Speech recognition in noise and presbycusis: relations to possible neural mechanisms.

This study is part of ongoing efforts to characterize and determine the neural bases of presbycusis. These efforts utilize humans and animals in sets of overlapping hypotheses and experiments. Here, 50 young adult and elderly subjects, with normal audiometric thresholds or high-frequency hearing loss, were presented three types of linguistic materials at suprathreshold levels to determine speech recognition performance in noise. The study sought to determine how peripheral and central auditory system dysfunctions might be implicated in the speech recognition problems of elderly humans. There were four main findings. (1) Peripheral auditory nervous system pathologies, manifested as reduced sensitivity for speech-frequency pure tones and speech materials, contribute to elevated speech reception thresholds in quiet, and to reduced speech recognition in noise. (2) Good cognitive ability was demonstrated in the old subjects who took advantage of supportive context as well or better than young subjects, strongly indicating that the cortical portions of the speech/language nervous system did not account for the speech understanding dysfunctions of the old subjects. (3) When audibility and cognitive functioning were not affected, the demonstrated speech-recognition in-noise dysfunction remained in old subjects. This implicates auditory brainstem or auditory cortex temporal-resolution dysfunctions in accounting for the observed differences in speech processing. (4) Performance differences between young and elderly subjects with elevated thresholds illustrate the effects of age plus hearing loss and thereby implicate both peripheral and central dysfunctions in presbycusics. This is because the differences in performance between young and elderly subjects with normal peripheral sensitivity identified a central auditory dysfunction.