Dual-electrode pitch discrimination with sequential interleaved stimulation by cochlear implant users

Full-array channel discrimination in cochlear implants: validation and clinical application

OBJECTIVE

We sought to validate our proposed tool for estimating channel discrimination of cochlear implant (CI) users along the full electrode array and to assess associations between place-pitch discrimination and speech perception.

DESIGN

In two tests, participants identified one stimulus (probe) as the odd-one-out compared with two reference stimuli. Probe stimuli were evoked using dual electrode stimulation characterised by the current steering coefficient α. The first test measured psychometric functions (PFs) on pre-defined contacts, with just a noticeable difference (JNDα) as the outcome variable. The second test estimated channel discrimination on the full electrode array, yielding a discrimination score of Dα. We measured speech perception as free-field consonant-vowel-consonant phoneme recognition scores.

STUDY SAMPLE

We included 25 adults with at least 6 months of CI experience.

RESULTS

JNDα and Dα scores measured on the same contact correlated significantly (rs = 0.64, p < 0.001). Mean JNDα and speech perception scores showed significant relationships in quiet and in noise.

CONCLUSIONS

Dα correlated strongly with JNDα scores obtained with the PFs. For poor performers, the full-array test may underestimate JNDα. The full-array pitch discrimination test could be a helpful clinical tool, such as for fitting regions of lesser pitch discrimination ability.

Combining Place and Rate of Stimulation Improves Frequency Discrimination in Cochlear Implant Users

In the auditory system, frequency is represented as tonotopic and temporal response properties of the auditory nerve. While these response properties are inextricably linked in normal hearing, cochlear implants can separately excite tonotopic location and temporal synchrony using different electrodes and stimulation rates, respectively. This separation allows for the investigation of the contributions of tonotopic and temporal cues for frequency discrimination. The present study examines frequency discrimination in adult cochlear implant users as conveyed by electrode position and stimulation rate, separately and combined. The working hypothesis is that frequency discrimination is better provided by place and rate cues combined compared to either cue alone. This hypothesis was tested in two experiments. In the first experiment, frequency discrimination needed for melodic contour identification was measured for frequencies near 100, 200, and 400 Hz using frequency allocation modeled after clinical processors. In the second experiment, frequency discrimination for pitch ranking was measured for frequencies between 100 and 1600 Hz using an experimental frequency allocation designed to provide better access to place cues. The results of both experiments indicate that frequency discrimination is better with place and rate cues combined than with either cue alone. These results clarify how signal processing for cochlear implants could better encode frequency into place and rate of electrical stimulation. Further, the results provide insight into the contributions of place and rate cues for pitch.

Effect of stimulation parameters on sequential current-steered stimuli in cochlear implants

Manipulation of cochlear implant (CI) place pitch was carried out with current steering by stimulating two CI electrodes sequentially. The objective was to investigate whether shifts in activated neural populations could be achieved to produce salient pitch differences and to determine which stimulation parameters would be more effective in steering of current. These were the pulse rate and pulse width of electrical stimuli and the distance between the two current-steering electrodes. Nine CI users participated, and ten ears were tested. The pattern of pitch changes was not consistent across listeners, but the data suggest that individualized selection of stimulation parameters may be used to effect place pitch changes with sequential current steering. Individual analyses showed that pulse width generally had little influence on the effectiveness of current steering with sequential stimuli, while more salient place pitch shifts were often achieved at wider electrode spacing or when the stimulation pulse rate was the same as that indicated on the clinical MAP (the set of stimulation parameters) of the listener. Results imply that current steering may be used in CIs that allow only sequential stimulation to achieve place pitch manipulation.

Creation of virtual channels in the retina using synchronous and asynchronous stimulation - a modelling study

OBJECTIVE

Implantable retinal prostheses aim to provide artificial vision to those suffering from retinal degenerative diseases by electrically stimulating the remaining retinal neurons using a multi-electrode array. The spatial resolution of these devices can be improved by creation of so-called virtual channels (VCs) that are commonly achieved through synchronized stimulation of multiple electrodes. It is largely unclear though if VCs can be created using asynchronous stimulation, which was the primary aim of this study.

APPROACH

A computational model of multi-layered retina and epi-retinal dual-electrode stimulation was developed to simulate the neural activity of populations of retinal ganglion cells (RGCs) using the VC strategy under both synchronous and asynchronous stimulation conditions.

MAIN RESULTS

Our simulation suggests that VCs can be created using asynchronous stimulation. VC performance under both synchronous and asynchronous stimulation conditions can be improved by optimizing stimulation parameters such as current intensity, current ratio (α) between two electrodes, electrode spacing and the stimulation waveform. In particular, two VC performance measures; (1) linear displacement of the centroid of RGC activation, and (2) the RGC activation size consistency as a function of different current ratios α, have comparable performance under asynchronous and synchronous stimulation with appropriately selected stimulation parameters.

SIGNIFICANCE

Our findings support the possibility of creating VCs in the retina under both synchronous and asynchronous stimulation conditions. The results provide theoretical evidence for future retinal prosthesis designs with higher spatial resolution and power efficiency whilst reducing the number of current sources required to achieve these outcomes.

Fitting prelingually deafened adult cochlear implant users based on electrode discrimination performance

OBJECTIVE

This study investigated the hypotheses that (1) prelingually deafened CI users do not have perfect electrode discrimination ability and (2) the deactivation of non-discriminable electrodes can improve auditory performance.

DESIGN

Electrode discrimination difference limens were determined for all electrodes of the array. The subjects' basic map was subsequently compared to an experimental map, which contained only discriminable electrodes, with respect to speech understanding in quiet and in noise, listening effort, spectral ripple discrimination and subjective appreciation.

STUDY SAMPLE

Subjects were six prelingually deafened, late implanted adults using the Nucleus cochlear implant.

RESULTS

Electrode discrimination difference limens across all subjects and electrodes ranged from 0.5 to 7.125, with significantly larger limens for basal electrodes. No significant differences were found between the basic map and the experimental map on auditory tests. Subjective appreciation was found to be significantly poorer for the experimental map.

CONCLUSIONS

Prelingually deafened CI users were unable to discriminate between all adjacent electrodes. There was no difference in auditory performance between the basic and experimental map. Potential factors contributing to the absence of improvement with the experimental map include the reduced number of maxima, incomplete adaptation to the new frequency allocation, and the mainly basal location of deactivated electrodes.

Effects of stimulus level and rate on psychophysical thresholds for interleaved pulse trains in cochlear implants

This study examined channel interactions using interleaved pulse trains to assess masking and potential facilitative effects in cochlear-implant recipients using clinically relevant stimuli. Psychophysical thresholds were measured for two adjacent mid-array electrodes; one served as the masker and the other as the probe. Two rates representative of those found in present-day strategies were tested: 1700 and 3400 pulses per second per channel. Four masker levels ranging from sub-threshold to loud-but-comfortable were tested. It was hypothesized that low-level maskers would produce facilitative effects, shifting to masking effects at high levels, and that faster rates would yield smaller masking effects due to greater stochastic neural firing patterns. Twenty-nine ears with Cochlear or Advanced Bionics devices were tested. High-level maskers produced more masking than low-level maskers, as expected. Facilitation was not observed for sub-threshold or threshold-level maskers in most cases. High masker levels yielded reduced probe thresholds for two Advanced Bionics subjects. This was partly eliminated with a longer temporal offset between each masker-probe pulse pair, as was used with Cochlear subjects. These findings support the use of temporal gaps between stimulation of subsequent electrodes to reduce channel interactions.

ECAP spread of excitation with virtual channels and physical electrodes

The primary goal of this study was to evaluate physiological spatial excitation patterns for stimulation of adjacent physical electrodes and intermediate virtual channels. Two experiments were conducted that utilized electrically evoked compound action potential (ECAP) spread-of-excitation (SOE) functions obtained with the traditional forward-masking subtraction method. These two experiments examined spatial excitation patterns for virtual-channel maskers and probes, respectively. In Experiment 1, ECAP SOE patterns were obtained for maskers applied to physical electrodes and virtual channels to determine whether virtual-channel maskers yield SOE patterns similar to those predicted from physical electrodes. In Experiment 2, spatial separation of SOE functions was compared for two adjacent physical probe electrodes and the intermediate virtual channel to determine the extent to which ECAP SOE patterns for virtual-channel probes are spatially separate from those obtained with physical electrodes. Data were obtained for three electrode regions (basal, middle, apical) for 35 ears implanted with Cochlear (N = 16) or Advanced Bionics (N = 19) devices. Results from Experiment 1 showed no significant difference between predicted and measured ECAP amplitudes for Advanced Bionics subjects. Measured ECAP amplitudes for virtual-channel maskers were significantly larger than the predicted amplitudes for Cochlear subjects; however, the difference was <2 μV and thus is likely not clinically significant. Results from Experiment 2 showed that the probe set in the apical region demonstrated the least amount of spatial separation amongst SOE functions, which may be attributed to more uniform nerve survival patterns, closer electrode spacing, and/or the tapered geometry of the cochlea. As expected, adjacent physical probes demonstrated greater spatial separation than for comparisons between each physical probe and the intermediate virtual channel. Finally, the virtual-channel SOE functions were generally weighted toward the basal electrode in the pair.

Threshold levels of dual electrode stimulation in cochlear implants

Simultaneous stimulation on two contacts (current steering) creates intermediate pitches between the physical contacts in cochlear implants. All recent studies on current steering have focused on Most Comfortable Loudness levels and not at low stimulation levels. This study investigates the efficacy of dual electrode stimulation at lower levels, thereby focusing on the requirements to correct for threshold variations. With a current steered signal, threshold levels were determined on 4 different electrode pairs for 7 different current steering coefficients (α). This was done psychophysically in twelve postlingually deafened cochlear implant (HiRes90K, HiFocus1J) users and, in a computer model, which made use of three different neural morphologies. The analysis on the psychophysical data taking all subjects into account showed that in all conditions there was no significant difference between the threshold level of the physical contacts and the intermediate created percepts, eliminating the need for current corrections at these very low levels. The model data showed unexpected drops in threshold in the middle of the two physical contacts (both contacts equal current). Results consistent with this prediction were obtained for a subset of 5 subjects for the apical pair with wider spacing (2.2 mm). Further analysis showed that this decrease was only observed in subjects with a long duration of deafness. For current steering on adjacent contacts, the results from the psychophysical experiments were in line with the results from computational modelling. However, the dip in the threshold profile could only be replicated in the computational model with surviving peripheral processes without an unmyelinated terminal. On the basis of this result, we put forward that the majority of the surviving spiral ganglion cells in the cochlea in humans with a long duration of deafness still retain peripheral processes, but have lost their unmyelinated terminals.

Detection of acoustic temporal fine structure by cochlear implant listeners: behavioral results and computational modeling

A test of within-channel detection of acoustic temporal fine structure (aTFS) cues is presented. Eight cochlear implant listeners (CI) were asked to discriminate between two Schroeder-phase (SP) complexes using a two-alternative, forced-choice task. Because differences between the acoustic stimuli are primarily constrained to their aTFS, successful discrimination reflects a combination of the subjects' perception of and the strategy's ability to deliver aTFS cues. Subjects were mapped with single-channel Continuous Interleaved Sampling (CIS) and Simultaneous Analog Stimulation (SAS) strategies. To compare within- and across- channel delivery of aTFS cues, a 16-channel clinical HiRes strategy was also fitted. Throughout testing, SAS consistently outperformed the CIS strategy (p ≤ 0.002). For SP stimuli with F0 = 50 Hz, the highest discrimination scores were achieved with the HiRes encoding, followed by scores with the SAS and the CIS strategies, respectively. At 200 Hz, single-channel SAS performed better than HiRes (p = 0.022), demonstrating that under a more challenging testing condition, discrimination performance with a single-channel analog encoding can exceed that of a 16-channel pulsatile strategy. To better understand the intermediate steps of discrimination, a biophysical model was used to examine the neural discharges evoked by the SP stimuli. Discrimination estimates calculated from simulated neural responses successfully tracked the behavioral performance trends of single-channel CI listeners.

Masking patterns for monopolar and phantom electrode stimulation in cochlear implants

Phantom electrode (PE) stimulation consists of out-of-phase stimulation of two electrodes. When presented at the apex of the electrode array, phantom stimulation is known to produce a lower pitch sensation than monopolar (MP) stimulation on the most apical electrode. The ratio of the current between the primary electrode (PEL) and the compensating electrode (CEL) is represented by the coefficient σ, which ranges from 0 (monopolar) to 1 (full bipolar). The exact mechanism by which PE stimulation produces a lower pitch sensation is unclear. In the present study, unmasked and masked thresholds were obtained using a forward masking paradigm to estimate the spread of current for MP and PE stimulation. Masked thresholds were measured for two phantom electrode configurations (1) PEL = 4, CEL = 5 (lower pitch phantom) and (2) PEL = 4, CEL = 3 (higher pitch phantom). The unmasked thresholds were subtracted from the masked thresholds to obtain masking patterns which were normalized to their peak. The masking patterns reveal (1) differences in the spread of excitation that are consistent with the direction of pitch shift produced by PE stimulation, and (2) narrower spread of electrical excitation for PE stimulation relative to MP stimulation.

Current steering with partial tripolar stimulation mode in cochlear implants

The large spread of excitation is a major cause of poor spectral resolution for cochlear implant (CI) users. Partial tripolar (pTP) mode has been proposed to reduce current spread by returning an equally distributed fraction (0.5 × σ) of current to two flanking electrodes and the rest to an extra-cochlear ground. This study tested the efficacy of incorporating current steering into pTP mode to add spectral channels. Different proportions of current [α × σ and (1 - α) × σ] were returned to the basal and apical flanking electrodes respectively to shape the electric field. Loudness and pitch perception with α from 0 to 1 in steps of 0.1 was simulated with a computational model of CI stimulation and tested on the apical, middle, and basal electrodes of six CI subjects. The highest σ allowing for full loudness growth within the implant compliance limit was chosen for each main electrode. Pitch ranking was measured between pairs of loudness-balanced steered pTP stimuli with an α interval of 0.1 at the most comfortable level. Results demonstrated that steered pTP stimuli with α around 0.5 required more current to achieve equal loudness than those with α around 0 or 1, maybe due to more focused excitation patterns. Subjects usually perceived decreasing pitches as α increased from 0 to 1, somewhat consistent with the apical shift of the center of gravity of excitation pattern in the model. Pitch discrimination was not better with α around 0.5 than with α around 0 or 1, except for some subjects and electrodes. For three subjects with better pitch discrimination, about half of the pitch ranges of two adjacent main electrodes overlapped with each other in steered pTP mode. These results suggest that current steering with focused pTP mode may improve spectral resolution and pitch perception with CIs.

Real-time spectrum estimation-based dual-channel speech-enhancement algorithm for cochlear implant

Background

Improvement of the cochlear implant (CI) front-end signal acquisition is needed to increase speech recognition in noisy environments. To suppress the directional noise, we introduce a speech-enhancement algorithm based on microphone array beamforming and spectral estimation. The experimental results indicate that this method is robust to directional mobile noise and strongly enhances the desired speech, thereby improving the performance of CI devices in a noisy environment.

Methods

The spectrum estimation and the array beamforming methods were combined to suppress the ambient noise. The directivity coefficient was estimated in the noise-only intervals, and was updated to fit for the mobile noise.

Results

The proposed algorithm was realized in the CI speech strategy. For actual parameters, we use Maxflat filter to obtain fractional sampling points and cepstrum method to differentiate the desired speech frame and the noise frame. The broadband adjustment coefficients were added to compensate the energy loss in the low frequency band.

Discussions

The approximation of the directivity coefficient is tested and the errors are discussed. We also analyze the algorithm constraint for noise estimation and distortion in CI processing. The performance of the proposed algorithm is analyzed and further be compared with other prevalent methods.

Conclusions

The hardware platform was constructed for the experiments. The speech-enhancement results showed that our algorithm can suppresses the non-stationary noise with high SNR. Excellent performance of the proposed algorithm was obtained in the speech enhancement experiments and mobile testing. And signal distortion results indicate that this algorithm is robust with high SNR improvement and low speech distortion.

Discrimination between sequential and simultaneous virtual channels with electrical hearing

In cochlear implants (CIs), simultaneous or sequential stimulation of adjacent electrodes can produce intermediate pitch percepts between those of the component electrodes. However, it is unclear whether simultaneous and sequential virtual channels (VCs) can be discriminated. In this study, CI users were asked to discriminate simultaneous and sequential VCs; discrimination was measured for monopolar (MP) and bipolar + 1 stimulation (BP + 1), i.e., relatively broad and focused stimulation modes. For sequential VCs, the interpulse interval (IPI) varied between 0.0 and 1.8 ms. All stimuli were presented at comfortably loud, loudness-balanced levels at a 250 pulse per second per electrode (ppse) stimulation rate. On average, CI subjects were able to reliably discriminate between sequential and simultaneous VCs. While there was no significant effect of IPI or stimulation mode on VC discrimination, some subjects exhibited better VC discrimination with BP + 1 stimulation. Subjects' discrimination between sequential and simultaneous VCs was correlated with electrode discrimination, suggesting that spatial selectivity may influence perception of sequential VCs. To maintain equal loudness, sequential VC amplitudes were nearly double those of simultaneous VCs, presumably resulting in a broader spread of excitation. These results suggest that perceptual differences between simultaneous and sequential VCs might be explained by differences in the spread of excitation.

Electrically evoked compound action potential measures for virtual channels versus physical electrodes

OBJECTIVES

The number of distinct pitch percepts for cochlear implant (CI) listeners is somewhat limited by the number of physical electrodes in the array. Newer-generation CIs have the capability to potentially increase this number by stimulating areas of the cochlea between the physical electrodes. Currently, this is achieved by electrically coupling adjacent electrodes or by simultaneously activating two electrodes with independent current sources (i.e., current steering). Presumably, either type of dual-electrode stimulation will generate neural excitation patterns that are intermediate to those generated by either physical electrode alone (henceforth termed virtual channel). However, it is not clear whether virtual-channel stimulation yields neural recruitment patterns with similar shapes and rates of growth as compared with each physical electrode alone. The purpose of this study was to compare basic electrically evoked compound action potential (ECAP) measures for physical electrodes and virtual channels to determine whether properties of the respective excitation patterns were similar.

DESIGN

Data were collected for 12 adult CI recipients (six Nucleus Freedom CI24RE, two Advanced Bionics HiResolution 90K, and four Advanced Bionics CII). ECAP responses were measured for a set of three adjacent physical electrodes and two corresponding intermediate virtual channels (e.g., physical electrodes 4, 5, and 6 and virtual channels 4 + 5 and 5 + 6) at three positions along the electrode array (basal, middle, and apical). Virtual channels for Nucleus subjects were produced via electrical coupling of adjacent electrode pairs (dual-electrode mode). For Advanced Bionics subjects, virtual channels were produced via simultaneous, in-phase stimulation of adjacent electrode pairs with 50% of the total current delivered to each electrode in the pair. Specific ECAP measures were as follows: (1) threshold and slope of the input/output functions, (2) amplitude for a masker-probe interval of 1500 μsecs (measure of refractory recovery), and (3) relative location of spread of excitation (SOE) functions among virtual channels and adjacent physical electrodes. Measures for virtual channels were compared with those for the flanking physical electrodes using a multivariate analysis of variance.

RESULTS

There were no statistically significant differences between physical electrodes and virtual channels for ECAP thresholds, slope of the input/output function, or refractory recovery. On average, SOE functions for the virtual channels were spatially located approximately halfway between SOE functions for the adjacent physical electrodes.

CONCLUSIONS

Results from this study suggest that virtual channels produce neural recruitment patterns with properties similar to those elicited by the adjacent physical electrodes.

Effects of stimulation configurations on place pitch discrimination in cochlear implants

The present study aimed to examine the effect of electrode configuration, specifically monopolar (MP) or bipolar (BP) stimulation, on place pitch discrimination in cochlear implants (CIs). Twelve subjects implanted with the Nucleus Freedom device were presented with various pairs of stimulation across the electrode array, with varying degrees of distance between stimulation sites, and asked to judge the higher of the two in pitch. Each pair was presented either in the same mode or in different modes of stimulation for the within-mode or across-mode condition, respectively, at least 20 times. The result of the within-mode condition revealed that subjects, on average, were able to discriminate pitches significantly better in MP than in BP, with the sensitivity index (d') for adjacent channels of 1.2 for MP and 0.8 for BP. The result of the across-mode condition revealed that while individual variability existed, there was a strong tendency for CI subjects to perceive a higher pitch in BP stimulation than in MP for a similar site of stimulation. In other words, an MP channel needed to be shifted in a basal direction by as much as two electrodes on average to elicit a pitch comparable to that of a BP channel.

Encoding pitch contours using current steering

This study investigated cochlear implant (CI) users' ability to perceive pitch cues from time-varying virtual channels (VCs) to identify pitch contours. Seven CI users were tested on apical, medial, and basal electrode pairs with stimulus durations from 100 to 1000 ms. In one stimulus set, 9 pitch contours were created by steering current between the component electrodes and the VC halfway between the electrodes. Another stimulus set only contained 3 pitch contours (flat, falling, and rising). VC discrimination was also tested on the same electrodes. The total current level of dual-electrode stimuli was linearly interpolated between those of single-electrode stimuli to minimize loudness changes. The results showed that pitch contour identification (PCI) scores were similar across electrode locations, and significantly improved at longer durations. For durations longer than 300 ms, 2 subjects had nearly perfect 9-contour identification, and 5 subjects perfectly identified the 3 basic contours. Both PCI and VC discrimination varied greatly across subjects. Cumulative d(') values for VC discrimination were significantly correlated with 100-, 200-, and 500-ms PCI scores. These results verify the feasibility of encoding pitch contours using current steering, and suggest that identification of such pitch contours strongly relies on CI users' sensitivity to VCs.

A mathematical model of vowel identification by users of cochlear implants

A simple mathematical model is presented that predicts vowel identification by cochlear implant users based on these listeners' resolving power for the mean locations of first, second, and/or third formant energies along the implanted electrode array. This psychophysically based model provides hypotheses about the mechanism cochlear implant users employ to encode and process the input auditory signal to extract information relevant for identifying steady-state vowels. Using one free parameter, the model predicts most of the patterns of vowel confusions made by users of different cochlear implant devices and stimulation strategies, and who show widely different levels of speech perception (from near chance to near perfect). Furthermore, the model can predict results from the literature, such as Skinner, et al. [(1995). Ann. Otol. Rhinol. Laryngol. 104, 307-311] frequency mapping study, and the general trend in the vowel results of Zeng and Galvin's [(1999). Ear Hear. 20, 60-74] studies of output electrical dynamic range reduction. The implementation of the model presented here is specific to vowel identification by cochlear implant users, but the framework of the model is more general. Computational models such as the one presented here can be useful for advancing knowledge about speech perception in hearing impaired populations, and for providing a guide for clinical research and clinical practice.

Excitation patterns of simultaneous and sequential dual-electrode stimulation in cochlear implant recipients

OBJECTIVE

Both simultaneous (SI) and sequential stimulation of intracochlear electrodes can be used to generate pitches that are intermediate to the physical electrodes (PEs). The goal of this study was to compare the spread of neural excitation for SI and sequential dual-electrode stimulation with the spread of neural excitation for the intermediate electrode using electrically evoked compound action potentials.

DESIGN

Seven Advanced Bionics cochlear implant users with either CII or HiRes 90k implant and HiFocus 1 or HiFocus 1j electrode array participated in this study. A masker-probe subtraction method was used to derive neural excitation patterns for SI nonadjacent dual-electrode stimulation, apical and basal-first sequential nonadjacent dual-electrode stimulation, and the intermediate PE. For apical-first sequential (SEa) stimulation, the masker pulse on the apical electrode immediately preceded the masker pulse on the basal electrode, and vice versa for basal-first sequential stimulation (SEb). The electrodes used for dual-electrode stimulation were separated by an intermediate PE, which represents a spatial distance of approximately 2 mm. Current levels necessary to achieve comfortable loudness were determined for each masker and probe stimulus. During the evoked compound action potential measurements, the masker was fixed in location, whereas the probe was varied across a subset of electrodes in the array. Neural responses were calculated by subtracting the response to the probe from the masked response.

RESULTS

Neural excitation patterns were normalized to their peak and analyzed in terms of their area and center of gravity. The area and center of gravity for SI nonadjacent dual-electrode stimulation were similar to those of the intermediate PE. In contrast, the area for the two modes of sequential nonadjacent dual-electrode (SEa and SEb) stimulation differed significantly from the intermediate PE. The center of gravity for SEa stimulation also differed significantly from the intermediate PE, whereas there was no significant difference in the center of gravity between SEb stimulation and the intermediate PE.

CONCLUSIONS

Peripheral neural activation patterns suggest a similar spread of excitation for SI dual-electrode stimulation and the intermediate PE. The spread of excitation associated with sequential dual-electrode stimulation is generally different from the intermediate PE, and it varies depending on the order of the sequential pulses.

A model of incomplete adaptation to a severely shifted frequency-to-electrode mapping by cochlear implant users

In the present study, a computational model of phoneme identification was applied to data from a previous study, wherein cochlear implant (CI) users' adaption to a severely shifted frequency allocation map was assessed regularly over 3 months of continual use. This map provided more input filters below 1 kHz, but at the expense of introducing a downwards frequency shift of up to one octave in relation to the CI subjects' clinical maps. At the end of the 3-month study period, it was unclear whether subjects' asymptotic speech recognition performance represented a complete or partial adaptation. To clarify the matter, the computational model was applied to the CI subjects' vowel identification data in order to estimate the degree of adaptation, and to predict performance levels with complete adaptation to the frequency shift. Two model parameters were used to quantify this adaptation; one representing the listener's ability to shift their internal representation of how vowels should sound, and the other representing the listener's uncertainty in consistently recalling these representations. Two of the three CI users could shift their internal representations towards the new stimulation pattern within 1 week, whereas one could not do so completely even after 3 months. Subjects' uncertainty for recalling these representations increased substantially with the frequency-shifted map. Although this uncertainty decreased after 3 months, it remained much larger than subjects' uncertainty with their clinically assigned maps. This result suggests that subjects could not completely remap their phoneme labels, stored in long-term memory, towards the frequency-shifted vowels. The model also predicted that even with complete adaptation, the frequency-shifted map would not have resulted in improved speech understanding. Hence, the model presented here can be used to assess adaptation, and the anticipated gains in speech perception expected from changing a given CI device parameter.

Virtual channel discrimination is improved by current focusing in cochlear implant recipients

Cochlear implant users' spectral resolution is limited by both the number of implanted electrodes and channel interactions between electrodes. Current steering (virtual channels) between two adjacent monopolar electrodes has been used to increase the number of spectral channels across the electrode array. However, monopolar stimulation is associated with large current spread and increased channel interaction. Current focusing across three adjacent electrodes (tripolar stimulation) has been used to reduce electrode current spread and improve channel selectivity. In the present study, current steering and current focusing were combined within a four-electrode stimulation pattern (quadrupolar virtual channels), thereby addressing the need for both increased channels and reduced current spread. Virtual channel discrimination was measured in 7 users of the Advanced Bionics Clarion II or HiRes 90K implants; virtual channel discrimination was compared between monopolar and quadrupolar virtual channels at three stimulation sites. The results showed that quadrupolar virtual channels provided better spectral resolution than monopolar virtual channels. The results suggested that quadrupolar virtual channels might provide the "best of both worlds" improving the number of spectral channels while reducing channel interactions.

Electrophysiological spread of excitation and pitch perception for dual and single electrodes using the Nucleus Freedom cochlear implant

OBJECTIVES

The first objective of the study was to determine whether there were any consistent differences in the electrophysiological spread of excitation (SOE) function, as measured using the electrically evoked compound action potential (ECAP), between dual and single electrode stimulation with the Nucleus Freedom cochlear implant system. Dual electrode stimulation is produced by electrically coupling two adjacent single electrodes. The second objective was to determine whether there were any relationships between the SOE functions and psychophysically measured pitch ranking of dual and single electrodes.

DESIGN

Nine adult cochlear implant subjects participated in the study. ECAPs for dual and single electrode stimulation were measured using the forward masking paradigm, as also used in the Neural Response Telemetry (NRT) software with the Nucleus implant. Research software was used to generate the dual and single electrode stimuli and record the ECAPs. Spread of excitations (SOEs) were measured on a dual electrode and the two adjacent single electrodes, at three positions on the array: apical, mid, and basal. Compared were the ECAP amplitudes at the peak of the SOE functions, the widths of the scaled SOE functions at the 75% point, and the electrode positions at the peak of the SOE function and at the 75%, 50%, and 25% points on apical and basal sides of the scaled functions. Pitch ranking was measured for the same sets of dual and single electrodes. A two-alternative forced choice procedure was used, with the electrodes in each set paired with each other as AB and BA pairs. The subject indicated which of the two stimuli had the higher pitch.

RESULTS

Dual electrode SOEs could be successfully obtained using the same methods as used to measure single electrode SOEs. The shapes of the dual and single electrodes SOEs were similar. There was a trend of a higher ECAP amplitude for the dual electrode at the peak of the SOE function, but this was only significant for two comparisons at the apical and basal positions. There were no significant differences in the SOE widths between dual and single electrodes. The electrodes at the peak of the SOE function and on the apical and basal sides of the function at the 75% position were, in most cases, tonotopically ordered. At the 50% and 25% positions, there were fewer significant differences between the dual and single electrodes The pitch ranking results showed that in 74% of cases, the single and dual electrodes at each position were successfully ranked in the expected tonotopic order. There were no statistically significant correlations between the pitch ranking results and the ordering of electrodes on the SOE functions.

CONCLUSIONS

Dual electrode stimulation produced similar SOE functions as single electrode stimulation. A tonotopic ordering of electrodes at the peak of the SOE and on the sides of the functions was found, but this was not statistically related to the pitch ranking results.

SUMMARY

Electrophysiological spread of neural excitation (SOE) and pitch perception using dual and single electrodes was investigated in nine subjects using the Nucleus Freedom cochlear implant. Dual electrodes are produced by electrically coupling two adjacent single electrodes. The dual and single electrodes SOEs were similar in shape. Higher electrophysiological response amplitudes were generally found for the dual electrodes. There were no differences in SOE widths between dual and single electrodes. In three quarters of cases, dual and single electrodes were successfully pitch ranked in the expected tonotopic order. No significant relationships between pitch ranking and the SOE functions were found.

Current-level discrimination and spectral profile analysis in multi-channel electrical stimulation

In experiment 1, six cochlear-implant (CI) listeners discriminated a stimulation pattern eliciting equal loudness for each electrode from a stimulation pattern in which the stimulation at one or more electrodes was increased (peak) or decreased (notch). Three cochlear locations and three bandwidths were tested, without and with level roving. Listeners could always detect peaks but not always notches. Increasing the bandwidth beyond two electrodes produced no improvement in just-noticeable differences (JNDs). JNDs for the basal location were higher than for the apical and middle locations, although listeners had highly individual tendencies. In experiment 2, listeners discriminated changes in the peak heights and notch depths. JNDs for higher peaks were better while JNDs for deeper notches were worse than for experiment 1. In experiment 3, listeners discriminated the electrode position of peaks or notches. JNDs were approximately one electrode. In experiment 4, the first three experiments were repeated with large amounts of level roving. There was no evidence that CI listeners performed an across-channel comparison in these tasks.

Cochlear implants: a remarkable past and a brilliant future

The aims of this paper are to (i) provide a brief history of cochlear implants; (ii) present a status report on the current state of implant engineering and the levels of speech understanding enabled by that engineering; (iii) describe limitations of current signal processing strategies; and (iv) suggest new directions for research. With current technology the "average" implant patient, when listening to predictable conversations in quiet, is able to communicate with relative ease. However, in an environment typical of a workplace the average patient has a great deal of difficulty. Patients who are "above average" in terms of speech understanding, can achieve 100% correct scores on the most difficult tests of speech understanding in quiet but also have significant difficulty when signals are presented in noise. The major factors in these outcomes appear to be (i) a loss of low-frequency, fine structure information possibly due to the envelope extraction algorithms common to cochlear implant signal processing; (ii) a limitation in the number of effective channels of stimulation due to overlap in electric fields from electrodes; and (iii) central processing deficits, especially for patients with poor speech understanding. Two recent developments, bilateral implants and combined electric and acoustic stimulation, have promise to remediate some of the difficulties experienced by patients in noise and to reinstate low-frequency fine structure information. If other possibilities are realized, e.g., electrodes that emit drugs to inhibit cell death following trauma and to induce the growth of neurites toward electrodes, then the future is very bright indeed.

An in vitro model of a retinal prosthesis

Epiretinal prostheses are being developed to bypass a degenerated photoreceptor layer and excite surviving ganglion and inner retinal cells. We used custom microfabricated multielectrode arrays with 200-microm-diameter stimulating electrodes and 10-microm-diameter recording electrodes to stimulate and record neural responses in isolated tiger salamander retina. Pharmacological agents were used to isolate direct excitation of ganglion cells from excitation of other inner retinal cells. Strength-duration data suggest that, if amplitude will be used for the coding of brightness or gray level in retinal prostheses, shorter pulses (200 micros) will allow for a smaller region in the area of the electrode to be excited over a larger dynamic range compared with longer pulses (1 ms). Both electrophysiological results and electrostatic finite-element modeling show that electrode-electrode interactions can lead to increased thresholds for sites half way between simultaneously stimulated electrodes (29.4 +/- 6.6 nC) compared with monopolar stimulation (13.3 +/- 1.7 nC, p < 0.02). Presynaptic stimulation of the same ganglion cell with both 200- and 10-microm-diameter electrodes yielded threshold charge densities of 12 +/- 6 and 7.66 +/- 1.30 nC/cm2, respectively, while the required charge was 12.5 +/- 6.2 and 19 +/- 3.3 nC.

Current focusing and steering: modeling, physiology, and psychophysics

Current steering and current focusing are stimulation techniques designed to increase the number of distinct perceptual channels available to cochlear implant (CI) users by adjusting currents applied simultaneously to multiple CI electrodes. Previous studies exploring current steering and current focusing stimulation strategies are reviewed, including results of research using computational models, animal neurophysiology, and human psychophysics. Preliminary results of additional neurophysiological and human psychophysical studies are presented that demonstrate the success of current steering strategies in stimulating auditory nerve regions lying between physical CI electrodes, as well as current focusing strategies that excite regions narrower than those stimulated using monopolar configurations. These results are interpreted in the context of perception and speech reception by CI users. Disparities between results of physiological and psychophysical studies are discussed. The differences in stimulation used for physiological and psychophysical studies are hypothesized to contribute to these disparities. Finally, application of current steering and focusing strategies to other types of auditory prostheses is also discussed.

Design and fabrication of multichannel cochlear implants for animal research

The effectiveness of multichannel cochlear implants depends on the activation of perceptually distinct regions of the auditory nerve. Increased information transfer is possible as the number of channels and dynamic range are increased and electrical and neural interaction among channels is reduced. Human and animal studies have demonstrated that specific design features of the intracochlear electrode directly affect these performance factors. These features include the geometry, size, and orientation of the stimulating sites, proximity of the device to spiral ganglion neurons, shape and position of the insulating carrier, and the stimulation mode (monopolar, bipolar, etc.). Animal studies to directly measure the effects of changes in electrode design are currently constrained by the lack of available electrodes that model contemporary clinical devices. This report presents methods to design and fabricate species-specific customizable electrode arrays. We have successfully implanted these arrays in guinea pigs and cats for periods of up to 14 months and have conducted acute electrophysiological experiments in these animals. Modifications enabling long-term intracochlear drug infusion are also described. Studies using these scale model arrays will improve our understanding of how these devices function in human subjects and how we can best optimize future cochlear implants.

The development of the Nucleus Freedom Cochlear implant system

Cochlear Limited (Cochlear) released the fourth-generation cochlear implant system, Nucleus Freedom, in 2005. Freedom is based on 25 years of experience in cochlear implant research and development and incorporates advances in medicine, implantable materials, electronic technology, and sound coding. This article presents the development of Cochlear's implant systems, with an overview of the first 3 generations, and details of the Freedom system: the CI24RE receiver-stimulator, the Contour Advance electrode, the modular Freedom processor, the available speech coding strategies, the input processing options of Smart Sound to improve the signal before coding as electrical signals, and the programming software. Preliminary results from multicenter studies with the Freedom system are reported, demonstrating better levels of performance compared with the previous systems. The final section presents the most recent implant reliability data, with the early findings at 18 months showing improved reliability of the Freedom implant compared with the earlier Nucleus 3 System. Also reported are some of the findings of Cochlear's collaborative research programs to improve recipient outcomes. Included are studies showing the benefits from bilateral implants, electroacoustic stimulation using an ipsilateral and/or contralateral hearing aid, advanced speech coding, and streamlined speech processor programming.