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Abstract
INTRODUCTION Cochlear implants (CIs) are biomedical devices that restore sound perception for people with severe-to-profound sensorineural hearing loss. Most postlingually deafened CI users are able to achieve excellent speech recognition in quiet environments. However, current CI sound processors remain limited in their ability to deliver fine spectrotemporal information, making it difficult for CI users to perceive complex sounds. Limited access to complex acoustic cues such as music, environmental sounds, lexical tones, and voice emotion may have significant ramifications on quality of life, social development, and community interactions. AREAS COVERED The purpose of this review article is to summarize the literature on CIs and music perception, with an emphasis on music training in pediatric CI recipients. The findings have implications on our understanding of noninvasive, accessible methods for improving auditory processing and may help advance our ability to improve sound quality and performance for implantees. EXPERT OPINION Music training, particularly in the pediatric population, may be able to continue to enhance auditory processing even after performance plateaus. The effects of these training programs appear generalizable to non-trained musical tasks, speech prosody and, emotion perception. Future studies should employ rigorous control groups involving a non-musical acoustic intervention, standardized auditory stimuli, and the provision of feedback.
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Affiliation(s)
- Nicole T Jiam
- Department of Otolaryngology-Head and Neck Surgery, University of California San Francisco School of Medicine , San Francisco, CA, USA
| | - Charles Limb
- Department of Otolaryngology-Head and Neck Surgery, University of California San Francisco School of Medicine , San Francisco, CA, USA
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Limb CJ, Roy AT. Technological, biological, and acoustical constraints to music perception in cochlear implant users. Hear Res 2014; 308:13-26. [DOI: 10.1016/j.heares.2013.04.009] [Citation(s) in RCA: 138] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2013] [Revised: 04/04/2013] [Accepted: 04/22/2013] [Indexed: 11/30/2022]
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Bader P, Kals M, Schatzer R, Griessner A, Zierhofer C. Compensation for channel interaction in a simultaneous cochlear implant coding strategy. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2013; 133:4124-4132. [PMID: 23742364 DOI: 10.1121/1.4803848] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
This study evaluated a concept to reduce detrimental effects of spatial channel interaction in case of simultaneous stimulation with cochlear implants. The hypothesis was that effects of simultaneous channel interaction can be compensated by an algorithm such that no difference in hearing performance between simultaneous pulsatile stimulation and a strictly sequential reference strategy can be found. The simultaneous strategies used in this study stimulated two or three electrodes simultaneously in a monopolar configuration and used a specific compensation algorithm to reduce detrimental effects of simultaneous channel interaction. Overall stimulation rate was kept constant throughout conditions. Three of the configurations applied extended pulse phase durations. The German Oldenburg sentence and a German vowel test were used to measure speech recognition in 12 cochlear implant users. The results support the initial hypothesis. No significant differences in performance were found. A small spatial distance between simultaneous electrodes yielded slightly better results than a large distance. Extending the pulse phase durations had no significant effect on hearing performance. However, it significantly reduced stimulation amplitudes. Thus strategies implementing channel interaction compensated simultaneous stimulation with extended pulse phase durations might be a viable option for reducing power consumption and increasing battery life in cochlear implants.
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Affiliation(s)
- Paul Bader
- Institute of Mechatronics, Faculty of Engineering Science, University of Innsbruck, Innsbruck, Austria.
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Riss D, Hamzavi JS, Katzinger M, Baumgartner WD, Kaider A, Gstoettner W, Arnoldner C. Effects of fine structure and extended low frequencies in pediatric cochlear implant recipients. Int J Pediatr Otorhinolaryngol 2011; 75:573-8. [PMID: 21324531 DOI: 10.1016/j.ijporl.2011.01.022] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2010] [Revised: 01/14/2011] [Accepted: 01/18/2011] [Indexed: 11/26/2022]
Abstract
OBJECTIVE In recent years, new speech coding strategies have been developed with the aim of improving the transmission of temporal fine structure to cochlear implant recipients. This study reports on the implementation of one such strategy (fine structure processing, FSP) in children. METHODS This was a prospective study investigating the upgrade to a new speech processor. The upgrade used a repeated measures design with an alternating order of conditions (A-B-A-B design). Twelve pre- and perilingually deaf children with MED-EL C40+ cochlear implants were enrolled in the study. Patients were upgraded from their Tempo+ speech processor, which used continuous interleaved sampling (CIS) in combination with a frequency spectrum of 200-8500 Hz, to an Opus speech processor, which used FSP with an extended frequency spectrum of 70-8500 Hz. The primary means of testing was an HSM (Hochmair, Schulz and Moser) sentence test at 65 and 80 dB in quiet. In addition, the "Mainzer Kindersprachtest" (Mainz audiometric speech test for children) was applied at 65 and 70 dB. RESULTS When the new FSP speech processor was used together with the extended low frequency range, HSM sentence tests at 65 and 80 dB resulted in scores indicating statistically significant improvements of 7.1 and 9.9 percentage points, respectively. Scores in the "Mainzer Kindersprachtest" at 65 and 70 dB indicated statistically significant improvements of 9.3 and 6.1 percentage points, respectively. CONCLUSIONS The present study clearly shows that children benefit from the fine structure speech coding strategy in combination with an extended frequency spectrum in the low frequencies, as is offered by the Opus speech processors. This should be taken into consideration when fitting pre- and perilingually deaf children implanted almost a decade previously.
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Affiliation(s)
- Dominik Riss
- Department of Otorhinolaryngology, Medical University of Vienna, Waehringer Guertel 18-20, A-1090 Vienna, Austria.
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Strydom T, Hanekom JJ. The performance of different synthesis signals in acoustic models of cochlear implants. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2011; 129:920-933. [PMID: 21361449 DOI: 10.1121/1.3518760] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Synthesis (carrier) signals in acoustic models embody assumptions about perception of auditory electric stimulation. This study compared speech intelligibility of consonants and vowels processed through a set of nine acoustic models that used Spectral Peak (SPEAK) and Advanced Combination Encoder (ACE)-like speech processing, using synthesis signals which were representative of signals used previously in acoustic models as well as two new ones. Performance of the synthesis signals was determined in terms of correspondence with cochlear implant (CI) listener results for 12 attributes of phoneme perception (consonant and vowel recognition; F1, F2, and duration information transmission for vowels; voicing, manner, place of articulation, affrication, burst, nasality, and amplitude envelope information transmission for consonants) using four measures of performance. Modulated synthesis signals produced the best correspondence with CI consonant intelligibility, while sinusoids, narrow noise bands, and varying noise bands produced the best correspondence with CI vowel intelligibility. The signals that performed best overall (in terms of correspondence with both vowel and consonant attributes) were modulated and unmodulated noise bands of varying bandwidth that corresponded to a linearly varying excitation width of 0.4 mm at the apical to 8 mm at the basal channels.
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Affiliation(s)
- Trudie Strydom
- Department of Electrical, Electronic, and Computer Engineering, University of Pretoria, Pretoria 0002, South Africa
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Kidd G, Streeter TM, Ihlefeld A, Maddox RK, Mason CR. The intelligibility of pointillistic speech. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2009; 126:EL196-EL201. [PMID: 20000894 PMCID: PMC2792325 DOI: 10.1121/1.3258062] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2009] [Accepted: 10/09/2009] [Indexed: 05/28/2023]
Abstract
A form of processed speech is described that is highly discriminable in a closed-set identification format. The processing renders speech into a set of sinusoidal pulses played synchronously across frequency. The processing and results from several experiments are described. The number and width of frequency analysis channels and tone-pulse duration were variables. In one condition, various proportions of the tones were randomly removed. The processed speech was remarkably resilient to these manipulations. This type of speech may be useful for examining multitalker listening situations in which a high degree of stimulus control is required.
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Affiliation(s)
- Gerald Kidd
- Hearing Research Center, Boston University, Boston, Massachusetts 02215, USA.
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Stohl JS, Throckmorton CS, Collins LM. Investigating the effects of stimulus duration and context on pitch perception by cochlear implant users. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2009; 126:318-326. [PMID: 19603888 PMCID: PMC2723905 DOI: 10.1121/1.3133246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2008] [Revised: 04/21/2009] [Accepted: 04/22/2009] [Indexed: 05/28/2023]
Abstract
Cochlear implant sound processing strategies that use time-varying pulse rates to transmit fine structure information are one proposed method for improving the spectral representation of a sound with the eventual goal of improving speech recognition in noisy conditions, speech recognition in tonal languages, and music identification and appreciation. However, many of the perceptual phenomena associated with time-varying rates are not well understood. In this study, the effects of stimulus duration on both the place and rate-pitch percepts were investigated via psychophysical experiments. Four Nucleus CI24 cochlear implant users participated in these experiments, which included a short-duration pitch ranking task and three adaptive pulse rate discrimination tasks. When duration was fixed from trial-to-trial and rate was varied adaptively, results suggested that both the place-pitch and rate-pitch percepts may be independent of duration for durations above 10 and 20 ms, respectively. When duration was varied and pulse rates were fixed, performance was highly variable within and across subjects. Implications for multi-rate sound processing strategies are discussed.
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Affiliation(s)
- Joshua S Stohl
- Department of Electrical and Computer Engineering, Duke University, Durham, North Carolina 27708-0291, USA
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Speech recognition in cochlear implant recipients: comparison of standard HiRes and HiRes 120 sound processing. Otol Neurotol 2009; 30:146-52. [PMID: 19106769 DOI: 10.1097/mao.0b013e3181924ff8] [Citation(s) in RCA: 74] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE HiRes (HR) 120 is a sound-processing strategy purported to offer an increase in the precision of frequency-to-place mapping through the use of current steering. This within-subject study was designed to compare speech recognition as well as music and sound quality ratings for HR and HR 120 processing. SETTING Cochlear implant/tertiary referral center. SUBJECTS Eight postlinguistically deafened adults implanted with an Advanced Bionics CII or HR 90K cochlear implant. STUDY DESIGN/MAIN OUTCOME MEASURES: Performance with HR and HR 120 was assessed during 4 test sessions with a battery of measures including monosyllabic words, sentences in quiet and in noise, and ratings of sound quality and musical passages. RESULTS Compared with HR, speech recognition results in adult cochlear implant recipients revealed small but significant improvements with HR 120 for single syllable words and for 2 of 3 sentence recognition measures in noise. Both easy and more difficult sentence material presented in quiet were not significantly different between strategies. Additionally, music quality ratings were significantly better for HR 120 than for HR, and 7 of 8 subjects preferred HR 120 over HR for listening in everyday life. CONCLUSION HR 120 may offer equivalent or improved benefit to patients compared with HR. Differences in performance on test measures between strategies are dependent on speech recognition materials and listening conditions.
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Zeng FG, Rebscher S, Harrison W, Sun X, Feng H. Cochlear implants: system design, integration, and evaluation. IEEE Rev Biomed Eng 2008; 1:115-42. [PMID: 19946565 PMCID: PMC2782849 DOI: 10.1109/rbme.2008.2008250] [Citation(s) in RCA: 330] [Impact Index Per Article: 20.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
As the most successful neural prosthesis, cochlear implants have provided partial hearing to more than 120000 persons worldwide; half of which being pediatric users who are able to develop nearly normal language. Biomedical engineers have played a central role in the design, integration and evaluation of the cochlear implant system, but the overall success is a result of collaborative work with physiologists, psychologists, physicians, educators, and entrepreneurs. This review presents broad yet in-depth academic and industrial perspectives on the underlying research and ongoing development of cochlear implants. The introduction accounts for major events and advances in cochlear implants, including dynamic interplays among engineers, scientists, physicians, and policy makers. The review takes a system approach to address critical issues in cochlear implant research and development. First, the cochlear implant system design and specifications are laid out. Second, the design goals, principles, and methods of the subsystem components are identified from the external speech processor and radio frequency transmission link to the internal receiver, stimulator and electrode arrays. Third, system integration and functional evaluation are presented with respect to safety, reliability, and challenges facing the present and future cochlear implant designers and users. Finally, issues beyond cochlear implants are discussed to address treatment options for the entire spectrum of hearing impairment as well as to use the cochlear implant as a model to design and evaluate other similar neural prostheses such as vestibular and retinal implants.
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Affiliation(s)
- Fan-Gang Zeng
- Department of Anatomy and Neurobiology, University of California, Irvine, CA 92697, USA.
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Morton KD, Torrione PA, Throckmorton CS, Collins LM. Mandarin Chinese tone identification in cochlear implants: predictions from acoustic models. Hear Res 2008; 244:66-76. [PMID: 18706497 DOI: 10.1016/j.heares.2008.07.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2008] [Revised: 07/15/2008] [Accepted: 07/22/2008] [Indexed: 10/21/2022]
Abstract
It has been established that current cochlear implants do not supply adequate spectral information for perception of tonal languages. Comprehension of a tonal language, such as Mandarin Chinese, requires recognition of lexical tones. New strategies of cochlear stimulation such as variable stimulation rate and current steering may provide the means of delivering more spectral information and thus may provide the auditory fine-structure required for tone recognition. Several cochlear implant signal processing strategies are examined in this study, the continuous interleaved sampling (CIS) algorithm, the frequency amplitude modulation encoding (FAME) algorithm, and the multiple carrier frequency algorithm (MCFA). These strategies provide different types and amounts of spectral information. Pattern recognition techniques can be applied to data from Mandarin Chinese tone recognition tasks using acoustic models as a means of testing the abilities of these algorithms to transmit the changes in fundamental frequency indicative of the four lexical tones. The ability of processed Mandarin Chinese tones to be correctly classified may predict trends in the effectiveness of different signal processing algorithms in cochlear implants. The proposed techniques can predict trends in performance of the signal processing techniques in quiet conditions but fail to do so in noise.
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Affiliation(s)
- Kenneth D Morton
- Duke University Department of Electrical and Computer Engineering, Box 90291, Durham, NC 27708-0291, USA
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Stohl JS, Throckmorton CS, Collins LM. Assessing the pitch structure associated with multiple rates and places for cochlear implant users. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2008; 123:1043-1053. [PMID: 18247906 DOI: 10.1121/1.2821980] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Cochlear implant subjects continue to experience difficulty understanding speech in noise and performing pitch-based musical tasks. Acoustic model studies have suggested that transmitting additional fine structure via multiple stimulation rates is a potential mechanism for addressing these issues [Nie et al., IEEE Trans. Biomed. Eng. 52, 64-73 (2005); Throckmorton et al., Hear. Res. 218, 30-42 (2006)]; however, results from preliminary cochlear implant studies have been less compelling. Multirate speech processing algorithms previously assumed a place-dependent pitch structure in that a basal electrode would always elicit a higher pitch percept than an apical electrode, independent of stimulation rate. Some subjective evidence contradicts this assumption [H. J. McDermott and C. M. McKay, J. Acoust. Soc. Am. 101, 1622-1630 (1997); R. V. Shannon, Hear. Res. 11, 157-189 (1983)]. The purpose of this study is to test the hypothesis that the introduction of multiple rates may invalidate the tonotopic pitch structure resulting from place-pitch alone. The SPEAR3 developmental speech processor was used to collect psychophysical data from five cochlear implant users to assess the tonotopic structure for stimuli presented at two rates on all active electrodes. Pitch ranking data indicated many cases where pitch percepts overlapped across electrodes and rates. Thus, the results from this study suggest that pitch-based tuning across rate and electrode may be necessary to optimize performance of a multirate sound processing strategy in cochlear implant subjects.
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Affiliation(s)
- Joshua S Stohl
- Department of Electrical and Computer Engineering, Duke University, P.O. Box 90291, Durham, North Carolina 27708-0291, USA.
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Throckmorton CS, Selin Kucukoglu M, Remus JJ, Collins LM. The effect of frequency estimation on speech recognition using an acoustic model of a cochlear implant. Hear Res 2007; 228:230-1. [PMID: 17467208 PMCID: PMC1950148 DOI: 10.1016/j.heares.2007.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2007] [Accepted: 03/06/2007] [Indexed: 11/23/2022]
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Lorenzi C, Gilbert G, Carn H, Garnier S, Moore BCJ. Speech perception problems of the hearing impaired reflect inability to use temporal fine structure. Proc Natl Acad Sci U S A 2006; 103:18866-9. [PMID: 17116863 PMCID: PMC1693753 DOI: 10.1073/pnas.0607364103] [Citation(s) in RCA: 366] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2006] [Indexed: 11/18/2022] Open
Abstract
People with sensorineural hearing loss have difficulty understanding speech, especially when background sounds are present. A reduction in the ability to resolve the frequency components of complex sounds is one factor contributing to this difficulty. Here, we show that a reduced ability to process the temporal fine structure of sounds plays an important role. Speech sounds were processed by filtering them into 16 adjacent frequency bands. The signal in each band was processed by using the Hilbert transform so as to preserve either the envelope (E, the relatively slow variations in amplitude over time) or the temporal fine structure (TFS, the rapid oscillations with rate close to the center frequency of the band). The band signals were then recombined and the stimuli were presented to subjects for identification. After training, normal-hearing subjects scored perfectly with unprocessed speech, and were approximately 90% correct with E and TFS speech. Both young and elderly subjects with moderate flat hearing loss performed almost as well as normal with unprocessed and E speech but performed very poorly with TFS speech, indicating a greatly reduced ability to use TFS. For the younger hearing-impaired group, TFS scores were highly correlated with the ability to take advantage of temporal dips in a background noise when identifying unprocessed speech. The results suggest that the ability to use TFS may be critical for "listening in the background dips." TFS stimuli may be useful in evaluating impaired hearing and in guiding the design of hearing aids and cochlear implants.
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Affiliation(s)
- Christian Lorenzi
- Equipe Audition, Laboratoire Psychologie de la Perception, Centre National de la Recherche Scientifique, Université René Descartes, Departement d'Etudes Cognitives, Ecole Normale Supérieure, 29 Rue d'Ulm, 75005 Paris, France.
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