Hellman R P
Dept. of Psychology and Institute for Hearing, Speech, and Language, Northeastern University, Boston, Massachusetts 02115, USA.
Ear Hear. 1999 Jun;20(3):193-213. doi: 10.1097/00003446-199906000-00003.
The main goal of this study was to establish the viability of cross-modality matching (CMM) for the measurement of individual loudness functions in sensorineural-impaired hearing. To achieve this goal, CMM was tested rigorously to assess four measurement requirements: 1) internal consistency; 2) small relative variance across listeners; 3) test-retest reliability; and 4) data validity.
The measurements involved two sensory continua: perceived length and loudness. Sensation-magnitude functions were generated for all listeners from absolute magnitude estimation (AME) of perceived length, from CMM between loudness and perceived length, and from AME and absolute magnitude production (AMP) of loudness. A total of 211 listeners, 83 with normal hearing at the stimulus frequency and 128 with a diagnosis of cochlear impairment of long duration, performed all four magnitude-scaling tasks. Supplementary loudness matches also were obtained.
Based on the analysis of data, the following results were obtained. First, in accord with loudness measures in normal hearing, loudness measures in cochlear-impaired hearing showed that individuals with bilateral impairments can produce internally consistent loudness data. Second, over the stimulus range where cochlear impairment steepens the loudness function, in a log-log plot loudness slopes derived from CMM, like those obtained from AME and AMP of loudness, were larger in cochlear-impaired hearing than in normal hearing. However, the results of CMM were typically less variable than those obtained from AME and AMP of loudness, permitting a clear-cut distinction between loudness growth rates (slopes) in normal and cochlear-impaired hearing. Third, the results showed that within a cochlear-impaired population, much of the intersubject variability of the slope of the loudness function can be ascribed to the heterogeneity of individual thresholds. Consistent with loudness matching, the size of the slopes increased with the degree of hearing loss. The dependence of the size of the slopes on the degree of hearing loss was observed for hearing losses as large as 75 dB. Fourth, test-retest reliability data for 36 listeners showed that CMM can yield reliable and stable loudness-growth measures in cochlear-impaired hearing over the long term. Finally, equal-sensation matches obtained directly from loudness matching closely agreed with those obtained indirectly from magnitude scaling, indicating that CMM is a valid method for the measurement of loudness magnitudes.
Taken together, the results demonstrate that CMM can yield stable, accurate, and robust loudness growth measures in cochlear-impaired hearing. Given its apparent reliability, validity, and ease of application, CMM has the potential to become a powerful tool for assessing the growth of loudness in a clinical population. Loudness-level functions derived from CMM may well be important for determining the frequency-gain response of a hearing aid that most closely compensates for the distorted input-output function of the impaired auditory system.
本研究的主要目标是确定交叉模态匹配(CMM)用于测量感音神经性听力受损个体响度函数的可行性。为实现这一目标,对CMM进行了严格测试,以评估四个测量要求:1)内部一致性;2)不同听众间的相对方差较小;3)重测信度;4)数据有效性。
测量涉及两个感觉连续体:感知长度和响度。通过感知长度的绝对量估计(AME)、响度与感知长度之间的CMM以及响度的AME和绝对量产生(AMP),为所有听众生成感觉量级函数。共有211名听众,其中83名在刺激频率下听力正常,128名被诊断为长期耳蜗损伤,他们完成了所有四项量级标度任务。还获得了补充响度匹配。
基于数据分析,得到了以下结果。首先,与正常听力中的响度测量结果一致,耳蜗损伤听力中的响度测量结果表明,双侧损伤个体能够产生内部一致的响度数据。其次,在耳蜗损伤使响度函数变陡的刺激范围内,在对数-对数图中,由CMM得出的响度斜率,与从响度的AME和AMP获得的斜率一样,在耳蜗损伤听力中比在正常听力中更大。然而,CMM的结果通常比从响度的AME和AMP获得的结果变异性更小,从而能够清晰地区分正常听力和耳蜗损伤听力中的响度增长率(斜率)。第三,结果表明,在耳蜗损伤人群中,响度函数斜率的大部分个体间变异性可归因于个体阈值的异质性。与响度匹配一致,斜率大小随听力损失程度增加。在高达75 dB的听力损失中都观察到了斜率大小对听力损失程度的依赖性。第四,36名听众的重测信度数据表明,CMM能够长期在耳蜗损伤听力中产生可靠且稳定的响度增长测量结果。最后,直接从响度匹配获得的等感觉匹配与从量级标度间接获得的匹配结果非常一致,表明CMM是测量响度量级的有效方法。
综上所述,结果表明CMM能够在耳蜗损伤听力中产生稳定、准确且可靠的响度增长测量结果。鉴于其明显的可靠性、有效性和易于应用的特点,CMM有潜力成为评估临床人群响度增长的有力工具。从CMM得出的响度级函数对于确定最能补偿受损听觉系统失真的输入-输出函数的助听器的频率增益响应可能非常重要。