Multichannel electrical stimulation of the auditory nerve in man. I. Basic psychophysics

Musical pitch and lexical tone perception with cochlear implants

OBJECTIVE

The purpose of the present study was to test the hypothesis that cochlear implant (CI) users' music perception is correlated with their lexical tone perception, and the two types of perception share similar mechanisms in electric hearing.

DESIGN

A lexical tone perception test and a pitch interval discrimination test were administered to a group of CI users and a group of normal-hearing (NH) listeners. SAMPLE STUDY: Nineteen adult CI users and 10 NH listeners who are native-Mandarin-Chinese speakers participated in the study.

RESULT

Tone-perception performance of the CI group was, on average, 58.3% correct (± 19.78% correct), and performance of the NH group was near perfect. The CI group had a mean threshold of 5.66 semitones (± 5.57 semitones) in pitch discrimination as compared to the threshold of 0.44 semitone from the NH group. There was a strong correlation between the CI users' tone-perception performance and their pitch discrimination threshold (r = -0.75, p < 0.001).

CONCLUSION

Musical and lexical pitch perceptions are strongly correlated with each other and they might share similar mechanisms in electric hearing.

Relationship between gap detection thresholds and loudness in cochlear-implant users

Gap detection threshold (GDT) is a commonly used measure of temporal acuity in cochlear-implant (CI) recipients. This measure, like other measures of temporal acuity, shows considerable variation across subjects and also varies across stimulation sites within subjects. The aims of this study were (1) to determine whether across-site variation in GDTs would be reduced or maintained with increased stimulation levels; (2) to determine whether across-site variation in GDTs at low stimulation levels was related to differences in loudness percepts at those same levels; and (3) to determine whether matching loudness levels could reduce across-site differences in GDTs. Thresholds and maximum comfortable loudness levels were measured in postlingually deaf adults using all available sites in their electrode arrays. All sites were then surveyed at 30% of the dynamic range (DR) to examine across-site variation. Two sites with the largest difference in GDTs were then selected and for those two sites GDTs were measured at multiple levels of the DR (10%, 30%, 50%, 70%, and 90%). Stimuli consisted of 500 ms trains of symmetric-biphasic pulses, 40 μs/phase, presented at a rate of 1000 pps using a monopolar (MP1+2) electrode configuration. To examine perceptual differences in loudness, the selected sites were loudness-matched at the same levels of the DR. Variations in GDTs and loudness patterns were observed across stimulation sites and across subjects. Variations in GDTs across sites tended to decrease with increasing stimulation levels. For the majority of the subjects, stimuli at a given level in %DR were perceived louder at sites with better GDTs than those presented at the same level in %DR at sites with poorer GDTs. These results suggest that loudness is a contributing factor to across-site variation in GDTs and that CI fittings based on more detailed loudness matching could reduce across-site variation and improve perceptual acuity.

Laser stimulation of single auditory nerve fibers

OBJECTIVES/HYPOTHESIS

One limitation with cochlear implants is the difficulty stimulating spatially discrete spiral ganglion cell groups because of electrode interactions. Multipolar electrodes have improved on this some, but also at the cost of much higher device power consumption. Recently, it has been shown that spatially selective stimulation of the auditory nerve is possible with a mid-infrared laser aimed at the spiral ganglion via the round window. However, these neurons must be driven at adequate rates for optical radiation to be useful in cochlear implants. We herein use single-fiber recordings to characterize the responses of auditory neurons to optical radiation.

STUDY DESIGN

In vivo study using normal-hearing adult gerbils.

METHODS

Two diode lasers were used for stimulation of the auditory nerve. They operated between 1.844 μm and 1.873 μm, with pulse durations of 35 μs to 1,000 μs, and at repetition rates up to 1,000 pulses per second (pps). The laser outputs were coupled to a 200-μm-diameter optical fiber placed against the round window membrane and oriented toward the spiral ganglion. The auditory nerve was exposed through a craniotomy, and recordings were taken from single fibers during acoustic and laser stimulation.

RESULTS

Action potentials occurred 2.5 ms to 4.0 ms after the laser pulse. The latency jitter was up to 3 ms. Maximum rates of discharge averaged 97 ± 52.5 action potentials per second. The neurons did not strictly respond to the laser at stimulation rates over 100 pps.

CONCLUSIONS

Auditory neurons can be stimulated by a laser beam passing through the round window membrane and driven at rates sufficient for useful auditory information. Optical stimulation and electrical stimulation have different characteristics; which could be selectively exploited in future cochlear implants.

Advantage of bimodal fitting in prosody perception for children using a cochlear implant and a hearing aid

Cochlear implants are largely unable to encode voice pitch information, which hampers the perception of some prosodic cues, such as intonation. This study investigated whether children with a cochlear implant in one ear were better able to detect differences in intonation when a hearing aid was added in the other ear ("bimodal fitting"). Fourteen children with normal hearing and 19 children with bimodal fitting participated in two experiments. The first experiment assessed the just noticeable difference in F0, by presenting listeners with a naturally produced bisyllabic utterance with an artificially manipulated pitch accent. The second experiment assessed the ability to distinguish between questions and affirmations in Dutch words, again by using artificial manipulation of F0. For the implanted group, performance significantly improved in each experiment when the hearing aid was added. However, even with a hearing aid, the implanted group required exaggerated F0 excursions to perceive a pitch accent and to identify a question. These exaggerated excursions are close to the maximum excursions typically used by Dutch speakers. Nevertheless, the results of this study showed that compared to the implant only condition, bimodal fitting improved the perception of intonation.

Spatiotemporal representation of the pitch of harmonic complex tones in the auditory nerve

The pitch of harmonic complex tones plays an important role in speech and music perception and the analysis of auditory scenes, yet traditional rate-place and temporal models for pitch processing provide only an incomplete description of the psychophysical data. To test physiologically a model based on spatiotemporal pitch cues created by the cochlear traveling wave (Shamma, 1985), we recorded from single fibers in the auditory nerve of anesthetized cat in response to harmonic complex tones with missing fundamentals and equal-amplitude harmonics. We used the principle of scaling invariance in cochlear mechanics to infer the spatiotemporal response pattern to a given stimulus from a series of measurements made in a single fiber as a function of fundamental frequency F0. We found that spatiotemporal cues to resolved harmonics are available for F0 values between 350 and 1100 Hz and that these cues are more robust than traditional rate-place cues at high stimulus levels. The lower F0 limit is determined by the limited frequency selectivity of the cochlea, whereas the upper limit is caused by the degradation of phase locking to the stimulus fine structure at high frequencies. The spatiotemporal representation is consistent with the upper F0 limit to the perception of the pitch of complex tones with a missing fundamental, and its effectiveness does not depend on the relative phase between resolved harmonics. The spatiotemporal representation is thus consistent with key trends in human psychophysics.

Effects of signal level and background noise on spectral representations in the auditory nerve of the domestic cat

Background noise poses a significant obstacle for auditory perception, especially among individuals with hearing loss. To better understand the physiological basis of this perceptual impediment, the present study evaluated the effects of background noise on the auditory nerve representation of head-related transfer functions (HRTFs). These complex spectral shapes describe the directional filtering effects of the head and torso. When a broadband sound passes through the outer ear en route to the tympanic membrane, the HRTF alters its spectrum in a manner that establishes the perceived location of the sound source. HRTF-shaped noise shares many of the acoustic features of human speech, while communicating biologically relevant localization cues that are generalized across mammalian species. Previous studies have used parametric manipulations of random spectral shapes to elucidate HRTF coding principles at various stages of the cat's auditory system. This study extended that body of work by examining the effects of sound level and background noise on the quality of spectral coding in the auditory nerve. When fibers were classified by their spontaneous rates, the coding properties of the more numerous low-threshold, high-spontaneous rate fibers were found to degrade at high presentation levels and in low signal-to-noise ratios. Because cats are known to maintain accurate directional hearing under these challenging listening conditions, behavioral performance may be disproportionally based on the enhanced dynamic range of the less common high-threshold, low-spontaneous rate fibers.

Encoding pitch contours using current steering

This study investigated cochlear implant (CI) users' ability to perceive pitch cues from time-varying virtual channels (VCs) to identify pitch contours. Seven CI users were tested on apical, medial, and basal electrode pairs with stimulus durations from 100 to 1000 ms. In one stimulus set, 9 pitch contours were created by steering current between the component electrodes and the VC halfway between the electrodes. Another stimulus set only contained 3 pitch contours (flat, falling, and rising). VC discrimination was also tested on the same electrodes. The total current level of dual-electrode stimuli was linearly interpolated between those of single-electrode stimuli to minimize loudness changes. The results showed that pitch contour identification (PCI) scores were similar across electrode locations, and significantly improved at longer durations. For durations longer than 300 ms, 2 subjects had nearly perfect 9-contour identification, and 5 subjects perfectly identified the 3 basic contours. Both PCI and VC discrimination varied greatly across subjects. Cumulative d(') values for VC discrimination were significantly correlated with 100-, 200-, and 500-ms PCI scores. These results verify the feasibility of encoding pitch contours using current steering, and suggest that identification of such pitch contours strongly relies on CI users' sensitivity to VCs.

Pitch comparisons between electrical stimulation of a cochlear implant and acoustic stimuli presented to a normal-hearing contralateral ear

Four cochlear implant users, having normal hearing in the unimplanted ear, compared the pitches of electrical and acoustic stimuli presented to the two ears. Comparisons were between 1,031-pps pulse trains and pure tones or between 12 and 25-pps electric pulse trains and bandpass-filtered acoustic pulse trains of the same rate. Three methods—pitch adjustment, constant stimuli, and interleaved adaptive procedures—were used. For all methods, we showed that the results can be strongly influenced by non-sensory biases arising from the range of acoustic stimuli presented, and proposed a series of checks that should be made to alert the experimenter to those biases. We then showed that the results of comparisons that survived these checks do not deviate consistently from the predictions of a widely-used cochlear frequency-to-place formula or of a computational cochlear model. We also demonstrate that substantial range effects occur with other widely used experimental methods, even for normal-hearing listeners.

Temporal pitch perception at high rates in cochlear implants

A recent study reported that a group of Med-El COMBI 40+CI (cochlear implant) users could, in a forced-choice task, detect changes in the rate of a pulse train for rates higher than the 300 pps "upper limit" commonly reported in the literature [Kong, Y.-Y., et al. (2009). J. Acoust. Soc. Am. 125, 1649-1657]. The present study further investigated the upper limit of temporal pitch in the same group of CI users on three tasks [pitch ranking, rate discrimination, and multidimensional scaling (MDS)]. The patterns of results were consistent across the three tasks and all subjects could follow rate changes above 300 pps. Two subjects showed exceptional ability to follow temporal pitch change up to about 900 pps. Results from the MDS study indicated that, for the two listeners tested, changes in pulse rate over the range of 500-840 pps were perceived along a perceptual dimension that was orthogonal to the place of excitation. Some subjects showed a temporal pitch reversal at rates beyond their upper limit of pitch and some showed a reversal within a small range of rates below the upper limit. These results are discussed in relation to the possible neural bases for temporal pitch processing at high rates.

Effect of stimulus level and place of stimulation on temporal pitch perception by cochlear implant users

Three experiments studied the effect of pulse rate on temporal pitch perception by cochlear implant users. Experiment 1 measured rate discrimination for pulse trains presented in bipolar mode to either an apical, middle, or basal electrode and for standard rates of 100 and 200 pps. In each block of trials the signals could have a level of -0.35, 0, or +0.35 dB re the standard, and performance for each signal level was recorded separately. Signal level affected performance for just over half of the combinations of subject, electrode, and standard rate studied. Performance was usually, but not always, better at the higher signal level. Experiment 2 showed that, for a given subject and condition, the direction of the effect was similar in monopolar and bipolar mode. Experiment 3 employed a pitch comparison procedure without feedback, and showed that the signal levels in experiment 1 that produced the best performance for a given subject and condition also led to the signal having a higher pitch. It is concluded that small level differences can have a robust and substantial effect on pitch judgments and argue that these effects are not entirely due to response biases or to co-variation of place-of-excitation with level.

Selective electrical stimulation of the auditory nerve activates a pathway specialized for high temporal acuity

Deaf people who use cochlear implants show surprisingly poor sensitivity to the temporal fine structure of sounds. One possible reason is that conventional cochlear implants cannot activate selectively the auditory-nerve fibers having low characteristic frequencies (CFs), which, in normal hearing, phase lock to stimulus fine structure. Recently, we tested in animals an alternative mode of auditory prosthesis using penetrating auditory-nerve electrodes that permit frequency-specific excitation in all frequency regions. We present here measures of temporal transmission through the auditory brainstem, from pulse trains presented with various auditory-nerve electrodes to phase-locked activity of neurons in the central nucleus of the inferior colliculus (ICC). On average, intraneural stimulation resulted in significant ICC phase locking at higher pulse rates (i.e., higher "limiting rates") than did cochlear-implant stimulation. That could be attributed, however, to the larger percentage of low-CF neurons activated selectively by intraneural stimulation. Most ICC neurons with limiting rates >500 pulses per second had CFs <1.5 kHz, whereas neurons with lower limiting rates tended to have higher CFs. High limiting rates also correlated strongly with short first-spike latencies. It follows that short latencies correlated significantly with low CFs, opposite to the correlation observed with acoustical stimulation. These electrical-stimulation results reveal a high-temporal-acuity brainstem pathway characterized by low CFs, short latencies, and high-fidelity transmission of periodic stimulation. Frequency-specific stimulation of that pathway by intraneural stimulation might improve temporal acuity in human users of a future auditory prosthesis, which in turn might improve musical pitch perception and speech reception in noise.

The upper limit of temporal pitch for cochlear-implant listeners: stimulus duration, conditioner pulses, and the number of electrodes stimulated

Three experiments studied discrimination of changes in the rate of electrical pulse trains by cochlear-implant (CI) users and investigated the effect of manipulations that would be expected to substantially affect the pattern of auditory nerve (AN) activity. Experiment 1 used single-electrode stimulation and tested discrimination at baseline rates between 100 and 500 pps. Performance was generally similar for stimulus durations of 200 and 800 ms, and, for the longer duration, for stimuli that were gated on abruptly or with 300-ms ramps. Experiment 2 used a similar procedure and found that no substantial benefit was obtained by the addition of background 5000-pps "conditioning" pulses. Experiment 3 used a pitch-ranking procedure and found that the range of rates over which pitch increased with increasing rate was not greater for multiple-electrode than for single-electrode stimulation. The results indicate that the limitation on pulse-rate discrimination by CI users, at high baseline rates, is not specific to a particular temporal pattern of the AN response.

Neural coding of periodicity in marmoset auditory cortex

Pitch, our perception of how high or low a sound is on a musical scale, crucially depends on a sound's periodicity. If an acoustic signal is temporally jittered so that it becomes aperiodic, the pitch will no longer be perceivable even though other acoustical features that normally covary with pitch are unchanged. Previous electrophysiological studies investigating pitch have typically used only periodic acoustic stimuli, and as such these studies cannot distinguish between a neural representation of pitch and an acoustical feature that only correlates with pitch. In this report, we examine in the auditory cortex of awake marmoset monkeys (Callithrix jacchus) the neural coding of a periodicity's repetition rate, an acoustic feature that covaries with pitch. We first examine if individual neurons show similar repetition rate tuning for different periodic acoustic signals. We next measure how sensitive these neural representations are to the temporal regularity of the acoustic signal. We find that neurons throughout auditory cortex covary their firing rate with the repetition rate of an acoustic signal. However, similar repetition rate tuning across acoustic stimuli and sensitivity to temporal regularity were generally only observed in a small group of neurons found near the anterolateral border of primary auditory cortex, the location of a previously identified putative pitch processing center. These results suggest that although the encoding of repetition rate is a general component of auditory cortical processing, the neural correlate of periodicity is confined to a special class of pitch-selective neurons within the putative pitch processing center of auditory cortex.

Excitation patterns of simultaneous and sequential dual-electrode stimulation in cochlear implant recipients

OBJECTIVE

Both simultaneous (SI) and sequential stimulation of intracochlear electrodes can be used to generate pitches that are intermediate to the physical electrodes (PEs). The goal of this study was to compare the spread of neural excitation for SI and sequential dual-electrode stimulation with the spread of neural excitation for the intermediate electrode using electrically evoked compound action potentials.

DESIGN

Seven Advanced Bionics cochlear implant users with either CII or HiRes 90k implant and HiFocus 1 or HiFocus 1j electrode array participated in this study. A masker-probe subtraction method was used to derive neural excitation patterns for SI nonadjacent dual-electrode stimulation, apical and basal-first sequential nonadjacent dual-electrode stimulation, and the intermediate PE. For apical-first sequential (SEa) stimulation, the masker pulse on the apical electrode immediately preceded the masker pulse on the basal electrode, and vice versa for basal-first sequential stimulation (SEb). The electrodes used for dual-electrode stimulation were separated by an intermediate PE, which represents a spatial distance of approximately 2 mm. Current levels necessary to achieve comfortable loudness were determined for each masker and probe stimulus. During the evoked compound action potential measurements, the masker was fixed in location, whereas the probe was varied across a subset of electrodes in the array. Neural responses were calculated by subtracting the response to the probe from the masked response.

RESULTS

Neural excitation patterns were normalized to their peak and analyzed in terms of their area and center of gravity. The area and center of gravity for SI nonadjacent dual-electrode stimulation were similar to those of the intermediate PE. In contrast, the area for the two modes of sequential nonadjacent dual-electrode (SEa and SEb) stimulation differed significantly from the intermediate PE. The center of gravity for SEa stimulation also differed significantly from the intermediate PE, whereas there was no significant difference in the center of gravity between SEb stimulation and the intermediate PE.

CONCLUSIONS

Peripheral neural activation patterns suggest a similar spread of excitation for SI dual-electrode stimulation and the intermediate PE. The spread of excitation associated with sequential dual-electrode stimulation is generally different from the intermediate PE, and it varies depending on the order of the sequential pulses.

Pitch estimation of a deeply inserted cochlear implant electrode

In this short communication, we evaluate the place-pitch relation of a newly designed, deeply inserted, cochlear implant electrode. The insertion depths ranged from 471 degrees to 662 degrees. Pitch perception was measured in eight subjects with monopolar stimulation on each electrode contact at intensities of 50% and 80% of the dynamic range. We observed a monotonic reduction of pitch estimate with insertion depth. For about half of the subjects, a flattening of the pitch estimate at the basal end of the electrode was seen, while for the other half, pitch continued to decrease monotonically up to the most apical part of the array. We conclude that deeper insertion could increase pitch range for at least some cochlear implant recipients, and could hence potentially increase group performance.

Sequential stream segregation using temporal periodicity cues in cochlear implant recipients

Sequential stream segregation involves the ability of a listener to perceptually segregate two rapidly alternating sounds into different perceptual streams. By studying auditory streaming in cochlear implants (CIs), one can obtain a better understanding of the cues that CI recipients can use to segregate different sound sources, which may have relevance to such everyday activities as the understanding of speech in background noise. This study focuses on the ability of CI users to use temporal periodicity cues to perform auditory stream segregation. A rhythmic discrimination task involving sequences of alternating amplitude-modulated (AM) noises is used. The results suggest that most CI users can stream AM noise bursts at relatively low modulation frequencies (near 80 Hz AM), but that this ability diminishes at higher modulation frequencies. Additionally, the ability of CI users to perform streaming using temporal periodicity cues appears to be comparable to that of normal-hearing listeners. These results imply that CI subjects may in certain contexts (i.e., when the talker has a low fundamental frequency voice) be able to use temporal periodicity cues to segregate and thus understand the voices of competing talkers.

Investigating the effects of stimulus duration and context on pitch perception by cochlear implant users

Cochlear implant sound processing strategies that use time-varying pulse rates to transmit fine structure information are one proposed method for improving the spectral representation of a sound with the eventual goal of improving speech recognition in noisy conditions, speech recognition in tonal languages, and music identification and appreciation. However, many of the perceptual phenomena associated with time-varying rates are not well understood. In this study, the effects of stimulus duration on both the place and rate-pitch percepts were investigated via psychophysical experiments. Four Nucleus CI24 cochlear implant users participated in these experiments, which included a short-duration pitch ranking task and three adaptive pulse rate discrimination tasks. When duration was fixed from trial-to-trial and rate was varied adaptively, results suggested that both the place-pitch and rate-pitch percepts may be independent of duration for durations above 10 and 20 ms, respectively. When duration was varied and pulse rates were fixed, performance was highly variable within and across subjects. Implications for multi-rate sound processing strategies are discussed.

Comparison of dual-time-constant and fast-acting automatic gain control (AGC) systems in cochlear implants

Cochlear implants usually employ an automatic gain control (AGC) system as a first stage of processing. AGC1 was a fast-acting (syllabic) compressor. AGC2 was a dual-time-constant system; it usually performed as a slow-acting compressor, but incorporated an additional fast-acting system to provide protection from sudden increases in sound level. Six experienced cochlear-implant users were tested in a counterbalanced order, receiving one-month of experience with a given AGC type before switching to the other type. Performance was evaluated shortly after provision of a given AGC type and after one-month of experience with that AGC type. Questionnaires, mainly relating to listening in quiet situations, did not reveal significant differences between the two AGC types. However, fixed-level and roving-level tests of sentence identification in noise both revealed significantly better performance for AGC2. It is suggested that the poorer performance for AGC1 occurred because AGC1 introduced cross-modulation between the target speech and background noise, which made perceptual separation of the target and background more difficult.

N1m amplitude growth function for bone-conducted ultrasound

CONCLUSION

N1m growth indicates the differences in central auditory processing between bone-conducted ultrasound and air-conducted audible sound.

OBJECTIVES

Bone conduction enables ultrasound to be heard by the human ear. Despite many studies, the perceptual mechanism of bone-conducted ultrasound has not yet been clarified completely. Therefore, this study investigated the ultrasonic perception of humans, especially as regards the effects of stimulus intensity or loudness.

SUBJECTS AND METHODS

The effect of the stimulus level on N1m amplitude was measured over the psycho-acoustical dynamic range.

RESULTS

The dynamic range for 30 kHz bone-conducted ultrasound (18.2 +/- 3.3 dB) was found to be significantly narrower than that for 1 kHz air-conducted sound (85.9 +/- 11.9 dB). As the stimulus level increased, the N1m amplitude in response to bone-conducted ultrasound grew faster than that to air-conducted sound. Although the growth of the N1m amplitude for air-conducted sound saturated below the uncomfortable loudness level (UCL), that for bone-conducted ultrasound continued to grow above the UCL.

The effect of temporal gap identification on speech perception by users of cochlear implants

PURPOSE

This study examined the ability of listeners using cochlear implants (CIs) and listeners with normal hearing (NH) to identify silent gaps of different duration and the relation of this ability to speech understanding in CI users.

METHOD

Sixteen NH adults and 11 postlingually deafened adults with CIs identified synthetic vowel-like stimuli that were either continuous or contained an intervening silent gap ranging from 15 ms to 90 ms. Cumulative d', an index of discriminability, was calculated for each participant. Consonant and consonant-nucleus-consonant (CNC) word identification tasks were administered to the CI group.

RESULTS

Overall, the ability to identify stimuli with gaps of different duration was better for the NH group than for the CI group. Seven CI users had cumulative d' scores that were no higher than those of any NH listener, and their CNC word scores ranged from 0% to 30%. The other 4 CI users had cumulative d' scores within the range of the NH group, and their CNC word scores ranged from 46% to 68%. For the CI group, cumulative d' scores were significantly correlated with their speech testing scores.

CONCLUSIONS

The ability to identify silent gap duration may help explain individual differences in speech perception by CI users.

Effects of frequency allocation on lexical tone identification by Mandarin-speaking children with a cochlear implant

CONCLUSION

Frequency allocation with extended frequency ranges yielded significantly higher accuracy in pediatric CI recipients' lexical tone identification. These findings suggest that frequency allocation with extended frequency ranges may be useful in improving lexical tone recognition for at least some pediatric CI recipients.

OBJECTIVES

To assess the effects of frequency allocation on lexical tone identification by Mandarin-speaking children with a cochlear implant (CI).

SUBJECTS AND METHODS

In a prospective study, 15 prelingually deafened children between 7.17 and 16.17 years of age served as participants. Using Med-el CI devices, each participant's accuracy in lexical tone identification was compared in two conditions: first, the experimental condition, i.e. use of the extended frequency range from 233 to 8501 Hz; second, the control condition, i.e. use of the participant's clinically assigned frequency range from 300 to 8404 Hz.

RESULTS

The group mean of pediatric CI users' accuracy in lexical tone identification was 88.02% (SD = 6.31%) in the experimental condition and 83.82% (SD = 9.84%) in the control condition. The group mean was 4.20% (SD = 5.48%) higher in the experimental condition than that in the control condition; this difference was statistically significant (t(14) = 2.97, p=0.010).

Speech recognition and temporal amplitude modulation processing by Mandarin-speaking cochlear implant users

OBJECTIVES

Fundamental frequency (F0) information is important to Chinese tone and speech recognition. Cochlear implant (CI) speech processors typically provide limited F0 information via temporal envelopes delivered to stimulating electrodes. Previous studies have shown that English-speaking CI users' speech performance is correlated with amplitude modulation detection thresholds (AMDTs). The present study investigated whether Chinese-speaking CI users' speech performance (especially tone recognition) is correlated with temporal processing capabilities.

DESIGN

Chinese tone, vowel, consonant, and sentence recognition were measured in 10 native Mandarin-speaking CI users via clinically assigned speech processors. AMDTs were measured in the same subjects for 20- and 100-Hz amplitude modulated (AM) stimuli presented to a middle electrode at five stimulation levels that spanned the dynamic range. To further investigate the CI users' sensitivity to temporal envelope cues, AM frequency discrimination thresholds (AMFDTs) were measured for two standard AM frequencies (50 and 100 Hz), presented to the same middle electrode at 30% and 70% dynamic range with a fixed modulation depth (50%).

RESULTS

Results showed that AMDTs significantly improved with increasing stimulation level and that individual subjects exhibited markedly different AMDT functions. AMFDTs also improved with increasing stimulation level and were better with the 100-Hz standard AM frequency than with the 50-Hz standard AM frequency. Statistical analyses revealed that both mean AMDTs (averaged for 20- or 100-Hz AM across all stimulation levels) and mean AMFDTs (averaged for the 50-Hz standard AM frequency across both stimulation levels) were significantly correlated with tone, consonant, and sentence recognition scores, but not with vowel recognition scores. Mean AMDTs were also significantly correlated with mean AMFDTs.

CONCLUSIONS

These preliminary results, obtained from a limited number of subjects, demonstrate the importance of temporal processing to CI speech recognition. The results further suggest that CI users' Chinese tone and speech recognition may be improved by enhancing temporal envelope cues delivered by speech processing algorithms.

Psychophysical versus physiological spatial forward masking and the relation to speech perception in cochlear implants

OBJECTIVES

The primary goal of this study was to determine if physiological forward masking patterns in cochlear implants are predictive of psychophysical forward masking (PFM) patterns. It was hypothesized that the normalized amount of physiological masking would be positively correlated with the normalized amount of psychophysical masking for different masker-probe electrode separations. A secondary goal was to examine the relation between the spatial forward masking patterns and speech perception performance. It was hypothesized that subjects with less channel interaction overall (either psychophysically or physiologically) would have better speech perception ability because of better spectral resolution.

DESIGN

Data were collected for 18 adult cochlear implant recipients [N = 9 Clarion CII or HiRes 90K, N = 9 Nucleus 24R(CS)]. Physiological spatial forward masking patterns were obtained with the electrically evoked compound action potential (ECAP) through the implant telemetry system. PFM patterns were obtained using a three-interval, two-alternative forced-choice adaptive procedure. Both measures used a fixed probe electrode with varied masker location. For each subject, spatial forward masking patterns were obtained for three probe electrodes with five masker locations per probe.

RESULTS

On an individual basis, the correlation between ECAP FM and PFM was strong for 10 subjects (r = 0.68-0.85, p <or= 0.02), moderately strong for two subjects (r = 0.54-0.55, p = 0.06-0.07), and poor for six subjects (r = 0.13-0.45, p > 0.14). Results across subjects and electrodes showed a highly significant correlation between ECAP FM and PFM (r = 0.55, p < 0.0001); the correlation was strongest for basal electrodes. There was no significant correlation between speech perception and ECAP FM or PFM. Subjects whose ECAP FM patterns correlated well with PFM patterns generally had the poorest speech perception and subjects with the poorest correlations had the best speech perception.

CONCLUSIONS

ECAP FM and PFM patterns correlated well for two-thirds of the subjects. Although the group correlation was statistically significant, ECAP FM patterns only accounted for 30% of the variance in the PFM measures. This suggests that the ECAP measures alone are not sufficient for accurately predicting PFM patterns for individual subjects.

Psychophysical assessment of stimulation sites in auditory prosthesis electrode arrays

Auditory prostheses use implanted electrode arrays that permit stimulation at many sites along the tonotopic axis of auditory neurons. Psychophysical studies demonstrate that measures of implant function, such as detection and discrimination thresholds, vary considerably across these sites, that the across-site patterns of these measures differ across subjects, and that the likely mechanisms underlying this variability differ across measures. Psychophysical and speech recognition studies suggest that not all stimulation sites contribute equally to perception with the prosthesis and that some sites might have negative effects on perception. Studies that reduce the number of active stimulation sites indicate that most cochlear implant users can effectively utilize a maximum of only about seven sites in their processors. These findings support a strategy for improving implant performance by selecting only the best stimulation sites for the processor map. Another approach is to revise stimulation parameters for ineffective sites in an effort to improve acuity at those sites. In this paper, we discuss data supporting these approaches and some potential pitfalls.

Cochlear-implant high pulse rate and narrow electrode configuration impair transmission of temporal information to the auditory cortex

In the most commonly used cochlear prosthesis systems, temporal features of sound are signaled by amplitude modulation of constant-rate pulse trains. Several convincing arguments predict that speech reception should be optimized by use of pulse rates > or approximately 2,000 pulses per second (pps) and by use of intracochlear electrode configurations that produce restricted current spread (e.g., bipolar rather than monopolar configurations). Neither of those predictions has been borne out in consistent improvements in speech reception. Neurons in the auditory cortex of anesthetized guinea pigs phase lock to the envelope of sine-modulated electric pulse trains presented through a cochlear implant. The present study used that animal model to quantify the effects of carrier pulse rate, electrode configuration, current level, and modulator wave shape on transmission of temporal information from a cochlear implant to the auditory cortex. Modulation sensitivity was computed using a signal-detection analysis of cortical phase-locking vector strengths. Increasing carrier pulse rate in 1-octave steps from 254 to 4,069 pps resulted in systematic decreases in sensitivity. Comparison of sine- versus square-wave modulator waveforms demonstrated that some, but not all, of the loss of modulation sensitivity at high pulse rates was a result of the decreasing size of pulse-to-pulse current steps at the higher rates. Use of a narrow bipolar electrode configuration, compared with the monopolar configuration, produced a marked decrease in modulation sensitivity. Results from this animal model suggest explanations for the failure of high pulse rates and/or bipolar electrode configurations to produce hoped-for improvements in speech reception.

Adaptation of the electrically evoked compound action potential (ECAP) recorded from nucleus CI24 cochlear implant users

OBJECTIVE

This study had three main goals. The first goal was to assess the extent to which neural adaptation varied across cochlear implant users. The second goal was to determine whether adaptation at the level of the auditory nerve was correlated with word recognition ability. The third goal was to determine whether peripheral neural adaptation had an impact on the relationship between the electrically evoked compound action potential (ECAP) thresholds and MAP levels.

DESIGN

Neural response telemetry software was used to record the ECAP in 21 Nucleus cochlear implant users. A series of 110 ECAP recordings were made over a 5-min period at three different stimulation rates: 15, 80, and 300 Hz. The stimulation levels used to record this series of responses were held constant at or near the level the subject identified as his or her maximum comfort level (C-level) for the 300-Hz stimulation rate. Consistent decreases in ECAP amplitude as measured from the beginning to the end of the 5-min stimulation interval were interpreted as evidence of neural adaptation. Regression analysis procedures were then used to assess the relationship between neural adaptation and word recognition.

RESULTS

Significant levels of adaptation were observed for all 21 subjects at stimulation rates of 80 and 300 Hz. Little or no adaptation was observed over the 5-min recording period when the 15-Hz rate was used. The amount of adaptation was greatest at the 300-Hz rate and varied substantially across cochlear implant users. No relationship between the amount of adaptation and word recognition was found. Neither was the degree of adaptation shown to influence the relationship between ECAP thresholds recorded at low rates and the levels used to program the speech processor.

CONCLUSIONS

Cochlear implant users experienced varying degrees of long-term adaptation in response to continuous electrical stimulation. The effects of adaptation on the ECAP were apparent even at stimulation rates as low as 80 Hz. Although variations in the amount of adaptation are likely to reflect cross-subject differences in the status of the auditory nerve, no predictable relationship was found between these physiologic measures of peripheral neural function and either word recognition or the relationship between ECAP thresholds and MAP levels.

Sensitivity to interaural level difference and loudness growth with bilateral bimodal stimulation

The interaural level difference (ILD) is an important cue for the localization of sound sources. The sensitivity to ILD was measured in 10 users of a cochlear implant (CI) in one ear and a hearing aid (HA) in the other severely impaired ear. For simultaneous presentation of a pulse train on the CI side and a sinusoid on the HA side the just noticeable difference (JND) in ILD and loudness growth functions were measured. The mean JND for pitch-matched electric and acoustic stimulation was 1.7 dB. A linear fit of the loudness growth functions on a decibel-versus-microampere scale shows that the slope depends on the subject's dynamic ranges.

Current focusing and steering: modeling, physiology, and psychophysics

Current steering and current focusing are stimulation techniques designed to increase the number of distinct perceptual channels available to cochlear implant (CI) users by adjusting currents applied simultaneously to multiple CI electrodes. Previous studies exploring current steering and current focusing stimulation strategies are reviewed, including results of research using computational models, animal neurophysiology, and human psychophysics. Preliminary results of additional neurophysiological and human psychophysical studies are presented that demonstrate the success of current steering strategies in stimulating auditory nerve regions lying between physical CI electrodes, as well as current focusing strategies that excite regions narrower than those stimulated using monopolar configurations. These results are interpreted in the context of perception and speech reception by CI users. Disparities between results of physiological and psychophysical studies are discussed. The differences in stimulation used for physiological and psychophysical studies are hypothesized to contribute to these disparities. Finally, application of current steering and focusing strategies to other types of auditory prostheses is also discussed.

The growth of loudness functions measured in cochlear implant listeners using absolute magnitude estimation and compared using Akaike's information criterion

The input/output function for acoustic hearing can be characterized by the growth of loudness with sound pressure level and generally follows a compressive power law. In contrast, in electric hearing, loudness reportedly is an expansive function of applied electrical current but the specific shape of the function has not been fully determined. Loudness growth models have implications for the implementation of cochlear implant speech processors. Having an appropriate loudness growth model is important to cochlear implant users because they have a small dynamic range of hearing compared to normal hearing listeners. To compensate for this, appropriate models of loudness are necessary for the design of cochlear implant speech processors. It is also necessary to understand how loudness is encoded and may affect the relative performance in speech recognition. Currently, there is no consensus on the actual shape of the loudness growth function, with power or exponential functions being suggested. In this study psychophysical loudness growth measures were obtained in twelve adult cochlear implant listeners, using the method of absolute magnitude estimation and production. Best-fit loudness growth functions as determined by Akaike's Information Criterion (AIC) method for finding the best-fit loudness model seem to show a difference in the loudness growth functions across subjects and across electrode pairs within individual subjects. The range of functions observed is greater than previously reported and goes from linear to expansive, suggesting that individual variations in dynamic range should be incorporated in the design of cochlear implant sound processors.

Spectral and temporal cues for speech recognition: implications for auditory prostheses

Features of stimulation important for speech recognition in people with normal hearing and in people using implanted auditory prostheses include spectral information represented by place of stimulation along the tonotopic axis and temporal information represented in low-frequency envelopes of the signal. The relative contributions of these features to speech recognition and their interactions have been studied using vocoder-like simulations of cochlear implant speech processors presented to listeners with normal hearing. In these studies, spectral/place information was manipulated by varying the number of channels and the temporal-envelope information was manipulated by varying the lowpass cutoffs of the envelope extractors. Consonant and vowel recognition in quiet reached plateau at 8 and 12 channels and lowpass cutoff frequencies of 16 Hz and 4 Hz, respectively. Phoneme (especially vowel) recognition in noise required larger numbers of channels. Lexical tone recognition required larger numbers of channels and higher lowpass cutoff frequencies. There was a tradeoff between spectral/place and temporal-envelope requirements. Most current auditory prostheses seem to deliver adequate temporal-envelope information, but the number of effective channels is suboptimal, particularly for speech recognition in noise, lexical tone recognition, and music perception.

Electrically evoked auditory steady-state responses in a guinea pig model: latency estimates and effects of stimulus parameters

Cochlear implant speech processors typically extract envelope information of speech signals for presentation to the auditory nerve as modulated trains of electric pulses. Recent studies showed the feasibility of recording, at the scalp, the electrically evoked auditory steady-state response using amplitude-modulated electric stimuli. Sinusoidally amplitude-modulated electric stimuli were used to elicit such responses from guinea pigs in order to characterize this response. Response latencies were derived to provide insight regarding neural generator sites. Two distinct sites, one cortical and another more peripheral, were indicated by latency estimates of 22 and 2 ms, respectively, with the former evoked by lower (13-49 Hz) and the latter by higher (55-320 Hz) modulation frequencies. Furthermore, response amplitudes declined with increasing carrier frequency, exhibited a compressive growth with increasing modulation depths, and were sensitive to modulation depths to as low as 5%.

Twenty-five years of auditory brainstem implants: perspectives

The auditory brainstem implant (ABI) provides auditory sensations, recognition of environmental sounds and aid in spoken communication in more than 300 patients worldwide. It is no more a device under investigation but it is widely accepted for the treatment of patients who have lost hearing due to bilateral tumors of the vestibulocochlear nerve. Most of these patients are completely deaf when the implant is switched off. In contrast to the cochlear implants (CI), only few of the implanted patients achieve open-set speech recognition without the help of visual cues. In the last few years, patients with lesions other than tumors have also been implanted. Auditory perceptual performance in patients who are deaf due to trauma, cochlea aplasia or other non-tumor lesions of the cochlea or the vestibulocochlear nerve turned out to be much better than in NF2 tumor patients. Until recently, the target region for ABI implantation has been the ventral cochlear nucleus (CN). The electrodes are implanted via the translabyrinthine or retrosigmoid approach. Currently, new targets along the central auditory pathways and new, minimally invasive techniques for implantation are under investigation. These techniques may further improve auditory perceptual performance in ABI patients and provide hearing to a variety of types of central deafness.

Processing F0 with cochlear implants: Modulation frequency discrimination and speech intonation recognition

Fundamental frequency (F0) processing by cochlear implant (CI) listeners was measured using a psychophysical task and a speech intonation recognition task. Listeners' Weber fractions for modulation frequency discrimination were measured using an adaptive, 3-interval, forced-choice paradigm: stimuli were presented through a custom research interface. In the speech intonation recognition task, listeners were asked to indicate whether resynthesized bisyllabic words, when presented in the free field through the listeners' everyday speech processor, were question-like or statement-like. The resynthesized tokens were systematically manipulated to have different initial-F0s to represent male vs. female voices, and different F0 contours (i.e. falling, flat, and rising) Although the CI listeners showed considerable variation in performance on both tasks, significant correlations were observed between the CI listeners' sensitivity to modulation frequency in the psychophysical task and their performance in intonation recognition. Consistent with their greater reliance on temporal cues, the CI listeners' performance in the intonation recognition task was significantly poorer with the higher initial-F0 stimuli than with the lower initial-F0 stimuli. Similar results were obtained with normal hearing listeners attending to noiseband-vocoded CI simulations with reduced spectral resolution.

Cochlear implant electrode configuration effects on activation threshold and tonotopic selectivity

The multichannel design of contemporary cochlear implants (CIs) is predicated on the assumption that each channel activates a relatively restricted and independent sector of the deaf auditory nerve array, just as a sound within a restricted frequency band activates a restricted region of the normal cochlea The independence of CI channels, however, is limited; and the factors that determine their independence, the relative overlap of the activity patterns that they evoke, are poorly understood. In this study, we evaluate the spread of activity evoked by cochlear implant channels by monitoring activity at 16 sites along the tonotopic axis of the guinea pig inferior colliculus (IC). "Spatial tuning curves" (STCs) measured in this way serve as an estimate of activation spread within the cochlea and the ascending auditory pathways. We contrast natural stimulation using acoustic tones with two kinds of electrical stimulation either (1) a loose fitting banded array consisting of a cylindrical silicone elastomer carrier with a linear series of ring contacts; or (2) a space-filling array consisting of a tapered silicone elastomer carrier that is designed to fit snugly into the guinea pig scala tympani with a linear series of ball contacts positioned along it Spatial tuning curves evoked by individual acoustic tones, and by activation of each contact of each array as a monopole, bipole or tripole were recorded. Several channel configurations and a wide range of electrode separations were tested for each array, and their thresholds and selectivity were estimated. The results indicate that the tapered space-filling arrays evoked more restricted activity patterns at lower thresholds than did the banded arrays. Monopolar stimulation (one intracochlear contact activated with an extracochlear return) using either array evoked broad activation patterns that involved the entire recording array at current levels <6dBSL, but at relatively low thresholds. Bi- and tri-polar configurations of both array types evoked more restricted activity patterns, but their thresholds were higher than those of monopolar configurations. Bipolar and tripolar configurations with closely spaced contacts evoked activity patterns that were comparable to those evoked by pure tones. As the spacing of bipolar electrodes was increased (separations >1mm), the activity patterns became broader and evoked patterns with two distinct threshold minima, one associated with each contact.

Current Steering Creates Additional Pitch Percepts in Adult Cochlear Implant Recipients

OBJECTIVE

The number of spectral channels is the number of discriminable pitches heard as current is delivered to distinct locations along the cochlea. This study aimed to determine whether cochlear implant users could hear additional spectral channels using current "steering." Current steering involves the simultaneous delivery of current to adjacent electrodes, where stimulation can be steered to sites between the contacts by varying the proportion of current delivered to each electrode in an electrode pair. Current steering may increase the number of spectral channels beyond the number of fixed electrode contacts.

STUDY DESIGN

Prospective clinical study.

SETTING

Twelve tertiary care centers in North America.

PATIENTS

The subjects were 106 adults with postlingual onset of severe-to-profound hearing loss.

INTERVENTIONS

Subjects received the Advanced Bionics CII or HiResolution 90K device (Advanced Bionics Corporation, Valencia, CA, USA).

MAIN OUTCOME MEASURES

After loudness balancing and pitch ranking the 3 electrode pairs (2 and 3, 8 and 9, and 13 and 14), the subjects identified the electrode with the higher pitch while current was varied proportionally between the electrodes in each pair. The smallest change in proportion yielding a discriminable change in pitch was defined as the spectral resolution.

RESULTS

The data from 115 ears indicate that the number of spectral channels averaged 3.8 for the basal pair, 6.0 for the midarray pair, and 5.3 for the apical pair. Assuming that the number of channels on these 3 electrode pairs represents the entire array, the total potential number of spectral channels was calculated and ranged from 8 to 451, with an average of 63.

CONCLUSION

These results indicate that additional pitch percepts can be created using current steering.

Melodic contour identification by cochlear implant listeners

OBJECTIVE

While the cochlear implant provides many deaf patients with good speech understanding in quiet, music perception and appreciation with the cochlear implant remains a major challenge for most cochlear implant users. The present study investigated whether a closed-set melodic contour identification (MCI) task could be used to quantify cochlear implant users' ability to recognize musical melodies and whether MCI performance could be improved with moderate auditory training. The present study also compared MCI performance with familiar melody identification (FMI) performance, with and without MCI training.

METHODS

For the MCI task, test stimuli were melodic contours composed of 5 notes of equal duration whose frequencies corresponded to musical intervals. The interval between successive notes in each contour was varied between 1 and 5 semitones; the "root note" of the contours was also varied (A3, A4, and A5). Nine distinct musical patterns were generated for each interval and root note condition, resulting in a total of 135 musical contours. The identification of these melodic contours was measured in 11 cochlear implant users. FMI was also evaluated in the same subjects; recognition of 12 familiar melodies was tested with and without rhythm cues. MCI was also trained in 6 subjects, using custom software and melodic contours presented in a different frequency range from that used for testing.

RESULTS

Results showed that MCI recognition performance was highly variable among cochlear implant users, ranging from 14% to 91% correct. For most subjects, MCI performance improved as the number of semitones between successive notes was increased; performance was slightly lower for the A3 root note condition. Mean FMI performance was 58% correct when rhythm cues were preserved and 29% correct when rhythm cues were removed. Statistical analyses revealed no significant correlation between MCI performance and FMI performance (with or without rhythmic cues). However, MCI performance was significantly correlated with vowel recognition performance; FMI performance was not correlated with cochlear implant subjects' phoneme recognition performance. Preliminary results also showed that the MCI training improved all subjects' MCI performance; the improved MCI performance also generalized to improved FMI performance.

CONCLUSIONS

Preliminary data indicate that the closed-set MCI task is a viable approach toward quantifying an important component of cochlear implant users' music perception. The improvement in MCI performance and generalization to FMI performance with training suggests that MCI training may be useful for improving cochlear implant users' music perception and appreciation; such training may be necessary to properly evaluate patient performance, as acute measures may underestimate the amount of musical information transmitted by the cochlear implant device and received by cochlear implant listeners.

Auditory prosthesis with a penetrating nerve array

Contemporary auditory prostheses ("cochlear implants") employ arrays of stimulating electrodes implanted in the scala tympani of the cochlea. Such arrays have been implanted in some 100,000 profoundly or severely deaf people worldwide and arguably are the most successful of present-day neural prostheses. Nevertheless, most implant users show poor understanding of speech in noisy backgrounds, poor pitch recognition, and poor spatial hearing, even when using bilateral implants. Many of these limitations can be attributed to the remote location of stimulating electrodes relative to excitable cochlear neural elements. That is, a scala tympani electrode array lies within a bony compartment filled with electrically conductive fluid. Moreover, scala tympani arrays typically do not extend to the apical turn of the cochlea in which low frequencies are represented. In the present study, we have tested in an animal model an alternative to the conventional cochlear implant: a multielectrode array implanted directly into the auditory nerve. We monitored the specificity of stimulation of the auditory pathway by recording extracellular unit activity at 32 sites along the tonotopic axis of the inferior colliculus. The results demonstrate the activation of specific auditory nerve populations throughout essentially the entire frequency range that is represented by characteristic frequencies in the inferior colliculus. Compared to conventional scala tympani stimulation, thresholds for neural excitation are as much as 50-fold lower and interference between electrodes stimulated simultaneously is markedly reduced. The results suggest that if an intraneural stimulating array were incorporated into an auditory prosthesis system for humans, it could offer substantial improvement in hearing replacement compared to contemporary cochlear implants.

Changes in pitch with a cochlear implant over time

In the normal auditory system, the perceived pitch of a tone is closely linked to the cochlear place of vibration. It has generally been assumed that high-rate electrical stimulation by a cochlear implant electrode also evokes a pitch sensation corresponding to the electrode's cochlear place ("place" code) and stimulation rate ("temporal" code). However, other factors may affect electric pitch sensation, such as a substantial loss of nearby nerve fibers or even higher-level perceptual changes due to experience. The goals of this study were to measure electric pitch sensations in hybrid (short-electrode) cochlear implant patients and to examine which factors might contribute to the perceived pitch. To look at effects of experience, electric pitch sensations were compared with acoustic tone references presented to the non-implanted ear at various stages of implant use, ranging from hookup to 5 years. Here, we show that electric pitch perception often shifts in frequency, sometimes by as much as two octaves, during the first few years of implant use. Additional pitch measurements in more recently implanted patients at shorter time intervals up to 1 year of implant use suggest two likely contributions to these observed pitch shifts: intersession variability (up to one octave) and slow, systematic changes over time. We also found that the early pitch sensations for a constant electrode location can vary greatly across subjects and that these variations are strongly correlated with speech reception performance. Specifically, patients with an early low-pitch sensation tend to perform poorly with the implant compared to those with an early high-pitch sensation, which may be linked to less nerve survival in the basal end of the cochlea in the low-pitch patients. In contrast, late pitch sensations show no correlation with speech perception. These results together suggest that early pitch sensations may more closely reflect peripheral innervation patterns, while later pitch sensations may reflect higher-level, experience-dependent changes. These pitch shifts over time not only raise questions for strict place-based theories of pitch perception, but also imply that experience may have a greater influence on cochlear implant perception than previously thought.

Differences between electrode-assigned frequencies and cochlear implant recipient pitch perception

CONCLUSION

This study demonstrated an evident mismatch between frequencies assigned to electrodes and frequencies evoked by stimulation of those same electrodes in implanted patients. We propose that the mapping procedures should include, whenever possible, a comparison with homolateral residual hearing in order to obtain an appropriate frequency range assignation for each electrode.

OBJECTIVES

The study aimed to investigate the correspondence between the frequencies assigned to each electrode and those actually perceived by the cochlear implant patient.

PATIENTS AND METHODS

We studied five post-lingually deaf adults with detectable residual hearing in the implanted and in the contralateral ear, who had each received a Cochlear implant. An ACE standard setting was used for mapping. The patients were asked to match the electric pitch with the acoustic one following presentation of pure tones to both the implanted and the contralateral ear.

RESULTS

In almost all patients the two most apical electrodes evoked higher frequencies than those assigned by the mapping software (E22 = 188-313, E21 = 313-438 Hz). Therefore, electric stimulation seems not to determine pitch sensations for frequencies <500 Hz. For most electrodes there is no correspondence between the acoustic pitch and the assigned frequency ranges. Moreover, these results were almost always different when stimulating the implanted and the contralateral ear.

Psychophysical assessment of spatial spread of excitation in electrical hearing with single and dual electrode contact maskers

OBJECTIVE

To evaluate psychophysically the spatial spread of excitation in electrical hearing with a new dual contact masker and to investigate under which conditions it is possible to stimulate fibers in the immediate neighborhood of an electrode contact, which were not excited by neighboring electrode contacts.

DESIGN

In this study a psychophysical forward masking paradigm with a dual contact masker was used to avoid off-site listening, the electrical analogue of off-frequency listening. The masker stimulus (300 msec) is presented nonsimultaneously on two electrode contacts, one on the apical side and another on the basal side of the probe contact, followed by a probe stimulus of 20 msec.Unmasked probe thresholds were compared with masked ones at a number of masker-probe distances, whereas growth of masking curves were measured for a fixed masker contact pair. Standard selectivity measurements (single contact masking) and the recovery of forward masking with one masker contact were included for comparison with existing methods. All experiments were carried out with six participants who use the Clarion CII device with a HiFocus I electrode array.

RESULTS

For dual contact masking the amount of masking was significantly greater than for single contact masking and the width of the masking patterns was on average 1.1 mm broader than for single contact masking, resulting in a broad region of excitation, with masker-probe overlap for distances greater than 3 mm. Masking widths for dual and single contact masking were highly correlated. Growth of masking curves were highly nonlinear. They showed a strong elevation of the slope that starts for most subjects around the middle of the dynamic range or above. For 4 out of 6 subjects, no probe threshold was found above a masker amplitude of about 400-500 microA. The ratio of the maximum measurable masked probe thresholds and unmasked probe threshold ranged from 1.7 to 2.6 (S4 excluded). Recovery of masking functions follow an exponential decay. Time constants tau for the recovery process ranged from 21.6 msec to 114.9 msec.

CONCLUSIONS

With a dual contact masker (1) off-site listening can be avoided, leading to larger estimates of the width of excitation patterns than in single contact masking, (2) it can be estimated for which stimulation level there is complete overlap of excitation patterns of adjacent electrode contacts, (3) it can be shown that stimulation of nerve fibers in the immediate neighborhood of an electrode contact which were not excited by neighboring electrode contacts is only possible if the probe stimulation amplitude is sufficiently high in comparison with amplitudes on neighboring contacts.

A dual-process integrator-resonator model of the electrically stimulated human auditory nerve

A phenomenological dual-process model of the electrically stimulated human auditory nerve is presented and compared to threshold and loudness data from cochlear implant users. The auditory nerve is modeled as two parallel processes derived from linearized equations of conductance-based models. The first process is an integrator, which dominates stimulation for short-phase duration biphasic pulses and high-frequency sinusoidal stimuli. It has a relatively short time constant (0.094 ms) arising from the passive properties of the membrane. The second process is a resonator, which induces nonmonotonic functions of threshold vs frequency with minima around 80 Hz. The ion channel responsible for this trend has a relatively large relaxation time constant of about 1 ms. Membrane noise is modeled as a Gaussian noise, and loudness sensation is assumed to relate to the probability of firing of a neuron during a 20-ms rectangular window. Experimental psychophysical results obtained in seven previously published studies can be interpreted with this model. The model also provides a physiologically based account of the nonmonotonic threshold vs frequency functions observed in biphasic and sinusoidal stimulation, the large threshold decrease obtained with biphasic pulses having a relatively long inter-phase gap and the effects of asymmetric pulses.

Implications of deep electrode insertion on cochlear implant fitting

Using long Med-El Combi40+ electrode arrays, it is now possible to cover the whole range of the cochlea, up to about two turns. Such insertion depths have received little attention. To evaluate the contribution of deeply inserted electrodes, five Med-El cochlear implant users were tested on vowel and consonant identification tests with fittings with first one, two, and up to five apical electrodes being deactivated. In addition, subjects performed pitch-ranking experiments, using loudness-balanced stimuli, to identify electrodes creating pitch confusions. Radiographs were taken to measure each electrode insertion depth. All subjects used each modified fitting for two periods of about 3 weeks. During the experiment, the same stimulation rate and frequency range were maintained across all the fittings used for each individual subject. After each trial period the subject had to perform three consonant and three vowel identification tests. All subjects showed deep electrode insertions ranging from 605 degrees to 720 degrees. The two subjects with the deepest electrode insertions showed significantly increased vowel- and consonant-identification performances with fittings with the two or three most apical electrodes deactivated compared to their standard fitting with all available electrodes activated. The other three subjects did not show significant improvements in performance when one or two of their most apical electrodes were deactivated. Four out of five subjects preferred to continue use of a fitting with one or more apical electrodes deactivated. The two subjects with the deepest insertions also showed pitch confusions between their most apical electrodes. Two possible reasons for these results are discussed. One is to reduce neural interactions related to electrodes producing pitch confusions. Another is to improve the alignment of the frequency components of sounds coded by the electrical signals delivered to each electrode to the overall pitch of the auditory perception produced by the electrical stimulation of auditory nerve fibers.

Concurrent sound segregation in electric and acoustic hearing

We investigated potential cues to sound segregation by cochlear implant (CI) and normal-hearing (NH) listeners. In each presentation interval of experiment 1a, CI listeners heard a mixture of four pulse trains applied concurrently to separate electrodes, preceded by a "probe" applied to a single electrode. In one of these two intervals, which the subject had to identify, the probe electrode was the same as a "target" electrode in the mixture. The pulse train on the target electrode had a higher level than the others in the mixture. Additionally, it could be presented either with a 200-ms onset delay, at a lower rate, or with an asynchrony produced by delaying each pulse by about 5 ms re those on the nontarget electrodes. Neither the rate difference nor the asynchrony aided performance over and above the level difference alone, but the onset delay produced a modest improvement. Experiment 1b showed that two subjects could perform the task using the onset delay alone, with no level difference. Experiment 2 used a method similar to that of experiment 1, but investigated the onset cue using NH listeners. In one condition, the mixture consisted of harmonics 5 to 40 of a 100-Hz fundamental, with the onset of either harmonics 13 to 17 or 26 to 30 delayed re the rest. Performance was modest in this condition, but could be improved markedly by using stimuli containing a spectral gap between the target and nontarget harmonics. The results suggest that (a) CI users are unlikely to use temporal pitch differences between adjacent channels to separate concurrent sounds, and that (b) they can use onset differences between channels, but the usefulness of this cue will be compromised by the spread of excitation along the nerve-fiber array. This deleterious effect of spread-of-excitation can also impair the use of onset cues by NH listeners.

The effect of Gaussian noise on the threshold, dynamic range, and loudness of analogue cochlear implant stimuli

The deliberate addition of Gaussian noise to cochlear implant signals has previously been proposed to enhance the time coding of signals by the cochlear nerve. Potentially, the addition of an inaudible level of noise could also have secondary benefits: it could lower the threshold to the information-bearing signal, and by desynchronization of nerve discharges, it could increase the level at which the information-bearing signal becomes uncomfortable. Both these effects would lead to an increased dynamic range, which might be expected to enhance speech comprehension and make the choice of cochlear implant compression parameters less critical (as with a wider dynamic range, small changes in the parameters would have less effect on loudness). The hypothesized secondary effects were investigated with eight users of the Clarion cochlear implant; the stimulation was analogue and monopolar. For presentations in noise, noise at 95% of the threshold level was applied simultaneously and independently to all the electrodes. The noise was found in two-alternative forced-choice (2AFC) experiments to decrease the threshold to sinusoidal stimuli (100 Hz, 1 kHz, 5 kHz) by about 2.0 dB and increase the dynamic range by 0.7 dB. Furthermore, in 2AFC loudness balance experiments, noise was found to decrease the loudness of moderate to intense stimuli. This suggests that loudness is partially coded by the degree of phase-locking of cochlear nerve fibers. The overall gain in dynamic range was modest, and more complex noise strategies, for example, using inhibition between the noise sources, may be required to get a clinically useful benefit.

Indication for the need of flexible and frequency specific mapping functions in cochlear implant speech processors

Categorical loudness scaling of electric and acoustic stimuli was performed in cochlear implant (CI) recipients equipped with Nucleus systems in order to achieve a normal loudness perception in the whole dynamic range of acoustic input. For each electrode, the lower and upper limits of electric stimulus were defined by the values corresponding to "very soft" and "too loud". Within this dynamic range, the stimulus strength intervals associated to the verbal categories "soft", "medium", "loud" and "very loud" were determined. The same loudness categories were used for the scaling of acoustic stimuli. From both scaling experiments, the transduction of the CI system can be assessed and the parameters of the individual mapping function yielding a normal loudness growth can be derived. Deviations from optimum mapping can be corrected at least partially by manipulating the parameters of the mapping function. In many cases, however, one mapping function is not sufficient for all channels. The results argue in favour of the development of flexible and channel-specific mapping function parameters in future CI systems.

Effects of pulse rate on thresholds and loudness of biphasic and alternating monophasic pulse trains in electrical hearing

Detection thresholds and most comfortable loudnesses (MCLs) were determined as a function of pulse rate for standard biphasic pulse trains (BP) and for anodic and cathodic monophasic phases alternating at fixed intervals (ALT-m). Three different phase durations were examined. With a 100-micros phase duration, thresholds for the ALT-m stimulus were substantially (up to 12 dB) lower than for the BP stimuli at relatively low rates (200 pps), but were similar to the BP thresholds at high rates (1000 pps). Thresholds for BP pulse trains decreased monotonically with increasing rate, whereas the function for ALT-m waveforms was non-monotonic with a maximum between 400 and 1000 pps. These trends occurred for three different cochlear implant devices, different electrode configurations, and, generally, for different phase durations (10.8, 25, and 100 micros/phase). However, at the shorter phase durations, thresholds remained lower for the ALT-m stimulus, even at 5000 pps, the highest rate studied. Dynamic ranges of the BP pulse trains increased with increasing rate, irrespective of the phase duration under test, but for the ALT-m stimuli this was only true at the shorter phase durations tested. At a 100-mus phase duration, dynamic ranges for the ALT-m waveforms did not differ significantly as a function of rate. The results confirm previous reports that delaying charge recovery, in this case by switching from a BP to an ALT-m wave shape, can substantially reduce thresholds [Van Wieringen, A., Carlyon, R.P., Laneau, J., Wouters, J., 2005. Effects of waveform shape on human sensitivity to electrical stimulation of the inner ear. Hear. Res. 200, 73-86; Carlyon, R.P., van Wieringen, A., Deeks, J.M., Long, C.J., Lyzenga, J, Wouters, J., 2005. Effect of inter-phase gap on the sensitivity of cochlear implant users to electrical stimulation. Hear. Res. 205, 210-224]. However, at high pulse rates, this advantage only occurs at short phase durations. In addition, we show that the complex interaction between the effects of pulse shape, rate, and phase duration on thresholds can be captured by the simple linear model described by Carlyon et al.

Acoustic model investigation of a multiple carrier frequency algorithm for encoding fine frequency structure: implications for cochlear implants

Current cochlear implants provide frequency resolution through the number of channels. Improving resolution by increasing channels is limited by factors such as the physiological feasibility of increasing the number of electrodes, the inability to increase the number of channels for those already implanted, and the increased possibility of channel interactions reducing channel efficacy. Recent studies have suggested an alternative method: providing a continuum of pitch percepts for each channel based on the frequency content of that channel. This study seeks to determine the frequency resolution necessary for the highest performance gain, which may give some indication of the feasibility for implementation in implants. A discrete set of carrier frequencies, instead of a continuum, are evaluated using an acoustic model to measure speech recognition. Performance increased as the number of available frequencies increased, and substantive improvement was seen with as few as two frequencies per channel. The effect of variable frequency discrimination was also assessed, and the results suggest that frequency modulation can still provide benefits with poor frequency discrimination on some channels. These results suggest that if two or more discriminable frequencies per channel can be generated for cochlear implant subjects then an improvement in speech recognition may be possible.