Time-adaptive Unsupervised Auditory Attention Decoding Using EEG-based Stimulus Reconstruction

The goal of auditory attention decoding (AAD) is to determine to which speaker out of multiple competing speakers a listener is attending based on the brain signals recorded via, e.g., electroencephalography (EEG). AAD algorithms are a fundamental building block of so-called neuro-steered hearing devices that would allow identifying the speaker that should be amplified based on the brain activity. A common approach is to train a subject-specific decoder that reconstructs the amplitude envelope of the attended speech signal. However, training this decoder requires a dedicated 'ground-truth' EEG recording of the subject under test, during which the attended speaker is known. Furthermore, this decoder remains fixed during operation and can thus not adapt to changing conditions and situations. Therefore, we propose an online time-adaptive unsupervised stimulus reconstruction method that continuously and automatically adapts over time when new EEG and audio data are streaming in. The adaptive decoder does not require ground-truth attention labels obtained from a training session with the end-user, and instead can be initialized with a generic subject-independent decoder or even completely random values. We propose two different implementations: a sliding window and recursive implementation, which we extensively validate based on multiple performance metrics on three independent datasets. We show that the proposed time-adaptive unsupervised decoder outperforms a time-invariant supervised decoder, representing an important step towards practically applicable AAD algorithms for neuro-steered hearing devices.

Molecular Pathways Modulating Sensory Hair Cell Regeneration in Adult Mammalian Cochleae: Progress and Perspectives

Noise-induced, drug-related, and age-related disabling hearing loss is a major public health problem and affect approximately 466 million people worldwide. In non-mammalian vertebrates, the death of sensory hair cells (HCs) induces the proliferation and transdifferentiation of adjacent supporting cells into new HCs; however, this capacity is lost in juvenile and adult mammalian cochleae leading to permanent hearing loss. At present, cochlear implants and hearing devices are the only available treatments and can help patients to a certain extent; however, no biological approach or FDA-approved drug is effective to treat disabling hearing loss and restore hearing. Recently, regeneration of mammalian cochlear HCs by modulating molecular pathways or transcription factors has offered some promising results, although the immaturity of the regenerated HCs remains the biggest concern. Furthermore, most of the research done is in neonates and not in adults. This review focuses on critically summarizing the studies done in adult mammalian cochleae and discusses various strategies to elucidate novel transcription factors for better therapeutics.

The Importance of Access to Bilateral Hearing through Cochlear Implants in Children

Children with hearing loss require early access to sound in both ears to support their development. In this article, we describe barriers to providing bilateral hearing and developmental consequences of delays during early sensitive periods. Barriers include late identification of hearing loss in one or both ears and delayed access to intervention with hearing devices such as cochlear implants. Effects of delayed bilateral input on the auditory pathways and brain are discussed as well as behavioral effects on speech perception and other developmental outcomes including language and academics. Evidence for these effects has supported an evolution in cochlear implant candidacy in children that was started with unilateral implantation in children with profound deafness bilaterally to bilateral implantation to implantation of children with asymmetric hearing loss including children with single-side deafness. Opportunities to enhance the developmental benefits of bilateral hearing in children with hearing loss are also discussed including efforts to improve binaural/spatial hearing and consideration of concurrent vestibular deficits which are common in children with hearing loss.

Dementia and hearing-aid use: a two-way street

Objectives: Hearing-aid use may reduce risk of dementia, but cognitive impairment makes hearing-aid use more challenging. These two causal pathways may both manifest as an association between reduced hearing-aid use and incident dementia. This study examined the effects of each pathway separately, through a unique combination of longitudinal data regarding hearing, general health, dementia diagnoses and continuity of HA use. Methods: Longitudinal health records data from 380,794 Veterans who obtained hearing aids from the US Veterans Affairs healthcare system were analysed. Analysis 1 (n=72,180) used logistic regression to model the likelihood of a dementia diagnosis at 3 year 6 months (3y6m) to 5 years post hearing-aid fitting for patients previously free of dementia and mild cognitive impairment (MCI). Analysis 2 (n=350,918) modelled the likelihood of being a persistent hearing aid user at 3y2m after fitting, contrasting subgroups with differing levels of cognitive function at the time of fitting. Models controlled for relevant predictors available in the dataset. Results: In analysis 1, the adjusted OR for incident dementia was 0.73 (ci 0.66-0.81) for persistent (vs. non persistent) hearing-aid users. In analysis 2, the adjusted OR for hearing-aid use persistence was 0.46 (ci 0.43-0.48) in those with pre-existing dementia (vs. those remaining free of MCI and dementia). Conclusion: The results indicate substantial effects from both causal pathways. Research studying protective effects of hearing-aid use against dementia needs to account for this. Clinically, hearing devices and hearing care processes must be accessible and usable for all, regardless of their level of cognitive function.

Facilitative Language Techniques Used in the Home by Caregivers of Young Children Who Are Deaf or Hard of Hearing

Purpose This research note reports preliminary data from an investigation of facilitative language techniques (FLTs) used in the natural environment by caregivers of children who are deaf or hard of hearing (DHH). The investigation seeks to establish a new method to collect and analyze data on caregiver FLT use in the home. Method This pilot investigation included two children under the age of 36 months with moderate-to-profound sensorineural hearing loss. Both children were consistent users of hearing devices and were pursing oral communication. Data were collected via the Language ENvironment Analysis (LENA) system in the participants' homes. Thirty-six 5-min segments containing the highest adult word count were extracted from each participant's sample. Researchers coded segments for the presence or absence of 10 FLTs within 30-s intervals. Results The collection, coding, and analysis of caregiver FLTs using LENA was a feasible method to investigate caregiver linguistic input in the natural environment. Despite differences in age, sex, and hearing level, the distribution of caregiver FLTs was similar for both participants. Caregivers used high levels of narration, closed-ended questions, and directives throughout the day. Conclusions Results of this investigation provide information about the types of FLTs that are used in the home by caregivers of young children who are DHH. Furthermore, results indicate the feasibility of this method to investigate in-home use of caregiver FLTs.

Evaluation and Management of Aural Atresia; Review Article

The absence of a patent ear canal, which can be acquired or congenital, is known as Aural Atresia. The most common cause of acquired Aural Atresia is an inflammatory response to trauma or otologic surgery. Although rare, acquired Aural Atresia is most commonly found after external ear trauma, such as car accidents, gunshot wounds, or recent otologic surgery. The main treatment of Aural Atresia is surgical, also the invention of bone anchored hearing devices provide greater alternative solution, each methods has its advantages of disadvantages, we hope In the future of developing more effective treatment options.