The purpose of this study was to investigate the effects of immersive virtual reality (VR)-based cognitive training in older adults with hearing impairment. Participants were three older adults with hearing impairment. Three assessment tools, audiometric, neuropsychological, and outcome measurements of the subjective hearing handicap inventory for the elderly, were examined before and after the VR cognitive training. The VR cognitive training was conducted once per week for 6 weeks and consisted of five different VR games classified into three specific cognitive domains (attention, memory, and executive function). The improved VR game performances were constantly observed across the training sessions in all three participants. After the VR cognitive training, first, the scores on the forward digit span test (attention), immediate recall on the SVLT-E (memory), and word reading and color reading on the K-CWST (executive function) were improved for all participants. In addition, the reaction time on the K-TMT-E (executive function) was shortened. Second, the sentence recognition scores in adverse listening conditions (SNR 0 dB and -5 dB) were improved. Third, the Korean version of hearing handicap inventory for the elderly (K-HHIE) scores which are reflective of subjective hearing handicap were decreased. Preventive intervention for cognitive deficits in older adults with hearing impairment is needed because hearing impairment is one of the major risk factors for dementia in older age. In this respect, the present case study demonstrates that VR cognitive training could improve cognitive function, speech-in-noise perception, and subjective hearing handicap in the hearing-impaired elderly.

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Purpose: Sound is localized by two ears. People with bilaterally severe-to-profound hearing loss may struggle to identify the direction of a sound if their hearing device delivers sound only one ear due to the loss of binaural advantage. The purpose of this study was to systematically investigate the sound localization performance of people with unilateral cochlear implant users. Methods: Ten unilateral cochlear implant users and 10 normal hearing adults participated in this study. Sound localization tests were conducted using five stimuli (speech, speech with noise, 500 Hz warble tone, 1 kHz warble tone, and 4 kHz warble tone) presented from eight loud-speakers. Correct responses and root- mean-square errors were obtained to investigate the localization performances and error patterns. Additional factors including the Korean-Speech Spatial and Qualities of Hearing Questionnaire were also analyzed. Results: Localization performance was significantly poor in the unilateral cochlear implant group showing polar patterns toward their hearing side. While the normal hearing group showed better localization for speech in quiet conditions compared to 500 Hz warble tone, the cochlear implant group did not show any statistical difference in performance across the stimuli due to their very poor performance. The Korean-Speech Spatial and Qualities of Hearing Questionnaire was associated with localization performance in limited conditions. Conclusion: The present study revealed that unilateral cochlear implant users correctly localize a sound at nearly chance levels. The Korean-Speech Spatial and Qualities of Hearing Questionnaire predict localization performance for unilateral cochlear implant users only for particular conditions.

Purpose: Despite a growing number of cochlear implant (CI) studies, little attention has been given to loudness perception. The overall purpose of this study is to obtain the perceptual loudness growth from CI users and systematically investigate it with other relevant variables.Methods: Fourteen CI users and 14 normal hearing (NH) adults participated in this study. Loudness growth functions were obtained using three warble tones presented at 500 Hz, 1 kHz, and 4 kHz. Sentence recognition tests were implemented under favorable and adverse noise conditions. Mapping parameters including T-level, C-level, and electrical dynamic range were analyzed in conjunction with outcomes from the loudness growth.Results: The loudness growth curves for CI group were sharper than those for NH group. CI group showed a narrower acoustic dynamic range than NH group. There was no significant relationship between acoustic dynamic range and electrical dynamic range for CI users. Sentence recognition scores in adverse noise conditions were associated with electrical dynamic range in CI users. In NH group, a significant positive relationship was found between sentence recognition scores in adverse condition and acoustic dynamic range.Conclusion: This study showed that the perceptual loudness growth of CI users is not identical to that of NH adults, due to the unique way of signal processing mechanisms. Acoustic dynamic range for CI users seems affected by gain control algorithms. The adjusting mapping parameters associated with loudness may improve speech perception performance regardless of the dynamic range of CIs.

Despite the significant contribution of hearing assistive devices, medications, and surgery to restoring auditory periphery, a large number of people with hearing loss still struggle with understanding speech. This leads many studies on speech perception to move towards the central auditory functions by looking at associated brain activities using macroscopic recording tools such as electroencephalography (EEG). Up until a few years ago, however, limitation has been given to the brain scientists who attempted to investigate speech perception mechanisms using the EEG. In particular, short duration of speech segments has inevitably been used to elicit auditory evoked potential, even though they were too brief to be considered as speech. Today, however, advance in neural engineering and better understanding of neural mechanism have better facilitated brain scientists to perform studies with running stream of continuous speech and expand the scope of EEG studies to include comprehension of more realistic speech envelope. The purpose of this study is to review literatures on neural tracking to speech envelope to discuss it in Audiology perspective. This review article consists of seven subjects including introduction, neural tracking theories, neural tracking measure, signal processing & analysis, literature review on neural tracking associated with hearing loss, application of neural tracking to audiology, and conclusion. We noted that neural tracking has potential to be used in clinical sets to objectively evaluate speech comprehension for people with hearing loss in the future.