Exponential fitting of spread of excitation response measurements in cochlear implants

BACKGROUND

Hearing performance in cochlear implant (CI) users is variable. An objective measure which can allow a prediction of this performance is desirable. Spread of neural excitation (SoE) curves are an objective measure that can be obtained using the fitting software of cochlear implants and might be able to be used as a predictor. A novel method to interpret SoE curves is presented. New Method Spread of excitation measurements for three recording sites were fitted using two exponential functions. An asymmetric width measure was developed, defined as the distance in mm to the point, where 25% or 50% of peak normalized amplitude was reached, for each half of the SoE separately. Also, a novel population of subjects with MED-EL CIs is used. Furthermore, speech perception (speech reception threshold, SRT) was evaluated using a matrix sentence test in a multi-source noise field.

RESULTS

SoE width was narrowest for the basal recording site and widest for the apical recording site. Fitted SoE exponential functions were most asymmetric for the apical recording site. A significant positive correlation between sentence test SRT and SoE width at the apical recording site was found. Comparison with Existing Methods The use of an asymmetric width measure correlated strongly and positively with speech perception for apical recording sites, unlike the symmetric width measure used in previous studies. Presumably, longer electrodes allow stimulation of a more apical part of the cochlear. At the apical part of the cochlea, dendrites from a large region of the basilar membrane map to a narrow portion on the spiral ganglion, which might explain the observed asymmetry.

CONCLUSIONS

For subjects implanted with long electrode arrays, an asymmetric width measure correlates positively with apical SoE distance. However, due to lack of a sufficient amount of data, the results are currently less conclusive and need to be consolidated in a larger cohort of subjects.

Word Recognition and Frequency Selectivity in Cochlear Implant Simulation: Effect of Channel Interaction

In cochlear implants (CI), spread of neural excitation may produce channel interaction. Channel interaction disturbs the spectral resolution and, among other factors, seems to impair speech recognition, especially in noise. In this study, two tests were performed with 20 adult normal-hearing (NH) subjects under different vocoded simulations. First, there was a measurement of word recognition in noise while varying the number of selected channels (4, 8, 12 or 16 maxima out of 20) and the degree of simulated channel interaction (“Low”, “Medium” and “High”). Then, there was an evaluation of spectral resolution function of the degree of simulated channel interaction, reflected by the sharpness (Q10dB) of psychophysical tuning curves (PTCs). The results showed a significant effect of the simulated channel interaction on word recognition but did not find an effect of the number of selected channels. The intelligibility decreased significantly for the highest degree of channel interaction. Similarly, the highest simulated channel interaction impaired significantly the Q10dB. Additionally, a strong intra-individual correlation between frequency selectivity and word recognition in noise was observed. Lastly, the individual changes in frequency selectivity were positively correlated with the changes in word recognition when the degree of interaction went from “Low” to “High”. To conclude, the degradation seen for the highest degree of channel interaction suggests a threshold effect on frequency selectivity and word recognition. The correlation between frequency selectivity and intelligibility in noise supports the hypothesis that PTCs Q10dB can account for word recognition in certain conditions. Moreover, the individual variations of performances observed among subjects suggest that channel interaction does not have the same effect on each individual. Finally, these results highlight the importance of taking into account subjects’ individuality and to evaluate channel interaction through the speech processor.

Assessing Cochlear-Place Specific Temporal Coding Using Multi-Band Complex Tones to Measure Envelope-Following Responses

Previous studies suggest that envelope-following responses (EFRs) reveal important differences in temporal coding fidelity amongst listeners who have normal hearing thresholds, consistent with these listeners differing in the degree to which they suffer from cochlear synaptopathy. Like conventional hearing loss, the severity of cochlear synaptopathy may vary along the cochlea. A number of earlier studies have suggested methods for estimating EFRs driven by specific frequency regions of the cochlea, which would allow synaptopathy to be estimated as a function of cochlear place. Here, we tested a method for measuring EFRs from multiple locations along the cochlea simultaneously, using narrowband stimuli. We compared responses to multiple simultaneous narrowband complex harmonic tones in three non-overlapping frequency bands, each having a unique fundamental frequency, to responses to the individual narrowband stimuli alone, and to responses when noise was added to different combinations of the frequency bands. Our results suggest that simultaneous presentation of multiple tone complexes with different fundamental frequencies leads to repeatable measures of temporal coding fidelity at the cochlear frequency regions corresponding to the narrowband carrier frequencies. Other results suggested that while off-frequency contributions to EFRs driven by narrowband signals (due to spread of excitation) can add destructively to the on frequency response, these interactions were small compared to EFR magnitude. Overall, our results point to the utility of using multi-band complex tone stimuli to estimate the profile of temporal coding fidelity, and thus the degree of synaptopathy, as a function of cochlear place. This article is part of a Special Issue entitled: Hearing Loss, Tinnitus, Hyperacusis, Central Gain.

Symmetric Electrode Spanning Narrows the Excitation Patterns of Partial Tripolar Stimuli in Cochlear Implants

In cochlear implants (CIs), standard partial tripolar (pTP) mode reduces current spread by returning a fraction of the current to two adjacent flanking electrodes within the cochlea. Symmetric electrode spanning (i.e., separating both the apical and basal return electrodes from the main electrode by one electrode) has been shown to increase the pitch of pTP stimuli, when the ratio of intracochlear return current was fixed. To explain the pitch increase caused by symmetric spanning in pTP mode, this study measured the electrical potentials of both standard and symmetrically spanned pTP stimuli on a main electrode EL8 in five CI ears using electrical field imaging (EFI). In addition, the spatial profiles of evoked compound action potentials (ECAP) and the psychophysical forward masking (PFM) patterns were also measured for both stimuli. The EFI, ECAP, and PFM patterns of a given stimulus differed in shape details, reflecting the different levels of auditory processing and different ratios of intracochlear return current across the measurement methods. Compared to the standard pTP stimuli, the symmetrically spanned pTP stimuli significantly reduced the areas under the curves of the normalized EFI and PFM patterns, without shifting the pattern peaks and centroids (both around EL8). The more focused excitation patterns with symmetric spanning may have caused the previously reported pitch increase, due to an interaction between pitch and timbre perception. Being able to reduce the spread of excitation, pTP mode symmetric spanning is a promising stimulation strategy that may further increase spectral resolution and frequency selectivity with CIs.

Excitation Patterns of Standard and Steered Partial Tripolar Stimuli in Cochlear Implants

Current steering in partial tripolar (pTP) mode has been shown to improve pitch perception and spectral resolution with cochlear implants (CIs). In this mode, a fraction (σ) of the main electrode current is returned within the cochlea and steered between the basal and apical flanking electrodes (with a proportion of α and 1 - α, respectively). Pitch generally decreases when α increases from 0 to 1, although the salience of pitch change varies across CI users. This study aimed to identify the mechanism of pitch changes with pTP-mode current steering and the factors contributing to the intersubject variability in pitch-ranking sensitivity. The electrical fields were measured for steered pTP stimuli on the same main electrode with α = 0, 0.5, and 1 in five implanted ears using electrical field imaging (EFI). The related excitation patterns were also measured physiologically using evoked compound action potential (ECAP) and psychophysically using psychophysical forward masking (PFM). Consistent with the pitch-ranking results in this study, the EFI, ECAP, and PFM centroids shifted apically with increasing α. An apical shift was also observed for the PFM peak but not for the EFI or ECAP peak. The pattern width was similar with different α values within a given measure (e.g., EFI, ECAP, or PFM), but the ECAP patterns were broader than the EFI and PFM patterns, possibly because ECAP was measured with smaller σ values than EFI and PFM. The amount of pattern shift with α depended on σ (i.e., the total amount of current used for steering) but was not correlated with the pitch-ranking sensitivity across subjects. The results revealed that the pitch changes elicited by pTP-mode current steering were not only driven by the shifts of excitation centroid.

ECAP spread of excitation with virtual channels and physical electrodes

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