A comparison of bottom-up and top-down training approaches: Brain responses as objective outcome measures of auditory training for improving speech perception in noise.

这项拟议的项目调查了听觉训练方法的有效性，通过了解语言感知的潜在神经元过程及其在衰老和听力丧失后的变化，来改善听力损失患者对噪声中的语音理解的有效性。近年来，一些研究证明了听觉训练计划对提高听力障碍者在噪声中的言语理解能力的有效性。然而，听众的个体利益各不相同，目前还不清楚哪种培训方法最有效。听力科学的研究发现，噪声中语音缺陷的多种原因存在于听觉外周、沿听觉通路的声音处理阶段、知觉的皮质过程和认知大脑。由于不同的训练方法在不同的水平上与加工相互作用，进一步研究的一个目标是记录和分析这些在言语感知中的过程以及与训练相关的人脑变化。一个机会是解开多模式、自下而上和自上而下的神经机制，这些机制促成了听觉皮质的变化。关键目标是在训练干预的同时记录脑磁图的大脑反应，以告知训练在哪个水平上改善噪音中的语音识别是有效的。在受控随机训练前到训练后的范式中，进行两个训练组。参与者将是健康的老年人(年龄在60岁到80岁之间)，他们经历了正常的年龄增长导致的听力和噪音中语音理解能力的下降，但没有使用助听器。两组都将进行为期6周的训练，并采用两种不同的训练方案(自下而上和自上而下)。根据训练前、训练结束时以及训练结束后2个月以上的行为测量和听觉诱发反应对训练结果进行评估。作为听神经科学基础研究的一部分，这项研究将产生重要的信息，以优化临床听力康复过程中的个人护理。

The proposed project investigates the effectiveness of auditory training approaches for improving speech-in-noise understanding in people with hearing loss by gaining knowledge about neuronal processes underlying speech perception and its changes in ageing and after hearing loss. In recent years, several studies proved the efficacy of auditory training programs to improve speech understanding in noise in the hearing impaired. However, the individual benefit varies among the listeners, and still it is not clear which training method is the most effective. Research in hearing science identified multiple causes of speech-in-noise deficits at the auditory periphery, the stages of sound processing along the auditory pathway, cortical processes of perception and the cognitive brain. As different training approaches interact with processing at different levels, one aim in further research is to document and analyze these processes in speech perception and the training-related changes in the human brain. One opportunity is to disentangle the multi modal bottom-up and top-down neural mechanism contributing to changes in the auditory cortex. The key objective is to record brain responses with MEG in parallel to a training intervention to inform at which level the training to improve speech recognition in noise is effective. In the controlled randomized pre- to posttraining paradigm two training groups are conducted. Participants will be healthy older adults (age range 60 to 80 years) who experience normal aging related decline in hearing and speech-in-noise understanding, and however are not using hearing aids. Both groups will train over a period of 6 weeks with two different training programs (a bottom-up and a top-down). Evaluation of training outcome based on behavioral measures and auditory evoked responses before and at the end of the training as well as more than 2 months after the end of the training. As being part of fundamental research in auditory neuroscience, the study will generate important information to optimize individual care in the clinical auditory rehabilitation process.