Behavioral measures of cochlear compression and temporal resolution as predictors of speech masking release in hearing-impaired listeners

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.

Predictors of Hearing-Aid Outcomes

Over 360 million people worldwide suffer from disabling hearing loss. Most of them can be treated with hearing aids. Unfortunately, performance with hearing aids and the benefit obtained from using them vary widely across users. Here, we investigate the reasons for such variability. Sixty-eight hearing-aid users or candidates were fitted bilaterally with nonlinear hearing aids using standard procedures. Treatment outcome was assessed by measuring aided speech intelligibility in a time-reversed two-talker background and self-reported improvement in hearing ability. Statistical predictive models of these outcomes were obtained using linear combinations of 19 predictors, including demographic and audiological data, indicators of cochlear mechanical dysfunction and auditory temporal processing skills, hearing-aid settings, working memory capacity, and pretreatment self-perceived hearing ability. Aided intelligibility tended to be better for younger hearing-aid users with good unaided intelligibility in quiet and with good temporal processing abilities. Intelligibility tended to improve by increasing amplification for low-intensity sounds and by using more linear amplification for high-intensity sounds. Self-reported improvement in hearing ability was hard to predict but tended to be smaller for users with better working memory capacity. Indicators of cochlear mechanical dysfunction, alone or in combination with hearing settings, did not affect outcome predictions. The results may be useful for improving hearing aids and setting patients’ expectations.

Influence of Instantaneous Compression on Recognition of Speech in Noise with Temporal Dips

BACKGROUND

In listening environments with background noise that fluctuates in level, listeners with normal hearing can "glimpse" speech during dips in the noise, resulting in better speech recognition in fluctuating noise than in steady noise at the same overall level (referred to as masking release). Listeners with sensorineural hearing loss show less masking release. Amplification can improve masking release but not to the same extent that it does for listeners with normal hearing.

PURPOSE

The purpose of this study was to compare masking release for listeners with sensorineural hearing loss obtained with an experimental hearing-aid signal-processing algorithm with instantaneous compression (referred to as a suppression hearing aid, SHA) to masking release obtained with fast compression. The suppression hearing aid mimics effects of normal cochlear suppression, i.e., the reduction in the response to one sound by the simultaneous presentation of another sound.

RESEARCH DESIGN

A within-participant design with repeated measures across test conditions was used.

STUDY SAMPLE

Participants included 29 adults with mild-to-moderate sensorineural hearing loss and 21 adults with normal hearing.

INTERVENTION

Participants with sensorineural hearing loss were fitted with simulators for SHA and a generic hearing aid (GHA) with fast (but not instantaneous) compression (5 ms attack and 50 ms release times) and no suppression. Gain was prescribed using either an experimental method based on categorical loudness scaling (CLS) or the Desired Sensation Level (DSL) algorithm version 5a, resulting in a total of four processing conditions: CLS-GHA, CLS-SHA, DSL-GHA, and DSL-SHA.

DATA COLLECTION

All participants listened to consonant-vowel-consonant nonwords in the presence of temporally-modulated and steady noise. An adaptive-tracking procedure was used to determine the signal-to-noise ratio required to obtain 29% and 71% correct. Measurements were made with amplification for participants with sensorineural hearing loss and without amplification for participants with normal hearing.

ANALYSIS

Repeated-measures analysis of variance was used to determine the influence of within-participant factors of noise type and, for participants with sensorineural hearing loss, processing condition on masking release. Pearson correlational analysis was used to assess the effect of age on masking release for participants with sensorineural hearing loss.

RESULTS

Statistically significant masking release was observed for listeners with sensorineural hearing loss for 29% correct, but not for 71% correct. However, the amount of masking release was less than masking release for participants with normal hearing. There were no significant differences among the amplification conditions for participants with sensorineural hearing loss.

CONCLUSIONS

The results suggest that amplification with either instantaneous or fast compression resulted in similar masking release for listeners with sensorineural hearing loss. However, the masking release was less for participants with hearing loss than it was for those with normal hearing.

Magnified Neural Envelope Coding Predicts Deficits in Speech Perception in Noise

Verbal communication in noisy backgrounds is challenging. Understanding speech in background noise that fluctuates in intensity over time is particularly difficult for hearing-impaired listeners with a sensorineural hearing loss (SNHL). The reduction in fast-acting cochlear compression associated with SNHL exaggerates the perceived fluctuations in intensity in amplitude-modulated sounds. SNHL-induced changes in the coding of amplitude-modulated sounds may have a detrimental effect on the ability of SNHL listeners to understand speech in the presence of modulated background noise. To date, direct evidence for a link between magnified envelope coding and deficits in speech identification in modulated noise has been absent. Here, magnetoencephalography was used to quantify the effects of SNHL on phase locking to the temporal envelope of modulated noise (envelope coding) in human auditory cortex. Our results show that SNHL enhances the amplitude of envelope coding in posteromedial auditory cortex, whereas it enhances the fidelity of envelope coding in posteromedial and posterolateral auditory cortex. This dissociation was more evident in the right hemisphere, demonstrating functional lateralization in enhanced envelope coding in SNHL listeners. However, enhanced envelope coding was not perceptually beneficial. Our results also show that both hearing thresholds and, to a lesser extent, magnified cortical envelope coding in left posteromedial auditory cortex predict speech identification in modulated background noise. We propose a framework in which magnified envelope coding in posteromedial auditory cortex disrupts the segregation of speech from background noise, leading to deficits in speech perception in modulated background noise.

SIGNIFICANCE STATEMENT People with hearing loss struggle to follow conversations in noisy environments. Background noise that fluctuates in intensity over time poses a particular challenge. Using magnetoencephalography, we demonstrate anatomically distinct cortical representations of modulated noise in normal-hearing and hearing-impaired listeners. This work provides the first link among hearing thresholds, the amplitude of cortical representations of modulated sounds, and the ability to understand speech in modulated background noise. In light of previous work, we propose that magnified cortical representations of modulated sounds disrupt the separation of speech from modulated background noise in auditory cortex.

Auditory Verbal Working Memory as a Predictor of Speech Perception in Modulated Maskers in Listeners With Normal Hearing

PURPOSE

Background noise can interfere with our ability to understand speech. Working memory capacity (WMC) has been shown to contribute to the perception of speech in modulated noise maskers. WMC has been assessed with a variety of auditory and visual tests, often pertaining to different components of working memory. This study assessed the relationship between speech perception in modulated maskers and components of auditory verbal working memory (AVWM) over a range of signal-to-noise ratios.

METHOD

Speech perception in noise and AVWM were measured in 30 listeners (age range 31-67 years) with normal hearing. AVWM was estimated using forward digit recall, backward digit recall, and nonword repetition.

RESULTS

After controlling for the effects of age and average pure-tone hearing threshold, speech perception in modulated maskers was related to individual differences in the phonological component of working memory (as assessed by nonword repetition) but only in the least favorable signal-to-noise ratio. The executive component of working memory (as assessed by backward digit) was not predictive of speech perception in any conditions.

CONCLUSIONS

AVWM is predictive of the ability to benefit from temporal dips in modulated maskers: Listeners with greater phonological WMC are better able to correctly identify sentences in modulated noise backgrounds.

Recognition of synthesized vowel sequences in steady-state and sinusoidally amplitude-modulated noises

Modulation masking is known to impact speech intelligibility, but it is not clear whether the mechanism underlying this phenomenon is an invariant, bottom-up process, or if it is subjected to factors such as perceptual segregation and stimulus uncertainty thereby showing a top-down component. In the main experiment of the current study (Exp. II), listeners' ability to recognize sequences of synthesized vowels (i.e., the target) in sinusoidally amplitude-modulated noises (i.e., the masker) was evaluated. The target and masker were designed to be perceptually distinct to limit the top-down component of modulation masking. The duration of each vowel was either 25 or 100 ms, the rate at which the vowels were presented was either 1 or 6 Hz, and the masker modulation rate was varied between 0.5 and 16 Hz. The selective performance degradation when the target and masker modulation spectra overlap, as would be expected from modulation masking, was not observed. In addition, these results were able to be adequately captured using a model of energetic masking without any modulation processing stages and fitted only using the vowel-recognition performance in steady-state maskers, as obtained from Exp. I. Results suggest that speech modulation masking might not be mediated through an early-sensory mechanism.

The Influence of Cochlear Mechanical Dysfunction, Temporal Processing Deficits, and Age on the Intelligibility of Audible Speech in Noise for Hearing-Impaired Listeners

The aim of this study was to assess the relative importance of cochlear mechanical dysfunction, temporal processing deficits, and age on the ability of hearing-impaired listeners to understand speech in noisy backgrounds. Sixty-eight listeners took part in the study. They were provided with linear, frequency-specific amplification to compensate for their audiometric losses, and intelligibility was assessed for speech-shaped noise (SSN) and a time-reversed two-talker masker (R2TM). Behavioral estimates of cochlear gain loss and residual compression were available from a previous study and were used as indicators of cochlear mechanical dysfunction. Temporal processing abilities were assessed using frequency modulation detection thresholds. Age, audiometric thresholds, and the difference between audiometric threshold and cochlear gain loss were also included in the analyses. Stepwise multiple linear regression models were used to assess the relative importance of the various factors for intelligibility. Results showed that (a) cochlear gain loss was unrelated to intelligibility, (b) residual cochlear compression was related to intelligibility in SSN but not in a R2TM, (c) temporal processing was strongly related to intelligibility in a R2TM and much less so in SSN, and (d) age per se impaired intelligibility. In summary, all factors affected intelligibility, but their relative importance varied across maskers.

Level variations in speech: Effect on masking release in hearing-impaired listeners

Acoustic speech is marked by time-varying changes in the amplitude envelope that may pose difficulties for hearing-impaired listeners. Removal of these variations (e.g., by the Hilbert transform) could improve speech reception for such listeners, particularly in fluctuating interference. Léger, Reed, Desloge, Swaminathan, and Braida [(2015b). J. Acoust. Soc. Am. 138, 389-403] observed that a normalized measure of masking release obtained for hearing-impaired listeners using speech processed to preserve temporal fine-structure (TFS) cues was larger than that for unprocessed or envelope-based speech. This study measured masking release for two other speech signals in which level variations were minimal: peak clipping and TFS processing of an envelope signal. Consonant identification was measured for hearing-impaired listeners in backgrounds of continuous and fluctuating speech-shaped noise. The normalized masking release obtained using speech with normal variations in overall level was substantially less than that observed using speech processed to achieve highly restricted level variations. These results suggest that the performance of hearing-impaired listeners in fluctuating noise may be improved by signal processing that leads to a decrease in stimulus level variations.

The effect of fluctuating maskers on speech understanding of high-performing cochlear implant users

OBJECTIVE

The present study evaluated whether the poorer baseline performance of cochlear implant (CI) users or the technical and/or physiological properties of CI stimulation are responsible for the absence of masking release.

DESIGN

This study measured speech reception thresholds (SRTs) in continuous and modulated noise as a function of signal to noise ratio (SNR).

STUDY SAMPLE

A total of 24 subjects participated: 12 normal-hearing (NH) listeners and 12 subjects provided with recent MED-EL CI systems.

RESULTS

The mean SRT of CI users in continuous noise was -3.0 ± 1.5 dB SNR (mean ± SEM), while the normal-hearing group reached -5.9 ± 0.8 dB SNR. In modulated noise, the difference across groups increased considerably. For CI users, the mean SRT worsened to -1.4 ± 2.3 dB SNR, while it improved for normal-hearing listeners to -18.9 ± 3.8 dB SNR.

CONCLUSIONS

The detrimental effect of fluctuating maskers on SRTs in CI users shown by prior studies was confirmed by the current study. Concluding, the absence of masking release is mainly caused by the technical and/or physiological properties of CI stimulation, not just the poorer baseline performance of many CI users compared to normal-hearing subjects. Speech understanding in modulated noise was more robust in CI users who had a relatively large electrical dynamic range.

Masking Release in Children and Adults With Hearing Loss When Using Amplification

PURPOSE

This study compared masking release for adults and children with normal hearing and hearing loss. For the participants with hearing loss, masking release using simulated hearing aid amplification with 2 different compression speeds (slow, fast) was compared.

METHOD

Sentence recognition in unmodulated noise was compared with recognition in modulated noise (masking release). Recognition was measured for participants with hearing loss using individualized amplification via the hearing-aid simulator.

RESULTS

Adults with hearing loss showed greater masking release than the children with hearing loss. Average masking release was small (1 dB) and did not depend on hearing status. Masking release was comparable for slow and fast compression.

CONCLUSIONS

The use of amplification in this study contrasts with previous studies that did not use amplification. The results suggest that when differences in audibility are reduced, participants with hearing loss may be able to take advantage of dips in the noise levels, similar to participants with normal hearing. Although children required a more favorable signal-to-noise ratio than adults for both unmodulated and modulated noise, masking release was not statistically different. However, the ability to detect a difference may have been limited by the small amount of masking release observed.

Speech Masking in Normal and Impaired Hearing: Interactions Between Frequency Selectivity and Inherent Temporal Fluctuations in Noise

Recent studies in normal-hearing listeners have used envelope-vocoded stimuli to show that the masking of speech by noise is dominated by the temporal-envelope fluctuations inherent in noise, rather than just overall power. Because these studies were based on vocoding, it was expected that cochlear-implant (CI) users would demonstrate a similar sensitivity to inherent fluctuations. In contrast, it was found that CI users showed no difference in speech intelligibility between maskers with and without inherent envelope fluctuations. Here, these initial findings in CI users were extended to listeners with cochlear hearing loss and the results were compared with those from normal-hearing listeners at either equal sensation level or equal sound pressure level. The results from hearing-impaired listeners (and in normal-hearing listeners at high sound levels) are consistent with a relative reduction in low-frequency inherent noise fluctuations due to broader cochlear filtering. The reduced effect of inherent temporal fluctuations in noise, due to either current spread (in CI users) or broader cochlear filters (in hearing-impaired listeners), provides a new way to explain the loss of masking release experienced in CI users and hearing-impaired listeners when additional amplitude fluctuations are introduced in noise maskers.

Psychometric functions for sentence recognition in sinusoidally amplitude-modulated noises

Listeners' speech reception is better when speech is masked by a modulated masker compared to an unmodulated masker with the same long-term root-mean-square level. It has been suggested that listeners take advantage of brief periods of quiescence in a modulated masker to extract speech information. Two experiments examined the contribution of such "dip-listening" models. The first experiment estimated psychometric functions for speech intelligibility using sentences masked by sinusoidally modulated and unmodulated speech-shaped noises and the second experiment estimated detection thresholds for a tone pip added at the central dip in the masker. Modulation rates ranging from 1 to 64 Hz were tested. In experiment 1 the slopes of the psychometric functions were shallower for lower modulation rates and the pattern of speech reception thresholds as a function of modulation rate was nonmonotonic with a minimum near 16 Hz. In contrast, the detection thresholds from experiment 2 increased monotonically with modulation rate. The results suggest that the benefits of listening to speech in temporally fluctuating maskers cannot be solely ascribed to the temporal acuity of the auditory system.

Why do I hear but not understand? Stochastic undersampling as a model of degraded neural encoding of speech

Hearing impairment is a serious disease with increasing prevalence. It is defined based on increased audiometric thresholds but increased thresholds are only partly responsible for the greater difficulty understanding speech in noisy environments experienced by some older listeners or by hearing-impaired listeners. Identifying the additional factors and mechanisms that impair intelligibility is fundamental to understanding hearing impairment but these factors remain uncertain. Traditionally, these additional factors have been sought in the way the speech spectrum is encoded in the pattern of impaired mechanical cochlear responses. Recent studies, however, are steering the focus toward impaired encoding of the speech waveform in the auditory nerve. In our recent work, we gave evidence that a significant factor might be the loss of afferent auditory nerve fibers, a pathology that comes with aging or noise overexposure. Our approach was based on a signal-processing analogy whereby the auditory nerve may be regarded as a stochastic sampler of the sound waveform and deafferentation may be described in terms of waveform undersampling. We showed that stochastic undersampling simultaneously degrades the encoding of soft and rapid waveform features, and that this degrades speech intelligibility in noise more than in quiet without significant increases in audiometric thresholds. Here, we review our recent work in a broader context and argue that the stochastic undersampling analogy may be extended to study the perceptual consequences of various different hearing pathologies and their treatment.

Speech perception in tones and noise via cochlear implants reveals influence of spectral resolution on temporal processing

Under normal conditions, human speech is remarkably robust to degradation by noise and other distortions. However, people with hearing loss, including those with cochlear implants, often experience great difficulty in understanding speech in noisy environments. Recent work with normal-hearing listeners has shown that the amplitude fluctuations inherent in noise contribute strongly to the masking of speech. In contrast, this study shows that speech perception via a cochlear implant is unaffected by the inherent temporal fluctuations of noise. This qualitative difference between acoustic and electric auditory perception does not seem to be due to differences in underlying temporal acuity but can instead be explained by the poorer spectral resolution of cochlear implants, relative to the normally functioning ear, which leads to an effective smoothing of the inherent temporal-envelope fluctuations of noise. The outcome suggests an unexpected trade-off between the detrimental effects of poorer spectral resolution and the beneficial effects of a smoother noise temporal envelope. This trade-off provides an explanation for the long-standing puzzle of why strong correlations between speech understanding and spectral resolution have remained elusive. The results also provide a potential explanation for why cochlear-implant users and hearing-impaired listeners exhibit reduced or absent masking release when large and relatively slow temporal fluctuations are introduced in noise maskers. The multitone maskers used here may provide an effective new diagnostic tool for assessing functional hearing loss and reduced spectral resolution.

Speech perception in tones and noise via cochlear implants reveals influence of spectral resolution on temporal processing

Under normal conditions, human speech is remarkably robust to degradation by noise and other distortions. However, people with hearing loss, including those with cochlear implants, often experience great difficulty in understanding speech in noisy environments. Recent work with normal-hearing listeners has shown that the amplitude fluctuations inherent in noise contribute strongly to the masking of speech. In contrast, this study shows that speech perception via a cochlear implant is unaffected by the inherent temporal fluctuations of noise. This qualitative difference between acoustic and electric auditory perception does not seem to be due to differences in underlying temporal acuity but can instead be explained by the poorer spectral resolution of cochlear implants, relative to the normally functioning ear, which leads to an effective smoothing of the inherent temporal-envelope fluctuations of noise. The outcome suggests an unexpected trade-off between the detrimental effects of poorer spectral resolution and the beneficial effects of a smoother noise temporal envelope. This trade-off provides an explanation for the long-standing puzzle of why strong correlations between speech understanding and spectral resolution have remained elusive. The results also provide a potential explanation for why cochlear-implant users and hearing-impaired listeners exhibit reduced or absent masking release when large and relatively slow temporal fluctuations are introduced in noise maskers. The multitone maskers used here may provide an effective new diagnostic tool for assessing functional hearing loss and reduced spectral resolution.

On the near non-existence of "pure" energetic masking release for speech

Stone et al. [(2012). J. Acoust. Soc. Am. 132, 317-326] showed that a masker constructed to produce a near-constant envelope at the output of each auditory filter reduced speech intelligibility less than maskers of the same mean level with fluctuating envelopes, produced by 100% sinusoidal amplitude modulation (SAM) at 8 Hz. Here, this effect was explored for a range of SAM rates from 1 to 81 Hz. Speech was filtered into 28 channels. A sinusoidal masker centered on each channel was added to the channel signal. The maskers were either unmodulated or had 100% SAM. In most conditions, even-numbered channels were presented to one ear and odd-numbered channels to the other. The signal-to-masker ratio was adapted to measure the Speech Reception Threshold (SRT) corresponding to 50% correct. The fluctuating masker benefit (FMB), the difference in SRT between the SAM and unmodulated masker, was negative for all SAM frequencies except 1 Hz. Due to the different slopes of the psychometric functions, when SRTs were inferred for more realistic performance levels, 74% or more, FMB was zero or negative for all SAM rates. It is concluded that a positive FMB, when it occurs, is a release from modulation and not energetic masking.