Jaime Undurraga

Polarity effects on neural responses of the electrically stimulated auditory nerve at different cochlear sites

Three experiments studied the effect of stimulus polarity on the Electrically Evoked Compound Action Potential (ECAP) obtained with the masker-probe paradigm on different sites along the cochlea in cochlear implant users. Experiment 1 used a biphasic cathodic-1st (BIC) masker and showed that ECAP N(1) peak latencies were longer for BIC than for biphasic anodic-1st (BIA) probes on all electrodes under test. Both the latency of each probe as well as the latency difference between BIA and BIC probes increased when the phase width (PW) of the masker and probe were increased together. Experiment 2 used maskers with long inter-phase gaps (IPGs), and, by manipulating the polarity of the second phase (closest in time to the biphasic probe), showed that only an anodic phase could mask the probe response. Experiment 3 used maskers and probes with long IPGs and measured ECAPs to the first phase of the probe; ECAPs could be measured when both this phase and the second phase of the masker were anodic, but not when they were cathodic. Our results extend those of a previous study, showing that the auditory nerve in humans is preferentially activated by anodic stimulation, to different sites along the cochlea.

Spread of excitation varies for different electrical pulse shapes and stimulation modes in cochlear implants.

In cochlear implants (CI) bipolar (BP) electrical stimulation has been suggested as a method to reduce the spread of current along the cochlea. However, behavioral measurements in BP mode have shown either similar or worse performance than in monopolar (MP) mode. This could be explained by a bimodal excitation pattern, with two main excitation peaks at the sites of the stimulating electrodes. We measured the spread of excitation (SOE) by means of the electrically evoked compound action potential (ECAP), obtained using the forward-masked paradigm. The aim was to measure the bimodality of the excitation and to determine whether it could be reduced by using asymmetric pulses. Three types of maskers shapes were used: symmetric (SYM), pseudomonophasic (PS), and symmetric with a long inter-phase gap (SYM-IPG) pulses. Maskers were presented in BP + 9 (wide), BP + 3 (narrow) and MP (only SYM) mode on fixed electrodes. The SOE obtained with the MP masker showed a main excitation peak close to the masker electrode. Wide SYM maskers produced bimodal excitation patterns showing two peaks close to the electrodes of the masker channel, whereas SYM-IPG maskers showed a single main peak near the electrode for which the maskers second phase (responsible for most of the masking) was anodic. Narrow SYM maskers showed complex and wider excitation patterns than asymmetric stimuli consistent with the overlap of the patterns produced by each channels electrodes. The masking produced by narrow SYM-IPG and PS stimuli was more pronounced close to the masker electrode for which the effective phase was anodic. These results showed that the anodic polarity is the most effective one in BP mode and that the bimodal patterns produced by SYM maskers could be partially reduced by using asymmetric pulses.

Evaluating the Noise in Electrically Evoked Compound Action Potential Measurements in Cochlear Implants

Electrically evoked compound action potentials (ECAPs) are widely used to study the excitability of the auditory nerve and stimulation properties in cochlear implant (CI) users. However, ECAP detection can be difficult and very subjective at near-threshold stimulation levels or in spread of excitation measurements. In this study, we evaluated the statistical properties of the background noise (BN) and the postaverage residual noise (RN) in ECAP measurements in order to determine an objective detection criterion. For the estimation of the BN and the RN, a method currently used in auditory brainstem response measurements was applied. The potential benefit of using weighted (Bayesian) averages was also examined. All estimations were performed with a set of approximately 360 ECAP measurements recorded from five human CI users of the CII or HiRes90K device (advanced bionics). Results demonstrated that the BN was normally distributed and the RN decreased according to the square root of the number of averages. No additional benefit was observed by using weighted averaging. The noise was not significantly different either at different stimulation intensities or across recording electrodes along the cochlea. The analysis of the statistical properties of the noise indicated that a signal-to-noise ratio of 1.7 dB as a detection criterion corresponds to a false positive detection rate of 1% with the used measurement setup.

A Comparison of Two Objective Measures of Binaural Processing: The Interaural Phase Modulation Following Response and the Binaural Interaction Component.

There has been continued interest in clinical objective measures of binaural processing. One commonly proposed measure is the binaural interaction component (BIC), which is obtained typically by recording auditory brainstem responses (ABRs)—the BIC reflects the difference between the binaural ABR and the sum of the monaural ABRs (i.e., binaural − (left + right)). We have recently developed an alternative, direct measure of sensitivity to interaural time differences, namely, a following response to modulations in interaural phase difference (the interaural phase modulation following response; IPM-FR). To obtain this measure, an ongoing diotically amplitude-modulated signal is presented, and the interaural phase difference of the carrier is switched periodically at minima in the modulation cycle. Such periodic modulations to interaural phase difference can evoke a steady state following response. BIC and IPM-FR measurements were compared from 10 normal-hearing subjects using a 16-channel electroencephalographic system. Both ABRs and IPM-FRs were observed most clearly from similar electrode locations—differential recordings taken from electrodes near the ear (e.g., mastoid) in reference to a vertex electrode (Cz). Although all subjects displayed clear ABRs, the BIC was not reliably observed. In contrast, the IPM-FR typically elicited a robust and significant response. In addition, the IPM-FR measure required a considerably shorter recording session. As the IPM-FR magnitude varied with interaural phase difference modulation depth, it could potentially serve as a correlate of perceptual salience. Overall, the IPM-FR appears a more suitable clinical measure than the BIC.

Electrophysiological and Behavioral Evidence of Reduced Binaural Temporal Processing in the Aging and Hearing Impaired Human Auditory System

A person’s ability to process temporal fine structure information is indispensable for speech understanding. As speech understanding typically deteriorates throughout adult life, this study aimed to disentangle age and hearing impairment (HI)-related changes in binaural temporal processing. This was achieved by examining neural and behavioral processing of interaural phase differences (IPDs). Neural IPD processing was studied electrophysiologically through steady-state activity in the electroencephalogram evoked by periodic changes in IPDs over time, embedded in the temporal fine structure of acoustic stimulation. In addition, behavioral IPD discrimination thresholds were determined for the same stimuli. To disentangle potential effects of age from those of HI, both measures were applied to six participant groups: young, middle-aged, and older persons, with either normal hearing or sensorineural HI. All participants passed a cognitive screening, and stimulus audibility was controlled for in participants with HI. The results demonstrated that HI changes neural processing of binaural temporal information for all age-groups included in this study. These outcomes were revealed, superimposed on age-related changes that emerge between young adulthood and middle age. Poorer neural outcomes were also associated with poorer behavioral performance, even though the behavioral IPD discrimination thresholds were affected by age rather than by HI. The neural outcomes of this study are the first to evidence and disentangle the dual load of age and HI on binaural temporal processing. These results could be a valuable first step toward future research on rehabilitation.

Spatial Selectivity in Cochlear Implants: Effects of Asymmetric Waveforms and Development of a Single-Point Measure

Three experiments studied the extent to which cochlear implant users’ spatial selectivity can be manipulated using asymmetric waveforms and tested an efficient method for comparing spatial selectivity produced by different stimuli. Experiment 1 measured forward-masked psychophysical tuning curves (PTCs) for a partial tripolar (pTP) probe. Maskers were presented on bipolar pairs separated by one unused electrode; waveforms were either symmetric biphasic (“SYM”) or pseudomonophasic with the short high-amplitude phase being either anodic (“PSA”) or cathodic (“PSC”) on the more apical electrode. For the SYM masker, several subjects showed PTCs consistent with a bimodal excitation pattern, with discrete excitation peaks on each electrode of the bipolar masker pair. Most subjects showed significant differences between the PSA and PSC maskers consistent with greater masking by the electrode where the high-amplitude phase was anodic, but the pattern differed markedly across subjects. Experiment 2 measured masked excitation patterns for a pTP probe and either a monopolar symmetric biphasic masker (“MP_SYM”) or pTP pseudomonophasic maskers where the short high-amplitude phase was either anodic (“TP_PSA”) or cathodic (“TP_PSC”) on the masker’s central electrode. Four of the five subjects showed significant differences between the masker types, but again the pattern varied markedly across subjects. Because the levels of the maskers were chosen to produce the same masking of a probe on the same channel as the masker, it was correctly predicted that maskers that produce broader masking patterns would sound louder. Experiment 3 exploited this finding by using a single-point measure of spread of excitation to reveal significantly better spatial selectivity for TP_PSA compared to TP_PSC maskers.

Objective assessment of electrode discrimination with the auditory change complex in adult cochlear implant users

ABSTRACT The spatial auditory change complex (ACC) is a cortical response elicited by a change in place of stimulation. There is growing evidence that it provides a useful objective measure of electrode discrimination in cochlear implant (CI) users. To date, the spatial ACC has only been measured in relatively experienced CI users with one type of device. Early assessment of electrode discrimination could allow auditory stimulation to be optimized during a potentially sensitive period of auditory rehabilitation. In this study we used a direct stimulation paradigm to measure the spatial ACC in both pre‐ and post‐lingually deafened adults. We show that it is feasible to measure the spatial ACC in different CI devices and as early as 1 week after CI switch‐on. The spatial ACC has a strong relationship with performance on a behavioural discrimination task and in some cases provides information over and above behavioural testing. We suggest that it may be useful to measure the spatial ACC to guide auditory rehabilitation and improve hearing performance in CI users. HIGHLIGHTSThe spatial ACC can be measured in different CI devices.It can be measured as early as 1‐week after switch‐on.It has a strong relationship with behavioural electrode discrimination.May be present despite poor behavioural discrimination in prelingually deaf adults.

Development of electrophysiological and behavioural measures of electrode discrimination in adult cochlear implant users

ABSTRACT The plasticity of the auditory system enables it to adjust to electrical stimulation from cochlear implants (CI). Whilst speech perception may develop for many years after implant activation, very little is known about the changes in auditory processing that underpin these improvements. Such an understanding could help guide interventions that improve hearing performance. In this longitudinal study, we examine how electrode discrimination ability changes over time in newly implanted adult CI users. Electrode discrimination was measured with a behavioural task as well as the spatial auditory change complex (ACC), which is a cortical response to a change in place of stimulation. We show that there was significant improvement in electrode discrimination ability over time, though in certain individuals the process of accommodation was slower and more limited. We found a strong relationship between objective and behavioural measures of electrode discrimination using pass‐fail rules. In several cases, the development of the spatial ACC preceded accurate behavioural discrimination. These data provide evidence for plasticity of auditory processing in adult CI users. Behavioural electrode discrimination score but not spatial ACC amplitude was found to be a significant predictor of speech perception. We suggest that it would be beneficial to measure electrode discrimination in CI users and that interventions that exploit the plastic capacity of the auditory system to improve basic auditory processing, could be used to optimize performance in CI users. HighlightsElectrode discrimination ability improves with hearing experience in CI users.There is marked inter‐individual variability in the pattern of change over time.The ACC has a strong relationship with behavioural electrode discrimination.In certain cases, the ACC can precede accurate behavioural discrimination.

An objective measure of temporal fine structure correlates with perception in a speech discrmination task

Sensitivity to the temporal fine structure (TFS) of sounds is considered important for understanding speech, especially in the presence of background noise, but few studies have employed objective measures to assess the relationship between sensitivity to TFS and listening to speech. Here, we used EEG (electroencephalography) to obtain an objective measure of sensitivity to the TFS of low-frequency sounds (520-Hz amplitude-modulated tones) in listeners who also undertook a speech-discrimination task (discrimination of vowel-consonant-vowel, VCV, sounds in background noise). Two different sound levels (60 and 80 dB SPL) and three different signal-to-noise ratios (SNRs; -6, 0 and + 6 dB) were used. Three symmetric interaural phase modulations (IPMs), were measured: -60°/60°, -90°/90°, and -120°/120°. A fourth condition used an IPM switching between 0° and 180° degrees. IPM-FRs were higher for the 0/180° degrees than all other conditions. Employing the ratio of the 3 symmetric to the asymmetric (0/180°) IPM-...