Effects of phase duration on detection of electrical stimulation of the human cochlea

Tripolar configuration and pulse shape in cochlear implants reduce channel interactions in the temporal domain

The present study investigates effects of current focusing and pulse shape on threshold, dynamic range, spread of excitation and channel interaction in the time domain using cochlear implant stimulation. The study was performed on 20 adult guinea pigs using a 6-channel animal cochlear implant, recording was performed in the auditory midbrain using a multielectrode array. After determining the best frequencies for individual recording contacts with acoustic stimulation, the ear was deafened and a cochlear implant was inserted into the cochlea. The position of the implant was controlled by x-ray. Stimulation with biphasic, pseudomonophasic and monophasic stimuli was performed with monopolar, monopolar with common ground, bipolar and tripolar configuration in two sets of experiments, allowing comparison of the effects of the different stimulation strategies on threshold, dynamic range, spread of excitation and channel interaction. Channel interaction was studied in the temporal domain, where two electrodes were activated with pulse trains and phase locking to these pulse trains in the midbrain was quantified. The results documented multifactorial influences on the response properties, with significant interaction between factors. Thresholds increased with increasing current focusing, but decreased with pseudomonophasic and monophasic pulse shapes. The results documented that current focusing, particularly tripolar configuration, effectively reduces channel interaction, but that also pseudomonophasic and monophasic stimulation and phase duration intensity coding reduce channel interactions.

Anodic Polarity Minimizes Facial Nerve Stimulation as a Side Effect of Cochlear Implantation

One severe side effect of the use of cochlear implants (CI) is coincidental facial nerve stimulation (FNS). Clinical methods to alleviate FNS range from the reprogramming of processor settings to revision surgery. We systematically assessed different changes in CI stimulation modes that have been discussed in the literature as "rescue factors" from FNS: electrode configuration (broad to focused), pulse shape (symmetric biphasic to pseudo-monophasic), and pulse polarity (cathodic to anodic). An FNS was assessed, based on electrophysiological thresholds, in 204 electrically evoked compound action potential (eCAP) input/output functions recorded from 33 ears of 26 guinea pigs. The stimulation level difference between auditory nerve eCAP threshold and FNS threshold was expressed as the eCAP-to-FNS offset. Coincidental FNS occurred in all animals and in 45% of all recordings. A change from monopolar to focused (bipolar, tripolar) configurations minimized FNS. The Euclidean distance between the CI contacts and the facial nerve explained no more than 33% of the variance in FNS thresholds. For both the FNS threshold and the eCAP-to-FNS offset, the change from cathodic to anodic pulse polarity significantly reduced FNS and permitted a gain of 14-71% of the dynamic range of the eCAP response. This "anodic rescue effect" was stronger for pseudo-monophasic pulses as compared to the symmetric biphasic pulse shape. These results provide possible mechanisms underlying recent clinical interventions to alleviate FNS. The "anodic-rescue effect" may offer a non-invasive therapeutic option for FNS in human CI users that should be tested clinically, preferably in combination with current-focusing methods.

Estimating health of the implanted cochlea using psychophysical strength-duration functions and electrode configuration

It is generally believed that the efficacy of cochlear implants is partly dependent on the condition of the stimulated neural population. Cochlear pathology is likely to affect the manner in which neurons respond to electrical stimulation, potentially resulting in differences in perception of electrical stimuli across cochlear implant recipients and across the electrode array in individual cochlear implant users. Several psychophysical and electrophysiological measures have been shown to predict cochlear health in animals and were used to assess conditions near individual stimulation sites in humans. In this study, we examined the relationship between psychophysical strength-duration functions and spiral ganglion neuron density in two groups of guinea pigs with cochlear implants who had minimally-overlapping cochlear health profiles. One group was implanted in a hearing ear (N = 10) and the other group was deafened by cochlear perfusion of neomycin, inoculated with an adeno-associated viral vector with an Ntf3-gene insert (AAV.Ntf3) and implanted (N = 14). Psychophysically measured strength-duration functions for both monopolar and tripolar electrode configurations were then compared for the two treatment groups. Results were also compared to their histological outcomes. Overall, there were considerable differences between the two treatment groups in terms of their psychophysical performance as well as the relation between their functional performance and histological data. Animals in the neomycin-deafened, neurotrophin-treated, and implanted group (NNI) exhibited steeper strength-duration function slopes; slopes were positively correlated with SGN density (steeper slopes in animals that had higher SGN densities). In comparison, the implanted hearing (IH) group had shallower slopes and there was no relation between slopes and spiral ganglion density. Across all animals, slopes were negatively correlated with ensemble spontaneous activity levels (shallower slopes with higher ensemble spontaneous activity levels). We hypothesize that differences in strength-duration function slopes between the two treatment groups were related to the condition of the inner hair cells, which generate spontaneous activity that could affect the across-fiber synchrony and/or the size of the population of neural elements responding to electrical stimulation. In addition, it is likely that spiral ganglion neuron peripheral processes were present in the IH group, which could affect membrane properties of the stimulated neurons. Results suggest that the two treatment groups exhibited distinct patterns of variation in conditions near the stimulating electrodes that altered detection thresholds. Overall, the results of this study suggest a complex relationship between psychophysical detection thresholds for cochlear implant stimulation and nerve survival in the implanted cochlea. This relationship seems to depend on the characteristics of the electrical stimulus, the electrode configuration, and other biological features of the implanted cochlea such as the condition of the inner hair cells and the peripheral processes.

Effect of Increasing Pulse Phase Duration on Neural Responsiveness of the Electrically Stimulated Cochlear Nerve

OBJECTIVES

The aim of this study is to (1) investigate the effects of increasing the pulse phase duration (PPD) on the neural response of the electrically stimulated cochlear nerve (CN) in children with CN deficiency (CND) and (2) compare the results from the CND population to those measured in children with normal-sized CNs.

DESIGN

Study participants included 30 children with CND and 30 children with normal-sized CNs. All participants used a Cochlear Nucleus device in the test ear. For each subject, electrically evoked compound action potential (eCAP) input/output (I/O) functions evoked by single biphasic pulses with different PPDs were recorded at three electrode locations across the electrode array. PPD durations tested in this study included 50, 62, 75, and 88 μsec/phase. For each electrode tested for each study participant, the amount of electrical charge corresponding to the maximum comfortable level measured for the 88 μsec PPD was used as the upper limit of stimulation. The eCAP amplitude measured at the highest electrical charge level, the eCAP threshold (i.e., the lowest level that evoked an eCAP), and the slope of the eCAP I/O function were measured. Generalized linear mixed effect models with study group, electrode location, and PPD as the fixed effects and subject as the random effect were used to compare these dependent variables measured at different electrode locations and PPDs between children with CND and children with normal-sized CNs.

RESULTS

Children with CND had smaller eCAP amplitudes, higher eCAP thresholds, and smaller slopes of the eCAP I/O function than children with normal-sized CNs. Children with CND who had fewer electrodes with a measurable eCAP showed smaller eCAP amplitudes and flatter eCAP I/O functions than children with CND who had more electrodes with eCAPs. Increasing the PPD did not show a statistically significant effect on any of these three eCAP parameters in the two subject groups tested in this study.

CONCLUSIONS

For the same amount of electrical charge, increasing the PPD from 50 to 88 μsec for a biphasic pulse with a 7 μsec interphase gap did not significantly affect CN responsiveness to electrical stimulation in human cochlear implant users. Further studies with different electrical pulse configurations are warranted to determine whether evaluating the eCAP sensitivity to changes in the PPD can be used as a testing paradigm to estimate neural survival of the CN for individual cochlear implant users.

Sensitivity to Pulse Phase Duration as a Marker of Neural Health Across Cochlear Implant Recipients and Electrodes

In cochlear implants, loudness has been shown to grow more slowly with increasing pulse phase duration (PPD) than with pulse amplitude (PA), possibly due to “leaky” charge integration. This leakiness has been recently quantified in terms of “charge integration efficiency,” defined as the log difference between the PPD dynamic range and PA dynamic range (both expressed in charge units), relative to a common threshold anchor. Such leakiness may differ across electrodes and/or test ears, and may reflect underlying neural health. In this study, we examined the across-site variation of charge integration in recipients of Cochlear© devices. PPD and PA dynamic ranges were measured relative to two threshold anchors with either a 25- or 50-microsecond PPD. Strength-duration functions, previously shown to relate to survival of spiral ganglion cells and peripheral processes, were compared to charge integration efficiency on selected electrodes. Results showed no significant or systematic relationship between the across-site variation in charge integration efficiency and electrode position or threshold levels. Charge integration efficiency was poorer with the 50-μs threshold anchor, suggesting that greater leakiness was associated with larger PPD dynamic ranges. Poorer and more variable charge integration efficiency across electrodes was associated with longer duration of any hearing loss, consistent with the idea that poor integration is related to neural degeneration. More variable integration efficiency was also associated with poorer speech recognition performance across test ears. The slopes of the strength-duration functions at maximum acceptable loudness were significantly correlated with charge integration efficiency. However, the strength-duration slopes were not predictive of duration of any hearing loss or speech recognition performance in our participants. As such, charge integration efficiency may be a better candidate to measure leakiness in neural populations across the electrode array, as well as the general health of the auditory nerve in human cochlear implant recipients.

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.

Effect of pulse phase duration on forward masking and spread of excitation in cochlear implant listeners

Previous cochlear implant (CI) research has shown that at a pulse train with a long pulse phase duration (PPD) requires less current but greater charge to obtain the same loudness as a pulse train with a short PPD. This might result in different excitation patterns between long and short PPDs. At equal loudness, long PPDs might produce greater masking due to greater charge. However, because they require less current, long PPDs may produce a smaller spatial spread of excitation (SOE) compared to short PPDs by evoking a greater neural firing probability within the relatively small current field. To investigate the effects of PPD on excitation patterns, overall masking and SOE were compared for equally loud stimuli with short or long PPD in 10 adult CI ears. Forward masking patterns were measured at relatively soft, medium, and loud presentation levels. Threshold shifts were calculated in terms of percent dynamic range (DR) of the probe. The area under the curve (AUC) of the masking functions was significantly larger for the long PPD than for the short PPD masker. The difference in AUC was proportional to the difference in charge between the short and long PPD maskers. To estimate SOE, the masking patterns were first normalized to the peak masking, and then AUC was calculated. SOE was significantly larger for the short PPD than for the long PPD masker. Thus, at equal loudness, long PPDs produced greater overall masking (possibly due to greater charge) but less SOE (possibly due to less current spread) than did short PPDs. The effect of the interaction between masking and SOE by long PPD stimulation remains to be tested.

Investigation of Electrically Evoked Auditory Brainstem Responses to Multi-Pulse Stimulation of High Frequency in Cochlear Implant Users

We investigated the effects of electric multi-pulse stimulation on electrically evoked auditory brainstem responses (eABRs). Multi-pulses with a high burst rate of 10,000 pps were assembled from pulses of 45-μs phase duration. Conditions of 1, 2, 4, 8, and 16 pulses were investigated. Psychophysical thresholds (THRs) and most comfortable levels (MCLs) in multi-pulse conditions were measured. Psychophysical temporal integration functions (slopes of THRs/MCLs as a function of number of pulses) were -1.30 and -0.93 dB/doubling of the number of pulses, which correspond to the doubling of pulse duration. A total of 15 eABR conditions with different numbers of pulses and amplitudes were measured. The morphology of eABRs to multi-pulse stimuli did not differ from those to conventional single pulses. eABR wave eV amplitudes and latencies were analyzed extensively. At a fixed stimulation amplitude, an increasing number of pulses caused increasing wave eV amplitudes up to a certain, subject-dependent number of pulses. Then, amplitudes either saturated or even decreased. This contradicted the conventional amplitude growth functions and also contradicted psychophysical results. We showed that destructive interference could be a possible reason for such a finding, where peaks and troughs of responses to the first pulses were suppressed by those of successive pulses in the train. This study provides data on psychophysical THRs and MCLs and corresponding eABR responses for stimulation with single-pulse and multi-pulse stimuli with increasing duration. Therefore, it provides insights how pulse trains integrate at the level of the brainstem.

Impedance measures for a better understanding of the electrical stimulation of the inner ear

The performance of cochlear implant (CI) listeners is limited by several factors among which the lack of spatial selectivity of the electrical stimulation. Recently, many studies have explored the use of multipolar strategies where several electrodes are stimulated simultaneously to focus the electrical field in a restricted region of the cochlea.

OBJECTIVE

These strategies are based on several assumptions concerning the electrical properties of the inner ear that need validation. The first, often implicit, assumption is that the medium is purely resistive and that the current waveforms produced by several electrodes sum linearly. The second assumption relates to the estimation of the contribution of each electrode to the overall electrical field. These individual contributions are usually obtained by stimulating each electrode and measuring the resulting voltage with the other inactive electrodes (i.e. the impedance matrix). However, measuring the voltage on active electrodes (i.e. the diagonal of the matrix) is not straightforward because of the polarization of the electrode-fluid interface. In existing multipolar strategies, the diagonal terms of the matrix are therefore inferred using linear extrapolation from measurements made at neighboring electrodes.

APPROACH

In experiment 1, several impedance measurements were carried out in vitro and in eight CI users using sinusoidal and pulsatile waveforms to test the resistivity and linearity hypotheses. In experiment 2, we used an equivalent electrical model including a constant phase element in order to isolate the polarization component of the contact impedance.

MAIN RESULTS

In experiment 1, high-resolution voltage recordings (1.1 MHz sampling) showed the resistivity assumption to be valid at 46.4 kHz, the highest frequency tested. However, these measures also revealed the presence of parasitic capacitive effects at high frequency that could be deleterious to multipolar strategies. Experiment 2 showed that the electrical model provides a better account of the high-resolution impedance measurements than previous approaches in the CI field that used resistor-capacitance circuit models.

SIGNIFICANCE

These results validate the main hypotheses underlying the use of multipolar stimulation but also suggest possible modifications to their implementation, including the use of an impedance model and the modification of the electrical pulse waveform.

ECAP growth function to increasing pulse amplitude or pulse duration demonstrates large inter-animal variability that is reflected in auditory cortex of the guinea pig

Despite remarkable advances made to ameliorate how cochlear implants process the acoustic environment, many improvements can still be made. One of most fundamental questions concerns a strategy to simulate an increase in sound intensity. Psychoacoustic studies indicated that acting on either the current, or the duration of the stimulating pulses leads to perception of changes in how loud the sound is. The present study compared the growth function of electrically evoked Compound Action Potentials (eCAP) of the 8^th nerve using these two strategies to increase electrical charges (and potentially to increase the sound intensity). Both with chronically (experiment 1) or acutely (experiment 2) implanted guinea pigs, only a few differences were observed between the mean eCAP amplitude growth functions obtained with the two strategies. However, both in chronic and acute experiments, many animals showed larger increases of eCAP amplitude with current increase, whereas some animals showed larger of eCAP amplitude with duration increase, and other animals show no difference between either approaches. This indicates that the parameters allowing the largest increase in eCAP amplitude considerably differ between subjects. In addition, there was a significant correlation between the strength of neuronal firing rate in auditory cortex and the effect of these two strategies on the eCAP amplitude. This suggests that pre-selecting only one strategy for recruiting auditory nerve fibers in a given subject might not be appropriate for all human subjects.

Effect of Pulse Polarity on Thresholds and on Non-monotonic Loudness Growth in Cochlear Implant Users

Most cochlear implants (CIs) activate their electrodes non-simultaneously in order to eliminate electrical field interactions. However, the membrane of auditory nerve fibers needs time to return to its resting state, causing the probability of firing to a pulse to be affected by previous pulses. Here, we provide new evidence on the effect of pulse polarity and current level on these interactions. In experiment 1, detection thresholds and most comfortable levels (MCLs) were measured in CI users for 100-Hz pulse trains consisting of two consecutive biphasic pulses of the same or of opposite polarity. All combinations of polarities were studied: anodic-cathodic-anodic-cathodic (ACAC), CACA, ACCA, and CAAC. Thresholds were lower when the adjacent phases of the two pulses had the same polarity (ACCA and CAAC) than when they were different (ACAC and CACA). Some subjects showed a lower threshold for ACCA than for CAAC while others showed the opposite trend demonstrating that polarity sensitivity at threshold is genuine and subject- or electrode-dependent. In contrast, anodic (CAAC) pulses always showed a lower MCL than cathodic (ACCA) pulses, confirming previous reports. In experiments 2 and 3, the subjects compared the loudness of several pulse trains differing in current level separately for ACCA and CAAC. For 40 % of the electrodes tested, loudness grew non-monotonically as a function of current level for ACCA but never for CAAC. This finding may relate to a conduction block of the action potentials along the fibers induced by a strong hyperpolarization of their central processes. Further analysis showed that the electrodes showing a lower threshold for ACCA than for CAAC were more likely to yield a non-monotonic loudness growth. It is proposed that polarity sensitivity at threshold reflects the local neural health and that anodic asymmetric pulses should preferably be used to convey sound information while avoiding abnormal loudness percepts.

Impact of modulating phase duration on electrically evoked auditory brainstem responses obtained during cochlear implantation

Objective To investigate the effect of increasing phase duration (pulse width, T-pulse) using a biphasic pulse composed of an initial anodic active phase followed by a balancing cathodic phase on the electrically evoked auditory brainstem responses (eABRs) recorded at the time of cochlear implantation. Design eABRs recorded during 188 surgeries for cochlear implantation from 1999 to 2006 in a single center were retrospectively reviewed by two independent observers. All patients were fitted with a NEURELEC cochlear implant (CI) device, initially DIGISONIC(®) then DIGISONIC SP(®) (2004-2006). Result Immediately following cochlear implantation, stimulation by the CI resulted in reliable wave III and V eABR waveforms (mean wave III latency 2.23 ± 0.38 ms SD and wave V latency 4.28 ± 0.42 ms SD). Latencies followed an apical to basal gradient (0.32 ms increase in mean eV latency and 0.12 ms for eIII latency). With increasing phase duration, wave III and wave V latencies significantly decreased in association with a shortening of the eIII-eV interwave gap, while amplitudes of both waves increased. Conclusion The impact of increasing phase duration on latency and amplitude of brainstem responses in a large set of patients implanted with NEURELEC CIs was reported.

Sensitivity to pulse phase duration in cochlear implant listeners: effects of stimulation mode

The objective of this study was to investigate charge-integration at threshold by cochlear implant listeners using pulse train stimuli in different stimulation modes (monopolar, bipolar, tripolar). The results partially confirmed and extended the findings of previous studies conducted in animal models showing that charge-integration depends on the stimulation mode. The primary overall finding was that threshold vs pulse phase duration functions had steeper slopes in monopolar mode and shallower slopes in more spatially restricted modes. While the result was clear-cut in eight users of the Cochlear Corporation(TM) device, the findings with the six user of the Advanced Bionics(TM) device who participated were less consistent. It is likely that different stimulation modes excite different neuronal populations and/or sites of excitation on the same neuron (e.g., peripheral process vs central axon). These differences may influence not only charge integration but possibly also temporal dynamics at suprathreshold levels and with more speech-relevant stimuli. Given the present interest in focused stimulation modes, these results have implications for cochlear implant speech processor design and protocols used to map acoustic amplitude to electric stimulation parameters.

Auditory-nerve responses to varied inter-phase gap and phase duration of the electric pulse stimulus as predictors for neuronal degeneration

After severe hair cell loss, secondary degeneration of spiral ganglion cells (SGCs) is observed-a gradual process that spans years in humans but only takes weeks in guinea pigs. Being the target for cochlear implants (CIs), the physiological state of the SGCs is important for the effectiveness of a CI. For assessment of the nerve's state, focus has generally been on its response threshold. Our goal was to add a more detailed characterization of SGC functionality. To this end, the electrically evoked compound action potential (eCAP) was recorded in normal-hearing guinea pigs and guinea pigs that were deafened 2 or 6 weeks prior to the experiments. We evaluated changes in eCAP characteristics when the phase duration (PD) and inter-phase gap (IPG) of a biphasic current pulse were varied. We correlated the magnitude of these changes to quantified histological measures of neurodegeneration (SGC packing density and SGC size). The maximum eCAP amplitude, derived from the input-output function, decreased after deafening, and increased with both PD and IPG. The eCAP threshold did not change after deafening, and decreased with increasing PD and IPG. The dynamic range was wider for the 6-weeks-deaf animals than for the other two groups. Excitability increased with IPG (steeper slope of the input-output function and lower stimulation level at the half-maximum eCAP amplitude), but to a lesser extent for the deafened animals than for normal-hearing controls. The latency was shorter for the 6-weeks-deaf animals than for the other two groups. For several of these eCAP characteristics, the effect size of IPG correlated well with histological measures of degeneration, whereas effect size of PD did not. These correlations depend on the use of high current levels, which could limit clinical application. Nevertheless, their potential of these correlations towards assessment of the condition of the auditory nerve may be of great benefit to clinical diagnostics and prognosis in cochlear implant recipients.

The polarity sensitivity of the electrically stimulated human auditory nerve measured at the level of the brainstem

Recent behavioral studies have suggested that the human auditory nerve of cochlear implant (CI) users is mainly excited by the positive (anodic) polarity. Those findings were only obtained using asymmetric pseudomonophasic (PS) pulses where the effect of one phase was measured in the presence of a counteracting phase of opposite polarity, longer duration, and lower amplitude than the former phase. It was assumed that only the short high-amplitude phase was responsible for the excitation. Similarly, it has been shown that electrically evoked compound action potentials could only be obtained in response to the anodic phases of asymmetric pulses. Here, experiment 1 measured electrically evoked auditory brainstem responses to standard symmetric, PS, reversed pseudomonophasic, and reversed pseudomonophasic with inter-phase gap (6 ms) pulses presented for both polarities. Responses were time locked to the short high-amplitude phase of asymmetric pulses and were smaller, but still measurable, when that phase was cathodic than when it was anodic. This provides the first evidence that cathodic stimulation can excite the auditory system of human CI listeners and confirms that this stimulation is nevertheless less effective than for the anodic polarity. A second experiment studied the polarity sensitivity at different intensities by means of a loudness balancing task between pseudomonophasic anodic (PSA) and pseudomonophasic cathodic (PSC) stimuli. Previous studies had demonstrated greater sensitivity to anodic stimulation only for stimuli producing loud percepts. The results showed that PSC stimuli required higher amplitudes than PSA stimuli to reach the same loudness and that this held for current levels ranging from 10 to 100% of the dynamic range.

Place-pitch manipulations with cochlear implants

Pitch can be conveyed to cochlear implant listeners via both place of excitation and temporal cues. The transmission of place cues may be hampered by several factors, including limitations on the insertion depth and number of implanted electrodes, and the broad current spread produced by monopolar stimulation. The following series of experiments investigate several methods to partially overcome these limitations. Experiment 1 compares two recently published techniques that aim to activate more apical fibers than produced by monopolar or bipolar stimulation of the most apical contacts. The first technique (phantom stimulation) manipulates the current spread by simultaneously stimulating two electrodes with opposite-polarity pulses of different amplitudes. The second technique manipulates the neural spread of excitation by using asymmetric pulses and exploiting the polarity-sensitive properties of auditory nerve fibers. The two techniques yielded similar results and were shown to produce lower place-pitch percepts than stimulation of monopolar and bipolar symmetric pulses. Furthermore, combining these two techniques may be advantageous in a clinical setting. Experiment 2 proposes a method to create place pitches intermediate to those produced by physical electrodes by using charge-balanced asymmetric pulses in bipolar mode with different degrees of asymmetry.

Extending the limits of place and temporal pitch perception in cochlear implant users

A series of experiments investigated the effects of asymmetric current waveforms on the perception of place and temporal pitch cues. The asymmetric waveforms were trains of pseudomonophasic (PS) pulses consisting of a short, high-amplitude phase followed by a longer (and lower amplitude) opposite-polarity phase. When such pulses were presented in a narrow bipolar ("BP+1") mode and with the first phase anodic relative to the most apical electrode (so-called PSA pulses), pitch was lower than when the first phase was anodic re the more basal electrode. For a pulse rate of 12 pulses per second (pps), pitch was also lower than with standard symmetric biphasic pulses in either monopolar or bipolar mode. This suggests that PSA pulses can extend the range of place-pitch percepts available to cochlear implant listeners by focusing the spread of excitation in a more apical region than common stimulation techniques. Temporal pitch was studied by requiring subjects to pitch-rank single-channel pulse trains with rates ranging from 105 to 1,156 pps; this task was repeated at several intra-cochlear stimulation sites and using both symmetric and pseudomonophasic pulses. For PSA pulses presented to apical electrodes, the upper limit of temporal pitch was significantly higher than that for all the other conditions, averaging 713 pps. Measures of discriminability obtained using the method of constant stimuli indicated that this pitch percept was probably weak. However, a multidimensional scaling study showed that the percept associated with a rate change, even at high rates, was orthogonal to that of a place change and therefore reflected a genuine change in the temporal pattern of neural activity.

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.

Effects of phase duration and pulse rate on loudness and pitch percepts in the first auditory midbrain implant patients: Comparison to cochlear implant and auditory brainstem implant results

The auditory midbrain implant (AMI), which is designed for stimulation of the inferior colliculus (IC), is now in clinical trials. The AMI consists of a single shank array (20 contacts) and uses a stimulation strategy originally designed for cochlear implants since it is already approved for human use and we do not yet know how to optimally activate the auditory midbrain. The goal of this study was to investigate the effects of different pulse rates and phase durations on loudness and pitch percepts because these parameters are required to implement the AMI stimulation strategy. Although each patient was implanted into a different region (i.e. lateral lemniscus, central nucleus of IC, dorsal cortex of IC), they generally exhibited similar threshold versus phase duration, threshold versus pulse rate, and pitch versus pulse rate curves. In particular, stimulation with 100 mus/phase, 250 pulse per second (pps) pulse trains achieved an optimal balance among safety, energy, and current threshold requirements while avoiding rate pitch effects. However, we observed large differences across patients in loudness adaptation to continuous pulse stimulation over long time scales. One patient (implanted in dorsal cortex of IC) even experienced complete loudness decay and elevation of thresholds with daily stimulation. Comparing these results with those of cochlear implant and auditory brainstem implant patients, it appears that stimulation of higher order neurons exhibits less and even no loudness summation for higher rate stimuli and greater current leakage for longer phase durations than that of cochlear neurons. The fact that all midbrain regions we stimulated, which includes three distinctly different nuclei, exhibited similar loudness summation effects (i.e. none for pulse rates above 250 pps) suggests a possible shift in some coding properties that is affected more by which stage along the auditory pathway rather than the types of neurons are being stimulated. However, loudness adaptation occurs at multiple stages from the cochlea up to the midbrain.

Higher sensitivity of human auditory nerve fibers to positive electrical currents

Most contemporary cochlear implants (CIs) stimulate the auditory nerve with trains of amplitude-modulated, symmetric biphasic pulses. Although both polarities of a pulse can depolarize the nerve fibers and generate action potentials, it remains unknown which of the two (positive or negative) phases has the stronger effect. Understanding the effects of pulse polarity will help to optimize the stimulation protocols and to deliver the most relevant information to the implant listeners. Animal experiments have shown that cathodic (negative) current flows are more effective than anodic (positive) ones in eliciting neural responses, and this finding has motivated the development of novel speech-processing algorithms. In this study, we show electrophysiologically and psychophysically that the human auditory system exhibits the opposite pattern, being more sensitive to anodic stimulation. We measured electrically evoked compound action potentials in CI listeners for phase-separated pulses, allowing us to tease out the responses to each of the two opposite-polarity phases. At an equal stimulus level, the anodic phase yielded the larger response. Furthermore, a measure of psychophysical masking patterns revealed that this polarity difference was still present at higher levels of the auditory system and was therefore not solely due to antidromic propagation of the neural response. This finding may relate to a particular orientation of the nerve fibers relative to the electrode or to a substantial degeneration and demyelination of the peripheral processes. Potential applications to improve CI speech-processing strategies are discussed.

Spatial selectivity to intracochlear electrical stimulation in the inferior colliculus is degraded after long-term deafness in cats

In an animal model of electrical hearing in prelingually deaf adults, this study examined the effects of deafness duration on response thresholds and spatial selectivity (i.e., cochleotopic organization, spatial tuning and dynamic range) in the central auditory system to intracochlear electrical stimulation. Electrically evoked auditory brain stem response (EABR) thresholds and neural response thresholds in the external (ICX) and central (ICC) nuclei of the inferior colliculus were estimated in cats after varying durations of neonatally induced deafness: in animals deafened <1.5 yr (short-deafened unstimulated, SDU cats) with a mean spiral ganglion cell (SGC) density of approximately 45% of normal and in animals deafened >2.5 yr (long-deafened, LD cats) with severe cochlear pathology (mean SGC density <7% of normal). LD animals were subdivided into unstimulated cats and those that received chronic intracochlear electrical stimulation via a feline cochlear implant. Acutely deafened, implanted adult cats served as controls. Independent of their stimulation history, LD animals had significantly higher EABR and ICC thresholds than SDU and control animals. Moreover, the spread of electrical excitation was significantly broader and the dynamic range significantly reduced in LD animals. Despite the prolonged durations of deafness the fundamental cochleotopic organization was maintained in both the ICX and the ICC of LD animals. There was no difference between SDU and control cats in any of the response properties tested. These findings suggest that long-term auditory deprivation results in a significant and possibly irreversible degradation of response thresholds and spatial selectivity to intracochlear electrical stimulation in the auditory midbrain.

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

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

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

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

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

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

Asymmetric pulses in cochlear implants: effects of pulse shape, polarity, and rate

Existing cochlear implants stimulate the auditory nerve with trains of symmetric biphasic (BP) pulses. Recent data have shown that modifying the pulse shape, while maintaining charge balance, may be beneficial in terms of reducing power consumption, increasing dynamic range, and limiting channel interactions. We measured thresholds and most comfortable levels (MCLs) for various 99-pulses-per-second (pps) stimuli. "Pseudomonophasic (PS)" pulses consist of a brief phase of one polarity followed immediately by a longer and lower-amplitude phase of the opposite polarity. We focused on a novel variant of PS pulses, termed the "delayed pseudomonophasic (DPS)" stimulus, in which the longer phase is presented midway between the short phases of two consecutive pulses. DPS pulse trains produced thresholds that were more than 10 dB lower than those obtained with BP pulses. This reduction was much greater than the 0- to 3-dB drop obtained with PS pulses and was still more than 6 dB when a pulse rate of 892 pps was used. A study of the relative contributions of the two phases of DPS suggested that the short, high-amplitude phase dominated the perceived loudness. This study showed major threshold and MCL reductions using a DPS stimulus compared to the widely used BP stimulus. These reductions, which were predicted by a simple linear filter model, might lead to considerable power savings if implemented in a cochlear implant speech processor.

Effects of waveform shape on human sensitivity to electrical stimulation of the inner ear

Psychophysical measures of the electrically stimulated human auditory system were obtained for different types of symmetric and asymmetric charge-balanced waveforms. Absolute detection thresholds of biphasic, pseudomonophasic, and 'alternating monophasic' current waveforms delivered by a bipolar intra-cochlear electrode pair were determined for four subjects implanted with the LAURA device. Thresholds for alternating monophasic stimuli, in which anodic and cathodic phases alternated every 5 ms, were 5-8 dB lower than for the biphasic waveforms for all four subjects. For two of the four subjects, thresholds for the pseudomonophasic waveforms were also significantly lower than for the biphasic waveforms. These pseudomonophasic thresholds were greatly affected neither by a 500-micros gap inserted between the two phases, nor by whether the shorter phase preceded or followed the longer one. Loudness balancing measures performed at the most comfortable levels also showed that, for equal loudness, alternating monophasic stimuli required a lower level than biphasic and pseudomonophasic waveforms. For three of the four subjects, the dynamic ranges of the pseudomonophasic (but not alternating monophasic) waveforms were greater than those of the biphasic waveforms. The results demonstrate that thresholds and dynamic ranges of human cochlear implant users can be controlled by manipulating the way in which the charge produced by the initial phase of an electrical pulse is recovered.

Effect of inter-phase gap on the sensitivity of cochlear implant users to electrical stimulation

Human behavioral thresholds for trains of biphasic pulses applied to a single channel of Nucleus CI24 and LAURA cochlear implants were measured as a function of inter-phase gap (IPG). Experiment 1 used bipolar stimulation, a 100-pps pulse rate, and a 400-ms stimulus duration. In one condition, the two phases of each pulse had opposite polarity. Thresholds continued to drop by 9-10 dB as IPG was increased from near zero to the longest value tested (2900 micros for CI24, 4900 micros for LAURA). This time course is much longer than reported for single-cell recordings from animals. In a second condition, the two phases of each pulse had the same polarity, which alternated from pulse to pulse. Thresholds were independent of IPG, and similar to those in condition 1 at IPG=4900 micros. Experiment 2 used monopolar stimulation. One condition was similar to condition 1 of experiment 1, and thresholds also dropped up to the longest IPG studied (2900 micros). This also happened when the pulse rate was reduced to 20 pps, and when only a single pulse was presented on each trial. Keeping IPG constant at 8 micros and adding an extra biphasic pulse x ms into each period produced thresholds that were roughly independent of x, indicating that the effect of IPG in the other conditions was not due to a release from refractoriness at sites central to the auditory nerve. Experiment 3 measured thresholds at three IPGs, which were less than, equal to, and more than one half of the interval between successive pulses. Thresholds were lowest at the intermediate IPG. The results of all experiments could be fit by a linear model consisting of a lowpass filter based on the function relating threshold to the frequency of sinusoidal electrical stimulation. The data and model have implications for reducing the power consumption of cochlear implants.

Psychophysical threshold variability in cochlear implant subjects

The dramatic differences observed when comparing auditory neural responses to electrical and acoustic stimulation may illustrate one of the important mechanisms underlying the sometimes poor speech recognition abilities of individuals with cochlear implants. Recent research has suggested that the absence of a stochastic component in neural responses to electrical activation may be an important potential mechanism for this degradation in speech recognition performance. There are few psychophysical data, however, demonstrating that this stochastic behavior can be measured directly in implant subjects. In this study, variability in psychophysical threshold was investigated as a measure of the stochastic nature of the underlying neural response in human and non-human subjects implanted with intracochlear electrode arrays. Threshold data collected in both monopolar and bipolar stimulation modes at several phase durations from cat and human subjects are presented. The nature of the neural input/output curve suggests that threshold variability should increase as the slope of the input/output curve is decreased, i.e. as phase duration is increased. These predictions are confirmed by the pattern of psychophysical results measured experimentally in cat and human subjects. Furthermore, the data may suggest that subjects with higher threshold variability, i.e. a relatively greater stochastic component, are more likely to have higher speech recognition scores.

Neuronal responses in cat primary auditory cortex to electrical cochlear stimulation: IV. Activation pattern for sinusoidal stimulation

Patterns of threshold distributions for single-cycle sinusoidal electrical stimulation and single pulse electrical stimulation were compared in primary auditory cortex of the adult cat. Furthermore, the effects of auditory deprivation on these distributions were evaluated and compared across three groups of adult cats. Threshold distributions for single and multiple unit responses from the middle cortical layers were obtained on the ectosylvian gyrus in an acutely implanted animal; 2 wk after deafening and implantation (short-term group); and neonatally deafened animals implanted following 2-5 yr of deafness (long-term group). For all three cases, we observed similar patterns of circumscribed regions of low response thresholds in the region of primary auditory cortex (AI). A dorsal and a ventral region of low response thresholds were found separated by a narrow, anterior-posterior strip of elevated thresholds. The ventral low-threshold regions in the short-term group were cochleotopically arranged. By contrast, the dorsal region in the short-term animals and both low-threshold regions in long-term deafened animals maintained only weak cochleotopicity. Analysis of the spatial extent of the low-threshold regions revealed that the activated area for sinusoidal stimulation was smaller and more circumscribed than for pulsatile stimulation for both dorsal and ventral AI. The width of the high-threshold ridge that separated the dorsal and ventral low-threshold regions was greater for sinusoidal stimulation. Sinusoidal and pulsatile threshold behavior differed significantly for electrode configurations with low and high minimum thresholds. Differences in threshold behavior and cortical response distributions between the sinusoidal and pulsatile stimulation suggest that stimulus shape plays a significant role in the activation of cortical activity. Differences in the activation pattern for short-term and long-term deafness reflect deafness-induced reorganizational changes based on factors such as differences in excitatory and inhibitory balance that are affected by the stimulation parameters.

Auditory cortical images of cochlear-implant stimuli: dependence on electrode configuration

This study examines patterns of auditory cortical activity elicited by single-pulse cochlear implant stimuli that vary in electrode configuration, cochlear place of stimulation, and stimulus level. Recordings were made from the primary auditory cortex (area A1) of ketamine-anesthetized guinea pigs. The spatiotemporal pattern of neural spike activity was measured simultaneously across 16 cortical locations spanning approximately 2-3 octaves of the tonotopic axis. Such a pattern, averaged over 40 presentations of any particular stimulus, was defined as the "cortical image" of that stimulus. Acutely deafened guinea pigs were implanted with a 6-electrode animal version of the 22-electrode Nucleus banded electrode array (Cochlear). Cochlear electrode configurations consisted of monopolar (MP), bipolar (BP + N) with N inactive electrodes between the active and return electrodes (0 < or = N < or = 4), tripolar (TP) with one active electrode and two flanking return electrodes, and common ground (CG) with one active electrode and as many as five return electrodes. Cortical images typically showed a focus of maximum spike probability and minimum latency. Spike probabilities tended to decrease, and latencies tended to increase, with increasing cortical distance from that focus. Cortical images of TP stimuli were the most spatially compact, followed by BP + N images, and then MP images, which were the broadest. Images of CG stimuli were rather variable across animals and stimulus channels. The locations of cortical images shifted systematically from caudal to rostral as the cochlear place of stimulation changed from basal to apical. At the most sensitive cortical site for each condition, the dynamic ranges over which spike rates increased with increased current level were restricted to about 1-2 dB, regardless of configuration. Dynamic ranges tended to increase with increasing cortical distance from the most sensitive site. Electrode configurations that produced compact cortical images (e.g., TP and BP + 0) showed the greatest range of thresholds within each cortical image and the largest dynamic range at cortical sites removed from the most sensitive site.

Electrical cochlear stimulation in the deaf cat: comparisons between psychophysical and central auditory neuronal thresholds

Cochlear prostheses for electrical stimulation of the auditory nerve ("electrical hearing") can provide auditory capacity for profoundly deaf adults and children, including in many cases a restored ability to perceive speech without visual cues. A fundamental challenge in auditory neuroscience is to understand the neural and perceptual mechanisms that make rehabilitation of hearing possible in these deaf humans. We have developed a feline behavioral model that allows us to study behavioral and physiological variables in the same deaf animals. Cats deafened by injection of ototoxic antibiotics were implanted with either a monopolar round window electrode or a multichannel scala tympani electrode array. To evaluate the effects of perceptually significant electrical stimulation of the auditory nerve on the central auditory system, an animal was trained to avoid a mild electrocutaneous shock when biphasic current pulses (0.2 ms/phase) were delivered to its implanted cochlea. Psychophysical detection thresholds and electrical auditory brain stem response (EABR) thresholds were estimated in each cat. At the conclusion of behavioral testing, acute physiological experiments were conducted, and threshold responses were recorded for single neurons and multineuronal clusters in the central nucleus of the inferior colliculus (ICC) and the primary auditory cortex (A1). Behavioral and neurophysiological thresholds were evaluated with reference to cochlear histopathology in the same deaf cats. The results of the present study include: 1) in the cats implanted with a scala tympani electrode array, the lowest ICC and A1 neural thresholds were virtually identical to the behavioral thresholds for intracochlear bipolar stimulation; 2) behavioral thresholds were lower than ICC and A1 neural thresholds in each of the cats implanted with a monopolar round window electrode; 3) EABR thresholds were higher than behavioral thresholds in all of the cats (mean difference = 6.5 dB); and 4) the cumulative number of action potentials for a sample of ICC neurons increased monotonically as a function of the amplitude and the number of stimulating biphasic pulses. This physiological result suggests that the output from the ICC may be integrated spatially across neurons and temporally integrated across pulses when the auditory nerve array is stimulated with a train of biphasic current pulses. Because behavioral thresholds were lower and reaction times were faster at a pulse rate of 30 pps compared with a pulse rate of 2 pps, spatial-temporal integration in the central auditory system was presumably reflected in psychophysical performance.

Behavioral and neurophysiological thresholds for electrical cochlear stimulation in the deaf cat

Psychophysical detection thresholds for unmodulated electrical pulse trains or for sinusoidally amplitude-modulated (SAM) pulse trains were estimated in deaf juvenile cats using a conditioned avoidance paradigm. Biphasic current pulses (0.2 ms/phase) were delivered by scala tympani electrodes consisting of 4-8 electrode contacts driven as bipolar pairs. Electrical auditory brainstem response (EABR) thresholds were obtained periodically, and at the conclusion of behavioral training, response thresholds were obtained for neurons in the inferior colliculus (IC) and the primary auditory cortex (A1) in acute physiological experiments in the same animals. The results of the study include: (1) detection thresholds for unmodulated pulse trains and for SAM pulse trains were virtually identical; (2) EABR thresholds and behavioral thresholds were significantly correlated, although EABR thresholds consistently overestimated behavioral thresholds; (3) the lowest thresholds in the IC and the A1 were significantly correlated with behavioral thresholds, and (4) mean lowest thresholds in the IC and the A1 were essentially the same as the mean psychophysical detection threshold in the trained deaf cats.

The effects of stochastic neural activity in a model predicting intensity perception with cochlear implants: low-rate stimulation

Most models of auditory nerve response to electrical stimulation are deterministic, despite significant physiological evidence for stochastic activity. Furthermore, psychophysical models and analyses of physiological data using deterministic descriptions do not accurately predict many psychophysical phenomena. In this paper we investigate whether inclusion of stochastic activity in neural models improves such predictions. To avoid the complication of interpulse interactions and to enable the use of a simpler and faster auditory nerve model we restrict our investigation to single pulses and low-rate (< 200 pulses/s) pulse trains. We apply signal detection theory to produce direct predictions of behavioral threshold, dynamic range and intensity difference limen. Specifically, we investigate threshold versus pulse duration (the strength-duration characteristics), threshold and uncomfortable loudness (and the corresponding dynamic range) versus phase duration, the effects of electrode configuration on dynamic range and on strength-duration, threshold versus number of pulses (the temporal-integration characteristics), intensity difference limen as a function of loudness, and the effects of neural survival on these measures. For all psychophysical measures investigated, the inclusion of stochastic activity in the auditory nerve model was found to produce more accurate predictions.

Across-species comparisons of psychophysical detection thresholds for electrical stimulation of the cochlea: II. Strength-duration functions for single, biphasic pulses

This paper compares psychophysical detection threshold data (new and previously published) for pulsatile electrical stimulation of the deafened inner ear, obtained from different human and nonhuman subjects. Subjects were grouped according to species. Other variables, however, such as the electrode array type and method of deafening, varied within and across species. Detection threshold levels and slopes of threshold versus phase duration functions for presentations of single, biphasic pulsatile stimuli (strength-duration functions) were compared for humans, macaques, cats, and guinea pigs. For bipolar stimulation, statistically significant differences in threshold level were observed between human subjects and all other species. The species difference did not depend on the phase duration tested. For monopolar stimulation, only nonhuman species were tested. Effects of electrode configuration on both the level and slope of psychophysical strength-duration functions were statistically significant across nonhuman species, but there was not a statistically significant interaction between species and electrode configuration. The similarity in function shape and relative paucity of significant differences in psychophysical functions across species support the continued use of multiple species for cochlear implant research.

The perceptual effects of current pulse duration in electrical stimulation of the auditory nerve

In cochlear implants employing pulsatile stimulation, loudness is controlled by current amplitude and/or pulse duration. Five experiments were conducted with cochlear implantees to investigate the hypothesis that perceptual effects other than loudness result from changes in pulse duration for durations from 50 to 266 microseconds. In experiment 1, five subjects' ability to discriminate equally loud pulse trains employing differing pulse durations was measured at four electrode positions. In 11 of the 20 cases, subjects could significantly discriminate these stimuli. In experiments 2 and 3, discrimination was measured of dual-electrode stimuli which differed in overall temporal pattern but had an equal temporal pattern on each of the individual electrodes (separated by 0 to 9 mm). Discrimination was compared for stimuli employing short or long pulse durations and, in experiment 3, employing different pulse durations on each electrode. When the pulse duration was longer, six out of seven subjects could either combine temporal information across electrode positions at wider electrode separations (experiment 2) or had better discrimination at the same electrode separation (experiment 3). This result was consistent with the hypothesis that longer pulse durations result in a greater spread of excitation than equally loud stimuli using shorter pulse durations. In experiment 4, pulse rate discrimination was compared for stimuli with differing pulse durations, and in four out of five subjects, there was no effect of pulse duration. Finally, the dB change in current per doubling of pulse duration for threshold and equally loud stimuli was calculated for nine subjects (52 electrodes). Values ranged from -5.9 to -2.0 dB/doubling, and were significantly correlated with the absolute intensity of the stimulus. This result was hypothesized to be due to a relationship between the neural charging characteristics and the distance of the excited neural elements from the electrode.

Across-species comparisons of psychophysical detection thresholds for electrical stimulation of the cochlea: I. Sinusoidal stimuli

Several species have been, and continue to be, used as subjects in studies of electrical stimulation of the cochlea. Few attempts, however, have been made to determine if data obtained from different species are quantitatively or qualitatively similar. The present work compares psychophysical absolute detection threshold vs. frequency functions for sinusoidal stimuli obtained from humans, nonhuman primates, cats, and guinea pigs. Threshold data for monopolar and bipolar electrode configurations from both previously published and unpublished studies are compared. In general, within all four species, significant intersubject variation in detection threshold level was found, but slopes of threshold vs. frequency functions were relatively well conserved within a species, under the conditions studied. With one exception (cat bipolar stimulation), threshold functions reached a minimum at or near 100 Hz across species and electrode configurations. In all cases, thresholds were significantly lower for monopolar, as compared with bipolar, configurations. Statistically, there were no significant differences in absolute threshold level across species. Threshold levels increased with frequency above 100 Hz at a rate of 3.0-7.9 dB/octave, depending on both electrode configuration and species. Slopes were steeper for monopolar than for bipolar configurations. When slopes were averaged between 200 and 2000 Hz, no statistically significant differences in overall slopes were found, nor was there a significant interaction between electrode configuration and species. There were, however, consistent species differences within more restricted regions of the function. Human functions for both monopolar and bipolar stimulation were steeper than all animal functions in the range of 100-300 Hz. Within this range, the differences between slopes for human and nonhuman subjects were statistically significant. In addition, differences were noted in the frequency at which slope decreased, with slopes for nonhuman subjects showing the decrease at higher frequencies than did those for human subjects. These differences may be true species differences, or may reflect the influence of confounding variables associated with each experimental-subject model.

Fos-like immunoreactivity in the auditory brainstem evoked by bipolar intracochlear electrical stimulation: effects of current level and pulse duration

Fos-like immunoreactivity was used to compare the auditory brain stem excitation elicited by bipolar electrical stimulation of the cochlea at various current levels relative to the electrically evoked auditory brain stem response threshold for a 50-micros/phase monophasic pulse. Fos-like immunoreactive cells were labeled in primary auditory brain stem regions. The distribution of labeled cells was restricted to regions known to be cochleotopically related to the stimulated region of the scala tympani. Some labeled cells were observed at 2x electrically evoked auditory brain stem response threshold. The number, density and spatial distribution of labeled cells were quantified in the dorsal cochlear nucleus and inferior colliculus, and found to increase with increasing level of stimulation. For 50-micros pulses, the location of labeled neurons remained reasonably restricted to narrow bands within each region until the 1Ox level of stimulation (20 dB above electrically evoked auditory brain stem response threshold) was reached. While a monotonic increase in Fos-like immunoreactivity with increasing stimulus level was observed in most nuclei, for cells of the superficial layer of the dorsal cochlear nucleus, a non-monotonic change with increasing stimulus level was seen. This dorsal cochlear nucleus non-monotonicity may indicate that, at higher levels of stimulation, a secondary indirect inhibitory input, probably associated with activation of deep layer dorsal cochlear nucleus cells, reduces excitatory responses at the superficial layer of the dorsal cochlear nucleus. Electrically evoked auditory brain stem response and Fos expression showed parallel changes as a function of stimulus level and pulse duration. The data indicate that discrete activation of cell populations within the central auditory pathways can occur with bipolar electrical stimulation to the highest levels of stimulation typically useful in humans. The data also indicate a close, but not identical, quantitative relationship between Fos-like immunoreactivity and electrophysiological response amplitude. These findings support the view that a study of Fos-like immunoreactivity can provide a powerful and quantitative tool for study of the dynamic response characteristics of cells of the central auditory system to electrical stimulation at suprathreshold levels. The data suggest that there is a monotonic increase in the number of neurons responsive to intracochlear electrical stimulation as a function of stimulus level, at least through the upper half of the dynamic range, but that this increase does not result in a complete loss of spatial selectivity. Coupled with previous psychophysical studies, these results suggest that the increase in the number of activated neurons is functionally beneficial, resulting in improved discrimination of changes in the electrical signals.

Loudness perception with pulsatile electrical stimulation: the effect of interpulse intervals

The effect of interpulse intervals on the perception of loudness of biphasic current pulse trains was investigated in eight adult cochlear implantees at three different stimulus levels encompassing the psychophysical dynamic range. Equal-loudness contours and thresholds were obtained for stimuli in which two biphasic pulses were presented in a fixed repetition period (4 and 20 ms), and also for single-pulse/period stimuli with rates varying between 20 and 750 Hz. All stimuli were of 500-ms duration, and the phase durations of each pulse were 100 microseconds or less. The results of these experiments were consistent with predictions of a three-stage model of loudness perception, consisting of a peripheral refractory effect function, a sliding central integration time window, and a central equal-loudness decision device. Application of the model to the data allowed the estimation of neural refractory characteristics of the subjects' remaining peripheral neural population. The average neural spike probability for a 50-Hz stimulus was predicted to be about 0.77, with an associated neural refractory time of 7.3 ms. These predictions did not vary systematically with level, implying that the effect of increasing current level on loudness results more from recruitment of neurons than from any increase in average spike probability.

Effects of stimulus configuration on psychophysical operating levels and on speech recognition with cochlear implants

Effects of electrode configuration and pulse duration on operating levels and on speech recognition performance were studied in a group of 14 adult postlingually deaf human subjects with Nucleus cochlear implants. The operating levels (based on detection threshold and maximum comfortable loudness levels) for narrowly spaced bipolar (BP) stimulation were found to be about 11 dB higher on average than those for widely spaced bipolar (BP+6) or monopolar (MP1) stimulation. Operating levels for common ground (CG) stimulation fell between those for BP and BP+6; the difference between BP and CG detection thresholds depended on pulse duration. Variation in detection thresholds and maximum comfortable loudness levels across the electrode array (electrodes 1-15) was larger for BP and CG stimulation than for BP+6 or MP1 stimulation, suggesting narrower spread of activation for the BP and CG configurations despite the higher current levels. Speech recognition performance was tested using experimental processor configurations. Among the experimental electrode configurations tested (BP, CG, and BP+6), the highest speech recognition scores were obtained with the BP+6 configuration in many subjects. Effects of pulse duration on speech recognition were less consistent and usually smaller than the effects of electrode configuration. The results indicate that electrode configuration is an important variable determining speech recognition performance and suggest that restriction of the size of neural population activated by individual channels of the prosthesis is not necessarily advantageous.

Effects of electrode configuration on psychophysical strength-duration functions for single biphasic electrical stimuli in cats

The interface between electrode and neural target tissue is thought to influence certain characteristics of neural and behavioral responses to electrical stimulation of the auditory system. At present, the biophysical properties of this interface are not well understood. Here the effects of biphasic phase duration and electrode configuration on psychophysical threshold in response to electrical stimulation in cats are described. Five cats were trained to respond to acoustic stimuli using food as a reward in an operant reinforcement paradigm. After training, the animals were unilaterally deafened and implanted with a multicontact intracochlear electrode array. Thresholds for single presentations of biphasic current pulses were measured as a function of phase duration and electrode arrangement. Statistical analyses of the data indicated that strength-duration function slopes between 200 and 1600 microseconds/phase were significantly different for the different electrode configurations and, overall, were unrelated to the absolute level of the strength-duration function (i.e., were independent of absolute threshold). For all subjects, the slope of this function for intermediate pulse durations was dependent on electrode configuration and most shallow for radial-bipolar configurations (-3.4 dB/doubling), was steepest for monopolar arrangements (-5.9 dB/doubling), and was intermediate for longitudinal-bipolar pairings. (-4.4 dB/doubling). Slopes for both shorter and longer phase duration stimuli were not significantly different. The underlying mechanisms for these effects may include, or be a combination of altered electrical field patterns, integrated activity across multiple fibers, and stochastic behavior of individual auditory neurons to electrical stimulation.

Interactions between pulse separation and pulse polarity order in cochlear implants

Interactions between pulse separation and pulse polarity order were examined using psychophysical studies of electrical detection thresholds in nonhuman primates. Subjects were trained using acoustic stimuli, then deafened in one ear and implanted with an electrode array for electrical stimulation of the cochlea. Threshold vs pulse separation functions for trains of biphasic electrical pulses were compared for constant and alternating leading phase polarity. When leading phase polarity was held constant, threshold vs pulse separation functions were nonmonotonic (U-shaped). Small polarity-dependent (cathodic vs anodic leading phase) differences in absolute thresholds were observed at long pulse separations, but function shape was independent of leading phase. When leading phase polarity alternated, there was a pronounced reduction in thresholds at short pulse separations (below about 1 ms), resulting in monotonically increasing threshold vs pulse separation functions. At long pulse separations, functions for alternating and constant polarity stimuli were similar. Polarity effects were most apparent for longer duration trains (20 pulses) at long pulse durations (1-2 ms/phase). For stimuli consisting of only two biphasic pulses, alternating polarity effects depended on whether cathodic or anodic phases were adjacent. The neural mechanisms underlying these effects probably include refractory properties and/or residual potentials.

Psychometric functions and temporal integration in electric hearing

Temporal-integration functions and psychometric functions for detection were obtained in eight users of the Nucleus 22-electrode cochlear implant. Stimuli were 100-Hz, 200-microseconds/phase trains of biphasic pulses with durations ranging from 0.44 to 630.4 ms (1 to 64 pulses). Temporal-integration functions were measured for 21 electrodes. Slopes of these functions were considerably shallower than the 2.5 dB/doubling slopes typically observed in acoustic hearing. They varied widely across subjects and for different electrodes in a given subject, ranging from 0.06 to 1.94 dB/doubling of stimulus pulses, with a mean [standard deviation (s.d.)] value of 0.42 (0.38). Psychometric functions were measured for 11 of the same 21 electrodes. Slopes of psychometric functions also varied across subjects and electrodes, and were 2-20 times steeper than those reported by other investigators for normal-hearing and cochlear-impaired acoustic listeners. Slopes of individual psychometric functions for 1-, 2-, 4-, and 8-pulse stimuli ranged from 0.20 to 1.84 log d'/dB with a mean (s.d.) value of 0.77 (0.45). Psychometric-function slopes did not vary systematically with stimulus duration in most cases. A clear inverse relation between slopes of psychometric functions and slopes of temporal-integration functions was observed. This relation was reasonably well described by a hyperbolic function predicted by the multiple-looks model of temporal integration [Viemeister and Wakefield, J. Acoust. Soc. Am. 90, 858-865 (1991)]. Psychometric-function slopes tended to increase with absolute threshold and were inversely correlated with dynamic range, suggesting that observed differences in psychometric-function slopes across subjects and electrodes may reflect underlying differences in neural survival.

Effects of pulse separation on detection thresholds for electrical stimulation of the human cochlea

Effects of pulse separation on detection of electrical stimulation of the cochlea were studied in 12 profoundly deaf human subjects with Nucleus 22 cochlear implants. Biphasic symmetric pulses were used. Pulse separation is the time from offset of one biphasic pulse to the onset of the next biphasic pulse in the train. Effects of pulse separation were studied in the context of different covariables in four stages of the experiment. Effects of pulse separation seen in the different stages were similar, despite the different covariables. Both pulse separation and the total number of pulses per stimulus seem to be important variables affecting stimulus detection. For 0.5 ms/phase pulses, thresholds were lowest at the shortest pulse separations tested (0.2-1.1 ms) and increased as a function of pulse separation. For 2 ms/phase pulses, detection thresholds were lowest at pulse separations around 7.5 ms, in most cases, and higher at both longer and shorter pulse separations. These results suggest that interactions among adjacent pulses can either hinder or facilitate detection of the signal depending on the magnitudes of pulse separation and phase duration. Pulse separations at which thresholds measured for 2 ms/phase pulses were minimum were fairly consistent across subjects and did not correlate well with speech recognition scores. However, significant variation in this measure across species has been seen.

Functional responses from guinea pigs with cochlear implants. I. Electrophysiological and psychophysical measures

We examined electrophysiological and psychophysical measures of the electrically stimulated auditory system of guinea pigs implanted with chronic intracochlear electrodes. Guinea pigs were trained to detect low-level acoustic stimuli and then unilaterally deafened and implanted with one extracochlear and two intracochlear electrodes. Electrically evoked auditory brainstem responses (EABRs) and psychophysical detection thresholds were obtained from the same animals using pulsatile stimuli. Supplementary EABR data were obtained from additional, untrained, animals. Thresholds were obtained as a function of stimulus phase duration and monopolar and longitudinal-bipolar electrode configurations. The slopes of the EABR and psychophysical functions for bipolar stimulation, averaged across subjects within 1 month after implantation, were -5.25 and -6.18 dB per doubling of pulse duration, respectively. These slopes were obtained with pulse durations ranging from 20 to 400 microseconds/phase; slope was reduced at longer pulse durations. Strength-duration slope also varied as a function of electrode configuration: monopolar stimulation produced steeper functions than did bipolar stimulation. Differences between EABR and psychophysical strength-duration measures suggest the existence of central mechanisms of stimulus integration in addition to that occurring at the level of the auditory nerve. Differences observed with variation of stimulus parameters (e.g., monopolar vs. bipolar stimulation modes) suggest that the specific mode of intracochlear electrical stimulation can influence stimulus integration. Such observations may be useful in the design of prosthetic devices and furthering our understanding of electrical excitation of the auditory system.

Functional responses from guinea pigs with cochlear implants. II. Changes in electrophysiological and psychophysical measures over time

This study, the second of a two-part investigation, assessed changes over time in functional measures of the electrically stimulated auditory system following ototoxic deafening. Guinea pigs were trained to respond behaviorally to threshold level acoustic stimuli and then unilaterally deafened and implanted with a bipolar pair of electrodes within the cochlea and a single extracochlear electrode. Using pulsatile stimuli, thresholds for the electrically evoked auditory brainstem response (EABR) and psychophysical detection were repeatedly collected from the same animals over 3-month post-implantation periods. Thresholds were obtained as a function of stimulus phase duration primarily using bipolar intracochlear stimulation. As in earlier studies, the threshold measures exhibited both intra- and intersubject variability. Analysis of group data failed to show any statistically significant changes over time in either EABR or psychophysical threshold at any fixed pulse duration. However, significant changes over time were found in the slopes of the strength-duration functions for both measures. Slopes became shallower with time, suggesting a reduction in the efficiency of stimulus current integration, a trend presumed to occur with neural degeneration. This result suggests that strength-duration functions could be useful as a clinical diagnostic measure.