Effects of broadband noise on cortical evoked auditory responses at different loudness levels in young adults

Left Lateralization of the Cortical Auditory-Evoked Potential Reflects Aided Processing and Speech-in-Noise Performance of Older Listeners With a Hearing Loss

OBJECTIVES

We analyzed the lateralization of the cortical auditory-evoked potential recorded previously from aided hearing-impaired listeners as part of a study on noise-mitigating hearing aid technologies. Specifically, we asked whether the degree of leftward lateralization in the magnitudes and latencies of these components was reduced by noise and, conversely, enhanced/restored by hearing aid technology. We further explored if individual differences in lateralization could predict speech-in-noise abilities in listeners when tested in the aided mode.

DESIGN

The study followed a double-blind within-subjects design. Nineteen older adults (8 females; mean age = 73.6 years, range = 56 to 86 years) with moderate to severe hearing loss participated. The cortical auditory-evoked potential was measured over 400 presentations of a synthetic /da/ stimulus which was delivered binaurally in a simulated aided mode using shielded ear-insert transducers. Sequences of the /da/ syllable were presented from the front at 75 dB SPL-C with continuous speech-shaped noise presented from the back at signal-to-noise ratios of 0, 5, and 10 dB. Four hearing aid conditions were tested: (1) omnidirectional microphone (OM) with noise reduction (NR) disabled, (2) OM with NR enabled, (3) directional microphone (DM) with NR disabled, and (4) DM with NR enabled. Lateralization of the P1 component and N1P2 complex was quantified across electrodes spanning the mid-coronal plane. Subsequently, listener speech-in-noise performance was assessed using the Repeat-Recall Test at the same signal-to-noise ratios and hearing aid conditions used to measure cortical activity.

RESULTS

As expected, both the P1 component and the N1P2 complex were of greater magnitude in electrodes over the left compared to the right hemisphere. In addition, N1 and P2 peaks tended to occur earlier over the left hemisphere, although the effect was mediated by an interaction of signal-to-noise ratio and hearing aid technology. At a group level, degrees of lateralization for the P1 component and the N1P2 complex were enhanced in the DM relative to the OM mode. Moreover, linear mixed-effects models suggested that the degree of leftward lateralization in the N1P2 complex, but not the P1 component, accounted for a significant portion of variability in speech-in-noise performance that was not related to age, hearing loss, hearing aid processing, or signal-to-noise ratio.

CONCLUSIONS

A robust leftward lateralization of cortical potentials was observed in older listeners when tested in the aided mode. Moreover, the degree of lateralization was enhanced by hearing aid technologies that improve the signal-to-noise ratio for speech. Accounting for the effects of signal-to-noise ratio, hearing aid technology, semantic context, and audiometric thresholds, individual differences in left-lateralized speech-evoked cortical activity were found to predict listeners' speech-in-noise abilities. Quantifying cortical auditory-evoked potential component lateralization may then be useful for profiling listeners' likelihood of communication success following clinical amplification.

The Maturation of the Acoustic Change Complex in Response to Iterated Ripple Noise in 'Normal'-Hearing Infants, Toddlers, and Adults

BACKGROUND

Infants and toddlers are still being evaluated for their hearing sensitivity but not their auditory-processing skills. Iterated rippled noise (IRN) stimuli require the auditory system to utilize the temporal periodicity and autocorrelate the iterations to perceive pitch.

PURPOSE

This study investigated the acoustic change complex (ACC) elicited by IRN in "normal"-hearing infants, toddlers, and adults to determine the maturation of cortical processing of IRN stimuli.

DESIGN

Cortical responses to filtered white noise (onset) concatenated with IRN stimuli (d = 10 milliseconds, gain = 0.7 dB: 4-32 iterations) were recorded in quiet, alert participants.

STUDY SAMPLE

Participants included 25 infants (2.5-15 months), 27 toddlers (22-59 months), and 8 adults (19-25 years) with "normal" hearing sensitivity.

DATA COLLECTION AND ANALYSIS

Cortical auditory-evoked responses were recorded for each participant, including the onset response to the noise and an ACC to the transition from noise to IRN. Group differences were assessed using repeated-measures analyses of variance.

RESULTS

Most infants had a replicable onset (P) response, while only about half had a measurable ACC (P_ACC) response to the high-saliency IRN condition. Most toddlers had onset responses and showed a P-N_ACC response to the IRN16 and IRN32 conditions. Most of the toddler group had responses present to the onset and showed a P-N_ACC response to all IRN conditions. Toddlers and adults showed similar P-N_ACC amplitudes; however, adults showed an increase in N1_ACC amplitude with increase in IRN iterations (i.e., increased salience).

CONCLUSION

While cortical responses to the percept of sound as determined by the onset response (P) to a stimulus are present in most infants, ACC responses to IRN stimuli are not mature in infancy. Most toddlers as young as 22 months, however, exhibited ACC responses to the IRN stimuli even when the pitch saliency was low (e.g., IRN4). The findings of the current study have implications for future research when investigating maturational effects on ACC and the optimal choice of stimuli.

Different priming effects of empathy on neural processing associated with firsthand pain and nonpain perception

The shared-representation model of empathy is still debated. One of the major questions is whether empathy-eliciting stimuli depicting others' pain selectively activate the representations of self-pain. To address this issue, we assessed the priming effects of empathy-eliciting pictures on firsthand pain and nonpain perception, as well as its associated neural processing. In Experiment 1, when compared with nonpainful pictures depicting individuals' body parts with no injury, participants primed by painful pictures showing individuals' body parts with injury reported higher ratings for perceived intensity, unpleasantness, and salience of nociceptive and auditory stimuli, but they only exhibited increased N2 amplitude in response to nociceptive stimuli. In Experiment 2, the results from another group of participants replicated the observations of Experiment 1 and validated the findings in the non-nociceptive somatosensory modality. Importantly, participants' concern ratings for priming pictures predicted their unpleasantness ratings for subsequent nociceptive stimuli, while participants' attention ratings predicted their unpleasantness ratings for subsequent auditory and tactile stimuli. This finding implies that empathy for pain might influence pain and nonpain perception via different psychological mechanisms. In summary, our findings highlight the existence of pain-selective representations in empathy for pain and contribute to a better understanding of the shared-representation model of empathy.

Informational Masking Effects of Similarity and Uncertainty on Early and Late Stages of Auditory Cortical Processing

PURPOSE

Understanding speech in a background of other people talking is a difficult listening situation for hearing-impaired individuals, and even for those with normal hearing. Speech-on-speech masking is known to contribute to increased perceptual difficulty over nonspeech background noise because of informational masking provided over and above the effects of energetic masking. While informational masking research has identified factors of similarity and uncertainty between target and masker that contribute to reduced behavioral performance in speech background noise, critical gaps in knowledge including the underlying neural-perceptual processes remain. By systematically manipulating aspects of acoustic similarity and uncertainty in the same auditory paradigm, the current study examined the time course and objectively quantified these informational masking effects at both early and late stages of auditory processing using auditory evoked potentials (AEPs).

METHOD

Thirty participants were included in a cross-sectional repeated measures design. Target-masker similarity was manipulated by varying the linguistic/phonetic similarity (i.e., language) of the talkers in the background. Specifically, four levels representing hypothesized increasing levels of informational masking were implemented: (1) no masker (quiet); (2) Mandarin; (3) Dutch; and (4) English. Stimulus uncertainty was manipulated by task complexity, specifically presentation of target-to-target interval (TTI) in the auditory evoked paradigm. Participants had to discriminate between English word stimuli (/bæt/ and /pæt/) presented in an oddball paradigm under each masker condition pressing buttons to either the target or standard stimulus. Responses were recorded simultaneously for P1-N1-P2 (standard waveform) and P3 (target waveform). This design allowed for simultaneous recording of multiple AEP peaks, as well as accuracy, reaction time, and d' behavioral discrimination to button press responses.

RESULTS

Several trends in AEP components were consistent with effects of increasing linguistic/phonetic similarity and stimulus uncertainty. All babble maskers significantly affected outcomes compared to quiet. In addition, the native language English masker had the largest effect on outcomes in the AEP paradigm, including reduced P3 amplitude and area, as well as decreased accuracy and d' behavioral discrimination to target word responses. AEP outcomes for the Mandarin and Dutch maskers, however, were not significantly different across any measured component. Latency outcomes for both N1 and P3 also supported an effect of stimulus uncertainty, consistent with increased processing time related to greater task complexity. An unanticipated result was the absence of the interaction of linguistic/phonetic similarity and stimulus uncertainty.

CONCLUSIONS

Observable effects of both similarity and uncertainty were evidenced at a level of the P3 more than the earlier N1 level of auditory cortical processing suggesting that higher-level active auditory processing may be more sensitive to informational masking deficits. The lack of significant interaction between similarity and uncertainty at either level of processing suggests that these informational masking factors operated independently. Speech babble maskers across languages altered AEP component measures, behavioral detection, and reaction time. Specifically, this occurred when the babble was in the native/same language as the target, while the effects of foreign language maskers did not differ. The objective results from this study provide a foundation for further investigation of how the linguistic content of target and masker and task difficulty contribute to difficulty understanding speech-in-noise.

Effects of spatial separation with better- ear listening on N1-P2 complex

OBJECTIVE

The purpose of this study was to determine better- ear listening effect on spatial separation with the N1-P2 complex.

METHODS

Twenty individuals with normal hearing participated in this study. The speech stimulus /ba/ was presented in front of the participant (0°). Continuous Speech Noise (5 dB signal-to-noise ratio) was presented either in front of the participant (0°), left-side (-90°), or right-side (+90°). N1- P2 complex has been recorded in quiet and three noisy conditions.

RESULTS

There was a remarkable effect of noise direction on N1, P2 latencies. When the noise was separated from the stimulus, N1 and P2 latency increased in terms of when noise was co-located with the stimulus. There was no statistically significant difference in N1-P2 amplitudes between the stimulus-only and co-located condition. N1-P2 amplitude was increased when the noise came from the sides, according to the stimulus-only and co-located conditions.

CONCLUSION

These findings demonstrate that the latency shifts on N1-P2 complex explain cortical mechanisms of spatial separation in better-ear listening.

Cochlear Implant and Hearing Aid: Objective Measures of Binaural Benefit

Cochlear implants (CI) improve hearing for the severely hearing impaired. With an extension of implantation candidacy, today many CI listeners use a hearing aid on their contralateral ear, referred to as bimodal listening. It is uncertain, however, whether the brains of bimodal listeners can combine the electrical and acoustical sound information and how much CI experience is needed to achieve an improved performance with bimodal listening. Patients with bilateral sensorineural hearing loss undergoing implant surgery were tested in their ability to understand speech in quiet and in noise, before and again 3 and 6 months after provision of a CI. Results of these bimodal listeners were compared to age-matched, normal hearing controls (NH). The benefit of adding a contralateral hearing aid was calculated in terms of head shadow, binaural summation, binaural squelch, and spatial release from masking from the results of a sentence recognition test. Beyond that, bimodal benefit was estimated from the difference in amplitudes and latencies of the N1, P2, and N2 potentials of the brains' auditory evoked response (AEP) toward speech. Data of fifteen participants contributed to the results. CI provision resulted in significant improvement of speech recognition with the CI ear, and in taking advantage of the head shadow effect for understanding speech in noise. Some amount of binaural processing was suggested by a positive binaural summation effect 6 month post-implantation that correlated significantly with symmetry of pure tone thresholds. Moreover, a significant negative correlation existed between binaural summation and latency of the P2 potential. With CI experience, morphology of the N1 and P2 potentials in the AEP response approximated that of NH, whereas, N2 remained different. Significant AEP differences between monaural and binaural processing were shown for NH and for bimodal listeners 6 month post-implantation. Although the grand-averaged difference in N1 amplitude between monaural and binaural listening was similar for NH and the bimodal group, source localization showed group-dependent differences in auditory and speech-relevant cortex, suggesting different processing in the bimodal listeners.

Effects of Directional Microphone and Noise Reduction on Subcortical and Cortical Auditory-Evoked Potentials in Older Listeners With Hearing Loss

OBJECTIVES

Understanding how signal processing influences neural activity in the brain with hearing loss is relevant to the design and evaluation of features intended to alleviate speech-in-noise deficits faced by many hearing aid wearers. Here, we examine whether hearing aid processing schemes that are designed to improve speech-in-noise intelligibility (i.e., directional microphone and noise reduction) also improve electrophysiological indices of speech processing in older listeners with hearing loss.

DESIGN

The study followed a double-blind within-subjects design. A sample of 19 older adults (8 females; mean age = 73.6 years, range = 56-86 years; 17 experienced hearing aid users) with a moderate to severe sensorineural hearing impairment participated in the experiment. Auditory-evoked potentials associated with processing in cortex (P1-N1-P2) and subcortex (frequency-following response) were measured over the course of two 2-hour visits. Listeners were presented with sequences of the consonant-vowel syllable /da/ in continuous speech-shaped noise at signal to noise ratios (SNRs) of 0, +5, and +10 dB. Speech and noise stimuli were pre-recorded using a Knowles Electronics Manikin for Acoustic Research (KEMAR) head and torso simulator outfitted with hearing aids programmed for each listener's loss. The study aid programs were set according to 4 conditions: (1) omnidirectional microphone, (2) omnidirectional microphone with noise reduction, (3) directional microphone, and (4) directional microphone with noise reduction. For each hearing aid condition, speech was presented from a loudspeaker located at 1 m directly in front of KEMAR (i.e., 0° in the azimuth) at 75 dB SPL and noise was presented from a matching loudspeaker located at 1 m directly behind KEMAR (i.e., 180° in the azimuth). Recorded stimulus sequences were normalized for speech level across conditions and presented to listeners over electromagnetically shielded ER-2 ear-insert transducers. Presentation levels were calibrated to match the output of listeners' study aids.

RESULTS

Cortical components from listeners with hearing loss were enhanced with improving SNR and with use of a directional microphone and noise reduction. On the other hand, subcortical components did not show sensitivity to SNR or microphone mode but did show enhanced encoding of temporal fine structure of speech for conditions where noise reduction was enabled.

CONCLUSIONS

These results suggest that auditory-evoked potentials may be useful in evaluating the benefit of different noise-mitigating hearing aid features.

Noise-Induced Change of Cortical Temporal Processing in Cochlear Implant Users

OBJECTIVES

Cochlear implant (CI) users typically report impaired ability to understand speech in noise. Speech understanding in CI users decreases with noise due to reduced temporal processing ability, and speech perceptual errors involve stop consonants distinguished by voice onset time (VOT). The current study examined the effects of noise on various speech perception tests while at the same time used cortical auditory evoked potentials (CAEPs) to quantify the change of neural processing of speech sounds caused by noise. We hypothesized that the noise effects on VOT processing can be reflected in N1/P2 measures, the neural changes relate to behavioral speech perception performances.

METHODS

Ten adult CI users and 15 normal-hearing (NH) people participated in this study. CAEPs were recorded from 64 scalp electrodes in both quiet and noise (signal-to-noise ratio +5 dB) and in passive and active (requiring consonant discrimination) listening. Speech stimulus was synthesized consonant-vowels with VOTs of 0 and 50 ms. N1-P2 amplitudes and latencies were analyzed as a function of listening condition. For the active condition, the P3b also was analyzed. Behavioral measures included a variety of speech perception tasks.

RESULTS

For good performing CI users, performance in most speech test was lower in the presence of noise masking. N1 and P2 latencies became prolonged with noise masking. The P3b amplitudes were smaller in CI groups compared to NH. The degree of P2 latency change (0 vs. 50 ms VOT) was correlated with consonant perception in noise.

CONCLUSION

The effects of noise masking on temporal processing can be reflected in cortical responses in CI users. N1/P2 latencies were more sensitive to noise masking than amplitude measures. Additionally, P2 responses appear to have a better relationship to speech perception in CI users compared to N1.

Impaired auditory processing and neural representation of speech in noise among symptomatic post-concussion adults

Background: The purpose of the study was to examine auditory event-related potential (AERP) evidence of changes in earlier and later stages of auditory processing in individuals with long-term post-concussion problems compared to healthy controls, with a secondary aim of comparing AERPs by functional auditory behavioral outcomes. Methods: P1-N1-P2 complex and P300 components recorded to speech in quiet and background noise conditions were completed in individuals with ongoing post-concussion symptoms following mTBI and healthy controls. AERPs were also examined between sub-groups with normal or impaired auditory processing by behavioral tests. Results: Group differences were present for later stages of auditory processing (P300). Earlier components did not significantly differ by group overall but were more affected by noise in the mTBI group. P2 amplitude in noise differed between mTBI sub-groups with normal or impaired auditory processing. Conclusion: AERPs revealed differences between healthy controls and those with chronic post-concussion symptoms following mTBI at a later stage of auditory processing (P300). Neural processing at the earlier stage (P1-N1-P2) was more affected by noise in the mTBI group. Preliminary evidence suggested that it may be only the proportion of individuals with functional evidence of central auditory dysfunction with changes in AERPs at earlier stages of processing.

Cortical auditory evoked potential in babies and children listeners

Introduction

Cortical auditory evoked potentials have been increasingly used in research and audiological routines. However, there is a lack of studies with a large number of children who are stratified by age group. These would help clarify the variations in latency and amplitude of cortical auditory evoked potentials, and thus help establish reference values in children of different ages.

Objective

To identify the variation in latency and amplitude of the cortical auditory evoked potentials and to establish reference values for the pediatric population.

Methods

This was a cross-sectional study. Subjects were born at term and presented with no auditory complaints. A total of 105 children, of up to 6 years and eleven months old, who were divided into 7 age groups, named 1, 2, 3, 4, 5, 6 and 7, participated in the study. The tests were carried out using Biologic Navigator Pro. Initially, brainstem auditory evoked potential testing was performed in order to investigate the electrophysiological threshold of the subjects. Then, cortical auditory evoked potentials were elicited through oddball paradigm with tone burst differing in frequency, 750 Hz (frequent) and 1000 Hz (rare), and stimuli differing in speech: /ba/ (frequent) and /da/ (rare). In this study, descriptive and comparative analyzes of tonal and speech stimuli were performed for the age groups.

Results

Significant differences were observed when comparing cortical auditory evoked potentials with speech stimulus in the right ear for P2 amplitude, for P1 latency the left ear, for P2 amplitude of the left ear; and for P1 amplitude of the left ear when performed with tonal stimuli.

Conclusion

The obtained results can be considered as reference values of latency and amplitude of cortical auditory potentials in infants and children, and be used for monitoring their cortical auditory development.

Electrophysiological and behavioural study of localisation in presence of noise

OBJECTIVE

The ability to determine the location of the sound source is often important for effective communication. However, it is not clear how the localisation is affected by background noise. In the current study, localisation in quiet versus noise was evaluated in adults both behaviourally, and using MMN and P3b.

DESIGN

The speech token/da/was presented in a multi-deviant oddball paradigm in quiet and in presence of speech babble at +5 dB SNR. The deviants were presented at locations that differed from the standard by 30°, 60° and 90°.

STUDY SAMPLE

Sixteen normal hearing adults between the age range of 18-35 years participated in the study.

RESULTS

The results showed that participants were significantly faster and more accurate at identifying deviants presented at 60° and 90° as compared to 30°. Neither reaction times nor electrophysiological measures (MMN/P3b) were affected by the background noise. The deviance magnitude (30°, 60° and 90°) did not affect the MMN amplitude, but the smaller deviant (30°) generated P3b with smaller amplitude.

CONCLUSIONS

Under the stimulus paradigm and measures employed in this study, localisation ability as effectively sampled appeared resistant to speech babble interference.

Effects of Amplification on Neural Phase Locking, Amplitude, and Latency to a Speech Syllable

OBJECTIVE

Older adults often have trouble adjusting to hearing aids when they start wearing them for the first time. Probe microphone measurements verify appropriate levels of amplification up to the tympanic membrane. Little is known, however, about the effects of amplification on auditory-evoked responses to speech stimuli during initial hearing aid use. The present study assesses the effects of amplification on neural encoding of a speech signal in older adults using hearing aids for the first time. It was hypothesized that amplification results in improved stimulus encoding (higher amplitudes, improved phase locking, and earlier latencies), with greater effects for the regions of the signal that are less audible.

DESIGN

Thirty-seven adults, aged 60 to 85 years with mild to severe sensorineural hearing loss and no prior hearing aid use, were bilaterally fit with Widex Dream 440 receiver-in-the-ear hearing aids. Probe microphone measures were used to adjust the gain of the hearing aids and verify the fitting. Unaided and aided frequency-following responses and cortical auditory-evoked potentials to the stimulus /ga/ were recorded in sound field over the course of 2 days for three conditions: 65 dB SPL and 80 dB SPL in quiet, and 80 dB SPL in six-talker babble (+10 signal to noise ratio).

RESULTS

Responses from midbrain were analyzed in the time regions corresponding to the consonant transition (18 to 68 ms) and the steady state vowel (68 to 170 ms). Generally, amplification increased phase locking and amplitude and decreased latency for the region and presentation conditions that had lower stimulus amplitudes-the transition region and 65 dB SPL level. Responses from cortex showed decreased latency for P1, but an unexpected decrease in N1 amplitude. Previous studies have demonstrated an exaggerated cortical representation of speech in older adults compared to younger adults, possibly because of an increase in neural resources necessary to encode the signal. Therefore, a decrease in N1 amplitude with amplification and with increased presentation level may suggest that amplification decreases the neural resources necessary for cortical encoding.

CONCLUSION

Increased phase locking and amplitude and decreased latency in midbrain suggest that amplification may improve neural representation of the speech signal in new hearing aid users. The improvement with amplification was also found in cortex, and, in particular, decreased P1 latencies and lower N1 amplitudes may indicate greater neural efficiency. Further investigations will evaluate changes in subcortical and cortical responses during the first 6 months of hearing aid use.

Restoration of sensory input may improve cognitive and neural function

Age-related hearing loss is one of the most prevalent health conditions among the elderly. Hearing loss may lead to social isolation, depression, and cognitive decline in older adults. The mechanistic basis for the association between hearing loss and decreased cognitive function remains unknown as does the potential for improving cognition through hearing rehabilitation. To that end, we asked whether the restoration of sensory input through the use of hearing aids would improve cognitive and auditory neural function. We compared a group of first-time hearing aid users with a hearing-matched control group after a period of six months. The use of hearing aids enhanced working memory performance and increased cortical response amplitudes. Neurophysiologic changes correlated with working memory changes, suggesting a mechanism for decreased cognitive function with hearing loss. These results suggest a neural mechanism for the sensory-cognitive connection and underscore the importance of providing auditory rehabilitation for individuals with age-related hearing loss to improve cognitive and neural function. Our findings of improved cognitive function with hearing aid use may lead to increased adoption of hearing loss remedies.

The Effect of Short-Term Auditory Training on Speech in Noise Perception and Cortical Auditory Evoked Potentials in Adults with Cochlear Implants

This study investigated whether a short intensive psychophysical auditory training program is associated with speech perception benefits and changes in cortical auditory evoked potentials (CAEPs) in adult cochlear implant (CI) users. Ten adult implant recipients trained approximately 7 hours on psychophysical tasks (Gap-in-Noise Detection, Frequency Discrimination, Spectral Rippled Noise [SRN], Iterated Rippled Noise, Temporal Modulation). Speech performance was assessed before and after training using Lexical Neighborhood Test (LNT) words in quiet and in eight-speaker babble. CAEPs evoked by a natural speech stimulus /baba/ with varying syllable stress were assessed pre- and post-training, in quiet and in noise. SRN psychophysical thresholds showed a significant improvement (78% on average) over the training period, but performance on other psychophysical tasks did not change. LNT scores in noise improved significantly post-training by 11% on average compared with three pretraining baseline measures. N1P2 amplitude changed post-training for /baba/ in quiet (p = 0.005, visit 3 pretraining versus visit 4 post-training). CAEP changes did not correlate with behavioral measures. CI recipients' clinical records indicated a plateau in speech perception performance prior to participation in the study. A short period of intensive psychophysical training produced small but significant gains in speech perception in noise and spectral discrimination ability. There remain questions about the most appropriate type of training and the duration or dosage of training that provides the most robust outcomes for adults with CIs.

Electrophysiology and Perception of Speech in Noise in Older Listeners: Effects of Hearing Impairment and Age

OBJECTIVES

Speech perception in background noise is difficult for many individuals, and there is considerable performance variability across listeners. The combination of physiological and behavioral measures may help to understand sources of this variability for individuals and groups and prove useful clinically with hard-to-test populations. The purpose of this study was threefold: (1) determine the effect of signal-to-noise ratio (SNR) and signal level on cortical auditory evoked potentials (CAEPs) and sentence-level perception in older normal-hearing (ONH) and older hearing-impaired (OHI) individuals, (2) determine the effects of hearing impairment and age on CAEPs and perception, and (3) explore how well CAEPs correlate with and predict speech perception in noise.

DESIGN

Two groups of older participants (15 ONH and 15 OHI) were tested using speech-in-noise stimuli to measure CAEPs and sentence-level perception of speech. The syllable /ba/, used to evoke CAEPs, and sentences were presented in speech-spectrum background noise at four signal levels (50, 60, 70, and 80 dB SPL) and up to seven SNRs (-10, -5, 0, 5, 15, 25, and 35 dB). These data were compared between groups to reveal the hearing impairment effect and then combined with previously published data for 15 young normal-hearing individuals to determine the aging effect.

RESULTS

Robust effects of SNR were found for perception and CAEPs. Small but significant effects of signal level were found for perception, primarily at poor SNRs and high signal levels, and in some limited instances for CAEPs. Significant effects of age were seen for both CAEPs and perception, while hearing impairment effects were only found with perception measures. CAEPs correlate well with perception and can predict SNR50s to within 2 dB for ONH. However, prediction error is much larger for OHI and varies widely (from 6 to 12 dB) depending on the model that was used for prediction.

CONCLUSIONS

When background noise is present, SNR dominates both perception-in-noise testing and cortical electrophysiological testing, with smaller and sometimes significant contributions from signal level. A mismatch between behavioral and electrophysiological results was found (hearing impairment effects were primarily only seen for behavioral data), illustrating the possible contributions of higher order cognitive processes on behavior. It is interesting that the hearing impairment effect size was more than five times larger than the aging effect size for CAEPs and perception. Sentence-level perception can be predicted well in normal-hearing individuals; however, additional research is needed to explore improved prediction methods for older individuals with hearing impairment.

Aided Electrophysiology Using Direct Audio Input: Effects of Amplification and Absolute Signal Level

PURPOSE

This study investigated (a) the effect of amplification on cortical auditory evoked potentials (CAEPs) at different signal levels when signal-to-noise ratios (SNRs) were equated between unaided and aided conditions, and (b) the effect of absolute signal level on aided CAEPs when SNR was held constant.

METHOD

CAEPs were recorded from 13 young adults with normal hearing. A 1000-Hz pure tone was presented in unaided and aided conditions with a linear analog hearing aid. Direct audio input was used, allowing recorded hearing aid noise floor to be added to unaided conditions to equate SNRs between conditions. An additional stimulus was created through scaling the noise floor to study the effect of signal level.

RESULTS

Amplification resulted in delayed N1 and P2 peak latencies relative to the unaided condition. An effect of absolute signal level (when SNR was constant) was present for aided CAEP area measures, such that larger area measures were found at higher levels.

CONCLUSION

Results of this study further demonstrate that factors in addition to SNR must also be considered before CAEPs can be used to clinically to measure aided thresholds.