Sound source localization patterns and bilateral cochlear implants: Age at onset of deafness effects.

The ability to determine a sound's location is critical in everyday life. However, sound source localization is severely compromised for patients with hearing loss who receive bilateral cochlear implants (BiCIs). Several patient factors relate to poorer performance in listeners with BiCIs, associated with auditory deprivation, experience, and age. Critically, characteristic errors are made by patients with BiCIs (e.g., medial responses at lateral target locations), and the relationship between patient factors and the type of errors made by patients has seldom been investigated across individuals. In the present study, several different types of analysis were used to understand localization errors and their relationship with patient-dependent factors (selected based on their robustness of prediction). Binaural hearing experience is required for developing accurate localization skills, auditory deprivation is associated with degradation of the auditory periphery, and aging leads to poorer temporal resolution. Therefore, it was hypothesized that earlier onsets of deafness would be associated with poorer localization acuity and longer periods without BiCI stimulation or older age would lead to greater amounts of variability in localization responses. A novel machine learning approach was introduced to characterize the types of errors made by listeners with BiCIs, making them simple to interpret and generalizable to everyday experience. Sound localization performance was measured in 48 listeners with BiCIs using pink noise trains presented in free-field. Our results suggest that older age at testing and earlier onset of deafness are associated with greater average error, particularly for sound sources near the center of the head, consistent with previous research. The machine learning analysis revealed that variability of localization responses tended to be greater for individuals with earlier compared to later onsets of deafness. These results suggest that early bilateral hearing is essential for best sound source localization outcomes in listeners with BiCIs.

Binaural hearing in children using Gaussian enveloped and transposed tones.

Children who use bilateral cochlear implants (BiCIs) show significantly poorer sound localization skills than their normal hearing (NH) peers. This difference has been attributed, in part, to the fact that cochlear implants (CIs) do not faithfully transmit interaural time differences (ITDs) and interaural level differences (ILDs), which are known to be important cues for sound localization. Interestingly, little is known about binaural sensitivity in NH children, in particular, with stimuli that constrain acoustic cues in a manner representative of CI processing. In order to better understand and evaluate binaural hearing in children with BiCIs, the authors first undertook a study on binaural sensitivity in NH children ages 8-10, and in adults. Experiments evaluated sound discrimination and lateralization using ITD and ILD cues, for stimuli with robust envelope cues, but poor representation of temporal fine structure. Stimuli were spondaic words, Gaussian-enveloped tone pulse trains (100 pulse-per-second), and transposed tones. Results showed that discrimination thresholds in children were adult-like (15-389 µs for ITDs and 0.5-6.0 dB for ILDs). However, lateralization based on the same binaural cues showed higher variability than seen in adults. Results are discussed in the context of factors that may be responsible for poor representation of binaural cues in bilaterally implanted children.

Evidence for a neural source of the precedence effect in sound localization.

Normal-hearing human listeners and a variety of studied animal species localize sound sources accurately in reverberant environments by responding to the directional cues carried by the first-arriving sound rather than spurious cues carried by later-arriving reflections, which are not perceived discretely. This phenomenon is known as the precedence effect (PE) in sound localization. Despite decades of study, the biological basis of the PE remains unclear. Though the PE was once widely attributed to central processes such as synaptic inhibition in the auditory midbrain, a more recent hypothesis holds that the PE may arise essentially as a by-product of normal cochlear function. Here we evaluated the PE in a unique human patient population with demonstrated sensitivity to binaural information but without functional cochleae. Users of bilateral cochlear implants (CIs) were tested in a psychophysical task that assessed the number and location(s) of auditory images perceived for simulated source-echo (lead-lag) stimuli. A parallel experiment was conducted in a group of normal-hearing (NH) listeners. Key findings were as follows: 1) Subjects in both groups exhibited lead-lag fusion. 2) Fusion was marginally weaker in CI users than in NH listeners but could be augmented by systematically attenuating the amplitude of the lag stimulus to coarsely simulate adaptation observed in acoustically stimulated auditory nerve fibers. 3) Dominance of the lead in localization varied substantially among both NH and CI subjects but was evident in both groups. Taken together, data suggest that aspects of the PE can be elicited in CI users, who lack functional cochleae, thus suggesting that neural mechanisms are sufficient to produce the PE.

Comparing sound localization deficits in bilateral cochlear-implant users and vocoder simulations with normal-hearing listeners.

Bilateral cochlear-implant (BiCI) users are less accurate at localizing free-field (FF) sound sources than normal-hearing (NH) listeners. This performance gap is not well understood but is likely due to a combination of compromises in acoustic signal representation by the two independent speech processors and neural degradation of auditory pathways associated with a patient's hearing loss. To exclusively investigate the effect of CI speech encoding on horizontal-plane sound localization, the present study measured sound localization performance in NH subjects listening to vocoder processed and nonvocoded virtual acoustic space (VAS) stimuli. Various aspects of BiCI stimulation such as independently functioning devices, variable across-ear channel selection, and pulsatile stimulation were simulated using uncorrelated noise (Nu), correlated noise (N0), or Gaussian-enveloped tone (GET) carriers during vocoder processing. Additionally, FF sound localization in BiCI users was measured in the same testing environment for comparison. Distinct response patterns across azimuthal locations were evident for both listener groups and were analyzed using a multilevel regression analysis. Simulated implant speech encoding, regardless of carrier, was detrimental to NH localization and the GET vocoder best simulated BiCI FF performance in NH listeners. Overall, the detrimental effect of vocoder processing on NH performance suggests that sound localization deficits may persist even for BiCI patients who have minimal neural degradation associated with their hearing loss and indicates that CI speech encoding plays a significant role in the sound localization deficits experienced by BiCI users.

Spatial hearing benefits demonstrated with presentation of acoustic temporal fine structure cues in bilateral cochlear implant listeners.

Most contemporary cochlear implant (CI) processing strategies discard acoustic temporal fine structure (TFS) information, and this may contribute to the observed deficits in bilateral CI listeners' ability to localize sounds when compared to normal hearing listeners. Additionally, for best speech envelope representation, most contemporary speech processing strategies use high-rate carriers (≥900 Hz) that exceed the limit for interaural pulse timing to provide useful binaural information. Many bilateral CI listeners are sensitive to interaural time differences (ITDs) in low-rate (<300 Hz) constant-amplitude pulse trains. This study explored the trade-off between superior speech temporal envelope representation with high-rate carriers and binaural pulse timing sensitivity with low-rate carriers. The effects of carrier pulse rate and pulse timing on ITD discrimination, ITD lateralization, and speech recognition in quiet were examined in eight bilateral CI listeners. Stimuli consisted of speech tokens processed at different electrical stimulation rates, and pulse timings that either preserved or did not preserve acoustic TFS cues. Results showed that CI listeners were able to use low-rate pulse timing cues derived from acoustic TFS when presented redundantly on multiple electrodes for ITD discrimination and lateralization of speech stimuli.

Effect of mismatched place-of-stimulation on binaural fusion and lateralization in bilateral cochlear-implant users.

Bilateral cochlear implants (CIs) have provided some success in improving spatial hearing abilities to patients, but with large variability in performance. One reason for the variability is that there may be a mismatch in the place-of-stimulation arising from electrode arrays being inserted at different depths in each cochlea. Goupell et al. [(2013b). J. Acoust. Soc. Am. 133(4), 2272-2287] showed that increasing interaural mismatch led to non-fused auditory images and poor lateralization of interaural time differences in normal hearing subjects listening to a vocoder. However, a greater bandwidth of activation helped mitigate these effects. In the present study, the same experiments were conducted in post-lingually deafened bilateral CI users with deliberate and controlled interaural mismatch of single electrode pairs. Results show that lateralization was still possible with up to 3 mm of interaural mismatch, even when off-center, or multiple, auditory images were perceived. However, mismatched inputs are not ideal since it leads to a distorted auditory spatial map. Comparison of CI and normal hearing listeners showed that the CI data were best modeled by a vocoder using Gaussian-pulsed tones with 1.5 mm bandwidth. These results suggest that interaural matching of electrodes is important for binaural cues to be maximally effective.

Effect of mismatched place-of-stimulation on the salience of binaural cues in conditions that simulate bilateral cochlear-implant listening.

Although bilateral cochlear implantation has the potential to improve sound localization and speech understanding in noise, obstacles exist in presenting maximally useful binaural information to bilateral cochlear-implant (CI) users. One obstacle is that electrode arrays may differ in cochlear position by several millimeters, thereby stimulating different neural populations. Effects of interaural frequency mismatch on binaural processing were studied in normal-hearing (NH) listeners using band-limited pulse trains, thereby avoiding confounding factors that may occur in CI users. In experiment 1, binaural image fusion was measured to capture perceptual number, location, and compactness. Subjects heard a single, compact image on 73% of the trials. In experiment 2, intracranial image location was measured for different interaural time differences (ITDs) and interaural level differences (ILDs). For larger mismatch, locations perceptually shifted towards the ear with the higher carrier frequency. In experiment 3, ITD and ILD just-noticeable differences (JNDs) were measured. JNDs increased with decreasing bandwidth and increasing mismatch, but were always measurable up to 3 mm of mismatch. If binaural-hearing mechanisms are similar between NH and CI subjects, these results may explain reduced sensitivity of ITDs and ILDs in CI users. Large mismatches may lead to distorted spatial maps and reduced binaural image fusion.

Mapping procedures can produce non-centered auditory images in bilateral cochlear implantees.

Good localization accuracy depends on an auditory spatial map that provides consistent binaural information across frequency and level. This study investigated whether mapping bilateral cochlear implants (CIs) independently contributes to distorted perceptual spatial maps. In a meta-analysis, interaural level differences necessary to perceptually center sound images were calculated for 127 pitch-matched pairs of electrodes; many needed large current adjustments to be perceptually centered. In a separate experiment, lateralization was also found to be inconsistent across levels. These findings suggest that auditory spatial maps are distorted in the mapping process, which likely reduces localization accuracy and target-noise separation in bilateral CIs.

A psychophysical evaluation of near-field head-related transfer functions synthesized using a distance variation function.

A method for synthesizing near-field head-related transfer functions (HRTFs) from far-field HRTFs measured using an acoustic point-source of sound is presented. Near-field HRTFs are synthesized by applying an analytic function describing the change in the transfer function when the location of a sound source changes from the far-field to the near-field: the distance variation function (DVF). The DVF is calculated from a rigid sphere model and approximates the change in the frequency-dependent interaural level cues as a function of the change in sound source distance. Using a sound localization experiment, the fidelity of the near-field virtual auditory space (VAS) generated using this technique is compared to that obtained by simply adjusting the intensity of the VAS stimulus to simulate changes in distance. Results show improved distance perception for sounds at simulated distances of up to 60 cm using the DVF compared to simple intensity adjustment, while maintaining directional accuracy. The largest improvement for distance perception were for sound sources located to the side and within 40 cm. When intensity was removed as a cue for sound source distance from near-field sounds generated using the DVF, results showed some discrimination of sound source distances but, in general, distance perception accuracy was poor.