Auditory and Cognitive Factors Associated with Speech-in-Noise Complaints following Mild Traumatic Brain Injury
Auditory and Cognitive Factors Associated with Speech-in-Noise Complaints following Mild Traumatic Brain Injury
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DOI：
10.3766/jaaa.16051
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发表时间：
2017-04-01
影响因子：
1.2
通讯作者：
Gallun, Frederick J.
中科院分区：
文献类型：
--
作者：
Hoover, Eric C.;Souza, Pamela E.;Gallun, Frederick J.
背景资料：轻度创伤性脑损伤（MTBI）后的听觉主诉很常见，但很少有研究涉及听觉时间处理在语音识别主诉中的作用。目的：本研究评估了MTBI后在语音噪声背景下的语音理解缺陷，目的是比较听觉和非听觉因素的相对贡献。采用匹配组设计，将一组有MTBI病史的听众与一组年龄和纯音听阈匹配的听众以及一组听力正常的年轻听众（YNH）进行比较。在参与研究的33名听众中，有13人被纳入MTBI组（平均年龄= 46.7岁），匹配组11例（平均年龄= 49岁），YNH组9例（平均年龄= 20.8岁）。数据收集和分析：使用主观测量以及单耳单词（噪音中的单词测试）和句子（快速噪音中的语音测试）任务和双耳空间释放任务来评估噪音中的语音缺陷。这些措施的性能进行了比较，以心理物理任务，评估单声道和双耳时间精细结构任务和频谱分辨率。注意力、处理速度和工作记忆的认知测量被评估为MTBI和匹配组之间差异的可能原因，这些差异可能导致噪声中的语音感知缺陷。与匹配组相比，MTBI组中有很高比例的听众报告难以理解噪音中的语音（84%）（9.1%），和听众谁报告困难更有可能有异常结果的客观措施的讲话噪音。在MTBI和匹配的听众之间没有发现显著的组间差异，但各组之间异常测试的数量不同。回归分析表明，听觉和听觉处理因素的组合有助于单耳语音噪声分数，但空间分离的好处是相关的工作记忆和周边听觉因素在所有的听众在study.Conclusions的组合：本研究的结果是一致的，与MTBI的听众的子集与以前的研究结果，客观的听觉缺陷。噪声中的语音表现与听觉和非听觉因素的结合有关，证实了听力学在MTBI康复中的重要作用。需要进一步的研究来评估MTBI后听觉缺陷的患病率和因果关系。
Background: Auditory complaints following mild traumatic brain injury (MTBI) are common, but few studies have addressed the role of auditory temporal processing in speech recognition complaints.Purpose: In this study, deficits understanding speech in a background of speech noise following MTBI were evaluated with the goal of comparing the relative contributions of auditory and nonauditory factors.Research Design: A matched-groups design was used in which a group of listeners with a history of MTBI were compared to a group matched in age and pure-tone thresholds, as well as a control group of young listeners with normal hearing (YNH).Study Sample: Of the 33 listeners who participated in the study, 13 were included in the MTBI group (mean age = 46.7 yr), 11 in the Matched group (mean age = 49 yr), and 9 in the YNH group (mean age = 20.8 yr).Data Collection and Analysis: Speech-in-noise deficits were evaluated using subjective measures as well as monaural word (Words-in-Noise test) and sentence (Quick Speech-in-Noise test) tasks, and a binaural spatial release task. Performance on these measures was compared to psychophysical tasks that evaluate monaural and binaural temporal fine-structure tasks and spectral resolution. Cognitive measures of attention, processing speed, and working memory were evaluated as possible causes of differences between MTBI and Matched groups that might contribute to speech-in-noise perception deficits.Results: A high proportion of listeners in the MTBI group reported difficulty understanding speech in noise (84%) compared to the Matched group (9.1%), and listeners who reported difficulty were more likely to have abnormal results on objective measures of speech in noise. No significant group differences were found between the MTBI and Matched listeners on any of the measures reported, but the number of abnormal tests differed across groups. Regression analysis revealed that a combination of auditory and auditory processing factors contributed to monaural speech-in-noise scores, but the benefit of spatial separation was related to a combination of working memory and peripheral auditory factors across all listeners in the study.Conclusions: The results of this study are consistent with previous findings that a subset of listeners with MTBI has objective auditory deficits. Speech-in-noise performance was related to a combination of auditory and nonauditory factors, confirming the important role of audiology in MTBI rehabilitation. Further research is needed to evaluate the prevalence and causal relationship of auditory deficits following MTBI.