Non‐auditory neurocognitive skills contribute to speech recognition in adults with cochlear implants

Abstract

ObjectiveUnexplained variability in speech recognition outcomes among postlingually deafened adults with cochlear implants (CIs) is an enormous clinical and research barrier to progress. This variability is only partially explained by patient factors (e.g., duration of deafness) and auditory sensitivity (e.g., spectral and temporal resolution). This study sought to determine whether non‐auditory neurocognitive skills could explain speech recognition variability exhibited by adult CI users.Study DesignThirty postlingually deafened adults with CIs and thirty age‐matched normal‐hearing (NH) controls were enrolled.MethodsParticipants were assessed for recognition of words in sentences in noise and several non‐auditory measures of neurocognitive function. These non‐auditory tasks assessed global intelligence (problem‐solving), controlled fluency, working memory, and inhibition‐concentration abilities.ResultsFor CI users, faster response times during a non‐auditory task of inhibition‐concentration predicted better recognition of sentences in noise; however, similar effects were not evident for NH listeners.ConclusionsFindings from this study suggest that inhibition‐concentration skills play a role in speech recognition for CI users, but less so for NH listeners. Further research will be required to elucidate this role and its potential as a novel target for intervention.

How does aging affect recognition of spectrally degraded speech?

“…In the sample of CI users tested in this study, inhibitory control abilities did not contribute substantially to speech recognition in CI users, but did partially mediate aging effects on speech recognition in NH controls. This finding is in contrast to previous findings using a Stroop task . In that study, correlations were found between Stroop response times for the incongruent condition and sentence recognition scores for CI users.…”

“…In addition to an aging‐related decline in verbal WM as a potential contributor to poorer speech recognition, a recent study identified the role of inhibitory control abilities on speech recognition in postlingual adult CI users. A significant correlation was found between sentence recognition in speech‐shaped noise and inhibitory control skills, assessed using a visual computerized version of a verbal Stroop task . Better inhibitory control may permit a listener to more effectively ignore nontarget auditory stimuli and to inhibit the activation of incorrect lexical units during recognition of running speech.…”

Relating quality of life to outcomes and predictors in adult cochlear implant users: Are we measuring the right things?

“…No patients used combined electric‐acoustic stimulation in the implanted ear. Some scores from testing previously were reported …”

Verbal working memory and inhibition‐concentration in adults with cochlear implants

“…In a study of adult CI users by Tao et al, relations were identified between auditory measures of WM and sentence recognition in quiet and in speech‐shaped noise . In contrast, a recent study by Moberly, Houston, and Castellanos demonstrated no correlations for adult CI users between scores of sentence recognition in speech‐shaped noise and verbal WM scores for visual tasks of forward and reverse memory taken from the Leiter‐3 International Performance Scale, a well‐validated and widely used assessment of neurocognitive performance . Together, these findings suggest that verbal WM tested in a modality‐specific auditory fashion, as compared to a modality‐general visual fashion, contributes to sentence recognition abilities for CI users.…”

“…To accomplish the three goals of the current study, a group of postlingually deafened adult experienced CI users, along with a group of age‐matched peers with NH, were tested using a modality‐general task of verbal WM capacity (visual RSpan) and a modality‐specific task of verbal WM capacity (auditory LSpan). These measures were examined for their relations to previously reported measures of speech recognition and more basic neurocognitive functions, in order to provide further evidence that modality‐general neurocognitive functions underlie performance on both modality‐general and modality‐specific verbal WM tasks, which, in turn, contribute to sentence recognition skills for adult CI users and NH peers listening to speech in noise.…”