Effects of stimulus level on electrode-place discrimination in human subjects with cochlear implants

Abstract

Effects of stimulus level on discrimination of one stimulation site from another were examined in 15 human subjects with Nucleus-22 cochlear implant systems. Bipolar stimulation was used in all cases with electrodes in the bipolar pair separated by 1.5 mm (center to center). Subjects were first tested at a medium loudness level, using an adaptive tracking procedure, to determine the regions of the electrode array where electrode-place discrimination was best and the regions where it was poorest. Electrode-place discrimination was then tested at three regions distributed throughout the array, which included the regions of best and poorest discrimination. At each region, electrode-place discrimination was tested at three levels: 25%, 50%, and 75% of the dynamic range. For each of these nine conditions (3 sites×3 levels), the test-electrode pairs were loudness balanced with the reference-electrode pairs. A two-interval forced-choice same-different procedure was then used to determine discriminability of the reference-electrode pair from the nearest, apical, test-electrode pair. If P(C) max was <0.707 at all three levels, additional testing was done using the next, more apical, electrode pair as the test-electrode pair. A tendency toward better discrimination at more apical regions of the array was observed. Electrode pairs with poor discrimination typically had smaller dynamic ranges than those with good discrimination. There was a weak tendency toward better discrimination at higher levels of stimulation. However, effects of level on electrode-place discrimination were less pronounced and less consistent than previously observed effects of level on temporal discriminations. These results suggest interactions between current spread and the condition of the implanted cochlea as underlying mechanisms.