Single fiber mapping of spatial excitation patterns in the electrically stimulated auditory nerve

Asymmetric pulses delivered by a cochlear implant allow a reduction in evoked firing rate and in spatial activation in the guinea pig auditory cortex

Despite that fact that the cochlear implant (CI) is one of the most successful neuro-prosthetic devices which allows hearing restoration, several aspects still need to be improved. Interactions between stimulating electrodes through current spread occurring within the cochlea drastically limit the number of discriminable frequency channels and thus can ultimately result in poor speech perception. One potential solution relies on the use of new pulse shapes, such as asymmetric pulses, which can potentially reduce the current spread within the cochlea. The present study characterized the impact of changing electrical pulse shapes from the standard biphasic symmetric to the asymmetrical shape by quantifying the evoked firing rate and the spatial activation in the guinea pig primary auditory cortex (A1). At a fixed charge, the firing rate and the spatial activation in A1 decreased by 15 to 25 % when asymmetric pulses were used to activate the auditory nerve fibers, suggesting a potential reduction of the spread of excitation inside the cochlea. A strong "polarity-order" effect was found as the reduction was more pronounced when the first phase of the pulse was cathodic with high amplitude. These results suggest that the use of asymmetrical pulse shapes in clinical settings can potentially reduce the channel interactions in CI users.

Dynamic Current Focusing Compared to Monopolar Stimulation in a Take-Home Trial of Cochlear Implant Users

OBJECTIVES

This study compared the performance of a dynamic partial tripolar cochlear implant speech encoding strategy termed dynamic current focusing (DCF) to monopolar stimulation (MP) using spectro-temporal, temporal, and speech-in-noise recognition testing.

DESIGN

DCF is a strategy that utilizes tripolar or high partial tripolar stimulation at threshold level and increases loudness by slowly widening current spread towards most comfortable level. Thirteen cochlear implant users were fitted with DCF and a non-steered MP matched on pulse rate, pulse width, and active electrodes. Nine participants completed the single-blinded within-subject crossover trial. Repeated testing consisted of four sessions. Strategies were allocated in a DCF-MP-DCF-MP or MP-DCF-MP-DCF design. Three-week adaptation periods ended with a test session in which speech-in-noise recognition (matrix speech-in-noise sentence test), spectro-temporal ripple tests (SMRT and STRIPES) and a temporal amplitude modulation detection test were conducted. All participants recorded their subjective experiences with both strategies using the Speech, Spatial and Qualities of Hearing Scale questionnaire.

RESULTS

Participants' SMRT thresholds improved 0.40 ripples per octave ( p = 0.02, Bonferroni-corrected: p = 0.1) with DCF over MP at 65 dB SPL. No significant differences between the strategies were found on speech-in-noise recognition at conversational (65 dB SPL) and soft (45 dB SPL) loudness levels, temporal testing, STRIPES, or the SMRT at 45 dB SPL. After Bonferroni correction, a learning effect remained on the matrix speech-in-noise sentence test at both loudness levels (65 dB SPL: p = 0.01; 45 dB SPL: p = 0.02). There was no difference in learning effects over time between DCF and MP. Similarly, no significant differences were found in subjective experience on the Speech, Spatial and Qualities of Hearing Scale questionnaire. DCF reduced average battery life by 48% (5.1 hours) ( p < 0.001) compared to MP.

CONCLUSIONS

DCF may improve spectral resolution over MP at comfortable loudness (65 dB SPL) in cochlear implant users. However, the evidence collected in this study was weak and the significant result disappeared after Bonferroni correction. Also, not all spectral tests revealed this improvement. As expected, battery life was reduced for DCF. Although the current study is limited by its small sample size, considering previous studies, DCF does not consistently improve speech recognition in noise over MP strategies.

Ramped pulse shapes are more efficient for cochlear implant stimulation in an animal model

In all commercial cochlear implant (CI) devices, the electric stimulation is performed with a rectangular pulse that generally has two phases of opposite polarity. To date, developing new stimulation strategies has relied on the efficacy of this shape. Here, we investigate the potential of a novel stimulation paradigm that uses biophysically-inspired electrical ramped pulses. Using electrically-evoked auditory brainstem response (eABR) recordings in mice, we found that less charge, but higher current level amplitude, is needed to evoke responses with ramped shapes that are similar in amplitude to responses obtained with rectangular shapes. The most charge-efficient pulse shape had a rising ramp over both phases, supporting findings from previous in vitro studies. This was also true for longer phase durations. Our study presents the first physiological data on CI-stimulation with ramped pulse shapes. By reducing charge consumption ramped pulses have the potential to produce more battery-efficient CIs and may open new perspectives for designing other efficient neural implants in the future.

Impulse Patterns of Auditory Nerve Fibres to Extra-and Intracochlear Electrical Stimulation

The impulse patterns of single auditory nerve fibres in cats with normal hearing and in deafened cats were studied during electrical stimulation of the cochlea at different locations. In the case of extracochlear round-window membrane stimulation, cats with normal hearing showed lowest thresholds (32 dB re 1 μA rms) for sinusoidal stimulation in the frequency range 50-300 Hz. These thresholds were independent of the acoustically determined characteristic frequencies of the fibres. The fibres of acutely deafened cats (by Neomycin) showed no spontaneous activity and could be activated only electrically with similar current values as in normal hearing cats. The action potentials were highly synchronized with the electrical signal up to 12.8 kHz. Intracochlear electrical stimulation was performed using a human multichannel cochlear implant electrode array. The excitation thresholds of the fibres for current stimulation showed poor place dependency when using different electrodes (monopolar) in the first turn of the cochlea with a remote indifferent electrode inside the middle ear. Better localization could be obtained when using bipolar stimulation with electrode pairs (electrode distance 0.75 mm) in the scala tympani. With parallel bipolar stimulation at two different locations (distance 1.5 mm) using two independent current sources a clear interaction could be observed in the firing pattern of single fibres. The measured gain and phase relations between current signal and neuronal response allowed the calculation of a model describing the summation of current density vectors acting on an excitable nerve membrane model. On the basis of these measurements, input networks were calculated to improve the channel separation of multichannel cochlear implants.

Input-Output Functions in Human Heads Obtained With Cochlear Implant and Transcranial Electric Stimulation

OBJECTIVES

Electric stimulation is used to treat a number of neurologic disorders such as epilepsy and depression. However, delivering the required current to far-field neural targets is often ineffective because of current spread through low-impedance pathways. Here, the specific aims are to develop an empirical measure for current passing through the human head and to optimize stimulation strategies for targeting deeper structures, including the auditory nerve, by utilizing the cochlear implant (CI).

MATERIALS AND METHODS

Outward input/output (I/O) functions were obtained by CI stimulation and recording scalp potentials in five CI subjects. Conversely, inward I/O functions were obtained by noninvasive transcranial electric stimulation (tES) and recording intracochlear potentials using the onboard recording capability of the CI.

RESULTS

I/O measures indicate substantial current spread, with a maximum of 2.2% gain recorded at the inner ear target during tES (mastoid-to-mastoid electrode configuration). Similarly, CI stimulation produced a maximum of 1.1% gain at the scalp electrode nearest the CI return electrode. Gain varied with electrode montage according to a point source model that accounted for distances between the stimulating and recording electrodes. Within the same electrode montages, current gain patterns varied across subjects suggesting the importance of tissue properties, geometry, and electrode positioning.

CONCLUSION

These results provide a novel objective measure of electric stimulation in the human head, which can help to optimize stimulation parameters that improve neural excitation of deep structures by reducing the influence of current spread.

Pitch of harmonic complex tones: rate and temporal coding of envelope repetition rate in inferior colliculus of unanesthetized rabbits

Harmonic complex tones (HCTs) found in speech, music, and animal vocalizations evoke strong pitch percepts at their fundamental frequencies. The strongest pitches are produced by HCTs that contain harmonics resolved by cochlear frequency analysis, but HCTs containing solely unresolved harmonics also evoke a weaker pitch at their envelope repetition rate (ERR). In the auditory periphery, neurons phase lock to the stimulus envelope, but this temporal representation of ERR degrades and gives way to rate codes along the ascending auditory pathway. To assess the role of the inferior colliculus (IC) in such transformations, we recorded IC neuron responses to HCT and sinusoidally modulated broadband noise (SAMN) with varying ERR from unanesthetized rabbits. Different interharmonic phase relationships of HCT were used to manipulate the temporal envelope without changing the power spectrum. Many IC neurons demonstrated band-pass rate tuning to ERR between 60 and 1,600 Hz for HCT and between 40 and 500 Hz for SAMN. The tuning was not related to the pure-tone best frequency of neurons but was dependent on the shape of the stimulus envelope, indicating a temporal rather than spectral origin. A phenomenological model suggests that the tuning may arise from peripheral temporal response patterns via synaptic inhibition. We also characterized temporal coding to ERR. Some IC neurons could phase lock to the stimulus envelope up to 900 Hz for either HCT or SAMN, but phase locking was weaker with SAMN. Together, the rate code and the temporal code represent a wide range of ERR, providing strong cues for the pitch of unresolved harmonics.NEW & NOTEWORTHY Envelope repetition rate (ERR) provides crucial cues for pitch perception of frequency components that are not individually resolved by the cochlea, but the neural representation of ERR for stimuli containing many harmonics is poorly characterized. Here we show that the pitch of stimuli with unresolved harmonics is represented by both a rate code and a temporal code for ERR in auditory midbrain neurons and propose possible underlying neural mechanisms with a computational model.

Development and Clinical Introduction of the Nurotron Cochlear Implant Electrode Array

As the only medical device used in the treatment for deafness, the cochlear implant has benefited to more than half a million individuals worldwide. However, the device has limited penetration due to its high cost, especially in low- and middle-income countries. China alone has 27.8 million deaf people, but less than 100,000 of them have received a cochlear implant. The Nurotron Venus device was developed to address the need for an affordable yet safe and effective cochlear implant. The present study describes the design, development, and evaluation of the Nurotron intracochlear electrode array. The standard array is 22 mm in length from the round window marker to the apical tip of the carrier and has 24 electrodes, with a surface area of 0.32 mm2 and center-to-center spacing of 0.85 mm. The Nurotron array has been tested to meet the mechanical, chemical, and electrical requirements specified by the ISO Standard 14708-07. Human temporal bone and clinical trial results showed that the Nurotron array is easy to insert (7.8/10 rating with 10 indicating the highest ease of use) and has a low complication rate (12.5%) of severe insertion trauma while achieving high device stability and reliability (6 array failures in 43,000 patient years of experience). As a critical component, the Nurotron array has contributed to the high level of Nurotron implant speech performance, equivalent to that produced by other existing devices. The Nurotron device has benefited 10,000 deaf people and helped reduce the unit cost from US$25,000 in 2011 to US$4,620 in 2017 through the Chinese Government Tender Program. New, slim, and micromachined electrodes are being developed to further improve performance and accessibility.

A multiobjective optimization procedure for the electrode design of cochlear implants

This paper presents a new procedure to design optimal electrodes for cochlear implants. The main objective of this study is to find a set of electrode designs that maximize the focalization and minimize the power consumption simultaneously. To achieve that, a criterion to measure the ability of focalization of an electrode is proposed. It is presented a procedure to determine (1) the electrical potential induced by an electrode by solving the Laplace equation through the finite element method; (2) the response of a neuron to an applied field using NEURON, a compartmentalized cell model; (3) the optimization to find the best electrode designs according to power consumption and focalization by 2 evolutionary multiobjective methods based on the non-dominated sorting genetic algorithm II: a straight multiobjective approach and a seeded multiobjective approach. An electrode design formed by 2 conductive rings with a possible difference of potential between them is proposed. It is analyzed that the response of the neuron is determined by the shape and the difference of the potential between the electrode rings. Our procedure successfully achieves a nondominated set of optimum electrode designs improving a standard electrode in both objectives, as designs with better focalization allow to include extra electrodes in the cochlear implant, and designs with lower power consumption extend the length of the battery.

Challenges for the application of optical stimulation in the cochlea for the study and treatment of hearing loss

INTRODUCTION

Electrical stimulation has long been the most effective strategy for evoking neural activity from bionic devices and has been used with great success in the cochlear implant to allow deaf people to hear speech and sound. Despite its success, the spread of electrical current stimulates a broad region of neural tissue meaning that contemporary devices have limited precision. Optical stimulation as an alternative has attracted much recent interest for its capacity to provide highly focused stimuli, and therefore, potentially improved sensory perception. Given its specificity of activation, optical stimulation may also provide a useful tool in the study of fundamental neuroanatomy and neurophysiological processes. Areas covered: This review examines the advances in optical stimulation - infrared, nanoparticle-enhanced, and optogenetic-based - and its application in the inner ear for the restoration of auditory function following hearing loss. Expert opinion: Initial outcomes suggest that optogenetic-based approaches hold the greatest potential and viability amongst optical techniques for application in the cochlea. The future success of this approach will be governed by advances in the targeted delivery of opsins to auditory neurons, improvements in channel kinetics, development of optical arrays, and innovation of opsins that activate within the optimal near-infrared therapeutic window.

Selective Neuronal Activation by Cochlear Implant Stimulation in Auditory Cortex of Awake Primate

Despite the success of cochlear implants (CIs) in human populations, most users perform poorly in noisy environments and music and tonal language perception. How CI devices engage the brain at the single neuron level has remained largely unknown, in particular in the primate brain. By comparing neuronal responses with acoustic and CI stimulation in marmoset monkeys unilaterally implanted with a CI electrode array, we discovered that CI stimulation was surprisingly ineffective at activating many neurons in auditory cortex, particularly in the hemisphere ipsilateral to the CI. Further analyses revealed that the CI-nonresponsive neurons were narrowly tuned to frequency and sound level when probed with acoustic stimuli; such neurons likely play a role in perceptual behaviors requiring fine frequency and level discrimination, tasks that CI users find especially challenging. These findings suggest potential deficits in central auditory processing of CI stimulation and provide important insights into factors responsible for poor CI user performance in a wide range of perceptual tasks.

SIGNIFICANCE STATEMENT

The cochlear implant (CI) is the most successful neural prosthetic device to date and has restored hearing in hundreds of thousands of deaf individuals worldwide. However, despite its huge successes, CI users still face many perceptual limitations, and the brain mechanisms involved in hearing through CI devices remain poorly understood. By directly comparing single-neuron responses to acoustic and CI stimulation in auditory cortex of awake marmoset monkeys, we discovered that neurons unresponsive to CI stimulation were sharply tuned to frequency and sound level. Our results point out a major deficit in central auditory processing of CI stimulation and provide important insights into mechanisms underlying the poor CI user performance in a wide range of perceptual tasks.

Effect of current focusing on the sensitivity of inferior colliculus neurons to amplitude-modulated stimulation

In multichannel cochlear implants (CIs), current is delivered to specific electrodes along the cochlea in the form of amplitude-modulated pulse trains, to convey temporal and spectral cues. Our previous studies have shown that focused multipolar (FMP) and tripolar (TP) stimulation produce more restricted neural activation and reduced channel interactions in the inferior colliculus (IC) compared with traditional monopolar (MP) stimulation, suggesting that focusing of stimulation could produce better transmission of spectral information. The present study explored the capability of IC neurons to detect modulated CI stimulation with FMP and TP stimulation compared with MP stimulation. The study examined multiunit responses of IC neurons in acutely deafened guinea pigs by systematically varying the stimulation configuration, modulation depth, and stimulation level. Stimuli were sinusoidal amplitude-modulated pulse trains (carrier rate of 120 pulses/s). Modulation sensitivity was quantified by measuring modulation detection thresholds (MDTs), defined as the lowest modulation depth required to differentiate the response of a modulated stimulus from an unmodulated one. Whereas MP stimulation showed significantly lower MDTs than FMP and TP stimulation (P values <0.05) at stimulation ≤2 dB above threshold, all stimulation configurations were found to have similar modulation sensitivities at 4 dB above threshold. There was no difference found in modulation sensitivity between FMP and TP stimulation. The present study demonstrates that current focusing techniques such as FMP and TP can adequately convey amplitude modulation and are comparable to MP stimulation, especially at higher stimulation levels, although there may be some trade-off between spectral and temporal fidelity with current focusing stimulation.

Cochlear Implant Stimulation of a Hearing Ear Generates Separate Electrophonic and Electroneural Responses

Electroacoustic stimulation in subjects with residual hearing is becoming more widely used in clinical practice. However, little is known about the properties of electrically induced responses in the hearing cochlea. In the present study, normal-hearing guinea pig cochleae underwent cochlear implantation through a cochleostomy without significant loss of hearing. Using recordings of unit activity in the midbrain, we were able to investigate the excitation patterns throughout the tonotopic field determined by acoustic stimulation. With the cochlear implant and the midbrain multielectrode arrays left in place, the ears were pharmacologically deafened and electrical stimulation was repeated in the deafened condition. The results demonstrate that, in addition to direct neuronal (electroneuronal) stimulation, in the hearing cochlea excitation of the hair cells occurs ("electrophonic responses") at the cochlear site corresponding to the dominant temporal frequency components of the electrical stimulus, provided these are < 12 kHz. The slope of the rate-level functions of the neurons in the deafened condition was steeper and the firing rate was higher than in the hearing condition at those sites that were activated in the two conditions. Finally, in a monopolar stimulation configuration, the differences between hearing status conditions were smaller than in the narrower (bipolar) configurations.

SIGNIFICANCE STATEMENT

Stimulation with cochlear implants and hearing aids is becoming more widely clinically used in subjects with residual hearing. The neurophysiological characteristics underlying electroacoustic stimulation and the mechanism of its benefit remain unclear. The present study directly demonstrates that cochlear implantation does not interfere with the normal mechanical and physiological function of the cochlea. For the first time, it double-dissociates the electrical responses of hair cells (electrophonic responses) from responses of the auditory nerve fibers (electroneural responses), with separate excited cochlear locations in the same animals. We describe the condition in which these two responses spatially overlap. Finally, the study implicates that using the clinical characteristics of stimulation makes electrophonic responses unlikely in implanted subjects.

The development of biophysical models of the electrically stimulated auditory nerve: Single-node and cable models

In the last few decades, biophysical models have emerged as a prominent tool in the study and improvement of cochlear implants, a neural prosthetic that restores a degree of sound perception to the profoundly deaf. Owing to the spatial phenomena associated with extracellular stimulation, these models have evolved to a relatively high degree of morphological and physiological detail: single-node models in the tradition of Hodgkin-Huxley are paired with cable descriptions of the auditory nerve fiber. No singular model has emerged as a frontrunner to the field; rather, parameter sets deriving from the channel kinetics and morphologies of numerous organisms (mammalian and otherwise) are combined and tuned to foster strong agreement with response properties observed in vivo, such as refractoriness, summation, and strength-duration relationships. Recently, biophysical models of the electrically stimulated auditory nerve have begun to incorporate adaptation and stochastic mechanisms, in order to better realize the goal of predicting realistic neural responses to a wide array of stimuli.

Evaluation of focused multipolar stimulation for cochlear implants in acutely deafened cats

OBJECTIVE

The conductive nature of the fluids and tissues of the cochlea can lead to broad activation of spiral ganglion neurons using contemporary cochlear implant stimulation configurations such as monopolar (MP) stimulation. The relatively poor spatial selectivity is thought to limit implant performance, particularly in noisy environments. Several current focusing techniques have been proposed to reduce the spread of activation with the aim towards achieving improved clinical performance.

APPROACH

The present research evaluated the efficacy of focused multipolar (FMP) stimulation, a relatively new focusing technique in the cochlea, and compared its efficacy to both MP stimulation and tripolar (TP) stimulation. The spread of neural activity across the inferior colliculus (IC), measured by recording the spatial tuning curve, was used as a measure of spatial selectivity. Adult cats (n = 6) were acutely deafened and implanted with an intracochlear electrode array before multi-unit responses were recorded across the cochleotopic gradient of the contralateral IC. Recordings were made in response to acoustic and electrical stimulation using the MP, TP and FMP configurations.

MAIN RESULTS

FMP and TP stimulation resulted in greater spatial selectivity than MP stimulation. However, thresholds were significantly higher (p < 0.001) for FMP and TP stimulation compared to MP stimulation. There were no differences found in spatial selectivity and threshold between FMP and TP stimulation.

SIGNIFICANCE

The greater spatial selectivity of FMP and TP stimulation would be expected to result in improved clinical performance. However, further research will be required to demonstrate the efficacy of these modes of stimulation after longer durations of deafness.

Evaluation of focused multipolar stimulation for cochlear implants in long-term deafened cats

OBJECTIVE

Focused multipolar (FMP) stimulation has been shown to produce restricted neural activation using intracochlear stimulation in animals with a normal population of spiral ganglion neurons (SGNs). However, in a clinical setting, the widespread loss of SGNs and peripheral fibres following deafness is expected to influence the effectiveness of FMP.

APPROACH

We compared the efficacy of FMP stimulation to both monopolar (MP) and tripolar (TP) stimulation in long-term deafened cat cochleae (n = 8). Unlike our previous study, these cochleae contained <10% of the normal SGN population adjacent to the electrode array. We also evaluated the effect of electrode position on stimulation modes by using either modiolar facing or lateral wall facing half-band electrodes. The spread of neural activity across the inferior colliculus, a major nucleus within the central auditory pathway, was used as a measure of spatial selectivity.

MAIN RESULTS

In cochleae with significant SGN degeneration, we observed that FMP and TP stimulation resulted in greater spatial selectivity than MP stimulation (p < 0.001). However, thresholds were significantly higher for FMP and TP stimulation compared to MP stimulation (p < 0.001). No difference between FMP and TP stimulation was found in any measures. The high threshold levels for FMP stimulation was significantly reduced without compromising spatial selectivity by varying the degree of current focusing (referred as 'partial-FMP' stimulation). Spatial selectivity of all stimulation modes was unaffected by the electrode position. Finally, spatial selectivity in long-term deafened cochleae was significantly less than that of cochleae with normal SGN population (George S S et al 2014 J. Neural Eng. 11 065003).

SIGNIFICANCE

The present results indicate that the greater spatial selectivity of FMP and TP stimulation over MP stimulation is maintained in cochleae with significant neural degeneration and is not adversely affected by electrode position. The greater spatial selectivity of FMP and TP stimulation would be expected to result in improved clinical performance.

Measurements of monopolar and bipolar current spreads using forward-masking with a fixed probe

OBJECTIVES

This research employed a forward-masking paradigm to estimate the current spread of monopolar (MP) and bipolar (BP) maskers, with current amplitudes adjusted to elicit the same loudness. Since the spatial separation between active and return electrodes is smaller in BP than in MP configurations, the BP current spread is more localized and presumably superior in terms of speech intelligibility. Because matching the loudness requires higher current in BP than in MP stimulation, previous forward-masking studies show that BP current spread is not consistently narrower across subjects or electrodes within a subject.

METHODS

The present forward-masking measures of current spread differ from those of previous studies by using the same BP probe electrode configuration for both MP and BP masker configurations, and adjusting the current levels of the MP and BP maskers so as to match them in loudness. With this method, the estimate of masker current spread would not be contaminated by differences in probe current spread. Forward masking was studied in four cochlear implant patients, two females and two males, with speech recognition scores higher than 50%; that is, their auditory-nerve survival status was more than adequate to carry out the experiments.

RESULTS

The data showed that MP and BP masker configurations produce equivalent masking patterns (and current spreads) in three participants. A fourth participant displayed asymmetrical patterns with enhancement rather than masking in some cases, especially when the probe and masker were at the same location.

DISCUSSION

This study showed equivalent masking patterns for MP and BP maskers when the BP masker current amplitude was increased to match the loudness of the MP masker, and the same BP probe configuration is used with both maskers. This finding could help to explain why cochlear implant users often fail to accrue higher speech intelligibility benefit from BP stimulation.

Abnormal pitch perception produced by cochlear implant stimulation

Contemporary cochlear implants with multiple electrode stimulation can produce good speech perception but poor music perception. Hindered by the lack of a gold standard to quantify electric pitch, relatively little is known about the nature and extent of the electric pitch abnormalities and their impact on cochlear implant performance. Here we overcame this obstacle by comparing acoustic and electric pitch perception in 3 unilateral cochlear-implant subjects who had functionally usable acoustic hearing throughout the audiometric frequency range in the non-implant ear. First, to establish a baseline, we measured and found slightly impaired pure tone frequency discrimination and nearly perfect melody recognition in all 3 subjects' acoustic ear. Second, using pure tones in the acoustic ear to match electric pitch induced by an intra-cochlear electrode, we found that the frequency-electrode function was not only 1-2 octaves lower, but also 2 times more compressed in frequency range than the normal cochlear frequency-place function. Third, we derived frequency difference limens in electric pitch and found that the equivalent electric frequency discrimination was 24 times worse than normal-hearing controls. These 3 abnormalities are likely a result of a combination of broad electric field, distant intra-cochlear electrode placement, and non-uniform spiral ganglion cell distribution and survival, all of which are inherent to the electrode-nerve interface in contemporary cochlear implants. Previous studies emphasized on the "mean" shape of the frequency-electrode function, but the present study indicates that the large "variance" of this function, reflecting poor electric pitch discriminability, is the main factor limiting contemporary cochlear implant performance.

Drug delivery to the inner ear

Bionic devices electrically activate neural populations to partially restore lost function. Of fundamental importance is the functional integrity of the targeted neurons. However, in many conditions the ongoing pathology can lead to continued neural degeneration and death that may compromise the effectiveness of the device and limit future strategies to improve performance. The use of drugs that can prevent nerve cell degeneration and promote their regeneration may improve clinical outcomes. In this paper we focus on strategies of delivering neuroprotective drugs to the auditory system in a way that is safe and clinically relevant for use in combination with a cochlear implant. The aim of this approach is to prevent neural degeneration and promote nerve regrowth in order to improve outcomes for cochlear implant recipients using techniques that can be translated to the clinic.

Monopolar intracochlear pulse trains selectively activate the inferior colliculus

Previous cochlear implant studies using isolated electrical stimulus pulses in animal models have reported that intracochlear monopolar stimulus configurations elicit broad extents of neuronal activation within the central auditory system-much broader than the activation patterns produced by bipolar electrode pairs or acoustic tones. However, psychophysical and speech reception studies that use sustained pulse trains do not show clear performance differences for monopolar versus bipolar configurations. To test whether monopolar intracochlear stimulation can produce selective activation of the inferior colliculus, we measured activation widths along the tonotopic axis of the inferior colliculus for acoustic tones and 1,000-pulse/s electrical pulse trains in guinea pigs and cats. Electrical pulse trains were presented using an array of 6-12 stimulating electrodes distributed longitudinally on a space-filling silicone carrier positioned in the scala tympani of the cochlea. We found that for monopolar, bipolar, and acoustic stimuli, activation widths were significantly narrower for sustained responses than for the transient response to the stimulus onset. Furthermore, monopolar and bipolar stimuli elicited similar activation widths when compared at stimulus levels that produced similar peak spike rates. Surprisingly, we found that in guinea pigs, monopolar and bipolar stimuli produced narrower sustained activation than 60 dB sound pressure level acoustic tones when compared at stimulus levels that produced similar peak spike rates. Therefore, we conclude that intracochlear electrical stimulation using monopolar pulse trains can produce activation patterns that are at least as selective as bipolar or acoustic stimulation.

Visual cortex responses to suprachoroidal electrical stimulation of the retina: effects of electrode return configuration

A clinically effective retinal prosthesis must evoke localized phosphenes in a retinotopic manner in response to stimulation of each of the retinal electrodes, evoke brightness cues over a wide dynamic range and function within safe stimulus limits. The effects of varying return configuration for retinal stimulation are currently unknown. To investigate this, we implanted a flexible, 7 × 12 electrode array into the suprachoroidal space of normally-sighted, anesthetized cats. Multi-unit activity in the primary visual cortex was recorded in response to electrical stimulation using various return configurations: monopolar vitreous (MPV), common ground (CG), hexagonal (HX), monopolar remote (MPR) and bipolar (BP_N). MPV stimulation was found to be the most charge efficient and was most likely to induce cortical activity within safe charge limits. HX and CG stimulation were found to exhibit greater retinal selectivity compared to the MPV return at the expense of lower cortical yield and higher P50 charge levels, while cortical selectivity was unaffected by choice of return. Responses using MPR and widely spaced BP_N configurations were similar to those using the MPV return. These results suggest that choice of return configuration for a retinal prosthesis will be balanced between resolution and stimulation within safe charge limits.

Intensity coding in electric hearing: effects of electrode configurations and stimulation waveforms

OBJECTIVES

Current cochlear implants typically stimulate the auditory nerve with biphasic pulses and monopolar electrode configurations. Tripolar stimulation can increase spatial selectivity and potentially improve place pitch related perception but requires higher current levels to elicit the same loudness as monopolar stimulation. The present study combined delayed pseudomonophonasic pulses, which produce lower thresholds, with tripolar stimulation in an attempt to solve the power-performance tradeoff problem.

DESIGN

The present study systematically measured thresholds, dynamic range, loudness growth, and intensity discrimination using either biphasic or delayed pseudomonophonasic pulses under both monopolar and tripolar stimulation. Participants were five Clarion cochlear implant users. For each subject, data from apical, middle, and basal electrode positions were collected when possible.

RESULTS

Compared with biphasic pulses, delayed pseudomonophonasic pulses increased the dynamic range by lowering thresholds while maintaining comparable maximum allowable levels under both electrode configurations. However, delayed pseudomonophonasic pulses did not change the shape of loudness growth function and actually increased intensity discrimination limens, especially at lower current levels.

CONCLUSIONS

The present results indicate that delayed pseudomonophonasic pulses coupled with tripolar stimulation cannot provide significant power savings nor can it increase the functional dynamic range. Whether this combined stimulation could improve functional spectral resolution remains to be seen.

Cochlear-implant spatial selectivity with monopolar, bipolar and tripolar stimulation

Sharp spatial selectivity is critical to auditory performance, particularly in pitch-related tasks. Most contemporary cochlear implants have employed monopolar stimulation that produces broad electric fields, which presumably contribute to poor pitch and pitch-related performance by implant users. Bipolar or tripolar stimulation can generate focused electric fields but requires higher current to reach threshold and, more interestingly, has not produced any apparent improvement in cochlear-implant performance. The present study addressed this dilemma by measuring psychophysical and physiological spatial selectivity with both broad and focused stimulations in the same cohort of subjects. Different current levels were adjusted by systematically measuring loudness growth for each stimulus, each stimulation mode, and in each subject. Both psychophysical and physiological measures showed that, although focused stimulation produced significantly sharper spatial tuning than monopolar stimulation, it could shift the tuning position or even split the tuning tips. The altered tuning with focused stimulation is interpreted as a result of poor electrode-to-neuron interface in the cochlea, and is suggested to be mainly responsible for the lack of consistent improvement in implant performance. A linear model could satisfactorily quantify the psychophysical and physiological data and derive the tuning width. Significant correlation was found between the individual physiological and psychophysical tuning widths, and the correlation was improved by log-linearly transforming the physiological data to predict the psychophysical data. Because the physiological measure took only one-tenth of the time of the psychophysical measure, the present model is of high clinical significance in terms of predicting and improving cochlear-implant performance.

Spatial extent of cochlear infrared neural stimulation determined by tone-on-light masking

Artificial neural stimulation is widely used in clinic, rehabilitation, and research. One of the limitations of electrical stimulation is the current spread in tissue. Recently, pulsed mid-infrared laser stimulation of nerves has been investigated as an alternative stimulation method. The likely benefits of infrared neural stimulation (INS) include spatial selectivity of stimulation, noncontact mode of operation, and the lack of stimulation artifact in simultaneous electrical recordings. The hypothesis for this study is that INS of the cochlear spiral ganglion at low pulse energy is as spatially selective as low-level tonal stimulation of the cochlea. Spatial selectivity was measured using a masking method. An optical pulse with fixed optical parameters was delivered through a 200-μm diameter optical fiber. An acoustic tone, variable in frequency and level, was presented simultaneously with the optical pulse. Tone-on-light masking in gerbils revealed tuning curves with best frequencies between 5.3 and 11.4 kHz. The width of the tone-on-light tuning curves was similar to the width of tone-on-tone tuning curves. The results indicate that the spatial area of INS in the gerbil cochlea is similar to the cochlear area excited by a low level acoustic tone, showing promising results for future use of INS in implantable cochlear prostheses.

Spread of cochlear excitation during stimulation with pulsed infrared radiation: inferior colliculus measurements

Infrared neural stimulation (INS) has received considerable attention over the last few years. It provides an alternative method to artificially stimulate neurons without electrical current or the introduction of exogenous chromophores. One of the primary benefits of INS could be the improved spatial selectivity when compared with electrical stimulation. In the present study, we have evaluated the spatial selectivity of INS in the acutely damaged cochlea of guinea pigs and compared it to stimulation with acoustic tone pips in normal-hearing animals. The radiation was delivered via a 200 µm diameter optical fiber, which was inserted through a cochleostomy into the scala tympani of the basal cochlear turn. The stimulated section along the cochlear spiral ganglion was estimated from the neural responses recorded from the central nucleus of the inferior colliculus (ICC). ICC responses were recorded in response to cochlear INS using a multichannel penetrating electrode array. Spatial tuning curves (STCs) were constructed from the responses. For INS, approximately 55% of the activation profiles showed a single maximum, ∼22% had two maxima and ∼13% had multiple maxima. The remaining 10% of the profiles occurred at the limits of the electrode array and could not be classified. The majority of ICC STCs indicated that the spread of activation evoked by optical stimuli is comparable to that produced by acoustic tone pips.

Effects of stimulation configurations on place pitch discrimination in cochlear implants

The present study aimed to examine the effect of electrode configuration, specifically monopolar (MP) or bipolar (BP) stimulation, on place pitch discrimination in cochlear implants (CIs). Twelve subjects implanted with the Nucleus Freedom device were presented with various pairs of stimulation across the electrode array, with varying degrees of distance between stimulation sites, and asked to judge the higher of the two in pitch. Each pair was presented either in the same mode or in different modes of stimulation for the within-mode or across-mode condition, respectively, at least 20 times. The result of the within-mode condition revealed that subjects, on average, were able to discriminate pitches significantly better in MP than in BP, with the sensitivity index (d') for adjacent channels of 1.2 for MP and 0.8 for BP. The result of the across-mode condition revealed that while individual variability existed, there was a strong tendency for CI subjects to perceive a higher pitch in BP stimulation than in MP for a similar site of stimulation. In other words, an MP channel needed to be shifted in a basal direction by as much as two electrodes on average to elicit a pitch comparable to that of a BP channel.

Neural stimulation with optical radiation

This paper reviews the existing research on infrared neural stimulation, a means of artificially stimulating neurons that has been proposed as an alternative to electrical stimulation. Infrared neural stimulation (INS) is defined as the direct induction of an evoked potential in response to a transient targeted deposition of optical energy. The foremost advantage of using optical radiation for neural stimulation is its spatial resolution. Exogenously applied or trans-genetically synthesized fluorophores are not used to achieve stimulation. Here, current work on INS is presented for motor nerves, sensory nerves, central nervous system, and in vitro preparations. A discussion follows addressing the mechanism of INS and its potential use in neuroprostheses. A brief review of neural depolarization involving other optical methods is also presented. Topics covered include optical stimulation concurrent with electrical stimulation, optical stimulation using exogenous fluorophores, and optical stimulation by transgenic induction of light-gated ion channels.

Probing the electrode-neuron interface with focused cochlear implant stimulation

Cochlear implants are highly successful neural prostheses for persons with severe or profound hearing loss who gain little benefit from hearing aid amplification. Although implants are capable of providing important spectral and temporal cues for speech perception, performance on speech tests is variable across listeners. Psychophysical measures obtained from individual implant subjects can also be highly variable across implant channels. This review discusses evidence that such variability reflects deviations in the electrode-neuron interface, which refers to an implant channel's ability to effectively stimulate the auditory nerve. It is proposed that focused electrical stimulation is ideally suited to assess channel-to-channel irregularities in the electrode-neuron interface. In implant listeners, it is demonstrated that channels with relatively high thresholds, as measured with the tripolar configuration, exhibit broader psychophysical tuning curves and smaller dynamic ranges than channels with relatively low thresholds. Broader tuning implies that frequency-specific information intended for one population of neurons in the cochlea may activate more distant neurons, and a compressed dynamic range could make it more difficult to resolve intensity-based information, particularly in the presence of competing noise. Degradation of both types of cues would negatively affect speech perception.

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.

Spiral ganglion cell survival after round window membrane application of brain-derived neurotrophic factor using gelfoam as carrier

Several studies have shown that treatment with various neurotrophins protects spiral ganglion cells (SGCs) from degeneration in hair-cell deprived cochleas. In most of these studies the neurotrophins are delivered by means of intracochlear delivery methods. Recently, other application methods that might be more suited in cochlear implant patients have been developed. We have examined if round window membrane application of gelfoam infiltrated with a neurotrophin resulted in SGC survival in deafened guinea pigs. Two weeks after deafening, gelfoam cubes infiltrated with 6 μg of brain-derived neurotrophic factor (BDNF) were deposited onto the round window membrane of the right cochleas. Electric pulses were delivered through an electrode positioned within the round window niche to electrically evoke auditory brainstem responses (eABRs). Two or four weeks after deposition of the gelfoam all cochleas were histologically examined. We found that local BDNF treatment enhances the survival of SGCs in the basal cochlear turn after two and four weeks. The treatment had no effect on SGC size or shape. In animals treated with BDNF, eABR amplitudes were smaller than in normal-hearing control animals and similar to those in deafened controls. We conclude that BDNF delivered by means of local gelfoam application provides a protective effect, which is limited compared to intracochlear delivery methods.

Measuring sound detection and reaction time in infant and toddler cochlear implant recipients using an observer-based procedure: a first report

OBJECTIVES

First, to establish the feasibility of the observer-based psychophysical procedure (OPP) in measuring sound detection in infant and toddler cochlear implant (CI) recipients. Second, to measure the psychometric function for detection (PFD) from individual subjects. Third, to determine whether reaction time (RT) provides information about the auditory sensitivity of young CI users.

DESIGN

Twelve CI recipients, 11 to 32 mo old, participated in our study. Initially, tones were presented in sound field, and children learned to respond when they heard tones but not at other times. Once an 80% correct criterion was met in sound field, a novel stimulation paradigm was used to present stimuli to a single electrode while the child listened to acoustic input on most other electrodes using their usual map. The PFD and RT were measured using this single-electrode stimulation paradigm.

RESULTS

Eleven subjects met criterion, 6 within the minimum possible number of trials. For eight subjects, the asymptotic level of detecting single-electrode stimuli averaged 86% correct, similar to levels achieved by normal-hearing infants and toddlers detecting pure tones. The PFD slope of infant and toddler CI recipients was less than or equal to the slope for adult CI users reported in previous studies. RT decreased significantly with stimulus level in four children.

CONCLUSIONS

These preliminary results suggest that psychophysical detection data can be obtained from infant and toddler CI recipients using OPP. The PFD of young CI users may be shallower than that of adult CI users. Relatively good asymptotic detection performance implies that young CI users are more attentive to sound than has been suggested in previous studies. RT tended to be a less reliable measure of detection, but methodological changes could improve its utility.

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.

Forward-masking patterns produced by symmetric and asymmetric pulse shapes in electric hearing

Two forward-masking experiments were conducted with six cochlear implant listeners to test whether asymmetric pulse shapes would improve the place-specificity of stimulation compared to symmetric ones. The maskers were either cathodic-first symmetric biphasic, pseudomonophasic (i.e., with a second anodic phase longer and lower in amplitude than the first phase), or "delayed pseudomonophasic" (identical to pseudomonophasic but with an inter-phase gap) stimuli. In experiment 1, forward-masking patterns for monopolar maskers were obtained by keeping each masker fixed on a middle electrode of the array and measuring the masked thresholds of a monopolar signal presented on several other electrodes. The results were very variable, and no difference between pulse shapes was found. In experiment 2, six maskers were used in a wide bipolar (bipolar+9) configuration: the same three pulse shapes as in experiment 1, either cathodic-first relative to the most apical or relative to the most basal electrode of the bipolar channel. The pseudomonophasic masker showed a stronger excitation proximal to the electrode of the bipolar pair for which the short, high-amplitude phase was anodic. However, no difference was obtained with the symmetric and, more surprisingly, with the delayed pseudomonophasic maskers. Implications for cochlear implant design are discussed.

The dependence of auditory nerve rate adaptation on electric stimulus parameters, electrode position, and fiber diameter: a computer model study

This paper describes results from a stochastic computational neuron model that simulates the effects of rate adaptation on the responses to electrical stimulation in the form of pulse trains. We recently reported results from a single-node computational model that included a novel element that tracks external potassium ion concentration so as to modify membrane voltage and cause adaptation-like responses. Here, we report on an improved version of the model that incorporates the anatomical components of a complete feline auditory nerve fiber (ANF) so that conduction velocity and effects of manipulating the site of excitation can be evaluated. Model results demonstrate rate adaptation and changes in spike amplitude similar to those reported for feline ANFs. Changing the site of excitation from a central to a peripheral axonal site resulted in plausible changes in latency and relative spread (i.e., dynamic range). Also, increasing the distance between a modeled ANF and a stimulus electrode tended to decrease the degree of rate adaptation observed in pulse-train responses. This effect was clearly observed for high-rate (5,000 pulse/s) trains but not low-rate (250 pulse/s) trains. Finally, for relatively short electrode-to-ANF distances, increases in modeled ANF diameter increased the degree of rate adaptation. These results are compared against available feline ANF data, and possible effects of individual parameters are discussed.

Suppression of the acoustically evoked auditory-nerve response by electrical stimulation in the cochlea of the guinea pig

There is increasing interest in the use of electro-acoustical stimulation in people with a cochlear implant that have residual low-frequency hearing in the implanted ear. This raises the issue of how electrical and acoustical stimulation interact in the cochlea. We have investigated the effect of electrical stimulation on the acoustically evoked compound action potential (CAP) in normal-hearing guinea pigs. CAPs were evoked by tone bursts, and electric stimuli were delivered at the base of the cochlea using extracochlear electrodes. CAPs could be suppressed by electrical stimulation under various conditions. The dependence of CAP suppression on several parameters was investigated, including frequency and level of the acoustic stimulus, current level of the electric stimulus and the interval between electric and acoustic stimulus (EAI). Most pronounced suppression was observed when CAPs were evoked with high-frequency tones of low level. Suppression increased with current level and at high currents low-frequency evoked CAPs could also be suppressed. Suppression was typically absent several milliseconds after the electric stimulus. Suppression mediated by direct neural responses and hair cell mediated (electrophonic) responses is discussed. We conclude that the high-frequency part of the cochlea can be stimulated electrically with little detrimental effects on CAPs evoked by low-frequency tones.

Estimation of stimulus attenuation in cochlear implants

Neural excitation profile widths at the neural level, for monopolar stimulation with Nucleus straight and contour arrays respectively, were simulated using a combined volume-conduction-neural model. The electrically evoked compound action potential profile widths at the electrode array level were calculated with a simple approximation method employing stimulus attenuation inside the cochlear duct, and the results compared to profile width data from literature. The objective of the article is to develop a simple method to estimate stimulus attenuation values by calculating the values that best fit the modelled excitation profile widths to the measured evoked compound action potential profile widths. Results indicate that the modelled excitation profile widths decrease with increasing stimulus attenuation. However, fitting of modelled excitation profile widths to measured evoked compound action potential profile widths show that different stimulus attenuation values are needed for different stimulation levels. It is suggested that the proposed simple model can provide an estimate of stimulus attenuation by calculating the value of the parameter that produces the best fit to experimental data in specific human subjects.

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.

Neurotrophins and electrical stimulation for protection and repair of spiral ganglion neurons following sensorineural hearing loss

Exogenous neurotrophins (NTs) have been shown to rescue spiral ganglion neurons (SGNs) from degeneration following a sensorineural hearing loss (SNHL). Furthermore, chronic electrical stimulation (ES) has been shown to retard SGN degeneration in some studies but not others. Since there is evidence of even greater SGN rescue when NT administration is combined with ES, we examined whether chronic ES can maintain SGN survival long after cessation of NT delivery. Young adult guinea pigs were profoundly deafened using ototoxic drugs; five days later they were unilaterally implanted with an electrode array and drug delivery system. Brain derived neurotrophic factor (BDNF) was continuously delivered to the scala tympani over a four week period while the animal simultaneously received ES via bipolar electrodes in the basal turn (i.e., turn 1) scala tympani. One cohort (n=5) received ES for six weeks (i.e., including a two week period after the cessation of BDNF delivery; ES(6)); a second cohort (n=5) received ES for 10 weeks (i.e., a six week period following cessation of BDNF delivery; ES(10)). The cochleae were harvested for histology and SGN density determined for each cochlear turn for comparison with normal hearing controls (n=4). The withdrawal of BDNF resulted in a rapid loss of SGNs in turns 2-4 of the deafened/BDNF-treated cochleae; this was significant as early as two weeks following removal of the NT when compared with normal controls (p<0.05). Importantly, there was not a significant reduction in SGNs in turn 1 (i.e., adjacent to the electrode array) two and six weeks after NT removal, as compared with normal controls. This result suggests that chronic ES can prevent the rapid loss of SGNs that occurs after the withdrawal of exogenous NTs. Implications for the clinical delivery of NTs are discussed.

Simulating the effect of spread of excitation in cochlear implants

A model was developed to simulate acoustically the effects of excitation spread in cochlear implants (CI). Based on neurophysiologic data, the proposed model simulates the electrical-current decay rate associated with broad and narrow types of excitation, such as those produced by monopolar and bipolar electrode configurations. The effect of excitation spread on speech intelligibility was simulated in normal-hearing subjects by varying the slopes of the synthesis bands in the noise vocoder. Sentences and monosyllabic words processed via 4-16 channels of stimulation with varying degrees of excitation spread were presented to normal-hearing listeners for identification. Results showed significant interaction between spectral resolution (number of channels) and spread of excitation. The effect of narrowing the excitation spread was minimal when the spectral resolution was sufficiently good (>8 channels) but it was significant when the spectral resolution was poor (4 channels). A significant decrement in performance was observed for extremely narrow excitation spread. This outcome is partly consistent with behavioral data obtained with cochlear implant studies in that CI users tend to do as well or better with monopolar stimulation than with bipolar stimulation.

Tissue resistivities determine the current flow in the cochlea

PURPOSE OF REVIEW

In individuals with severe to profound hearing loss, cochlear implants bypass normal inner ear function by applying electrical current directly into the cochlea, thereby stimulating cochlear nerve fibers. Stimulating discrete populations of spiral ganglion cells in cochlear implant users' ears is similar to the encoding of small acoustic frequency bands in a normal-hearing person's ear. Thus, spiral ganglion cells stimulated by an electrode convey the information contained by a small acoustic frequency band. Problems that refer to the current spread and subsequent nonselective stimulation of spiral ganglion cells in the cochlea are reviewed.

RECENT FINDINGS

Cochlear anatomy and tissue properties determine the current path in the cochlea. Current spreads largely via scala tympani and across turns. While most of the current leaves the cochlea via the modiolus, the facial canal and the round window constitute additional natural escape paths for the current from the cochlea. Moreover, degenerative processes change tissue resistivities and thus may affect current spread in the cochlea.

SUMMARY

Electrode design and coding strategies may result in more spatial stimulation of spiral ganglion cells, resulting in a better performance of the electrode-tissue interface.

Laser stimulation of auditory neurons: effect of shorter pulse duration and penetration depth

We have pioneered what we believe is a novel method of stimulating cochlear neurons, using pulsed infrared radiation, based on the hypothesis that optical radiation can provide more spatially selective stimulation of the cochlea than electric current. Very little of the available optical parameter space has been used for optical stimulation of neurons. Here, we use a pulsed diode laser (1.94 microm) to stimulate auditory neurons of the gerbil. Radiant exposures measured at CAP threshold are similar for pulse durations of 5, 10, 30, and 100 micros, but greater for 300-micros-long pulses. There is evidence that water absorption of optical radiation is a significant factor in optical stimulation. Heat-transfer-based analysis of the data indicates that potential structures involved in optical stimulation of cochlear neurons have a dimension on the order of approximately 10 microm. The implications of these data could direct further research and design of an optical cochlear implant.

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.

Sensitivity of inferior colliculus neurons to interaural time differences in the envelope versus the fine structure with bilateral cochlear implants

Bilateral cochlear implantation seeks to improve hearing by taking advantage of the binaural processing of the central auditory system. Cochlear implants typically encode sound in each spectral channel by amplitude modulating (AM) a fixed-rate pulse train, thus interaural time differences (ITD) are only delivered in the envelope. We investigated the ITD sensitivity of inferior colliculus (IC) neurons with sinusoidally AM pulse trains. ITD was introduced independently to the AM and/or carrier pulses to measure the relative efficacy of envelope and fine structure for delivering ITD information. We found that many IC cells are sensitive to ITD in both the envelope (ITD(env)) and fine structure (ITD(fs)) for appropriate modulation frequencies and carrier rates. ITD(env) sensitivity was generally similar to that seen in normal-hearing animals with AM tones. ITD(env) tuning generally improved with increasing modulation frequency up to the maximum modulation frequency that elicited a sustained response in a neuron (tested </=160 Hz). ITD(fs) sensitivity was present in about half the neurons for 1,000 pulse/s (pps) carriers and was nonexistent at 5,000 pps. The neurons that were sensitive to ITD(fs) at 1,000 pps were those that showed the best ITD sensitivity to low-rate pulse trains. Overall, the best ITD sensitivity was found for ITD contained in the fine structure of a moderate rate AM pulse train (1,000 pps). These results suggest that the interaural timing of current pulses should be accurately controlled in a bilateral cochlear implant processing strategy that provides salient ITD cues.

Optical stimulation of auditory neurons: effects of acute and chronic deafening

In developing neural prostheses, particular success has been realized with cochlear implants. These devices bypass damaged hair cells in the auditory system and electrically stimulate the auditory nerve directly. In contemporary cochlear implants, however, the injected electric current spreads widely along the scala tympani and across turns. Consequently, stimulation of spatially discrete spiral ganglion cell populations is difficult. In contrast to electrical stimulation, it has been shown that extremely spatially selective stimulation is possible using infrared radiation (e.g. [Izzo, A.D., Su, H.S., Pathria, J., Walsh Jr., J.T., Whitlon, D.S., Richter, C.-P., 2007a. Selectivity of neural stimulation in the auditory system: a comparison of optic and electric stimuli. J. Biomed. Opt. 12, 1-7]). Here, we explore the correlation between surviving spiral ganglion cells, following acute and chronic deafness induced by neomycin application into the middle ear, and neural stimulation using optical radiation and electrical current. In vivo experiments were conducted in gerbils. Before the animals were deafened, acoustic thresholds were obtained and neurons were stimulated with optical radiation at various pulse durations, radiation exposures, and pulse repetition rates. In one group of animals, measurements were made immediately after deafening, while the other group was tested at least four weeks after deafening. Deafness was confirmed by measuring acoustically evoked compound action potentials. Optically and electrically evoked compound action potentials and auditory brainstem responses were determined for different radiation exposures and for different electrical current amplitudes, respectively. After completion of the experiments, the animals were euthanized and the cochleae were harvested for histology. Acoustically evoked compound action potential thresholds were elevated by more than 40 dB after neomycin application in acutely deaf and more than 60 dB in chronically deaf animals. Compound action potential thresholds, which were determined with optical radiation pulses, were not significantly elevated in acutely deaf animals. However, in chronically deaf animals optically evoked CAP thresholds were elevated. Changes correlated with the number of surviving spiral ganglion cells and the optical parameters that were used for stimulation.