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Hearing impairment goes with speech perception difficulties, presumably not only because of poor hearing sensitivity but also because of altered central auditory processing. Critical herein is temporal processing of the speech envelope, mediated by synchronization of neural activity to the envelope modulations. It has been suggested that hearing impairment is associated with enhanced sensitivity to envelope modulations which, in turn, relates to poorer speech perception. To verify this hypothesis, we performed a comparative electrophysiological study in hearing-impaired (HI) and normal-hearing (NH) human listeners of three age groups, investigating neural envelope encoding. HI young and middle-aged adults showed enhanced neural synchronization to envelope modulations relative to NH controls, particularly when stimulus audibility was corrected for. At an older age, the degree of neural synchronization was similar for HI and NH persons, yet HI persons showed a synchronization asymmetry toward the right hemisphere. This study demonstrates that hearing impairment is characterized by changes in the neural encoding of envelope modulations, the nature of which varies with age., (Copyright © 2018 Elsevier Inc. All rights reserved.)

A language-independent automated self-test on tablet based on masked recognition of ecological sounds, the Sound Ear Check (SEC), was developed. In this test, 24 trials of eight different sounds are randomly presented in a noise that was spectrally shaped according to the average frequency spectra of the stimulus sounds, using a 1-up 2-down adaptive procedure. The test was evaluated in adults with normal hearing and hearing loss, and its feasibility was investigated in young children, who are the target population of this test. Following equalization of perceptual difficulty across sounds by applying level adjustments to the individual tokens, a reference curve with a steep slope of 18%/dB was obtained, resulting in a test with a high test-retest reliability of 1 dB. The SEC sound reception threshold was significantly associated with the averaged pure tone threshold ( r  = .70), as well as with the speech reception threshold for the Digit Triplet Test ( r  = .79), indicating that the SEC is susceptible to both audibility and signal-to-noise ratio loss. Sensitivity and specificity values on the order of magnitude of ∼70% and ∼80% to detect individuals with mild and moderate hearing loss, respectively, and ∼80% to detect individuals with slight speech-in-noise recognition difficulties were obtained. Homogeneity among sounds was verified in children. Psychometric functions fitted to the data indicated a steep slope of 16%/dB, and test-retest reliability of sound reception threshold estimates was 1.3 dB. A reference value of -9 dB signal-to-noise ratio was obtained. Test duration was around 6 minutes, including training and acclimatization.

Objectives: Auditory steady state responses (ASSRs) are used in clinical practice for objective hearing assessments. The response is called steady state because it is assumed to be stable over time, and because it is evoked by a stimulus with a certain periodicity, which will lead to discrete frequency components that are stable in amplitude and phase over time. However, the stimuli commonly used to evoke ASSRs are also known to be able to induce loudness adaptation behaviorally. Researchers and clinicians using ASSRs assume that the response remains stable over time. This study investigates (1) the stability of ASSR amplitudes over time, within one recording, and (2) whether loudness adaptation can be reflected in ASSRs., Design: ASSRs were measured from 14 normal-hearing participants. The ASSRs were evoked by the stimuli that caused the most loudness adaptation in a previous behavioral study, that is, mixed-modulated sinusoids with carrier frequencies of either 500 or 2000 Hz, a modulation frequency of 40 Hz, and a low sensation level of 30 dB SL. For each carrier frequency and participant, 40 repetitions of 92 sec recordings were made. Two types of analyses were used to investigate the ASSR amplitudes over time: with the more traditionally used Fast Fourier Transform and with a novel Kalman filtering approach. Robust correlations between the ASSR amplitudes and behavioral loudness adaptation ratings were also calculated., Results: Overall, ASSR amplitudes were stable. Over all individual recordings, the median change of the amplitudes over time was -0.0001 μV/s. Based on group analysis, a significant but very weak decrease in amplitude over time was found, with the decrease in amplitude over time around -0.0002 μV/s. Correlation coefficients between ASSR amplitudes and behavioral loudness adaptation ratings were significant but low to moderate, with r = 0.27 and r = 0.39 for the 500 and 2000 Hz carrier frequency, respectively., Conclusions: The decrease in amplitude of ASSRs over time (92 sec) is small. Consequently, it is safe to use ASSRs in clinical practice, and additional correction factors for objective hearing assessments are not needed. Because only small decreases in amplitudes were found, loudness adaptation is probably not reflected by the ASSRs.

Psychophysical procedures are used to balance loudness across the ears. However, they can be difficult and require active cooperation. We investigated whether 40-Hz auditory steady-state response (ASSR) amplitudes can be used to objectively estimate the balanced loudness across the ears for a group of young, normal-hearing participants. The 40-Hz ASSRs were recorded using monaural stimuli with carrier frequencies of 500, 1000, or 2000 Hz over a range of levels between 40 and 80 dB SPL. Behavioral loudness balancing was performed for at least one reference level of the left ear. ASSR amplitude growth functions were listener dependent, but median across-ear ratios in ASSR amplitudes were close to 1. The differences between the ASSR-predicted balanced levels and the behaviorally found balanced levels were smaller than 5 dB in 59% of cases and smaller than 10 dB in 85% of cases. The differences between the ASSR-predicted balanced levels and the reference levels were smaller than 5 dB in 54% of cases and smaller than 10 dB in 87% of cases. No clear hemispheric lateralization was found for 40-Hz ASSRs, with the exception of responses evoked by stimulus levels of 40 to 60 dB SPL at 2000 Hz.

Objectives: Auditory stimuli modulated by modulation frequencies within the 30 to 50 Hz region evoke auditory steady state responses (ASSRs) with high signal to noise ratios in adults, and can be used to determine the frequency-specific hearing thresholds of adults who are unable to give behavioral feedback reliably. To measure ASSRs as efficiently as possible a multiple stimulus paradigm can be used, stimulating both ears simultaneously. The response strength of 30 to 50Hz ASSRs is, however, affected when both ears are stimulated simultaneously. The aim of the present study is to gain insight in the measurement efficiency of 30 to 50 Hz ASSRs evoked with a 2-ear stimulation paradigm, by systematically investigating the binaural interaction effects of 30 to 50 Hz ASSRs in normal-hearing adults., Design: ASSRs were obtained with a 64-channel EEG system in 23 normal-hearing adults. All participants participated in one diotic, multiple dichotic, and multiple monaural conditions. Stimuli consisted of a modulated one-octave noise band, centered at 1 kHz, and presented at 70 dB SPL. The diotic condition contained 40 Hz modulated stimuli presented to both ears. In the dichotic conditions, the modulation frequency of the left ear stimulus was kept constant at 40 Hz, while the stimulus at the right ear was either the unmodulated or modulated carrier. In case of the modulated carrier, the modulation frequency varied between 30 and 50 Hz in steps of 2 Hz across conditions. The monaural conditions consisted of all stimuli included in the diotic and dichotic conditions., Results: Modulation frequencies ≥36 Hz resulted in prominent ASSRs in all participants for the monaural conditions. A significant enhancement effect was observed (average: ~3 dB) in the diotic condition, whereas a significant reduction effect was observed in the dichotic conditions. There was no distinct effect of the temporal characteristics of the stimuli on the amount of reduction. The attenuation was in 33% of the cases >3 dB for ASSRs evoked with modulation frequencies ≥40 Hz and 50% for ASSRs evoked with modulation frequencies ≤36 Hz., Conclusions: Binaural interaction effects as observed in the diotic condition are similar to the binaural interaction effects of middle latency responses as reported in the literature, suggesting that these responses share a same underlying mechanism. Our data also indicated that 30 to 50 Hz ASSRs are attenuated when presented dichotically and that this attenuation is independent of the stimulus characteristics as used in the present study. These findings are important as they give insight in how binaural interaction affects the measurement efficiency. The 2-ear stimulation paradigm of the present study was, for the most optimal modulation frequencies (i.e., ≥40 Hz), more efficient than a 1-ear sequential stimulation paradigm in 66% of the cases.

Objective: Interaural time differences (ITDs) are important for sound source localisation. We present a model to predict the just noticeable differences (JNDs) in ITD discrimination for normal hearing and electric stimulation through a cochlear implant., Approach: We combined periphery models of acoustic and electric stimulation with a novel JND in the ITD estimation stage, which consists of a shuffled cross correlogram and a binary classifier characterisation method. Furthermore, an evaluation framework is presented based on a large behavioural dataset., Main Results: The model correctly predicts behavioural observations for unmodulated stimuli (such as pure tones and electric pulse trains) and modulated stimuli for modulation frequencies below 30 Hz. For higher modulation frequencies, the model predicts the observed behavioural trends, but tends to estimate higher ITD sensitivity., Significance: The presented model can be used to investigate the implications of modifying the stimulus waveform on ITD sensitivity, and as such be applied in investigating sound encoding strategies.

Objective: Binaural processing can be measured objectively as a desynchronisation of phase-locked neural activity to changes in interaural phase differences (IPDs). This was reported in a magnetoencephalography study for 40 Hz amplitude modulated tones. The goal of this study was to measure this desynchronisation using electroencephalography and explore the outcomes for different modulation frequencies., Design: Auditory steady-state responses (ASSRs) were recorded to pure tones, amplitude modulated at 20, 40 or 80 Hz. IPDs switched between 0 and 180° at fixed time intervals., Study Sample: Sixteen young listeners with bilateral normal hearing thresholds (≤25 dB HL at 125-8000 Hz) participated in this study., Results: Significant ASSR phase desynchronisations to IPD changes were detected in 14 out of 16 participants for 40 Hz and in 8, respectively 9, out of 13 participants for 20 and 80 Hz modulators. Desynchronisation and restoration of ASSR phase took place significantly faster for 80 Hz than for 40 and 20 Hz., Conclusions: ASSR desynchronisation to IPD changes was successfully recorded using electroencephalography. It was feasible for 20, 40 and 80 Hz modulators and could be an objective tool to assess processing of changes in binaural information.

The main objective of this study is to investigate memory task performance in different age groups, irrespective of hearing status. Data are collected on a short-term memory task (WAIS-III Digit Span forward) and two working memory tasks (WAIS-III Digit Span backward and the Reading Span Test). The tasks are administered to young (20-30 years, n = 56), middle-aged (50-60 years, n = 47), and older participants (70-80 years, n = 16) with normal hearing thresholds. All participants have passed a cognitive screening task (Montreal Cognitive Assessment (MoCA)). Young participants perform significantly better than middle-aged participants, while middle-aged and older participants perform similarly on the three memory tasks. Our data show that older clinically normal hearing persons perform equally well on the memory tasks as middle-aged persons. However, even under optimal conditions of preserved sensory processing, changes in memory performance occur. Based on our data, these changes set in before middle age.

Objectives: The purpose of the study is to compare real ear to coupler difference (RECD) curves based on physical and psychophysical measures. For the physically measured RECD, the RECD was measured with real ear and coupler measurements for the ear simulator and HA1- and HA2 2-cc couplers. The psychophysically measured RECDs were derived from audiogram measures., Design: RECDs were measured in 19 normally hearing subjects. The coupler measurement was done with the probe microphone and the coupler microphone itself. Psychophysically measured RECDs were derived for all subjects by measuring the audiogram in sound field and with an ER-3A insert phone., Results: Reference data were obtained for the three coupler types. It was possible to derive the RECD curve with psychophysical methods. There was no overall statistical difference between the physically and psychophysically measured RECD curves for the HA2 2-cc coupler and the ear simulator. The standard deviation was, however, much higher for the psychophysically derived RECD, indicating that physically measured RECDs are more precise than psychophysically derived RECDs., Conclusions: For the physical RECD measurements, the coupler microphone should be used for the coupler measurement. Physically measured RECDs were validated on group level by the reliable derivation of the RECD curve from audiogram measures.

In a previous study, it was shown that users of a cochlear implant and a contralateral hearing aid are sensitive to interaural time differences (ITDs). In the current study, we investigated (1) the influence on ITD sensitivity of bilaterally varying the place of excitation in the cochlea and of modulation frequency, and (2) the sensitivity to ITD with a 3-channel stimulus generated using continuous-interleaved-sampling (CIS)-like processing. The stimuli were (1) a high-frequency carrier (acoustic sinusoid and single-electrode electric pulse train), modulated with a half-wave-rectified low-frequency sinusoid (a so-called transposed stimulus), and (2) a 3-channel stimulus, generated by sending an acoustic click train through processing similar to the CIS strategy. Four bimodal listeners were sensitive to ITD for both stimulus types. For the first stimulus type, there was no significant influence on ITD sensitivity of the acoustic carrier frequency. Performance decreased with increasing modulation frequency with a limit of sensitivity at around 150-200 Hz. Sensitivity was similar for the single- and 3-channel stimulus. The results indicate the possibility of ITD perception with adapted clinical processors, which can lead to improved sound source localization and binaural unmasking., (Copyright © 2010 S. Karger AG, Basel.)

Objectives: Several studies have demonstrated better speech perception performance in children using two rather than one cochlear implant (CI). The extent to which bilaterally implanted children benefit from binaural cues to segregate speech and noise in a spatial configuration is less clear. Although better-ear effects are expected to be similar to adults, it is unknown whether electrical stimulation allows true binaural processing of speech signals in noise. Moreover, little data are available on the binaural hearing abilities of normal-hearing children. This study aimed at (1) developing and evaluating a speech test based on numbers to determine speech reception thresholds (SRTs) fast and accurately in young children, (2) evaluating a setup for measuring benefits of speech perception in a spatial configuration in young children and determining normative values of normal-hearing children, and (3) measuring spatial speech benefits in cochlear-implanted children with good sound localization abilities., Design: The speech test was conducted using the Leuven Intelligibility Number Test (LINT) data base. The test was limited to the numbers 1 to 10 spoken by one female speaker ("LittleLINT"). The LINT speech-weighted noise was used as a masker. Perception of this speech material was evaluated at fixed signal-to-noise ratios (SNRs) through monaural presentation via headphones in 34 normal-hearing children of 4 and 5 yrs of age and 20 normal-hearing adults. Subsequently, spatial speech perception benefits were measured in 50 normal-hearing children between 4 and 8 yrs of age, 15 normal-hearing adults, and eight children with bilateral CIs. An adaptive procedure was used for estimating unilateral and bilateral SRTs for different spatial configurations of speech and noise. Speech was always presented at 0 degrees azimuth (the front) and noise at the front, 90 degrees to the right, or 90 degrees to the left., Results: Unilateral headphone SRTs for the LittleLINT were higher for children (-9 dB SNR) than for adults (-13 dB SNR) and were lower than those for the LINT (-10 dB SNR for adults). Slopes (12 to 14%/dB) were comparable with that of the LINT (15%/dB), suggesting equal efficiency for the limited set of numbers. Normal-hearing subjects demonstrated several benefits of two-ear listening in spatial configurations (spatial release from masking [SRM], head shadow, summation, and squelch). Only SRM was influenced by age. Implanted children clearly benefited from bilateral implantation, as shown by SRM (3 dB) and head shadow effects (4 to 6 dB) comparable with normal-hearing children, but no summation or binaural squelch was established. The first CI seemed to contribute most to spatial speech perception., Conclusions: The steep slope, the familiarity to children, and the repeatability of lists make the LittleLINT suitable for fast and accurate SRT estimation in children. Spatial speech perception benefits were observed in normal-hearing subjects from the age of 4 yrs. Cochlear-implanted children showed better-ear effects but there was no evidence of true binaural processing.

Users of a cochlear implant and contralateral hearing aid are sensitive to interaural level differences (ILDs). However, when using their clinical devices, most of these subjects cannot use ILD cues for localization in the horizontal plane. This is partly due to a lack of high-frequency residual hearing in the acoustically stimulated ear. Using acoustic simulations of a cochlear implant and hearing loss, it is shown that localization performance can be improved by up to 14 degrees rms error relative to 48 degrees rms error for broadband noise by artificially introducing ILD cues in the low frequencies. The algorithm that was used for ILD introduction is described.

Objectives: In this study, procedures for measuring sound localization, sound lateralization, and binaural masking level differences (BMLDs) in young children were developed. Sensitivity for these tasks was assessed in large groups of children between 4 and 9 yr of age to investigate potential developmental trends., Design: Sound localization was measured in the sound field, with a broadband bell-ring presented from one of nine loudspeakers positioned in the frontal horizontal field. A group of 33 children between 4 and 6 yr of age and 5 adults took part in this experiment. Sound lateralization based on interaural time differences was measured with headphones in 49 children between 4 and 9 yr of age and 10 adults. A low-frequency stimulus containing harmonics 2 to 5 from a click train with a rate of 160 Hz was used. In the BMLD test, the same filtered click train was presented diotically or dichotically (phase reversed or time delayed) in a broadband (200 to 1000 Hz) frozen noise to 23 children between 4 and 6 yr of age and 10 adults. For comparison with literature, additional measurements with a 500-Hz sinusoid were administered to adults. All tasks were adapted to the interest and attention span of young children., Results: Children of 5 yr of age did not perform significantly different from adults on the sound localization task, but mean absolute errors were larger for the 4-yr-olds. Also on the BMLD task, 5-yr-old children performed at the adult level, whereas the 4-yr-old children obtained significantly less binaural unmasking compared with the adults. Concerning sound lateralization, a small but significant difference between adults and children existed, but no age effects were apparent in the 4- to 9-yr-old group. Overall, the variation was relatively large in the 4-yr-old group, with some of the children performing at adult level, in all three tasks., Conclusions: The results of this study show that the modified procedures are suitable for testing children from the age of 4 to 5 yr. Furthermore, it seems that binaural hearing capacities of the 5-yr-olds are similar to those of adults. Several observations led to the hypothesis that the observed age differences between 4-yr-olds and older subjects on localization and BMLD or between those 4- to 9-yr old and adults on lateralization, were attributable to both a development in binaural hearing and to nonauditory factors, such as task comprehension, attention, and testing conditions. It is possible that the developmental process is more obvious and prolonged in other aspects of binaural hearing, which require more dynamic or more central processing.

To obtain combined behavioural and electrophysiological measures of pitch perception, we presented harmonic complexes, bandpass filtered to contain only high-numbered harmonics, to normal-hearing listeners. These stimuli resemble bandlimited pulse trains and convey pitch using a purely temporal code. A core set of conditions consisted of six stimuli with baseline pulse rates of 94, 188 and 280 pps, filtered into a HIGH (3365-4755 Hz) or VHIGH (7800-10,800 Hz) region, alternating with a 36% higher pulse rate. Brainstem and cortical processing were measured using the frequency following response (FFR) and auditory change complex (ACC), respectively. Behavioural rate change difference limens (DLs) were measured by requiring participants to discriminate between a stimulus that changed rate twice (up-down or down-up) during its 750-ms presentation from a constant-rate pulse train. FFRs revealed robust brainstem phase locking whose amplitude decreased with increasing rate. Moderate-sized but reliable ACCs were obtained in response to changes in purely temporal pitch and, like the psychophysical DLs, did not depend consistently on the direction of rate change or on the pulse rate for baseline rates between 94 and 280 pps. ACCs were larger and DLs lower for stimuli in the HIGH than in the VHGH region. We argue that the ACC may be a useful surrogate for behavioural measures of rate discrimination, both for normal-hearing listeners and for cochlear-implant users. We also showed that rate DLs increased markedly when the baseline rate was reduced to 48 pps, and compared the behavioural and electrophysiological findings to recent cat data obtained with similar stimuli and methods.

The aim of this study was to develop an open-set word recognition task in speech-weighted noise and in quiet for young children and examine age effects for open versus closed response formats. Dutch monosyllabic words were presented in quiet and in stationary speech-weighted noise to 4- and 5-year-old children as well as to young adults in an open-set response format. Additionally, performance in open and closed context was assessed, as well as in a picture-pointing paradigm More than 200 children and 50 adults with normal hearing participated in the various validation phases. Average fitted speech reception thresholds (50%) yielded an age effect between 4-year and 5-year olds (and adults), both in speech-weighted noise and in quiet. The closed-set format yielded lower (better) SNRs than the open-set format, and children benefitted to the same extent as adults from phonetically similar words in speech-weighted noise. Additionally, the 4 AFC picture-pointing paradigm can be used to assess word recognition in quiet from 3 years of age. The same materials reveal performance differences between 4 and 5 years of age (and adults), both in quiet and speech-weighted noise using an open-set response format. This relatively small yet significant difference in SRT for a gap of only 1 year shows a developmental change for word recognition in speech-weighted noise and in quiet in the first decade of life. The study is part of the protocol registered on ClinicalTrials.gov (ID = NCT04063748). [ABSTRACT FROM AUTHOR]

Hearing aids (HA) are a fundamental component in restoring auditory function; however, they cannot completely alleviate all problems encountered by adults with hearing impairment. The aim of this study is twofold. Firstly, we assess the health-related quality of life and coping strategies of experienced HA users. Secondly, we assess whether HA users can benefit from auditory training. To this end, 40 participants who had worn HAs for more than 6 months participated in this study. Half of the participants received auditory training, while the other half served as a passive control. The training consisted of a personalized training scheme, with outcome measures including speech in noise perception in free-field and via direct streaming to the HA, phoneme identification, cognitive control, and health-related quality of life. Results showed that experienced HA users reported a relatively good quality of life. Health-related quality of life was correlated with aided speech perception in noise, but not with aided pure tone audiometry. Coping strategies were adaptive, leading to improved communication. Participants showed improvements in trained tasks, consonant identification, and speech in noise perception. While both groups yielded improved speech in noise perception at the end, post hoc analysis following a three-way interaction showed a significantly larger pre-post difference for the trained group in the streaming condition. Although training showed some improvements, the study suggests that the training paradigm was not sufficiently challenging for HA users. To optimize daily life listening, we recommend that future training should incorporate more exercises in noise and focus on cognitive control. [ABSTRACT FROM AUTHOR]

Different computational models have been developed to study the interaural time difference (ITD) perception. However, only few have used a physiologically inspired architecture to study ITD discrimination. Furthermore, they do not include aspects of hearing impairment. In this work, a framework was developed to predict ITD thresholds in listeners with normal and impaired hearing. It combines the physiologically inspired model of the auditory periphery proposed by Zilany, Bruce, Nelson, and Carney [(2009). J. Acoust. Soc. Am. 126(5), 2390–2412] as a front end with a coincidence detection stage and a neurometric decision device as a back end. It was validated by comparing its predictions against behavioral data for narrowband stimuli from literature. The framework is able to model ITD discrimination of normal-hearing and hearing-impaired listeners at a group level. Additionally, it was used to explore the effect of different proportions of outer- and inner-hair cell impairment on ITD discrimination. [ABSTRACT FROM AUTHOR]

The main objective of this study is to investigate memory task performance in different age groups, irrespective of hearing status. Data are collected on a short-term memory task (WAIS-III Digit Span forward) and two working memory tasks (WAIS-III Digit Span backward and the Reading Span Test). The tasks are administered to young (20–30 years,n = 56), middle-aged (50–60 years,n = 47), and older participants (70–80 years,n = 16) with normal hearing thresholds. All participants have passed a cognitive screening task (Montreal Cognitive Assessment (MoCA)). Young participants perform significantly better than middle-aged participants, while middle-aged and older participants perform similarly on the three memory tasks. Our data show that older clinically normal hearing persons perform equally well on the memory tasks as middle-aged persons. However, even under optimal conditions of preserved sensory processing, changes in memory performance occur. Based on our data, these changes set in before middle age. [ABSTRACT FROM PUBLISHER]

Objective: Listening to music is still one of the more challenging aspects of using a cochlear implant (CI) for most users. Simple musical structures, a clear rhythm/beat, and lyrics that are easy to follow are among the top factors contributing to music appreciation for CI users. Modifying the audio mix of complex music potentially improves music enjoyment in CI users. Methods: A stereo music preprocessing scheme is described in which vocals, drums, and bass are emphasized based on the representation of the harmonic and the percussive components in the input spectrogram, combined with the spatial allocation of instruments in typical stereo recordings. The scheme is assessed with postlingually deafened CI subjects (N = 7) using pop/rock music excerpts with different complexity levels. Results: The scheme is capable of modifying relative instrument level settings, with the aim of improving music appreciation in CI users, and allows individual preference adjustments. The assessment with CI subjects confirms the preference for more emphasis on vocals, drums, and bass as offered by the preprocessing scheme, especially for songs with higher complexity. Conclusion: The stereo music preprocessing scheme has the potential to improve music enjoyment in CI users by modifying the audio mix in widespread (stereo) music recordings. Significance: Since music enjoyment in CI users is generally poor, this scheme can assist the music listening experience of CI users as a training or rehabilitation tool. [ABSTRACT FROM PUBLISHER]

Recent studies have shown that transient parts of a speech signal contribute most to speech intelligibility in normal-hearing listeners. In this study, the influence of enhancing the onsets of the envelope of the speech signal on speech intelligibility in noisy conditions using an eight channel cochlear implant vocoder simulation was investigated. The enhanced envelope (EE) strategy emphasizes the onsets of the speech envelope by deriving an additional peak signal at the onsets in each frequency band. A sentence recognition task in stationary speech shaped noise showed a significant speech reception threshold (SRT) improvement of 2.5 dB for the EE in comparison to the reference continuous interleaved sampling strategy and of 1.7 dB when an ideal Wiener filter was used for the onset extraction on the noisy signal. In a competitive talker condition, a significant SRT improvement of 2.6 dB was measured. A benefit was obtained in all experiments with the peak signal derived from the clean speech. Although the EE strategy is not effective in many real-life situations, the results suggest that there is potential for speech intelligibility improvement when an enhancement of the onsets of the speech envelope is included in the signal processing of auditory prostheses. [ABSTRACT FROM AUTHOR]

Objective: To compare results on the everyday sentence test 'FIST', the new closed-set sentence test 'FrMatrix', and the digit triplet screening test 'FrDigit3'. Design: First, the FrMatrix was developed and normative values were obtained. Subsequently, speech reception thresholds (SRTs) for the three types of tests were gathered at four study centers representing different geographic regions in Belgium and France. Study sample: Fifty-seven normal-hearing listeners took part in the normative study of the FrMatrix, and 118 subjects, with a wide range of hearing thresholds, participated in the comparative study. Results: Homogenizing the individual words of the FrMatrix with regard to their intelligibility resulted in a reference SRT of −6.0 (±0.6) dB SNR and slope at the SRT of 14.0 %/dB. The within-subject variability was only 0.4 dB. Comparison of the three tests showed high correlations between the SRTs mutually (>0.81). The FrMatrix had the highest discriminative power, both in stationary and in fluctuating noise. For all three tests, differences across the participating study centers were small and not significant. Conclusions: The FIST, the FrMatrix, and the FrDigit3 provide similar results and reliably evaluate speech recognition performance in noise both in normal-hearing and hearing-impaired listeners. [ABSTRACT FROM AUTHOR]

Abstract A French speech intelligibility screening test in noise that applies digit triplets as stimuli has been developed and evaluated for both telephone and broadband headphone use. After optimizing the speech material based on the intelligibility of the individual digits, norms for normal-hearing subjects were established. speech reception thresholds (SRTs) of −6.4 ± 0.4 and −10.5 ± 0.3 dB SNR, and slopes of 17.1 and 27.1 %/dB were obtained for telephone and broadband headphone presentation, respectively. The French digit triplet test by telephone was then implemented as an automatic self-screening test by home telephone, and further evaluated in normal-hearing and hearing-impaired listeners. A test-retest variability of 0.7 dB was found and the correlation between SRT and pure-tone average (PTA0.5,1,2,4) was 0.77. One month after launching the test, 20 000 calls were registered. It can be concluded that both versions of the newly developed test have steep slopes and small SRT differences across normal-hearing listeners. The screening test by telephone is highly reliable and proves to fulfill the need for an easily accessible and objective hearing screening. Sumario Se desarrolló y evaluó una prueba de tamiz de inteligibilidad del lenguaje en ruido, utilizando ternas de dígitos como estímulo, tanto para teléfono como para auriculares de banda ancha. Después de optimizar el material lingüístico basado en la inteligibilidad de los dígitos individuales, se establecieron las normas para los sujetos normoyentes. Se obtuvieron umbrales de recepción del lenguaje (SRTs) de -6.4 ± 0.4 y -10.5 ± 0.3dB SNR y pendientes de 17.1 y 27.1%/dB para teléfono y auriculares de banda ancha, respectivamente. Se implementó la prueba de terna de dígitos en francés por teléfono como una prueba de tamiz autoaplicable por teléfono en casa y después se evaluó en normoyentes e hipoacúsicos. Se encontró una variabilidad de test-re-test de 0.7 dB y la correlación entre SRT y el promedio de tonos puros (PTA0.5,1,2,4) fue de 0.77. Un mes después de lanzar la prueba, se registraron 20,000 llamadas. Se puede concluir que ambas versiones de la prueba recientemente desarrollada tiene pendientes pronunciadas y pequeñas diferencias del SRT entre los normoyentes. La prueba de tamiz por teléfono es altamente confiable y demuestra que satisface las necesidades de una prueba de tamiz auditivo fácil, accesible y objetiva. [ABSTRACT FROM AUTHOR]

Two forward-masking experiments were conducted with six cochlear implant listeners to test whether asymmetric pulse shapes would improve the place-specificity of stimulation compared to symmetric ones. The maskers were either cathodic-first symmetric biphasic, pseudomonophasic (i.e., with a second anodic phase longer and lower in amplitude than the first phase), or “delayed pseudomonophasic” (identical to pseudomonophasic but with an inter-phase gap) stimuli. In experiment 1, forward-masking patterns for monopolar maskers were obtained by keeping each masker fixed on a middle electrode of the array and measuring the masked thresholds of a monopolar signal presented on several other electrodes. The results were very variable, and no difference between pulse shapes was found. In experiment 2, six maskers were used in a wide bipolar (bipolar+9) configuration: the same three pulse shapes as in experiment 1, either cathodic-first relative to the most apical or relative to the most basal electrode of the bipolar channel. The pseudomonophasic masker showed a stronger excitation proximal to the electrode of the bipolar pair for which the short, high-amplitude phase was anodic. However, no difference was obtained with the symmetric and, more surprisingly, with the delayed pseudomonophasic maskers. Implications for cochlear implant design are discussed. [ABSTRACT FROM AUTHOR]

This paper describes low-frequency auditory steady-state responses (ASSRs) to speech-weighted noise stimuli. The effect of modulation frequency was evaluated within the frequency range below 40 Hz. Furthermore, objective ASSR measures were related to speech understanding performance in normal-hearing and hearing-impaired listeners. The variability in ASSR recordings over independent test sessions was larger between subjects than within. Trends of increased responses around 10 and/or 20 Hz were found in all subjects. Obtained latency estimates of the responses pointed to primarily cortical sources involved in ASSR generation at low frequencies. Furthermore, significant differences between normal-hearing and hearing-impaired adults were found for ASSRs to stimuli related to the temporal envelope of speech. Comparing these responses with phoneme identification scores over different stimulus levels showed both measures increased with stimulus level in a similar way (ρ=0.82). At a fixed stimulus level, ASSRs were significantly correlated with speech reception thresholds for phonemes and sentences in noise (ρ from -0.45 to -0.53). These results indicate that objective low-frequency ASSRs are related to behavioral speech understanding, independently of level. [ABSTRACT FROM AUTHOR]

Auditory steady-state responses (ASSRs) in EEG measurements are currently used for reliable hearing threshold estimation at audiometric frequencies. Especially, newborns with hearing problems benefit from this technique, as with this information, diagnosis can be better specified and hearing aids can be better fitted at an early age. Unfortunately, measurement duration is still very long for clinical widespread use due to the lack of efficient signal detection techniques with sufficient robustness against artifacts. In this paper, a simplified procedural framework for ASSR detection is worked out that allows the development of a multichannel processing strategy, starting from a detection theory approach. It is shown that a sufficient statistic can be calculated that best captures the amount of ASSR in the recorded data. The evaluation is conducted using data from ten normal-hearing adults. It is concluded that most single- and multichannel approaches are similar in performance when applied to uncontaminated EEG. When artifact-rich EEG is used, the proposed detection-theory-based approach significantly improves the number of ASSR detections compared with a noise-weighted common EEG channel derivation (vertex-occiput). [ABSTRACT FROM AUTHOR]

This paper evaluates speech enhancement in binaural multimicrophone hearing aids by noise reduction algorithms based on the multichannel Wiener filter (MWF) and the MWF with partial noise estimate (MWF-N). Both algorithms are specifically developed to combine noise reduction with the preservation of binaural cues. Objective and perceptual evaluations were performed with different speech-in-multitalker-babble configurations in two different acoustic environments. The main conclusions are as follows: (a) A bilateral MWF with perfect voice activity detection equals or outperforms a bilateral adaptive directional microphone in terms of speech enhancement while preserving the binaural cues of the speech component. (b) A significant gain in speech enhancement is found when transmitting one contralateral microphone signal to the MWF active at the ipsilateral hearing aid. Adding a second contralateral microphone showed a significant improvement during the objective evaluations but not in the subset of scenarios tested during the perceptual evaluations. (c) Adding the partial noise estimate to the MWF, done to improve the spatial awareness of the hearing aid user, reduces the amount of speech enhancement in a limited way. In some conditions the MWF-N even outperformed the MWF possibly due to an improved spatial release from masking. [ABSTRACT FROM AUTHOR]

The interaural level difference (ILD) is an important cue for the localization of sound sources. Just noticeable differences (JND) in ILD were measured in 12 normal hearing subjects for uncorrelated noise bands with a bandwidth of 1/3 octave and a different center frequency in both ears. In one ear the center frequency was either 250, 500, 1000, or 4000 Hz. In the other ear, a frequency shift of 0, 1/6, 1/3, or 1 octave was introduced. JNDs in ILD for unshifted, uncorrelated noise bands of 1/3 octave width were 2.6, 2.6, 2.5, and 1.4 dB for 250, 500, 1000, and 4000 Hz, respectively. Averaged over all shifts, JNDs decreased significantly with increasing frequency. For the shifted conditions, JNDs increased significantly with increasing shift. Performance on average worsened by 0.5, 0.9, and 1.5 dB for shifts of 1/6, 1/3, and 1 octave. Though performance decreases, the just noticeable ILDs for the shifted conditions were still in a range usable for lateralization. This has implications for signal processing algorithms for bilateral bimodal hearing instruments and the fitting of bilateral cochlear implants. [ABSTRACT FROM AUTHOR]

Music perception and appraisal is very poor in cochlear implant (CI) subjects partly because (musical) pitch is inadequately transmitted by the current clinically used sound processors. A new sound processing scheme (F0mod) was designed to optimize pitch perception, and its performance for music and pitch perception was compared in four different experiments to that of the current clinically used sound processing scheme (ACE) in six Nucleus CI24 subjects. In the F0mod scheme, slowly varying channel envelopes are explicitly modulated sinusoidally at the fundamental frequency (F0) of the input signal, with 100% modulation depth and in phase across channels to maximize temporal envelope pitch cues. The results of the four experiments show that: (1) F0 discrimination of single-formant stimuli was not significantly different for the two schemes, (2) F0 discrimination of musical notes of five instruments was three times better with the F0mod scheme for F0 up to 250 Hz, (3) melody recognition of familiar Flemish songs (with all rhythm cues removed) was improved with the F0mod scheme, and (4) estimates of musical pitch intervals, obtained in a musically trained CI subject, matched more closely the presented intervals with the F0mod scheme. These results indicate that explicit F0 modulation of the channel envelopes improves music perception in CI subjects. Copyright © 2006 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Although in a number of experiments noise-band vocoders have been shown to provide acoustic models for speech perception in cochlear implants (CI), the present study assesses in four experiments whether and under what limitations noise-band vocoders can be used as an acoustic model for pitch perception in CI. The first two experiments examine the effect of spectral smearing on simulated electrode discrimination and fundamental frequency (F0) discrimination. The third experiment assesses the effect of spectral mismatch in an F0-discrimination task with two different vocoders. The fourth experiment investigates the effect of amplitude compression on modulation rate discrimination. For each experiment, the results obtained from normal-hearing subjects presented with vocoded stimuli are compared to results obtained directly from CI recipients. The results show that place pitch sensitivity drops with increased spectral smearing and that place pitch cues for multi-channel stimuli can adequately be mimicked when the discriminability of adjacent channels is adjusted by varying the spectral slopes to match that of CI subjects. The results also indicate that temporal pitch sensitivity is limited for noise-band carriers with low center frequencies and that the absence of a compression function in the vocoder might alter the saliency of the temporal pitch cues. [ABSTRACT FROM AUTHOR]

This paper studies the effect of bilateral hearing aids on directional hearing in the frontal horizontal plane. Localization tests evaluated bilateral hearing aid users using different stimuli and different noise scenarios. Normal hearing subjects were used as a reference. The main research questions raised in this paper are: (i) How do bilateral hearing aid users perform on a localization task, relative to normal hearing subjects? (ii) Do bilateral hearing aids preserve localization cues, and (iii) Is there an influence of state of the art noise reduction algorithms, more in particular an adaptive directional microphone configuration, on localization performance? The hearing aid users were tested without and with their hearing aids, using both a standard omnidirectional microphone configuration and an adaptive directional microphone configuration. The following main conclusions are drawn. (i) Bilateral hearing aid users perform worse than normal hearing subjects in a localization task, although more than one-half of the subjects reach normal hearing performance when tested unaided. For both groups, localization performance drops significantly when acoustical scenarios become more complex. (ii) Bilateral, i.e., independently operating hearing aids do not preserve localization cues. (iii) Overall, adaptive directional noise reduction can have an additional and significant negative impact on localization performance. [ABSTRACT FROM AUTHOR]

The influence of test duration on the precision of hearing thresholds estimated by recording multiple auditory steady-state responses (ASSRs) was investigated. ASSR thresholds at four frequencies in both ears were assessed in 10 normal-hearing and 10 hearing-impaired subjects. The precision of the estimated hearing thresholds was compared for ASSR recordings of 5, 10 and 15 min per intensity level, corresponding to total test durations of approximately 30, 55 and 70 min for hearing-impaired ears. Furthermore, an intensity step size of 10 dB was compared to a step size of 5 dB. The mean difference scores averaged over the four frequencies were 15 ± 10, 12 ± 9 and 11 ± 8 dB after recordings of 5, 10 and 15 min respectively. The corresponding Pearson correlation coefficients were 0.93, 0.95 and 0.96. Increasing the length of the separate recordings increases the precision of the estimates, independent of tested frequency. A compromise between both will have to be made. With a total test duration of approximately 1 h, four hearing thresholds in both ears can be estimated with a standard error of the estimate of 8 dB. [ABSTRACT FROM AUTHOR]

The pitch of stimuli was studied under conditions where place-of-excitation was held constant, and where pitch was therefore derived from “purely temporal” cues. In experiment 1, the acoustical and electrical pulse trains consisted of pulses whose amplitudes alternated between a high and a low value, and whose interpulse intervals alternated between 4 and 6 ms. The attenuated pulses occurred after the 4-ms intervals in condition A, and after the 6-ms intervals in condition B. For both normal-hearing subjects and cochlear implantees, the period of an isochronous pulse train equal in pitch to this “4–6” stimulus increased from near 6 ms at the smallest modulation depth to nearly 10 ms at the largest depth. Additionally, the modulated pulse trains in condition A were perceived as being lower in pitch than those in condition B. Data are interpreted in terms of increased refractoriness in condition A, where the larger pulses are more closely followed by the smaller ones than in condition B. Consistent with this conclusion, the A-B difference was reduced at longer interpulse intervals. These findings provide a measure of supra-threshold effects of refractoriness on pitch perception, and increase our understanding of coding of temporal information in cochlear implant speech processing schemes. © 2003 Acoustical Society of America. [ABSTRACT FROM AUTHOR]

In Part I, we investigated 40-Hz auditory steady-state response (ASSR) amplitudes for the use of objective loudness balancing across the ears for normal-hearing participants and found median across-ear ratios in ASSR amplitudes close to 1. In this part, we further investigated whether the ASSR can be used to estimate binaural loudness balance for listeners with asymmetric hearing, for whom binaural loudness balancing is of particular interest. We tested participants with asymmetric hearing and participants with bimodal hearing, who hear with electrical stimulation through a cochlear implant (CI) in one ear and with acoustical stimulation in the other ear. Behavioral loudness balancing was performed at different percentages of the dynamic range. Acoustical carrier frequencies were 500, 1000, or 2000 Hz, and CI channels were stimulated in apical or middle regions in the cochlea. For both groups, the ASSR amplitudes at balanced loudness levels were similar for the two ears, with median ratios between left and right ear stimulation close to 1. However, individual variability was observed. For participants with asymmetric hearing loss, the difference between the behavioral balanced levels and the ASSR-predicted balanced levels was smaller than 10 dB in 50% and 56% of cases, for 500 Hz and 2000 Hz, respectively. For bimodal listeners, these percentages were 89% and 60%. Apical CI channels yielded significantly better results (median difference near 0 dB) than middle CI channels, which had a median difference of −7.25 dB. [ABSTRACT FROM AUTHOR]

Objectives: In contrast to asymmetric hearing (AH), normal- hearing (NH) listeners perceive balanced loudness at both ears, leading to good sound source localization skills. We aimed to objectively measure binaural balanced loudness in case of AH. Material and methods: We tested NH and AH listeners in two tasks: 1) EEC was recorded to the stimuli presented monaurally at different intensities to obtain 40-Hz ASSR amplitude growth of both ears, and 2) behavioral binaural loudness balancing was performed. Results: For NH listeners, who have equal loudness growth across the ears, the difference between the left and right ear 40-Hz ASSR amplitude growth was small. For listeners with an AHL, similar ASSR amplitudes were found corresponding to similar loudness. Conclusions: This demonstrates the potential of using 40-Hz ASSRs to objectively find the binaural balanced loudness for fitting in case of AH. Such an objective measure can contribute to more automatic and objective fitting of hearing aids. [ABSTRACT FROM AUTHOR]

The article describes the development of the French Intelligibility Sentence Test (FIST). The procedures include preparation of test materials, estimation of the performance-intensity function, equalization of sentence difficulty, formation of sentence lists and development of norms and reliability. Reference data have been obtained for normal-hearing listeners and the performance of Francophone listeners from France and Belgium was compared.

Abstract: The present study investigates the most important factors that limit the intelligibility of the cochlear implant (CI) processed speech in noisy environments. The electrical stimulation sequences provided in CIs are affected by the noise in the following three manners. First of all, the natural gaps in the speech are filled, which distorts the low-frequency ON/OFF modulations of the speech signal. Secondly, speech envelopes are distorted to include modulations of both speech and noise. Lastly, the N-of-M type of speech coding strategies may select the noise dominated channels instead of the dominant speech channels at low signal-to-noise ratio''s (SNRs). Different stimulation sequences are tested with CI subjects to study how these three noise effects individually limit the intelligibility of the CI processed speech. Tests are also conducted with normal hearing (NH) subjects using vocoded speech to identify any significant differences in the noise reduction requirements and speech distortion limitations between the two subject groups. Results indicate that compared to NH subjects CI subjects can tolerate significantly lower levels of steady state speech shaped noise in the speech gaps but at the same time can tolerate comparable levels of distortions in the speech segments. Furthermore, modulations in the stimulus current level have no effect on speech intelligibility as long as the channel selection remains ideal. Finally, wrong maxima selection together with the introduction of noise in the speech gaps significantly degrades the intelligibility. At low SNRs wrong maxima selection introduces interruptions in the speech and makes it difficult to fuse noisy and interrupted speech signals into a coherent speech stream. [Copyright &y& Elsevier]

Abstract: Detection thresholds and most comfortable loudnesses (MCLs) were determined as a function of pulse rate for standard biphasic pulse trains (BP) and for anodic and cathodic monophasic phases alternating at fixed intervals (ALT-m). Three different phase durations were examined. With a 100-μs phase duration, thresholds for the ALT-m stimulus were substantially (up to 12dB) lower than for the BP stimuli at relatively low rates (200pps), but were similar to the BP thresholds at high rates (⩾1000pps). Thresholds for BP pulse trains decreased monotonically with increasing rate, whereas the function for ALT-m waveforms was non-monotonic with a maximum between 400 and 1000pps. These trends occurred for three different cochlear implant devices, different electrode configurations, and, generally, for different phase durations (10.8, 25, and 100μs/phase). However, at the shorter phase durations, thresholds remained lower for the ALT-m stimulus, even at 5000pps, the highest rate studied. Dynamic ranges of the BP pulse trains increased with increasing rate, irrespective of the phase duration under test, but for the ALT-m stimuli this was only true at the shorter phase durations tested. At a 100-μs phase duration, dynamic ranges for the ALT-m waveforms did not differ significantly as a function of rate. The results confirm previous reports that delaying charge recovery, in this case by switching from a BP to an ALT-m wave shape, can substantially reduce thresholds [Van Wieringen, A., Carlyon, R.P., Laneau, J., Wouters, J., 2005. Effects of waveform shape on human sensitivity to electrical stimulation of the inner ear. Hear. Res. 200, 73–86; Carlyon, R.P., van Wieringen, A., Deeks, J.M., Long, C.J., Lyzenga, J, Wouters, J., 2005. Effect of inter-phase gap on the sensitivity of cochlear implant users to electrical stimulation. Hear. Res. 205, 210–224]. However, at high pulse rates, this advantage only occurs at short phase durations. In addition, we show that the complex interaction between the effects of pulse shape, rate, and phase duration on thresholds can be captured by the simple linear model described by Carlyon et al. [Copyright &y& Elsevier]

Abstract: Human behavioral thresholds for trains of biphasic pulses applied to a single channel of Nucleus CI24 and LAURA cochlear implants were measured as a function of inter-phase gap (IPG). Experiment 1 used bipolar stimulation, a 100-pps pulse rate, and a 400-ms stimulus duration. In one condition, the two phases of each pulse had opposite polarity. Thresholds continued to drop by 9–10dB as IPG was increased from near zero to the longest value tested (2900μs for CI24, 4900μs for LAURA). This time course is much longer than reported for single-cell recordings from animals. In a second condition, the two phases of each pulse had the same polarity, which alternated from pulse to pulse. Thresholds were independent of IPG, and similar to those in condition 1 at IPG=4900μs. Experiment 2 used monopolar stimulation. One condition was similar to condition 1 of experiment 1, and thresholds also dropped up to the longest IPG studied (2900μs). This also happened when the pulse rate was reduced to 20pps, and when only a single pulse was presented on each trial. Keeping IPG constant at 8μs and adding an extra biphasic pulse x ms into each period produced thresholds that were roughly independent of x, indicating that the effect of IPG in the other conditions was not due to a release from refractoriness at sites central to the auditory nerve. Experiment 3 measured thresholds at three IPGs, which were less than, equal to, and more than one half of the interval between successive pulses. Thresholds were lowest at the intermediate IPG. The results of all experiments could be fit by a linear model consisting of a lowpass filter based on the function relating threshold to the frequency of sinusoidal electrical stimulation. The data and model have implications for reducing the power consumption of cochlear implants. [Copyright &y& Elsevier]

Objective: To report on clinical experience using dichotic multiple-stimulus auditory steady-state responses (ASSRs) as an objective technique to estimate frequency-specific hearing thresholds in hearing-impaired infants. Methods: A comparison was made between the click-evoked auditory brainstem response (ABR), auditory steady-state responses and behavioral hearing thresholds (BHTs). Both ears of 10 infants between 3 and 14 months of age were tested. ABR and ASSRs were recorded during the same test session. ABR was evoked by 100 μs clicks. ASSRs were evoked by amplitude- and frequency-modulated tones with carrier frequencies of 0.5, 1, 2 and 4 kHz and modulation frequencies ranging from 82 to 110 Hz. Eight signals (four to each ear) were presented simultaneously. ASSR thresholds were derived after separate recordings of approximately 5, 7.5 and 10 min to compare the influence of test duration. BHTs were defined in later test sessions as soon as possible after the ASSR test, dependent on medical and developmental factors. Results: For the subjects tested in this study 60% of ABR thresholds and 95% of ASSR thresholds for 1, 2 and 4 kHz were found at an average age of 7 months. Only 51% of frequency-specific BHTs could be obtained but on average 5 months later. The correlation of ABR thresholds and ASSR thresholds at 2 kHz was 0.77. The correlation of ASSRs and BHTs was 0.92. The mean differences and associated standard deviations were 4±14, 4±11, -2±14 and -1±13 dB for 0.5, 1, 2 and 4 kHz, respectively. The average test duration was 45 min for ABR (one threshold in both ears) and 58 min for ASSR (four thresholds in both ears). By reducing the duration of the separate recordings of ASSR, the precision of the hearing threshold estimate decreased and the number of outlying and missing values increased. Correlation coefficients were 0.92, 0.89 and 0.83 for recordings of maximum 10, 7.5 and 5 min, respectively. A compromise between test duration and precision has to be sought. Conclusions: Multiple-frequency ASSRs offer the possibility to estimate frequency-specific hearing thresholds in babies in a time-efficient way. [Copyright &y& Elsevier]