Age and measurement time-of-day effects on speech recognition in noise

Remote Cochlear Implant Assessments: Validity and Stability in Self-Administered Smartphone-Based Testing

OBJECTIVES

The stability of remote testing in cochlear implant care was studied by testing the influence of time-of-day, listener fatigue, and motivation on the outcomes of the aided threshold test (ATT) and digit triplets test (DTT) in cochlear implant (CI) recipients using self-tests at-home on a smartphone or tablet.

DESIGN

A single-center repeated measures cohort study design (n = 50 adult CI recipients). The ATT and DTT were tested at-home ten times, with nine of these sessions planned within a period of eight days. Outcomes were modeled as a function of time-of-day, momentary motivation, listeners' task-related fatigue, and chronotype (i.e., someone's preference for morning or evening due to the sleep-wake cycle) using linear mixed models. Additional factors included aided monosyllabic word recognition in quiet, daily-life fatigue, age, and CI experience.

RESULTS

Out of 500 planned measurements, 407 ATTs and 476 DTTs were completed. The ATT determined thresholds and impedances were stable across sessions. The factors in the DTT model explained 75% of the total variance. Forty-nine percent of the total variance was explained by individual differences in the participants' DTT performance. For each 10% increase in word recognition in quiet, the DTT speech reception threshold improved by an average of 1.6 dB. DTT speech reception threshold improved, on average by 0.1 dB per repeated session and correlated with the number of successful DTTs per participant. There was no significant time-of-day effect on auditory performance in at-home administered tests.

CONCLUSIONS

This study is one of the first to report on the validity and stability of remote assessments in CI recipients and reveals relevant factors. CI recipients can be self-tested at any waking hour to monitor performance via smartphone or tablet. Motivation, task-related fatigue, and chronotype did not affect the outcomes of ATT or DTT in the studied cohort. Word recognition in quiet is a good predictor for deciding whether the DTT should be included in an individual's remote test battery. At-home testing is reliable for cochlear implant recipients and offers an opportunity to provide care in a virtual hearing clinic setting.

Impact of SNR, peripheral auditory sensitivity, and central cognitive profile on the psychometric relation between pupillary response and speech performance in CI users

Despite substantial technical advances and wider clinical use, cochlear implant (CI) users continue to report high and elevated listening effort especially under challenging noisy conditions. Among all the objective measures to quantify listening effort, pupillometry is one of the most widely used and robust physiological measures. Previous studies with normally hearing (NH) and hearing-impaired (HI) listeners have shown that the relation between speech performance in noise and listening effort (as measured by peak pupil dilation) is not linear and exhibits an inverted-U shape. However, it is unclear whether the same psychometric relation exists in CI users, and whether individual differences in auditory sensitivity and central cognitive capacity affect this relation. Therefore, we recruited 17 post-lingually deaf CI adults to perform speech-in-noise tasks from 0 to 20 dB SNR with a 4 dB step size. Simultaneously, their pupillary responses and self-reported subjective effort were recorded. To characterize top-down and bottom-up individual variabilities, a spectro-temporal modulation task and a set of cognitive abilities were measured. Clinical word recognition in quiet and Quality of Life (QoL) were also collected. Results showed that at a group level, an inverted-U shape psychometric curve between task difficulty (SNR) and peak pupil dilation (PPD) was not observed. Individual shape of the psychometric curve was significantly associated with some individual factors: CI users with higher clinical word and speech-in-noise recognition showed a quadratic decrease of PPD over increasing SNRs; CI users with better non-verbal intelligence and lower QoL showed smaller average PPD. To summarize, individual differences in CI users had a significant impact on the psychometric relation between pupillary response and task difficulty, hence affecting the interpretation of pupillary response as listening effort (or engagement) at different task difficulty levels. Future research and clinical applications should further characterize the possible effects of individual factors (such as motivation or engagement) in modulating CI users' occurrence of 'tipping point' on their psychometric functions, and develop an individualized method for reliably quantifying listening effort using pupillometry.

The effect of rhythm on selective listening in multiple-source environments for young and older adults

Understanding continuous speech with competing background sounds is challenging, particularly for older adults. One stimulus property that may aid listeners understanding of to-be-attended (target) material is temporal regularity (rhythm). In the context of speech-in-noise understanding, McAuley and colleagues recently showed a target rhythm effect whereby recognition of target speech was better when natural speech rhythm of a target talker was intact than when it was temporally altered. The current study replicates the target rhythm effect using a synthetic vowel sequence paradigm in young adults (Experiment 1) and then uses this paradigm to investigate potential age-related changes in the effect of rhythm on recognition (Experiment 2). Listeners identified the last three vowels of temporally regular (isochronous) and irregular (anisochronous) synthetic vowel sequences in quiet and with a competing background sequence of vowel-like harmonic tone complexes presented at various tempos. The results replicated the target rhythm effect whereby temporal regularity in the vowel sequences improved identification accuracy of young listeners compared to irregular vowel sequences. The magnitude of the effect was not found to be influenced by background tempo, but faster background tempos led to greater vowel identification accuracy independent of regularity. Older listeners also demonstrated a target rhythm effect but received less benefit from the temporal regularity of the target sequences than did young listeners. This study highlights the importance of rhythm for understanding age-related differences in selective listening in complex environments and provides a novel paradigm for investigating effects of rhythm on perception.

Sensory-Processing Sensitivity Predicts Fatigue From Listening, But Not Perceived Effort, in Young and Older Adults

PURPOSE

Listening-related fatigue is a potential negative consequence of challenges experienced during everyday listening and may disproportionately affect older adults. Contrary to expectation, we recently found that increased reports of listening-related fatigue were associated with better performance on a dichotic listening task. However, this link was found only in individuals who reported heightened sensitivity to a variety of physical, social, and emotional stimuli (i.e., increased "sensory-processing sensitivity" [SPS]). This study examined whether perceived effort may underlie the link between performance and fatigue.

METHOD

Two hundred six young adults, aged 18-30 years (Experiment 1), and 122 older adults, aged 60-80 years (Experiment 2), performed a dichotic listening task and were administered a series of questionnaires including the NASA Task Load Index of perceived effort, the Vanderbilt Fatigue Scale (measuring daily life listening-related fatigue), and the Highly Sensitive Person Scale (measuring SPS). Both experiments were completed online.

RESULTS

SPS predicted listening-related fatigue, but perceived effort during the listening task was not associated with SPS or listening-related fatigue in either age group. We were also unable to replicate the interaction between dichotic listening performance and SPS in either group. Exploratory analyses revealed contrasting effects of age; older adults found the dichotic listening task more effortful but indicated lower overall fatigue.

CONCLUSIONS

These findings suggest that SPS is a better predictor of listening-related fatigue than performance or effort ratings on a dichotic listening task. SPS may be an important factor in determining an individual's likelihood of experiencing listening-related fatigue irrespective of hearing or cognitive ability.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.21893013.

Assessment methods for determining small changes in hearing performance over time

Although the behavioral pure-tone threshold audiogram is considered the gold standard for quantifying hearing loss, assessment of speech understanding, especially in noise, is more relevant to quality of life but is only partly related to the audiogram. Metrics of speech understanding in noise are therefore an attractive target for assessing hearing over time. However, speech-in-noise assessments have more potential sources of variability than pure-tone threshold measures, making it a challenge to obtain results reliable enough to detect small changes in performance. This review examines the benefits and limitations of speech-understanding metrics and their application to longitudinal hearing assessment, and identifies potential sources of variability, including learning effects, differences in item difficulty, and between- and within-individual variations in effort and motivation. We conclude by recommending the integration of non-speech auditory tests, which provide information about aspects of auditory health that have reduced variability and fewer central influences than speech tests, in parallel with the traditional audiogram and speech-based assessments.

Sharper in the morning: Cognitive time of day effects revealed with high-frequency smartphone testing

Decades of research has established a shift from an "eveningness" preference to a "morningness" preference with increasing age. Accordingly, older adults typically have better cognition in morning hours compared to evening hours. We present the first known attempt to capture circadian fluctuations in cognition in individuals at risk for Alzheimer disease (AD) using a remotely administered smartphone assessment that samples cognition rapidly and repeatedly over several days. Older adults (N = 169, aged 61-94 years; 93% cognitively normal) completed four brief smartphone-based testing sessions per day for 7 consecutive days at quasi-random time intervals, assessing associate memory, processing speed, and visual working memory. Scores completed during early hours were averaged for comparison with averaged scores completed during later hours. Mixed effects models evaluated time of day effects on cognition. Additional models included clinical status and cerebrospinal fluid (CSF) biomarkers for beta amyloid (Aβ42) and phosphorylated tau181 (pTau). Models with terms for age, gender, education, APOE ε4 status, and clinical status revealed significantly worse performance on associate memory in evening hours compared to morning hours. Contemporaneously reported mood and fatigue levels did not moderate relationships. Using CSF data to classify individuals with and without significant AD pathology, there were no group differences in performance in morning hours, but subtle impairment emerged in associate memory in evening hours in those with CSF-confirmed AD pathology. These findings indicate that memory is worse in evening hours in older adults, that this pattern is consistent across several days, and is independent of measures of mood and fatigue. Further, they provide preliminary evidence of a "cognitive sundowning" in the very earliest stages of AD. Time of day may be an important consideration for assessments in observational studies and clinical trials in AD populations.

Temporal characteristics of the cochlear response after noise exposure

The effect of intense noise on cochlear sensitivity has been extensively studied, but its influence on the temporal characteristics of the cochlear response is still unclear. This study investigated the effects of noise exposure on the latency of cochlear response and cochlear forward masking. Rats were exposed to an octave band noise (8-16 kHz) at 90 dB SPL for 5 days. Cochlear compound action potentials (CAPs) induced by single- and double-tone stimuli and distortion product otoacoustic emissions (DPOAE) were recorded 1 day or 2 months after the noise exposure. The latency of the CAP and its forward masking were compared between the noise-exposed rats and normal control rats. The noise exposure significantly reduced DPOAE and elevated CAP threshold in the noise band region, but not in the other areas. Even in the noise band area, the noise did not reduce CAP-amplitude at the high stimulation level (80 dB SPL). Correspondingly, about one-third of the outer hair cells (OHC) in the noise band area disappeared, while the inner hair cells (IHC) did not. However, the noise exposure in the frequency range of 4-24 kHz significantly prolonged CAP latency and increased its variability, while the CAP forward masking effect was significantly enhanced in the frequency range of 16-30 kHz. The frequency-dependent changes in CAP latency and forward masking after noise exposure may reflect different types of synaptic subinjury in the cochlea, which may lead to psychophysical consequences of sound localization and speech recognition.

Effects of diurnal changes on temporal processing in morning-type and evening-type individuals with normal hearing

OBJECTIVE

The present study aims at determining the influence of diurnal changes in duration discrimination and temporal resolution in the morning- and evening-type individuals with normal hearing sensitivity.

METHOD

Sixty individuals with normal hearing were divided into morning, evening and intermediate types using the Morningness-Eveningness Questionnaire. Tests for Duration discrimination, Gap detection, and Temporal modulation transfer function were carried out in all the participants during morning and evening. The performance of subjects of all the three groups during both morning and evening was analyzed.

RESULTS

Results revealed a diurnal effect on morning and evening type individuals' performance where morning type exhibited better performance when tested during morning and evening individuals when tested during the evening. At the same time, there were no significant diurnal effects seen in the intermediate type.

CONCLUSIONS

The poor cognitive performance and lack of inhibitory control at the time of the off-peak hours possibly result in the poor scores. Furthermore, the diurnal effects on objective audiological tests in morning and evening type individuals should be studied. The influence of diurnal changes could be considered an extraneous variable in future research on psychoacoustic tests in younger adults.

Sensory Inhibition Is Related to Variable Speech Perception in Noise in Adults With Normal Hearing

Purpose Speech perception in noise (SPiN) varies widely in individuals with normal hearing, which may be attributed to factors that are not reflected in the audiogram, such as inhibition. However, inhibition is involved at both sensory and cognitive stages of auditory perception, and while inhibition at the cognitive level has been shown to be a significant factor in SPiN processes, it is unknown whether sensory inhibition may also contribute to SPiN variability. Therefore, the goal of this study was to evaluate sensory inhibition in adults with normal hearing and mild SPiN impairment. Method Cortical auditory evoked potentials (CAEPs) were recorded in 49 adults via high-density electroencephalography using an auditory gating paradigm. Participants were categorized according to a median signal-to-noise ratio (SNR) loss of 1.5 dB: typical SNR loss ≤ 1.5 dB (n = 32), mild SNR loss > 1.5 dB (n = 17). CAEP gating responses were compared and correlated with SNR loss and extended high-frequency thresholds. Current density reconstructions were performed to qualitatively observe underlying cortical inhibitory networks in each group. Results In comparison to adults with typical SPiN ability, adults with mild SPiN impairment showed an absence of the gating response. A CAEP gating component (P2) reflected decreased sensory inhibition and correlated with increased SNR loss. Extended high-frequency thresholds were also found to correlate with SNR loss, but not gating function. An atypical cortical inhibitory network was observed in the mild SNR loss group, with reduced frontal and absent prefrontal activation. Conclusion Sensory inhibition appears to be atypical and related to SPiN deficits in adults with mild impairment. In addition, cortical inhibitory networks appear to be incomplete, with a possible compensatory parietal network. Further research is needed to delineate between types or levels of central inhibitory mechanisms and their contribution to SPiN processes.

Serial Recall Predicts Vocoded Sentence Recognition Across Spectral Resolutions

Purpose The goal of this study was to determine how various aspects of cognition predict speech recognition ability across different levels of speech vocoding within a single group of listeners. Method We tested the ability of young adults (N = 32) with normal hearing to recognize Perceptually Robust English Sentence Test Open-set (PRESTO) sentences that were degraded with a vocoder to produce different levels of spectral resolution (16, eight, and four carrier channels). Participants also completed tests of cognition (fluid intelligence, short-term memory, and attention), which were used as predictors of sentence recognition. Sentence recognition was compared across vocoder conditions, predictors were correlated with individual differences in sentence recognition, and the relationships between predictors were characterized. Results PRESTO sentence recognition performance declined with a decreasing number of vocoder channels, with no evident floor or ceiling performance in any condition. Individual ability to recognize PRESTO sentences was consistent relative to the group across vocoder conditions. Short-term memory, as measured with serial recall, was a moderate predictor of sentence recognition (ρ = 0.65). Serial recall performance was constant across vocoder conditions when measured with a digit span task. Fluid intelligence was marginally correlated with serial recall, but not sentence recognition. Attentional measures had no discernible relationship to sentence recognition and a marginal relationship with serial recall. Conclusions Verbal serial recall is a substantial predictor of vocoded sentence recognition, and this predictive relationship is independent of spectral resolution. In populations that show variable speech recognition outcomes, such as listeners with cochlear implants, it should be possible to account for the independent effects of spectral resolution and verbal serial recall in their speech recognition ability. Supplemental Material https://doi.org/10.23641/asha.12021051.

A Delayed Advantage: Multi-Session Training at Evening Hours Leads to Better Long-Term Retention of Motor Skill in the Elderly

The acquisition and retention of motor skills is necessary for everyday functioning in the elderly and may be critical in the context of motor rehabilitation. Recent studies indicate that motor training closely followed by sleep may result in better engagement of procedural (“how to”) memory consolidation processes in the elderly. Nevertheless, elderly individuals are mostly morning oriented and a common practice is to time rehabilitation programs to morning hours. Here, we tested whether the time-of-day wherein training is afforded (morning, 8–10:30 a.m., or evening, 6–9 p.m.) affects the long-term outcome of a multi-session motor practice program (10 sessions across 3–4 weeks) in healthy elderly participants. Twenty-nine (15 women) older adults (60–75 years) practiced an explicitly instructed five-element key-press sequence by repeatedly generating the sequence “as fast and accurately as possible.” The groups did not differ in terms of sleep habits and quality (1-week long actigraphy); all were morning-oriented individuals. All participants gained robustly from the intervention, shortening sequence tapping duration and retaining the gains (> 90%) at 1-month post-intervention, irrespective of the time-of-day of training. However, retesting at 7-months post-intervention showed that the attrition of the training induced gains was more pronounced in the morning trained group compared to the evening group (76 and 56.5% loss in sequence tapping time; 7/14 and 3/14 participants showed a > 5% decline in accuracy relative to end of training, respectively). Altogether, the results show that morning-oriented older adults effectively acquired skill in the performance of a sequence of finger movements, in both morning and evening practice sessions. However, evening training leads to a significant advantage, over morning training, in the long-term retention of the skill. Evening training should be considered an appropriate time window for motor skill learning in older adults, even in individuals with morning chronotype. The results are in line with the notion that motor training preceding a sleep interval may be better consolidated into long-term memory in the elderly, and thus result in lower forgetting rates.

Relationship Between Working Memory and Speech-in-Noise Recognition in Young and Older Adult Listeners With Age-Appropriate Hearing

Purpose The purpose of this study was to investigate the relationship between working memory (WM) capacity and speech recognition in noise in both a group of young adults and a group of older adults. Method Thirty-three older adults with a mean age of 71.0 (range: 60.4-82.7) years and 27 young adults with a mean age of 21.7 (range: 19.1-25.0) years participated in the study. All participants had age-appropriate hearing and no history of central nervous system dysfunction. WM capacity was measured using the van den Noort version of the Reading Span Test, and recognition of sentences in the presence of a stationary speech-shaped noise was measured as the speech reception threshold for 50% correct identification by using the Leuven Intelligibility Sentence Test. Results The older adults had significantly worse WM capacity scores, t(58) = 8.266, p < .001, and significantly more difficulty understanding sentences in noise than the younger adults, t(58) = -6.068, p < .001. In the group of older adults, a correlation was found (r = -.488, n = 33, p = .004) between the results of the WM capacity test (Reading Span Test) and the results of the speech-recognition-in-noise test (Leuven Intelligibility Sentence Test), meaning that the higher the WM performance was, the better was the speech recognition in noise. This correlation cannot be found in young normal-hearing listeners. Conclusions This study shows deleterious effects of age on both WM capacity and speech recognition in noise. Interestingly, only in the group of older adults was a significant relation found between WM capacity and speech recognition in noise. The current results caution against the assumption that WM necessarily supports speech-in-noise identification independently of the age and hearing status of the listener.

Listening Effort by Native and Nonnative Listeners Due to Noise, Reverberation, and Talker Foreign Accent During English Speech Perception

Purpose Understanding speech in complex realistic acoustic environments requires effort. In everyday listening situations, speech quality is often degraded due to adverse acoustics, such as excessive background noise level (BNL) and reverberation time (RT), or talker characteristics such as foreign accent ( Mattys, Davis, Bradlow, & Scott, 2012 ). In addition to factors affecting the quality of the input acoustic signals, listeners' individual characteristics such as language abilities can also make it more difficult and effortful to understand speech. Based on the Framework for Understanding Effortful Listening ( Pichora-Fuller et al., 2016 ), factors such as adverse acoustics, talker accent, and listener language abilities can all contribute to increasing listening effort. In this study, using both a dual-task paradigm and a self-report questionnaire, we seek to understand listening effort in a wide range of realistic classroom acoustic conditions as well as varying talker accent and listener English proficiency. Method One hundred fifteen native and nonnative adult listeners with normal hearing were tested in a dual task of speech comprehension and adaptive pursuit rotor (APR) under 15 acoustic conditions from combinations of BNLs and RTs. Listeners provided responses on the NASA Task Load Index (TLX) questionnaire immediately after completing the dual task under each acoustic condition. The NASA TLX surveyed 6 dimensions of perceived listening effort: mental demand, physical demand, temporal demand, effort, frustration, and perceived performance. Fifty-six listeners were tested with speech produced by native American English talkers; the other 59 listeners, with speech from native Mandarin Chinese talkers. Based on their 1st language learned during childhood, 3 groups of listeners were recruited: listeners who were native English speakers, native Mandarin Chinese speakers, and native speakers of other languages (e.g., Hindu, Korean, and Portuguese). Results Listening effort was measured objectively through the APR task performance and subjectively using the NASA TLX questionnaire. Performance on the APR task did not vary with changing acoustic conditions, but it did suggest increased listening effort for native listeners of other languages compared to the 2 other listener groups. From the NASA TLX, listeners reported feeling more frustrated and less successful in understanding Chinese-accented speech. Nonnative listeners reported more listening effort (i.e., physical demand, temporal demand, and effort) than native listeners in speech comprehension under adverse acoustics. When listeners' English proficiency was controlled, higher BNL was strongly related to a decrease in perceived performance, whereas such relationship with RT was much weaker. Nonnative listeners who shared the foreign talkers' accent reported no change in listening effort, whereas other listeners reported more difficulty in understanding the accented speech. Conclusions Adverse acoustics required more effortful listening as measured subjectively with a self-report NASA TLX. This subjective scale was more sensitive than a dual task that involved speech comprehension, which was beyond sentence recall. It was better at capturing the negative impacts on listening effort from acoustic factors (i.e., both BNL and RT), talker accent, and listener language abilities.

Time of Day and Hearing Aid Adoption

To date, there is little understanding of how contextual factors may influence the decisions individuals make regarding the adoption of options for hearing rehabilitation. This explorative retrospective study investigated whether hearing aid adoption and return rates are associated with the time of the day at which an appointment takes place. The study sample consisted of 24,842 patients experiencing their first audiology appointment. It was observed that hearing aid adoption was significantly associated with appointment times whereby lower hearing aid adoption rates were observed at noon and 4 p.m. It was also observed that hearing aid return rates were significantly associated with appointment times whereby lower return rates were observed at noon and 4 p.m. In light of the methodology employed in the study, it is not possible to unequivocally determine why time of day is associated with hearing aid adoption and return rates. Several possible explanations for the patterns of associations are discussed. In light of previous research observing that hunger lowers risk tolerance and glucose consumption increases risk tolerance, the results are consistent with an interpretation based on risk-aversion resulting from hunger. To establish causality between hunger and decision-making in audiology, additional research employing experimental methodologies are necessary.

Diurnal changes in differential sensitivity and temporal resolution in morning-type and evening-type individuals with normal hearing

The present study attempts to determine diurnal changes by testing the differential sensitivity and temporal resolution in morning-type, evening-type, and intermediate-type individuals with normal hearing. Thirty participants with normal hearing were divided into morning-type, evening-type, and intermediate-type using “Morningness–Eveningness Questionnaire”. The tests of differential sensitivity and temporal resolution were administered to all the participants in the morning and evening, respectively. The differences in the test results between different timing across all the three groups were analyzed. The results of the study showed that there was a significant diurnal effect on psychoacoustic tests as morning-type individuals performed better when tested in morning and evening-type performed better when they were tested in evening. However, there was no diurnal effect found in intermediate group. The lack of inhibitory control and poor cognitive load in off peak time could have lead to poor scores. Thus, the variable of diurnal effects should be considered in further studies on psychoacoustic tests, especially in young adults. Furthermore, studies could be performed to explore diurnal effects on objective audiological tests in a larger group of population in the future.

What to Do When Cochlear Implant Users Plateau in Performance: a Pilot Study of Clinician-guided Aural Rehabilitation

HYPOTHESIS

For experienced adult cochlear implant (CI) users who have reached a plateau in performance, a clinician-guided aural rehabilitation (CGAR) approach can improve speech recognition and hearing-related quality of life (QOL).

BACKGROUND

A substantial number of CI users do not reach optimal performance in terms of speech recognition ability and/or personal communication goals. Although self-guided computerized auditory training programs have grown in popularity, compliance and efficacy for these programs are poor. We propose that CGAR can improve speech recognition and hearing-related QOL in experienced CI users.

METHODS

Twelve adult CI users were enrolled in an 8-week CGAR program guided by a speech-language pathologist and audiologist. Nine patients completed the program along with pre-AR and immediate post-AR testing of speech recognition (AzBio sentences in quiet and in multitalker babble, Consonant-Nucleus-Consonant words in quiet), QOL (Nijmegen Cochlear Implant Questionnaire, Hearing Handicap Inventory for Adults/Elderly, and Speech, Spatial and Qualities of Hearing Scale), and neurocognitive functioning (working memory capacity, information-processing speed, inhibitory control, speed of lexical/phonological access, and nonverbal reasoning). Pilot data for these nine patients are presented.

RESULTS

From pre-CGAR to post-CGAR, group mean improvements in word recognition were found. Improvements were also demonstrated on some composite and subscale measures of QOL. Patients who demonstrated improvements in word recognition were those who performed most poorly at baseline.

CONCLUSIONS

CGAR represents a potentially efficacious approach to improving speech recognition and QOL for experienced CI users. Limitations and considerations in implementing and studying aural rehabilitation approaches are discussed.

Best Practices and Advice for Using Pupillometry to Measure Listening Effort: An Introduction for Those Who Want to Get Started

Within the field of hearing science, pupillometry is a widely used method for quantifying listening effort. Its use in research is growing exponentially, and many labs are (considering) applying pupillometry for the first time. Hence, there is a growing need for a methods paper on pupillometry covering topics spanning from experiment logistics and timing to data cleaning and what parameters to analyze. This article contains the basic information and considerations needed to plan, set up, and interpret a pupillometry experiment, as well as commentary about how to interpret the response. Included are practicalities like minimal system requirements for recording a pupil response and specifications for peripheral, equipment, experiment logistics and constraints, and different kinds of data processing. Additional details include participant inclusion and exclusion criteria and some methodological considerations that might not be necessary in other auditory experiments. We discuss what data should be recorded and how to monitor the data quality during recording in order to minimize artifacts. Data processing and analysis are considered as well. Finally, we share insights from the collective experience of the authors and discuss some of the challenges that still lie ahead.

Cortical and Sensory Causes of Individual Differences in Selective Attention Ability Among Listeners With Normal Hearing Thresholds

PURPOSE

This review provides clinicians with an overview of recent findings relevant to understanding why listeners with normal hearing thresholds (NHTs) sometimes suffer from communication difficulties in noisy settings.

METHOD

The results from neuroscience and psychoacoustics are reviewed.

RESULTS

In noisy settings, listeners focus their attention by engaging cortical brain networks to suppress unimportant sounds; they then can analyze and understand an important sound, such as speech, amidst competing sounds. Differences in the efficacy of top-down control of attention can affect communication abilities. In addition, subclinical deficits in sensory fidelity can disrupt the ability to perceptually segregate sound sources, interfering with selective attention, even in listeners with NHTs. Studies of variability in control of attention and in sensory coding fidelity may help to isolate and identify some of the causes of communication disorders in individuals presenting at the clinic with "normal hearing."

CONCLUSIONS

How well an individual with NHTs can understand speech amidst competing sounds depends not only on the sound being audible but also on the integrity of cortical control networks and the fidelity of the representation of suprathreshold sound. Understanding the root cause of difficulties experienced by listeners with NHTs ultimately can lead to new, targeted interventions that address specific deficits affecting communication in noise.

PRESENTATION VIDEO

http://cred.pubs.asha.org/article.aspx?articleid=2601617.

The Association Between Cognitive Performance and Speech-in-Noise Perception for Adult Listeners: A Systematic Literature Review and Meta-Analysis

Published studies assessing the association between cognitive performance and speech-in-noise (SiN) perception examine different aspects of each, test different listeners, and often report quite variable associations. By examining the published evidence base using a systematic approach, we aim to identify robust patterns across studies and highlight any remaining gaps in knowledge. We limit our assessment to adult unaided listeners with audiometric profiles ranging from normal hearing to moderate hearing loss. A total of 253 articles were independently assessed by two researchers, with 25 meeting the criteria for inclusion. Included articles assessed cognitive measures of attention, memory, executive function, IQ, and processing speed. SiN measures varied by target (phonemes or syllables, words, and sentences) and masker type (unmodulated noise, modulated noise, >2-talker babble, and ≤2-talker babble. The overall association between cognitive performance and SiN perception was r = .31. For component cognitive domains, the association with (pooled) SiN perception was as follows: processing speed ( r = .39), inhibitory control ( r = .34), working memory ( r = .28), episodic memory ( r = .26), and crystallized IQ ( r = .18). Similar associations were shown for the different speech target and masker types. This review suggests a general association of r≈.3 between cognitive performance and speech perception, although some variability in association appeared to exist depending on cognitive domain and SiN target or masker assessed. Where assessed, degree of unaided hearing loss did not play a major moderating role. We identify a number of cognitive performance and SiN perception combinations that have not been tested and whose future investigation would enable further fine-grained analyses of these relationships.

Contributions of Sensory Coding and Attentional Control to Individual Differences in Performance in Spatial Auditory Selective Attention Tasks

Listeners with normal hearing thresholds (NHTs) differ in their ability to steer attention to whatever sound source is important. This ability depends on top-down executive control, which modulates the sensory representation of sound in the cortex. Yet, this sensory representation also depends on the coding fidelity of the peripheral auditory system. Both of these factors may thus contribute to the individual differences in performance. We designed a selective auditory attention paradigm in which we could simultaneously measure envelope following responses (EFRs, reflecting peripheral coding), onset event-related potentials (ERPs) from the scalp (reflecting cortical responses to sound) and behavioral scores. We performed two experiments that varied stimulus conditions to alter the degree to which performance might be limited due to fine stimulus details vs. due to control of attentional focus. Consistent with past work, in both experiments we find that attention strongly modulates cortical ERPs. Importantly, in Experiment I, where coding fidelity limits the task, individual behavioral performance correlates with subcortical coding strength (derived by computing how the EFR is degraded for fully masked tones compared to partially masked tones); however, in this experiment, the effects of attention on cortical ERPs were unrelated to individual subject performance. In contrast, in Experiment II, where sensory cues for segregation are robust (and thus less of a limiting factor on task performance), inter-subject behavioral differences correlate with subcortical coding strength. In addition, after factoring out the influence of subcortical coding strength, behavioral differences are also correlated with the strength of attentional modulation of ERPs. These results support the hypothesis that behavioral abilities amongst listeners with NHTs can arise due to both subcortical coding differences and differences in attentional control, depending on stimulus characteristics and task demands.

Contributions of Sensory Coding and Attentional Control to Individual Differences in Performance in Spatial Auditory Selective Attention Tasks

Listeners with normal hearing thresholds (NHTs) differ in their ability to steer attention to whatever sound source is important. This ability depends on top-down executive control, which modulates the sensory representation of sound in the cortex. Yet, this sensory representation also depends on the coding fidelity of the peripheral auditory system. Both of these factors may thus contribute to the individual differences in performance. We designed a selective auditory attention paradigm in which we could simultaneously measure envelope following responses (EFRs, reflecting peripheral coding), onset event-related potentials (ERPs) from the scalp (reflecting cortical responses to sound) and behavioral scores. We performed two experiments that varied stimulus conditions to alter the degree to which performance might be limited due to fine stimulus details vs. due to control of attentional focus. Consistent with past work, in both experiments we find that attention strongly modulates cortical ERPs. Importantly, in Experiment I, where coding fidelity limits the task, individual behavioral performance correlates with subcortical coding strength (derived by computing how the EFR is degraded for fully masked tones compared to partially masked tones); however, in this experiment, the effects of attention on cortical ERPs were unrelated to individual subject performance. In contrast, in Experiment II, where sensory cues for segregation are robust (and thus less of a limiting factor on task performance), inter-subject behavioral differences correlate with subcortical coding strength. In addition, after factoring out the influence of subcortical coding strength, behavioral differences are also correlated with the strength of attentional modulation of ERPs. These results support the hypothesis that behavioral abilities amongst listeners with NHTs can arise due to both subcortical coding differences and differences in attentional control, depending on stimulus characteristics and task demands.

Speech perception and quality of life of open-fit hearing aid users

Objective

To relate the performance of individuals with hearing loss at high frequencies in speech perception with the quality of life before and after the fitting of an open-fit hearing aid (HA).

Methods

The WHOQOL-BREF had been used before the fitting and 90 days after the use of HA. The Hearing in Noise Test (HINT) had been conducted in two phases: (1) at the time of fitting without an HA (situation A) and with an HA (situation B); (2) with an HA 90 days after fitting (situation C).

Study Sample

Thirty subjects with sensorineural hearing loss at high frequencies.

Results

By using an analysis of variance and the Tukey’s test comparing the three HINT situations in quiet and noisy environments, an improvement has been observed after the HA fitting. The results of the WHOQOL-BREF have showed an improvement in the quality of life after the HA fitting (paired t-test). The relationship between speech perception and quality of life before the HA fitting indicated a significant relationship between speech recognition in noisy environments and in the domain of social relations after the HA fitting (Pearson’s correlation coefficient).

Conclusions

The auditory stimulation has improved speech perception and the quality of life of individuals.

Temporal changes in calcium-binding proteins in the medial geniculate nucleus of the monkey Sapajus apella

The subdivisions of the medial geniculate complex can be distinguished based on the immunostaining of calcium-binding proteins and by the properties of the neurons within each subdivision. The possibility of changes in neurochemistry in this and other central auditory areas are important aspects to understand the basis that contributing to functional variations determined by environmental cycles or the animal's cycles of activity and rest. This study investigated, for the first time, day/night differences in the amounts of parvalbumin-, calretinin- and calbindin-containing neurons in the thalamic auditory center of a non-human primate, Sapajus apella. The immunoreactivity of the PV-IR, CB-IR and CR-IR neurons demonstrated different distribution patterns among the subdivisions of the medial geniculate. Moreover, a high number of CB- and CR-IR neurons were found during day, whereas PV-IR was predominant at night. We conclude that in addition to the chemical heterogeneity of the medial geniculate nucleus with respect to the expression of calcium-binding proteins, expression also varied relative to periods of light and darkness, which may be important for a possible functional adaptation of central auditory areas to environmental changes and thus ensure the survival and development of several related functions.

Short-term variability of pure-tone thresholds obtained with TDH-39P earphones

OBJECTIVE

To estimate the short-term variability and correlates of variability in pure-tone thresholds obtained using audiometric equipment designed for occupational use, and to examine the justification for excluding 8 kHz as a mandatory threshold in occupational hearing conservation programs.

METHOD

Pure-tone thresholds and other hearing-related tests (e.g. noise dosimetry, otoscopy, middle-ear assessment) were conducted with a group of 527 adults between 20 and 69 years of age. Five measurement visits were completed by participants within 14 days.

RESULTS

The 50% critical difference boundaries were - 5 and 0 dB at 4 kHz and below and - 5 and 5 dB at 6 and 8 kHz. The likelihood of spurious notches due to test-retest variability was substantially lower than the likelihood of failing to detect a notched configuration when present. Correlates of variability included stimulus frequency, baseline threshold, acoustic reflectance of the ear, average noise exposure during the previous eight hours, age, and the tester's level of education in audiology.

CONCLUSION

The short-term variability in 8-kHz pure-tone thresholds obtained with the TDH-39P earphone was slightly greater than at other frequencies, but this difference was not large enough to justify the disadvantages stemming from the inability to detect a 6-kHz notch.

Spatial separation benefit for unaided and aided listening

OBJECTIVES

The benefit attributable to spatial separation of speech and noise was measured as a function of low-pass cutoff frequency with and without bilateral hearing aids.

DESIGN

Fourteen younger and 10 older adults with normal hearing and 12 older adults with mild-to-moderate sloping high frequency hearing loss were included to assess the effects of age and hearing loss. Subjects with hearing loss were provided commercially available bilateral hearing aids. Consonant recognition was measured at 70 dB SPL in a background of speech-shaped noise at 66 dB SPL. Speech and noise were low-pass filtered at 1.7, 3.4, and 7.1 kHz. Nonsense syllables were always at 0° and noise was at either 0° or 90°. Speech and noise spectra for all conditions were digitally recorded using a probe microphone placed in each ear canal of each subject. Spectra and levels of speech, and quiet thresholds for narrowband noises, were used to calculate the Articulation Index and provide predictions of unaided and aided (hearing-impaired only) consonant recognition, spatial benefit, and hearing aid benefit for each condition. Subjective ratings of workload (NASA Task Load Index) were obtained for all unaided and aided measures of speech recognition.

RESULTS

Consonant recognition in noise improved for all groups with speech and noise spatially separated and with the addition of high-frequency speech information. Scores were poorer overall for the older adults with hearing loss than for the other groups. For normal-hearing subjects, observed scores and spatial benefit were better than predicted. For hearing-impaired subjects, scores did not significantly improve with hearing aids, even with higher frequencies and spatial separation, and were poorer than predicted especially for aided listening. Similar to subjects with normal hearing, spatial benefit for hearing-impaired subjects was larger than predicted.

CONCLUSIONS

Younger and older adults with normal hearing benefited from spatial separation of speech and noise sources to a greater extent than predicted based on simple audibility. Thus, no age-related deficits in the use of interaural difference cues were observed. Although hearing aid benefit was negligible, perceived listening effort was lower aided than unaided, especially with spatial separation. Articulation Index predictions revealed that speech audibility was generally restored with hearing aids across a wide bandwidth of speech, especially in the far ear. Thus, reduced audibility was not a primary factor in limited hearing aid benefit, suggesting that peripheral, central-auditory and/or cognitive changes may have played a role. In contrast, unaided and aided spatial benefit was better than predicted, and spatial benefit was slightly larger with hearing aids than without. Thus, these older adults with hearing loss using bilateral hearing aids were able to take advantage of binaural cues to improve consonant recognition in noise.