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Sheffield SW, Larson E, Butera IM, DeFreese A, Rogers BP, Wallace MT, Stecker GC, Lee AKC, Gifford RH. Sound Level Changes the Auditory Cortical Activation Detected with Functional Near-Infrared Spectroscopy. Brain Topogr 2023; 36:686-697. [PMID: 37393418 DOI: 10.1007/s10548-023-00981-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 06/19/2023] [Indexed: 07/03/2023]
Abstract
BACKGROUND Functional near-infrared spectroscopy (fNIRS) is a viable non-invasive technique for functional neuroimaging in the cochlear implant (CI) population; however, the effects of acoustic stimulus features on the fNIRS signal have not been thoroughly examined. This study examined the effect of stimulus level on fNIRS responses in adults with normal hearing or bilateral CIs. We hypothesized that fNIRS responses would correlate with both stimulus level and subjective loudness ratings, but that the correlation would be weaker with CIs due to the compression of acoustic input to electric output. METHODS Thirteen adults with bilateral CIs and 16 with normal hearing (NH) completed the study. Signal-correlated noise, a speech-shaped noise modulated by the temporal envelope of speech stimuli, was used to determine the effect of stimulus level in an unintelligible speech-like stimulus between the range of soft to loud speech. Cortical activity in the left hemisphere was recorded. RESULTS Results indicated a positive correlation of cortical activation in the left superior temporal gyrus with stimulus level in both NH and CI listeners with an additional correlation between cortical activity and perceived loudness for the CI group. The results are consistent with the literature and our hypothesis. CONCLUSIONS These results support the potential of fNIRS to examine auditory stimulus level effects at a group level and the importance of controlling for stimulus level and loudness in speech recognition studies. Further research is needed to better understand cortical activation patterns for speech recognition as a function of both stimulus presentation level and perceived loudness.
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Affiliation(s)
- Sterling W Sheffield
- Department of Speech, Language, and Hearing Science, University of Florida, 1225 Center Drive Room 2130, Gainesville, FL, 32160, USA.
| | - Eric Larson
- Institute for Learning & Brain Sciences, University of Washington, Seattle, WA, USA
| | - Iliza M Butera
- Vanderbilt Brain Institute, Vanderbilt University, Nashville, TN, USA
| | - Andrea DeFreese
- Department of Hearing and Speech Sciences, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Baxter P Rogers
- Department of Radiology & Radiological Sciences, Vanderbilt University, Nashville, TN, USA
| | - Mark T Wallace
- Department of Psychology, Vanderbilt University, Nashville, TN, USA
| | | | - Adrian K C Lee
- Institute for Learning & Brain Sciences, University of Washington, Seattle, WA, USA
- Department of Speech and Hearing Sciences, University of Washington, Seattle, WA, USA
| | - Rene H Gifford
- Department of Hearing and Speech Sciences, Vanderbilt University School of Medicine, Nashville, TN, USA
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Butera IM, Stevenson RA, Gifford RH, Wallace MT. Visually biased Perception in Cochlear Implant Users: A Study of the McGurk and Sound-Induced Flash Illusions. Trends Hear 2023; 27:23312165221076681. [PMID: 37377212 PMCID: PMC10334005 DOI: 10.1177/23312165221076681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 12/08/2021] [Accepted: 01/10/2021] [Indexed: 06/29/2023] Open
Abstract
The reduction in spectral resolution by cochlear implants oftentimes requires complementary visual speech cues to facilitate understanding. Despite substantial clinical characterization of auditory-only speech measures, relatively little is known about the audiovisual (AV) integrative abilities that most cochlear implant (CI) users rely on for daily speech comprehension. In this study, we tested AV integration in 63 CI users and 69 normal-hearing (NH) controls using the McGurk and sound-induced flash illusions. To our knowledge, this study is the largest to-date measuring the McGurk effect in this population and the first that tests the sound-induced flash illusion (SIFI). When presented with conflicting AV speech stimuli (i.e., the phoneme "ba" dubbed onto the viseme "ga"), we found that 55 CI users (87%) reported a fused percept of "da" or "tha" on at least one trial. After applying an error correction based on unisensory responses, we found that among those susceptible to the illusion, CI users experienced lower fusion than controls-a result that was concordant with results from the SIFI where the pairing of a single circle flashing on the screen with multiple beeps resulted in fewer illusory flashes for CI users. While illusion perception in these two tasks appears to be uncorrelated among CI users, we identified a negative correlation in the NH group. Because neither illusion appears to provide further explanation of variability in CI outcome measures, further research is needed to determine how these findings relate to CI users' speech understanding, particularly in ecological listening conditions that are naturally multisensory.
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Affiliation(s)
- Iliza M. Butera
- Vanderbilt Brain Institute, Vanderbilt University, Nashville, TN, USA
| | - Ryan A. Stevenson
- Department of Psychology, University of
Western Ontario, London, ON, Canada
- Brain and Mind Institute, University of
Western Ontario, London, ON, Canada
| | - René H. Gifford
- Department of Hearing and Speech
Sciences, Vanderbilt University, Nashville, TN, USA
| | - Mark T. Wallace
- Vanderbilt Brain Institute, Vanderbilt University, Nashville, TN, USA
- Department of Hearing and Speech
Sciences, Vanderbilt University, Nashville, TN, USA
- Vanderbilt Kennedy Center, Vanderbilt
University Medical Center, Nashville, TN, USA
- Department of Psychology, Vanderbilt University, Nashville, TN, USA
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Butera IM, Larson ED, DeFreese AJ, Lee AKC, Gifford RH, Wallace MT. Functional localization of audiovisual speech using near infrared spectroscopy. Brain Topogr 2022; 35:416-430. [PMID: 35821542 PMCID: PMC9334437 DOI: 10.1007/s10548-022-00904-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Accepted: 05/19/2022] [Indexed: 11/21/2022]
Abstract
Visual cues are especially vital for hearing impaired individuals such as cochlear implant (CI) users to understand speech in noise. Functional Near Infrared Spectroscopy (fNIRS) is a light-based imaging technology that is ideally suited for measuring the brain activity of CI users due to its compatibility with both the ferromagnetic and electrical components of these implants. In a preliminary step toward better elucidating the behavioral and neural correlates of audiovisual (AV) speech integration in CI users, we designed a speech-in-noise task and measured the extent to which 24 normal hearing individuals could integrate the audio of spoken monosyllabic words with the corresponding visual signals of a female speaker. In our behavioral task, we found that audiovisual pairings provided average improvements of 103% and 197% over auditory-alone listening conditions in -6 and -9 dB signal-to-noise ratios consisting of multi-talker background noise. In an fNIRS task using similar stimuli, we measured activity during auditory-only listening, visual-only lipreading, and AV listening conditions. We identified cortical activity in all three conditions over regions of middle and superior temporal cortex typically associated with speech processing and audiovisual integration. In addition, three channels active during the lipreading condition showed uncorrected correlations associated with behavioral measures of audiovisual gain as well as with the McGurk effect. Further work focusing primarily on the regions of interest identified in this study could test how AV speech integration may differ for CI users who rely on this mechanism for daily communication.
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Affiliation(s)
- Iliza M. Butera
- grid.152326.10000 0001 2264 7217Vanderbilt Brain Institute, Vanderbilt University, Nashville, TN USA
| | - Eric D. Larson
- grid.34477.330000000122986657Institute for Learning & Brain Sciences, University of Washington, Seattle Washington, USA
| | - Andrea J. DeFreese
- grid.152326.10000 0001 2264 7217Department of Hearing and Speech Sciences, Vanderbilt University, Nashville, TN USA
| | - Adrian KC Lee
- grid.34477.330000000122986657Institute for Learning & Brain Sciences, University of Washington, Seattle Washington, USA ,grid.34477.330000000122986657Department of Speech and Hearing Sciences, University of Washington, Seattle, Washington USA
| | - René H. Gifford
- grid.152326.10000 0001 2264 7217Department of Hearing and Speech Sciences, Vanderbilt University, Nashville, TN USA
| | - Mark T. Wallace
- grid.152326.10000 0001 2264 7217Vanderbilt Brain Institute, Vanderbilt University, Nashville, TN USA ,grid.152326.10000 0001 2264 7217Department of Hearing and Speech Sciences, Vanderbilt University, Nashville, TN USA ,grid.412807.80000 0004 1936 9916Vanderbilt Kennedy Center, Vanderbilt University Medical Center, Nashville, TN USA
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Dwyer RT, Kessler D, Butera IM, Gifford RH. Contralateral Routing of Signal Yields Significant Speech in Noise Benefit for Unilateral Cochlear Implant Recipients. J Am Acad Audiol 2019; 30:235-242. [PMID: 30461413 PMCID: PMC6542640 DOI: 10.3766/jaaa.17117] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Bilateral cochlear implantation is the standard of care for individuals with moderate sloping-to-profound sensorineural hearing loss who do not receive benefit from appropriately fit hearing aids. Because of financial, insurance, or medical reasons, some unilateral cochlear implant (CI) recipients are unable to obtain a second CI. Here, we evaluated the first clinically available solution for individuals who have been unilaterally implanted and who do not or cannot use technology (e.g., hearing aid or CI) on the non-implanted ear. PURPOSE We aimed to investigate how the addition of a contralateral routing of signal (CROS) device could provide objective and/or subjective benefit to adult CI recipients with moderate-to-profound hearing loss in the non-implanted ear. RESEARCH DESIGN Single-center prospective study using a within-subjects repeated-measures design. STUDY SAMPLE Participants included ten experienced unilateral CI recipients with severe-to-profound (n = 9) or moderate-to-profound (n = 1) sensorineural hearing loss in the non-implanted ear. At the time of study enrollment, participants did not use any technology on the non-implanted ear. No other exclusion criteria were used. INTERVENTION Individuals were tested with and without a CROS device worn on the non-implanted ear. DATA COLLECTION AND ANALYSIS We obtained measures of speech understanding in quiet (50 and 65 dBA) and in noise (+5-dB signal-to-noise ratio with a 65-dBA speech signal) both with and without the CROS device in an acute listening condition. Subjective benefit was assessed via the Speech, Spatial and Qualities 12-item questionnaire before CROS fitting and after two weeks of continuous use. A mixed-model, repeated-measures analysis of variance was completed with three talker locations and three presentation levels included as within-subjects factors and the presence or absence of a CROS device as a between-subjects factor. RESULTS There was an 11% improvement in speech understanding in noise with the addition of the CROS device when speech was located at 0° azimuth. Subjective benefit in the speech domain of the SSQ was also observed. CONCLUSIONS Use of CROS provided both subjective and objective speech recognition benefit for unilateral CI recipients who do not have access to bilateral cochlear implantation.
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Affiliation(s)
- Robert T. Dwyer
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, TN
| | - David Kessler
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, TN
| | - Iliza M. Butera
- Vanderbilt Brain Institute, Vanderbilt University, Nashville, TN
| | - René H. Gifford
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, TN
- Department of Otolaryngology, Vanderbilt University Medical Center, Nashville, TN
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Butera IM, Stevenson RA, Mangus BD, Woynaroski TG, Gifford RH, Wallace MT. Audiovisual Temporal Processing in Postlingually Deafened Adults with Cochlear Implants. Sci Rep 2018; 8:11345. [PMID: 30054512 PMCID: PMC6063927 DOI: 10.1038/s41598-018-29598-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Accepted: 07/09/2018] [Indexed: 11/17/2022] Open
Abstract
For many cochlear implant (CI) users, visual cues are vitally important for interpreting the impoverished auditory speech information that an implant conveys. Although the temporal relationship between auditory and visual stimuli is crucial for how this information is integrated, audiovisual temporal processing in CI users is poorly understood. In this study, we tested unisensory (auditory alone, visual alone) and multisensory (audiovisual) temporal processing in postlingually deafened CI users (n = 48) and normal-hearing controls (n = 54) using simultaneity judgment (SJ) and temporal order judgment (TOJ) tasks. We varied the timing onsets between the auditory and visual components of either a syllable/viseme or a simple flash/beep pairing, and participants indicated either which stimulus appeared first (TOJ) or if the pair occurred simultaneously (SJ). Results indicate that temporal binding windows-the interval within which stimuli are likely to be perceptually 'bound'-are not significantly different between groups for either speech or non-speech stimuli. However, the point of subjective simultaneity for speech was less visually leading in CI users, who interestingly, also had improved visual-only TOJ thresholds. Further signal detection analysis suggests that this SJ shift may be due to greater visual bias within the CI group, perhaps reflecting heightened attentional allocation to visual cues.
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Affiliation(s)
- Iliza M Butera
- Vanderbilt Brain Institute, Vanderbilt University, Nashville, TN, USA.
| | - Ryan A Stevenson
- Department of Psychology, University of Western Ontario, London, ON, Canada
- Brain and Mind Institute, University of Western Ontario, London, ON, Canada
| | - Brannon D Mangus
- Murfreesboro Medical Clinic and Surgicenter, Murfreesboro, TN, USA
| | - Tiffany G Woynaroski
- Vanderbilt Brain Institute, Vanderbilt University, Nashville, TN, USA
- Department of Hearing and Speech Sciences, Vanderbilt University, Nashville, TN, USA
- Vanderbilt Kennedy Center, Vanderbilt University Medical Center, Nashville, TN, USA
| | - René H Gifford
- Vanderbilt Brain Institute, Vanderbilt University, Nashville, TN, USA
- Department of Hearing and Speech Sciences, Vanderbilt University, Nashville, TN, USA
- Vanderbilt Kennedy Center, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Mark T Wallace
- Vanderbilt Brain Institute, Vanderbilt University, Nashville, TN, USA
- Department of Hearing and Speech Sciences, Vanderbilt University, Nashville, TN, USA
- Vanderbilt Kennedy Center, Vanderbilt University Medical Center, Nashville, TN, USA
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Abstract
Speech perception is inherently a multisensory process involving integration of auditory and visual cues. Multisensory integration in cochlear implant (CI) recipients is a unique circumstance in that the integration occurs after auditory deprivation and the provision of hearing via the CI. Despite the clear importance of multisensory cues for perception, in general, and for speech intelligibility, specifically, the topic of multisensory perceptual benefits in CI users has only recently begun to emerge as an area of inquiry. We review the research that has been conducted on multisensory integration in CI users to date and suggest a number of areas needing further research. The overall pattern of results indicates that many CI recipients show at least some perceptual gain that can be attributable to multisensory integration. The extent of this gain, however, varies based on a number of factors, including age of implantation and specific task being assessed (e.g., stimulus detection, phoneme perception, word recognition). Although both children and adults with CIs obtain audiovisual benefits for phoneme, word, and sentence stimuli, neither group shows demonstrable gain for suprasegmental feature perception. Additionally, only early-implanted children and the highest performing adults obtain audiovisual integration benefits similar to individuals with normal hearing. Increasing age of implantation in children is associated with poorer gains resultant from audiovisual integration, suggesting a sensitive period in development for the brain networks that subserve these integrative functions, as well as length of auditory experience. This finding highlights the need for early detection of and intervention for hearing loss, not only in terms of auditory perception, but also in terms of the behavioral and perceptual benefits of audiovisual processing. Importantly, patterns of auditory, visual, and audiovisual responses suggest that underlying integrative processes may be fundamentally different between CI users and typical-hearing listeners. Future research, particularly in low-level processing tasks such as signal detection will help to further assess mechanisms of multisensory integration for individuals with hearing loss, both with and without CIs.
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Affiliation(s)
- Ryan A Stevenson
- 1Department of Psychology, University of Western Ontario, London, Ontario, Canada; 2Brain and Mind Institute, University of Western Ontario, London, Ontario, Canada; 3Walter Reed National Military Medical Center, Audiology and Speech Pathology Center, London, Ontario, Canada; 4Vanderbilt Brain Institute, Nashville, Tennesse; 5Vanderbilt Kennedy Center, Nashville, Tennesse; 6Department of Psychology, Vanderbilt University, Nashville, Tennesse; 7Department of Psychiatry, Vanderbilt University Medical Center, Nashville, Tennesse; and 8Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, Tennesse
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