Reducing Channel Interaction Through Cochlear Implant Programming May Improve Speech Perception: Current Focusing and Channel Deactivation.

Speech perception among cochlear implant (CI) listeners is highly variable. High degrees of channel interaction are associated with poorer speech understanding. Two methods for reducing channel interaction, focusing electrical fields, and deactivating subsets of channels were assessed by the change in vowel and consonant identification scores with different program settings. The main hypotheses were that (a) focused stimulation will improve phoneme recognition and (b) speech perception will improve when channels with high thresholds are deactivated. To select high-threshold channels for deactivation, subjects' threshold profiles were processed to enhance the peaks and troughs, and then an exclusion or inclusion criterion based on the mean and standard deviation was used. Low-threshold channels were selected manually and matched in number and apex-to-base distribution. Nine ears in eight adult CI listeners with Advanced Bionics HiRes90k devices were tested with six experimental programs. Two, all-channel programs, (a) 14-channel partial tripolar (pTP) and (b) 14-channel monopolar (MP), and four variable-channel programs, derived from these two base programs, (c) pTP with high- and (d) low-threshold channels deactivated, and (e) MP with high- and (f) low-threshold channels deactivated, were created. Across subjects, performance was similar with pTP and MP programs. However, poorer performing subjects (scoring < 62% correct on vowel identification) tended to perform better with the all-channel pTP than with the MP program (1 > 2). These same subjects showed slightly more benefit with the reduced channel MP programs (5 and 6). Subjective ratings were consistent with performance. These finding suggest that reducing channel interaction may benefit poorer performing CI listeners.

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.

A fast method for measuring psychophysical thresholds across the cochlear implant array.

A rapid threshold measurement procedure, based on Bekesy tracking, is proposed and evaluated for use with cochlear implants (CIs). Fifteen postlingually deafened adult CI users participated. Absolute thresholds for 200-ms trains of biphasic pulses were measured using the new tracking procedure and were compared with thresholds obtained with a traditional forced-choice adaptive procedure under both monopolar and quadrupolar stimulation. Virtual spectral sweeps across the electrode array were implemented in the tracking procedure via current steering, which divides the current between two adjacent electrodes and varies the proportion of current directed to each electrode. Overall, no systematic differences were found between threshold estimates with the new channel sweep procedure and estimates using the adaptive forced-choice procedure. Test-retest reliability for the thresholds from the sweep procedure was somewhat poorer than for thresholds from the forced-choice procedure. However, the new method was about 4 times faster for the same number of repetitions. Overall the reliability and speed of the new tracking procedure provides it with the potential to estimate thresholds in a clinical setting. Rapid methods for estimating thresholds could be of particular clinical importance in combination with focused stimulation techniques that result in larger threshold variations between electrodes.

Topographic spread of inferior colliculus activation in response to acoustic and intracochlear electric stimulation.

The design of contemporary multichannel cochlear implants is predicated on the presumption that they activate multiple independent sectors of the auditory nerve array. The independence of these channels, however, is limited by the spread of activation from each intracochlear electrode across the auditory nerve array. In this study, we evaluated factors that influence intracochlear spread of activation using two types of intracochlear electrodes: (1) a clinical-type device consisting of a linear series of ring contacts positioned along a silicon elastomer carrier, and (2) a pair of visually placed (VP) ball electrodes that could be positioned independently relative to particular intracochlear structures, e.g., the spiral ganglion. Activation spread was estimated by recording multineuronal evoked activity along the cochleotopic axis of the central nucleus of the inferior colliculus (ICC). This activity was recorded using silicon-based single-shank, 16-site recording probes, which were fixed within the ICC at a depth defined by responses to acoustic tones. After deafening, electric stimuli consisting of single biphasic electric pulses were presented with each electrode type in various stimulation configurations (monopolar, bipolar, tripolar) and/or various electrode orientations (radial, off-radial, longitudinal). The results indicate that monopolar (MP) stimulation with either electrode type produced widepread excitation across the ICC. Bipolar (BP) stimulation with banded pairs of electrodes oriented longitudinally produced activation that was somewhat less broad than MP stimulation, and tripolar (TP) stimulation produced activation that was more restricted than MP or BP stimulation. Bipolar stimulation with radially oriented pairs of VP ball electrodes produced the most restricted activation. The activity patterns evoked by radial VP balls were comparable to those produced by pure tones in normal-hearing animals. Variations in distance between radially oriented VP balls had little effect on activation spread, although increases in interelectrode spacing tended to reduce thresholds. Bipolar stimulation with longitudinally oriented VP electrodes produced broad activation that tended to broaden as the separation between electrodes increased.