RESUMEN
During continuous speech perception, endogenous neural activity becomes time-locked to acoustic stimulus features, such as the speech amplitude envelope. This speech-brain coupling can be decoded using non-invasive brain imaging techniques, including electroencephalography (EEG). Neural decoding may provide clinical use as an objective measure of stimulus encoding by the brain-for example during cochlear implant listening, wherein the speech signal is severely spectrally degraded. Yet, interplay between acoustic and linguistic factors may lead to top-down modulation of perception, thereby complicating audiological applications. To address this ambiguity, we assess neural decoding of the speech envelope under spectral degradation with EEG in acoustically hearing listeners (n = 38; 18-35 years old) using vocoded speech. We dissociate sensory encoding from higher-order processing by employing intelligible (English) and non-intelligible (Dutch) stimuli, with auditory attention sustained using a repeated-phrase detection task. Subject-specific and group decoders were trained to reconstruct the speech envelope from held-out EEG data, with decoder significance determined via random permutation testing. Whereas speech envelope reconstruction did not vary by spectral resolution, intelligible speech was associated with better decoding accuracy in general. Results were similar across subject-specific and group analyses, with less consistent effects of spectral degradation in group decoding. Permutation tests revealed possible differences in decoder statistical significance by experimental condition. In general, while robust neural decoding was observed at the individual and group level, variability within participants would most likely prevent the clinical use of such a measure to differentiate levels of spectral degradation and intelligibility on an individual basis.
Asunto(s)
Estimulación Acústica , Electroencefalografía , Inteligibilidad del Habla , Percepción del Habla , Humanos , Percepción del Habla/fisiología , Femenino , Masculino , Adolescente , Adulto , Adulto Joven , Acústica del Lenguaje , Encéfalo/fisiologíaRESUMEN
PURPOSE: Attempts to use current-focussing strategies with cochlear implants (CI) to reduce neural spread-of-excitation have met with only mixed success in human studies, in contrast to promising results in animal studies. Although this discrepancy could stem from between-species anatomical and aetiological differences, the masking experiments used in human studies may be insufficiently sensitive to differences in excitation-pattern width. METHODS: We used an interleaved-masking method to measure psychophysical excitation patterns in seven participants with four masker stimulation configurations: monopolar (MP), partial tripolar (pTP), a wider partial tripolar (pTP + 2), and, importantly, a condition (RP + 2) designed to produce a broader excitation pattern than MP. The probe was always in partial-tripolar configuration. RESULTS: We found a significant effect of stimulation configuration on both the amount of on-site masking (mask and probe on same electrode; an indirect indicator of sharpness) and the difference between off-site and on-site masking. Differences were driven solely by RP + 2 producing a broader excitation pattern than the other configurations, whereas monopolar and the two current-focussing configurations did not statistically differ from each other. CONCLUSION: A method that is sensitive enough to reveal a modest broadening in RP + 2 showed no evidence for sharpening with focussed stimulation. We also showed that although voltage recordings from the implant accurately predicted a broadening of the psychophysical excitation patterns with RP + 2, they wrongly predicted a strong sharpening with pTP + 2. We additionally argue, based on our recent research, that the interleaved-masking method can usefully be applied to non-human species and objective measures of CI excitation patterns.
Asunto(s)
Implantación Coclear , Implantes Cocleares , Animales , Humanos , Enmascaramiento Perceptual , Estimulación EléctricaRESUMEN
Electrically evoked frequency-following responses (eFFRs) provide insight in the phase-locking ability of brainstem of cochlear-implant (CI) users. eFFRs can potentially be used to gain insight in the individual differences in the biological limitation on temporal encoding of the electrically stimulated auditory pathway, which can be inherent to the electrical stimulation itself and/or the degenerative processes associated with hearing loss. One of the major challenge of measuring eFFRs in CI users is the process of isolating the stimulation artifact from the neural response, as both the response and the artifact overlap in time and have similar frequency characteristics. Here we introduce a new artifact removal method based on template subtraction that successfully removes the stimulation artifacts from the recordings when CI users are stimulated with pulse trains from 128 to 300 pulses per second in a monopolar configuration. Our results show that, although artifact removal was successful in all CI users, the phase-locking ability of the brainstem to the different pulse rates, as assessed with the eFFR differed substantially across participants. These results show that the eFFR can be measured, free from artifacts, in CI users and that they can be used to gain insight in individual differences in temporal processing of the electrically stimulated auditory pathway.
Asunto(s)
Implantación Coclear , Implantes Cocleares , Sordera , Pérdida Auditiva , Humanos , Potenciales Evocados Auditivos/fisiología , Estimulación Eléctrica/métodosRESUMEN
Difference limens for fundamental frequency (F0), F0DLs, are usually small for complex tones containing low harmonics that are resolved in the auditory periphery, but worsen when the rank of the lowest harmonic increases above about 6-8 and harmonics become less resolved. The traditional explanation for this, in terms of resolvability, has been challenged and an alternative explanation in terms of harmonic rank was suggested. Here, to disentangle the effects of resolvability and harmonic rank the complex tones were presented either diotically (all harmonics to both ears) or dichotically (even and odd harmonics to opposite ears); the latter increases resolvability but does not affect harmonic rank. F0DLs were measured for 14 listeners for complex tones containing harmonics 6-10 with F0s of 280 and 1400 Hz, presented diotically or dichotically. For the low F0, F0DLs were significantly lower for the dichotic than for the diotic condition. This is consistent with a benefit of increased resolvability of harmonics for F0 discrimination and extends previous results to harmonics as low as the sixth. In contrast, for the high F0, F0DLs were similar for the two presentation modes, adding to evidence for differences in pitch perception between tones with low-to-medium and very-high frequency content.
Asunto(s)
Discriminación de la Altura Tonal , Percepción de la Altura Tonal , Niacinamida , Estimulación AcústicaRESUMEN
Two EEG experiments measured the sustained neural response to amplitude-modulated (AM) high-rate pulse trains presented to a single cochlear-implant (CI) electrode. Stimuli consisted of two interleaved pulse trains with AM rates F1 and F2 close to 80 and 120 Hz respectively, and where F2 = 1.5F1. Following Carlyon et al. (J Assoc Res Otolaryngol, 2021), we assume that such stimuli can produce a neural distortion response (NDR) at F0 = F2-F1 Hz if temporal dependencies ("smoothing") in the auditory system are followed by one or more neural nonlinearities. In experiment 1, the rate of each pulse train was 480 pps and the gap between pulses in the F1 and F2 pulse trains ranged from 0 to 984 µs. The NDR had a roughly constant amplitude for gaps between 0 and about 200-400 µs, and decreased for longer gaps. We argue that this result is consistent with a temporal dependency, such as facilitation, operating at the level of the auditory nerve and/or with co-incidence detection by cochlear-nucleus neurons. Experiment 2 first measured the NDR for stimuli at each listener's most comfortable level ("MCL") and for F0 = 37, 40, and 43 Hz. This revealed a group delay of about 42 ms, consistent with a thalamic/cortical source. We then showed that the NDR grew steeply with stimulus amplitude and, for most listeners, decreased by more than 12 dB between MCL and 75% of the listener's dynamic range. We argue that the NDR is a potentially useful objective estimate of MCL.
Asunto(s)
Implantación Coclear , Implantes Cocleares , Nervio Coclear/fisiología , Electrodos Implantados , Estimulación Eléctrica , ElectroencefalografíaRESUMEN
The spectro-temporal ripple for investigating processor effectiveness (STRIPES) test is a psychophysical measure of spectro-temporal resolution in cochlear-implant (CI) listeners. It has been validated using direct-line input and loudspeaker presentation with listeners of the Advanced Bionics CI. This article investigates the suitability of an online application using wireless streaming (webSTRIPES) as a remote test. It reports a strong across-listener correlation between STRIPES thresholds obtained using laboratory testing with loudspeaker presentation vs remote testing with streaming presentation, with no significant difference in STRIPES thresholds between the two measures. WebSTRIPES also produced comparable and robust thresholds with users of the Cochlear CI.
Asunto(s)
Implantación Coclear , Implantes Cocleares , Percepción del Habla , Percepción del TiempoRESUMEN
OBJECTIVES: Electrically evoked compound action-potentials (ECAPs) can be recorded using the electrodes in a cochlear implant (CI) and represent the synchronous responses of the electrically stimulated auditory nerve. ECAPs can be obtained using a forward-masking method that measures the neural response to a probe and masker electrode separately and in combination. The panoramic ECAP (PECAP) analyses measured ECAPs obtained using multiple combinations of masker and probe electrodes and uses a nonlinear optimization algorithm to estimate current spread from each electrode and neural health along the cochlea. However, the measurement of ECAPs from multiple combinations of electrodes is too time consuming for use in clinics. Here, we propose and evaluate SpeedCAP, a speedy method for obtaining the PECAP measurements that minimizes recording time by exploiting redundancies between multiple ECAP measures. DESIGN: In the first study, 11 users of Cochlear Ltd. CIs took part. ECAPs were recorded using the forward-masking artifact-cancelation technique at the most comfortable loudness level (MCL) for every combination of masker and probe electrodes for all active electrodes in the users' MAPs, as per the standard PECAP recording paradigm. The same current levels and recording parameters were then used to collect ECAPs in the same users with the SpeedCAP method. The ECAP amplitudes were then compared between the two conditions, as were the corresponding estimates of neural health and current spread calculated using the PECAP method previously described by Garcia et al. The second study measured SpeedCAP intraoperatively in 8 CI patients and with all maskers and probes presented at the same current level to assess feasibility. ECAPs for the subset of conditions where the masker and probe were presented on the same electrode were compared with those obtained using the slower approach leveraged by the standard clinical software. RESULTS: Data collection time was reduced from ≈45 to ≈8 minutes. There were no significant differences between normalized root mean squared error (RMSE) repeatability metrics for post-operative PECAP and SpeedCAP data, nor for the RMSEs calculated between PECAP and SpeedCAP data. The comparison achieved 80% power to detect effect sizes down to 8.2% RMSE. When between-participant differences were removed, both the neural-health (r = 0.73) and current-spread (r = 0.65) estimates were significantly correlated ( p < 0.0001, df = 218) between SpeedCAP and PECAP conditions across all electrodes, and showed RMSE errors of 12.7 ± 4.7% and 16.8 ± 8.8%, respectively (with the ± margins representing 95% confidence intervals). Valid ECAPs were obtained in all patients in the second study, demonstrating intraoperative feasibility of SpeedCAP. No significant differences in RMSEs were detectable between post- and intra-operative ECAP measurements, with the comparison achieving 80% power to detect effect sizes down to 13.3% RMSE. CONCLUSIONS: The improved efficiency of SpeedCAP provides time savings facilitating multi-electrode ECAP recordings in routine clinical practice. SpeedCAP data collection is sufficiently quick to record intraoperatively, and adds no more than 8.2% error to the ECAP amplitudes. Such measurements could thereafter be submitted to models such as PECAP to provide patient-specific patterns of neural activation to inform programming of clinical MAPs and identify causes of poor performance at the electrode-nerve interface of CI users. The speed and accuracy of these measurements also opens up a wide range of additional research questions to be addressed.
Asunto(s)
Implantación Coclear , Implantes Cocleares , Humanos , Implantación Coclear/métodos , Cóclea/fisiología , Potenciales Evocados , Potenciales Evocados Auditivos/fisiología , Potenciales de Acción/fisiología , Nervio Coclear/fisiología , Estimulación EléctricaRESUMEN
To obtain combined behavioural and electrophysiological measures of pitch perception, we presented harmonic complexes, bandpass filtered to contain only high-numbered harmonics, to normal-hearing listeners. These stimuli resemble bandlimited pulse trains and convey pitch using a purely temporal code. A core set of conditions consisted of six stimuli with baseline pulse rates of 94, 188 and 280 pps, filtered into a HIGH (3365-4755 Hz) or VHIGH (7800-10,800 Hz) region, alternating with a 36% higher pulse rate. Brainstem and cortical processing were measured using the frequency following response (FFR) and auditory change complex (ACC), respectively. Behavioural rate change difference limens (DLs) were measured by requiring participants to discriminate between a stimulus that changed rate twice (up-down or down-up) during its 750-ms presentation from a constant-rate pulse train. FFRs revealed robust brainstem phase locking whose amplitude decreased with increasing rate. Moderate-sized but reliable ACCs were obtained in response to changes in purely temporal pitch and, like the psychophysical DLs, did not depend consistently on the direction of rate change or on the pulse rate for baseline rates between 94 and 280 pps. ACCs were larger and DLs lower for stimuli in the HIGH than in the VHGH region. We argue that the ACC may be a useful surrogate for behavioural measures of rate discrimination, both for normal-hearing listeners and for cochlear-implant users. We also showed that rate DLs increased markedly when the baseline rate was reduced to 48 pps, and compared the behavioural and electrophysiological findings to recent cat data obtained with similar stimuli and methods.
Asunto(s)
Implantación Coclear , Implantes Cocleares , Percepción de la Altura Tonal/fisiología , Implantación Coclear/métodos , Tronco Encefálico , Audición , Discriminación de la Altura Tonal/fisiologíaRESUMEN
This study assessed the detection of mistuning of a single harmonic in complex tones (CTs) containing either low-frequency harmonics or very high-frequency harmonics, for which phase locking to the temporal fine structure is weak or absent. CTs had F0s of either 280 or 1400 Hz and contained harmonics 6-10, the 8th of which could be mistuned. Harmonics were presented either diotically or dichotically (odd and even harmonics to different ears). In the diotic condition, mistuning-detection thresholds were very low for both F0s and consistent with detection of temporal interactions (beats) produced by peripheral interactions of components. In the dichotic condition, for which the components in each ear were more widely spaced and beats were not reported, the mistuned component was perceptually segregated from the complex for the low F0, but subjects reported no "popping out" for the high F0 and performance was close to chance. This is consistent with the idea that phase locking is required for perceptual segregation to occur. For diotic presentation, the perceived beat rate corresponded to the amount of mistuning (in Hz). It is argued that the beat percept cannot be explained solely by interactions between the mistuned component and its two closest harmonic neighbours.
Asunto(s)
Percepción , Estimulación Acústica , Humanos , PsicoacústicaRESUMEN
We describe a scalp-recorded measure of tonotopic selectivity, the "cortical onset response" (COR) and compare the results between humans and cats. The COR results, in turn, were compared with psychophysical masked-detection thresholds obtained using similar stimuli and obtained from both species. The COR consisted of averaged responses elicited by 50-ms tone-burst probes presented at 1-s intervals against a continuous noise masker. The noise masker had a bandwidth of 1 or 1/8th octave, geometrically centred on 4000 Hz for humans and on 8000 Hz for cats. The probe frequency was either - 0.5, - 0.25, 0, 0.25 or 0.5 octaves re the masker centre frequency. The COR was larger for probe frequencies more distant from the centre frequency of the masker, and this effect was greater for the 1/8th-octave than for the 1-octave masker. This pattern broadly reflected the masked excitation patterns obtained psychophysically with similar stimuli in both species. However, the positive signal-to-noise ratio used to obtain reliable COR measures meant that some aspects of the data differed from those obtained psychophysically, in a way that could be partly explained by the upward spread of the probe's excitation pattern. Our psychophysical measurements also showed that the auditory filter width obtained at 8000 Hz using notched-noise maskers was slightly wider in cat than previous measures from humans. We argue that although conclusions from COR measures differ in some ways from conclusions based on psychophysics, the COR measures provide an objective, noninvasive, valid measure of tonotopic selectivity that does not require training and that may be applied to acoustic and cochlear-implant experiments in humans and laboratory animals.
Asunto(s)
Ruido , Enmascaramiento Perceptual , Animales , Umbral Auditivo/fisiología , Gatos , Electrofisiología , Humanos , Enmascaramiento Perceptual/fisiología , PsicofísicaRESUMEN
Cochlear implant (CI) users show limited sensitivity to the temporal pitch conveyed by electric stimulation, contributing to impaired perception of music and of speech in noise. Neurophysiological studies in cats suggest that this limitation is due, in part, to poor transmission of the temporal fine structure (TFS) by the brainstem pathways that are activated by electrical cochlear stimulation. It remains unknown, however, how that neural limit might influence perception in the same animal model. For that reason, we developed non-invasive psychophysical and electrophysiological measures of temporal (i.e., non-spectral) pitch processing in the cat. Normal-hearing (NH) cats were presented with acoustic pulse trains consisting of band-limited harmonic complexes that simulated CI stimulation of the basal cochlea while removing cochlear place-of-excitation cues. In the psychophysical procedure, trained cats detected changes from a base pulse rate to a higher pulse rate. In the scalp-recording procedure, the cortical-evoked acoustic change complex (ACC) and brainstem-generated frequency following response (FFR) were recorded simultaneously in sedated cats for pulse trains that alternated between the base and higher rates. The range of perceptual sensitivity to temporal pitch broadly resembled that of humans but was shifted to somewhat higher rates. The ACC largely paralleled these perceptual patterns, validating its use as an objective measure of temporal pitch sensitivity. The phase-locked FFR, in contrast, showed strong brainstem encoding for all tested pulse rates. These measures demonstrate the cat's perceptual sensitivity to pitch in the absence of cochlear-place cues and may be valuable for evaluating neural mechanisms of temporal pitch perception in the feline animal model of stimulation by a CI or novel auditory prostheses.
Asunto(s)
Implantación Coclear , Implantes Cocleares , Estimulación Acústica/métodos , Animales , Gatos , Humanos , Percepción de la Altura Tonal/fisiología , Psicofísica , Cuero CabelludoRESUMEN
HYPOTHESIS: Stimulation-Current-Induced Non-Stimulating Electrode Voltage Recordings (SCINSEVs) can help detect extracochlear electrodes for a variety of Cochlear Implant (CI) devices. BACKGROUND: Extracochlear electrodes (EEs) occur in 9 to 13% of cochlear implantations and commonly go unnoticed without imaging. Electrodes on the electrode array located extracochlearly are associated with non-auditory stimulation and a decrease in speech outcomes. We have previously shown that SCINSEVs, with hardware and software from one manufacturer, could detect EEs. Here, we test the generalizability to other manufacturers. METHODS: Fresh-frozen human cadaveric heads were implanted with Cochlear Ltd. CI522 (CI-A) and MED-EL's FLEX24 (CI-B) electrodes. Contact impedances and SCIN- SEVs were measured, with Cochlear Ltd. research Custom Sound software (Transimpedance Matrix) and MED-EL's clinical MAESTRO (Impedance Field Telemetry), for full insertion and EEs in air, saline and soft tissue. An automated detection tool was optimized and tested for these implants. Intra-operative SCINSEVs with EEs were collected for clinical purposes for six patients. RESULTS: The pattern of SCINSEVs changed in the transition zone from intracochlear to extracochlear electrodes, even with low contact impedances on EEs. Automated detection in the cadaveric specimens, with two or more EEs in saline or soft tissue, showed a mean 91% sensitivity and specificity for CI-A and 100% sensitivity and specificity for CI-B. Quantification of EEs showed significant correlations of râ =â0.69 between estimated and actual EEs for CI-A and râ=â0.76 for CI-B. CONCLUSION: The applicability of SCINSEVs to detect extra- cochlear electrodes could be expanded to other cochlear implant companies despite differences in electrode array design and measurement software.
Asunto(s)
Implantación Coclear , Implantes Cocleares , Cadáver , Cóclea/cirugía , Impedancia Eléctrica , Electrodos , Electrodos Implantados , HumanosRESUMEN
OBJECTIVES: To investigate the combined effect of changing pulse shape and grounding configuration to manage facial nerve stimulation (FNS) in cochlear implant (CI) recipients. PATIENTS: Three adult CI recipients with severe FNS were offered a replacement implant when standard stimulation strategies and programming adjustments did not resolve symptoms. Our hypothesis was that the facial nerve was less likely to be activated when using anodic pulses with "mixed-mode" intra-cochlear and extra-cochlear current return. INTERVENTION: All patients were reimplanted with an implant that uses a pseudo-monophasic anodic pulse shape, with mixed-mode grounding (stimulus mixed-mode anodic)-the Neuro Zti CI (Oticon Medical). This device also allows measurements of neural function and loudness with monopolar, symmetric biphasic pulses (stimulus MB), the clinical standard used by most CIs as a comparison. MAIN OUTCOME MEASURES: The combined effect of pulse shape and grounding configuration on FNS was monitored during surgery. Following CI activation, FNS symptoms and performance with the Neuro Zti implant were compared with outcomes before reimplantation. RESULTS: FNS could only be recorded using stimulus MB for all patients. In clinical use, all patients reported reduced FNS and showed an improvement in Bamford-Kowal-Bench sentences recognition compared with immediately before reimplantation. Bamford-Kowal-Bench scores with a male speaker were lower compared with measurements taken before the onset of severe FNS for patients 1 and 2. CONCLUSIONS: In patients where CI auditory performance was severely limited by FNS, charge-balanced pseudo-monophasic stimulation mode with a mixed-mode grounding configuration limited FNS and improved loudness percept compared with standard biphasic stimulation with monopolar grounding.
Asunto(s)
Implantación Coclear , Implantes Cocleares , Adulto , Cóclea , Implantación Coclear/efectos adversos , Implantes Cocleares/efectos adversos , Nervio Coclear , Estimulación Eléctrica , Nervio Facial/cirugía , Humanos , Masculino , ReimplantaciónRESUMEN
Cochlear implants (CIs) convey the amplitude envelope of speech by modulating high-rate pulse trains. However, not all of the envelope may be necessary to perceive amplitude modulations (AMs); the effective envelope depth may be limited by forward and backward masking from the envelope peaks. Three experiments used modulated pulse trains to measure which portions of the envelope can be effectively processed by CI users as a function of AM frequency. Experiment 1 used a three-interval forced-choice task to test the ability of CI users to discriminate less-modulated pulse trains from a fully modulated standard, without controlling for loudness. The stimuli in experiment 2 were identical, but a two-interval task was used in which participants were required to choose the less-modulated interval, ignoring loudness. Catch trials, in which judgements based on level or modulation depth would give opposing answers, were included. Experiment 3 employed novel stimuli whose modulation envelope could be modified below a variable point in the dynamic range, without changing the loudness of the stimulus. Overall, results showed that substantial portions of the envelope are not accurately encoded by CI users. In experiment 1, where loudness cues were available, participants on average were insensitive to changes in the bottom 30% of their dynamic range. In experiment 2, where loudness was controlled, participants appeared insensitive to changes in the bottom 50% of the dynamic range. In experiment 3, participants were insensitive to changes in the bottom 80% of the dynamic range. We discuss potential reasons for this insensitivity and implications for CI speech-processing strategies.
Asunto(s)
Implantación Coclear , Implantes Cocleares , Sordera , Estimulación Acústica , Implantación Coclear/métodos , Señales (Psicología) , Sordera/rehabilitación , HumanosRESUMEN
We simulated the effect of several automatic gain control (AGC) and AGC-like systems and head movement on the output levels, and resulting interaural level differences (ILDs) produced by bilateral cochlear-implant (CI) processors. The simulated AGC systems included unlinked AGCs with a range of parameter settings, linked AGCs, and two proprietary multi-channel systems used in contemporary CIs. The results show that over the range of values used clinically, the parameters that most strongly affect dynamic ILDs are the release time and compression ratio. Linking AGCs preserves ILDs at the expense of monaural level changes and, possibly, comfortable listening level. Multichannel AGCs can whiten output spectra, and/or distort the dynamic changes in ILD that occur during and after head movement. We propose that an unlinked compressor with a ratio of approximately 3:1 and a release time of 300-500 ms can preserve the shape of dynamic ILDs, without causing large spectral distortions or sacrificing listening comfort.
Asunto(s)
Implantación Coclear , Implantes Cocleares , Localización de Sonidos , Percepción del Habla , Percepción Auditiva , Movimientos de la CabezaRESUMEN
Cochlear implants (CIs) are the world's most successful sensory prosthesis and have been the subject of intense research and development in recent decades. We critically review the progress in CI research, and its success in improving patient outcomes, from the turn of the century to the present day. The review focuses on the processing, stimulation, and audiological methods that have been used to try to improve speech perception by human CI listeners, and on fundamental new insights in the response of the auditory system to electrical stimulation. The introduction of directional microphones and of new noise reduction and pre-processing algorithms has produced robust and sometimes substantial improvements. Novel speech-processing algorithms, the use of current-focusing methods, and individualised (patient-by-patient) deactivation of subsets of electrodes have produced more modest improvements. We argue that incremental advances have and will continue to be made, that collectively these may substantially improve patient outcomes, but that the modest size of each individual advance will require greater attention to experimental design and power. We also briefly discuss the potential and limitations of promising technologies that are currently being developed in animal models, and suggest strategies for researchers to collectively maximise the potential of CIs to improve hearing in a wide range of listening situations.
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Implantación Coclear , Implantes Cocleares , Percepción del Habla , Estimulación Acústica , Implantes Cocleares/historia , Implantes Cocleares/tendencias , Historia del Siglo XX , Historia del Siglo XXI , Humanos , RuidoRESUMEN
Cochlear implants (CIs) are neuroprostheses that partially restore hearing for people with severe-to-profound hearing loss. While CIs can provide good speech perception in quiet listening situations for many, they fail to do so in environments with interfering sounds for most listeners. Previous research suggests that this is due to detrimental interaction effects between CI electrode channels, limiting their function to convey frequency-specific information, but evidence is still scarce. In this study, an experimental manipulation called spectral blurring was used to increase channel interaction in CI listeners using Advanced Bionics devices with HiFocus 1J and MS electrode arrays to directly investigate its causal effect on speech perception. Instead of using a single electrode per channel as in standard CI processing, spectral blurring used up to 6 electrodes per channel simultaneously to increase the overlap between adjacent frequency channels as would occur in cases with severe channel interaction. Results demonstrated that this manipulation significantly degraded CI speech perception in quiet by 15% and speech reception thresholds in babble noise by 5 dB when all channels were blurred by a factor of 6. Importantly, when channel interaction was increased just on a subset of electrodes, speech scores were mostly unaffected and were only significantly degraded when the 5 most apical channels were blurred. These apical channels convey information up to 1 kHz at the apical end of the electrode array and are typically located at angular insertion depths of about 250 up to 500°. These results confirm and extend earlier findings indicating that CI speech perception may not benefit from deactivating individual channels along the array and that efforts should instead be directed towards reducing channel interaction per se and in particular for the most-apical electrodes. Hereby, causal methods such as spectral blurring could be used in future research to control channel interaction effects within listeners for evaluating compensation strategies.
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Percepción Auditiva/fisiología , Cóclea/patología , Sordera/prevención & control , Percepción del Habla/fisiología , Estimulación Acústica , Anciano , Implantación Coclear/métodos , Implantes Cocleares/normas , Sordera/patología , Femenino , Humanos , Masculino , Persona de Mediana Edad , RuidoRESUMEN
Listeners appear able to extract a residue pitch from high-frequency harmonics for which phase locking to the temporal fine structure is weak or absent. The present study investigated musical interval perception for high-frequency harmonic complex tones using the same stimuli as Lau, Mehta, and Oxenham [J. Neurosci. 37, 9013-9021 (2017)]. Nine young musically trained listeners with especially good high-frequency hearing adjusted various musical intervals using harmonic complex tones containing harmonics 6-10. The reference notes had fundamental frequencies (F0s) of 280 or 1400 Hz. Interval matches were possible, albeit markedly worse, even when all harmonic frequencies were above the presumed limit of phase locking. Matches showed significantly larger systematic errors and higher variability, and subjects required more trials to finish a match for the high than for the low F0. Additional absolute pitch judgments from one subject with absolute pitch, for complex tones containing harmonics 1-5 or 6-10 with a wide range of F0s, were perfect when the lowest frequency component was below about 7 kHz, but at least 50% of responses were incorrect when it was 8 kHz or higher. The results are discussed in terms of the possible effects of phase-locking information and familiarity with high-frequency stimuli on pitch.
Asunto(s)
Música , Audición , Humanos , Percepción , Discriminación de la Altura Tonal , Percepción de la Altura TonalRESUMEN
The knowledge of patient-specific neural excitation patterns from cochlear implants (CIs) can provide important information for optimizing efficacy and improving speech perception outcomes. The Panoramic ECAP ('PECAP') method (Cosentino et al. 2015) uses forward-masked electrically evoked compound action-potentials (ECAPs) to estimate neural activation patterns of CI stimulation. The algorithm requires ECAPs be measured for all combinations of probe and masker electrodes, exploiting the fact that ECAP amplitudes reflect the overlapping excitatory areas of both probes and maskers. Here we present an improved version of the PECAP algorithm that imposes biologically realistic constraints on the solution, that, unlike the previous version, produces detailed estimates of neural activation patterns by modelling current spread and neural health along the intracochlear electrode array and is capable of identifying multiple regions of poor neural health. The algorithm was evaluated for reliability and accuracy in three ways: (1) computer-simulated current-spread and neural-health scenarios, (2) comparisons to psychophysical correlates of neural health and electrode-modiolus distances in human CI users, and (3) detection of simulated neural 'dead' regions (using forward masking) in human CI users. The PECAP algorithm reliably estimated the computer-simulated scenarios. A moderate but significant negative correlation between focused thresholds and the algorithm's neural-health estimates was found, consistent with previous literature. It also correctly identified simulated 'dead' regions in all seven CI users evaluated. The revised PECAP algorithm provides an estimate of neural excitation patterns in CIs that could be used to inform and optimize CI stimulation strategies for individual patients in clinical settings.
Asunto(s)
Implantación Coclear , Implantes Cocleares , Potenciales de Acción , Algoritmos , Cóclea/fisiología , Estimulación Eléctrica , Potenciales Evocados Auditivos/fisiología , Humanos , Reproducibilidad de los ResultadosRESUMEN
The upper limit of rate-based pitch perception and rate discrimination can differ substantially across cochlear implant (CI) users. One potential reason for this difference is the presence of a biological limitation on temporal encoding in the electrically-stimulated auditory pathway, which can be inherent to the electrical stimulation itself and/or to the degenerative processes associated with hearing loss. Electrophysiological measures, like the electrically-evoked frequency following response (eFFR) and auditory change complex (eACC), could potentially provide valuable insights in the temporal processing limitations at the level of the brainstem and cortex in the electrically-stimulated auditory pathway. Obtaining these neural responses, free from stimulation artifacts, is challenging, especially when the neural response is phase-locked to the stimulation rate, as is the case for the eFFR. In this study we investigated the feasibility of measuring eFFRs, free from stimulation artifacts, to stimulation rates ranging from 94 to 196 pulses per second (pps) and eACCs to pulse rate changes ranging from 36 to 108%, when stimulating in a monopolar configuration. A high-sampling rate EEG system was used to measure the electrophysiological responses in five CI users, and linear interpolation was applied to remove the stimulation artifacts from the EEG. With this approach, we were able to measure eFFRs for pulse rates up to 162 pps and eACCs to the different rate changes. Our results show that it is feasible to measure electrophysiological responses, free from stimulation artifacts, that could potentially be used as neural correlates for rate and pitch processing in CI users.