Department of Otorhinolaryngology/Head and Neck Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Department of Otolaryngology - Head and Neck Surgery, The Ohio State University Wexner Medical Center, Columbus, OH.
J Am Acad Audiol. 2020 May;31(5):324-335. doi: 10.3766/jaaa.18106. Epub 2020 Jun 9.
Postlingually deafened adult cochlear implant (CI) users routinely display large individual differences in the ability to recognize and understand speech, especially in adverse listening conditions. Although individual differences have been linked to several sensory (''bottom-up'') and cognitive (''top-down'') factors, little is currently known about the relative contributions of these factors in high- and low-performing CI users.
The aim of the study was to investigate differences in sensory functioning and neurocognitive functioning between high- and low-performing CI users on the Perceptually Robust English Sentence Test Open-set (PRESTO), a high-variability sentence recognition test containing sentence materials produced by multiple male and female talkers with diverse regional accents.
CI users with accuracy scores in the upper (HiPRESTO) or lower quartiles (LoPRESTO) on PRESTO in quiet completed a battery of behavioral tasks designed to assess spectral resolution and neurocognitive functioning.
Twenty-one postlingually deafened adult CI users, with 11 HiPRESTO and 10 LoPRESTO participants.
A discriminant analysis was carried out to determine the extent to which measures of spectral resolution and neurocognitive functioning discriminate HiPRESTO and LoPRESTO CI users. Auditory spectral resolution was measured using the Spectral-Temporally Modulated Ripple Test (SMRT). Neurocognitive functioning was assessed with visual measures of working memory (digit span), inhibitory control (Stroop), speed of lexical/phonological access (Test of Word Reading Efficiency), and nonverbal reasoning (Raven's Progressive Matrices).
HiPRESTO and LoPRESTO CI users were discriminated primarily by performance on the SMRT and secondarily by the Raven's test. No other neurocognitive measures contributed substantially to the discriminant function.
High- and low-performing CI users differed by spectral resolution and, to a lesser extent, nonverbal reasoning. These findings suggest that the extreme groups are determined by global factors of richness of sensory information and domain-general, nonverbal intelligence, rather than specific neurocognitive processing operations related to speech perception and spoken word recognition. Thus, although both bottom-up and top-down information contribute to speech recognition performance, low-performing CI users may not be sufficiently able to rely on neurocognitive skills specific to speech recognition to enhance processing of spectrally degraded input in adverse conditions involving high talker variability.
后天失聪的成年人工耳蜗（CI）使用者在识别和理解言语方面的能力存在显著的个体差异，尤其是在不利的听力条件下。尽管个体差异与多种感觉（“自下而上”）和认知（“自上而下”）因素有关，但目前对于高、低表现 CI 用户中这些因素的相对贡献知之甚少。
本研究旨在探讨高、低表现 CI 用户在感知稳健英语句子测试开放式（PRESTO）上的感觉功能和神经认知功能差异，该测试包含由具有不同地区口音的多个男性和女性说话者生成的句子材料，具有高变异性的句子识别测试。
在安静环境中 PRESTO 得分在上四分位（HiPRESTO）或下四分位（LoPRESTO）的 CI 用户完成了一系列行为任务，旨在评估光谱分辨率和神经认知功能。
21 名后天失聪的成年 CI 用户，包括 11 名 HiPRESTO 和 10 名 LoPRESTO 参与者。
进行判别分析以确定光谱分辨率和神经认知功能测量值在多大程度上区分 HiPRESTO 和 LoPRESTO CI 用户。听觉光谱分辨率使用频谱时变调制纹波测试（SMRT）进行测量。神经认知功能通过视觉工作记忆（数字跨度）、抑制控制（Stroop）、词汇/语音访问速度（单词阅读效率测试）和非言语推理（瑞文渐进矩阵）的测量来评估。
HiPRESTO 和 LoPRESTO CI 用户主要通过 SMRT 表现和其次通过 Raven 测试进行区分。其他神经认知测量值没有对判别函数做出重要贡献。
高、低表现 CI 用户在光谱分辨率上存在差异，在非言语推理方面的差异较小。这些发现表明，极端群体由丰富的感觉信息和非言语智力等全局因素决定，而不是与语音感知和口语识别相关的特定神经认知处理操作。因此，尽管自下而上和自上而下的信息都有助于语音识别表现，但低表现 CI 用户可能无法充分依赖于特定于语音识别的神经认知技能来增强在涉及高说话者变异性的不利条件下对频谱退化输入的处理。
