Intensity Discrimination and Speech Recognition of Cochlear Implant Users

Electrically evoked mismatch negativity responses to loudness and pitch cues in cochlear implant users

Objective measurements could improve cochlear implant (CI) fitting, especially for CI users who have difficulty assessing their hearing impressions. In this study, we investigated the electrically evoked mismatch negativity (eMMN) brain potential as a mainly preattentive response to pitch and loudness changes. In an electrophysiological exploratory study with 21 CI users, pitch and loudness cues were presented in controlled oddball paradigms that directly electrically stimulated the CI via software. Out of them 17 valid data sets were analyzed. A pitch cue was produced by changing the stimulating CI electrodes (pairs of adjacent electrodes). A loudness cue originated from changing the stimulation amplitude on one CI electrode. MMN responses were measured unsing clinical electroencephalography recording according to a standard recording protocol. At the group level, significant eMMN responses were elicited for loudness cues and for pitch cues at basal electrode pairs but not at apical electrode pairs. The effect of deviance direction was not significant and no stimulus artifacts were observed. Recording an electrically evoked MMN in response to loudness changes in CI users is generally feasible, and is, therefore, promising to support CI fitting procedures in the future. Detection of pitch cues would require a greater electrode distance between selected electrodes for standard and deviant stimuli, especially in apical regions. A routine clinical setup can be used to measure eMMN.

Applications of Phenomenological Loudness Models to Cochlear Implants

Cochlear implants electrically stimulate surviving auditory neurons in the cochlea to provide severely or profoundly deaf people with access to hearing. Signal processing strategies derive frequency-specific information from the acoustic signal and code amplitude changes in frequency bands onto amplitude changes of current pulses emitted by the tonotopically arranged intracochlear electrodes. This article first describes how parameters of the electrical stimulation influence the loudness evoked and then summarizes two different phenomenological models developed by McKay and colleagues that have been used to explain psychophysical effects of stimulus parameters on loudness, detection, and modulation detection. The Temporal Model is applied to single-electrode stimuli and integrates cochlear neural excitation using a central temporal integration window analogous to that used in models of normal hearing. Perceptual decisions are made using decision criteria applied to the output of the integrator. By fitting the model parameters to a variety of psychophysical data, inferences can be made about how electrical stimulus parameters influence neural excitation in the cochlea. The Detailed Model is applied to multi-electrode stimuli, and includes effects of electrode interaction at a cochlear level and a transform between integrated excitation and specific loudness. The Practical Method of loudness estimation is a simplification of the Detailed Model and can be used to estimate the relative loudness of any multi-electrode pulsatile stimuli without the need to model excitation at the cochlear level. Clinical applications of these models to novel sound processing strategies are described.

Cognitive factors contribute to speech perception in cochlear-implant users and age-matched normal-hearing listeners under vocoded conditions

This study examined the contribution of perceptual and cognitive factors to speech-perception abilities in cochlear-implant (CI) users. Thirty CI users were tested on word intelligibility in sentences with and without semantic context, presented in quiet and in noise. Performance was compared with measures of spectral-ripple detection and discrimination, thought to reflect peripheral processing, as well as with cognitive measures of working memory and non-verbal intelligence. Thirty age-matched and thirty younger normal-hearing (NH) adults also participated, listening via tone-excited vocoders, adjusted to produce mean performance for speech in noise comparable to that of the CI group. Results suggest that CI users may rely more heavily on semantic context than younger or older NH listeners, and that non-auditory working memory explains significant variance in the CI and age-matched NH groups. Between-subject variability in spectral-ripple detection thresholds was similar across groups, despite the spectral resolution for all NH listeners being limited by the same vocoder, whereas speech perception scores were more variable between CI users than between NH listeners. The results highlight the potential importance of central factors in explaining individual differences in CI users and question the extent to which standard measures of spectral resolution in CIs reflect purely peripheral processing.