Attenuation and distortion components of age-related hearing loss: Contributions to recognizing temporal-envelope filtered speech in modulated noise.

Older adults with hearing loss may experience difficulty recognizing speech in noise due to factors related to attenuation (e.g., reduced audibility and sensation levels, SLs) and distortion (e.g., reduced temporal fine structure, TFS, processing). Furthermore, speech recognition may improve when the amplitude modulation spectrum of the speech and masker are non-overlapping. The current study investigated this by filtering the amplitude modulation spectrum into different modulation rates for speech and speech-modulated noise. The modulation depth of the noise was manipulated to vary the SL of speech glimpses. Younger adults with normal hearing and older adults with normal or impaired hearing listened to natural speech or speech vocoded to degrade TFS cues. Control groups of younger adults were tested on all conditions with spectrally shaped speech and threshold matching noise, which reduced audibility to match that of the older hearing-impaired group. All groups benefitted from increased masker modulation depth and preservation of syllabic-rate speech modulations. Older adults with hearing loss had reduced speech recognition across all conditions. This was explained by factors related to attenuation, due to reduced SLs, and distortion, due to reduced TFS processing, which resulted in poorer auditory processing of speech cues during the dips of the masker.

Talker change detection by listeners varying in age and hearing loss.

Despite a vast literature on how speech intelligibility is affected by hearing loss and advanced age, remarkably little is known about the perception of talker-related information in these populations. Here, we assessed the ability of listeners to detect whether a change in talker occurred while listening to and identifying sentence-length sequences of words. Participants were recruited in four groups that differed in their age (younger/older) and hearing status (normal/impaired). The task was conducted in quiet or in a background of same-sex two-talker speech babble. We found that age and hearing loss had detrimental effects on talker change detection, in addition to their expected effects on word recognition. We also found subtle differences in the effects of age and hearing loss for trials in which the talker changed vs trials in which the talker did not change. These findings suggest that part of the difficulty encountered by older listeners, and by listeners with hearing loss, when communicating in group situations, may be due to a reduced ability to identify and discriminate between the participants in the conversation.

Sentence recognition with modulation-filtered speech segments for younger and older adults: Effects of hearing impairment and cognition.

This study investigated word recognition for sentences temporally filtered within and across acoustic-phonetic segments providing primarily vocalic or consonantal cues. Amplitude modulation was filtered at syllabic (0-8 Hz) or slow phonemic (8-16 Hz) rates. Sentence-level modulation properties were also varied by amplifying or attenuating segments. Participants were older adults with normal or impaired hearing. Older adult speech recognition was compared to groups of younger normal-hearing adults who heard speech unmodified or spectrally shaped with and without threshold matching noise that matched audibility to hearing-impaired thresholds. Participants also completed cognitive and speech recognition measures. Overall, results confirm the primary contribution of syllabic speech modulations to recognition and demonstrate the importance of these modulations across vowel and consonant segments. Group differences demonstrated a hearing loss-related impairment in processing modulation-filtered speech, particularly at 8-16 Hz. This impairment could not be fully explained by age or poorer audibility. Principal components analysis identified a single factor score that summarized speech recognition across modulation-filtered conditions; analysis of individual differences explained 81% of the variance in this summary factor among the older adults with hearing loss. These results suggest that a combination of cognitive abilities and speech glimpsing abilities contribute to speech recognition in this group.

Neural Presbyacusis in Humans Inferred from Age-Related Differences in Auditory Nerve Function and Structure.

A common complaint of older adults is difficulty understanding speech, particularly in challenging listening conditions. Accumulating evidence suggests that these difficulties may reflect a loss and/or dysfunction of auditory nerve (AN) fibers. We used a novel approach to study age-related changes in AN structure and several measures of AN function, including neural synchrony, in 58 older adults and 42 younger adults. AN activity was measured in response to an auditory click (compound action potential; CAP), presented at stimulus levels ranging from 70 to 110 dB pSPL. Poorer AN function was observed for older than younger adults across CAP measures at higher but not lower stimulus levels. Associations across metrics and stimulus levels were consistent with age-related AN disengagement and AN dyssynchrony. High-resolution T2-weighted structural imaging revealed age-related differences in the density of cranial nerve VIII, with lower density in older adults with poorer neural synchrony. Individual differences in neural synchrony were the strongest predictor of speech recognition, such that poorer synchrony predicted poorer recognition of time-compressed speech and poorer speech recognition in noise for both younger and older adults. These results have broad clinical implications and are consistent with an interpretation that age-related atrophy at the level of the AN contributes to poorer neural synchrony and may explain some of the perceptual difficulties of older adults.SIGNIFICANCE STATEMENT Differences in auditory nerve (AN) pathophysiology may contribute to the large variations in hearing and communication abilities of older adults. However, current diagnostics focus largely on the increase in detection thresholds, which is likely because of the absence of indirect measures of AN function in standard clinical test batteries. Using novel metrics of AN function, combined with estimates of AN structure and auditory function, we identified age-related differences across measures that we interpret to represent age-related reductions in AN engagement and poorer neural synchrony. Structure-function associations are consistent with an explanation of AN deficits that arise from age-related atrophy of the AN. Associations between neural synchrony and speech recognition suggest that individual and age-related deficits in neural synchrony contribute to speech recognition deficits.

Evidence for cortical adjustments to perceptual decision criteria during word recognition in noise.

Extensive increases in cingulo-opercular frontal activity are typically observed during speech recognition in noise tasks. This elevated activity has been linked to a word recognition benefit on the next trial, termed "adaptive control," but how this effect might be implemented has been unclear. The established link between perceptual decision making and cingulo-opercular function may provide an explanation for how those regions benefit subsequent word recognition. In this case, processes that support recognition such as raising or lowering the decision criteria for more accurate or faster recognition may be adjusted to optimize performance on the next trial. The current neuroimaging study tested the hypothesis that pre-stimulus cingulo-opercular activity reflects criterion adjustments that determine how much information to collect for word recognition on subsequent trials. Participants included middle-age and older adults (N = 30; age = 58.3 ± 8.8 years; m ± sd) with normal hearing or mild sensorineural hearing loss. During a sparse fMRI experiment, words were presented in multitalker babble at +3 dB or +10 dB signal-to-noise ratio (SNR), which participants were instructed to repeat aloud. Word recognition was significantly poorer with increasing participant age and lower SNR compared to higher SNR conditions. A perceptual decision-making model was used to characterize processing differences based on task response latency distributions. The model showed that significantly less sensory evidence was collected (i.e., lower criteria) for lower compared to higher SNR trials. Replicating earlier observations, pre-stimulus cingulo-opercular activity was significantly predictive of correct recognition on a subsequent trial. Individual differences showed that participants with higher criteria also benefitted the most from pre-stimulus activity. Moreover, trial-level criteria changes were significantly linked to higher versus lower pre-stimulus activity. These results suggest cingulo-opercular cortex contributes to criteria adjustments to optimize speech recognition task performance.

Glimpsing keywords across sentences in noise: A microstructural analysis of acoustic, lexical, and listener factors.

This study investigated how acoustic and lexical word-level factors and listener-level factors of auditory thresholds and cognitive-linguistic processing contribute to the microstructure of sentence recognition in unmodulated and speech-modulated noise. The modulation depth of the modulated masker was changed by expanding and compressing the temporal envelope to control glimpsing opportunities. Younger adults with normal hearing (YNH) and older adults with normal and impaired hearing were tested. A second group of YNH was tested under acoustically identical conditions to the hearing-impaired group, who received spectral shaping. For all of the groups, speech recognition declined and masking release increased for later keywords in the sentence, which is consistent with the word position decreases in the signal-to-noise ratio. The acoustic glimpse proportion and lexical word frequency of individual keywords predicted recognition under different noise conditions. For the older adults, better auditory thresholds and better working memory abilities facilitated sentence recognition. Vocabulary knowledge contributed more to sentence recognition for younger than for older adults. These results demonstrate that acoustic and lexical factors contribute to the recognition of individual words within a sentence, but relative contributions vary based on the noise modulation characteristics. Taken together, acoustic, lexical, and listener factors contribute to how individuals recognize keywords during sentences.

Sentence perception in noise by hearing-aid users predicted by syllable-constituent perception and the use of context.

Masked sentence perception by hearing-aid users is strongly correlated with three variables: (1) the ability to hear phonetic details as estimated by the identification of syllable constituents in quiet or in noise; (2) the ability to use situational context that is extrinsic to the speech signal; and (3) the ability to use inherent context provided by the speech signal itself. This approach is called "the syllable-constituent, contextual theory of speech perception" and is supported by the performance of 57 hearing-aid users in the identification of 109 syllable constituents presented in a background of 12-talker babble and the identification of words in naturally spoken sentences presented in the same babble. A simple mathematical model, inspired in large part by Boothroyd and Nittrouer [(1988). J. Acoust. Soc. Am. 84, 101-114] and Fletcher [Allen (1996) J. Acoust. Soc. Am. 99, 1825-1834], predicts sentence perception from listeners' abilities to recognize isolated syllable constituents and to benefit from context. When the identification accuracy of syllable constituents is greater than about 55%, individual differences in context utilization play a minor role in determining the sentence scores. As syllable-constituent scores fall below 55%, individual differences in context utilization play an increasingly greater role in determining sentence scores. Implications for hearing-aid design goals and fitting procedures are discussed.

Age effects on the contributions of envelope and periodicity cues to recognition of interrupted speech in quiet and with a competing talker.

Envelope and periodicity cues may provide redundant, additive, or synergistic benefits to speech recognition. The contributions of these cues may change under different listening conditions and may differ for younger and older adults. To address these questions, younger and older adults with normal hearing listened to interrupted sentences containing different combinations of envelope and periodicity cues in quiet and with a competing talker. Envelope and periodicity cues improved speech recognition for both groups, and their benefits were additive when both cues were available. Envelope cues were particularly important for older adults and for sentences with a competing talker.

Age effects on perceptual organization of speech: Contributions of glimpsing, phonemic restoration, and speech segregation.

In realistic listening environments, speech perception requires grouping together audible fragments of speech, filling in missing information, and segregating the glimpsed target from the background. The purpose of this study was to determine the extent to which age-related difficulties with these tasks can be explained by declines in glimpsing, phonemic restoration, and/or speech segregation. Younger and older adults with normal hearing listened to sentences interrupted with silence or envelope-modulated noise, presented either in quiet or with a competing talker. Older adults were poorer than younger adults at recognizing keywords based on short glimpses but benefited more when envelope-modulated noise filled silent intervals. Recognition declined with a competing talker but this effect did not interact with age. Results of cognitive tasks indicated that faster processing speed and better visual-linguistic closure were predictive of better speech understanding. Taken together, these results suggest that age-related declines in speech recognition may be partially explained by difficulty grouping short glimpses of speech into a coherent message.

Amplitude modulation detection with a short-duration carrier: Effects of a precursor and hearing loss.

This study tests the hypothesis that amplitude modulation (AM) detection will be better under conditions where basilar membrane (BM) response growth is expected to be linear rather than compressive. This hypothesis was tested by (1) comparing AM detection for a tonal carrier as a function of carrier level for subjects with and without cochlear hearing impairment (HI), and by (2) comparing AM detection for carriers presented with and without an ipsilateral notched-noise precursor, under the assumption that the precursor linearizes BM responses. Average AM detection thresholds were approximately 5 dB better for subjects with HI than for subjects with normal hearing (NH) at moderate-level carriers. Average AM detection for low-to-moderate level carriers was approximately 2 dB better with the precursor than without the precursor for subjects with NH, whereas precursor effects were absent or smaller for subjects with HI. Although effect sizes were small and individual differences were noted, group differences are consistent with better AM detection for conditions where BM responses are less compressive due to cochlear hearing loss or due to a reduction in cochlear gain. These findings suggest the auditory system may quickly adjust to the local soundscape to increase effective AM depth and improve signal-to-noise ratios.

Talker identification: Effects of masking, hearing loss, and age.

The ability to identify who is talking is an important aspect of communication in social situations and, while empirical data are limited, it is possible that a disruption to this ability contributes to the difficulties experienced by listeners with hearing loss. In this study, talker identification was examined under both quiet and masked conditions. Subjects were grouped by hearing status (normal hearing/sensorineural hearing loss) and age (younger/older adults). Listeners first learned to identify the voices of four same-sex talkers in quiet, and then talker identification was assessed (1) in quiet, (2) in speech-shaped, steady-state noise, and (3) in the presence of a single, unfamiliar same-sex talker. Both younger and older adults with hearing loss, as well as older adults with normal hearing, generally performed more poorly than younger adults with normal hearing, although large individual differences were observed in all conditions. Regression analyses indicated that both age and hearing loss were predictors of performance in quiet, and there was some evidence for an additional contribution of hearing loss in the presence of masking. These findings suggest that both hearing loss and age may affect the ability to identify talkers in "cocktail party" situations.

Cingulo-opercular activity affects incidental memory encoding for speech in noise.

Correctly understood speech in difficult listening conditions is often difficult to remember. A long-standing hypothesis for this observation is that the engagement of cognitive resources to aid speech understanding can limit resources available for memory encoding. This hypothesis is consistent with evidence that speech presented in difficult conditions typically elicits greater activity throughout cingulo-opercular regions of frontal cortex that are proposed to optimize task performance through adaptive control of behavior and tonic attention. However, successful memory encoding of items for delayed recognition memory tasks is consistently associated with increased cingulo-opercular activity when perceptual difficulty is minimized. The current study used a delayed recognition memory task to test competing predictions that memory encoding for words is enhanced or limited by the engagement of cingulo-opercular activity during challenging listening conditions. An fMRI experiment was conducted with twenty healthy adult participants who performed a word identification in noise task that was immediately followed by a delayed recognition memory task. Consistent with previous findings, word identification trials in the poorer signal-to-noise ratio condition were associated with increased cingulo-opercular activity and poorer recognition memory scores on average. However, cingulo-opercular activity decreased for correctly identified words in noise that were not recognized in the delayed memory test. These results suggest that memory encoding in difficult listening conditions is poorer when elevated cingulo-opercular activity is not sustained. Although increased attention to speech when presented in difficult conditions may detract from more active forms of memory maintenance (e.g., sub-vocal rehearsal), we conclude that task performance monitoring and/or elevated tonic attention supports incidental memory encoding in challenging listening conditions.

Simultaneous and forward masking of vowels and stop consonants: Effects of age, hearing loss, and spectral shaping.

Fluctuating noise, common in everyday environments, has the potential to mask acoustic cues important for speech recognition. This study examined the extent to which acoustic cues for perception of vowels and stop consonants differ in their susceptibility to simultaneous and forward masking. Younger normal-hearing, older normal-hearing, and older hearing-impaired adults identified initial and final consonants or vowels in noise-masked syllables that had been spectrally shaped. The amount of shaping was determined by subjects' audiometric thresholds. A second group of younger adults with normal hearing was tested with spectral shaping determined by the mean audiogram of the hearing-impaired group. Stimulus timing ensured that the final 10, 40, or 100 ms of the syllable occurred after the masker offset. Results demonstrated that participants benefited from short temporal delays between the noise and speech for vowel identification, but required longer delays for stop consonant identification. Older adults with normal and impaired hearing, with sufficient audibility, required longer delays to obtain performance equivalent to that of the younger adults. Overall, these results demonstrate that in forward masking conditions, younger listeners can successfully identify vowels during short temporal intervals (i.e., one unmasked pitch period), with longer durations required for consonants and for older adults.

Syllable-constituent perception by hearing-aid users: Common factors in quiet and noise.

The abilities of 59 adult hearing-aid users to hear phonetic details were assessed by measuring their abilities to identify syllable constituents in quiet and in differing levels of noise (12-talker babble) while wearing their aids. The set of sounds consisted of 109 frequently occurring syllable constituents (45 onsets, 28 nuclei, and 36 codas) spoken in varied phonetic contexts by eight talkers. In nominal quiet, a speech-to-noise ratio (SNR) of 40 dB, scores of individual listeners ranged from about 23% to 85% correct. Averaged over the range of SNRs commonly encountered in noisy situations, scores of individual listeners ranged from about 10% to 71% correct. The scores in quiet and in noise were very strongly correlated, R = 0.96. This high correlation implies that common factors play primary roles in the perception of phonetic details in quiet and in noise. Otherwise said, hearing-aid users' problems perceiving phonetic details in noise appear to be tied to their problems perceiving phonetic details in quiet and vice versa.

Cortical activity predicts which older adults recognize speech in noise and when.

Speech recognition in noise can be challenging for older adults and elicits elevated activity throughout a cingulo-opercular network that is hypothesized to monitor and modify behaviors to optimize performance. A word recognition in noise experiment was used to test the hypothesis that cingulo-opercular engagement provides performance benefit for older adults. Healthy older adults (N = 31; 50-81 years of age; mean pure tone thresholds <32 dB HL from 0.25 to 8 kHz, best ear; species: human) performed word recognition in multitalker babble at 2 signal-to-noise ratios (SNR = +3 or +10 dB) during a sparse sampling fMRI experiment. Elevated cingulo-opercular activity was associated with an increased likelihood of correct recognition on the following trial independently of SNR and performance on the preceding trial. The cingulo-opercular effect increased for participants with the best overall performance. These effects were lower for older adults compared with a younger, normal-hearing adult sample (N = 18). Visual cortex activity also predicted trial-level recognition for the older adults, which resulted from discrete decreases in activity before errors and occurred for the oldest adults with the poorest recognition. Participants demonstrating larger visual cortex effects also had reduced fractional anisotropy in an anterior portion of the left inferior frontal-occipital fasciculus, which projects between frontal and occipital regions where activity predicted word recognition. Together, the results indicate that older adults experience performance benefit from elevated cingulo-opercular activity, but not to the same extent as younger adults, and that declines in attentional control can limit word recognition.

Effects of age and hearing loss on concurrent vowel identification.

Differences in formant frequencies and fundamental frequencies (F0) are important cues for segregating and identifying two simultaneous vowels. This study assessed age- and hearing-loss-related changes in the use of these cues for recognition of one or both vowels in a pair and determined differences related to vowel identity and specific vowel pairings. Younger adults with normal hearing, older adults with normal hearing, and older adults with hearing loss listened to different-vowel and identical-vowel pairs that varied in F0 differences. Identification of both vowels as a function of F0 difference revealed that increased age affects the use of F0 and formant difference cues for different-vowel pairs. Hearing loss further reduced the use of these cues, which was not attributable to lower vowel sensation levels. High scores for one vowel in the pair and no effect of F0 differences suggested that F0 cues are important only for identifying both vowels. In contrast to mean scores, widely varying differences in effects of F0 cues, age, and hearing loss were observed for particular vowels and vowel pairings. These variations in identification of vowel pairs were not explained by acoustical models based on the location and level of formants within the two vowels.

Effects of age and hearing loss on overshoot.

The detection of a brief, sinusoidal probe in a long broadband, simultaneous masker improves as the probe is delayed from the masker's onset. This improvement ("overshoot") may be mediated by a reduction in cochlear amplifier gain over the timecourse of the masker via the medial olivocochlear (MOC) reflex. Overshoot was measured in younger adults with normal hearing and in older adults with normal and impaired hearing to test the hypothesis that aging and cochlear hearing loss result in abnormal overshoot, consistent with changes in certain structures along the MOC pathway. Overshoot decreased with increasing quiet probe thresholds and was only minimally influenced by increasing age. Marked individual differences in overshoot were observed due to differences in masking thresholds for probes presented near the masker's onset. Model simulations support the interpretation that reduced overshoot in hearing-impaired listeners is due to limited cochlear amplifier gain and therefore less gain to adjust over the timecourse of the masker. Similar overshoot among younger and older adults with normal hearing suggests that age-related changes to mechanisms underlying overshoot do not result in significant differences in overshoot among younger and older adults with normal hearing.

Cingulo-Opercular Function During Word Recognition in Noise for Older Adults with Hearing Loss.

BACKGROUND/STUDY CONTEXT: Adaptive control, reflected by elevated activity in cingulo-opercular brain regions, optimizes performance in challenging tasks by monitoring outcomes and adjusting behavior. For example, cingulo-opercular function benefits trial-level word recognition in noise for normal-hearing adults. Because auditory system deficits may limit the communicative benefit from adaptive control, we examined the extent to which cingulo-opercular engagement supports word recognition in noise for older adults with hearing loss (HL). METHODS: Participants were selected to form groups with Less HL (n = 12; mean pure tone threshold, pure tone average [PTA] = 19.2 ± 4.8 dB HL [hearing level]) and More HL (n = 12; PTA = 38.4 ± 4.5 dB HL, 0.25-8 kHz, both ears). A word recognition task was performed with words presented in multitalker babble at +3 or +10 dB signal-to-noise ratios (SNRs) during a sparse acquisition fMRI experiment. The participants were middle-aged and older (ages: 64.1 ± 8.4 years) English speakers with no history of neurological or psychiatric diagnoses. RESULTS: Elevated cingulo-opercular activity occurred with increased likelihood of correct word recognition on the next trial (t(23) = 3.28, p = .003), and this association did not differ between hearing loss groups. During trials with word recognition errors, the More HL group exhibited higher blood oxygen level-dependent (BOLD) contrast in occipital and parietal regions compared with the Less HL group. Across listeners, more pronounced cingulo-opercular activity during recognition errors was associated with better overall word recognition performance. CONCLUSION: The trial-level word recognition benefit from cingulo-opercular activity was equivalent for both hearing loss groups. When speech audibility and performance levels are similar for older adults with mild to moderate hearing loss, cingulo-opercular adaptive control contributes to word recognition in noise.

Task-Related Vigilance During Word Recognition in Noise for Older Adults with Hearing Loss.

BACKGROUND/STUDY CONTEXT: Vigilance refers to the ability to sustain and adapt attentional focus in response to changing task demands. For older adults with hearing loss, vigilant listening may be particularly effortful and variable across individuals. This study examined the extent to which neural responses to sudden, unexpected changes in task structure (e.g., from rest to word recognition epochs) were related to pupillometry measures of listening effort. METHODS: Individual differences in the task-evoked pupil response during word recognition were used to predict functional magnetic resonance imaging (MRI) estimates of neural responses to salient transitions between quiet rest, noisy rest, and word recognition in unintelligible, fluctuating background noise. Participants included 29 older adults (M = 70.2 years old) with hearing loss (pure tone average across all frequencies = 36.1 dB HL [hearing level], SD = 6.7). RESULTS: Individuals with a greater average pupil response exhibited a more vigilant pattern of responding on a standardized continuous performance test (response time variability across varying interstimulus intervals r(27) = .38, p = .04). Across participants there was widespread engagement of attention- and sensory-related cortices in response to transitions between blocks of rest and word recognition conditions. Individuals who exhibited larger task-evoked pupil dilation also showed even greater activity in the right primary auditory cortex in response to changes in task structure. CONCLUSION: Pupillometric estimates of word recognition effort predicted variation in activity within cortical regions that were responsive to salient changes in the environment for older adults with hearing loss. The results of the current study suggest that vigilant attention is increased amongst older adults who exert greater listening effort.

Sentence intelligibility during segmental interruption and masking by speech-modulated noise: Effects of age and hearing loss.

This study investigated how single-talker modulated noise impacts consonant and vowel cues to sentence intelligibility. Younger normal-hearing, older normal-hearing, and older hearing-impaired listeners completed speech recognition tests. All listeners received spectrally shaped speech matched to their individual audiometric thresholds to ensure sufficient audibility with the exception of a second younger listener group who received spectral shaping that matched the mean audiogram of the hearing-impaired listeners. Results demonstrated minimal declines in intelligibility for older listeners with normal hearing and more evident declines for older hearing-impaired listeners, possibly related to impaired temporal processing. A correlational analysis suggests a common underlying ability to process information during vowels that is predictive of speech-in-modulated noise abilities. Whereas, the ability to use consonant cues appears specific to the particular characteristics of the noise and interruption. Performance declines for older listeners were mostly confined to consonant conditions. Spectral shaping accounted for the primary contributions of audibility. However, comparison with the young spectral controls who received identical spectral shaping suggests that this procedure may reduce wideband temporal modulation cues due to frequency-specific amplification that affected high-frequency consonants more than low-frequency vowels. These spectral changes may impact speech intelligibility in certain modulation masking conditions.