The utility of the cognitive Mini-Mental State Examination and the Stroop Color and Word Test in explaining variations in speech perception outcomes among adult cochlear implant users: A pilot study

To explore the potential of the internationally-renowned ‘Mini-Mental State Examination’ (MMSE) cognitive measure to explain variability in cochlear implant (CI) recipients’ speech recognition outcomes. The Stroop Color-Word Test (SCWT) was also employed as a measure of cognitive inhibition, an ability essential for focusing on target speech whilst ignoring background noise. The authors hypothesize that MMSE and SCWT scores correlate with CI users’ performance on established speech recognition tests. Cognitive screening was assessed by the MMSE and SCWT in adult CI users one year postoperatively. In addition, speech recognition was assessed using word and sentence lists, in both quiet and noise. Study sample: 28 participants, postlingually deafened adult CI users, median age 75 years. Total MMSE scores correlated significantly with sentence recognition in noise (r = 0.621, P = .004), although no correlation was identified in quiet. Furthermore, the SCWT incongruent condition correlated significantly with CI users’ speech recognition in noise (r = −0.644, P = .007). Global cognition (as assessed using the MMSE), and inhibition-concentration (as assessed using the SCWT), seem to be important factors in influencing CI recipients’ speech intelligibility in noise. This pilot study recommends a larger-scale study; given the global popularity of the MMSE and SCWT as quick cognitive screening tests, they may be useful in CI clinics when speech perception outcomes are unexpectedly poor for older adults and when questions of cognition arise. These standardized cognitive measures may prove helpful in counseling patients and families when coming to terms with CI outcomes and optimizing multidisciplinary rehabilitation strategies.

本研究旨在探讨国际知名的简易精神状态检查（Mini-Mental State Examination, MMSE）这一认知评估工具，对解释人工耳蜗（cochlear implant, CI）植入者言语识别结局差异的潜力。本研究同时采用斯特鲁普色词测验（Stroop Color-Word Test, SCWT）作为认知抑制能力的评估工具——该能力是在背景噪声中聚焦目标言语的必备条件。研究者提出假设：MMSE与SCWT得分与人工耳蜗使用者在标准言语识别测验中的表现存在相关性。研究纳入术后1年的成人人工耳蜗植入者，采用MMSE与SCWT进行认知筛查评估。此外，分别在安静与噪声环境下，通过单词表与句子表测试评估受试者的言语识别能力。研究样本：共28名受试者，均为语后聋成人人工耳蜗植入者，年龄中位数为75岁。MMSE总分与噪声环境下的句子识别得分呈显著正相关（r=0.621，P=0.004），但在安静环境下未发现此类相关性。此外，斯特鲁普色词测验的不一致任务条件得分与人工耳蜗使用者在噪声环境下的言语识别能力呈显著负相关（r=-0.644，P=0.007）。整体认知功能（通过MMSE评估）与抑制-集中注意力能力（通过SCWT评估）似乎是影响人工耳蜗植入者在噪声环境下言语可懂度的重要因素。本初步研究建议开展更大规模的后续研究：鉴于MMSE与SCWT作为快速认知筛查工具在全球范围内的广泛应用，当老年人工耳蜗使用者的言语感知结果出乎意料地差，或存在认知相关疑问时，这两项量表可在人工耳蜗临床诊疗中发挥实用价值。在患者及家属接纳人工耳蜗植入结局、优化多学科康复策略的过程中，这些标准化认知评估工具可为临床咨询提供有效帮助。