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Although it is clear that sighted listeners use both auditory and visual cues during speech perception, the manner in which multisensory information is combined is a matter of active debate. One approach to measuring multisensory integration is to use variants of the McGurk illusion, in which discrepant auditory and visual cues produce auditory percepts that differ from those based solely on unimodal input. Not all listeners show the same degree of susceptibility to the McGurk illusion, and these individual differences in susceptibility are frequently used as a measure of audiovisual integration ability. However, despite their popularity, we argue that McGurk tasks are ill-suited for studying the kind of multisensory speech perception that occurs in real life: McGurk stimuli are often based on isolated syllables (which are rare in conversations) and necessarily rely on audiovisual incongruence that does not occur naturally. Furthermore, recent data show that susceptibility on McGurk tasks does not correlate with performance during natural audiovisual speech perception. Although the McGurk effect is a fascinating illusion, truly understanding the combined use of auditory and visual information during speech perception requires tasks that more closely resemble everyday communication: namely, words, sentences, and stories with congruent auditory and visual speech cues.

Little is known about residual cognitive function in the earliest stages of serious brain injury. Functional neuroimaging has yielded valuable diagnostic and prognostic information in chronic disorders of consciousness, such as the vegetative state (also termed unresponsive wakefulness syndrome). The objective of the current study was to determine if functional neuroimaging could be efficacious in the assessment of cognitive function in acute disorders of consciousness, such as coma, where decisions about the withdrawal of life-sustaining therapies are often made.A hierarchical functional magnetic resonance imaging (fMRI) approach assessed sound perception, speech perception, language comprehension, and covert command following in 17 critically ill patients admitted to the intensive care unit (ICU).Preserved auditory function was observed in 15 patients (88%), whereas 5 (29%) also had preserved higher-order language comprehension. Notably, one patient could willfully modulate his brain activity when instructed to do so, suggesting a level of covert conscious awareness that was entirely inconsistent with his clinical diagnosis at the time of the scan. Across patients, a positive relationship was also observed between fMRI responsivity and the level of functional recovery, such that patients with the greatest functional recovery had neural responses most similar to those observed in healthy control participants.These results suggest that fMRI may provide important diagnostic and prognostic information beyond standard clinical assessment in acutely unresponsive patients, which may aid discussions surrounding the continuation or removal of life-sustaining therapies during the early post-injury period. ANN NEUROL 2022.

Sensory deprivation can lead to cross-modal cortical changes, whereby sensory brain regions deprived of input may be recruited to perform atypical function. Enhanced cross-modal responses to visual stimuli observed in auditory cortex of postlingually deaf cochlear implant (CI) users are hypothesized to reflect increased activation of cortical language regions, but it is unclear if this cross-modal activity is “adaptive” or “mal-adaptive” for speech understanding. To determine if increased activation of language regions is correlated with better speech understanding in CI users, we assessed task-related activation and functional connectivity of auditory and visual cortices to auditory and visual speech and non-speech stimuli in CI users (n = 14) and normal-hearing listeners (n = 17) and used functional near-infrared spectroscopy to measure hemodynamic responses. We used visually presented speech and non-speech to investigate neural processes related to linguistic content and observed that CI users show beneficial cross-modal effects. Specifically, an increase in connectivity between the left auditory and visual cortices—presumed primary sites of cortical language processing—was positively correlated with CI users’ abilities to understand speech in background noise. Cross-modal activity in auditory cortex of postlingually deaf CI users may reflect adaptive activity of a distributed, multimodal speech network, recruited to enhance speech understanding.

We present a response to Calzavarini (2023) arguing that modality-specificity is not a necessary condition for grounded semantic cognition. Modality-specific perceptuomotor simulations scaffold word and object meaning. We argue that the question of whether these simulations are executed by primary sensory regions, networks, or association cortices is not essential for grounded semantic theories.

Face masks offer essential protection but also interfere with speech communication. Here, audio-only sentences spoken through four types of masks were presented in noise to young adult listeners. Pupil dilation (an index of cognitive demand), intelligibility, and subjective effort and performance ratings were collected. Dilation increased significantly in response to each mask relative to the no-mask condition and differed among mask types. These results suggest that the acoustic impact of the mask drives not only the intelligibility of speech, but also the cognitive demands of listening. Subjective effort ratings reflected but did not correlate with pupillometry data.

The potential negative impact of head movement during fMRI has long been appreciated. Although a variety of prospective and retrospective approaches have been developed to help mitigate these effects, reducing head movement in the first place remains the most appealing strategy for optimizing data quality. Real-time interventions, in which participants are provided feedback regarding their scan-to-scan motion, have recently shown promise in reducing motion during resting state fMRI. However, whether feedback might similarly reduce motion during task-based fMRI is an open question. In particular, it is unclear whether participants can effectively monitor motion feedback while attending to task-related demands. Here we assessed whether a combination of real-time and between-run feedback could reduce head motion during task-based fMRI. During an auditory word repetition task, 78 adult participants (aged 18–81) were pseudorandomly assigned to receive feedback, implemented in FIRMM software, or not. We quantified movement using framewise displacement (FD). We found that motion feedback resulted in a statistically significant reduction in participant head motion, with a small-to-moderate effect size (reducing average FD from 0.347 to 0.282). There was some evidence for a change of effect over the course of six runs, but no clear evidence for practice effects based on motion feedback. We conclude that under some circumstances real-time feedback may reduce head motion during task-based fMRI, although its effectiveness may depend on the specific participant population and task demands of a given study.

Subject motion during fMRI can affect our ability to accurately measure signals of interest. In recent years, frame censoring-that is, statistically excluding motion-contaminated data within the general linear model using nuisance regressors-has appeared in several task-based fMRI studies as a mitigation strategy. However, there have been few systematic investigations quantifying its efficacy. In the present study, we compared the performance of frame censoring to several other common motion correction approaches for task-based fMRI using open data and reproducible workflows. We analyzed eight publicly available datasets representing 11 distinct tasks in child, adolescent, and adult participants. Performance was quantified using maximum

Stable individual differences in cognitive motivation (i.e., the tendency to engage in and enjoy effortful cognitive activities) have been documented with self-report measures, yet convergent support for a trait-level construct is still lacking. In the present study, we use an innovative decision-making paradigm (COG-ED) to quantify the costs of cognitive effort, a metric of cognitive motivation, across two distinct cognitive domains (working memory and speech comprehension). We hypothesize that cognitive motivation operates similarly within individuals, regardless of domain. Specifically, we test whether individual differences in effort costs are stable across domains, even after controlling for other potential sources of shared individual variation. Conversely, we evaluate whether the costs of cognitive effort across domains may be better explained in terms of other relevant cognitive and personality-related constructs, such as working memory capacity or reward sensitivity.

Issue Online: 08 June 2023 Pupillometry has a rich history in the study of perception and cognition. One perennial challenge is that the magnitude of the task-evoked pupil response diminishes over the course of an experiment, a phenomenon we refer to as a fatigue effect. Reducing fatigue effects may improve sensitivity to task effects and reduce the likelihood of confounds due to systematic physiological changes over time. In this paper, we investigated the degree to which fatigue effects could be ameliorated by experimenter intervention. In Experiment 1, we assigned participants to one of three groups—no breaks, kinetic breaks (playing with toys, but no social interaction), or chatting with a research assistant—and compared the pupil response across conditions. In Experiment 2, we additionally tested the effect of researcher observation. Only breaks including social interaction significantly reduced the fatigue of the pupil response across trials. However, in all conditions we found robust evidence for fatigue effects: that is, regardless of protocol, the task-evoked pupil response was substantially diminished (at least 60%) over the duration of the experiment. We account for the variance of fatigue effects in our pupillometry data using multiple common statistical modeling approaches (e.g., linear mixed-effects models of peak, mean, and baseline pupil diameters, as well as growth curve models of time-course data). We conclude that pupil attenuation is a predictable phenomenon that should be accommodated in our experimental designs and statistical models. Agencia Estatal de Investigación, Grant/Award Number: CEX2020-001010- S; Eusko Jaurlaritza; National Institutes of Health, Grant/ Award Number: R01 DC014281 and R01 DC019507; National Science Foundation, Grant/Award Number: DGE-1745038

Life-long engagement in cognitively demanding activities may mitigate against declines in cognitive ability observed in healthy or pathological aging. However, the “mental costs” associated with completing cognitive tasks also increases with age and may be partly attributed to increases in preclinical levels of Alzheimer disease (AD) pathology. We test whether cognitive costs increase in a domain-general fashion in older adults, and further, whether such age-related increases in cognitive effort cost are associated with amyloid burden, a signature pathology of AD. In two experiments, we administered an objective measure of cognitive effort (Cognitive Effort Discounting: COG-ED) to a sample of older adults recruited from online sources (Experiment 1) or from ongoing longitudinal studies of aging and dementia (Experiment 2). Experiment 1 compared age-related differences in cognitive effort across two distinct domains, working memory and speech comprehension. Experiment 2 compared cognitive costs between a group of participants who were rated positive for amyloid burden relative to those who had no evidence of amyloid. Results showed age-related increases in cognitive effort cost were evident in both domains. Cost estimates were highly correlated between the working memory and speech comprehension tasks and were present even when controlling for overall working memory capacity. In addition, older adults who were amyloid positive had higher cognitive cost estimates than those who were amyloid negative. Cognitive effort costs may index a domain-general trait that consistently increases in healthy aging. Differences in amyloid burden suggest a potential neurobiological mechanism for age-related increases in cost.

In everyday language processing, sentence context affects how readers and listeners process upcoming words. In experimental situations, it can be useful to identify words that are predicted to greater or lesser degrees by the preceding context. Here we report completion norms for 3085 English sentences, collected online using a written cloze procedure in which participants were asked to provide their best guess for the word completing a sentence. Sentences varied between eight and ten words in length. At least 100 unique participants contributed to each sentence. All responses were reviewed by human raters to mitigate the influence of mis-spellings and typographical errors. The responses provide a range of predictability values for 13,438 unique target words, 6790 of which appear in more than one sentence context. We also provide entropy values based on the relative predictability of multiple responses. A searchable set of norms is available at http://sentencenorms.net. Finally, we provide the code used to collate and organize the responses to facilitate additional analyses and future research projects.

In everyday conversation, we usually process the talker's face as well as the sound of the talker's voice. Access to visual speech information is particularly useful when the auditory signal is degraded. Here, we used fMRI to monitor brain activity while adult humans (n= 60) were presented with visual-only, auditory-only, and audiovisual words. The audiovisual words were presented in quiet and in several signal-to-noise ratios. As expected, audiovisual speech perception recruited both auditory and visual cortex, with some evidence for increased recruitment of premotor cortex in some conditions (including in substantial background noise). We then investigated neural connectivity using psychophysiological interaction analysis with seed regions in both primary auditory cortex and primary visual cortex. Connectivity between auditory and visual cortices was stronger in audiovisual conditions than in unimodal conditions, including a wide network of regions in posterior temporal cortex and prefrontal cortex. In addition to whole-brain analyses, we also conducted a region-of-interest analysis on the left posterior superior temporal sulcus (pSTS), implicated in many previous studies of audiovisual speech perception. We found evidence for both activity and effective connectivity in pSTS for visual-only and audiovisual speech, although these were not significant in whole-brain analyses. Together, our results suggest a prominent role for cross-region synchronization in understanding both visual-only and audiovisual speech that complements activity in integrative brain regions like pSTS.SIGNIFICANCE STATEMENTIn everyday conversation, we usually process the talker's face as well as the sound of the talker's voice. Access to visual speech information is particularly useful when the auditory signal is hard to understand (e.g., background noise). Prior work has suggested that specialized regions of the brain may play a critical role in integrating information from visual and auditory speech. Here, we show a complementary mechanism relying on synchronized brain activity among sensory and motor regions may also play a critical role. These findings encourage reconceptualizing audiovisual integration in the context of coordinated network activity.

BackgroundDifficulty understanding speech is a common complaint of older adults. In quiet, speech perception is often assumed to be relatively automatic. In background noise, however, higher-level cognitive processes play a more substantial role in successful communication. Cognitive resources are often limited in adults with dementia, which may therefore hamper word recognition. ObjectiveThe goal of this study was to determine the impact of mild dementia on spoken word recognition in quiet and noise.MethodsParticipants were adults aged 53–86 years with (n=16) or without (n=32) dementia symptoms as classified by a clinical dementia rating scale. Participants performed a word identification task with two levels of neighborhood density in quiet and in speech shaped noise at two signal-to-noise ratios (SNRs), +6 dB and +3 dB. Our hypothesis was that listeners with mild dementia would have more difficulty with speech perception in noise under conditions that tax cognitive resources. ResultsListeners with mild dementia had poorer speech perception accuracy in both quiet and noise, which held after accounting for differences in age and hearing level. Notably, even in quiet, adults with dementia symptoms correctly identified words only about 80% of the time. However, phonological neighborhood density was not a factor in the identification task performance for either group.ConclusionThese results affirm the difficulty that listeners with mild dementia have with spoken word recognition, both in quiet and in background noise, consistent with a key role of cognitive resources in spoken word identification. However, the impact of neighborhood density in these listeners is less clear.

Cochlear implants are neuroprosthetic devices that can restore hearing in people with severe to profound hearing loss by electrically stimulating the auditory nerve. Because of physical limitations on the precision of this stimulation, the acoustic information delivered by a cochlear implant does not convey the same level of acoustic detail as that conveyed by normal hearing. As a result, speech understanding in listeners with cochlear implants is typically poorer and more effortful than in listeners with normal hearing. The brain networks supporting speech understanding in listeners with cochlear implants are not well understood, partly due to difficulties obtaining functional neuroimaging data in this population. In the current study, we assessed the brain regions supporting spoken word understanding in adult listeners with right unilateral cochlear implants (n=20) and matched controls (n=18) using high-density diffuse optical tomography (HD-DOT), a quiet and non-invasive imaging modality with spatial resolution comparable to that of functional MRI. We found that while listening to spoken words in quiet, listeners with cochlear implants showed greater activity in left prefrontal cortex than listeners with normal hearing, specifically in a region engaged in a separate spatial working memory task. These results suggest that listeners with cochlear implants require greater cognitive processing during speech understanding than listeners with normal hearing, supported by compensatory recruitment of left prefrontal cortex.

Subject motion during fMRI can affect our ability to accurately measure signals of interest. In recent years, frame censoring—that is, statistically excluding motion-contaminated data within the general linear model using nuisance regressors—has appeared in several task-based fMRI studies as a mitigation strategy. However, there have been few systematic investigations quantifying its efficacy. In the present study, we compared the performance of frame censoring to several other common motion correction approaches for task-based fMRI using open data and reproducible workflows. We analyzed eight publicly-available datasets representing eleven distinct tasks in child, adolescent, and adult participants. Performance was quantified using maximum t-values in group analyses, and ROI-based mean activation and split-half reliability in single subjects. We compared frame censoring across several thresholds to the use of 6 and 24 canonical motion regressors, wavelet despiking, robust weighted least squares, and untrained ICA-based denoising, for a total of 240 separate analyses. Thresholds used to identify censored frames were based on both motion estimates (FD) and image intensity changes (DVARS). Relative to standard motion regressors, we found consistent improvements for modest amounts of frame censoring (e.g., 1–2% data loss), although these gains were frequently comparable to what could be achieved using other techniques. Importantly, no single approach consistently outperformed the others across all datasets and tasks. These findings suggest that the choice of a motion mitigation strategy depends on both the dataset and the outcome metric of interest.

In most contemporary activation-competition frameworks for spoken word recognition, candidate words compete against phonological “neighbors” with similar acoustic properties (e.g., “cap” vs. “cat”). Thus, processing words with more competitors should come at a greater cognitive cost than processing words with fewer competitors, due to increased demands for selecting the correct item and inhibiting incorrect candidates. Importantly, these processes should operate even in the absence of differences in accuracy. In the present study, we tested this proposal by examining differences in processing costs associated with neighborhood density for highly intelligible items presented in the absence of noise. A second goal was to examine whether the cognitive demands associated with increased neighborhood density were greater for older adults compared with young adults. Using pupillometry as an index of cognitive processing load, we compared the cognitive demands associated with spoken word recognition for words from dense and sparse neighborhoods, presented in quiet, for young (n = 67) and older (n = 69) adult listeners. Growth curve analysis of the pupil data indicated that older adults showed a greater evoked pupil response for spoken words than do young adults, consistent with increased cognitive load during spoken word recognition. Words from dense neighborhoods were marginally more demanding to process than words from sparse neighborhoods. There was also an interaction between age and neighborhood density, indicating larger effects of density in young adult listeners. These results highlight the importance of assessing both cognitive demands and accuracy when investigating the mechanisms underlying spoken word recognition.

Importance Viral upper respiratory tract infections are a major cause of olfactory loss. Olfactory training (OT) is a promising intervention for smell restoration; however, a mechanistic understanding of the changes in neural plasticity induced by OT is absent. Objective To evaluate functional brain connectivity in adults with postviral olfactory dysfunction (PVOD) before and after OT using resting-state functional magnetic resonance imaging. Design, Setting, and Participants This prospective cohort study, conducted from September 1, 2017, to November 30, 2019, recruited adults with clinically diagnosed or self-reported PVOD of 3 months or longer. Baseline olfaction was measured using the University of Pennsylvania Smell Identification Test (UPSIT) and the Sniffin’ Sticks test. Analysis was performed between December 1, 2020, and July 1, 2020. Interventions Participants completed 12 weeks of OT using 4 essential oils: rose, eucalyptus, lemon, and clove. The resting-state functional magnetic resonance imaging measurements were obtained before and after intervention. Main Outcome and Measures The primary outcome measure was the change in functional brain connectivity before and after OT. Secondary outcome measures included changes in UPSIT and Sniffin’ Sticks test scores, as well as patient-reported changes in treatment response as measured by subjective changes in smell and quality-of-life measures. Results A total of 16 participants with PVOD (11 female [69%] and 14 White [88%]; mean [SD] age, 60.0 [10.5] years; median duration of smell loss, 12 months [range, 3-240 months]) and 20 control participants (15 [75%] female; 17 [85%] White; mean [SD] age, 55.0 [9.2] years; median UPSIT score, 37 [range, 34-39]) completed the study. At baseline, participants had increased connectivity within the visual cortex when compared with normosmic control participants, a connection that subsequently decreased after OT. Furthermore, 4 other network connectivity values were observed to change after OT, including an increase in connectivity between the left parietal occipital junction, a region of interest associated with olfactory processing, and the cerebellum. Conclusions and Relevance The use of OT is associated with connectivity changes within the visual cortex. This case-control cohort study suggests that there is a visual connection to smell that has not been previously explored with OT and that further studies examining the efficacy of a bimodal visual and OT program are needed.

Stable individual differences in cognitive motivation (i.e., the tendency to engage in and enjoy effortful cognitive activities) have been documented with self-report measures, yet convergent support for a trait-level construct is still lacking. In the present study, we used an innovative decision-making paradigm (COG-ED) to quantify the costs of cognitive effort, a metric of cognitive motivation, across two distinct cognitive domains: working memory (an N-back task) and speech comprehension (understanding spoken sentences in background noise). We hypothesized that cognitive motivation operates similarly within individuals, regardless of domain. Specifically, in 104 adults aged 18–40 years, we tested whether individual differences in effort costs are stable across domains, even after controlling for other potential sources of shared individual variation. Conversely, we evaluated whether the costs of cognitive effort across domains may be better explained in terms of other relevant cognitive and personality-related constructs, such as working memory capacity or reward sensitivity. We confirmed a reliable association among effort costs in both domains, even when these other sources of individual variation, as well as task load, are statistically controlled. Taken together, these results add support for trait-level variation in cognitive motivation impacting effort-based decision making across multiple domains.

Botvinik-Nezer, Rotem et al., Data analysis workflows in many scientific domains have become increasingly complex and flexible. Here we assess the effect of this flexibility on the results of functional magnetic resonance imaging by asking 70 independent teams to analyse the same dataset, testing the same 9 ex-ante hypotheses. The flexibility of analytical approaches is exemplified by the fact that no two teams chose identical workflows to analyse the data. This flexibility resulted in sizeable variation in the results of hypothesis tests, even for teams whose statistical maps were highly correlated at intermediate stages of the analysis pipeline. Variation in reported results was related to several aspects of analysis methodology. Notably, a meta-analytical approach that aggregated information across teams yielded a significant consensus in activated regions. Furthermore, prediction markets of researchers in the field revealed an overestimation of the likelihood of significant findings, even by researchers with direct knowledge of the dataset. Our findings show that analytical flexibility can have substantial effects on scientific conclusions, and identify factors that may be related to variability in the analysis of functional magnetic resonance imaging. The results emphasize the importance of validating and sharing complex analysis workflows, and demonstrate the need for performing and reporting multiple analyses of the same data. Potential approaches that could be used to mitigate issues related to analytical variability are discussed., European Union’s Horizon 2020 research and innovation programme (https://ec.europa.eu/programmes/horizon2020/en) under the Marie Skłodowska-Curie grant agreement no. 665501. A. Eed was supported by a predoctoral fellowship La Caixa-Severo Ochoa from Obra Social La Caixa. S.B.E. was supported by the European Union’s Horizon 2020 Research and Innovation Programme under grant agreement no. 785907 (HBP SGA2).

The meanings of most open class words are suffused with sensory and affective features. A word such as beach, for example, evokes polymodal associations ranging from gritty sand (tactile) and crashing waves (auditory) to the distinctive smell of sunscreen (olfactory). Aristotle argued for a hierarchy of the senses where vision and audition eclipse the lesser modalities of odor, taste, and touch. A direct test of Aristotle's premise was recently made possible with the establishment of the Lancaster Sensorimotor Norms (2019), a crowdsourced database cataloging sensorimotor salience for nearly 40,000 English words. Neurosynth, a metanalytic database of functional magnetic resonance imaging studies, can potentially confirm if Aristotle's sensory hierarchy is reflected in functional activation within the human brain. We correlated sensory salience of English words as assessed by subjective ratings of vision, audition, olfaction, touch, and gustation (Lancaster Ratings) with volumes of cortical activation for each of these respective sensory modalities (Neurosynth). English word ratings reflected the following sensory hierarchy: vision > audition > haptic > olfaction ≈ gustation. This linguistic hierarchy nearly perfectly correlated with voxel counts of functional activation maps by each sensory modality (Pearson r=.99). These findings are grossly consistent with Aristotle's hierarchy of the senses. We discuss implications and counterevidence from other natural languages.

PurposeObjective measures of listening effort have been gaining prominence, as they provide metrics to quantify the difficulty of understanding speech under a variety of circumstances. A key challenge has been to develop paradigms that enable the complementary measurement of subjective listening effort in a quantitatively precise manner. In this study, we introduce a novel decision-making paradigm to examine age-related and individual differences in subjective effort during listening.MethodOlder and younger adults were presented with spoken sentences mixed with speech-shaped noise at multiple signal-to-noise ratios (SNRs). On each trial, subjects were offered the choice between completing an easier listening trial (presented at +20 dB SNR) for a smaller monetary reward and completing a harder listening trial (presented at either +4, 0, −4, −8, or −12 dB SNR) for a greater monetary reward. By varying the amount of the reward offered for the easier option, the subjective value of performing effortful listening trials at each SNR could be assessed.ResultsOlder adults discounted the value of effortful listening to a greater degree than young adults, opting to accept less money in order to avoid more difficult SNRs. Additionally, older adults with poorer hearing and smaller working memory capacities were more likely to choose easier trials; however, in younger adults, no relationship with hearing or working memory was found. Self-reported measures of economic status did not affect these relationships.ConclusionsThese findings suggest that subjective listening effort depends on factors including, but not necessarily limited to, hearing and working memory. Additionally, this study demonstrates that economic decision-making paradigms can be a useful approach for assessing subjective listening effort and may prove beneficial in future research.

Neural correlates of speech perception is poorly understood in listeners with Cochlear implants (CIs) due to contraindications with fMRI. Here, we measure cortical activity during speech perception in CI recipients using high-density diffuse optical tomography.

This study assessed the effects of age, word frequency, and background noise on the time course of lexical activation during spoken word recognition. Participants (41 young adults and 39 older adults) performed a visual world word recognition task while we monitored their gaze position. On each trial, four phonologically unrelated pictures appeared on the screen. A target word was presented auditorily following a carrier phrase (“Click on ________”), at which point participants were instructed to use the mouse to click on the picture that corresponded to the target word. High- and low-frequency words were presented in quiet to half of the participants. The other half heard the words in a low level of noise in which the words were still readily identifiable. Results showed that, even in the absence of phonological competitors in the visual array, high-frequency words were fixated more quickly than low-frequency words by both listener groups. Young adults were generally faster to fixate on targets compared to older adults, but the pattern of interactions among noise, word frequency, and listener age showed that older adults’ lexical activation largely matches that of young adults in a modest amount of noise.

This article summarizes the presentations and recommendations of the tenth annual American Geriatrics Society and National Institute on Aging Bench-to-Bedside research conference, "Sensory Impairment and Cognitive Decline," on October 2-3, 2017, in Bethesda, Maryland. The risk of impairment in hearing, vision, and other senses increases with age, and almost 15% of individuals aged 70 and older have dementia. As the number of older adults increases, sensory and cognitive impairments will affect a growing proportion of the population. To limit its scope, this conference focused on sensory impairments affecting vision and hearing. Comorbid vision, hearing, and cognitive impairments in older adults are more common than would be expected by chance alone, suggesting that some common mechanisms might affect these neurological systems. This workshop explored the mechanisms and consequences of comorbid vision, hearing, and cognitive impairment in older adults; effects of sensory loss on the aging brain; and bench-to-bedside innovations and research opportunities. Presenters and participants identified many research gaps and questions; the top priorities fell into 3 themes: mechanisms, measurement, and interventions. The workshop delineated specific research questions that provide opportunities to improve outcomes in this growing population. J Am Geriatr Soc 66:2052-2058, 2018.

Everyday conversation frequently includes challenges to the clarity of the acoustic speech signal, including hearing impairment, background noise, and foreign accents. Although an obvious problem is the increased risk of making word identification errors, extracting meaning from a degraded acoustic signal is also cognitively demanding, which contributes to increased listening effort. The concepts of cognitive demand and listening effort are critical in understanding the challenges listeners face in comprehension, which are not fully predicted by audiometric measures. In this article, the authors review converging behavioral, pupillometric, and neuroimaging evidence that understanding acoustically degraded speech requires additional cognitive support and that this cognitive load can interfere with other operations such as language processing and memory for what has been heard. Behaviorally, acoustic challenge is associated with increased errors in speech understanding, poorer performance on concurrent secondary tasks, more difficulty processing linguistically complex sentences, and reduced memory for verbal material. Measures of pupil dilation support the challenge associated with processing a degraded acoustic signal, indirectly reflecting an increase in neural activity. Finally, functional brain imaging reveals that the neural resources required to understand degraded speech extend beyond traditional perisylvian language networks, most commonly including regions of prefrontal cortex, premotor cortex, and the cingulo-opercular network. Far from being exclusively an auditory problem, acoustic degradation presents listeners with a systems-level challenge that requires the allocation of executive cognitive resources. An important point is that a number of dissociable processes can be engaged to understand degraded speech, including verbal working memory and attention-based performance monitoring. The specific resources required likely differ as a function of the acoustic, linguistic, and cognitive demands of the task, as well as individual differences in listeners’ abilities. A greater appreciation of cognitive contributions to processing degraded speech is critical in understanding individual differences in comprehension ability, variability in the efficacy of assistive devices, and guiding rehabilitation approaches to reducing listening effort and facilitating communication. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.

The use of face masks recently has raised awareness about their effects on speech comprehension. In a series of two studies, we assess how different masks speech intelligibility and listening effort. In the first study, we compared four mask types in three noise levels for young and older adult listeners. Stimuli were presented audiovisually. Results showed that, in quiet, speech intelligibility was not greatly affected by any of the masks relative to no-mask conditions. However, in background noise, all masks reduced intelligibility. Masks with transparent windows and cloth masks with filters resulted in the lowest intelligibility scores, while surgical face masks had the least effect. Participants’ subjective effort ratings also reflect that comprehending speech through face masks requires greater effort. Overall, older adults’ listening effort ratings were higher and their intelligibility scores were lower. In the second study, we assess listening effort with pupillometry. We present the same stimuli to a group of young adults in six audio-only conditions: no-mask in quiet, no-mask in moderate noise, and four masks in moderate noise. In addition to intelligibility accuracy and pupil dilation, we also collect subjective effort and performance ratings, pure tone averages, and working memory performance scores.

Background The scientific understanding of tinnitus and its etiology has transitioned from thinking of tinnitus as solely a peripheral auditory problem to an increasing awareness that cortical networks may play a critical role in tinnitus percept or bother. With this change, studies that seek to use structural brain imaging techniques to better characterize tinnitus patients have become more common. These studies include using voxel-based morphometry (VBM) to determine if there are differences in regional gray matter volume in individuals who suffer from tinnitus and those who do not. However, studies using VBM in patients with tinnitus have produced inconsistent and sometimes contradictory results. Objective This paper is a systematic review of all of the studies to date that have used VBM to study regional gray matter volume in people with tinnitus, and explores ways in which methodological differences in these studies may account for their heterogeneous results. We also aim to provide guidance on how to conduct future studies using VBM to produce more reproducible results to further our understanding of disease processes such as tinnitus. Methods Studies about tinnitus and VBM were searched for using PubMed and Embase. These returned 15 and 25 results respectively. Of these, nine met the study criteria and were included for review. An additional 5 studies were identified in the literature as pertinent to the topic at hand and were added to the review, for a total of 13 studies. Results There was significant heterogeneity among the studies in several areas, including inclusion and exclusion criteria, software programs, and statistical analysis. We were not able to find publicly shared data or code for any study. Discussion The differences in study design, software analysis, and statistical methodology make direct comparisons between the different studies difficult. Especially problematic are the differences in the inclusion and exclusion criteria of the study, and the statistical design of the studies, both of which could radically alter findings. Thus, heterogeneity has complicated efforts to explore the etiology of tinnitus using structural MRI. Conclusion There is a pressing need to standardize the use of VBM when evaluating tinnitus patients. While some heterogeneity is expected given the rapid advances in the field, more can be done to ensure that there is internal validity between studies.