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Hearing impairment is a serious disease with increasing prevalence. It is defined based on increased audiometric thresholds but increased thresholds are only partly responsible for the greater difficulty understanding speech in noisy environments experienced by some older listeners or by hearing-impaired listeners. Identifying the additional factors and mechanisms that impair intelligibility is fundamental to understanding hearing impairment but these factors remain uncertain. Traditionally, these additional factors have been sought in the way the speech spectrum is encoded in the pattern of impaired mechanical cochlear responses. Recent studies, however, are steering the focus toward impaired encoding of the speech waveform in the auditory nerve. In our recent work, we gave evidence that a significant factor might be the loss of afferent auditory nerve fibers, a pathology that comes with aging or noise overexposure. Our approach was based on a signal-processing analogy whereby the auditory nerve may be regarded as a stochastic sampler of the sound waveform and deafferentation may be described in terms of waveform undersampling. We showed that stochastic undersampling simultaneously degrades the encoding of soft and rapid waveform features, and that this degrades speech intelligibility in noise more than in quiet without significant increases in audiometric thresholds. Here, we review our recent work in a broader context and argue that the stochastic undersampling analogy may be extended to study the perceptual consequences of various different hearing pathologies and their treatment.

Why do I hear but not understand? Stochastic undersampling as a model of degraded neural encoding of speech