Effects of hearing loss and spectral shaping on identification and neural response patterns of stop-consonant stimuli in young adults

Central Auditory Changes Associated with Age-related Hearing Loss

Objective. This study aimed to investigate age-related changes in cortical auditory evoked potentials (CAEPs) while considering three crucial factors: aging, high-frequency hearing loss and sensation level of the CAEP stimulus. Method. The electrophysiological and audiometric data of 71 elderly participants were analyzed using multiple regression analysis to investigate the association of CAEPs with the factors of aging, high-frequency hearing loss and sensation level of the CAEP test stimulus. Results. Aging was significantly associated with prolonged N1 and P2 latencies and reduced P2 amplitude. Elevated thresholds related to the sensation level of the CAEP stimulus were significantly associated with increased N1 and P2 amplitudes and decreased N1 latency. A significant relationship was detected between high-frequency hearing thresholds and the shortening of P2 latencies and the reduction of P2 amplitudes. Conclusion. The results of this study highlight the complex interplay of aging, high-frequency hearing loss and the sensation level of the CAEP stimulus on CAEP components in elderly people. These factors should be considered in future research using CAEPs to enhance overall understanding of auditory processing in the aging population.

The effect of sensorineural hearing loss on central auditory processing of signals in noise in older adults

OBJECTIVES

The study aimed to explore the effect of sensorineural hearing loss on the central auditory processing of signals in noise using cortical auditory evoked potentials (CAEPs) in a cohort of older adults.

DESIGN

Three groups of individuals participated in the study. Each group included 33 older adults with normal hearing, those with mild hearing loss and those with moderate hearing loss. N1-P2 peaks of CAEPs by speech stimuli in silent conditions and with varying sound pressure levels of background noise were recorded. CAEP latencies, amplitudes and relative changes in CAEP amplitudes as a function of decreasing signal-to-noise ratios (SNR) in three groups were analyzed using the mixed analysis of variance method.

RESULTS

There was a significant main effect of SNR on all CAEP components, as well as significant main effects of hearing status on N1 latencies, amplitudes and relative changes in N1 amplitudes. A significant interaction was found between hearing status and SNR for relative changes in N1 amplitudes. The normal hearing group differed from both the mild and moderate hearing loss groups in terms of relative changes in N1 amplitudes at SNR 10 dB.

CONCLUSION

The results showed decreased amplitudes and increased latencies for N1-P2 response as the SNR of CAEP stimuli was lowered. The degree of reduction in the N1 amplitudes of the older people with normal hearing resulting from the increase in the background noise level was greater than those in their sensorineural hearing-impaired counterparts, providing evidence for decreased central inhibition for individuals with age-related hearing loss.

Effects of aging on neural processing during an active listening task

Factors affecting successful listening in older adults and the corresponding electrophysiological signatures are not well understood. The present study investigated age-related differences in attention and temporal processing, as well as differences in the neural activity related to signal degradation during a number comparison task. Participants listened to digits presented in background babble and were tested at two levels of signal clarity, clear and degraded. Behavioral and electrophysiological measures were examined in 30 older and 20 younger neurologically-healthy adults. Relationships between performance on the number comparison task, behavioral measures, and neural activity were used to determine correlates of listening deficits associated with aging. While older participants showed poorer performance overall on all behavioral measures, their scores on the number comparison task were largely predicted (based on regression analyses) by their sensitivity to temporal fine structure cues. Compared to younger participants, older participants required higher signal-to-noise ratios (SNRs) to achieve equivalent performance on the number comparison task. With increasing listening demands, age-related changes were observed in neural processing represented by the early-N1 and later-P3 time windows. Source localization analyses revealed age differences in source activity for the degraded listening condition that was located in the left prefrontal cortex. In addition, this source activity negatively correlated with task performance in the older group. Together, these results suggest that older adults exhibit reallocation of processing resources to complete a demanding listening task. However, this effect was evident only for poorer performing older adults who showed greater posterior to anterior shift in P3 response amplitudes than older adults who were good performers and younger adults. These findings might reflect less efficient recruitment of neural resources that is associated with aging during effortful listening performance.

Hearing loss is associated with delayed neural responses to continuous speech

We investigated the impact of hearing loss on the neural processing of speech. Using a forward modeling approach, we compared the neural responses to continuous speech of 14 adults with sensorineural hearing loss with those of age-matched normal-hearing peers. Compared to their normal-hearing peers, hearing-impaired listeners had increased neural tracking and delayed neural responses to continuous speech in quiet. The latency also increased with the degree of hearing loss. As speech understanding decreased, neural tracking decreased in both populations; however, a significantly different trend was observed for the latency of the neural responses. For normal-hearing listeners, the latency increased with increasing background noise level. However, for hearing-impaired listeners, this increase was not observed. Our results support the idea that the neural response latency indicates the efficiency of neural speech processing: more or different brain regions are involved in processing speech, which causes longer communication pathways in the brain. These longer communication pathways hamper the information integration among these brain regions, reflected in longer processing times. Altogether, this suggests decreased neural speech processing efficiency in HI listeners as more time and more or different brain regions are required to process speech. Our results suggest that this reduction in neural speech processing efficiency occurs gradually as hearing deteriorates. From our results, it is apparent that sound amplification does not solve hearing loss. Even when listening to speech in silence at a comfortable loudness, hearing-impaired listeners process speech less efficiently.

Does the Speech Cue Profile Affect Response to Amplitude Envelope Distortion?

Purpose A broad area of interest to our group is to understand the consequences of the "cue profile" (a measure of how well a listener can utilize audible temporal and/or spectral cues for listening scenarios in which a subset of cues is distorted. The study goal was to determine if listeners whose cue profile indicated that they primarily used temporal cues for recognition would respond differently to speech-envelope distortion than listeners who utilized both spectral and temporal cues. Method Twenty-five adults with sensorineural hearing loss participated in the study. The listener's cue profile was measured by analyzing identification patterns for a set of synthetic syllables in which envelope rise time and formant transitions were varied. A linear discriminant analysis quantified the relative contributions of spectral and temporal cues to identification patterns. Low-context sentences in noise were processed with time compression, wide-dynamic range compression, or a combination of time compression and wide-dynamic range compression to create a range of speech-envelope distortions. An acoustic metric, a modified version of the Spectral Correlation Index, was calculated to quantify envelope distortion. Results A binomial generalized linear mixed-effects model indicated that envelope distortion, the cue profile, the interaction between envelope distortion and the cue profile, and the pure-tone average were significant predictors of sentence recognition. Conclusions The listeners with good perception of spectro-temporal contrasts were more resilient to the detrimental effects of envelope compression than listeners who used temporal cues to a greater extent. The cue profile may provide information about individual listening that can direct choice of hearing aid parameters, especially those parameters that affect the speech envelope.

Frontal Cortical Modulation of Temporal Visual Cross-Modal Re-organization in Adults with Hearing Loss

Recent research has demonstrated frontal cortical involvement to co-occur with visual re-organization, suggestive of top-down modulation of cross-modal mechanisms. However, it is unclear whether top-down modulation of visual re-organization takes place in mild hearing loss, or is dependent upon greater degrees of hearing loss severity. Thus, the purpose of this study was to determine if frontal top-down modulation of visual cross-modal re-organization increased across hearing loss severity. We recorded visual evoked potentials (VEPs) in response to apparent motion stimuli in 17 adults with mild-moderate hearing loss using 128-channel high-density electroencephalography (EEG). Current density reconstructions (CDRs) were generated using sLORETA to visualize VEP generators in both groups. VEP latency and amplitude in frontal regions of interest (ROIs) were compared between groups and correlated with auditory behavioral measures. Activation of frontal networks in response to visual stimulation increased across mild to moderate hearing loss, with simultaneous activation of the temporal cortex. In addition, group differences in VEP latency and amplitude correlated with auditory behavioral measures. Overall, these findings support the hypothesis that frontal top-down modulation of visual cross-modal re-organization is dependent upon hearing loss severity.

Auditory cortical activity to different voice onset times in cochlear implant users

OBJECTIVE

Voice onset time (VOT) is a critical temporal cue for perception of speech in cochlear implant (CI) users. We assessed the cortical auditory evoked potentials (CAEPs) to consonant vowels (CVs) with varying VOTs and related these potentials to various speech perception measures.

METHODS

CAEPs were recorded from 64 scalp electrodes during passive listening in CI and normal-hearing (NH) groups. Speech stimuli were synthesized CVs from a 6-step VOT /ba/-/pa/ continuum ranging from 0 to 50 ms VOT in 10-ms steps. Behavioral measures included the 50% boundary point for categorical perception ("ba" to "pa") from an active condition task.

RESULTS

Behavioral measures: CI users with poor speech perception performance had prolonged 50% VOT boundary points compared to NH subjects. The 50% boundary point was also significantly correlated to the ability to discriminate consonants in quiet and noise masking. Electrophysiology: The most striking difference between the NH and CI subjects was that the P2 response was significantly reduced in amplitude in the CI group compared to NH. N1 amplitude did not differ between NH and CI groups. P2 latency increased with increases in VOT for both NH and CI groups. P2 was delayed more in CI users with poor speech perception compared to NH subjects. N1 amplitude was significantly related to consonant perception in noise while P2 latency was significantly related to vowel perception in noise. When dipole source modelling in auditory cortex was used to characterize N1/P2, more significant relationships were observed with speech perception measures compared to the same N1/P2 activity when measured at the scalp. N1 dipole amplitude measures were significantly correlated with consonants in noise discrimination. Like N1, the P2 dipole amplitude was correlated with consonant discrimination, but additional significant relationships were observed such as sentence and word identification.

CONCLUSIONS

P2 responses to a VOT continuum stimulus were different between NH subjects and CI users. P2 responses show more significant relationships with speech perception than N1 responses.

SIGNIFICANCE

The current findings indicate that N1/P2 measures during a passive listening task relate to speech perception outcomes after cochlear implantation.

Auditory Spatial Discrimination and the Mismatch Negativity Response in Hearing-Impaired Individuals

The aims of the present study were to investigate the ability of hearing-impaired (HI) individuals with different binaural hearing conditions to discriminate spatial auditory-sources at the midline and lateral positions, and to explore the possible central processing mechanisms by measuring the minimal audible angle (MAA) and mismatch negativity (MMN) response. To measure MAA at the left/right 0°, 45° and 90° positions, 12 normal-hearing (NH) participants and 36 patients with sensorineural hearing loss, which included 12 patients with symmetrical hearing loss (SHL) and 24 patients with asymmetrical hearing loss (AHL) [12 with unilateral hearing loss on the left (UHLL) and 12 with unilateral hearing loss on the right (UHLR)] were recruited. In addition, 128-electrode electroencephalography was used to record the MMN response in a separate group of 60 patients (20 UHLL, 20 UHLR and 20 SHL patients) and 20 NH participants. The results showed MAA thresholds of the NH participants to be significantly lower than the HI participants. Also, a significantly smaller MAA threshold was obtained at the midline position than at the lateral position in both NH and SHL groups. However, in the AHL group, MAA threshold for the 90° position on the affected side was significantly smaller than the MMA thresholds obtained at other positions. Significantly reduced amplitudes and prolonged latencies of the MMN were found in the HI groups compared to the NH group. In addition, contralateral activation was found in the UHL group for sounds emanating from the 90° position on the affected side and in the NH group. These findings suggest that the abilities of spatial discrimination at the midline and lateral positions vary significantly in different hearing conditions. A reduced MMN amplitude and prolonged latency together with bilaterally symmetrical cortical activations over the auditory hemispheres indicate possible cortical compensatory changes associated with poor behavioral spatial discrimination in individuals with HI.

Mitigation of informational masking in individuals with single-sided deafness by integrated bone conduction hearing aids

OBJECTIVES

To confirm an increased susceptibility to informational masking among individuals with single-sided deafness (SSD). To demonstrate a reduction in informational masking when SSD is treated with an integrated bone conduction hearing aid (IBC). To identify the acoustic cues that contribute to IBC-aided masking release. To determine the effects of device experience on the IBC advantage.

DESIGN

Informational masking was evaluated with the coordinate-response measure. Participants performed the task by reporting color and number coordinates that changed randomly within target sentences. The target sentences were presented in free field accompanied by zero to three distracting sentences. Target and distracting sentences were spoken by different talkers and originated from different source locations, creating two sources of information for auditory streaming. Susceptibility to informational masking was inferred from the error rates of unaided SSD patients relative to normal controls. These baseline measures were derived by testing inexperienced IBC users without the device on the day of their initial fitting. The benefits of IBC-aided listening were assessed by measuring the aided performance of users who had at least 3 months' device experience. The acoustic basis of the listening advantage was isolated by correlating response errors with the voice pitch and location of distracting sentences. The effects of learning on cue effectiveness were evaluated by comparing the error rates of experienced and inexperienced users.

RESULTS

Unaided SSD participants (inexperienced users) performed as well as normal controls when tested without distracting sentences but produced significantly higher error rates when tested with distracting sentences. Most errors involved responding with coordinates that were contained in distracting sentences. This increased susceptibility to informational masking was significantly reduced when experienced IBC users were tested with the device. The listening advantage was most strongly correlated with the availability of voice pitch cues, although performance was also influenced by the location of distracting sentences. Directional asymmetries appear to be dictated by location-dependent cues that are derived from the distinctive transmission characteristics of IBC stimulation. Experienced users made better use of these cues than inexperienced users.

CONCLUSIONS

These results suggest that informational masking is a significant source of communication impairment among individuals with SSD. Despite the lateralization of auditory function, unaided SSD subjects experience informational masking when distractors occur in either the deaf or normal spatial hemifield. Restoration of aural sensitivity in the deaf hemifield with an IBC enhances speech intelligibility under complex listening conditions, presumably by providing additional sound-segregation cues that are derived from voice pitch and spatial location. The optimal use of these cues is not immediate, but a significant listening advantage is observed after 3 months of unstructured use.

Gated auditory speech perception in elderly hearing aid users and elderly normal-hearing individuals: effects of hearing impairment and cognitive capacity

This study compared elderly hearing aid (EHA) users and elderly normal-hearing (ENH) individuals on identification of auditory speech stimuli (consonants, words, and final word in sentences) that were different when considering their linguistic properties. We measured the accuracy with which the target speech stimuli were identified, as well as the isolation points (IPs: the shortest duration, from onset, required to correctly identify the speech target). The relationships between working memory capacity, the IPs, and speech accuracy were also measured. Twenty-four EHA users (with mild to moderate hearing impairment) and 24 ENH individuals participated in the present study. Despite the use of their regular hearing aids, the EHA users had delayed IPs and were less accurate in identifying consonants and words compared with the ENH individuals. The EHA users also had delayed IPs for final word identification in sentences with lower predictability; however, no significant between-group difference in accuracy was observed. Finally, there were no significant between-group differences in terms of IPs or accuracy for final word identification in highly predictable sentences. Our results also showed that, among EHA users, greater working memory capacity was associated with earlier IPs and improved accuracy in consonant and word identification. Together, our findings demonstrate that the gated speech perception ability of EHA users was not at the level of ENH individuals, in terms of IPs and accuracy. In addition, gated speech perception was more cognitively demanding for EHA users than for ENH individuals in the absence of semantic context.

Compensatory changes in cortical resource allocation in adults with hearing loss

Hearing loss has been linked to many types of cognitive decline in adults, including an association between hearing loss severity and dementia. However, it remains unclear whether cortical re-organization associated with hearing loss occurs in early stages of hearing decline and in early stages of auditory processing. In this study, we examined compensatory plasticity in adults with mild-moderate hearing loss using obligatory, passively-elicited, cortical auditory evoked potentials (CAEP). High-density EEG elicited by speech stimuli was recorded in adults with hearing loss and age-matched normal hearing controls. Latency, amplitude and source localization of the P1, N1, P2 components of the CAEP were analyzed. Adults with mild-moderate hearing loss showed increases in latency and amplitude of the P2 CAEP relative to control subjects. Current density reconstructions revealed decreased activation in temporal cortex and increased activation in frontal cortical areas for hearing-impaired listeners relative to normal hearing listeners. Participants' behavioral performance on a clinical test of speech perception in noise was significantly correlated with the increases in P2 latency. Our results indicate that changes in cortical resource allocation are apparent in early stages of adult hearing loss, and that these passively-elicited cortical changes are related to behavioral speech perception outcome.