Temporal pitch perception at high rates in cochlear implants

Temporal pitch matching with bilateral cochlear implants

Interaural pitch matching is a common task used with bilateral cochlear implant (CI) users, although studies measuring this have largely focused on place-based pitch matches. Temporal-based pitch also plays an important role in CI users' perception, but interaural temporal-based pitch matching has not been well characterized for CI users. To investigate this, bilateral CI users were asked to match amplitude modulation frequencies of stimulation across ears. Comparisons were made to previous place-based pitch matching data that were collected using similar procedures. The results indicate that temporal-based pitch matching is particularly sensitive to the choice of reference ear.

How to vocode: Using channel vocoders for cochlear-implant research

The channel vocoder has become a useful tool to understand the impact of specific forms of auditory degradation-particularly the spectral and temporal degradation that reflect cochlear-implant processing. Vocoders have many parameters that allow researchers to answer questions about cochlear-implant processing in ways that overcome some logistical complications of controlling for factors in individual cochlear implant users. However, there is such a large variety in the implementation of vocoders that the term "vocoder" is not specific enough to describe the signal processing used in these experiments. Misunderstanding vocoder parameters can result in experimental confounds or unexpected stimulus distortions. This paper highlights the signal processing parameters that should be specified when describing vocoder construction. The paper also provides guidance on how to determine vocoder parameters within perception experiments, given the experimenter's goals and research questions, to avoid common signal processing mistakes. Throughout, we will assume that experimenters are interested in vocoders with the specific goal of better understanding cochlear implants.

Shouting affects temporal properties of the speech amplitude envelope

Distinguishing shouted from non-shouted speech is crucial in communication. We examined how shouting affects temporal properties of the amplitude envelope (ENV) in a total of 720 sentences read by 18 Swiss German speakers in normal and shouted modes; shouting was characterised by maintaining sound pressure levels of ≥80 dB sound pressure level (dB-SPL) (C-weighted) at a 1-meter distance from the mouth. Generalized additive models revealed significant temporal alterations of ENV in shouted speech, marked by steeper ascent, delayed peak, and extended high levels. These findings offer potential cues for identifying shouting, particularly useful when fine-structure and dynamic range cues are absent, for example, in cochlear implant users.

Review of Binaural Processing With Asymmetrical Hearing Outcomes in Patients With Bilateral Cochlear Implants

Bilateral cochlear implants (BiCIs) result in several benefits, including improvements in speech understanding in noise and sound source localization. However, the benefit bilateral implants provide among recipients varies considerably across individuals. Here we consider one of the reasons for this variability: difference in hearing function between the two ears, that is, interaural asymmetry. Thus far, investigations of interaural asymmetry have been highly specialized within various research areas. The goal of this review is to integrate these studies in one place, motivating future research in the area of interaural asymmetry. We first consider bottom-up processing, where binaural cues are represented using excitation-inhibition of signals from the left ear and right ear, varying with the location of the sound in space, and represented by the lateral superior olive in the auditory brainstem. We then consider top-down processing via predictive coding, which assumes that perception stems from expectations based on context and prior sensory experience, represented by cascading series of cortical circuits. An internal, perceptual model is maintained and updated in light of incoming sensory input. Together, we hope that this amalgamation of physiological, behavioral, and modeling studies will help bridge gaps in the field of binaural hearing and promote a clearer understanding of the implications of interaural asymmetry for future research on optimal patient interventions.

Pitch discrimination in electric hearing with inconsistent and consistent amplitude-modulation and inter-pulse rate cues

Users of cochlear implants (CIs) struggle in situations that require selective hearing to focus on a target source while ignoring other sources. One major reason for that is the limited access to timing cues such as temporal pitch or interaural time differences (ITDs). Various approaches to improve timing-cue sensitivity while maintaining speech understanding have been proposed, among them inserting extra pulses with short inter-pulse intervals (SIPIs) into amplitude-modulated (AM) high-rate pulse trains. Indeed, SIPI rates matching the naturally occurring AM rates improve pitch discrimination. For ITD, however, low SIPI rates are required, potentially mismatching the naturally occurring AM rates and thus creating unknown pitch effects. In this study, we investigated the perceptual contribution of AM and SIPI rate to pitch discrimination in five CI listeners and with two AM depths (0.1 and 0.5). Our results show that the SIPI-rate cue generally dominated the percept for both consistent and inconsistent cues. When tested with inconsistent cues, also the AM rate contributed, however, at the large AM depth only. These findings have implications when aiming at jointly improving temporal-pitch and ITD sensitivity in a future mixed-rate stimulation approach.

Differential Effects of Binaural Pitch Fusion Range on the Benefits of Voice Gender Differences in a "Cocktail Party" Environment for Bimodal and Bilateral Cochlear Implant Users

OBJECTIVES

Some cochlear implant (CI) users are fitted with a CI in each ear ("bilateral"), while others have a CI in one ear and a hearing aid in the other ("bimodal"). Presently, evaluation of the benefits of bilateral or bimodal CI fitting does not take into account the integration of frequency information across the ears. This study tests the hypothesis that CI listeners, especially bimodal CI users, with a more precise integration of frequency information across ears ("sharp binaural pitch fusion") will derive greater benefit from voice gender differences in a multi-talker listening environment.

DESIGN

Twelve bimodal CI users and twelve bilateral CI users participated. First, binaural pitch fusion ranges were measured using the simultaneous, dichotic presentation of reference and comparison stimuli (electric pulse trains for CI ears and acoustic tones for HA ears) in opposite ears, with reference stimuli fixed and comparison stimuli varied in frequency/electrode to find the range perceived as a single sound. Direct electrical stimulation was used in implanted ears through the research interface, which allowed selective stimulation of one electrode at a time, and acoustic stimulation was used in the non-implanted ears through the headphone. Second, speech-on-speech masking performance was measured to estimate masking release by voice gender difference between target and maskers (VGRM). The VGRM was calculated as the difference in speech recognition thresholds of target sounds in the presence of same-gender or different-gender maskers.

RESULTS

Voice gender differences between target and masker talkers improved speech recognition performance for the bimodal CI group, but not the bilateral CI group. The bimodal CI users who benefited the most from voice gender differences were those who had the narrowest range of acoustic frequencies that fused into a single sound with stimulation from a single electrode from the CI in the opposite ear. There was no similar voice gender difference benefit of narrow binaural fusion range for the bilateral CI users.

CONCLUSIONS

The findings suggest that broad binaural fusion reduces the acoustical information available for differentiating individual talkers in bimodal CI users, but not for bilateral CI users. In addition, for bimodal CI users with narrow binaural fusion who benefit from voice gender differences, bilateral implantation could lead to a loss of that benefit and impair their ability to selectively attend to one talker in the presence of multiple competing talkers. The results suggest that binaural pitch fusion, along with an assessment of residual hearing and other factors, could be important for assessing bimodal and bilateral CI users.

Asymmetric temporal envelope sensitivity: Within- and across-ear envelope comparisons in listeners with bilateral cochlear implants

For listeners with bilateral cochlear implants (BiCIs), patient-specific differences in the interface between cochlear implant (CI) electrodes and the auditory nerve can lead to degraded temporal envelope information, compromising the ability to distinguish between targets of interest and background noise. It is unclear how comparisons of degraded temporal envelope information across spectral channels (i.e., electrodes) affect the ability to detect differences in the temporal envelope, specifically amplitude modulation (AM) rate. In this study, two pulse trains were presented simultaneously via pairs of electrodes in different places of stimulation, within and/or across ears, with identical or differing AM rates. Results from 11 adults with BiCIs indicated that sensitivity to differences in AM rate was greatest when stimuli were paired between different places of stimulation in the same ear. Sensitivity from pairs of electrodes was predicted by the poorer electrode in the pair or the difference in fidelity between both electrodes in the pair. These findings suggest that electrodes yielding poorer temporal fidelity act as a bottleneck to comparisons of temporal information across frequency and ears, limiting access to the cues used to segregate sounds, which has important implications for device programming and optimizing patient outcomes with CIs.

Stimulation Rate and Voice Pitch Perception in Cochlear Implants

The stimulation rate in cochlear implant (CI) sound coding, or the "carrier" rate in pulses per second (pps), is known to influence pitch perception, as well as loudness perception and sound quality. Our main objective was to investigate the effects of reduced carrier rate on the loudness and pitch of coded speech samples. We describe two experiments with 16 Nucleus® CI users, where we controlled modulation characteristics and carrier rate using Spectral and Temporal Enhanced Processing (STEP), a novel experimental multichannel sound coder. We used a fixed set of threshold and comfortable stimulation levels for each subject, obtained from clinical MAPs. In the first experiment, we determined equivalence for voice pitch ranking and voice gender categorization between the Advanced Combination Encoder (ACE), a widely used clinical strategy in Nucleus® recipients, and STEP for fundamental frequencies (F0) 120-250 Hz. In the second experiment, loudness was determined as a function of the input amplitude of speech samples for carrier rates of 1000, 500, and 250 pps per channel. Then, using equally loud sound coder programs, we evaluated the effect of carrier rate on voice pitch perception. Although nearly all subjects could categorize voice gender significantly above chance, pitch ranking varied across subjects. Overall, carrier rate did not substantially affect voice pitch ranking or voice gender categorization: as long as the carrier rate was at least twice the fundamental frequency, or when stimulation pulses for the lowest, 250 pps carrier were aligned to F0 peaks. These results indicate that carrier rates as low as 250 pps per channel are sufficient to support functional voice pitch perception for those CI users sensitive to temporal pitch cues; at least when temporal modulations and pulse timings in the coder output are well controlled by novel strategies such as STEP.

Pitch perception with the temporal limits encoder for cochlear implants

The temporal-limits-encoder (TLE) strategy has been proposed to enhance the representation of temporal fine structure (TFS) in cochlear implants (CIs), which is vital for many aspects of sound perception but is typically discarded by most modern CI strategies. TLE works by computing an envelope modulator that is within the temporal pitch limits of CI electric hearing. This paper examines the TFS information encoded by TLE and evaluates the salience and usefulness of this information in CI users. Two experiments were conducted to compare pitch perception performance of TLE versus the widely-used Advanced Combinational Encoder (ACE) strategy. Experiment 1 investigated whether TLE processing improved pitch discrimination compared to ACE. Experiment 2 parametrically examined the effect of changing the lower frequency limit of the TLE modulator on pitch ranking. In both experiments, F0 difference limens were measured with synthetic harmonic complex tones using an adaptive procedure. Signal analysis of the outputs of TLE and ACE strategies showed that TLE introduces important temporal pitch cues that are not available with ACE. Results showed an improvement in pitch discrimination with TLE when the acoustic input had a lower F0 frequency. No significant effect of lower frequency limit was observed for pitch ranking, though a lower limit did tend to provide better outcomes. These results suggest that the envelope modulation introduced by TLE can improve pitch perception for CI listeners.

Temporal Pitch Sensitivity in an Animal Model: Psychophysics and Scalp Recordings : Temporal Pitch Sensitivity in Cat

Cochlear implant (CI) users show limited sensitivity to the temporal pitch conveyed by electric stimulation, contributing to impaired perception of music and of speech in noise. Neurophysiological studies in cats suggest that this limitation is due, in part, to poor transmission of the temporal fine structure (TFS) by the brainstem pathways that are activated by electrical cochlear stimulation. It remains unknown, however, how that neural limit might influence perception in the same animal model. For that reason, we developed non-invasive psychophysical and electrophysiological measures of temporal (i.e., non-spectral) pitch processing in the cat. Normal-hearing (NH) cats were presented with acoustic pulse trains consisting of band-limited harmonic complexes that simulated CI stimulation of the basal cochlea while removing cochlear place-of-excitation cues. In the psychophysical procedure, trained cats detected changes from a base pulse rate to a higher pulse rate. In the scalp-recording procedure, the cortical-evoked acoustic change complex (ACC) and brainstem-generated frequency following response (FFR) were recorded simultaneously in sedated cats for pulse trains that alternated between the base and higher rates. The range of perceptual sensitivity to temporal pitch broadly resembled that of humans but was shifted to somewhat higher rates. The ACC largely paralleled these perceptual patterns, validating its use as an objective measure of temporal pitch sensitivity. The phase-locked FFR, in contrast, showed strong brainstem encoding for all tested pulse rates. These measures demonstrate the cat's perceptual sensitivity to pitch in the absence of cochlear-place cues and may be valuable for evaluating neural mechanisms of temporal pitch perception in the feline animal model of stimulation by a CI or novel auditory prostheses.

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.

Computational Modeling of Synchrony in the Auditory Nerve in Response to Acoustic and Electric Stimulation

Cochlear implants are medical devices that provide hearing to nearly one million people around the world. Outcomes are impressive with most recipients learning to understand speech through this new way of hearing. Music perception and speech reception in noise, however, are notably poor. These aspects of hearing critically depend on sensitivity to pitch, whether the musical pitch of an instrument or the vocal pitch of speech. The present article examines cues for pitch perception in the auditory nerve based on computational models. Modeled neural synchrony for pure and complex tones is examined for three different electric stimulation strategies including Continuous Interleaved Sampling (CIS), High-Fidelity CIS (HDCIS), and Peak-Derived Timing (PDT). Computational modeling of current spread and neuronal response are used to predict neural activity to electric and acoustic stimulation. It is shown that CIS does not provide neural synchrony to the frequency of pure tones nor to the fundamental component of complex tones. The newer HDCIS and PDT strategies restore synchrony to both the frequency of pure tones and to the fundamental component of complex tones. Current spread reduces spatial specificity of excitation as well as the temporal fidelity of neural synchrony, but modeled neural excitation restores precision of these cues. Overall, modeled neural excitation to electric stimulation that incorporates temporal fine structure (e.g., HDCIS and PDT) indicates neural synchrony comparable to that provided by acoustic stimulation. Discussion considers the importance of stimulation rate and long-term rehabilitation to provide temporal cues for pitch perception.

Perception of speaker sincerity in complex social interactions by cochlear implant users

Understanding insincere language (sarcasm and teasing) is a fundamental part of communication and crucial for maintaining social relationships. This can be a challenging task for cochlear implant (CIs) users who receive degraded suprasegmental information important for perceiving a speaker’s attitude. We measured the perception of speaker sincerity (literal positive, literal negative, sarcasm, and teasing) in 16 adults with CIs using an established video inventory. Participants were presented with audio-only and audio-visual social interactions between two people with and without supporting verbal context. They were instructed to describe the content of the conversation and answer whether the speakers meant what they said. Results showed that subjects could not always identify speaker sincerity, even when the content of the conversation was perfectly understood. This deficit was greater for perceiving insincere relative to sincere utterances. Performance improved when additional visual cues or verbal context cues were provided. Subjects who were better at perceiving the content of the interactions in the audio-only condition benefited more from having additional visual cues for judging the speaker’s sincerity, suggesting that the two modalities compete for cognitive recourses. Perception of content also did not correlate with perception of speaker sincerity, suggesting that what was said vs. how it was said were perceived using unrelated segmental versus suprasegmental cues. Our results further showed that subjects who had access to lower-order resolved harmonic information provided by hearing aids in the contralateral ear identified speaker sincerity better than those who used implants alone. These results suggest that measuring speech recognition alone in CI users does not fully describe the outcome. Our findings stress the importance of measuring social communication functions in people with CIs.

Acoustic analysis of tone production in Mandarin-speaking bimodal cochlear implant users

The benefit of using a hearing aid with a cochlear implant (bimodal hearing) has been demonstrated for tone perception under certain conditions. The present study evaluated bimodal effects for tone production by comparing performance between a bimodal and a unimodal implant group. Results showed that acoustic differentiation of tones produced by the bimodal group was better than the unimodal implant group, and performance was dependent on the subject's acoustic thresholds but not related to implant experience or age at implantation. The findings support the use of amplified acoustic hearing in conjunction with the implant for better development of pitch production.

Advantages of Pulse Rate Compared to Modulation Frequency for Temporal Pitch Perception in Cochlear Implant Users

Most cochlear implants encode the fundamental frequency of periodic sounds by amplitude modulation of constant-rate pulsatile stimulation. Pitch perception provided by such stimulation strategies is markedly poor. Two experiments are reported here that consider potential advantages of pulse rate compared to modulation frequency for providing stimulation timing cues for pitch. The first experiment examines beat frequency distortion that occurs when modulating constant-rate pulsatile stimulation. This distortion has been reported on previously, but the results presented here indicate that distortion occurs for higher stimulation rates than previously reported. The second experiment examines pitch resolution as provided by pulse rate compared to modulation frequency. The results indicate that pitch discrimination is better with pulse rate than with modulation frequency. The advantage was large for rates near what has been suggested as the upper limit of temporal pitch perception conveyed by cochlear implants. The results are relevant to sound processing design for cochlear implants particularly for algorithms that encode fundamental frequency into deep envelope modulations or into precisely timed pulsatile stimulation.

Estimating the reduced benefit of infant-directed speech in cochlear implant-related speech processing

Caregivers modify their speech when talking to infants, a specific type of speech known as infant-directed speech (IDS). This speaking style facilitates language learning compared to adult-directed speech (ADS) in infants with normal hearing (NH). While infants with NH and those with cochlear implants (CIs) prefer listening to IDS over ADS, it is yet unknown how CI processing may affect the acoustic distinctiveness between ADS and IDS, as well as the degree of intelligibility of these. This study analyzed speech of seven female adult talkers to model the effects of simulated CI processing on (1) acoustic distinctiveness between ADS and IDS, (2) estimates of intelligibility of caregivers' speech in ADS and IDS, and (3) individual differences in caregivers' ADS-to-IDS modification and estimated speech intelligibility. Results suggest that CI processing is substantially detrimental to the acoustic distinctiveness between ADS and IDS, as well as to the intelligibility benefit derived from ADS-to-IDS modifications. Moreover, the observed variability across individual talkers in acoustic implementation of ADS-to-IDS modification and the estimated speech intelligibility was significantly reduced due to CI processing. The findings are discussed in the context of the link between IDS and language learning in infants with CIs.

Pitch perception is more robust to interference and better resolved when provided by pulse rate than by modulation frequency of cochlear implant stimulation

Cochlear implants are medical devices that have been used to restore hearing to more than half a million people worldwide. Most recipients achieve high levels of speech comprehension through these devices, but speech comprehension in background noise and music appreciation in general are markedly poor compared to normal hearing. A key aspect of hearing that is notably diminished in cochlear implant outcomes is the sense of pitch provided by these devices. Pitch perception is an important factor affecting speech comprehension in background noise and is critical for music perception. The present article summarizes two experiments that examine the robustness and resolution of pitch perception as provided by cochlear implant stimulation timing. The driving hypothesis is that pitch conveyed by stimulation timing cues is more robust and better resolved when provided by variable pulse rates than by modulation frequency of constant-rate stimulation. Experiment 1 examines the robustness for hearing a large, one-octave, pitch difference in the presence of interfering electrical stimulation. With robustness to interference characterized for an otherwise easily discernible pitch difference, Experiment 2 examines the resolution of discrimination thresholds in the presence of interference as conveyed by modulation frequency or by pulse rate. These experiments test for an advantage of stimulation with precise temporal cues. The results indicate that pitch provided by pulse rate is both more robust to interference and is better resolved compared to when provided by modulation frequency. These results should inform the development of new sound processing strategies for cochlear implants designed to encode fundamental frequency of sounds into precise temporal stimulation.

Binaural Pitch Fusion: Binaural Pitch Averaging in Cochlear Implant Users With Broad Binaural Fusion

OBJECTIVES

Individuals who use hearing aids (HAs) or cochlear implants (CIs) can experience broad binaural pitch fusion, such that sounds differing in pitch by as much as 3 to 4 octaves are perceptually integrated across ears. Previously, it was shown in HA users that the fused pitch is a weighted average of the two monaural pitches, ranging from equal weighting to dominance by the lower pitch. The goal of this study was to systematically measure the fused pitches in adult CI users, and determine whether CI users experience similar pitch averaging effects as observed in HA users.

DESIGN

Twelve adult CI users (Cochlear Ltd, Sydney, Australia) participated in this study: six bimodal CI users, who wear a CI with a contralateral HA, and six bilateral CI users. Stimuli to HA ears were acoustic pure tones, and stimuli to CI ears were biphasic pulse trains delivered to individual electrodes. Fusion ranges, the ranges of frequencies/electrodes in the comparison ear that were fused with a single electrode (electrode 22, 18, 12, or 6) in the reference ear, were measured using simultaneous, dichotic presentation of reference and comparison stimuli in opposite ears, and varying the comparison stimulus. Once the fusion ranges were measured, the fused binaural pitch of a reference-pair stimulus combination was measured by finding a pitch match to monaural comparison stimuli presented to the paired stimulus ear.

RESULTS

Fusion pitch weighting in CI users varied depending on the pitch difference of the reference-pair stimulus combination, with equal pitch averaging occurring for stimuli closer in pitch and lower pitch dominance occurring for stimuli farther apart in pitch. The averaging region was typically 0.5 to 2.3 octaves around the reference for bimodal CI users and 0.4 to 1.5 octaves for bilateral CI users. In some cases, a bias in the averaging region was observed toward the ear with greater stimulus variability.

CONCLUSIONS

Fusion pitch weighting effects in CI users were similar to those observed previously in HA users. However, CI users showed greater inter-subject variability in both pitch averaging ranges and bias effects. These findings suggest that binaural pitch averaging could be a common underlying mechanism in hearing-impaired listeners.

Effect of Chronological Age on Pulse Rate Discrimination in Adult Cochlear-Implant Users

Cochlear-implant (CI) users rely heavily on temporal envelope cues to understand speech. Temporal processing abilities may decline with advancing age in adult CI users. This study investigated the effect of age on the ability to discriminate changes in pulse rate. Twenty CI users aged 23 to 80 years participated in a rate discrimination task. They attempted to discriminate a 35% rate increase from baseline rates of 100, 200, 300, 400, or 500 pulses per second. The stimuli were electrical pulse trains delivered to a single electrode via direct stimulation to an apical (Electrode 20), a middle (Electrode 12), or a basal location (Electrode 4). Electrically evoked compound action potential amplitude growth functions were recorded at each of those electrodes as an estimate of peripheral neural survival. Results showed that temporal pulse rate discrimination performance declined with advancing age at higher stimulation rates (e.g., 500 pulses per second) when compared with lower rates. The age-related changes in temporal pulse rate discrimination at higher stimulation rates persisted after statistical analysis to account for the estimated peripheral contributions from electrically evoked compound action potential amplitude growth functions. These results indicate the potential contributions of central factors to the limitations in temporal pulse rate discrimination ability associated with aging in CI users.

Rate and Temporal Coding of Regular and Irregular Pulse Trains in Auditory Midbrain of Normal-Hearing and Cochlear-Implanted Rabbits

Although pitch is closely related to temporal periodicity, stimuli with a degree of temporal irregularity can evoke a pitch sensation in human listeners. However, the neural mechanisms underlying pitch perception for irregular sounds are poorly understood. Here, we recorded responses of single units in the inferior colliculus (IC) of normal hearing (NH) rabbits to acoustic pulse trains with different amounts of random jitter in the inter-pulse intervals and compared with responses to electric pulse trains delivered through a cochlear implant (CI) in a different group of rabbits. In both NH and CI animals, many IC neurons demonstrated tuning of firing rate to the average pulse rate (APR) that was robust against temporal jitter, although jitter tended to increase the firing rates for APRs ≥ 1280 Hz. Strength and limiting frequency of spike synchronization to stimulus pulses were also comparable between periodic and irregular pulse trains, although there was a slight increase in synchronization at high APRs with CI stimulation. There were clear differences between CI and NH animals in both the range of APRs over which firing rate tuning was observed and the prevalence of synchronized responses. These results suggest that the pitches of regular and irregular pulse trains are coded differently by IC neurons depending on the APR, the degree of irregularity, and the mode of stimulation. In particular, the temporal pitch produced by periodic pulse trains lacking spectral cues may be based on a rate code rather than a temporal code at higher APRs.

Perceptual learning of pitch provided by cochlear implant stimulation rate

Cochlear implant users hear pitch evoked by stimulation rate, but discrimination diminishes for rates above 300 Hz. This upper limit on rate pitch is surprising given the remarkable and specialized ability of the auditory nerve to respond synchronously to stimulation rates at least as high as 3 kHz and arguably as high as 10 kHz. Sensitivity to stimulation rate as a pitch cue varies widely across cochlear implant users and can be improved with training. The present study examines individual differences and perceptual learning of stimulation rate as a cue for pitch ranking. Adult cochlear implant users participated in electrode psychophysics that involved testing once per week for three weeks. Stimulation pulse rate discrimination was measured in bipolar and monopolar configurations for apical and basal electrodes. Base stimulation rates between 100 and 800 Hz were examined. Individual differences were quantified using psychophysically derived metrics of spatial tuning and temporal integration. This study examined distribution of measures across subjects, predictive power of psychophysically derived metrics of spatial tuning and temporal integration, and the effect of training on rate discrimination thresholds. Psychophysical metrics of spatial tuning and temporal integration were not predictive of stimulation rate discrimination, but discrimination thresholds improved at lower frequencies with training. Since most clinical devices do not use variable stimulation rates, it is unknown to what extent recipients may learn to use stimulation rate cues if provided in a clear and consistent manner.

The Effect of Phantom Stimulation and Pseudomonophasic Pulse Shapes on Pitch Perception by Cochlear Implant Listeners

It has been suggested that a specialized high-temporal-acuity brainstem pathway can be activated by stimulating more apically in the cochlea than is achieved by cochlear implants (CIs) when programmed with contemporary clinical settings. We performed multiple experiments to test the effect on pitch perception of phantom stimulation and asymmetric current pulses, both supposedly stimulating beyond the most apical electrode of a CI. The two stimulus types were generated using a bipolar electrode pair, composed of the most apical electrode of the array and a neighboring, more basal electrode. Experiment 1 used a pitch-ranking procedure where neural excitation was shifted apically or basally using so-called phantom stimulation. No benefit of apical phantom stimulation was found on the highest rate up to which pitch ranks increased (upper limit), nor on the slopes of the pitch-ranking function above 300 pulses per second (pps). Experiment 2 used the same procedure to study the effects of apical pseudomonophasic pulses, where the locus of excitation was manipulated by changing stimulus polarity. A benefit of apical stimulation was obtained for the slopes above 300 pps. Experiment 3 used an adaptive rate discrimination procedure and found a small but significant benefit of both types of apical stimulation. Overall, the results show some benefit for apical stimulation on temporal pitch processing at high pulse rates but reveal that the effect is smaller and more variable across listeners than suggested by previous research. The results also provide some indication that the benefit of apical stimulation may decline over time since implantation.

Place-Pitch Interval Perception With a Cochlear Implant

OBJECTIVES

Pitch is poorly perceived by cochlear implant (CI) users. However, as it is not well understood how pitch is encoded with electric stimulation, improving pitch representation with a CI is challenging. Changes in place of stimulation along the cochlea have been described as changes in pitch and can be accurately ranked by CI users. However, it remains unknown if place-pitch can be used to encode musical intervals, which are a necessary attribute of pitch. The objective of these experiments is to determine if place-pitch coding can be used to represent musical intervals with a CI.

DESIGN

In the first experiment, 10 CI users and 10 normal hearing (NH) controls were tested on their sensitivity to changes in the semitone spacing between each of the notes in the melody "Happy Birthday." The changes were implemented by uniformly expanding or compressing the frequency differences between each note in the melody. The participant's task was to scale how "out-of-tune" the melody was for various semitone spacing distortions. The notes were represented by pure-tones ≥440 Hz to minimize potential useful temporal information from the stimuli. A second experiment replicated the first experiment using single-sided deafened CI users allowing for a within-subject control. A third experiment verified that the CI users who participated in Experiment 1 were each able to determine pitch direction reliably.

RESULTS

Unlike NH listeners, CI listeners often ranked all distortions of interval spacing similarly in both the first and second experiment, and no effect of interval spacing was detected across CI users. Some participants found distorted interval spacings to be less out-of-tune than the nominally correct interval spacings. However, these patterns were inconsistent across listeners. Although performance was better for the NH listeners, the third experiment demonstrated that the CI listeners were able to reliably identify changes in pitch direction from place-pitch coding.

CONCLUSIONS

The data suggest that place-pitch intervals are not properly represented through a CI sound processor. Some limited support is found for place-pitch being useful for interval encoding as some participants demonstrated improved ratings for certain interval distortions. Presumably the interval representation for these participants could be improved by a change to the frequencies represented by each electrode. However, as these patterns vary across listeners, there is not a universal correction to frequency representation that will solve this issue. As results are similar for single-sided deafened CI users, the limitations in ratings are likely not limited by an eroded representation of the melody caused by an extended duration of deafness.

Comparison of the Effects of Two Cochlear Implant Fine Structure Coding Strategies on Speech Perception

Purpose This study aims to investigate the effect of upgrading from the fine structure processing (FSP) coding strategy to the novel fine structure strategy "FS4" in adults in adults with cochlear implants manufactured by MED-EL GmbH (Innsbruck, Austria). Method A crossover, double-blinded study was conducted for 12 weeks. Twelve adult participants were randomly assigned to two groups. During the first 6-week test interval, one group continued to use their everyday FSP strategy, whereas the other group was upgraded to the FS4 strategy. In the second 6-week interval, the two groups switched coding strategies. Speech perception was measured at the end of each test interval with the Oldenburg Sentence Test and the Göttingen Sentence Test. Participants completed the Speech, Spatial and Qualities of Hearing Scale at the end of each test interval and a simple preference test at the end of the study. Results There was no significant difference in speech perception test results obtained with the Oldenburg Sentence Test and the Göttingen Sentence Test, neither in quiet nor in noise. Participants' Speech, Spatial and Qualities of Hearing Scale self-evaluation and preference test results showed that the two coding strategies had similar effects on their hearing perception. No clear preference for either of the strategies was found. Conclusions Speech perception test results and the participants' level of satisfaction were similar for the two FS coding strategies. Despite differences in the presentation of temporal fine structure between FSP and FS4, a clear benefit of the newer FS4 strategy could not be shown.

Searching for the Sound of a Cochlear Implant: Evaluation of Different Vocoder Parameters by Cochlear Implant Users With Single-Sided Deafness

Cochlear implantation in subjects with single-sided deafness (SSD) offers a unique opportunity to directly compare the percepts evoked by a cochlear implant (CI) with those evoked acoustically. Here, nine SSD-CI users performed a forced-choice task evaluating the similarity of speech processed by their CI with speech processed by several vocoders presented to their healthy ear. In each trial, subjects heard two intervals: their CI followed by a certain vocoder in Interval 1 and their CI followed by a different vocoder in Interval 2. The vocoders differed either (i) in carrier type-(sinusoidal [SINE], bandfiltered noise [NOISE], and pulse-spreading harmonic complex) or (ii) in frequency mismatch between the analysis and synthesis frequency ranges-(no mismatch, and two frequency-mismatched conditions of 2 and 4 equivalent rectangular bandwidths [ERBs]). Subjects had to state in which of the two intervals the CI and vocoder sounds were more similar. Despite a large intersubject variability, the PSHC vocoder was judged significantly more similar to the CI than SINE or NOISE vocoders. Furthermore, the No-mismatch and 2-ERB mismatch vocoders were judged significantly more similar to the CI than the 4-ERB mismatch vocoder. The mismatch data were also interpreted by comparing spiral ganglion characteristic frequencies with electrode contact positions determined from postoperative computed tomography scans. Only one subject demonstrated a pattern of preference consistent with adaptation to the CI sound processor frequency-to-electrode allocation table and two subjects showed possible partial adaptation. Those subjects with adaptation patterns presented overall small and consistent frequency mismatches across their electrode arrays.

The Perception of Multiple Simultaneous Pitches as a Function of Number of Spectral Channels and Spectral Spread in a Noise-Excited Envelope Vocoder

Cochlear implant (CI) listeners typically perform poorly on tasks involving the pitch of complex tones. This limitation in performance is thought to be mainly due to the restricted number of active channels and the broad current spread that leads to channel interactions and subsequent loss of precise spectral information, with temporal information limited primarily to temporal-envelope cues. Little is known about the degree of spectral resolution required to perceive combinations of multiple pitches, or a single pitch in the presence of other interfering tones in the same spectral region. This study used noise-excited envelope vocoders that simulate the limited resolution of CIs to explore the perception of multiple pitches presented simultaneously. The results show that the resolution required for perceiving multiple complex pitches is comparable to that found in a previous study using single complex tones. Although relatively high performance can be achieved with 48 channels, performance remained near chance when even limited spectral spread (with filter slopes as steep as 144 dB/octave) was introduced to the simulations. Overall, these tight constraints suggest that current CI technology will not be able to convey the pitches of combinations of spectrally overlapping complex tones.

Temporal-pitch sensitivity in electric hearing with amplitude modulation and inserted pulses with short inter-pulse intervals

Listeners with cochlear implants (CIs) typically show poor sensitivity to the temporal-envelope pitch of high-rate pulse trains. Sensitivity to interaural time differences improves when adding pulses with short inter-pulse intervals (SIPIs) to high-rate pulse trains. In the current study, monaural temporal-pitch sensitivity with SIPI pulses was investigated for six CI listeners. Amplitude-modulated single-electrode stimuli, representing the coding of the fundamental frequency (F0) in the envelope of a high-rate carrier, were used. Two SIPI-insertion approaches, five modulation depths, two typical speech-F0s, and two carrier rates were tested. SIPI pulses were inserted either in every amplitude-modulation period (full-rate SIPI) to support the F0 cue or in every other amplitude-modulation period (half-rate SIPI) to circumvent a potential rate limitation at higher F0s. The results demonstrate that full-rate SIPI pulses improve temporal-pitch sensitivity across F0s and particularly at low modulation depths where envelope-pitch cues are weak. The half-rate SIPI pulses did not circumvent the limitation and further increased variability across listeners. Further, no effect of the carrier rate was found. Thus, the SIPI approach appears to be a promising approach to enhance CI listeners' access to temporal-envelope pitch cues at pulse rates used clinically.

Effects of rate and age in processing interaural time and level differences in normal-hearing and bilateral cochlear-implant listeners

Bilateral cochlear implants (BICIs) provide improved sound localization and speech understanding in noise compared to unilateral CIs. However, normal-hearing (NH) listeners demonstrate superior binaural processing abilities compared to BICI listeners. This investigation sought to understand differences between NH and BICI listeners' processing of interaural time differences (ITDs) and interaural level differences (ILDs) as a function of fine-structure and envelope rate using an intracranial lateralization task. The NH listeners were presented band-limited acoustical pulse trains and sinusoidally amplitude-modulated tones using headphones, and the BICI listeners were presented single-electrode electrical pulse trains using direct stimulation. Lateralization range increased as fine-structure rate increased for ILDs in BICI listeners. Lateralization range decreased for rates above 100 Hz for fine-structure ITDs, but decreased for rates lower or higher than 100 Hz for envelope ITDs in both groups. Lateralization ranges for ITDs were smaller for BICI listeners on average. After controlling for age, older listeners showed smaller lateralization ranges and BICI listeners had a more rapid decline for ITD sensitivity at 300 pulses per second. This work suggests that age confounds comparisons between NH and BICI listeners in temporal processing tasks and that some NH-BICI binaural processing differences persist even when age differences are adequately addressed.

Rate pitch discrimination in cochlear implant users with the use of double pulses and different interpulse intervals

The rate pitch discrimination ability of cochlear implant (CI) users is poor compared to normal-hearing (NH) listeners. At low pulse rates, the just noticeable difference (JND) is on average 20% of the base rate, while NH listeners can discriminate small frequency differences of 0.2% at 1 kHz. Recent investigations suggest that double pulses with short interpulse intervals (IPIs) may have a beneficial effect on rate pitch discrimination in CI users. In a first experiment psychophysical tests were carried out to establish whether rate pitch in CI users could be improved by applying double pulses with equal amplitude and short IPIs. Pulse trains with base rates of 200 and 400 pps, composed of either single pulses or double pulses with IPIs of 15, 50, and 150 μs were presented. In a second experiment pairwise comparisons were carried out between pitch of a pulse train composed of alternating double and single pulses with pitch of pulse trains composed of single pulses. The alternating pulse train had a base rate of 400 pps, the pulse trains with solely single pulses had base rates of 200, 300, and 400 pps. The loudness and pitch perception of the different stimulus types were evaluated and compared. A significant loudness difference was found between single and double pulses for both pulse rates. The JND for pitch discrimination between double-pulse IPIs had a high inter-subject variability, and no significant group effect was found. No subject reported a pitch change between double pulse and single pulse stimulation. In contrast, most of the subjects recognized a change in pitch between single-pulse trains and pulse trains with alternating double and single pulses. The latter was lower in pitch than the single-pulse train stimulation. To conclude, using (equal amplitude) double pulses instead of single pulses in a pulse train does not effect pitch perception. Instead, loudness differs between double pulses and single pulses with the same amplitude.

Effect of Chronic Stimulation and Stimulus Level on Temporal Processing by Cochlear Implant Listeners

A series of experiments investigated potential changes in temporal processing during the months following activation of a cochlear implant (CI) and as a function of stimulus level. Experiment 1 tested patients on the day of implant activation and 2 and 6 months later. All stimuli were presented using direct stimulation of a single apical electrode. The dependent variables were rate discrimination ratios (RDRs) for pulse trains with rates centred on 120 pulses per second (pps), obtained using an adaptive procedure, and a measure of the upper limit of temporal pitch, obtained using a pitch-ranking procedure. All stimuli were presented at their most comfortable level (MCL). RDRs decreased from 1.23 to 1.16 and the upper limit increased from 357 to 485 pps from 0 to 2 months post-activation, with no overall change from 2 to 6 months. Because MCLs and hence the testing level increased across sessions, two further experiments investigated whether the performance changes observed across sessions could be due to level differences. Experiment 2 re-tested a subset of subjects at 9 months post-activation, using current levels similar to those used at 0 months. Although the stimuli sounded softer, some subjects showed lower RDRs and/or higher upper limits at this re-test. Experiment 3 measured RDRs and the upper limit for a separate group of subjects at levels equal to 60 %, 80 % and 100 % of the dynamic range. RDRs decreased with increasing level. The upper limit increased with increasing level for most subjects, with two notable exceptions. Implications of the results for temporal plasticity are discussed, along with possible influences of the effects of level and of across-session learning.

Interaural Pitch-Discrimination Range Effects for Bilateral and Single-Sided-Deafness Cochlear-Implant Users

By allowing bilateral access to sound, bilateral cochlear implants (BI-CIs) or unilateral CIs for individuals with single-sided deafness (SSD; i.e., normal or near-normal hearing in one ear) can improve sound localization and speech understanding in noise. Spatial hearing in the horizontal plane is primarily conveyed by interaural time and level differences computed from neurons in the superior olivary complex that receive frequency-matched inputs. Because BI-CIs and SSD-CIs do not necessarily convey frequency-matched information, it is critical to understand how to align the inputs to CI users. Previous studies show that interaural pitch discrimination for SSD-CI listeners is highly susceptible to contextual biases, questioning its utility for establishing interaural frequency alignment. Here, we replicate this finding for SSD-CI listeners and show that these biases also extend to BI-CI listeners. To assess the testing-range bias, three ranges of comparison electrodes (BI-CI) or pure-tone frequencies (SSD-CI) were tested: full range, apical/lower half, or basal/upper half. To assess the reference bias, the reference electrode was either held fixed throughout a testing block or randomly chosen from three electrodes (basal end, middle, or apical end of the array). Results showed no effect of reference electrode randomization, but a large testing range bias; changing the center of the testing-range shifted the pitch match by an average 63 % (BI-CI) or 43 % (SSD-CI) of the change magnitude. This bias diminished pitch-match accuracy, with a change in reference electrode shifting the pitch match only an average 34 % (BI-CI) or 40 % (SSD-CI) of the expected amount. Because these effects extended to the relatively more symmetric BI-CI listeners, the results suggest that the bias cannot be attributed to interaural asymmetry. Unless the range effect can be minimized or accounted for, a pitch-discrimination task will produce interaural place-of-stimulation estimates that are highly influenced by the conditions tested, rather than reflecting a true interaural place-pitch comparison.

Evaluation of Possible Effects of a Potassium Channel Modulator on Temporal Processing by Cochlear Implant Listeners

Temporal processing by cochlear implant listeners is degraded and is affected by auditory deprivation. The fast-acting Kv3.1 potassium channel is important for sustained temporally accurate firing and is also susceptible to deprivation, the effects of which can be partially restored in animals by the molecule AUT00063. We report the results of a randomised placebo-controlled double-blind study on psychophysical tests of the effects of AUT00063 on temporal processing by CI listeners. The study measured the upper limit of temporal pitch, gap detection, and discrimination of low rates (centred on 120 pps) for monopolar pulse trains presented to an apical electrode. The upper limit was measured using the optimally efficient midpoint comparison (MPC) pitch-ranking procedure; thresholds were obtained for the other two measures using an adaptive procedure. Twelve CI users (MedEl and Cochlear) were tested before and after two periods of AUT00063 or placebo in a within-subject crossover study. No significant differences occurred between post-drug and post-placebo conditions. This absence of effect occurred despite high test-retest reliability for all three measures, obtained by comparing performance on the two baseline visits, and despite the demonstrated sensitivity of the measures to modest changes in temporal processing obtained in other studies from our laboratory. Hence, we have no evidence that AUT00063 improves temporal processing for the doses and patient population employed.

Pulse-rate discrimination deficit in cochlear implant users: is the upper limit of pitch peripheral or central?

Cochlear implant (CI) users do not reliably associate an increase in pulse rate above 300 pulses per second (pps) with an increase in pitch. The locus of this upper limit of pitch remains unknown. The present study tested the hypothesis that this deficit resides at least initially at the auditory nerve. The hypothesis was tested by comparing pulse rate discrimination in different neural excitation patterns, in which a large versus small population of auditory nerve fibers was activated. If poorer pulse rate discrimination was found under conditions where narrower spread of neural excitation (SOE) was anticipated where a relatively small neural population was activated, then it would support the hypothesis that the rate processing deficit found in CI users is related to peripheral neural degeneration. Nine listeners (12 ears) implanted with the Cochlear Americas Nucleus^® devices participated in the study. Different SOE conditions were created by (1) selecting electrodes that showed narrow versus broad forward-masked psychophysical spatial tuning curves, and (2) by measuring these electrodes in monopolar (MP) and narrow bipolar (BP0) electrode configurations. Rate discrimination difference limen (DL) was measured at the selected electrodes in two electrode configurations at three base rates (200, 300 and 500 pps). Consistent with the prediction, group mean DL was better (1) at stimulation sites measured with broader tuning, and (2) in MP relative to BP stimulation. These effects were more salient at the more challenging base rates. There was a weak relationship between rate discrimination (above thresholds) and the effect of rate on detection thresholds. Finally, rate discrimination at rates above the known upper limit (i.e., 500 pps) was correlated with duration of deafness and highly predicted the subjects' speech recognition performance in noise. These findings support that pulse rate discrimination depends, at least partially, on neural conditions at the auditory periphery and this peripheral limit predicts speech recognition outcomes with a CI.

Development and validation of a spectro-temporal processing test for cochlear-implant listeners

Psychophysical tests of spectro-temporal resolution may aid the evaluation of methods for improving hearing by cochlear implant (CI) listeners. Here the STRIPES (Spectro-Temporal Ripple for Investigating Processor EffectivenesS) test is described and validated. Like speech, the test requires both spectral and temporal processing to perform well. Listeners discriminate between complexes of sine sweeps which increase or decrease in frequency; difficulty is controlled by changing the stimulus spectro-temporal density. Care was taken to minimize extraneous cues, forcing listeners to perform the task only on the direction of the sweeps. Vocoder simulations with normal hearing listeners showed that the STRIPES test was sensitive to the number of channels and temporal information fidelity. An evaluation with CI listeners compared a standard processing strategy with one having very wide filters, thereby spectrally blurring the stimulus. Psychometric functions were monotonic for both strategies and five of six participants performed better with the standard strategy. An adaptive procedure revealed significant differences, all in favour of the standard strategy, at the individual listener level for six of eight CI listeners. Subsequent measures validated a faster version of the test, and showed that STRIPES could be performed by recently implanted listeners having no experience of psychophysical testing.

Neural Coding of Interaural Time Differences with Bilateral Cochlear Implants in Unanesthetized Rabbits

Although bilateral cochlear implants (CIs) provide improvements in sound localization and speech perception in noise over unilateral CIs, bilateral CI users' sensitivity to interaural time differences (ITDs) is still poorer than normal. In particular, ITD sensitivity of most CI users degrades with increasing stimulation rate and is lacking at the high carrier pulse rates used in CI processors to deliver speech information. To gain a better understanding of the neural basis for this degradation, we characterized ITD tuning of single neurons in the inferior colliculus (IC) for pulse train stimuli in an unanesthetized rabbit model of bilateral CIs. Approximately 73% of IC neurons showed significant ITD sensitivity in their overall firing rates. On average, ITD sensitivity was best for pulse rates near 80-160 pulses per second (pps) and degraded for both lower and higher pulse rates. The degradation in ITD sensitivity at low pulse rates was caused by strong, unsynchronized background activity that masked stimulus-driven responses in many neurons. Selecting synchronized responses by temporal windowing revealed ITD sensitivity in these neurons. With temporal windowing, both the fraction of ITD-sensitive neurons and the degree of ITD sensitivity decreased monotonically with increasing pulse rate. To compare neural ITD sensitivity to human performance in ITD discrimination, neural just-noticeable differences (JNDs) in ITD were computed using signal detection theory. Using temporal windowing at lower pulse rates, and overall firing rate at higher pulse rates, neural ITD JNDs were within the range of perceptual JNDs in human CI users over a wide range of pulse rates.

SIGNIFICANCE STATEMENT

Many profoundly deaf people wearing cochlear implants (CIs) still face challenges in everyday situations, such as understanding conversations in noise. Even with CIs in both ears, they have difficulty making full use of subtle differences in the sounds reaching the two ears [interaural time difference (ITD)] to identify where the sound is coming from. This problem is especially acute at the high stimulation rates used in clinical CI processors. This study provides a better understanding of ITD processing with bilateral CIs and shows a parallel between human performance in ITD discrimination and neural responses in the auditory midbrain. The present study is the first report on binaural properties of auditory neurons with CIs in unanesthetized animals.

Representations of Time-Varying Cochlear Implant Stimulation in Auditory Cortex of Awake Marmosets (Callithrix jacchus)

Electrical stimulation of the auditory periphery organ by cochlear implant (CI) generates highly synchronized inputs to the auditory system. It has long been thought such inputs would lead to highly synchronized neural firing along the ascending auditory pathway. However, neurophysiological studies with hearing animals have shown that the central auditory system progressively converts temporal representations of time-varying sounds to firing rate-based representations. It is not clear whether this coding principle also applies to highly synchronized CI inputs. Higher-frequency modulations in CI stimulation have been found to evoke largely transient responses with little sustained firing in previous studies of the primary auditory cortex (A1) in anesthetized animals. Here, we show that, in addition to neurons displaying synchronized firing to CI stimuli, a large population of A1 neurons in awake marmosets (Callithrix jacchus) responded to rapid time-varying CI stimulation with discharges that were not synchronized to CI stimuli, yet reflected changing repetition frequency by increased firing rate. Marmosets of both sexes were included in this study. By comparing directly each neuron's responses to time-varying acoustic and CI signals, we found that individual A1 neurons encode both modalities with similar firing patterns (stimulus-synchronized or nonsynchronized). These findings suggest that A1 neurons use the same basic coding schemes to represent time-varying acoustic or CI stimulation and provide new insights into mechanisms underlying how the brain processes natural sounds via a CI device.SIGNIFICANCE STATEMENT In modern cochlear implant (CI) processors, the temporal information in speech or environmental sounds is delivered through modulated electric pulse trains. How the auditory cortex represents temporally modulated CI stimulation across multiple time scales has remained largely unclear. In this study, we compared directly neuronal responses in primary auditory cortex (A1) to time-varying acoustic and CI signals in awake marmoset monkeys (Callithrix jacchus). We found that A1 neurons encode both modalities using similar coding schemes, but some important differences were identified. Our results provide insights into mechanisms underlying how the brain processes sounds via a CI device and suggest a candidate neural code underlying rate-pitch perception limitations often observed in CI users.

Temporal Regularity Detection and Rate Discrimination in Cochlear-Implant Listeners

Cochlear implants (CIs) convey fundamental-frequency information using primarily temporal cues. However, temporal pitch perception in CI users is weak and, when measured using rate discrimination tasks, deteriorates markedly as the rate increases beyond 300 pulses-per-second. Rate pitch may be weak because the electrical stimulation of the surviving neural population of the implant recipient may not allow accurate coding of inter-pulse time intervals. If so, this phenomenon should prevent listeners from detecting when a pulse train is physically temporally jittered. Performance in a jitter detection task was compared to that in a rate-pitch discrimination task. Stimuli were delivered using direct stimulation in cochlear implants, on a mid-array and an apical electrode, and at two different rates (100 and 300 pps). Average performance on both tasks was worse at the higher pulse rate and did not depend on electrode. However, there was a large variability across and within listeners that did not correlate between the two tasks, suggesting that rate-pitch judgement and regularity detection are to some extent limited by task-specific processes. Simulations with filtered pulse trains presented to NH listeners yielded broadly similar results, except that, for the rate discrimination task, the difference between performance with 100- and 300-pps base rates was smaller than observed for CI users.

Sequential stream segregation in normally-hearing and cochlear-implant listeners

Sequential stream segregation by normal hearing (NH) and cochlear implant (CI) listeners was investigated using an irregular rhythm detection (IRD) task. Pure tones and narrowband noises of different bandwidths were presented monaurally to older and younger NH listeners via headphones. For CI users, stimuli were delivered as pure tones via soundfield and via direct electrical stimulation. Results confirmed that tonal pitch is not essential for stream segregation by NH listeners and that aging does not reduce NH listeners' stream segregation. CI listeners' stream segregation was significantly poorer than NH listeners' with pure tone stimuli. With direct stimulation, however, CI listeners showed significantly stronger stream segregation, with a mean normalized pattern similar to NH listeners, implying that the CI speech processors possibly degraded acoustic cues. CI listeners' performance on an electrode discrimination task indicated that cues that are salient enough to make two electrodes highly discriminable may not be sufficiently salient for stream segregation, and that gap detection/discrimination, which must depend on perceptual electrode differences, did not play a role in the IRD task. Although the IRD task does not encompass all aspects of full stream segregation, these results suggest that some CI listeners may demonstrate aspects of stream segregation.

Clinically Paired Electrodes Are Often Not Perceived as Pitch Matched

For bilateral cochlear implant (CI) patients, electrodes that receive the same frequency allocation often stimulate locations in the left and right ear that do not yield the same perceived pitch, resulting in a pitch mismatch. This pitch mismatch may be related to degraded binaural abilities. Pitch mismatches have been found for some bilateral CI users and the goal of this study was to determine whether pitch mismatches are prevalent in bilateral CI patients, including those with extensive experience with bilateral CIs. To investigate this possibility, pitch matching was conducted with 16 bilateral CI patients. For 14 of the 16 participants, there was a significant difference between those electrodes in the left and right ear that yielded the same pitch and those that received the same frequency allocation in the participant’s clinical map. The results suggest that pitch mismatches are prevalent with bilateral CI users. The results also indicated that pitch mismatches persist even with extended bilateral CI experience. Such mismatches may reduce the benefits patients receive from bilateral CIs.

Rate discrimination, gap detection and ranking of temporal pitch in cochlear implant users

Cochlear implant (CI) users have poor temporal pitch perception, as revealed by two key outcomes of rate discrimination tests: (i) rate discrimination thresholds (RDTs) are typically larger than the corresponding frequency difference limen for pure tones in normal hearing listeners, and (ii) above a few hundred pulses per second (i.e. the "upper limit" of pitch), CI users cannot discriminate further increases in pulse rate. Both RDTs at low rates and the upper limit of pitch vary across listeners and across electrodes in a given listener. Here, we compare across-electrode and across-subject variation in these two measures with the variation in performance on another temporal processing task, gap detection, in order to explore the limitations of temporal processing in CI users. RDTs were obtained for 4-5 electrodes in each of 10 Advanced Bionics CI users using two interleaved adaptive tracks, corresponding to standard rates of 100 and 400 pps. Gap detection was measured using the adaptive procedure and stimuli described by Bierer et al. (JARO 16:273-284, 2015), and for the same electrodes and listeners as for the rate discrimination measures. Pitch ranking was also performed using a mid-point comparison technique. There was a marginal across-electrode correlation between gap detection and rate discrimination at 400 pps, but neither measure correlated with rate discrimination at 100 pps. Similarly, there was a highly significant across-subject correlation between gap detection and rate discrimination at 400, but not 100 pps, and these two correlations differed significantly from each other. Estimates of low-rate sensitivity and of the upper limit of pitch, obtained from the pitch ranking experiment, correlated well with rate discrimination for the 100- and 400-pps standards, respectively. The results are consistent with the upper limit of rate discrimination sharing a common basis with gap detection. There was no evidence that this limitation also applied to rate discrimination at lower rates.

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.

Sensitivity to Envelope Interaural Time Differences at High Modulation Rates

Sensitivity to interaural time differences (ITDs) conveyed in the temporal fine structure of low-frequency tones and the modulated envelopes of high-frequency sounds are considered comparable, particularly for envelopes shaped to transmit similar fidelity of temporal information normally present for low-frequency sounds. Nevertheless, discrimination performance for envelope modulation rates above a few hundred Hertz is reported to be poor-to the point of discrimination thresholds being unattainable-compared with the much higher (>1,000 Hz) limit for low-frequency ITD sensitivity, suggesting the presence of a low-pass filter in the envelope domain. Further, performance for identical modulation rates appears to decline with increasing carrier frequency, supporting the view that the low-pass characteristics observed for envelope ITD processing is carrier-frequency dependent. Here, we assessed listeners' sensitivity to ITDs conveyed in pure tones and in the modulated envelopes of high-frequency tones. ITD discrimination for the modulated high-frequency tones was measured as a function of both modulation rate and carrier frequency. Some well-trained listeners appear able to discriminate ITDs extremely well, even at modulation rates well beyond 500 Hz, for 4-kHz carriers. For one listener, thresholds were even obtained for a modulation rate of 800 Hz. The highest modulation rate for which thresholds could be obtained declined with increasing carrier frequency for all listeners. At 10 kHz, the highest modulation rate at which thresholds could be obtained was 600 Hz. The upper limit of sensitivity to ITDs conveyed in the envelope of high-frequency modulated sounds appears to be higher than previously considered.

Revisiting Place-Pitch Match in CI Recipients Using 3D Imaging Analysis

Objective:

To improve the estimation of the perceived pitch in a single-sided deaf cochlear implant (CI) listener by using accurate 3-dimensional (3D) image analysis of the cochlear electrode positions together with the predicted tonotopical function for humans.

Methods:

An SSD CI user underwent a Cone-Beam computed tomography (CBCT) scan. Electrode contacts were marked in 3D space in relation to the nearest point on the cochlear lateral wall. Distance to the base of the lateral wall was calculated and plotted against the place-pitch function for humans. An adaptive procedure was used to elicit the perceived pitch of electrically evoked stimulation by matching it with a contralateral acoustic pitch.

Results:

The electrically evoked pitch percept matched well with the calculated frequency. The median mismatch in octaves was 0.12 for our method in comparison to 0.69 using the conventional Stenvers view.

Conclusion:

A method of improved image analysis is described that can be used to predict the pitch percept on corresponding cochlear electrode positions. This method shows the potential of 3D imaging in CI fitting optimization.

Combined neural and behavioural measures of temporal pitch perception in cochlear implant users

Four experiments measured the perceptual and neural correlates of the temporal pattern of electrical stimulation applied to one cochlear-implant (CI) electrode, for several subjects. Neural effects were estimated from the electrically evoked compound action potential (ECAP) to each pulse. Experiment 1 attenuated every second pulse of a 200-pps pulse train. Increasing attenuation caused pitch to drop and the ECAP to become amplitude modulated, thereby providing an estimate of the relationship between neural modulation and pitch. Experiment 2 showed that the pitch of a 200-pps pulse train can be reduced by delaying every second pulse, so that the inter-pulse-intervals alternate between longer and shorter intervals. This caused the ECAP to become amplitude modulated, but not by enough to account for the change in pitch. Experiment 3 replicated the finding that rate discrimination deteriorates with increases in baseline rate. This was accompanied by an increase in ECAP modulation, but by an amount that produced only a small effect on pitch in experiment 1. Experiment 4 showed that preceding a pulse train with a carefully selected "pre-pulse" could reduce ECAP modulation, but did not improve rate discrimination. Implications for theories of pitch and for limitations of pitch perception in CI users are discussed.

Design and evaluation of a cochlear implant strategy based on a "Phantom" channel

Unbalanced bipolar stimulation, delivered using charge balanced pulses, was used to produce "Phantom stimulation", stimulation beyond the most apical contact of a cochlear implant's electrode array. The Phantom channel was allocated audio frequencies below 300 Hz in a speech coding strategy, conveying energy some two octaves lower than the clinical strategy and hence delivering the fundamental frequency of speech and of many musical tones. A group of 12 Advanced Bionics cochlear implant recipients took part in a chronic study investigating the fitting of the Phantom strategy and speech and music perception when using Phantom. The evaluation of speech in noise was performed immediately after fitting Phantom for the first time (Session 1) and after one month of take-home experience (Session 2). A repeated measures of analysis of variance (ANOVA) within factors strategy (Clinical, Phantom) and interaction time (Session 1, Session 2) revealed a significant effect for the interaction time and strategy. Phantom obtained a significant improvement in speech intelligibility after one month of use. Furthermore, a trend towards a better performance with Phantom (48%) with respect to F120 (37%) after 1 month of use failed to reach significance after type 1 error correction. Questionnaire results show a preference for Phantom when listening to music, likely driven by an improved balance between high and low frequencies.

Stimulating on multiple electrodes can improve temporal pitch perception

OBJECTIVE

The objective of this study was to test if stimulating multiple electrodes can improve temporal pitch ranking performance at low and high stimulation rates.

DESIGN

Temporal pitch cues are usually based on modifying the stimulation rate of the implant and thereby provide a continuum of pitches on a single electrode up to approximately 300 Hz.

STUDY SAMPLE

Ten cochlear implant subjects were asked to pitch rank stimuli presented with direct electrical stimulation. The pulses were applied on one, three, six, or eleven electrodes. In one of the conditions the current amplitude of each pulse was randomly varied between 0 and 100%. Their frequency ranged from 100 up to 500 pps.

RESULTS

Listeners showed the previously reported performance pattern in most conditions with very good performance at the lowest standard rates and deteriorating performance to near chance level at the highest rate tested. Performance with eleven electrodes was significantly better than performance with one electrode at 500 pps.

CONCLUSION

Stimulating on multiple electrodes can improve temporal pitch perception.

Re-examining the upper limit of temporal pitch

Five normally hearing listeners pitch-ranked harmonic complexes of different fundamental frequencies (F0s) filtered in three different frequency regions. Harmonics were summed either in sine, alternating sine-cosine (ALT), or pulse-spreading (PSHC) phase. The envelopes of ALT and PSHC complexes repeated at rates of 2F0 and 4F0. Pitch corresponded to those rates at low F0s, but, as F0 increased, there was a range of F0s over which pitch remained constant or dropped. Gammatone-filterbank simulations showed that, as F0 increased and the number of harmonics interacting in a filter dropped, the output of that filter switched from repeating at 2F0 or 4F0 to repeating at F0. A model incorporating this phenomenon accounted well for the data, except for complexes filtered into the highest frequency region (7800-10 800 Hz). To account for the data in that region it was necessary to assume either that auditory filters at very high frequencies are sharper than traditionally believed, and/or that the auditory system applies smaller weights to filters whose outputs repeat at high rates. The results also provide evidence on the highest pitch that can be derived from purely temporal cues, and corroborate recent reports that a complex pitch can be derived from very-high-frequency resolved harmonics.

Deficits in the pitch sensitivity of cochlear-implanted children speaking English or Mandarin

Sensitivity to complex pitch is notoriously poor in adults with cochlear implants (CIs), but it is unclear whether this is true for children with CIs. Many are implanted today at a very young age, and factors related to brain plasticity (age at implantation, duration of CI experience, and speaking a tonal language) might have strong influences on pitch sensitivity. School-aged children participated, speaking English or Mandarin, having normal hearing (NH) or wearing a CI, using their clinically assigned settings with envelope-based coding strategies. Percent correct was measured in three-interval three-alternative forced choice tasks, for the discrimination of fundamental frequency (F0) of broadband harmonic complexes, and for the discrimination of sinusoidal amplitude modulation rate (AMR) of broadband noise, with reference frequencies at 100 and 200 Hz to focus on voice pitch processing. Data were fitted using a maximum-likelihood technique. CI children displayed higher thresholds and shallower slopes than NH children in F0 discrimination, regardless of linguistic background. Thresholds and slopes were more similar between NH and CI children in AMR discrimination. Once the effect of chronological age was extracted from the variance, the aforementioned factors related to brain plasticity did not contribute significantly to the CI children's sensitivity to pitch. Unless different strategies attempt to encode fine structure information, potential benefits of plasticity may be missed.