Auditory Acclimatization to Bilateral Hearing Aids: Effects on Sentence-in-Noise Processing Times and Speech-Evoked Potentials.

OBJECTIVES: Using a longitudinal design, the present study sought to substantiate indications from two previous cross-sectional studies that hearing aid (HA) experience leads to improved speech processing abilities as quantified using eye-gaze measurements. Another aim was to explore potential concomitant changes in event-related potentials (ERPs) to speech stimuli. DESIGN: Groups of elderly novice (novHA) and experienced (expHA) HA users matched in terms of age and working memory capacity participated. The novHA users were acclimatized to bilateral HA fittings for up to 24 weeks. The expHA users continued to use their own HAs during the same period. The participants' speech processing abilities were assessed after 0 weeks (novHA: N = 16; expHA: N = 14), 12 weeks (novHA: N = 16; expHA: N = 14), and 24 weeks (N = 10 each). To that end, an eye-tracking paradigm was used for estimating how quickly the participants could grasp the meaning of sentences presented against background noise together with two similar pictures that either correctly or incorrectly depicted the meaning conveyed by the sentences (the "processing time"). Additionally, ERPs were measured with an active oddball paradigm requiring the participants to categorize word stimuli as living (targets) or nonliving (nontargets) entities. For all measurements, the stimuli were spectrally shaped according to individual real-ear insertion gains and presented via earphones. RESULTS: Concerning the processing times, no changes across time were found for the expHA group. After 0 weeks of HA use, the novHA group had significantly longer (poorer) processing times than the expHA group, consistent with previous findings. After 24 weeks, a significant mean improvement of ~30% was observed for the novHA users, leading to a performance comparable with that of the expHA group. Concerning the ERPs, no changes across time were found. CONCLUSIONS: The results from this exploratory study are consistent with the view that auditory acclimatization to HAs positively impacts speech comprehension in noise. Further research is needed to substantiate them.

Exploring Differences in Speech Processing Among Older Hearing-Impaired Listeners With or Without Hearing Aid Experience: Eye-Tracking and fMRI Measurements.

Recently, evidence has been accumulating that untreated hearing loss can lead to neurophysiological changes that affect speech processing abilities in noise. To shed more light on how aiding may impact these effects, this study explored the influence of hearing aid (HA) experience on the cognitive processes underlying speech comprehension. Eye-tracking and functional magnetic resonance imaging (fMRI) measurements were carried out with acoustic sentence-in-noise (SiN) stimuli complemented by pairs of pictures that either correctly (target picture) or incorrectly (competitor picture) depicted the sentence meanings. For the eye-tracking measurements, the time taken by the participants to start fixating the target picture (the 'processing time') was measured. For the fMRI measurements, brain activation inferred from blood-oxygen-level dependent responses following sentence comprehension was measured. A noise-only condition was also included. Groups of older hearing-impaired individuals matched in terms of age, hearing loss, and working memory capacity with (eHA; N = 13) or without (iHA; N = 14) HA experience participated. All acoustic stimuli were presented via earphones with individual linear amplification to ensure audibility. Consistent with previous findings, the iHA group had significantly longer (poorer) processing times than the eHA group, despite no differences in speech recognition performance. Concerning the fMRI measurements, there were indications of less brain activation in some right frontal areas for SiN relative to noise-only stimuli in the eHA group compared to the iHA group. Together, these results suggest that HA experience leads to faster speech-in-noise processing, possibly related to less recruitment of brain regions outside the core sentence-comprehension network. Follow-up research is needed to substantiate the findings related to changes in cortical speech processing with HA use.

Are Experienced Hearing Aid Users Faster at Grasping the Meaning of a Sentence Than Inexperienced Users? An Eye-Tracking Study.

This study assessed the effects of hearing aid (HA) experience on how quickly a participant can grasp the meaning of an acoustic sentence-in-noise stimulus presented together with two similar pictures that either correctly (target) or incorrectly (competitor) depict the meaning conveyed by the sentence. Using an eye tracker, the time taken by the participant to start fixating the target (the processing time) was measured for two levels of linguistic complexity (low vs. high) and three HA conditions: clinical linear amplification (National Acoustic Laboratories-Revised), single-microphone noise reduction with National Acoustic Laboratories-Revised, and linear amplification ensuring a sensation level of ≥ 15 dB up to at least 4 kHz for the speech material used here. Timed button presses to the target stimuli after the end of the sentences (offline reaction times) were also collected. Groups of experienced (eHA) and inexperienced (iHA) HA users matched in terms of age, hearing loss, and working memory capacity took part (N = 15 each). For the offline reaction times, no effects were found. In contrast, processing times increased with linguistic complexity. Furthermore, for all HA conditions, processing times were longer (poorer) for the iHA group than for the eHA group, despite comparable speech recognition performance. Taken together, these results indicate that processing times are more sensitive to speech processing-related factors than offline reaction times. Furthermore, they support the idea that HA experience positively impacts the ability to process noisy speech quickly, irrespective of the precise gain characteristics.