Variability in the Estimated Amplitude of Vowel-Evoked Envelope Following Responses Caused by Assumed Neurophysiologic Processing Delays

Neural Envelope Processing at Low Frequencies Predicts Speech Understanding of Children With Hearing Loss in Noise and Reverberation

OBJECTIVE

Children with hearing loss experience greater difficulty understanding speech in the presence of noise and reverberation relative to their normal hearing peers despite provision of appropriate amplification. The fidelity of fundamental frequency of voice (f0) encoding-a salient temporal cue for understanding speech in noise-could play a significant role in explaining the variance in abilities among children. However, the nature of deficits in f0 encoding and its relationship with speech understanding are poorly understood. To this end, we evaluated the influence of frequency-specific f0 encoding on speech perception abilities of children with and without hearing loss in the presence of noise and/or reverberation.

METHODS

In 14 school-aged children with sensorineural hearing loss fitted with hearing aids and 29 normal hearing peers, envelope following responses (EFRs) were elicited by the vowel /i/, modified to estimate f0 encoding in low (<1.1 kHz) and higher frequencies simultaneously. EFRs to /i/ were elicited in quiet, in the presence of speech-shaped noise at +5 dB signal to noise ratio, with simulated reverberation time of 0.62 sec, as well as both noise and reverberation. EFRs were recorded using single-channel electroencephalogram between the vertex and the nape while children watched a silent movie with captions. Speech discrimination accuracy was measured using the University of Western Ontario Distinctive Features Differences test in each of the four acoustic conditions. Stimuli for EFR recordings and speech discrimination were presented monaurally.

RESULTS

Both groups of children demonstrated a frequency-dependent dichotomy in the disruption of f0 encoding, as reflected in EFR amplitude and phase coherence. Greater disruption (i.e., lower EFR amplitudes and phase coherence) was evident in EFRs elicited by low frequencies due to noise and greater disruption was evident in EFRs elicited by higher frequencies due to reverberation. Relative to normal hearing peers, children with hearing loss demonstrated: (a) greater disruption of f0 encoding at low frequencies, particularly in the presence of reverberation, and (b) a positive relationship between f0 encoding at low frequencies and speech discrimination in the hardest listening condition (i.e., when both noise and reverberation were present).

CONCLUSIONS

Together, these results provide new evidence for the persistence of suprathreshold temporal processing deficits related to f0 encoding in children despite the provision of appropriate amplification to compensate for hearing loss. These objectively measurable deficits may underlie the greater difficulty experienced by children with hearing loss.

Predicting Hearing aid Benefit Using Speech-Evoked Envelope Following Responses in Children With Hearing Loss

Electroencephalography could serve as an objective tool to evaluate hearing aid benefit in infants who are developmentally unable to participate in hearing tests. We investigated whether speech-evoked envelope following responses (EFRs), a type of electroencephalography-based measure, could predict improved audibility with the use of a hearing aid in children with mild-to-severe permanent, mainly sensorineural, hearing loss. In 18 children, EFRs were elicited by six male-spoken band-limited phonemic stimuli--the first formants of /u/ and /i/, the second and higher formants of /u/ and /i/, and the fricatives /s/ and /∫/--presented together as /su∫i/. EFRs were recorded between the vertex and nape, when /su∫i/ was presented at 55, 65, and 75 dB SPL using insert earphones in unaided conditions and individually fit hearing aids in aided conditions. EFR amplitude and detectability improved with the use of a hearing aid, and the degree of improvement in EFR amplitude was dependent on the extent of change in behavioral thresholds between unaided and aided conditions. EFR detectability was primarily influenced by audibility; higher sensation level stimuli had an increased probability of detection. Overall EFR sensitivity in predicting audibility was significantly higher in aided (82.1%) than unaided conditions (66.5%) and did not vary as a function of stimulus or frequency. EFR specificity in ascertaining inaudibility was 90.8%. Aided improvement in EFR detectability was a significant predictor of hearing aid-facilitated change in speech discrimination accuracy. Results suggest that speech-evoked EFRs could be a useful objective tool in predicting hearing aid benefit in children with hearing loss.

External and middle ear influence on envelope following responses

Considerable between-subject variability in envelope following response (EFR) amplitude limits its clinical translation. Based on a pattern of lower amplitude and larger variability in the low (<1.2 kHz) and high (>8 kHz), relative to mid (1-3 kHz) frequency carriers, we hypothesized that the between-subject variability in external and middle ear (EM) contribute to between-subject variability in EFR amplitude. It is predicted that equalizing the stimulus reaching the cochlea by accounting for EM differences using forward pressure level (FPL) calibration would at least partially improve response amplitude and reduce between-subject variability. In 21 young normal hearing adults, EFRs of four modulation rates (91, 96, 101, and 106 Hz) were measured concurrently from four frequency bands [low (0.091-1.2 kHz), mid (1-3 kHz), high (4-5.4 kHz), and very high (vHigh; 8-9.4 kHz)], respectively, with 12 harmonics each. The results indicate that FPL calibration in-ear and in a coupler leads to larger EFR amplitudes in the low and vHigh frequency bands relative to conventional coupler root-mean-square calibration. However, improvement in variability was modest with FPL calibration. This lack of a statistically significant improvement in variability suggests that the dominant source of variability in EFR amplitude may arise from cochlear and/or neural processing.

The Influence of Male- and Female-Spoken Vowel Acoustics on Envelope-Following Responses

The influence of male and female vowel characteristics on the envelope-following responses (EFRs) is not well understood. This study explored the role of vowel characteristics on the EFR at the fundamental frequency (f0) in response to the vowel /ε/ (as in "head"). Vowel tokens were spoken by five males and five females and EFRs were measured in 25 young adults (21 females). An auditory model was used to estimate changes in auditory processing that might account for talker effects on EFR amplitude. There were several differences between male and female vowels in relation to the EFR. For male talkers, EFR amplitudes were correlated with the bandwidth and harmonic count of the first formant, and the amplitude of the trough below the second formant. For female talkers, EFR amplitudes were correlated with the range of f0 frequencies and the amplitude of the trough above the second formant. The model suggested that the f0 EFR reflects a wide distribution of energy in speech, with primary contributions from high-frequency harmonics mediated from cochlear regions basal to the peaks of the first and second formants, not from low-frequency harmonics with energy near f0. Vowels produced by female talkers tend to produce lower-amplitude EFR, likely because they depend on higher-frequency harmonics where speech sound levels tend to be lower. This work advances auditory electrophysiology by showing how the EFR evoked by speech relates to the acoustics of speech, for both male and female voices.

The influence of phoneme contexts on adaptation in vowel-evoked envelope following responses

Repeated stimulus presentation leads to neural adaptation and consequent amplitude reduction in vowel-evoked envelope following responses (EFRs)-a response that reflects neural activity phase-locked to envelope periodicity. EFRs are elicited by vowels presented in isolation or in the context of other phonemes such as in syllables. While context phonemes could exert some forward influence on vowel-evoked EFRs, they may reduce the degree of adaptation. Here, we evaluated whether the properties of context phonemes between consecutive vowel stimuli influence adaptation. EFRs were elicited by the low-frequency first formant (resolved harmonics) and mid-to-high frequency second and higher formants (unresolved harmonics) of a male-spoken/i/when the presence, number, and predictability of context phonemes (/s/, /a/, /∫/, /u/) between vowel repetitions varied. Monitored over four iterations of /i/, adaptation was evident only for EFRs elicited by the unresolved harmonics. EFRs elicited by the unresolved harmonics decreased in amplitude by ~16-20 nV (10-17%) after the first presentation of/i/and remained stable thereafter. EFR adaptation was reduced by the presence of a context phoneme, but the reduction did not change with their number or predictability. The presence of a context phoneme, however, attenuated EFRs by a degree similar to that caused by adaptation (~21-23 nV). Such a trade-off in the short- and long-term influence of context phonemes suggests that the benefit of interleaving EFR-eliciting vowels with other context phonemes depends on whether the use of consonant-vowel syllables is critical to improve the validity of EFR applications.