Midlife Speech Perception Deficits: Impact of Extended High-Frequency Hearing, Peripheral Neural Function, and Cognitive Abilities.

OBJECTIVES: The objectives of the present study were to investigate the effects of age-related changes in extended high-frequency (EHF) hearing, peripheral neural function, working memory, and executive function on speech perception deficits in middle-aged individuals with clinically normal hearing. DESIGN: We administered a comprehensive assessment battery to 37 participants spanning the age range of 20 to 56 years. This battery encompassed various evaluations, including standard and EHF pure-tone audiometry, ranging from 0.25 to 16 kHz. In addition, we conducted auditory brainstem response assessments with varying stimulation rates and levels, a spatial release from masking (SRM) task, and cognitive evaluations that involved the Trail Making test (TMT) for assessing executive function and the Abbreviated Reading Span test (ARST) for measuring working memory. RESULTS: The results indicated a decline in hearing sensitivities at EHFs and an increase in completion times for the TMT with age. In addition, as age increased, there was a corresponding decrease in the amount of SRM. The declines in SRM were associated with age-related declines in hearing sensitivity at EHFs and TMT performance. While we observed an age-related decline in wave I responses, this decline was primarily driven by age-related reductions in EHF thresholds. In addition, the results obtained using the ARST did not show an age-related decline. Neither the auditory brainstem response results nor ARST scores were correlated with the amount of SRM. CONCLUSIONS: These findings suggest that speech perception deficits in middle age are primarily linked to declines in EHF hearing and executive function, rather than cochlear synaptopathy or working memory.

Assessing subclinical hearing loss in musicians and nonmusicians using auditory brainstem responses and speech perception measures.

In this study, the physiological and perceptual correlates of auditory function in student musicians and nonmusicians with normal hearing thresholds were investigated. The measures involved were auditory brainstem responses as a function of stimulation rate, spatial release from masking, and word intensity rollover functions. The results indicated that as the stimulation rate was increased, the wave I amplitude reductions were more abrupt in musicians than in nonmusicians. However, no significant group differences were observed for speech tasks. There were also no significant correlations between the results of speech perception and the measures of peripheral neural function.

Differential Effects of Binaural Pitch Fusion Range on the Benefits of Voice Gender Differences in a "Cocktail Party" Environment for Bimodal and Bilateral Cochlear Implant Users.

OBJECTIVES: Some cochlear implant (CI) users are fitted with a CI in each ear ("bilateral"), while others have a CI in one ear and a hearing aid in the other ("bimodal"). Presently, evaluation of the benefits of bilateral or bimodal CI fitting does not take into account the integration of frequency information across the ears. This study tests the hypothesis that CI listeners, especially bimodal CI users, with a more precise integration of frequency information across ears ("sharp binaural pitch fusion") will derive greater benefit from voice gender differences in a multi-talker listening environment. DESIGN: Twelve bimodal CI users and twelve bilateral CI users participated. First, binaural pitch fusion ranges were measured using the simultaneous, dichotic presentation of reference and comparison stimuli (electric pulse trains for CI ears and acoustic tones for HA ears) in opposite ears, with reference stimuli fixed and comparison stimuli varied in frequency/electrode to find the range perceived as a single sound. Direct electrical stimulation was used in implanted ears through the research interface, which allowed selective stimulation of one electrode at a time, and acoustic stimulation was used in the non-implanted ears through the headphone. Second, speech-on-speech masking performance was measured to estimate masking release by voice gender difference between target and maskers (VGRM). The VGRM was calculated as the difference in speech recognition thresholds of target sounds in the presence of same-gender or different-gender maskers. RESULTS: Voice gender differences between target and masker talkers improved speech recognition performance for the bimodal CI group, but not the bilateral CI group. The bimodal CI users who benefited the most from voice gender differences were those who had the narrowest range of acoustic frequencies that fused into a single sound with stimulation from a single electrode from the CI in the opposite ear. There was no similar voice gender difference benefit of narrow binaural fusion range for the bilateral CI users. CONCLUSIONS: The findings suggest that broad binaural fusion reduces the acoustical information available for differentiating individual talkers in bimodal CI users, but not for bilateral CI users. In addition, for bimodal CI users with narrow binaural fusion who benefit from voice gender differences, bilateral implantation could lead to a loss of that benefit and impair their ability to selectively attend to one talker in the presence of multiple competing talkers. The results suggest that binaural pitch fusion, along with an assessment of residual hearing and other factors, could be important for assessing bimodal and bilateral CI users.

Factors underlying masking release by voice-gender differences and spatial separation cues in multi-talker listening environments in listeners with and without hearing loss.

Voice-gender differences and spatial separation are important cues for auditory object segregation. The goal of this study was to investigate the relationship of voice-gender difference benefit to the breadth of binaural pitch fusion, the perceptual integration of dichotic stimuli that evoke different pitches across ears, and the relationship of spatial separation benefit to localization acuity, the ability to identify the direction of a sound source. Twelve bilateral hearing aid (HA) users (age from 30 to 75 years) and eleven normal hearing (NH) listeners (age from 36 to 67 years) were tested in the following three experiments. First, speech-on-speech masking performance was measured as the threshold target-to-masker ratio (TMR) needed to understand a target talker in the presence of either same- or different-gender masker talkers. These target-masker gender combinations were tested with two spatial configurations (maskers co-located or 60° symmetrically spatially separated from the target) in both monaural and binaural listening conditions. Second, binaural pitch fusion range measurements were conducted using harmonic tone complexes around a 200-Hz fundamental frequency. Third, absolute localization acuity was measured using broadband (125-8000 Hz) noise and one-third octave noise bands centered at 500 and 3000 Hz. Voice-gender differences between target and maskers improved TMR thresholds for both listener groups in the binaural condition as well as both monaural (left ear and right ear) conditions, with greater benefit in co-located than spatially separated conditions. Voice-gender difference benefit was correlated with the breadth of binaural pitch fusion in the binaural condition, but not the monaural conditions, ruling out a role of monaural abilities in the relationship between binaural fusion and voice-gender difference benefits. Spatial separation benefit was not significantly correlated with absolute localization acuity. In addition, greater spatial separation benefit was observed in NH listeners than in bilateral HA users, indicating a decreased ability of HA users to benefit from spatial release from masking (SRM). These findings suggest that sharp binaural pitch fusion may be important for maximal speech perception in multi-talker environments for both NH listeners and bilateral HA users.

Effect of gap detection threshold and localisation acuity on spatial release from masking in older adults.

OBJECTIVE: The primary objective of this experiment was to measure the temporal and spatial processing capabilities of older individuals and use statistical models to identify the individual contributions of these temporal and spatial processing capabilities to spatial release from masking (SRM). DESIGN: Repeated measures. STUDY SAMPLE: Twenty-five older listeners with varying degrees of hearing loss participated in this experiment. SRM using the coordinate response measure, gap detection thresholds and localisation acuity for 1/3-octave-wide Gaussian noise bands centred at 500 and 4000 Hz were measured for all the listeners. RESULTS: Older listeners had better speech recognition thresholds when target and maskers were spatially separated as compared to when they were co-located. In addition, hearing loss and localisation acuity at 500 Hz were significant predictors in a multiple regression model predicting SRM. However, gap detection thresholds did not significantly contribute to the multiple regression model predicting SRM. CONCLUSION: Based on our data, we conclude that SRM at 30° spatial separation between the target and symmetric maskers is driven by the ability of the individuals to use interaural time difference cues.

Comparing Spatial Release From Masking Using Traditional Methods and Portable Automated Rapid Testing iPad App.

Purpose The purpose of this study was to compare speech identification abilities of individuals of various ages and hearing abilities using traditional methods and Portable Automated Rapid Testing (PART) iPad app. Method Speech identification data were collected using three techniques: over headphones using a virtual speaker array, using PART iPad app (UCR Brain Game Center, 2018), and using loudspeaker presentation in a sound-attenuated room. For all three techniques, Coordinate Response Measure sentences were used as the stimuli and "Charlie" was used as the call sign. A progressive tracking procedure was used to estimate the speech identification thresholds for listeners with varying hearing thresholds. The target sentence was always presented at 0° azimuth angle, whereas the maskers were colocated (0°) with the target or symmetrically spatially separated by ±15°, ±30°, or ±45°. Results Data analysis revealed similar speech identification thresholds for the iPad and headphone conditions and slightly poorer thresholds for the loudspeaker array condition across participant groups. This was true for all spatial separations between the target and the maskers. Conclusion Strong correlation between the headphone and iPad data presented in this study indicated that the spatial release from masking module in the PART iPad app can be used as a clinical tool to assess spatial processing ability prior to audiologic evaluation in the clinic and can also be used to make recommendations for and to track progress with aural rehabilitation programs over time.

Pilot Comparison of Adjustment Protocols of Personal Sound Amplification Products.

The Over-the-Counter Hearing Aid Act of 2017 was signed into law in August 2017 and facilitates the introduction of direct-to-consumer sales of hearing aids for adults with mild-to-moderate hearing loss. Among many questions surrounding over-the-counter sales is the ability of users to self-fit amplification. Many studies have conducted self-fitting procedures using guidance materials provided by audiologists. In this pilot, we explore the ability of users to self-adjust personal sound amplification devices using only materials provided by the manufacturer and contrast this with models that involve a hearing professional. Outcomes to assess adjustments included clinic-based speech-in-noise measures and ability to approximate NAL-NL2 prescriptive targets. We found that an audiologist-driven model provided the best outcomes. However, it is unknown if the difference is clinically meaningful.

The role of early and late reflections on spatial release from masking: Effects of age and hearing loss.

Early reflections have been linked to improved speech intelligibility, while later-arriving reverberant sound has been shown to limit speech understanding. Here, these effects were examined by artificially removing either early reflections or late reflections. Removing late reflections improved performance more for colocated than for spatially separated maskers. Results of a multiple regression analysis suggest that pure-tone average (PTA) is a significant predictor of spatial release from masking (SRM) in all acoustic conditions. Controlling for the effects of PTA, age is a significant predictor of SRM only when early reflections are absent.

Release from masking for small spatial separations: Effects of age and hearing loss.

Spatially separating target and masking speech can result in substantial spatial release from masking (SRM) for normal-hearing listeners. In this study, SRM was examined at eight spatial configurations of azimuth angle: maskers co-located with the target (0°) or symmetrically separated by 2°, 4°, 6°, 8°, 10°, 15°, or 30°. Results revealed that different listening groups (young normal-hearing, older normal-hearing, and older hearing-impaired) required different minimum amounts of spatial separation between target and maskers to achieve SRM. The results also indicated that aging was the contributing factor predicting SRM at smaller separations, whereas hearing loss was the contributing factor at larger separations.

Prior exposure to a reverberant listening environment improves speech intelligibility in adult cochlear implant listeners.

OBJECTIVES: The goal of this study is to investigate whether prior exposure to reverberant listening environment improves speech intelligibility of adult cochlear implant (CI) users. METHODS: Six adult CI users participated in this study. Speech intelligibility was measured in five different simulated reverberant listening environments with two different speech corpuses. Within each listening environment, prior exposure was varied by either having the same environment across all trials (blocked presentation) or having different environment from trial to trial (unblocked). RESULTS: Speech intelligibility decreased as reverberation time increased. Although substantial individual variability was observed, all CI listeners showed an increase in the blocked presentation condition as compared to the unblocked presentation condition for both speech corpuses. CONCLUSION: Prior listening exposure to a reverberant listening environment improves speech intelligibility in adult CI listeners. Further research is required to understand the underlying mechanism of adaptation to listening environment.

Enhancement of speech intelligibility in reverberant rooms: role of amplitude envelope and temporal fine structure.

The temporal envelope and fine structure of speech make distinct contributions to the perception of speech in normal-hearing listeners, and are differentially affected by room reverberation. Previous work has demonstrated enhanced speech intelligibility in reverberant rooms when prior exposure to the room was provided. Here, the relative contributions of envelope and fine structure cues to this intelligibility enhancement were tested using an open-set speech corpus and virtual auditory space techniques to independently manipulate the speech cues within a simulated room. Intelligibility enhancement was observed only when the envelope was reverberant, indicating that the enhancement is envelope-based.

Prior listening exposure to a reverberant room improves open-set intelligibility of high-variability sentences.

Previous studies have demonstrated that speech understanding in reverberant rooms improves when listeners are given prior exposure to the room. Results from these room-adaptation studies are limited, however, because they were conducted with materials that are not representative of the high acoustic variability observed in speech signals during everyday communication. Here, room adaptation effects were measured using an open-set speech corpus with high lexical and indexical variability and virtual auditory space techniques to simulate binaural listening in rooms. Room adaptation effects of comparable magnitude to previous studies were observed, suggesting general importance for facilitating speech intelligibility in reverberation.

Phonemic restoration effect reversed in a reverberant room.

Classic demonstrations of the phonemic restoration effect show increased intelligibility of interrupted speech when the interruptions are caused by a plausible masking sound rather than by silent periods. Previous studies of this effect have been conducted exclusively under anechoic or nearly anechoic listening conditions. This study demonstrates that the effect is reversed when sounds are presented in a realistically simulated reverberant room (broadband T(60) = 1.1 s): intelligibility is greater for silent interruptions than for interruptions by unmodulated noise. Additional results suggest that the reversal is primarily due to filling silent intervals with reverberant energy from the speech signal.