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Smits C, Festen JM, Swanepoel DW, Moore DR, Dillon H. The one-up one-down adaptive (staircase) procedure in speech-in-noise testing: Standard error of measurement and fluctuations in the track. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2022; 152:2357. [PMID: 36319224 DOI: 10.1121/10.0014898] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 09/20/2022] [Indexed: 06/16/2023]
Abstract
The one-up one-down adaptive (staircase or up-down) procedure is often used to estimate the speech recognition threshold (SRT) in speech-in-noise testing. This article provides a brief historical overview of the one-up one-down procedure in psychophysics, discussing the groundbreaking early work that is still relevant to clinical audiology and scientific research. Next, this article focuses on two aspects of the one-up one-down adaptive procedure: first, the standard error of measurement (SEM) and, second, the fluctuations in the track [i.e., the standard deviation of the signal-to-noise ratios of the stimuli within the track (SDtrack)]. Simulations of ideal and non-ideal listeners and experimental data are used to determine and evaluate different relationships between the parameters slope of the speech recognition function, SRT, SEM, and SDtrack. Hearing loss and non-ideal behavior (inattentiveness, fatigue, and giving up when the task becomes too difficult) slightly increase the average value of SDtrack. SDtrack, however, poorly discriminates between reliable and unreliable SRT estimates.
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Affiliation(s)
- Cas Smits
- Amsterdam UMC location University of Amsterdam, Otolaryngology-Head and Neck Surgery, Ear and Hearing, Amsterdam Public Health Research Institute, Meibergdreef 9, Amsterdam, Netherlands
| | - Joost M Festen
- Amsterdam UMC location Vrije Universiteit Amsterdam, Otolaryngology-Head and Neck Surgery, Ear and Hearing, Amsterdam Public Health Research Institute, De Boelelaan 1117, Amsterdam, Netherlands
| | - De Wet Swanepoel
- Department of Speech-Language Pathology and Audiology, University of Pretoria, Pretoria, Gauteng, South Africa
| | - David R Moore
- Communication Sciences Research Center, Cincinnati Children's Hospital Medical Center and University of Cincinnati, Cincinnati, Ohio 45229, USA
| | - Harvey Dillon
- Manchester Centre for Audiology and Deafness, University of Manchester, Manchester, United Kingdom
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Dietz A, Heinrich A, Törmäkangas T, Iso-Mustajärvi M, Miettinen P, Willberg T, Linder PH. The Effectiveness of Unilateral Cochlear Implantation on Performance-Based and Patient-Reported Outcome Measures in Finnish Recipients. Front Neurosci 2022; 16:786939. [PMID: 35733938 PMCID: PMC9207276 DOI: 10.3389/fnins.2022.786939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 04/19/2022] [Indexed: 11/13/2022] Open
Abstract
Understanding speech is essential for adequate social interaction, and its functioning affects health, wellbeing, and quality of life (QoL). Untreated hearing loss (HL) is associated with reduced social activity, depression and cognitive decline. Severe and profound HL is routinely rehabilitated with cochlear implantation. The success of treatment is mostly assessed by performance-based outcome measures such as speech perception. The ultimate goal of cochlear implantation, however, is to improve the patient’s QoL. Therefore, patient-reported outcomes measures (PROMs) would be clinically valuable as they assess subjective benefits and overall effectiveness of treatment. The aim of this study was to assess the patient-reported benefits of unilateral cochlear implantation in an unselected Finnish patient cohort of patients with bilateral HL. The study design was a prospective evaluation of 118 patients. The patient cohort was longitudinally followed up with repeated within-subject measurements preoperatively and at 6 and 12 months postoperatively. The main outcome measures were one performance-based speech-in-noise (SiN) test (Finnish Matrix Sentence Test), and two PROMs [Finnish versions of the Speech, Spatial, Qualities of Hearing questionnaire (SSQ) and the Nijmegen Cochlear Implant Questionnaire (NCIQ)]. The results showed significant average improvements in SiN scores, from +0.8 dB signal-to-noise ratio (SNR) preoperatively to −3.7 and −3.8 dB SNR at 6 and12 month follow-up, respectively. Significant improvements were also found for SSQ and NCIQ scores in all subdomains from the preoperative state to 6 and 12 months after first fitting. No clinically significant improvements were observed in any of the outcome measures between 6 and 12 months. Preoperatively, poor SiN scores were associated with low scoring in several subdomains of the SSQ and NCIQ. Poor preoperative SiN scores and low PROMs scoring were significantly associated with larger postoperative improvements. No significant association was found between SiN scores and PROMs postoperatively. This study demonstrates significant benefits of cochlear implantation in the performance-based and patient-reported outcomes in an unselected patient sample. The lack of association between performance and PROMs scores postoperatively suggests that both capture unique aspects of benefit, highlighting the need to clinically implement PROMs in addition to performance-based measures for a more holistic assessment of treatment benefit.
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Affiliation(s)
- Aarno Dietz
- Department of Otolaryngology, Kuopio University Hospital, Kuopio, Finland
- *Correspondence: Aarno Dietz,
| | - Antje Heinrich
- Division of Human Communication, Development and Hearing, School of Health Sciences, University of Manchester, Manchester, United Kingdom
| | - Timo Törmäkangas
- Department of Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | | | - Petrus Miettinen
- Department of Otolaryngology, Kuopio University Hospital, Kuopio, Finland
- Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
| | - Tytti Willberg
- Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
- Department of Otorhinolaryngology – Head and Neck Surgery, Turku University Hospital, Turku, Finland
| | - Pia H. Linder
- Department of Otolaryngology, Kuopio University Hospital, Kuopio, Finland
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Dingemanse G, Goedegebure A. Listening Effort in Cochlear Implant Users: The Effect of Speech Intelligibility, Noise Reduction Processing, and Working Memory Capacity on the Pupil Dilation Response. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2022; 65:392-404. [PMID: 34898265 DOI: 10.1044/2021_jslhr-21-00230] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
PURPOSE This study aimed to evaluate the effect of speech recognition performance, working memory capacity (WMC), and a noise reduction algorithm (NRA) on listening effort as measured with pupillometry in cochlear implant (CI) users while listening to speech in noise. METHOD Speech recognition and pupil responses (peak dilation, peak latency, and release of dilation) were measured during a speech recognition task at three speech-to-noise ratios (SNRs) with an NRA in both on and off conditions. WMC was measured with a reading span task. Twenty experienced CI users participated in this study. RESULTS With increasing SNR and speech recognition performance, (a) the peak pupil dilation decreased by only a small amount, (b) the peak latency decreased, and (c) the release of dilation after the sentences increased. The NRA had no effect on speech recognition in noise or on the peak or latency values of the pupil response but caused less release of dilation after the end of the sentences. A lower reading span score was associated with higher peak pupil dilation but was not associated with peak latency, release of dilation, or speech recognition in noise. CONCLUSIONS In CI users, speech perception is effortful, even at higher speech recognition scores and high SNRs, indicating that CI users are in a chronic state of increased effort in communication situations. The application of a clinically used NRA did not improve speech perception, nor did it reduce listening effort. Participants with a relatively low WMC exerted relatively more listening effort but did not have better speech reception thresholds in noise.
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Affiliation(s)
- Gertjan Dingemanse
- Department of Otorhinolaryngology, Head and Neck Surgery, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - André Goedegebure
- Department of Otorhinolaryngology, Head and Neck Surgery, Erasmus University Medical Center, Rotterdam, the Netherlands
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Faramarzi M, Kasten FH, Altaş G, Aleman A, Ćurčić-Blake B, Herrmann CS. Similar EEG Activity Patterns During Experimentally-Induced Auditory Illusions and Veridical Perceptions. Front Neurosci 2021; 15:602437. [PMID: 33867913 PMCID: PMC8047478 DOI: 10.3389/fnins.2021.602437] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Accepted: 03/12/2021] [Indexed: 12/31/2022] Open
Abstract
Hallucinations and illusions are two instances of perceptual experiences illustrating how perception might diverge from external sensory stimulations and be generated or altered based on internal brain states. The occurrence of these phenomena is not constrained to patient populations. Similar experiences can be elicited in healthy subjects by means of suitable experimental procedures. Studying the neural mechanisms underlying these experiences not only has the potential to expand our understanding of the brain's perceptual machinery but also of how it might get impaired. In the current study, we employed an auditory signal detection task to induce auditory illusions by presenting speech snippets at near detection threshold intensity embedded in noise. We investigated the neural correlates of auditory false perceptions by examining the EEG activity preceding the responses in speech absent (false alarm, FA) trials and comparing them to speech present (hit) trials. The results of the comparison of event-related potentials (ERPs) in the activation period vs. baseline revealed the presence of an early negativity (EN) and a late positivity (LP) similar in both hits and FAs, which were absent in misses, correct rejections (CR) and control button presses (BPs). We postulate that the EN and the LP might represent the auditory awareness negativity (AAN) and centro-parietal positivity (CPP) or P300, respectively. The event-related spectral perturbations (ERSPs) exhibited a common power enhancement in low frequencies (<4 Hz) in hits and FAs. The low-frequency power enhancement has been frequently shown to be accompanied with P300 as well as separately being a marker of perceptual awareness, referred to as slow cortical potentials (SCP). Furthermore, the comparison of hits vs. FAs showed a significantly higher LP amplitude and low frequency power in hits compared to FAs. Generally, the observed patterns in the present results resembled some of the major neural correlates associated with perceptual awareness in previous studies. Our findings provide evidence that the neural correlates associated with conscious perception, can be elicited in similar ways in both presence and absence of externally presented sensory stimuli. The present findings did not reveal any pre-stimulus alpha and beta modulations distinguishing conscious vs. unconscious perceptions.
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Affiliation(s)
- Maryam Faramarzi
- Experimental Psychology Lab, Department of Psychology, European Medical School, Cluster of Excellence “Hearing4All,” Carl von Ossietzky University, Oldenburg, Germany
- Department of Biomedical Sciences of Cells and Systems, Cognitive Neuroscience Center, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
| | - Florian H. Kasten
- Experimental Psychology Lab, Department of Psychology, European Medical School, Cluster of Excellence “Hearing4All,” Carl von Ossietzky University, Oldenburg, Germany
- Neuroimaging Unit, European Medical School, Carl von Ossietzky University, Oldenburg, Germany
| | - Gamze Altaş
- Experimental Psychology Lab, Department of Psychology, European Medical School, Cluster of Excellence “Hearing4All,” Carl von Ossietzky University, Oldenburg, Germany
| | - André Aleman
- Department of Biomedical Sciences of Cells and Systems, Cognitive Neuroscience Center, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
| | - Branislava Ćurčić-Blake
- Department of Biomedical Sciences of Cells and Systems, Cognitive Neuroscience Center, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
| | - Christoph S. Herrmann
- Experimental Psychology Lab, Department of Psychology, European Medical School, Cluster of Excellence “Hearing4All,” Carl von Ossietzky University, Oldenburg, Germany
- Neuroimaging Unit, European Medical School, Carl von Ossietzky University, Oldenburg, Germany
- Research Center Neurosensory Science, Carl von Ossietzky University, Oldenburg, Germany
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