Dataset Information

Effects of Removing Low-Frequency Electric Information on Speech Perception With Bimodal Hearing.

ABSTRACT: The objective was to determine whether speech perception could be improved for bimodal listeners (those using a cochlear implant [CI] in one ear and hearing aid in the contralateral ear) by removing low-frequency information provided by the CI, thereby reducing acoustic-electric overlap.Subjects were adult CI subjects with at least 1 year of CI experience. Nine subjects were evaluated in the CI-only condition (control condition), and 26 subjects were evaluated in the bimodal condition. CIs were programmed with 4 experimental programs in which the low cutoff frequency (LCF) was progressively raised. Speech perception was evaluated using Consonant-Nucleus-Consonant words in quiet, AzBio sentences in background babble, and spondee words in background babble.The CI-only group showed decreased speech perception in both quiet and noise as the LCF was raised. Bimodal subjects with better hearing in the hearing aid ear (< 60 dB HL at 250 and 500 Hz) performed best for words in quiet as the LCF was raised. In contrast, bimodal subjects with worse hearing (> 60 dB HL at 250 and 500 Hz) performed similarly to the CI-only group.These findings suggest that reducing low-frequency overlap of the CI and contralateral hearing aid may improve performance in quiet for some bimodal listeners with better hearing.

SUBMITTER: Fowler JR

PROVIDER: S-EPMC4862739 | biostudies-literature | 2016 Feb

REPOSITORIES: biostudies-literature

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Effects of Removing Low-Frequency Electric Information on Speech Perception With Bimodal Hearing.

Fowler Jennifer R JR Eggleston Jessica L JL Reavis Kelly M KM McMillan Garnett P GP Reiss Lina A J LA

Journal of speech, language, and hearing research : JSLHR 20160201 1

<h4>Purpose</h4>The objective was to determine whether speech perception could be improved for bimodal listeners (those using a cochlear implant [CI] in one ear and hearing aid in the contralateral ear) by removing low-frequency information provided by the CI, thereby reducing acoustic-electric overlap.<h4>Method</h4>Subjects were adult CI subjects with at least 1 year of CI experience. Nine subjects were evaluated in the CI-only condition (control condition), and 26 subjects were evaluated in t ...[more]

PMID: 26535803

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Project description:OBJECTIVE:The primary objective of this study was to assess the effect of electric and acoustic overlap for speech understanding in typical listening conditions using semidiffuse noise. DESIGN:This study used a within-subjects, repeated measures design including 11 experienced adult implant recipients (13 ears) with functional residual hearing in the implanted and nonimplanted ear. The aided acoustic bandwidth was fixed and the low-frequency cutoff for the cochlear implant (CI) was varied systematically. Assessments were completed in the R-SPACE sound-simulation system which includes a semidiffuse restaurant noise originating from eight loudspeakers placed circumferentially about the subject's head. AzBio sentences were presented at 67 dBA with signal to noise ratio varying between +10 and 0 dB determined individually to yield approximately 50 to 60% correct for the CI-alone condition with full CI bandwidth. Listening conditions for all subjects included CI alone, bimodal (CI + contralateral hearing aid), and bilateral-aided electric and acoustic stimulation (EAS; CI + bilateral hearing aid). Low-frequency cutoffs both below and above the original "clinical software recommendation" frequency were tested for all patients, in all conditions. Subjects estimated listening difficulty for all conditions using listener ratings based on a visual analog scale. RESULTS:Three primary findings were that (1) there was statistically significant benefit of preserved acoustic hearing in the implanted ear for most overlap conditions, (2) the default clinical software recommendation rarely yielded the highest level of speech recognition (1 of 13 ears), and (3) greater EAS overlap than that provided by the clinical recommendation yielded significant improvements in speech understanding. CONCLUSIONS:For standard-electrode CI recipients with preserved hearing, spectral overlap of acoustic and electric stimuli yielded significantly better speech understanding and less listening effort in a laboratory-based, restaurant-noise simulation. In conclusion, EAS patients may derive more benefit from greater acoustic and electric overlap than given in current software fitting recommendations, which are based solely on audiometric threshold. These data have larger scientific implications, as previous studies may not have assessed outcomes with optimized EAS parameters, thereby underestimating the benefit afforded by hearing preservation.

Project description:ObjectivesPrevious studies have documented the benefits of bimodal hearing as compared with a cochlear implant alone, but most have focused on the importance of bottom-up, low-frequency cues. The purpose of the present study was to evaluate the role of top-down processing in bimodal hearing by measuring the effect of sentence context on bimodal benefit for temporally interrupted sentences. It was hypothesized that low-frequency acoustic cues would facilitate the use of contextual information in the interrupted sentences, resulting in greater bimodal benefit for the higher context (CUNY) sentences than for the lower context (IEEE) sentences.DesignYoung normal-hearing listeners were tested in simulated bimodal listening conditions in which noise band vocoded sentences were presented to one ear with or without low-pass (LP) filtered speech or LP harmonic complexes (LPHCs) presented to the contralateral ear. Speech recognition scores were measured in three listening conditions: vocoder-alone, vocoder combined with LP speech, and vocoder combined with LPHCs. Temporally interrupted versions of the CUNY and IEEE sentences were used to assess listeners' ability to fill in missing segments of speech by using top-down linguistic processing. Sentences were square-wave gated at a rate of 5 Hz with a 50% duty cycle. Three vocoder channel conditions were tested for each type of sentence (8, 12, and 16 channels for CUNY; 12, 16, and 32 channels for IEEE) and bimodal benefit was compared for similar amounts of spectral degradation (matched-channel comparisons) and similar ranges of baseline performance. Two gain measures, percentage-point gain and normalized gain, were examined.ResultsSignificant effects of context on bimodal benefit were observed when LP speech was presented to the residual-hearing ear. For the matched-channel comparisons, CUNY sentences showed significantly higher normalized gains than IEEE sentences for both the 12-channel (20 points higher) and 16-channel (18 points higher) conditions. For the individual gain comparisons that used a similar range of baseline performance, CUNY sentences showed bimodal benefits that were significantly higher (7% points, or 15 points normalized gain) than those for IEEE sentences. The bimodal benefits observed here for temporally interrupted speech were considerably smaller than those observed in an earlier study that used continuous speech. Furthermore, unlike previous findings for continuous speech, no bimodal benefit was observed when LPHCs were presented to the LP ear.ConclusionsFindings indicate that linguistic context has a significant influence on bimodal benefit for temporally interrupted speech and support the hypothesis that low-frequency acoustic information presented to the residual-hearing ear facilitates the use of top-down linguistic processing in bimodal hearing. However, bimodal benefit is reduced for temporally interrupted speech as compared with continuous speech, suggesting that listeners' ability to restore missing speech information depends not only on top-down linguistic knowledge but also on the quality of the bottom-up sensory input.

Project description:Listeners vary in their ability to understand speech in noisy environments. Hearing sensitivity, as measured by pure-tone audiometry, can only partly explain these results, and cognition has emerged as another key concept. Although cognition relates to speech perception, the exact nature of the relationship remains to be fully understood. This study investigates how different aspects of cognition, particularly working memory and attention, relate to speech intelligibility for various tests. Perceptual accuracy of speech perception represents just one aspect of functioning in a listening environment. Activity and participation limits imposed by hearing loss, in addition to the demands of a listening environment, are also important and may be better captured by self-report questionnaires. Understanding how speech perception relates to self-reported aspects of listening forms the second focus of the study. Forty-four listeners aged between 50 and 74 years with mild sensorineural hearing loss were tested on speech perception tests differing in complexity from low (phoneme discrimination in quiet), to medium (digit triplet perception in speech-shaped noise) to high (sentence perception in modulated noise); cognitive tests of attention, memory, and non-verbal intelligence quotient; and self-report questionnaires of general health-related and hearing-specific quality of life. Hearing sensitivity and cognition related to intelligibility differently depending on the speech test: neither was important for phoneme discrimination, hearing sensitivity alone was important for digit triplet perception, and hearing and cognition together played a role in sentence perception. Self-reported aspects of auditory functioning were correlated with speech intelligibility to different degrees, with digit triplets in noise showing the richest pattern. The results suggest that intelligibility tests can vary in their auditory and cognitive demands and their sensitivity to the challenges that auditory environments pose on functioning.

Dataset Information

Effects of Removing Low-Frequency Electric Information on Speech Perception With Bimodal Hearing.

Publications

Effects of Removing Low-Frequency Electric Information on Speech Perception With Bimodal Hearing.

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