Cochlear Implants and Listening Effort: the Interaction of Cognitive and Sensory Constraints

NCT ID: NCT07279441

Last Updated: 2025-12-12

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Clinical Phase

NA

Total Enrollment

460 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-01-02

Study Completion Date

2030-01-02

Brief Summary

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This study examines how cochlear implant users understand and comprehend speech in realistic communication situations. Through six experiments measuring listening effort via pupillometry and discourse comprehension, we will investigate how linguistic context, cognitive demands, and processing time affect speech understanding in CI users, and in normal-hearing controls) to identify factors underlying communication resilience versus vulnerability and develop improved, ecologically valid assessment and rehabilitation strategies.

Detailed Description

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This research study examines how adults using cochlear implants (CIs) understand and comprehend speech in realistic communication situations. While current clinical tests focus on how well CI users can recognize single words and simple sentences, this study investigates whether success in recognizing speech sounds actually translates to understanding the meaning and content of longer conversations and discourse.

The study will include six interconnected experiments examining: (1) how CI users use linguistic context (both adaptively and maladaptively) to understand degraded speech; (2) how listening effort affects comprehension when faced with communicative challenges like remembering multiple sentences or narratives; (3) whether giving listeners control over the speed of speech presentation improves comprehension; and (4) a clinically-applicable version of these assessments.

Throughout the experiments, researchers will measure listening effort using pupillometry (tracking pupil dilation as an index of cognitive effort) combined with behavioral measures of speech recognition and comprehension. Comprehension will be assessed using a validated framework that distinguishes between understanding main ideas versus minor details in discourse passages.

The study will include cochlear implant users and normal-hearing adults listening to degraded speech simulations via vocoders. Participants will range in age from 18 to 80 years. A comprehensive baseline battery will assess perceptual abilities (speech recognition, spectral resolution, temporal processing) and cognitive abilities (working memory, processing speed, executive function).

OBJECTIVES:

Primary objectives are to identify mechanisms underlying successful speech comprehension in CI users and to determine factors associated with resilience versus vulnerability to communicative challenges. Secondary objectives include examining relationships between cognitive abilities, listening effort, and discourse comprehension outcomes.

OUTCOMES:

This research is expected to provide more ecologically valid assessment methods for CI users, identify which individuals may benefit from specific communication strategies (such as self-paced speech), and inform development of improved rehabilitation approaches that enhance real-world communication success rather than just word recognition ability.

Conditions

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Cochlear Implant Users

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

OTHER

Blinding Strategy

NONE

Study Groups

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Cochlear Implant Users

Postlingually deaf adults (age 18-80) with at least one year of CI experience. Participants will complete behavioral speech perception and comprehension tasks with pupillometry measurement.

Group Type EXPERIMENTAL

Experiment 2: False Hearing and Context Overuse

Intervention Type BEHAVIORAL

* Two-choice word recognition task with semantic priming/luring in multi-talker babble
* Three Signal-to-Noise Ratio (SNR) levels (heavy, medium, light noise)
* Confidence ratings for responses
* Pupillometry measurement

Experiment 3: Two-Sentence Problem

Intervention Type BEHAVIORAL

* Speech recognition and recall of single sentences vs. paired sentences
* Manipulation of inter-sentence semantic predictability (high vs. low)
* Four test conditions: 1-sentence, 2-sentences, 2-sentences+pre-prompt, 2-sentences+post-prompt
* Pupillometry during task

Experiment 4: Cascading Effects on Discourse Comprehension

Intervention Type BEHAVIORAL

* Recall of 27 narrative passages (67-97 words each)
* Propositional analysis scoring (main ideas, mid-level ideas, details)
* Measurement of semantic hierarchy effect
* Pupillometry during listening

Experiment 5: Self-Paced Discourse Comprehension

Intervention Type BEHAVIORAL

* 24 discourse passages (150 words each): 12 narrative, 12 expository
* Continuous presentation vs. self-paced presentation (stops at clause/sentence boundaries)
* Measurement of pause times and comprehension recall
* Pupillometry during task

Experiment 6: Clinical Application

Intervention Type BEHAVIORAL

* Self-Paced Sentence Comprehension
* Sentences with varying syntactic complexity (active-conjoined, subject-relative, object-relative)
* Continuous vs. self-paced (with pause at major clause boundary) presentation
* True/false comprehension verification statements
* Pupillometry measurement

Experiment 1: Syntactic and Semantic Context

Intervention Type BEHAVIORAL

* Recall of meaningful sentences, anomalous word strings, and unstructured word lists
* Measurement of syntactic and semantic gain
* Pupillometry during auditory and visual presentation

Normal-Hearing Controls (Vocoder Simulation)

Normal-hearing adults (age 18-80) listening to degraded speech via 4- and 8-channel vocoders. Participants will complete the same behavioral tasks as CI users but with (or without) acoustically degraded speech simulation.

Group Type ACTIVE_COMPARATOR

Experiment 2: False Hearing and Context Overuse

Intervention Type BEHAVIORAL

* Two-choice word recognition task with semantic priming/luring in multi-talker babble
* Three Signal-to-Noise Ratio (SNR) levels (heavy, medium, light noise)
* Confidence ratings for responses
* Pupillometry measurement

Experiment 3: Two-Sentence Problem

Intervention Type BEHAVIORAL

* Speech recognition and recall of single sentences vs. paired sentences
* Manipulation of inter-sentence semantic predictability (high vs. low)
* Four test conditions: 1-sentence, 2-sentences, 2-sentences+pre-prompt, 2-sentences+post-prompt
* Pupillometry during task

Experiment 4: Cascading Effects on Discourse Comprehension

Intervention Type BEHAVIORAL

* Recall of 27 narrative passages (67-97 words each)
* Propositional analysis scoring (main ideas, mid-level ideas, details)
* Measurement of semantic hierarchy effect
* Pupillometry during listening

Experiment 5: Self-Paced Discourse Comprehension

Intervention Type BEHAVIORAL

* 24 discourse passages (150 words each): 12 narrative, 12 expository
* Continuous presentation vs. self-paced presentation (stops at clause/sentence boundaries)
* Measurement of pause times and comprehension recall
* Pupillometry during task

Experiment 6: Clinical Application

Intervention Type BEHAVIORAL

* Self-Paced Sentence Comprehension
* Sentences with varying syntactic complexity (active-conjoined, subject-relative, object-relative)
* Continuous vs. self-paced (with pause at major clause boundary) presentation
* True/false comprehension verification statements
* Pupillometry measurement

Experiment 1: Syntactic and Semantic Context

Intervention Type BEHAVIORAL

* Recall of meaningful sentences, anomalous word strings, and unstructured word lists
* Measurement of syntactic and semantic gain
* Pupillometry during auditory and visual presentation

Interventions

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Experiment 2: False Hearing and Context Overuse

* Two-choice word recognition task with semantic priming/luring in multi-talker babble
* Three Signal-to-Noise Ratio (SNR) levels (heavy, medium, light noise)
* Confidence ratings for responses
* Pupillometry measurement

Intervention Type BEHAVIORAL

Experiment 3: Two-Sentence Problem

* Speech recognition and recall of single sentences vs. paired sentences
* Manipulation of inter-sentence semantic predictability (high vs. low)
* Four test conditions: 1-sentence, 2-sentences, 2-sentences+pre-prompt, 2-sentences+post-prompt
* Pupillometry during task

Intervention Type BEHAVIORAL

Experiment 4: Cascading Effects on Discourse Comprehension

* Recall of 27 narrative passages (67-97 words each)
* Propositional analysis scoring (main ideas, mid-level ideas, details)
* Measurement of semantic hierarchy effect
* Pupillometry during listening

Intervention Type BEHAVIORAL

Experiment 5: Self-Paced Discourse Comprehension

* 24 discourse passages (150 words each): 12 narrative, 12 expository
* Continuous presentation vs. self-paced presentation (stops at clause/sentence boundaries)
* Measurement of pause times and comprehension recall
* Pupillometry during task

Intervention Type BEHAVIORAL

Experiment 6: Clinical Application

* Self-Paced Sentence Comprehension
* Sentences with varying syntactic complexity (active-conjoined, subject-relative, object-relative)
* Continuous vs. self-paced (with pause at major clause boundary) presentation
* True/false comprehension verification statements
* Pupillometry measurement

Intervention Type BEHAVIORAL

Experiment 1: Syntactic and Semantic Context

* Recall of meaningful sentences, anomalous word strings, and unstructured word lists
* Measurement of syntactic and semantic gain
* Pupillometry during auditory and visual presentation

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* Subjects will be otherwise healthy normal-hearing and cochlear implant (CI) adult listeners (between 18 and 80 years old).

Exclusion Criteria

* Individuals below 18 years of age.
* Individuals with evidence of neurologic, vascular or psychiatric disease or dementia, and taking medications that might interfere with task performance.
* Individuals with a history of language disorders (besides those associated with hearing loss for the CI users). Individuals who are non-native speakers of American English.
Minimum Eligible Age

18 Years

Maximum Eligible Age

80 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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National Institute on Deafness and Other Communication Disorders (NIDCD)

NIH

Sponsor Role collaborator

NYU Langone Health

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Mario A. Svirsky, PhD

Role: PRINCIPAL_INVESTIGATOR

NYU Langone Health

Locations

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Brandeis University

Waltham, Massachusetts, United States

Site Status RECRUITING

NYU Langone Health

New York, New York, United States

Site Status RECRUITING

Countries

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United States

Central Contacts

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Mario A. Svirsky, PhD

Role: CONTACT

212-263-7217

Nicole Capach

Role: CONTACT

646-501-6905

Other Identifiers

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2R01DC016834-06A1

Identifier Type: NIH

Identifier Source: secondary_id

View Link

18-01806

Identifier Type: -

Identifier Source: org_study_id

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