Speech intelligibility is currently measured by scoring how well a person can identify a speech signal. The results of such behavioral measures reflect neural processing of the speech signal, but are also influenced by language processing, motivation, and memory. Very often, electrophysiological measures of hearing give insight in the neural processing of sound. However, in most methods, non-speech stimuli are used, making it hard to relate the results to behavioral measures of speech intelligibility. The use of natural running speech as a stimulus in electrophysiological measures of hearing is a paradigm shift which allows to bridge the gap between behavioral and electrophysiological measures. Here, by decoding the speech envelope from the electroencephalogram, and correlating it with the stimulus envelope, we demonstrate an electrophysiological measure of neural processing of running speech. We show that behaviorally measured speech intelligibility is strongly correlated with our electrophysiological measure. Our results pave the way towards an objective and automatic way of assessing neural processing of speech presented through auditory prostheses, reducing confounds such as attention and cognitive capabilities. We anticipate that our electrophysiological measure will allow better differential diagnosis of the auditory system, and will allow the development of closed-loop auditory prostheses that automatically adapt to individual users.

When we grow older, understanding speech in noise becomes more challenging. Research has demonstrated the role of auditory temporal and cognitive deficits in these age-related speech-in-noise difficulties. To better understand the underlying neural mechanisms, we recruited young, middle-aged, and older normal-hearing adults and investigated the interplay between speech understanding, cognition, and neural tracking of the speech envelope using electroencephalography. The stimuli consisted of natural speech masked by speech-weighted noise or a competing talker and were presented at several subject-specific speech understanding levels. In addition to running speech, we recorded auditory steady-state responses at low modulation frequencies to assess the effect of age on nonspeech sounds. The results show that healthy aging resulted in a supralinear increase in the speech reception threshold, i.e., worse speech understanding, most pronounced for the competing talker. Similarly, advancing age was associated with a supralinear increase in envelope tracking, with a pronounced enhancement for older adults. Additionally, envelope tracking was found to increase with speech understanding, most apparent for older adults. Because we found that worse cognitive scores were associated with enhanced envelope tracking, our results support the hypothesis that enhanced envelope tracking in older adults is the result of a higher activation of brain regions for processing speech, compared with younger adults. From a cognitive perspective, this could reflect the inefficient use of cognitive resources, often observed in behavioral studies. Interestingly, the opposite effect of age was found for auditory steady-state responses, suggesting a complex interplay of different neural mechanisms with advancing age. NEW & NOTEWORTHY We measured neural tracking of the speech envelope across the adult lifespan and found a supralinear increase in envelope tracking with age. Using a more ecologically valid approach than auditory steady-state responses, we found that young and older, as well as middle-aged, normal-hearing adults showed an increase in envelope tracking with increasing speech understanding and that this association is stronger for older adults.

11Speech intelligibility is currently measured by scoring how well a person can identify 12 a speech signal. The results of such behavioral measures reflect neural processing of the 13 speech signal, but are also influenced by language processing, motivation and memory. Very 14 often electrophysiological measures of hearing give insight in the neural processing of sound. 15However, in most methods non-speech stimuli are used, making it hard to relate the re- 1. CC-BY-NC-ND 4.0 International license It is made available under a (which was not peer-reviewed) is the author/funder, who has granted bioRxiv a license to display the preprint in perpetuity.The copyright holder for this preprint . http://dx.doi.org/10.1101/246660 doi: bioRxiv preprint first posted online bridge the gap between behavioral and electrophysiological measures. Here, by decoding

Highlights: Objective EEG-based measure of speech intelligibility  Improved prediction of speech intelligibility by combining speech representations  Cortical tracking of speech in the delta EEG band monotonically increased with SNRs  Cortical responses in the theta EEG band best predicted the speech reception threshold Disclosure: The authors report no disclosures relevant to the manuscript.

Elevated hearing thresholds in hearing impaired adults are usually compensated by providing amplification through a hearing aid. In spite of restoring hearing sensitivity, difficulties with understanding speech in noisy environments often remain. One main reason is that sensorineural hearing loss not only causes loss of audibility but also other deficits, including peripheral distortion but also central temporal processing deficits. To investigate the neural consequences of hearing impairment in the brain underlying speech-in-noise difficulties, we compared EEG responses to natural speech of 14 hearing impaired adults with those of 14 age-matched normal-hearing adults. We measured neural envelope tracking to sentences and a story masked by different levels of a stationary noise or competing talker. Despite their sensorineural hearing loss, hearing impaired adults showed higher neural envelope tracking of the target than the competing talker, similar to their normal-hearing peers. Furthermore, hearing impairment was related to an additional increase in neural envelope tracking of the target talker, suggesting that hearing impaired adults may have an enhanced sensitivity to envelope modulations or require a larger differential neural tracking of target versus competing talker to segregate speech from noise. Lastly, both normal-hearing and hearing impaired participants showed an increase in neural envelope tracking with increasing speech understanding. Hence, our results open avenues towards new clinical applications, such as neuro-steered prostheses as well as objective and automatic measurements of speech understanding performance.

AbstractElevated hearing thresholds in hearing impaired adults are usually compensated by providing amplification through a hearing aid. In spite of restoring hearing sensitivity, difficulties with understanding speech in noisy environments often remain. One main reason is that sensorineural hearing loss not only causes loss of audibility but also other deficits, including peripheral distortion but also central temporal processing deficits. To investigate the neural consequences of hearing impairment in the brain underlying speech-in-noise difficulties, we compared EEG responses to natural speech of 14 hearing impaired adults with those of 14 age-matched normal-hearing adults. We measured neural envelope tracking to sentences and a story masked by different levels of a stationary noise or competing talker. Despite their sensorineural hearing loss, hearing impaired adults showed higher neural envelope tracking of the target than the competing talker, similar to their normal-hearing peers. Furthermore, hearing impairment was related to an additional increase in neural envelope tracking of the target talker, suggesting that hearing impaired adults may have an enhanced sensitivity to envelope modulations or require a larger differential tracking of target versus competing talker to neurally segregate speech from noise. Lastly, both normal-hearing and hearing impaired participants showed an increase in neural envelope tracking with increasing speech understanding. Hence, our results open avenues towards new clinical applications, such as neuro-steered prostheses as well as objective and automatic measurements of speech understanding performance.HighlightsAdults with hearing impairment can neurally segregate speech from background noiseHearing loss is related to enhanced neural envelope tracking of the target talkerNeural envelope tracking has potential to objectively measure speech understanding

Search Terms: cortical speech tracking, objective measure, speech intelligibility, auditory processing, speech representations. Highlights: Objective EEG-based measure of speech intelligibility  Improved prediction of speech intelligibility by combining speech representations  Cortical tracking of speech in the delta EEG band monotonically increased with SNRs  Cortical responses in the theta EEG band best predicted the speech reception threshold ABSTRACT Objective -To objectively measure speech intelligibility of individual subjects from the EEG, based on cortical tracking of different representations of speech: low-level acoustical, higher-level discrete, or a combination. To compare each model's prediction of the speech reception threshold (SRT) for each individual with the behaviorally measured SRT.Methods -Nineteen participants listened to Flemish Matrix sentences presented at different signal-to-noise ratios (SNRs), corresponding to different levels of speech understanding. For different EEG frequency bands (delta, theta, alpha, beta or low-gamma), a model was built to predict the EEG signal from various speech representations: envelope, spectrogram, phonemes, phonetic features or a combination of phonetic Features and Spectrogram (FS). The same model was used for all subjects. The model predictions were then compared to the actual EEG of each subject for the different SNRs, and the prediction accuracy in function of SNR was used to predict the SRT.Results -The model based on the FS speech representation and the theta EEG band yielded the best SRT predictions, with a difference between the behavioral and objective SRT below 1 decibel for 53% and below 2 decibels for 89% of the subjects.Conclusion -A model including low-and higher-level speech features allows to predict the speech reception threshold from the EEG of people listening to natural speech. It has potential applications in diagnostics of the auditory system.

EEG-based measures of neural tracking of natural running speech are becoming increasingly popular to investigate neural processing of speech and have applications in audiology. When the stimulus is a single speaker, it is usually assumed that the listener actively attends to and understands the stimulus. However, as the level of attention of the listener is inherently variable, we investigated how this affected neural envelope tracking. Using a movie as a distractor, we varied the level of attention while we estimated neural envelope tracking. We varied the intelligibility level by adding stationary noise. We found a significant difference in neural envelope tracking between the condition with maximal attention and the movie condition. This difference was most pronounced in the right-frontal region of the brain. The degree of neural envelope tracking was highly correlated with the stimulus signal-to-noise ratio, even in the movie condition. This could be due to residual neural resources to passively attend to the stimulus. When envelope tracking is used to measure speech understanding objectively, this means that the procedure can be made more enjoyable and feasible by letting participants watch a movie during stimulus presentation.