Speech Recognition and Listening Effort in Cochlear Implant Recipients and Normal-Hearing Listeners

Abstract

The outcome of cochlear implantation is typically assessed by speech recognition tests in quiet and in noise. Many cochlear implant recipients reveal satisfactory speech recognition especially in quiet situations. However, since cochlear implants provide only limited spectro-temporal cues the effort associated with understanding speech might be increased. In this respect, measures of listening effort could give important extra information regarding the outcome of cochlear implantation. In order to shed light on this topic and to gain knowledge for clinical applications we compared speech recognition and listening effort in cochlear implants (CI) recipients and age-matched normal-hearing listeners while considering potential influential factors, such as cognitive abilities. Importantly, we estimated speech recognition functions for both listener groups and compared listening effort at similar performance level. Therefore, a subjective listening effort test (adaptive scaling, “ACALES”) as well as an objective test (dual-task paradigm) were applied and compared. Regarding speech recognition CI users needed about 4 dB better signal-to-noise ratio to reach the same performance level of 50% as NH listeners and even 5 dB better SNR to reach 80% speech recognition revealing shallower psychometric functions in the CI listeners. However, when targeting a fixed speech intelligibility of 50 and 80%, respectively, CI users and normal hearing listeners did not differ significantly in terms of listening effort. This applied for both the subjective and the objective estimation. Outcome for subjective and objective listening effort was not correlated with each other nor with age or cognitive abilities of the listeners. This study did not give evidence that CI users and NH listeners differ in terms of listening effort – at least when the same performance level is considered. In contrast, both listener groups showed large inter-individual differences in effort determined with the subjective scaling and the objective dual-task. Potential clinical implications of how to assess listening effort as an outcome measure for hearing rehabilitation are discussed.

Age effects on cognitive functions and speech-in-noise processing: An event-related potential study with cochlear-implant users and normal-hearing listeners

“…Our results revealed no significant interaction between “age” and “hearing group,” suggesting that the age effect on cognitive functions is comparable between the CI users and the NH listeners. These findings expand previous research ( Abdel-Latif and Meister, 2022 ) by pointing to similar cognitive abilities between CI users and NH listeners, for both elderly and young individuals. Nevertheless, future longitudinal studies are necessary to better understand the role of hearing rehabilitation on the age-related decline in cognitive abilities of CI users.…”

Exploring neurocognitive factors and brain activation in adult cochlear implant recipients associated with speech perception outcomes—A scoping review

“…Of these 150 articles, 96 were excluded based on reading the full-text. In 26 studies, there was no speech perception outcome reported or used in the relevant analysis ( Giraud et al, 2000 , 2001a , b ; Gfeller et al, 2003 ; Oba et al, 2013 ; Berding et al, 2015 ; Finke et al, 2015 ; Jorgensen and Messersmith, 2015 ; Song et al, 2015b ; Wang et al, 2015 ; McKay et al, 2016 ; Shafiro et al, 2016 ; Perreau et al, 2017 ; Amichetti et al, 2018 ; Butera et al, 2018 ; Bönitz et al, 2018 ; Cartocci et al, 2018 ; Lawrence et al, 2018 ; Moberly et al, 2018b ; Patro and Mendel, 2018 , 2020 ; Dimitrijevic et al, 2019 ; Chari et al, 2020 ; Zaltz et al, 2020 ; Schierholz et al, 2021 ; Abdel-Latif and Meister, 2022 ). Twenty-two studies were excluded based on population criteria, studies testing children and adults with prelingual onset of hearing loss ( El-Kashlan et al, 2001 ; Most and Adi-Bensaid, 2001 ; Lyxell et al, 2003 ; Rönnberg, 2003 ; Middlebrooks et al, 2005 ; Doucet et al, 2006 ; Heydebrand et al, 2007 ; Rouger et al, 2007 ; Hafter, 2010 ; Li et al, 2013 ; Lazard et al, 2014 ; Bisconti et al, 2016 ; Anderson et al, 2017 ; Finke et al, 2017 ; Miller et al, 2017 ; Moradi et al, 2017 ; Purdy et al, 2017 ; McKee et al, 2018 ; Verhulst et al, 2018 ; Winn and Moore, 2018 ; Lee et al, 2019 ; Smith et al, 2019 ).…”

Neural Activity During Audiovisual Speech Processing: Protocol For a Functional Neuroimaging Study

“…To assess listening effort during the fNIRS task, we will use a validated questionnaire (ie, ACALES) [ 65 ]. Listening effort in CI users is an active topic of discussion [ 82 ]; its possible influence on the measured cortical activation, to the best of our knowledge, has never been reported before. To describe the subjective hearing perception in their daily lives, participants will complete validated questionnaires (ie, SSQ-12) on the day of the test [ 38 ].…”