Recovery from forward masking in elderly cochlear implant users.

OBJECTIVE: To compare temporal aspects of peripheral neural responses and central auditory perception between groups of younger adult and elderly cochlear implant users. STUDY DESIGN: Cohort study. SETTING: Academic hospital and cochlear implant center. PATIENTS: Adult cochlear implant users aged 28 to 57 years in the younger group (n = 5) and 61 to 89 years (n = 9) in the elderly group. All subjects used Advanced Bionics devices. INTERVENTION: Diagnostic. MAIN OUTCOME MEASURES: Time constants of neural (i.e., electrically evoked compound action potentials [ECAPs]) and perceptual recovery from forward masking. Interstimulus intervals (ISIs) were varied in both experiments. RESULTS: ECAP recovery rates were equivalent between groups, and no correlation was found between ECAP recovery and age. No correlations were found between ECAP recovery and speech perception. Psychophysical recovery was significantly slower in the elderly compared with the younger subjects (p < 0.0005), with a significant effect of age (R2 = 0.70, p < 0.0005). At the longest ISI (240 ms), elderly subjects experienced a mean maximum threshold shift of 35.2% (relative to 1 ms ISI) versus 14.8% for younger subjects. There was a significant positive relationship between psychophysical recovery and consonant-nucleus-consonant word scores (R2 = 0.62, p < 0.001), although no relationship was found with Hearing in Noise Test sentences. CONCLUSION: These findings suggest that difficulties observed in speech perception by elderly CI users may be due to age-related changes in the central rather than peripheral auditory system. With further study, these results may provide information to allow clinicians to assess patients' temporal processing abilities and facilitate setting program parameters that will maximize their auditory perceptual experience with a cochlear implant.

Aging and cortical mechanisms of speech perception in noise.

Spoken language processing in noisy environments, a hallmark of the human brain, is subject to age-related decline, even when peripheral hearing might be intact. The present study examines the cortical cerebral hemodynamics (measured by fMRI) associated with such processing in the aging brain. Younger and older subjects identified single words in quiet and in two multi-talker babble noise conditions (SNR 20 and -5dB). Behaviorally, older and younger subjects did not show significant differences in the first two conditions but older adults performed less accurately in the SNR -5 condition. The fMRI results showed reduced activation in the auditory cortex but an increase in working memory and attention-related cortical areas (prefrontal and precuneus regions) in older subjects, especially in the SNR -5 condition. Increased cortical activities in general cognitive regions were positively correlated with behavioral performance in older listeners, suggestive of a compensatory strategy. Furthermore, inter-regional correlation revealed that while younger subjects showed a more streamlined cortical network of auditory regions in response to spoken word processing in noise, older subjects showed a more diffused network involving frontal and ventral brain regions. These results are consistent with the decline-compensation hypothesis, suggestive of its applicability to the auditory domain.