Cochlear implantation restores cortical processing for spatial hearing in asymmetric hearing loss

In asymmetric hearing loss (AHL), the normal pattern of contralateral hemispheric dominance for monaural stimulation is modified, with a shift towards the hemisphere ipsilateral to the better ear. The extent of this shift has been shown to relate to sound localisation deficits. In this study, we examined whether cochlear implantation to treat AHL can restore the normal functional pattern of auditory cortical activity and whether this relates to improved sound localisation. We recruited 10 subjects with a cochlear implant for AHL (AHL-CI) and 10 normally-hearing controls. The participants performed a voice/non-voice discrimination task with binaural and monaural presentation of the sounds, and the cortical activity was measured using positron emission tomography (PET) brain imaging with a H215O tracer. The auditory cortical activity was found to be lower in the AHL-CI participants for all of the conditions. A cortical asymmetry index was calculated and showed that a normal contralateral dominance was restored in the AHL-CI patients for the non-implanted ear, but not for the ear with the cochlear implant. It was found that the contralateral dominance for the non-implanted ear strongly correlated with sound localisation performance (rho = 0.8, p < 0.05). We conclude that the restoration of binaural mechanisms in AHL-CI subjects reverses the abnormal lateralisation pattern induced by the deafness, and that this leads to improved spatial hearing. Our results suggest that cochlear implantation fosters the rehabilitation of binaural excitatory/inhibitory cortical interactions, which could enable the reconstruction of the auditory spatial selectivity needed for sound localisation.

Short-term outcomes of cochlear implantation for single-sided deafness compared to bone conduction devices and contralateral routing of sound hearing aids—Results of a Randomised controlled trial (CINGLE-trial)

Single-sided deafness (SSD) leads to difficulties with speech perception in noise, sound localisation, and sometimes tinnitus. Current treatments (Contralateral Routing of Sound hearing aids (CROS) and Bone Conduction Devices (BCD)) do not sufficiently overcome these problems. Cochlear implants (CIs) may help. Our aim was to evaluate these treatments in a Randomised Controlled Trial (RCT). Adult SSD patients were randomised using a web-based randomisation tool into one of three groups: CI; trial period of ‘first BCD, then CROS’; trial period of ‘first CROS, then BCD’. After these trial periods, patients opted for BCD, CROS, or No treatment. The primary outcome was speech perception in noise (directed from the front (S0N0)). Secondary outcomes were speech perception in noise with speech directed to the poor ear and noise to the better ear (SpeNbe) and vice versa (SbeNpe), sound localisation, tinnitus burden, and disease-specific quality of life (QoL). We described results at baseline (unaided situation) and 3 and 6 months after device activation. 120 patients were randomised. Seven patients did not receive the allocated intervention. The number of patients per group after allocation was: CI (n = 28), BCD (n = 25), CROS (n = 34), and No treatment (n = 26). In S0N0, the CI group performed significantly better when compared to baseline, and when compared to the other groups. In SpeNbe, there was an advantage for all treatment groups compared to baseline. However, in SbeNpe, BCD and CROS groups performed worse compared to baseline, whereas the CI group improved. Only in the CI group sound localisation improved and tinnitus burden decreased. In general, all treatment groups improved on disease-specific QoL compared to baseline. This RCT demonstrates that cochlear implantation for SSD leads to improved speech perception in noise, sound localisation, tinnitus burden, and QoL after 3 and 6 months of follow-up. For most outcome measures, CI outperformed BCD and CROS. Trial registration: Netherlands Trial Register (www.trialregister.nl): NTR4580, CINGLE-trial.

Applicability of MEMS microphones for environmental sound level monitoring

This paper explores the challenges associated with the integration of MEMS microphone technology into IEC 61672 classified or type-approved environmental sound level monitors. A comparison is drawn between MEMS microphones and electret condenser capsule microphones to highlight key performance differences within the technologies, and a basic integration method for both technologies is suggested. A review of the IEC 61672 and type-approval standards is conducted against the suggested integration method for a MEMS microphone; key shortcomings are reported and objectively reviewed. Development trends for MEMS microphones are explored, providing key insights into the progression of the technology against electret condenser capsule microphones. Furthermore, the evolution of environmental sound level monitoring systems is explored with a key focus on networked and sound localisation technology. The importance of MEMS microphones within the evolution of environmental sound level monitoring systems is presented alongside key arguments for the practical suitability of MEMS technology over electret condenser capsule technology.

Neurophysiology goes wild: from exploring sensory coding in sound proof rooms to natural environments

To perform adaptive behaviours, animals have to establish a representation of the physical “outside” world. How these representations are created by sensory systems is a central issue in sensory physiology. This review addresses the history of experimental approaches toward ideas about sensory coding, using the relatively simple auditory system of acoustic insects. I will discuss the empirical evidence in support of Barlow’s “efficient coding hypothesis”, which argues that the coding properties of neurons undergo specific adaptations that allow insects to detect biologically important acoustic stimuli. This hypothesis opposes the view that the sensory systems of receivers are biased as a result of their phylogeny, which finally determine whether a sound stimulus elicits a behavioural response. Acoustic signals are often transmitted over considerable distances in complex physical environments with high noise levels, resulting in degradation of the temporal pattern of stimuli, unpredictable attenuation, reduced signal-to-noise levels, and degradation of cues used for sound localisation. Thus, a more naturalistic view of sensory coding must be taken, since the signals as broadcast by signallers are rarely equivalent to the effective stimuli encoded by the sensory system of receivers. The consequences of the environmental conditions for sensory coding are discussed.

Bone-anchored hearing system, contralateral routing of signals hearing aid or cochlear implant: what is best in single-sided deafness?

Purpose The aim of the study was to compare long-term results after 1 year in patients with single-sided deafness (SSD) who were fitted with different hearing aids. The participants tested contralateral routing of signals (CROS) hearing aids and bone-anchored hearing systems (BAHS). They were also informed about the possibility of a cochlear implant (CI) and chose one of the three devices. We also investigated which factors influenced the choice of device. Methods Prospective study with 89 SSD participants who were divided into three groups by choosing BAHS, CROS, or CI. All participants received test batteries with both objective hearing tests (speech perception in noise and sound localisation) and subjective questionnaires. Results 16 participants opted for BAHS-, 13 for CROS- and 30 for CI-treatment. The greater the subjective impairment caused by SSD, the more likely patients were to opt for surgical treatment (BAHS or CI). The best results in terms of speech perception in noise (especially when sound reaches the deaf ear and noise the hearing ear), sound localization, and subjective results were achieved with CI. Conclusion The best results regarding the therapy of SSD are achieved with a CI, followed by BAHS. This was evident both in objective tests and in the subjective questionnaires. Nevertheless, an individual decision is required in each case as to which SSD therapy option is best for the patient. Above all, the patient's subjective impairment and expectations should be included in the decision-making process.

A Biologically Inspired Sound Localisation System Using a Silicon Cochlea Pair

We present a biologically inspired sound localisation system for reverberant environments using the Cascade of Asymmetric Resonators with Fast-Acting Compression (CAR-FAC) cochlear model. The system exploits a CAR-FAC pair to pre-process binaural signals that travel through the inherent delay line of the cascade structures, as each filter acts as a delay unit. Following the filtering, each cochlear channel is cross-correlated with all the channels of the other cochlea using a quantised instantaneous correlation function to form a 2-D instantaneous correlation matrix (correlogram). The correlogram contains both interaural time difference and spectral information. The generated correlograms are analysed using a regression neural network for localisation. We investigate the effect of the CAR-FAC nonlinearity on the system performance by comparing it with a CAR only version. To verify that the CAR/CAR-FAC and the quantised instantaneous correlation provide a suitable basis with which to perform sound localisation tasks, a linear regression, an extreme learning machine, and a convolutional neural network are trained to learn the azimuthal angle of the sound source from the correlogram. The system is evaluated using speech data recorded in a reverberant environment. We compare the performance of the linear CAR and nonlinear CAR-FAC models with current sound localisation systems as well as with human performance.

Towards modelling active sound localisation based on Bayesian inference in a static environment

Over the decades, Bayesian statistical inference has become a staple technique for modelling human multisensory perception. Many studies have successfully shown how sensory and prior information can be combined to optimally interpret our environment. Because of the multiple sound localisation cues available in the binaural signal, sound localisation models based on Bayesian inference are a promising way of explaining behavioural human data. An interesting aspect is the consideration of dynamic localisation cues obtained through self-motion. Here we provide a review of the recent developments in modelling dynamic sound localisation with a particular focus on Bayesian inference. Further, we describe a theoretical Bayesian framework capable to model dynamic and active listening situations in humans in a static auditory environment. In order to demonstrate its potential in future implementations, we provide results from two examples of simplified versions of that framework.