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Article: Can Haptic Stimulation Enhance Music Perception in Hearing-Impaired Listeners?

Fletcher, Mark D

2021 Volume 15, Page(s) 723877

Abstract: Cochlear implants (CIs) have been remarkably successful at restoring hearing in severely-to-profoundly hearing-impaired individuals. However, users often struggle to deconstruct complex auditory scenes with multiple simultaneous sounds, which can result ... ...

Abstract	Cochlear implants (CIs) have been remarkably successful at restoring hearing in severely-to-profoundly hearing-impaired individuals. However, users often struggle to deconstruct complex auditory scenes with multiple simultaneous sounds, which can result in reduced music enjoyment and impaired speech understanding in background noise. Hearing aid users often have similar issues, though these are typically less acute. Several recent studies have shown that haptic stimulation can enhance CI listening by giving access to sound features that are poorly transmitted through the electrical CI signal. This "electro-haptic stimulation" improves melody recognition and pitch discrimination, as well as speech-in-noise performance and sound localization. The success of this approach suggests it could also enhance auditory perception in hearing-aid users and other hearing-impaired listeners. This review focuses on the use of haptic stimulation to enhance music perception in hearing-impaired listeners. Music is prevalent throughout everyday life, being critical to media such as film and video games, and often being central to events such as weddings and funerals. It represents the biggest challenge for signal processing, as it is typically an extremely complex acoustic signal, containing multiple simultaneous harmonic and inharmonic sounds. Signal-processing approaches developed for enhancing music perception could therefore have significant utility for other key issues faced by hearing-impaired listeners, such as understanding speech in noisy environments. This review first discusses the limits of music perception in hearing-impaired listeners and the limits of the tactile system. It then discusses the evidence around integration of audio and haptic stimulation in the brain. Next, the features, suitability, and success of current haptic devices for enhancing music perception are reviewed, as well as the signal-processing approaches that could be deployed in future haptic devices. Finally, the cutting-edge technologies that could be exploited for enhancing music perception with haptics are discussed. These include the latest micro motor and driver technology, low-power wireless technology, machine learning, big data, and cloud computing. New approaches for enhancing music perception in hearing-impaired listeners could substantially improve quality of life. Furthermore, effective haptic techniques for providing complex sound information could offer a non-invasive, affordable means for enhancing listening more broadly in hearing-impaired individuals.
Language	English
Publishing date	2021-08-31
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2411902-7
ISSN	1662-453X ; 1662-4548
ISSN (online)	1662-453X
ISSN	1662-4548
DOI	10.3389/fnins.2021.723877
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Using haptic stimulation to enhance auditory perception in hearing-impaired listeners.

Fletcher, Mark D

Expert review of medical devices

2020 Volume 18, Issue 1, Page(s) 63–74

Abstract: Introduction: Hearing-assistive devices, such as hearing aids and cochlear implants, transform the lives of hearing-impaired people. However, users often struggle to locate and segregate sounds. This leads to impaired threat detection and an inability ... ...

Abstract	Introduction: Hearing-assistive devices, such as hearing aids and cochlear implants, transform the lives of hearing-impaired people. However, users often struggle to locate and segregate sounds. This leads to impaired threat detection and an inability to understand speech in noisy environments. Recent evidence suggests that segregation and localization can be improved by providing missing sound-information through haptic stimulation. Areas covered: This article reviews the evidence that haptic stimulation can effectively provide sound information. It then discusses the research and development required for this approach to be implemented in a clinically viable device. This includes discussion of what sound information should be provided and how that information can be extracted and delivered. Expert opinion: Although this research area has only recently emerged, it builds on a significant body of work showing that sound information can be effectively transferred through haptic stimulation. Current evidence suggests that haptic stimulation is highly effective at providing missing sound-information to cochlear implant users. However, a great deal of work remains to implement this approach in an effective wearable device. If successful, such a device could offer an inexpensive, noninvasive means of improving educational, work, and social experiences for hearing-impaired individuals, including those without access to hearing-assistive devices.
MeSH term(s)	Auditory Perception/physiology ; Hearing ; Humans ; Noise ; Persons With Hearing Impairments/rehabilitation ; Physical Stimulation ; Prosthesis Design ; Touch/physiology
Language	English
Publishing date	2020-12-29
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	2250857-0
ISSN	1745-2422 ; 1743-4440
ISSN (online)	1745-2422
ISSN	1743-4440
DOI	10.1080/17434440.2021.1863782
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Article: A Compact Two-Loudspeaker Virtual Sound Reproduction System for Clinical Testing of Spatial Hearing With Hearing-Assistive Devices.

Hamdan, Eric C / Fletcher, Mark D

Frontiers in neuroscience

2022 Volume 15, Page(s) 725127

Abstract: Exciting developments in hearing aid and cochlear implant technology for linking signal processing across the ears have improved spatial hearing outcomes. This has resulted in an increased emphasis on clinical assessment of the spatial hearing abilities ... ...

Abstract	Exciting developments in hearing aid and cochlear implant technology for linking signal processing across the ears have improved spatial hearing outcomes. This has resulted in an increased emphasis on clinical assessment of the spatial hearing abilities of hearing-assistive device users. Effective assessment of spatial hearing currently requires a large and costly loudspeaker array system, housed in a heavily acoustically treated testing room. This imposes economic and logistical constraints that limit proliferation of array systems, particularly in developing nations. Despite their size and cost, the ability of current clinical array systems to reproduce realistic spatial sound fields is limited, which substantially reduces the range of realistic acoustic scenes that can be used for diagnostic testing. We propose an alternative low-cost, compact virtual acoustics system with just two loudspeakers. This system uses crosstalk cancelation to reproduce pressure signals at the device microphones that match those for real-world sound sources. Furthermore, in contrast to clinical array systems, the system can adapt to different room acoustics, removing the requirement for a heavily acoustically treated testing environment. We conducted a proof-of-concept study in two stages: in the first, we evaluated the physical performance of the system for a stationary listener in anechoic conditions and in a small audiological testing booth with moderate acoustic treatment. To do this, a head and torso simulator was fitted with specially adapted hearing-assistive devices that allowed direct access to the microphone signals. These microphone signals were compared for real and virtual sound sources at numerous source locations. In the second stage, we quantified the system's robustness to head rotations with and without the system adapting for head position. In the stationary case, the system was found to be highly effective at reproducing signals, such as speech, at all tested source locations. When head rotation was added, it performed well for rotations of up to 2°, even without adapting. However, performance improved markedly for larger rotations when the system adapted. These findings suggest that a compact, low-cost virtual acoustics system can give wider access to advanced and ecologically valid audiological testing, which could substantially improve clinical assessment of hearing-assistive device users.
Language	English
Publishing date	2022-01-28
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2411902-7
ISSN	1662-453X ; 1662-4548
ISSN (online)	1662-453X
ISSN	1662-4548
DOI	10.3389/fnins.2021.725127
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Article ; Online: Improved tactile speech perception using audio-to-tactile sensory substitution with formant frequency focusing.

Fletcher, Mark D / Akis, Esma / Verschuur, Carl A / Perry, Samuel W

Scientific reports

2024 Volume 14, Issue 1, Page(s) 4889

Abstract: Haptic hearing aids, which provide speech information through tactile stimulation, could substantially improve outcomes for both cochlear implant users and for those unable to access cochlear implants. Recent advances in wide-band haptic actuator ... ...

Abstract	Haptic hearing aids, which provide speech information through tactile stimulation, could substantially improve outcomes for both cochlear implant users and for those unable to access cochlear implants. Recent advances in wide-band haptic actuator technology have made new audio-to-tactile conversion strategies viable for wearable devices. One such strategy filters the audio into eight frequency bands, which are evenly distributed across the speech frequency range. The amplitude envelopes from the eight bands modulate the amplitudes of eight low-frequency tones, which are delivered through vibration to a single site on the wrist. This tactile vocoder strategy effectively transfers some phonemic information, but vowels and obstruent consonants are poorly portrayed. In 20 participants with normal touch perception, we tested (1) whether focusing the audio filters of the tactile vocoder more densely around the first and second formant frequencies improved tactile vowel discrimination, and (2) whether focusing filters at mid-to-high frequencies improved obstruent consonant discrimination. The obstruent-focused approach was found to be ineffective. However, the formant-focused approach improved vowel discrimination by 8%, without changing overall consonant discrimination. The formant-focused tactile vocoder strategy, which can readily be implemented in real time on a compact device, could substantially improve speech perception for haptic hearing aid users.
MeSH term(s)	Humans ; Speech Perception ; Speech ; Touch ; Touch Perception ; Cochlear Implants
Language	English
Publishing date	2024-02-28
Publishing country	England
Document type	Journal Article
ZDB-ID	2615211-3
ISSN	2045-2322 ; 2045-2322
ISSN (online)	2045-2322
ISSN	2045-2322
DOI	10.1038/s41598-024-55429-3
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Article ; Online: Improving speech perception for hearing-impaired listeners using audio-to-tactile sensory substitution with multiple frequency channels.

Fletcher, Mark D / Verschuur, Carl A / Perry, Samuel W

Scientific reports

2023 Volume 13, Issue 1, Page(s) 13336

Abstract: Cochlear implants (CIs) have revolutionised treatment of hearing loss, but large populations globally cannot access them either because of disorders that prevent implantation or because they are expensive and require specialist surgery. Recent technology ...

Abstract	Cochlear implants (CIs) have revolutionised treatment of hearing loss, but large populations globally cannot access them either because of disorders that prevent implantation or because they are expensive and require specialist surgery. Recent technology developments mean that haptic aids, which transmit speech through vibration, could offer a viable low-cost, non-invasive alternative. One important development is that compact haptic actuators can now deliver intense stimulation across multiple frequencies. We explored whether these multiple frequency channels can transfer spectral information to improve tactile phoneme discrimination. To convert audio to vibration, the speech amplitude envelope was extracted from one or more audio frequency bands and used to amplitude modulate one or more vibro-tactile tones delivered to a single-site on the wrist. In 26 participants with normal touch sensitivity, tactile-only phoneme discrimination was assessed with one, four, or eight frequency bands. Compared to one frequency band, performance improved by 5.9% with four frequency bands and by 8.4% with eight frequency bands. The multi-band signal-processing approach can be implemented in real-time on a compact device, and the vibro-tactile tones can be reproduced by the latest compact, low-powered actuators. This approach could therefore readily be implemented in a low-cost haptic hearing aid to deliver real-world benefits.
MeSH term(s)	Humans ; Speech Perception ; Touch ; Hearing Loss/therapy ; Deafness ; Caffeine ; Niacinamide ; Hearing
Chemical Substances	Caffeine (3G6A5W338E) ; Niacinamide (25X51I8RD4)
Language	English
Publishing date	2023-08-16
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2615211-3
ISSN	2045-2322 ; 2045-2322
ISSN (online)	2045-2322
ISSN	2045-2322
DOI	10.1038/s41598-023-40509-7
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Article: Electro-Haptic Stimulation: A New Approach for Improving Cochlear-Implant Listening.

Fletcher, Mark D / Verschuur, Carl A

Frontiers in neuroscience

2021 Volume 15, Page(s) 581414

Abstract: Cochlear implants (CIs) have been remarkably successful at restoring speech perception for severely to profoundly deaf individuals. Despite their success, several limitations remain, particularly in CI users' ability to understand speech in noisy ... ...

Abstract	Cochlear implants (CIs) have been remarkably successful at restoring speech perception for severely to profoundly deaf individuals. Despite their success, several limitations remain, particularly in CI users' ability to understand speech in noisy environments, locate sound sources, and enjoy music. A new multimodal approach has been proposed that uses haptic stimulation to provide sound information that is poorly transmitted by the implant. This augmenting of the electrical CI signal with haptic stimulation (electro-haptic stimulation; EHS) has been shown to improve speech-in-noise performance and sound localization in CI users. There is also evidence that it could enhance music perception. We review the evidence of EHS enhancement of CI listening and discuss key areas where further research is required. These include understanding the neural basis of EHS enhancement, understanding the effectiveness of EHS across different clinical populations, and the optimization of signal-processing strategies. We also discuss the significant potential for a new generation of haptic neuroprosthetic devices to aid those who cannot access hearing-assistive technology, either because of biomedical or healthcare-access issues. While significant further research and development is required, we conclude that EHS represents a promising new approach that could, in the near future, offer a non-invasive, inexpensive means of substantially improving clinical outcomes for hearing-impaired individuals.
Language	English
Publishing date	2021-06-09
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2411902-7
ISSN	1662-453X ; 1662-4548
ISSN (online)	1662-453X
ISSN	1662-4548
DOI	10.3389/fnins.2021.581414
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Article ; Online: Improved tactile speech robustness to background noise with a dual-path recurrent neural network noise-reduction method.

Fletcher, Mark D / Perry, Samuel W / Thoidis, Iordanis / Verschuur, Carl A / Goehring, Tobias

Scientific reports

2024 Volume 14, Issue 1, Page(s) 7357

Abstract: Many people with hearing loss struggle to understand speech in noisy environments, making noise robustness critical for hearing-assistive devices. Recently developed haptic hearing aids, which convert audio to vibration, can improve speech-in-noise ... ...

Abstract	Many people with hearing loss struggle to understand speech in noisy environments, making noise robustness critical for hearing-assistive devices. Recently developed haptic hearing aids, which convert audio to vibration, can improve speech-in-noise performance for cochlear implant (CI) users and assist those unable to access hearing-assistive devices. They are typically body-worn rather than head-mounted, allowing additional space for batteries and microprocessors, and so can deploy more sophisticated noise-reduction techniques. The current study assessed whether a real-time-feasible dual-path recurrent neural network (DPRNN) can improve tactile speech-in-noise performance. Audio was converted to vibration on the wrist using a vocoder method, either with or without noise reduction. Performance was tested for speech in a multi-talker noise (recorded at a party) with a 2.5-dB signal-to-noise ratio. An objective assessment showed the DPRNN improved the scale-invariant signal-to-distortion ratio by 8.6 dB and substantially outperformed traditional noise-reduction (log-MMSE). A behavioural assessment in 16 participants showed the DPRNN improved tactile-only sentence identification in noise by 8.2%. This suggests that advanced techniques like the DPRNN could substantially improve outcomes with haptic hearing aids. Low-cost haptic devices could soon be an important supplement to hearing-assistive devices such as CIs or offer an alternative for people who cannot access CI technology.
MeSH term(s)	Humans ; Speech ; Speech Perception ; Hearing Loss/surgery ; Cochlear Implants ; Cochlear Implantation/methods ; Neural Networks, Computer
Language	English
Publishing date	2024-03-28
Publishing country	England
Document type	Journal Article
ZDB-ID	2615211-3
ISSN	2045-2322 ; 2045-2322
ISSN (online)	2045-2322
ISSN	2045-2322
DOI	10.1038/s41598-024-57312-7
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Haptic sound-localisation for use in cochlear implant and hearing-aid users.

Fletcher, Mark D / Zgheib, Jana

Scientific reports

2020 Volume 10, Issue 1, Page(s) 14171

Abstract: Users of hearing-assistive devices often struggle to locate and segregate sounds, which can make listening in schools, cafes, and busy workplaces extremely challenging. A recent study in unilaterally implanted CI users showed that sound-localisation was ... ...

Abstract	Users of hearing-assistive devices often struggle to locate and segregate sounds, which can make listening in schools, cafes, and busy workplaces extremely challenging. A recent study in unilaterally implanted CI users showed that sound-localisation was improved when the audio received by behind-the-ear devices was converted to haptic stimulation on each wrist. We built on this work, using a new signal-processing approach to improve localisation accuracy and increase generalisability to a wide range of stimuli. We aimed to: (1) improve haptic sound-localisation accuracy using a varied stimulus set and (2) assess whether accuracy improved with prolonged training. Thirty-two adults with normal touch perception were randomly assigned to an experimental or control group. The experimental group completed a 5-h training regime and the control group were not trained. Without training, haptic sound-localisation was substantially better than in previous work on haptic sound-localisation. It was also markedly better than sound-localisation by either unilaterally or bilaterally implanted CI users. After training, accuracy improved, becoming better than for sound-localisation by bilateral hearing-aid users. These findings suggest that a wrist-worn haptic device could be effective for improving spatial hearing for a range of hearing-impaired listeners.
MeSH term(s)	Adult ; Cochlear Implants ; Correction of Hearing Impairment/instrumentation ; Equipment Design ; Female ; Hearing Aids ; Hearing Loss, Bilateral/physiopathology ; Hearing Loss, Bilateral/rehabilitation ; Humans ; Male ; Patient Education as Topic ; Persons With Hearing Impairments/psychology ; Sensory Aids ; Signal Processing, Computer-Assisted ; Sound Localization/physiology ; Speech Perception ; Touch/physiology ; Wearable Electronic Devices ; Wrist ; Young Adult
Language	English
Publishing date	2020-08-25
Publishing country	England
Document type	Comparative Study ; Journal Article ; Randomized Controlled Trial ; Research Support, Non-U.S. Gov't
ZDB-ID	2615211-3
ISSN	2045-2322 ; 2045-2322
ISSN (online)	2045-2322
ISSN	2045-2322
DOI	10.1038/s41598-020-70379-2
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Sensitivity to haptic sound-localisation cues.

Fletcher, Mark D / Zgheib, Jana / Perry, Samuel W

Scientific reports

2021 Volume 11, Issue 1, Page(s) 312

Abstract: Hearing aid and cochlear implant (CI) users often struggle to locate and segregate sounds. The dominant sound-localisation cues are time and intensity differences across the ears. A recent study showed that CI users locate sounds substantially better ... ...

Abstract	Hearing aid and cochlear implant (CI) users often struggle to locate and segregate sounds. The dominant sound-localisation cues are time and intensity differences across the ears. A recent study showed that CI users locate sounds substantially better when these cues are provided through haptic stimulation on each wrist. However, the sensitivity of the wrists to these cues and the robustness of this sensitivity to aging is unknown. The current study showed that time difference sensitivity is much poorer across the wrists than across the ears and declines with age. In contrast, high sensitivity to across-wrist intensity differences was found that was robust to aging. This high sensitivity was observed across a range of stimulation intensities for both amplitude modulated and unmodulated sinusoids and matched across-ear intensity difference sensitivity for normal-hearing individuals. Furthermore, the usable dynamic range for haptic stimulation on the wrists was found to be around four times larger than for CIs. These findings suggest that high-precision haptic sound-localisation can be achieved, which could aid many hearing-impaired listeners. Furthermore, the finding that high-fidelity across-wrist intensity information can be transferred could be exploited in human-machine interfaces to enhance virtual reality and improve remote control of military, medical, or research robots.
MeSH term(s)	Adult ; Aging/physiology ; Cochlear Implants ; Cues ; Female ; Humans ; Male ; Middle Aged ; Sound Localization/physiology ; Touch Perception
Language	English
Publishing date	2021-01-11
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2615211-3
ISSN	2045-2322 ; 2045-2322
ISSN (online)	2045-2322
ISSN	2045-2322
DOI	10.1038/s41598-020-79150-z
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Sensitivity to Haptic Sound-Localization Cues at Different Body Locations.

Fletcher, Mark D / Zgheib, Jana / Perry, Samuel W

Sensors (Basel, Switzerland)

2021 Volume 21, Issue 11

Abstract: Cochlear implants (CIs) recover hearing in severely to profoundly hearing-impaired people by electrically stimulating the cochlea. While they are extremely effective, spatial hearing is typically severely limited. Recent studies have shown that haptic ... ...

Abstract	Cochlear implants (CIs) recover hearing in severely to profoundly hearing-impaired people by electrically stimulating the cochlea. While they are extremely effective, spatial hearing is typically severely limited. Recent studies have shown that haptic stimulation can supplement the electrical CI signal (electro-haptic stimulation) and substantially improve sound localization. In haptic sound-localization studies, the signal is extracted from the audio received by behind-the-ear devices and delivered to each wrist. Localization is achieved using tactile intensity differences (TIDs) across the wrists, which match sound intensity differences across the ears (a key sound localization cue). The current study established sensitivity to across-limb TIDs at three candidate locations for a wearable haptic device, namely: the lower tricep and the palmar and dorsal wrist. At all locations, TID sensitivity was similar to the sensitivity to across-ear intensity differences for normal-hearing listeners. This suggests that greater haptic sound-localization accuracy than previously shown can be achieved. The dynamic range was also measured and far exceeded that available through electrical CI stimulation for all of the locations, suggesting that haptic stimulation could provide additional sound-intensity information. These results indicate that an effective haptic aid could be deployed for any of the candidate locations, and could offer a low-cost, non-invasive means of improving outcomes for hearing-impaired listeners.
MeSH term(s)	Acoustic Stimulation ; Cochlear Implantation ; Cochlear Implants ; Cues ; Humans ; Sound Localization ; Speech Perception
Language	English
Publishing date	2021-05-28
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2052857-7
ISSN	1424-8220 ; 1424-8220
ISSN (online)	1424-8220
ISSN	1424-8220
DOI	10.3390/s21113770
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