Portable Smart-Space Research Interface to Predetermine Environment Acoustics for Cochlear implant and Hearing aid users with CCi-MOBILE.
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ABSTRACT:
SUBMITTER: Ghosh R
PROVIDER: S-EPMC8041484 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:Many cochlear implant users with binaural residual (acoustic) hearing benefit from combining electric and acoustic stimulation (EAS) in the implanted ear with acoustic amplification in the other. These bimodal EAS listeners can potentially use low-frequency binaural cues to localize sounds. However, their hearing is generally asymmetric for mid- and high-frequency sounds, perturbing or even abolishing binaural cues. Here, we investigated the effect of a frequency-dependent binaural asymmetry in hearing thresholds on sound localization by seven bimodal EAS listeners. Frequency dependence was probed by presenting sounds with power in low-, mid-, high-, or mid-to-high-frequency bands. Frequency-dependent hearing asymmetry was present in the bimodal EAS listening condition (when using both devices) but was also induced by independently switching devices on or off. Using both devices, hearing was near symmetric for low frequencies, asymmetric for mid frequencies with better hearing thresholds in the implanted ear, and monaural for high frequencies with no hearing in the non-implanted ear. Results show that sound-localization performance was poor in general. Typically, localization was strongly biased toward the better hearing ear. We observed that hearing asymmetry was a good predictor for these biases. Notably, even when hearing was symmetric a preferential bias toward the ear using the hearing aid was revealed. We discuss how frequency dependence of any hearing asymmetry may lead to binaural cues that are spatially inconsistent as the spectrum of a sound changes. We speculate that this inconsistency may prevent accurate sound-localization even after long-term exposure to the hearing asymmetry.
| S-EPMC9829999 | biostudies-literature
Project description:Dissatisfaction with the sound of one's own voice is common among hearing-aid users. Little is known regarding how hearing impairment and hearing aids separately affect own-voice perception. This study examined own-voice perception and associated issues before and after a hearing-aid fitting for new hearing-aid users and refitting for experienced users to investigate whether it was possible to differentiate between the effect of (unaided) hearing impairment and hearing aids. Further aims were to investigate whether First-Time and Experienced users as well as users with dome and mold inserts differed in the severity of own-voice problems. The study had a cohort design with three groups: First-Time hearing-aid users going from unaided to aided hearing (n = 70), Experienced hearing-aid users replacing their old hearing aids (n = 70), and an unaided control group (n = 70). The control group was surveyed once and the hearing-aid users twice; once before hearing-aid fitting/refitting and once after. The results demonstrated that own-voice problems are common among both First-Time and Experienced hearing-aid users with either dome- or mold-type fittings, while people with near-normal hearing and not using hearing aids report few problems. Hearing aids increased ratings of own-voice problems among First-Time users, particularly those with mold inserts. The results suggest that altered auditory feedback through unaided hearing impairment or through hearing aids is likely both to change own-voice perception and complicate regulation of vocal intensity, but hearing aids are the primary reason for poor perceived sound quality of one's own voice.
| S-EPMC7887686 | biostudies-literature
Project description:Purpose:There is a growing interest in speech intelligibility and auditory perception of deaf children. The aim of the present study was to compare speech intelligibility and auditory perception of pre-school children with Hearing Aid (HA), Cochlear Implant (CI), and Typical Hearing (TH). Methods:The research design was descriptive-analytic and comparative. The participants comprised 75 male pre-school children aged 4-6 years in the 2017-2018 from Tehran, Iran. The participants were divided into three groups, and each group consisted of 25 children. The first and second groups were respectively selected from pre-school children with HA and CI using the convenience sampling method, while the third group was selected from pre-school children with TH by random sampling method. All children completed Speech Intelligibility Rating and Categories of Auditory Performance Questionnaires. Results:The findings indicated that the mean scores of speech intelligibility and auditory perception of the group with TH were significantly higher than those of the other groups (P < 0.0001). The mean scores of speech intelligibility in the group with CI did not significantly differ from those of the group with HA (P < 0.38). Also, the mean scores of auditory perception in the group with CI were significantly higher than those of the group with HA (P < 0.002). Conclusion:The results showed that auditory perception in children with CI was significantly higher than children with HA. This finding highlights the importance of cochlear implantation at a younger age and its significant impact on auditory perception in deaf children.
| S-EPMC7231984 | biostudies-literature
Project description:The purpose of this project was to evaluate differences between groups and device configurations for emotional responses to non-speech sounds. Three groups of adults participated: 1) listeners with normal hearing with no history of device use, 2) hearing aid candidates with or without hearing aid experience, and 3) bimodal cochlear-implant listeners with at least 6 months of implant use. Participants (n = 18 in each group) rated valence and arousal of pleasant, neutral, and unpleasant non-speech sounds. Listeners with normal hearing rated sounds without hearing devices. Hearing aid candidates rated sounds while using one or two hearing aids. Bimodal cochlear-implant listeners rated sounds while using a hearing aid alone, a cochlear implant alone, or the hearing aid and cochlear implant simultaneously. Analysis revealed significant differences between groups in ratings of pleasant and unpleasant stimuli; ratings from hearing aid candidates and bimodal cochlear-implant listeners were less extreme (less pleasant and less unpleasant) than were ratings from listeners with normal hearing. Hearing aid candidates' ratings were similar with one and two hearing aids. Bimodal cochlear-implant listeners' ratings of valence were higher (more pleasant) in the configuration without a hearing aid (implant only) than in the two configurations with a hearing aid (alone or with an implant). These data support the need for further investigation into hearing device optimization to improve emotional responses to non-speech sounds for adults with hearing loss.
| S-EPMC9019384 | biostudies-literature
Project description:In the Western world, for deaf and hard-of-hearing children, hearing aids or cochlear implants are available to provide access to sound, with the overall goal of increasing their wellbeing. If and how this goal is achieved becomes increasingly multifarious when these children reach adolescence and young adulthood and start to participate in society in other ways. An approach to wellbeing that includes personal differences and the relative advantages and disadvantages that people have, is the capability approach, as developed by Nobel Prize laureate Amartya Sen. Capability is the set of real opportunities people have to do and be things they have reason to value. We interviewed 59 young people, aged 13 through 25, with cochlear implants (37) or hearing aids (22) to capture their capability. We found that their hearing devices enabled them to actively participate in a predominantly hearing society, with few differences between cochlear implant and hearing aid recipients. They did, however, report challenges associated with prejudices and expectations, and with feeling poorly understood, all of which appeared to impact their capability. Through the lens of capability, alleged differences between hearing aid and cochlear implant recipients began to fade. We discuss the implications for initiatives focused on the long-term support young recipients of hearing devices to meet their specific requirements over time.
| S-EPMC9261909 | biostudies-literature
Project description:Neuroprostheses designed to interface with the nervous system to replace injured or missing senses can significantly improve a patient's quality of life. The challenge remains to provide implants that operate optimally over several decades. Changes in the implant-tissue interface may precede performance problems. Tools to identify and characterize such changes using existing clinical measures would be highly valuable. Modern cochlear implant (CI) systems allow easy and regular measurements of electrode impedance (EI). This measure is routinely performed as a hardware integrity test, but it also allows a level of insight into the immune-mediated response to the implant, which is associated with performance outcomes. This study is a 5-year retrospective investigation of MED-EL CI users at the University of Southampton Auditory Implant Service including 176 adult ears (18-91) and 74 pediatric ears (1-17). The trend in EI in adults showed a decrease at apical electrodes. An increase was seen at the basal electrodes which are closest to the surgery site. The trend in the pediatric cohort was increasing EI over time for nearly all electrode positions, although this group showed greater variability and had a smaller sample size. We applied an outlier-labeling rule to statistically identify individuals that exhibit raised impedance. This highlighted 14 adult ears (8%) and 3 pediatric ears (5%) with impedance levels that deviated from the group distribution. The slow development of EI suggests intra-cochlear fibrosis and/or osteogenesis as the underlying mechanism. The usual clinical intervention for extreme impedance readings is to deactivate the relevant electrode. Our findings highlight some interesting clinical contradictions: some cases with raised (but not extreme) impedance had not prompted an electrode deactivation; and many cases of electrode deactivation had been informed by subjective patient reports. This emphasizes the need for improved objective evidence to inform electrode deactivations in borderline cases, for which our outlier-labeling approach is a promising candidate. A data extraction and analysis protocol that allows ongoing and automated statistical analysis of routinely collected data could benefit both the CI and wider neuroprosthetics communities. Our approach provides new tools to inform practice and to improve the function and longevity of neuroprosthetic devices.
| S-EPMC6340939 | biostudies-literature
Project description:In the case of hearing loss, cochlear implants (CI) allow for the restoration of hearing. Despite the advantages of CIs for speech perception, CI users still complain about their poor perception of their auditory environment. Aiming to assess non-verbal auditory perception in CI users, we developed five listening tests. These tests measure pitch change detection, pitch direction identification, pitch short-term memory, auditory stream segregation, and emotional prosody recognition, along with perceived intensity ratings. In order to test the potential benefit of visual cues for pitch processing, the three pitch tests included half of the trials with visual indications to perform the task. We tested 10 normal-hearing (NH) participants with material being presented as original and vocoded sounds, and 10 post-lingually deaf CI users. With the vocoded sounds, the NH participants had reduced scores for the detection of small pitch differences, and reduced emotion recognition and streaming abilities compared to the original sounds. Similarly, the CI users had deficits for small differences in the pitch change detection task and emotion recognition, as well as a decreased streaming capacity. Overall, this assessment allows for the rapid detection of specific patterns of non-verbal auditory perception deficits. The current findings also open new perspectives about how to enhance pitch perception capacities using visual cues.
| S-EPMC8152499 | biostudies-literature
Project description:ImportanceCochlear implants were approved for use in adults in the 1980s, but use remains low owing to a lack of awareness regarding cochlear implantation candidacy criteria and expected outcomes. There have been limited, small series examining the safety and effectiveness of cochlear implantation in adult hearing aid (HA) users with and without mild cognitive impairment (MCI).ObjectiveTo investigate the safety and effectiveness of a single-ear cochlear implant in a group of optimized adult HA users with and without MCI across a variety of domains.Design, setting, and participantsIn this nonrandomized controlled trial, a multicenter, prospective, repeated-measures investigation was conducted at 13 US institutions. The setting was academic and community-based cochlear implant programs. Eligible participants were 100 adults (aged >18 years) with postlinguistic onset of bilateral moderate sloping to profound or worse sensorineural hearing loss (≤20 years' duration). Fluent English speakers underwent an optimized bilateral HA trial for at least 30 days. Individuals with aided Consonant-Vowel Nucleus-Consonant (CNC) word score in quiet of 40% or less correct in the ear to be implanted and 50% or less correct in the contralateral ear were offered cochlear implants. The first participant was enrolled on February 20, 2017, and the last participant was enrolled on May 3, 2018. The final follow-up was on December 21, 2018.InterventionsParticipants received the same cochlear implant system and contralateral HA.Main outcomes and measuresThe primary outcome measure was speech understanding in quiet (CNC word score) using both the cochlear implant and opposite ear HA. Secondary outcome measures included the following: adverse events; speech understanding in noise (AzBio signal-to-noise ratio of +10 db [+10 SNR]) Health Utilities Index Mark 3 (HUI3); Speech, Spatial, and Qualities of Hearing Questionnaire 49 (SSQ49); and Montreal Cognitive Assessment (MoCA).ResultsThe median age at cochlear implantation of the 96 patients included in the trial was 71 years (range, 23-91 years), and 62 patients (65%) were male. Three serious adverse events requiring revision surgery occurred, and all resolved without sequelae. By 6 months after activation, the absolute marginal mean change in CNC word score and AzBio +10 SNR was 40.5% (95% CI, 35.9%-45.0%) and 24.1% (95% CI, 18.9%-29.4%), respectively. Ninety-one percent (87 of 96) of participants had a clinically important improvement (>15%) in the CNC word score in the implant ear. Mild cognitive impairment (MoCA total score ≤25) was observed in 48 of 81 study participants (59%) at baseline. Speech perception marginal mean improvements were similar between individuals with and without baseline MCI, with values of 40.9% (95% CI, 35.2%-46.6%) and 39.6% (95% CI, 31.8%-47.4%), respectively, for CNC word score and 27.5% (95% CI, 21.0%-33.9%) and 17.8% (95% CI, 9.0%-26.6%), respectively, for AzBio +10 SNR. Statistically significant and clinically important improvements in the HUI3 and SSQ49 were evident at 6 months.Conclusions and relevanceThe findings of this nonrandomized controlled trial seem to indicate that cochlear implants are safe and effective in restoring speech understanding in both quiet and noise and improve quality of life in individuals with and without MCI.Trial registrationClinicalTrials.gov Identifier: NCT03007472.
| S-EPMC7453346 | biostudies-literature
Project description:For the perception of timbre of a musical instrument, the attack time is known to hold crucial information. The first 50 to 150 ms of sound onset reflect the excitation mechanism, which generates the sound. Since auditory processing and music perception in particular are known to be hampered in cochlear implant (CI) users, we conducted an electroencephalography (EEG) study with an oddball paradigm to evaluate the processing of small differences in musical sound onset. The first 60 ms of a cornet sound were manipulated in order to examine whether these differences are detected by CI users and normal-hearing controls (NH controls), as revealed by auditory evoked potentials (AEPs). Our analysis focused on the N1 as an exogenous component known to reflect physical stimuli properties as well as on the P2 and the Mismatch Negativity (MMN). Our results revealed different N1 latencies as well as P2 amplitudes and latencies for the onset manipulations in both groups. An MMN could be elicited only in the NH control group. Together with additional findings that suggest an impact of musical training on CI users' AEPs, our findings support the view that impaired timbre perception in CI users is at partly due to altered sound onset feature detection.
| S-EPMC3448664 | biostudies-literature
Project description:The study tests the hypothesis that vibrotactile stimulation can affect timbre perception. A multidimensional scaling experiment was conducted. Twenty listeners with normal hearing and nine cochlear implant users were asked to judge the dissimilarity of a set of synthetic sounds that varied in attack time and amplitude modulation depth. The listeners were simultaneously presented with vibrotactile stimuli, which varied also in attack time and amplitude modulation depth. The results showed that alterations to the temporal waveform of the tactile stimuli affected the listeners' dissimilarity judgments of the audio. A three-dimensional analysis revealed evidence of crossmodal processing where the audio and tactile equivalents combined accounted for their dissimilarity judgments. For the normal-hearing listeners, 86% of the first dimension was explained by audio impulsiveness and 14% by tactile impulsiveness; 75% of the second dimension was explained by the audio roughness or fast amplitude modulation, while its tactile counterpart explained 25%. Interestingly, the third dimension revealed a combination of 43% of audio impulsiveness and 57% of tactile amplitude modulation. For the CI listeners, the first dimension was mostly accounted for by the tactile roughness and the second by the audio impulsiveness. This experiment shows that the perception of timbre can be affected by tactile input and could lead to the developing of new audio-tactile devices for people with hearing impairment.
| S-EPMC9932763 | biostudies-literature