scholarly journals Neural envelope tracking as a measure of speech understanding in cochlear implant users

2018 ◽  
Author(s):  
Eline Verschueren ◽  
Ben Somers ◽  
Tom Francart

ABSTRACTThe speech envelope is essential for speech understanding and can be reconstructed from the electroencephalogram (EEG) recorded while listening to running speech. This so-called neural envelope tracking has been shown to relate to speech understanding in normal hearing listeners, but has barely been investigated in persons wearing cochlear implants (CI). We investigated the relation between speech understanding and neural envelope tracking in CI users.EEG was recorded in 8 CI users while they listened to a story. Speech understanding was varied by changing the intensity of the presented speech. The speech envelope was reconstructed from the EEG using a linear decoder and then correlated with the envelope of the speech stimulus as a measure of neural envelope tracking which was compared to actual speech understanding.This study showed that neural envelope tracking increased with increasing speech understanding in every participant. Furthermore behaviorally measured speech understanding was correlated with participant specific neural envelope tracking results indicating the potential of neural envelope tracking as an objective measure of speech understanding in CI users. This could enable objective and automatic fitting of CIs and pave the way towards closed-loop CIs that adjust continuously and automatically to individual CI users.


Author(s):  
A. Molisz ◽  
A. Zarowski ◽  
E. Cardinael ◽  
A. Vermeiren ◽  
T. Theunen ◽  
...  

Abstract Background Fitting cochlear implants in babies and noncooperative patients is cumbersome and time consuming. Therefore, objective parameters have been sought in order to predict the subjective threshold (T) and maximum comfort (C) levels. Measurements of the electrically evoked compound action potentials (ECAPs) have been widely used for this purpose, yet the correlation between these objective measures and the subjective T/C levels is weak to moderate. Purpose This article aims (1) to evaluate correlations between the subjective parameters of the fitting maps such as thresholds (T level) and maximum comfort levels (C level), the impedance of the electrode contacts, and the ECAP thresholds, and (2) to compare the value of the electrode impedances and the ECAP measures for prediction of the T/C levels. Research Design Case review study in a quaternary otologic referral center. Study Sample Ninety-eight consecutive CI patients were enrolled. The average age of the patients was 49 years. All patients were users of the Nucleus 24RECA (Freedom, Contour Advance-of-Stylet electrode) cochlear implant. Data Collection and Analysis Data on impedance of the electrode contacts and the behavioral T/C levels at the first fitting session (2–5 weeks after surgery) and at the 5th fitting session (4–6 months after surgery) have been retrospectively collected in 98 consecutive CI patients. Additionally, the intraoperative impedance values and the ECAP thresholds (tNRT) have been recorded. Results Impedances of electrode contacts show significant strong negative correlations with the stabilized T/C levels at 4 to 6 months after implantation and are an important predictor for the behavioral T/C levels. They can explain R 2 = 28 to 41% of the variability of the behavioral T/C levels. In multiple regression analysis electrode contact impedances can explain twice as much of the variability of the stabilized T/C levels than the tNRT values. The electrode impedances together with the tNRT values are able to explain R 2 = 37 to 40% of the global variability of the T/C levels while the tNRT thresholds solely are able to explain only R 2 = 5 to 14% of the T/C levels variability. Conclusion Impedances of electrode contacts correlate strongly with the stabilized behavioral T/C levels and may be used as an objective measure for fitting of cochlear implants.



1987 ◽  
Vol 96 (1_suppl) ◽  
pp. 148-149
Author(s):  
C. K. Pauka ◽  
W. P. R. Gibson ◽  
C. J. A. Game

Three single-channel and three multichannel cochlear implant patients were tested with warble tone audiometry and with part of the Minimal Auditory Capabilities (MAC) battery. Patients were also asked to report on their devices. The ratio of House result to Melbourne result was calculated for each MAC battery test. Many tests scarcely discriminated between the two sets of patients, but some tests discriminated sharply; these latter were open set tests of speech understanding.



2019 ◽  
Vol 373 ◽  
pp. 23-31 ◽  
Author(s):  
Eline Verschueren ◽  
Ben Somers ◽  
Tom Francart


2011 ◽  
Vol 22 (09) ◽  
pp. 623-632 ◽  
Author(s):  
René H. Gifford ◽  
Amy P. Olund ◽  
Melissa DeJong

Background: Current cochlear implant recipients are achieving increasingly higher levels of speech recognition; however, the presence of background noise continues to significantly degrade speech understanding for even the best performers. Newer generation Nucleus cochlear implant sound processors can be programmed with SmartSound strategies that have been shown to improve speech understanding in noise for adult cochlear implant recipients. The applicability of these strategies for use in children, however, is not fully understood nor widely accepted. Purpose: To assess speech perception for pediatric cochlear implant recipients in the presence of a realistic restaurant simulation generated by an eight-loudspeaker (R-SPACE™) array in order to determine whether Nucleus sound processor SmartSound strategies yield improved sentence recognition in noise for children who learn language through the implant. Research Design: Single subject, repeated measures design. Study Sample: Twenty-two experimental subjects with cochlear implants (mean age 11.1 yr) and 25 control subjects with normal hearing (mean age 9.6 yr) participated in this prospective study. Intervention: Speech reception thresholds (SRT) in semidiffuse restaurant noise originating from an eight-loudspeaker array were assessed with the experimental subjects’ everyday program incorporating Adaptive Dynamic Range Optimization (ADRO) as well as with the addition of Autosensitivity control (ASC). Data Collection and Analysis: Adaptive SRTs with the Hearing In Noise Test (HINT) sentences were obtained for all 22 experimental subjects, and performance—in percent correct—was assessed in a fixed +6 dB SNR (signal-to-noise ratio) for a six-subject subset. Statistical analysis using a repeated-measures analysis of variance (ANOVA) evaluated the effects of the SmartSound setting on the SRT in noise. Results: The primary findings mirrored those reported previously with adult cochlear implant recipients in that the addition of ASC to ADRO significantly improved speech recognition in noise for pediatric cochlear implant recipients. The mean degree of improvement in the SRT with the addition of ASC to ADRO was 3.5 dB for a mean SRT of 10.9 dB SNR. Thus, despite the fact that these children have acquired auditory/oral speech and language through the use of their cochlear implant(s) equipped with ADRO, the addition of ASC significantly improved their ability to recognize speech in high levels of diffuse background noise. The mean SRT for the control subjects with normal hearing was 0.0 dB SNR. Given that the mean SRT for the experimental group was 10.9 dB SNR, despite the improvements in performance observed with the addition of ASC, cochlear implants still do not completely overcome the speech perception deficit encountered in noisy environments accompanying the diagnosis of severe-to-profound hearing loss. Conclusion: SmartSound strategies currently available in latest generation Nucleus cochlear implant sound processors are able to significantly improve speech understanding in a realistic, semidiffuse noise for pediatric cochlear implant recipients. Despite the reluctance of pediatric audiologists to utilize SmartSound settings for regular use, the results of the current study support the addition of ASC to ADRO for everyday listening environments to improve speech perception in a child's typical everyday program.



2019 ◽  
Vol 122 (2) ◽  
pp. 601-615 ◽  
Author(s):  
Lien Decruy ◽  
Jonas Vanthornhout ◽  
Tom Francart

When we grow older, understanding speech in noise becomes more challenging. Research has demonstrated the role of auditory temporal and cognitive deficits in these age-related speech-in-noise difficulties. To better understand the underlying neural mechanisms, we recruited young, middle-aged, and older normal-hearing adults and investigated the interplay between speech understanding, cognition, and neural tracking of the speech envelope using electroencephalography. The stimuli consisted of natural speech masked by speech-weighted noise or a competing talker and were presented at several subject-specific speech understanding levels. In addition to running speech, we recorded auditory steady-state responses at low modulation frequencies to assess the effect of age on nonspeech sounds. The results show that healthy aging resulted in a supralinear increase in the speech reception threshold, i.e., worse speech understanding, most pronounced for the competing talker. Similarly, advancing age was associated with a supralinear increase in envelope tracking, with a pronounced enhancement for older adults. Additionally, envelope tracking was found to increase with speech understanding, most apparent for older adults. Because we found that worse cognitive scores were associated with enhanced envelope tracking, our results support the hypothesis that enhanced envelope tracking in older adults is the result of a higher activation of brain regions for processing speech, compared with younger adults. From a cognitive perspective, this could reflect the inefficient use of cognitive resources, often observed in behavioral studies. Interestingly, the opposite effect of age was found for auditory steady-state responses, suggesting a complex interplay of different neural mechanisms with advancing age. NEW & NOTEWORTHY We measured neural tracking of the speech envelope across the adult lifespan and found a supralinear increase in envelope tracking with age. Using a more ecologically valid approach than auditory steady-state responses, we found that young and older, as well as middle-aged, normal-hearing adults showed an increase in envelope tracking with increasing speech understanding and that this association is stronger for older adults.



2010 ◽  
Vol 124 (8) ◽  
pp. 828-834 ◽  
Author(s):  
W Di Nardo ◽  
A Scorpecci ◽  
S Giannantonio ◽  
F Cianfrone ◽  
C Parrilla ◽  
...  

AbstractObjective:To assess the electrode pitch function in a series of adults with postlingually implanted cochlear implants and with contralateral residual hearing, in order to investigate the correlation between the degree of frequency map mismatch and the subjects' speech understanding in quiet and noisy conditions.Design:Case series.Subjects:Seven postlingually deafened adults with cochlear implants, all with detectable contralateral residual hearing. Subjects' electrode pitch function was assessed by means of a pitch-matching test, in which they were asked to match an acoustic pitch (pure tones delivered to the non-implanted ear by an audiometer) to a perceived ‘pitch’ elicited by stimulation of the cochlear implant electrodes. A mismatch score was calculated for each subject. Speech recognition was tested using lists of sentences presented in quiet conditions and at +10, 0 and 5 dB HL signal-to-noise ratio levels (i.e. noise 10 dB HL lower than signal, noise as loud as signal and noise 5 dB HL higher than signal, respectively). Correlations were assessed using a linear regression model, with significance set at p < 0.05.Results:All patients presented some degree of mismatch between the acoustic frequencies assigned to their implant electrodes and the pitch elicited by stimulation of the same electrode, with high between-individual variability. A significant correlation (p < 0.005) was found between mismatch and speech recognition scores at +10 and 0 dB HL signal-to-noise ratio levels (r2 = 0.91 and 0.89, respectively).Conclusion:The mismatch between frequencies allocated to electrodes and the pitch perceived on stimulation of the same electrodes could partially account for our subjects' difficulties with speech understanding in noisy conditions. We suggest that these subjects could benefit from mismatch correction, through a procedure allowing individualised reallocation of frequency bands to electrodes.



2021 ◽  
Vol 10 (14) ◽  
pp. 3078
Author(s):  
Sara Akbarzadeh ◽  
Sungmin Lee ◽  
Chin-Tuan Tan

In multi-speaker environments, cochlear implant (CI) users may attend to a target sound source in a different manner from normal hearing (NH) individuals during a conversation. This study attempted to investigate the effect of conversational sound levels on the mechanisms adopted by CI and NH listeners in selective auditory attention and how it affects their daily conversation. Nine CI users (five bilateral, three unilateral, and one bimodal) and eight NH listeners participated in this study. The behavioral speech recognition scores were collected using a matrix sentences test, and neural tracking to speech envelope was recorded using electroencephalography (EEG). Speech stimuli were presented at three different levels (75, 65, and 55 dB SPL) in the presence of two maskers from three spatially separated speakers. Different combinations of assisted/impaired hearing modes were evaluated for CI users, and the outcomes were analyzed in three categories: electric hearing only, acoustic hearing only, and electric + acoustic hearing. Our results showed that increasing the conversational sound level degraded the selective auditory attention in electrical hearing. On the other hand, increasing the sound level improved the selective auditory attention for the acoustic hearing group. In the NH listeners, however, increasing the sound level did not cause a significant change in the auditory attention. Our result implies that the effect of the sound level on selective auditory attention varies depending on the hearing modes, and the loudness control is necessary for the ease of attending to the conversation by CI users.



Author(s):  
C Thomas ◽  
J Westwood ◽  
G F Butt

Abstract Background YouTube is increasingly used as a source of healthcare information. This study evaluated the quality of videos on YouTube about cochlear implants. Methods YouTube was searched using the phrase ‘cochlear implant’. The first 60 results were screened by two independent reviewers. A modified Discern tool was used to evaluate the quality of each video. Results Forty-seven videos were analysed. The mean overall Discern score was 2.0 out of 5.0. Videos scored higher for describing positive elements such as the benefits of a cochlear implant (mean score of 3.4) and scored lower for negative elements such as the risks of cochlear implant surgery (mean score of 1.3). Conclusion The quality of information regarding cochlear implant surgery on YouTube is highly variable. These results demonstrated a bias towards the positive attributes of cochlear implants, with little mention of the risks or uncertainty involved. Although videos may be useful as supplementary information, critical elements required to make an informed decision are lacking. This is of particular importance when patients are considering surgery.



2018 ◽  
Vol 39 (5) ◽  
pp. 571-575 ◽  
Author(s):  
Jason A. Brant ◽  
Steven J. Eliades ◽  
Hannah Kaufman ◽  
Jinbo Chen ◽  
Michael J. Ruckenstein


2016 ◽  
Vol 21 (03) ◽  
pp. 206-212 ◽  
Author(s):  
Grace Ciscare ◽  
Erika Mantello ◽  
Carla Fortunato-Queiroz ◽  
Miguel Hyppolito ◽  
Ana Reis

Introduction A cochlear implant in adolescent patients with pre-lingual deafness is still a debatable issue. Objective The objective of this study is to analyze and compare the development of auditory speech perception in children with pre-lingual auditory impairment submitted to cochlear implant, in different age groups in the first year after implantation. Method This is a retrospective study, documentary research, in which we analyzed 78 reports of children with severe bilateral sensorineural hearing loss, unilateral cochlear implant users of both sexes. They were divided into three groups: G1, 22 infants aged less than 42 months; G2, 28 infants aged between 43 to 83 months; and G3, 28 older than 84 months. We collected medical record data to characterize the patients, auditory thresholds with cochlear implants, assessment of speech perception, and auditory skills. Results There was no statistical difference in the association of the results among groups G1, G2, and G3 with sex, caregiver education level, city of residence, and speech perception level. There was a moderate correlation between age and hearing aid use time, age and cochlear implants use time. There was a strong correlation between age and the age cochlear implants was performed, hearing aid use time and age CI was performed. Conclusion There was no statistical difference in the speech perception in relation to the patient's age when cochlear implant was performed. There were statistically significant differences for the variables of auditory deprivation time between G3 - G1 and G2 - G1 and hearing aid use time between G3 - G2 and G3 - G1.



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