Audiology seminars

Comprehending speech under acoustically challenging conditions is an everyday task that we can often execute with ease. However, accomplishing this requires the engagement of cognitive resources, such as auditory attention and working memory. The mechanisms that contribute to the robustness of speech comprehension are of substantial interest in the context of hearing mild to moderate hearing impairment, in which affected individuals typically report specific difficulties in understanding speech in background noise. Although hearing aids can help to mitigate this, they do not represent a universal solution, thus, finding alternative interventions is necessary. Given that age-related hearing loss (“presbycusis”) is inevitable, developing new approaches is all the more important in the context of aging populations. Moreover, untreated hearing loss in middle age has been identified as the most significant potentially modifiable predictor of dementia in later life. I will present research that has used a multi-methodological approach (fMRI, EEG, MEG and non-invasive brain stimulation) to try to elucidate the mechanisms that comprise the cognitive “last mile” in speech acousticallychallenging speech comprehension and to find ways to enhance them.

Results: the main areas which were modified based on participatory feedback were the variety of immersive scenarios to cover a range of ages and interests, the number of levels of complexity to ensure small improvements were measured, the feedback and reward schemes to ensure positive reinforcement, and specific provision for participants with balance issues, who had difficulties when using head-mounted displays. The effectiveness of the finalised BEARS suite will be evaluated in a large-scale clinical trial. We have added in additional login options for other members of the family and based on patient feedback we have improved the accompanying reward schemes. Conclusions: Through participatory design we have developed a training package (BEARS) for young people with bilateral cochlear implants. The training games are appropriate for use by the study population and ultimately should lead to patients taking control of their own management and reducing the reliance upon outpatient-based rehabilitation programmes. Virtual reality training provides a more relevant and engaging approach to rehabilitation for young people.

Perception of object motion is fundamentally multisensory, yet little is known about similarities and differences in the computations that give rise to our experience across senses. Insight can be provided by examining auditory motion processing in early blind individuals. In those who become blind early in life, the ‘visual’ motion area hMT+ responds to auditory motion. Meanwhile, the planum temporale, associated with auditory motion in sighted individuals, shows reduced selectivity for auditory motion, suggesting competition between cortical areas for functional role. According to the metamodal hypothesis of cross-modal plasticity developed by Pascual-Leone, the recruitment of hMT+ is driven by it being a metamodal structure containing “operators that execute a given function or computation regardless of sensory input modality”. Thus, the metamodal hypothesis predicts that the computations underlying auditory motion processing in early blind individuals should be analogous to visual motion processing in sighted individuals - relying on non-separable spatiotemporal filters. Inconsistent with the metamodal hypothesis, evidence suggests that the computational algorithms underlying auditory motion processing in early blind individuals fail to undergo a qualitative shift as a result of cross-modal plasticity. Auditory motion filters, in both blind and sighted subjects, are separable in space and time, suggesting that the recruitment of hMT+ to extract motion information from auditory input includes a significant modification of its normal computational operations.