Speech Perception With Novel Stimulation Strategies for CombinedCochleo-Vestibular Systems.

Cochlear implants are very well established in the rehabilitation of hearing loss and are regarded as the most successful neuroprostheses to date. While a lot of progress has also been made in the neighboring field of specific vestibular implants, some diseases affect the entire inner ear, leading to both hearing and vestibular hypo- or dysfunction. The proximity of the cochlear and vestibular organs suggests a single combined implant as a means to alleviate the associated impairments. While both organs can be stimulated in a similar way with electric pulses applied through implanted electrodes, the typical phase durations needed in the vestibular system seem to be substantially larger than those typically needed in the cochlear system. Therefore, when using sequential stimulation in a combined implant, the pulse stream to the cochlea is interrupted by comparatively large gaps in which vestibular stimulation can occur. We investigate the impact of these gaps in the auditory stream on speech perception. Specifically, we compare a number of stimulation strategies with different gap lengths and distributions and evaluate whether it is feasible to use them without having a noticeable decline in perception and quality of speech. This is a prerequisite for any practicable stimulation strategy of a combined system and can be investigated even in recipients of a normal cochlear implant. Our results show that there is no significant deterioration in speech perception for the different strategies examined in this paper, leaving the strategies as viable candidates for prospective combined cochleo-vestibular implants.

Temporal Pitch Perception in Cochlear-Implant Users: Channel Independence in Apical Cochlear Regions.

Two-electrode stimuli presented on adjacent mid-array contacts in cochlear-implant users elicit pitch percepts that are not consistent with a summation of the two temporal patterns. This indicates that low-rate temporal rate codes can be applied with considerable independence on adjacent mid-array electrodes. At issue in this study was whether a similar independence of temporal pitch cues can also be observed for more apical sites of stimulation, where temporal cues have been shown to be more reliable than place cues, in contrast to middle and basal sites. In cochlear-implant recipients with single-sided deafness implanted with long lateral-wall electrode arrays, pitch percepts were assessed by matching the pitch of dual-electrode stimuli with pure tones presented to the contralateral normal-hearing ear. The results were supported with an additional pitch-ranking experiment, in a different subject population with bilateral deafness. Unmodulated pulse trains with 100, 200, and 400 pulses per second were presented on three pairs of adjacent electrodes. Pulses were separated by the minimal interchannel delay (1.7 µs) in a short-delay configuration and by half the pulse period in a long-delay configuration. The hypothesis was that subjects would perceive a pitch corresponding to the doubled temporal pattern for the long-delay stimuli due to the summation of excitation patterns from adjacent apical electrodes, if those electrodes were to activate largely overlapping neural populations. However, we found that the mean matched acoustic pitch of the long-delay pulses was not significantly different from that of the short-delay pulses. These findings suggest that also in the apical region in long-array cochlear-implant recipients, temporal cues can be transmitted largely independently on adjacent electrodes.

The effect of tinnitus specific intracochlear stimulation on speech perception in patients with unilateral or asymmetric hearing loss accompanied with tinnitus and the effect of formal auditory training.

OBJECTIVES: Previous studies show that intracochlear electrical stimulation independent of environmental sounds appears to suppress tinnitus, even long-term. In order to assess the viability of this potential treatment option it is essential to study the effects of this tinnitus specific electrical stimulation on speech perception. DESIGN: A randomised, prospective crossover design. STUDY SAMPLE: Ten patients with unilateral or asymmetric hearing loss and severe tinnitus complaints. RESULTS: The audiological effects of standard clinical CI, formal auditory training and tinnitus specific electrical stimulation were investigated. Results show that standard clinical CI in unilateral or asymmetric hearing loss is shown to be beneficial for speech perception in quiet, speech perception in noise and subjective hearing ability. Formal auditory training does not appear to improve speech perception performance. However, CI-related discomfort reduces significantly more rapidly during CI rehabilitation in subjects receiving formal auditory training. Furthermore, tinnitus specific electrical stimulation has neither positive nor negative effects on speech perception. CONCLUSIONS: In combination with the findings from previous studies on tinnitus suppression using intracochlear electrical stimulation independent of environmental sounds, the results of this study contribute to the viability of cochlear implantation based on tinnitus complaints.

Reduction of eddy current losses in inductive transmission systems with ferrite sheets.

BACKGROUND: Improvements in eddy current suppression are necessary to meet the demand for increasing miniaturization of inductively driven transmission systems in industrial and biomedical applications. The high magnetic permeability and the simultaneously low electrical conductivity of ferrite materials make them ideal candidates for shielding metallic surfaces. For systems like cochlear implants the transmission of data as well as energy over an inductive link is conducted within a well-defined parameter set. For these systems, the shielding can be of particular importance if the properties of the link can be preserved. RESULTS: In this work, we investigate the effect of single and double-layered substrates consisting of ferrite and/or copper on the inductance and coupling of planar spiral coils. The examined link systems represent realistic configurations for active implantable systems such as cochlear implants. Experimental measurements are complemented with analytical calculations and finite element simulations, which are in good agreement for all measured parameters. The results are then used to study the transfer efficiency of an inductive link in a series-parallel resonant topology as a function of substrate size, the number of coil turns and coil separation. CONCLUSIONS: We find that ferrite sheets can be used to shield the system from unwanted metallic surfaces and to retain the inductive link parameters of the unperturbed system, particularly its transfer efficiency. The required size of the ferrite plates is comparable to the size of the coils, which makes the setup suitable for practical implementations. Since the sizes and geometries chosen for the studied inductive links are comparable to those of cochlear implants, our conclusions apply in particular to these systems.

Long-term effects of intracochlear electrical stimulation with looped patterns on tinnitus: A case study.

Electrical stimulation by cochlear implant (CI) has been proven to be a viable treatment option for tinnitus in many recent studies. In addition, intracochlear electrical stimulation independent of an acoustic input appears to suppress tinnitus, at least in the short term. We conducted a case study to investigate the long-term effects of both standard CI and intracochlear electrical stimulation independent of an acoustic input on tinnitus in a patient with single-sided deafness and tinnitus. We found no negative effects of intracochlear electrical stimulation independent of an acoustic input on speech perception in noise. Furthermore, the additional use of a standard CI was advantageous for speech discrimination in our patient. We conclude that long-term tinnitus suppression can be achieved via intracochlear electrical stimulation with looped patterns. Our findings in terms of speech discrimination in our patient were consistent with those reported in previous studies.

Tinnitus Suppression by Intracochlear Electrical Stimulation in Single Sided Deafness - A Prospective Clinical Trial: Follow-Up.

INTRODUCTION: Earlier studies show that a Cochlear Implant (CI), capable of providing intracochlear electrical stimulation independent of environmental sounds, appears to suppress tinnitus at least for minutes. The current main objective is to compare the long-term suppressive effects of looped (i.e. repeated) electrical stimulation (without environmental sound perception) with the standard stimulation pattern of a CI (with environmental sound perception). This could open new possibilities for the development of a "Tinnitus Implant" (TI), an intracochlear pulse generator for the suppression of tinnitus. MATERIALS AND METHODS: Ten patients with single sided deafness suffering from unilateral tinnitus in the deaf ear are fitted with a CI (MED-EL Corporation, Innsbruck, Austria). Stimulation patterns are optimized for each individual patient, after which they are compared using a randomized crossover design, with a follow-up of six months, followed by a 3 month period using the modality of patient's choice. RESULTS: Results show that tinnitus can be suppressed with intracochlear electrical stimulation independent of environmental sounds, even long term. No significant difference in tinnitus suppression was found between the standard clinical CI and the TI. CONCLUSION: It can be concluded that coding of environmental sounds is no requirement for tinnitus suppression with intracochlear electrical stimulation. It is therefore plausible that tinnitus suppression by CI is not solely caused by an attention shift from the tinnitus to environmental sounds. Both the standard clinical CI and the experimental TI are potential treatment options for tinnitus. These findings offer perspectives for a successful clinical application of the TI, possibly even in patients with significant residual hearing. TRIAL REGISTRATION: TrialRegister.nl NTR3374.

Tinnitus Suppression by Intracochlear Electrical Stimulation in Single-Sided Deafness: A Prospective Clinical Trial - Part I.

Cochlear implantation is a viable treatment option for tinnitus, but the underlying mechanism is yet unclear. Is the tinnitus suppression due to the reversal of the assumed maladaptive neuroplasticity or is it the shift in attention from the tinnitus to environmental sounds and therefore a reduced awareness that reduces tinnitus perception? In this prospective trial, 10 patients with single-sided deafness were fitted with a cochlear implant to investigate the effect of looped intracochlear electrical stimulation (i.e. stimulation that does not encode environmental sounds) on tinnitus, in an effort to find optimal stimulation parameters. Variables under investigation were: amplitude (perceived stimulus loudness), anatomical location inside the cochlea (electrode/electrodes), amplitude modulation, polarity (cathodic/anodic first biphasic stimulation) and stimulation rate. The results suggest that tinnitus can be reduced with looped electrical stimulation, in some cases even with inaudible stimuli. The optimal stimuli for tinnitus suppression appear to be subject specific. However, medium-to-loud stimuli suppress tinnitus significantly better than soft stimuli, which partly can be explained by the masking effect. Although the long-term effects on tinnitus would still have to be investigated and will be described in part II, intracochlear electrical stimulation seems a potential treatment option for tinnitus in this population.

Frequency-place map for electrical stimulation in cochlear implants: Change over time.

The relationship between the place of electrical stimulation from a cochlear implant and the corresponding perceived pitch remains uncertain. Previous studies have estimated what the pitch corresponding to a particular location should be. However, perceptual verification is difficult because a subject needs both a cochlear implant and sufficient residual hearing to reliably compare electric and acoustic pitches. Additional complications can arise from the possibility that the pitch corresponding to an electrode may change as the auditory system adapts to a sound processor. In the following experiment, five subjects with normal or near-to-normal hearing in one ear and a cochlear implant with a long electrode array in the other ear were studied. Pitch matches were made between single electrode pulse trains and acoustic tones before activation of the speech processor to gain an estimate of the pitch provided by electrical stimulation at a given insertion angle without the influence of exposure to a sound processor. The pitch matches were repeated after 1, 3, 6, and 12 months of experience with the sound processor to evaluate the effect of adaptation over time. Pre-activation pitch matches were lower than would be estimated by a spiral ganglion pitch map. Deviations were largest for stimulation below 240° degrees and smallest above 480°. With experience, pitch matches shifted towards the frequency-to-electrode allocation. However, no statistically significant pitch shifts were observed over time. The likely explanation for the lack of pitch change is that the frequency-to-electrode allocations for the long electrode arrays were already similar to the pre-activation pitch matches. Minimal place pitch shifts over time suggest a minimal amount of perceptual remapping needed for the integration of electric and acoustic stimuli, which may contribute to shorter times to asymptotic performance.

Speech perception with interaction-compensated simultaneous stimulation and long pulse durations in cochlear implant users.

Early multi-channel designs in the history of cochlear implant development were based on a vocoder-type processing of frequency channels and presented bands of compressed analog stimulus waveforms simultaneously on multiple tonotopically arranged electrodes. The realization that the direct summation of electrical fields as a result of simultaneous electrode stimulation exacerbates interactions among the stimulation channels and limits cochlear implant outcome led to the breakthrough in the development of cochlear implants, the continuous interleaved (CIS) sampling coding strategy. By interleaving stimulation pulses across electrodes, CIS activates only a single electrode at each point in time, preventing a direct summation of electrical fields and hence the primary component of channel interactions. In this paper we show that a previously presented approach of simultaneous stimulation with channel interaction compensation (CIC) may also ameliorate the deleterious effects of simultaneous channel interaction on speech perception. In an acute study conducted in eleven experienced MED-EL implant users, configurations involving simultaneous stimulation with CIC and doubled pulse phase durations have been investigated. As pairs of electrodes were activated simultaneously and pulse durations were doubled, carrier rates remained the same. Comparison conditions involved both CIS and fine structure (FS) strategies, either with strictly sequential or paired-simultaneous stimulation. Results showed no statistical difference in the perception of sentences in noise and monosyllables for sequential and paired-simultaneous stimulation with doubled phase durations. This suggests that CIC can largely compensate for the effects of simultaneous channel interaction, for both CIS and FS coding strategies. A simultaneous stimulation paradigm has a number of potential advantages over a traditional sequential interleaved design. The flexibility gained when dropping the requirement of interleaving pulses across electrodes may be instrumental in designing coding strategies for a more accurate transmission of stimulus features such as temporal fine structure or interaural time delays to the auditory nerve. Also, longer pulse phase durations may be implemented while maintaining relatively high stimulation pulse rates. Utilizing longer pulse durations may relax requirements on implant compliance and facilitate the design of more energy-efficient implant receivers for a longer battery lifetime or a reduction in implant size. This article is part of a Special Issue entitled .

[Development of Mandarin tonal identification in noise test materials].

OBJECTIVE: The aim of this study was to develop comprehensive test material for Mandarin tone identification in noise (M-TINT) based on the linguistic characteristics in Chinese. METHODS: In keeping with both the reliability and efficiency in clinical practice, a primary list consisted of 320 words(80 syllables in four tones each) was designed according to the following principles: shortness of the lists, word familiarity and with a meaning in all four tones. The digital sound file was recorded by a male speaker and a female speaker (both of them are radio broadcaster). RESULTS: The tonal identification material database, which included 288 items (72 loudness-balanced syllables in all 4 Mandarin tones) was established by digital filler and balanced for equal loudness. The complete material was recorded in two CDs in a male version and a female version. The speaker-specific masking noises were generated by filtering Gaussian white noise to the speaker's long-term average speech spectrum (LTASS) and by scaling the masking noises to the same RMS amplitudes, as those of the speech, in order to acquire the effective sound masking. The speaker-specific masking noises could be able or disable during the word presentation. The sound pressure level could be selected concerning on the test setting. CONCLUSIONS: The mandarin tonal identification materials were designed by both the tonal acoustic properties and the psychophysics characteristic of adults. It is an useful speech test in clinical work and research, and can potentially be used as the basic list for other tonal language identification test in the future.

Electric-acoustic pitch comparisons in single-sided-deaf cochlear implant users: frequency-place functions and rate pitch.

Eight cochlear implant users with near-normal hearing in their non-implanted ear compared pitch percepts for pulsatile electric and acoustic pure-tone stimuli presented to the two ears. Six subjects were implanted with a 31-mm MED-EL FLEX(SOFT) electrode, and two with a 24-mm medium (M) electrode, with insertion angles of the most apical contacts ranging from 565° to 758°. In the first experiment, frequency-place functions were derived from pure-tone matches to 1500-pps unmodulated pulse trains presented to individual electrodes and compared to Greenwood's frequency position map along the organ of Corti. While the overall median downward shift of the obtained frequency-place functions (-0.16 octaves re. Greenwood) and the mean shifts in the basal (<240°; -0.33 octaves) and middle (-0.35 octaves) regions were statistically significant, the shift in the apical region (>480°; 0.26 octaves) was not. Standard deviations of frequency-place functions were approximately half an octave at electrode insertion angles below 480°, increasing to an octave at higher angular locations while individual functions were gradually leveling off. In a second experiment, subjects matched the rates of unmodulated pulse trains presented to individual electrodes in the apical half of the array to low-frequency pure tones between 100 Hz and 450 Hz. The aim was to investigate the influence of electrode place on the salience of temporal pitch cues, for coding strategies that present temporal fine structure information via rate modulations on select apical channels. Most subjects achieved reliable matches to tone frequencies from 100 Hz to 300 Hz only on electrodes at angular insertion depths beyond 360°, while rate-matches to 450-Hz tones were primarily achieved on electrodes at shallower insertion angles. Only for electrodes in the second turn the average slopes of rate-pitch functions did not differ significantly from the pure-tone references, suggesting their use for the encoding of within-channel fine frequency information via rate modulations in temporal fine structure stimulation strategies.

Compensation for channel interaction in a simultaneous cochlear implant coding strategy.

This study evaluated a concept to reduce detrimental effects of spatial channel interaction in case of simultaneous stimulation with cochlear implants. The hypothesis was that effects of simultaneous channel interaction can be compensated by an algorithm such that no difference in hearing performance between simultaneous pulsatile stimulation and a strictly sequential reference strategy can be found. The simultaneous strategies used in this study stimulated two or three electrodes simultaneously in a monopolar configuration and used a specific compensation algorithm to reduce detrimental effects of simultaneous channel interaction. Overall stimulation rate was kept constant throughout conditions. Three of the configurations applied extended pulse phase durations. The German Oldenburg sentence and a German vowel test were used to measure speech recognition in 12 cochlear implant users. The results support the initial hypothesis. No significant differences in performance were found. A small spatial distance between simultaneous electrodes yielded slightly better results than a large distance. Extending the pulse phase durations had no significant effect on hearing performance. However, it significantly reduced stimulation amplitudes. Thus strategies implementing channel interaction compensated simultaneous stimulation with extended pulse phase durations might be a viable option for reducing power consumption and increasing battery life in cochlear implants.

Effects of temporal fine structure stimulation on Mandarin speech recognition in cochlear implant users.

CONCLUSION: The investigated experimental coding strategies significantly improved tone identification as compared with the participants' everyday audio processor settings. However, this benefit could not be attributed entirely to temporal fine structure stimulation but seems to be caused by decreasing the lower corner frequency of the filter bank. The 6 week habituation period used in this study might have been too short to allow the listeners to derive additional lexical information from the unfamiliar stimulation patterns. OBJECTIVES: To evaluate a cochlear implant coding strategy that explicitly conveys temporal fine structure information in the context of the tonal language Mandarin. METHODS: The study was designed as a longitudinal, monocentric, prospective, controlled, and randomized cross-over study and included 12 postlingually deafened adults, who were experienced cochlear implant users. Two experimental coding strategies, one of which explicitly presents temporal fine structure information, were compared to the participants' personal TEMPO+ speech processors, which do not convey fine structure information. RESULTS: Both experimental coding strategies improved tone identification by approximately 11 percentage points. This improvement was significant in the female speaker test. Sentence perception, as assessed with the M-HINT test, and quality of life scores were identical with all three coding strategies.

Clinical trial results with the MED-EL fine structure processing coding strategy in experienced cochlear implant users.

OBJECTIVES: To assess the subjective and objective performance of the new fine structure processing strategy (FSP) compared to the previous generation coding strategies CIS+ and HDCIS. METHODS: Forty-six adults with a minimum of 6 months of cochlear implant experience were included. CIS+, HDCIS and FSP were compared in speech perception tests in noise, pitch scaling and questionnaires. The randomized tests were performed acutely (interval 1) and again after 3 months of FSP experience (interval 3). The subjective evaluation included questionnaire 1 at intervals 1 and 3, and questionnaire 2 at interval 2, 1 month after interval 1. RESULTS: Comparison between FSP and CIS+ showed that FSP performed at least as well as CIS+ in all speech perception tests, and outperformed CIS+ in vowel and monosyllabic word discrimination. Comparison between FSP and HDCIS showed that both performed equally well in all speech perception tests. Pitch scaling showed that FSP performed at least as well as HDCIS. With FSP, sound quality was at least as good and often better than with HDCIS. CONCLUSIONS: Results indicate that FSP performs better than CIS+ in vowel and monosyllabic word understanding. Subjective evaluation demonstrates strong user preferences for FSP when listening to speech and music.

In-vitro characterization of a cochlear implant system for recording of evoked compound action potentials.

BACKGROUND: Modern cochlear implants have integrated recording systems for measuring electrically evoked compound action potentials of the auditory nerve. The characterization of such recording systems is important for establishing a reliable basis for the interpretation of signals acquired in vivo. In this study we investigated the characteristics of the recording system integrated into the MED-EL PULSARCI100 cochlear implant, especially its linearity and resolution, in order to develop a mathematical model describing the recording system. METHODS: In-vitro setup: The cochlear implant, including all attached electrodes, was fixed in a tank of physiologic saline solution. Sinusoidal signals of the same frequency but with different amplitudes were delivered via a signal generator for measuring and recording on a single electrode.Computer simulations: A basic mathematical model including the main elements of the recording system, i.e. amplification and digitalization stage, was developed. For this, digital output for sinusoidal input signals of different amplitudes were calculated using in-vitro recordings as reference. RESULTS: Using an averaging of 100 measurements the recording system behaved linearly down to approximately -60 dB of the input signal range. Using the same method, a system resolution of 10 µV was determined for sinusoidal signals. The simulation results were in very good agreement with the results obtained from in-vitro experiments. CONCLUSIONS: The recording system implemented in the MED-EL PULSARCI100 cochlear implant for measuring the evoked compound action potential of the auditory nerve operates reliably. The developed mathematical model provides a good approximation of the recording system.

Development of a Mandarin tone identification test: sensitivity index d' as a performance measure for individual tones.

OBJECTIVE: The aim of this study was to develop comprehensive test material for Mandarin tone identification in noise for a male and a female talker. Additionally, the sensitivity index d' as a measure for the listeners' performance to identify individual tones was evaluated. DESIGN: The study followed a prospective design. STUDY SAMPLE: The complete material comprises 72 loudness-balanced syllables in all 4 Mandarin tones. For a selection of 20 syllables, i.e. 80 test words, performance-versus-intensity functions were measured in spectrally matched noise for 16 normal-hearing participants. RESULTS: The average speech reception thresholds in noise were -12.9 dB for the male and -13.6 dB for the female talker recordings. The corresponding slopes were 8.6%/dB and 7.3%/dB. As a performance measure for individual tones, the proportion of correct responses to specific tones was substantially contaminated by response bias. The sensitivity index d', calculated according to detection theory, provided reasonable and unbiased performance versus intensity functions. CONCLUSIONS: The results firstly indicate that the material is homogenous enough for use as a speech test in clinical work and research. Secondly, to assess the discrimination performance for individual tones, d' values outperform the simple proportion of correct responses.

Torque measurements of the ossicular chain: implication on the MRI safety of the hearing implant Vibrant Soundbridge.

HYPOTHESIS: Is the human ossicular chain stabile enough to withstand the torque of a Vibrant Soundbridge middle ear hearing implant in the magnetic field of a 1.5 T magnetic resonance imaging (MRI) system? BACKGROUND: The Vibrant Soundbridge is a semi-implantable hearing device in which a tiny electromechanical transducer, called floating mass transducer (FMT), is clipped to the ossicular chain within the middle ear. The FMT contains a permanent magnet, which can generate a torque when exposed to a static magnetic field of MRI systems. Since the transducer is routinely attached to the long process of the incus, this torque could affect or even disrupt the ossicular chain. This study investigates the likelihood of a middle ear injury by an FMT in an MRI system. METHODS: Torque measurements were performed on 10 unpreserved human temporal bones. A brass fork was attached to the long process of the incus via a posterior tympanotomy, and a defined torque was applied by a calibrated torque meter. The torque was increased stepwise until an injury of the middle ear was observed. RESULTS: The mean torque at which the middle ear was injured was 4.3 mN.m +/- 1.7 mN.m. The lowest value measured was 1.5 mN.m, and the highest was 6.5 mN.m. CONCLUSION: Even the lowest torque measured is more than 1.5 times higher than the "worst-case" torque affecting the FMT during a 1.5 T MRI examination. The torque on an FMT crimped to the long process of the incus should therefore not harm the human middle ear.

Temporal fine structure in cochlear implants: preliminary speech perception results in Cantonese-speaking implant users.

CONCLUSION: Acute comparisons between continuous interleaved sampling (CIS) and a temporal fine structure (TFS) coding strategy in Cantonese-speaking cochlear implant (CI) users did not reveal any significant differences in speech perception. Performance with the unfamiliar TFS coding strategy was on a par with CIS. Benefits of extended fine structure use observed in other studies should be investigated for tonal languages. OBJECTIVES: CIS-based stimulation strategies lack an explicit representation of fine structure, which is crucial for tonal language speech perception. The aim of this study was to assess speech recognition with a TFS coding strategy in Cantonese-speaking CI users with no prior fine structure experience. METHODS: The fine structure coding strategy encodes TFS on a few apical channels, while the remaining more basal channels carry CIS stimuli. Twelve MED-EL implantees and long-term CIS users participated in a study comparing recognition for Cantonese lexical tones and CHINT sentences between CIS and fine structure stimulation. RESULTS: Mean tone identification scores in 12 subjects were 59.2% with CIS and 59.2% with fine structure stimulation using 4 TFS channels, mean scores of CHINT sentences in 8 subjects were 54.2% with CIS and 55.9% with TFS stimulation. Differences between the two strategies were not significant for any speech test. Two additional versions of TFS strategy and pulse rates were tested in six subjects. No significant differences between strategies were found.

Results with a cochlear implant channel-picking strategy based on "Selected Groups".

A novel channel-picking strategy for cochlear implants (CIs) which considers the spatial distribution and the spectral relevance of the channels selected for stimulation is described. In the proposed strategy, the available channels are subdivided into groups, designated as "Selected Groups" (SG), and within each group, a specified number of active channels with the largest amplitudes are selected for stimulation. The hypothesis is that most of the spectral information that can be perceived by CI listeners is conveyed by taking the highest filter band outputs within a stimulation area represented by a group of neighboring channels. Two experiments were conducted in subjects with MED-EL implant systems, measuring recognition of sentences in speech-shaped noise. In experiment 1, the SG group size was varied from two to four while selecting one active channel per group and keeping the pulse phase durations constant. Results showed no significant difference in sentence recognition between continuous interleaved sampling and SG configurations up to a group size of three. In experiment 2, phase durations were doubled, using groups of two channels with one active channel each. This resulted in a reduction of pulse amplitudes by about 40%. Intelligibility of sentences in noise was unaffected, making a substantial reduction of implant supply voltages feasible. In all experiments, the stimulation frame rate was kept constant in order to avoid rate-change effects.