Age-Related Differences in EEG-Based Speech Reception Threshold Estimation Using Scalp and Ear-EEG

(1) To present hearing threshold data from a recent nationally representative survey in the United States (National Health and Nutrition Examination Survey, 1999-2004) in a distributional format that might be appropriate to replace Annex B in international (ISO-1999) and national (ANSI S3.44) standards and (2) to compare these recent data with older survey data (National Health Examination Survey I, 1959-1962) on which the current Annex B is based. Better-ear threshold distributions (selected percentiles and their confidence intervals) were estimated using linear interpolation. The 95% confidence intervals for the medians for the two surveys were compared graphically for each of the four age groups and for both men and women. In addition, we calculated odds ratios comparing the prevalences of better-ear hearing impairment (thresholds > 25 dB HL) between the two surveys, for 500, 1000, 2000, and 4000 Hz, and for their four-frequency average. Across age and sex groups, median thresholds were lower (better) in the 1999-2004 survey at 500, 3000, 4000, and 6000 Hz (8000 Hz was not tested in the 1959-1962 survey). For both men and women, the prevalence of hearing impairment was significantly lower in 1999-2004 at 500, 2000, and 4000 Hz, but not at 1000 Hz. For men and women of a specific age, high-frequency hearing thresholds were lower (better) in 1999-2004 than in 1959-1962. The prevalences of hearing impairment were also lower in the recent survey. Differences seen at 500 Hz may be attributable at least in part to changes in standards for ambient noise in audiometry. The National Health and Nutrition Examination Survey 1999-2004 distributions are offered as a possible replacement for Annex B in ISO-1999 and ANSI S3.44.

This study investigates the potential of speech reception threshold (SRT) estimation through electroencephalography (EEG) based envelope reconstruction techniques with continuous speech. Additionally, we investigate the influence of the stimuli's signal-to-noise ratio (SNR) on the temporal response function (TRF). Twenty young normal-hearing participants listened to audiobook excerpts with varying background noise levels while EEG was recorded. A linear decoder was trained to reconstruct the speech envelope from the EEG data. The reconstruction accuracy was calculated as the Pearson's correlation between the reconstructed and actual speech envelopes. An EEG SRT estimate (SRTneuro) was obtained as the midpoint of a sigmoid function fitted to the reconstruction accuracy versus SNR data points. Additionally, the TRF was estimated at each SNR level, followed by a statistical analysis to reveal significant effects of SNR levels on the latencies and amplitudes of the most prominent components. The SRTneuro was within 3 dB of the behavioral SRT for all participants. The TRF analysis showed a significant latency decrease for N1 and P2 and a significant amplitude magnitude increase for N1 and P2 with increasing SNR. The results suggest that both envelope reconstruction accuracy and the TRF components are influenced by changes in SNR, indicating they may be linked to the same underlying neural process.

The purpose of this research was twofold: firstly, to develop a music perception test (MPT) for hearing-aid users, and secondly, to evaluate the influence of non-linear frequency compression (NFC) on music perception with the use of the self-compiled test. This article focuses on the description of the development and validation of the MPT. To date, the main direction in frequency-lowering hearing-aid studies has been in relation to speech perception abilities. As hearing-aid technology has improved, interest has grown in musical perception as a dimension that could improve hearing-aid users' quality of life. The MPT was designed to evaluate different aspects of rhythm, timbre, pitch and melody. The development of the MPT could be described as design-based. Phase 1 of the study included test development and recording, while phase 2 entailed presentation of stimuli to normal hearing listeners (n = 15) and hearing-aid users (n = 4). Based on the findings of phase 2, item analysis was performed to eliminate or change stimuli that resulted in high error rates. During phase 3 the adapted version of the test was performed on a smaller group of normal hearing listeners (n = 4) and 20 hearing-aid users. Results proved that adults with normal hearing as well as adults using hearing aids were able to complete all the sub-tests of the MPT, although hearing-aid users scored lower on the various sub-tests than normal hearing listeners. For the rhythm section of the MPT normal hearing listeners scored on average 93.8% versus 75.5% of hearing-aid users; for the timbre section the scores were 83% versus 62.3% respectively. Normal hearing listeners obtained an average score of 86.3% for the pitch section and 88.2% for the melody section, compared with the 70.8% and 61.9% respectively obtained by hearing-aid users. This implies that the MPT can be used successfully for assessment of music perception in hearing-aid users within the South African context and may therefore result in more effective hearing-aid fittings taking place. The test can be used as a counselling tool to assist audiologists and patients in understanding the problems they experience regarding music perception, and might be used for future musical training in areas where participants experience problems in customising individual fittings.

This paper considers the factors of presbyacusis and age-related psychological changes in older adults in terms of their effects on the use or potential use of hearing aids as a means of improving aural communication. Data are presented on the prevalence of hearing impairment and the extent of hearing aid use in aging listeners. Four major classes of presbyacusis are described (sensory, neural, metabolic, and cochlear conduvtive) and a hearing aid prognosis is made for each type of disorder. It is shown that aging produces deficits in pure-tone thresholds, the speech reception threshold, and speech discrimination, but not all losses can be 'corrected' with a hearing aid. Binaural (stereophonic) devices are psychoacoustically superior to monaural devices; however, behavioral and personality changes in older patients often create problems of adaptation to the binaural aid. These changes may also affect the fitting of an aid and the patient's ability to learn to use it. Some practical suggestions are offered on the evaluation of hearing aids and it is emphasized that adequate orientation and counseling are typically required if hearing aid treatment is to be successful in presbyacusis.

Objective The purpose of this study was to determine the current prevalence of childhood hearing impairment (HI) in Sweden and to compare our data with previous studies from Sweden and other high-income countries.Design This was a cross-sectional study based on a register of children diagnosed with HI. Our results were compared with prevalence data from 18 studies from Sweden and other high-income countries, covering data collected from 1964 to the present.Study sample In December 2017, a total of 1911 out of 524,957 children 0–18 years of age and living in Stockholm County were enrolled in the regional programme for HI intervention.Results The overall prevalence of unilateral and bilateral HI >20 dB was 3.6/1000. The overall prevalence of bilateral HI >40 dB HL was 1.5/1000, split into age groups the prevalence was 0.4/1000 (<1 year of age), 1/1000 (1–4 years), 1.5/1000 (5–9 years), 1.6/1000 (10–14 years), and 2.14/1000 (15–18 years). From 1 to 18 years of age, the prevalence increased by a factor of 3.5 for moderate to profound HI >40 dB HL (0.7 to 2.4/1000).Conclusion The prevalence of HI across childhood in Stockholm County today is not significantly different from previous reports from Sweden and other high-income countries.

Speech perception in noise is an important aspect of the rehabilitation of children with hearing loss. We aimed to evaluate the feasibility and reliability of the Dutch digits-in-noise (DIN) test in the clinical follow-up of children with hearing aids (HAs) and/or cochlear implants (CIs). A second aim of the study was to gain insight in the speech perception in noise performance of children with different degrees of hearing loss. We retrospectively analyzed DIN test data of Dutch-speaking children with hearing loss (N = 188; 5 to 18 years old). A free-field version of the DIN-test was used. Children with open-set phoneme recognition in quiet of >70% at 65 dB SPL (best aided condition) were included. Ages ranged from 5 to 18 years old. All were experienced HA or CI users and had used their device(s) for at least 1 year before the measurement in the study. The DIN-test was performed in the framework of a clinical rehabilitation program. During testing, children wore their own devices with normal daily programs. The average speech reception threshold (SRT) was -3.6 dB (SD 3.6) for the first list and significantly improved to -4.0 dB (SD 3.1) for the second list. HA users had a 4-dB better SRT compared with CI users. The larger the child's hearing loss, the worse the SRT is. However, 15% of the children who completed a first list of 24 trials were unable to complete a second list. Mean adaptive staircase trajectories across trials suggested that learning occurred throughout the first list, and that loss of sustained attention contributed to response variability during the second list. The DIN test can be used to assess speech perception in noise abilities for children with different degrees of hearing loss and using HAs or CIs. The children with hearing loss required a higher signal-to-noise ratio (SNR) than did normal-hearing children and the required SNR is larger as the hearing loss increases. However, the current measurement procedure should be optimized for use in standard pediatric audiological care, as 15% of the children were unable to conduct a second list after the first list to reach a more stable SNR.

As people age, they experience reduced temporal processing abilities. This results in poorer ability to understand speech, particularly for degraded input signals. Cochlear implants (CIs) convey speech information via the temporal envelopes of a spectrally degraded input signal. Because there is an increasing number of older CI users, there is a need to understand how temporal processing changes with age. Therefore, the goal of this study was to quantify age-related reduction in temporal processing abilities when attempting to discriminate words based on temporal envelope information from spectrally degraded signals. Younger normal-hearing (YNH) and older normal-hearing (ONH) participants were presented a continuum of speech tokens that varied in silence duration between phonemes (0 to 60 ms in 10-ms steps), and were asked to identify whether the stimulus was perceived more as the word "dish" or "ditch." Stimuli were vocoded using tonal carriers. The number of channels (1, 2, 4, 8, 16, and unprocessed) and temporal envelope low-pass filter cutoff frequency (50 and 400 Hz) were systematically varied. For the unprocessed conditions, the YNH participants perceived the word ditch for smaller silence durations than the ONH participants, indicating that aging affects temporal processing abilities. There was no difference in performance between the unprocessed and 16-channel, 400-Hz vocoded stimuli. Decreasing the number of spectral channels caused decreased ability to distinguish dish and ditch. Decreasing the envelope cutoff frequency also caused decreased ability to distinguish dish and ditch. The overall pattern of results revealed that reductions in spectral and temporal information had a relatively larger effect on the ONH participants compared with the YNH participants. Aging reduces the ability to utilize brief temporal cues in speech segments. Reducing spectral information-as occurs in a channel vocoder and in CI speech processing strategies-forces participants to use temporal envelope information; however, older participants are less capable of utilizing this information. These results suggest that providing as much spectral and temporal speech information as possible would benefit older CI users relatively more than younger CI users. In addition, the present findings help set expectations of clinical outcomes for speech understanding performance by adult CI users as a function of age.

This study investigates the neural encoding of speech features in hearing aid users using electroencephalography (EEG) during a simulated cocktail party scenario. The objective was to investigate neural tracking of various acoustic and linguistic features and how hearing aid noise reduction influenced this tracking. The features analyzed included the acoustic envelope, phonetic features, word onset, and word surprisal, the latter derived from GPT-2. Temporal Response Functions (TRFs) were used to correlate these features with EEG signals, revealing how the brain tracks attended (target) versus unattended (masker) speech. TRFs were estimated using a boosting algorithm, with speech features as predictors and EEG signals as responses. Results revealed a significant distinction between target and masker speech. The acoustic envelope showed the strongest correlation with EEG responses. Distinct tracking patterns were observed: the acoustic envelope and phonetic features correlated with early processing stages, while word onset and word suprisal were linked to later stages. Noise reduction further influenced the tracking of these features. These findings improve our understanding of how hearing aid users process speech and provide insight for developing hearing aids that adapt to individual neural responses.

SummaryThere is a paucity of studies exploring the frequency of problem behaviours in people with learning disability and hearing impairment. Deafness in learning disability has been described as a ‘double jeopardy‘ because the difficulties are compounded to be more than the sum of their parts. The aim of the study was to ascertain the prevalence of hearing impairment in a community population of adults with learning disability and then investigate their access to audiology. We also aimed to collect information on the prevalence of problem behaviours in this population and explore links between hearing impairment and the use of hearing aids and problem behaviours. The prevalence of hearing impairment was 9.2%, 70% had been seen by audiology services at some time in their life but only 24% had ongoing assessments and hearing‐aid maintenance. Sixty‐two percent of the population had problem behaviours and 34% had self‐injurious behaviour. The high prevalence of problem behaviours and self‐injurious behaviour found in this population compared with other studies suggests a need for further research. These findings also reveal that the hearing status of people with a learning disability continues to be overlooked as the deafness often gets lost among their other problems.

Objective: The purpose of this study was to describe factors that are related to hearing aid and hearing assistance technology ownership and use in Aotearoa/New Zealand. Design: Adults with hearing impairment living in New Zealand were surveyed regarding health-related quality of life and device usage. Audiometric data (hearing sensitivity and speech in noise) were collected. Study sample: Data were obtained from 123 adults with hearing impairment: 73 reported current hearing-aid use, 81 reported current hearing assistance technology use. Results: In both analyses, device users had more difficulty understanding speech in background noise, had poor hearing in both their better and worse hearing ears, and perceived more consequences of hearing impairment in their everyday lives (both emotionally and socially) than non-hearing-aid users. Discriminant analyses showed that the social consequences of hearing impairment and the better ear hearing best classified hearing aid users from non-users but social consequences and worse ear hearing best classified hearing assistance technology users from non-users. Conclusions: Quality of life measurements and speech-in-noise assessments provide useful clinical information. Hearing-impaired adults in New Zealand who use hearing aids also tend to use hearing assistance technology, which has important clinical implications.

Objectives: The aim of our investigation was to explore the relationship between unaided pure-tone and speech audiometry and self-reported aided performance measured according to five predetermined COSI categories among first-time hearing aid users and experienced hearing aid users. Methods: Data from 286 patients were retrospectively evaluated. We divided the sample into first-time hearing aid users (G1) and experienced hearing aid users (G2). The correlation between unaided tonal and speech audiometry and five preliminary selected client-oriented scale of improvement (COSI) categories was studied. Results: A greater percentage of hearing aid users aged >80 years and a higher prevalence of severe-to-profound hearing loss in G2 group were observed (p < 0.05). For the total cohort, a mean hearing threshold of 60.37 ± 18.77 db HL emerged in the right ear, and 59.97 ± 18.76 db HL was detected in the left ear (p > 0.05). A significant statistical difference was observed in the group of first-time hearing aid users for the "Television/Radio at normal volume" item, where patients with a lower speech intellection threshold (SIT) were associated with higher COSI scores (p = 0.019). Studying the relationship between the speech reception threshold (SRT) and the COSI item "conversation with 1 or 2 in noise" evidenced worse speech audiometry in patients who scored ≤2 among experienced hearing aid users (p = 0.00012); a higher mean 4-8 kHz frequencies threshold for the better ear was found within the G2 group among those who scored ≤2 in the COSI item "conversation with 1 or 2 in quiet" (p = 0.043). Conclusions: Our study confirms a poor correlation between unaided tonal and speech audiometry and self-reported patient assessment. Although we included only five COSI categories in this study, it is clear that unaided audiometric tests may drive the choice of proper hearing rehabilitation, but their value in predicting the benefit of hearing aids remains limited.

The goal was to evaluate the potential effects of increasing hearing loss and advancing age on spectral envelope perception. Spectral modulation detection was measured as a function of spectral modulation frequency from 0.5 to 8.0 cycles/octave. The spectral modulation task involved discrimination of a noise carrier (3 octaves wide from 400 to 3200 Hz) with a flat spectral envelope from a noise having a sinusoidal spectral envelope across a logarithmic audio frequency scale. Spectral modulation transfer functions (SMTFs; modulation threshold vs. modulation frequency) were computed and compared 4 listener groups: young normal hearing, older normal hearing, older with mild hearing loss, and older with moderate hearing loss. Estimates of the internal spectral contrast were obtained by computing excitation patterns. SMTFs for young listeners with normal hearing were bandpass with a minimum modulation detection threshold at 2 cycles/octave, and older listeners with normal hearing were remarkably similar to those of the young listeners. SMTFs for older listeners with mild and moderate hearing loss had a low-pass rather than a bandpass shape. Excitation patterns revealed that limited spectral resolution dictated modulation detection thresholds at high but not low spectral modulation frequencies. Even when factoring out (presumed) differences in frequency resolution among groups, the spectral envelope perception was worse for the group with moderate hearing loss than the other 3 groups. The spectral envelope perception as measured by spectral modulation detection thresholds is compromised by hearing loss at higher spectral modulation frequencies, consistent with predictions of reduced spectral resolution known to accompany sensorineural hearing loss. Spectral envelope perception is not negatively impacted by advancing age at any spectral modulation frequency between 0.5 and 8.0 cycles/octave.

Response criteria from a yes-no task and detection thresholds from two test procedures were measured for four groups of adults: younger normal-hearing, older normal-hearing, younger hearing-impaired, and older hearing-impaired. The two test procedures were an audiological procedure (which does not control for response bias) and a 21FC adaptive procedure (which does control for bias). The signal was a 500 or 4000 Hz tone presented in quiet. All four groups showed an equally conservative response bias in the yes-no task. In addition, neither age nor hearing loss affected the difference (6.5 dB) between the two threshold measures.

The Speech Transmission Index (STI; Houtgast, Steeneken, & Plomp, 1980; Steeneken & Houtgast, 1980) is commonly used to quantify the adverse effects of reverberation and stationary noise on speech intelligibility for normal-hearing listeners. Duquesnoy and Plomp (1980) showed that the STI can be applied for presbycusic listeners, relating speech reception thresholds (SRTs) in various reverberant conditions to a fixed, subject-dependent STI value. The current study aims at extending their results to a wider range of hearing-impaired listeners. A reverberant analogue of the SRT is presented--the speech reception reverberation threshold (SRRT)--which determines the amount of reverberation that a listener can sustain to understand 50% of the presented sentences. SRTs are performed and evaluated in terms of STI for 5 normal-hearing participants and 36 randomly selected hearing-impaired participants. Results show that differences in STI between reverberant and noisy conditions are only small, equivalent to a change in speech-to-noise ratio < 1.3 dB. The STI appears to be a convenient, single number to quantify speech reception of hearing-impaired listeners in noise and/or reverberation, regardless of the nature of the hearing loss. In future research, the SRRT may be applied to further investigate the supposed importance of cognitive processing in reverberant listening conditions.

Objective:To report on the safety and efficacy of an investigational active middle ear implant (AMEI) in Japan, and to compare results to preoperative results with a hearing aid.Design:Prospective study conducted in Japan in which 23 Japanese-speaking adults suffering from conductive or mixed hearing loss received a VIBRANT SOUNDBRIDGE with implantation at the round window. Postoperative thresholds, speech perception results (word recognition scores, speech reception thresholds, signal-to-noise ratio [SNR]), and quality of life questionnaires at 20 weeks were compared with preoperative results with all patients receiving the same, best available hearing aid (HA).Results:Statistically significant improvements in postoperative AMEI-aided thresholds (1, 2, 4, and 8 kHz) and on the speech reception thresholds and word recognition scores tests, compared with preoperative HA-aided results, were observed. On the SNR, the subjects’ mean values showed statistically significant improvement, with −5.7 dB SNR for the AMEI-aided mean and −2.1 dB SNR for the preoperative HA-assisted mean. The APHAB quality of life questionnaire also showed statistically significant improvement with the AMEI.Conclusion:Results with the AMEI applied to the round window exceeded those of the best available hearing aid in speech perception as well as quality of life questionnaires. There were minimal adverse events or changes to patients’ residual hearing.