Max Planck Research Group "Auditory Cognition", Max Planck Institute for Cognitive and Brain Sciences, Leipzig, Germany.
Department of Cognitive Neuroscience, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands.
Ear Hear. 2019 Jan/Feb;40(1):27-33. doi: 10.1097/AUD.0000000000000588.
Psychoacoustic tests assessed shortly after cochlear implantation are useful predictors of the rehabilitative speech outcome. While largely independent, both spectral and temporal resolution tests are important to provide an accurate prediction of speech recognition. However, rapid tests of temporal sensitivity are currently lacking. Here, we propose a simple amplitude modulation rate discrimination (AMRD) paradigm that is validated by predicting future speech recognition in adult cochlear implant (CI) patients.
In 34 newly implanted patients, we used an adaptive AMRD paradigm, where broadband noise was modulated at the speech-relevant rate of ~4 Hz. In a longitudinal study, speech recognition in quiet was assessed using the closed-set Freiburger number test shortly after cochlear implantation (t0) as well as the open-set Freiburger monosyllabic word test 6 months later (t6).
Both AMRD thresholds at t0 (r = -0.51) and speech recognition scores at t0 (r = 0.56) predicted speech recognition scores at t6. However, AMRD and speech recognition at t0 were uncorrelated, suggesting that those measures capture partially distinct perceptual abilities. A multiple regression model predicting 6-month speech recognition outcome with deafness duration and speech recognition at t0 improved from adjusted R = 0.30 to adjusted R = 0.44 when AMRD threshold was added as a predictor.
These findings identify AMRD thresholds as a reliable, nonredundant predictor above and beyond established speech tests for CI outcome. This AMRD test could potentially be developed into a rapid clinical temporal-resolution test to be integrated into the postoperative test battery to improve the reliability of speech outcome prognosis.
耳蜗植入后不久进行的心理声学测试是康复言语效果的有用预测指标。虽然频谱和时间分辨率测试在很大程度上是独立的，但它们对于准确预测言语识别能力都很重要。然而，目前缺乏快速的时间敏感性测试。在这里，我们提出了一种简单的幅度调制率辨别（AMRD）范式，该范式通过预测成人耳蜗植入（CI）患者未来的言语识别能力得到验证。
在 34 名新植入的患者中，我们使用了自适应 AMRD 范式，其中宽带噪声以约 4 Hz 的言语相关速率进行调制。在一项纵向研究中，我们在耳蜗植入后不久（t0）使用闭集弗赖堡数字测试评估安静环境下的言语识别能力，6 个月后（t6）使用开集弗赖堡单音节词测试评估言语识别能力。
t0 时的 AMRD 阈值（r = -0.51）和言语识别得分（r = 0.56）均能预测 t6 时的言语识别得分。然而，AMRD 和 t0 时的言语识别之间没有相关性，这表明这些测量方法捕捉到了部分不同的感知能力。当将 AMRD 阈值作为预测因子添加到预测 6 个月言语识别结果的多元回归模型中时，模型的调整 R 从 0.30 提高到 0.44。
这些发现表明，AMRD 阈值是耳蜗植入后言语效果的可靠、非冗余预测指标，超过了既定的言语测试。该 AMRD 测试有可能发展成为一种快速的临床时间分辨率测试，整合到术后测试组合中，以提高言语预后预测的可靠性。
