An advanced multiple channel cochlear implant

A Multichannel High-Frequency Power-Isolated Neural Stimulator With Crosstalk Reduction

In neuroprostheses applications requiring simultaneous stimulations on a multielectrode array, electric crosstalk, the spatial interaction between electric fields from various electrodes is a major limitation to the performance of multichannel stimulation. This paper presents a multichannel stimulator design that combines high-frequency current stimulation (using biphasic charge-balanced chopped pulse profile) with a switched-capacitor power isolation method. The approach minimizes crosstalk and is particularly suitable for fully integrated realization. A stimulator fabricated in a 0.6 μm CMOS high-voltage technology is presented. It is used to implement a multichannel, high-frequency, power-isolated stimulator. Crosstalk reduction is demonstrated with electrodes in physiological media while the efficacy of the high-frequency stimulator chip is proven in vivo. The stimulator provides fully independent operation on multiple channels and full flexibility in the design of neural modulation protocols.

Wireless Passive Stimulation of Engineered Cardiac Tissues

We present a battery-free radio frequency (RF) microwave activated wireless stimulator, 25 × 42 × 1.6 mm³ on a flexible substrate, featuring high current delivery, up to 60 mA, to stimulate engineered cardiac tissues. An external antenna shines 2.4 GHz microwave, which is modulated by an inverted pulse to directly control the stimulating waveform, to the wireless passive stimulator. The stimulator is equipped with an on-board antenna, multistage diode multipliers, and a control transistor. Rat cardiomyocytes, seeded on electrically conductive gelatin-based hydrogels, demonstrate synchronous contractions and Ca²⁺ transients immediately upon stimulation. Notably, the stimulator output voltage and current profiles match the tissue contraction frequency within 0.5-2 Hz. Overall, our results indicate the promising potential of the proposed wireless passive stimulator for cardiac stimulation and therapy by induction of precisely controlled and synchronous contractions.

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

INTRODUCTION

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

SiC protective coating for photovoltaic retinal prosthesis

OBJECTIVE

To evaluate plasma-enhanced, chemically vapor deposited (PECVD) amorphous silicon carbide (α-SiC:H) as a protective coating for retinal prostheses and other implantable devices, and to study their failure mechanisms in vivo.

APPROACH

Retinal prostheses were implanted in rats sub-retinally for up to 1 year. Degradation of implants was characterized by optical and scanning electron microscopy. Dissolution rates of SiC, SiN x and thermal SiO2 were measured in accelerated soaking tests in saline at 87 °C. Defects in SiC films were revealed and analyzed by selectively removing the materials underneath those defects.

MAIN RESULTS

At 87 °C SiN x dissolved at 18.3 ± 0.3 nm d(-1), while SiO2 grown at high temperature (1000 °C) dissolved at 0.104 ± 0.008 nm d(-1). SiC films demonstrated the best stability, with no quantifiable change after 112 d. Defects in thin SiC films appeared primarily over complicated topography and rough surfaces.

SIGNIFICANCE

SiC coatings demonstrating no erosion in accelerated aging test for 112 d at 87 °C, equivalent to about 10 years in vivo, can offer effective protection of the implants. Photovoltaic retinal prostheses with PECVD SiC coatings exhibited effective protection from erosion during the 4 month follow-up in vivo. The optimal thickness of SiC layers is about 560 nm, as defined by anti-reflective properties and by sufficient coverage to eliminate defects.

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

OBJECTIVE

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

APPROACH

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

MAIN RESULTS

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

SIGNIFICANCE

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

Electrical stimulation of the brain and the development of cortical visual prostheses: An historical perspective

Rapid advances are occurring in neural engineering, bionics and the brain-computer interface. These milestones have been underpinned by staggering advances in micro-electronics, computing, and wireless technology in the last three decades. Several cortically-based visual prosthetic devices are currently being developed, but pioneering advances with early implants were achieved by Brindley followed by Dobelle in the 1960s and 1970s. We have reviewed these discoveries within the historical context of the medical uses of electricity including attempts to cure blindness, the discovery of the visual cortex, and opportunities for cortex stimulation experiments during neurosurgery. Further advances were made possible with improvements in electrode design, greater understanding of cortical electrophysiology and miniaturisation of electronic components. Human trials of a new generation of prototype cortical visual prostheses for the blind are imminent. This article is part of a Special Issue entitled Hold Item.

Behavioral frequency discrimination ability of partially deafened cats using cochlear implants

The aim of this study was to determine the effects of cochlear implant (CI) use on behavioral frequency discrimination ability in partially deafened cats. We hypothesized that the additional information provided by the CI would allow subjects to perform better on a frequency discrimination task. Four cats with a high frequency hearing loss induced by ototoxic drugs were first trained on a go/no-go, positive reinforcement, frequency discrimination task and reached asymptotic performance (measured by d' - detection theory). Reference frequencies (1, 4, and 7 kHz) were systematically rotated (Block design) every 9-11 days to cover the hearing range of the cats while avoiding bias arising from the order of testing. Animals were then implanted with an intracochlear electrode array connected to a CI and speech processor. They then underwent 6 months of continuous performance measurement with the CI turned on, except for one month when the stimulator was turned off. Overall, subjects performed the frequency discrimination task significantly better with their CI turned on than in the CI-off condition (3-way ANOVA, p < 0.001). The analysis showed no dependence on subject (3-way ANOVA, subject × on-off condition, p > 0.5); however, the CI only significantly improved performance for two (1 and 7 kHz) of the three reference frequencies. In this study we were able to show, for the first time, that cats can utilize information provided by a CI in performing a behavioral frequency discrimination task.

Drug delivery to the inner ear

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

An overview of the recent wideband transcutaneous wireless communication techniques

Neuroprosthetic devices such as cochlear and retinal implants need to deliver a large volume of data from external sensors into the body, while invasive brain-computer interfaces need to deliver sizeable amounts of data from the central nervous system to target devices outside of the body. Nonetheless, the skin should remain intact. This paper reviews some of the latest techniques to establish wideband wireless communication links across the skin.

Electrotactile Display with Real-Time Impedance Feedback Using Pulse Width Modulation

An electrotactile display is a tactile interface composed of skin surface electrodes. The use of such a device is limited by the variability of the elicited sensation. One possible solution to this problem is to monitor skin electrical impedance. Previous studies revealed a correlation between impedance and threshold, but did not construct real-time feedback loops. In this study, an electrotactile display was constructed using a 1.45 μs feedback loop. Real-time pulse width modulation was proposed, and the relationship between skin resistance and absolute threshold was measured to find a function for determining a suitable pulse width from skin resistance. An evaluation experiment revealed that the proposed algorithm suppressed spatial variation and reduced temporal change.

A CMOS retinal neurostimulator capable of focussed, simultaneous stimulation

Restoring vision to the blind by way of medical device technology has been an objective of several research teams for a number of years. It is known that spots of light-phosphenes-can be elicited by way of electrical stimulation of surviving retinal neurons. Beyond this our understanding of prosthetic vision remains rudimentary. We have designed and manufactured an integrated circuit neurostimulator with substantial versatility, able to provide focussed, simultaneous stimulation using current sources and sinks, steering the current to the intended site of stimulation. The ASIC utilizes high-voltage CMOS transistors in key circuits, to manage voltage compliance issues (due to an unknown or changing electrode/tissue interface impedance) given the relatively high stimulation thresholds necessary to elicit physiological excitation of retinal neurons. In addition, a unique multiplexing system comprised of electrodes arranged in a hexagonal mosaic is used, wherein each electrode can be addressed to be a stimulating electrode and all adjacent electrodes serve as the return path. This allows for simultaneous stimulation to be delivered while appropriately managing cross-talk between the stimulating electrodes. Test results indicate highly linear current sources and sinks (differential nonlinearity error of 0.13 least significant bits -2.6 microA), with the ASIC clearly able to provide focussed stimulation using electrodes immersed in a saline solution.

Wireless neural stimulation in freely behaving small animals

We introduce a novel wireless, low-power neural stimulation system for use in freely behaving animals. The system consists of an external transmitter and a miniature, implantable wireless receiver-stimulator. The implant uses a custom integrated chip to deliver biphasic current pulses to four addressable bipolar electrodes at 32 selectable current levels (10 microA to 1 mA). To achieve maximal battery life, the chip enters a sleep mode when not needed and can be awakened remotely when required. To test our device, we implanted bipolar stimulating electrodes into the songbird motor nucleus HVC (formerly called the high vocal center) of zebra finches. Single-neuron recordings revealed that wireless stimulation of HVC led to a strong increase of spiking activity in its downstream target, the robust nucleus of the arcopallium. When we used this device to deliver biphasic pulses of current randomly during singing, singing activity was prematurely terminated in all birds tested. Thus our device is highly effective for remotely modulating a neural circuit and its corresponding behavior in an untethered, freely behaving animal.

Cochlear implants: system design, integration, and evaluation

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.

An Integrated Implantable Stimulator That is Fail-Safe Without Off-Chip Blocking-Capacitors

We present a neural stimulator chip with an output stage (electrode driving circuit) that is fail-safe under single-fault conditions without the need for off-chip blocking-capacitors. To miniaturize the stimulator output stage two novel techniques are introduced. The first technique is a new current generator circuit reducing to a single step the translation of the digital input bits into the stimulus current, thus minimizing silicon area and power consumption compared to previous works. The current generator uses voltage-controlled resistors implemented by MOS transistors in the deep triode region. The second technique is a new stimulator output stage circuit with blocking-capacitor safety protection using a high-frequency current-switching (HFCS) technique. Unlike conventional stimulator output stage circuits for implantable functional electrical stimulation (FES) systems which require blocking-capacitors in the microfarad range, our proposed approach allows capacitance reduction to the picofarad range, thus the blocking-capacitors can be integrated on-chip. The prototype four-channel neural stimulator chip was fabricated in XFAB's 1-mum silicon-on-insulator CMOS technology and can operate from a power supply between 5-18 V. The stimulus current is generated by active charging and passive discharging. We obtained recordings of action potentials and a strength-duration curve from the sciatic nerve of a frog with the stimulator chip which demonstrate the HFCS technique. The average power consumption for a typical 1-mA 20-Hz single-channel stimulation using a book electrode, is 200 muW from a 6 V power supply. The silicon area occupation is 0.38 mm(2) per channel.

A dual band wireless power and data telemetry for retinal prosthesis

Inductive coupling is commonly used for wireless power and data transfer in biomedical telemetry systems. The increasing demand on the performance of medical devices requires high data rate and high power efficiency at the same time. If only one radio frequency carrier is used, it is difficult to achieve both high data rate and high power efficiency due to the competing requirements on carrier frequency and system-Q of the power and data transmission. We propose a dual band telemetry system to implement power and data transmission using different frequencies by allocating lower frequency for power transmission and higher frequency for data transmission. However, the magnetic coupling between the power carrier and data carrier will affect the operation of both links. In this paper, this interference is analyzed and design equations are derived, which are used to design coils to maximize the data signal level received at the implant side. A prototype of dual band telemetry for a retinal prosthetic device has been built and experimental results show that both power and data can be transmitted and high data rate can be achieved without compromising the power transmission efficiency.

Analytical calculation of the self-resonant frequency of biomedical telemetry coils

Inductive link is commonly used in biomedical telemetry as a method to wirelessly transmit power and/or data, where coil is very critical to achieve high efficiency. One of the most important but often ignored parameters of the coils is the self-resonant frequency. Due to the fact that the parasitic capacitances are functions of the geometry and winding sequence of the coil, it is very difficult to calculate the self-resonant frequency. The lack of knowledge about the self-resonant frequency greatly limits the design efficiency, especially when the target operating frequency is high, on the order of tens of MHz. This paper presents an analytical model to calculate the self-resonant frequency of multiple-layer coils. A general model of coils to calculate the total parasitic capacitance is given first and then an analytical equation for self-resonant frequency is obtained. The experimental measurement results demonstrate that the equation can accurately predict the self-resonant frequency, therefore can be used for guiding the coil design.

An efficient multiplexing method for addressing large numbers of electrodes in a visual neuroprosthesis

Recent clinical trials using modified cochlear implants employ a small number of electrodes to stimulate surviving retinal neurons in blind patients and indicate that spatially-mapped phosphenes may indeed be elicited through these means. The next obvious step forward in the path toward achieving a useful visual prosthesis for the blind will be to increase the quantity of stimulation sites such that shapes, characters and rudimentary images may be conveyed. An important objective that must be obtained in the pursuit of this task is the ability to configure and deliver the stimulation with sufficient speed so as to avoid delays that are perceived by the patient as flicker within the visual scene. As the quantity of electrodes within the prosthesis increases, so too does the complexity of achieving this objective. This paper describes a means through which large numbers of electrode sites may be efficiently addressed in a neurostimulation circuit so as to increase the rate at which said circuit may be configured for the delivery of stimulation.

A Model for Cochlear Implant Electrode Insertion and Force Evaluation: Results with a New Electrode Design and Insertion Technique

OBJECTIVES AND HYPOTHESIS

This study has the specific aim of evaluating the insertion characteristics of a new cochlear implant electrode. Techniques for evaluation of fluoroscopic real time mechanical insertion dynamics, histologic electrode position and trauma results, hydraulic force, and mechanical insertion forces are presented. In addition, this study should serve to present a novel model for cochlear implant electrode insertion evaluations.

STUDY DESIGN

Prospective analysis using a series of analytical techniques.

METHODS

All studies are conducted in fixed cadaveric temporal bones. Real time fluoroscopic insertion evaluations, histologic evaluations for trauma and electrode position in embedded bones, hydraulic measures, and mechanical intracochlear force measurements are conducted with a current and new electrode.

RESULTS

The Contour Advance electrode provides a more reliable and less traumatic insertion when deployed with the Advance Off Stylet technique. This is largely because of a reduction in intracochlear outer wall force generation. Fluoroscopic and histologic analysis reveal a smooth insertion without reliance on cochlear outer wall contact. No hydraulic forces were detected when measured from the superior semicircular canal ampulla.

CONCLUSION

The model used for this study provides valuable information to cochlear implant surgeons and design engineers. The Contour Advance electrode, inserted with the Advance Off Stylet technique, represents an improvement over the Contour electrode inserted with the standard insertion technique.

A compact large voltage-compliance high output-impedance programmable current source for implantable microstimulators

A new CMOS current source is described for biomedical implantable microstimulator applications, which utilizes MOS transistors in deep triode region as linearized voltage controlled resistors (VCR). The VCR current source achieves large voltage compliance, up to 97% of the supply voltage, while maintaining high output impedance in the 100 MOmega range to keep the stimulus current constant within 1% of the desired value irrespective of the site and tissue impedances. This approach improves stimulation efficiency, extends power supply lifetime, and saves chip area especially when the stimulation current level is high in the milliampere range. A prototype 4-channel microstimulator chip is fabricated in the AMI 1.5-microm, 2-metal, 2-poly, n-well standard CMOS process. With a 5-V supply, each stimulating site driver provides at least 425-V compliance and > 10 MOmega output impedance, while sinking up to 210 microA, and occupies 0.05 mm2 in chip area. A modular 32-site wireless neural stimulation microsystem, utilizing the VCR current source, is under development.

Cochlear and brainstem implantation

Cochlear implantation is an established habilitative and rehabilitative option for profoundly deafened individuals over 1 year of age who derive limited benefit from conventional hearing aids. Auditory performance varies among individuals and is determined primarily by age at implantation, pre-existence of speech and language skills, and the time interval between onset of deafness and implantation. Successful implant users generally demonstrate improved auditory abilities and speech production skills beyond those achieved with hearing aids. Multichannel ABIs can provide useful auditory information to patients with NF-2 who have lost integrity of auditory nerves following removal of vestibular schwannomas. The implant allows for awareness of environmental sounds and, potentially, speech recognition. Most patients undergoing implantation demonstrate improved lip-reading skills, and exceptional performers achieve understanding of open-set speech.

Conversion from the SPEAK to the ACE strategy in children using the nucleus 24 cochlear implant system: speech perception and speech production outcomes

OBJECTIVE

The main objective of this study was to assess whether speech perception and speech production in children using the Nucleus 24 cochlear implant system improved with a change in speech processing strategy from the SPEAK to the Advanced Combination Encoder (ACE) strategy. The major difference between the two strategies is that ACE uses a higher stimulation rate (in this study the stimulation rate was 900 Hz per channel) compared with the SPEAK strategy, where the stimulation rate is 250 Hz per channel. Information also was obtained regarding the adjustment period after conversion to the ACE strategy.

DESIGN

An ABA experimental design was used where scores were initially obtained using the SPEAK strategy' (in the initial A time interval), and subsequently performance was assessed using the ACE strategy (B time interval) and then again with the SPEAK strategy (second A time interval). The duration of the B interval was 10 wk, and the duration for the second A interval was 4 wk. Seven children aged between 9 and 16 yr who had at least 6 mo experience with the SPEAK strategy participated. Open-set monosyllabic CNC word perception in quiet and Speech Intelligibility Test sentence perception in noise was evaluated at the end of each of the time intervals. Word perception was also monitored at fortnightly intervals during the B time interval. Speech production was assessed at the end of the initial A time interval and at the end of the B time interval.

RESULTS

Mean word and phoneme scores for open-set words in quiet for the group of seven children were significantly higher with the ACE strategy as compared with the SPEAK strategy scores obtained in both of the A time intervals. For sentences in noise, mean scores using the ACE strategy as well as the SPEAK strategy at the second A evaluation point were significantly higher than the scores using the SPEAK strategy measured at the first A time interval. This suggests that learning effects may have influenced outcomes. For some subjects, an initial decrease in scores was found during the initial 2-wk period after fitting the ACE strategy; however, scores subsequently were found to be similar to or higher than those when using the initial SPEAK strategy. Analysis of speech production assessments showed an improvement in the medial consonant scores after using the ACE strategy.

CONCLUSIONS

This study demonstrated that some children were able to benefit from the additional information provided by the ACE strategy as compared with the SPEAK strategy. However, the differences in overall performance between the two strategies appear to be relatively small.

Electrical stimulation of the auditory nerve: II. Effect of stimulus waveshape on single fibre response properties

To investigate the generation of action potentials by electrical stimulation we studied the response of auditory nerve fibres (ANFs) to a variety of stimulus waveforms. Current pulses were presented to longitudinal bipolar scala tympani electrodes implanted in normal and deafened cochleae. Capacitively coupled monophasic current pulses evoked single ANF responses that were more sensitive to one phase (the 'excitatory' phase) than the other. Anodic pulses produced a significantly shorter mean latency compared with cathodic pulses, indicating that their site for spike initiation is located more centrally along the ANF. The fine temporal structure of ANF responses to biphasic pulses appeared similar to that evoked by monophasic pulses. An excitatory monophasic pulse evoked a significantly lower threshold than a biphasic current pulse having the same polarity and duration leading phase, i.e. the addition of a second phase leads to an increase in threshold. Increasing the temporal separation of the two phases of a biphasic pulse resulted in a moderate reduction in threshold which approached that of an excitatory monophasic pulse for interphase gaps > 100 micros. Greater threshold reductions were observed with narrower current pulses. There was a systematic reduction in threshold with increasing pulse width for biphasic current pulses, reflecting the general charge-dependent properties of ANFs for narrow pulse widths. Chopped biphasic current pulses, which uniformly delivered multiple packets of charge (2 x 30 micros, 3 x 20 micros or 6 x 10 micros) with the same polarity over a 120 micros period, followed by a similar series in the reverse polarity, demonstrated the ability of the neural membrane to integrate sub-threshold packets of charge to achieve depolarisation. Moreover, thresholds for these current pulses were approximately 1.5 dB lower than 60 micros/phase biphasic current pulses with no interphase gap. Finally, stimulation using charge-balanced triphasic and asymmetric current pulses produced systematic changes in threshold and latency consistent with the charge-dependent properties of ANFs. These findings provide insight into the mechanisms underlying the generation of action potentials using electrical stimuli. Moreover, a number of these novel stimuli may have potential clinical application.

Speech perception performance in experienced cochlear-implant patients receiving the SPEAK processing strategy in the Nucleus Spectra-22 cochlear implant

Sixteen experienced cochlear implant patients with a wide range of speech-perception abilities received the SPEAK processing strategy in the Nucleus Spectra-22 cochlear implant. Speech perception was assessed in quiet and in noise with SPEAK and with the patients' previous strategies (for most, Multipeak) at the study onset, as well as after using SPEAK for 6 months. Comparisons were made within and across the two test sessions to elucidate possible learning effects. Patients were also asked to rate the strategies on seven speech recognition and sound quality scales. After 6 months' experience with SPEAK, patients showed significantly improved mean performance on a range of speech recognition measures in quiet and noise. When mean subjective ratings were compared over time there were no significant differences noted between strategies. However, many individuals rated the SPEAK strategy better for two or more of the seven subjective measures. Ratings for "appreciation of music" and "quality of my own voice" in particular were generally higher for SPEAK. Improvements were realized by patients with a wide range of speech perception abilities, including those with little or no open-set speech recognition.

Gap detection as a measure of electrode interaction in cochlear implants

Gap detection thresholds were measured as an indication of the amount of interaction between electrodes in a cochlear implant. The hypothesis in this study was as follows: when the two stimuli that bound the gap stimulate the same electrode, and thus the same neural population, the gap detection threshold will be short. As two stimuli are presented to two electrodes that are more widely separated, the amount of neural overlap of the two stimuli decreases, the stimuli sound more dissimilar, and the gap thresholds increase. Gap detection thresholds can thus be used to infer the amount of overlap in neural populations stimulated by two electrodes. Three users of the Nucleus cochlear implant participated in this study. Gap detection thresholds were measured as a function of the distance between the two electrode pairs and as a function of the spacing between the two electrodes of a bipolar pair (i.e., using different modes of stimulation). The results indicate that measuring gap detection thresholds may provide an estimate of the amount of electrode interaction. Gap detection thresholds were a function of the physical separation of the electrode pairs used for the two stimuli that bound the gap. Lower gap thresholds were observed when the two electrode pairs were closely spaced, and gap thresholds increased as the separation increased, resulting in a "psychophysical tuning curve" as a function of electrode separation. The sharpness of tuning varied across subjects, and for the three subjects in this study, the tuning was generally sharper for the subjects with better speech recognition. The data also indicate that increasing the separation between active and reference electrodes has limited effect on spatial selectivity (or tuning) as measured perceptually.

Speech recognition as a function of the number of electrodes used in the SPEAK cochlear implant speech processor

Speech recognition was measured in listeners with the Nucleus-22 SPEAK speech processing strategy as a function of the number of electrodes. Speech stimuli were analyzed into 20 frequency bands and processed according to the usual SPEAK processing strategy. In the normal clinical processor each electrode is assigned to represent the output of one filter. To create reduced-electrode processors the output of several adjacent filters were directed to a single electrode, resulting in processors with 1, 2, 4, 7, 10, and 20 electrodes. The overall spectral bandwidth was preserved, but the number of active electrodes was progressively reduced. After a 2-day period of adjustment to each processor, speech recognition performance was measured on medial consonants, vowels, monosyllabic words, and sentences. Performance with a single electrode processor was poor in all listeners, and average performance increased dramatically on all test materials as the number of electrodes was increased from 1 to 4. No differences in average performance were observed on any test in the 7-, 10-, and 20-electrode conditions. On sentence and consonant tests there was no difference between average performance with the 4-electrode and 20-electrode processors. This pattern of results suggests that cochlear implant listeners are not able to make full use of the spectral information on all 20 electrodes. Further research is necessary to understand the reasons for this limitation and to understand how to increase the amount of spectral information in speech received by implanted listeners.

A comparison of speech perception of cochlear implantees using the Spectral Maxima Sound Processor (SMSP) and the MSP (MULTIPEAK) processor

The Spectral Maxima Sound Processor (SMSP) is a portable speech processor which has recently been developed at the University of Melbourne for use with multiple-electrode cochlear implants. In this processor, the six largest outputs (maxima) of 16 bandpass filters are used to stimulate the cochlea on a place basis at a constant rate. This speech processing strategy has been compared with the MSP(MULTIPEAK) strategy, in which four electrodes are selected for stimulation in every glottal pulse period. The study was undertaken on four postlinguistically deaf adults. The results show that, for this group of subjects, the performance of the SMSP processor was significantly better than that of the MSP(MULTIPEAK) processor for the recognition of closed-set vowels and consonants, open-set monosyllabic words, and open-set sentences in noise, when using electrical stimulation alone. The SMSP mean scores were: vowels 91.3%, consonants 74.9%, words 57.4%, and sentences in noise 78.7%. The MSP(MULTIPEAK) mean scores were: vowels 76.3%, consonants 59.4%, words 39.9%, and sentences in noise 50.0%.