Pupillometry Assessment of Speech Recognition and Listening Experience in Adult Cochlear Implant Patients

Francesca Yoshie Russo, Michel Hoen, Chadlia Karoui, Thomas Demarcy, Marine Ardoint, Maria-Pia Tuset, Daniele De Seta, Olivier Sterkers, Ghizlène Lahlou, Isabelle Mosnier, Francesca Yoshie Russo, Michel Hoen, Chadlia Karoui, Thomas Demarcy, Marine Ardoint, Maria-Pia Tuset, Daniele De Seta, Olivier Sterkers, Ghizlène Lahlou, Isabelle Mosnier

Abstract

Objective: The aim of the present study was to investigate the pupillary response to word identification in cochlear implant (CI) patients. Authors hypothesized that when task difficulty (i.e., addition of background noise) increased, pupil dilation markers such as the peak dilation or the latency of the peak dilation would increase in CI users, as already observed in normal-hearing and hearing-impaired subjects.

Methods: Pupillometric measures in 10 CI patients were combined to standard speech recognition scores used to evaluate CI outcomes, namely, speech audiometry in quiet and in noise at +10 dB signal-to-noise ratio (SNR). The main outcome measures of pupillometry were mean pupil dilation, maximal pupil dilation, dilation latency, and mean dilation during return to baseline or retention interval. Subjective hearing quality was evaluated by means of one self-reported fatigue questionnaire, and the Speech, Spatial, and Qualities (SSQ) of Hearing scale.

Results: All pupil dilation data were transformed to percent change in event-related pupil dilation (ERPD, %). Analyses show that the peak amplitudes for both mean pupil dilation and maximal pupil dilation were higher during the speech-in-noise test. Mean peak dilation was measured at 3.47 ± 2.29% noise vs. 2.19 ± 2.46 in quiet and maximal peak value was detected at 9.17 ± 3.25% in noise vs. 8.72 ± 2.93% in quiet. Concerning the questionnaires, the mean pupil dilation during the retention interval was significantly correlated with the spatial subscale score of the SSQ Hearing scale [r(8) = -0.84, p = 0.0023], and with the global score [r(8) = -0.78, p = 0.0018].

Conclusion: The analysis of pupillometric traces, obtained during speech audiometry in quiet and in noise in CI users, provided interesting information about the different processes engaged in this task. Pupillometric measures could be indicative of listening difficulty, phoneme intelligibility, and were correlated with general hearing experience as evaluated by the SSQ of Hearing scale. These preliminary results show that pupillometry constitutes a promising tool to improve objective quantification of CI performance in clinical settings.

Keywords: cochlear implant; listening effort; pupil dilatation; pupillometery; speech in noise.

Copyright © 2020 Russo, Hoen, Karoui, Demarcy, Ardoint, Tuset, De Seta, Sterkers, Lahlou and Mosnier.

Figures

FIGURE 1
FIGURE 1
General trial structure and timing of events.
FIGURE 2
FIGURE 2
Scatter-plot of individual speech audiometry scores obtained in quiet (Q) and in noise (N) percent correct identification scores for Lafon words (W) and phonemes (P), in red: mean and standard error of mean.
FIGURE 3
FIGURE 3
Effect of conditions. Grand-averaged (N = 10) pupillometry traces showing percent change in event-related pupil dilation (ERPD) for correctly recognized words, presented in Quiet (black line) or +10 dB speech-weighed noise background (gray dashed). Time is given relative to the onset of the noise in noisy background set at 0 s, words are presented at 3 s, and noise fades-out at 6 s.
FIGURE 4
FIGURE 4
Bar-graphs representing percent change in event-related pupil dilation (ERPD) averaged over the three time-windows (Background, Peak, and Retention interval) for correct words presented in the Quiet (black) or Noise (gray) conditions. Error bars represent standard deviation of the mean.
FIGURE 5
FIGURE 5
Performance effect. Grand-averaged (N = 10) pupillometry traces showing percent change in event-related pupil dilation (ERPD) for correctly recognized words (black line) or incorrect trials (gray line), independently of the listening condition.
FIGURE 6
FIGURE 6
Grand-averaged (N = 10) pupillometry traces showing percent change in event-related pupil dilation (ERPD) analyzed across trials leading to 0, 1, 2, or 3 phonemes recognition.

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