Listeners repeated target sentences presented in quiet from a loudspeaker at 0 azimuth Responses were scored by an experimenter Peak pupil dilation during the poststimulus wait period was used to evaluate listening effort Figure 1 ID: 779355
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Slide1
Task
Three conditions were tested: Better ear only, Poorer ear only, and Bilateral.
Listeners
repeated target sentences presented in quiet from a loudspeaker at 0° azimuth. Responses were scored by an experimenter.
Peak pupil dilation during the post-stimulus wait period was used to evaluate listening effort (Figure 1
).
3Participants completed 30 trials per condition.Trials with significant artifacts were discarded from analysis. 6 Remaining trials were averaged into a single pupil track, and plotted as proportion change from baseline.
Listening effort in bilateral cochlear implant users with asymmetric across-ear performance in speech
perceptionEmily Burg1, Tanvi Thakkar1, Shelly P. Godar1, Matthew B. Winn2, Ruth Y. Litovsky11University of Wisconsin-Madison, Madison, WI 2Univsersity of Minnesota, Minneapolis, MNe-mail: eburg@wisc.edu
RESULTS
SUMMARY
Binaural Hearing and Speech Laboratory
WAISMAN
CENTER
INTRODUCTION
Individuals with hearing loss experience elevated listening effort relative to normal hearing
individuals, and e
ffortful
listening
gives rise to stress
, fatigue, and social
withdrawal.
1,2,3
Individuals with severe-to-profound hearing loss can improve listening performance with bilateral cochlear implants (
BiCIs
).
4However, factors like electrode placement and neural survival can cause asymmetries between ears.It has been shown that listeners with small speech asymmetries between ears perform best when listening bilaterally compared to either ear alone, and that individuals with large asymmetries perform best when listening with only their better ear. 5It is unknown how bilateral implantation influences listening effort, particularly when there are differences in speech perception abilities between ears.
1
Edwards, B. (2007). The future of hearing aid technology. Trends in amplification, 11(1), 31-45.
2Hughes, S. E., Hutchings, H. A., Rapport, F. L., McMahon, C. M., & Boisvert, I. (2018). Social connectedness and perceived listening effort in adult cochlear implant users: A grounded theory to establish content validity for a new patient-reported outcome measure. Ear and hearing, 39(5), 922-934.4Litovsky, R. Y., Parkinson, A., Arcaroli, J., Peters, R., Lake, J., Johnstone, P., & Yu, G. (2004). Bilateral cochlear implants in adults and children. Archives of Otolaryngology–Head & Neck Surgery, 130(5), 648-655.5Litovsky, R., Parkinson, A., Arcaroli, J., & Sammeth, C. (2006). Simultaneous bilateral cochlear implantation in adults: a multicenter clinical study. Ear and hearing, 27(6), 714-31. 6Winn, M. B., Wendt, D., Koelewijn, T., & Kuchinsky, S. E. (2018). Best Practices and Advice for Using Pupillometry to Measure Listening Effort: An Introduction for Those Who Want to Get Started. Trends in hearing, 22.3Zekveld, A. A., Kramer, S. E., & Festen, J. M. (2010). Pupil response as an indication of effortful listening: The influence of sentence intelligibility. Ear and hearing, 31(4), 480-490.
METHODS
ACKNOWLEDGEMENTS
: We would like to thank all of the individuals who participated in this study. This
work was supported by NIH-NIDCD (R01DC003083 to RYL) and in part by NIH-NICHD (U54HD090256 to Waisman Center).
2019 ARO MeetingBaltimore, MDPS621
For
individuals with both
small
and large asymmetries, there
were no noticeable trends in speech intelligibility or pupil dilation from the better ear to bilateral condition (Figure 3). When treating asymmetry on a continuum, we found that there was a subtle inverse relationship between asymmetry and intelligibility in the bilateral condition. No relationship was observed between asymmetry and pupil dilation in the bilateral condition, suggesting that asymmetry may impact performance but not listening effort/engagement (Figure 4).Secondary analyses revealed that bilateral experience did not predict pupil dilation in the bilateral condition (Figure 5).We plan to test a larger sample in order to further explore these relationships and what they may indicate about effort or engagement in BiCI users.
Participants 11 adults with BiCIs.StimuliHarvard IEEE sentences spoken by a woman.Stimuli were presented at 65dB SPL-A. Determining the “better” earPrevious word recognition scores for each ear were compared. If there was no difference, the participant’s preferred ear was labeled the “better” ear.
Large vs. small asymmetry: differences from better ear to bilateral listening reflect influence of poorer ear
Speech intelligibility and pupil dilation
Pupil dilation as a function of
bilateral experience
Is increased effort in the bilateral condition due to large asymmetries across ears?
PURPOSE
To determine the impact of
asymmetry in speech intelligibility on
bilateral listening in individuals with
BiCIs
.We hypothesized that small asymmetries would facilitate decreased pupil dilation for bilateral compared to better ear listening due to binaural redundancy.2) Alternatively, large asymmetries would result in similar or increased pupil dilation for bilateral compared to better ear listening due to discrepancies between signals which could hinder performance.
Listening Conditions
Bilateral
Poorer ear only
Better ear only
Table 1. Participant demographics (ordered
by years of bilateral experience)
.
Figure 5. Pupil
dilation as a function of
bilateral
experience for better ear (p=0.
40)
, bilateral (p=0.57), and poorer ear (p=0.13) conditions.
r
2
=0.08
r
2
=0.04
r
2
=0.24
Less effort or engagement
More effort or engagement
How can we measure
listening
effort
?
Pupillometry
:
As tasks get harder and cognitive load increases, pupil size also increases.
5
Less effort or engagement
B.
Figure 2:
On average, participants scored lowest in speech and exerted the most effort with the poorer ear only.
Mean speech scores were similar for better ear and bilateral listening, but the latter required slightly more effort.
Three subjects scored below 50% correct in their poorer ear (IBL, ICW, ICJ) and demonstrated greater pupil dilation than in their better ear, suggesting
that they
remained engaged in the task even when performance was low.
What other factors are related to listening effort in
BiCI
users
?
Examining asymmetry more closely
revealed
a
subtle relationship
with bilateral performance
Figure 4A. Speech intelligibility (p=0.06
) and
4B. pupil dilation (p=0.77) in the bilateral condition as a function of
speech between ears
.
r
2
=
0.01
r
2
=0.34
There
was
a modest association between asymmetry and speech intelligibility in the bilateral condition. This
suggests that
it may be a predictor
of performance,
but not effort.
Figure 2A. Percentage of correctly repeated words and 2B. peak pupil dilation in each listening condition. Participants are ordered from small to large speech asymmetry.
Less Effort
More Effort
Figure 1. Example of two pupil tracks.
Baseline
Stimulus
Wait
Response
Proportion change re: baseline
Time
relative
to stimulus offset (s)
-4
-2 0 2 4 6
0.80.6
0.4
0.2
0
-0.2
Subject ID
Age (
yrs
)
Better ear
Inter-implant delay (
yrs
)
BiCI
experience (
yrs
)
IDI
52
Right
0.6
4.6
ICW
25
Right
18.6
4.9
ICK
75
Left
1.0
7.2
IBY
55
Right
4.2
7.3
IDG
70
Right
2.0
7.7ICJ69Right0.08.8IBK78Left6.09.8ICD61Left6.010.0IBZ51Right1.311.0IBL72Right4.812.8ICB67Left2.812.9
Subject IDIBYIBZIDIIBKICDICBIDGICKIBLICWICJSpeech Asymmetry0%3%4%7%10%12%12%22%45%53%55%
Table 2. Difference in speech intelligibility between ears for each participant.
Better
A.
Listeners with
large
speech asymmetry (difference=45-55%)
Listeners with
small
speech asymmetry (
difference=0-22%)
Figure 3. Comparison of speech scores and pupil dilation between better ear and bilateral conditions for
A,B
) participants with small
asymmetries and C,D
) large
asymmetries
in speech intelligibility
between
ears.
Speech Intelligibility
Pupil Dilation
A.
C.
D.
B.
Figure 3:
Overall, there was no consistent trend in intelligibility from the better ear to bilateral condition across groups (A,C). Most participants exhibited slightly greater pupil dilation in the bilateral vs. better ear condition (B,D).
A portion of participants
with small asymmetries (A,B) had
higher
intelligibility in the bilateral vs. better ear
condition. For some individuals this was accompanied by a decrease in pupil dilation (
e.g. ICD
), and for others an increase (e.g. IDI).
Participants
with large asymmetries (C,D) did not exhibit any consistent relationship between better ear and
bilateral
conditions.
Less effort or engagement
Less effort or engagement
Better
Better
B.
A.