title: Amplitude Modulation Detection and Speech Recognition in Late-Implanted Prelingually and Postlingually Deafened Cochlear Implant Users.
abstract: OBJECTIVE
  Many late-implanted prelingually deafened cochlear implant (CI) patients struggle to obtain open-set speech understanding. Because it is known that low-frequency temporal-envelope information contains important cues for speech understanding, the goal of this study was to compare the temporal-envelope processing abilities of late-implanted prelingually and postlingually deafened CI users. Furthermore, the possible relation between temporal processing abilities and speech recognition performances was investigated.
  
  
  METHODS
  Amplitude modulation detection thresholds were obtained in eight prelingually and 18 postlingually deafened CI users, by means of a sinusoidally modulated broadband noise carrier, presented through a loudspeaker to the CI user's clinical device. Thresholds were determined with a two-down-one-up three-interval oddity adaptive procedure, at seven modulation frequencies. Phoneme recognition (consonant-nucleus-consonant [CNC]) scores (percentage correct at 65 dB SPL) were gathered for all CI users. For the prelingually deafened group, scores on two additional speech tests were obtained: (1) a closed-set monosyllable-trochee-spondee test (percentage correct scores at 65 dB SPL on word recognition and categorization of the suprasegmental word patterns), and (2) a speech tracking test (number of correctly repeated words per minute) with texts specifically designed for this population.
  
  
  RESULTS
  The prelingually deafened CI users had a significantly lower sensitivity to amplitude modulations than the postlingually deafened CI users, and the attenuation rate of their temporal modulation transfer function (TMTF) was greater. None of the prelingually deafened CI users were able to detect modulations at 150 and 200 Hz. High and significant correlations were found between the results on the amplitude modulation detection test and CNC phoneme scores, for the entire group of CI users. In the prelingually deafened group, CNC phoneme scores, word scores on the monosyllable-trochee-spondee test, and speech tracking scores correlated significantly with the mean amplitude modulation detection threshold of the modulation frequencies between 5 and 100 Hz and with almost all separate amplitude modulation thresholds. High correlations with these speech measures were also found for the attenuation rate of and the surface area below the TMTF. In postlingually deafened CI users, CNC phoneme scores only correlated significantly with the 100-Hz and 150-Hz amplitude modulation thresholds, as well as with the attenuation rate of and surface area below the TMTF.
  
  
  CONCLUSIONS
  Prelingually deafened CI users were less sensitive to temporal modulations than postlingually deafened CI users, and the attenuation rate of their TMTF was steeper. For all CI users, subjects with better amplitude modulation detection skills tended to score better on measures of speech understanding. Significant correlations with low modulation frequencies were found only for the prelingually deafened CI users and not for the postlingually deafened CI users.
authors: 1Department of Otorhinolaryngology, Head and Neck Surgery, Maastricht University Medical Center, Maastricht, The Netherlands; 2Adelante, Centre of Expertise in Rehabilitation and Audiology, Hoensbroek, The Netherlands; 3School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands; 4Department of Methodology & Statistics, Maastricht University, Maastricht, The Netherlands; and 5KU Leuven Department of Neurosciences, ExpORL, Leuven, Belgium.
authors: Anke M
authors: AM
authors: De Ruiter
authors: Joke A
authors: JA
authors: Debruyne
authors: Michelene N
authors: MN
authors: Chenault
authors: Tom
authors: T
authors: Francart
authors: Jan P L
authors: JP
authors: Brokx
mesh_terms: D000328:Adult; D000368:Aged; D019929:Cochlear Implantation; D003463:Cues; D003638:Deafness / Q000534:rehabilitation*; D006801:Humans; D008875:Middle Aged; D013067:Speech Perception; D061665:Time-to-Treatment