Investigating the Effect of Blurring and Focusing Current in Cochlear Implant Users with the Panoramic ECAP Method.

Blurred stimulation Cochlear implant Current spread Electrically evoked compound action potential (ECAP) Focused stimulation Neural responsiveness

Journal

Journal of the Association for Research in Otolaryngology : JARO
ISSN: 1438-7573
Titre abrégé: J Assoc Res Otolaryngol
Pays: United States
ID NLM: 100892857

Informations de publication

Date de publication:
16 Oct 2024
Historique:
received: 29 01 2024
accepted: 27 09 2024
medline: 17 10 2024
pubmed: 17 10 2024
entrez: 16 10 2024
Statut: aheadofprint

Résumé

For some cochlear implants (CIs), it is possible to focus electrical stimulation by partially returning current from the active electrode to nearby, intra-cochlear electrodes (partial tripolar (pTP) stimulation). Another method achieves the opposite: "blurring" by stimulating multiple electrodes simultaneously. The Panoramic ECAP (PECAP) method provides a platform to investigate their effects in detail by measuring electrically evoked compound action potentials and estimating current spread and neural responsiveness along the length of the CI electrode array. We investigate how sharpening and broadening the electrical current spread are reflected in PECAP estimates. PECAP measurements were recorded at most comfortable level in 12 ears of Advanced Bionics CI users. Focused thresholds were also determined. For the electrodes with the highest and lowest focused thresholds, additional PECAP measurements were recorded while stimulating in pTP mode and in "blurred" mode with 3 or 5 adjacent electrodes simultaneously stimulated. Current spread and neural responsiveness were then estimated along the electrode array using PECAP. PECAP revealed increased current spread estimates across participants for blurred stimulation of the targeted electrodes towards the apex of the cochlea. Variable results for pTP stimulation were found, with two of eight ears appearing to drive a small group-level effect of increased current spread. When stimulating multiple electrodes simultaneously, PECAP detected localized increases in current spread towards the apex (but not the base) of the cochlea. pTP stimulation showed mixed effects on PECAP current spread estimates. These findings are in line with behavioral speech perception studies and have implications for cochlear implant optimization.

Identifiants

pubmed: 39414747
doi: 10.1007/s10162-024-00966-x
pii: 10.1007/s10162-024-00966-x
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Subventions

Organisme : Wellcome Trust
ID : RG91976
Pays : United Kingdom
Organisme : Medical Research Council
ID : MR/T03095X/1
Pays : United Kingdom
Organisme : International Project Grant (GB)
ID : G82

Informations de copyright

© 2024. The Author(s).

Références

Friesen LM, Shannon RV, Baskent D, Wang X (2001) Speech recognition in noise as a function of the number of spectral channels: comparison of acoustic hearing and cochlear implants. J Acoust Soc Am 110:1150–1163. https://doi.org/10.1121/1.1381538
doi: 10.1121/1.1381538
Firszt JB, Holden LK, Skinner MW, Tobey EA, Peterson A, Gaggl W, Runge-Samuelson CL, Wackym PA (2004) Recognition of speech presented at soft to loud levels by adult cochlear implant recipients of three cochlear implant systems. Ear Hear 25:375–387. https://doi.org/10.1097/01.aud.0000134552.22205.ee
doi: 10.1097/01.aud.0000134552.22205.ee
Shannon RV (1983) Multichannel electrical stimulation of the auditory nerve in man II Channel interaction. Hear Res 12:1–16. https://doi.org/10.1016/0378-5955(83)90115-6
doi: 10.1016/0378-5955(83)90115-6
Nelson DA, Van Tasell DJ, Schroder AC, Soli S, Levine S (1995) Electrode ranking of “place pitch” and speech recognition in electrical hearing. J Acoust Soc Am 98:1987–1999. https://doi.org/10.1121/1.413317
doi: 10.1121/1.413317
Abbas PJ, Hughes ML, Brown CJ, Miller CA, South H (2004) Channel interaction in cochlear implant users evaluated using the electrically evoked compound action potential. Audiol Neurootol 9:203–213. https://doi.org/10.1159/000078390
doi: 10.1159/000078390
van den Honert C, Kelsall DC (2007) Focused intracochlear electric stimulation with phased array channels. J Acoust Soc Am 121:3703–3716. https://doi.org/10.1121/1.2722047
doi: 10.1121/1.2722047
Long CJ, Holden TA, McClelland GH, Parkinson WS, Shelton C, Kelsall DC, Smith ZM (2014) Examining the electro-neural interface of cochlear implant users using psychophysics, CT scans, and speech understanding. J Assoc Res Otolaryngol 15:293–304
doi: 10.1007/s10162-013-0437-5
Kral A, Hatrmann R, Mortazavi D, Klinke R (1998) Spatial resolution of cochlear implants: the electrical field and excitation of auditory afferents. Hear Res 121:11–28. https://doi.org/10.1016/S0378-5955(98)00061-6
doi: 10.1016/S0378-5955(98)00061-6
Bierer JA, Middlebrooks JC (2002) Auditory cortical images of cochlear-implant stimuli: dependence on electrode configuration. J Neurophysiol 87:478–492. https://doi.org/10.1152/jn.00212.2001
doi: 10.1152/jn.00212.2001
Bonham BH, Litvak LM (2008) Current focusing and steering: modeling, physiology, and psychophysics. Hear Res 242:141–153. https://doi.org/10.1016/j.heares.2008.03.006
doi: 10.1016/j.heares.2008.03.006
Bierer JA (2007) Threshold and channel interaction in cochlear implant users: evaluation of the tripolar electrode configuration. J Acoust Soc Am 121:1642–1653. https://doi.org/10.1121/1.2436712
doi: 10.1121/1.2436712
Bierer JA (2010) Probing the electrode-neuron interface with focused cochlear implant stimulation. Trends Amplif 14:84–95. https://doi.org/10.1177/1084713810375249
doi: 10.1177/1084713810375249
Jiang C, Singhal S, Landry T, Roberts IV, de Rijk SR, Brochier T, Goehring T, Tam YC, Carlyon RP, Malliaras GG, Bance ML (2021) An instrumented cochlea model for the evaluation of cochlear implant electrical stimulus spread. IEEE Trans Biomed Eng 68:2281–2288. https://doi.org/10.1109/TBME.2021.3059302
doi: 10.1109/TBME.2021.3059302
Srinivasan AG, Padilla M, Shannon RV, Landsberger DM (2013) Improving speech perception in noise with current focusing in cochlear implant users. Hear Res 200:29–36. https://doi.org/10.1016/j.heares.2013.02.004
doi: 10.1016/j.heares.2013.02.004
Landsberger DM, Srinivasan AG (2009) Virtual channel discrimination is improved by current focusing in cochlear implant recipients. Hear Res 254:34–41. https://doi.org/10.1016/j.heares.2009.04.007
doi: 10.1016/j.heares.2009.04.007
Chari DA, Jiradejvong P, Limb CJ (2019) Tripolar stimulation improves polyphonic pitch detection in cochlear implant users. Otol Neurotol 40:38–46. https://doi.org/10.1097/MAO.0000000000002061
doi: 10.1097/MAO.0000000000002061
Berenstein CK, Mens LHM, Mulder JJS, Vanpoucke FJ (2008) Current steering and current focusing in cochlear implants: comparison of monopolar, tripolar, and virtual channel electrode configurations. Ear Hear 29:250–260. https://doi.org/10.1097/aud.0b013e3181645336
doi: 10.1097/aud.0b013e3181645336
Bierer JA, Litvak L (2016) Reducing channel interaction through cochlear implant programming may improve speech perception: current focusing and channel deactivation. Trends Hear 20:2331216516653389. https://doi.org/10.1177/2331216516653389
doi: 10.1177/2331216516653389
DeVries L, Arenberg JG (2018) Current focusing to reduce channel interaction for distant electrodes in cochlear implant programs. Trends Hear 22:2331216518813811. https://doi.org/10.1177/2331216518813811
doi: 10.1177/2331216518813811
Archer-Boyd AW, Southwell RV, Deeks JM, Turner RE, Carlyon RP (2018) Development and validation of a spectro-temporal processing test for cochlear-implant listeners. J Acoust Soc Am 144:2983–2997. https://doi.org/10.1121/1.5079636
doi: 10.1121/1.5079636
Goehring T, Arenberg JG, Carlyon RP (2020) Using spectral blurring to assess effects of channel interaction on speech-in-noise perception with cochlear implants. J Assoc Res Otolaryngol 21:353–371. https://doi.org/10.1007/s10162-020-00758-z
doi: 10.1007/s10162-020-00758-z
Goehring T, Archer-Boyd AW, Arenberg JG, Carlyon RP (2021) The effect of increased channel interaction on speech perception with cochlear implants. Sci Rep 11:10383. https://doi.org/10.1038/s41598-021-89932-8
doi: 10.1038/s41598-021-89932-8
Shannon RV, Galvin JJ, Baskent D (2002) Holes in hearing. J Assoc Res Otolaryngol 3:185–199. https://doi.org/10.1007/s101620020021
doi: 10.1007/s101620020021
Bosen AK, Chatterjee M (2016) Band importance functions of listeners with cochlear implants using clinical maps. J Acoust Soc Am 140:3718–3727. https://doi.org/10.1121/1.4967298
doi: 10.1121/1.4967298
Guérit F, Middlebrooks JC, Gransier R, Richardson ML, Wouters J, Carlyon RP (2024) Exploring the use of interleaved stimuli to measure cochlear-implant excitation patterns. J Assoc Res Otolaryngol. https://doi.org/10.1007/s10162-024-00937-2
doi: 10.1007/s10162-024-00937-2
Garcia C, Goehring T, Cosentino S, Turner RE, Deeks JM, Brochier T, Rughooputh T, Bance M, Carlyon RP (2021) The Panoramic ECAP method: estimating patient-specific patterns of current spread and neural health in cochlear implant users. J Assoc Res Otolaryngol 22:567–589. https://doi.org/10.1007/s10162-021-00795-2
doi: 10.1007/s10162-021-00795-2
Garcia C (2022) The Panoramic ECAP method: estimating patient-specific patterns of current spread and neural health in cochlear-implant users. Dissertation, University of Cambridge. https://doi.org/10.17863/CAM.89113
Goldwyn JH, Bierer SM, Bierer JA (2010) Modeling the electrode-neuron interface of cochlear implants: effects of neural survival, electrode placement, and the partial tripolar configuration. Hear Res 268:93–104. https://doi.org/10.1016/j.heares.2010.05.005
doi: 10.1016/j.heares.2010.05.005
Bierer JA, Faulkner KF (2010) Identifying cochlear implant channels with poor electrode-neuron interface: partial tripolar, single-channel thresholds and psychophysical tuning curves. Ear Hear 31:247–258. https://doi.org/10.1097/AUD.0b013e3181c7daf4
doi: 10.1097/AUD.0b013e3181c7daf4
Bierer JA, Bierer SM, Kreft HA, Oxenham AJ (2015) A fast method for measuring psychophysical thresholds across the cochlear implant array. Trends Hear 19:2331216515569792. https://doi.org/10.1177/2331216515569792
doi: 10.1177/2331216515569792
DeVries L, Scheperle R, Bierer JA (2016) Assessing the electrode-neuron interface with the electrically evoked compound action potential, electrode position, and behavioral thresholds. J Assoc Res Otolaryngol 17:237–252. https://doi.org/10.1007/s10162-016-0557-9
doi: 10.1007/s10162-016-0557-9
Garcia C, Deeks JM, Goehring T, Borsetto D, Bance M, Carlyon RP (2023) SpeedCAP: an efficient method for estimating neural activation patterns using electrically evoked compound action-potentials in cochlear implant users. Ear Hear 44:627–640. https://doi.org/10.1097/AUD.0000000000001305
doi: 10.1097/AUD.0000000000001305
Lakens D (2016) Error control in exploratory ANOVA’s the how and the why. The 20% Statistician. https://daniellakens.blogspot.com/2016/01/error-control-in-exploratory-anovas-how.html?m=1 . Accessed 23 January 2024
Dunn OJ (1961) Multiple comparisons among means. J Am Stat Assoc 56:52–64. https://doi.org/10.2307/2282330
doi: 10.2307/2282330
Lakens D (2021) Why p-values should be interpreted as p-values and not as measures of evidence. The 20% Statistician. https://daniellakens.blogspot.com/2021/11/why-p-values-should-be-interpreted-as-p.html . Accessed 23 January 2024
Lakens D (2022) Why P values are not measures of evidence. Trends Ecol Evol 37:289–290. https://doi.org/10.1016/j.tree.2021.12.006
doi: 10.1016/j.tree.2021.12.006
Erixon E, Hӧgstorp H, Karin W, Rask-Andersen H (2009) Variational anatomy of the human cochlea: implications for cochlear implantation. Otol Neurotol 30:14–22. https://doi.org/10.1097/MAO.0b013e31818a08e8
doi: 10.1097/MAO.0b013e31818a08e8
Avci E, Nauwelaers T, Lenarz T, Hamacher V, Kral A (2014) Variations in microanatomy of the human cochlea. J Comp Neurol 522:3245–3261. https://doi.org/10.1002/cne.23594
doi: 10.1002/cne.23594
de Rijk SR, Tam YC, Carlyon RP, Bance ML (2020) Detection of extracochlear electrodes in cochlear implants with electric field imaging/transimpedance measurements: a human cadaver study. Ear Hear 41:1196–1207. https://doi.org/10.1097/aud.0000000000000837
doi: 10.1097/aud.0000000000000837
Vanpoucke FJ, Zarowski AJ, Peeters SA (2004) Identification of the impedance model of an implanted cochlear prosthesis from intracochlear potential measurements. IEEE Trans Biomed Eng 51:2174–2183. https://doi.org/10.1109/tbme.2004.836518
doi: 10.1109/tbme.2004.836518
Lei IM, Jiang C, Lei CL, de Rijk SM, Tam YC, Swords C, Sutcliffe MPE, Malliaras GG, Bance M, Huang YYS (2021) 3D printed biomimetic cochleae and machine learning co-modelling provides clinical informatics for cochlear implant patients. Nat Commun 12:6260. https://doi.org/10.1038/s41467-021-26491-6
doi: 10.1038/s41467-021-26491-6
Carlyon RP, Deeks JM, Underraga J, Macherey O, van Wieringen A (2017) Spatial selectivity in cochlear implants: effects of asymmetric waveforms and development of a single-point measure. J Assoc Res Otolaryngol 18:711–727. https://doi.org/10.1007/s10162-017-0625-9
doi: 10.1007/s10162-017-0625-9
Litvak LM, Spahr AJ, Emadi G (2007) Loudness growth observed under partially tripolar stimulation: model and data from cochlear implant listeners. J Acoust Soc Am 122:967–981. https://doi.org/10.1121/1.2749414
doi: 10.1121/1.2749414
Snyder RL, Bierer JA, Middlebrooks JC (2004) Topographic spread of inferior colliculus activation in response to acoustic and intracochlear electric stimulation. J Assoc Res Otolaryngol 5:305–322. https://doi.org/10.1007/s10162-004-4026-5
doi: 10.1007/s10162-004-4026-5
Padilla M, Landsberger DM (2016) Reduction in spread of excitation from current focusing at multiple cochlear locations in cochlear implant users. Hear Res 333:98–107. https://doi.org/10.1016/j.heares.2016.01.002
doi: 10.1016/j.heares.2016.01.002
Frijns JH, Dekker DMT, Briaire JJ (2011) Neural excitation patterns induced by phased-array stimulation in the implanted human cochlea. Acta Otolaryngol 131:362–370. https://doi.org/10.3109/00016489.2010.541939
doi: 10.3109/00016489.2010.541939
Marozeau J, McDermott HJ, Swanson BA, McKay CM (2015) Perceptual interactions between electrodes using focused and monopolar cochlear stimulation. J Assoc Res Otolaryngol 16:401–412. https://doi.org/10.1007/s10162-015-0511-2
doi: 10.1007/s10162-015-0511-2
George SS, Wise AK, Shivdasani MH, Shepherd RK, Fallon JB (2014) Evaluations of focused multipolar stimulation for cochlear implants in acutely deafened cats. J Neural Eng 11:065003. https://doi.org/10.1088/1741-2560/11/6/065003
doi: 10.1088/1741-2560/11/6/065003
Guérit F, de Rijk SR, Bance ML, Carlyon RP (2019) Replication and use of a ladder network of resistors for modelling intra-cochlear voltage measurements. Conference on Implantable Auditory Prostheses (CIAP). Granlibakken, Lake Tahoe, California, USA
Guérit F, Roberts IV, Swords C, Carlyon RP (2023) A “hilltop” approach for tackling channel interactions in cochlear implant users. Virtual Conference on Computational Audiology. https://computationalaudiology.com/a-hilltop-approach-for-tackling-channel-interactions-in-cochlear-implant-users/

Auteurs

Charlotte Garcia (C)

Cambridge Hearing Group, MRC Cognition & Brain Sciences Unit, University of Cambridge, 15 Chaucer Road, Cambridge, CB27EF, UK. charlotte.garcia@mrc-cbu.cam.ac.uk.

Charlotte Morse-Fortier (C)

Eaton Peabody Laboratories (EPL), Massachusetts Eye and Ear, Harvard Medical School, 243 Charles Street, Boston, MA, 02114, USA.

François Guérit (F)

Cambridge Hearing Group, MRC Cognition & Brain Sciences Unit, University of Cambridge, 15 Chaucer Road, Cambridge, CB27EF, UK.

Scott Hislop (S)

Cambridge Hearing Group, MRC Cognition & Brain Sciences Unit, University of Cambridge, 15 Chaucer Road, Cambridge, CB27EF, UK.

Tobias Goehring (T)

Cambridge Hearing Group, MRC Cognition & Brain Sciences Unit, University of Cambridge, 15 Chaucer Road, Cambridge, CB27EF, UK.

Robert P Carlyon (RP)

Cambridge Hearing Group, MRC Cognition & Brain Sciences Unit, University of Cambridge, 15 Chaucer Road, Cambridge, CB27EF, UK.

Julie G Arenberg (JG)

Eaton Peabody Laboratories (EPL), Massachusetts Eye and Ear, Harvard Medical School, 243 Charles Street, Boston, MA, 02114, USA.

Classifications MeSH