Psychophysical studies for two multiple-channel cochlear implant patients

Pitch estimation by early-deafened subjects using a multiple-electrode cochlear implant

Numerical estimates of pitch for stimulation of electrodes along the 22-electrode array of the Cochlear Limited cochlear implant were obtained from 18 subjects who became deaf very early in life. Examined were the relationships between subject differences in pitch estimation, subject variables related to auditory deprivation and experience, and speech-perception scores for closed-set monosyllabic words and open-set Bamford-Kowal-Bench (BKB) sentences. Reliability in the estimation procedure was examined by comparing subject performance in pitch estimation with that for loudness estimation for current levels between hearing threshold and comfortable listening level. For 56% of subjects, a tonotopic order of pitch percepts for electrodes on the array was found. A deviant but reliable order of pitch percepts was found for 22% of subjects, and essentially no pitch order was found for the remaining 22% of subjects. Subject differences in pitch estimation were significantly related to the duration of auditory deprivation prior to implantation, with the poorest performance for subjects who had a longer duration of deafness and a later age at implantation. Subjects with no tonotopic order of pitch percepts had the lowest scores for the BKB sentence test, but there were no differences across subjects for monosyllabic words. Performance in pitch estimation for electrodes did not appear to be related to performance in the estimation procedure, as all subjects were successful in loudness estimation for current level.

Across-species comparisons of psychophysical detection thresholds for electrical stimulation of the cochlea: I. Sinusoidal stimuli

Several species have been, and continue to be, used as subjects in studies of electrical stimulation of the cochlea. Few attempts, however, have been made to determine if data obtained from different species are quantitatively or qualitatively similar. The present work compares psychophysical absolute detection threshold vs. frequency functions for sinusoidal stimuli obtained from humans, nonhuman primates, cats, and guinea pigs. Threshold data for monopolar and bipolar electrode configurations from both previously published and unpublished studies are compared. In general, within all four species, significant intersubject variation in detection threshold level was found, but slopes of threshold vs. frequency functions were relatively well conserved within a species, under the conditions studied. With one exception (cat bipolar stimulation), threshold functions reached a minimum at or near 100 Hz across species and electrode configurations. In all cases, thresholds were significantly lower for monopolar, as compared with bipolar, configurations. Statistically, there were no significant differences in absolute threshold level across species. Threshold levels increased with frequency above 100 Hz at a rate of 3.0-7.9 dB/octave, depending on both electrode configuration and species. Slopes were steeper for monopolar than for bipolar configurations. When slopes were averaged between 200 and 2000 Hz, no statistically significant differences in overall slopes were found, nor was there a significant interaction between electrode configuration and species. There were, however, consistent species differences within more restricted regions of the function. Human functions for both monopolar and bipolar stimulation were steeper than all animal functions in the range of 100-300 Hz. Within this range, the differences between slopes for human and nonhuman subjects were statistically significant. In addition, differences were noted in the frequency at which slope decreased, with slopes for nonhuman subjects showing the decrease at higher frequencies than did those for human subjects. These differences may be true species differences, or may reflect the influence of confounding variables associated with each experimental-subject model.

Clinical findings for a group of infants and young children with auditory neuropathy

OBJECTIVE

To examine the prevalence of auditory neuropathy in a group of infants at risk for hearing impairment and to present an overview of the clinical findings for affected children.

DESIGN

Results for 20 subjects who showed repeatable cochlear microphonic potentials in the absence of click-evoked auditory brain stem responses are included in this study. Behavioral and steady state evoked potential thresholds were established in each case. Where possible, otoacoustic emission and speech perception results (unaided and aided) also were obtained.

RESULTS

One in 433 (0.23%) of the children in our series had evidence of auditory neuropathy. The audiometric findings for these subjects varied significantly, with behavioral thresholds ranging from normal to profound levels. Discrimination skills were also variable. Approximately half of the subjects showed little understanding, or even awareness, of speech inputs in both the unaided and aided conditions. There were, however, a number of children who could score at significant levels on speech discrimination tasks and who benefited from the provision of amplification.

CONCLUSION

The results suggest that auditory neuropathy is more common in the infant population than previously suspected. The effects of neuropathy on auditory function appear to be idiosyncratic, producing significant variations in both the detection and discrimination of auditory signals. As such, the management of children with this disorder must allow for individual differences.

The nerve-electrode interface of the cochlear implant: current spread

One of the fundamental facets of the cochlear implant that must be understood to predict accurately the effect of an electrical stimulus on the auditory nerve is the nerve-electrode interface. One aspect of this interface is the degree to which current delivered by an electrode spreads to neurons distant from it. This paper reports a direct mapping of this current spread using recordings from single units from the cat auditory nerve. Large variations were seen in the degree to which the different units are selective in responding to electrodes at different positions within the scala tympani. Three types of units could be identified based on the selectiveness of their response to the different electrodes in a linear array. The first type of unit exhibited a gradual increase in threshold as the stimulating site was moved from more apical to more basal locations within the scala tympani. The second type of unit exhibited a sharp local minimum, with rapid increases in threshold in excess of 6 dB/mm in the vicinity of the minimum. At electrode sites distant from the local minima the rate of change of the threshold approached that of the first type of units. The final type of unit also demonstrated a gradual change in threshold with changing electrode position, however, two local minima, one apical and one basal, could be identified. These three types are hypothesized to correspond to units which originate apical to the electrode array, along the electrode array and basal to the electrode array.

Studies of prosody perception by cochlear implant patients

Prosodic information is conveyed to normally-hearing listeners by variations in acoustic fundamental frequency, amplitude envelope, and duration of speech segments. This study measured cochlear implant patients' sensitivity to these parameters in electrically coded speech. The psychophysical discrimination of electric parameters used to code prosodic information, were examined, together with prosody perception using speech processing strategies which modified the contributions of these parameters. Patients were implanted with the Cochlear Limited prosthesis and used the MPEAK speech processing strategy. In the psychophysical studies, difference limens were measured for steady-state and time-varying stimuli, of different pulse rates and pulse durations, over a series of different stimulus durations. These limens were obtained using an adaptive procedure which converged on the 50 per cent correct point. In the prosody perception studies, performance was measured for the MPEAK strategy and for strategies which modified the contributions of pulse rate and pulse duration. Data were collected for five tests of prosodic contrasts. Difference limens for steady-state pulse rates were larger at higher rates (17 per cent at 400 pulses/s) than at lower rates (6 per cent at 100 pulses/s). For some patients, limens for the time-varying pulse rates were larger than those for the steady-state pulse rates while for the other patients, the limens were similar. Difference limens for pulse duration were 0.3 dB, corresponding to 4 per cent of the dynamic range, for steady-state stimuli and doubled in size for the time-varying stimuli. Prosody perception performance was generally poorer for the modified strategies than for the MPEAK strategy, suggesting that the removal of information coded by pulse rate and pulse duration reduced the perception of prosodic contrasts.

Research advances for cochlear implants

Considerable progress has been made with speech processing for multiple-channel cochlear implants, with a mean open-set CNC word score of 40% for electrical stimulation alone for the Nucleus SPEAK strategy. Further advances should be achieved through the following: beam-forming dual microphone systems for hearing in noise; better reproduction of the coding of sound frequencies; and taking advantage of plasticity in the central auditory pathways in young children. The reproduction of frequency coding will be facilitated with speech processors such as the Nucleus 24 system which can provide higher stimulus rates, and a new generation of electrode arrays where a greater number of electrodes lie close to the spiral ganglion cells.

Electrode discrimination and speech recognition in postlingually deafened adult cochlear implant subjects

This study investigated the relationship between electrode discrimination and speech recognition in 11 postlingually deafened adult cochlear implant subjects who were implanted with the Nucleus/Cochlear Corporation multichannel device. The discriminability of each electrode included in a subject's clinical map was measured using adaptive and fixed-level discrimination tasks. Considerable variability in electrode discriminability was observed across subjects. Two subjects could discriminate all electrodes, and discrimination performance by the remaining nine subjects varied from near perfect to very poor. In these nine subjects, the results obtained from the discrimination tasks were used to create a map that contained only discriminable electrodes, and subjects' performance on speech recognition tasks using this experimental map was measured. Four different speech recognition tests were administered: a nine-choice closed-set medial vowel recognition task, a 14-choice closed-set medial consonant recognition task, the NU6 Monosyllabic Words Test [T. W. Tillman and T. Carhart, Tech. Rep. No. SAM-TR-66-55, USAF School of Aerospace Medicine, Brooks Air Force Base, Texas (1966)] scored for both words and phonemes correct, and the Central Institute for the Deaf (CID) Everyday Sentences test [H. Davis and S. R. Silverman, Hearing and Deafness (Holt, Rinehart, and Winston, New York, 1978)]. Seven of the nine subjects tested with the experimental map showed significant improvement on at least one speech recognition measure, even though the experimental map contained fewer electrodes than the original map. Three subjects' scores improved significantly on the CID Everyday Sentences test, three subjects' scores improved significantly on the NU6 Monosyllabic Words test, and five subjects' scores improved significantly on the NU6 Monosyllabic Words test scored for phonemes correct. None of the subjects' scores improved significantly on either the vowel or consonant tests. No significant correlation was observed between electrode discrimination ability and speech recognition scores or between electrode discrimination ability and improvement in speech recognition scores when programmed with the experimental map. The results of this study suggest that electrode discrimination tasks may be used to improve speech recognition of some cochlear implant subjects, and that each electrode site does not necessarily provide perceptually distinct information.

Discrimination of temporal asymmetry in cochlear implantees

Several studies have recently demonstrated that normal-hearing listeners are sensitive to short-term temporal asymmetry in the envelopes of sinusoidal or noise carriers. This paper presents a study in which cochlear implantees were presented trains of current pulses with temporally asymmetric envelopes through one channel of an implant that stimulates the auditory nerve directly, thereby bypassing cochlear processes. When the level of the stimuli was adjusted to fit their audibility range, the implantees were able to discriminate temporal asymmetry over a much wider range than normal-hearing listeners. The results suggest that the perception of temporal asymmetry is limited by compression in the normal cochlea.

Multi-unit mapping of acoustic stimuli in gerbil inferior colliculus

Multi-unit peristimulus time (MU-PST) histograms were recorded in the gerbil inferior colliculus (IC) in response to tone burst stimuli. Histograms were collected every 100 microns as the recording electrode was advanced along the tonotopic axis of the central nucleus of the IC. Space/time maps of neural activity were constructed from these data. In most of our sample the pattern of response changed systematically as the stimulating frequency was increased in octave steps. At low frequencies (< 500 Hz) the pattern of response was broadly distributed spatially and phase-locked to the stimulus frequency. At higher frequencies (> 1 kHz) the pattern of response was more localized and showed no evidence of phase locking. The location of the maximum response to tones from 1 to 32 kHz moved ventrally along the tonotopic axis at an approximate rate of 230 microns/stimulus octave. The patterns of response were localized near stimulus threshold and spread over a larger region as level increased. This method of collecting and displaying multi-unit response maps provides an overview of ensemble activity that allows concurrent observation of spatial and temporal variations in activity patterns. The quantitative analysis of components of MU-PST Maps are consistent with trends illustrated with single-unit tuning and level functions. This perspective of IC activity suggests potential processing mechanisms that are congruent with single-unit reconstructions.

Electrical stimulation of the auditory nerve. I. Correlation of physiological responses with cochlear status

The purpose of the present study was to evaluate evoked potential and single fibre responses to biphasic current pulses in animals with varying degrees of cochlear pathology, and to correlate any differences in the physiological response with status of the auditory nerve. Six cats, whose cochleae ranged from normal to a severe neural loss (< 5% spiral ganglion survival), were used. Morphology of the electrically evoked auditory brainstem response (EABR) was similar across all animals, although electrophonic responses were only observed from the normal animal. In animals with extensive neural pathology, EABR thresholds were elevated and response amplitudes throughout the dynamic range were moderately reduced. Analysis of single VIIIth nerve fibre responses were based on 207 neurons. Spontaneous discharge rates among fibres depended on hearing status, with the majority of fibres recorded from deafened animals exhibiting little or no spontaneous activity. Electrical stimulation produced a monotonic increase in discharge rate, and a systematic reduction in response latency and temporal jitter as a function of stimulus intensity for all fibres examined. Short-duration current pulses elicited a highly synchronous response (latency < 0.7 ms), with a less well synchronized response sometimes present (0.7-1.1 ms). There were, however, a number of significant differences between responses from normal and deafened cochleae. Electrophonic activity was only present in recordings from the normal animal, while mean threshold, dynamic range and latency of the direct electrical response varied with cochlear pathology. Differences in the ability of fibres to follow high stimulation rates were also observed; while neurons from the normal cochlea were capable of 100% entrainment at high rates (600-800 pulses per second (pps)), fibres recorded from deafened animals were often not capable of such entrainment at rates above 400 pps. Finally, a number of fibres in deafened animals showed evidence of 'bursting', in which responses rapidly alternated between high entrainment and periods of complete inactivity. This bursting pattern was presumably associated with degenerating auditory nerve fibres, since it was not recorded from the normal animal. The present study has shown that the pathological response of the cochlea following a sensorineural hearing loss can lead to a number of significant changes in the patterns of neural activity evoked via electrical stimulation. Knowledge of the extent of these changes have important implications for the clinical application of cochlear implants.

Comparison of electrode discrimination, pitch ranking, and pitch scaling data in postlingually deafened adult cochlear implant subjects

The goal of this study was to investigate the relationship between variation in electrode site of stimulation and the perceptual dimensions along which such stimuli vary. This information may allow more effective use of electrode place when encoding speech information. To achieve this goal, two procedures which measure pitch in subjects implanted with the Nucleus/Cochlear Corporation multichannel device were performed. Estimates of electrode discriminability that can be obtained from these procedures were compared to a more direct measure of electrode discriminability that was obtained in a previous study [Collins et al., Assoc. Res. Otolaryng. Abstracts, No. 642 (1994)]. In the first task, subjects performed a pitch ranking procedure similar to that used in previous studies [Townshend et al., J. Acoust. Soc. Am. 82, 106-115 (1987); Nelson et al., J. Acoust. Soc. Am. 98, 1987-1999 (1995)]. Estimates of the pitch percept elicited by stimulation of each electrode as well as the discriminability of the electrodes were generated from the data using two different statistical analyses. In the second task, subjects performed a pitch scaling procedure similar to one used in a previous study [Busby et al., J. Acoust. Soc. Am. 95, 2658-2669 (1994)]. Again, two different statistical analyses were performed to generate estimates of the pitch percept corresponding to stimulation of each electrode and to generate estimates of electrode discriminability. In general, the estimates of the relationships between the pitch percepts obtained from the two procedures were not identical. In addition, the estimates of electrode discriminability were not equivalent to the electrode discrimination measures obtained from the same subjects during the previous study. Signal detection theory has been used to model the decision processes required by each of the procedures described above [e.g., Jesteadt and Bilger, J. Acoust. Soc. Am. 55, 1266-1276 (1974)]. However, these models do not predict the differences that were observed between the data sets obtained during this study. An alternate model is proposed which may explain the data obtained from these subjects. This model is based on the assumption that the percept that is elicited by electrical stimulation of an electrode is multidimensional, as opposed to unidimensional in nature. Therefore, the perceived signal is more appropriately modeled using a multidimensional random vector, where each element of the vector represents the perceived value of one of the dimensions of the signal.

Pitch comparisons of acoustically and electrically evoked auditory sensations

Cochlear implant users with some residual hearing in the non-implanted ear compared the pitch sensations produced by acoustic pure tones and pulsatile electric stimuli. Pitch comparisons were obtained for pure tones and electrical stimuli presented at different positions (electrodes) in the scala tympani, keeping the electric pulse rate fixed at 100, 250, or 800 pps. Similarly, pitch comparisons were obtained for electrical stimuli with variable pulse rates presented to two fixed electrode positions (apical and basal) in the cochlea. Both electrode position and pulse rate influenced the perceived pitch of the electrical signal and 'matched' electric and acoustic signals were found over a wide range of frequencies. There was a large variation between listeners. For some stimuli, listeners had difficulty in deciding whether the acoustic or electric stimulus was higher in pitch. Despite the variability, consistent trends were obtained from the data: higher frequencies tended to be matched by more basal electrodes for all pulse rates. Higher frequencies tended to be matched by higher pulse rates for both electrode positions. The electrode positions that 'matched' pure tones were more basal than predicted from the characteristic frequency coordinates of the basilar membrane in a normal human cochlea.

Electrical stimulation of the auditory nerve: the coding of frequency, the perception of pitch and the development of cochlear implant speech processing strategies for profoundly deaf people

1. The development of speech processing strategies for multiple-channel cochlear implants has depended on encoding sound frequencies and intensities as temporal and spatial patterns of electrical stimulation of the auditory nerve fibres so that speech information of most importance of intelligibility could be transmitted. 2. Initial physiological studies showed that rate encoding of electrical stimulation above 200 pulses/s could not reproduce the normal response patterns in auditory neurons for acoustic stimulation in the speech frequency range above 200 Hz and suggested that place coding was appropriate for the higher frequencies. 3. Rate difference limens in the experimental animal were only similar to those for sound up to 200 Hz. 4. Rate difference limens in implant patients were similar to those obtained in the experimental animal. 5. Satisfactory rate discrimination could be made for durations of 50 and 100 ms, but not 25 ms. This made rate suitable for encoding longer duration suprasegmental speech information, but not segmental information, such as consonants. The rate of stimulation could also be perceived as pitch, discriminated at different electrode sites along the cochlea and discriminated for stimuli across electrodes. 6. Place pitch could be scaled according to the site of stimulation in the cochlea so that a frequency scale was preserved and it also had a different quality from rate pitch and was described as tonality. Place pitch could also be discriminated for the shorter durations (25 ms) required for identifying consonants. 7. The inaugural speech processing strategy encoded the second formant frequencies (concentrations of frequency energy in the mid frequency range of most importance for speech intelligibility) as place of stimulation, the voicing frequency as rate of stimulation and the intensity as current level. Our further speech processing strategies have extracted additional frequency information and coded this as place of stimulation. The most recent development, however, presents temporal frequency information as amplitude variations at a constant rate of stimulation. 8. As additional speech frequencies have been encoded as place of stimulation, the mean speech perception scores have continued to increase and are now better than the average scores that severely-profoundly deaf adults and children with some residual hearing obtain with a hearing aid.

Electrode discrimination by early-deafened cochlear implant patients

Electrode discrimination was measured in six cochlear-implant patients who became profoundly deaf prior to the full development of auditory and speech skills. The cochlear implant manufactured by Cochlear Limited was used. Comparisons were made between two electric stimulation paradigms and two data collection procedures. The paradigms consisted of electrode trajectories and electrodes with random variation in electric current levels. The data collection methods consisted of an adaptive procedure to obtain difference limens and a method of constant stimuli that gives psychometric functions of discrimination performance. Data were collected for reference electrodes at the apical, mid, and basal positions on the array. The psychometric functions showed that discrimination performance improved with increases in the spatial separation between reference and comparison electrodes. The difference limens were similar to the corresponding spatial separation estimated from the psychometric function in most cases. The discrimination performance of most patients was consistent across the two stimulation paradigms. Difference limens were 1-4 electrodes from the reference electrode for most patients. There were differences in performance across patients and the three positions on the array.

Electrical stimulation of the auditory nerve: the effect of electrode position on neural excitation

Histological studies have shown that the Melbourne/Cochlear electrode array lies along the outer wall of the scala tympani and is therefore some distance from the residual VIIIth nerve elements. In order to investigate the influence of electrode position on neural excitation we systematically varied the position of the electrode array within the cat scala tympani while recording electrically evoked auditory brainstem responses (EABRs). Using both normal hearing and long-term deafened animals, we observed significant reductions in EABR thresholds as the electrode array was moved from the outer wall towards the modiolus. Further threshold reductions were observed when the array was placed underneath the osseous spiral lamina (OSL) close to the peripheral dendrites. These changes were independent of the bipolar inter-electrode separation, and were observed over a wide range of cochlear pathologies varying from normal to a moderate spiral ganglion cell loss. Interestingly, the one animal exhibiting extensive neural loss showed no correlation between EABR threshold and electrode position. There was also a general decrease in the gradient of the EABR input-output function as the electrode array was moved closer to the neural elements. This was, however, only statistically significant when the electrode was positioned adjacent to the peripheral dendrites. Significant reductions in EABR threshold were also observed as the inter-electrode spacing of the bipolar electrodes was increased. The gradient of the EABR input-output function also increased with increasing inter-electrode spacing, although again, this was only significant when the electrode array was positioned close to the neural elements. The present results indicate that the optimum placement of a Melbourne/Cochlear electrode array is adjacent to the peripheral dendrites. However, such a site would be difficult to achieve in practice while minimizing insertion trauma. An array lying adjacent to the modiolus would be a safe alternative while ensuring a significant reduction in threshold compared with the existing site (outer wall). This placement should result in more localized neural excitation patterns, an increase in the number of bipolar electrodes available, together with an increase in their dynamic range. These changes may lead to further improvements in speech perception among cochlear implant patients.

Cochleotopic selectivity of a multichannel scala tympani electrode array using the 2-deoxyglucose technique

The 2-deoxyglucose (2-DG) technique was used to study the cochleotopic selectivity of a multichannel scala tympani electrode array in four cats with another acting as an unstimulated control. Each animal was unilaterally deafened and a multichannel electrode array inserted 6 mm into the scala tympani. Thresholds to electrical stimulation were determined by recording electrically evoked auditory brainstem responses (EABRs). Each animal was injected with 2-DG, and electrically stimulated using bipolar electrodes located either distal or proximal to the round window. The contralateral ear was stimulated with acoustic tone pips at frequencies that matched the electrode place. Stimulation of both distal and proximal bipolar electrodes at 3 x EABR threshold, evoked localized 2-DG labelling in both ipsilateral cochlear nucleus (CN) and the contralateral inferior colliculus (IC), which was very similar in orientation and breadth to labelling evoked by the contralateral tone pips. The cochleotopic position of labelling to proximal stimulation was located in the 24-26 kHz region of each structure, whereas the distal labelling was located around 12 kHz. Distal stimulation at 10 x EABR threshold produced very broad 2-DG labelling in IC centered around the 12 kHz place. The present 2-DG results clearly illustrate cochleotopic selectivity using multichannel bipolar scala tympani electrodes. The extent of this selectivity is dependent on electrical stimulus levels. The 2-DG technique has great potential in evaluating the efficacy of new electrode array designs.

Phase-locking of auditory-nerve discharges to sinusoidal electric stimulation of the cochlea

The activity of auditory-nerve fibers was recorded in anesthetized cats in response to sinusoidal electric stimuli applied through a bipolar electrode pair inserted about 5 mm into the cochlea through the round window. The synchronization index was calculated from period histograms for frequencies ranging from 0.2 to over 10 kHz. The stimulus artifact was largely eliminated through the use of differential micropipettes and an adaptive digital filter. Measured synchronization indices were many times larger than the indices that could be attributed to the residual stimulus artifact. Synchronization indices at each stimulus frequency varied considerably from fiber to fiber, even in the same animal. The dependence of synchrony on stimulus frequency was also variable, decreasing monotonically in some fibers and nonmonotonically in others. The average electric synchronization index for all fibers did not fall as steeply with frequency as does the average synchrony for acoustic stimuli. The finding of significant phase locking to electric stimuli well above 1 kHz suggests that the poor frequency discrimination of cochlear-implant recipients for single-channel stimulation above this frequency may be due to the inability of the central processor to make effective use of the available phase-locking information for monaural stimulation.

Psychophysical studies using a multiple-electrode cochlear implant in patients who were deafened early in life

Psychophysical studies were conducted on 10 cochlear implant patients, between 5 and 23 years of age at the time of surgery, who were deafened prior to 4 years of age. The multiple-electrode prosthesis manufactured by Cochlear Ltd. was used. Identification studies, the recognition of 2-4 stimuli after some training, were conducted on 3 of the 10 patients. For current level and repetition rate identification, performance was comparable to that observed for postlingual adult patients. For electrode position identification, however, performance was much poorer than that observed for postlingual adults. In general, the difference limens for current level, repetition rate and duration, and the gap detection thresholds were similar to those observed for postlingual adults. For 3 patients whose etiology was Usher's syndrome, the repetition rate limens at higher rates were larger than those of the other patients. The limens for electrode position, measured in a discrimination task, were 1-3 electrodes for most patients. However, for 3 patients, limens of 6-10 electrodes were recorded. For numerosity judgements, the counting of stimuli in a temporal series as a function of the rate of presentation, the patients were less successful at counting for rates of 3-8/s than for lower rates (1-2/s).

Comparative speech recognition results in eight subjects using two different coding strategies with the Nucleus 22 channel cochlear implant

This study was designed to compare the results of several speech tests administered to eight subjects who used two types of speech-coding strategies with the Nucleus 22 channel cochlear implant. The subjects had an average experience of 40 months with the F0F1F2 coding strategy implemented in their previous wearable speech processor. Three subjects were good performers (showing significant open-set understanding without lip-reading) and five were moderate performers (not able to do speech-tracking by auditory means alone). All subjects were evaluated again after 1 month and 6 months of experience with the MULTIPEAK coding strategy of the miniature speech processor. The test materials included vowel and consonant identification, monosyllabic words, everyday sentences and numbers in noise. All eight subjects showed an improvement on more than three of five measures. The group of moderate performers showed a larger improvement in vowel (+16%) and consonant (+17%) identification scores than the group of good performers. For the open-set sentence test, the better patients were able to increase their score from 52% to 80% correct; two of the moderate performers did not improve. Six subjects achieved significantly higher scores at moderate signal-to-noise ratios (up to 10 dB S/N) in the (Freiburger) number test. Results of information transmission analysis are also discussed.

Electrode placements for cochlear implants: a review

Of the variety of different sites that have been proposed and used for cochlear implants, only two are now seeing widespread use. For single-channel electrodes, it appears that a placement at the round window, or just inside it, leads to no disadvantages (and perhaps some advantages) over deeper insertions. For multichannel implants, it appears that intra-cochlear electrodes are, generally speaking, preferable to extra-cochlear ones in a variety of ways, especially as the early fears about the dangers of intra-cochlear placement now seem exaggerated. One way in which extra-cochlear approaches may play an important accessory role in multichannel intra-cochlear implants is in allowing access to the apical end of the cochlea where residual nerve survival is likely to be best. Special considerations may apply for groups of patients who until recently have been implanted relatively infrequently--adults with significant residual hearing and children.

An advanced multiple channel cochlear implant

An advanced multiple channel cochlear implant hearing prosthesis is described. Stimulation is presented through an array of 20 electrodes located in the scala tympani. Any two electrodes can be configured as a bipolar pair to conduct a symmetrical, biphasic, constant-current pulsatile stimulus. Up to three stimuli can be presented in rapid succession or effectively simultaneously. For simultaneous stimulation, a novel time-division current multiplexing technique has been developed to obviate electrode interactions that may compromise safety. The stimuli are independently controllable in current amplitude, duration, and onset time. Groups of three stimuli can be generated at a rate of typically 500 Hz. Stimulus control data and power are conveyed to the implant through a single transcutaneous inductive link. The device also incorporates a telemetry system that enables electrode voltage waveforms to be monitored externally in real time. The electronics of the implant are contained almost entirely on a custom designed integrated circuit. Preliminary results obtained with the first patient to receive the advanced implant are included.

Perception of connected speech without lipreading, using a multi-channel hearing prosthesis

Four of 13 totally deaf patients implanted with the Nucleus multi-channel hearing prosthesis at the University of Melbourne have demonstrated the ability to understand connected speech without lipreading or other visual cues. These patients were able to repeat verbatim unknown material read by a tester at rates of up to 35 words per minute. They were also able to understand an average of 78% of key words in everyday sentences in ideal acoustic conditions and 51% of equivalent material over the telephone. These results show that with a good proportion of postlingually deaf patients, the multi-channel hearing prosthesis can not only act as an aid to lipreading, but also restore effective speech understanding without lipreading.

Current distributions in the cat cochlea: a modelling and electrophysiological study

The current distribution of bipolar electrodes implanted into the scala tympani of the cat cochlea was investigated using a two-electrode masking technique. Two electrode masking is a non-invasive technique which requires two electrically independent electrodes and relies upon the forward masking of the electrically evoked brainstem response to a probe stimulus by that of a preceding test stimulus. The technique was described in terms of a model, which enabled an approach for estimating the scala tympani length constant to be established. Model results have shown good agreement with electrophysiological results. Application of the model confirmed the scala tympani length constant within the basal turn of the cochlea to lie between 3 and 4 mm.

Threshold and loudness functions for pulsatile stimulation of cochlear implants

Thresholds and loudness estimates were measured for biphasic pulsatile electrical stimulation of the auditory nerve. Measures were collected as a function of the parameters: pulse duration, and pulse rate. The results indicate that the sensations of threshold and loudness are determined by a complex function of the stimulating current waveform. For stimuli with the same charge, maximum loudness is seen at the shortest pulse durations, and a secondary maximum is seen at pulse durations of 2-3 ms/phase. It is possible that the secondary peak in the loudness function and the slow growth of loudness just above threshold for long pulses are indications of dendrite survival near the electrode. If this interpretation is valid, these measures could lead to perceptual tests of peripheral nerve viability. In addition, a speech processor device could use these measures to equalize the loudness of stimuli with different pulse durations and pulse rates.

Multichannel electrical stimulation of the auditory nerve in man. II. Channel interaction

A multichannel cochlear implant can be an effective prosthesis only if its channels are independent of each other. Presumably independence is achieved by stimulating different populations of surviving neurons. Two types of interaction might occur between channels: electrical current field summation peripheral to stimulation of the nerves and neural-perceptual interaction following stimulation. Two psychophysical techniques to assess channel independence are discussed. In one technique a masker is presented on one channel in order to adapt the nerves responding to that channel. The forward masked threshold of a signal is then measured on all other channels and elevation of threshold is assumed to indicate overlapping neural populations. In the second procedure channel interaction is evaluated by measuring the loudness summation of stimuli presented simultaneously to two channels. The magnitude, distribution, and phasic components of the loudness summation are measures of interaction between channels. Data from two subjects suggests that monopolar stimulation produces broader interaction patterns than bipolar stimulation as a function of electrode separation. Considerable differences in the extent of channel interaction were observed between the two subjects, possibly because of the difference in the absolute current levels needed for equivalent sensation levels.

Multichannel electrical stimulation of the auditory nerve in man. I. Basic psychophysics

Basic psychophysical measurements were obtained from three patients implanted with multichannel cochlear implants. This paper presents measurements from stimulation of a single channel at a time (either monopolar or bipolar). The shape of the threshold vs. frequency curve can be partially related to the membrane biophysics of the remaining spiral ganglion and/or dendrites. Nerve survival in the region of the electrode may produce some increase in the dynamic range on that electrode. Loudness was related to the stimulus amplitude by a power law with exponents between 1.6 and 3.4, depending on frequency. Intensity discrimination was better than for normal auditory stimulation, but not enough to offset the small dynamic range for electrical stimulation. Measures of temporal integration were comparable to normals, indicating a central mechanism that is still intact in implant patients. No frequency analysis of the electrical signal was observed. Each electrode produced a unique pitch sensation, but they were not simply related to the tonotopic position of the stimulated electrode. Pitch increased over more than 4 octaves (for one patient) as the frequency was increased from 100 to 300 Hz, but above 300 Hz no pitch change was observed. Possibly the major limitation of single channel cochlear implants is the 1-2 ms integration time (probably due to the capacitative properties of the nerve membrane which acts as a low-pass filter at 100 Hz). Another limitation of electrical stimulation is that there is no spectral analysis of the electrical waveform so that temporal waveform alone determines the effective stimulus.

Percepts from scala tympani stimulation

The characteristics of the sensations produced by activating one electrode at a time are summarized as follows: (a) Loudness was found to increase with current level and pitch with repetition rate. (b) Pitch and sharpness increased in the apical-to-basal direction, and vowel labels could be assigned to sensations produced by individual electrodes in accordance with the tonotopical organization of the cochlea. (c) Results from triadic comparisons provided evidence that the sensations produced by repetition rate and electrode position are perceptually separable. (d) For short-duration stimuli, the discrimination performance for electrode trajectories was much better than that for repetition rate trajectories. For noncoincidental two-electrode stimulation, triadic comparisons showed that two perceptual components, one related to the more basal electrode and the other to the more apical one, could be discerned. Speech-coding considerations based on these psychophysical results are discussed.

Comparison of percepts found with cochlear implant devices

Much of what has been observed in psychoacoustic testing of implanted listeners is similar to that seen in normal or hearing-impaired listeners with only parametric modification. What is lacking is evidence for critical band phenomena and for frequency selectivity. The unique interaction of waveform and sensation level with pitch, loudness, and threshold appears only in implanted listeners. Direct waveform processing, without spectral decomposition, appears to be the means by which information is brought to the nervous system through electrical stimulation. The operations by which this is coded to create percepts of pitch and loudness remain to be elucidated.

Two-component hearing sensations produced by two-electrode stimulation in the cochlea of a deaf patient

Dissimilarities in perception elicited by stimulation with two electrodes were estimated. A two-dimensional spatial configuration was found to be suitable to represent the dissimilarity data, and the two dimensions could be interpreted as corresponding to the position of the apical and basal electrode of the two-electrode combination. A speech-processing strategy that converts acoustic, first and second formants to two-electrode stimulation is proposed.