Speech Test Research Articles

Cochlear Implantation in Pediatric Cochlear Nerve Deficiency: A Systematic Review and Meta‐Analysis

ObjectiveCochlear nerve deficiency (CND) is commonly implicated in moderate‐to‐profound pediatric sensorineural hearing loss (SNHL). Although cochlear implantation (CI) was previously contraindicated in CND patients, recent studies have demonstrated the potential for auditory response to CI in a subset of CND patients, though clinical outcomes remain variable. This study aims to evaluate pre‐ and postoperative speech and auditory outcomes of CI in pediatric patients with bilateral SNHL and radiographically confirmed CND.Data SourcesEmbase and Ovid MEDLINE.Review MethodsA systematic review was conducted to identify studies reporting pre‐ and postoperative outcomes of children with CND confirmed by magnetic resonance imaging who underwent CI. A random‐effects model was used to account for within‐ and between‐study variance in speech and auditory outcomes.ResultsAfter abstract screening of 818 distinct articles, 16 studies were selected for final inclusion, consisting of 248 patients with cochlear nerve hypoplasia or aplasia who underwent CI. Various speech perception and language development tests were investigated across studies (Speech Intelligibility Rating, Speech Perception Category, Speech Awareness Thresholds, Meaningful Auditory Integration Scale, Meaningful Use of Speech Scale, Categories of Auditory Performance, and Auditory Level). Pooled outcomes demonstrated improvement in speech perception after CI in pediatric patients with CND (SMD 2.18, 95% CI 1.68–2.69).ConclusionIndications for CI are expanding as research demonstrates benefit in populations previously thought inappropriate. Our study demonstrates global postoperative improvement in speech and auditory outcomes in children with bilateral SNHL and CND after CI.Level of EvidenceNA Laryngoscope, 2024

Development and evaluatıon of the Turkısh mobıle real-noıse speech dıscrımınatıon test

BackgroundWhile there is a list of monosyllabic words available for use in speaking tests in our country, the list of sentences is limited. The aim of this study is to evaluate the effectiveness of the mobile application we developed by creating a list of 4-word sentences that are frequently encountered in daily life, well-known, and spectrally balanced, to be used in speech tests in children aged 8–12 with normal hearing. A total of 50 participants, 25 girls (mean age 9.56 ± 1.56) and 25 boys (mean age 10.60 ± 1.55) with normal hearing, aged 8–12, were included in the study. Familiarity was evaluated by listening to a list of 200 sentences consisting of 4-word sentences to 70 children in 7 geographical regions of Turkey, and the sentences that 80% of the children did not understand were excluded. A list of 60 balanced sentences was determined by performing spectral and coherence analysis of the sentences. The recording of each sentence at 80 dB, 60 dB, and 40 dB intensity levels, respectively, increased in 5 dB steps between the − 10/ + 10 signal-to-noise ratio value and was combined separately with 3 different environmental noises (classroom, shopping mall, amusement park) and uploaded to the developed mobile application.ResultsFor all participants, speech comprehension scores at 80 dB, 60 dB, and 40 dB sound intensity were lowest in the amusement park environment. Speech comprehension scores are lowest in noise levels of 40 dB in amusement park and shopping mall environments. Speech comprehension scores are lowest in noise levels of 60 dB in the classroom environment. There is a statistically significant difference between ambient noises (p < 0.05). When male and female participants are compared, it is seen that male participants’ comprehension scores in noise in the shopping mall environment are higher than female participants. There is a statistically significant difference between genders (p < 0.05).ConclusionWhen the speech in noise tests developed in the literature are examined, even though the word lists are equalized with the phonemic equalization method, they do not reflect the reality of daily life. The Turkish Mobile Speech Discrimination in Real Noise 4-Word Sentence Test that we have developed will contribute to the literature. It is recommended that future research compare the results by adding different ambient noises.

Reference Speech-recognition curves for a German monosyllabic test in noise: effects of loudspeaker configuration and room acoustics

Objective Measurement of reference speech-recognition curves for a specific speech test in typical clinical testing environments and for different loudspeaker configurations. Design Speech-recognition scores were measured at four signal-to-noise ratios for five loudspeaker configurations in two anechoic rooms, and in four audiometric test rooms with low reverberation times. Study sample 240 young participants (aged 18–25 years) without hearing impairment participated in the measurements. Results Reference speech-recognition curves for speech and noise from the front (S0N0) were similar across rooms. Compared to S0N0, lower speech-recognition thresholds (SRTs) were observed for all other loudspeaker configurations in which speech and noise were spatially separated. This spatial release from masking was significantly reduced for the audiometric test rooms compared to the anechoic rooms. A binaural speech-intelligibility model was used to verify the influence of room acoustic properties and loudspeaker configuration on SRT. Conclusions Speech-recognition curves for spatially separated loudspeaker configurations depend on the room acoustic properties, even in audiometric test rooms with low reverberation times. This makes it more difficult to compare clinical measurements with reference speech-recognition curves, or even with data measured in a different test room. It is thus recommended to document the loudspeaker configuration and test room for each clinical measurement.

A Non-Surgical Wearable Option for Bone Conduction Hearing Implants: A Comparative Study with Conventional Bone Conduction Hearing Aids Mounted on Eyeglasses.

This study aimed to compare the audiological benefits of a non-implantable wearable option for a bone conduction (BC) implant mounted on an arch (SoundArc) to those of traditional BC hearing aids (HAs) mounted on eyeglasses (BCHAs) in patients with moderate to severe conductive or mixed hearing loss. A preliminary cross-sectional observational prospective cohort study was conducted in the Tertiary Audiological Department, University Hospital. Fourteen adults with conductive or mixed hearing loss (PTA at 0.5-1-2-4 KHz = 67 ± 15 dB HL) who had been wearing conventional BCHAs mounted on eyeglasses for at least 3 years and had declined surgical implantation of a bone conduction hearing implant (BCHI) were included in the study. Unaided and aided pure-tone air conduction (AC) and bone conduction (BC) thresholds, as well as speech tests in quiet and noise, were recorded at baseline and in two different settings: with a BCHI mounted on SoundArc® and with their own BCHAs mounted on eyeglasses using two couplers. Participants completed questionnaires in both conditions, including the International Inventory for Hearing Aids (IOI-HA), the Hearing Handicap Inventory for Adults/Elderly (HHIA/E), the Speech, Spatial, and Qualities of Hearing Scale (SSQ), a 10-point visual analog scale (VAS), and the Fatigue Impact Scale (FIS). A significant functional gain was observed in both settings (p = 0.0001). Better speech perception in quiet and noise was observed with SoundArc compared to conventional BCHAs on eyeglasses (improvements in word repetition scores in noise: +19.3 at SNR +10 dB, p = 0.002; +12.1 at SNR 0 dB, p = 0.006; and +11.4 at SNR -10 dB, p = 0.002). No significant differences were found in IOI-HA, FIS, and HHIA/E scores. However, significantly better SSQ scores were reported for SoundArc in all domains (p = 0.0038). Although patients were accustomed to using BCHAs mounted on eyeglasses, the bone conduction wearable option of the BCHI (SoundArc) proved to be a viable alternative for adult patients with conductive or mixed hearing loss who are unable or unwilling to undergo BCHI surgery.

Subjective and functional outcome measures to evaluate performance of pediatric cochlear implant

BackgroundThe majority of research on the effects of cochlear implants has been on clinical evaluations of efficacy (hearing and speech skills and auditory thresholds). But it is unclear how much clinical efficacy metrics (speech, hearing, and language tests) actually demonstrate how beneficial cochlear implants (CI) are in everyday circumstances. In this study, we aim to assess the performance of a child’s current CI with both subjective and functional outcomes measures. Also, we aimed to assess factors affecting these outcomes after CI.MethodsThe study group included 45 cochlear-implanted children, and their chronological age ranges between 4 and 12 years. Children were divided according to their language age into three groups: group 1 (G1) includes15 children with a language age of less than 2 years, group 2 (G2) includes 15 children with a language age of 2 to less than 4 years, and group 3 (G3) includes 15 children with language age 4 to 6 years. Assessment was done in two sessions: one for phoniatric evaluation and another for audiological evaluation.ResultsCI enabled children to develop speech perception in a closed manner evidenced by the early speech perception (ESP) test with pattern perception being the easiest and monosyllabic words being the most difficult and the least to develop. Most children with CI were able to control their voice, to a lesser extent to use speech in meaningful use in social situations and to develop communication strategies in oral situations which were the least to develop, and this was evident by Meaningful Use of Speech Scale. Children with CI were able to acquire language, and their receptive language was better than expressive language, but their language age was below their chronological age.ConclusionThe cochlear implant is an effective rehabilitative tool for the treatment of prelingually deafened children, and this was evident by our results. A hierarchal approach of speech assessment according to the language age of the child and selection of age-appropriate speech perception test is very important to assess cochlear-implanted children Speech recognition had a high degree of variability. Early implantation age and increased duration of implant experience were the most important factors associated with good performance with CI, better speech perception, and better language outcomes.

Smartphone automated motor and speech analysis for early detection of Alzheimer's disease and Parkinson's disease: Validation of TapTalk across 20 different devices.

Smartphones are proving useful in assessing movement and speech function in Alzheimer's disease and other neurodegenerative conditions. Valid outcomes across different smartphones are needed before population-level tests are deployed. This study introduces the TapTalk protocol, a novel app designed to capture hand and speech function and validate it in smartphones against gold-standard measures. Twenty different smartphones collected video data from motor tests and audio data from speech tests. Features were extracted using Google Mediapipe (movement) and Python audio analysis packages (speech). Electromagnetic sensors (60Hz) and a microphone acquired simultaneous movement and voice data, respectively. TapTalk video and audio outcomes were comparable to gold-standard data: 90.3% of video, and 98.3% of audio, data recorded tapping/speech frequencies within±1Hz of the gold-standard measures. Validation of TapTalk across a range of devices is an important step in the development of smartphone-based telemedicine and was achieved in this study. TapTalk evaluates hand motor and speechfunctions across a wide range of smartphones.Data showed 90.3% motor and 98.3% speech accuracy within +/-1Hz of gold standards.Validation advances smartphone-based telemedicine for neurodegenerative diseases.

Toolkit to Examine Lifelike Language v.2.0: Optimizing Speech Biomarkers of Neurodegeneration

Plain Language SummaryNeurodegenerative disorders (NDs), such as Alzheimer’s and Parkinson’s disease, are a leading cause of disability, caregiver stress, and financial strain worldwide. The number of cases, now estimated at 60 million, will triple by 2050. Early detection is crucial to improve treatments, management, and financial planning. Unfortunately, standard diagnostic methods are costly, stressful, and often hard to access due to scheduling delays and availability issues. A promising alternative consists in digital speech analysis. This affordable, noninvasive approach can identify NDs based on individuals’ voice recordings and their transcriptions. In 2023, we launched the Toolkit to Examine Lifelike Language (TELL), an online app providing robust speech biomarkers for clinical and research purposes. This paper introduces TELL v.2.0, a novel version with improved data collection, encryption, processing, storing, download, and visualization features. First, we explain the app’s basic operations and its possibilities for online and offline data collection. Second, we describe its language survey, which covers questions about demographics as well as language history, usage, competence, and difficulties. Third, we describe TELL’s speech tests, which assess key clinical features. Fourth, we outline the app’s functions for analyzing, visualizing, and downloading data. We finish by discussing the main challenges and future opportunities for TELL and the speech biomarker field. With this effort, we hope to boost the use of digital speech markers in medical and research fields.

Analysis of the Spanish Auditory Test of Speech in Noise (PAHRE) in a Population with Hearing Loss.

Speech recognition in noise is one of the difficulties faced by people with hearing loss that increases with age. The recently developed Spanish Auditory Test of Speech in Noise (Prueba Auditiva de Habla en Ruido en Español, PAHRE) allows for the identification of these intelligibility difficulties in noise. The aim of this study was to assess speech recognition in noise in people with hearing loss and to test the benefits of the Lombard effect. The participants were 104 people with hearing difficulties, ranging in age from 37 to 98 years. The variables age, degree of hearing loss, presence of high-frequency dropout, and years of formal education were assessed. Psychometric curves were obtained as a function of signal-to-noise ratio as well as threshold values of speech reception as a function of age group for mild and moderate hearing loss. The results indicated that the speech reception threshold increased with both age and the degree of hearing loss, becoming particularly significant after the age of 70. Furthermore, it was found that the combined factors of age, degree of hearing loss, and educational level predicted a high percentage of the variability in the speech reception threshold. Therefore, the Spanish Auditory Test of Speech in Noise could be a useful clinical tool for diagnosis, monitoring, auditory rehabilitation planning, and hearing aid fitting.

Objective validation of alternative speech test sources for person-to-person speech intelligibility assessments

A sound source that mimics the acoustics characteristics of a human talker is required in objective assessments of speech intelligibility in person-to-person speech communications (PP) scenarios. The few special speech test sources available that meet the strict specifications of the relevant standards are costly and can be inaccessible to practitioners. This can prevent investigations or can lead to non-special and more affordable loudspeakers to be used as alternative sources without knowledge of their suitability. This study evaluates the validity of non-special loudspeakers in PP assessments and supplements a previous preliminary examination by consolidating and expanding early findings. Speech Transmission Index Public Address (STIPA) assessments were conducted employing three representative non-special loudspeakers and one standardized reference speech test source under laboratory conditions. Absolute errors of STIPA measurements were analysed and evaluated against two just perceivable difference (JND) threshold levels. The mean absolute errors obtained for all non-special loudspeakers for almost all scenarios were within one JND of any of the two JND levels. The striking and consistent low level of error found validated the proposition that non-special and affordable loudspeakers may be used as suitable speech sources in pilot or survey-grade speech intelligibility assessments in place of a special standardized speech source when that source is not available, or in full investigations when the relevant standard to adhere to allows the use of those alternative speech sources.

The Noise Reduction Algorithm May Not Compensate for the Degradation in Output Signal-to-Noise Ratio Caused by Wide Dynamic Range Compression.

Most modern hearing aids (HAs) employ wide dynamic range compression (WDRC) and noise reduction (NR) algorithms. It is known that the nonlinear effects of WDRC and NR cause changes to the output signal-to-noise ratio (SNR) of an HA. However, the relative contributions of WDRC and NR to the nonlinear effects are not fully understood. The current study investigated (a) whether WDRC or NR dominates the nonlinear effects measured at the output of a digital HA and (b) whether the electroacoustic effectiveness of NR depends on WDRC parameters while input SNR and background noise are systematically varied. Test stimuli were Connected Speech Test sentences in multitalker babble noise (2- or 20-talker), presented at input SNRs ranging from -10 to +10 dB. The HA was programmed using multiband WDRC set according to the National Acoustic Laboratories for Nonlinear HA fitting formula 2 prescriptive fits for four standard audiograms and two compression speeds. The NR algorithm of the HA was switched on or off in separate conditions. Nonlinear electroacoustic effects from the WDRC and NR algorithms were assessed by measuring the output SNR of the HA using a phase-inversion technique. To investigate whether there are other factors that may be important besides the output SNR, the Hearing Aid Speech Intelligibility Index and the Hearing Aid Speech Quality Index were applied to the recordings to generate inferences on aided speech intelligibility and perceived speech quality. Results showed that WDRC dominated the net nonlinear effect at low-input SNRs, and the net nonlinear effect of WDRC and NR was reduced at high-input SNRs. Results also showed that the effectiveness of NR depended on compression parameters. The effectiveness of NR was partially explained by the trend of Hearing Aid Speech Intelligibility Index and Hearing Aid Speech Quality Index scores, potentially indicating that the Hearing Aid Speech Intelligibility Index and Hearing Aid Speech Quality Index scores may capture factors that cannot be captured by the output SNR metric. Results suggest that the individual signal-processing stages in an HA should not be considered as independent. Electroacoustic evaluation of WDRC and NR algorithms in isolation is not sufficient to capture the combined nonlinear effect of the two algorithms. https://doi.org/10.23641/asha.25962541.

Cochlear implants for hereditary ATTR amyloidosis: a case report of two cases.

To analyze the clinical presentation, management, and outcome of two sisters affected by hereditary transthyretin related amyloidosis (ATTRv) and bilateral severe-to-profound hearing loss treated with cochlear implant. A description of two patients underwent three cochlear implant (CI) surgery was performed. Age at time of implantation ranged from 48 to 53years. Both patients were initially equipped with a bilateral hearing aid and subsequently underwent cochlear implant. A bimodal stimulation was maintained thereafter. One case underwent bilateral surgery. Hearing outcomes were assessed by comparing pre- and post-operatively tonal and vocal hearing thresholds and speech perception tests (Common Evaluation Protocol Results in Rehabilitation Audiology). In both patients, a significant and stable improvement of hearing threshold and speech perception was observed up to the last follow-up. No post-operative complication were observed during the follow-up. ATTRv amyloidosis may be the cause of cochlear function impairment. Restoring the hearing in these group of patients is of paramount importance since the vision is often compromised too. Cochlear implant could be a viable strategy of rehabilitation for selected patients affected by severe-to-profound sensorineural hearing loss caused by ATTRv amyloidosis.

Pediatric Failure Rates and Speech Outcomes in the HiRes Ultra and Ultra 3D Series Recall.

The recent Field Corrective Action (FCA) for the HiRes Ultra and Ultra 3D (V1) cochlear implants (CIs) triggered much research investigating clinical identification, failure rates, and postrevision outcomes. Pediatric data remain limited, especially with regards to speech outcomes. We aim to characterize the trajectory of children implanted with these devices with specific attention to speech outcomes. Retrospective cohort study of pediatric patients with FCA-affected CIs from March 2017 to January 2020 at a tertiary children's hospital. CI placement, device monitoring, audiologic evaluation, revision surgery. CI failure rates, revision surgery rate, speech recognition outcomes. Forty-one devices were implanted in 27 pediatric patients. Average age at implantation was 4.01 years (range, 0.87-12.75). To date, 30 devices (73%) are known failures with 90% of these having undergone revision surgery. No statically significant difference was noted on open-set speech testing across best prerevision, immediate prerevision, and best postrevision time points. Best postrevision CNC scores had a mean score of 71% ± 26%, n = 16. Pediatric patients implanted with FCA-affected CI devices have a high risk of device failure. Open-set speech recognition was not significantly different from prerevision to postrevision testing, suggesting preserved speech outcomes. This may be partially attributable to limitations of cohort size and the pediatric population with open-set speech testing. However, we suspect that close follow-up with standardized testing and a low threshold for revision surgery provided by our multidisciplinary team may have mitigated these changes. Postrevision open-set speech testing remains positive for these patients.

P1 and N1 Characteristics in Individuals with Normal Hearing and Hearing Loss, and Cochlear Implant Users: A Pilot Study.

Background: It has been reported in many previous studies that the lack of auditory input due to hearing loss (HL) can induce changes in the brain. However, most of these studies have focused on individuals with pre-lingual HL and have predominantly compared the characteristics of those with normal hearing (NH) to cochlear implant (CI) users in children. This study examined the visual and auditory evoked potential characteristics in NH listeners, individuals with bilateral HL, and CI users, including those with single-sided deafness. Methods: A total of sixteen participants (seven NH listeners, four individuals with bilateral sensorineural HL, and five CI users) completed speech testing in quiet and noise and evoked potential testing. For speech testing, the Korean version of the Hearing in Noise Test was used to assess individuals' speech understanding ability in quiet and in noise (noise from the front, +90 degrees, and -90 degrees). For evoked potential testing, visual and auditory (1000 Hz, /ba/, and /da/) evoked potentials were measured. Results: The results showed that CI users understood speech better than those with HL in all conditions except for the noise from +90 and -90 degrees. In the CI group, a decrease in P1 amplitudes was noted across all channels after implantation. The NH group exhibited the highest amplitudes, followed by the HL group, with the CI group (post-CI) showing the lowest amplitudes. In terms of auditory evoked potentials, the smallest amplitude was observed in the pre-CI condition regardless of the type of stimulus. Conclusions: To the best of our knowledge, this is the first study that examined visual and auditory evoked potentials based on various hearing profiles. The characteristics of evoked potentials varied across participant groups, and further studies with CI users are necessary, as there are significant challenges in collecting and analyzing evoked potentials due to artifact issues on the CI side.

Exploring Psychological State and Performance Within the Speech Contest EFL Competitors

Research into the mental well-being of students participating in English speech competitions and its influence on their performance is limited. Thus, this investigation aimed to analyze and compare the mental conditions, including depression, anxiety, and stress, among English speech contestants. Using a quantitative approach with a correlational design, the research included a sample of 60 participants. from 60 schools in Badung Regency. Given the population size was under 100, all participants were included, though 21 were later disqualified, resulting in 39 eligible competitors. Research tools encompassed a 7-minute English speech test and a Depression Anxiety Stress (DAS) questionnaire. Analysis entailed descriptive techniques, including correlation and simple regression t-tests. Initial findings revealed that 54% of participants experienced "mild" depression, 95% encountered "moderate" anxiety, and 59% underwent "mild" stress. Moreover, 58% performed "very well," while 43% presented "well" in their speeches. Notably, a significant correlation existed (depression (r= 0.661), anxiety (r= 0.867), stress (r= 0.929)) between psychological pressure and speech performance. The findings emphasize the need to bolster participants’ confidence and alleviate apprehension as lower levels of anxiety and stress were associated with better speech performance.

Speech recognition and speech audiometry parameters in evaluation of aural rehabilitation progress in cochlear implant patients. Review paper.

&lt;b&gt;Introduction:&lt;/b&gt; Speech audiometry is well established and frequently used test in audiology as well as in cochlear implant recipient's performance evaluation. Expanding indications for cochlear implantation forces use of more refined methods of both assessment and prognosis of outcome of aural rehabilitation. Variability of speech intelligibility tests and materials require standardized protocol facilitating outcome comparison.&lt;b&gt;Aim:&lt;/b&gt; Aim of this review paper is analysis of usage of speech audiometry and other speech intelligibility tests and its results reporting in patients with cochlear implant in Poland and in the World.&lt;b&gt;Materials and methods:&lt;/b&gt; Protocols of many different domestic and foreign health centers where compared, showing many methodological differences. Selection of literature for analysis was made according to PRISMA algorithm recommendations. Twenty research papers were chosen for review process.&lt;b&gt;Discussion:&lt;/b&gt; In many papers we found lack of data regarding methodology of performed tests. Many authors indicate difficulties in comparing results, especially if publication lacks basic technical information. Despite that if right method is applied, results can be compared. In literature only one level of material presentation in test is prevalent. Speech audiometry is significant in exploring connections between multiple pre-op and post-op prognostic aspects of cochlear implantation.&lt;b&gt;Conclusions:&lt;/b&gt; Because of variability in presentation and reporting of CI patients outcomes, consensus is needed in area of system facilitating comparison of research results. This may provide simple solution for accurate analysis and choosing right set of data. Schematic of presentation of audiological data in authors health center was proposed as example.

A Consensus to Revise the Minimum Speech Test Battery-Version 3.

The Minimum Speech Test Battery (MSTB) for adults was introduced in 1996 (Nilsson et al., 1996) and subsequently updated in 2011 (Advanced-Bionics et al., 2011). The MSTB has been widely used by clinicians as a guide for cochlear implant (CI) candidacy evaluations and to document post-operative speech recognition performance. Due to changes in candidacy over the past 10 years, a revision to the MSTB was needed. In 2022, the Institute for Cochlear Implant Training (ICIT) recruited a panel of expert CI audiologists to update and revise the MSTB. This panel utilized a modified Delphi consensus process to revise the test battery and to improve its applicability considering recent changes in CI care. This resulted in the MTSB-Version 3 (MSTB-3), which includes test protocols for identifying not only traditional CI candidates but also possible candidates for electric-acoustic stimulation and patients with single-sided deafness and asymmetric hearing loss. The MSTB-3 provides information that supplements the earlier versions of the MSTB, such as recommendations of when to refer patients for a CI, recommended patient-reported outcome measures, considerations regarding the use of cognitive screeners, and sample report templates for clinical documentation of pre- and post-operative care. Electronic versions of test stimuli, along with all the materials described above, will be available to clinicians via the ICIT website (https://www.cochlearimplanttraining.com). The goal of the MSTB-3 is to be an evidence-based test battery that will facilitate a streamlined standard of care for adult CI candidates and recipients that will be widely used by CI clinicians.

Client Oriented Scale of Improvement in First-Time and Experienced Hearing Aid Users: An Analysis of Five Predetermined Predictability Categories through Audiometric and Speech Testing.

Objectives: The aim of our investigation was to explore the relationship between unaided pure-tone and speech audiometry and self-reported aided performance measured according to five predetermined COSI categories among first-time hearing aid users and experienced hearing aid users. Methods: Data from 286 patients were retrospectively evaluated. We divided the sample into first-time hearing aid users (G1) and experienced hearing aid users (G2). The correlation between unaided tonal and speech audiometry and five preliminary selected client-oriented scale of improvement (COSI) categories was studied. Results: A greater percentage of hearing aid users aged >80 years and a higher prevalence of severe-to-profound hearing loss in G2 group were observed (p < 0.05). For the total cohort, a mean hearing threshold of 60.37 ± 18.77 db HL emerged in the right ear, and 59.97 ± 18.76 db HL was detected in the left ear (p > 0.05). A significant statistical difference was observed in the group of first-time hearing aid users for the "Television/Radio at normal volume" item, where patients with a lower speech intellection threshold (SIT) were associated with higher COSI scores (p = 0.019). Studying the relationship between the speech reception threshold (SRT) and the COSI item "conversation with 1 or 2 in noise" evidenced worse speech audiometry in patients who scored ≤2 among experienced hearing aid users (p = 0.00012); a higher mean 4-8 kHz frequencies threshold for the better ear was found within the G2 group among those who scored ≤2 in the COSI item "conversation with 1 or 2 in quiet" (p = 0.043). Conclusions: Our study confirms a poor correlation between unaided tonal and speech audiometry and self-reported patient assessment. Although we included only five COSI categories in this study, it is clear that unaided audiometric tests may drive the choice of proper hearing rehabilitation, but their value in predicting the benefit of hearing aids remains limited.

A Scoping Review and Meta-Analysis of the Relations Between Cognition and Cochlear Implant Outcomes and the Effect of Quiet Versus Noise Testing Conditions.

Evidence continues to emerge of associations between cochlear implant (CI) outcomes and cognitive functions in postlingually deafened adults. While there are multiple factors that appear to affect these associations, the impact of speech recognition background testing conditions (i.e., in quiet versus noise) has not been systematically explored. The two aims of this study were to (1) identify associations between speech recognition following cochlear implantation and performance on cognitive tasks, and to (2) investigate the impact of speech testing in quiet versus noise on these associations. Ultimately, we want to understand the conditions that impact this complex relationship between CI outcomes and cognition. A scoping review following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines was performed on published literature evaluating the relation between outcomes of cochlear implantation and cognition. The current review evaluates 39 papers that reported associations between over 30 cognitive assessments and speech recognition tests in adult patients with CIs. Six cognitive domains were evaluated: Global Cognition, Inhibition-Concentration, Memory and Learning, Controlled Fluency, Verbal Fluency, and Visuospatial Organization. Meta-analysis was conducted on three cognitive assessments among 12 studies to evaluate relations with speech recognition outcomes. Subgroup analyses were performed to identify whether speech recognition testing in quiet versus in background noise impacted its association with cognitive performance. Significant associations between cognition and speech recognition in a background of quiet or noise were found in 69% of studies. Tests of Global Cognition and Inhibition-Concentration skills resulted in the highest overall frequency of significant associations with speech recognition (45% and 57%, respectively). Despite the modest proportion of significant associations reported, pooling effect sizes across samples through meta-analysis revealed a moderate positive correlation between tests of Global Cognition ( r = +0.37, p < 0.01) as well as Verbal Fluency ( r = +0.44, p < 0.01) and postoperative speech recognition skills. Tests of Memory and Learning are most frequently utilized in the setting of CI (in 26 of 39 included studies), yet meta-analysis revealed nonsignificant associations with speech recognition performance in a background of quiet ( r = +0.30, p = 0.18), and noise ( r = -0.06, p = 0.78). Background conditions of speech recognition testing may influence the relation between speech recognition outcomes and cognition. The magnitude of this effect of testing conditions on this relationship appears to vary depending on the cognitive construct being assessed. Overall, Global Cognition and Inhibition-Concentration skills are potentially useful in explaining speech recognition skills following cochlear implantation. Future work should continue to evaluate these relations to appropriately unify cognitive testing opportunities in the setting of cochlear implantation.

Current trends on the early diagnosis of Alzheimer’s Disease by means of neural computation methods

Abstract—The prevalence of dementia is expected to increment in the next decades as the elderly population grows and ages. Hence, Alzheimer’s Disease (AD), as the most frequent dementia, will be more problematic from a socioeconomic point of view. Different diagnostic criteria have been proposed by clinicians for the early diagnosis of AD. After discarding the longitudinal and prognosis articles, a selection of articles from the last decade and based on Artificial Neural Networks (ANNs) was collated from the PubMed database, and complemented with researches extracted from others. The latest trends on this field were discovered in these selected articles, which were later discussed. Only articles based whether on shallow ANNs, Deep Learning (DL) or a mix of both were included. The total number of cross-sectional articles that complied with our selection criteria was 154. Convolutional Neural Networks (CNNs) combined with neuroimaging has been the most popular approach, yielding very good performance results. Approaches based on nonneuroimaging techniques, such as gait, genetics, speech and neuropsychological tests, were less common but have their own advantages. Multimodality solutions may become even more prevalent in the near future. Similarly, novel diagnostic criteria will appear and the popularity of currently not-so-common ones will expand. A new proposal emerged from these trends, which is based on ontogenetic ANNs.

Measurement and optimisation of the perceptual equivalence of the Dutch consonant-vowel-consonant (CVC) word lists using synthetic speech and list pairs

Objectives (1) to determine whether the standard Dutch word lists for speech audiometry are equally intelligible in normal-hearing listeners (Experiment 1), (2) to investigate whether synthetic speech can be used to create word lists (Experiment 1) and (3) to determine whether the list effect found in Experiment 1 can be reduced by combining two lists into pairs (Experiment 2). Design Participants performed speech tests in quiet with the original (natural) and synthetic word lists (Experiment 1.). In Experiment 2, new participants performed speech tests with list pairs from the original lists constructed from the results of Experiment 1. Study samples Twenty-four and twenty-eight normal-hearing adults. Results There was a significant list effect in the natural speech lists; not in the synthetic speech lists. Variability in intelligibility was significantly higher in the former, with list differences up to 20% at fixed presentation levels. The 95% confidence interval of a list with a score of approximately 70% is around 10%-points wider than of a list pair. Conclusions The original Dutch word lists show large variations in intelligibility. List effects can be reduced by combining two lists per condition. Synthetic speech is a promising alternative to natural speech in speech audiometry in quiet.