听觉障碍患者的空间听觉*

空间听觉是对声音空间属性或特性的主观感觉,包括对声源的定位、对环境反射声的主观感觉等。复杂声学环境下的语言获取也和空间听觉密切相关。听觉障碍通常会包括空间听觉能力的下降甚至缺失,影响语言的获取能力。人工听觉是治疗听觉障碍的手段,理想情况下应能恢复或改善患者的空间听觉能力。该文综述了听觉障碍患者的空间听觉及其人工恢复方面的研究、进展及存在的问题。     

Comparing different estimates of cochlear compression in listeners with normal and impaired hearing

A loss of cochlear compression may underlie many of the difficulties experienced by hearing-impaired listeners. Two behavioral forward-masking paradigms that have been used to estimate the magnitude of cochlear compression are growth of masking (GOM) and temporal masking (TM). The aim of this study was to determine whether these two measures produce within-subjects results that are consistent across a range of signal frequencies and, if so, to compare them in terms of reliability or efficiency. GOM and TM functions were measured in a group of five normal-hearing and five hearing-impaired listeners at signal frequencies of 1000, 2000, and 4000 Hz. Compression values were derived from the masking data and confidence intervals were constructed around these estimates. Both measures produced comparable estimates of compression, but both measures have distinct advantages and disadvantages, so that the more appropriate measure depends on factors such as the frequency region of interest and the degree of hearing loss. Because of the long testing times needed, neither measure is suitable for clinical use in its current form.     

The negative effect of amplitude compression in multichannel hearing aids in the light of the modulation-transfer function

The article deals with the question of why multichannel amplitude compression appears to have a negative rather than a positive effect on speech intelligibility by hearing-impaired listeners. It is argued that the small time constants of amplitude compression diminish the temporal as well as the spectral contrasts in the speech signal. According to the modulation-transfer function concept, this results in reduced intelligibility scores. Experimental evidence is reviewed indicating that the following two arguments in favor of amplitude compression in case of sensorineural hearing loss are not valid: (1) to compensate for the effects of loudness recruitment and (2) to get weak consonants above threshold. The author concludes that, in multichannel hearing aids, automatic gain control with time constants of 0.25-0.5 s should be given preference to amplitude compression.     

Auditory filter asymmetry in the hearing impaired

Thresholds for 2-kHz sinusoidal signals were determined in the presence of a notched-noise masker, for six normal-hearing listeners and 12 listeners with cochlear hearing losses. Following Patterson and Nimmo Smith [J. Acoust. Soc. Am. 67, 229-245 (1980)], conditions were used where the notch was placed both symmetrically and asymmetrically about the signal frequency. The auditory filter shape for both the low- and high-frequency side of the filter was calculated using the rounded-exponential form of the filter. In six hearing-impaired listeners, the auditory filter shape showed a shallow low-frequency skirt indicating pronounced susceptibility to the upward spread of masking. In two hearing-impaired listeners, the filter shape showed a shallow high-frequency skirt, indicating pronounced susceptibility to the downward spread of masking. Two other listeners with mild threshold losses had steeper and more symmetric filters than normal, suggesting either a small conductive loss or an attenuation factor of sensorineural origin not associated with a degradation of frequency resolution. In the remaining two listeners, the auditory filter had too little selectivity for its shape to be reliably determined.     

Evaluation of two multichannel tactile aids for the hearing impaired

Two multichannel tactile devices for the hearing impaired were compared in speech perception tasks of varying levels of complexity. Both devices implemented the "vocoder" principle in their stimulus processing: One device had a 16-element linear vibratory array worn on the forearm and displayed activity in 16 overlapping frequency channels; the other device delivered tactile stimulation to a linear array of 16 electrodes worn on the abdomen. Subjects were tested in several phoneme discrimination tasks, ranging from discrimination of pairs of words differing in only one phoneme under tactile aid alone conditions to identification of stimuli in a larger set under tactile aid alone, lipreading alone, and lipreading plus tactile aid conditions. Results showed both devices to be better transmitters of manner and voicing features of articulation than of place features, when tested in single-item tasks. No systematic differences in performance with the two devices were observed. However, in a connected discourse tracking task, the vibrotactile vocoder in conjunction with lipreading yielded much greater improvements over lipreading alone than did the electrotactile vocoder. One possible explanation for this difference in performance, the inclusion of a noise suppression circuit in the electrotactile aid, was evaluated, but did not appear to account for the differences observed. Results are discussed in terms of additional differences between the two devices that may influence performance.     

Effective compression and noise reduction configurations for hearing protectors

The author proposed to adopt wide dynamic range compression and adaptive multichannel modulation-based noise reduction algorithms to enhance hearing protector performance. Three experiments were conducted to investigate the effects of compression and noise reduction configurations on the amount of noise reduction, speech intelligibility, and overall preferences using existing digital hearing aids. In Experiment 1, sentence materials were recorded in speech spectrum noise and white noise after being processed by eight digital hearing aids. When the hearing aids were set to 3:1 compression, the amount of noise reduction achieved was enhanced or maintained for hearing aids with parallel configurations, but reduced for hearing aids with serial configurations. In Experiments 2 and 3, 16 normal-hearing listeners' speech intelligibility and perceived sound quality were tested when they listened to speech recorded through hearing aids with parallel and serial configurations. Regardless of the configuration, the noise reduction algorithms reduced the noise level and maintained speech intelligibility in white noise. Additionally, the listeners preferred the parallel rather than the serial configuration in 3:1 conditions and the serial configuration in 1:1 rather than 3:1 compression when the noise reduction algorithms were activated. Implications for hearing protector and hearing aid design are discussed.     

Loudness relations for individuals and groups in normal and impaired hearing

Individual and group loudness relations were obtained at a frequency in the region of impaired hearing for 100 people, 98 with bilateral cochlear impairment. Slope distributions were determined from absolute magnitude estimation (AME) and absolute magnitude production (AMP) of loudness; they were also derived from cross-modality matching (CMM) and AME of apparent length. With respect to both the means and the individual slope values, the two distributions closely agree. More than half of the measured deviations are less than 20%, with an overall average of -1.5%, meaning that transitivity is preserved for bilaterally impaired individuals. Moreover, over the stimulus range where cochlear impairment steepens the loudness function, both the group means and the individual slope values are clearly larger than in normal hearing. The results also show that, for groups of people with approximately similar losses, the standard deviation is a nearly constant proportion of the mean slope value giving a coefficient of variation of about 27% in normal and impaired hearing. This indicates, in accord with loudness matching, that the size of the slopes depends directly on the degree of hearing loss. The results disclose that loudness measurements obtained by magnitude scaling are able to reveal the operating characteristic of the ear for individuals.     

Lateralization and frequency selectivity in normal and impaired hearing

The onset-time difference delta T required to lateralize a 30-ms bifrequency tone burst toward the leading ear was measured as a function of the frequency difference delta F between the tone in the left ear and the tone in the right ear. At center frequencies of 0.5 and 4 kHz, four normal listeners tested at 80 and 100 dB SPL had delta Ts that were relatively constant at subcritical delta Fs, but increased at delta Fs wider than a critical band. At 1 kHz, delta T increased with delta F even at subcritical delta Fs. Ten listeners with cochlear impairments were tested at 100 dB SPL. Seven had normal delta Ts at 4 kHz, despite hearing losses between 50 and 70 dB. At 0.5 and 1 kHz, mildly impaired listeners had nearly normal lateralization functions, whereas more severely imparied listeners had very large delta Ts and no frequency selectivity. These and other findings indicate that listeners even with moderate to severe hearing losses can lateralize normally on the basis of interaural differences in onset envelope, but not on the basis of temporal differences in the fine structure.     

Intensity discrimination and detection of amplitude modulation in electric hearing

Wojtczak and Viemeister [J. Acoust. Soc. Am. 106, 1917-1924 (1999)] demonstrated a close relationship between intensity difference limens (DLs) and 4-Hz amplitude modulation (AM) detection thresholds in normal-hearing acoustic listeners. The present study demonstrates a similar relationship between intensity DLs and AM detection thresholds in cochlear-implant listeners, for gated stimuli. This suggests that acoustic and cochlear-implant listeners make use of a similar decision variable to perform intensity discrimination and modulation detection tasks. It can be shown that the absence of compression in electric hearing does not preclude this possibility.     

Detection and rate discrimination of amplitude modulation in electrical hearing

Three experiments were designed to examine temporal envelope processing by cochlear implant (CI) listeners. In experiment 1, the hypothesis that listeners' modulation sensitivity would in part determine their ability to discriminate between temporal modulation rates was examined. Temporal modulation transfer functions (TMTFs) obtained in an amplitude modulation detection (AMD) task were compared to threshold functions obtained in an amplitude modulation rate discrimination (AMRD) task. Statistically significant nonlinear correlations were observed between the two measures. In experiment 2, results of loudness-balancing showed small increases in the loudness of modulated over unmodulated stimuli beyond a modulation depth of 16%. Results of experiment 3 indicated small but statistically significant effects of level-roving on the overall gain of the TMTF, but no impact of level-roving on the average shape of the TMTF across subjects. This suggested that level-roving simply increased the task difficulty for most listeners, but did not indicate increased use of intensity cues under more challenging conditions. Data obtained with one subject, however, suggested that the most sensitive listeners may derive some benefit from intensity cues in these tasks. Overall, results indicated that intensity cues did not play an important role in temporal envelope processing by the average CI listener.     

Individual and level-dependent differences in masking for adults with normal and impaired hearing

Simultaneous, on-frequency masking is commonly assumed to be linear with increasing noise intensity. However, some evidence suggests that, expressed in terms of signal-to-noise ratio changes with background level changes, masking slopes can vary from 0 dB/dB. These results and evidence from a large sample of subjects with normal and impaired hearing demonstrate level-dependent changes in masking, large individual differences in masking among subjects with similar thresholds in quiet, and significant correlations of masking slope with other estimates of auditory function measured in the same backgrounds.     

Proportional frequency compression of speech for listeners with sensorineural hearing loss.

This study examined proportional frequency compression as a strategy for improving speech recognition in listeners with high-frequency sensorineural hearing loss. This method of frequency compression preserved the ratios between the frequencies of the components of natural speech, as well as the temporal envelope of the unprocessed speech stimuli. Nonsense syllables spoken by a female and a male talker were used as the speech materials. Both frequency-compressed speech and the control condition of unprocessed speech were presented with high-pass amplification. For the materials spoken by the female talker, significant increases in speech recognition were observed in slightly less than one-half of the listeners with hearing impairment. For the male-talker materials, one-fifth of the hearing-impaired listeners showed significant recognition improvements. The increases in speech recognition due solely to frequency compression were generally smaller than those solely due to high-pass amplification. The results indicate that while high-pass amplification is still the most effective approach for improving speech recognition of listeners with high-frequency hearing loss, proportional frequency compression can offer significant improvements in addition to those provided by amplification for some patients.     

Effect of enhancement of spectral changes on speech intelligibility and clarity preferences for the hearing impaired

Most information in speech is carried in spectral changes over time, rather than in static spectral shape per se. A form of signal processing aimed at enhancing spectral changes over time was developed and evaluated using hearing-impaired listeners. The signal processing was based on the overlap-add method, and the degree and type of enhancement could be manipulated via four parameters. Two experiments were conducted to assess speech intelligibility and clarity preferences. Three sets of parameter values (one corresponding to a control condition), two types of masker (steady speech-spectrum noise and two-talker speech) and two signal-to-masker ratios (SMRs) were used for each masker type. Generally, the effects of the processing were small, although intelligibility was improved by about 8 percentage points relative to the control condition for one set of parameter values using the steady noise masker at -6 dB SMR. The processed signals were not preferred over those for the control condition, except for the steady noise masker at -6 dB SMR. Further work is needed to determine whether tailoring the processing to the characteristics of the individual hearing-impaired listener is beneficial.     

Use of high-rate envelope speech cues and their perceptually relevant dynamic range for the hearing impaired

The ability of hearing-impaired (HI) listeners to use high-rate envelope information in a competing-talker situation was assessed. In experiment 1, signals were tone vocoded and the cutoff frequency (f(c)) of the envelope extraction filter was either 50?Hz (E filter) or 200?Hz (P filter). The channels for which the P or E filter was used were varied. Intelligibility was higher with the P filter regardless of whether it was used for low or high center frequencies. Performance was best when the P filter was used for all channels. Experiment 2 explored the dynamic range over which HI listeners made use of high-rate cues. In each channel of a vocoder, the envelope extracted using f(c)?=?16?Hz was replaced by the envelope extracted using f(c)?=?300?Hz, either at the peaks or valleys, with a parametrically varied "switching threshold." For a target-to-background ratio of +5?dB, changes in speech intelligibility occurred mainly when the switching threshold was between -8 and +8?dB relative to the channel root-mean-square level. This range is similar in width to, but about 3?dB higher in absolute level than, that found for normal-hearing listeners, despite the reduced dynamic range of the HI listeners.     

Effects of fluctuating noise and interfering speech on the speech-reception threshold for impaired and normal hearing

The speech-reception threshold (SRT) for sentences presented in a fluctuating interfering background sound of 80 dBA SPL is measured for 20 normal-hearing listeners and 20 listeners with sensorineural hearing impairment. The interfering sounds range from steady-state noise, via modulated noise, to a single competing voice. Two voices are used, one male and one female, and the spectrum of the masker is shaped according to these voices. For both voices, the SRT is measured as well in noise spectrally shaped according to the target voice as shaped according to the other voice. The results show that, for normal-hearing listeners, the SRT for sentences in modulated noise is 4-6 dB lower than for steady-state noise; for sentences masked by a competing voice, this difference is 6-8 dB. For listeners with moderate sensorineural hearing loss, elevated thresholds are obtained without an appreciable effect of masker fluctuations. The implications of these results for estimating a hearing handicap in everyday conditions are discussed. By using the articulation index (AI), it is shown that hearing-impaired individuals perform poorer than suggested by the loss of audibility for some parts of the speech signal. Finally, three mechanisms are discussed that contribute to the absence of unmasking by masker fluctuations in hearing-impaired listeners. The low sensation level at which the impaired listeners receive the masker seems a major determinant. The second and third factors are: reduced temporal resolution and a reduction in comodulation masking release, respectively.     

Frequency difference limens in normal and sensorineural hearing impaired chinchillas

This study assessed normal frequency discrimination ability in the chinchilla and determined how this ability changes as a function of an experimentally induced sensorineural hearing loss. Four chinchillas were trained by the methods of positive reinforcement to report absolute thresholds and frequency difference limens (FDLs). Subjects were then treated with the aminoglycosidic antibiotic amikacin until a 30-dB hearing loss was measured at 10.0 kHz. Absolute and frequency difference thresholds were determined during and after drug treatment. When post-drug thresholds had stabilized, subjects were sacrificed and their cochleas stained, embedded in plastic, microdissected, and viewed with phase contrast microscopy to permit examination of the cochlear tissue. Post-drug data suggest that frequency discrimination at a high frequency is unaffected by a 40- to 45-dB sensorineural hearing loss, considerable hair cell damage, and the resultant disruption of the cochlear micromechanics. The data, in concert with previously published reports, suggest that FDLs may be less affected by a high-frequency sensorineural hearing loss than by a low-frequency sensorineural hearing loss.     

Performance of hearing-impaired listeners under various types of amplitude compression

Speech perception by subjects with sensorineural hearing impairment was studied using various types of short-term (syllabic) amplitude compression. Average speech level was approximately constant. In quiet, a single-channel wideband compression (WBC) with compression ratio equal to 10, attack time 10 ms and release time 90 ms produced significantly higher scores than a three-channel multiband compression (MBC) or no compression when a nonsense syllable test (City University of New York) was used. The scores under MBC, WBC, or no compression were not significantly different when the modified rhyme test (MRT) was used. But when overshoots caused by compression were clipped, the MRT scores improved significantly. The influence of MBC on reverberant speech and of WBC on noisy speech were tested with the MRT. Reverberation reduced the scores, and this reduction was the same with compression as without. Noise added to speech before compression also reduced the scores, but the reduction was larger with compression than without. When noise was added after compression, an improvement was observed when WBC had a compression ratio of about 5, attack time 1 ms, and release time 30 ms. Other compression modes (e.g., with high-frequency pre-emphasis) did not show an improvement. The results indicate that WBC with a compression ratio around 5, attack time shorter than 3 ms, and release time between 30 and 90 ms can be beneficial if signal-to-noise ratio is large, or, if in a noisy or reverberant environment, the effects of noise or reverberation are eliminated by using listening systems.     

Auditory-nerve responses predict pitch attributes related to musical consonance-dissonance for normal and impaired hearing

Human listeners prefer consonant over dissonant musical intervals and the perceived contrast between these classes is reduced with cochlear hearing loss. Population-level activity of normal and impaired model auditory-nerve (AN) fibers was examined to determine (1) if peripheral auditory neurons exhibit correlates of consonance and dissonance and (2) if the reduced perceptual difference between these qualities observed for hearing-impaired listeners can be explained by impaired AN responses. In addition, acoustical correlates of consonance-dissonance were also explored including periodicity and roughness. Among the chromatic pitch combinations of music, consonant intervals/chords yielded more robust neural pitch-salience magnitudes (determined by harmonicity/periodicity) than dissonant intervals/chords. In addition, AN pitch-salience magnitudes correctly predicted the ordering of hierarchical pitch and chordal sonorities described by Western music theory. Cochlear hearing impairment compressed pitch salience estimates between consonant and dissonant pitch relationships. The reduction in contrast of neural responses following cochlear hearing loss may explain the inability of hearing-impaired listeners to distinguish musical qualia as clearly as normal-hearing individuals. Of the neural and acoustic correlates explored, AN pitch salience was the best predictor of behavioral data. Results ultimately show that basic pitch relationships governing music are already present in initial stages of neural processing at the AN level.