Bernstein Joshua G W, Goupell Matthew J
National Military Audiology and Speech Pathology Center, Walter Reed National Military Medical Center, Bethesda, Maryland, USA.
Department of Hearing and Speech Sciences, University of Maryland-College Park, College Park, Maryland, USA.
Ear Hear. 2025 Jun 19. doi: 10.1097/AUD.0000000000001687.
OBJECTIVES: For many (especially older) single-sided-deafness (SSD) cochlear-implant (CI) users (one normal hearing and one CI ear), masking speech in the acoustic ear can interfere with CI-ear speech recognition. This study examined two possible explanations for this "bilateral speech interference." First, it might reflect a general (i.e., not specific to spatial hearing or CI use) age-related "selective-attention" deficit, with some listeners having difficulty attending to target speech while ignoring an interferer. Second, it could be specific to asymmetric-hearing experience, reflecting maladaptive plasticity with the better ear becoming favored over time. DESIGN: Twenty-eight listeners with bilaterally normal or near-normal hearing (NH) through 4 kHz completed a series of speech-on-speech masking tasks. Vocoder simulations of SSD-CI listening (four- or eight-channel noise-vocoded speech in the right ear, unprocessed speech in the left) tested whether acutely simulated asymmetric hearing would produce interference comparable to that previously observed for 13 SSD-CI listeners. Both groups had a wide age range (NH: 20 to 84 years; SSD-CI: 36 to 74 years) and were therefore expected to exhibit a wide range of selective-attention ability. The primary set of conditions measured bilateral speech interference. Target coordinate-response-measure sentences mixed with a masker of similar fundamental frequency (F0) were presented to the right (vocoded) ear at target-to-masker ratios of 0, 4, 8, or 16 dB. Silence or a copy of the masker was presented to the left (unprocessed) ear. Bilateral speech interference-the performance decrease from adding the masker copy to the left ear-was compared with previous SSD-CI results. NH listeners also completed two additional sets of conditions. The first set measured the F0-difference benefit for unprocessed monaural speech-on-speech masking. This is a likely indicator of non-spatial selective-attention ability, based on previous findings that older adults benefit less than younger adults from target-masker F0 differences. The second set measured contralateral-unmasking benefit. Target and masking speech were presented to the unprocessed ear and the benefit from presenting a copy of the masking speech to the vocoded ear was measured. A linear-mixed model analysis examined relationships between NH bilateral speech interference and age, monaural speech-on-speech masking (to estimate non-spatial selective attention), and contralateral unmasking. An additional analysis compared NH-Vocoder to SSD-CI interference. RESULTS: The strongest predictor of NH-vocoder interference was performance in the monaural different-F0 speech-on-speech masking condition (p = 0.0024). Neither similar-F0 speech-on-speech masking performance, nor age, nor contralateral unmasking accounted for significant additional variance (p = 0.11 to 0.69). Mean SSD-CI interference magnitude was comparable to the four-channel NH-vocoder condition (p = 0.75) but larger than the eight-channel condition (p < 0.001). CONCLUSIONS: The association between bilateral speech interference and monaural speech recognition with different-F0 interferers for NH listeners suggests that (possibly age-related) non-spatial selective-attention ability might also explain SSD-CI interference variability. Regardless of hearing status, some people might have difficulty attending to one sound while ignoring others, with asymmetrically distorted inputs exacerbating this problem. Comparable SSD-CI and NH-Vocoder interference challenges the idea that SSD-CI interference reflects long-term maladaptive changes from asymmetric hearing. Future work should explore selective-attention measures as predictors of SSD-CI performance in competing-talker environments.
目的:对于许多(尤其是老年)单侧耳聋(SSD)人工耳蜗(CI)使用者(一只耳朵听力正常,另一只耳朵植入CI),在听力正常的耳朵中掩蔽语音会干扰CI耳的语音识别。本研究探讨了这种“双侧语音干扰”的两种可能解释。首先,它可能反映了一种普遍的(即并非特定于空间听觉或CI使用)与年龄相关的“选择性注意”缺陷,一些听者在忽略干扰音的同时难以专注于目标语音。其次,它可能特定于不对称听力体验,反映了随着时间推移,较好的耳朵变得更受青睐的适应不良可塑性。 设计:28名通过4kHz听力双侧正常或接近正常(NH)的听者完成了一系列语音对语音掩蔽任务。对SSD-CI听力进行声码器模拟(右耳为四通道或八通道噪声声码语音,左耳为未处理语音),以测试急性模拟的不对称听力是否会产生与之前观察到的13名SSD-CI听者相当的干扰。两组的年龄范围都很广(NH组:20至84岁;SSD-CI组:36至74岁),因此预计会表现出广泛的选择性注意能力。主要的一组条件测量双侧语音干扰。将目标坐标响应测量句子与具有相似基频(F0)的掩蔽音混合,以0、4、8或16dB的目标与掩蔽音比率呈现给右(声码)耳。向左(未处理)耳呈现静音或掩蔽音的副本。将双侧语音干扰(即从向左耳添加掩蔽音副本导致的性能下降)与之前的SSD-CI结果进行比较。NH听者还完成了另外两组条件。第一组测量未处理的单耳语音对语音掩蔽的F0差异益处。基于之前的研究结果,即老年人从目标与掩蔽音的F0差异中获得的益处少于年轻人,这可能是非空间选择性注意能力的一个指标。第二组测量对侧解掩蔽益处。将目标语音和掩蔽语音呈现给未处理耳,并测量向声码耳呈现掩蔽语音副本所带来的益处。线性混合模型分析研究了NH双侧语音干扰与年龄、单耳语音对语音掩蔽(以估计非空间选择性注意)和对侧解掩蔽之间的关系。另一项分析比较了NH声码器与SSD-CI干扰。 结果:NH声码器干扰的最强预测因素是单耳不同F0语音对语音掩蔽条件下的表现(p = 0.0024)。相似F0语音对语音掩蔽表现、年龄或对侧解掩蔽均未解释显著的额外方差(p = 0.11至0.69)。平均SSD-CI干扰幅度与四通道NH声码器条件相当(p = 0.75),但大于八通道条件(p < 0.001)。 结论:NH听者双侧语音干扰与不同F0干扰音的单耳语音识别之间的关联表明,(可能与年龄相关的)非空间选择性注意能力也可能解释SSD-CI干扰的变异性。无论听力状况如何,有些人在忽略其他声音的同时专注于一个声音可能会有困难,而不对称失真的输入会加剧这个问题。SSD-CI与NH声码器干扰相当,这对SSD-CI干扰反映不对称听力长期适应不良变化的观点提出了挑战。未来的工作应探索选择性注意测量方法,作为竞争言语环境中SSD-CI性能的预测指标。
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