Cochlear-Implant Simulated Signal Degradation Exacerbates Listening Effort in Older Listeners.

OBJECTIVES: Individuals with cochlear implants (CIs) often report that listening requires high levels of effort. Listening effort can increase with decreasing spectral resolution, which occurs when listening with a CI, and can also increase with age. What is not clear is whether these factors interact; older CI listeners potentially experience even higher listening effort with greater signal degradation than younger CI listeners. This study used pupillometry as a physiological index of listening effort to examine whether age, spectral resolution, and their interaction affect listening effort in a simulation of CI listening. DESIGN: Fifteen younger normal-hearing listeners (ages 18 to 31 years) and 15 older normal-hearing listeners (ages 65 to 75 years) participated in this experiment; they had normal hearing thresholds from 0.25 to 4 kHz. Participants repeated sentences presented in quiet that were either unprocessed or vocoded, simulating CI listening. Stimuli frequency spectra were limited to below 4 kHz (to control for effects of age-related high-frequency hearing loss), and spectral resolution was decreased by decreasing the number of vocoder channels, with 32-, 16-, and 8-channel conditions. Behavioral speech recognition scores and pupil dilation were recorded during this task. In addition, cognitive measures of working memory and processing speed were obtained to examine if individual differences in these measures predicted changes in pupil dilation. RESULTS: For trials where the sentence was recalled correctly, there was a significant interaction between age and spectral resolution, with significantly greater pupil dilation in the older normal-hearing listeners for the 8- and 32-channel vocoded conditions. Cognitive measures did not predict pupil dilation. CONCLUSIONS: There was a significant interaction between age and spectral resolution, such that older listeners appear to exert relatively higher listening effort than younger listeners when the signal is highly degraded, with the largest effects observed in the eight-channel condition. The clinical implication is that older listeners may be at higher risk for increased listening effort with a CI.

Effect of experimentally introduced interaural frequency mismatch on sentence recognition in bilateral cochlear-implant listeners.

Bilateral cochlear-implant users experience interaural frequency mismatch because of asymmetries in array insertion and frequency-to-electrode assignment. To explore the acute perceptual consequences of such mismatch, sentence recognition in quiet was measured in nine bilateral cochlear-implant listeners as frequency allocations in the poorer ear were shifted by ±1.5, ±3, and ±4.5 mm using experimental programs. Shifts in frequency allocation >3 mm reduced bilateral sentence scores below those for the better ear alone, suggesting that the poorer ear interfered with better-ear perception. This was not a result of fewer active channels; deactivating electrodes without frequency shifting had minimal effect.

Effect of experimentally introduced interaural frequency mismatch on sentence recognition in bilateral cochlear-implant listeners.

Bilateral cochlear-implant users experience interaural frequency mismatch because of asymmetries in array insertion and frequency-to-electrode assignment. To explore the acute perceptual consequences of such mismatch, sentence recognition in quiet was measured in nine bilateral cochlear-implant listeners as frequency allocations in the poorer ear were shifted by ±1.5, ±3 and ±4.5 mm using experimental programs. Shifts in frequency allocation >3 mm were found to reduce bilateral sentence scores below those for the better ear alone, suggesting that the poorer ear interfered with better-ear perception. This was not a result of fewer active channels; deactivating electrodes without frequency shifting had minimal effect.

Behavioral Measures of Cochlear Gain Reduction Depend on Precursor Frequency, Bandwidth, and Level.

Sensory systems adjust to the environment to maintain sensitivity to change. In the auditory system, the medial olivocochlear reflex (MOCR) is a known physiological mechanism capable of such adjustment. The MOCR provides efferent feedback between the brainstem and cochlea, reducing cochlear gain in response to sound. The perceptual effects of the MOCR are not well understood, such as how gain reduction depends on elicitor characteristics in human listeners. Physiological and behavioral data suggest that ipsilateral MOCR tuning is only slightly broader than it is for afferent fibers, and that the fibers feed back to the frequency region of the cochlea that stimulated them. However, some otoacoustic emission (OAE) data suggest that noise is a more effective elicitor than would be consistent with sharp tuning, and that a broad region of the cochlea may be involved in elicitation. If the elicitor is processed in a cochlear channel centered at the signal frequency, the growth of gain reduction with elicitor level would be expected to depend on the frequency content of the elicitor. In the current study, the effects of the frequency content and level of a preceding sound (called a precursor) on signal threshold was examined. The results show that signal threshold increased with increasing precursor level at a shallower slope for a tonal precursor at the signal frequency than for a tonal precursor nearly an octave below the signal frequency. A broadband noise was only slightly more effective than a tone at the signal frequency, with a relatively shallow slope similar to that of the tonal precursor at the signal frequency. Overall, these results suggest that the excitation at the signal cochlear place, regardless of elicitor frequency, determines the magnitude of ipsilateral cochlear gain reduction, and that it increases with elicitor level.

Dichotic listening performance and effort as a function of spectral resolution and interaural symmetry.

One potential benefit of bilateral cochlear implants is reduced listening effort in speech-on-speech masking situations. However, the symmetry of the input across ears, possibly related to spectral resolution, could impact binaural benefits. Fifteen young adults with normal hearing performed digit recall with target and interfering digits presented to separate ears and attention directed to the target ear. Recall accuracy and pupil size over time (used as an index of listening effort) were measured for unprocessed, 16-channel vocoded, and 4-channel vocoded digits. Recall accuracy was significantly lower for dichotic (with interfering digits) than for monotic listening. Dichotic recall accuracy was highest when the target was less degraded and the interferer was more degraded. With matched target and interferer spectral resolution, pupil dilation was lower with more degradation. Pupil dilation grew more shallowly over time when the interferer had more degradation. Overall, interferer spectral resolution more strongly affected listening effort than target spectral resolution. These results suggest that interfering speech both lowers performance and increases listening effort, and that the relative spectral resolution of target and interferer affect the listening experience. Ignoring a clearer interferer is more effortful.

The relationship between ipsilateral cochlear gain reduction and speech-in-noise recognition at positive and negative signal-to-noise ratios.

Active mechanisms that regulate cochlear gain are hypothesized to influence speech-in-noise perception. However, evidence of a relationship between the amount of cochlear gain reduction and speech-in-noise recognition is mixed. Findings may conflict across studies because different signal-to-noise ratios (SNRs) were used to evaluate speech-in-noise recognition. Also, there is evidence that ipsilateral elicitation of cochlear gain reduction may be stronger than contralateral elicitation, yet, most studies have investigated the contralateral descending pathway. The hypothesis that the relationship between ipsilateral cochlear gain reduction and speech-in-noise recognition depends on the SNR was tested. A forward masking technique was used to quantify the ipsilateral cochlear gain reduction in 24 young adult listeners with normal hearing. Speech-in-noise recognition was measured with the PRESTO-R sentence test using speech-shaped noise presented at -3, 0, and +3 dB SNR. Interestingly, greater cochlear gain reduction was associated with lower speech-in-noise recognition, and the strength of this correlation increased as the SNR became more adverse. These findings support the hypothesis that the SNR influences the relationship between ipsilateral cochlear gain reduction and speech-in-noise recognition. Future studies investigating the relationship between cochlear gain reduction and speech-in-noise recognition should consider the SNR and both descending pathways.

Dichotic listening performance with cochlear-implant simulations of ear asymmetry is consistent with difficulty ignoring clearer speech.

There are an increasing number of bilateral and single-sided-deafness cochlear-implant (CI) users who hope to achieve improved spatial-hearing abilities through access to sound in both ears. It is, however, unclear how speech is processed when inputs are functionally asymmetrical, which may have an impact on spatial-hearing abilities. Therefore, functionally asymmetrical hearing was controlled and parametrically manipulated using a channel vocoder as a CI simulation. In Experiment 1, normal-hearing (NH) listeners performed a dichotic listening task (i.e., selective attention to one ear, ignoring the other) using asymmetrical signal degradation. Spectral resolution varied independently in each ear (4, 8, 16 channels, and unprocessed control). Performance decreased with decreasing resolution in the target ear and increasing resolution in the interferer ear. In Experiment 2, these results were replicated using a divided attention task (attend to both ears, report one after sentence completion) in both NH and bilateral CI listeners, although overall performance was lower than in Experiment 1. In Experiment 3, frequency-to-place mismatch simulated shallow CI insertion depths (0, 3, 6-mm shifts, and unprocessed control). Performance mostly decreased with increasing shift in the target ear and decreasing shift in the interferer ear; however, performance nonmonotonicities occurred. The worst performance occurred when the shift matched across ears, suggesting that pitch similarity increases difficulty. The results show that it is more difficult to attend an ear that is relatively degraded or distorted, which may set spatial-hearing limitations for CI users when trying to attend to a target in complex auditory scenes.

Psychoacoustic measurements of ipsilateral cochlear gain reduction as a function of signal frequency.

Forward masking experiments at 4 kHz have demonstrated that preceding sound can elicit changes in masking patterns consistent with a change in cochlear gain. However, the acoustic environment is filled with complex sounds, often dominated by lower frequencies, and ipsilateral cochlear gain reduction at frequencies below 4 kHz is largely unstudied in the forward masking literature. In this experiment, the magnitude of ipsilateral cochlear gain reduction was explored at 1, 2, and 4 kHz using forward masking techniques in an effort to evaluate a range of frequencies in listeners with normal hearing. Gain reduction estimates were not significantly different at 2 and 4 kHz using two forward masking measurements. Although the frequency was a significant factor in the analysis, post hoc testing supported the interpretation that gain reduction estimates measured without a masker were not significantly different at 1, 2, and 4 kHz. A second experiment provided evidence that forward masking in this paradigm at 1 kHz cannot be explained by excitation alone. This study provides evidence of ipsilateral cochlear gain reduction in humans at frequencies below the 4 kHz region.