Perception of envelope-enhanced speech in the presence of noise by individuals with auditory neuropathy

Is Working Memory Compromised in Individuals with Sensorineural Hearing Loss with Auditory Neural Origin?

The study aimed to investigate the working memory and speech recognition in noise from individuals with Sensori Neural Hearing Loss (SNHL) with and without auditory neuropathy spectrum disorder (ANSD). The purpose of assessing working memory recommends for a potential intervention program to perceive speech. Twenty participants in the age range of 16-44 years, diagnosed as having mild to moderate SNHL were recruited for the study. The participants were divided into two groups based on the presence and absence of ANSD (10 in each group). The visual working memory was assessed in all the participants using the Operation Span Test, Reading Span Test and Visual Backward Test. Speech perception ability was assessed using the SNR 50 test. There was no significant difference between the scores of Operation Span, Reading Span, and Visual Backward Span for individuals with SNHL with and without ANSD. There was a significant difference between the scores of SNR 50 for individuals with SNHL with and without ANSD. The visual working memory in individuals with and without ANSD is similar. Speech perception in noise is significantly affected in ANSD than SNHL without ANSD. Thus, it is recommended to use speech reading, which utilizes visual working memory to interpret the message, as previous studies have reported that individuals with ANSD show limited benefit in auditory mode of rehabilitation alone.

Binaural consequences of speech envelope enhancement

The potential binaural consequences of two envelope-based speech enhancement strategies (broadband compression and expansion) were examined. Sensitivity to interaural time differences imposed on four single-word stimuli was measured in listeners with normal hearing and sensorineural hearing loss. While there were no consistent effects of compression or expansion across all words, some potentially interesting word-specific effects were observed.

Acoustical and Perceptual Analysis of Noise Reduction Strategies in Individuals With Auditory Neuropathy Spectrum Disorders

Purpose The conventional amplification devices render minimal or no benefit at abating the speech perception problems of individuals with auditory neuropathy spectrum disorder (ANSD). This study was undertaken to evaluate the effect of noise reduction strategies (multiband spectral subtraction, Wiener-as, Karhunen-Loeve transform [Subspace], and ideal binary mask [IdBM] algorithm) on speech using speech perception measures and acoustic measure among individuals with ANSD. Method Two groups of participants (age: 17-43 years) were recruited in the study. Group I comprised 12 individuals with a confirmed diagnosis of ANSD and not exceeding moderate degree of hearing loss and Group II of 10 individuals with normal hearing in both ears. The signal-to-noise required for 50% speech recognition (SNR-50) was measured for the participants in five conditions, that is, unprocessed speech and speech processed with four noise reduction strategies. Additionally, an acoustic objective measure Extended Short-Time Objective Intelligibility algorithm was employed to estimate the intelligibility index across the conditions. Results Significant difference was found across conditions in both the groups. Pairwise comparison revealed significantly better speech perception on SNR-50 measure with IdBM strategy, for both the groups. No significant difference in SNR-50 was observed with other noise reduction strategies. IdBM condition also gave the highest intelligibility index (d) values using Extended Short-Time Objective Intelligibility algorithm. This finding needs to be verified on a larger group of individuals with ANSD. Conclusions IdBM noise reduction strategy rendered significantly lower SNR-50 compared to other noise reduction strategies for individuals with ANSD in this study. This provides clinical evidence for the same and also recommends trying on a larger group of participants before its implementation in hearing devices. Apart from this, the current strategies used in hearing aids provide no improvement in speech identification in noise for this population. Hence, though the present hearing aids may show benefit in quiet condition, chances of its rejection are high in noisy backgrounds.

Perceptual and Objective Assessment of Envelope Enhancement for Children With Auditory Processing Disorder

This paper evaluated the performance of an envelope enhancement (EE) algorithm subjectively by children with auditory processing disorder (APD), and objectively through computational models. Speech intelligibility data was collected from children with APD, for unprocessed and envelope-enhanced speech in the presence of stationary and non-stationary background noise at different signal to noise ratios (SNRs), both with and without noise reduction (NR) algorithms as a front-end to the EE algorithm. Furthermore, intrusive and non-intrusive objective speech intelligibility metrics were derived to predict the perceptual impact of this EE algorithm. Subjective data for stationary noise conditions revealed that the combination of NR and EE algorithms significantly improved the speech intelligibility scores at poor SNRs. In contrast, the same combination was ineffective in improving speech intelligibility in non-stationary noise conditions. Taken together, subjective results suggest that exaggerating the envelope cues improves speech identification scores for children with APD. However, the benefit obtained varies depending upon the type and level of the background noise. Both intrusive and non-intrusive objective speech intelligibility estimators exhibited good correlation with the subjective data, with the intrusive metric demonstrating better generalization capabilities. Implications of these results for hearing aid applications for children with APD is discussed.

Dynamics of Speech Perception in the Auditory-Visual Mode: An Empirical Evidence for the Management of Auditory Neuropathy Spectrum Disorders

BACKGROUND AND OBJECTIVES

The present study probed into the relative and combined contribution of auditory and visual modalities in the speech perception of individuals with auditory neuropathy spectrum disorders (ANSD). Specifically, the identification scores of consonantvowel (CV) syllables, visual enhancement (VE), and auditory enhancement in different signal to noise ratios (SNRs) were compared with that of the control group. Subjects and.

METHODS

The study used a repeated measure standard group comparison research design. Two groups of individuals in the age range of 16 to 35 years participated in the study. The clinical group included 35 participants diagnosed as ANSD, while the control group had 35 age and gender matched individuals with typical auditory abilities. The participants were assessed for CV syllable identification in auditory only (A), visual only (V), and auditory-visual (AV) modalities. The syllables were presented in quiet and at 0 dB SNR.

RESULTS

The speech identification score was maximum in AV condition followed by A-condition and least in V condition. This was true in both the groups. The individuals with ANSD were able to make better use of visual cues than the control group, as evident in the VE score.

CONCLUSIONS

The dynamics of speech perception in the AV mode is different between ANSD and control. There is definite benefit of auditory as well as visual cues to individuals with ANSD, suggesting the need to facilitate both the modalities as part of the audiological rehabilitation. Future studies can focus on independently facilitating the two modalities and testing the benefits in the AV mode of speech perception in individuals with ANSD.

Effectiveness of Low Cut Modified Amplification using Receiver in the Canal Hearing Aid in Individuals with Auditory Neuropathy Spectrum Disorder

Introduction  The studies on hearing aid benefit in individuals with auditory neuropathy spectrum disorder (ANSD) shows limited benefit. Low cut modified amplification is found to be effective in few individuals with ANSD. With advancement in technology, receiver in the canal (RIC) hearing aids have proven to be more effective than traditional behind the ear (BTE) hearing aids. Objective  Thus, the present study attempts to determine the effectiveness of low cut modified amplification using RIC and BTE. Method  Twenty participants with ANSD were fitted with BTE and RIC using traditional and low cut modified amplification. We divided them into good and poor performers based on unaided speech identification scores (SIS). We then compared aided SIS and aided benefit across conditions in good and poor performers with ANSD across both conditions using BTE and RIC. Results  The results of the study showed that the aided performance improved with low cut modified amplification in both BTE and RIC hearing aids. The improvement noticed with low-cut modified fitting with RIC was significant in more than BTE, especially in good performers with ANSD. Conclusion  The improved clarity and naturalness of sound with RIC may have led to better aided scores and better acceptance of the hearing aid. Thus, low-cut modified amplification, preferably with RIC, needs to be attempted in fitting individuals with ANSD, especially in those with good unaided SIS in quiet.

The Role of Temporal Envelope and Fine Structure in Mandarin Lexical Tone Perception in Auditory Neuropathy Spectrum Disorder

Temporal information in a signal can be partitioned into temporal envelope (E) and fine structure (FS). Fine structure is important for lexical tone perception for normal-hearing (NH) listeners, and listeners with sensorineural hearing loss (SNHL) have an impaired ability to use FS in lexical tone perception due to the reduced frequency resolution. The present study was aimed to assess which of the acoustic aspects (E or FS) played a more important role in lexical tone perception in subjects with auditory neuropathy spectrum disorder (ANSD) and to determine whether it was the deficit in temporal resolution or frequency resolution that might lead to more detrimental effects on FS processing in pitch perception. Fifty-eight native Mandarin Chinese-speaking subjects (27 with ANSD, 16 with SNHL, and 15 with NH) were assessed for (1) their ability to recognize lexical tones using acoustic E or FS cues with the “auditory chimera” technique, (2) temporal resolution as measured with temporal gap detection (TGD) threshold, and (3) frequency resolution as measured with the Q_10dB values of the psychophysical tuning curves. Overall, 26.5%, 60.2%, and 92.1% of lexical tone responses were consistent with FS cues for tone perception for listeners with ANSD, SNHL, and NH, respectively. The mean TGD threshold was significantly higher for listeners with ANSD (11.9 ms) than for SNHL (4.0 ms; p < 0.001) and NH (3.9 ms; p < 0.001) listeners, with no significant difference between SNHL and NH listeners. In contrast, the mean Q_10dB for listeners with SNHL (1.8±0.4) was significantly lower than that for ANSD (3.5±1.0; p < 0.001) and NH (3.4±0.9; p < 0.001) listeners, with no significant difference between ANSD and NH listeners. These results suggest that reduced temporal resolution, as opposed to reduced frequency selectivity, in ANSD subjects leads to greater degradation of FS processing for pitch perception.

Masking effects in patients with auditory neuropathy-possible involvement of suppression mechanism caused by normal outer hair cell function

OBJECTIVE

Variations in the effects of masking noise were evaluated in different pathologies of sensorineural hearing loss.

STUDY DESIGN

Retrospective chart review.

SETTING

Tertiary referral center.

PATIENTS

Fifty-five ears of 30 patients with sensorineural hearing loss who underwent noise audiometry in the Department of Otolaryngology-Head and Neck Surgery, Tohoku University Hospital, since 2010, because of complaints of hearing difficulty in noisy environments.

MAIN OUTCOME MEASURES

Masked threshold for narrow band and white noise.

RESULTS AND DISCUSSION

Masking effects in patients with auditory neuropathy were significantly larger than those in patients with other types of hearing losses. Masking effects of broad band white noise were greater than those of narrow band noise. Masking effects could be observed for white noise even in the elevated unmasked threshold region, where little contribution of excitatory masking effect would be expected. The present findings support the idea that the suppression mechanism caused by normal outer hair cell function is important in the masking phenomenon in patients with auditory neuropathy.

Temporal processing and speech perception in noise by listeners with auditory neuropathy

Aim

The present study evaluated the relation between speech perception in the presence of background noise and temporal processing ability in listeners with Auditory Neuropathy (AN).

Method

The study included two experiments. In the first experiment, temporal resolution of listeners with normal hearing and those with AN was evaluated using measures of temporal modulation transfer function and frequency modulation detection at modulation rates of 2 and 10 Hz. In the second experiment, speech perception in quiet and noise was evaluated at three signal to noise ratios (SNR) (0, 5, and 10 dB).

Results

Results demonstrated that listeners with AN performed significantly poorer than normal hearing listeners in both amplitude modulation and frequency modulation detection, indicating significant impairment in extracting envelope as well as fine structure cues from the signal. Furthermore, there was significant correlation seen between measures of temporal resolution and speech perception in noise.

Conclusion

Results suggested that an impaired ability to efficiently process envelope and fine structure cues of the speech signal may be the cause of the extreme difficulties faced during speech perception in noise by listeners with AN.

Impairments of the medial olivocochlear system increase the risk of noise-induced auditory neuropathy in laboratory mice

HYPOTHESIS

Impairments of the medial olivocochlear system (MOCS) increase the risk of environmentally induced auditory neuropathy spectrum disorder (ANSD).

BACKGROUND

ANSD is a problem in the neural transmission of auditory information that accounts for 10% to 15% of the cases of pediatric hearing loss. The underlying mechanisms of the disorder remain poorly understood, but noise exposure is an important risk factor. The goal of this study was to identify environmental conditions and genetic predispositions that lead to ANSD. Our approach was based on the assumption that noise induces ANSD by impeding the functional maturation of the brain's sound coding pathways. Because the MOCS adjusts the sensitivity of the inner ear to noise, impairments of this feedback are predicted to increase the disruptive effects of environmental exposures.

METHODS

An animal model of ANSD was created by rearing mice in noise. MOCS protection was assessed by comparing the incidence of noise-induced ANSD among knockout mice lacking feedback and wild-type (WT) controls. The mice were screened for ANSD with distortion product otoacoustic emissions, auditory brainstem responses, and behavioral measures of gap detection. Single-unit recording procedures were used to link these deficits to impaired synaptic transmission in the ventral cochlear nucleus.

RESULTS

ANSD manifested in noise-reared mice as intact distortion product otoacoustic emissions, abnormal auditory brainstem responses, and impaired gap detection. The phenotype was not observed among quiet-reared WT mice but was occasionally noted among noise-reared WT mice. The incidence of ANSD significantly increased among knockout mice, especially when they were reared in noise.

CONCLUSION

Noise promotes ANSD by altering the functional maturation of the brain's temporal pathways. Noise-induced impairments are reduced by the sound-attenuating effects of the MOCS. Noise levels do not need to be unnaturally loud to constitute significant risk in MOCS-compromised individuals.