Electrophysiological method for assessing the effectiveness of a hearing aid
10299696 ยท 2019-05-28
Assignee
Inventors
- Hung Thai-Van (Lyons, FR)
- Anne Caclin (Serezin de la Tour, FR)
- Ludovic Bellier (Lyons, FR)
- Jean-Francois Vesson (Francheville, FR)
- Evelyne Veuillet (Lyons, FR)
Cpc classification
A61B5/374
HUMAN NECESSITIES
A61B5/4836
HUMAN NECESSITIES
H04R25/70
ELECTRICITY
A61B5/7246
HUMAN NECESSITIES
International classification
Abstract
A method of evaluating the effectiveness of an auditory prosthesis comprises transmitting a stimulus via an auditory prosthesis, thereby delivering an auditory stimulus to the auditory nervous system of a person fitted with said auditory prosthesis, picking up the neurophysiological signals transmitted by said auditory nervous system in response to the auditory stimulus by means of an electro- or magneto-encephalography system, and processing the received signals. The method also includes transmitting a stimulus made up of at least one pair of linguistic units selected from a phonetic confusion matrix, picking up a neurophysiological signal in response separately for each linguistic unit, and comparing the signals in order to evaluate the effectiveness of the prosthesis.
Claims
1. A method of evaluating the effectiveness of an auditory prosthesis (3), the method comprising: transmitting a stimulus via an auditory prosthesis (3), thereby delivering an auditory stimulus to the auditory nervous system of a person fitted with said auditory prosthesis; picking up the neurophysiological signals transmitted by said auditory nervous system in response to the auditory stimulus by means of an electro- or magneto-encephalography system; and processing the received neurophysiological signals; the method further comprising: transmitting a stimulus made up of at least one pair of linguistic units selected from a phonetic confusion matrix; picking up separately the electrophysiological signals in response to each linguistic unit administered via the auditory prosthesis (3); and processing the neurophysiological and electrophysiological signals: by comparing the electrophysiological signals corresponding to the various tested linguistic units by performing one or more of the following steps comprising: extracting peak latencies, peak amplitudes, latency differences between peaks, slopes of the curve between two peaks, or areas under portions of the curve; searching in waveforms and/or in time-frequency decompositions for a response specifically expected for one of said linguistic units; directly comparing the waveforms of each neurophysiological signal picked up in response by subtraction; and comparing the time-frequency decompositions; and evaluating the effectiveness of the auditory prosthesis on the basis of the result of this comparison between the electrophysiological signals corresponding to the different linguistic units under test, wherein the method further comprises picking up speech ABR signals as electrophysiological signals, wherein as a function of the result of said processing of the neurophysiological and electrophysiological signals, the method comprising identifying at least one acoustic trait of said stimulus for which the processing by said auditory nervous system is insufficient to enable said neurophysiological discrimination of said transmitted linguistic units, and wherein the method further comprises changing at least one adjustment parameter of said auditory prosthesis as a function of said acoustic trait that is processed by said auditory nervous system insufficiently to enable said neurophysiological discrimination of said transmitted linguistic units.
2. A method of evaluating the effectiveness according to claim 1, wherein cortical AEP signals are picked up as electrophysiological signals.
3. A method of evaluating the effectiveness of an auditory prosthesis according to claim 1, wherein the linguistic units are selected from phonemes, tonemes, or chronemes, or assemblies thereof as syllables.
4. A method of evaluating the effectiveness of an auditory prosthesis according to claim 1, wherein the stimulus is transmitted to a prosthesis via a wireless link.
Description
(1) Various other characteristics appear from the following description made with reference to the accompanying drawings, which show implementations of the invention as non-limiting examples:
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(11) In particular, the control module 1.1 of the central unit 1 is connected to a transmitter 2 suitable for transmitting control signals to an auditory prosthesis 3. The auditory prosthesis 3 may be of the external auditory prosthesis type: traditional BTE, slim-tubing BTE, RIC hearing aids, intra-auricular hearing aids, spectacle hearing aids, or indeed prostheses that are totally or partially implanted: bone anchored implants, middle ear implants that are semi- or totally implantable (with air conduction or bone conduction), cochlear implants, electro-acoustic cochlear implants, brainstem implants. Signals may be transmitted between the transmitter 2 and the auditory prosthesis 3 over a wire type connection or a wireless type connection, i.e. by radio transmission (frequency modulation), digital transmission (e.g. Bluetooth?), or any type of transmission by means of electromagnetic waves. The auditory prosthesis 3 is designed to be worn by an individual 4. Thus, the central unit 1 enables an auditory stimulus to be transmitted to the auditory nervous system of the individual 4 via the auditory prosthesis 3.
(12) Furthermore, the central unit 1 is connected to an electro- or magneto-encephalographic amplifier 5 (referred to below as an EG amplifier). This EG amplifier 5 is connected to electro-encephalographic electrodes or to magneto-encephalographic sensors 6 arranged in contact with or in the proximity of the head of the individual 4. These electrodes or sensors 6 are adapted to measure or pick up the specific electrophysiological activity in the auditory central nervous system of the individual 4. Thus, the central unit 1 can record this speech ABR type specific electrophysiological activity or the response of the brainstem to a speech sound, or it can record cortical AEP type specific electrophysiological activity (responses of the cerebral cortex to a speech sound).
(13) Finally, the central unit 1 is adapted to synchronize the recording of the electrophysiological activity received via the EG amplifier 5 with the transmitted auditory stimulus by means of a synchronization connection 7 between the control module 1.1 and the EG amplifier 5.
(14) In particular, in the invention, the transmitted auditory stimulus is of the type comprising a pair of linguistic units selected from a phonetic confusion matrix. The term linguistic unit is used to mean a phoneme, a toneme, or a chroneme, or indeed an assembly of them making up a syllable. For example, assembling the phoneme /t/ with the phoneme /a/ results in the consonant-vowel type syllable /ta/. Phonemes, tonemes, and chronemes are known as the basic units of phonetics, and they enable all the words that make up languages to be constituted. Confusion matrices are known in phonology and they depend on the language (
(15) In French, in order to compare two linguistic units, it may suffice to select two phonetically similar consonants, pronounced with the same vowel, e.g. the syllables /ta/ and /da/.
(16) The person skilled in the art knows how to insert an insert into the auditory canal of an individual in order to measure specific electrophysiological activity. The term insert is used to mean an intra-auricular earpiece constituted by a plastic tube filled with air serving to transmit soundwaves and a foam plug enabling it to be fitted to the diameter of the outer auditory canal. In general manner, the person skilled in the art does not use a prosthesis instead of the insert since there is a prejudice that it is not possible under such conditions to take measurements of the electrophysiological activity of the brainstem.
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(18) The syllable /ta/ has been tested by means of inserts (
(19) In
(20) As shown in
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(22) Furthermore, the syllable shown in
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(25) In the same manner,
(26) Finally,
(27) The beginning of signal emission from the inserts is referenced T2D0 and the beginning of signal emission from the prostheses 3 is referenced T2H0. The curves present prominent responses referenced at times T2D1, T2D2, and T2D3, and also at times T2H1, T2H2, and T2H3. The various peaks characteristic of the cortical response to the syllable /ta/ shown in
T2H1=T2D1+(T2H0?2D0)=T2D1+67 ms
More precisely, each transient event, i.e. each rapid change in acoustic energy level, gives rise in the auditory nervous system to a series of at least three waves: P50, N100, and P200, the letter giving the polarity (P for positive and N for negative), and the number giving the latency in milliseconds. Since the syllable /ta/ is made up of a plurality of transient events such as the deocclusion or the setting into vibration of the vocal chords, a corresponding number of series of three waves are evoked in the central auditory nervous system, and they are superposed in the cortical AEPs.
(28) The Applicant has thus overcome a prejudice of the person skilled in the art. It is possible to make measurements of speech ABRs and cortical AEPs by using a device that has an auditory prosthesis instead of a conventional insert type earpiece.
(29) The purpose of the method of the invention is to evaluate the effectiveness of the prosthesis 3 in the sense that proper adjustment of the prosthesis should assist the individual 4 in discriminating or distinguishing between linguistic units selected from the confusion matrix. The understanding of speech by the individual 4 relies on the individual's ability to discern the various phonemes of the language used; this is where the various possible adjustments of the prosthesis 3 play a crucial role.
(30) The method of the invention consists in transmitting an auditory stimulus to the auditory central nervous system of the individual 4 via the prosthesis 3. This stimulus is made up of at least one pair of linguistic units selected from a phonetic confusion matrix. The method then consists in using the data recorder module 1.2 of the central unit 1 to pick up the neurophysiological signals generated in said auditory central nervous system in response to the auditory stimulus for each linguistic unit by means of the electrodes 6 and the EG amplifier 5. The received signals are then processed separately for each of the linguistic units and then at least one of the parameters of the electrophysiological responses to these two linguistic units are compared in order to test whether or not the auditory central nervous system exhibits any neurophysiological discrimination between the various units, with the effectiveness of the auditory prosthesis being evaluated on the basis of the result of this comparison.
(31) In practice, the stimulation is repeated a number N of times lying in the range 100 to 6000, preferably in the range 1000 to 2000 for sub-cortical responses, and at least 100 for cortical responses. By way of example, the two linguistic units are transmitted the same number of times each, i.e. N times each. The linguistic units are preferably transmitted randomly, and with alternating polarities in order to minimize stimulation artifacts, if any.
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(35) The beginning of the emission of the signal of the sound /da/ is written T3D0 for the emission time of the deocclusion. The curve of the cortical AEPs for the syllable/da/as presented via the auditory prostheses 3, and as shown in
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(38) The beginning of the emission of the signal of the sound /ta/ is written T3H0 for the time of the deocclusion. The curve of the cortical AEPs for the syllable /ta/ transmitted by the auditory prostheses 3 is shown in
(39) In order to compare the electrophysiological signals corresponding to the linguistic units /ta/ and /da/, one or more of the following steps may be performed. After the preprocessing step (rejecting artifacts, filtering, averaging, other denoising steps), that serve to obtain the speech ABR and/or the cortical AEP curves, it is possible: to extract peak latencies, peak amplitudes, latency differences between peaks, slopes of the curve between two peaks, or the areas under portions of the curve; to search in the waveforms and/or in time-frequency decompositions for a response specifically expected for one of said linguistic units; to compare the waveforms of each neurophysiological signal picked up in response directly by subtraction; and to compare the time-frequency decompositions.
(40) By way of example, in order to compare the waveforms of each signal directly, it is possible to perform subtraction.
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(42) Thus, the time samples for which the electrophysiological signals are significantly different between the two linguistic units are shown up by black bars under the curve. This means that by asserting that these signal zones are different for the two stimuli, there is less than 5% probability of being wrong (for p<0.05).
(43) In particular,
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(46) Finally, the method of the invention for evaluating the effectiveness of an auditory prosthesis makes it possible to change at least one adjustment parameter of said auditory prosthesis. Specifically, for example by using the information of a phonetic frequency chart, it is possible to determine the acoustic trait(s) that is/are processed poorly by said auditory nervous system, and thus to change the adjustment parameters of the auditory prosthesis in order to enable said neurophysiological discrimination to take place between the transmitted linguistic units.
(47) For example, if /da/ and /ta/ are not discriminated between by the individual 4, that means that the individual is not perceiving the difference in voicing, which is due to hearing loss at low frequencies, i.e. for frequencies in the range 100 Hz to 300 Hz. Consequently, the prosthesis parameter for changing is gain in the frequency range 100 Hz to 300 Hz.
(48) In certain kinds of hearing loss, and in particular in presbycusis, hearing at low frequencies is relatively well preserved. That is why low frequencies are usually amplified little or not at all by the auditory prosthesis, so they reach the auditory nervous system solely via such preserved hearing at low frequencies. Nevertheless, it is essential for the auditory nervous system to be able to encode as well as possible all of the spectral components of speech, including low frequencies, so as to enable the user of an auditory prosthesis to understand a speaker. The above-described method of picking up speech ABRs, while delivering speech sounds directly via an auditory prosthesis, relies on administering sound levels that are defined by the adjustment parameters of said auditory prosthesis. A tested subject is thus deprived of naturally hearing low frequencies. By stimulating directly via the prosthesis, the method consequently makes provision for delivering a signal that is enriched at low frequencies compared with the amplification that would otherwise be applied in a natural situation, in order to add to the input signal the acoustic information that would normally arrive in daily listening via the preserved hearing at low frequencies. This methodological precaution formally conditions the transcription of spectral characteristics of speech sounds in the speech ABR signal that is picked up using said method in accordance with the invention.
(49) The invention is not limited to the examples described and shown since various modifications may be applied thereto without going beyond its ambit.