scholarly journals Sensitivity to Pulse Phase Duration as a Marker of Neural Health Across Cochlear Implant Recipients and Electrodes

2021 ◽  
Author(s):  
Ning Zhou ◽  
Zhen Zhu ◽  
Lixue Dong ◽  
John Galvin
Keyword(s):  
Hearing Loss ◽  
Speech Recognition ◽  
Cochlear Implant ◽  
Dynamic Range ◽  
Recognition Performance ◽  
Phase Duration ◽  
Pulse Phase ◽  
Site Variation ◽  
Integration Efficiency ◽  
Charge Integration

AbstractIn cochlear implants, loudness has been shown to grow more slowly with increasing pulse phase duration (PPD) than with pulse amplitude (PA), possibly due to “leaky” charge integration. This leakiness has been recently quantified in terms of “charge integration efficiency,” defined as the log difference between the PPD dynamic range and PA dynamic range (both expressed in charge units), relative to a common threshold anchor. Such leakiness may differ across electrodes and/or test ears, and may reflect underlying neural health. In this study, we examined the across-site variation of charge integration in recipients of Cochlear© devices. PPD and PA dynamic ranges were measured relative to two threshold anchors with either a 25- or 50-microsecond PPD. Strength-duration functions, previously shown to relate to survival of spiral ganglion cells and peripheral processes, were compared to charge integration efficiency on selected electrodes. Results showed no significant or systematic relationship between the across-site variation in charge integration efficiency and electrode position or threshold levels. Charge integration efficiency was poorer with the 50-μs threshold anchor, suggesting that greater leakiness was associated with larger PPD dynamic ranges. Poorer and more variable charge integration efficiency across electrodes was associated with longer duration of any hearing loss, consistent with the idea that poor integration is related to neural degeneration. More variable integration efficiency was also associated with poorer speech recognition performance across test ears. The slopes of the strength-duration functions at maximum acceptable loudness were significantly correlated with charge integration efficiency. However, the strength-duration slopes were not predictive of duration of any hearing loss or speech recognition performance in our participants. As such, charge integration efficiency may be a better candidate to measure leakiness in neural populations across the electrode array, as well as the general health of the auditory nerve in human cochlear implant recipients.

Efficacy of a Cochlear Implant Simultaneous Analog Stimulation Strategy Coupled with a Monopolar Electrode Configuration

2005 ◽  
Vol 114 (11) ◽  
pp. 886-893 ◽  
Author(s):  
Li Xu ◽  
Teresa A. Zwolan ◽  
Catherine S. Thompson ◽  
Bryan E. Pfingst
Keyword(s):  
Speech Recognition ◽  
Cochlear Implant ◽  
Speech Processing ◽  
Dynamic Range ◽  
Recognition Performance ◽  
Electrode Configuration ◽  
Processing Strategy ◽  
Open Set ◽  
Hearing In Noise ◽  
Noise Test

Objectives: The present study was performed to evaluate the efficacy and clinical feasibility of using monopolar stimulation with the Clarion Simultaneous Analog Stimulation (SAS) strategy in patients with cochlear implants. Methods: Speech recognition by 10 Clarion cochlear implant users was evaluated by means of 4 different speech processing strategy/electrode configuration combinations; ie, SAS and Continuous Interleaved Sampling (CIS) strategies were each used with monopolar (MP) and bipolar (BP) electrode configurations. The test measures included consonants, vowels, consonant-nucleus-consonant words, and Hearing in Noise Test sentences with a +10 dB signal-to-noise ratio. Additionally, subjective judgments of sound quality were obtained for each strategy/configuration combination. Results: All subjects but 1 demonstrated open-set speech recognition with the SAS/MP combination. The group mean Hearing in Noise Test sentence score for the SAS/MP combination was 31.6% (range, 0% to 92%) correct, as compared to 25.0%, 46.7%, and 37.8% correct for the CIS/BP, CIS/MP, and SAS/BP combinations, respectively. Intersubject variability was high, and there were no significant differences in mean speech recognition scores or mean preference ratings among the 4 strategy/configuration combinations tested. Individually, the best speech recognition performance was with the subject's everyday strategy/configuration combination in 72% of the applicable cases. If the everyday strategy was excluded from the analysis, the subjects performed best with the SAS/MP combination in 37.5% of the remaining cases. Conclusions: The SAS processing strategy with an MP electrode configuration gave reasonable speech recognition in most subjects, even though subjects had minimal previous experience with this strategy/configuration combination. The SAS/MP combination might be particularly appropriate for patients for whom a full dynamic range of electrical hearing could not be achieved with a BP configuration.

scholarly journals The Effect of Hearing Aid Bandwidth and Configuration of Hearing Loss on Bimodal Speech Recognition in Cochlear Implant Users

2019 ◽  
Vol 40 (3) ◽  
pp. 621-635 ◽  
Author(s):  
Arlene C. Neuman ◽  
Annette Zeman ◽  
Jonathan Neukam ◽  
Binhuan Wang ◽  
Mario A. Svirsky
Keyword(s):  
Hearing Loss ◽  
Speech Recognition ◽  
Cochlear Implant ◽  
Hearing Aid

Working Memory Capacity May Influence Perceived Effort during Aided Speech Recognition in Noise

2012 ◽  
Vol 23 (08) ◽  
pp. 577-589 ◽  
Author(s):  
Mary Rudner ◽  
Thomas Lunner ◽  
Thomas Behrens ◽  
Elisabet Sundewall Thorén ◽  
Jerker Rönnberg
Keyword(s):  
Working Memory ◽  
Hearing Loss ◽  
Speech Recognition ◽  
Hearing Aid ◽  
Recognition Performance ◽  
Cognitive Capacity ◽  
Subjective Ratings ◽  
Perceived Effort ◽  
Noise Type ◽  
Speech Recognition In Noise

Background: Recently there has been interest in using subjective ratings as a measure of perceived effort during speech recognition in noise. Perceived effort may be an indicator of cognitive load. Thus, subjective effort ratings during speech recognition in noise may covary both with signal-to-noise ratio (SNR) and individual cognitive capacity. Purpose: The present study investigated the relation between subjective ratings of the effort involved in listening to speech in noise, speech recognition performance, and individual working memory (WM) capacity in hearing impaired hearing aid users. Research Design: In two experiments, participants with hearing loss rated perceived effort during aided speech perception in noise. Noise type and SNR were manipulated in both experiments, and in the second experiment hearing aid compression release settings were also manipulated. Speech recognition performance was measured along with WM capacity. Study Sample: There were 46 participants in all with bilateral mild to moderate sloping hearing loss. In Experiment 1 there were 16 native Danish speakers (eight women and eight men) with a mean age of 63.5 yr (SD = 12.1) and average pure tone (PT) threshold of 47. 6 dB (SD = 9.8). In Experiment 2 there were 30 native Swedish speakers (19 women and 11 men) with a mean age of 70 yr (SD = 7.8) and average PT threshold of 45.8 dB (SD = 6.6). Data Collection and Analysis: A visual analog scale (VAS) was used for effort rating in both experiments. In Experiment 1, effort was rated at individually adapted SNRs while in Experiment 2 it was rated at fixed SNRs. Speech recognition in noise performance was measured using adaptive procedures in both experiments with Dantale II sentences in Experiment 1 and Hagerman sentences in Experiment 2. WM capacity was measured using a letter-monitoring task in Experiment 1 and the reading span task in Experiment 2. Results: In both experiments, there was a strong and significant relation between rated effort and SNR that was independent of individual WM capacity, whereas the relation between rated effort and noise type seemed to be influenced by individual WM capacity. Experiment 2 showed that hearing aid compression setting influenced rated effort. Conclusions: Subjective ratings of the effort involved in speech recognition in noise reflect SNRs, and individual cognitive capacity seems to influence relative rating of noise type.

scholarly journals Multivariate Predictors of Music Perception and Appraisal by Adult Cochlear Implant Users

2008 ◽  
Vol 19 (02) ◽  
pp. 120-134 ◽  
Author(s):  
Kate Gfeller ◽  
Jacob Oleson ◽  
John F. Knutson ◽  
Patrick Breheny ◽  
Virginia Driscoll ◽  
...  
Keyword(s):  
Speech Recognition ◽  
Cochlear Implant ◽  
Music Perception ◽  
Life Experience ◽  
Recognition Performance ◽  
Strong Predictor ◽  
Music Listening ◽  
Linear Regression Models ◽  
Hearing Aid Use ◽  
Music Appraisal

The research examined whether performance by adult cochlear implant recipients on a variety of recognition and appraisal tests derived from real-world music could be predicted from technological, demographic, and life experience variables, as well as speech recognition scores. A representative sample of 209 adults implanted between 1985 and 2006 participated. Using multiple linear regression models and generalized linear mixed models, sets of optimal predictor variables were selected that effectively predicted performance on a test battery that assessed different aspects of music listening. These analyses established the importance of distinguishing between the accuracy of music perception and the appraisal of musical stimuli when using music listening as an index of implant success. Importantly, neither device type nor processing strategy predicted music perception or music appraisal. Speech recognition performance was not a strong predictor of music perception, and primarily predicted music perception when the test stimuli included lyrics. Additionally, limitations in the utility of speech perception in predicting musical perception and appraisal underscore the utility of music perception as an alternative outcome measure for evaluating implant outcomes. Music listening background, residual hearing (i.e., hearing aid use), cognitive factors, and some demographic factors predicted several indices of perceptual accuracy or appraisal of music. La investigación examinó si el desempeño, por parte de adultos receptores de un implante coclear, sobre una variedad de pruebas de reconocimiento y evaluación derivadas de la música del mundo real, podrían predecirse a partir de variables tecnológicas, demográficas y de experiencias de vida, así como de puntajes de reconocimiento del lenguaje. Participó una muestra representativa de 209 adultos implantados entre 1965 y el 2006. Usando múltiples modelos de regresión lineal y modelos mixtos lineales generalizados, se seleccionaron grupos de variables óptimas de predicción, que pudieran predecir efectivamente el desempeño por medio de una batería de pruebas que permitiera evaluar diferentes aspectos de la apreciación musical. Estos análisis establecieron la importancia de distinguir entre la exactitud en la percepción musical y la evaluación de estímulos musicales cuando se utiliza la apreciación musical como un índice de éxito en la implantación. Importantemente, ningún tipo de dispositivo o estrategia de procesamiento predijo la percepción o la evaluación musical. El desempeño en el reconocimiento del lenguaje no fue un elemento fuerte de predicción, y llegó a predecir primariamente la percepción musical cuando los estímulos de prueba incluyeron las letras. Adicionalmente, las limitaciones en la utilidad de la percepción del lenguaje a la hora de predecir la percepción y la evaluación musical, subrayan la utilidad de la percepción de la música como una medida alternativa de resultado para evaluar la implantación coclear. La música de fondo, la audición residual (p.e., el uso de auxiliares auditivos), los factores cognitivos, y algunos factores demográficos predijeron varios índices de exactitud y evaluación perceptual de la música.

Evaluation of Automatic Directional Processing with Cochlear Implant Recipients

2021 ◽  
Vol 32 (08) ◽  
pp. 478-486
Author(s):  
Lisa G. Potts ◽  
Soo Jang ◽  
Cory L. Hillis
Keyword(s):  
Signal Processing ◽  
Speech Recognition ◽  
Cochlear Implant ◽  
Mixed Model ◽  
Dynamic Range ◽  
Individual Variability ◽  
Noise Performance ◽  
Mixed Model Analysis ◽  
Speech In Noise ◽  
Speech Recognition In Noise

Abstract Background For cochlear implant (CI) recipients, speech recognition in noise is consistently poorer compared with recognition in quiet. Directional processing improves performance in noise and can be automatically activated based on acoustic scene analysis. The use of adaptive directionality with CI recipients is new and has not been investigated thoroughly, especially utilizing the recipients' preferred everyday signal processing, dynamic range, and/or noise reduction. Purpose This study utilized CI recipients' preferred everyday signal processing to evaluate four directional microphone options in a noisy environment to determine which option provides the best speech recognition in noise. A greater understanding of automatic directionality could ultimately improve CI recipients' speech-in-noise performance and better guide clinicians in programming. Study Sample Twenty-six unilateral and seven bilateral CI recipients with a mean age of 66 years and approximately 4 years of CI experience were included. Data Collection and Analysis Speech-in-noise performance was measured using eight loudspeakers in a 360-degree array with HINT sentences presented in restaurant noise. Four directional options were evaluated (automatic [SCAN], adaptive [Beam], fixed [Zoom], and Omni-directional) with participants' everyday use signal processing options active. A mixed-model analysis of variance (ANOVA) and pairwise comparisons were performed. Results Automatic directionality (SCAN) resulted in the best speech-in-noise performance, although not significantly better than Beam. Omni-directional performance was significantly poorer compared with the three other directional options. A varied number of participants performed their best with each of the four-directional options, with 16 performing best with automatic directionality. The majority of participants did not perform best with their everyday directional option. Conclusion The individual variability seen in this study suggests that CI recipients try with different directional options to find their ideal program. However, based on a CI recipient's motivation to try different programs, automatic directionality is an appropriate everyday processing option.

scholarly journals Effect of pulse phase duration on forward masking and spread of excitation in cochlear implant listeners

PLoS ONE ◽  
2020 ◽  
Vol 15 (7) ◽  
pp. e0236179
Author(s):  
Ning Zhou ◽  
Zhen Zhu ◽  
Lixue Dong ◽  
John J. Galvin
Keyword(s):  
Cochlear Implant ◽  
Forward Masking ◽  
Phase Duration ◽  
Pulse Phase ◽  
Spread Of Excitation

The Effects of Changes in Head Angle on Auditory and Visual Input for Omnidirectional and Directional Microphone Hearing Aids

2003 ◽  
Vol 12 (1) ◽  
pp. 41-51 ◽  
Author(s):  
Paula Henry ◽  
Todd Ricketts
Keyword(s):  
Hearing Loss ◽  
Speech Recognition ◽  
Hearing Aids ◽  
Visual Cues ◽  
Signal To Noise Ratio ◽  
Hearing Aid ◽  
Recognition Performance ◽  
Binaural Hearing ◽  
Increase Signal Intensity ◽  
Visual Mode

Improving the signal-to-noise ratio (SNR) for individuals with hearing loss who are listening to speech in noise provides an obvious benefit. Although binaural hearing provides the greatest advantage over monaural hearing in noise, some individuals with symmetrical hearing loss choose to wear only one hearing aid. The present study tested the hypothesis that individuals with symmetrical hearing loss fit with one hearing aid would demonstrate improved speech recognition in background noise with increases in head turn. Fourteen individuals were fit monaurally with a Starkey Gemini in-the-ear (ITE) hearing aid with directional and omnidirectional microphone modes. Speech recognition performance in noise was tested using the audiovisual version of the Connected Speech Test (CST v.3). The test was administered in auditory-only conditions as well as with the addition of visual cues for each of three head angles: 0°, 20°, and 40°. Results indicated improvement in speech recognition performance with changes in head angle for the auditory-only presentation mode at the 20° and 40° head angles when compared to 0°. Improvement in speech recognition performance for the auditory + visual mode was noted for the 20° head angle when compared to 0°. Additionally, a decrement in speech recognition performance for the auditory + visual mode was noted for the 40° head angle when compared to 0°. These results support a speech recognition advantage for listeners fit with one ITE hearing aid listening in a close listener-to-speaker distance when they turn their head slightly in order to increase signal intensity.

scholarly journals Hearing Aid Treatment for Patients with Mixed Hearing Loss. Part II: Speech Recognition in Comparison to Direct Acoustic Cochlear Stimulation

2020 ◽  
Vol 25 (3) ◽  
pp. 133-142
Author(s):  
Nina Wardenga ◽  
Ad F.M. Snik ◽  
Eugen Kludt ◽  
Bernd Waldmann ◽  
Thomas Lenarz ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Speech Recognition ◽  
Middle Ear ◽  
Hearing Aids ◽  
Dynamic Range ◽  
Hearing Aid ◽  
Middle Ear Surgery ◽  
Promising Alternative ◽  
Mixed Hearing Loss ◽  
Technical Specifications

Background: The conventional therapy for severe mixed hearing loss is middle ear surgery combined with a power hearing aid. However, a substantial group of patients with severe mixed hearing loss cannot be treated adequately with today’s state-of-the-art (SOTA) power hearing aids, as predicted by the accompanying part I of this publication, where we compared the available maximum power output (MPO) and gain from technical specifications to requirements for optimum benefit using a common fitting rule. Here, we intended to validate the theoretical assumptions from part I experimentally in a mixed hearing loss cohort fitted with SOTA power hearing aids. Additionally, we compared the results with an implantable hearing device that circumvents the impaired middle ear, directly stimulating the cochlea, as this might be a better option. Objectives: Speech recognition outcomes obtained from patients with severe mixed hearing loss supplied acutely with a SOTA hearing aid were studied to validate the outcome predictions as described in part I. Further, the results obtained with hearing aids were compared to those in direct acoustic cochlear implant (DACI) users. Materials and Methods: Twenty patients (37 ears with mixed hearing loss) were provided and fitted with a SOTA power hearing aid. Before and after an acclimatization period of at least 4 weeks, word recognition scores (WRS) in quiet and in noise were studied, as well as the speech reception threshold in noise (SRT). The outcomes were compared retrospectively to a second group of 45 patients (47 ears) using the DACI device. Based on the severity of the mixed hearing loss and the available gain and MPO of the SOTA hearing aid, the hearing aid and DACI users were subdivided into groups with prediction of sufficient, partially insufficient, or very insufficient hearing aid performance. Results: The patients with predicted adequate SOTA hearing aid performance indeed showed the best WRS in quiet and in noise when compared to patients with predicted inferior outcomes. Insufficient hearing aid performance at one or more frequencies led to a gradual decrease in hearing aid benefit, validating the criteria used here and in the accompanying paper. All DACI patients showed outcomes at the same level as the adequate hearing aid performance group, being significantly better than those of the groups with inadequate hearing aid performance. Whereas WRS in quiet and noise were sensitive to insufficient gain or output, showing significant differences between the SOTA hearing aid and DACI groups, the SRT in noise was less sensitive. Conclusions: Limitations of outcomes in mixed hearing loss individuals due to insufficient hearing aid performance can be accurately predicted by applying a commonly used fitting rule and the 35-dB dynamic range rule on the hearing aid specifications. Evidently, when outcomes in patients with mixed hearing loss using the most powerful hearing aids are insufficient, bypassing the middle ear with a powerful active middle ear implant or direct acoustic implant can be a promising alternative treatment.

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