Towards decoding selective attention through cochlear implant electrodes as sensors in subjects with contralateral acoustic hearing

Phoneme-related potentials recorded from normal hearing listeners and cochlear implant users in a selective attention paradigm to continuous speech

Cochlear implants can restore the ability to understand speech in patients with profound sensorineural hearing loss. At present, it is not fully understood how cochlear implant users perceive speech and how electric hearing provided by a cochlear implant differs from acoustic hearing. Phoneme-related potentials characterize neural responses to individual instances of phonemes extracted from continuous speech. This retrospective study investigated phoneme-related potentials in cochlear implant users in a selective attention paradigm. Responses were compared between normal hearing listeners and cochlear implant users, and between attended and unattended conditions. Differences between phoneme categories were compared and a classifier was trained to predict the phoneme category from the neural representation. The phoneme-related potentials of cochlear implant users showed similar responses to the ones obtained in normal hearing listeners for early responses (< 100 ms) but not for later responses (> 100 ms) where peaks were smaller or absent. Attention led to an enhancement of the response, whereas latency was mostly not affected by attention. The temporal morphology of the response was influenced by the phonetic features of the stimulus, allowing a classification of the phoneme category based on the phoneme-related potentials. There is a clinical need for methods that can rapidly and objectively assess the speech understanding performance of cochlear implant users. Phoneme-related potentials may provide such a link between the acoustic and the neural representations of phonemes. They may also reveal the challenges of individual subjects and thus provide indications for patient-specific auditory training, rehabilitation programs or the fitting of cochlear implant parameters.

A Review of Auditory Attention: Neural Mechanisms, Theories, and Affective Disorders

Attention is a fundamental aspect of human cognitive function and is crucial for essential activities such as learning, social interaction, and routine tasks. Notably, Auditory attention involves complex interactions and collaboration among multiple brain networks. Recognizing the impairment of auditory attention, comprehending its underlying mechanisms, and identifying the activated brain regions essential for the development of treatments and interventions for individuals facing auditory attention deficits, emphasizes the significance of investigating these matters. In the current study, we conducted a review by searching for the full text of 53 articles published related to auditory attention, mechanisms, and networks in databases like Science Direct, Google Scholar, ProQuest, and PubMed using the keywords Attention, Auditory Attention, Auditory Attention Impairment, theories of attention were investigated in the years 2000 to 2023 And focused on articles that provided discussions within this research domain. The studies have demonstrated that auditory attention exceeds being an acoustic attribute and assumes a fundamental role in complex acoustic environments, information processing, and even speech comprehension. In the context of this study, we have conducted a review and summary of the proposed theories related to attention and the brain networks involved in different forms of auditory attention. In conclusion, the integration of auditory attention assessments, behavioral observations, and an understanding of the neural mechanisms and brain regions implicated in auditory attention proves to be an effective approach for the diagnosis and treatment of attention-related disorders.

Psychoacoustic and electroencephalographic responses to changes in amplitude modulation depth and frequency in relation to speech recognition in cochlear implantees

Temporal envelope modulations (TEMs) are one of the most important features that cochlear implant (CI) users rely on to understand speech. Electroencephalographic assessment of TEM encoding could help clinicians to predict speech recognition more objectively, even in patients unable to provide active feedback. The acoustic change complex (ACC) and the auditory steady-state response (ASSR) evoked by low-frequency amplitude-modulated pulse trains can be used to assess TEM encoding with electrical stimulation of individual CI electrodes. In this study, we focused on amplitude modulation detection (AMD) and amplitude modulation frequency discrimination (AMFD) with stimulation of a basal versus an apical electrode. In twelve adult CI users, we (a) assessed behavioral AMFD thresholds and (b) recorded cortical auditory evoked potentials (CAEPs), AMD-ACC, AMFD-ACC, and ASSR in a combined 3-stimulus paradigm. We found that the electrophysiological responses were significantly higher for apical than for basal stimulation. Peak amplitudes of AMFD-ACC were small and (therefore) did not correlate with speech-in-noise recognition. We found significant correlations between speech-in-noise recognition and (a) behavioral AMFD thresholds and (b) AMD-ACC peak amplitudes. AMD and AMFD hold potential to develop a clinically applicable tool for assessing TEM encoding to predict speech recognition in CI users.

Selective attention decoding in bimodal cochlear implant users

The growing group of cochlear implant (CI) users includes subjects with preserved acoustic hearing on the opposite side to the CI. The use of both listening sides results in improved speech perception in comparison to listening with one side alone. However, large variability in the measured benefit is observed. It is possible that this variability is associated with the integration of speech across electric and acoustic stimulation modalities. However, there is a lack of established methods to assess speech integration between electric and acoustic stimulation and consequently to adequately program the devices. Moreover, existing methods do not provide information about the underlying physiological mechanisms of this integration or are based on simple stimuli that are difficult to relate to speech integration. Electroencephalography (EEG) to continuous speech is promising as an objective measure of speech perception, however, its application in CIs is challenging because it is influenced by the electrical artifact introduced by these devices. For this reason, the main goal of this work is to investigate a possible electrophysiological measure of speech integration between electric and acoustic stimulation in bimodal CI users. For this purpose, a selective attention decoding paradigm has been designed and validated in bimodal CI users. The current study included behavioral and electrophysiological measures. The behavioral measure consisted of a speech understanding test, where subjects repeated words to a target speaker in the presence of a competing voice listening with the CI side (CIS) only, with the acoustic side (AS) only or with both listening sides (CIS+AS). Electrophysiological measures included cortical auditory evoked potentials (CAEPs) and selective attention decoding through EEG. CAEPs were recorded to broadband stimuli to confirm the feasibility to record cortical responses with CIS only, AS only, and CIS+AS listening modes. In the selective attention decoding paradigm a co-located target and a competing speech stream were presented to the subjects using the three listening modes (CIS only, AS only, and CIS+AS). The main hypothesis of the current study is that selective attention can be decoded in CI users despite the presence of CI electrical artifact. If selective attention decoding improves combining electric and acoustic stimulation with respect to electric stimulation alone, the hypothesis can be confirmed. No significant difference in behavioral speech understanding performance when listening with CIS+AS and AS only was found, mainly due to the ceiling effect observed with these two listening modes. The main finding of the current study is the possibility to decode selective attention in CI users even if continuous artifact is present. Moreover, an amplitude reduction of the forward transfer response function (TRF) of selective attention decoding was observed when listening with CIS+AS compared to AS only. Further studies to validate selective attention decoding as an electrophysiological measure of electric acoustic speech integration are required.

Predicting speech intelligibility from a selective attention decoding paradigm in cochlear implant users

OBJECTIVES

Electroencephalography (EEG) can be used to decode selective attention in cochlear implant (CI) users. This work investigates if selective attention to an attended speech source in the presence of a concurrent speech source can predict speech understanding in CI users.

APPROACH

CI users were instructed to attend to one out of two speech streams while EEG was recorded. Both speech streams were presented to the same ear and at different signal to interference ratios (SIRs). Speech envelope reconstruction of the to-be-attended speech from EEG was obtained by training decoders using regularized least squares. The correlation coefficient between the reconstructed and the attended (ρ_(A_SIR )) or the unattended (ρ_(U_SIR )) speech stream at each SIR was computed. Additionally, we computed the difference correlation coefficient at the same 〖(ρ〗_Diff= ρ_(A_SIR )-ρ_(U_SIR )) and opposite SIR (ρ_DiffOpp= ρ_(A_SIR )-ρ_(U_(-SIR) )). ρ_Diff compares the attended and unattended correlation coefficient to speech sources presented at different presentation levels depending on SIR. In contrast, ρ_DiffOpp compares the attended and unattended correlation coefficients to speech sources presented at the same presentation level irrespective of SIR.

MAIN RESULTS

Selective attention decoding in CI users is possible even if both speech streams are presented monaurally. A significant effect of SIR on ρ_(A_SIR ), ρ_Diff and ρ_DiffOpp, but not on ρ_(U_SIR ), was observed. Finally, the results show a significant correlation between speech understanding performance and ρ_(A_SIR ) as well as with ρ_(U_SIR ) across subjects. Moreover, ρ_DiffOpp which is less affected by the CI artifact, also demonstrated a significant correlation with speech understanding.

SIGNIFICANCE

Selective attention decoding in CI users is possible, however care needs to be taken with the CI artifact and the speech material used to train the decoders. These results are important for future development of objective speech understanding measures for CI users.