Training improves cochlear implant rate discrimination on a psychophysical task.
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ABSTRACT:
SUBMITTER: Goldsworthy RL
PROVIDER: S-EPMC3985914 | biostudies-other | 2014 Jan
REPOSITORIES: biostudies-other
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Project description:ObjectivesTo compare the sound-source localization, discrimination, and tracking performance of bilateral cochlear implant users with omnidirectional (OMNI) and pinna-imitating (PI) microphone directionality modes.DesignTwelve experienced bilateral cochlear implant users participated in the study. Their audio processors were fitted with two different programs featuring either the OMNI or PI mode. Each subject performed static and dynamic sound field spatial hearing tests in the horizontal plane. The static tests consisted of an absolute sound localization test and a minimum audible angle test, which was measured at eight azimuth directions. Dynamic sound tracking ability was evaluated by the subject correctly indicating the direction of a moving stimulus along two circular paths around the subject.ResultsPI mode led to statistically significant sound localization and discrimination improvements. For static sound localization, the greatest benefit was a reduction in the number of front-back confusions. The front-back confusion rate was reduced from 47% with OMNI mode to 35% with PI mode (p = 0.03). The ability to discriminate sound sources straight to the sides (90° and 270° angle) was only possible with PI mode. The averaged minimum audible angle value for the 90° and 270° angle positions decreased from a 75.5° to a 37.7° angle when PI mode was used (p < 0.001). Furthermore, a non-significant trend towards an improvement in the ability to track moving sound sources was observed for both trajectories tested (p = 0.34 and p = 0.27).ConclusionsOur results demonstrate that PI mode can lead to improved spatial hearing performance in bilateral cochlear implant users, mainly as a consequence of improved front-back discrimination with PI mode.
| S-EPMC7757747 | biostudies-literature
Project description:This article summarizes the available evidence on pediatric cochlear implantation to provide current guidelines for clinical protocols and candidacy recommendations in the United States. Candidacy determination involves specification of audiologic and medical criteria per guidelines of the Food and Drug Administration. However, recommendations for a cochlear implant evaluation also should maintain flexibility and consider a child's skill progression (i.e., month-for-month progress in speech, language, and auditory development) and quality of life with appropriately fit hearing aids. Moreover, evidence supports medical and clinical decisions based on other factors, including (a) ear-specific performance, which affords inclusion of children with asymmetric hearing loss and single-sided deafness as implant candidates; (b) ear-specific residual hearing, which influences surgical technique and device selection to optimize hearing; and (c) early intervention to minimize negative long-term effects on communication and quality of life related to delayed identification of implant candidacy, later age at implantation, and/or limited commitment to an audiologic rehabilitation program. These evidence-based guidelines for current clinical protocols in determining pediatric cochlear implant candidacy encourage a team-based approach focused on the whole child and the family system.
| S-EPMC8862774 | biostudies-literature
Project description:The physiological integrity of spiral ganglion neurons is presumed to influence cochlear implant (CI) outcomes, but it is difficult to measure neural health in CI listeners. Modeling data suggest that, when peripheral processes have degenerated, anodic stimulation may be a more effective neural stimulus than cathodic stimulation. The primary goal of the present study was to evaluate the emerging theory that polarity sensitivity reflects neural health in CI listeners. An ideal in vivo estimate of neural integrity should vary independently of other factors known to influence the CI electrode-neuron interface, such as electrode position and tissue impedances. Thus, the present analyses quantified the relationships between polarity sensitivity and (1) electrode position estimated via computed tomography imaging, (2) intracochlear resistance estimated via electrical field imaging, and (3) focused (steered quadrupolar) behavioral thresholds, which are believed to reflect a combination of local neural health, electrode position, and intracochlear resistance. Eleven adults with Advanced Bionics devices participated. To estimate polarity sensitivity, electrode-specific behavioral thresholds in response to monopolar, triphasic pulses where the central high-amplitude phase was either anodic (CAC) or cathodic (ACA) were measured. The polarity effect was defined as the difference in threshold response to the ACA compared to the CAC stimulus. Results indicated that the polarity effect was not related to electrode-to-modiolus distance, electrode scalar location, or intracochlear resistance. Large, positive polarity effects, which may indicate SGN degeneration, were associated with relatively high focused behavioral thresholds. The polarity effect explained a significant portion of the variation in focused thresholds, even after controlling for electrode position and intracochlear resistance. Overall, these results provide support for the theory that the polarity effect may reflect neural integrity in CI listeners. Evidence from this study supports further investigation into the use of polarity sensitivity for optimizing individual CI programming parameters.
| S-EPMC6646612 | biostudies-literature
Project description:Cochlear implant users hear pitch evoked by stimulation rate, but discrimination diminishes for rates above 300 Hz. This upper limit on rate pitch is surprising given the remarkable and specialized ability of the auditory nerve to respond synchronously to stimulation rates at least as high as 3 kHz and arguably as high as 10 kHz. Sensitivity to stimulation rate as a pitch cue varies widely across cochlear implant users and can be improved with training. The present study examines individual differences and perceptual learning of stimulation rate as a cue for pitch ranking. Adult cochlear implant users participated in electrode psychophysics that involved testing once per week for three weeks. Stimulation pulse rate discrimination was measured in bipolar and monopolar configurations for apical and basal electrodes. Base stimulation rates between 100 and 800 Hz were examined. Individual differences were quantified using psychophysically derived metrics of spatial tuning and temporal integration. This study examined distribution of measures across subjects, predictive power of psychophysically derived metrics of spatial tuning and temporal integration, and the effect of training on rate discrimination thresholds. Psychophysical metrics of spatial tuning and temporal integration were not predictive of stimulation rate discrimination, but discrimination thresholds improved at lower frequencies with training. Since most clinical devices do not use variable stimulation rates, it is unknown to what extent recipients may learn to use stimulation rate cues if provided in a clear and consistent manner.
| S-EPMC7714175 | biostudies-literature
Project description:RationalePrevious cochlear implant (CI) studies have shown that single-channel amplitude modulation frequency discrimination (AMFD) can be improved when coherent modulation is delivered to additional channels. It is unclear whether the multi-channel advantage is due to increased loudness, multiple envelope representations, or to component channels with better temporal processing. Measuring envelope interference may shed light on how modulated channels can be combined.MethodsIn this study, multi-channel AMFD was measured in CI subjects using a 3-alternative forced-choice, non-adaptive procedure ("which interval is different?"). For the reference stimulus, the reference AM (100 Hz) was delivered to all 3 channels. For the probe stimulus, the target AM (101, 102, 104, 108, 116, 132, 164, 228, or 256 Hz) was delivered to 1 of 3 channels, and the reference AM (100 Hz) delivered to the other 2 channels. The spacing between electrodes was varied to be wide or narrow to test different degrees of channel interaction.ResultsResults showed that CI subjects were highly sensitive to interactions between the reference and target envelopes. However, performance was non-monotonic as a function of target AM frequency. For the wide spacing, there was significantly less envelope interaction when the target AM was delivered to the basal channel. For the narrow spacing, there was no effect of target AM channel. The present data were also compared to a related previous study in which the target AM was delivered to a single channel or to all 3 channels. AMFD was much better with multiple than with single channels whether the target AM was delivered to 1 of 3 or to all 3 channels. For very small differences between the reference and target AM frequencies (2-4 Hz), there was often greater sensitivity when the target AM was delivered to 1 of 3 channels versus all 3 channels, especially for narrowly spaced electrodes.ConclusionsBesides the increased loudness, the present results also suggest that multiple envelope representations may contribute to the multi-channel advantage observed in previous AMFD studies. The different patterns of results for the wide and narrow spacing suggest a peripheral contribution to multi-channel temporal processing. Because the effect of target AM frequency was non-monotonic in this study, adaptive procedures may not be suitable to measure AMFD thresholds with interfering envelopes. Envelope interactions among multiple channels may be quite complex, depending on the envelope information presented to each channel and the relative independence of the stimulated channels.
| S-EPMC4592255 | biostudies-literature
Project description:The upper limit of rate-based pitch perception and rate discrimination can differ substantially across cochlear implant (CI) users. One potential reason for this difference is the presence of a biological limitation on temporal encoding in the electrically-stimulated auditory pathway, which can be inherent to the electrical stimulation itself and/or to the degenerative processes associated with hearing loss. Electrophysiological measures, like the electrically-evoked frequency following response (eFFR) and auditory change complex (eACC), could potentially provide valuable insights in the temporal processing limitations at the level of the brainstem and cortex in the electrically-stimulated auditory pathway. Obtaining these neural responses, free from stimulation artifacts, is challenging, especially when the neural response is phase-locked to the stimulation rate, as is the case for the eFFR. In this study we investigated the feasibility of measuring eFFRs, free from stimulation artifacts, to stimulation rates ranging from 94 to 196 pulses per second (pps) and eACCs to pulse rate changes ranging from 36 to 108%, when stimulating in a monopolar configuration. A high-sampling rate EEG system was used to measure the electrophysiological responses in five CI users, and linear interpolation was applied to remove the stimulation artifacts from the EEG. With this approach, we were able to measure eFFRs for pulse rates up to 162 pps and eACCs to the different rate changes. Our results show that it is feasible to measure electrophysiological responses, free from stimulation artifacts, that could potentially be used as neural correlates for rate and pitch processing in CI users.
| S-EPMC8052190 | biostudies-literature
Project description:For French cochlear implant (CI) recipients, in-person clinical auditory rehabilitation is typically provided during the first few years post-implantation. However, this is often inconvenient, it requires substantial time resources and can be problematic when appointments are unavailable. In response, we developed a computer-based home training software ("French AngelSound™") for French CI recipients. We recently conducted a pilot study to evaluate the newly developed French AngelSound™ in 15 CI recipients (5 unilateral, 5 bilateral, 5 bimodal). Outcome measures included phoneme recognition in quiet and sentence recognition in noise. Unilateral CI users were tested with the CI alone. Bilateral CI users were tested with each CI ear alone to determine the poorer ear to be trained, as well as with both ears (binaural performance). Bimodal CI users were tested with the CI ear alone, and with the contralateral hearing aid (binaural performance). Participants trained at home over a one-month period (10 hours total). Phonemic contrast training was used; the level of difficulty ranged from phoneme discrimination in quiet to phoneme identification in multi-talker babble. Unilateral and bimodal CI users trained with the CI alone; bilateral CI users trained with the poorer ear alone. Outcomes were measured before training (pre-training), immediately after training was completed (post-training), and one month after training was stopped (follow-up). For all participants, post-training CI-only vowel and consonant recognition scores significantly improved after phoneme training with the CI ear alone. For bilateral and bimodal CI users, binaural vowel and consonant recognition scores also significantly improved after training with a single CI ear. Follow-up measures showed that training benefits were largely retained. These preliminary data suggest that the phonemic contrast training in French AngelSound™ may significantly benefit French CI recipients and may complement clinical auditory rehabilitation, especially when in-person visits are not possible.
| S-EPMC10146517 | biostudies-literature
Project description:Cochlear implant (CI) users can achieve remarkable speech understanding, but there is great variability in outcomes that is only partially accounted for by age, residual hearing, and duration of deafness. Results might be improved with the use of psychophysical tests to predict which sound processing strategies offer the best potential outcomes. In particular, the spectral-ripple discrimination test offers a time-efficient, nonlinguistic measure that is correlated with perception of both speech and music by CI users. Features that make this "one-point" test time-efficient, and thus potentially clinically useful, are also connected to controversy within the CI field about what the test measures. The current work examined the relationship between thresholds in the one-point spectral-ripple test, in which stimuli are presented acoustically, and interaction indices measured under the controlled conditions afforded by direct stimulation with a research processor. Results of these studies include the following: (1) within individual subjects there were large variations in the interaction index along the electrode array, (2) interaction indices generally decreased with increasing electrode separation, and (3) spectral-ripple discrimination improved with decreasing mean interaction index at electrode separations of one, three, and five electrodes. These results indicate that spectral-ripple discrimination thresholds can provide a useful metric of the spectral resolution of CI users.
| S-EPMC3548834 | biostudies-other
Project description:OBJECTIVES:When listening to two competing speakers, normal-hearing (NH) listeners can take advantage of voice differences between the speakers. Users of cochlear implants (CIs) have difficulty in perceiving speech on speech. Previous literature has indicated sensitivity to voice pitch (related to fundamental frequency, F0) to be poor among implant users, while sensitivity to vocal-tract length (VTL; related to the height of the speaker and formant frequencies), the other principal voice characteristic, has not been directly investigated in CIs. A few recent studies evaluated F0 and VTL perception indirectly, through voice gender categorization, which relies on perception of both voice cues. These studies revealed that, contrary to prior literature, CI users seem to rely exclusively on F0 while not utilizing VTL to perform this task. The objective of the present study was to directly and systematically assess raw sensitivity to F0 and VTL differences in CI users to define the extent of the deficit in voice perception. DESIGN:The just-noticeable differences (JNDs) for F0 and VTL were measured in 11 CI listeners using triplets of consonant-vowel syllables in an adaptive three-alternative forced choice method. RESULTS:The results showed that while NH listeners had average JNDs of 1.95 and 1.73 semitones (st) for F0 and VTL, respectively, CI listeners showed JNDs of 9.19 and 7.19 st. These JNDs correspond to differences of 70% in F0 and 52% in VTL. For comparison to the natural range of voices in the population, the F0 JND in CIs remains smaller than the typical male-female F0 difference. However, the average VTL JND in CIs is about twice as large as the typical male-female VTL difference. CONCLUSIONS:These findings, thus, directly confirm that CI listeners do not seem to have sufficient access to VTL cues, likely as a result of limited spectral resolution, and, hence, that CI listeners' voice perception deficit goes beyond poor perception of F0. These results provide a potential common explanation not only for a number of deficits observed in CI listeners, such as voice identification and gender categorization, but also for competing speech perception.
| S-EPMC5839701 | biostudies-other
Project description:We estimated the electrically-evoked auditory brainstem response thresholds (eABR THRs) in response to multi-pulses with high burst rate of 10,000 pulses-per-second (pps). Growth functions of wave eV amplitudes, root mean square (RMS) values, peak of phase-locking value (PLV), and the lowest valid data point (LVDP) were calculated in 1-, 2-, 4-, 8-, and 16-pulses conditions. The growth functions were then fitted and extrapolated with linear and exponential functions to find eABR THRs. The estimated THRs were compared to psychophysical THRs determined for multi-pulse conditions as well as to the clinical THRs measured behaviorally at the rate of 1,000 pps. The growth functions of features showed shallower growth slopes when the number of pulses increased. eABR THRs estimated in 4-, 8-, and 16-pulses conditions were closer to the clinical THRs, when compared to 1- and 2-pulses conditions. However, the smallest difference between estimated eABR THRs and clinical THRs was not always achieved from the same number of pulses. The smallest absolute difference of 30.3 μA was found for the linear fittings on growth functions of eABR RMS values in 4-pulses condition. Pearson's correlation coefficients (PCCs) between eABR THRs and psychophysical THRs were significant and relatively large in all but 16-pulses conditions. The PCCs between eABR THRs and clinical THRs, however, were smaller and in less cases significant. Results of this study showed that eABRs to multi-pulse stimulation could, to some extent, represent clinical stimulation paradigms, and thus in comparison to single pulses, could estimate clinical THRs with smaller errors.
| S-EPMC8358126 | biostudies-literature