Biomedical subjects

Ruth Y Litovsky

Publications and source records attributed to Ruth Y Litovsky.

10 recordsLinked to original sources

PubMed2006

Binaural unmasking with bilateral cochlear implants.

Nearly 100,000 deaf patients worldwide have had their hearing restored by a cochlear implant (CI) fitted to one ear. However, although many patients understand speech well in quiet, even the most successful experience difficulty in noisy situations. In contrast, normal-hearing (NH) listeners achieve improved speech understanding in noise by processing the differences between the waveforms reaching the two ears. Here we show that a form of binaural processing can be achieved by patients fitted with an implant in each ear, leading to substantial improvements in signal detection in the presence of competing sounds. The stimulus in each ear consisted of a narrowband noise masker, to which a tonal signal was sometimes added; this mixture was half-wave rectified, lowpass-filtered, and then used to modulate a 1000-pps biphasic pulse train. All four CI users tested showed significantly better signal detection when the signal was presented out of phase at the two ears than when it was in phase. This advantage occurred even though subjects only received information about the slowly varying sound envelope to be presented, contrary to previous reports that waveform fine structure dominates binaural processing. If this advantage generalizes to multichannel situations, it would demonstrate that envelope-based CI speech-processing strategies may allow patients to exploit binaural unmasking in order to improve speech understanding in noise. Furthermore, because the tested patients had been deprived of binaural hearing for eight or more years, our results show that some sensitivity to time-varying interaural cues can persist over extended periods of binaural deprivation.

Adult↗

PubMed2006

Benefits of bilateral cochlear implants and/or hearing aids in children.

This study evaluated functional benefits from bilateral stimulation in 20 children ages 4-14, 10 use two CIs and 10 use one CI and one HA. Localization acuity was measured with the minimum audible angle (MAA). Speech intelligibility was measured in quiet, and in the presence of 2-talker competing speech using the CRISP forced-choice test. Results show that both groups perform similarly when speech reception thresholds are evaluated. However, there appears to be benefit (improved MAA and speech thresholds) from wearing two devices compared with a single device that is significantly greater in the group with two CI than in the bimodal group. Individual variability also suggests that some children perform similarly to normal-hearing children, while others clearly do not. Future advances in binaural fitting strategies and improved speech processing schemes that maximize binaural sensitivity will no doubt contribute to increasing the binaurally-driven advantages in persons with bilateral CIs.

Adolescent↗

PubMed2006

Bilateral cochlear implants in children: localization acuity measured with minimum audible angle.

OBJECTIVE: To evaluate sound localization acuity in a group of children who received bilateral (BI) cochlear implants in sequential procedures and to determine the extent to which BI auditory experience affects sound localization acuity. In addition, to investigate the extent to which a hearing aid in the nonimplanted ear can also provide benefits on this task. DESIGN: Two groups of children participated, 13 with BI cochlear implants (cochlear implant + cochlear implant), ranging in age from 3 to 16 yrs, and six with a hearing aid in the nonimplanted ear (cochlear implant + hearing aid), ages 4 to 14 yrs. Testing was conducted in large sound-treated booths with loudspeakers positioned on a horizontal arc with a radius of 1.5 m. Stimuli were spondaic words recorded with a male voice. Stimulus levels typically averaged 60 dB SPL and were randomly roved between 56 and 64 dB SPL (+/-4 dB rove); in a few instances, levels were held fixed (60 dB SPL). Testing was conducted by using a "listening game" platform via computerized interactive software, and the ability of each child to discriminate sounds presented to the right or left was measured for loudspeakers subtending various angular separations. Minimum audible angle thresholds were measured in the BI (cochlear implant + cochlear implant or cochlear implant + hearing aid) listening mode and under monaural conditions. RESULTS: Approximately 70% (9/13) of children in the cochlear implant + cochlear implant group discriminated left/right for source separations of <or=20 degrees , and, of those, 77% (7/9) performed better when listening bilaterally than with either cochlear implant alone. Several children were also able to perform the task when using a single cochlear implant, under some conditions. Minimum audible angle thresholds were better in the first cochlear implant than the second cochlear implant listening mode for nearly all (8/9) subjects. Repeated testing of a few individual subjects over a 2-yr period suggests that robust improvements in performance occurred with increased auditory experience. Children who wore hearing aids in the nonimplanted ear were at times also able to perform the task. Average group performance was worse than that of the children with BI cochlear implants when both ears were activated (cochlear implant + hearing aid versus cochlear implant + cochlear implant) but not significantly different when listening with a single cochlear implant. CONCLUSIONS: Children with sequential BI cochlear implants represent a unique population of individuals who have undergone variable amounts of auditory deprivation in each ear. Our findings suggest that many but not all of these children perform better on measures of localization acuity with two cochlear implants compared with one and are better at the task than children using the cochlear implant + hearing aid. These results must be interpreted with caution, because benefits on other tasks as well as the long-term benefits of BI cochlear implants are yet to be fully understood. The factors that might contribute to such benefits must be carefully evaluated in large populations of children using a variety of measures.

Adolescent↗

PubMed2006

Effect of masker type and age on speech intelligibility and spatial release from masking in children and adults.

Speech recognition in noisy environments improves when the speech signal is spatially separated from the interfering sound. This effect, known as spatial release from masking (SRM), was recently shown in young children. The present study compared SRM in children of ages 5-7 with adults for interferers introducing energetic, informational, and/or linguistic components. Three types of interferers were used: speech, reversed speech, and modulated white noise. Two female voices with different long-term spectra were also used. Speech reception thresholds (SRTs) were compared for: Quiet (target 0 degrees front, no interferer), Front (target and interferer both 0 degrees front), and Right (interferer 90 degrees right, target 0 degrees front). Children had higher SRTs and greater masking than adults. When spatial cues were not available, adults, but not children, were able to use differences in interferer type to separate the target from the interferer. Both children and adults showed SRM. Children, unlike adults, demonstrated large amounts of SRM for a time-reversed speech interferer. In conclusion, masking and SRM vary with the type of interfering sound, and this variation interacts with age; SRM may not depend on the spectral peculiarities of a particular type of voice when the target speech and interfering speech are different sex talkers.

Acoustic Stimulation↗

PubMed2005

Speech intelligibility and spatial release from masking in young children.

Children between the ages of 4 and 7 and adults were tested in free field on speech intelligibility using a four-alternative forced choice paradigm with spondees. Target speech was presented from front (0 degrees); speech or modulated speech-shaped-noise competitors were either in front or on the right (90 degrees). Speech reception thresholds were measured adaptively using a three-down/one-up algorithm. The primary difference between children and adults was seen in elevated thresholds in children in quiet and in all masked conditions. For both age groups, masking was greater with the speech-noise versus speech competitor and with two versus one competitor(s). Masking was also greater when the competitors were located in front compared with the right. The amount of masking did not differ across the two age groups. Spatial release from masking was similar in the two age groups, except for in the one-speech condition, when it was greater in children than adults. These findings suggest that, similar to adults, young children are able to utilize spatial and/or head shadow cues to segregate sounds in noisy environments. The potential utility of the measures used here for studying hearing-impaired children is also discussed.

Adult↗

PubMed2004

Bilateral cochlear implants in adults and children.

OBJECTIVE: To measure the benefit (ie, sound localization and speech intelligibility in noise) of bilateral cochlear implants (CIs) in adults and in children. DESIGN, SETTING, AND PATIENTS: Seventeen adults and 3 children underwent testing 3 months after activation of bilateral hearing. Adults received their devices in a simultaneous procedure and children in sequential procedures (3-8 years apart). Adults underwent testing of sound localization and speech intelligibility, with a single CI and bilaterally. Children underwent testing of sound localization, right/left discrimination, and speech intelligibility, with the first CI alone and bilaterally. We used computer games to attract the children's attention and engage them in the psychophysical tasks for long periods of time. RESULTS: Preliminary findings suggest that, for adults, bilateral hearing leads to better performance on the localization task, and on the speech task when the noise is near the poorer of the 2 ears. In children, localization and discrimination are slightly better under bilateral conditions, but not remarkably so. On the speech tasks, 1 child did not benefit from bilateral hearing. Two children showed consistent improvement with bilateral hearing when the noise was near the side that underwent implantation first. CONCLUSIONS: Bilateral CIs may offer advantages to some listeners. The tasks described in this study might offer a powerful tool for measuring such advantages, especially in young children. The extent of the advantage, however, is difficult to ascertain after 3 months of bilateral listening experience, and might require a more prolonged period of adjustment and learning. Future work should be aimed at examining these issues.

Adult↗

PubMed2004

The benefit of binaural hearing in a cocktail party: effect of location and type of interferer.

The "cocktail party problem" was studied using virtual stimuli whose spatial locations were generated using anechoic head-related impulse responses from the AUDIS database [Blauert et al., J. Acoust. Soc. Am. 103, 3082 (1998)]. Speech reception thresholds (SRTs) were measured for Harvard IEEE sentences presented from the front in the presence of one, two, or three interfering sources. Four types of interferer were used: (1) other sentences spoken by the same talker, (2) time-reversed sentences of the same talker, (3) speech-spectrum shaped noise, and (4) speech-spectrum shaped noise, modulated by the temporal envelope of the sentences. Each interferer was matched to the spectrum of the target talker. Interferers were placed in several spatial configurations, either coincident with or separated from the target. Binaural advantage was derived by subtracting SRTs from listening with the "better monaural ear" from those for binaural listening. For a single interferer, there was a binaural advantage of 2-4 dB for all interferer types. For two or three interferers, the advantage was 2-4 dB for noise and speech-modulated noise, and 6-7 dB for speech and time-reversed speech. These data suggest that the benefit of binaural hearing for speech intelligibility is especially pronounced when there are multiple voiced interferers at different locations from the target, regardless of spatial configuration; measurements with fewer or with other types of interferers can underestimate this benefit.

Adolescent↗

PubMed2004

Localization dominance in the median-sagittal plane: effect of stimulus duration.

Localization dominance is an aspect of the precedence effect (PE) in which the leading source dominates the perceived location of a simulated echo (lagging source). It is known to be robust in the horizontal/azimuthal dimension, where binaural cues dominate localization. However, little is known about localization dominance in conditions that minimize binaural cues, and most models of precedence treat the phenomena as "belonging" to the binaural system. Here, localization dominance in the median-sagittal plane was studied where binaural cues are greatly reduced, and monaural spectral/level cues are thought to be the primary cues used for localization. Lead-lag pairs of noise bursts were presented from locations spaced in 15 degrees increments in the frontal, median-sagittal plane, with a 2-ms delay in their onsets, for source durations of 1, 10, 25, and 50-ms. Intermixed with these trials were single-speaker trials, in which lead and lag were summed and presented from one speaker. Listeners identified the speaker that was nearest to the perceived source location. With single-speaker stimuli, localization improves as signal duration is increased. Furthermore, evidence of elevation compression was found with a dependence on duration. With lead-lag pairs, localization dominance occurs in the median plane, and becomes more robust with increased signal duration. These results suggest that accurate localization of a co-located lead-lag pair is necessary for localization dominance to occur when the lag is spatially separated from the lead.

Acoustic Stimulation↗

PubMed2004

The role of head-induced interaural time and level differences in the speech reception threshold for multiple interfering sound sources.

Three experiments investigated the roles of interaural time differences (ITDs) and level differences (ILDs) in spatial unmasking in multi-source environments. In experiment 1, speech reception thresholds (SRTs) were measured in virtual-acoustic simulations of an anechoic environment with three interfering sound sources of either speech or noise. The target source lay directly ahead, while three interfering sources were (1) all at the target's location (0 degrees,0 degrees,0 degrees), (2) at locations distributed across both hemifields (-30 degrees,60 degrees,90 degrees), (3) at locations in the same hemifield (30 degrees,60 degrees,90 degrees), or (4) co-located in one hemifield (90 degrees,90 degrees,90 degrees). Sounds were convolved with head-related impulse responses (HRIRs) that were manipulated to remove individual binaural cues. Three conditions used HRIRs with (1) both ILDs and ITDs, (2) only ILDs, and (3) only ITDs. The ITD-only condition produced the same pattern of results across spatial configurations as the combined cues, but with smaller differences between spatial configurations. The ILD-only condition yielded similar SRTs for the (-30 degrees,60 degrees,90 degrees) and (0 degrees,0 degrees,0 degrees) configurations, as expected for best-ear listening. In experiment 2, pure-tone BMLDs were measured at third-octave frequencies against the ITD-only, speech-shaped noise interferers of experiment 1. These BMLDs were 4-8 dB at low frequencies for all spatial configurations. In experiment 3, SRTs were measured for speech in diotic, speech-shaped noise. Noises were filtered to reduce the spectrum level at each frequency according to the BMLDs measured in experiment 2. SRTs were as low or lower than those of the corresponding ITD-only conditions from experiment 1. Thus, an explanation of speech understanding in complex listening environments based on the combination of best-ear listening and binaural unmasking (without involving sound-localization) cannot be excluded.

Analysis of Variance↗

PubMed2002

Functional role of the human inferior colliculus in binaural hearing.

Psychophysical experiments were carried out in a rare case involving a 48 year old man (RJC) with a small traumatic hemorrhage of the right dorsal midbrain, including the inferior colliculus (IC). RJC had normal audiograms bilaterally, but there was a marked decrease in wave V amplitude on click-evoked brainstem auditory evoked potentials following left ear stimulation. RJC demonstrated a deficit in sound localization identification when the loudspeakers lay within the auditory hemifield contralateral to his IC lesion. Errors showed a consistent bias towards the hemifield ipsilateral to the lesion. Echo suppression was abnormally weak compared with that seen in control subjects, but only for sources contralateral to the lesion. Finally, speech intelligibility tests showed normal ability to benefit from spatial separation of target and competing speech sources. These results suggest that: (1) localizing sounds within a given hemifield relies on the integrity of the contralateral IC, (2) unilateral IC lesions give the illusion that sound sources in the 'bad' hemifield are displaced towards the 'good' hemifield, (3) the IC mediates aspects of echo suppression, and (4) lesion in the IC does not impede spatial release from masking in speech intelligibility, possibly due to that ability being more heavily mediated by cortical regions.

Acoustic Stimulation↗