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Zhang F, McGuire K, Skeeters M, Barbara M, Chang PF, Zhang N, Xiang J, Huang B. Cognitive Functions and Subjective Hearing in Cochlear Implant Users. J Audiol Otol 2024; 28:176-185. [PMID: 38685833 PMCID: PMC11273187 DOI: 10.7874/jao.2023.00276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 09/06/2023] [Accepted: 09/15/2023] [Indexed: 05/02/2024] Open
Abstract
BACKGROUND AND OBJECTIVES A cochlear implant (CI) is an effective prosthetic device used to treat severe-to-profound hearing loss. The present study examined cognitive function in CI users by employing a web-based cognitive testing platform, i.e., BrainCheck, and explored the correlation between cognitive function and subjective evaluation of hearing. SUBJECTS AND METHODS Forty-two CI users (mean age: 58.90 years) were surveyed in the subjective evaluation of hearing, and 20/42 participated in the BrainCheck cognitive tests (immediate recognition, Trail Making A, Trail Making B, Stroop, digit symbol substitution, and delayed recognition). As controls for cognitive function, young normal-hearing (YNH, mean age=23.83 years) and older normal-hearing (ONH, mean age=52.67 years) listener groups were subjected to Brain-Check testing. RESULTS CI users exhibited poorer cognitive function than the normal hearing groups in all tasks except for immediate and delayed recognition. The highest percentage of CI users who had "possible" and "likely" cognitive impairment, based on BrainCheck scores (ranging from 0-200), was observed in tests assessing executive function. The composite cognitive score across domains tended to be related to subjective hearing (p=0.07). CONCLUSIONS The findings of the current study suggest that CI users had a higher likelihood of cognitive impairment in the executive function domain than in lower-level domains. BrianCheck online cognitive testing affords a convenient and effective tool to self-evaluate cognitive function in CI users.
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Affiliation(s)
- Fawen Zhang
- Department of Communication Sciences and Disorders, University of Cincinnati, Cincinnati, OH, USA
| | - Kelli McGuire
- Department of Communication Sciences and Disorders, University of Cincinnati, Cincinnati, OH, USA
| | - Madeline Skeeters
- Department of Communication Sciences and Disorders, University of Cincinnati, Cincinnati, OH, USA
| | - Matthew Barbara
- Department of Communication Sciences and Disorders, University of Cincinnati, Cincinnati, OH, USA
| | - Pamara F. Chang
- Department of Information & Logistics Technology, College of Technology, University of Houston, Houston, TX, USA
| | - Nanhua Zhang
- Cincinnati Children’s Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Jing Xiang
- Cincinnati Children’s Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA
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Everhardt MK, Sarampalis A, Coler M, Bașkent D, Lowie W. Lexical Stress Identification in Cochlear Implant-Simulated Speech by Non-Native Listeners. LANGUAGE AND SPEECH 2024:238309231222207. [PMID: 38282517 DOI: 10.1177/00238309231222207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/30/2024]
Abstract
This study investigates whether a presumed difference in the perceptibility of cues to lexical stress in spectro-temporally degraded simulated cochlear implant (CI) speech affects how listeners weight these cues during a lexical stress identification task, specifically in their non-native language. Previous research suggests that in English, listeners predominantly rely on a reduction in vowel quality as a cue to lexical stress. In Dutch, changes in the fundamental frequency (F0) contour seem to have a greater functional weight than the vowel quality contrast. Generally, non-native listeners use the cue-weighting strategies from their native language in the non-native language. Moreover, few studies have suggested that these cues to lexical stress are differently perceptible in spectro-temporally degraded electric hearing, as CI users appear to make more effective use of changes in vowel quality than of changes in the F0 contour as cues to linguistic phenomena. In this study, native Dutch learners of English identified stressed syllables in CI-simulated and non-CI-simulated Dutch and English words that contained changes in the F0 contour and vowel quality as cues to lexical stress. The results indicate that neither the cue-weighting strategies in the native language nor in the non-native language are influenced by the perceptibility of cues in the spectro-temporally degraded speech signal. These results are in contrast to our expectations based on previous research and support the idea that cue weighting is a flexible and transferable process.
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Affiliation(s)
- Marita K Everhardt
- Center for Language and Cognition Groningen, University of Groningen, The Netherlands; Department of Otorhinolaryngology/Head and Neck Surgery, University Medical Center Groningen, University of Groningen, The Netherlands; Research School of Behavioural and Cognitive Neurosciences, University of Groningen, The Netherlands
| | - Anastasios Sarampalis
- Research School of Behavioural and Cognitive Neurosciences, University of Groningen, The Netherlands; Department of Psychology, University of Groningen, The Netherlands
| | - Matt Coler
- Research School of Behavioural and Cognitive Neurosciences, University of Groningen, The Netherlands; Campus Fryslân, University of Groningen, The Netherlands
| | - Deniz Bașkent
- Department of Otorhinolaryngology/Head and Neck Surgery, University Medical Center Groningen, University of Groningen, The Netherlands; Research School of Behavioural and Cognitive Neurosciences, University of Groningen, The Netherlands; W. J. Kolff Institute for Biomedical Engineering and Materials Science, University Medical Center Groningen, University of Groningen, The Netherlands
| | - Wander Lowie
- Center for Language and Cognition Groningen, University of Groningen, The Netherlands; Research School of Behavioural and Cognitive Neurosciences, University of Groningen, The Netherlands
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Everhardt MK, Jung DE, Stiensma B, Lowie W, Başkent D, Sarampalis A. Foreign Language Acquisition in Adolescent Cochlear Implant Users. Ear Hear 2024; 45:174-185. [PMID: 37747307 PMCID: PMC10718217 DOI: 10.1097/aud.0000000000001410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 06/20/2023] [Indexed: 09/26/2023]
Abstract
OBJECTIVES This study explores to what degree adolescent cochlear implant (CI) users can learn a foreign language in a school setting similar to their normal-hearing (NH) peers despite the degraded auditory input. DESIGN A group of native Dutch adolescent CI users (age range 13 to 17 years) learning English as a foreign language at secondary school and a group of NH controls (age range 12 to 15 years) were assessed on their Dutch and English language skills using various language tasks that either relied on the processing of auditory information (i.e., listening task) or on the processing of orthographic information (i.e., reading and/or gap-fill task). The test battery also included various auditory and cognitive tasks to assess whether the auditory and cognitive functioning of the learners could explain the potential variation in language skills. RESULTS Results showed that adolescent CI users can learn English as a foreign language, as the English language skills of the CI users and their NH peers were comparable when assessed with reading or gap-fill tasks. However, the performance of the adolescent CI users was lower for English listening tasks. This discrepancy between task performance was not observed in their native language Dutch. The auditory tasks confirmed that the adolescent CI users had coarser temporal and spectral resolution than their NH peers, supporting the notion that the difference in foreign language listening skills may be due to a difference in auditory functioning. No differences in the cognitive functioning of the CI users and their NH peers were found that could explain the variation in the foreign language listening tasks. CONCLUSIONS In short, acquiring a foreign language with degraded auditory input appears to affect foreign language listening skills, yet does not appear to impact foreign language skills when assessed with tasks that rely on the processing of orthographic information. CI users could take advantage of orthographic information to facilitate foreign language acquisition and potentially support the development of listening-based foreign language skills.
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Affiliation(s)
- Marita K. Everhardt
- Center for Language and Cognition Groningen, University of Groningen, Netherlands
- Department of Otorhinolaryngology/Head and Neck Surgery, University Medical Center Groningen, University of Groningen, Netherlands
- Research School of Behavioural and Cognitive Neurosciences, University of Groningen, Netherlands
| | - Dorit Enja Jung
- Department of Otorhinolaryngology/Head and Neck Surgery, University Medical Center Groningen, University of Groningen, Netherlands
- Research School of Behavioural and Cognitive Neurosciences, University of Groningen, Netherlands
- Department of Psychology, University of Groningen, Netherlands
| | - Berrit Stiensma
- Research School of Behavioural and Cognitive Neurosciences, University of Groningen, Netherlands
| | - Wander Lowie
- Center for Language and Cognition Groningen, University of Groningen, Netherlands
- Research School of Behavioural and Cognitive Neurosciences, University of Groningen, Netherlands
| | - Deniz Başkent
- Department of Otorhinolaryngology/Head and Neck Surgery, University Medical Center Groningen, University of Groningen, Netherlands
- Research School of Behavioural and Cognitive Neurosciences, University of Groningen, Netherlands
- W.J. Kolff Institute for Biomedical Engineering and Materials Science, University Medical Center Groningen, University of Groningen, Netherlands
| | - Anastasios Sarampalis
- Research School of Behavioural and Cognitive Neurosciences, University of Groningen, Netherlands
- Department of Psychology, University of Groningen, Netherlands
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Zhang Y, Callejón-Leblic MA, Picazo-Reina AM, Blanco-Trejo S, Patou F, Sánchez-Gómez S. Impact of SNR, peripheral auditory sensitivity, and central cognitive profile on the psychometric relation between pupillary response and speech performance in CI users. Front Neurosci 2023; 17:1307777. [PMID: 38188029 PMCID: PMC10768066 DOI: 10.3389/fnins.2023.1307777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 12/05/2023] [Indexed: 01/09/2024] Open
Abstract
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.
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Affiliation(s)
- Yue Zhang
- Department of Research and Technology, Oticon Medical, Vallauris, France
| | - M. Amparo Callejón-Leblic
- Oticon Medical, Madrid, Spain
- ENT Department, Virgen Macarena University Hospital, Seville, Spain
- Biomedical Engineering Group, University of Sevillel, Sevillel, Spain
| | | | | | - François Patou
- Department of Research and Technology, Oticon Medical, Smørum, Denmark
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Patel TR, Moberly AC, Tamati TN. Development of a Sentence Verification Task to Measure Speech Comprehension and Listening Effort in Cochlear Implant Users. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2023; 66:4150-4159. [PMID: 37721457 PMCID: PMC10713013 DOI: 10.1044/2023_jslhr-23-00202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Revised: 06/13/2023] [Accepted: 07/27/2023] [Indexed: 09/19/2023]
Abstract
PURPOSE Tests measuring speech comprehension and listening effort for cochlear implant (CI) users may reflect important aspects of real-world speech communication. In this study, we describe the development of a multiple-talker, English-language sentence verification task (SVT) for use in adult CI users to measure speech comprehension and listening effort. We also examine whether talker differences affect speech comprehension and listening effort. METHOD Thirteen experienced adult CI users participated in the study and underwent testing using a newly developed multiple-talker SVT. Participants were sequentially presented with audio recordings of unique sentences spoken in English by six different talkers. Participants classified each sentence as either true or false. Accuracy of classification and the response time (RT) for correct responses were used as measures of comprehension and listening effort, respectively. The effect of talker on the results was further analyzed. RESULTS All 13 participants successfully completed the SVT. The mean verification accuracy for participants was 87.2% ± 8.8%. The mean RT for correct responses across participants was 1,050 ms ± 391 ms. When stratified by talker, verification accuracy ranged from 83.7% to 95.2% and mean RTs across participant ranged from 786 ms to 1,254 ms. Talker did not have a significant effect on sentence classification accuracy, but it did have a significant effect on RTs (p < .001). CONCLUSIONS The SVT is an easily implemented test that can assess speech comprehension and listening effort simultaneously. CI users may experience increased effort for comprehending certain talkers' speech, despite showing similar levels of comprehension accuracy. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.24126630.
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Affiliation(s)
- Tirth R. Patel
- Department of Otolaryngology—Head and Neck Surgery, Rush University Medical Center, Chicago, IL
| | - Aaron C. Moberly
- Department of Otolaryngology—Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, TN
| | - Terrin N. Tamati
- Department of Otolaryngology—Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, TN
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Everhardt MK, Sarampalis A, Coler M, Başkent D, Lowie W. Prosodic Focus Interpretation in Spectrotemporally Degraded Speech by Non-Native Listeners. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2023; 66:3649-3664. [PMID: 37616276 DOI: 10.1044/2023_jslhr-22-00568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/26/2023]
Abstract
PURPOSE This study assesses how spectrotemporal degradations that can occur in the sound transmission of a cochlear implant (CI) may influence the ability of non-native listeners to recognize the intended meaning of utterances based on the position of the prosodically focused word. Previous research suggests that perceptual accuracy and listening effort are negatively affected by CI processing (or CI simulations) or when the speech is presented in a non-native language, in a number of tasks and circumstances. How these two factors interact to affect prosodic focus interpretation, however, remains unclear. METHOD In an online experiment, normal-hearing (NH) adolescent and adult native Dutch learners of English and a small control group of NH native English adolescents listened to CI-simulated (eight-channel noise-band vocoded) and non-CI-simulated English sentences differing in prosodically marked focus. For assessing perceptual accuracy, listeners had to indicate which of four possible context questions the speaker answered. For assessing listening effort, a dual-task paradigm was used with a secondary free recall task. RESULTS The results indicated that prosodic focus interpretation was significantly less accurate in the CI-simulated condition compared with the non-CI-simulated condition but that listening effort was not increased. Moreover, there was no interaction between the influence of the degraded CI-simulated speech signal and listening groups in either their perceptual accuracy or listening effort. CONCLUSION Non-native listeners are not more strongly affected by spectrotemporal degradations than native listeners, and less proficient non-native listeners are not more strongly affected by these degradations than more proficient non-native listeners.
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Affiliation(s)
- Marita K Everhardt
- Center for Language and Cognition Groningen, University of Groningen, the Netherlands
- Department of Otorhinolaryngology/Head and Neck Surgery, University Medical Center Groningen, University of Groningen, the Netherlands
- Research School of Behavioural and Cognitive Neurosciences, University of Groningen, the Netherlands
| | - Anastasios Sarampalis
- Research School of Behavioural and Cognitive Neurosciences, University of Groningen, the Netherlands
- Department of Psychology, University of Groningen, the Netherlands
| | - Matt Coler
- Research School of Behavioural and Cognitive Neurosciences, University of Groningen, the Netherlands
- Campus Fryslân, University of Groningen, the Netherlands
| | - Deniz Başkent
- Department of Otorhinolaryngology/Head and Neck Surgery, University Medical Center Groningen, University of Groningen, the Netherlands
- Research School of Behavioural and Cognitive Neurosciences, University of Groningen, the Netherlands
- W.J. Kolff Institute for Biomedical Engineering and Materials Science, University Medical Center Groningen, University of Groningen, the Netherlands
| | - Wander Lowie
- Center for Language and Cognition Groningen, University of Groningen, the Netherlands
- Research School of Behavioural and Cognitive Neurosciences, University of Groningen, the Netherlands
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Sulas E, Hasan PY, Zhang Y, Patou F. Streamlining experiment design in cognitive hearing science using OpenSesame. Behav Res Methods 2023; 55:1965-1979. [PMID: 35794416 PMCID: PMC10250502 DOI: 10.3758/s13428-022-01886-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/23/2022] [Indexed: 11/08/2022]
Abstract
Auditory science increasingly builds on concepts and testing paradigms originated in behavioral psychology and cognitive neuroscience - an evolution of which the resulting discipline is now known as cognitive hearing science. Experimental cognitive hearing science paradigms call for hybrid cognitive and psychobehavioral tests such as those relating the attentional system, working memory, and executive functioning to low-level auditory acuity or speech intelligibility. Building complex multi-stimuli experiments can rapidly become time-consuming and error-prone. Platform-based experiment design can help streamline the implementation of cognitive hearing science experimental paradigms, promote the standardization of experiment design practices, and ensure reliability and control. Here, we introduce a set of features for the open-source python-based OpenSesame platform that allows the rapid implementation of custom behavioral and cognitive hearing science tests, including complex multichannel audio stimuli while interfacing with various synchronous inputs/outputs. Our integration includes advanced audio playback capabilities with multiple loudspeakers, an adaptive procedure, compatibility with standard I/Os and their synchronization through implementation of the Lab Streaming Layer protocol. We exemplify the capabilities of this extended OpenSesame platform with an implementation of the three-alternative forced choice amplitude modulation detection test and discuss reliability and performance. The new features are available free of charge from GitHub: https://github.com/elus-om/BRM_OMEXP .
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Kral A. Hearing and Cognition in Childhood. Laryngorhinootologie 2023; 102:S3-S11. [PMID: 37130527 PMCID: PMC10184669 DOI: 10.1055/a-1973-5087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
The human brain shows extensive development of the cerebral cortex after birth. This is extensively altered by the absence of auditory input: the development of cortical synapses in the auditory system is delayed and their degradation is increased. Recent work shows that the synapses responsible for corticocortical processing of stimuli and their embedding into multisensory interactions and cognition are particularly affected. Since the brain is heavily reciprocally interconnected, inborn deafness manifests not only in deficits in auditory processing, but also in cognitive (non-auditory) functions that are affected differently between individuals. It requires individualized approaches in therapy of deafness in childhood.
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Affiliation(s)
- Andrej Kral
- Institut für AudioNeuroTechnologie (VIANNA) & Abt. für experimentelle Otologie, Exzellenzcluster Hearing4All, Medizinische Hochschule Hannover (Abteilungsleiter und Institutsleiter: Prof. Dr. A. Kral) & Australian Hearing Hub, School of Medicine and Health Sciences, Macquarie University, Sydney, Australia
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Großmann W. Listening with an Ageing Brain - a Cognitive Challenge. Laryngorhinootologie 2023; 102:S12-S34. [PMID: 37130528 PMCID: PMC10184676 DOI: 10.1055/a-1973-3038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
Hearing impairment has been recently identified as a major modifiable risk factor for cognitive decline in later life and has been becoming of increasing scientific interest. Sensory and cognitive decline are connected by complex bottom-up and top-down processes, a sharp distinction between sensation, perception, and cognition is impossible. This review provides a comprehensive overview on the effects of healthy and pathological aging on auditory as well as cognitive functioning on speech perception and comprehension, as well as specific auditory deficits in the 2 most common neurodegenerative diseases in old age: Alzheimer disease and Parkinson syndrome. Hypotheses linking hearing loss to cognitive decline are discussed, and current knowledge on the effect of hearing rehabilitation on cognitive functioning is presented. This article provides an overview of the complex relationship between hearing and cognition in old age.
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Affiliation(s)
- Wilma Großmann
- Universitätsmedizin Rostock, Klinik und Poliklinik für Hals-Nasen-Ohrenheilkunde,Kopf- und Halschirurgie "Otto Körner"
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Nittrouer S, Lowenstein JH. Recognition of Sentences With Complex Syntax in Speech Babble by Adolescents With Normal Hearing or Cochlear Implants. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2023; 66:1110-1135. [PMID: 36758200 PMCID: PMC10205108 DOI: 10.1044/2022_jslhr-22-00407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 10/17/2022] [Accepted: 11/22/2022] [Indexed: 05/25/2023]
Abstract
PURPOSE General language abilities of children with cochlear implants have been thoroughly investigated, especially at young ages, but far less is known about how well they process language in real-world settings, especially in higher grades. This study addressed this gap in knowledge by examining recognition of sentences with complex syntactic structures in backgrounds of speech babble by adolescents with cochlear implants, and peers with normal hearing. DESIGN Two experiments were conducted. First, new materials were developed using young adults with normal hearing as the normative sample, creating a corpus of sentences with controlled, but complex syntactic structures presented in three kinds of babble that varied in voice gender and number of talkers. Second, recognition by adolescents with normal hearing or cochlear implants was examined for these new materials and for sentence materials used with these adolescents at younger ages. Analyses addressed three objectives: (1) to assess the stability of speech recognition across a multiyear age range, (2) to evaluate speech recognition of sentences with complex syntax in babble, and (3) to explore how bottom-up and top-down mechanisms account for performance under these conditions. RESULTS Results showed: (1) Recognition was stable across the ages of 10-14 years for both groups. (2) Adolescents with normal hearing performed similarly to young adults with normal hearing, showing effects of syntactic complexity and background babble; adolescents with cochlear implants showed poorer recognition overall, and diminished effects of both factors. (3) Top-down language and working memory primarily explained recognition for adolescents with normal hearing, but the bottom-up process of perceptual organization primarily explained recognition for adolescents with cochlear implants. CONCLUSIONS Comprehension of language in real-world settings relies on different mechanisms for adolescents with cochlear implants than for adolescents with normal hearing. A novel finding was that perceptual organization is a critical factor. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.21965228.
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Affiliation(s)
- Susan Nittrouer
- Department of Speech, Language, and Hearing Sciences, University of Florida, Gainesville
| | - Joanna H. Lowenstein
- Department of Speech, Language, and Hearing Sciences, University of Florida, Gainesville
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Harris MS, Hamel BL, Wichert K, Kozlowski K, Mleziva S, Ray C, Pisoni DB, Kronenberger WG, Moberly AC. Contribution of Verbal Learning & Memory and Spectro-Temporal Discrimination to Speech Recognition in Cochlear Implant Users. Laryngoscope 2023; 133:661-669. [PMID: 35567421 PMCID: PMC9659673 DOI: 10.1002/lary.30210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 04/01/2022] [Accepted: 05/03/2022] [Indexed: 11/10/2022]
Abstract
OBJECTIVES Existing cochlear implant (CI) outcomes research demonstrates a high degree of variability in device effectiveness among experienced CI users. Increasing evidence suggests that verbal learning and memory (VL&M) may have an influence on speech recognition with CIs. This study examined the relations in CI users between visual measures of VL&M and speech recognition in a series of models that also incorporated spectro-temporal discrimination. Predictions were that (1) speech recognition would be associated with VL&M abilities and (2) VL&M would contribute to speech recognition outcomes above and beyond spectro-temporal discrimination in multivariable models of speech recognition. METHODS This cross-sectional study included 30 adult postlingually deaf experienced CI users who completed a nonauditory visual version of the California Verbal Learning Test-Second Edition (v-CVLT-II) to assess VL&M, and the Spectral-Temporally Modulated Ripple Test (SMRT), an auditory measure of spectro-temporal processing. Participants also completed a battery of word and sentence recognition tasks. RESULTS CI users showed significant correlations between some v-CVLT-II measures (short-delay free- and cued-recall, retroactive interference, and "subjective" organizational recall strategies) and speech recognition measures. Performance on the SMRT was correlated with all speech recognition measures. Hierarchical multivariable linear regression analyses showed that SMRT performance accounted for a significant degree of speech recognition outcome variance. Moreover, for all speech recognition measures, VL&M scores contributed independently in addition to SMRT. CONCLUSION Measures of spectro-temporal discrimination and VL&M were associated with speech recognition in CI users. After accounting for spectro-temporal discrimination, VL&M contributed independently to performance on measures of speech recognition for words and sentences produced by single and multiple talkers. LEVEL OF EVIDENCE 3 Laryngoscope, 133:661-669, 2023.
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Affiliation(s)
- Michael S. Harris
- Department of Otolaryngology & Communication Sciences, Medical College of Wisconsin, Milwaukee, WI
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI
| | | | - Kristin Wichert
- Department of Communication Sciences & Disorders, University of Wisconsin - Eau Claire, Eau Claire, WI
| | - Kristin Kozlowski
- Department of Otolaryngology & Communication Sciences, Medical College of Wisconsin, Milwaukee, WI
| | - Sarah Mleziva
- Department of Otolaryngology & Communication Sciences, Medical College of Wisconsin, Milwaukee, WI
| | - Christin Ray
- Department of Otolaryngology – Head & Neck Surgery, The Ohio State Wexner Medical Center, Columbus, OH
| | - David B. Pisoni
- Speech Research Laboratory, Department of Psychology, Indiana University, Bloomington, IN
| | | | - Aaron C. Moberly
- Department of Otolaryngology – Head & Neck Surgery, The Ohio State Wexner Medical Center, Columbus, OH
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Beckers L, Tromp N, Philips B, Mylanus E, Huinck W. Exploring neurocognitive factors and brain activation in adult cochlear implant recipients associated with speech perception outcomes-A scoping review. Front Neurosci 2023; 17:1046669. [PMID: 36816114 PMCID: PMC9932917 DOI: 10.3389/fnins.2023.1046669] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 01/05/2023] [Indexed: 02/05/2023] Open
Abstract
Background Cochlear implants (CIs) are considered an effective treatment for severe-to-profound sensorineural hearing loss. However, speech perception outcomes are highly variable among adult CI recipients. Top-down neurocognitive factors have been hypothesized to contribute to this variation that is currently only partly explained by biological and audiological factors. Studies investigating this, use varying methods and observe varying outcomes, and their relevance has yet to be evaluated in a review. Gathering and structuring this evidence in this scoping review provides a clear overview of where this research line currently stands, with the aim of guiding future research. Objective To understand to which extent different neurocognitive factors influence speech perception in adult CI users with a postlingual onset of hearing loss, by systematically reviewing the literature. Methods A systematic scoping review was performed according to the PRISMA guidelines. Studies investigating the influence of one or more neurocognitive factors on speech perception post-implantation were included. Word and sentence perception in quiet and noise were included as speech perception outcome metrics and six key neurocognitive domains, as defined by the DSM-5, were covered during the literature search (Protocol in open science registries: 10.17605/OSF.IO/Z3G7W of searches in June 2020, April 2022). Results From 5,668 retrieved articles, 54 articles were included and grouped into three categories using different measures to relate to speech perception outcomes: (1) Nineteen studies investigating brain activation, (2) Thirty-one investigating performance on cognitive tests, and (3) Eighteen investigating linguistic skills. Conclusion The use of cognitive functions, recruiting the frontal cortex, the use of visual cues, recruiting the occipital cortex, and the temporal cortex still available for language processing, are beneficial for adult CI users. Cognitive assessments indicate that performance on non-verbal intelligence tasks positively correlated with speech perception outcomes. Performance on auditory or visual working memory, learning, memory and vocabulary tasks were unrelated to speech perception outcomes and performance on the Stroop task not to word perception in quiet. However, there are still many uncertainties regarding the explanation of inconsistent results between papers and more comprehensive studies are needed e.g., including different assessment times, or combining neuroimaging and behavioral measures. Systematic review registration https://doi.org/10.17605/OSF.IO/Z3G7W.
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Affiliation(s)
- Loes Beckers
- Cochlear Ltd., Mechelen, Belgium,Department of Otorhinolaryngology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, Netherlands,*Correspondence: Loes Beckers,
| | - Nikki Tromp
- Cochlear Ltd., Mechelen, Belgium,Department of Otorhinolaryngology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, Netherlands
| | | | - Emmanuel Mylanus
- Department of Otorhinolaryngology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, Netherlands
| | - Wendy Huinck
- Department of Otorhinolaryngology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, Netherlands
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Moberly AC, Afreen H, Schneider KJ, Tamati TN. Preoperative Reading Efficiency as a Predictor of Adult Cochlear Implant Outcomes. Otol Neurotol 2022; 43:e1100-e1106. [PMID: 36351224 PMCID: PMC9694592 DOI: 10.1097/mao.0000000000003722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
HYPOTHESES 1) Scores of reading efficiency (the Test of Word Reading Efficiency, second edition) obtained in adults before cochlear implant surgery will be predictive of speech recognition outcomes 6 months after surgery; and 2) Cochlear implantation will lead to improvements in language processing as measured through reading efficiency from preimplantation to postimplantation. BACKGROUND Adult cochlear implant (CI) users display remarkable variability in speech recognition outcomes. "Top-down" processing-the use of cognitive resources to make sense of degraded speech-contributes to speech recognition abilities in CI users. One area that has received little attention is the efficiency of lexical and phonological processing. In this study, a visual measure of word and nonword reading efficiency-relying on lexical and phonological processing, respectively-was investigated for its ability to predict CI speech recognition outcomes, as well as to identify any improvements after implantation. METHODS Twenty-four postlingually deaf adult CI candidates were tested on the Test of Word Reading Efficiency, Second Edition preoperatively and again 6 months post-CI. Six-month post-CI speech recognition measures were also assessed across a battery of word and sentence recognition. RESULTS Preoperative nonword reading scores were moderately predictive of sentence recognition outcomes, but real word reading scores were not; word recognition scores were not predicted by either. No 6-month post-CI improvement was demonstrated in either word or nonword reading efficiency. CONCLUSION Phonological processing as measured by the Test of Word Reading Efficiency, Second Edition nonword reading predicts to a moderate degree 6-month sentence recognition outcomes in adult CI users. Reading efficiency did not improve after implantation, although this could be because of the relatively short duration of CI use.
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Affiliation(s)
- Aaron C Moberly
- Department of Otolaryngology-Head & Neck Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Hajera Afreen
- Department of Otolaryngology-Head & Neck Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Kara J Schneider
- Department of Otolaryngology-Head & Neck Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio
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Dorman MF, Natale SC, Noble JH, Zeitler DM. Upward Shifts in the Internal Representation of Frequency Can Persist Over a 3-Year Period for Cochlear Implant Patients Fit With a Relatively Short Electrode Array. Front Hum Neurosci 2022; 16:863891. [PMID: 35399353 PMCID: PMC8990937 DOI: 10.3389/fnhum.2022.863891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Accepted: 02/28/2022] [Indexed: 11/16/2022] Open
Abstract
Patients fit with cochlear implants (CIs) commonly indicate at the time of device fitting and for some time after, that the speech signal sounds abnormal. A high pitch or timbre is one component of the abnormal percept. In this project, our aim was to determine whether a number of years of CI use reduced perceived upshifts in frequency spectrum and/or voice fundamental frequency. The participants were five individuals who were deaf in one ear and who had normal hearing in the other ear. The deafened ears had been implanted with a 18.5 mm electrode array which resulted in signal input frequencies being directed to locations in the spiral ganglion (SG) that were between one and two octaves higher than the input frequencies. The patients judged the similarity of a clean signal (a male-voice sentence) presented to their implanted ear and candidate, implant-like, signals presented to their normal-hearing (NH) ear. Matches to implant sound quality were obtained, on average, at 8 months after device activation (see section “Time 1”) and at 35 months after activation (see section “Time 2”). At Time 1, the matches to CI sound quality were characterized, most generally, by upshifts in the frequency spectrum and in voice pitch. At Time 2, for four of the five patients, frequency spectrum values remained elevated. For all five patients F0 values remained elevated. Overall, the data offer little support for the proposition that, for patients fit with shorter electrode arrays, cortical plasticity nudges the cortical representation of the CI voice toward more normal, or less upshifted, frequency values between 8 and 35 months after device activation. Cortical plasticity may be limited when there are large differences between frequencies in the input signal and the locations in the SG stimulated by those frequencies.
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Affiliation(s)
- Michael F Dorman
- College of Health Solutions, Speech and Hearing Science, Arizona State University, Tempe, AZ, United States
| | - Sarah C Natale
- College of Health Solutions, Speech and Hearing Science, Arizona State University, Tempe, AZ, United States
| | - Jack H Noble
- Department of Electrical Engineering & Computer Science, Vanderbilt University, Nashville, TN, United States
| | - Daniel M Zeitler
- Otolaryngology, Virginia Mason Medical Center, Seattle, WA, United States
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Tamati TN, Sevich VA, Clausing EM, Moberly AC. Lexical Effects on the Perceived Clarity of Noise-Vocoded Speech in Younger and Older Listeners. Front Psychol 2022; 13:837644. [PMID: 35432072 PMCID: PMC9010567 DOI: 10.3389/fpsyg.2022.837644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 02/16/2022] [Indexed: 11/13/2022] Open
Abstract
When listening to degraded speech, such as speech delivered by a cochlear implant (CI), listeners make use of top-down linguistic knowledge to facilitate speech recognition. Lexical knowledge supports speech recognition and enhances the perceived clarity of speech. Yet, the extent to which lexical knowledge can be used to effectively compensate for degraded input may depend on the degree of degradation and the listener's age. The current study investigated lexical effects in the compensation for speech that was degraded via noise-vocoding in younger and older listeners. In an online experiment, younger and older normal-hearing (NH) listeners rated the clarity of noise-vocoded sentences on a scale from 1 ("very unclear") to 7 ("completely clear"). Lexical information was provided by matching text primes and the lexical content of the target utterance. Half of the sentences were preceded by a matching text prime, while half were preceded by a non-matching prime. Each sentence also consisted of three key words of high or low lexical frequency and neighborhood density. Sentences were processed to simulate CI hearing, using an eight-channel noise vocoder with varying filter slopes. Results showed that lexical information impacted the perceived clarity of noise-vocoded speech. Noise-vocoded speech was perceived as clearer when preceded by a matching prime, and when sentences included key words with high lexical frequency and low neighborhood density. However, the strength of the lexical effects depended on the level of degradation. Matching text primes had a greater impact for speech with poorer spectral resolution, but lexical content had a smaller impact for speech with poorer spectral resolution. Finally, lexical information appeared to benefit both younger and older listeners. Findings demonstrate that lexical knowledge can be employed by younger and older listeners in cognitive compensation during the processing of noise-vocoded speech. However, lexical content may not be as reliable when the signal is highly degraded. Clinical implications are that for adult CI users, lexical knowledge might be used to compensate for the degraded speech signal, regardless of age, but some CI users may be hindered by a relatively poor signal.
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Affiliation(s)
- Terrin N. Tamati
- Department of Otolaryngology – Head and Neck Surgery, The Ohio State University Wexner Medical Center, Columbus, OH, United States
- Department of Otorhinolaryngology/Head and Neck Surgery, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Victoria A. Sevich
- Department of Speech and Hearing Science, The Ohio State University, Columbus, OH, United States
| | - Emily M. Clausing
- Department of Otolaryngology – Head and Neck Surgery, The Ohio State University Wexner Medical Center, Columbus, OH, United States
| | - Aaron C. Moberly
- Department of Otolaryngology – Head and Neck Surgery, The Ohio State University Wexner Medical Center, Columbus, OH, United States
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