Binaural Integration of Spectrally Degraded Speech in Adult Cochlear Implant Recipients with Single-Sided Deafness.

INTRODUCTION: Our purpose was to investigate binaural integration for spectrally degraded speech in normal-hearing (NH) subjects, single-sided deafness (SSD) cochlear implant (CI) recipients, and bilateral deaf bilateral CI recipients. METHODS: We tested ten adult subjects in each group with a modified version of the binaural fusion test according to Matzker. Speech recognition was assessed for monotic listening with the better-hearing ear or CI, monotic listening with the poorer-hearing ear or CI, and dichotic listening. We employed two presentation modes: (1) low pass (LP)-filtered speech to the better ear or CI and high pass (HP)-filtered speech to the poorer ear or CI, and (2) LP-filtered speech to the poorer ear or CI and HP-filtered speech to the better ear or CI. Five magnitudes of LP and HP filtering, i.e., spectral degradation, for each presentation mode were applied yielding two spectrally overlapping and three nonoverlapping presentation conditions. Sentences from the Oldenburg Children's sentence test were applied to assess speech recognition. RESULTS: NH subjects, SSD CI recipients, and bilateral CI recipients were able to understand spectrally degraded speech under both monotic and dichotic listening conditions for both the presentation modes. Speech performance decreased with the increasing loss of spectral information in all the three subject groups. In the NH subjects, speech recognition scores significantly improved for dichotic compared with each monotic listening type under two spectrally nonoverlapping conditions. The SSD CI subjects showed a significant improvement in speech scores for dichotic listening compared with monotic listening with the NH ear under one nonoverlapping condition, i.e., a dichotic benefit in speech recognition with CI. We saw a dichotic benefit in the bilateral CI recipients who achieved significantly better speech scores for dichotic compared with monotic listening with the better CI in three nonoverlapping conditions. CONCLUSIONS: All the three groups (NH subjects, SSD CI recipients, and BiCI recipients) showed binaural integration for the side-separated presentation of spectrally degraded speech. Use of strictly side-separated dichotic stimulus presentation avoided the possible occurrence of physical effects such as the head shadow effect and therefore, confirmed the binaural benefit attributable to central binaural processing.

Effect of different blood groups on tympanometric findings and acoustic reflex thresholds.

PURPOSE: The blood group can have an effect on the auditory system, and it is suggested that it could be an indicator of noise-induced hearing loss. There could be changes in the immittance findings, too, in adults having different blood groups. The present study attempted to determine if there are any differences in tympanometric results (admittance, peak pressure, gradient, resonance frequency, and ear canal volume) and acoustic reflex thresholds (ART) at 500, 1000, 2000 and 4000 Hz between individuals with different blood groups (A positive, B positive, O positive and AB positive). METHODS: Eighty normal hearing adults between the age of 18 and 27 years were considered for the study. They were divided into 20 participants, each with blood groups A, B, AB, and O. The immittance findings were recorded from all the participants of the study. RESULTS: The results showed that the resonance frequency was slightly higher in blood group O compared to other blood groups. Also, the acoustic reflex thresholds were slightly elevated at all frequencies (ipsilateral and contralateral) for individuals with blood group O. CONCLUSIONS: The results of the study suggest possible reduced outer hair cells in persons with blood group O. This could have resulted in elevated acoustic reflex thresholds.

Adverse effects of pesticides on central auditory functions in tobacco growers.

OBJECTIVE: To investigate the effects of exposure to pesticides on the central auditory functions (CAF) of Brazilian tobacco growers. DESIGN: This was a cross-sectional study carried out between 2010 and 2012. Participants were evaluated with two behavioural procedures to investigate CAF, the random gap detection test (RGDT) and the dichotic digit test in Portuguese (DDT). STUDY SAMPLE: A total of 22 growers exposed to pesticides (study group) and 21 subjects who were not exposed to pesticides (control group) were selected. RESULTS: No significant differences between groups were observed for pure-tone thresholds. A significant association between pesticide exposure and the results for RGDT and DDT was found. Significant differences between pesticide-exposed and nonexposed subjects were found for RGDT frequency average and DDT binaural average, when including age and hearing level as covariates. Age was significantly associated with RGDT frequency average, DDT left ear score, DDT binaural average and DDT right ear advantage. Hearing levels were not significantly associated with any of the test scores. The relative risk of failing the DDT and RGDT for the study group was 1.88 (95% CI: 1.10-3.20) and 1.74 (95% CI: 1.06-2.86), respectively, as compared with the control group. CONCLUSIONS: The results showed that tobacco growers exposed to pesticides exhibited signs of central auditory dysfunction characterised by decrements in temporal processing and binaural integration processes/abilities.

Diagnosis of amblyaudia in children referred for auditory processing assessment.

Children (n = 141) referred to 5 clinical sites for auditory processing disorder assessment were tested with two dichotic listening tests, one with word pairs and the other with pairs of digits, as part of a comprehensive diagnostic battery. Scores from the Randomized Dichotic Digits Test and the Dichotic Words Test were compared to age-appropriate norms and used to place children into one of four diagnostic categories (normal, dichotic dysaudia, amblyaudia, or amblyaudia plus) or to identify them as undiagnosed. Results from the two dichotic tests led to diagnosis of 56% of the children tested, leaving 44% undiagnosed. When results from a third dichotic listening test were used as a tie-breaker among originally undiagnosed children, a total of 79% of the children's scores were placed into diagnostic categories (13% normal, 19% dichotic dysaudia, 35% amblyaudia, 12% amblyaudia plus). Amblyaudia, a binaural integration deficit evident only from dichotic listening test results, was most prevalent (35% + 12% = 47%) in this population of children suspected of auditory processing weaknesses. Since amblyaudia responds to treatment with Auditory Rehabilitation for Interaural Asymmetry (ARIA), clinicians are guided through the protocol for identifying diagnostic categories so that they can make appropriate referrals for rehabilitation.

A function for binaural integration in auditory grouping and segregation in the inferior colliculus.

Responses of neurons to binaural, harmonic complex stimuli in urethane-anesthetized guinea pig inferior colliculus (IC) are reported. To assess the binaural integration of harmonicity cues for sound segregation and grouping, responses were measured to harmonic complexes with different fundamental frequencies presented to each ear. Simultaneously gated harmonic stimuli with fundamental frequencies of 125 Hz and 145 Hz were presented to the left and right ears, respectively, and recordings made from 96 neurons with characteristic frequencies >2 kHz in the central nucleus of the IC. Of these units, 70 responded continuously throughout the stimulus and were excited by the stimulus at the contralateral ear. The stimulus at the ipsilateral ear excited (EE: 14%; 10/70), inhibited (EI: 33%; 23/70), or had no significant effect (EO: 53%; 37/70), defined by the effect on firing rate. The neurons phase locked to the temporal envelope at each ear to varying degrees depending on signal level. Many of the cells (predominantly EO) were dominated by the response to the contralateral stimulus. Another group (predominantly EI) synchronized to the contralateral stimulus and were suppressed by the ipsilateral stimulus in a phasic manner. A third group synchronized to the stimuli at both ears (predominantly EE). Finally, a group only responded when the waveform peaks from each ear coincided. We conclude that these groups of neurons represent different "streams" of information but exhibit modifications of the response rather than encoding a feature of the stimulus, like pitch.

Differential advantages of musical backgrounds on binaural integration and interaction skills in instrumentalists, vocalists, and non-musicians.

Background: Musical perception requires a host of skills. Instrumental musicians place greater emphasis on motor coordination, whereas vocal musicians rehearse vocal sounds. The study explored the differential advantages of musical background on binaural integration and interaction in musicians (instrumentalists, vocalists) and compared them with age-matched non-musicians. Methods: Eight six participants aged 20-40 y with normal hearing sensitivity were subjected to binaural tests using a standard group comparison research design. The participants were segregated into three groups - Group 1 included instrumentalists (n = 26, mean age: 17.73 ± 2.83 y), while Group 2 and Group 3 consisted of vocalists (n = 30, mean age: 19.30 ± 2.47 y) and non-musicians (n = 30, mean age: 18.20 ± 3.02 y) respectively. The binaural processes namely integration (Dichotic syllable test, DST; and virtual acoustic space identification - VASI) and interaction (Interaural difference thresholds for time and level: ITD & ILD), were administered on all the participants. Results: Statistical analyses showed the main effect of musicianship. Bonferroni pair-wise test revealed that the musicians (instrumentalists and vocalists) outperformed (p < 0.05) non-musicians in all the tests. The differential advantage of the musical background was seen on the binaural integration test with instrumentalists performing better in the VASI test compared to vocalists, and vice-versa for DST. No difference was observed in interaction tasks (ITD & ILD) between vocalists and instrumentalists (p > 0.05). Conclusion: Musical background-induced differential advantages can be reasonably noted in the binaural skills of instrumentalists and vocalists (compared to non-musicians).

Age-Related Dichotic Listening Skills in Impaired and Non-Impaired Readers: A Comparative Study.

Dichotic listening is the high-level auditory process which enables the perception of different verbal stimuli delivered simultaneously to the right and left ears (binaural integration), as well as the perception of a verbal stimulus presented to one ear while ignoring a different stimulus in the other ear (binaural separation). Deficits in central auditory processing have been reported in children with learning disabilities. The present study aimed to compare dichotic listening performances in right-handed impaired readers (IR) and non-impaired readers (non-IR) according to age. For this, a cross-sectional study was conducted in 120 IR (56 males and 64 females) divided into five age groups and 120 non-IR (63 male and 57 female) matched on chronological age (8 to 9 years; 9 to 10 years; 10 to 12 years; 12 to 18 years; adult). They were tested for binaural integration and binaural separation, allowing for the calculation of dichotic aptitude (DA), ear prevalence (EP), and attentional shift index (ASI). A series of ANOVAs showed an effect of age and of the reading group for all the dichotic-related measures, except for EP. Binaural separation scores were lower in IR who also showed more intrusive responses compared to non-IR. These intrusive responses, which were more frequent on the right ear for IR, decreased with age in both groups. Overall, these results suggest that dichotic listening scores improve with age as the central auditory pathways mature. However, whatever the age, performances are lower in IR than in non-IR. This might be explained by an incomplete maturation of the auditory pathways in IR; an early start for long-term follow-up and auditory training is suggested.

Effects of the intensified frequency and time ranges on consonant enhancement in bilateral cochlear implant and hearing aid users.

A previous study demonstrated that consonant recognition improved significantly in normal hearing listeners when useful frequency and time ranges were intensified by 6 dB. The goal of this study was to determine whether bilateral cochlear implant (BCI) and bilateral hearing aid (BHA) users experienced similar enhancement on consonant recognition with these intensified spectral and temporal cues in noise. In total, 10 BCI and 10 BHA users participated in a recognition test using 14 consonants. For each consonant, we used the frequency and time ranges that are critical for its recognition (called "target frequency and time range"), identified from normal hearing listeners. Then, a signal processing tool called the articulation-index gram (AI-Gram) was utilized to add a 6 dB gain to target frequency and time ranges. Consonant recognition was monaurally and binaurally measured under two signal processing conditions, unprocessed and intensified target frequency and time ranges at +5 and +10 dB signal-to-noise ratio and in quiet conditions. We focused on three comparisons between the BCI and BHA groups: (1) AI-Gram benefits (i.e., before and after intensifying target ranges by 6 dB), (2) enhancement in binaural benefits (better performance with bilateral devices compared to the better ear alone) via the AI-Gram processing, and (3) reduction in binaural interferences (poorer performance with bilateral devices compared to the better ear alone) via the AI-Gram processing. The results showed that the mean AI-Gram benefit was significantly improved for the BCI (max 5.9%) and BHA (max 5.2%) groups. However, the mean binaural benefit was not improved after AI-Gram processing. Individual data showed wide ranges of the AI-Gram benefit (max -1 to 23%) and binaural benefit (max -7.6 to 13%) for both groups. Individual data also showed a decrease in binaural interference in both groups after AI-Gram processing. These results suggest that the frequency and time ranges, intensified by the AI-Gram processing, contribute to consonant enhancement for monaural and binaural listening and both BCI and BHA technologies. The intensified frequency and time ranges helped to reduce binaural interference but contributed less to the synergistic binaural benefit in consonant recognition for both groups.

Dichotic spectral integration range for consonant recognition in listeners with normal hearing.

Dichotic spectral integration range, or DSIR, was measured for consonant recognition with normal-hearing listeners. DSIR is defined as a frequency range needed from 0 to 8,000 Hz band in one ear for consonant recognition when low-frequency information of the same consonant was presented to the opposite ear. DSIR was measured under the three signal processing conditions: (1) unprocessed, (2) target: intensified target spectro-temporal regions by 6 dB responsible for consonant recognition, and (3) target minus conflicting: intensified target regions minus spectro-temporal regions that increase confusion. Each consonant was low-pass filtered with a cutoff frequency of 250, 500, 750, and 1,000 Hz, and then was presented in the left ear or low-frequency (LF) ear. To create dichotic listening, the same consonant was simultaneously presented to the right ear or high-frequency (HF) ear. This was high-pass filtered with an initial cutoff frequency of 7,000 Hz, which was adjusted using an adaptive procedure to find the maximum high-pass cutoff for 99.99% correct consonant recognition. Mean DSIRs spanned from 3,198-8,000 Hz to 4,668-8,000 Hz (i.e., mid-to-high frequencies were unnecessary), depending on low-frequency information in the LF ear. DSIRs narrowed (i.e., required less frequency information) with increasing low-frequency information in the LF ear. However, the mean DSIRs were not significantly affected by the signal processing except at the low-pass cutoff frequency of 250 Hz. The individual consonant analyses revealed that /ta/, /da/, /sa/, and /za/ required the smallest DSIR, while /ka/, /ga/, /fa/, and /va/ required the largest DSIRs. DSIRs also narrowed with increasing low-frequency information for the two signal processing conditions except for 250 vs. 1,000 Hz under the target-conflicting condition. The results suggest that consonant recognition is possible with large amounts of spectral information missing if complementary spectral information is integrated across ears. DSIR is consonant-specific and relatively consistent, regardless of signal processing. The results will help determine the minimum spectral range needed in one ear for consonant recognition if limited low spectral information is available in the opposite ear.

Bilateral EABR stimulating mode testing bilateral CI patients refecting binaural integration:a preliminary study.

OBJECTIVE: To analyze binaural integration, we used a new stimulation mode of the electrically evoked auditory brainstem response (EABR), to reflect bilaterally implanted cochlear function. DESIGN: EABR was tested using the following procedure: First, both ears were evaluated separately, with the contralateral speech processor closed (C), followed by another measurement with both processors open (O). Subsequently, the eV latencies and amplitudes were assessed. The Speech, Spatial, and Qualities of Hearing Scale (SSQ), Categories of auditory performance (CAP) and speech intelligibility rating (SIR) scores were used to assess binaural hearing ability subjectively. STUDY SAMPLE: Fifteen subjects with bilateral CI from 1997 to 2018 were recruited, each diagnosed with severe to profound hearing loss. RESULTS: All SSQ scores, except for one, were greater than six (the exception scored 1.3/0.8/1.0). All CAP/SIR scores except one were greater than 6/4 (the exception scored 0/1). All patients exhibited good quality EABR measurements. The open contralateral processor significantly reduced the eV latency while enhancing the eV amplitude compared to monaural stimulation. The objective EABR results were consistent with subjective speech perception and auditory ability assessed using the SSQ scale. CONCLUSION: The EABR accurately reflected auditory pathway maturation and development after CI; thus, reflecting accordance with subjective speech and hearing performances. Furthermore, bilateral CI facilitates binaural integration and auditory brainstem plasticity.

Towards a unifying basis of auditory thresholds: Thresholds for multicomponent stimuli.

Sounds consisting of multiple simultaneous or consecutive components can be detected by listeners when the stimulus levels of the components are lower than those needed to detect the individual components alone. The mechanisms underlying such spectral, spectrotemporal, temporal, or across-ear integration are not completely understood. Here, we report threshold measurements from human subjects for multicomponent stimuli (tone complexes, tone sequences, diotic or dichotic tones) and for their individual sinusoidal components in quiet. We examine whether the data are compatible with the detection model developed by Heil, Matysiak, and Neubauer (HMN model) to account for temporal integration (Heil et al. 2017), and we compare its performance to that of the statistical summation model (Green 1958), the model commonly used to account for spectral and spectrotemporal integration. In addition, we compare the performance of both models with respect to previously published thresholds for sequences of identical tones and for diotic tones. The HMN model is similar to the statistical summation model but is based on the assumption that the decision variable is a number of sensory events generated by the components via independent Poisson point processes. The rate of events is low without stimulation and increases with stimulation. The increase is proportional to the time-varying amplitude envelope of the bandpass-filtered component(s) raised to an exponent of 3. For an ideal observer, the decision variable is the sum of the events from all channels carrying information, for as long as they carry information. We find that the HMN model provides a better account of the thresholds for multicomponent stimuli than the statistical summation model, and it offers a unifying account of spectral, spectrotemporal, temporal, and across-ear integration at threshold.

Benefits of Binaural Integration in Cochlear Implant Patients with Single-Sided Deafness and Residual Hearing in the Implanted Ear.

The purpose of the study is to gauge the benefits of binaural integration effects (redundancy and squelch) due to preserved low-frequency residual hearing in the implanted ear of cochlear implant users with single-sided deafness. There were 11 cochlear implant users (age 18-61 years old) who had preserved low-frequency hearing in the implanted ear; they had a normal hearing or mild hearing loss in the contralateral ear. Patients were tested with monosyllabic words, under different spatial locations of speech and noise and with the cochlear implant activated and deactivated, in two listening configurations-one in which low frequencies in the implanted ear were masked and another in which they were unmasked. We also investigated how cochlear implant benefit due to binaural integration depended on unaided sound localization ability. Patients benefited from the binaural integration effects of redundancy and squelch only in the unmasked condition. Pearson correlations between binaural integration effects and unaided sound localization error showed significance only for squelch (r = -0.67; p = 0.02). Hearing preservation after cochlear implantation has considerable benefits because the preserved low-frequency hearing in the implanted ear contributes to binaural integration, presumably through the preserved temporal fine structure.

Spectrotemporal window of binaural integration in auditory object formation.

Binaural integration of interaural temporal information is essential for sound source localization and segregation. Current models of binaural interaction have shown that accurate sound localization in the horizontal plane depends on the resolution of phase ambiguous information by across-frequency integration. However, as such models are mostly static, it is not clear how proximate in time binaural events in different frequency channels should occur to form an auditory object with a unique lateral position. The present study examined the spectrotemporal window required for effective integration of binaural cues across frequency to form the perception of a stationary position. In Experiment 1, listeners judged whether dichotic frequency-modulated (FM) sweeps with a constant large nominal interaural delay (1500 µs), whose perceived laterality was ambiguous depending on the sweep rate (1500, 3000, 6000, and 12,000 Hz/s), produced a percept of continuous motion or a stationary image. Motion detection performance, indexed by d-prime (d') values, showed a clear effect of sweep rate, with auditory motion effects most pronounced for low sweep rates, and a punctate stationary image at high rates. Experiment 2 examined the effect of modulation rate (0.5, 3, 20, and 50 Hz) on lateralizing sinusoidally frequency-modulated (SFM) tones to confirm the effect of sweep rate on motion detection, independent of signal duration. Lateralization accuracy increased with increasing modulation rate up to 20 Hz and saturated at 50 Hz, with poorest performance occurring below 3 Hz depending on modulator phase. Using the transition point where percepts changed from motion to stationary images, we estimated a spectrotemporal integration window of approximately 150 ms per octave required for effective integration of interaural temporal cues across frequency channels. A Monte Carlo simulation based on a cross-correlation model of binaural interaction predicted 90% of the variance on perceptual motion detection performance as a function of FM sweep rate. Findings suggest that the rate of frequency channel convergence of binaural cues is essential to binaural lateralization.

Two Ears Are Not Always Better than One: Mandatory Vowel Fusion Across Spectrally Mismatched Ears in Hearing-Impaired Listeners.

Hearing loss and auditory prostheses can alter auditory processing by inducing large pitch mismatches and broad pitch fusion between the two ears. Similar to integration of incongruent inputs in other sensory modalities, the mismatched, fused pitches are often averaged across ears for simple stimuli. Here, we measured parallel effects on complex stimulus integration using a new technique based on vowel classification in five bilateral hearing aid users and eight bimodal cochlear implant users. Continua between five pairs of synthetic vowels were created by varying the first formant spectral peak while keeping the second formant constant. Comparison of binaural and monaural vowel classification functions for each vowel pair continuum enabled visualization of the following frequency-dependent integration trends: (1) similar monaural and binaural functions, (2) ear dominance, (3) binaural averaging, and (4) binaural interference. Hearing aid users showed all trends, while bimodal cochlear implant users showed mostly ear dominance or interference. Interaural pitch mismatches, frequency ranges of binaural pitch fusion, and the relative weightings of pitch averaging across ears were also measured using tone and/or electrode stimulation. The presence of both large interaural pitch mismatches and broad pitch fusion was not sufficient to predict vowel integration trends such as binaural averaging or interference. The way that pitch averaging was weighted between ears also appears to be important for determining binaural vowel integration trends. Abnormally broad spectral fusion and the associated phoneme fusion across mismatched ears may underlie binaural speech perception interference observed in hearing aid and cochlear implant users.

Electrophysiological and psychophysical asymmetries in sensitivity to interaural correlation gaps and implications for binaural integration time.

Brief deviations of interaural correlation (IAC) can provide valuable cues for detection, segregation and localization of acoustic signals. This study investigated the processing of such "binaural gaps" in continuously running noise (100-2000 Hz), in comparison to silent "monaural gaps", by measuring late auditory evoked potentials (LAEPs) and perceptual thresholds with novel, iteratively optimized stimuli. Mean perceptual binaural gap duration thresholds exhibited a major asymmetry: they were substantially shorter for uncorrelated gaps in correlated and anticorrelated reference noise (1.75 ms and 4.1 ms) than for correlated and anticorrelated gaps in uncorrelated reference noise (26.5 ms and 39.0 ms). The thresholds also showed a minor asymmetry: they were shorter in the positive than in the negative IAC range. The mean behavioral threshold for monaural gaps was 5.5 ms. For all five gap types, the amplitude of LAEP components N1 and P2 increased linearly with the logarithm of gap duration. While perceptual and electrophysiological thresholds matched for monaural gaps, LAEP thresholds were about twice as long as perceptual thresholds for uncorrelated gaps, but half as long for correlated and anticorrelated gaps. Nevertheless, LAEP thresholds showed the same asymmetries as perceptual thresholds. For gap durations below 30 ms, LAEPs were dominated by the processing of the leading edge of a gap. For longer gap durations, in contrast, both the leading and the lagging edge of a gap contributed to the evoked response. Formulae for the equivalent rectangular duration (ERD) of the binaural system's temporal window were derived for three common window shapes. The psychophysical ERD was 68 ms for diotic and about 40 ms for anti- and uncorrelated noise. After a nonlinear Z-transform of the stimulus IAC prior to temporal integration, ERDs were about 10 ms for reference correlations of ±1 and 80 ms for uncorrelated reference. Hence, a physiologically motivated peripheral nonlinearity changed the rank order of ERDs across experimental conditions in a plausible manner.

Binaural integration abilities in bilateral cochlear implant user.

Bilateral Cochlear implants (CIs) improved speech intelligibility, speech perception in background noise, and sound localization in quiet and noisy situations. However, it is unclear whether these advantages essentially result in binaural integration of acoustic stimuli from each ear. In this study, we investigated the effectiveness of binaural integration by bilateral CIs placement using binaural hearing tests and subjective auditory perceptual assessment. A 61-year-old bilateral CIs subject underwent the following four tests: the Japanese Hearing in Noise Test (HINT-J), the dichotic listening test (DLT), the Rapidly Alternating Speech Perception (RASP) test, and subjective auditory perceptual assessment. The HINT-J score was significantly higher for bilateral CIs than for a unilateral CI. However, DLT and the RASP test revealed contradictory results. Subjective auditory perceptual assessment revealed active and bright impressions for bilateral hearing, which were also noisy and strong compared with those for unilateral hearing. The results of this study revealed that bilateral CIs improved speech perception in background noise and an improved auditory impression, although the bilateral integration abilities were not improved. This was probably because the patient was required to combine information from the two ears into a single perception in DLT and the RASP test. More longitudinal data should be collected and analyzed in future studies to evaluate the long-term effects of bilateral CIs.