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The Sound of a Cochlear Implant Investigated in Patients With Single-Sided Deafness and a Cochlear Implant. Otol Neurotol 2019; 39:707-714. [PMID: 29889780 DOI: 10.1097/mao.0000000000001821] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
HYPOTHESIS A cochlear implant (CI) restores hearing in patients with profound sensorineural hearing loss by electrical stimulation of the auditory nerve. It is unknown how this electrical stimulation sounds. BACKGROUND Patients with single-sided deafness (SSD) and a CI form a unique population, since they can compare the sound of their CI with simulations of the CI sound played to their nonimplanted ear. METHODS We tested six stimuli (speech and music) in 10 SSD patients implanted with a CI (Cochlear Ltd). Patients listened to the original stimulus with their CI ear while their nonimplanted ear was masked. Subsequently, patients listened to two CI simulations, created with a vocoder, with their nonimplanted ear alone. They selected the CI simulation with greatest similarity to the sound as perceived by their CI ear and they graded similarity on a 1 to 10 scale. We tested three vocoders: two known from the literature, and one supplied by Cochlear Ltd. Two carriers (noise, sine) were tested for each vocoder. RESULTS Carrier noise and the vocoders from the literature were most often selected as best match to the sound as perceived by the CI ear. However, variability in selections was substantial both between patients and within patients between sound samples. The average grade for similarity was 6.8 for speech stimuli and 6.3 for music stimuli. CONCLUSION We obtained a fairly good impression of what a CI can sound like for SSD patients. This may help to better inform and educate patients and family members about the sound of a CI.
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Abstract
OBJECTIVE Cochlear implantation is associated with poor music perception and enjoyment. Reducing music complexity has been shown to enhance music enjoyment in cochlear implant (CI) recipients. In this study, we assess the impact of harmonic series reduction on music enjoyment. STUDY DESIGN Prospective analysis of music enjoyment in normal-hearing (NH) individuals and CI recipients. SETTING Single tertiary academic medical center. PATIENTS NH adults (N = 20) and CI users (N = 8) rated the Happy Birthday song on three validated enjoyment modalities-musicality, pleasantness, and naturalness. INTERVENTION Subjective rating of music excerpts. MAIN OUTCOME MEASURES Participants listened to seven different instruments play the melody, each with five levels of harmonic reduction (Full, F3+F2+F1+F0, F2+F1+F0, F1+F0, F0). NH participants listened to the segments both with and without CI simulation. Linear mixed effect models (LME) and likelihood ratio tests were used to assess the impact of harmonic reduction on enjoyment. RESULTS NH listeners without simulation rated segments with the first four harmonics (F3+F2+F1+F0) most pleasant and natural (p <0.001, p = 0.004). NH listeners with simulation rated the first harmonic alone (F0) most pleasant and natural (p <0.001, p = 0.003). Their ratings demonstrated a positive linear relationship between harmonic reduction and both pleasantness (slope estimate = 0.030, SE = 0.004, p <0.001, LME) and naturalness (slope estimate = 0.012, SE = 0.003, p = 0.003, LME). CI recipients also found the first harmonic alone (F0) to be most pleasant (p = 0.003), with a positive linear relationship between harmonic reduction and pleasantness (slope estimate = 0.029, SE = 0.008, p <0.001, LME). CONCLUSION Harmonic series reduction increases music enjoyment in CI and NH individuals with or without CI simulation. Therefore, minimization of the harmonics may be a useful strategy for enhancing musical enjoyment among both NH and CI listeners.
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Rader T, Döge J, Adel Y, Weissgerber T, Baumann U. Place dependent stimulation rates improve pitch perception in cochlear implantees with single-sided deafness. Hear Res 2016; 339:94-103. [PMID: 27374479 DOI: 10.1016/j.heares.2016.06.013] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2015] [Revised: 04/06/2016] [Accepted: 06/21/2016] [Indexed: 11/18/2022]
Abstract
In normal hearing, the pitch of an acoustic tone can theoretically be encoded by either the place of stimulation in the cochlea or the corresponding rate of vibration. Thus spectral attributes and temporal fine structure of an acoustic signal are naturally correlated. Cochlear implants (CIs), neural prosthetic devices that restore hearing in the profoundly hearing impaired, currently disregard this mechanism; electrical stimulation is provided at fixed electrode positions with default place independent stimulation rate assignments. This does not account for individual cochlear encoding depending on electrode array placement, variations in insertion depth, and the proximity to nerve fibers. Encoding pitch in such manner delivers limited tonal information. Consequently, music appraisal in CI users is often rated cacophonic while speech perception in quiet is close to normal in top performers. We hypothesize that this limitation in electric stimulation is at least partially due to the mismatch between frequency and place encoding in CIs. In the present study, we determined individual electrode locations by analysis of cochlear radiographic images obtained after surgery and calculated place dependent stimulation rates according to models of the normal tonotopic function. Pitch matching in CI users with single-sided deafness shows that place dependent stimulation rates allow thus far unparalleled restoration of tonotopic pitch perception. Collapsed data of matched pitch frequencies as a function of calculated electrical stimulation rate were well fitted by linear regression (R(2) = 0.878). Sound processing strategies incorporating place dependent stimulation rates are expected to improve pitch perception in CI users.
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Affiliation(s)
- Tobias Rader
- Audiological Acoustics, ENT Department, University Hospital Frankfurt, Germany
| | - Julia Döge
- Audiological Acoustics, ENT Department, University Hospital Frankfurt, Germany
| | - Youssef Adel
- Audiological Acoustics, ENT Department, University Hospital Frankfurt, Germany
| | - Tobias Weissgerber
- Audiological Acoustics, ENT Department, University Hospital Frankfurt, Germany
| | - Uwe Baumann
- Audiological Acoustics, ENT Department, University Hospital Frankfurt, Germany.
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Guevara N, Hoen M, Truy E, Gallego S. A Cochlear Implant Performance Prognostic Test Based on Electrical Field Interactions Evaluated by eABR (Electrical Auditory Brainstem Responses). PLoS One 2016; 11:e0155008. [PMID: 27149268 PMCID: PMC4858145 DOI: 10.1371/journal.pone.0155008] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2015] [Accepted: 04/22/2016] [Indexed: 11/18/2022] Open
Abstract
Background Cochlear implants (CIs) are neural prostheses that have been used routinely in the clinic over the past 25 years. They allow children who were born profoundly deaf, as well as adults affected by hearing loss for whom conventional hearing aids are insufficient, to attain a functional level of hearing. The “modern” CI (i.e., a multi-electrode implant using sequential coding strategies) has yielded good speech comprehension outcomes (recognition level for monosyllabic words about 50% to 60%, and sentence comprehension close to 90%). These good average results however hide a very important interindividual variability as scores in a given patients’ population often vary from 5 to 95% in comparable testing conditions. Our aim was to develop a prognostic model for patients with unilateral CI. A novel method of objectively measuring electrical and neuronal interactions using electrical auditory brainstem responses (eABRs) is proposed. Methods and Findings The method consists of two measurements: 1) eABR measurements with stimulation by a single electrode at 70% of the dynamic range (four electrodes distributed within the cochlea were tested), followed by a summation of these four eABRs; 2) Measurement of a single eABR with stimulation from all four electrodes at 70% of the dynamic range. A comparison of the eABRs obtained by these two measurements, defined as the monaural interaction component (MIC), indicated electrical and neural interactions between the stimulation channels. Speech recognition performance without lip reading was measured for each patient using a logatome test (64 "vowel-consonant-vowel"; VCV; by forced choice of 1 out of 16). eABRs were measured in 16 CI patients (CIs with 20 electrodes, Digisonic SP; Oticon Medical ®, Vallauris, France). Significant correlations were found between speech recognition performance and the ratio of the amplitude of the V wave of the eABRs obtained with the two measurements (Pearson's linear regression model, parametric correlation: r2 = 0.26, p<0.05). Conclusions This prognostic model allowed a substantial amount of the interindividual variance in speech recognition scores to be explained. The present study used measurements of electrical and neuronal interactions by eABR to assess patients' bio-electric capacity to use multiple information channels supplied by the implant. This type of prognostic information may be valuable in several ways. On the patient level, it allows customizing of individual treatments. ClinicalTrials.gov Identifier: NCT01805167
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Affiliation(s)
- Nicolas Guevara
- University Head and Neck Institute, CHU de Nice, 31 Avenue de Valombrose, 06107 Nice cedex 2, France
| | - Michel Hoen
- Oticon Medical, Clinical and Scientific Research Department, 2720 chemin St Bernard, 06220 Vallauris, France
| | - Eric Truy
- Department of Audiology and Otorhinolaryngology, Edouard Herriot Hospital, 5 Place d'Arsonval, 69437 Lyon, France
| | - Stéphane Gallego
- Institute for Readaptation Sciences and Techniques, 8 Avenue Rockefeller, 69373 Lyon Cedex 08, France
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Guevara N, Bozorg-Grayeli A, Bebear JP, Ardoint M, Saaï S, Gnansia D, Hoen M, Romanet P, Lavieille JP. The Voice Track multiband single-channel modified Wiener-filter noise reduction system for cochlear implants: patients' outcomes and subjective appraisal. Int J Audiol 2016; 55:431-8. [DOI: 10.3109/14992027.2016.1172267] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Nicolas Guevara
- CHU de Nice, University Head and Neck Institute, Nice, France,
| | - Alexis Bozorg-Grayeli
- Department of Head and Neck Surgery, CHU - University Hospital of Dijon, Dijon, France,
| | - Jean-Pierre Bebear
- ENT Department, Pellegrin Hospital, University of Bordeaux, Bordeaux, France,
| | - Marine Ardoint
- Clinical and Scientific Research Department, Oticon Medical - Neurelec, Vallauris, France, and
| | - Sonia Saaï
- Clinical and Scientific Research Department, Oticon Medical - Neurelec, Vallauris, France, and
| | - Dan Gnansia
- Clinical and Scientific Research Department, Oticon Medical - Neurelec, Vallauris, France, and
| | - Michel Hoen
- Clinical and Scientific Research Department, Oticon Medical - Neurelec, Vallauris, France, and
| | - Philippe Romanet
- Department of Head and Neck Surgery, CHU - University Hospital of Dijon, Dijon, France,
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Dorman MF, Parkin JL. The role of the Utah Artificial Ear project in the development of the modern cochlear implant. Cochlear Implants Int 2015; 16 Suppl 2:S1-S11. [DOI: 10.1179/1467010015z.000000000246] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Lumbreras V, Bas E, Gupta C, Rajguru SM. Pulsed infrared radiation excites cultured neonatal spiral and vestibular ganglion neurons by modulating mitochondrial calcium cycling. J Neurophysiol 2014; 112:1246-55. [PMID: 24920028 DOI: 10.1152/jn.00253.2014] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Cochlear implants are currently the most effective solution for profound sensorineural hearing loss, and vestibular prostheses are under development to treat bilateral vestibulopathies. Electrical current spread in these neuroprostheses limits channel independence and, in some cases, may impair their performance. In comparison, optical stimuli that are spatially confined may result in a significant functional improvement. Pulsed infrared radiation (IR) has previously been shown to elicit responses in neurons. This study analyzes the response of neonatal rat spiral and vestibular ganglion neurons in vitro to IR (wavelength = 1,863 nm) using Ca(2+) imaging. Both types of neurons responded consistently with robust intracellular Ca(2+) ([Ca(2+)]i) transients that matched the low-frequency IR pulses applied (4 ms, 0.25-1 pps). Radiant exposures of ∼637 mJ/cm(2) resulted in continual neuronal activation. Temperature or [Ca(2+)] variations in the media did not alter the IR-evoked transients, ruling out extracellular Ca(2+) involvement or primary mediation by thermal effects on the plasma membrane. While blockage of Na(+), K(+), and Ca(2+) plasma membrane channels did not alter the IR-evoked response, blocking of mitochondrial Ca(2+) cycling with CGP-37157 or ruthenium red reversibly inhibited the IR-evoked [Ca(2+)]i transients. Additionally, the magnitude of the IR-evoked transients was dependent on ryanodine and cyclopiazonic acid-dependent Ca(2+) release. These results suggest that IR modulation of intracellular calcium cycling contributes to stimulation of spiral and vestibular ganglion neurons. As a whole, the results suggest selective excitation of neurons in the IR beam path and the potential of IR stimulation in future auditory and vestibular prostheses.
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Affiliation(s)
- Vicente Lumbreras
- Department of Biomedical Engineering, University of Miami, Miami, Florida; and
| | - Esperanza Bas
- Department of Otolaryngology, University of Miami, Miami, Florida
| | - Chhavi Gupta
- Department of Otolaryngology, University of Miami, Miami, Florida
| | - Suhrud M Rajguru
- Department of Biomedical Engineering, University of Miami, Miami, Florida; and Department of Otolaryngology, University of Miami, Miami, Florida
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Zeng FG, Tang Q, Lu T. Abnormal pitch perception produced by cochlear implant stimulation. PLoS One 2014; 9:e88662. [PMID: 24551131 PMCID: PMC3923805 DOI: 10.1371/journal.pone.0088662] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2013] [Accepted: 01/14/2014] [Indexed: 11/19/2022] Open
Abstract
Contemporary cochlear implants with multiple electrode stimulation can produce good speech perception but poor music perception. Hindered by the lack of a gold standard to quantify electric pitch, relatively little is known about the nature and extent of the electric pitch abnormalities and their impact on cochlear implant performance. Here we overcame this obstacle by comparing acoustic and electric pitch perception in 3 unilateral cochlear-implant subjects who had functionally usable acoustic hearing throughout the audiometric frequency range in the non-implant ear. First, to establish a baseline, we measured and found slightly impaired pure tone frequency discrimination and nearly perfect melody recognition in all 3 subjects' acoustic ear. Second, using pure tones in the acoustic ear to match electric pitch induced by an intra-cochlear electrode, we found that the frequency-electrode function was not only 1-2 octaves lower, but also 2 times more compressed in frequency range than the normal cochlear frequency-place function. Third, we derived frequency difference limens in electric pitch and found that the equivalent electric frequency discrimination was 24 times worse than normal-hearing controls. These 3 abnormalities are likely a result of a combination of broad electric field, distant intra-cochlear electrode placement, and non-uniform spiral ganglion cell distribution and survival, all of which are inherent to the electrode-nerve interface in contemporary cochlear implants. Previous studies emphasized on the "mean" shape of the frequency-electrode function, but the present study indicates that the large "variance" of this function, reflecting poor electric pitch discriminability, is the main factor limiting contemporary cochlear implant performance.
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Affiliation(s)
- Fan-Gang Zeng
- Center for Hearing Research, Departments of Anatomy and Neurobiology, Biomedical Engineering, Cognitive Sciences, and Otolaryngology – Head and Neck Surgery, University of California Irvine, Irvine, California, United States of America
- * E-mail:
| | - Qing Tang
- Center for Hearing Research, Departments of Anatomy and Neurobiology, Biomedical Engineering, Cognitive Sciences, and Otolaryngology – Head and Neck Surgery, University of California Irvine, Irvine, California, United States of America
| | - Thomas Lu
- Center for Hearing Research, Departments of Anatomy and Neurobiology, Biomedical Engineering, Cognitive Sciences, and Otolaryngology – Head and Neck Surgery, University of California Irvine, Irvine, California, United States of America
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Richter CP, Rajguru S, Bendett M. Infrared neural stimulation in the cochlea. PROCEEDINGS OF SPIE--THE INTERNATIONAL SOCIETY FOR OPTICAL ENGINEERING 2013; 8565:85651Y. [PMID: 25075260 DOI: 10.1117/12.2010337] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
The application of photonics to manipulate and stimulate neurons and to study neural networks has gained momentum over the last decade. Two general methods have been used: the genetic expression of light or temperature sensitive ion channels in the plasma membrane of neurons (Optogenetics and Thermogenetics) and the direct stimulation of neurons using infrared radiation (Infrared Neural Stimulation, INS). Both approaches have their strengths and challenges, which are well understood with a profound understanding of the light tissue interaction(s). This paper compares the opportunities of the methods for the use in cochlear prostheses. Ample data are already available on the stimulation of the cochlea with INS. The data show that the stimulation is selective, feasible at rates that would be sufficient to encode acoustic information and may be beneficial over conventional pulsed electrical stimulation. A third approach, using lasers in stress confinement to generate pressure waves and to stimulate the functional cochlea mechanically will also be discussed.
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Affiliation(s)
- Claus-Peter Richter
- Department of Otolaryngology, Northwestern University, 303 E. Chicago Ave, Searle 12-561, Chicago, IL 60611, USA ; Department of Biomedical Engineering, Northwestern University, 2145 Sheridan Road, Tech E310, Evanston, IL 60208, USA ; The Hugh Knowles Center, Department of Communication Sciences and Disorders, Northwestern University, Evanston, IL 60208, USA
| | - Suhrud Rajguru
- Department of Biomedical Engineering, University of Miami, Miami FL 33146, USA ; Department of Otolaryngology, University of Miami, Miami FL 33136, USA
| | - Mark Bendett
- Lockheed Martin Aculight, 22121 20th Ave SE, Bothell WA, USA
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Digeser FM, Hast A, Wesarg T, Hessel H, Hoppe U. Melody identification for cochlear implant users and normal hearers using expanded pitch contours. Eur Arch Otorhinolaryngol 2011; 269:2317-26. [DOI: 10.1007/s00405-011-1885-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2011] [Accepted: 12/09/2011] [Indexed: 11/29/2022]
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Philips B, Vinck B, De Vel E, Maes L, D'Haenens W, Keppler H, Dhooge I. Characteristics and determinants of music appreciation in adult CI users. Eur Arch Otorhinolaryngol 2011; 269:813-21. [PMID: 21847672 DOI: 10.1007/s00405-011-1718-4] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2011] [Accepted: 07/12/2011] [Indexed: 10/17/2022]
Abstract
The main objective of this study was to assess the associations between self-reported listening habits and perception of music and speech perception outcomes in quiet and noise for both unilateral cochlear implant (CI) users and bimodal (CI in one ear, hearing aid in contra-lateral ear) users. Information concerning music appreciation was gathered by means of a newly developed questionnaire. Moreover, audiological data (pure-tone audiometry, speech tests in noise and quiet) were gathered and the relationship between speech perception and music appreciation is studied. Bimodal users enjoy listening to music more in comparison with unilateral CI users. Also, music training within rehabilitation is still uncommon, while CI recipients believe that music training might be helpful to maximize their potential with current CI technology. Music training should not be exclusively reserved for the good speech performers. Therefore, a music training program (MTP) that consists of different difficulty levels should be developed. Hopefully, early implementation of MTP in rehabilitation programs can enable adult CI users to enjoy and appreciate music and to maximize their potential with commercially available technology. Furthermore, because bimodal users consider the bimodal stimulation to be the most enjoyable way to listen to music, CI users with residual hearing in the contra-lateral ear should be encouraged to continue wearing their hearing aid in that ear.
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Affiliation(s)
- Birgit Philips
- Ear-Nose-Throat and Logopaedic-Audiologic Sciences, Faculty of Medicine and Health Sciences, Ghent University, De Pintelaan 185, 2P1, 9000, Ghent, Belgium.
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