Medizinische Physik, Oldenburg University, Oldenburg, Germany.
Ear Hear. 2018 Jan/Feb;39(1):161-171. doi: 10.1097/AUD.0000000000000476.
Using a longitudinal design, the present study sought to substantiate indications from two previous cross-sectional studies that hearing aid (HA) experience leads to improved speech processing abilities as quantified using eye-gaze measurements. Another aim was to explore potential concomitant changes in event-related potentials (ERPs) to speech stimuli.
Groups of elderly novice (novHA) and experienced (expHA) HA users matched in terms of age and working memory capacity participated. The novHA users were acclimatized to bilateral HA fittings for up to 24 weeks. The expHA users continued to use their own HAs during the same period. The participants' speech processing abilities were assessed after 0 weeks (novHA: N = 16; expHA: N = 14), 12 weeks (novHA: N = 16; expHA: N = 14), and 24 weeks (N = 10 each). To that end, an eye-tracking paradigm was used for estimating how quickly the participants could grasp the meaning of sentences presented against background noise together with two similar pictures that either correctly or incorrectly depicted the meaning conveyed by the sentences (the "processing time"). Additionally, ERPs were measured with an active oddball paradigm requiring the participants to categorize word stimuli as living (targets) or nonliving (nontargets) entities. For all measurements, the stimuli were spectrally shaped according to individual real-ear insertion gains and presented via earphones.
Concerning the processing times, no changes across time were found for the expHA group. After 0 weeks of HA use, the novHA group had significantly longer (poorer) processing times than the expHA group, consistent with previous findings. After 24 weeks, a significant mean improvement of ~30% was observed for the novHA users, leading to a performance comparable with that of the expHA group. Concerning the ERPs, no changes across time were found.
The results from this exploratory study are consistent with the view that auditory acclimatization to HAs positively impacts speech comprehension in noise. Further research is needed to substantiate them.
本研究采用纵向设计，旨在证实之前两项横断面研究的结果，即使用眼动测量评估，助听器（HA）使用经验可提高言语处理能力。另一个目的是探索言语刺激的事件相关电位（ERP）的潜在伴随变化。
匹配年龄和工作记忆能力的老年新手（novHA）和经验丰富（expHA）HA 用户组参与了研究。novHA 用户适应双侧 HA 适配，最长达 24 周。在此期间，expHA 用户继续使用自己的 HA。参与者的言语处理能力在 0 周（novHA：N=16；expHA：N=14）、12 周（novHA：N=16；expHA：N=14）和 24 周（各 N=10）后进行评估。为此，使用眼动追踪范式来估计参与者在背景噪声中以及与正确或不正确地描绘句子含义的两幅相似图片一起理解句子的速度（“处理时间”）。此外，使用主动Oddball 范式测量 ERP，要求参与者将单词刺激归类为生物（目标）或非生物（非目标）实体。对于所有测量，根据个体实际耳插入增益对刺激进行频谱整形，并通过耳机呈现。
关于处理时间，expHA 组没有随时间变化。在 HA 使用 0 周后，novHA 组的处理时间明显长于（表现较差）expHA 组，这与之前的研究结果一致。24 周后，novHA 用户的处理时间显著改善了约 30%，表现与 expHA 组相当。关于 ERP，没有随时间变化。
这项探索性研究的结果与听觉适应 HA 可积极影响噪声下的言语理解的观点一致。需要进一步研究来证实这些结果。
