scholarly journals Behavioral Measures of Temporal Processing and Speech Perception in Cochlear Implant Users

2016 ◽  
Vol 27 (09) ◽  
pp. 701-713 ◽  
Author(s):  
Chelsea Blankenship ◽  
Fawen Zhang ◽  
Robert Keith
Keyword(s):  
Speech Perception ◽  
Cochlear Implant ◽  
Recognition Test ◽  
Temporal Processing ◽  
Acoustic Stimulation ◽  
Gap Detection ◽  
Temporal Acuity ◽  
Significant Difference ◽  
The Difference ◽  
The Relationship

Background: Although most cochlear implant (CI) users achieve improvements in speech perception, there is still a wide variability in speech perception outcomes. There is a growing body of literature that supports the relationship between individual differences in temporal processing and speech perception performance in CI users. Previous psychophysical studies have emphasized the importance of temporal acuity for overall speech perception performance. Measurement of gap detection thresholds (GDTs) is the most common measure currently used to assess temporal resolution. However, most GDT studies completed with CI participants used direct electrical stimulation not acoustic stimulation and they used psychoacoustic research paradigms that are not easy to administer clinically. Therefore, it is necessary to determine if the variance in GDTs assessed with clinical measures of temporal processing such as the Randomized Gap Detection Test (RGDT) can be used to explain the variability in speech perception performance. Purpose: The primary goal of this study was to investigate the relationship between temporal processing and speech perception performance in CI users. Research Design: A correlational study investigating the relationship between behavioral GDTs (assessed with the RGDT or the Expanded Randomized Gap Detection Test) and commonly used speech perception measures (assessed with the Speech Recognition Test [SRT], Central Institute for the Deaf W-22 Word Recognition Test [W-22], Consonant-Nucleus-Consonant Test [CNC], Arizona Biomedical Sentence Recognition Test [AzBio], Bamford–Kowal–Bench Speech-in-Noise Test [BKB-SIN]). Study Sample: Twelve postlingually deafened adult CI users (24–83 yr) and ten normal-hearing (NH; 22–30 yr) adults participated in the study. Data Collection and Analysis: The data were collected in a sound-attenuated test booth. After measuring pure-tone thresholds, GDTs and speech perception performance were measured. The difference in performance between-participant groups on the aforementioned tests, as well as the correlation between GDTs and speech perception performance was examined. The correlations between participants’ biologic factors, performance on the RGDT and speech perception measures were also explored. Results: Although some CI participants performed as well as the NH listeners, the majority of the CI participants displayed temporal processing impairments (GDTs > 20 msec) and poorer speech perception performance than NH participants. A statistically significant difference was found between the NH and CI test groups in GDTs and some speech tests (SRT, W-22, and BKB-SIN). For the CI group, there were significant correlations between GDTs and some measures of speech perception (CNC Phoneme, AzBio, BKB-SIN); however, no significant correlations were found between biographic factors and GDTs or speech perception performance. Conclusions: Results support the theory that the variability in temporal acuity in CI users contributes to the variability in speech performance. Results also indicate that it is reasonable to use the clinically available RGDT to identify CI users with temporal processing impairments for further appropriate rehabilitation.

scholarly journals Within-Frequency Temporal Processing and Speech Perception in Cochlear Implant Recipients and Normal Hearing Listeners

2020 ◽  
Author(s):  
Chelsea Blankenship ◽  
Jareen Meinzen-Derr ◽  
Fawen Zhang
Keyword(s):  
Speech Perception ◽  
Correlation Analysis ◽  
Cochlear Implant ◽  
Temporal Resolution ◽  
Temporal Processing ◽  
Gap Detection ◽  
Speech Understanding ◽  
Behavioral Measures ◽  
Speech In Noise ◽  
Noise Test

ABSTRACT Objective: Speech recognition performance among cochlear implant (CI) recipients is highly variable and is influenced by their ability to perceive rapid changes within the acoustic signal (i.e., temporal resolution). A behavioral gap detection test is commonly used to assess temporal processing however it requires active participation, and therefore may be infeasible for young children and individuals with disabilities. Alternatively, cortical auditory evoked potentials (CAEPs) can be elicited by a silent gap embedded in a longer duration stimulus and have been used as an objective measure of temporal resolution. Only a few studies have examined within-frequency gap detection (identical pre- and post-gap frequency), most of which were conducted with normal hearing (NH) individuals and did not include speech perception. The purpose of the study is to evaluate behavioral and electrophysiological measures of within-frequency temporal processing and speech perception in NH and CI recipients. Design: Eleven post-lingually deafened adult CI recipients (n = 15 ears; mean age = 50.4 yrs.) and eleven age- and gender-matched NH individuals (n = 15 ears; mean age = 49.0 yrs.) were recruited. Speech perception was assessed with the CNC word test, AzBio sentence test, and BKB Speech-in-Noise test. Within-frequency (2 kHz pre- and post-gap tone) behavioral gap detection thresholds (GDT) were measured using an adaptive, two-alternative, forced-choice paradigm. Within-frequency CAEPs were measured using four gap duration conditions based on the individual's behavioral GDT including a supra-threshold (GDTx3), threshold (GDT), sub-threshold (GDT/3), and reference (no gap) condition. Mixed effect models examined group differences in speech perception, behavioral GDTs, and CAEP amplitude and latency. Correlation analyses examined the relationship between the CAEP response, behavioral measures of speech perception and temporal processing, and demographic factors. Results: CI recipients had significantly poorer speech perception scores with no significant differences in behavioral within-frequency GDTs compared to NH participants. CI recipients had poorer CAEP waveform morphology, smaller N1, larger P2 amplitude, and increased P1 latency compared to NH participants. Additionally, older participants displayed smaller N1-P2 amplitude compared to younger participants. Bivariate group correlation analysis showed that individuals with poorer within-frequency GDTs displayed significantly poorer performance on the AzBio sentences in noise and BKB Speech-in-Noise test. Multivariate canonical correlation analysis showed a significant relationship between the within-frequency CAEP amplitude and latency and behavioral measures of speech perception and temporal processing. Conclusions: CI recipients had poorer speech understanding in quiet and noise yet similar behavioral GDTs compared to NH participants. NH participants showed the anticipated trend of increased N1-P2 amplitude as CAEP gap duration increased. However, CAEP amplitude and latency remained relatively stable across gap duration conditions for CI recipients. Instead, significant group and age effects for CAEP peak amplitude and latency were found that can likely be attributed to differences in cortical neuron density, adaptation, and recovery between the groups. Lastly correlation analysis indicates that individuals with poorer temporal processing are likely to have adequate speech perception in quiet but worse speech understanding in noise.

scholarly journals Across-Frequency Temporal Processing and Speech Perception in Cochlear Implant Recipients and Normal Hearing Listeners

2020 ◽  
Author(s):  
Chelsea Blankenship ◽  
Jareen Meinzen-Derr ◽  
Fawen Zhang
Keyword(s):  
Speech Recognition ◽  
Speech Perception ◽  
Correlation Analysis ◽  
Cochlear Implant ◽  
Canonical Correlation Analysis ◽  
Temporal Processing ◽  
Canonical Correlation ◽  
Normal Hearing ◽  
Gap Detection ◽  
Bivariate Correlation

Objective: Individual differences in temporal processing contributes strongly to the large variability in speech recognition performance observed among cochlear implant (CI) recipients. Temporal processing is traditionally measured using a behavioral gap detection task, and therefore, it can be challenging or infeasible to obtain reliable responses from young children and individuals with disabilities. Within-frequency gap detection (pre- and post-gap markers are identical in frequency) is more common, yet across-frequency gap detection (pre- and post-gap markers are spectrally distinct), is thought to be more important for speech perception because the phonemes that proceed and follow the rapid temporal cues are rarely identical in frequency. However, limited studies have examined across-frequency temporal processing in CI recipients. None of which have included across-frequency cortical auditory evoked potentials (CAEP), nor was the correlation between across-frequency gap detection and speech perception examined. The purpose of the study is to evaluate behavioral and electrophysiological measures of across-frequency temporal processing and speech recognition in normal hearing (NH) and CI recipients. Design: Eleven post-lingually deafened adult CI recipients (n = 15 ears, mean age = 50.4 yrs.) and eleven age- and gender-matched NH individuals participated (n = 15 ears; mean age = 49.0 yrs.). Speech perception was evaluated using the Minimum Speech Test Battery for Adult Cochlear Implant Users (CNC, AzBio, BKB-SIN). Across-frequency behavioral gap detection thresholds (GDT; 2 kHz to 1 kHz post-gap tone) were measured using an adaptive, two-alternative, forced-choice paradigm. Across-frequency CAEPs were measured using four gap duration conditions; supra-threshold (behavioral GDT x 3), threshold (behavioral GDT), sub-threshold (behavioral GDT/3), and reference (no gap) condition. Group differences in behavioral GDTs, and CAEP amplitude and latency were evaluated using multiple mixed effects models. Bivariate and multivariate canonical correlation analyses were used to evaluate the relationship between the CAEP amplitude and latency, behavioral GDTs, and speech perception. Results: A significant effect of participant group was not observed for across-frequency GDTs, instead older participants (> 50 yrs.) displayed larger GDTs than younger participants. CI recipients displayed increased P1 and N1 latency compared to NH participants and older participants displayed delayed N1 and P2 latency compared to younger adults. Bivariate correlation analysis between behavioral GDTs and speech perception measures were not significant (p > 0.01). Across-frequency canonical correlation analysis showed a significant relationship between CAEP reference condition and behavioral measures of speech perception and temporal processing. Conclusions: CI recipients show similar across-frequency temporal GDTs compared to NH participants, however older participants (> 50 yrs.) displayed poorer temporal processing (larger GDTs) compared to younger participants. CI recipients and older participants displayed less efficient neural processing of the acoustic stimulus and slower transmission to the auditory cortex. An effect of gap duration on CAEP amplitude or latency was not observed. Canonical correlation analysis suggests better cortical detection of frequency changes is correlated with better word and sentence understanding in quiet and noise.

4971Blood viscosity and its relevance to the diagnosis and management of pulmonary hypertension: a new elephant in the cathlab

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
A Kempny ◽  
K Dimopoulos ◽  
A E Fraisse ◽  
G P Diller ◽  
L C Price ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
Cardiac Catheterization ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Pulmonary Vasculature ◽  
Pulmonary Vascular Disease ◽  
Significant Difference ◽  
The Difference ◽  
Clinically Significant ◽  
The Relationship

Abstract Background Pulmonary vascular resistance (PVR) is an essential parameter assessed during cardiac catheterization. It is used to confirm pulmonary vascular disease, to assess response to targeted pulmonary hypertension (PH) therapy and to determine the possibility of surgery, such as closure of intra-cardiac shunt or transplantation. While PVR is believed to mainly reflect the properties of the pulmonary vasculature, it is also related to blood viscosity (BV). Objectives We aimed to assess the relationship between measured (mPVR) and viscosity-corrected PVR (cPVR) and its impact on clinical decision-making. Methods We assessed consecutive PH patients undergoing cardiac catheterization. BV was assessed using the Hutton method. Results We included 465 patients (56.6% female, median age 63y). The difference between mPVR and cPVR was highest in patients with abnormal Hb levels (anemic patients: 5.6 [3.4–8.0] vs 7.8Wood Units (WU) [5.1–11.9], P<0.001; patients with raised Hb: 10.8 [6.9–15.4] vs. 7.6WU [4.6–10.8], P<0.001, respectively). Overall, 33.3% patients had a clinically significant (>2.0WU) difference between mPVR and cPVR, and this was more pronounced in those with anemia (52.9%) or raised Hb (77.6%). In patients in the upper quartile for this difference, mPVR and cPVR differed by 4.0WU [3.4–5.2]. Adjustment of PVR required Conclusions We report, herewith, a clinically significant difference between mPVR and cPVR in a third of contemporary patients assessed for PH. This difference is most pronounced in patients with anemia, in whom mPVR significantly underestimates PVR, whereas in most patients with raised Hb, mPVR overestimates it. Our data suggest that routine adjustment for BV is necessary.

scholarly journals Meta-Analysis—Correlation between Spiral Ganglion Cell Counts and Speech Perception with a Cochlear Implant

2021 ◽  
Vol 11 (2) ◽  
pp. 220-226
Author(s):  
Yew-Song Cheng ◽  
Mario A. Svirsky
Keyword(s):  
Speech Perception ◽  
Cochlear Implant ◽  
Ganglion Cells ◽  
Meta Analysis ◽  
Spiral Ganglion ◽  
Spiral Ganglion Cell ◽  
Cell Counts ◽  
Temporal Bones ◽  
The Relationship ◽  
Existing Data

The presence of spiral ganglion cells (SGCs) is widely accepted to be a prerequisite for successful speech perception with a cochlear implant (CI), because SGCs provide the only known conduit between the implant electrode and the central auditory system. By extension, it has been hypothesized that the number of SGCs might be an important factor in CI outcomes. An impressive body of work has been published on findings from the laborious process of collecting temporal bones from CI users and counting the number of SGCs to correlate those numbers with speech perception scores, but the findings thus far have been conflicting. We performed a meta-analysis of all published studies with the hope that combining existing data may help us reach a more definitive conclusion about the relationship between SGC count and speech perception scores in adults.

A Role for Acoustic Stimulation in Advanced Otosclerosis: Direct Acoustic Cochlear Implant versus Cochlear Implant

2018 ◽  
Vol 23 (2) ◽  
pp. 89-97
Author(s):  
Nicolas Verhaert ◽  
Charlotte Borgers ◽  
Katleen De Voecht ◽  
Ellen Boon ◽  
Christian Desloovere
Keyword(s):  
Speech Perception ◽  
Cochlear Implant ◽  
Hearing Aids ◽  
Standard Treatment ◽  
Acoustic Stimulation ◽  
Grading System ◽  
Effective Treatment Option ◽  
Computed Tomographic ◽  
Direct Acoustic Cochlear Implant ◽  
Acoustic Component

Recent findings support the efficacy of the direct acoustic cochlear implant (DACI) in patients with advanced otosclerosis whose rehabilitation is very challenging. Standard treatment consists of stapes surgery combined with hearing aids or a cochlear implant (CI). CI surgery, however, is often challenging depending on the grade of otosclerosis. This study aims to compare speech perception scores in quiet and noise of 6 DACI and 12 CI patients with advanced otosclerosis at 3 and 12 months after fitting. Preoperative computed tomographic scans of all patients were scored by experts using an existing otosclerosis grading system (stages 1–3). Speech perception in quiet was significantly better for DACI compared to CI users at 3 months after fitting. At 12 months, no difference was found between DACI and CI patients. Speech perception scores in noise were significantly better in the DACI group. In summary, a DACI system seems to provide an effective treatment option as the acoustic component can be preserved in patients with advanced otosclerosis.

scholarly journals Multiple Sclerosis and Diabetes Mellitus: Further Evidence of a Relationship

1982 ◽  
Vol 9 (4) ◽  
pp. 415-419 ◽  
Author(s):  
Sharon A. Warren ◽  
K.G. Warren
Keyword(s):  
Diabetes Mellitus ◽  
Multiple Sclerosis ◽  
Healthy Controls ◽  
Degree Relative ◽  
Significant Difference ◽  
The Difference ◽  
The Relationship ◽  
Prevalence Of Diabetes Mellitus ◽  
Second Degree

SUMMARY:One hundred multiple sclerosis (MS) patients were compared to healthy controls to determine the prevalence of diabetes mellitus in their families. Significantly, more MS patients than controls were diabetic or reported at least one first degree relative (parent, sibling, child) with diabetes. The relationship between MS and diabetes persisted when second degree relatives (grandparents, aunts and uncles) were taken into consideration.A greater percentage of MS patients with another MS relative were diabetic or reported a first degree relative with diabetes mellitus than MS patients without an MS relative. However the difference was not statistically significant. Nor was there a significant difference when percentages reporting either a first or a second degree relative with diabetes were compared.

scholarly journals Migraine in Obesity: Is It Prevalent?

2020 ◽  
Vol 19 (2) ◽  
pp. 1-5
Author(s):  
Aso Sabir Saeed ◽  
◽  
Osama MohammadAmin Shukr
Keyword(s):  
Body Mass Index ◽  
Waist Circumference ◽  
P Value ◽  
Cross Sectional ◽  
Waist To Hip Ratio ◽  
Migraine Prevalence ◽  
Significant Difference ◽  
Keywords Migraine ◽  
The Difference ◽  
The Relationship

Background: Several studies have demonstrated an association between obesity and migraine. It’s still unclear whether migraine is the cause or it's the result of obesity. Objective: We investigated the prevalence of migraine among obese and non-obese individuals and analyzed the relationship between migraine prevalence and obesity. Patients and Methods: This is cross-sectional observational study was carried out at the neurology outpatients’ department of the Rizgary Teaching Hospital in Erbil, Iraq, from July 1st , 2018 to September 30, 2019. We interviewed and examined 300 persons, both obese (n=154) and non-obese (n=146), and of both gender. All of them were adults (>18 years old). Each person's weight, height, body mass index (BMI), and waist circumference were measured.The diagnosis of migraine was made according to the International Headache Society’s criteria. Obesity was present if the individual’s BMI is ≥30 and/or waist-to-hip ratio is >0.9 in females and >1.0 in males. Results: Out of the 300 persons, 14 males (8.5%) got migraines while migraine was found in 37 females (27.4%), irrespective of their weight. Out of the 300 persons, the prevalence of migraine among obese individuals was 21.4% (n=33) and while in non-obese individuals was 12.3% (n=18). There was a statistically significant difference between the groups (p-value=0.045). The overall prevalence of migraine was 16.9% of the persons interviewed. Conclusion: The results showed that migraine is more prevalent among obese persons than non-obese persons and the difference was statistically significant. Keywords: Migraine, obesity, BMI, headache

scholarly journals The relationship between speech intelligibility and speech perception in cochlear implant patients

2018 ◽  
Author(s):  
N Freimann ◽  
D Polterauer ◽  
S Gollwitzer ◽  
J Müller ◽  
ME Schuster
Keyword(s):  
Speech Perception ◽  
Cochlear Implant ◽  
Speech Intelligibility ◽  
The Relationship

The relationship between CSR disclosure and competitive advantage

2017 ◽  
Vol 8 (5) ◽  
pp. 547-570 ◽  
Author(s):  
Hui-Cheng Yu ◽  
Lopin Kuo ◽  
Mao-Feng Kao
Keyword(s):  
Competitive Advantage ◽  
Signaling Theory ◽  
Content Type ◽  
Csr Strategies ◽  
Significant Difference ◽  
Strategic Csr ◽  
Environmentally Sensitive ◽  
The Difference ◽  
Csr Disclosure ◽  
The Relationship

Purpose This study aims to apply signaling theory to examine whether corporate social responsibility (CSR) disclosure can deliver effective signals to stakeholders to increase a firm’s competitive advantage in China. Whether ownership patterns or environmental sensitivity causes a significant difference in the relationship between a firm’s CSR disclosure and competitive advantage is also examined. Design/methodology/approach Data analysis is based on a regression model. Content analysis is performed to convert qualitative CSR information of Chinese firms into quantitative data, while intellectual capital (IC) is used as a proxy variable for competitive advantage. Findings The difference in competitive advantage impairment between environmentally sensitive industries (ESIs) and non-environmentally sensitive industries (NESIs) is significant. Further comparisons on the relationship between overall CSR disclosure and competitive advantage among state-owned enterprises, privately owned enterprises, ESIs and NESIs suggest that the relationship is negative. Research limitations/implications The study extends research of strategic CSR to signaling theory and competitive advantage. In particular, a research using IC as a proxy for competitive advantage is rare. It also contributes to the literature on competitive advantage and strategic CSR by examining the effects of both CSR disclosure and IC. Originality/value This paper provides evidence related to stakeholders’ reaction to managers’ various CSR strategies in China. The contribution of this study is that it confirms that different CSR initiatives have different effects on the competitiveness of enterprises in China.

scholarly journals Visual Temporal Acuity Is Related to Auditory Speech Perception Abilities in Cochlear Implant Users

2017 ◽  
Vol 38 (2) ◽  
pp. 236-243 ◽  
Author(s):  
Kelly N. Jahn ◽  
Ryan A. Stevenson ◽  
Mark T. Wallace
Keyword(s):  
Speech Perception ◽  
Cochlear Implant ◽  
Temporal Acuity ◽  
Auditory Speech
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