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Pleasantness Ratings for Harmonic Intervals With Acoustic and Electric Hearing in Unilaterally Deaf Cochlear Implant Patients.

ABSTRACT: Background:Harmony is an important part of tonal music that conveys context, form and emotion. Two notes sounded simultaneously form a harmonic interval. In normal-hearing (NH) listeners, some harmonic intervals (e.g., minor 2nd, tritone, major 7th) typically sound more dissonant than others (e.g., octave, major 3rd, 4th). Because of the limited spectro-temporal resolution afforded by cochlear implants (CIs), music perception is generally poor. However, CI users may still be sensitive to relative dissonance across intervals. In this study, dissonance ratings for harmonic intervals were measured in 11 unilaterally deaf CI patients, in whom ratings from the CI could be compared to those from the normal ear. Methods:Stimuli consisted of pairs of equal amplitude MIDI piano tones. Intervals spanned a range of two octaves relative to two root notes (F3 or C4). Dissonance was assessed in terms of subjective pleasantness ratings for intervals presented to the NH ear alone, the CI ear alone, and both ears together (NH + CI). Ratings were collected for both root notes for within- and across-octave intervals (1-12 and 13-24 semitones). Participants rated the pleasantness of each interval by clicking on a line anchored with "least pleasant" and "most pleasant." A follow-up experiment repeated the task with a smaller stimulus set. Results:With NH-only listening, within-octave intervals minor 2nd, major 2nd, and major 7th were rated least pleasant; major 3rd, 5th, and octave were rated most pleasant. Across-octave counterparts were similarly rated. With CI-only listening, ratings were consistently lower and showed a reduced range. Mean ratings were highly correlated between NH-only and CI-only listening (r = 0.845, p < 0.001). Ratings were similar between NH-only and NH + CI listening, with no significant binaural enhancement/interference. The follow-up tests showed that ratings were reliable for the least and most pleasant intervals. Discussion:Although pleasantness ratings were less differentiated for the CI ear than the NH ear, there were similarities between the two listening modes. Given the lack of spectro-temporal detail needed for harmonicity-based distinctions, temporal envelope interactions (within and across channels) associated with a perception of roughness may contribute to dissonance perception for harmonic intervals with CI-only listening.

SUBMITTER: Spitzer ER

PROVIDER: S-EPMC6733976 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:The aim of this study was to assess the frequency-position function resulting from electric stimulation of electrodes in cochlear implant subjects with significant residual hearing in their nonimplanted ear. Six cochlear implant users compared the pitch of the auditory sensation produced by stimulation of an intracochlear electrode to the pitch of acoustic pure tones presented to their contralateral nonimplanted ear. Subjects were implanted with different Clarion electrode arrays, designed to lie close to the inner wall of the cochlea. High-resolution radiographs were used to determine the electrode positions in the cochlea. Four out of six subjects presented electrode insertions deeper than 450 degrees . We used a two-interval (one acoustic, one electric), two-alternative forced choice protocol (2I-2AFC), asking the subject to indicate which stimulus sounded the highest in pitch. Pure tones were used as acoustic stimuli. Electric stimuli consisted of trains of biphasic pulses presented at relatively high rates [higher than 700 pulses per second (pps)]. First, all electric stimuli were balanced in loudness across electrodes. Second, acoustic pure tones, chosen to approximate roughly the pitch sensation produced by each electrode, were balanced in loudness to electric stimuli. When electrode insertion lengths were used to describe electrode positions, the pitch sensations produced by electric stimulation were found to be more than two octaves lower than predicted by Greenwood's frequency-position function. When insertion angles were used to describe electrode positions, the pitch sensations were found about one octave lower than the frequency-position function of a normal ear. The difference found between both descriptions is because of the fact that these electrode arrays were designed to lie close to the modiolus. As a consequence, the site of excitation produced at the level of the organ of Corti corresponds to a longer length than the electrode insertion length, which is used in Greenwood's function. Although exact measurements of the round window position as well as the length of the cochlea could explain the remaining one octave difference found when insertion angles were used, physiological phenomena (e.g., stimulation of the spiral ganglion cells) could also create this difference. From these data, analysis filters could be determined in sound coding strategies to match the pitch percepts elicited by electrode stimulation. This step might be of main importance for music perception and for the fitting of bilateral cochlear implants.

Project description:A cochlear implant (CI) is an auditory prosthesis which can partially restore the auditory function in patients with severe to profound hearing loss. However, this bionic device provides only limited auditory information, and CI patients may compensate for this limitation by means of a stronger interaction between the auditory and visual system. To better understand the electrophysiological correlates of audiovisual speech perception, the present study used electroencephalography (EEG) and a redundant target paradigm. Postlingually deafened CI users and normal-hearing (NH) listeners were compared in auditory, visual and audiovisual speech conditions. The behavioural results revealed multisensory integration for both groups, as indicated by shortened response times for the audiovisual as compared to the two unisensory conditions. The analysis of the N1 and P2 event-related potentials (ERPs), including topographic and source analyses, confirmed a multisensory effect for both groups and showed a cortical auditory response which was modulated by the simultaneous processing of the visual stimulus. Nevertheless, the CI users in particular revealed a distinct pattern of N1 topography, pointing to a strong visual impact on auditory speech processing. Apart from these condition effects, the results revealed ERP differences between CI users and NH listeners, not only in N1/P2 ERP topographies, but also in the cortical source configuration. When compared to the NH listeners, the CI users showed an additional activation in the visual cortex at N1 latency, which was positively correlated with CI experience, and a delayed auditory-cortex activation with a reversed, rightward functional lateralisation. In sum, our behavioural and ERP findings demonstrate a clear audiovisual benefit for both groups, and a CI-specific alteration in cortical activation at N1 latency when auditory and visual input is combined. These cortical alterations may reflect a compensatory strategy to overcome the limited CI input, which allows the CI users to improve the lip-reading skills and to approximate the behavioural performance of NH listeners in audiovisual speech conditions. Our results are clinically relevant, as they highlight the importance of assessing the CI outcome not only in auditory-only, but also in audiovisual speech conditions.

Project description:ObjectiveSelf-esteem is a good predictor of mental health and is crucial for well-being and psychological functioning. It is especially important in situations where there are potential mental health problems, such as in people suffering from hearing loss or total deafness. This study aims to gauge the level of self-esteem in adults with hearing problems, in particular those who, in adulthood, had received a cochlear implant (CI). The subjects had different onset (pre-lingual/post-lingual) and amount (deafness/partial deafness) of hearing loss, and their current level of self-esteem was compared to that of the general population. The association of self-esteem with other deafness-related variables (e.g. satisfaction with their CI or whether they also used a hearing aid) and sociodemographic factors was also investigated.MethodsData were obtained from questionnaires mailed to patients who, when adult, had received a CI. The subjects were divided into four subgroups: subjects with pre-lingual deafness, post-lingual deafness, pre-lingual partial deafness, and post-lingual partial deafness. To evaluate their self-esteem, the Rosenberg Self-Esteem Scale (RSES) was used. For data on sociodemographic status and information related to deafness and CI, we used our own Information Inquiry form. For statistical analysis of the results, we compared means (t-test, ANOVA), investigated correlations, and applied linear regression.ResultsThe self-esteem of deaf and partially deaf CI users was significantly lower than in the general population, especially for post-lingually deafened subjects. The only factor related to deafness and CIs that explained self-esteem was self-rated satisfaction with the CI-meaning that higher satisfaction was associated with higher self-esteem. The major sociodemographic factor that explained self-esteem was marital/partnership status (being in a relationship was helpful). Also men had higher self-esteem than women. Those with higher levels of education, and those working or studying, had higher self-esteem than those who did not. RSES was found to have a single-factor structure.ConclusionDeafness and partial deafness appear to be risk factors for lower self-esteem, a finding that rehabilitation, medical, educational, and employment communities should be made aware of. Medical intervention in the form of a CI supplies the person with improved hearing, but it is not a panacea: their self-esteem is still vulnerable, and reinforcement of self-esteem is an aspect that professionals should focus on. Psychological, psycho-educational, and psychotherapeutic interventions have important roles to play for CI recipients.

Project description:PurposeCochlear implant (CI) recipients demonstrate variable speech recognition when listening with a CI-alone or electric-acoustic stimulation (EAS) device, which may be due in part to electric frequency-to-place mismatches created by the default mapping procedures. Performance may be improved if the filter frequencies are aligned with the cochlear place frequencies, known as place-based mapping. Performance with default maps versus an experimental place-based map was compared for participants with normal hearing when listening to CI-alone or EAS simulations to observe potential outcomes prior to initiating an investigation with CI recipients.MethodA noise vocoder simulated CI-alone and EAS devices, mapped with default or place-based procedures. The simulations were based on an actual 24-mm electrode array recipient, whose insertion angles for each electrode contact were used to estimate the respective cochlear place frequency. The default maps used the filter frequencies assigned by the clinical software. The filter frequencies for the place-based maps aligned with the cochlear place frequencies for individual contacts in the low- to mid-frequency cochlear region. For the EAS simulations, low-frequency acoustic information was filtered to simulate aided low-frequency audibility. Performance was evaluated for the AzBio sentences presented in a 10-talker masker at +5 dB signal-to-noise ratio (SNR), +10 dB SNR, and asymptote.ResultsPerformance was better with the place-based maps as compared with the default maps for both CI-alone and EAS simulations. For instance, median performance at +10 dB SNR for the CI-alone simulation was 57% correct for the place-based map and 20% for the default map. For the EAS simulation, those values were 59% and 37% correct. Adding acoustic low-frequency information resulted in a similar benefit for both maps.ConclusionsReducing frequency-to-place mismatches, such as with the experimental place-based mapping procedure, produces a greater benefit in speech recognition than maximizing bandwidth for CI-alone and EAS simulations. Ongoing work is evaluating the initial and long-term performance benefits in CI-alone and EAS users.Supplemental materialhttps://doi.org/10.23641/asha.19529053.

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:Objectivesto characterize differences in wideband power reflectance for ears with and without cochlear implants (CIs), to describe electrically evoked stapedial reflex (eSR)-induced changes in reflectance, and to evaluate the benefit of a broadband probe for reflex threshold determination for CI recipients. It was hypothesized that reflectance patterns in ears with CIs would be consistent with increased middle ear stiffness and that reflex thresholds measured with a broadband probe would be lower compared with thresholds obtained with a single-frequency probe.DesignEleven CI recipients participated in both wideband reflectance and eSR testing. Ipsilateral reflexes were measured with three probes: a broadband chirp (swept from 200 to 8000 Hz), a 226 Hz tone, and a 678 Hz tone. Wideband reflectance measures acquired from 28 adults without CIs and with normal middle ear function served as a normative data set for comparison.ResultsConsidering the group data, average reflectance was significantly greater for ears with CIs across 250 to 891 Hz and 4238 to 4490 Hz compared with the normative data set, although individual reflectance curves were variable. Some CI recipients also had low 226 Hz admittance, which contributed to the group finding, considering the control group had clinically normal 226 Hz admittance by design. Electrically evoked stapedial reflexes were measurable in nine of 14 ears (64.3%) and in 24 of 46 electrodes (52.5%) tested. Reflex-induced changes in reflectance patterns were unique to the participant/ear, but similar across activators (electrodes) within a given ear. In addition, reflectance values at or above 1000 Hz were affected most by activating the stapedial reflex, even in ears with clinically normal 226 Hz admittance. This is a higher-frequency range than has been reported for acoustically evoked reflex-induced reflectance changes and is consistent with increased middle ear stiffness at rest. Electrically evoked reflexes could be measured more often with the 678 Hz or the broadband probe compared with the 226 Hz probe tone. Although reflex thresholds were lower with the broadband probe compared with the 678 Hz probe in 16 of 24 conditions, this was not a statistically significant finding (Wilcoxon signed-rank test; p = 0.072).ConclusionsThe applications of wideband acoustic immittance measurements (reflectance and reflexes) should also be considered for ears with CIs. Further work is needed to describe changes across time in ears with CIs to more fully understand the reflectance pattern indicating increased middle ear stiffness and to optimize measuring eSRs with a broadband probe.

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Pleasantness Ratings for Harmonic Intervals With Acoustic and Electric Hearing in Unilaterally Deaf Cochlear Implant Patients.

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