Spatial rehabilitation using virtual auditory space training paradigm in individuals with sensorineural hearing impairment

PURPOSE: The present study aimed to quantify the effects of spatial training using virtual sources on a battery of spatial acuity measures in listeners with sensorineural hearing impairment (SNHI). METHODS: An intervention-based time-series comparison design involving 82 participants divided into three groups was adopted. Group I (n = 27, SNHI-spatially trained) and group II (n = 25, SNHI-untrained) consisted of SNHI listeners, while group III (n = 30) had listeners with normal hearing (NH). The study was conducted in three phases. In the pre-training phase, all the participants underwent a comprehensive assessment of their spatial processing abilities using a battery of tests including spatial acuity in free-field and closed-field scenarios, tests for binaural processing abilities (interaural time threshold [ITD] and level difference threshold [ILD]), and subjective ratings. While spatial acuity in the free field was assessed using a loudspeaker-based localization test, the closed-field source identification test was performed using virtual stimuli delivered through headphones. The ITD and ILD thresholds were obtained using a MATLAB psychoacoustic toolbox, while the participant ratings on the spatial subsection of speech, spatial, and qualities questionnaire in Kannada were used for the subjective ratings. Group I listeners underwent virtual auditory spatial training (VAST), following pre-evaluation assessments. All tests were re-administered on the group I listeners halfway through training (mid-training evaluation phase) and after training completion (post-training evaluation phase), whereas group II underwent these tests without any training at the same time intervals. RESULTS AND DISCUSSION: Statistical analysis showed the main effect of groups in all tests at the pre-training evaluation phase, with post hoc comparisons that revealed group equivalency in spatial performance of both SNHI groups (groups I and II). The effect of VAST in group I was evident on all the tests, with the localization test showing the highest predictive power for capturing VAST-related changes on Fischer discriminant analysis (FDA). In contrast, group II demonstrated no changes in spatial acuity across timelines of measurements. FDA revealed increased errors in the categorization of NH as SNHI-trained at post-training evaluation compared to pre-training evaluation, as the spatial performance of the latter improved with VAST in the post-training phase. CONCLUSION: The study demonstrated positive outcomes of spatial training using VAST in listeners with SNHI. The utility of this training program can be extended to other clinical population with spatial auditory processing deficits such as auditory neuropathy spectrum disorder, cochlear implants, central auditory processing disorders etc.