Comparison of the Spectral-Temporally Modulated Ripple Test With the Arizona Biomedical Institute Sentence Test in Cochlear Implant Users

Abstract

Objectives Although speech perception is the gold standard for measuring cochlear implant (CI) users’ performance, speech perception tests often require extensive adaptation to obtain accurate results, particularly after large changes in maps. Spectral ripple tests, which measure spectral resolution, are an alternate measure that has been shown to correlate with speech perception. A modified spectral ripple test, the spectral-temporally modulated ripple test (SMRT) has recently been developed, and the objective of this study is to compare speech perception and performance on the SMRT for a heterogeneous population of unilateral CI users, bilateral CI users, and bimodal users. Design Twenty-five CI users (eight using unilateral CIs, nine using bilateral CIs, and eight using a CI and a hearing aid) were tested on the Arizona Biomedical Institute Sentence Test (AzBio) with a +8 dB signal-to-noise ratio, and on the SMRT. All participants were tested with their clinical programs. Results There was a significant correlation between SMRT and AzBio performance. After a practice block, an improvement of 1 ripple per octave for SMRT corresponded to an improvement of 12.1% for AzBio. Additionally, there was no significant difference in slope or intercept between any of the CI populations. Conclusion The results indicate that performance on the SMRT correlates with speech recognition in noise when measured across unilateral, bilateral, and bimodal CI populations. These results suggest that SMRT scores are strongly associated with speech recognition in noise ability in experienced CI users. Further studies should focus on increasing both the size and diversity of the tested participants, and on determining whether the SMRT technique can be used for early predictions of long-term speech scores, or for evaluating differences among different stimulation strategies or parameter settings.

Dynamic current focusing for loudness encoding in cochlear implants: a take-home trial

“…A recently published pilot study of the DCF strategy (de Jong, Briaire, and Frijns 2018) showed there was better performance on the SMRT with DCF, especially at lower loudness levels. Because the SMRT correlates with speech understanding (Holden et al 2016;Lawler, Yu and Aronoff 2017;Zhou 2017), speech perception in noise was also expected to improve after some adaptation time. As the pilot study revealed a decrease in DCF battery life to 1.5-4 hours, some alterations to the fitting parameters were required to enhance clinical suitability.…”

“…This was unexpected, as both psychophysical measures are known to correlate independently with speech understanding (Fu 2002;Holden et al 2016;Zhou 2017;Won et al 2007Won et al , 2013. The adaptation period of 5 weeks may not have been long enough to completely adjust to the novel strategy, so the final performance was still not reached (Lawler, Yu, and Aronoff 2017). This study intended to examine the effect of using the DCF strategy chronically; thus, an extra analysis was performed excluding subjects who did not use the strategy for at least 4 weeks.…”

“…This spectral ripple test was chosen because it deals with potential confounders, such as loudness cues. Although it is unclear whether the SMRT scores represent frequency resolution or other perceptual abilities (Dinino and Arenberg 2018), the scores correlate with speech understanding under multiple listening conditions (Holden et al 2016;Lawler, Yu, and Aronoff 2017;Zhou 2017). The SMRT is a three-alternative forced choice (3AFC) task that determines the maximum ripples per octave (RPO) that a listener can distinguish from two reference stimuli with unresolvable high ripple densities of 20 RPO.…”

Comprehensive auditory rehabilitation in adults receiving cochlear implants: A pilot study

“…However, broad outcome variability persists on measures of speech recognition, [1][2][3] some of which can be attributed to patient-related factors (eg, residual hearing) 4 and spectrotemporal resolution. 3,5,6 Additionally, neurocognitive functions, such as verbal learning, working memory, and inhibitory control, relate to outcomes. 3,7,8 Evidence for the efficacy of auditory rehabilitation on both auditory processing and neurocognitive functions continues to grow.…”

Flaws in Spectral Ripple Stimuli for Listeners with Cochlear Implants

“…One reason for the spectral ripple test's popularity is that spectral ripple thresholds have been demonstrated to correlate with speech perception tests, including word, consonant, and vowel recognition (Henry et al 2005), and speech recognition in 111 noise (Won et al 2007;Lawler et al 2017; although note that Anderson et al 2011, did not observe robust correlations with any speech perception measure). Higher (better) 113 ripple discrimination thresholds are also associated with better musical perception (Won et al 2010).…”