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Objectives: To evaluate whether hearing aid directivity based on multistream architecture (MSA) might enhance the mismatch negativity (MMN) evoked by phonemic contrasts in noise. Design: Single-blind within-subjects design. Fifteen older adults (mean age = 72.7 years, range = 40 to 88 years, 8 females) with a moderate-to-severe degree of sensorineural hearing loss participated. Participants first performed an adaptive two-alternative forced choice phonemic discrimination task to determine the speech level—that is, signal to noise ratio (SNR)—required to reliably discriminate between two monosyllabic stimuli (/ba/ and /da/) presented in the presence of ongoing fixed-level background noise. Participants were then presented with a phonemic oddball sequence alternating on each trial between two loudspeakers located in the front at 0° and −30° azimuth. This sequence presented the same monosyllabic stimuli in the same background noise at individualized SNRs determined by the phonemic discrimination task. The MMN was measured as participants passively listened to the oddball sequence in two hearing aid conditions: MSA-ON and MSA-OFF. Results: The magnitude of the MMN component was significantly enhanced when evoked in MSA-ON relative to MSA-OFF conditions. Unexpectedly, MMN magnitudes were also positively related to degrees of hearing loss. Neither MSA nor the participant’s hearing loss was found to independently affect MMN latency. However, MMN latency was significantly affected by the interaction of hearing aid condition and individualized SNRs, where a negative relationship between individualized SNR and MMN latency was observed only in the MSA-OFF condition. Conclusions: Hearing aid directivity based on the MSA approach was found to improve preattentive detection of phonemic contrasts in a simulated multi-talker situation as indexed by larger MMN component magnitudes. The MMN may generally be useful for exploring the underlying nature of speech-in-noise benefits conferred by some hearing aid features.
Objectives: To evaluate whether hearing aid directivity based on multistream architecture (MSA) might enhance the mismatch negativity (MMN) evoked by phonemic contrasts in noise. Design: Single-blind within-subjects design. Fifteen older adults (mean age = 72.7 years, range = 40 to 88 years, 8 females) with a moderate-to-severe degree of sensorineural hearing loss participated. Participants first performed an adaptive two-alternative forced choice phonemic discrimination task to determine the speech level—that is, signal to noise ratio (SNR)—required to reliably discriminate between two monosyllabic stimuli (/ba/ and /da/) presented in the presence of ongoing fixed-level background noise. Participants were then presented with a phonemic oddball sequence alternating on each trial between two loudspeakers located in the front at 0° and −30° azimuth. This sequence presented the same monosyllabic stimuli in the same background noise at individualized SNRs determined by the phonemic discrimination task. The MMN was measured as participants passively listened to the oddball sequence in two hearing aid conditions: MSA-ON and MSA-OFF. Results: The magnitude of the MMN component was significantly enhanced when evoked in MSA-ON relative to MSA-OFF conditions. Unexpectedly, MMN magnitudes were also positively related to degrees of hearing loss. Neither MSA nor the participant’s hearing loss was found to independently affect MMN latency. However, MMN latency was significantly affected by the interaction of hearing aid condition and individualized SNRs, where a negative relationship between individualized SNR and MMN latency was observed only in the MSA-OFF condition. Conclusions: Hearing aid directivity based on the MSA approach was found to improve preattentive detection of phonemic contrasts in a simulated multi-talker situation as indexed by larger MMN component magnitudes. The MMN may generally be useful for exploring the underlying nature of speech-in-noise benefits conferred by some hearing aid features.
IntroductionCurrent hearing aids have an abundance of feature options and technologies. It is important to understand the clinical impact of hearing aid technology selection and how to individualize fittings to optimize hearing aid performance according to listening environment. To probe the naturalistic listening experiences researchers can use in-situ outcome measures. Survey-based real-world assessments can increase knowledge of hearing aid users' everyday scenarios, beyond the limits of lab-based scenarios. This study aimed to assess the relationship between subjective preference ratings of adult listeners and hearing aid technology level using Ecological Momentary Assessment (EMA). A secondary research question explored survey completion as a function of real-world participation in socially involved situations.MethodsThis study aimed to capture and assess in-the-moment listening situations and participant preference for hearing aid technology levels, using EMA through an app-based survey. Surveying was completed indoors (at home), indoors (away from home); and outdoors, and while in a listening situation with at least one communication partner. Fourteen older adults, aged 61–82 years, who were experienced bilateral hearing aids users were included in this study. Participants completed a 2-week acclimatization period wearing study-provided hearing aids, and a 2-week data collection period. In-situ surveying was used to evaluate technology-level preference in real-world listening situations with at least one communication partner. Survey data captured in-the-moment details surrounding environment, activity, and listening preference. Mixed methods were used to analyze the data, including Bayesian analyses for preference data and content analysis for text-based survey responses, including the use of the International Classification of Functioning, Disability and Health to guide activity categorization.ResultsAcross a wide variety of categorized activities, participants demonstrated a preference for mid- to high-level hearing aid technologies when compared to the lowest level. Technology preference also varied according to reported activity location.DiscussionThe use of in-situ surveying provided a broader understanding of hearing aid users' listening environments when conversing with one or more communication partners and related technology preferences. EMA was found to be a feasible method of data collection for this cohort and may help guide clinical, person-centered selection of technology level.
Objectives: Investigate factors contributing to the effective management of age-related hearing loss (ARHL) rehabilitation. Methods: A systematic review was conducted following PRISMA guidelines. The protocol was registered in PROSPERO (CRD42022374811). Articles were identified through systematic searches in the Scopus, PubMed, Web of Science, and Cochrane databases in May 2024. Only articles published between January 2005 and May 2024 were included. Studies were assessed for eligibility by two independent researchers and evaluated using the Crowe Critical Appraisal Tool v1.4 (CCAT). Results: Of the 278 articles identified, 54 were included. Three factors explain effective HA use. First, hearing aid signal processing, with directional microphones and noise reduction, improves user comfort and understanding regarding noise. Second, there is hearing aid fitting, with the NAL prescription rules as the gold standard, and bilateral, high-level HA performance for spatial localization and noise comprehension. Third, there is a patient-centered approach, using patient-related outcome measures (PROMs), questionnaires, counseling, and regular follow-up to involve patients in their therapeutic rehabilitation. Conclusions: Reaching a consensus on acoustic parameters is challenging due to variability in audiological results. Involving patients in their rehabilitation, addressing their needs and expectations, and offering individualized care are crucial.
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