Speech Pathology and Audiology, Kent State University, Kent, Ohio, USA.
Department of Communication Sciences and Disorders/Department of Otolaryngology - Head and Neck Surgery, University of Iowa, Iowa City, Iowa, USA.
Ear Hear. 2019 Nov/Dec;40(6):1328-1344. doi: 10.1097/AUD.0000000000000732.
The mechanisms underlying age-related changes in speech perception are still unclear, most likely multifactorial and often can be difficult to parse out from the effects of hearing loss. Age-related changes in temporal resolution (i.e., the ability to track rapid changes in sounds) have long been associated with speech perception declines exhibited by many older individuals. The goals of this study were as follows: (1) to assess age-related changes in temporal resolution in cochlear implant (CI) users, and (2) to examine the impact of changes in temporal resolution and cognition on the perception of speech in noise. In this population, it is possible to bypass the cochlea and stimulate the auditory nerve directly in a noninvasive way. Additionally, CI technology allows for manipulation of the temporal properties of a signal without changing its spectrum.
Twenty postlingually deafened Nucleus CI users took part in this study. They were divided into groups of younger (18 to 40 years) and older (68 to 82 years) participants. A cross-sectional study design was used. The speech processor was bypassed and a mid-array electrode was used for stimulation. We compared peripheral and central physiologic measures of temporal resolution with perceptual measures obtained using similar stimuli. Peripherally, temporal resolution was assessed with measures of the rate of recovery of the electrically evoked compound action potential (ECAP), evoked using a single pulse and a pulse train as maskers. The acoustic change complex (ACC) to gaps in pulse trains was used to assess temporal resolution more centrally. Psychophysical gap detection thresholds were also obtained. Cognitive assessment included two tests of processing speed (Symbol Search and Coding) and one test of working memory (Digit Span Test). Speech perception was tested in the presence of background noise (QuickSIN test). A correlational design was used to explore the relationship between temporal resolution, cognition, and speech perception.
The only metric that showed significant age effects in temporal processing was the ECAP recovery function recorded using pulse train maskers. Younger participants were found to have faster rates of neural recovery following presentation of pulse trains than older participants. Age was not found to have a significant effect on speech perception. When results from both groups were combined, digit span was the only measure significantly correlated with speech perception performance.
In this sample of CI users, few effects of advancing age on temporal resolution were evident. While this finding would be consistent with a general lack of aging effects on temporal resolution, it is also possible that aging effects are influenced by processing peripheral to the auditory nerve, which is bypassed by the CI. However, it is known that cross-fiber neural synchrony is improved with electrical (as opposed to acoustic) stimulation. This change in neural synchrony may, in turn, make temporal cues more robust/perceptible to all CI users. Future studies involving larger sample sizes should be conducted to confirm these findings. Results of this study also add to the growing body of literature that suggests that working memory is important for the perception of degraded speech.
年龄相关的言语感知变化的机制尚不清楚,很可能是多因素的,并且通常很难从听力损失的影响中分辨出来。与许多老年人表现出的言语感知下降相关的,一直是年龄相关的时间分辨率(即跟踪声音快速变化的能力)变化。本研究的目的如下:(1)评估人工耳蜗使用者年龄相关的时间分辨率变化,(2)研究时间分辨率和认知变化对噪声中言语感知的影响。在这个人群中,可以以非侵入的方式绕过耳蜗并直接刺激听神经。此外,人工耳蜗技术允许在不改变信号频谱的情况下对信号的时间特性进行操作。
20 名后天失聪的 Nucleus 人工耳蜗使用者参加了这项研究。他们被分为年轻(18 至 40 岁)和年老(68 至 82 岁)组。采用横断面研究设计。绕过言语处理器,使用中数组电极进行刺激。我们将感知类似刺激时获得的外周和中枢生理时间分辨率测量值与感知测量值进行比较。在外周,使用测量单个脉冲和脉冲串掩蔽时电诱发复合动作电位(ECAP)的恢复率来评估时间分辨率。使用脉冲串中的间隙来评估中央的时间分辨率。听性复合动作电位(ACAP)的恢复功能记录使用脉冲串掩蔽时出现显著的年龄影响。与脉冲串掩蔽相比,年轻参与者在呈现脉冲串后表现出更快的神经恢复率。年龄对言语感知没有显著影响。当结合两组的结果时,只有数字跨度与言语感知表现显著相关。
在这个人工耳蜗使用者样本中,只有少数与年龄相关的时间分辨率变化明显。虽然这一发现与一般的时间分辨率无老化效应一致,但也有可能老化效应受到绕过听神经的听觉神经外处理的影响。然而,众所周知,交叉纤维神经同步性随电刺激(而不是声学刺激)而改善。这种神经同步性的变化反过来可能使所有人工耳蜗使用者的时间线索更加稳健/可感知。应进行涉及更大样本量的进一步研究来证实这些发现。这项研究的结果也增加了越来越多的文献,表明工作记忆对于感知退化的言语很重要。