The perception of complex pitch in cochlear implants: A comparison of monopolar and tripolar stimulation

Spatially precise activation of the mouse cochlea with a multi-channel hybrid cochlear implant

Objective.Cochlear implants are among the few clinical interventions for people with severe or profound hearing loss. However, current spread during monopolar electrical stimulation results in poor spectral resolution, prompting the exploration of optical stimulation as an alternative approach. Enabled by introducing light-sensitive ion channels into auditory neurons (optogenetics), optical stimulation has been shown to activate a more discrete neural area with minimal overlap between each frequency channel during simultaneous stimulation. However, the utility of optogenetic approaches is uncertain due to the low fidelity of responses to light and high-power requirements compared to electrical stimulation.Approach.Hybrid stimulation, combining sub-threshold electrical and optical pulses, has been shown to improve fidelity and use less light, but the impact on spread of activation and channel summation using a translatable, multi-channel hybrid implant is unknown. This study examined these factors during single channel and simultaneous multi-channel hybrid stimulation in transgenic mice expressing the ChR2/H134R opsin. Acutely deafened mice were implanted with a hybrid cochlear array containing alternating light emitting diodes and platinum electrode rings. Spiking activity in the inferior colliculus was recorded during electrical-only or hybrid stimulation in which optical and electrical stimuli were both at sub-threshold intensities. Thresholds, spread of activation, and threshold shifts during simultaneous hybrid stimulation were compared to electrical-only stimulation.Main results.The electrical current required to reach activation threshold during hybrid stimulation was reduced by 7.3 dB compared to electrical-only stimulation (p< 0.001). The activation width measured at two levels of discrimination above threshold and channel summation during simultaneous hybrid stimulation were significantly lower compared to electrical-only stimulation (p< 0.05), but there was no spatial advantage of hybrid stimulation at higher electrical stimulation levels.Significance.Reduced channel interaction would facilitate multi-channel simultaneous stimulation, thereby enhancing the perception of temporal fine structure which is crucial for music and speech in noise.

Combined-electrical optogenetic stimulation but not channelrhodopsin kinetics improves the fidelity of high rate stimulation in the auditory pathway in mice

Novel stimulation methods are needed to overcome the limitations of contemporary cochlear implants. Optogenetics is a technique that confers light sensitivity to neurons via the genetic introduction of light-sensitive ion channels. By controlling neural activity with light, auditory neurons can be activated with higher spatial precision. Understanding the behaviour of opsins at high stimulation rates is an important step towards their translation. To elucidate this, we compared the temporal characteristics of auditory nerve and inferior colliculus responses to optogenetic, electrical, and combined optogenetic-electrical stimulation in virally transduced mice expressing one of two channelrhodopsins, ChR2-H134R or ChIEF, at stimulation rates up to 400 pulses per second (pps). At 100 pps, optogenetic responses in ChIEF mice demonstrated higher fidelity, less change in latency, and greater response stability compared to responses in ChR2-H134R mice, but not at higher rates. Combined stimulation improved the response characteristics in both cohorts at 400 pps, although there was no consistent facilitation of electrical responses. Despite these results, day-long stimulation (up to 13 h) led to severe and non-recoverable deterioration of the optogenetic responses. The results of this study have significant implications for the translation of optogenetic-only and combined stimulation techniques for hearing loss.

The Role of Word Content, Sentence Information, and Vocoding for Voice Cue Perception

PURPOSE

For voice perception, two voice cues, the fundamental frequency (fo) and/or vocal tract length (VTL), seem to largely contribute to identification of voices and speaker characteristics. Acoustic content related to these voice cues is altered in cochlear implant transmitted speech, rendering voice perception difficult for the implant user. In everyday listening, there could be some facilitation from top-down compensatory mechanisms such as from use of linguistic content. Recently, we have shown a lexical content benefit on just-noticeable differences (JNDs) in VTL perception, which was not affected by vocoding. Whether this observed benefit relates to lexicality or phonemic content and whether additional sentence information can affect voice cue perception as well were investigated in this study.

METHOD

This study examined lexical benefit on VTL perception, by comparing words, time-reversed words, and nonwords, to investigate the contribution of lexical (words vs. nonwords) or phonetic (nonwords vs. reversed words) information. In addition, we investigated the effect of amount of speech (auditory) information on fo and VTL voice cue perception, by comparing words to sentences. In both experiments, nonvocoded and vocoded auditory stimuli were presented.

RESULTS

The outcomes showed a replication of the detrimental effect reversed words have on VTL perception. Smaller JNDs were shown for stimuli containing lexical and/or phonemic information. Experiment 2 showed a benefit in processing full sentences compared to single words in both fo and VTL perception. In both experiments, there was an effect of vocoding, which only interacted with sentence information for fo.

CONCLUSIONS

In addition to previous findings suggesting a lexical benefit, the current results show, more specifically, that lexical and phonemic information improves VTL perception. fo and VTL perception benefits from more sentence information compared to words. These results indicate that cochlear implant users may be able to partially compensate for voice cue perception difficulties by relying on the linguistic content and rich acoustic cues of everyday speech.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.23796405.

Effects of Degrees of Degeneration on the Electrical Excitation of Human Spiral Ganglion Neurons Based on a High-Resolution Computer Model

After hearing loss retrograde degeneration of spiral ganglion neurons (SGNs) has been described. Studies modeling the effects of degeneration mostly omitted peripheral processes (dendrites). Recent experimental observations indicated that degenerating SGNs manifested also a reduced diameter of their dendrites. We simulated populations of 400 SGNs inside a high resolution cochlear model with a cochlear implant, based on μCT scans of a human temporal bone. Cochlear implant stimuli were delivered as biphasic pulses in a monopolar configuration. Three SGN situations were simulated, based on our previous measurements of human SGN dendrites: (A) SGNs with intact dendrites (before degeneration), (B) degenerating SGNs, dendrites with a smaller diameter but original length, (C) degenerating SGNs, dendrites omitted. SGN fibers were mapped to characteristic frequency, and place pitch was estimated from excitation profiles. Results from degenerating SGNs (B, C) were similar. Most action potentials were initiated in the somatic area for all cases (A, B, C), except for areas near stimulating electrodes in the apex with intact SGNs (A), where action potentials were initiated in the distal dendrite. In most cases, degenerating SGNs had lower thresholds than intact SGNs (A) (down to -2 dB). Excitation profiles showed increased ectopic activation, i.e., activation of unintended neuronal regions, as well as similar neuronal regions excited by different apical electrodes, for degenerating SGNs (B, C). The estimated pitch showed cases of pitch reversals in apical electrodes for intact SGNs (A), as well as mostly identical pitches evoked by the four most apical electrodes for degenerating SGNs (B, C). In conclusion, neuronal excitation profiles to electrical stimulation exhibited similar traits in both ways of modeling SGN degeneration. Models showed degeneration of dendrites caused increased ectopic activation, as well as similar excitation profiles and pitch evoked by different apical electrodes. Therefore, insertion of electrodes beyond approximately 450° may not provide any benefit if SGN dendrites are degenerated.

The effects of lexical content, acoustic and linguistic variability, and vocoding on voice cue perception

Perceptual differences in voice cues, such as fundamental frequency (F0) and vocal tract length (VTL), can facilitate speech understanding in challenging conditions. Yet, we hypothesized that in the presence of spectrotemporal signal degradations, as imposed by cochlear implants (CIs) and vocoders, acoustic cues that overlap for voice perception and phonemic categorization could be mistaken for one another, leading to a strong interaction between linguistic and indexical (talker-specific) content. Fifteen normal-hearing participants performed an odd-one-out adaptive task measuring just-noticeable differences (JNDs) in F0 and VTL. Items used were words (lexical content) or time-reversed words (no lexical content). The use of lexical content was either promoted (by using variable items across comparison intervals) or not (fixed item). Finally, stimuli were presented without or with vocoding. Results showed that JNDs for both F0 and VTL were significantly smaller (better) for non-vocoded compared with vocoded speech and for fixed compared with variable items. Lexical content (forward vs reversed) affected VTL JNDs in the variable item condition, but F0 JNDs only in the non-vocoded, fixed condition. In conclusion, lexical content had a positive top-down effect on VTL perception when acoustic and linguistic variability was present but not on F0 perception. Lexical advantage persisted in the most degraded conditions and vocoding even enhanced the effect of item variability, suggesting that linguistic content could support compensation for poor voice perception in CI users.

No Evidence That Music Training Benefits Speech Perception in Hearing-Impaired Listeners: A Systematic Review

As musicians have been shown to have a range of superior auditory skills to non-musicians (e.g., pitch discrimination ability), it has been hypothesized by many researchers that music training can have a beneficial effect on speech perception in populations with hearing impairment. This hypothesis relies on an assumption that the benefits seen in musicians are due to their training and not due to innate skills that may support successful musicianship. This systematic review examined the evidence from 13 longitudinal training studies that tested the hypothesis that music training has a causal effect on speech perception ability in hearing-impaired listeners. The papers were evaluated for quality of research design and appropriate analysis techniques. Only 4 of the 13 papers used a research design that allowed a causal relation between music training and outcome benefits to be validly tested, and none of those 4 papers with a better quality study design demonstrated a benefit of music training for speech perception. In spite of the lack of valid evidence in support of the hypothesis, 10 of the 13 papers made claims of benefits of music training, showing a propensity for confirmation bias in this area of research. It is recommended that future studies that aim to evaluate the association of speech perception ability and music training use a study design that differentiates the effects of training from those of innate perceptual and cognitive skills in the participants.

Investigating the Electrical Properties of Different Cochlear Implants

AIM

This study characterises and compares electrical properties and current spread across four different makes of cochlear implants with differing electrode designs using a 3D-printed artificial cochlear model.

BACKGROUND

Cochlear implants are currently limited by current spread within the cochlea, which causes low spectral resolution of auditory nerve stimulation. Different cochlear implant makes vary in electrode size, shape, number, and configuration. How these differences affect cochlear implant current spread and function is not well known.

METHOD

Each cochlear implant was inserted into a linear cochlear model containing recording electrodes along its length. Biphasic monopolar stimulation of each implant electrode was carried out, and the resultant waveform and transimpedance matrix (TIM) data obtained from the recording electrodes. This was repeated with each implant rotated 180 degrees in the cochlea model to examine the effects of electrode orientation. Impedance spectroscopy was also carried out at the apex, middle, and base of the model.

RESULTS

The four cochlear implants displayed similar TIM profiles and waveforms. One hundred eighty degrees rotation of each cochlear implant made little difference to the TIM profiles. Impedance spectroscopy demonstrated broad similarities in amplitude and phase across the implants, but exhibited differences in certain electrical parameters.

CONCLUSION

Implants with different designs demonstrate similar electrical performance, regardless of electrode size and spacing or electrode array dimension. In addition, rotatory maneuvers during cochlear implantation surgery are unlikely to change implant impedance properties.

Effect of Channel Interaction on Vocal Cue Perception in Cochlear Implant Users

Speech intelligibility in multitalker settings is challenging for most cochlear implant (CI) users. One possibility for this limitation is the suboptimal representation of vocal cues in implant processing, such as the fundamental frequency (F0), and the vocal tract length (VTL). Previous studies suggested that while F0 perception depends on spectrotemporal cues, VTL perception relies largely on spectral cues. To investigate how spectral smearing in CIs affects vocal cue perception in speech-on-speech (SoS) settings, adjacent electrodes were simultaneously stimulated using current steering in 12 Advanced Bionics users to simulate channel interaction. In current steering, two adjacent electrodes are simultaneously stimulated forming a channel of parallel stimulation. Three such stimulation patterns were used: Sequential (one current steering channel), Paired (two channels), and Triplet stimulation (three channels). F0 and VTL just-noticeable differences (JNDs; Task 1), in addition to SoS intelligibility (Task 2) and comprehension (Task 3), were measured for each stimulation strategy. In Tasks 2 and 3, four maskers were used: the same female talker, a male voice obtained by manipulating both F0 and VTL (F0+VTL) of the original female speaker, a voice where only F0 was manipulated, and a voice where only VTL was manipulated. JNDs were measured relative to the original voice for the F0, VTL, and F0+VTL manipulations. When spectral smearing was increased from Sequential to Triplet, a significant deterioration in performance was observed for Tasks 1 and 2, with no differences between Sequential and Paired stimulation. Data from Task 3 were inconclusive. These results imply that CI users may tolerate certain amounts of channel interaction without significant reduction in performance on tasks relying on voice perception. This points to possibilities for using parallel stimulation in CIs for reducing power consumption.

Influence of bilateral cochlear implants on vocal control

Receiving a cochlear implant (CI) can improve fundamental frequency (F0) control for deaf individuals, resulting in increased vocal pitch control. However, it is unclear whether using bilateral CIs, which often result in mismatched pitch perception between ears, will counter this benefit. To investigate this, 23 bilateral CI users were asked to produce a sustained vocalization using one CI, the other CI, both CIs, or neither. Additionally, a set of eight normal hearing participants completed the sustained vocalization task as a control group. The results indicated that F0 control is worse with both CIs compared to using the ear that yields the lowest vocal variability. The results also indicated that there was a large range of F0 variability even for the relatively stable portion of the vocalization, spanning from 6 to 46 cents. These results suggest that bilateral CIs can detrimentally affect vocal control.

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.

Tripolar Stimulation Improves Polyphonic Pitch Detection in Cochlear Implant Users

OBJECTIVE

Cochlear implant (CI) users struggle with pitch perception, particularly for polyphonic stimuli. Tripolar (TP) stimulation has been proposed as a way to mitigate the broad spread of neural excitation observed in traditional monopolar (MP) stimulation, thereby potentially improving perception of polyphony.

STUDY DESIGN

Prospective cohort study.

SETTING

Tertiary academic center.

PATIENTS

Eleven postlingually deafened adults with Advanced Bionics HiRes 90K CIs.

INTERVENTION(S)

We performed pitch ranking and polyphonic pitch detection testing under MP and TP configurations. To assess pitch ranking, users were asked to identify the higher pitch between two notes. In polyphonic pitch detection, users were asked to distinguish between single-pitch tones and two-pitch tones. Two-pitch stimuli consisted of one pitch of three base frequencies (392, 523, 740 Hz) and a second pitch between 1 and 12 semitones above the base frequency.

MAIN OUTCOME MEASURE

Pitch performance was analyzed as a function of current delivery mode (tripolar vs. monopolar), with smaller semitone interval pitch resolution indicating better performance.

RESULTS

In pitch ranking tasks, TP configuration did not confer an advantage over MP stimulation. In polyphonic perception, however, tripolar stimulation improved performance in lower frequencies and resulted in statistically significant (p < 0.05) improvement at the highest base frequency, 740 Hz.

CONCLUSIONS

These data suggest that TP configuration may confer an advantage in the perception of polyphonic pitch, which may not be observed in monophonic pitch ranking tasks. Since music is typically polyphonic, such data offer approaches toward improving perception of real-world musical stimuli.

Discrimination of Voice Pitch and Vocal-Tract Length in Cochlear Implant Users

OBJECTIVES

When listening to two competing speakers, normal-hearing (NH) listeners can take advantage of voice differences between the speakers. Users of cochlear implants (CIs) have difficulty in perceiving speech on speech. Previous literature has indicated sensitivity to voice pitch (related to fundamental frequency, F0) to be poor among implant users, while sensitivity to vocal-tract length (VTL; related to the height of the speaker and formant frequencies), the other principal voice characteristic, has not been directly investigated in CIs. A few recent studies evaluated F0 and VTL perception indirectly, through voice gender categorization, which relies on perception of both voice cues. These studies revealed that, contrary to prior literature, CI users seem to rely exclusively on F0 while not utilizing VTL to perform this task. The objective of the present study was to directly and systematically assess raw sensitivity to F0 and VTL differences in CI users to define the extent of the deficit in voice perception.

DESIGN

The just-noticeable differences (JNDs) for F0 and VTL were measured in 11 CI listeners using triplets of consonant-vowel syllables in an adaptive three-alternative forced choice method.

RESULTS

The results showed that while NH listeners had average JNDs of 1.95 and 1.73 semitones (st) for F0 and VTL, respectively, CI listeners showed JNDs of 9.19 and 7.19 st. These JNDs correspond to differences of 70% in F0 and 52% in VTL. For comparison to the natural range of voices in the population, the F0 JND in CIs remains smaller than the typical male-female F0 difference. However, the average VTL JND in CIs is about twice as large as the typical male-female VTL difference.

CONCLUSIONS

These findings, thus, directly confirm that CI listeners do not seem to have sufficient access to VTL cues, likely as a result of limited spectral resolution, and, hence, that CI listeners' voice perception deficit goes beyond poor perception of F0. These results provide a potential common explanation not only for a number of deficits observed in CI listeners, such as voice identification and gender categorization, but also for competing speech perception.

Vocoder Simulations Explain Complex Pitch Perception Limitations Experienced by Cochlear Implant Users

Pitch plays a crucial role in speech and music, but is highly degraded for people with cochlear implants, leading to severe communication challenges in noisy environments. Pitch is determined primarily by the first few spectrally resolved harmonics of a tone. In implants, access to this pitch is limited by poor spectral resolution, due to the limited number of channels and interactions between adjacent channels. Here we used noise-vocoder simulations to explore how many channels, and how little channel interaction, are required to elicit pitch. Results suggest that two to four times the number of channels are needed, along with interactions reduced by an order of magnitude, than available in current devices. These new constraints not only provide insights into the basic mechanisms of pitch coding in normal hearing but also suggest that spectrally based complex pitch is unlikely to be generated in implant users without significant changes in the method or site of stimulation.

Effect of current focusing on the sensitivity of inferior colliculus neurons to amplitude-modulated stimulation

In multichannel cochlear implants (CIs), current is delivered to specific electrodes along the cochlea in the form of amplitude-modulated pulse trains, to convey temporal and spectral cues. Our previous studies have shown that focused multipolar (FMP) and tripolar (TP) stimulation produce more restricted neural activation and reduced channel interactions in the inferior colliculus (IC) compared with traditional monopolar (MP) stimulation, suggesting that focusing of stimulation could produce better transmission of spectral information. The present study explored the capability of IC neurons to detect modulated CI stimulation with FMP and TP stimulation compared with MP stimulation. The study examined multiunit responses of IC neurons in acutely deafened guinea pigs by systematically varying the stimulation configuration, modulation depth, and stimulation level. Stimuli were sinusoidal amplitude-modulated pulse trains (carrier rate of 120 pulses/s). Modulation sensitivity was quantified by measuring modulation detection thresholds (MDTs), defined as the lowest modulation depth required to differentiate the response of a modulated stimulus from an unmodulated one. Whereas MP stimulation showed significantly lower MDTs than FMP and TP stimulation (P values <0.05) at stimulation ≤2 dB above threshold, all stimulation configurations were found to have similar modulation sensitivities at 4 dB above threshold. There was no difference found in modulation sensitivity between FMP and TP stimulation. The present study demonstrates that current focusing techniques such as FMP and TP can adequately convey amplitude modulation and are comparable to MP stimulation, especially at higher stimulation levels, although there may be some trade-off between spectral and temporal fidelity with current focusing stimulation.