Mancini Patrizia, Odabaşı Yılmaz, Portanova Ginevra, Russo Francesca Yoshie, Iannella Giannicola, Dincer D'Alessandro Hilal
Department of Sense Organs, Sapienza University of Rome, Rome, Italy.
Department of Audiology, Faculty of Health Sciences, Hacettepe University, Ankara, Turkey.
Eur Arch Otorhinolaryngol. 2025 May 20. doi: 10.1007/s00405-025-09449-y.
Cochlear implant (CI) users may perceive pitch changes via repetition rate (RP) and place-of-stimulation (PP) coding mechanisms. This study investigated whether CI users fitted with fine structure (FS) strategies can discriminate low-frequency (LF) pitch changes via RP and whether RP performers show better speech recognition than PP performers.
Thirty postlingually deafened adult CI users (15 unilateral, 15 bilateral) participated in this study. LF pitch discrimination linked to temporal fine structure (TFS) sensitivity was assessed with the Disharmonic Intonation test (A§E psychoacoustic test suite), while speech perception was evaluated with phonetically balanced words and everyday sentences (both in quiet and noise), and the Italian Matrix test (in adaptive mode).
Just noticeable differences (JNDs) in RP performers were significantly better compared to PP JNDs (p < 0.001, r = 0.80). No significant differences were found between unilateral and bilateral CI users for LF pitch perception (p > 0.05). Within-group comparisons (better ear versus bilateral listening) revealed that better ear JNDs were not significantly different from the bilateral performance (p > 0.05), whereas significant bilateral benefit was observed for word recognition score (WRS) + 10 (p = 0.016, r = 1.00), WRS + 5 (p = 0.021, r = 1.00), and Matrix performance (p = 0.033, r = 0.80). Speech recognition in noise was significantly better in RP performers compared to PP performers across multiple tests, including WRS + 10 (p = 0.002, r = 0.90), WRS + 5 (p = 0.001, r = 0.90), and the Matrix test (p = 0.03, r = 0.60).
These findings highlight the advantages of FS coding strategies in improving TFS sensitivity and speech perception in complex listening environments.
人工耳蜗（CI）使用者可通过重复率（RP）和刺激部位（PP）编码机制感知音高变化。本研究调查了采用精细结构（FS）策略的CI使用者是否能通过RP辨别低频（LF）音高变化，以及采用RP的使用者在语音识别方面是否比采用PP的使用者表现更好。
30名语后聋成年CI使用者（15名单侧，15名双侧）参与了本研究。使用不和谐语调测试（A§E心理声学测试套件）评估与时间精细结构（TFS）敏感性相关的LF音高辨别能力，同时使用语音平衡词和日常句子（安静和噪声环境下）以及意大利矩阵测试（自适应模式）评估语音感知能力。
与PP的恰可辨别差异（JND）相比，RP使用者的JND明显更好（p < 0.001，r = 0.80）。单侧和双侧CI使用者在LF音高感知方面未发现显著差异（p > 0.05）。组内比较（较好耳与双侧聆听）显示，较好耳的JND与双侧表现无显著差异（p > 0.05），而在单词识别得分（WRS）+10（p = 0.016，r = 1.00）、WRS +5（p = 0.021，r = 1.00）和矩阵测试表现（p = 0.033，r = 0.80）方面观察到显著的双侧获益。在包括WRS +10（p = 0.002，r = 0.90）、WRS +5（p = 0.001，r = 0.90）和矩阵测试（p = 0.03，r = 0.60）在内的多项测试中，RP使用者在噪声环境下的语音识别明显优于PP使用者。
这些发现突出了FS编码策略在改善复杂聆听环境中的TFS敏感性和语音感知方面的优势。
