Does hearing aid use affect audiovisual integration in mild hearing impairment?
There is converging evidence for altered audiovisual integration abilities in hearing-impaired individuals and those with profound hearing loss who are provided with cochlear implants, compared to normal-hearing adults. Still, little is known on the effects of hearing aid use on audiovisual integration in mild hearing loss, although this constitutes one of the most prevalent conditions in the elderly and, yet, often remains untreated in its early stages. This study investigated differences in the strength of audiovisual integration between elderly hearing aid users and those with the same degree of mild hearing loss who were not using hearing aids, the non-users, by measuring their susceptibility to the sound-induced flash illusion. We also explored the corresponding window of integration by varying the stimulus onset asynchronies. To examine general group differences that are not attributable to specific hearing aid settings but rather reflect overall changes associated with habitual hearing aid use, the group of hearing aid users was tested unaided while individually controlling for audibility. We found greater audiovisual integration together with a wider window of integration in hearing aid users compared to their age-matched untreated peers. Signal detection analyses indicate that a change in perceptual sensitivity as well as in bias may underlie the observed effects. Our results and comparisons with other studies in normal-hearing older adults suggest that both mild hearing impairment and hearing aid use seem to affect audiovisual integration, possibly in the sense that hearing aid use may reverse the effects of hearing loss on audiovisual integration. We suggest that these findings may be particularly important for auditory rehabilitation and call for a longitudinal study.
KeywordsFlash illusion Fission Window of integration Multisensory integration Hearing loss Aging
The authors would like to thank the Hörzentrum Oldenburg GmbH for data acquisition. Particularly, we acknowledge Kirsten C. Wagener, Matthias Vormann, Michael Schulte, and Niklas Grunewald for their support and helpful comments. We also thank Ladan Shams for the suggestions regarding the signal detection theory analysis. Furthermore, we would like to thank the reviewers for their valuable comments, effort, and time.
AG and MT prepared the study. Data acquisition was conducted by the Hörzentrum Oldenburg GmbH. AG conceptualized the research question, analyzed the data, interpreted the results, wrote the manuscript, and prepared the figures and tables. CT and HC supervised the work. MT, CT, and HC critically reviewed and significantly contributed to the manuscript. All authors approved the final version of the manuscript for publication. All authors agree to be accountable for all aspects of the work and in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
This work was supported by the DFG Cluster of Excellence EXC 1077/1 “Hearing4all”.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
All procedures performed in this study were approved by the institutional review board of the University of Oldenburg and in accordance with the ethical standards of with the Declaration of Helsinki.
All participants gave their written informed consent prior to the study.
- Barone P, Deguine O (2012) Multisensory Processing in Cochlear Implant Listeners. In: Zeng F-G, Popper AN, Fay RR (eds) Auditory prostheses: new horizons. Springer, New York, NY, pp 365–381Google Scholar
- Bolognini N, Rossetti A, Casati C, Mancini F, Vallar G (2011) Neuromodulation of multisensory perception: a tDCS study of the sound-induced flash illusion. Neuropsychologia 49:231–237. https://doi.org/10.1016/j.neuropsychologia.2010.11.015 PubMedCrossRefGoogle Scholar
- Bolognini N, Convento S, Casati C, Mancini F, Brighina F, Vallar G (2016) Multisensory integration in hemianopia and unilateral spatial neglect: Evidence from the sound induced flash illusion. Neuropsychologia 87:134–143. https://doi.org/10.1016/j.neuropsychologia.2016.05.015 PubMedCrossRefGoogle Scholar
- Calvert G, Spence C, Stein BE (2004) The handbook of multisensory processes. MIT Press, CambridgeGoogle Scholar
- Diederich A, Colonius H, Schomburg A (2008) Assessing age-related multisensory enhancement with the time-window-of-integration model. Neuropsychologia 46:2556–2562. https://doi.org/10.1016/j.neuropsychologia.2008.03.026 PubMedCrossRefGoogle Scholar
- Herbig R, Chalupper J (2010) acceptable processing delay in digital hearing aids. Hearing Review 17:28–31Google Scholar
- Hillock AR, Powers AR, Wallace MT (2011) Binding of sights and sounds: age-related changes in multisensory temporal processing. Neuropsychologia 49:461–467. https://doi.org/10.1016/j.neuropsychologia.2010.11.041 PubMedCrossRefGoogle Scholar
- Kalbe E, Kessler J, Calabrese P, Smith R, Passmore AP, Brand M, Bullock R (2004) DemTect: a new, sensitive cognitive screening test to support the diagnosis of mild cognitive impairment and early dementia. Int J Geriatr Psychiatry 19:136–143. https://doi.org/10.1002/gps.1042 PubMedCrossRefGoogle Scholar
- Laurienti PJ, Burdette JH, Maldjian JA, Wallace MT (2006) Enhanced multisensory integration in older adults. Neurobiol Aging 27:1155–1163. https://doi.org/10.1016/j.neurobiolaging.2005.05.024 PubMedCrossRefGoogle Scholar
- MacMillan NA, Creelman CD (2004) Detection theory: a user’s guide. Psychology Press, MahwahGoogle Scholar
- Meister H, Rahlmann S, Walger M, Margolf-Hackl S, Kiessling J (2015) Hearing aid fitting in older persons with hearing impairment: the influence of cognitive function, age, and hearing loss on hearing aid benefit. Clin Interv Aging 10:435–443. https://doi.org/10.2147/CIA.S77096 PubMedPubMedCentralCrossRefGoogle Scholar
- Moradi S, Lidestam B, Ronnberg J (2016) Comparison of gated audiovisual speech identification in elderly hearing aid users and elderly normal-hearing individuals: effects of adding visual cues to auditory speech stimuli. Trends Hear 20. https://doi.org/10.1177/2331216516653355
- Mozolic JL, Hugenschmidt CE, Peiffer AM, Laurienti PJ (2012) Multisensory integration and aging. In: Murray MM, Wallace MT (eds) The neural bases of multisensory processes, CRC Press, Boca Raton (FL), Chap. 20. https://www.ncbi.nlm.nih.gov/books/NBK92841/
- Poliakoff E, Ashworth S, Lowe C, Spence C (2006) Vision and touch in ageing: crossmodal selective attention and visuotactile spatial interactions. Neuropsychologia 44:507–517. https://doi.org/10.1016/j.neuropsychologia.2005.07.004 PubMedCrossRefGoogle Scholar
- Schmidt K-H, Metzler P (1992) Wortschatztest: WST. BeltzGoogle Scholar
- Setti A, Stapleton J, Leahy D, Walsh C, Kenny RA, Newell FN (2014) Improving the efficiency of multisensory integration in older adults: audio-visual temporal discrimination training reduces susceptibility to the sound-induced flash illusion. Neuropsychologia 61:259–268. https://doi.org/10.1016/j.neuropsychologia.2014.06.027 PubMedCrossRefGoogle Scholar
- Strelnikov K, Rouger J, Lagleyre S, Fraysse B, Demonet JF, Deguine O, Barone P (2015) Increased audiovisual integration in cochlear-implanted deaf patients: independent components analysis of longitudinal positron emission tomography data. Eur J Neurosci 41:677–685. https://doi.org/10.1111/ejn.12827 PubMedCrossRefGoogle Scholar
- van Wassenhove V, Grant KW, Poeppel D (2007) Temporal window of integration in auditory-visual speech perception. Neuropsychologia 45:598–607. https://doi.org/10.1016/j.neuropsychologia.2006.01.001 PubMedCrossRefGoogle Scholar
- Wallace MT, Stevenson RA (2014) The construct of the multisensory temporal binding window and its dysregulation in developmental disabilities. Neuropsychologia 64:105–123. https://doi.org/10.1016/j.neuropsychologia.2014.08.005 PubMedPubMedCentralCrossRefGoogle Scholar
- WHO Prevention of Blindness and Deafness (PBD) Programme. Prevention of deafness. Grades of hearing impairment. http://www.who.int/pbd/deafness/hearing_impairment_grades/en. Accessed 14 March 2016