Is there a fundamental 300 Hz limit to pulse rate discrimination in cochlear implants?

Combining Place and Rate of Stimulation Improves Frequency Discrimination in Cochlear Implant Users

In the auditory system, frequency is represented as tonotopic and temporal response properties of the auditory nerve. While these response properties are inextricably linked in normal hearing, cochlear implants can separately excite tonotopic location and temporal synchrony using different electrodes and stimulation rates, respectively. This separation allows for the investigation of the contributions of tonotopic and temporal cues for frequency discrimination. The present study examines frequency discrimination in adult cochlear implant users as conveyed by electrode position and stimulation rate, separately and combined. The working hypothesis is that frequency discrimination is better provided by place and rate cues combined compared to either cue alone. This hypothesis was tested in two experiments. In the first experiment, frequency discrimination needed for melodic contour identification was measured for frequencies near 100, 200, and 400 Hz using frequency allocation modeled after clinical processors. In the second experiment, frequency discrimination for pitch ranking was measured for frequencies between 100 and 1600 Hz using an experimental frequency allocation designed to provide better access to place cues. The results of both experiments indicate that frequency discrimination is better with place and rate cues combined than with either cue alone. These results clarify how signal processing for cochlear implants could better encode frequency into place and rate of electrical stimulation. Further, the results provide insight into the contributions of place and rate cues for pitch.

Effect of stimulation parameters on sequential current-steered stimuli in cochlear implants

Manipulation of cochlear implant (CI) place pitch was carried out with current steering by stimulating two CI electrodes sequentially. The objective was to investigate whether shifts in activated neural populations could be achieved to produce salient pitch differences and to determine which stimulation parameters would be more effective in steering of current. These were the pulse rate and pulse width of electrical stimuli and the distance between the two current-steering electrodes. Nine CI users participated, and ten ears were tested. The pattern of pitch changes was not consistent across listeners, but the data suggest that individualized selection of stimulation parameters may be used to effect place pitch changes with sequential current steering. Individual analyses showed that pulse width generally had little influence on the effectiveness of current steering with sequential stimuli, while more salient place pitch shifts were often achieved at wider electrode spacing or when the stimulation pulse rate was the same as that indicated on the clinical MAP (the set of stimulation parameters) of the listener. Results imply that current steering may be used in CIs that allow only sequential stimulation to achieve place pitch manipulation.

The burst gap is a peripheral temporal code for pitch perception that is shared across audition and touch

When tactile afferents were manipulated to fire in periodic bursts of spikes, we discovered that the perceived pitch corresponded to the inter-burst interval (burst gap) in a spike train, rather than the spike rate or burst periodicity as previously thought. Given that tactile frequency mechanisms have many analogies to audition, and indications that temporal frequency channels are linked across the two modalities, we investigated whether there is burst gap temporal encoding in the auditory system. To link this putative neural code to perception, human subjects (n = 13, 6 females) assessed pitch elicited by trains of temporally-structured acoustic pulses in psychophysical experiments. Each pulse was designed to excite a fixed population of cochlear neurons, precluding place of excitation cues, and to elicit desired temporal spike trains in activated afferents. We tested periodicities up to 150 Hz using a variety of burst patterns and found striking deviations from periodicity-predicted pitch. Like the tactile system, the duration of the silent gap between successive bursts of neural activity best predicted perceived pitch, emphasising the role of peripheral temporal coding in shaping pitch. This suggests that temporal patterning of stimulus pulses in cochlear implant users might improve pitch perception.

Pleasantness Ratings of Musical Dyads in Cochlear Implant Users

Cochlear implants have been used to restore hearing to more than half a million people around the world. The restored hearing allows most recipients to understand spoken speech without relying on visual cues. While speech comprehension in quiet is generally high for recipients, many complain about the sound of music. The present study examines consonance and dissonance perception in nine cochlear implant users and eight people with no known hearing loss. Participants completed web-based assessments to characterize low-level psychophysical sensitivities to modulation and pitch, as well as higher-level measures of musical pleasantness and speech comprehension in background noise. The underlying hypothesis is that sensitivity to modulation and pitch, in addition to higher levels of musical sophistication, relate to higher-level measures of music and speech perception. This hypothesis tested true with strong correlations observed between measures of modulation and pitch with measures of consonance ratings and speech recognition. Additionally, the cochlear implant users who were the most sensitive to modulations and pitch, and who had higher musical sophistication scores, had similar pleasantness ratings as those with no known hearing loss. The implication is that better coding and focused rehabilitation for modulation and pitch sensitivity will broadly improve perception of music and speech for cochlear implant users.

Interaural time difference tuning in the rat inferior colliculus is predictive of behavioral sensitivity

While a large body of literature has examined the encoding of binaural spatial cues in the auditory midbrain, studies that ask how quantitative measures of spatial tuning in midbrain neurons compare with an animal's psychoacoustic performance remain rare. Researchers have tried to explain deficits in spatial hearing in certain patient groups, such as binaural cochlear implant users, in terms of declines in apparent reductions in spatial tuning of midbrain neurons of animal models. However, the quality of spatial tuning can be quantified in many different ways, and in the absence of evidence that a given neural tuning measure correlates with psychoacoustic performance, the interpretation of such finding remains very tentative. Here, we characterize ITD tuning in the rat inferior colliculus (IC) to acoustic pulse train stimuli with varying envelopes and at varying rates, and explore whether quality of tuning correlates behavioral performance. We quantified both mutual information (MI) and neural d' as measures of ITD sensitivity. Neural d' values paralleled behavioral ones, declining with increasing click rates or when envelopes changed from rectangular to Hanning windows, and they correlated much better with behavioral performance than MI. Meanwhile, MI values were larger in an older, more experienced cohort of animals than in naive animals, but neural d' did not differ between cohorts. However, the results obtained with neural d' and MI were highly correlated when ITD values were coded simply as left or right ear leading, rather than specific ITD values. Thus, neural measures of lateralization ability (e.g. d' or left/right MI) appear to be highly predictive of psychoacoustic performance in a two-alternative forced choice task.

Perceptual learning of pitch provided by cochlear implant stimulation rate

Cochlear implant users hear pitch evoked by stimulation rate, but discrimination diminishes for rates above 300 Hz. This upper limit on rate pitch is surprising given the remarkable and specialized ability of the auditory nerve to respond synchronously to stimulation rates at least as high as 3 kHz and arguably as high as 10 kHz. Sensitivity to stimulation rate as a pitch cue varies widely across cochlear implant users and can be improved with training. The present study examines individual differences and perceptual learning of stimulation rate as a cue for pitch ranking. Adult cochlear implant users participated in electrode psychophysics that involved testing once per week for three weeks. Stimulation pulse rate discrimination was measured in bipolar and monopolar configurations for apical and basal electrodes. Base stimulation rates between 100 and 800 Hz were examined. Individual differences were quantified using psychophysically derived metrics of spatial tuning and temporal integration. This study examined distribution of measures across subjects, predictive power of psychophysically derived metrics of spatial tuning and temporal integration, and the effect of training on rate discrimination thresholds. Psychophysical metrics of spatial tuning and temporal integration were not predictive of stimulation rate discrimination, but discrimination thresholds improved at lower frequencies with training. Since most clinical devices do not use variable stimulation rates, it is unknown to what extent recipients may learn to use stimulation rate cues if provided in a clear and consistent manner.

Comparison of the Effects of Two Cochlear Implant Fine Structure Coding Strategies on Speech Perception

Purpose This study aims to investigate the effect of upgrading from the fine structure processing (FSP) coding strategy to the novel fine structure strategy "FS4" in adults in adults with cochlear implants manufactured by MED-EL GmbH (Innsbruck, Austria). Method A crossover, double-blinded study was conducted for 12 weeks. Twelve adult participants were randomly assigned to two groups. During the first 6-week test interval, one group continued to use their everyday FSP strategy, whereas the other group was upgraded to the FS4 strategy. In the second 6-week interval, the two groups switched coding strategies. Speech perception was measured at the end of each test interval with the Oldenburg Sentence Test and the Göttingen Sentence Test. Participants completed the Speech, Spatial and Qualities of Hearing Scale at the end of each test interval and a simple preference test at the end of the study. Results There was no significant difference in speech perception test results obtained with the Oldenburg Sentence Test and the Göttingen Sentence Test, neither in quiet nor in noise. Participants' Speech, Spatial and Qualities of Hearing Scale self-evaluation and preference test results showed that the two coding strategies had similar effects on their hearing perception. No clear preference for either of the strategies was found. Conclusions Speech perception test results and the participants' level of satisfaction were similar for the two FS coding strategies. Despite differences in the presentation of temporal fine structure between FSP and FS4, a clear benefit of the newer FS4 strategy could not be shown.

Pulse-rate discrimination deficit in cochlear implant users: is the upper limit of pitch peripheral or central?

Cochlear implant (CI) users do not reliably associate an increase in pulse rate above 300 pulses per second (pps) with an increase in pitch. The locus of this upper limit of pitch remains unknown. The present study tested the hypothesis that this deficit resides at least initially at the auditory nerve. The hypothesis was tested by comparing pulse rate discrimination in different neural excitation patterns, in which a large versus small population of auditory nerve fibers was activated. If poorer pulse rate discrimination was found under conditions where narrower spread of neural excitation (SOE) was anticipated where a relatively small neural population was activated, then it would support the hypothesis that the rate processing deficit found in CI users is related to peripheral neural degeneration. Nine listeners (12 ears) implanted with the Cochlear Americas Nucleus^® devices participated in the study. Different SOE conditions were created by (1) selecting electrodes that showed narrow versus broad forward-masked psychophysical spatial tuning curves, and (2) by measuring these electrodes in monopolar (MP) and narrow bipolar (BP0) electrode configurations. Rate discrimination difference limen (DL) was measured at the selected electrodes in two electrode configurations at three base rates (200, 300 and 500 pps). Consistent with the prediction, group mean DL was better (1) at stimulation sites measured with broader tuning, and (2) in MP relative to BP stimulation. These effects were more salient at the more challenging base rates. There was a weak relationship between rate discrimination (above thresholds) and the effect of rate on detection thresholds. Finally, rate discrimination at rates above the known upper limit (i.e., 500 pps) was correlated with duration of deafness and highly predicted the subjects' speech recognition performance in noise. These findings support that pulse rate discrimination depends, at least partially, on neural conditions at the auditory periphery and this peripheral limit predicts speech recognition outcomes with a CI.

Pediatric Auditory Brainstem Implant Surgery

Auditory brainstem implants (ABIs) provide auditory perception in patients with profound hearing loss who are not candidates for the cochlear implant (CI) because of anatomic constraints or failed CI surgery. Herein, the authors discuss (1) preoperative evaluation of pediatric ABI candidates, (2) surgical approaches, and (3) contemporary ABI devices and their use in the pediatric population. The authors also review the surgical and audiologic outcomes following pediatric ABI surgery. The authors' institutional experience and the nearly 200 cases performed in Europe and the United States indicate that ABI surgery in children can be safe and effective.

Effects of Stimulation Rate With the FS4 and HDCIS Coding Strategies in Cochlear Implant Recipients

OBJECTIVE

The aim of the present study was to evaluate the effect of stimulation rate on speech perception and sound quality for the fine structure strategy FS4 and the envelope-based strategy high definition continuous interleaved sampling (HDCIS).

STUDY DESIGN

Randomized crossover trial with four conditions.

SETTING

Tertiary referral.

PATIENTS

Twenty-six postlingually deafened adult cochlear implant (CI) recipients were included.

INTERVENTION

All subjects were equipped with four coding strategies: FS4 with high rate on the envelope channels (on average 1376 pps/ch), FS4 low rate (750 pps/ch), and HDCIS with the same high and low rates. A "flat-charge map" was used for all four strategies. Only the loudness was balanced between programs. All tests were performed acutely in a double blind manner and a randomized sequence.

MAIN OUTCOME MEASURES

Monosyllables in quiet and subjective sound quality.

RESULTS

Mean monosyllables scores at 65 dB in quiet were 25.5% correct with HDCIS low rate, 27.2% correct with HDCIS high rate, 25.2% with FS4 low rate, and 33.1% with FS4 high rate. Performance with high stimulation rates was significantly higher than with the low rate settings. Subjective sound quality measured with visual analogue scales showed that for naturalness of speech, the improvement with a high rate version was only evident with the FS4 strategy. In both FS4 and HDCIS, higher stimulation rates elicited a higher pitch and were perceived as less dull than lower rates.

CONCLUSION

A high rate of stimulation resulted in better speech recognition in both strategies and a favorable subjective sound quality for FS4 in all tested settings.

Cochlear Implant Rate Pitch and Melody Perception as a Function of Place and Number of Electrodes

Six Nucleus cochlear implant recipients participated in a study investigating the effect of place of stimulation on melody perception using rate-pitch cues. Each stimulus was a pulse train delivered on either a single electrode or multiple electrodes sequentially. Four spatial stimulation patterns were used: a single apical electrode, a single mid electrode, a pair of electrodes (apical and mid), and 11 electrodes (from apical to mid). Within one block of trials, all stimuli had the same spatial stimulation pattern, with pulse rate varying from 131 to 262 pps. An additional pulse rate range of 262 to 523 pps was tested with the single-electrode stimuli. Two experimental procedures were used: note ranking; and a modified melodies test with backwards and warp modification. In each trial of the modified melodies test, a familiar melody and a version with modified pitch were presented (in random order), and the subject’s task was to select the unmodified melody. There were no significant differences in performance for stimulation on 1, 2, or 11 electrodes, implying that recipients were unable to combine temporal information from different places in the cochlea to give a stronger pitch cue. No advantage of apical electrodes was found: at the lower pulse rates, there were no significant differences between electrodes; and at the higher pulse rates, scores on the apical electrode dropped more than those on the mid electrode.

Mandarin speech-in-noise and tone recognition using vocoder simulations of the temporal limits encoder for cochlear implants

Temporal envelope-based signal processing strategies are widely used in cochlear-implant (CI) systems. It is well recognized that the inability to convey temporal fine structure (TFS) in the stimuli limits CI users' performance, but it is still unclear how to effectively deliver the TFS. A strategy known as the temporal limits encoder (TLE), which employs an approach to derive the amplitude modulator to generate the stimuli coded in an interleaved-sampling strategy, has recently been proposed. The TLE modulator contains information related to the original temporal envelope and a slow-varying TFS from the band signal. In this paper, theoretical analyses are presented to demonstrate the superiority of TLE compared with two existing strategies, the clinically available continuous-interleaved-sampling (CIS) strategy and the experimental harmonic-single-sideband-encoder strategy. Perceptual experiments with vocoder simulations in normal-hearing listeners are conducted to compare the performance of TLE and CIS on two tasks (i.e., Mandarin speech reception in babble noise and tone recognition in quiet). The performance of the TLE modulator is mostly better than (for most tone-band vocoders) or comparable to (for noise-band vocoders) the CIS modulator on both tasks. This work implies that there is some potential for improving the representation of TFS with CIs by using a TLE strategy.

Combined neural and behavioural measures of temporal pitch perception in cochlear implant users

Four experiments measured the perceptual and neural correlates of the temporal pattern of electrical stimulation applied to one cochlear-implant (CI) electrode, for several subjects. Neural effects were estimated from the electrically evoked compound action potential (ECAP) to each pulse. Experiment 1 attenuated every second pulse of a 200-pps pulse train. Increasing attenuation caused pitch to drop and the ECAP to become amplitude modulated, thereby providing an estimate of the relationship between neural modulation and pitch. Experiment 2 showed that the pitch of a 200-pps pulse train can be reduced by delaying every second pulse, so that the inter-pulse-intervals alternate between longer and shorter intervals. This caused the ECAP to become amplitude modulated, but not by enough to account for the change in pitch. Experiment 3 replicated the finding that rate discrimination deteriorates with increases in baseline rate. This was accompanied by an increase in ECAP modulation, but by an amount that produced only a small effect on pitch in experiment 1. Experiment 4 showed that preceding a pulse train with a carefully selected "pre-pulse" could reduce ECAP modulation, but did not improve rate discrimination. Implications for theories of pitch and for limitations of pitch perception in CI users are discussed.

Limitations on Monaural and Binaural Temporal Processing in Bilateral Cochlear Implant Listeners

Monaural rate discrimination and binaural interaural time difference (ITD) discrimination were studied as functions of pulse rate in a group of bilaterally implanted cochlear implant users. Stimuli for the rate discrimination task were pulse trains presented to one electrode, which could be in the apical, middle, or basal part of the array, and in either the left or the right ear. In each two-interval trial, the standard stimulus had a rate of 100, 200, 300, or 500 pulses per second and the signal stimulus had a rate 35 % higher. ITD discrimination between pitch-matched electrode pairs was measured for the same standard rates as in the rate discrimination task and with an ITD of +/− 500 μs. Sensitivity (d′) on both tasks decreased with increasing rate, as has been reported previously. This study tested the hypothesis that deterioration in performance at high rates occurs for the two tasks due to a common neural basis, specific to the stimulation of each electrode. Results show that ITD scores for different pairs of electrodes correlated with the lower rate discrimination scores for those two electrodes. Statistical analysis, which partialed out overall differences between listeners, electrodes, and rates, supports the hypothesis that monaural and binaural temporal processing limitations are at least partly due to a common mechanism.

Judgment of musical emotions after cochlear implantation in adults with progressive deafness

While cochlear implantation is rather successful in restoring speech comprehension in quiet environments (Nimmons et al., 2008), other auditory tasks, such as music perception, can remain challenging for implant users. Here, we tested how patients who had received a cochlear implant (CI) after post-lingual progressive deafness perceive emotions in music. Thirteen adult CI recipients with good verbal comprehension (dissyllabic words ≥70%) and 13 normal hearing participants matched for age, gender, and education listened to 40 short musical excerpts that selectively expressed fear, happiness, sadness, and peacefulness ( Vieillard et al., 2008). The participants were asked to rate (on a 0–100 scale) how much the musical stimuli expressed these four cardinal emotions, and to judge their emotional valence (unpleasant–pleasant) and arousal (relaxing–stimulating). Although CI users performed above chance level, their emotional judgments (mean correctness scores) were generally impaired for happy, scary, and sad, but not for peaceful excerpts. CI users also demonstrated deficits in perceiving arousal of musical excerpts, whereas rating of valence remained unaffected. The current findings indicate that judgments of emotional categories and dimensions of musical excerpts are not uniformly impaired after cochlear implantation. These results are discussed in relation to the relatively spared abilities of CI users in perceiving temporal (rhythm and metric) as compared to spectral (pitch and timbre) musical dimensions, which might benefit the processing of musical emotions (Cooper et al., 2008).

Superior temporal resolution of Chronos versus channelrhodopsin-2 in an optogenetic model of the auditory brainstem implant

Contemporary auditory brainstem implant (ABI) performance is limited by reliance on electrical neurostimulation with its accompanying channel cross talk and current spread to non-auditory neurons. A new generation ABI based on optogenetic technology may ameliorate limitations fundamental to electrical stimulation. The most widely studied opsin is channelrhodopsin-2 (ChR2); however, its relatively slow kinetic properties may prevent the encoding of auditory information at high stimulation rates. In the present study, we compare the temporal resolution of light-evoked responses of ChR2 to a recently developed fast opsin, Chronos, to ChR2 in a murine ABI model. Viral mediated gene transfer via a posterolateral craniotomy was used to express Chronos or ChR2 in the cochlear nucleus (CN). Following a four to eight week incubation period, blue light (473 nm) was delivered via an optical fiber placed directly on the surface of the infected CN, and neural activity was recorded in the contralateral inferior colliculus (IC). Both ChR2 and Chronos evoked sustained responses to all stimuli, even at high pulse rates. In addition, optical stimulation evoked excitatory responses throughout the tonotopic axis of the IC. Synchrony of the light-evoked response to stimulus rates of 14-448 pulses/s was higher in Chronos compared to ChR2 mice (p < 0.05 at 56, 168, and 224 pulses/s). Our results demonstrate that Chronos has the ability to drive the auditory system at higher stimulation rates than ChR2 and may be a more ideal opsin for manipulation of auditory pathways in future optogenetic-based neuroprostheses. This article is part of a Special Issue entitled "Lasker Award".