Listening Effort in Cochlear Implant Users
Condition: Sensorineural Hearing Loss; Cochlear Hearing Loss
MeSH terms: Hearing Loss; Deafness; Hearing Loss, Sensorineural
Study type: Interventional

Summary: 
      Listening with a cochlear implant remains difficult and most listeners will report high
      levels of listening effort.The present study is a "pilot" aiming to evaluate listening effort
      for cochlear implant users. The listening effort is measured with pupillometry, by monitoring
      the variations of pupil size in response to different stimuli. The size of the pupil is known
      to increase with the listening effort. The listening effort is evaluated in two different
      situation: speech perception in quiet and speech perception in noise. The pupillometry
      measures will be compared for the two listening conditions. Moreover, the study will evaluate
      the relationship between objective (pupil dilatation) and subjective measures (auto
      evaluation) of listening effort, and between speech comprehension, cognitive abilities and
      listening effort.
    

Detailed description: 
      Nowadays, cochlear implants (CI) are successfully used to rehabilitate severe to profound
      sensorineural hearing loss. Most CI users can understand speech in quiet, but comprehension
      scores drop in the presence of background noise and in adverse conditions. Listening with a
      cochlear implant remains very demanding and most listeners report high levels of listening
      effort. The aim of current auditory prostheses and cochlear implants is not only restore
      speech understanding, but also to restore all the cognitive functions that are associated to
      a listening task (e.g., memory, executive functions, attention). Evaluating the listening
      effort is a new way to assess the efficiency of the hearing aids or cochlear implants. The
      listening effort indicates the amount of cognitive resources that are dedicated to a
      listening task; it evaluates also the cognitive resources remaining available for the other
      cognitive functions. The present study is a "pilot" aiming to evaluate listening effort for
      cochlear implant users. The listening effort is measured with pupillometry, i. e. by
      measuring the pupil dilatation in response to different stimuli. The size of the pupil is
      known to increase with the listening effort. The listening effort is evaluated in two
      different situation: speech perception in quiet and speech perception in noise. Speech
      comprehension is measured for the two listening conditions and cognitive functions are
      assessed by the MOCA (Montreal Cognitive Assessment). In addition, the subjects are asked to
      subjectively evaluate the amount of listening effort they used in each listening situation.
      The pupillometry measures will be compared for the two listening conditions. Moreover, the
      study will evaluate the relationship between objective (pupil dilatation) and subjective
      measures (self evaluation) of listening effort, and between speech comprehension, cognitive
      abilities and listening effort.
    

Intervention name(s): Pupillometry; Evaluation of speech comprehension in quiet; Evaluation of speech comprehension in noise; MOCA; auto evaluation of listening effort in quiet; auto evaluation of listening effort in noise
Intervention type(s): Behavioral; Behavioral; Behavioral; Behavioral; Behavioral; Behavioral
Intervention description(s): Measure of pupil dilatation simultaneously to the evaluation of speech intelligibility. The variation of the pupil size is monitored during the presentation of speech stimuli in quiet and in the presence of a background noise.; Three lists of 17 monosyllabic words (Lafon) are presented in quiet at 65 dB SPL. Listeners have to repeat what they understood. The results correspond to the percent of phonemes correctly identified.; Three lists of 17 monosyllabic words (Lafon) are presented in a wide band noise at 65 dB SPL with a SNR (signal to noise ratio) of +10 dB. Listeners have to repeat what they understood. The results correspond to the percent of phonemes correctly identified.; The Montreal Cognitive Assessment (MoCA) is a screening instrument to detect cognitive dysfunction. It assesses different cognitive domains: attention and concentration, executive functions, memory, language, visuoconstructional skills, conceptual thinking, calculations, and orientation. The time to administer the MoCA is approximately 10 minutes. The total possible score is 30 points. The test suggests the existence of a cognitive impairment if the participant scores less than 26 points. The test is presented on a single sheet of paper.; The participant has to represent, on a continuous line, the amount of listening effort he used when listening to the monosyllabic words presented in quiet. A score from 0 (no listening effort) to 10 (effort maximum) is extracted from his response.; The participant has to represent, on a continuous line, the amount of listening effort he used when listening to the monosyllabic words presented in the background noise. A score from 0 (no listening effort) to 10 (effort maximum) is extracted from his response.
Other intervention name(s): Montreal Cognitive Assessment; VAS (visual analog scale) in quiet; VAS (visual analog scale) in noise
Intervention model: Single Group Assignment
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: cochlear implant; Listening effort; pupillometry