Effects of Sensorineural Hearing Loss and Personal Hearing Aids on Cortical Event-Related Potential and Behavioral Measures of Speech-Sound Processing.

摘要

OBJECTIVE:: To systematically investigate the combined effects of sensorineural hearing loss and prescribed personal hearing aid(s) on cortical event-related potentials (ERPs) (waves N1, MMN, N2b, and P3b) and their related behavioral measures of discrimination (d-prime sensitivity and reaction time) to the speech sounds /ba/ and /da/ presented at 65 and 80 dB peak-to-peak equivalent SPL. DESIGN:: Cortical ERPs were recorded to /ba/ and /da/ speech stimuli presented at 65 and 80 dB peak-to-peak equivalent SPL from 20 normal-hearing adults and 14 adults with sensorineural hearing losses. The degree of sensorineural impairment at 1000 to 2000 Hz ranged from moderate losses (50 to 74 dB HL) to severe-profound losses (75 to 120 dB HL). The speech stimuli were presented in an oddball paradigm and cortical ERPs were recorded in both active and passive listening conditions at both stimulus intensities. The adults with hearing impairments were tested in the unaided and aided conditions at each stimulus intensity. Electroacoustic and real-ear testing was performed on each subject's hearing aid(s) before electrophysiology testing to ensure that the hearing aids were functioning at the time of testing. RESULTS:: The use of personal hearing aids substantially improved the detectability of all the cortical ERPs and behavioral d-prime performance scores at both stimulus intensities. This was especially true for individuals with severe-profound hearing losses. At 65 dB SPL, mean ERP amplitudes and d-prime sensitivity scores were all significantly higher or better in the aided versus unaided condition. At 80 dB SPL, only the N1 amplitudes and d-prime sensitivity scores were significantly better in the aided condition. Even though the majority of the hearing-impaired subjects showed increased amplitudes, decreased latencies, and better waveform morphology in the aided condition, the amount of response change (improvements) seen in these measures showed considerable variability across subjects. When compared with theresponses obtained from the normal-hearing subjects, both hearing-impaired groups had significantly prolonged aided RT latencies at both stimulus intensities and N2b latencies at the higher stimulus intensities. CONCLUSIONS:: These results suggest that hearing-impaired individuals' brains process speech stimuli with greater accuracy and in a more effective manner when these individuals use their personal hearing aids. This is especially true at the lower stimulus intensity. The effects of sensorineural hearing loss and personal hearing aids on cortical ERPs and behavioral measures of discrimination are dependent on the degree of sensorineural loss, the intensity of the stimuli, and the level of cortical auditory processing that the response measure is assessing. The possible clinical significance of these cortical ERP and behavioral findings is discussed.