Speech Comprehension In Noise Research Articles

Neural processing of speech comprehension in noise predicts individual age using fNIRS-based brain-behavior models.

Speech comprehension in noise depends on complex interactions between peripheral sensory and central cognitive systems. Despite having normal peripheral hearing, older adults show difficulties in speech comprehension. It remains unclear whether the brain's neural responses could indicate aging. The current study examined whether individual brain activation during speech perception in different listening environments could predict age. We applied functional near-infrared spectroscopy to 93 normal-hearing human adults (20 to 70years old) during a sentence listening task, which contained a quiet condition and 4 different signal-to-noise ratios (SNR = 10, 5, 0, -5dB) noisy conditions. A data-driven approach, the region-based brain-age predictive modeling was adopted. We observed a significant behavioral decrease with age under the 4 noisy conditions, but not under the quiet condition. Brain activations in SNR = 10dB listening condition could successfully predict individual's age. Moreover, we found that the bilateral visual sensory cortex, left dorsal speech pathway, left cerebellum, right temporal-parietal junction area, right homolog Wernicke's area, and right middle temporal gyrus contributed most to prediction performance. These results demonstrate that the activations of regions about sensory-motor mapping of sound, especially in noisy conditions, could be sensitive measures for age prediction than external behavior measures.

A Study of Event-Related Potentials During Monaural and Bilateral Hearing in Single-Sided Deaf Cochlear Implant Users.

Single-sided deafness (SSD) is characterized by a profoundly deaf ear and normal hearing in the contralateral ear. A cochlear implant (CI) is the only method to restore functional hearing in a profoundly deaf ear. In a previous study, we identified that the cortical processing of a CI signal differs from the normal-hearing ear (NHE) when directly compared using an auditory oddball paradigm consisting of pure tones. However, exactly how the brain integrates the electrical and acoustic signal is not well investigated. This study aims to understand how the provision of the CI in combination with the NHE may improve SSD CI users' ability to discriminate and evaluate auditory stimuli. Electroencephalography from 10 SSD-CI participants (4 participated in the previous pure-tone study) were recorded during a semantic acoustic oddball task, where they were required to discriminate between odd and even numbers. Stimuli were presented in four hearing conditions: directly through the CI, directly to the NHE, or in free field with the CI switched on and off. We examined task-performance (response time and accuracy) and measured N1, P2, N2N4, and P3b event-related brain potentials (ERPs) linked to the detection, discrimination, and evaluation of task relevant stimuli. Sound localization and speech in noise comprehension was also examined. In direct presentation, task performance was superior during NHE compared with CI (shorter and less varied reaction times [~720 versus ~842 msec], higher target accuracy [~93 versus ~70%]) and early neural responses (N1 and P2) were enhanced for NHE suggesting greater signal saliency. However, the size of N2N4 and P3b target-standard effects did not differ significantly between NHE and CI. In free field, target accuracy was similarly high with the CI (FF-On) and without the CI (FF-Off) (~95%), with some evidence of CI interference during FF-On (more variable and slightly but significantly delayed reaction times [~737 versus ~709 msec]). Early neural responses and late effects were also greater during FF-On. Performance on sound localization and speech in noise comprehension (S CI N NHE configuration only) was significantly greater during FF-On. Both behavioral and neural responses in the semantic oddball task were sensitive to CI in both direct and free-field presentations. Direct conditions revealed that participants could perform the task with the CI alone, although performance was suboptimal and early neural responses were reduced when compared with the NHE. For free-field, the addition of the CI was associated with enhanced early and late neural responses, but this did not result in improved task performance. Enhanced neural responses show that the additional input from the CI is modulating relevant perceptual and cognitive processes, but the benefit of binaural hearing on behavior may not be realized in simple oddball tasks which can be adequately performed with the NHE. Future studies interested in binaural hearing should examine performance under noisy conditions and/or use spatial cues to allow headroom for the measurement of binaural benefit.

Online Assessment of Speech Perception and Auditory Spectrotemporal Processing in Spanish-English Bilinguals.

There is limited access to audiology services for the growing population of Spanish-English bilinguals in the United States. Online auditory testing can potentially provide a cost-effective alternative to in-person visits. However, even for bilinguals with high English proficiency, age of English acquisition may affect speech perception accuracy. This study used a comprehensive test battery to assess speech perception and spectrotemporal processing abilities in Spanish-English bilinguals and to evaluate susceptibility of different tests to effects of native language. The online battery comprised three tests of speech in quiet (vowel and consonant identification and words in sentences), four tests of speech perception in noise (two for intelligibility and two for comprehension), and three tests of spectrotemporal processing (two tests of stochastically modulated pattern discrimination and one test of spectral resolution). Participants were 28 adult Spanish-English bilinguals whose English acquisition began either early (≤ 6 years old) or late (≥ 7 years old) and 18 English monolingual speakers. Significant differences were found in six of the 10 tests. The differences were most pronounced for vowel perception in quiet, speech-in-noise test, and two tests of speech comprehension in noise. Late bilinguals consistently scored lower than native English speakers or early bilinguals. In contrast, no differences between groups were observed for digits-in-noise or three tests of spectrotemporal processing abilities. The findings suggest initial feasibility of online assessment in this population and can inform selection of tests for auditory assessment of Spanish-English bilinguals.

Age of Acquisition Modulates Alpha Power During Bilingual Speech Comprehension in Noise.

Research on bilingualism has grown exponentially in recent years. However, the comprehension of speech in noise, given the ubiquity of both bilingualism and noisy environments, has seen only limited focus. Electroencephalogram (EEG) studies in monolinguals show an increase in alpha power when listening to speech in noise, which, in the theoretical context where alpha power indexes attentional control, is thought to reflect an increase in attentional demands. In the current study, English/French bilinguals with similar second language (L2) proficiency and who varied in terms of age of L2 acquisition (AoA) from 0 (simultaneous bilinguals) to 15 years completed a speech perception in noise task. Participants were required to identify the final word of high and low semantically constrained auditory sentences such as “Stir your coffee with a spoon” vs. “Bob could have known about the spoon” in both of their languages and in both noise (multi-talker babble) and quiet during electrophysiological recording. We examined the effects of language, AoA, semantic constraint, and listening condition on participants’ induced alpha power during speech comprehension. Our results show an increase in alpha power when participants were listening in their L2, suggesting that listening in an L2 requires additional attentional control compared to the first language, particularly early in processing during word identification. Additionally, despite similar proficiency across participants, our results suggest that under difficult processing demands, AoA modulates the amount of attention required to process the second language.

Speech-Driven Facial Animations Improve Speech-in-Noise Comprehension of Humans.

Understanding speech becomes a demanding task when the environment is noisy. Comprehension of speech in noise can be substantially improved by looking at the speaker’s face, and this audiovisual benefit is even more pronounced in people with hearing impairment. Recent advances in AI have allowed to synthesize photorealistic talking faces from a speech recording and a still image of a person’s face in an end-to-end manner. However, it has remained unknown whether such facial animations improve speech-in-noise comprehension. Here we consider facial animations produced by a recently introduced generative adversarial network (GAN), and show that humans cannot distinguish between the synthesized and the natural videos. Importantly, we then show that the end-to-end synthesized videos significantly aid humans in understanding speech in noise, although the natural facial motions yield a yet higher audiovisual benefit. We further find that an audiovisual speech recognizer (AVSR) benefits from the synthesized facial animations as well. Our results suggest that synthesizing facial motions from speech can be used to aid speech comprehension in difficult listening environments.

Visual Speech Improves Older and Younger Adults' Response Time and Accuracy for Speech Comprehension in Noise.

Past research suggests that older adults expend more cognitive resources when processing visual speech than younger adults. If so, given resource limitations, older adults may not get as large a visual speech benefit as younger ones on a resource-demanding speech processing task. We tested this using a speech comprehension task that required attention across two talkers and a simple response (i.e., the question-and-answer task) and measured response time and accuracy. Specifically, we compared the size of visual speech benefit for older and younger adults. We also examined whether the presence of a visual distractor would reduce the visual speech benefit more for older than younger adults. Twenty-five older adults (12 females, MAge = 72) and 25 younger adults (17 females, MAge = 22) completed the question-and-answer task under time pressure. The task included the following conditions: auditory and visual (AV) speech; AV speech plus visual distractor; and auditory speech with static face images. Both age groups showed a visual speech benefit regardless of whether a visual distractor was also presented. Likewise, the size of the visual speech benefit did not significantly interact with age group for accuracy or the potentially more sensitive response time measure.

EEG Phase Synchrony Reflects SNR Levels During Continuous Speech-in-Noise Tasks.

Comprehension of speech in noise is a challenge for hearing-impaired (HI) individuals. Electroencephalography (EEG) provides a tool to investigate the effect of different levels of signal-to-noise ratio (SNR) of the speech. Most studies with EEG have focused on spectral power in well-defined frequency bands such as alpha band. In this study, we investigate how local functional connectivity, i.e. functional connectivity within a localized region of the brain, is affected by two levels of SNR. Twenty-two HI participants performed a continuous speech in noise task at two different SNRs (+3 dB and +8 dB). The local connectivity within eight regions of interest was computed by using a multivariate phase synchrony measure on EEG data. The results showed that phase synchrony increased in the parietal and frontal area as a response to increasing SNR. We contend that local connectivity measures can be used to discriminate between speech-evoked EEG responses at different SNRs.

Mishearing as a Side Effect of Rational Language Comprehension in Noise.

Language comprehension in noise can sometimes lead to mishearing, due to the noise disrupting the speech signal. Some of the difficulties in dealing with the noisy signal can be alleviated by drawing on the context – indeed, top-down predictability has shown to facilitate speech comprehension in noise. Previous studies have furthermore shown that strong reliance on the top-down predictions can lead to increased rates of mishearing, especially in older adults, which are attributed to general deficits in cognitive control in older adults. We here propose that the observed mishearing may be a simple consequence of rational language processing in noise. It should not be related to failure on the side of the older comprehenders, but instead would be predicted by rational processing accounts. To test this hypothesis, we extend earlier studies by running an online listening experiment with younger and older adults, carefully controlling the target and direct competitor in our stimuli. We show that mishearing is directly related to the perceptibility of the signal. We furthermore add an analysis of wrong responses, which shows that results are at odds with the idea that participants overly strongly rely on context in this task, as most false answers are indeed close to the speech signal, and not to the semantics of the context.

The importance of working memory capacity for improving speech in noise comprehension in children with hearing aid

BackgroundOne of the most common complaints of hearing aid users is difficulty in receiving speech in noise which is very important for all hearing impaired specially children with limited auditory and language experiences. Since working memory plays a significant role in speech perception, especially in challenging auditory situations such as background noise, it is likely that differences in its performance and capacity may impair the ability to understand speech in noise in hearing aid users. Therefore, we aimed to compare memory capacity between two groups of children using hearing aids in both ears, who differed only in the ability to understand speech in noise. MethodsIn this cross-sectional study, 31 children with moderate to severe hearing impairment and the same medical and demographical conditions that using bilateral hearing aids, were examined. These students were divided into two groups according to the scores obtained in speech comprehension as follows: group one (high performance) included students whose SNR loss score in BKB-Speech In Noise test was equal or less than 7, and group two (low performance) included students whose SNR loss score was more than 7. Then, the scores of auditory working memory tests were examined in these two groups. ResultsThe scores of two working memory tests of forward and backward digit span between the two groups no differed significantly based on statistical findings (P = 0.06). But The score of working memory test of non-word repetition differed significantly between the two groups (P = 0.03) A significant correlation was found between the scores of speech comprehension in noise test and working memory tests, including forward (P = 0.004) and backward digit (P = 0.002) span tests and non-word repetition test (P = 0.000) in all subjects. ConclusionThe significant correlation founded between speech perception in noise scores and working memory span, indicating the importance of working memory capacity in the ability to understand speech in noise in children with hearing aids.

Speaker-Listener Neural Coupling Reveals an Adaptive Mechanism for Speech Comprehension in a Noisy Environment.

Comprehending speech in noise is an essential cognitive skill for verbal communication. However, it remains unclear how our brain adapts to the noisy environment to achieve comprehension. The present study investigated the neural mechanisms of speech comprehension in noise using an functional near-infrared spectroscopy-based inter-brain approach. A group of speakers was invited to tell real-life stories. The recorded speech audios were added with meaningless white noise at four signal-to-noise levels and then played to listeners. Results showed that speaker-listener neural couplings of listener's left inferior frontal gyri (IFG), that is, sensorimotor system, and right middle temporal gyri (MTG), angular gyri (AG), that is, auditory system, were significantly higher in listening conditions than in the baseline. More importantly, the correlation between neural coupling of listener's left IFG and the comprehension performance gradually became more positive with increasing noise level, indicating an adaptive role of sensorimotor system in noisy speech comprehension; however, the top behavioral correlations for the coupling of listener's right MTG and AG were only obtained in mild noise conditions, indicating a different and less robust mechanism. To sum up, speaker-listener coupling analysis provides added value and new sight to understand the neural mechanism of speech-in-noise comprehension.

FNIRS Assessment of Speech Comprehension in Children with Normal Hearing and Children with Hearing Aids in Virtual Acoustic Environments: Pilot Data and Practical Recommendations.

The integration of virtual acoustic environments (VAEs) with functional near-infrared spectroscopy (fNIRS) offers novel avenues to investigate behavioral and neural processes of speech-in-noise (SIN) comprehension in complex auditory scenes. Particularly in children with hearing aids (HAs), the combined application might offer new insights into the neural mechanism of SIN perception in simulated real-life acoustic scenarios. Here, we present first pilot data from six children with normal hearing (NH) and three children with bilateral HAs to explore the potential applicability of this novel approach. Children with NH received a speech recognition benefit from low room reverberation and target-distractors’ spatial separation, particularly when the pitch of the target and the distractors was similar. On the neural level, the left inferior frontal gyrus appeared to support SIN comprehension during effortful listening. Children with HAs showed decreased SIN perception across conditions. The VAE-fNIRS approach is critically compared to traditional SIN assessments. Although the current study shows that feasibility still needs to be improved, the combined application potentially offers a promising tool to investigate novel research questions in simulated real-life listening. Future modified VAE-fNIRS applications are warranted to replicate the current findings and to validate its application in research and clinical settings.

Comparison of Speech Recognition and Localization Ability in Single-sided Deaf Patients Implanted With Different Cochlear Implant Electrode Array Designs.

Choice of electrode array (EA) design and differences in outcome are major concerns both to patients with single-sided deafness (SSD) and to surgeons before cochlear implant (CI) surgery. The present work investigates the effects of EA design on 1) insertion depths, and 2) audiological outcomes of SSD CI recipients. Retrospective study. Tertiary academic center. Forty patients with acquired SSD matched according to duration of deafness MAIN OUTCOME MEASURES:: Fourteen CI recipients were implanted with a perimodiolar electrode (cochlear perimodiolar [CPM]), 12 with a shorter lateral wall electrode (cochlear lateral wall [CLW]), and 14 with a longer lateral wall electrode array (medEl lateral wall [MLW]). Postoperative rotational tomography was evaluated to determine cochlear size and EA angle of insertion depth (AID). Binaural speech comprehension in noise (in three configuration presentations) and localization ability were assessed 12 months postoperatively with CI. AID was significantly deeper in MLW (mean 527.94 degrees) compared with the CPM (mean 366.35 degrees) and CLW groups (mean 367.01 degrees). No significant difference in AID was seen between the CPM and CLW groups (difference 0.66 degrees). Cochlear sizes revealed no significant differences between any groups. All three groups showed significant improvement in head shadow effect (difference on average CPM: 6.3 dB SPL, CLW 5 dB SPL, and MLW 4.05 dB SPL) and localization ability at 12 months postoperatively (difference on average CPM: 19.72 degrees, CLW: 24 degrees, and MLW: 12.9 degrees). No significant difference in the extent of audiological benefit was observed between any groups. No effect on binaural benefit was apparent from the selection of the three EA designs in SSD CI recipients. Further studies focusing on subjective results, sound quality, and music perception depending on EA design in SSD CI recipients are needed.

Cortical Tracking of Speech in Delta Band Relates to Individual Differences in Speech in Noise Comprehension in Older Adults.

Understanding speech in adverse listening environments is challenging for older adults. Individual differences in pure tone averages and working memory are known to be critical indicators of speech in noise comprehension. Recent studies have suggested that tracking of the speech envelope in cortical oscillations <8 Hz may be an important mechanism related to speech comprehension by segmenting speech into words and phrases (delta, 1 to 4 Hz) or phonemes and syllables (theta, 4 to 8 Hz). The purpose of this study was to investigate the extent to which individual differences in pure tone averages, working memory, and cortical tracking of the speech envelope relate to speech in noise comprehension in older adults. Cortical tracking of continuous speech was assessed using electroencephalography in older adults (60 to 80 years). Participants listened to speech in quiet and in the presence of noise (time-reversed speech) and answered comprehension questions. Participants completed Forward Digit Span and Backward Digit Span as measures of working memory, and pure tone averages were collected. An index of reduction in noise (RIN) was calculated by normalizing the difference between raw cortical tracking in quiet and in noise. Comprehension question performance was greater for speech in quiet than for speech in noise. The relationship between RIN and speech in noise comprehension was assessed while controlling for the effects of individual differences in pure tone averages and working memory. Delta band RIN correlated with speech in noise comprehension, while theta band RIN did not. Cortical tracking by delta oscillations is robust to the effects of noise. These findings demonstrate that the magnitude of delta band RIN relates to individual differences in speech in noise comprehension in older adults. Delta band RIN may serve as a neural metric of speech in noise comprehension beyond the effects of pure tone averages and working memory.

Aging and working memory modulate the ability to benefit from visible speech and iconic gestures during speech-in-noise comprehension

When comprehending speech-in-noise (SiN), younger and older adults benefit from seeing the speaker’s mouth, i.e. visible speech. Younger adults additionally benefit from manual iconic co-speech gestures. Here, we investigate to what extent younger and older adults benefit from perceiving both visual articulators while comprehending SiN, and whether this is modulated by working memory and inhibitory control. Twenty-eight younger and 28 older adults performed a word recognition task in three visual contexts: mouth blurred (speech-only), visible speech, or visible speech + iconic gesture. The speech signal was either clear or embedded in multitalker babble. Additionally, there were two visual-only conditions (visible speech, visible speech + gesture). Accuracy levels for both age groups were higher when both visual articulators were present compared to either one or none. However, older adults received a significantly smaller benefit than younger adults, although they performed equally well in speech-only and visual-only word recognition. Individual differences in verbal working memory and inhibitory control partly accounted for age-related performance differences. To conclude, perceiving iconic gestures in addition to visible speech improves younger and older adults’ comprehension of SiN. Yet, the ability to benefit from this additional visual information is modulated by age and verbal working memory. Future research will have to show whether these findings extend beyond the single word level.

Tinnitus Affects Speech in Noise Comprehension in Individuals With Hearing Loss.

Tinnitus is a prevalent auditory disorder that frequently co-occurs with hearing loss. It is suggested that tinnitus might have negative impact on speech perception. However, studies thus far have not been able to disentangle tinnitus, hearing loss, and speech in noise intelligibility. We therefore investigated whether there is an association between tinnitus and speech understanding in noise, independent of hearing loss. Of 4,211 participants from the population-based Rotterdam Study (mean age 67.8 [SD 8.9], 57.3% female) data was available on tinnitus, pure-tone audiometry, and digits in noise test. We compared the speech reception threshold in noise (SRTn) in participants with and without tinnitus for the whole population as well as for subgroups stratified for average hearing threshold in 10-dB strata. Additionally, we regressed tinnitus on SRTn with a multivariable regression model, adjusting for sex, age, highest achieved education, and cognitive function. Participants with tinnitus (20.8%) had a higher SRTn (-3.6 dB [SD 3.7] versus -4.6 dB [SD 3.1]). This difference remained only in the subgroups of participants with hearing loss, between 0.6 and 0.8 dB difference in the SRTn for the different subgroups. In the fully adjusted model tinnitus was associated with 0.2 dB (95% CI 0.00, 0.39) SRTn increase. We have shown that tinnitus is associated with speech intelligibility in noise, but it is a small effect, only found in people with co-occurring hearing loss.

Transcranial Alternating Current Stimulation With the Theta-Band Portion of the Temporally-Aligned Speech Envelope Improves Speech-in-Noise Comprehension.

Transcranial alternating current stimulation with the speech envelope can modulate the comprehension of speech in noise. The modulation stems from the theta- but not the delta-band portion of the speech envelope, and likely reflects the entrainment of neural activity in the theta frequency band, which may aid the parsing of the speech stream. The influence of the current stimulation on speech comprehension can vary with the time delay between the current waveform and the audio signal. While this effect has been investigated for current stimulation based on the entire speech envelope, it has not yet been measured when the current waveform follows the theta-band portion of the speech envelope. Here, we show that transcranial current stimulation with the speech envelope filtered in the theta frequency band improves speech comprehension as compared to a sham stimulus. The improvement occurs when there is no time delay between the current and the speech stimulus, as well as when the temporal delay is comparatively short, 90 ms. In contrast, longer delays, as well as negative delays, do not impact speech-in-noise comprehension. Moreover, we find that the improvement of speech comprehension at no or small delays of the current stimulation is consistent across participants. Our findings suggest that cortical entrainment to speech is most influenced through current stimulation that follows the speech envelope with at most a small delay. They also open a path to enhancing the perception of speech in noise, an issue that is particularly important for people with hearing impairment.

Developmental trajectories of control of verbal and non-verbal interference in speech comprehension in monolingual and multilingual children

Research on speech comprehension in noise indicates that a multilinguistic experience may confer advantages in filtering out verbal interference, an effect observed both in children acquiring two or more languages since birth (Filippi, Morris, Richardson, et al., 2015) and in second language learner adults (Filippi, Leech, Thomas, et al., 2012). A possible interpretation for this advantage is that the multilingual mind is “trained” to control interference from the language not in use. This constant effort may support optimization of cognitive resources that are necessary for successfully selecting, processing and interpreting complex linguistic information. The present study aimed to extend this line of research by including a non-verbal interference condition. 209 typically developing children (132 English monolinguals and 77 multilinguals from different linguistic backgrounds) carried out a sentence interpretation task in the presence of verbal and non-verbal interference. We found no evidence for a reliable group difference in our data. Instead, findings indicated that background cognitive ability and socioeconomic status were the best indicators of successful control of interference, irrespective of whether participants were bilingual or monolingual. These findings are discussed in the light of previous research and, more widely, on the account of the current debate on the bilingual advantage.

The emerging role of hearing loss rehabilitation in patients with vestibular schwannoma treated with Gamma Knife radiosurgery: literature review.

Stereotactic radiosurgery (SRS) is currently the most common treatment for small- to medium-size vestibular schwannoma (VS). Despite favorable outcome, hearing deterioration still remains an underestimated problem, and the role of hearing rehabilitation is an underinvestigated topic. Among available technologies, cochlear implant (CI) should represent a valid alternative in sporadic VS with single-sided deafness and in neurofibromatosis (NF2) with bilateral profound hearing loss. A literature review of the current clinical data was performed searching scientific literature databases. From all of the articles found, 16 papers were selected. Forty-four subjects treated with radiosurgery (18 male, 19 female, and in 7 cases, sex were not specified; 43 NF2 and 1 sporadic VS) were included in the analysis. Epidemiological, clinical, tumor, treatment, and audiological data were collected. Clinical outcome at last follow-up showed an audiological improvement in 25 of the 44 patients. The audiological outcome was unchanged in 16 cases. Audiological deterioration was recorded in 3 cases. Severity of NF2 phenotype, long history of ipsilateral profound deafness before implantation, progressive tumor growth, and high radiation dose (20 and 40Gy) were found in patients with a worst audiological outcome. Hearing rehabilitation can improve audiological results for VS patients following SRS in selected cases. Hearing rehabilitation with cochlear implant (CI) in SSD leads to partial restoration of binaural hearing with an improvement in speech comprehension in noise and in sound localization, and partial suppression of subjective incapacitating tinnitus. SRS followed by CI may represent in selected cases a potential emerging option in the management of these patients, aimed at improving their quality of life. Possible implications for the follow-up of these patients are still present, although partially resolved.

Verbal task and motor responses (VTMR) in an adult hearing screening programme.

SUMMARYThe aim of this study was to test the efficacy of Verbal Tasks and Motor Responses (VTMR) speech audiometry in providing a rapid and true-to-life assessment of hearing-related problems as a single test in adult hearing screening programmes. The VTMR consists in manual execution of 5 verbal commands received by patients at different signal intensity levels and fixed masking noise; it provides a score of speech comprehension in noise. This was a prospective observational study in 916 individuals out of 1,300 volunteers (605 males, 695 females, aged 56 ± 17 years) who completed adult hearing screening. VTMR speech audiometry was performed at signal to noise (S/N) ratios of 0 dB and –10 dB. The difference between normal and hearing impaired subjects in terms of all the considered variables was statistically significant for pure-tone audiometry and VTMR testing. VTMR testing at a S/N ratio of –10 dB with a cut-off of four correctly executed tasks and was a rapid, feasible and efficient means of differentiating between normal and hearing impaired subjects. When used to screen hearing impaired subjects with participation restrictions, the sensitivity and specificity of the VTMR test rose to 90% and 62%, respectively. The VTMR test in noise could be used as a stand-alone tool when screening for impairment and self-perceived participation restriction together.

Transcranial alternating current stimulation in the theta band but not in the delta band modulates the comprehension of naturalistic speech in noise

Auditory cortical activity entrains to speech rhythms and has been proposed as a mechanism for online speech processing. In particular, neural activity in the theta frequency band (4–8 ​Hz) tracks the onset of syllables which may aid the parsing of a speech stream. Similarly, cortical activity in the delta band (1–4 ​Hz) entrains to the onset of words in natural speech and has been found to encode both syntactic as well as semantic information. Such neural entrainment to speech rhythms is not merely an epiphenomenon of other neural processes, but plays a functional role in speech processing: modulating the neural entrainment through transcranial alternating current stimulation influences the speech-related neural activity and modulates the comprehension of degraded speech. However, the distinct functional contributions of the delta- and of the theta-band entrainment to the modulation of speech comprehension have not yet been investigated. Here we use transcranial alternating current stimulation with waveforms derived from the speech envelope and filtered in the delta and theta frequency bands to alter cortical entrainment in both bands separately. We find that transcranial alternating current stimulation in the theta band but not in the delta band impacts speech comprehension. Moreover, we find that transcranial alternating current stimulation with the theta-band portion of the speech envelope can improve speech-in-noise comprehension beyond sham stimulation. Our results show a distinct contribution of the theta- but not of the delta-band stimulation to the modulation of speech comprehension. In addition, our findings open up a potential avenue of enhancing the comprehension of speech in noise.