Electro-Tactile Stimulation Enhances Cochlear Implant Speech Recognition in Noise.

For cochlear implant users, combined electro-acoustic stimulation (EAS) significantly improves the performance. However, there are many more users who do not have any functional residual acoustic hearing at low frequencies. Because tactile sensation also operates in the same low frequencies (<500 Hz) as the acoustic hearing in EAS, we propose electro-tactile stimulation (ETS) to improve cochlear implant performance. In ten cochlear implant users, a tactile aid was applied to the index finger that converted voice fundamental frequency into tactile vibrations. Speech recognition in noise was compared for cochlear implants alone and for the bimodal ETS condition. On average, ETS improved speech reception thresholds by 2.2 dB over cochlear implants alone. Nine of the ten subjects showed a positive ETS effect ranging from 0.3 to 7.0 dB, which was similar to the amount of the previously-reported EAS benefit. The comparable results indicate similar neural mechanisms that underlie both the ETS and EAS effects. The positive results suggest that the complementary auditory and tactile modes also be used to enhance performance for normal hearing listeners and automatic speech recognition for machines.

Central masking with bilateral cochlear implants.

Across bilateral cochlear implants, contralateral threshold shift has been investigated as a function of electrode difference between the masking and probe electrodes. For contralateral electric masking, maximum threshold elevations occurred when the position of the masker and probe electrode was approximately place-matched across ears. The amount of masking diminished with increasing masker-probe electrode separation. Place-dependent masking occurred in both sequentially implanted ears, and was not affected by the masker intensity or the time delay from the masker onset. When compared to previous contralateral masking results in normal hearing, the similarities between place-dependent central masking patterns suggest comparable mechanisms of overlapping excitation in the central auditory nervous system.

Ipsilateral masking between acoustic and electric stimulations.

Residual acoustic hearing can be preserved in the same ear following cochlear implantation with minimally traumatic surgical techniques and short-electrode arrays. The combined electric-acoustic stimulation significantly improves cochlear implant performance, particularly speech recognition in noise. The present study measures simultaneous masking by electric pulses on acoustic pure tones, or vice versa, to investigate electric-acoustic interactions and their underlying psychophysical mechanisms. Six subjects, with acoustic hearing preserved at low frequencies in their implanted ear, participated in the study. One subject had a fully inserted 24 mm Nucleus Freedom array and five subjects had Iowa/Nucleus hybrid implants that were only 10 mm in length. Electric masking data of the long-electrode subject showed that stimulation from the most apical electrodes produced threshold elevations over 10 dB for 500, 625, and 750 Hz probe tones, but no elevation for 125 and 250 Hz tones. On the contrary, electric stimulation did not produce any electric masking in the short-electrode subjects. In the acoustic masking experiment, 125-750 Hz pure tones were used to acoustically mask electric stimulation. The acoustic masking results showed that, independent of pure tone frequency, both long- and short-electrode subjects showed threshold elevations at apical and basal electrodes. The present results can be interpreted in terms of underlying physiological mechanisms related to either place-dependent peripheral masking or place-independent central masking.