Auditory steady-state responses as neural correlates of loudness growth

Detection of Electrically Evoked Auditory Steady-State Responses in Cochlear-Implant Recipients With a System Identification Based Method

OBJECTIVE

Electrically evoked auditory steady-state responses (EASSRs) can potentially be used as an objective measure to realize the automatic fitting of cochlear implants (CIs). They can be recorded using electroencephalography (EEG) and objectively detected at the modulation frequency of the stimulus. The main roadblock in using EASSRs is the presence of CI stimulation artifacts in the EEG recording. In this article, we present an improvement of a recently introduced system identification (SI) based artifact removal method. We evaluate its applicability for objective CI fitting on a larger dataset.

METHODS

The parameter estimation problem of the SI is solved using ordinary least squares (OLS), where an additional regularization term is added to the cost function. We compare EASSR latencies as determined by the commonly used linear interpolation artifact removal method and SI, to evaluate the artifact removal and EASSR detection quality on a dataset of 16 CI recipients and four different stimulation levels.

RESULTS

SI can fully remove stimulation artifacts and detect EASSRs, even for recordings from ipsilateral EEG channels, where all other artifact removal methods fail so far. Using OLS with regularization prevents false positive response detection.

CONCLUSION

Using SI, EASSRs can reliably be detected in EEG recordings, even for ipsilateral recording channels and recordings with lower stimulation levels. As the recordings are obtained with clinically relevant settings of the CI, they reveal the potential impact of SI on the objective fitting of CIs.

SIGNIFICANCE

We argue, that SI enables therefore a big step towards automated CI fitting with EASSRs.

Effects of analysis window on 40-Hz auditory steady-state responses in cochlear implant users

Auditory steady-state responses (ASSRs) are phase-locked responses of the auditory system to the envelope of a stimulus. These responses can be used as an objective proxy to assess temporal envelope processing and its related functional outcomes such as hearing thresholds and speech perception, in normal-hearing listeners, in persons with hearing impairment, as well as in cochlear-implant (CI) users. While ASSRs are traditionally measured using a continuous stimulation paradigm, an alternative is the intermittent stimulation paradigm, whereby stimuli are presented with silence intervals in between. This paradigm could be more useful in a clinical setting as it allows for other neural responses to be analysed concurrently. One clinical use case of the intermittent paradigm is to objectively program CIs during an automatic fitting session whereby electrically evoked ASSRs (eASSRs) as well as other evoked potentials are used to predict behavioural thresholds. However, there is no consensus yet about the optimal analysis parameters for an intermittent paradigm in order to detect and measure eASSRs reliably. In this study, we used the intermittent paradigm to evoke eASSRs in adult CI users and investigated whether the early response buildup affects the response measurement outcomes. To this end, we varied the starting timepoint and length of the analysis window within which the responses were analysed. We used the amplitude, signal-to-noise ratio (SNR), phase, and pairwise phase consistency (PPC) to characterize the responses. Moreover, we set out to find the optimal stimulus duration for efficient and reliable eASSR measurements. These analyses were performed at two stimulation levels, i.e., 100% and 50% of the dynamic range of each participant. Results revealed that inclusion of the first 300 ms in the analysis window leads to overestimation of response amplitude and underestimation of response phase. Additionally, the response SNR and PPC were not affected by the inclusion of the first 300 ms in the analysis window. However, the latter two metrics were highly dependent on the stimulus duration which complicates comparisons across studies. Finally, the optimal stimulus duration for quick and reliable characterization of eASSRs was found to be around 800 ms for the stimulation level of 100% DR. These findings suggest that inclusion of the early onset period of eASSR recordings negatively influences the response measurement outcomes and that efficient and reliable eASSR measurements are possible using stimuli of around 800 ms long. This will pave the path for the development of a clinically feasible eASSR measurement in CI users.

Acoustic deprivation modulates central gain in human auditory brainstem and cortex

Beyond reduced audibility, there is convincing evidence that the auditory system adapts according to the principles of homeostatic plasticity in response to a hearing loss. Such compensatory changes include modulation of central auditory gain mechanisms. Earplugging is a common experimental method that has been used to introduce a temporary, reversible hearing loss that induces changes consistent with central gain modulation. In the present study, young, normal-hearing adult participants wore a unilateral earplug for two weeks, during which we measured changes in the acoustic reflex threshold (ART), loudness perception, and cortically-evoked (40 Hz) auditory steady-state response (ASSR) to assess potential modulation in central gain with reduced peripheral input. The ART decreased on average by 8 to 10 dB during the treatment period, with modest increases in loudness perception after one week but not after two weeks of earplug use. Significant changes in both the magnitude and hemispheric laterality of source-localized cortical ASSR measures revealed asymmetrical changes in stimulus-driven cortical activity over time. The ART results following unilateral earplugging are consistent with the literature and suggest that homeostatic plasticity is evident in the brainstem. The novel findings from the cortical ASSR in the present study indicates that reduced peripheral input induces adaptive homeostatic plasticity reflected as both an increase in central gain in the auditory brainstem and reduced cortical activity ipsilateral to the deprived ear. Both the ART and the novel use of the 40-Hz ASSR provide sensitive measures of central gain modulation in the brainstem and cortex of young, normal hearing listeners, and thus may be useful in future studies with other clinical populations.

Age-related hearing loss is associated with alterations in temporal envelope processing in different neural generators along the auditory pathway

People with age-related hearing loss suffer from speech understanding difficulties, even after correcting for differences in hearing audibility. These problems are not only attributed to deficits in audibility but are also associated with changes in central temporal processing. The goal of this study is to obtain an understanding of potential alterations in temporal envelope processing for middle-aged and older persons with and without hearing impairment. The time series of activity of subcortical and cortical neural generators was reconstructed using a minimum-norm imaging technique. This novel technique allows for reconstructing a wide range of neural generators with minimal prior assumptions regarding the number and location of the generators. The results indicated that the response strength and phase coherence of middle-aged participants with hearing impairment (HI) were larger than for normal-hearing (NH) ones. In contrast, for the older participants, a significantly smaller response strength and phase coherence were observed in the participants with HI than the NH ones for most modulation frequencies. Hemispheric asymmetry in the response strength was also altered in middle-aged and older participants with hearing impairment and showed asymmetry toward the right hemisphere. Our brain source analyses show that age-related hearing loss is accompanied by changes in the temporal envelope processing, although the nature of these changes varies with age.

Clinical and investigational tools for monitoring noise-induced hyperacusis

Hyperacusis is a recognized perceptual consequence of acoustic overexposure that can lead to debilitating psychosocial effects. Despite the profound impact of hyperacusis on quality of life, clinicians and researchers lack objective biomarkers and standardized protocols for its assessment. Outcomes of conventional audiologic tests are highly variable in the hyperacusis population and do not adequately capture the multifaceted nature of the condition on an individual level. This presents challenges for the differential diagnosis of hyperacusis, its clinical surveillance, and evaluation of new treatment options. Multiple behavioral and objective assays are emerging as contenders for inclusion in hyperacusis assessment protocols but most still await rigorous validation. There remains a pressing need to develop tools to quantify common nonauditory symptoms, including annoyance, fear, and pain. This review describes the current literature on clinical and investigational tools that have been used to diagnose and monitor hyperacusis, as well as those that hold promise for inclusion in future trials.

Premium versus entry-level hearing aids: using group concept mapping to investigate the drivers of preference

OBJECTIVES

To investigate the difference in outcome measures and drivers of user preference between premium and entry-level hearing aids using group concept mapping.

DESIGN

A single-blind crossover trial was conducted. Aided behavioural outcomes measured were loudness rating, speech/consonant recognition, and speech quality. Preference between hearing aids was measured with a 7-point Likert scale. Group concept mapping was utilised to investigate preference results. Participants generated statements based on what influenced their preferences. These were sorted into categories with underlying themes. Participants rated each statement on a 5-point Likert scale of importance.

STUDY SAMPLE

Twenty-three adult participants (mean: 62.4 years; range: 24-78) with mild to moderately severe bilateral SNHL (PTA_{500-4000 Hz} > 20 dB HL).

RESULTS

A total of 83 unique statements and nine distinct clusters, with underlying themes driving preference, were generated. Clusters that differed significantly in importance between entry-level and premium hearing aid choosers were: Having access to smartphone application-based user-controlled settings, the ability to stream calls and music, and convenience features such as accessory compatibility.

CONCLUSION

This study has identified non-signal-processing factors which significantly influenced preference for a premium hearing aid over an entry-level hearing aid, indicating the importance of these features as drivers of user preference.

Envelope reconstruction of speech and music highlights stronger tracking of speech at low frequencies

The human brain tracks amplitude fluctuations of both speech and music, which reflects acoustic processing in addition to the encoding of higher-order features and one's cognitive state. Comparing neural tracking of speech and music envelopes can elucidate stimulus-general mechanisms, but direct comparisons are confounded by differences in their envelope spectra. Here, we use a novel method of frequency-constrained reconstruction of stimulus envelopes using EEG recorded during passive listening. We expected to see music reconstruction match speech in a narrow range of frequencies, but instead we found that speech was reconstructed better than music for all frequencies we examined. Additionally, models trained on all stimulus types performed as well or better than the stimulus-specific models at higher modulation frequencies, suggesting a common neural mechanism for tracking speech and music. However, speech envelope tracking at low frequencies, below 1 Hz, was associated with increased weighting over parietal channels, which was not present for the other stimuli. Our results highlight the importance of low-frequency speech tracking and suggest an origin from speech-specific processing in the brain.

The effect of stimulus intensity on neural envelope tracking

Objectives In recent years, there has been significant interest in recovering the temporal envelope of a speech signal from the neural response to investigate neural speech processing. The research focus is now broadening from neural speech processing in normal-hearing listeners towards hearing-impaired listeners. When testing hearing-impaired listeners, speech has to be amplified to resemble the effect of a hearing aid and compensate for peripheral hearing loss. Today it is not known with certainty how or if neural speech tracking is influenced by sound amplification. As these higher intensities could influence the outcome, we investigated the influence of stimulus intensity on neural speech tracking. Design We recorded the electroencephalogram (EEG) of 20 normal-hearing participants while they listened to a narrated story. The story was presented at intensities from 10 to 80 dB A. To investigate the brain responses, we analyzed neural tracking of the speech envelope by reconstructing the envelope from the EEG using a linear decoder and by correlating the reconstructed with the actual envelope. We investigated the delta (0.5-4 Hz) and the theta (4-8 Hz) band for each intensity. We also investigated the latencies and amplitudes of the responses in more detail using temporal response functions, which are the estimated linear response functions between the stimulus envelope and the EEG. Results Neural envelope tracking is dependent on stimulus intensity in both the TRF and envelope reconstruction analysis. However, provided that the decoder is applied to the same stimulus intensity as it was trained on, envelope reconstruction is robust to stimulus intensity. Besides, neural envelope tracking in the delta (but not theta) band seems to relate to speech intelligibility. Similar to the linear decoder analysis, TRF amplitudes and latencies are dependent on stimulus intensity: The amplitude of peak 1 (30-50 ms) increases, and the latency of peak 2 (140-160 ms) decreases with increasing stimulus intensity. Conclusion Although brain responses are influenced by stimulus intensity, neural envelope tracking is robust to stimulus intensity when using the same intensity to test and train the decoder. Therefore we can assume that intensity will not be a confounder when testing hearing-impaired participants with amplified speech using the linear decoder approach. In addition, neural envelope tracking in the delta band appears to be correlated with speech intelligibility, showing the potential of neural envelope tracking as an objective measure of speech intelligibility.

Stimulus-evoked phase-locked activity along the human auditory pathway strongly varies across individuals

Phase-locking to the temporal envelope of speech is associated with envelope processing and speech perception. The phase-locked activity of the auditory pathway, across modulation frequencies, is generally assessed at group level and shows a decrease in response magnitude with increasing modulation frequency. With the exception of increased activity around 40 and 80 to 100 Hz. Furthermore, little is known about the phase-locked response patterns to modulation frequencies ≤ 20 Hz, which are modulations predominately present in the speech envelope. In the present study we assess the temporal modulation transfer function (TMTF_ASSR) of the phase-locked activity of the auditory pathway, from 0.5 to 100 Hz at a high-resolution and by means of auditory steady-state responses. Although the group-averaged TMTF_ASSR corresponds well with those reported in the literature, the individual TMTF_ASSR shows a remarkable intersubject variability. This intersubject variability is especially present for ASSRs that originate from the cortex and are evoked with modulation frequencies ≤ 20 Hz. Moreover, we found that these cortical phase-locked activity patterns are robust over time. These results show the importance of the individual TMTF_ASSR when assessing phase-locked activity to envelope fluctuations, which can potentially be used as a marker for auditory processing.

Neural Representation of Loudness: Cortical Evoked Potentials in an Induced Loudness Reduction Experiment

Loudness context effects comprise differences in judgments of the loudness of a target stimulus depending on the presence of a preceding inducer tone. Interstimulus intervals (ISIs) between inducer tone and target tone of about 200 ms and above cause an induced loudness reduction (ILR) of the target tone. As the ILR increases, respectively, the perceived loudness of the target stimuli decreases with increasing ISI. This in turn means that identical stimuli in a different context have a differently perceived loudness. A correlation between specific characteristics in the electroencephalography responses and perceived loudness in an ILR experiment would therefore provide a neurophysiological indication of loudness processing beyond a neural representation of stimulus intensity only. To examine if such a correlation exists, we investigated cortical electroencephalography responses in a latency range from 75 to 510 ms during a psychoacoustical ILR experiment with different ISIs. With increasing ISI, the strength of the N1-P2 deflection of the respective electroencephalography response decreases similarly to the loudness perception of the target tone pulse. This indicates a representation based on loudness rather than on intensity at the corresponding processing stage.

Perceptual Benefits of Extended Bandwidth Hearing Aids With Children: A Within-Subject Design Using Clinically Available Hearing Aids

Purpose The aim of the study was to investigate the achieved audibility with clinically available, modern, high-end, behind-the-ear hearing aids fitted using the Desired Sensation Level v5.0 child prescription for a clinical sample of children with hearing impairment and the effect of the extended bandwidth provided by the hearing aids on several outcome measures. Method The achieved audibility was measured using the maximum audible output frequency method. Twenty-eight children (7-17 years old) with mild to severe hearing losses completed this study. Two hearing aid conditions were fitted for each participant: an extended bandwidth condition, which was fitted to targets as closely as possible, and a restricted bandwidth condition, for which aided output was restricted above 4.5 kHz. Consonant discrimination in noise, subjective preference, aided loudness growth, and preferred listening levels were evaluated in both conditions. Results The extended bandwidth hearing aid fittings provided speech audibility above 4.5 kHz for all children, with an average maximum audible output frequency of 7376 Hz (SD = 1669 Hz). When compared to a restricted bandwidth, the extended bandwidth condition led to an improvement of 5.4% for consonant discrimination in noise scores, mostly attributable to /s/, /z/, and /t/ phoneme perception. Aided loudness results and preferred listening levels were not significantly different across bandwidth conditions; however, 65% of the children indicated a subjective preference for the extended bandwidth. Conclusion The study suggests that providing the full bandwidth available, with modern, behind-the-ear hearing aids, leads to improved audibility, when compared to restricted bandwidth hearing aids, and that it leads to beneficial outcomes for children who use hearing aids, fitted to the Desired Sensation Level v5.0 child prescription, without causing significant increases in their loudness perception.

Speech recognition, loudness, and preference with extended bandwidth hearing aids for adult hearing aid users

Objective: In contrast to the past, some current hearing aids can provide gain for frequencies above 4-5 kHz. This study assessed the effect of wider bandwidth on outcome measures using hearing aids fitted with the DSL v5.0 prescription.Design: There were two conditions: an extended bandwidth condition, for which the maximum available bandwidth was provided, and a restricted bandwidth condition, in which gain was reduced for frequencies above 4.5 kHz. Outcome measures were assessed in both conditions.Study sample: Twenty-four participants with mild-to-moderately-severe sensorineural high-frequency sloping hearing loss.Results: Providing extended bandwidth resulted in maximum audible output frequency values of 7.5 kHz on average for an input level of 65 dB SPL. An improvement in consonant discrimination scores (4.1%), attributable to better perception of /s/, /z/, and /t/ phonemes, was found in the extended bandwidth condition, but no significant change in loudness perception or preferred listening levels was found. Most listeners (79%) had either no preference (33%) or some preference for the extended bandwidth condition (46%).Conclusions: The results suggest that providing the maximum bandwidth available with modern hearing aids fitted with DSL v5.0, using targets from 0.25 to 8 kHz, can be beneficial for the tested population.

Binaural Beats through the Auditory Pathway: From Brainstem to Connectivity Patterns

Binaural beating is a perceptual auditory illusion occurring when presenting two neighboring frequencies to each ear separately. Several controversial claims have been attributed to binaural beats regarding their ability to entrain human brain activity and mood, in both the scientific literature and the marketing realm. Here, we sought to address those questions in a robust fashion using a single-blind, active-controlled protocol. To do so, we compared the effects of binaural beats with a control beat stimulation (monaural beats, known to entrain brain activity but not mood) across four distinct levels in the human auditory pathway: subcortical and cortical entrainment, scalp-level functional connectivity and self-reports. Both stimuli elicited standard subcortical responses at the pure tone frequencies of the stimulus [i.e., frequency following response (FFR)], and entrained the cortex at the beat frequency [i.e., auditory steady state response (ASSR)]. Furthermore, functional connectivity patterns were modulated differentially by both kinds of stimuli, with binaural beats being the only one eliciting cross-frequency activity. Despite this, we did not find any mood modulation related to our experimental manipulation. Our results provide evidence that binaural beats elicit cross frequency connectivity patterns, but weakly entrain the cortex when compared with monaural beat stimuli. Whether binaural beats have an impact on cognitive performance or other mood measurements remains to be seen and can be further investigated within the proposed methodological framework.

On the loudness of low-frequency sounds with fluctuating amplitudes

Some environmental sounds have strong amplitude fluctuations that may affect their perceived loudness and annoyance. This study assessed the effect of beat rate (f_b) and center frequency (f_c) on the loudness of low-frequency beating tones. The loudness of two-tone complexes (TTCs) with f_c = 40, 63, 80, and 1000 Hz was matched with that of unmodulated tones (UTs). Frequency differences between the TTC components, corresponding to f_b = 1, 2, 5, and 12 Hz, were used. To compensate for the steep decline in hearing sensitivity below 100 Hz, prior to the loudness match, subjects adjusted the relative levels (ΔL) of the TTC components to give maximum beat perception. Twenty-four normal-hearing subjects were tested. The values of ΔL giving best beats were well predicted from the transfer function of the middle ear and the estimated shapes of the auditory filters, assuming that the auditory filter whose output dominated the beat percept was centered somewhat above f_c. At the same root-mean-square level and independent of f_c, TTCs were perceived as louder than UTs for f_b ≤ 2 Hz, had roughly equal loudness to UTs for f_b = 5 Hz, and were less loud than UTs for f_b = 12 Hz.

Stability of Auditory Steady State Responses Over Time

OBJECTIVES

Auditory steady state responses (ASSRs) are used in clinical practice for objective hearing assessments. The response is called steady state because it is assumed to be stable over time, and because it is evoked by a stimulus with a certain periodicity, which will lead to discrete frequency components that are stable in amplitude and phase over time. However, the stimuli commonly used to evoke ASSRs are also known to be able to induce loudness adaptation behaviorally. Researchers and clinicians using ASSRs assume that the response remains stable over time. This study investigates (1) the stability of ASSR amplitudes over time, within one recording, and (2) whether loudness adaptation can be reflected in ASSRs.

DESIGN

ASSRs were measured from 14 normal-hearing participants. The ASSRs were evoked by the stimuli that caused the most loudness adaptation in a previous behavioral study, that is, mixed-modulated sinusoids with carrier frequencies of either 500 or 2000 Hz, a modulation frequency of 40 Hz, and a low sensation level of 30 dB SL. For each carrier frequency and participant, 40 repetitions of 92 sec recordings were made. Two types of analyses were used to investigate the ASSR amplitudes over time: with the more traditionally used Fast Fourier Transform and with a novel Kalman filtering approach. Robust correlations between the ASSR amplitudes and behavioral loudness adaptation ratings were also calculated.

RESULTS

Overall, ASSR amplitudes were stable. Over all individual recordings, the median change of the amplitudes over time was -0.0001 μV/s. Based on group analysis, a significant but very weak decrease in amplitude over time was found, with the decrease in amplitude over time around -0.0002 μV/s. Correlation coefficients between ASSR amplitudes and behavioral loudness adaptation ratings were significant but low to moderate, with r = 0.27 and r = 0.39 for the 500 and 2000 Hz carrier frequency, respectively.

CONCLUSIONS

The decrease in amplitude of ASSRs over time (92 sec) is small. Consequently, it is safe to use ASSRs in clinical practice, and additional correction factors for objective hearing assessments are not needed. Because only small decreases in amplitudes were found, loudness adaptation is probably not reflected by the ASSRs.

Objective Binaural Loudness Balancing Based on 40-Hz Auditory Steady-State Responses. Part I: Normal Hearing

Psychophysical procedures are used to balance loudness across the ears. However, they can be difficult and require active cooperation. We investigated whether 40-Hz auditory steady-state response (ASSR) amplitudes can be used to objectively estimate the balanced loudness across the ears for a group of young, normal-hearing participants. The 40-Hz ASSRs were recorded using monaural stimuli with carrier frequencies of 500, 1000, or 2000 Hz over a range of levels between 40 and 80 dB SPL. Behavioral loudness balancing was performed for at least one reference level of the left ear. ASSR amplitude growth functions were listener dependent, but median across-ear ratios in ASSR amplitudes were close to 1. The differences between the ASSR-predicted balanced levels and the behaviorally found balanced levels were smaller than 5 dB in 59% of cases and smaller than 10 dB in 85% of cases. The differences between the ASSR-predicted balanced levels and the reference levels were smaller than 5 dB in 54% of cases and smaller than 10 dB in 87% of cases. No clear hemispheric lateralization was found for 40-Hz ASSRs, with the exception of responses evoked by stimulus levels of 40 to 60 dB SPL at 2000 Hz.

Estimation of auditory steady-state responses based on the averaging of independent EEG epochs

The amplitude of auditory steady-state responses (ASSRs) generated in the brainstem of rats exponentially decreases over the sequential averaging of EEG epochs. This behavior is partially due to the adaptation of the ASSR induced by the continuous and monotonous stimulation. In this study, we analyzed the potential clinical relevance of the ASSR adaptation. ASSR were elicited in eight anesthetized adult rats by 8-kHz tones, modulated in amplitude at 115 Hz. We called independent epochs to those EEG epochs acquired with sufficiently long inter-stimulus interval, so the ASSR contained in any given epoch is not affected by the previous stimulation. We tested whether the detection of ASSRs is improved when the response is computed by averaging independent EEG epochs, containing only unadapted auditory responses. The improvements in the ASSR detection obtained with standard, weighted and sorted averaging were compared. In the absence of artifacts, when the ASSR was elicited by continuous acoustic stimulation, the computation of the ASSR amplitude relied upon the averaging method. While the adaptive behavior of the ASSR was still evident after the weighting of epochs, the sorted averaging resulted in under-estimations of the ASSR amplitude. In the absence of artifacts, the ASSR amplitudes computed by averaging independent epochs did not depend on the averaging procedure. Averaging independent epochs resulted in higher ASSR amplitudes and halved the number of EEG epochs needed to be acquired to achieve the maximum detection rate of the ASSR. Acquisition protocols based on averaging independent EEG epochs, in combination with appropriate averaging methods for artifact reduction might contribute to develop more accurate hearing assessments based on ASSRs.

Coding-in-Noise Deficits are Not Seen in Responses to Amplitude Modulation in Subjects with cochlear Synaptopathy Induced by a Single Noise Exposure

Since the first report of noise-induced synaptic damage in animals without permanent threshold shifts (PTSs), the concept of noise-induced hidden hearing loss (NIHHL) has been proposed to cover the functional deficits in hearing associated with noise-induced synaptopathy. Moreover, the potential functional deficit associated with the noise-induced synaptopathy has been largely attributed to the loss of auditory nerve fibers (ANFs) with a low spontaneous spike rate (SSR). As this group of ANFs is critical for coding at suprathreshold levels and in noisy background, coding-in-noise deficit (CIND) has been considered to be main consequence of the synaptopathy. However, such deficits have not been verified after a single, brief exposure to noise without PTS. In the present study, synaptopathy was generated by such noise exposure in both mice and guinea pigs. Responses to amplitude modulation (AM) were recorded at a high sound level in combination with masking to evaluate the existence of CINDs that might be associated with loss of low-SSR ANFs. An overall reduction in response amplitude was seen in AM-evoked compound action potential (CAP). However, no such reduction was seen in the scalp-recorded envelope following response (EFR), suggesting a compensation due to increased central gain. Moreover, there was no significant difference in masking effect between the control and noise groups. The results suggest that either there is no significant CIND after the synaptopathy we created, or the AM response tested with our protocol was not sufficiently sensitive to detect such a deficit; far-field EFR is not sensitive to cochlear pathology.

Objective Binaural Loudness Balancing Based on 40-Hz Auditory Steady-State Responses. Part II: Asymmetric and Bimodal Hearing

In Part I, we investigated 40-Hz auditory steady-state response (ASSR) amplitudes for the use of objective loudness balancing across the ears for normal-hearing participants and found median across-ear ratios in ASSR amplitudes close to 1. In this part, we further investigated whether the ASSR can be used to estimate binaural loudness balance for listeners with asymmetric hearing, for whom binaural loudness balancing is of particular interest. We tested participants with asymmetric hearing and participants with bimodal hearing, who hear with electrical stimulation through a cochlear implant (CI) in one ear and with acoustical stimulation in the other ear. Behavioral loudness balancing was performed at different percentages of the dynamic range. Acoustical carrier frequencies were 500, 1000, or 2000 Hz, and CI channels were stimulated in apical or middle regions in the cochlea. For both groups, the ASSR amplitudes at balanced loudness levels were similar for the two ears, with median ratios between left and right ear stimulation close to 1. However, individual variability was observed. For participants with asymmetric hearing loss, the difference between the behavioral balanced levels and the ASSR-predicted balanced levels was smaller than 10 dB in 50% and 56% of cases, for 500 Hz and 2000 Hz, respectively. For bimodal listeners, these percentages were 89% and 60%. Apical CI channels yielded significantly better results (median difference near 0 dB) than middle CI channels, which had a median difference of −7.25 dB.

Neural envelope encoding predicts speech perception performance for normal-hearing and hearing-impaired adults

Peripheral hearing impairment cannot fully account for speech perception difficulties that emerge with advancing age. As the fluctuating speech envelope bears crucial information for speech perception, changes in temporal envelope processing are thought to contribute to degraded speech perception. Previous research has demonstrated changes in neural encoding of envelope modulations throughout the adult lifespan, either due to age or due to hearing impairment. To date, however, it remains unclear whether such age- and hearing-related neural changes are associated with impaired speech perception. In the present study, we investigated the potential relationship between perception of speech in different types of masking sounds and neural envelope encoding for a normal-hearing and hearing-impaired adult population including young (20-30 years), middle-aged (50-60 years), and older (70-80 years) people. Our analyses show that enhanced neural envelope encoding in the cortex and in the brainstem, respectively, is related to worse speech perception for normal-hearing and for hearing-impaired adults. This neural-behavioral correlation is found for the three age groups and appears to be independent of the type of masking noise, i.e., background noise or competing speech. These findings provide promising directions for future research aiming to develop advanced rehabilitation strategies for speech perception difficulties that emerge throughout adult life.

Electrically-evoked auditory steady-state responses as neural correlates of loudness growth in cochlear implant users

Loudness growth functions characterize how the loudness percept changes with current level between the threshold and most comfortable loudness level in cochlear implant users. Even though loudness growth functions are highly listener-dependent, currently default settings are used in clinical devices. This study investigated whether electrically-evoked auditory steady-state response amplitude growth functions correspond to behaviorally measured loudness growth functions. Seven cochlear implant listeners participated in two behavioral loudness growth tasks and an EEG recording session. The 40-Hz sinusoidally amplitude-modulated pulse trains were presented to CI channels stimulating at a more apical and basal region of the cochlea, and were presented at different current levels encompassing the listeners' dynamic ranges. Behaviorally, loudness growth was measured using an Absolute Magnitude Estimation and a Graphic Rating Scale with loudness categories. A good correspondence was found between the response amplitude functions and the behavioral loudness growth functions. The results are encouraging for future advances in individual, more automatic, and objective fitting of cochlear implants.