Effect of stimulation parameters on sequential current-steered stimuli in cochlear implants.

Manipulation of cochlear implant (CI) place pitch was carried out with current steering by stimulating two CI electrodes sequentially. The objective was to investigate whether shifts in activated neural populations could be achieved to produce salient pitch differences and to determine which stimulation parameters would be more effective in steering of current. These were the pulse rate and pulse width of electrical stimuli and the distance between the two current-steering electrodes. Nine CI users participated, and ten ears were tested. The pattern of pitch changes was not consistent across listeners, but the data suggest that individualized selection of stimulation parameters may be used to effect place pitch changes with sequential current steering. Individual analyses showed that pulse width generally had little influence on the effectiveness of current steering with sequential stimuli, while more salient place pitch shifts were often achieved at wider electrode spacing or when the stimulation pulse rate was the same as that indicated on the clinical MAP (the set of stimulation parameters) of the listener. Results imply that current steering may be used in CIs that allow only sequential stimulation to achieve place pitch manipulation.

Apical Reference Stimulation: A Possible Solution to Facial Nerve Stimulation.

OBJECTIVES: Postimplantation facial nerve stimulation is a common side-effect of intracochlear electrical stimulation. Facial nerve stimulation occurs when electric current intended to stimulate the auditory nerve, spread beyond the cochlea to excite the nearby facial nerve, causing involuntarily facial muscle contractions. Facial nerve stimulation can often be resolved through adjustments in speech processor fitting but, in some instances, these measures exhibit limited benefit or may have a detrimental effect on speech perception. In this study, apical reference stimulation mode was investigated as a potential intervention to facial nerve stimulation. Apical reference stimulation is a bipolar stimulation strategy in which the most apical electrode is used as the reference electrode for stimulation on all the other intracochlear electrodes. DESIGN: A person-specific model of the human cochlea, facial nerve and electrode array, coupled with a neural model, was used to predict excitation of auditory and facial nerve fibers. These predictions were used to evaluate the effectiveness in reducing facial nerve stimulation using apical reference stimulation. Predictions were confirmed in psychoacoustic tests by determining auditory comfort and threshold levels for the apical reference stimulation mode while capturing electromyography data in two participants. RESULTS: Models predicted a favorable outcome for apical reference stimulation, as facial nerve fiber thresholds were higher and auditory thresholds were lower, in direct comparison to conventional monopolar stimulation. Psychophysical tests also illustrated decreased auditory thresholds and increased dynamic range during apical reference stimulation. Furthermore, apical reference stimulation resulted in lower electromyography energy levels, compared to conventional monopolar stimulation, which suggests a reduction in facial nerve stimulation. Subjective feedback corroborated that apical reference stimulation alleviated facial nerve stimulation. CONCLUSION: Apical reference stimulation may be a viable strategy to alleviate facial nerve stimulation considering the improvements in dynamic range and auditory thresholds, complemented with a reduction in facial nerve stimulation symptoms.

Facial nerve stimulation in a post-meningitic cochlear implant user: using computational modelling as a tool to probe mechanisms and progression of complications on a case-by-case basis.

Facial nerve stimulation (FNS) is a side-effect of cochlear implantation that can result in severe discomfort for the user and essentially limits the optimal use of the implant. Three-dimensional cochlear implant modelling research has led to the progression from generic models to user-specific models with one of the intentions to develop model-based diagnostic tools. The objective of this study is to investigate the mechanisms that underlie the manifestation of FNS in the post-meningitic cochleae of a specific CI user through computational modelling. Bilateral models were created using a method previously developed for the construction of a three-dimensional user-specific volume conduction model of the cochlea and was expanded to include the facial nerve geometry. Reduced temporal bone density based on bone densitometry, cochlear duct ossification and degenerate auditory neural fibres were incorporated into a comprehensive FNS model. Auditory and facial nerve thresholds were predicted with the models showing good correspondence to perceptual thresholds and the user's FNS experience. Ossified cochlear ducts appear to aggravate the increase in thresholds caused by the otic capsule's decreased resistivity. This translational case study demonstrates the application of computational modelling as a clinical instrument in the assessment and management of complications with cochlear implantation.

Analysis of a purely conductance-based stochastic nerve fibre model as applied to compound models of populations of human auditory nerve fibres used in cochlear implant simulations.

The study presents the application of a purely conductance-based stochastic nerve fibre model to human auditory nerve fibres within finite element volume conduction models of a semi-generic head and user-specific cochleae. The stochastic, threshold and temporal characteristics of the human model are compared and successfully validated against physiological feline results with the application of a mono-polar, bi-phasic, cathodic first stimulus. Stochastic characteristics validated include: (i) the log(Relative Spread) versus log(fibre diameter) distribution for the discharge probability versus stimulus intensity plots and (ii) the required exponential membrane noise versus transmembrane voltage distribution. Intra-user, and to a lesser degree inter-user, comparisons are made with respect to threshold and dynamic range at short and long pulse widths for full versus degenerate single fibres as well as for populations of degenerate fibres of a single user having distributed and aligned somas with varying and equal diameters. Temporal characteristics validated through application of different stimulus pulse rates and different stimulus intensities include: (i) discharge rate, latency and latency standard deviation versus stimulus intensity, (ii) period histograms and (iii) interspike interval histograms. Although the stochastic population model does not reduce the modelled single deterministic fibre threshold, the simulated stochastic and temporal characteristics show that it could be used in future studies to model user-specific temporally encoded information, which influences the speech perception of CI users.

Development of a voltage-dependent current noise algorithm for conductance-based stochastic modelling of auditory nerve fibres.

This study presents the development of an alternative noise current term and novel voltage-dependent current noise algorithm for conductance-based stochastic auditory nerve fibre (ANF) models. ANFs are known to have significant variance in threshold stimulus which affects temporal characteristics such as latency. This variance is primarily caused by the stochastic behaviour or microscopic fluctuations of the node of Ranvier's voltage-dependent sodium channels of which the intensity is a function of membrane voltage. Though easy to implement and low in computational cost, existing current noise models have two deficiencies: it is independent of membrane voltage, and it is unable to inherently determine the noise intensity required to produce in vivo measured discharge probability functions. The proposed algorithm overcomes these deficiencies while maintaining its low computational cost and ease of implementation compared to other conductance and Markovian-based stochastic models. The algorithm is applied to a Hodgkin-Huxley-based compartmental cat ANF model and validated via comparison of the threshold probability and latency distributions to measured cat ANF data. Simulation results show the algorithm's adherence to in vivo stochastic fibre characteristics such as an exponential relationship between the membrane noise and transmembrane voltage, a negative linear relationship between the log of the relative spread of the discharge probability and the log of the fibre diameter and a decrease in latency with an increase in stimulus intensity.

Three-dimensional models of cochlear implants: A review of their development and how they could support management and maintenance of cochlear implant performance.

Three-dimensional (3D) computational modeling of the auditory periphery forms an integral part of modern-day research in cochlear implants (CIs). These models consist of a volume conduction description of implanted stimulation electrodes and the current distribution around these, coupled with auditory nerve fiber models. Cochlear neural activation patterns can then be predicted for a given input stimulus. The objective of this article is to present the context of 3D modeling within the field of CIs, the different models, and approaches to models that have been developed over the years, as well as the applications and potential applications of these models. The process of development of 3D models is discussed, and the article places specific emphasis on the complementary roles of generic models and user-specific models, as the latter is important for translation of these models into clinical application.

Fuzzy information transmission analysis for continuous speech features.

Feature information transmission analysis (FITA) estimates information transmitted by an acoustic feature by assigning tokens to categories according to the feature under investigation and comparing within-category to between-category confusions. FITA was initially developed for categorical features (e.g., voicing) for which the category assignments arise from the feature definition. When used with continuous features (e.g., formants), it may happen that pairs of tokens in different categories are more similar than pairs of tokens in the same category. The estimated transmitted information may be sensitive to category boundary location and the selected number of categories. This paper proposes a fuzzy approach to FITA that provides a smoother transition between categories and compares its sensitivity to grouping parameters with that of the traditional approach. The fuzzy FITA was found to be sufficiently robust to boundary location to allow automation of category boundary selection. Traditional and fuzzy FITA were found to be sensitive to the number of categories. This is inherent to the mechanism of isolating a feature by dividing tokens into categories, so that transmitted information values calculated using different numbers of categories should not be compared. Four categories are recommended for continuous features when twelve tokens are used.

Is there a fundamental 300 Hz limit to pulse rate discrimination in cochlear implants?

Literature often refers to a 300 pps limit for cochlear implant (CI) electrical stimulation, above which pulse rate discrimination deteriorates or above which rate pitch is not perceived to increase. The present study investigated the effect on pulse rate difference limens (PRDLs) when using compound stimuli in which identical pulse trains were applied to multiple electrodes across the length of the electrode array and compared the results to those of single-electrode stimuli. PRDLs of seven CI users were determined in two stimulus pulse phase conditions, one in which the phase delays between pulses on different electrodes were minimised (burst mode) and a second in which they were maximised (spread mode). PRDLs were measured at base rates of 100 to 600 pps in 100 pps intervals, using compound stimuli on one, two, five, nine and 18 electrodes. As smaller PRDLs were expected to reflect improved rate pitch perception, 18-electrode spread mode stimuli were also included in a pitch ranking task. PRDLs improved markedly when multi-electrode compound stimuli were used, with average spread mode PRDLs across listeners between 6 and 8 % of the base rate in the whole range tested (i.e. up to 600 pps). PRDLs continued to improve as more electrodes were included, up to at least nine electrodes in the compound stimulus. Stimulus pulse phase had a significant influence on the results, with PRDLs being smaller in spread mode. Results indicate that pulse rate discrimination may be manipulated with stimulus parameter choice so that previously observed deterioration of PRDLs at 300 pps probably does not reflect a fundamental limitation to rate discrimination. However, rate pitch perception did not improve in the conditions that resulted in smaller PRDLs. This may indicate that listeners used cues other than pitch to perform the rate discrimination task or may reflect limitations in the electrically evoked neural excitation patterns presented to a rate pitch extraction mechanism.

Perception of vowels and prosody by cochlear implant recipients in noise.

UNLABELLED: The aim of the present study was to compare the ability of cochlear implant (CI) recipients to recognise speech prosody in the presence of speech-weighted noise to their ability to recognise vowels in the same test paradigm and listening condition. All test materials were recorded from four different speakers (two male, two female). Two prosody recognition tasks were developed, both using single words as stimuli. The first task involved a question/statement distinction, while the second task required listeners to make a judgement about the speaker's attitude. Vowel recognition tests were conducted using vowel pairs selected on the basis of specific acoustic cues (frequencies of the first two formants and duration). Ten CI users and ten normal-hearing controls were tested in both quiet and an adaptive noise condition, using a two-alternative forced-choice test paradigm for all the tests. Results indicated that vowel recognition was significantly better than prosody recognition in both listener groups in both quiet and noise, and that question/statement discrimination was the most difficult task for CI listeners in noise. Data from acoustic analyses were used to interpret differences in performance on different tasks and with different speakers. LEARNING OUTCOMES: As a result of this activity, readers will be able to (1) describe suitable methods for comparing vowel and prosody perception in noise, (2) compare performance on vowel and prosody perception tasks in quiet in normal-hearing listeners and cochlear implant recipients, (3) compare performance on vowel and prosody perception tasks in noise in normal-hearing listeners and cochlear implant recipients and (4) relate performance on prosody tasks in quiet to performance on these tasks in noise.

Preparation of stimuli for timbre perception studies.

Stimuli used in timbre perception studies must be controlled carefully in order to yield meaningful results. During psychoacoustic testing of individual timbre properties, (1) it must be ensured that timbre properties do not co-vary, as timbre properties are often not independent from one another, and (2) the potential influence of loudness, pitch, and perceived duration must be eliminated. A mathematical additive synthesis method is proposed which allows complete control over two spectral parameters, the spectral centroid (corresponding to brightness) and irregularity, and two temporal parameters, log rise-time (LRT) and a parameter characterizing the sustain/decay segment, while controlling for covariation in the spectral centroid and irregularity. Thirteen musical instrument sounds were synthesized. Perceptual data from six listeners indicate that variation in the four timbre properties mainly influences loudness and that perceived duration and pitch are not influenced significantly for the stimuli of longer duration (2 s) used here. Trends across instruments were found to be similar.

When "okay" is not okay: acoustic characteristics of single-word prosody conveying reluctance.

The present study explored the acoustic characteristics of prosodic cues that indicate a speaker's reluctance when giving permission or agreement using a single word ("okay"). Eight speakers (four male, four female) produced the recorded materials that were subsequently validated through a listening experiment using 12 normal-hearing listeners. Acoustic analyses revealed that significantly longer word duration was the cue used most consistently across speakers to communicate reluctance. Voice quality, fundamental voice frequency, and intensity cues also differed significantly between the two prosodic conditions, but the manner in which these cues were applied varied greatly across speakers.

Can subject-specific single-fibre electrically evoked auditory brainstem response data be predicted from a model?

This article investigates whether prediction of subject-specific physiological data is viable through an individualised computational model of a cochlear implant. Subject-specific predictions could be particularly useful to assess and quantify the peripheral factors that cause inter-subject variations in perception. The results of such model predictions could potentially be translated to clinical application through optimisation of mapping parameters for individual users, since parameters that affect perception would be reflected in the model structure and parameters. A method to create a subject-specific computational model of a guinea pig with a cochlear implant is presented. The objectives of the study are to develop a method to construct subject-specific models considering translation of the method to in vivo human models and to assess the effectiveness of subject-specific models to predict peripheral neural excitation on subject level. Neural excitation patterns predicted by the model are compared with single-fibre electrically evoked auditory brainstem responses obtained from the inferior colliculus in the same animal. Results indicate that the model can predict threshold frequency location, spatial spread of bipolar and tripolar stimulation and electrode thresholds relative to one another where electrodes are located in different cochlear structures. Absolute thresholds and spatial spread using monopolar stimulation are not predicted accurately. Improvements to the model should address this.

The relative importance of spectral cues for vowel recognition in severe noise.

The importance of formants and spectral shape was investigated for vowel perception in severe noise. Twelve vowels were synthesized using two different synthesis methods, one where the original spectral detail was preserved, and one where the vowel was represented by the spectral peaks of the first three formants. In addition, formants F1 and F2 were suppressed individually to investigate the importance of each in severe noise. Vowels were presented to listeners in quiet and in speech-shaped noise at signal to noise ratios (SNRs) of 0, -5, and -10 dB, and vowel confusions were determined in a number of conditions. Results suggest that the auditory system relies on formant information for vowel perception irrespective of the SNR, but that, as noise increases, it relies increasingly on more complete spectral information to perform formant extraction. A second finding was that, while F2 is more important in quiet or low noise conditions, F1 and F2 are of similar importance in severe noise.

An analysis of the effects of electrical field interaction with an acoustic model of cochlear implants.

Electrical field interaction caused by current spread in a cochlear implant was modeled in an explicit way in an acoustic model (the SPREAD model) presented to six listeners with normal hearing. The typical processing of cochlear implants was modeled more closely than in traditional acoustic models by careful selection of parameters related to current spread or parameters that could amplify the electrical field interactions caused by current spread. These parameters were the insertion depth, electrode spacing, electrical dynamic range, and dynamic range compression function. The hypothesis was that current spread could account for the asymptote in performance in speech intelligibility experiments observed at around seven stimulation channels in a number of cochlear implant studies. Speech intelligibility for sentences, vowels, and consonants at three noise levels (SNR of +15 dB, +10 dB, and +5 dB) was measured as a function of the number of spectral channels (4, 7, and 16). The SPREAD model appears to explain the asymptote in speech intelligibility at seven channels for all noise levels for all speech material used in this study. It is shown that the compressive amplitude mapping used in cochlear implants can have a detrimental effect on the number of effective channels.

The performance of different synthesis signals in acoustic models of cochlear implants.

Synthesis (carrier) signals in acoustic models embody assumptions about perception of auditory electric stimulation. This study compared speech intelligibility of consonants and vowels processed through a set of nine acoustic models that used Spectral Peak (SPEAK) and Advanced Combination Encoder (ACE)-like speech processing, using synthesis signals which were representative of signals used previously in acoustic models as well as two new ones. Performance of the synthesis signals was determined in terms of correspondence with cochlear implant (CI) listener results for 12 attributes of phoneme perception (consonant and vowel recognition; F1, F2, and duration information transmission for vowels; voicing, manner, place of articulation, affrication, burst, nasality, and amplitude envelope information transmission for consonants) using four measures of performance. Modulated synthesis signals produced the best correspondence with CI consonant intelligibility, while sinusoids, narrow noise bands, and varying noise bands produced the best correspondence with CI vowel intelligibility. The signals that performed best overall (in terms of correspondence with both vowel and consonant attributes) were modulated and unmodulated noise bands of varying bandwidth that corresponded to a linearly varying excitation width of 0.4 mm at the apical to 8 mm at the basal channels.

The development of an Afrikaans test for sentence recognition thresholds in noise.

OBJECTIVE: The development of a valid and reliable Afrikaans test of sentence recognition thresholds in noise. DESIGN: A collection of sentences was developed, rated for naturalness and grammatical complexity, and digitally recorded using a female speaker. Sentences found to have similar psychometric curve slopes, with equivalent intelligibility at three different noise levels, were arranged into 22 phonemically matched lists of ten sentences each. List equivalence was evaluated in normal-hearing listeners in full and reduced bandwidth conditions. Test-retest reliability of the remaining lists was evaluated in a second group of listeners. STUDY SAMPLE: All listeners were native speakers of Afrikaans with normal hearing. For evaluation of list equivalence, ten listeners were used. Twenty other listeners were used to evaluate test-retest reliability. RESULTS: A collection of eighteen phonemically matched lists was produced. Lists were found to be of equivalent difficulty in full and reduced bandwidth conditions, and to have good test-retest reliability in normal-hearing listeners. The average recognition threshold of these lists was -2.73 dB signal-to-noise ratio (standard deviation = 0.64 dB), and within-subject variability was 1.22 dB. CONCLUSIONS: The developed test provides a valid and reliable means of measuring sentence recognition thresholds in noise in Afrikaans.

Threshold predictions of different pulse shapes using a human auditory nerve fibre model containing persistent sodium and slow potassium currents.

The ability of a human auditory nerve fibre computational model to predict threshold differences for biphasic, pseudomonophasic and alternating monophasic waveforms was investigated. The effect of increasing the interphase gap, interpulse interval and pulse rate on thresholds was also simulated. Simulations were performed for both anodic-first and cathodic-first stimuli. Results indicated that the model correctly predicted threshold reductions for pseudomonophasic compared to biphasic waveforms, although reduction for alternating monophasic waveforms was underestimated. Threshold reductions were more pronounced for cathodic-first stimuli compared to anodic-first stimuli. Reversal of the phases in pseudomonophasic stimuli suggested a threshold reduction for anodic-first stimuli, but a threshold increase in cathodic-first stimuli. Inclusion of the persistent sodium and slow potassium currents in the model resulted in a reasonably accurate prediction of the non-monotonic threshold behaviour for pulse rates higher than 1000 pps. However, the model did not correctly predict the threshold changes observed for low pulse rate biphasic and alternating monophasic waveforms. It was suggested that these results could in part be explained by the difference in the refractory periods between real and simulated auditory nerve fibres, but also by the lack of representation of stochasticity observed in real auditory nerve fibres in our auditory nerve model.

Modelled temperature-dependent excitability behaviour of a generalised human peripheral sensory nerve fibre.

The objective of this study was to determine if a recently developed human Ranvier node model, which is based on a modified version of the Hodgkin-Huxley model, could predict the excitability behaviour in human peripheral sensory nerve fibres with diameters ranging from 5.0 to 15.0 microm. The Ranvier node model was extended to include a persistent sodium current and was incorporated into a generalised single cable nerve fibre model. Parameter temperature dependence was included. All calculations were performed in Matlab. Sensory nerve fibre excitability behaviour characteristics predicted by the new nerve fibre model at different temperatures and fibre diameters compared well with measured data. Absolute refractory periods deviated from measured data, while relative refractory periods were similar to measured data. Conduction velocities showed both fibre diameter and temperature dependence and were underestimated in fibres thinner than 12.5 microm. Calculated strength-duration time constants ranged from 128.5 to 183.0 micros at 37 degrees C over the studied nerve fibre diameter range, with chronaxie times about 30% shorter than strength-duration time constants. Chronaxie times exhibited temperature dependence, with values overestimated by a factor 5 at temperatures lower than body temperature. Possible explanations include the deviated absolute refractory period trend and inclusion of a nodal strangulation relationship.

Estimation of stimulus attenuation in cochlear implants.

Neural excitation profile widths at the neural level, for monopolar stimulation with Nucleus straight and contour arrays respectively, were simulated using a combined volume-conduction-neural model. The electrically evoked compound action potential profile widths at the electrode array level were calculated with a simple approximation method employing stimulus attenuation inside the cochlear duct, and the results compared to profile width data from literature. The objective of the article is to develop a simple method to estimate stimulus attenuation values by calculating the values that best fit the modelled excitation profile widths to the measured evoked compound action potential profile widths. Results indicate that the modelled excitation profile widths decrease with increasing stimulus attenuation. However, fitting of modelled excitation profile widths to measured evoked compound action potential profile widths show that different stimulus attenuation values are needed for different stimulation levels. It is suggested that the proposed simple model can provide an estimate of stimulus attenuation by calculating the value of the parameter that produces the best fit to experimental data in specific human subjects.

Modelled temperature-dependent excitability behaviour of a single ranvier node for a human peripheral sensory nerve fibre.

The objective of this study was to determine whether the Hodgkin-Huxley model for unmyelinated nerve fibres could be modified to predict excitability behaviour at Ranvier nodes. Only the model parameters were modified to those of human, with the equations left unaltered. A model of a single Ranvier node has been developed as part of a larger model to describe excitation behaviour in a generalised human peripheral sensory nerve fibre. Parameter values describing the ionic and leakage conductances, corresponding equilibrium potentials, resting membrane potential and membrane capacitance of the original Hodgkin-Huxley model were modified to reflect the corresponding parameter values for human. Parameter temperature dependence was included. The fast activating potassium current kinetics were slowed down to represent those of a slow activating and deactivating potassium current, which do not inactivate. All calculations were performed in MATLAB. Action potential shape and amplitude were satisfactorily predicted at 20, 25 and 37 degrees C, and were not influenced by activation or deactivation of the slow potassium current. The calculated chronaxie time constant was 65.5 micros at 37 degrees C. However, chronaxie times were overestimated at temperatures lower than body temperature.