Cortical Measures of Binaural Processing Predict Spatial Release from Masking Performance

Objective measure of binaural processing: Acoustic change complex in response to interaural phase differences

Combining cochlear implants with binaural acoustic hearing via preserved hearing in the implanted ear(s) is commonly referred to as combined electric and acoustic stimulation (EAS). EAS fittings can provide patients with significant benefit for speech recognition in complex noise, perceived listening difficulty, and horizontal-plane localization as compared to traditional bimodal hearing conditions with contralateral and monaural acoustic hearing. However, EAS benefit varies across patients and the degree of benefit is not reliably related to the underlying audiogram. Previous research has indicated that EAS benefit for speech recognition in complex listening scenarios and localization is significantly correlated with the patients' binaural cue sensitivity, namely interaural time differences (ITD). In the context of pure tones, interaural phase differences (IPD) and ITD can be understood as two perspectives on the same phenomenon. Through simple mathematical conversion, one can be transformed into the other, illustrating their inherent interrelation for spatial hearing abilities. However, assessing binaural cue sensitivity is not part of a clinical assessment battery as psychophysical tasks are time consuming, require training to achieve performance asymptote, and specialized programming and software all of which render this clinically unfeasible. In this study, we investigated the possibility of using an objective measure of binaural cue sensitivity by the acoustic change complex (ACC) via imposition of an IPD of varying degrees at stimulus midpoint. Ten adult listeners with normal hearing were assessed on tasks of behavioral and objective binaural cue sensitivity for carrier frequencies of 250 and 1000 Hz. Results suggest that 1) ACC amplitude increases with IPD; 2) ACC-based IPD sensitivity for 250 Hz is significantly correlated with behavioral ITD sensitivity; 3) Participants were more sensitive to IPDs at 250 Hz as compared to 1000 Hz. Thus, this objective measure of IPD sensitivity may hold clinical application for pre- and post-operative assessment for individuals meeting candidacy indications for cochlear implantation with low-frequency acoustic hearing preservation as this relatively quick and objective measure may provide clinicians with information identifying patients most likely to derive benefit from EAS technology.

Rate dependent neural responses of interaural-time-difference cues in fine-structure and envelope

Advancements in cochlear implants (CIs) have led to a significant increase in bilateral CI users, especially among children. Yet, most bilateral CI users do not fully achieve the intended binaural benefit due to potential limitations in signal processing and/or surgical implant positioning. One crucial auditory cue that normal hearing (NH) listeners can benefit from is the interaural time difference (ITD), i.e., the time difference between the arrival of a sound at two ears. The ITD sensitivity is thought to be heavily relying on the effective utilization of temporal fine structure (very rapid oscillations in sound). Unfortunately, most current CIs do not transmit such true fine structure. Nevertheless, bilateral CI users have demonstrated sensitivity to ITD cues delivered through envelope or interaural pulse time differences, i.e., the time gap between the pulses delivered to the two implants. However, their ITD sensitivity is significantly poorer compared to NH individuals, and it further degrades at higher CI stimulation rates, especially when the rate exceeds 300 pulse per second. The overall purpose of this research thread is to improve spatial hearing abilities in bilateral CI users. This study aims to develop electroencephalography (EEG) paradigms that can be used with clinical settings to assess and optimize the delivery of ITD cues, which are crucial for spatial hearing in everyday life. The research objective of this article was to determine the effect of CI stimulation pulse rate on the ITD sensitivity, and to characterize the rate-dependent degradation in ITD perception using EEG measures. To develop protocols for bilateral CI studies, EEG responses were obtained from NH listeners using sinusoidal-amplitude-modulated (SAM) tones and filtered clicks with changes in either fine structure ITD (ITDFS) or envelope ITD (ITDENV). Multiple EEG responses were analyzed, which included the subcortical auditory steady-state responses (ASSRs) and cortical auditory evoked potentials (CAEPs) elicited by stimuli onset, offset, and changes. Results indicated that acoustic change complex (ACC) responses elicited by ITDENV changes were significantly smaller or absent compared to those elicited by ITDFS changes. The ACC morphologies evoked by ITDFS changes were similar to onset and offset CAEPs, although the peak latencies were longest for ACC responses and shortest for offset CAEPs. The high-frequency stimuli clearly elicited subcortical ASSRs, but smaller than those evoked by lower carrier frequency SAM tones. The 40-Hz ASSRs decreased with increasing carrier frequencies. Filtered clicks elicited larger ASSRs compared to high-frequency SAM tones, with the order being 40 > 160 > 80> 320 Hz ASSR for both stimulus types. Wavelet analysis revealed a clear interaction between detectable transient CAEPs and 40-Hz ASSRs in the time-frequency domain for SAM tones with a low carrier frequency.

Age-related differences in auditory spatial processing revealed by acoustic change complex

Objectives

The auditory spatial processing abilities mature throughout childhood and degenerate in older adults. This study aimed to compare the differences in onset cortical auditory evoked potentials (CAEPs) and location-evoked acoustic change complex (ACC) responses among children, adults, and the elderly and to investigate the impact of aging and development on ACC responses.

Design

One hundred and seventeen people were recruited in the study, including 57 typically-developed children, 30 adults, and 30 elderlies. The onset-CAEP evoked by white noise and ACC by sequential changes in azimuths were recorded. Latencies and amplitudes as a function of azimuths were analyzed using the analysis of variance, Pearson correlation analysis, and multiple linear regression model.

Results

The ACC N1'-P2' amplitudes and latencies in adults, P1'-N1' amplitudes in children, and N1' amplitudes and latencies in the elderly were correlated with angles of shifts. The N1'-P2' and P2' amplitudes decreased in the elderly compared to adults. In Children, the ACC P1'-N1' responses gradually differentiated into the P1'-N1'-P2' complex. Multiple regression analysis showed that N1'-P2' amplitudes (R2 = 0.33) and P2' latencies (R2 = 0.18) were the two most variable predictors in adults, while in the elderly, N1' latencies (R2 = 0.26) explained most variances. Although the amplitudes of onset-CAEP differed at some angles, it could not predict angle changes as effectively as ACC responses.

Conclusion

The location-evoked ACC responses varied among children, adults, and the elderly. The N1'-P2' amplitudes and P2' latencies in adults and N1' latencies in the elderly explained most variances of changes in spatial position. The differentiation of the N1' waveform was observed in children. Further research should be conducted across all age groups, along with behavioral assessments, to confirm the relationship between aging and immaturity in objective ACC responses and poorer subjective spatial performance.

Significance

ACCs evoked by location changes were assessed in adults, children, and the elderly to explore the impact of aging and development on these differences.

Frequency and Time Domain Analysis of EEG Based Auditory Evoked Potentials to Detect Binaural Hearing in Noise

Hearing loss is a prevalent health issue that affects individuals worldwide. Binaural hearing refers to the ability to integrate information received simultaneously from both ears, allowing individuals to identify, locate, and separate sound sources. Auditory evoked potentials (AEPs) refer to the electrical responses that are generated within any part of the auditory system in response to auditory stimuli presented externally. Electroencephalography (EEG) is a non-invasive technology used for the monitoring of AEPs. This research aims to investigate the use of audiometric EEGs as an objective method to detect specific features of binaural hearing with frequency and time domain analysis techniques. Thirty-five subjects with normal hearing and a mean age of 27.35 participated in the research. The stimuli used in the current study were designed to investigate the impact of binaural phase shifts of the auditory stimuli in the presence of noise. The frequency domain and time domain analyses provided statistically significant and promising novel findings. The study utilized Blackman windowed 18 ms and 48 ms pure tones as stimuli, embedded in noise maskers, of frequencies 125 Hz, 250 Hz, 500 Hz, 750 Hz, 1000 Hz in homophasic (the same phase in both ears) and antiphasic (180-degree phase difference between the two ears) conditions. The study focuses on the effect of phase reversal of auditory stimuli in noise of the middle latency response (MLR) and late latency response (LLR) regions of the AEPs. The frequency domain analysis revealed a significant difference in the frequency bands of 20 to 25 Hz and 25 to 30 Hz when elicited by antiphasic and homophasic stimuli of 500 Hz for MLRs and 500 Hz and 250 Hz for LLRs. The time domain analysis identified the Na peak of the MLR for 500 Hz, the N1 peak of the LLR for 500 Hz stimuli and the P300 peak of the LLR for 250 Hz as significant potential markers in detecting binaural processing in the brain.

The electrophysiological masking level difference: effects of age and mediation of hearing and cognition

OBJECTIVE

Evaluate the conceptual framework that age effects on the electrophysiological binaural masking level difference (MLD) are partially mediated by age-related hearing loss and/or global cognitive function via mediation analysis.

DESIGN

Participants underwent a series of audiometric tests. The MLD was measured via cortical auditory evoked potentials using a speech stimulus (/ɑ/) in speech-weighted background noise. We used mediation analyses to determine the total effect, natural direct effects, and natural indirect effects, which are displayed as regression coefficients ([95% CI]; p value).

STUDY SAMPLE

Twenty-eight individuals aged 19-87 years (mean [SD]: 53.3 [25.2]), recruited from the community.

RESULTS

Older age had a significant total effect on the MLD (-0.69 [95% CI: -0.96, -0.45]; p < 0.01). Neither pure tone average (-0.11 [95% CI: -0.43, 0.24; p = 0.54] nor global cognitive function (-0.02 [95% CI: -0.13, 0.02]; p = 0.55) mediated the relationship of age and the MLD and effect sizes were small. Results were insensitive to use of alternative hearing measures or inclusion of interaction terms.

CONCLUSIONS

The electrophysiological MLD may be an age-sensitive measure of binaural temporal processing that is minimally affected by age-related hearing loss and global cognitive function.

Individualized Assays of Temporal Coding in the Ascending Human Auditory System

Neural phase-locking to temporal fluctuations is a fundamental and unique mechanism by which acoustic information is encoded by the auditory system. The perceptual role of this metabolically expensive mechanism, the neural phase-locking to temporal fine structure (TFS) in particular, is debated. Although hypothesized, it is unclear whether auditory perceptual deficits in certain clinical populations are attributable to deficits in TFS coding. Efforts to uncover the role of TFS have been impeded by the fact that there are no established assays for quantifying the fidelity of TFS coding at the individual level. While many candidates have been proposed, for an assay to be useful, it should not only intrinsically depend on TFS coding, but should also have the property that individual differences in the assay reflect TFS coding per se over and beyond other sources of variance. Here, we evaluate a range of behavioral and electroencephalogram (EEG)-based measures as candidate individualized measures of TFS sensitivity. Our comparisons of behavioral and EEG-based metrics suggest that extraneous variables dominate both behavioral scores and EEG amplitude metrics, rendering them ineffective. After adjusting behavioral scores using lapse rates, and extracting latency or percent-growth metrics from EEG, interaural timing sensitivity measures exhibit robust behavior-EEG correlations. Together with the fact that unambiguous theoretical links can be made relating binaural measures and phase-locking to TFS, our results suggest that these "adjusted" binaural assays may be well suited for quantifying individual TFS processing.

Comparison of two cortical measures of binaural hearing acuity

OBJECTIVE

Multiple studies have demonstrated binaural hearing deficits in the aging and those with hearing loss. Consequently, there is great interest in developing efficient clinical tests of binaural hearing acuity to improve diagnostic assessments and to assist clinicians when fitting binaural hearing aids and/or cochlear implants.

DESIGN

Two cortical measures of interaural phase difference sensitivity, the acoustic change complex (ACC) and interaural phase modulation following response (IPM-FR), were compared on three metrics using five different stimulus interaural phase differences (IPDs; 0°, ±22.5°, ±45°, ±67.5° and ±90°). These metrics were scalp topography, time-to-detect, and input-output characteristics.

STUDY SAMPLE

Ten young, normal-hearing listeners.

RESULTS

Scalp topography qualitatively differed between ACC and IPM-FR. The IPM-FR demonstrated better time-to-detect performance on smaller (±22.5° and ±45°) but not larger (67.5°, and ±90°) IPDs. Input-output characteristics of each response were similar.

CONCLUSIONS

The IPM-FR may be a faster and more efficient tool for assessing neural sensitivity to subtle IPD changes. However, the ACC may be useful for research or clinical questions concerned with the topographic representation of binaural cues.

Hemodynamic Responses Link Individual Differences in Informational Masking to the Vicinity of Superior Temporal Gyrus

Suppressing unwanted background sound is crucial for aural communication. A particularly disruptive type of background sound, informational masking (IM), often interferes in social settings. However, IM mechanisms are incompletely understood. At present, IM is identified operationally: when a target should be audible, based on suprathreshold target/masker energy ratios, yet cannot be heard because target-like background sound interferes. We here confirm that speech identification thresholds differ dramatically between low- vs. high-IM background sound. However, speech detection thresholds are comparable across the two conditions. Moreover, functional near infrared spectroscopy recordings show that task-evoked blood oxygenation changes near the superior temporal gyrus (STG) covary with behavioral speech detection performance for high-IM but not low-IM background sound, suggesting that the STG is part of an IM-dependent network. Moreover, listeners who are more vulnerable to IM show increased hemodynamic recruitment near STG, an effect that cannot be explained based on differences in task difficulty across low- vs. high-IM. In contrast, task-evoked responses near another auditory region of cortex, the caudal inferior frontal sulcus (cIFS), do not predict behavioral sensitivity, suggesting that the cIFS belongs to an IM-independent network. Results are consistent with the idea that cortical gating shapes individual vulnerability to IM.

Electrophysiological Evidence of Auditory and Cognitive Processing Deficits in Parkinson Disease

Background

Parkinson's disease (PD) patients are at increased risk for central auditory processing (CAP) deficits and cognitive dysfunction. However, behavioral assessments of CAP and cognitive processing used in a previous study by our research team found few significant differences in performance between early-stage PD patients and age-matched control subjects. The objective of this study is to use auditory event-related potentials (AERPs) to compare CAP and cognitive functions in a population of PD patients with a group of age-matched control subjects.

Methods

AERPs in response to tonal and speech stimuli were recorded from 35 adults who had a medical diagnosis of PD (23 males and 12 females; mean age = 66.9 ± s.d.11.2 years), and 35 age-matched control subjects who did not have PD or any other neurological disorders (31 males and 4 females; mean age = 65.4 ± s.d.12.3 years). Auditory stimuli included pure tones (500 and 1000 Hz) to elicit the P300 response and a dichotic digits paradigm to elicit the N200 processing negativity.

Results

Compared to control subjects, PD patients exhibited significantly longer latencies of P300 and N200 components and smaller amplitude N200 components. Latency and amplitude of the N200 component were significantly correlated with participants' age. N200 amplitude was correlated with results from the Rey Auditory Verbal Learning Test (RAVLT) of cognitive ability. Latency of the P300 and amplitude of the N200 components were significantly correlated with results from the Spatial Release From Masking (SRM) behavioral CAP assessment.

Conclusions

AERP assessments used in this study appear to be sensitive indicators of CAP and cognitive deficits exhibited by early-stage PD patients. While few significant differences in performance on behavioral CAP and cognitive tests were previously observed between this population of PD patients and age-matched control subjects, N200 and P300 components recorded in the present study revealed impaired neural processing by the PD group.

Effects of interaural decoherence on sensitivity to interaural level differences across frequency

The interaural level difference (ILD) is a robust indicator of sound source azimuth, and human ILD sensitivity persists under conditions that degrade normally-dominant interaural time difference (ITD) cues. Nonetheless, ILD sensitivity varies somewhat with both stimulus frequency and interaural correlation (coherence). To further investigate the combined binaural perceptual influence of these variables, the present study assessed ILD sensitivity at frequencies 250-4000 Hz using stimuli of varied interaural correlation. In the first of two experiments, ILD discrimination thresholds were modestly elevated, and subjective lateralization slightly reduced, for both half-correlated and uncorrelated narrowband noise tokens relative to correlated tokens. Different from thresholds in the correlated condition, which were worst at 1000 Hz [Grantham, D.W. (1984). J. Acoust. Soc. Am. 75, 1191-1194], thresholds in the decorrelated conditions were independent of frequency. However, intrinsic envelope fluctuations in narrowband stimuli caused moment-to-moment variation of the nominal ILD, complicating interpretation of measured thresholds. Thus, a second experiment employed low-fluctuation noise tokens, revealing a clear effect of interaural decoherence per se that was strongly frequency-dependent, decreasing in magnitude from low to high frequencies. Measurements are consistent with known integration times in ILD-sensitive neurons and also suggest persistent influences of covert ITD cues in putative "ILD" tasks.

Effects of spatial separation with better- ear listening on N1-P2 complex

OBJECTIVE

The purpose of this study was to determine better- ear listening effect on spatial separation with the N1-P2 complex.

METHODS

Twenty individuals with normal hearing participated in this study. The speech stimulus /ba/ was presented in front of the participant (0°). Continuous Speech Noise (5 dB signal-to-noise ratio) was presented either in front of the participant (0°), left-side (-90°), or right-side (+90°). N1- P2 complex has been recorded in quiet and three noisy conditions.

RESULTS

There was a remarkable effect of noise direction on N1, P2 latencies. When the noise was separated from the stimulus, N1 and P2 latency increased in terms of when noise was co-located with the stimulus. There was no statistically significant difference in N1-P2 amplitudes between the stimulus-only and co-located condition. N1-P2 amplitude was increased when the noise came from the sides, according to the stimulus-only and co-located conditions.

CONCLUSION

These findings demonstrate that the latency shifts on N1-P2 complex explain cortical mechanisms of spatial separation in better-ear listening.

Impaired Binaural Hearing in Adults: A Selected Review of the Literature

Despite over 100 years of study, there are still many fundamental questions about binaural hearing that remain unanswered, including how impairments of binaural function are related to the mechanisms of binaural hearing. This review focuses on a number of studies that are fundamental to understanding what is known about the effects of peripheral hearing loss, aging, traumatic brain injury, strokes, brain tumors, and multiple sclerosis (MS) on binaural function. The literature reviewed makes clear that while each of these conditions has the potential to impair the binaural system, the specific abilities of a given patient cannot be known without performing multiple behavioral and/or neurophysiological measurements of binaural sensitivity. Future work in this area has the potential to bring awareness of binaural dysfunction to patients and clinicians as well as a deeper understanding of the mechanisms of binaural hearing, but it will require the integration of clinical research with animal and computational modeling approaches.

Speech induced binaural beats: Electrophysiological assessment of binaural interaction

This paper introduces and evaluates a speech signal manipulation scheme that generates transient speech induced binaural beats (SBBs). These SBBs can only be perceived when different signals are presented dichotically (to both ears). Event-related potentials were recorded in 22 normal-hearing subjects. Dichotic stimulus presentation reliably evoked auditory late responses (ALRs) in all subjects using such manipulated signals. As control measurements, diotic stimulation modalities were presented to confirm that the ALRs were not evoked by the speech signal itself or that the signal manipulation scheme created audible artifacts. Since diotic measurements evoked no ALRs, responses from dichotic stimulation are a pure correlate of binaural interaction. While there are several auditory stimuli (mostly modulated sinusoids or noise) that share this characteristic, none of them are based on running speech. Because SBBs can be added to any arbitrary speech signal, they could easily be combined with psychoacoustic tests, for example speech reception thresholds, adding an objective measure of binaural interaction.

Cochlear Implant and Hearing Aid: Objective Measures of Binaural Benefit

Cochlear implants (CI) improve hearing for the severely hearing impaired. With an extension of implantation candidacy, today many CI listeners use a hearing aid on their contralateral ear, referred to as bimodal listening. It is uncertain, however, whether the brains of bimodal listeners can combine the electrical and acoustical sound information and how much CI experience is needed to achieve an improved performance with bimodal listening. Patients with bilateral sensorineural hearing loss undergoing implant surgery were tested in their ability to understand speech in quiet and in noise, before and again 3 and 6 months after provision of a CI. Results of these bimodal listeners were compared to age-matched, normal hearing controls (NH). The benefit of adding a contralateral hearing aid was calculated in terms of head shadow, binaural summation, binaural squelch, and spatial release from masking from the results of a sentence recognition test. Beyond that, bimodal benefit was estimated from the difference in amplitudes and latencies of the N1, P2, and N2 potentials of the brains' auditory evoked response (AEP) toward speech. Data of fifteen participants contributed to the results. CI provision resulted in significant improvement of speech recognition with the CI ear, and in taking advantage of the head shadow effect for understanding speech in noise. Some amount of binaural processing was suggested by a positive binaural summation effect 6 month post-implantation that correlated significantly with symmetry of pure tone thresholds. Moreover, a significant negative correlation existed between binaural summation and latency of the P2 potential. With CI experience, morphology of the N1 and P2 potentials in the AEP response approximated that of NH, whereas, N2 remained different. Significant AEP differences between monaural and binaural processing were shown for NH and for bimodal listeners 6 month post-implantation. Although the grand-averaged difference in N1 amplitude between monaural and binaural listening was similar for NH and the bimodal group, source localization showed group-dependent differences in auditory and speech-relevant cortex, suggesting different processing in the bimodal listeners.

Binaural Frequency Modulation Detection in School-Age Children, Young Adults, and Older Adults: Effects of Interaural Modulator Phase

OBJECTIVES

The purpose of this study was to measure low-rate binaural frequency modulation (FM) detection across the lifespan as a gauge of temporal fine structure processing. Children and older adults were expected to perform more poorly than young adults but for different reasons.

DESIGN

Detection of 2-Hz FM carried by a 500-Hz pure tone was measured for modulators that were either in-phase or out-of-phase across ears. Thresholds were measured in quiet and in noise. Participants were school-age children (n = 44), young adults (n = 11), and older adults (n = 17) with normal or near-normal hearing.

RESULTS

Thresholds were lower for out-of-phase than in-phase modulators among all listening groups. Detection thresholds improved with child age, with larger effects of age for dichotic than diotic FM. Introduction of masking noise tended to elevate thresholds; this effect was larger for the dichotic condition than the diotic condition, and larger for older adults than young adults. In noise, young adults received the greatest dichotic benefit, followed by older adults, then young children. The relative effects of noise on dichotic benefit did not differ for young adults compared to young children and older adults; however, young children saw greater reduction in benefit due to noise than older adults.

CONCLUSION

The difference in dichotic benefit between children and young adults is consistent with maturation of central auditory processing. Differences in the effect of noise on dichotic benefit in young children and older adults support the idea that different factors or combinations of factors limit performance in these two groups. Although dichotic FM detection appears to be more sensitive to the effects of development and aging than diotic FM detection, the positive correlation between diotic and dichotic FM detection thresholds for all listeners suggests contribution of one or more factors common to both conditions.

Age-Related Deficits in Electrophysiological and Behavioral Measures of Binaural Temporal Processing

Binaural processing, particularly the processing of interaural phase differences, is important for sound localization and speech understanding in background noise. Age has been shown to impact the neural encoding and perception of these binaural temporal cues even in individuals with clinically normal hearing sensitivity. This work used a new electrophysiological response, called the interaural phase modulation-following response (IPM-FR), to examine the effects of age on the neural encoding of interaural phase difference cues. Relationships between neural recordings and performance on several behavioral measures of binaural processing were used to determine whether the IPM-FR is predictive of interaural phase difference sensitivity and functional speech understanding deficits. Behavioral binaural frequency modulation detection thresholds were measured to assess sensitivity to interaural phase differences while spatial release-from-masking thresholds were used to assess speech understanding abilities in spatialized noise. Thirty adults between the ages of 35 to 74 years with normal low-frequency hearing thresholds were used in this study. Data showed that older participants had weaker neural responses to the interaural phase difference cue and were less able to take advantage of binaural cues for speech understanding compared to younger participants. Results also showed that the IPM-FR was predictive of performance on the binaural frequency modulation detection task, but not on the spatial release-from-masking task after accounting the effects of age. These results confirm previous work that showed that the IPM-FR reflects age-related declines in binaural temporal processing and provide further evidence that this response may represent a useful objective tool for assessing binaural function. However, further research is needed to understand how the IPM-FR is related to speech understanding abilities.

Sensitivity to interaural time differences and localization accuracy in cochlear implant users with combined electric-acoustic stimulation

OBJECTIVES

In this study, localization accuracy and sensitivity to acoustic interaural time differences (ITDs) in subjects using cochlear implants with combined electric-acoustic stimulation (EAS) were assessed and compared with the results of a normal hearing control group.

METHODS

Eight CI users with EAS (2 bilaterally implanted, 6 unilaterally implanted) and symmetric binaural acoustic hearing and 24 normal hearing subjects participated in the study. The first experiment determined mean localization error (MLE) for different angles of sound incidence between ± 60° (frontal and dorsal presentation). The stimuli were either low-pass, high-pass or broadband noise bursts. In a second experiment, just noticeable differences (JND) of ITDs were measured for pure tones of 125 Hz, 250 Hz and 500 Hz (headphone presentation).

RESULTS

Experiment 1: MLE of EAS subjects was 8.5°, 14.3° and 14.7°, (low-, high-pass and broadband stimuli respectively). In the control group, MLE was 1.8° (broadband stimuli). In the differentiation between sound incidence from front and back, EAS subjects performed on chance level. Experiment 2: The JND-ITDs were 88.7 μs for 125 Hz, 48.8 μs for 250 Hz and 52.9 μs for 500 Hz (EAS subjects). Compared to the control group, JND-ITD for 125 Hz was on the same level of performance. No statistically significant correlation was found between MLE and JND-ITD in the EAS cohort.

CONCLUSIONS

Near to normal ITD sensitivity in the lower frequency acoustic hearing was demonstrated in a cohort of EAS users. However, in an acoustic localization task, the majority of the subjects did not reached the level of accuracy of normal hearing. Presumably, signal processing time delay differences between devices used on both sides are deteriorating the transfer of precise binaural timing cues.

An examination of electrophysiological release from masking in young and older adults

The effect of age on release from masking (RFM) was examined using cortical auditory evoked potentials (CAEPs). Two speech-in-noise paradigms [i.e., fixed speech with varying signal-to-noise ratios (SNRs) and fixed noise with varying speech levels], similar to those used in behavioral measures of RFM, were employed with competing continuous and interrupted noises. Young and older normal-hearing adults participated (N = 36). Cortical responses were evoked in the fixed speech paradigm at SNRs of -10, 0, and 10 dB. In the fixed noise paradigm, the CAEP SNR threshold was determined in both noises as the lowest SNR that yielded a measurable response. RFM was demonstrated in the fixed speech paradigm with a significant amount of missing responses, longer P1 and N1 latencies, and smaller N1 response amplitudes in continuous noise at the poorest -10 dB SNR. In the fixed noise paradigm, RFM was demonstrated with significantly lower CAEP SNR thresholds in interrupted noise. Older participants demonstrated significantly longer P2 latencies and reduced P1 and N1 amplitudes. There was no evidence of a group difference in RFM in either paradigm.

Sensitivity to Interaural Phase in Older Hearing-Impaired Listeners Correlates With Nonauditory Trail Making Scores and With a Spatial Auditory Task of Unrelated Peripheral Origin

Interaural phase difference (IPD) discrimination upper frequency limits and just-noticeable differences (JNDs), interaural level difference (ILD) JNDs, and diotic intensity JNDs were measured for 20 older hearing-impaired listeners with matched moderate sloping to severe sensorineural hearing losses. The JNDs were measured using tone stimuli at 500 Hz. In addition to these auditory tests, the participants completed a cognitive test (Trail Making Test). Significant performance improvements in IPD discrimination were observed across test sessions. Strong correlations were found between IPD and ILD discrimination performance. Very strong correlations were observed between IPD discrimination and Trail Making performance as well as strong correlations between ILD discrimination and Trail Making performance. These relationships indicate that interindividual variability in IPD discrimination performance did not exclusively reflect deficits specific to any auditory processing, including early auditory processing of temporal information. The observed relationships between spatial audition and cognition may instead be attributable to a modality-general spatial processing deficit and/or individual differences in global processing speed.

Binaural sensitivity and release from speech-on-speech masking in listeners with and without hearing loss

Listeners with sensorineural hearing loss routinely experience less spatial release from masking (SRM) in speech mixtures than listeners with normal hearing. Hearing-impaired listeners have also been shown to have degraded temporal fine structure (TFS) sensitivity, a consequence of which is degraded access to interaural time differences (ITDs) contained in the TFS. Since these "binaural TFS" cues are critical for spatial hearing, it has been hypothesized that degraded binaural TFS sensitivity accounts for the limited SRM experienced by hearing-impaired listeners. In this study, speech stimuli were noise-vocoded using carriers that were systematically decorrelated across the left and right ears, thus simulating degraded binaural TFS sensitivity. Both (1) ITD sensitivity in quiet and (2) SRM in speech mixtures spatialized using ITDs (or binaural release from masking; BRM) were measured as a function of TFS interaural decorrelation in young normal-hearing and hearing-impaired listeners. This allowed for the examination of the relationship between ITD sensitivity and BRM over a wide range of ITD thresholds. This paper found that, for a given ITD sensitivity, hearing-impaired listeners experienced less BRM than normal-hearing listeners, suggesting that binaural TFS sensitivity can account for only a modest portion of the BRM deficit in hearing-impaired listeners. However, substantial individual variability was observed.

British children's performance on the listening in spatialised noise-sentences test (LISN-S)

Objective: To investigate whether British children's performance is equivalent to North American norms on the listening in spatialised noise-sentences test (LiSN-S). Design: Prospective study comparing the performance of a single British group of children to North-American norms on the LiSN-S (North American version). Study sample: The British group was composed of 46 typically developing children, aged 6-11 years 11 months, from a mainstream primary school in London. Results: No significant difference was observed between the British's group performance and the North-American norms for Low-cue, High-cue, Spatial Advantage and Total Advantage measure. The British group presented a significantly lower performance only for Talker Advantage measure (z-score: 0.35, 95% confidence interval -0.12 to -0.59). Age was significantly correlated with all unstandardised measures. Conclusion: Our results indicate that, when assessing British children, it would be appropriate to add a corrective factor of 0.35 to the z-score value obtained for the Talker Advantage in order to compare it to the North-American norms. This strategy would enable the use of LiSN-S in the UK to assess auditory stream segregation based on spatial cues.

Cortical Correlates of Binaural Temporal Processing Deficits in Older Adults

OBJECTIVES

This study was designed to evaluate binaural temporal processing in young and older adults using a binaural masking level difference (BMLD) paradigm. Using behavioral and electrophysiological measures within the same listeners, a series of stimulus manipulations was used to evaluate the relative contribution of binaural temporal fine-structure and temporal envelope cues. We evaluated the hypotheses that age-related declines in the BMLD task would be more strongly associated with temporal fine-structure than envelope cues and that age-related declines in behavioral measures would be correlated with cortical auditory evoked potential (CAEP) measures.

DESIGN

Thirty adults participated in the study, including 10 young normal-hearing, 10 older normal-hearing, and 10 older hearing-impaired adults with bilaterally symmetric, mild-to-moderate sensorineural hearing loss. Behavioral and CAEP thresholds were measured for diotic (So) and dichotic (Sπ) tonal signals presented in continuous diotic (No) narrowband noise (50-Hz wide) maskers. Temporal envelope cues were manipulated by using two different narrowband maskers; Gaussian noise (GN) with robust envelope fluctuations and low-noise noise (LNN) with minimal envelope fluctuations. The potential to use temporal fine-structure cues was controlled by varying the signal frequency (500 or 4000 Hz), thereby relying on the natural decline in phase-locking with increasing frequency.

RESULTS

Behavioral and CAEP thresholds were similar across groups for diotic conditions, while the masking release in dichotic conditions was larger for younger than for older participants. Across all participants, BMLDs were larger for GN than LNN and for 500-Hz than for 4000-Hz conditions, where envelope and fine-structure cues were most salient, respectively. Specific age-related differences were demonstrated for 500-Hz dichotic conditions in GN and LNN, reflecting reduced binaural temporal fine-structure coding. No significant age effects were observed for 4000-Hz dichotic conditions, consistent with similar use of binaural temporal envelope cues across age in these conditions. For all groups, thresholds and derived BMLD values obtained using the behavioral and CAEP methods were strongly correlated, supporting the notion that CAEP measures may be useful as an objective index of age-related changes in binaural temporal processing.

CONCLUSIONS

These results demonstrate an age-related decline in the processing of binaural temporal fine-structure cues with preserved temporal envelope coding that was similar with and without mild-to-moderate peripheral hearing loss. Such age-related changes can be reliably indexed by both behavioral and CAEP measures in young and older adults.

Electrophysiological and Behavioral Evidence of Reduced Binaural Temporal Processing in the Aging and Hearing Impaired Human Auditory System

A person’s ability to process temporal fine structure information is indispensable for speech understanding. As speech understanding typically deteriorates throughout adult life, this study aimed to disentangle age and hearing impairment (HI)-related changes in binaural temporal processing. This was achieved by examining neural and behavioral processing of interaural phase differences (IPDs). Neural IPD processing was studied electrophysiologically through steady-state activity in the electroencephalogram evoked by periodic changes in IPDs over time, embedded in the temporal fine structure of acoustic stimulation. In addition, behavioral IPD discrimination thresholds were determined for the same stimuli. To disentangle potential effects of age from those of HI, both measures were applied to six participant groups: young, middle-aged, and older persons, with either normal hearing or sensorineural HI. All participants passed a cognitive screening, and stimulus audibility was controlled for in participants with HI. The results demonstrated that HI changes neural processing of binaural temporal information for all age-groups included in this study. These outcomes were revealed, superimposed on age-related changes that emerge between young adulthood and middle age. Poorer neural outcomes were also associated with poorer behavioral performance, even though the behavioral IPD discrimination thresholds were affected by age rather than by HI. The neural outcomes of this study are the first to evidence and disentangle the dual load of age and HI on binaural temporal processing. These results could be a valuable first step toward future research on rehabilitation.

Normative Data for a Rapid, Automated Test of Spatial Release From Masking

Purpose

The purpose of this study is to report normative data and predict thresholds for a rapid test of spatial release from masking for speech perception. The test is easily administered and has good repeatability, with the potential to be used in clinics and laboratories. Normative functions were generated for adults varying in age and amounts of hearing loss.

Method

The test of spatial release presents a virtual auditory scene over headphones with 2 conditions: colocated (with target and maskers at 0°) and spatially separated (with target at 0° and maskers at ± 45°). Listener thresholds are determined as target-to-masker ratios, and spatial release from masking (SRM) is determined as the difference between the colocated condition and spatially separated condition. Multiple linear regression was used to fit the data from 82 adults 18–80 years of age with normal to moderate hearing loss (0–40 dB HL pure-tone average [PTA]). The regression equations were then used to generate normative functions that relate age (in years) and hearing thresholds (as PTA) to target-to-masker ratios and SRM.

Results

Normative functions were able to predict thresholds with an error of less than 3.5 dB in all conditions. In the colocated condition, the function included only age as a predictive parameter, whereas in the spatially separated condition, both age and PTA were included as parameters. For SRM, PTA was the only significant predictor. Different functions were generated for the 1st run, the 2nd run, and the average of the 2 runs. All 3 functions were largely similar in form, with the smallest error being associated with the function on the basis of the average of 2 runs.

Conclusion

With the normative functions generated from this data set, it would be possible for a researcher or clinician to interpret data from a small number of participants or even a single patient without having to first collect data from a control group, substantially reducing the time and resources needed.

Supplemental Material

https://doi.org/10.23641/asha.7080878

How aging impacts the encoding of binaural cues and the perception of auditory space

Over the years, the effect of aging on auditory function has been investigated in animal models and humans in an effort to characterize age-related changes in both perception and physiology. Here, we review how aging may impact neural encoding and processing of binaural and spatial cues in human listeners with a focus on recent work by the authors as well as others. Age-related declines in monaural temporal processing, as estimated from measures of gap detection and temporal fine structure discrimination, have been associated with poorer performance on binaural tasks that require precise temporal processing. In lateralization and localization tasks, as well as in the detection of signals in noise, marked age-related changes have been demonstrated in both behavioral and electrophysiological measures and have been attributed to declines in neural synchrony and reduced central inhibition with advancing age. Evidence for such mechanisms, however, are influenced by the task (passive vs. attending) and the stimulus paradigm (e.g., static vs. continuous with dynamic change). That is, cortical auditory evoked potentials (CAEP) measured in response to static interaural time differences (ITDs) are larger in older versus younger listeners, consistent with reduced inhibition, while continuous stimuli with dynamic ITD changes lead to smaller responses in older compared to younger adults, suggestive of poorer neural synchrony. Additionally, the distribution of cortical activity is broader and less asymmetric in older than younger adults, consistent with the hemispheric asymmetry reduction in older adults model of cognitive aging. When older listeners attend to selected target locations in the free field, their CAEP components (N1, P2, P3) are again consistently smaller relative to younger listeners, and the reduced asymmetry in the distribution of cortical activity is maintained. As this research matures, proper neural biomarkers for changes in spatial hearing can provide objective evidence of impairment and targets for remediation. Future research should focus on the development and evaluation of effective approaches for remediating these spatial processing deficits associated with aging and hearing loss.

Binaural sensitivity to temporal fine structure and lateralization ability in children with suspected (central) auditory processing disorder

OBJECTIVE

Previous studies have shown that a subgroup of children with suspected (central) auditory processing disorder (SusCAPD) have insufficient ability to use binaural cues to benefit from spatial processing. Thus, they experience considerable listening difficulties in challenging auditory environments, such as classrooms. Some researchers have also indicated the probable role of binaural temporal fine structure (TFS) in the perceptual segregation of target signal from noise and hence in speech perception in noise. Therefore, in the present study, in order to further investigate the underlying reason for listening problems against background noise in this group of children, their performance was measured using binaural TFS sensitivity test (TFS-LF) as well as behavioral auditory lateralization in noise test, both of which are based on binaural temporal cues processing.

METHODS

Participants in this analytical study included 91 children with normal hearing and no listening problems and 41 children (9-12 years old) with SusCAPD who found it challenging to understand speech in noise. Initially, the ability to use binaural TFS was measured at three frequencies (250, 500 and 750Hz) in both the groups, and the results of preliminary evaluations were compared between normal children and those with SusCAPD who participated in the study. Thereafter, the binaural performance of the 16 children with SusCAPD who had higher thresholds than the normal group at all three frequencies tested in TFS-LF test was examined using the lateralization test in 7 spatial locations.

RESULTS

Total 16 of the 41 children with SusCAPD who participated in this study (39%) showed poor performance on the TFS-LF test at all three frequencies, compared to both normal children and other children in the APD group (p<0.05). Furthermore, children in the APD group with binaural TFS coding deficits at all three frequencies revealed significant differences in the lateralization test results compared to normal children (p<0.05).

CONCLUSION

Findings of the current study demonstrated that one of the underlying causes for the difficulty understanding speech in noisy environments experienced by a subgroup of children with SusCAPD can be the reduced ability to benefit from binaural TFS information. This study also showed that a reduced ability to use binaural TFS cues in the group of children with SusCAPD was accompanied by reduced binaural processing abilities in the lateralization test which also admit the presence of binaural temporal processing deficits in this group of children.

Spatial Release From Informational Masking: Evidence From Functional Near Infrared Spectroscopy

Informational masking (IM) can greatly reduce speech intelligibility, but the neural mechanisms underlying IM are not understood. Binaural differences between target and masker can improve speech perception. In general, improvement in masked speech intelligibility due to provision of spatial cues is called spatial release from masking. Here, we focused on an aspect of spatial release from masking, specifically, the role of spatial attention. We hypothesized that in a situation with IM background sound (a) attention to speech recruits lateral frontal cortex (LFCx) and (b) LFCx activity varies with direction of spatial attention. Using functional near infrared spectroscopy, we assessed LFCx activity bilaterally in normal-hearing listeners. In Experiment 1, two talkers were simultaneously presented. Listeners either attended to the target talker (speech task) or they listened passively to an unintelligible, scrambled version of the acoustic mixture (control task). Target and masker differed in pitch and interaural time difference (ITD). Relative to the passive control, LFCx activity increased during attentive listening. Experiment 2 measured how LFCx activity varied with ITD, by testing listeners on the speech task in Experiment 1, except that talkers either were spatially separated by ITD or colocated. Results show that directing of auditory attention activates LFCx bilaterally. Moreover, right LFCx is recruited more strongly in the spatially separated as compared with colocated configurations. Findings hint that LFCx function contributes to spatial release from masking in situations with IM.