A comparison of binaural cues transmitted by clinically available cochlear-implant stimulation strategies

Abstract

Cochlear implants (Cis) effectively restore speech understanding in quiet for many recipients. However, bilateral CI listeners continue to perform poorer than acoustic-hearing listeners on spatial-hearing tasks (e.g., speech understanding in noise and sound localization). One explanation is that current clinically available stimulation strategies and unsynchronized sound processors degrade the fidelity of binaural cues. However, no conclusive comparison of the binaural cues transmitted by different stimulation strategies has been made. Therefore, this study compared binaural cues transmitted by two clinically available cochlear implant stimulation strategies. Two unsynchronized Cochlear Ltd. Nucleus 6 sound processors were placed on a binaural mannequin centered in a horizontal ring of loudspeakers in an anechoic chamber. Acoustic stimuli were presented from the loudspeakers and the resulting electrical pulse trains were recorded for both a peak-picking stimulation strategy and constantly stimulating strategy. Envelope interaural time differences and interaural level differences were extracted from the recordings and compared between stimulation strategies. Compared to the constantly stimulating strategy, results show that the peak-picking strategy led to more variable and less monotonic binaural cues, which could constrain sound-localization abilities. These findings argue for the bilateral synchronization of CIs in multiple domains, including electrode selection in peak-picking stimulation strategies and pulse timing.