Individual differences in working memory capacity (WMC) are associated with speech recognition in adverse conditions, reflecting the need to maintain and process speech fragments until lexical access can be achieved. When working memory resources are engaged in unlocking the lexicon, there is less Cognitive Spare Capacity (CSC) available for higher level processing of speech. CSC is essential for interpreting the linguistic content of speech input and preparing an appropriate response, that is, engaging in conversation. Previously, we showed, using a Cognitive Spare Capacity Test (CSCT) that in young adults with normal hearing, CSC was not generally related to WMC and that when CSC decreased in noise it could be restored by visual cues. In the present study, we investigated CSC in 24 older adults with age-related hearing loss, by administering the CSCT and a battery of cognitive tests. We found generally reduced CSC in older adults with hearing loss compared to the younger group in our previous study, probably because they had poorer cognitive skills and deployed them differently. Importantly, CSC was not reduced in the older group when listening conditions were optimal. Visual cues improved CSC more for this group than for the younger group in our previous study. CSC of older adults with hearing loss was not generally related to WMC but it was consistently related to episodic long term memory, suggesting that the efficiency of this processing bottleneck is important for executive processing of speech in this group.
Several alternative ear-canal measures are similar to absorbance in their requirement for prior determination of a Thévenin-equivalent sound source. Examples are (1) sound intensity level, (2) forward pressure level, (3) time-domain ear-canal reflectance, and (4) cochlear reflectance. These four related measures are similar to absorbance in their utilization of wideband stimuli and their focus on recording ear-canal sound pressure. The related measures differ from absorbance in how the ear-canal pressure is analyzed and in the type of information that is extracted from the recorded response. Sound intensity level and forward pressure level have both been shown to be better as measures of sound level in the ear canal compared with sound pressure level because they reduced calibration errors due to standing waves in studies of behavioral thresholds and otoacoustic emissions. Time-domain ear-canal reflectance may be used to estimate ear-canal geometry and may have the potential to assess middle ear pathology. Cochlear reflectance reveals information about the inner ear that is similar to what is provided by other types of otoacoustic emissions, and may have theoretical advantages that strengthen its interpretation.
To understand speech, the slowly varying outline, or envelope, of the acoustic stimulus is used to distinguish words. A small amount of information about the envelope is sufficient for speech recognition, but the mechanism used by the auditory system to extract the envelope is not known. Several different theories have been proposed, including envelope detection by auditory nerve dendrites as well as various mechanisms involving the sensory hair cells. We used recordings from human and animal inner ears to show that the dominant mechanism for envelope detection is distortion introduced by mechanoelectrical transduction channels. This electrical distortion, which is not apparent in the sound-evoked vibrations of the basilar membrane, tracks the envelope, excites the auditory nerve, and transmits information about the shape of the envelope to the brain.
Degradations in external, acoustic stimulation have long been suspected to increase the load on working memory (WM). One neural signature of WM load is enhanced power of alpha oscillations (6–12 Hz). However, it is unknown to what extent common internal, auditory degradation, that is, hearing impairment, affects the neural mechanisms of WM when audibility has been ensured via amplification. Using an adapted auditory Sternberg paradigm, we varied the orthogonal factors memory load and background noise level, while the electroencephalogram was recorded. In each trial, participants were presented with 2, 4, or 6 spoken digits embedded in one of three different levels of background noise. After a stimulus-free delay interval, participants indicated whether a probe digit had appeared in the sequence of digits. Participants were healthy older adults (62–86 years), with normal to moderately impaired hearing. Importantly, the background noise levels were individually adjusted and participants were wearing hearing aids to equalize audibility across participants. Irrespective of hearing loss (HL), behavioral performance improved with lower memory load and also with lower levels of background noise. Interestingly, the alpha power in the stimulus-free delay interval was dependent on the interplay between task demands (memory load and noise level) and HL; while alpha power increased with HL during low and intermediate levels of memory load and background noise, it dropped for participants with the relatively most severe HL under the highest memory load and background noise level. These findings suggest that adaptive neural mechanisms for coping with adverse listening conditions break down for higher degrees of HL, even when adequate hearing aid amplification is in place.
The purpose of this article was to review the effectiveness of wideband acoustic immittance (WAI) and tympanometry in detecting conductive hearing loss (CHL). Eight studies were included that measured CHL through air-and bone-conducted thresholds in at least a portion of their participants. One study included infants, three studies included children, one study included older children and adults, and three studies included adults. WAI identified CHL well in all populations. In infants and children, WAI in several single-frequency bands identified CHL with equal accuracy to measures of middle ear admittance using clinical tympanometry with a single probe tone (1000 Hz for infants; 226 Hz for children and adults). When WAI was combined across frequency bands, it identified CHL superior to traditional, single-frequency tympanometry. Only two studies used WAI tympanometry, which assesses the outer/middle ear across both frequency and introduced air pressure, and differing results were reported as to whether introducing pressure into the ear canal provides better identification of CHL. In general, WAI appears to be a promising clinical tool, and further investigation is warranted.
Objectives: Since the technique to implant bone-anchored hearing aids (BAHAs) with the use of osseointegrated implants was developed in 1977, more than 15,000 patients have been fitted with BAHAs worldwide. Although the majority have bilateral hearing loss, they are primarily fitted unilaterally. The main objective of this study was to reveal benefits and drawbacks of bilateral fitting of BAHAs in patients with symmetric or slight asymmetric bone-conduction thresholds. The possible effects were divided into three categories: hearing thresholds, directional hearing, and binaural hearing. Study Design: Prospective study of 12 patients with bilateral BAHAs. Methods: Baseline audiometry, directional hearing, speech reception thresholds in quiet and in noise, and binaural masking level difference were tested when BAHAs were fitted unilaterally and bilaterally. Results: Eleven of the 12 patients used bilateral BAHAs on a daily basis. Tests performed in the study show a significant improvement in sound localization with bilateral BAHAs; the results with unilateral fitting were close to the chance level. Furthermore, with bilateral application, the improvement of the speech reception threshold in quiet was 5.4 dB. An improvement with bilateral fitting was also found for speech reception in noise. Conclusions: Overall, the results with bilateral fitted BAHAs were better than with unilaterally fitted BA-HA; the benefit is not only caused simply by bilateral stimulation but also, to some extent, by binaural hearing. Bilateral BAHAs should be considered for patients with bilateral hearing loss otherwise suitable for BAHAs.
Hypothesis: The aim of this study is to investigate how a mastoidectomy surgery affects bone conduction (BC) sound transmission using a whole head finite element model. Background: Air conduction (AC) and BC hearing thresholds are normally used to evaluate the effect of an ear surgery. It is then assumed that the BC hearing thresholds are unaffected by the surgery. Moreover, BC hearing aids are used in cases of unilateral or conductive hearing loss in heads that have undergone a mastoidectomy surgery. Given the invasiveness of the surgery, the BC hearing sensitivity may be altered by the surgery itself. Methods: Two types of mastoid surgery, canal wall up and canal wall down, with and without obliteration, were simulated in a whole head finite element model for BC stimulation, the LiUHead. The evaluations were conducted for two different methods of applying the BC sound, at the skin surface (B71 transducer) and directly at the bone (BC hearing aid). Results: The results showed that a mastoidectomy surgery increased the cochlear vibration responses with BC stimulation. The increase was less than 5 dB, except for a canal wall down surgery which gave an increase of up to 8 dB at frequencies close to 10 kHz. The increase was greater at the ipsilateral cochlea compared with the contralateral cochlea. Conclusion: A mastoidectomy surgery increases the vibration at both cochleae for BC stimulation and the increase generally improved with frequency. Obliteration of the surgical cavity does not influence BC sound transmission.
Bone conduction sound transmission in humans has been extensively studied using cochlear promontory vibrations. These studies use vibration data collected from measurements in live humans, whole cadavers, and severed cadaver heads, with stimulation applied either at an implant in the skull bone or directly on the skin. Experimental protocols, methods, and preparation of cadavers or cadaver heads vary among the studies, and it is currently unknown to what extent the aforementioned variables affect the outcome of those studies. The current study has two aims. The first aim is to review and compare available experimental data and assess the effects of the experimental protocol and methods. The second aim is to investigate similarities and differences found between the experimental studies based on simulations in a finite element model, the LiUHead. With implant stimulation, the average cochlear promontory vibration levels were within 10 dB, independent of the experimental setup and preparations of the cadavers or cadaver heads. With on-skin stimulation, the results were consistent between cadaver heads and living humans. Partial or complete replacement of the brain with air does not affect the cochlear promontory vibration, whereas replacing the brain with liquid reduces the vibration level by up to 5 dB. An intact head-neck connection affects the vibration of the head at frequencies below 300-400 Hz with a significant vibration reduction at frequencies below 200 Hz. Removing all soft tissue, brain tissue, and intracranial fluid from the head increases the overall cochlear promontory vibration level by around 5 dB.
The relationship between the bone conduction (BC) part and the air conduction (AC) part of ones own voice has previously not been well determined. This relation is important for hearing impaired subjects as a hearing aid affects these two parts differently and thereby changes the perception of ones own voice. A large ear-muff that minimized the occlusion effect while still attenuating AC sound was designed. During vocalization and wearing the ear muff the ear-canal sound pressure could be related to the BC component of a persons own voice while the AC component was derived from the sound pressure at the entrance of an open ear-canal. The BC relative to AC sensitivity of ones own voice was defined as the ratio between these two components related to the ear-canal sound pressure at hearing thresholds for BC and AC stimulation. The results of ten phonemes showed that the BC part of ones own voice dominated at frequencies between 1 and 2 kHz for most of the phonemes. The different phonemes gave slightly different results caused by differences during vocalization. However, similarities were seen for phonemes with comparable vocalization.
Bone conduction (BC) relative to air conduction (AC) sound field sensitivity is here defined as the perceived difference between a sound field transmitted to the ear by BC and by AC. Previous investigations of BC-AC sound field sensitivity have used different estimation methods and report estimates that vary by up to 20 dB at some frequencies. In this study, the BC-AC sound field sensitivity was investigated by hearing threshold shifts, ear canal sound pressure measurements, and skull bone vibrations measured with an accelerometer. The vibration measurement produced valid estimates at 400 Hz and below, the threshold shifts produced valid estimates at 500 Hz and above, while the ear canal sound pressure measurements were found erroneous for estimating the BC-AC sound field sensitivity. The BC-AC sound field sensitivity is proposed, by combining the present result with others, as frequency independent at 50 to 60 dB at frequencies up to 900 Hz. At higher frequencies, it is frequency dependent with minima of 40 to 50 dB at 2 and 8 kHz, and a maximum of 50 to 60 dB at 4 kHz. The BC-AC sound field sensitivity is the theoretical limit of maximum attenuation achievable with ordinary hearing protection devices. © 2007 Acoustical Society of America.
This book includes representative, peer-reviewed articles of the lectures and papers presented during the symposium, and thereby gives an overview of the ongoing research and current knowledge in the function and mechanics of the normal, diseased and reconstructed middle ear. It covers basic research, engineering and clinical aspects of evaluation, diagnosis and surgery of the middle ear as well as implantable hearing devices in a very broad and interdisciplinary way. Following the tradition of the organizers of the previous conferences to collect the contributions of the symposium, this volume further initialized and promotes many fruitful discussions on middle ear mechanics with different points of view.
Bone conduction sound transmission in the human skull and the occlusion effect were estimated from hearing thresholds and ear-canal sound pressure (ECSP) measured by a probe tube microphone when stimulation was at three positions on the skull (ipsilateral mastoid, contralateral mastoid, and forehead). The measurements were done with the ear-canal open as well as occluded by an ear-plug. Depending on the estimation method, transcranial transmission at frequencies below 1 kHz was between −8 and 5 dB, around 0 dB at 1 kHz that decreased with frequency to between −17 and −7 dB at 8 kHz. The forehead transmission was, except at frequencies between 1 and 2 kHz, similar to that proposed in the standard ISO:389-3 (1994) when the threshold measurements were conducted with open ear-canals. Compared with the same measurements using hearing thresholds, the ECSP gave similar transmission results at most frequencies, but differed at 0.5, 0.75, 2 and 3 kHz. One probable reason for the differences between thresholds and ECSP might be a significant perception improvement (lower thresholds) when the stimulation was at the ipsilateral mastoid that was not found at the other positions. This improvement, which also was present in the occlusion effect data, was hypothesized to originate in greater sensitivity of the cochlea for vibration in line with the ipsilateral stimulation direction than from other directions.
Hypothesis:Intracranial pressure and skull vibrations are correlated and depend on the stimulation position and frequency.Background:A hearing sensation can be elicited by vibratory stimulation on the skin covered skull, or by stimulation on soft tissue such as the neck. It is not fully understood whether different stimulation sites induce the skull vibrations responsible for the perception or whether other transmission pathways are dominant. The aim of this study was to assess the correlation between intracranial pressure and skull vibration measured on the promontory for stimulation to different sites on the head.Methods:Measurements were performed on four human cadaver heads. A bone conduction hearing aid was held in place with a 5-Newton steel headband at four locations (mastoid, forehead, eye, and neck). While stimulating in the frequency range of 0.3 to 10kHz, acceleration of the cochlear promontory was measured with a Laser Doppler Vibrometer, and intracranial pressure at the center of the head with a hydrophone.Results:Promontory acceleration and intracranial pressure was measurable for all stimulation sites. The ratios were comparable between all stimulation sites for frequencies below 2kHz.Conclusion:These findings indicate that both promontory acceleration and intracranial pressure are involved for stimulation on the sites investigated. The transmission pathway of sound energy is comparable for the four stimulation sites.
This article reviews the relationships among different acoustic measurements of the mobility of the tympanic membrane, including impedance, admittance, reflectance, and absorbance, which the authors group under the rubric of immittance measures. Each of these quantities is defined and related to the others. The relationship is most easily grasped in terms of a straight rigid ear canal of uniform area terminated by a uniform middle ear immittance placed perpendicular to the long axis of the ear canal. Complications due to variations from this geometry are discussed. Different methods for measuring these quantities are described, and the assumptions inherent within each method are made explicit. The benefits of wideband measurements of these quantities are described, as are the benefits and limitations of different components of immittance and reflectance/absorbance. While power reflectance (the square of the magnitude of pressure reflectance) is relatively invariant along the length of the ear canal, it has the disadvantage that it ignores phase information that may be useful in assessing the presence of acoustic leaks in ear-canal measurements and identifying other potential error sources. A combination of reflectance and impedance magnitude and angle give a more complete description of the middle ear from measurements in the ear canal.
Purpose Seeing the talker's face improves speech understanding in noise, possibly releasing resources for cognitive processing. We investigated whether it improves free recall of spoken two-digit numbers.
Method Twenty younger adults with normal hearing and 24 older adults with hearing loss listened to and subsequently recalled lists of 13 two-digit numbers, with alternating male and female talkers. Lists were presented in quiet as well as in stationary and speech-like noise at a signal-to-noise ratio giving approximately 90% intelligibility. Amplification compensated for loss of audibility.
Results Seeing the talker's face improved free recall performance for the younger but not the older group. Poorer performance in background noise was contingent on individual differences in working memory capacity. The effect of seeing the talker's face did not differ in quiet and noise.
Conclusions We have argued that the absence of an effect of seeing the talker's face for older adults with hearing loss may be due to modulation of audiovisual integration mechanisms caused by an interaction between task demands and participant characteristics. In particular, we suggest that executive task demands and interindividual executive skills may play a key role in determining the benefit of seeing the talker's face during a speech-based cognitive task
There has been a recent interest in listening effort as a factor to be taken into account in the audiological clinic. However, the term “listening effort” is poorly determined and needs to be defined before it can be used as a clinical or research tool. One way of understanding listening effort is in terms of the cognitive resources expended during listening. Cognitive capacity is finite and thus if cognitive capacity is used up during the act of listening to speech there will be fewer cognitive resources left to process the content of the message conveyed. We have introduced the term Cognitive Spare Capacity (CSC) to refer to residual cognitive capacity once successful listening has taken place. This extended abstract described the work we have carried out to date on measures of CSC for research and clinical use. In the course of this work we have developed tests to assess the role of memory load, executive function and audiovisual integration in CSC under challenging conditions. When these tests are fully developed, our aim is that they should allow objective individual assessment of listening effort in cognitive terms. Results to date indicate that under challenging conditions, CSC is an arena for executive processing of temporarily stored information; it is related to individual working memory capacity and can be enhanced by hearing aid signal processing.
Objective: The aims of the current n200 study were to assess the structural relations between three classes of test variables (i.e. HEARING, COGNITION and aided speech-in-noise OUTCOMES) and to describe the theoretical implications of these relations for the Ease of Language Understanding (ELU) model. Study sample: Participants were 200 hard-of-hearing hearing-aid users, with a mean age of 60.8 years. Forty-three percent were females and the mean hearing threshold in the better ear was 37.4dB HL. Design: LEVEL1 factor analyses extracted one factor per test and/or cognitive function based on a priori conceptualizations. The more abstract LEVEL 2 factor analyses were performed separately for the three classes of test variables. Results: The HEARING test variables resulted in two LEVEL 2 factors, which we labelled SENSITIVITY and TEMPORAL FINE STRUCTURE; the COGNITIVE variables in one COGNITION factor only, and OUTCOMES in two factors, NO CONTEXT and CONTEXT. COGNITION predicted the NO CONTEXT factor to a stronger extent than the CONTEXT outcome factor. TEMPORAL FINE STRUCTURE and SENSITIVITY were associated with COGNITION and all three contributed significantly and independently to especially the NO CONTEXT outcome scores (R-2 = 0.40). Conclusions: All LEVEL 2 factors are important theoretically as well as for clinical assessment.
Working memory is important for online language processing in a dialogue. We use it to store relevant information, to inhibit or ignore irrelevant information, and to attend to conversation selectively. Working memory helps us keep track of a dialogue while taking turns and following the gist. This paper examines the Ease-of Language Understanding model (i.e., the ELU model, Rönnberg, 2003; Rönnberg et al., 2008) in light of new behavioral and neural findings concerning the role of working memory capacity (WMC) in sound and speech processing. The new ELU model is a meaning prediction system that depends on phonological and semantic interactions in rapid implicit and slower explicit processing mechanisms that both depend on working memory, albeit in different ways. New predictions and clinical implications are outlined.
Working memory is important for online language processing during conversation. We use it to maintain relevant information, to inhibit or ignore irrelevant information, and to attend to conversation selectively. Working memory helps us to keep track of and actively participate in conversation, including taking turns and following the gist. This paper examines the Ease of Language Understanding model (i.e., the ELU model, Rönnberg, 2003; Rönnberg et al., 2008) in light of new behavioral and neural findings concerning the role of working memory capacity (WMC) in uni-modal and bimodal language processing. The new ELU model is a meaning prediction system that depends on phonological and semantic interactions in rapid implicit and slower explicit processing mechanisms that both depend on WMC albeit in different ways. It is based on findings that address the relationship between WMC and (a) early attention processes in listening to speech, (b) signal processing in hearing aids and its effects on short-term memory, (c) inhibition of speech maskers and its effect on episodic long-term memory, (d) the effects of hearing impairment on episodic and semantic long-term memory, and finally, (e) listening effort. New predictions and clinical implications are outlined. Comparisons with other WMC and speech perception models are made.
Keywords: working memory capacity, speech in noise, attention, long-term memory, hearing loss, brain imaging analysis, oscillations, language understanding
A working memory based model for Ease of Language Understanding (ELU) has been developed (Rönnberg, 2003; Rönnberg et al., 2008; Rönnberg et al., 2011). It predicts that speech understanding in adverse, mismatching noise conditions is dependent on explicit processing resources such as working memory capacity (WMC). This presentation will examine the details of this prediction by addressing some recent data on (1) how brainstem responses are modulated by working memory load and WMC, (2) how cortical correlates of speech understanding in noise are modulated by WMC, and (3) how WMC determines episodic long-term memory for spoken discourse masked by speech.
This paper is about the role of working memory capacity in speech understanding under challenging listening conditions. The theoretical model that has driven most of the research reported in this paper is called the Ease-of-Language understanding model (Ronnberg, 2003; Ronnberg et al., 2008). The Ease-of-Language understanding model is part of a larger scientific endeavor called cognitive hearing science.
Purpose: Previous work has shown an effect of noise type on memory for intelligible speech. The aim ofthis study was to investigate the effect of background noise on memory performance of intelligible speech for older adults with hearing impairment using the Auditory Inference Span Test (AIST).
Method: Twenty participants with ages between 67 and 80 years with symmetrical hearing loss (29 to 47dB HL) performed the AIST, which requires processing of five-word sentences at three memoryload levels (MLLs) in three listening conditions: Quiet, steady-state noise (SSN), and backgroundvoices (ISTS). Individualized SNRs targeted 90% speech intelligibility. AIST performance reflects the amount of cognitive capacity occupied in listening, and consequently indicates the amount of listening effort. Working memory capacity (WMC) was assessed using the reading span test, and updating ability (UA) was assessed using the letter memory test.
Results: AIST performance decreased in background noise and with increasing MLL. It was related to UA and age but not to WMC. Response times on questions designed to probe sentence recognition increased with the addition of background noise.
Conclusions: The results demonstrate that the addition of background noise requires more cognitive resourcesto maintain speech recognition performance, leading to higher demands on the cognitive capacity,higher listening effort as measured by poorer memory performance, and longer AIST responsetimes. However, the type of background noise, SSN or ISTS, affected memory performance similarly.
Objective
The aim of this study was to investigate the effect of working memory capacity (WMC) and updating ability (UA) on listening effort measured using a new test, the Auditory Inference Span Test (AIST), as an objective measure of listening effort.
Design
The AIST is based on Swedish five-word sentences and taps into three memory load levels (MLLs). It was administered in stationary speech-shaped noise at −2, −4, and −6 dB signal-to-noise ratio (SNR). WMC was assessed using the reading span test, and UA was assessed using the letter memory test. We also collected data on speech-in-noise performance and subjectively rated listening effort at the three SNRs.
Study sample
Thirty-nine participants with normal hearing thresholds (≤20 dB HL for 250 to 4000 Hz) took part in the study.
Results
AIST performance decreased with increasing MLL and was related to WMC and UA. Participants with high WMC performed better than those with low WMC at more favorable SNRs. Participants with high UA performed better than participants with low UA at the intermediate MLL, which made particular demands on the UA. Neither speech recognition scores nor subjectively rated listening effort was associated with AIST performance or either of the cognitive variables.
Conclusion
AIST taps into cognitive functions necessary for understanding speech in noise. However, in its current form AIST may be too cognitively taxing to successfully measure graded listening effort in participants with lower cognitive capacity.
Listening in noise is often perceived to be effortful. This is partly because cognitive resources are engaged in separating the target signal from background noise, leaving fewer resources for storage and processing of the content of the message in working memory. The Auditory Inference Span Test (AIST) is designed to assess listening effort by measuring the ability to maintain and process heard information. The aim of this study was to use AIST to investigate the effect of background noise types and signal-to-noise ratio (SNR) on listening effort, as a function of working memory capacity (WMC) and updating ability (UA). The AIST was administered in three types of background noise: steady-state speech-shaped noise, amplitude modulated speech-shaped noise, and unintelligible speech. Three SNRs targeting 90% speech intelligibility or better were used in each of the three noise types, giving nine different conditions. The reading span test assessed VVMC, while UA was assessed with the letter memory test. Twenty young adults with normal hearing participated in the study. Results showed that AIST performance was not influenced by noise type at the same intelligibility level, but became worse with worse SNR when background noise was speech-like. Performance on AIST also decreased with increasing memory load level. Correlations between AIST performance and the cognitive measurements suggested that WMC is of more importance for listening when SNRs are worse, while UA is of more importance for listening in easier SNRs. The results indicated that in young adults with normal hearing, the effort involved in listening in noise at high intelligibility levels is independent of the noise type. However, when noise is speech-like and intelligibility decreases, listening effort increases, probably due to extra demands on cognitive resources added by the informational masking created by the speech fragments and vocal sounds in the background noise.