Zhang Yue, Callejón-Leblic M Amparo, Picazo-Reina Ana M, Blanco-Trejo Sergio, Patou François, Sánchez-Gómez Serafín
Department of Research and Technology, Oticon Medical, Vallauris, France.
Oticon Medical, Madrid, Spain.
Front Neurosci. 2023 Dec 21;17:1307777. doi: 10.3389/fnins.2023.1307777. eCollection 2023.
Despite substantial technical advances and wider clinical use, cochlear implant (CI) users continue to report high and elevated listening effort especially under challenging noisy conditions. Among all the objective measures to quantify listening effort, pupillometry is one of the most widely used and robust physiological measures. Previous studies with normally hearing (NH) and hearing-impaired (HI) listeners have shown that the relation between speech performance in noise and listening effort (as measured by peak pupil dilation) is not linear and exhibits an inverted-U shape. However, it is unclear whether the same psychometric relation exists in CI users, and whether individual differences in auditory sensitivity and central cognitive capacity affect this relation. Therefore, we recruited 17 post-lingually deaf CI adults to perform speech-in-noise tasks from 0 to 20 dB SNR with a 4 dB step size. Simultaneously, their pupillary responses and self-reported subjective effort were recorded. To characterize top-down and bottom-up individual variabilities, a spectro-temporal modulation task and a set of cognitive abilities were measured. Clinical word recognition in quiet and Quality of Life (QoL) were also collected. Results showed that at a group level, an inverted-U shape psychometric curve between task difficulty (SNR) and peak pupil dilation (PPD) was not observed. Individual shape of the psychometric curve was significantly associated with some individual factors: CI users with higher clinical word and speech-in-noise recognition showed a quadratic decrease of PPD over increasing SNRs; CI users with better non-verbal intelligence and lower QoL showed smaller average PPD. To summarize, individual differences in CI users had a significant impact on the psychometric relation between pupillary response and task difficulty, hence affecting the interpretation of pupillary response as listening effort (or engagement) at different task difficulty levels. Future research and clinical applications should further characterize the possible effects of individual factors (such as motivation or engagement) in modulating CI users' occurrence of 'tipping point' on their psychometric functions, and develop an individualized method for reliably quantifying listening effort using pupillometry.
尽管有重大的技术进步和更广泛的临床应用,但人工耳蜗(CI)使用者仍继续报告称,尤其是在具有挑战性的嘈杂环境中,他们的听觉努力程度很高且不断增加。在所有用于量化听觉努力的客观测量方法中,瞳孔测量法是使用最广泛且可靠的生理测量方法之一。先前针对听力正常(NH)和听力受损(HI)听众的研究表明,噪声环境下的言语表现与听觉努力(通过瞳孔最大扩张来衡量)之间的关系并非线性,而是呈现倒U形。然而,目前尚不清楚人工耳蜗使用者是否存在同样的心理测量关系,以及听觉敏感性和中枢认知能力的个体差异是否会影响这种关系。因此,我们招募了17名语后聋的成年人工耳蜗使用者,以4dB的步长执行信噪比从0到20dB的噪声中的言语任务。同时,记录他们的瞳孔反应和自我报告的主观努力程度。为了表征自上而下和自下而上的个体变异性,我们测量了一个频谱-时间调制任务和一组认知能力。还收集了安静环境下的临床单词识别能力和生活质量(QoL)。结果表明,在群体水平上,未观察到任务难度(信噪比)与瞳孔最大扩张(PPD)之间呈倒U形的心理测量曲线。心理测量曲线的个体形状与一些个体因素显著相关:临床单词和噪声中言语识别能力较高的人工耳蜗使用者,随着信噪比的增加,PPD呈二次下降;非言语智力较好且生活质量较低的人工耳蜗使用者,其平均PPD较小。总之,人工耳蜗使用者的个体差异对瞳孔反应与任务难度之间的心理测量关系有显著影响,从而影响了在不同任务难度水平下将瞳孔反应解释为听觉努力(或参与度)。未来的研究和临床应用应进一步表征个体因素(如动机或参与度)在调节人工耳蜗使用者心理测量功能上“临界点”出现情况的可能影响,并开发一种个性化方法,以使用瞳孔测量法可靠地量化听觉努力。
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