Relations between self-reported daily-life fatigue, hearing status and pupil dilation during a speech perception in noise task

Objective: people with hearing impairment are likely to experience higher levels of fatigue due to effortful listening in daily communication. This hearing-related fatigue might not only constrain their work performance, but also result in withdrawal from major social roles. Therefore, it is important to understand the relationships between fatigue, listening effort, and hearing impairment, by examining the evidence from both subjective and objective measurements. The aim of the present study was to investigate these relationships by assessing subjectively measured daily-life fatigue (self-report questionnaires) and objectively measured listening effort (pupillometry) in both normally-hearing and hearing-impaired participants. Design: twenty-seven normally-hearing and 19 age-matched participants with hearing impairment were included in this study. Two self-report fatigue questionnaires: Need For Recovery and Checklist Individual Strength were given to the participants before the test session to evaluate the subjectively measured daily fatigue. Participants were asked to perform a speech reception threshold test with single-talker masker targeting a 50% correct response criterion. The pupil diameter was recorded during the speech processing, and we used peak pupil dilation as the main outcome measure of the pupillometry. Results: No correlation was found between subjectively measured fatigue and hearing acuity, nor was a group difference found between the normally-hearing and the hearing-impaired participants on the fatigue scores. A significant negative correlation was found between self-reported fatigue and peak pupil dilation. A similar correlation was also found between Speech Intelligibility Index required for 50% correct and peak pupil dilation. Multiple regression analysis showed that factors representing 'hearing acuity' and 'self-reported fatigue' had equal and independent associations with the peak pupil dilation during the speech in noise test. Less fatigue and better hearing acuity were associated with a larger pupil dilation. Conclusions: To the best of our knowledge, this is the first study to investigate the relationship between a subjective measure of daily-life fatigue and an objective measure of pupil dilation, as an indicator of listening effort. These findings help to provide an empirical link between pupil responses, as observed in the laboratory, and daily life fatigue

Pupillary Stroop effects

We recorded the pupil diameters of participants performing the words’ color-naming Stroop task (i.e., naming the color of a word that names a color). Non-color words were used as baseline to firmly establish the effects of semantic relatedness induced by color word distractors. We replicated the classic Stroop effects of color congruency and color incongruency with pupillary diameter recordings: relative to non-color words, pupil diameters increased for color distractors that differed from color responses, while they reduced for color distractors that were identical to color responses. Analyses of the time courses of pupil responses revealed further differences between color-congruent and color-incongruent distractors, with the latter inducing a steep increase of pupil size and the former a relatively lower increase. Consistent with previous findings that have demonstrated that pupil size increases as task demands rise, the present results indicate that pupillometry is a robust measure of Stroop interference, and it represents a valuable addition to the cognitive scientist’s toolbox

The moderating effect of success importance on the relationship between listening demand and listening effort

A common element of the psychophysiological research on listening effort is the focus on listening demand as determinant of effort. The paper discusses preceding studies and theorizing on effort to show that the link between listening demand and listening effort is moderated by various variables. Moreover, I will present a recent study that examined the joint effect of listening demand and success importance on effort-related cardiovascular reactivity in an auditory discrimination task. Results for pre-ejection period reactivity—an indicator of sympathetic activity—supported the hypothesis that the relationship between listening demand and listening effort is moderated by other variables: Pre-ejection period reactivity was higher in the high-demand-high-success-importance condition than in the other three conditions. This new finding as well as the findings of previous research on effort suggest that a broader perspective on the determinants of listening effort is warranted

Hearing impairment and cognitive energy: The Framework for Understanding Effortful Listening (FUEL)

The Fifth Eriksholm Workshop on “Hearing Impairment and Cognitive Energy” was convened to develop a consensus amongst interdisciplinary experts about what is known on the topic, gaps in knowledge, the use of terminology, priorities for future research and implications for practice. The general term cognitive energy was chosen to facilitate the broadest possible discussion of the topic. It goes back to Titchener (1908) who described the effects of attention on perception; he used the term psychic energy for the notion that limited mental resources can be flexibly allocated among perceptual and mental activities. The workshop focused on three main areas: 1) theories, models, concepts, definitions, and frameworks; 2) methods and measures; and 3) knowledge translation. We defined effort as the deliberate allocation of mental resources to overcome obstacles in goal pursuit when carrying out a task, with listening effort applying more specifically when tasks involve listening. We adapted Kahneman’s seminal (1973) Capacity Model of Attention to listening and proposed a heuristically useful Framework for Understanding Effortful Listening (FUEL). Our FUEL incorporates the well-known relationship between cognitive demand and the supply of cognitive capacity that is the foundation of cognitive theories of attention. Our FUEL also incorporates a motivation dimension based on complementary theories of motivational intensity, adaptive gain control and optimal performance, fatigue, and pleasure. Using a 3D illustration, we highlight how listening effort depends not only on hearing difficulties and task demands, but also on the listener’s motivation to expend mental effort in the challenging situations of everyday life

The hidden effect of hearing acuity on speech recall, and compensatory effects of self-paced listening

OBJECTIVE: The purpose of this research was to determine whether negative effects of hearing loss on recall accuracy for spoken narratives can be mitigated by allowing listeners to control the rate of speech input. DESIGN: Paragraph-length narratives were presented for recall under two listening conditions in a within-participants design: presentation without interruption (continuous) at an average speech-rate of 150 words per minute; and presentation interrupted at periodic intervals at which participants were allowed to pause before initiating the next segment (self-paced). STUDY SAMPLE: Participants were 24 adults ranging from 21 to 33 years of age. Half had age-normal hearing acuity and half had mild-to-moderate hearing loss. The two groups were comparable for age, years of formal education, and vocabulary. RESULTS: When narrative passages were presented continuously, without interruption, participants with hearing loss recalled significantly fewer story elements, both main ideas and narrative details, than those with age-normal hearing. The recall difference was eliminated when the two groups were allowed to self-pace the speech input. CONCLUSION: Results support the hypothesis that the listening effort associated with reduced hearing acuity can slow processing operations and increase demands on working memory, with consequent negative effects on accuracy of narrative recall

Chronic Stroke Outcome Measures for Motor Function Intervention Trials: Expert Panel Recommendations.

BackgroundAbout half of survivors with stroke experience severe and significant long-term disability. The purpose of this article is to review the state of the science and to make recommendations for measuring patient-centric outcomes in interventions for motor improvement in the chronic stroke phase.Methods and resultsA 9-member expert panel reviewed evidence to identify measures of upper and lower extremity function used to date as outcomes in trials with patients who experienced a stroke ≥6 months before assessment. Outcome measures were screened using StrokEDGE consensus panel recommendations, and evaluated for availability of a published minimal clinically important difference. Measures meeting these criteria were further evaluated with regard to their level of measurement, psychometric properties, and ability of minimal clinically important difference to capture gains associated with improved function and clinical relevance to patients, to arrive at recommendations. A systematic literature review yielded 115 clinical trials of upper and lower extremity function in chronic stroke that used a total of 34 outcome measures. Seven of these had published minimal clinically important differences and were recommended or highly recommended by StrokEDGE. Those are the Fugl-Meyer Upper Extremity and Lower Extremity scales, Wolf Motor Function Test, Action Research Arm Test, Ten-Meter and Six-Minute Walk Tests, and the Stroke Impact Scale. All had evidence for their psychometric performance, although the strength of evidence for validity varied, especially in populations with chronic stroke Fugl-Meyer Upper and Lower Extremity scales showing the strongest evidence for validity.ConclusionsThe panel recommends that the Fugl-Meyer Upper and Lower Extremity scales be used as primary outcomes in intervention trials targeting motor function in populations with chronic stroke. The other 6 measures are recommended as secondary outcomes