Department of Otolaryngology - Head and Neck Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio.
Otol Neurotol. 2018 Dec;39(10):e1010-e1018. doi: 10.1097/MAO.0000000000002052.
Clinical adult cochlear implant (CI) candidacy evaluations rely heavily on measures of sentence recognition under the best-aided listening conditions. The hypothesis tested in this study was that nonauditory measures of neurocognitive processes would contribute to scores on preoperative sentence recognition for CI candidates, above and beyond hearing ability as assessed using pure-tone average (PTA). Support for this hypothesis would suggest that best-aided sentence recognition is not simply a measure of hearing ability; rather, neurocognitive functions contribute to performance and should be considered while counseling patients during CI candidacy evaluation about postoperative rehabilitative and outcome expectations.
Neurocognitive functions, such as working memory capacity, inhibition-concentration, information processing speed, and nonverbal reasoning contribute to aided speech recognition outcomes in adults with hearing loss. This study examined the roles of these neurocognitive factors on preoperative speech recognition performance in adults evaluated for CI candidacy.
Thirty-one postlingually deafened adult CI candidates were enrolled. Participants were assessed using nonauditory measures of working memory capacity, inhibition-concentration, information processing speed, and nonverbal reasoning. Measures of sentence recognition in quiet and in multitalker babble (AzBio sentences) as well as sentences from the City University of New York in quiet were collected under best-aided conditions.
AzBio sentence recognition scores in babble were predicted significantly by scores of working memory capacity after accounting for PTA. Similarly, the City University of New York sentence recognition scores were predicted significantly by nonverbal reasoning after accounting for PTA.
Findings support the idea that clinical measures of sentence recognition may be affected to varying degrees by neurocognitive functions, and these functions should be considered during evaluation for CI candidacy.
临床成人人工耳蜗（CI）植入候选者的评估严重依赖于最佳辅助听力条件下的句子识别测试。本研究检验的假设是，神经认知过程的非听觉测量指标将有助于 CI 候选者术前句子识别的评分，超出了使用纯音平均（PTA）评估的听力能力。如果该假设得到支持，这将表明最佳辅助的句子识别不仅仅是听力能力的衡量标准；相反，神经认知功能有助于表现，在对 CI 候选者进行候选评估时，在与患者进行咨询时，应考虑到这些功能，以便对术后康复和结果期望进行讨论。
神经认知功能，如工作记忆能力、抑制-集中、信息处理速度和非言语推理，有助于听力损失成年人的助听言语识别结果。本研究检查了这些神经认知因素在评估成人 CI 候选者的术前言语识别表现中的作用。
31 名后天失聪的成人 CI 候选者被纳入研究。参与者接受了非听觉工作记忆能力、抑制-集中、信息处理速度和非言语推理的测试。在最佳辅助条件下，收集了安静和多说话者嘈杂环境（AzBio 句子）以及纽约城市大学安静句子下的句子识别测试。
在考虑 PTA 后，AzBio 句子识别在嘈杂环境中的分数可以被工作记忆能力的分数显著预测。同样，在考虑 PTA 后，纽约城市大学句子识别分数可以被非言语推理显著预测。
这些发现支持了这样的观点，即临床句子识别测量可能在不同程度上受到神经认知功能的影响，并且在评估 CI 候选者时应考虑这些功能。
