Speech-in-noise representation in the aging midbrain and cortex: Effects of hearing loss.

Age-related deficits in speech-in-noise understanding pose a significant problem for older adults. Despite the vast number of studies conducted to investigate the neural mechanisms responsible for these communication difficulties, the role of central auditory deficits, beyond peripheral hearing loss, remains unclear. The current study builds upon our previous work that investigated the effect of aging on normal-hearing individuals and aims to estimate the effect of peripheral hearing loss on the representation of speech in noise in two critical regions of the aging auditory pathway: the midbrain and cortex. Data from 14 hearing-impaired older adults were added to a previously published dataset of 17 normal-hearing younger adults and 15 normal-hearing older adults. The midbrain response, measured by the frequency-following response (FFR), and the cortical response, measured with the magnetoencephalography (MEG) response, were recorded from subjects listening to speech in quiet and noise conditions at four signal-to-noise ratios (SNRs): +3, 0, -3, and -6 dB sound pressure level (SPL). Both groups of older listeners showed weaker midbrain response amplitudes and overrepresentation of cortical responses compared to younger listeners. No significant differences were found between the two older groups when the midbrain and cortical measurements were analyzed independently. However, significant differences between the older groups were found when investigating the midbrain-cortex relationships; that is, only hearing-impaired older adults showed significant correlations between midbrain and cortical measurements, suggesting that hearing loss may alter reciprocal connections between lower and higher levels of the auditory pathway. The overall paucity of differences in midbrain or cortical responses between the two older groups suggests that age-related temporal processing deficits may contribute to older adults' communication difficulties beyond what might be predicted from peripheral hearing loss alone; however, hearing loss does seem to alter the connectivity between midbrain and cortex. These results may have important ramifications for the field of audiology, as it indicates that algorithms in clinical devices, such as hearing aids, should consider age-related temporal processing deficits to maximize user benefit.