Comparison of Multipole Stimulus Configurations With Respect to Loudness and Spread of Excitation.

OBJECTIVE: Current spread is a substantial limitation of speech coding strategies in cochlear implants. Multipoles have the potential to reduce current spread and thus generate more discriminable pitch percepts. The difficulty with multipoles is reaching sufficient loudness. The primary goal was to compare the loudness characteristics and spread of excitation (SOE) of three types of phased array stimulation, a novel multipole, with three more conventional configurations. DESIGN: Fifteen postlingually deafened cochlear implant users performed psychophysical experiments addressing SOE, loudness scaling, loudness threshold, loudness balancing, and loudness discrimination. Partial tripolar stimulation (pTP, σ = 0.75), TP, phased array with 16 (PA16) electrodes, and restricted phased array with five (PA5) and three (PA3) electrodes was compared with a reference monopolar stimulus. RESULTS: Despite a similar loudness growth function, there were considerable differences in current expenditure. The most energy efficient multipole was the pTP, followed by PA16 and PA5/PA3. TP clearly stood out as the least efficient one. Although the electric dynamic range was larger with multipolar configurations, the number of discriminable steps in loudness was not significantly increased. The SOE experiment could not demonstrate any difference between the stimulation strategies. CONCLUSIONS: The loudness characteristics all five multipolar configurations tested are similar. Because of their higher energy efficiency, pTP and PA16 are the most favorable candidates for future testing in clinical speech coding strategies.

Reducing interaction in simultaneous paired stimulation with CI.

In this study simultaneous paired stimulation of electrodes in cochlear implants is investigated by psychophysical experiments in 8 post-lingually deaf subjects (and one extra subject who only participated in part of the experiments). Simultaneous and sequential monopolar stimulation modes are used as references and are compared to channel interaction compensation, partial tripolar stimulation and a novel sequential stimulation strategy named phased array compensation. Psychophysical experiments are performed to investigate both the loudness integration during paired stimulation at the main electrodes as well as the interaction with the electrode contact located halfway between the stimulating pair. The study shows that simultaneous monopolar stimulation has more loudness integration on the main electrodes and more interaction in between the electrodes than sequential stimulation. Channel interaction compensation works to reduce the loudness integration at the main electrodes, but does not reduce the interaction in between the electrodes caused by paired stimulation. Partial tripolar stimulation uses much more current to reach the needed loudness, but shows the same interaction in between the electrodes as sequential monopolar stimulation. In phased array compensation we have used the individual impedance matrix of each subject to calculate the current needed on each electrode to exactly match the stimulation voltage along the array to that of sequential stimulation. The results show that the interaction in between the electrodes is the same as monopolar stimulation. The strategy uses less current than partial tripolar stimulation, but more than monopolar stimulation. In conclusion, the paper shows that paired stimulation is possible if the interaction is compensated.

Restoring speech perception with cochlear implants by spanning defective electrode contacts.

CONCLUSION: Even with six defective contacts, spanning can largely restore speech perception with the HiRes 120 speech processing strategy to the level supported by an intact electrode array. Moreover, the sound quality is not degraded. OBJECTIVES: Previous studies have demonstrated reduced speech perception scores (SPS) with defective contacts in HiRes 120. This study investigated whether replacing defective contacts by spanning, i.e. current steering on non-adjacent contacts, is able to restore speech recognition to the level supported by an intact electrode array. METHODS: Ten adult cochlear implant recipients (HiRes90K, HiFocus1J) with experience with HiRes 120 participated in this study. Three different defective electrode arrays were simulated (six separate defective contacts, three pairs or two triplets). The participants received three take-home strategies and were asked to evaluate the sound quality in five predefined listening conditions. After 3 weeks, SPS were evaluated with monosyllabic words in quiet and in speech-shaped background noise. RESULTS: The participants rated the sound quality equal for all take-home strategies. SPS with background noise were equal for all conditions tested. However, SPS in quiet (85% phonemes correct on average with the full array) decreased significantly with increasing spanning distance, with a 3% decrease for each spanned contact.

Novel extracellular matrix structures in the neural stem cell niche capture the neurogenic factor fibroblast growth factor 2 from the extracellular milieu.

The novel extracellular matrix structures called fractones are found in the lateral ventricle walls, the principal adult brain stem cell niche. By electron microscopy, fractones were shown to contact neural stem and progenitor cells (NSPC), suggesting a role in neurogenesis. Here, we investigated spatial relationships between proliferating NSPC and fractones and identified basic components and the first function of fractones. Using bromodeoxyuridine (BrdU) for birth-dating cells in the adult mouse lateral ventricle wall, we found most mitotic cells next to fractones, although some cells emerged next to capillaries. Like capillary basement membranes, fractones were immunoreactive for laminin beta1 and gamma1, collagen IV, nidogen, and perlecan, but not laminin-alpha1, in the adult rat, mouse, and human. Intriguingly, N-sulfate heparan sulfate proteoglycan (HSPG) immunoreactivity was restricted to fractone subpopulations and infrequent subependymal capillaries. Double immunolabel for BrdU and N-sulfate HSPG revealed preferential mitosis next to N-sulfate HSPG immunoreactive fractones. To determine whether N sulfate HSPG immunoreactivity within fractones reflects a potential for binding neurogenic growth factors, we identified biotinylated fibroblast growth factor 2 (FGF-2) binding sites in situ on frozen sections, and in vivo after intracerebroventricular injection of biotinylated FGF-2 in the adult rat or mouse. Both binding assays revealed biotinylated FGF-2 on fractone subpopulations and on infrequent subependymal capillaries. The binding of biotinylated FGF-2 was specific and dependent upon HSPG, as demonstrated in vitro and in vivo by inhibition with heparatinase and by the concomitant disappearance of N-sulfate HSPG immunoreactivity. These results strongly suggest that fractones promote growth factor activity in the neural stem cell niche.