potential therapies to improve speech sound processing. Rats can accurately detect and discriminate human speech sounds in the presence of quiet and background noise. Further, it is known that profound hearing loss results in functional deafness in rats. In this study, we generated rats with a range of impairments which model the large range of hearing impairments observed in patients with NIHL. One month after noise exposure, we stratified rats into three distinct deficit groups based on their auditory brainstem response (ABR) thresholds. These groups exhibited markedly different behavioral outcomes across a range of tasks. Rats with moderate hearing loss (30 dB shifts in ABR threshold) were not impaired in speech sound detection or discrimination. Rats with severe hearing loss (55 dB shifts) were impaired at discriminating speech sounds in the presence of background noise. Rats with profound hearing loss (70 dB shifts) were unable to detect and discriminate speech sounds above chance level performance. Across groups, ABR threshold accurately predicted behavioral performance on all tasks. This model of long-term impaired speech discrimination in noise, demonstrated by the severe group, mimics the most common clinical presentation of NIHL and represents a useful tool for developing and improving interventions to target restoration of hearing.

Estimating the reduced benefit of infant-directed speech in cochlear implant-related speech processing

Caregivers modify their speech when talking to infants, a specific type of speech known as infant-directed speech (IDS). This speaking style facilitates language learning compared to adult-directed speech (ADS) in infants with normal hearing (NH). While infants with NH and those with cochlear implants (CIs) prefer listening to IDS over ADS, it is yet unknown how CI processing may affect the acoustic distinctiveness between ADS and IDS, as well as the degree of intelligibility of these. This study analyzed speech of seven female adult talkers to model the effects of simulated CI processing on (1) acoustic distinctiveness between ADS and IDS, (2) estimates of intelligibility of caregivers' speech in ADS and IDS, and (3) individual differences in caregivers' ADS-to-IDS modification and estimated speech intelligibility. Results suggest that CI processing is substantially detrimental to the acoustic distinctiveness between ADS and IDS, as well as to the intelligibility benefit derived from ADS-to-IDS modifications. Moreover, the observed variability across individual talkers in acoustic implementation of ADS-to-IDS modification and the estimated speech intelligibility was significantly reduced due to CI processing. The findings are discussed in the context of the link between IDS and language learning in infants with CIs.

Accuracy and cue use in word segmentation for cochlear-implant listeners and normal-hearing listeners presented vocoded speech

Cochlear-implant (CI) listeners experience signal degradation, which leads to poorer speech perception than normal-hearing (NH) listeners. In the present study, difficulty with word segmentation, the process of perceptually parsing the speech stream into separate words, is considered as a possible contributor to this decrease in performance. CI listeners were compared to a group of NH listeners (presented with unprocessed speech and eight-channel noise-vocoded speech) in their ability to segment phrases with word segmentation ambiguities (e.g., "an iceman" vs "a nice man"). The results showed that CI listeners and NH listeners were worse at segmenting words when hearing processed speech than NH listeners were when presented with unprocessed speech. When viewed at a broad level, all of the groups used cues to word segmentation in similar ways. Detailed analyses, however, indicated that the two processed speech groups weighted top-down knowledge cues to word boundaries more and weighted acoustic cues to word boundaries less relative to NH listeners presented with unprocessed speech.