Investigating perceptual features of electrode stimulation via a multidimensional scaling paradigm

Pitch Discrimination: An Independent Factor in Cochlear Implant Performance Outcomes

Objective:

To assess differences in pitch-ranking ability across a range of speech understanding performance levels and as a function of electrode position.

Study Design:

An observational study of a cross-section of cochlear implantees.

Setting:

Tertiary referral center for cochlear implantation.

Patients:

A total of 22 patients were recruited. All three manufacturers’ devices were included (MED-EL, Innsbruck, Austria, n = 10; Advanced Bionics, California, USA, n = 8; and Cochlear, Sydney, Australia, n = 4) and all patients were long-term users (more than 18 months). Twelve of these were poor performers (scores on BKB sentence lists <60%) and 10 were excellent performers (BKB >90%).

Intervention:

After measurement of threshold and comfort levels, and loudness balancing across the array, all patients underwent thorough pitch-ranking assessments at 80% of comfort levels.

Main Outcome Measure:

Ability to discriminate pitch across the electrode array, measured by consistency in discrimination of adjacent pairs of electrodes, as well as an assessment of the pitch order across the array using the midpoint comparison task.

Results:

Within the poor performing group there was wide variability in ability to pitch rank, from no errors, to a complete inability to reliably and consistently differentiate pitch change across the electrode array. Good performers were overall significantly more accurate at pitch ranking (p = 0.026). Consistent pitch ranking was found to be a significant independent predictor of BKB score, even after adjusting for age. Users of the MED-EL implant experienced significantly more pitch confusions at the apex than at more basal parts of the electrode array.

Conclusions:

Many cochlear implant users struggle to discriminate pitch effectively. Accurate pitch ranking appears to be an independent predictor of overall outcome. Future work will concentrate on manipulating maps based upon pitch discrimination findings in an attempt to improve speech understanding.

Pitch ranking, electrode discrimination, and physiological spread of excitation using current steering in cochlear implants

The first objective of this study was to determine whether adaptive pitch-ranking and electrode-discrimination tasks with cochlear-implant (CI) recipients produce similar results for perceiving intermediate "virtual-channel" pitch percepts using current steering. Previous studies have not examined both behavioral tasks in the same subjects with current steering. A second objective was to determine whether a physiological metric of spatial separation using the electrically evoked compound action potential spread-of-excitation (ECAP SOE) function could predict performance in the behavioral tasks. The metric was the separation index (Σ), defined as the difference in normalized amplitudes between two adjacent ECAP SOE functions, summed across all masker electrodes. Eleven CII or 90 K Advanced Bionics (Valencia, CA) recipients were tested using pairs of electrodes from the basal, middle, and apical portions of the electrode array. The behavioral results, expressed as d', showed no significant differences across tasks. There was also no significant effect of electrode region for either task. ECAP Σ was not significantly correlated with pitch ranking or electrode discrimination for any of the electrode regions. Therefore, the ECAP separation index is not sensitive enough to predict perceptual resolution of virtual channels.

Pitch ranking, electrode discrimination, and physiological spread-of-excitation using Cochlear's dual-electrode mode

This study compared pitch ranking, electrode discrimination, and electrically evoked compound action potential (ECAP) spatial excitation patterns for adjacent physical electrodes (PEs) and the corresponding dual electrodes (DEs) for newer-generation Cochlear devices (Cochlear Ltd., Macquarie, New South Wales, Australia). The first goal was to determine whether pitch ranking and electrode discrimination yield similar outcomes for PEs and DEs. The second goal was to determine if the amount of spatial separation among ECAP excitation patterns (separation index, Σ) between adjacent PEs and the PE-DE pairs can predict performance on the psychophysical tasks. Using non-adaptive procedures, 13 subjects completed pitch ranking and electrode discrimination for adjacent PEs and the corresponding PE-DE pairs (DE versus each flanking PE) from the basal, middle, and apical electrode regions. Analysis of d' scores indicated that pitch-ranking and electrode-discrimination scores were not significantly different, but rather produced similar levels of performance. As expected, accuracy was significantly better for the PE-PE comparison than either PE-DE comparison. Correlations of the psychophysical versus ECAP Σ measures were positive; however, not all test/region correlations were significant across the array. Thus, the ECAP separation index is not sensitive enough to predict performance on behavioral tasks of pitch ranking or electrode discrimination for adjacent PEs or corresponding DEs.

Multidimensional scaling between acoustic and electric stimuli in cochlear implant users with contralateral hearing

This study investigated the perceptual relationship between acoustic and electric stimuli presented to CI users with functional contralateral hearing. Fourteen subjects with unilateral profound deafness implanted with a MED-EL CI scaled the perceptual differences between pure tones presented to the acoustic hearing ear and electric biphasic pulse trains presented to the implanted ear. The differences were analyzed with a multidimensional scaling (MDS) analysis. Additionally, speech performance in noise was tested using sentence material presented in different spatial configurations while patients listened with both their acoustic hearing and implanted ears. Results of alternating least squares scaling (ALSCAL) analysis consistently demonstrate that a change in place of stimulation is in the same perceptual dimension as a change in acoustic frequency. However, the relative perceptual differences between the acoustic and the electric stimuli varied greatly across subjects. A degree of perceptual separation between acoustic and electric stimulation (quantified by relative dimensional weightings from an INDSCAL analysis) was hypothesized that would indicate a change in perceptual quality, but also be predictive of performance with combined acoustic and electric hearing. Perceptual separation between acoustic and electric stimuli was observed for some subjects. However, no relationship between the degree of perceptual separation and performance was found.

Stream segregation on a single electrode as a function of pulse rate in cochlear implant listeners

While cochlear implants (CIs) usually provide high levels of speech recognition in quiet, speech recognition in noise remains challenging. To overcome these difficulties, it is important to understand how implanted listeners separate a target signal from interferers. Stream segregation has been studied extensively in both normal and electric hearing, as a function of place of stimulation. However, the effects of pulse rate, independent of place, on the perceptual grouping of sequential sounds in electric hearing have not yet been investigated. A rhythm detection task was used to measure stream segregation. The results of this study suggest that while CI listeners can segregate streams based on differences in pulse rate alone, the amount of stream segregation observed decreases as the base pulse rate increases. Further investigation of the perceptual dimensions encoded by the pulse rate and the effect of sequential presentation of different stimulation rates on perception could be beneficial for the future development of speech processing strategies for CIs.

Effects of extreme tonotopic mismatches between bilateral cochlear implants on electric pitch perception: a case study

OBJECTIVES

Recent studies suggest that pitch perceived through cochlear implants (CIs) changes with experience to minimize spectral mismatches between electric and acoustic hearing. This study aimed to test whether perceived spectral mismatches are similarly minimized between two electric inputs.

DESIGN

Pitch perception was studied in a subject with a 10-mm CI in one ear and a 24-mm CI in the other ear. Both processors were programmed to allocate information from the same frequency range of 188-7938 Hz, despite the large differences in putative insertion depth and stimulated cochlear locations between the CIs.

RESULTS

After 2 and 3 years of experience, pitch-matched electrode pairs between CIs were aligned closer to the processor-provided frequencies than to cochlear position.

CONCLUSIONS

Pitch perception may have adapted to reduce perceived spectral discrepancies between bilateral CI inputs, despite 2-3 octave differences in tonotopic mapping.

Probing the electrode-neuron interface with focused cochlear implant stimulation

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

Effects of stimulation level and electrode pairing on the binaural interaction component of the electrically evoked auditory brain stem response

OBJECTIVES

The purpose of this study was to investigate the effects of stimulation level and electrode pairing on the binaural interaction component (BIC) of the electrically evoked auditory brain stem response (EABR) in Nucleus cochlear implant (CI) users.

DESIGN

Ten postlingually deafened adult CI users participated in this study. EABRs were measured using loudness balanced, biphasic current pulses presented in the left monaural, right monaural, and bilateral stimulation conditions. BICs were computed based on measures of the EABR obtained for each subject by pairing the electrode 12 (of 22 intracochlear electrodes) in the right ear with each of 11 electrodes spaced across the electrode array in the left ear. The effect of stimulation level on the amplitude of the BIC was investigated by measuring growth functions of the BIC from six subjects. The effect of electrode pairing on the amplitude of the BIC was studied at high stimulation levels in 10 subjects and at low stimulation levels in seven subjects. The high stimulation level was chosen as the 90% point of the subject's dynamic range (DR) or the highest stimulation level in which the electrophysiologic recordings were not contaminated by muscle artifacts. The low stimulation level was chosen as a level that was 10% point of subject's DR higher than the BIC threshold for six of these seven subjects. For one subject, BIC thresholds were not available and the low stimulation level was referred to the 70% point of subject's DR.

RESULTS

BICs were successfully recorded from all 11 interaural electrode pairs for a majority of subjects tested at both stimulation levels. BIC amplitudes increased with stimulation level. The effect of stimulation level on latencies of the BIC was less robust. At high stimulation levels, BIC amplitudes did not change significantly as the stimulating electrode used in the left ear was systematically varied. When low stimulation levels were used, BIC amplitude was maximal for interaural electrode pairs with similar intracochlear positions and decreased when the offset between interaural electrodes increased.

CONCLUSIONS

This study demonstrates that stimulation level affects amplitudes of the BIC response. It is possible to record the BIC of the EABR in bilateral CI users even from interaural electrode pairs that have large interaural offsets. This finding suggests that when high-level stimuli are used, there is a broad pattern of current spread within the two cochleae. At lower stimulation levels, the spread of excitation within the cochlea is reduced making the effect of electrode pairing on the amplitude of the BIC more pronounced.

Temporal pitch perception at high rates in cochlear implants

A recent study reported that a group of Med-El COMBI 40+CI (cochlear implant) users could, in a forced-choice task, detect changes in the rate of a pulse train for rates higher than the 300 pps "upper limit" commonly reported in the literature [Kong, Y.-Y., et al. (2009). J. Acoust. Soc. Am. 125, 1649-1657]. The present study further investigated the upper limit of temporal pitch in the same group of CI users on three tasks [pitch ranking, rate discrimination, and multidimensional scaling (MDS)]. The patterns of results were consistent across the three tasks and all subjects could follow rate changes above 300 pps. Two subjects showed exceptional ability to follow temporal pitch change up to about 900 pps. Results from the MDS study indicated that, for the two listeners tested, changes in pulse rate over the range of 500-840 pps were perceived along a perceptual dimension that was orthogonal to the place of excitation. Some subjects showed a temporal pitch reversal at rates beyond their upper limit of pitch and some showed a reversal within a small range of rates below the upper limit. These results are discussed in relation to the possible neural bases for temporal pitch processing at high rates.

Role of electrode placement as a contributor to variability in cochlear implant outcomes

HYPOTHESIS

Suboptimal cochlear implant (CI) electrode array placement may reduce presentation of coded information to the central nervous system and, consequently, limit speech recognition.

BACKGROUND

Generally, mean speech reception scores for CI recipients are similar across different CI systems, yet large outcome variation is observed among recipients implanted with the same device. These observations suggest significant recipient-dependent factors influence speech reception performance. This study examines electrode array insertion depth and scalar placement as recipient-dependent factors affecting outcome.

METHODS

Scalar location and depth of insertion of intracochlear electrodes were measured in 14 patients implanted with Advanced Bionics electrode arrays and whose word recognition scores varied broadly. Electrode position was measured using computed tomographic images of the cochlea and correlated with stable monosyllabic word recognition scores.

RESULTS

Electrode placement, primarily in terms of depth of insertion and scala tympani versus scala vestibuli location, varies widely across subjects. Lower outcome scores are associated with greater insertion depth and greater number of contacts being located in scala vestibuli. Three patterns of scalar placement are observed suggesting variability in insertion dynamics arising from surgical technique.

CONCLUSION

A significant portion of variability in word recognition scores across a broad range of performance levels of CI subjects is explained by variability in scalar location and insertion depth of the electrode array. We suggest that this variability in electrode placement can be reduced and average speech reception improved by better selection of cochleostomy sites, revised insertion approaches, and control of insertion depth during surgical placement of the array.

Pitch ranking of complex tones by normally hearing subjects and cochlear implant users

The ability of 10 normally hearing (NH) adults and eight cochlear implant (CI) users to pitch-rank pairs of complex tones was assessed. The acoustically presented stimuli differed in fundamental frequency (F0) by either one or six semitones (F0 range: 98 to 740 Hz). The NH group obtained significantly higher mean scores for both experiments: (NH: one semitone - 81.2%, six semitones - 89.0%; CI: one semitone - 49.0%, six semitones - 60.2%; p<0.001). Prior musical experience was found to be associated with higher pitch-ranking scores for the NH subjects. Those with musical experience ratings <3 obtained significantly lower scores for both interval sizes (p<0.001) than those with higher ratings. Nevertheless, the scores obtained by the musically inexperienced, NH adults were significantly higher than those obtained by the CI group for both the one-semitone (p=0.022) and six-semitone (p=0.018) intervals. These results suggest that the pitch information CI users obtain from their implant systems is less accurate than that obtained by NH listeners when listening to the same complex sounds. Furthermore, the relatively poor pitch-ranking ability of at least some CI users may be associated with a more-limited experience of music in general.

Auditory stream segregation of tone sequences in cochlear implant listeners

Previous claims that auditory stream segregation occurs in cochlear implant listeners are based on limited evidence. In experiment 1, eight listeners heard tones presented in a 30-s repeating ABA-sequence, with frequencies matching the centre frequencies of the implant's 22 electrodes. Tone A always stimulated electrode 11 (centre of the array); tone B stimulated one of the others. Tone repetition times (TRTs) from 50 to 200 ms were used. Listeners reported when they heard one or two streams. The proportion of time that each sequence was reported as segregated was consistently greater with increased electrode separation. However, TRT had no significant effect, and the perceptual reversals typical of normal-hearing listeners rarely occurred. The results may reflect channel discrimination rather than stream segregation. In experiment 2, six listeners performed a pitch-ranking task using tone pairs (reference=electrode 11). Listeners reported which tone was higher in pitch (or brighter in timbre) and their confidence in the pitch judgement. Similarities were observed in the individual pattern of results for reported segregation and pitch discrimination. Many implant listeners may show little or no sign of automatic stream segregation owing to the reduced perceptual space within which sounds can differ from one another.

Implications of deep electrode insertion on cochlear implant fitting

Using long Med-El Combi40+ electrode arrays, it is now possible to cover the whole range of the cochlea, up to about two turns. Such insertion depths have received little attention. To evaluate the contribution of deeply inserted electrodes, five Med-El cochlear implant users were tested on vowel and consonant identification tests with fittings with first one, two, and up to five apical electrodes being deactivated. In addition, subjects performed pitch-ranking experiments, using loudness-balanced stimuli, to identify electrodes creating pitch confusions. Radiographs were taken to measure each electrode insertion depth. All subjects used each modified fitting for two periods of about 3 weeks. During the experiment, the same stimulation rate and frequency range were maintained across all the fittings used for each individual subject. After each trial period the subject had to perform three consonant and three vowel identification tests. All subjects showed deep electrode insertions ranging from 605 degrees to 720 degrees. The two subjects with the deepest electrode insertions showed significantly increased vowel- and consonant-identification performances with fittings with the two or three most apical electrodes deactivated compared to their standard fitting with all available electrodes activated. The other three subjects did not show significant improvements in performance when one or two of their most apical electrodes were deactivated. Four out of five subjects preferred to continue use of a fitting with one or more apical electrodes deactivated. The two subjects with the deepest insertions also showed pitch confusions between their most apical electrodes. Two possible reasons for these results are discussed. One is to reduce neural interactions related to electrodes producing pitch confusions. Another is to improve the alignment of the frequency components of sounds coded by the electrical signals delivered to each electrode to the overall pitch of the auditory perception produced by the electrical stimulation of auditory nerve fibers.

Perceptual dissimilarities among acoustic stimuli and ipsilateral electric stimuli

Five users of cochlear implants who had residual acoustic hearing in the implanted ear postoperatively participated in a study comparing the percepts elicited by acoustic and electric stimuli. The stimuli comprised pulse trains delivered to single electrodes and pure tones presented ipsilaterally. In the experiments, 12 equally loud stimuli with differing frequencies, electrode positions, and pulse rates were generated. Subjects listened to all of the possible pairs of stimuli in each set, and provided a relative dissimilarity rating for the members of each stimulus pair. The data were analyzed using non-metric multi-dimensional scaling techniques. Stimulus spaces were plotted in two dimensions to represent the results for each subject with each stimulus set. The results suggested that one dimension was associated with a pitch-like percept, related to the acoustic tone frequency and the active electrode position. The second dimension separated the acoustic stimuli from the electric stimuli. Generally, the electric pulse rate seemed to have a relatively small perceptual effect in this experimental context. Overall, the results show that acoustic pure tones are perceived as very different from electric pulse trains delivered to single electrode positions with constant rate, even when both the acoustic and the electric stimuli are presented to the same ear.

Acoustic to electric pitch comparisons in cochlear implant subjects with residual hearing

The aim of this study was to assess the frequency-position function resulting from electric stimulation of electrodes in cochlear implant subjects with significant residual hearing in their nonimplanted ear. Six cochlear implant users compared the pitch of the auditory sensation produced by stimulation of an intracochlear electrode to the pitch of acoustic pure tones presented to their contralateral nonimplanted ear. Subjects were implanted with different Clarion electrode arrays, designed to lie close to the inner wall of the cochlea. High-resolution radiographs were used to determine the electrode positions in the cochlea. Four out of six subjects presented electrode insertions deeper than 450 degrees . We used a two-interval (one acoustic, one electric), two-alternative forced choice protocol (2I-2AFC), asking the subject to indicate which stimulus sounded the highest in pitch. Pure tones were used as acoustic stimuli. Electric stimuli consisted of trains of biphasic pulses presented at relatively high rates [higher than 700 pulses per second (pps)]. First, all electric stimuli were balanced in loudness across electrodes. Second, acoustic pure tones, chosen to approximate roughly the pitch sensation produced by each electrode, were balanced in loudness to electric stimuli. When electrode insertion lengths were used to describe electrode positions, the pitch sensations produced by electric stimulation were found to be more than two octaves lower than predicted by Greenwood's frequency-position function. When insertion angles were used to describe electrode positions, the pitch sensations were found about one octave lower than the frequency-position function of a normal ear. The difference found between both descriptions is because of the fact that these electrode arrays were designed to lie close to the modiolus. As a consequence, the site of excitation produced at the level of the organ of Corti corresponds to a longer length than the electrode insertion length, which is used in Greenwood's function. Although exact measurements of the round window position as well as the length of the cochlea could explain the remaining one octave difference found when insertion angles were used, physiological phenomena (e.g., stimulation of the spiral ganglion cells) could also create this difference. From these data, analysis filters could be determined in sound coding strategies to match the pitch percepts elicited by electrode stimulation. This step might be of main importance for music perception and for the fitting of bilateral cochlear implants.

The effect of rate of stimulation on perception of spectral shape by cochlear implantees

The effect of rate of stimulation on spectral shape perception was measured in six users of the Nucleus CI24 cochlear implant. Three spectral shapes were created by using three profiles of current across seven electrode positions. Each current profile was replicated in three stimuli that interleaved stimulus pulses across the seven electrodes with cycle rates (rate per electrode) of 450, 900, and 1800 Hz. The stimulus space resulting from a multidimensional scaling experiment showed a clear dimension related to the rate of stimulation that was orthogonal to the dimension related to the spectral shapes. A second experiment was performed with the same subjects to investigate whether the perceptual dimension related to rate in Experiment 1 could be attributed to different perceptual flatness of the profiles at different rates. In Experiment 2, the rate of stimulation was fixed at 900 Hz and three profiles were created for each spectral shape that differed in flatness. This experiment did not, however, result in an independent perceptual dimension related to the flatness of the profile. In conclusion, rate of stimulation provided an independent perceptual dimension in the multiple-electrode stimuli, in spite of the rates being not discriminable or barely discriminable in single-electrode stimulation.

Multichannel place pitch sensitivity in cochlear implant recipients

Cochlear implant recipients perceive a rise in pitch when the site of stimulation is moved from the apex toward the base. The place pitch sensitivity is typically measured using the stimulation of single channels. However, all current cochlear implant devices stimulate multiple channels simultaneously or with pulses temporally interleaved. The primary goal of the present study is to test whether the sensitivity of a cochlear implant recipient to changes in perceived pitch associated with changes of place of excitation improves or deteriorates when the number of active channels is increased, compared with stimulation with only one active channel. Place pitch sensitivity was recorded in four Nucleus CI24 subjects as a function of number of active channels (from 1 to 8). Just noticeable differences were estimated from a constant stimuli 2AFC pitch-ranking experiment with roving loudness. Reference and comparison stimuli contained the same number of active channels but were shifted one or two electrodes toward the base or toward the apex. The place pitch sensitivity was measured using monopolar stimulation at two locations along the electrode array. To minimize cues related to loudness, the multichannel stimuli were loudness balanced relative to the single-channel stimuli presented at C-level. The number of active channels did not affect place pitch sensitivity. This is consistent with a model that compares the edges of the excitation pattern irrespective of the overlap between excitation patterns. There was a significant difference in sensitivity to place pitch among subjects. The average just noticeable differences of place pitch, extrapolated from a fitting procedure, for the subjects ranged from 0.25 mm to 0.46 mm.

Spatial spread of neural excitation in cochlear implant recipients: comparison of improved ECAP method and psychophysical forward masking

This study introduces and evaluates a method for measurement of the longitudinal spread of electrically evoked neural excitation in the cochlea, using the Neural Response Telemetry system (NRT) available with the Nucleus((R)) 24 cochlear implant system. The recently released version of the NRT software (version 3.0) enables presentation of the 'masker' and 'probe' on different electrodes. In the present method the probe position was fixed, while the masker position was varied across the electrode array. The amplitude of the response to the partially masked probe provides a measure of the amount of masking, which is dependent on the extent of overlap of the excitation regions of the masker and probe. These measurements were performed in seven subjects implanted with the Nucleus 24 cochlear implant system (four with straight and three with Contour electrode arrays), for basal, middle and apical probe electrodes. Similar excitation profiles were obtained using either the standard NRT subtraction paradigm or an alternative 'Miller' method. The excitation profiles were compared with those obtained from psychophysical forward masking and good agreement was found. The widths of electrically evoked compound action potential (ECAP) and forward masking profiles did not differ significantly. Whereas the width of the ECAP measure was significantly correlated with both the maximum comfortable level and the distance of the electrode band from the modiolus, the width of the forward masking profile was not.

The effect of channel interactions on speech recognition in cochlear implant subjects: predictions from an acoustic model

Acoustic models that produce speech signals with information content similar to that provided to cochlear implant users provide a mechanism by which to investigate the effect of various implant-specific processing or hardware parameters independent of other complicating factors. This study compares speech recognition of normal-hearing subjects listening through normal and impaired acoustic models of cochlear implant speech processors. The channel interactions that were simulated to impair the model were based on psychophysical data measured from cochlear implant subjects and include pitch reversals, indiscriminable electrodes, and forward masking effects. In general, spectral interactions degraded speech recognition more than temporal interactions. These effects were frequency dependent with spectral interactions that affect lower-frequency information causing the greatest decrease in speech recognition, and interactions that affect higher-frequency information having the least impact. The results of this study indicate that channel interactions, quantified psychophysically, affect speech recognition to different degrees. Investigation of the effects that channel interactions have on speech recognition may guide future research whose goal is compensating for psychophysically measured channel interactions in cochlear implant subjects.

Frequency-to-electrode allocation and speech perception with cochlear implants

The hypothesis was investigated that selectively increasing the discrimination of low-frequency information (below 2600 Hz) by altering the frequency-to-electrode allocation would improve speech perception by cochlear implantees. Two experimental conditions were compared, both utilizing ten electrode positions selected based on maximal discrimination. A fixed frequency range (200-10513 Hz) was allocated either relatively evenly across the ten electrodes, or so that nine of the ten positions were allocated to the frequencies up to 2600 Hz. Two additional conditions utilizing all available electrode positions (15-18 electrodes) were assessed: one with each subject's usual frequency-to-electrode allocation; and the other using the same analysis filters as the other experimental conditions. Seven users of the Nucleus CI22 implant wore processors mapped with each experimental condition for 2-week periods away from the laboratory, followed by assessment of perception of words in quiet and sentences in noise. Performance with both ten-electrode maps was significantly poorer than with both full-electrode maps on at least one measure. Performance with the map allocating nine out of ten electrodes to low frequencies was equivalent to that with the full-electrode maps for vowel perception and sentences in noise, but was worse for consonant perception. Performance with the evenly allocated ten-electrode map was equivalent to that with the full-electrode maps for consonant perception, but worse for vowel perception and sentences in noise. Comparison of the two full-electrode maps showed that subjects could fully adapt to frequency shifts up to ratio changes of 1.3, given 2 weeks' experience. Future research is needed to investigate whether speech perception may be improved by the manipulation of frequency-to-electrode allocation in maps which have a full complement of electrodes in Nucleus implants.

Auditory cortical images of cochlear-implant stimuli: coding of stimulus channel and current level

This study quantified the accuracy with which populations of neurons in the auditory cortex can represent aspects of electrical cochlear stimuli presented through a cochlear implant. We tested the accuracy of coding of the place of stimulation (i.e., identification of the active stimulation channel) and of the stimulus current level. Physiological data came from the companion study, which recorded spike activity of neurons simultaneously from 16 sites along the tonotopic axis of the guinea pig's auditory cortex. In that study, cochlear electrical stimuli were presented to acutely deafened animals through 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 = 3), 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. In the present analysis, an artificial neural network was trained to recognize spatiotemporal patterns of cortical activity in response to single presentations of particular stimuli and, thereby, to identify those stimuli. The accuracy of pair-wise discrimination of stimulation channels or of current levels was represented by the discrimination index, d', where d' = 1 was taken as threshold. In many cases, the threshold for discrimination of place of cochlear stimulation was < 0.75 mm, and the threshold for discrimination of current levels was < 1 dB. Cochlear electrode configurations varied in the accuracy with which they signaled to the auditory cortex the place of cochlear stimulation. The BP + N and TP configurations provided considerably greater sensitivity to place of stimulation than did the MP configuration. The TP configuration maintained accurate signaling of place of stimulation up to the highest current levels, whereas sensitivity was degraded at high current levels in BP + N configurations. Electrode configurations also varied in the dynamic range over which they signaled stimulus current level. Dynamic ranges were widest for the BP + 0 configuration and narrowest for the TP configuration. That is, the configuration that showed the most accurate signaling of cochlear place of stimulation (TP) showed the most restricted dynamic range for signaling of current level. These results suggest that the choice of the optimal electrode configuration for use by human cochlear-prosthesis users would depend on the particular demands of the speech-processing strategy that is to be employed.

A comparison of two loudness balancing tasks in cochlear implant subjects using bipolar stimulation

OBJECTIVE

In this study, the accuracy of independent measurement of the loudness of different electrodes in a cochlear implant (the "reference" method) was compared with the accuracy of measurements that depend on the results of previous measurements (the "adjacent" method) by evaluating the similarity between and the slopes of the loudness balance curves, and the variability in the measured loudness balance values.

DESIGN

The two methods of loudness balancing differed only in the reference electrode used. In the adjacent method, the loudness of the test electrode was sequentially adjusted to match the loudness of an adjacent reference electrode, whereas in the reference method, the loudness of all test electrodes was adjusted to match that of a common reference electrode. Five subjects implanted with the Nucleus 22 device completed both methods of loudness balancing for all of their functioning electrodes. Each test/reference electrode pair was loudness balanced six times to assess the variability of the two methods.

RESULTS

The loudness balance curves for the two methods were statistically correlated (p < 0.001) for all subjects. The slopes of the regression lines for the loudness balance curves were statistically different from zero (p < 0.05) for roughly half of the subjects for each method. A sign test indicated statistically different means for the basal set and apical set of measurements for only one subject for both methods. The variance in the measured values across electrodes for the reference method was significantly greater for three of the five subjects (p < 0.01).

CONCLUSIONS

It was hypothesized that because of its dependence on previously measured values, the adjacent method could be susceptible to "drift," i.e., a shift in the overall loudness to which the electrodes are balanced. However, none of the statistical measures employed to test for drift indicated that the adjacent method was more susceptible to drift than the reference method, nor were the responses to the adjacent method more variable. Thus, based on these results, dependent measurements do not seem to be less accurate than independent measurements. The relatively higher variance for the reference method in some subjects may be due to the difficulty of comparing the loudness of stimuli that are far apart in pitch.