Effect Of Interphase Gap Research Articles

Evaluating and Comparing Behavioural and Electrophysiological Estimates of Neural Health in Cochlear Implant Users

Variations in neural health along the cochlea can degrade the spectral and temporal representation of sounds conveyed by cochlear implants (CIs). We evaluated and compared one electrophysiological measure and two behavioural measures that have been proposed as estimates of neural health patterns, in order to explore the extent to which the different measures provide converging and consistent neural health estimates. All measures were obtained from the same 11 users of the Cochlear Corporation CI. The two behavioural measures were multipulse integration (MPI) and the polarity effect (PE), both measured on each of seven electrodes per subject. MPI was measured as the difference between thresholds at 80 pps and 1000 pps, and PE as the difference in thresholds between cathodic- and anodic-centred quadraphasic (QP) 80-pps pulse trains. It has been proposed that good neural health corresponds to a large MPI and to a large negative PE (lower thresholds for cathodic than anodic pulses). The electrophysiological measure was the effect of interphase gap (IPG) on the offset of the ECAP amplitude growth function (AGF), which has been correlated with spiral ganglion neuron density in guinea pigs. This ‘IPG offset’ was obtained on the same subset of electrodes used for the behavioural measures. Despite high test–retest reliability, there were no significant correlations between the neural health estimates for either within-subject comparisons across the electrode array, or between-subject comparisons of the means. A phenomenological model of a population of spiral ganglion neurons was then used to investigate physiological mechanisms that might underlie the different neural health estimates. The combined experimental and modelling results provide evidence that PE, MPI and IPG offset may reflect different characteristics of the electrode-neural interface.

Interpreting the Effect of Stimulus Parameters on the Electrically Evoked Compound Action Potential and on Neural Health Estimates

Variations in the condition of the neural population along the length of the cochlea can degrade the spectral and temporal representation of sounds conveyed by CIs, thereby limiting speech perception. One measurement that has been proposed as an estimate of neural survival (the number of remaining functional neurons) or neural health (the health of those remaining neurons) is the effect of stimulation parameters, such as the interphase gap (IPG), on the amplitude growth function (AGF) of the electrically evoked compound action potential (ECAP). The extent to which such measures reflect neural factors, rather than non-neural factors (e.g. electrode orientation, electrode-modiolus distance, and impedance), depends crucially upon how the AGF data are analysed. However, there is currently no consensus in the literature for the correct method to interpret changes in the ECAP AGF due to changes in stimulation parameters. We present a simple theoretical model for the effect of IPG on ECAP AGFs, along with a re-analysis of both animal and human data that measured the IPG effect. Both the theoretical model and the re-analysis of the animal data suggest that the IPG effect on ECAP AGF slope (IPG slope effect), measured using either a linear or logarithmic input-output scale, does not successfully control for the effects of non-neural factors. Both the model and the data suggest that the appropriate method to estimate neural health is by measuring the IPG offset effect, defined as the dB offset between the linear portions of ECAP AGFs for two stimuli differing only in IPG.

The Effect of Interphase Gap on Neural Response of the Electrically Stimulated Cochlear Nerve in Children With Cochlear Nerve Deficiency and Children With Normal-Sized Cochlear Nerves.

This study aimed to compare the effects of increasing the interphase gap (IPG) on the neural response of the electrically stimulated cochlear nerve (CN) between children with CN deficiency (CND) and children with normal-sized CNs. Study participants included 30 children with CND and 30 children with normal-sized CNs. All subjects were implanted with a Cochlear Nucleus device with the internal electrode array 24RE[CA] in the test ear. The stimulus was a charge-balanced, cathodic leading, biphasic pulse with a pulse-phase duration of 50 μsec. For each subject, the electrically evoked compound action potential (eCAP) input/output (I/O) function was measured for 6 IPGs (i.e., 7, 14, 21, 28, 35, and 42 μsec) at 3 electrode locations across the electrode array. For each subject and each testing electrode, the highest stimulation used to measure the eCAP I/O function was the maximum comfortable level measured with an IPG of 42 μsec. Dependent variables (DVs) were the maximum eCAP amplitude, the eCAP threshold, and the slope of the eCAP I/O function estimated using both linear and sigmoidal regression functions. For each DV, the size of the IPG effect was defined as the proportional change relative to the result measured for the 7 μsec IPG at the basal electrode location. Generalized linear mixed effect models with subject group, electrode location, and IPG duration as the fixed effects and subject as the random effect were used to compare these DVs and the size of the IPG effect on these DVs. Children with CND showed smaller maximum eCAP amplitudes, higher eCAP thresholds, and smaller slopes of eCAP I/O function estimated using either linear or sigmoidal regression function than children with normal-sized CNs. Increasing the IPG duration resulted in larger maximum eCAP amplitudes, lower eCAP thresholds and larger slopes of eCAP I/O function estimated using sigmoidal regression function at all three electrode locations in both study groups. Compared with children with normal-sized CNs, children with CND showed larger IPG effects on both the maximum eCAP amplitude and the slope of the eCAP I/O function estimated using either linear or sigmoidal regression function, and a smaller IPG effect on the eCAP threshold than those measured in children with normal-sized CNs. Increasing the IPG increases responsiveness of the electrically stimulated CN in both children with CND and children with normal-sized CNs. The maximum eCAP amplitude and the slope of the eCAP I/O function measured in human listeners with poorer CN survival are more sensitive to changes in the IPG. In contrast, the eCAP threshold in listeners with poorer CN survival is less sensitive to increases in the IPG. Further studies are warranted to identify the best parameters of eCAP results for predicting CN survival before this eCAP testing paradigm can be used as a clinical tool for evaluating neural health for individual cochlear implant patients.

Effects of pulse rate on thresholds and loudness of biphasic and alternating monophasic pulse trains in electrical hearing

Detection thresholds and most comfortable loudnesses (MCLs) were determined as a function of pulse rate for standard biphasic pulse trains (BP) and for anodic and cathodic monophasic phases alternating at fixed intervals (ALT-m). Three different phase durations were examined. With a 100-μs phase duration, thresholds for the ALT-m stimulus were substantially (up to 12 dB) lower than for the BP stimuli at relatively low rates (200 pps), but were similar to the BP thresholds at high rates (⩾1000 pps). Thresholds for BP pulse trains decreased monotonically with increasing rate, whereas the function for ALT-m waveforms was non-monotonic with a maximum between 400 and 1000 pps. These trends occurred for three different cochlear implant devices, different electrode configurations, and, generally, for different phase durations (10.8, 25, and 100 μs/phase). However, at the shorter phase durations, thresholds remained lower for the ALT-m stimulus, even at 5000 pps, the highest rate studied. Dynamic ranges of the BP pulse trains increased with increasing rate, irrespective of the phase duration under test, but for the ALT-m stimuli this was only true at the shorter phase durations tested. At a 100-μs phase duration, dynamic ranges for the ALT-m waveforms did not differ significantly as a function of rate. The results confirm previous reports that delaying charge recovery, in this case by switching from a BP to an ALT-m wave shape, can substantially reduce thresholds [Van Wieringen, A., Carlyon, R.P., Laneau, J., Wouters, J., 2005. Effects of waveform shape on human sensitivity to electrical stimulation of the inner ear. Hear. Res. 200, 73–86; Carlyon, R.P., van Wieringen, A., Deeks, J.M., Long, C.J., Lyzenga, J, Wouters, J., 2005. Effect of inter-phase gap on the sensitivity of cochlear implant users to electrical stimulation. Hear. Res. 205, 210–224]. However, at high pulse rates, this advantage only occurs at short phase durations. In addition, we show that the complex interaction between the effects of pulse shape, rate, and phase duration on thresholds can be captured by the simple linear model described by Carlyon et al.

Effect of interphase gap and pulse duration on electrically evoked potentials is correlated with auditory nerve survival

We investigated the effect of pulse duration (PD) and interphase-gap (IPG) on the electrically-evoked auditory brain stem response (EABR) and viiith nerve compound action potential (ECAP) of deafened guinea pigs in order to test the hypothesis that the extent of change in these neural responses is affected by the histological status of the auditory nerve. Fifteen guinea pigs were deafened by co-administration of kanamycin and furosemide. Animals were acutely implanted with an 8-band electrode array at 1, 4 or 12 weeks following deafening. EABR and ECAP input/output functions were recorded in response to charge balanced biphasic current pulses. We determined the change in current required to equalize; (i) the EABR amplitude when the duration of the current pulse was doubled (104–208 μs/phase); and (ii) the EABR and ECAP amplitudes when the IPG was increased from 8 to 58 μs using a 104 μs/phase current pulse. Following the completion of each experiment the cochleae were examined quantitatively for spiral ganglion neuron survival. As expected, the current level required to evoke an EABR with equal amplitude was lower when the animal was stimulated with current pulses of 208 compared with 104 μs/phase. Moreover, the current level required to evoke EABR/ECAPs with equal amplitude was lower when current pulses had an IPG of 58 versus 8 μs. Importantly, there was a reduction in the magnitude of this effect with greater neural loss; the reduced efficacy of changing both PD and IPG on these electrically-evoked potentials was statistically correlated with neural survival. These results may provide a tool for investigating the contribution of auditory nerve survival to clinical performance among cochlear implant subjects.

Effect of inter-phase gap on the sensitivity of cochlear implant users to electrical stimulation

Human behavioral thresholds for trains of biphasic pulses applied to a single channel of Nucleus CI24 and LAURA cochlear implants were measured as a function of inter-phase gap (IPG). Experiment 1 used bipolar stimulation, a 100-pps pulse rate, and a 400-ms stimulus duration. In one condition, the two phases of each pulse had opposite polarity. Thresholds continued to drop by 9–10 dB as IPG was increased from near zero to the longest value tested (2900 μs for CI24, 4900 μs for LAURA). This time course is much longer than reported for single-cell recordings from animals. In a second condition, the two phases of each pulse had the same polarity, which alternated from pulse to pulse. Thresholds were independent of IPG, and similar to those in condition 1 at IPG = 4900 μs. Experiment 2 used monopolar stimulation. One condition was similar to condition 1 of experiment 1, and thresholds also dropped up to the longest IPG studied (2900 μs). This also happened when the pulse rate was reduced to 20 pps, and when only a single pulse was presented on each trial. Keeping IPG constant at 8 μs and adding an extra biphasic pulse x ms into each period produced thresholds that were roughly independent of x, indicating that the effect of IPG in the other conditions was not due to a release from refractoriness at sites central to the auditory nerve. Experiment 3 measured thresholds at three IPGs, which were less than, equal to, and more than one half of the interval between successive pulses. Thresholds were lowest at the intermediate IPG. The results of all experiments could be fit by a linear model consisting of a lowpass filter based on the function relating threshold to the frequency of sinusoidal electrical stimulation. The data and model have implications for reducing the power consumption of cochlear implants.

Effect of interphase-gap and pulse-duration on evoked-potential amplitudes and loudness in cochlear implantees

There is evidence that individual differences in the effects of interphase-gap and pulse-duration are related to the degree of neural survival. This experiment explored the effect of interphase gap and pulse duration on loudness in cochlear implantees. Also, the current change required to equalise loudness after an interphase gap or pulse duration change was compared to the current required to maintain constant EABR and NRT amplitude for the same interphase gap or pulse duration change. It was found that these measures varied among implantees and some of the objective measures were correlated with the psychophysical measures.

The perceptual effects of interphase gap duration in cochlear implant stimulation

The most common current pulse shape used for cochlear implants is a biphasic rectangular pulse. The interphase gap (IPG) is the duration of the zero-current portion which lies between the two phases. It is known from single-nerve studies in animals that, as the IPG decreases, the biphasic pulse becomes less efficient in activating the nerve cell. Thus, it can be predicted that stimulation using smaller IPGs will necessitate the use of higher currents to maintain the loudness required by the cochlear implantee. The development of contemporary processing schemes commonly involves the maximization of the rate parameter, and to achieve this in sequential pulsatile stimulation, the IPG as well as the pulse phase duration must be minimized. This experiment investigated the effect of IPG on loudness in eight cochlear implantees who use the CI24 implant manufactured by Cochlear Ltd. An exponential increase in current level was required to maintain equal loudness when IPG is reduced from 100 to 45 and 8.4 μs. The effect of IPG was greater at lower levels, was greater for shorter pulse durations (26 μs compared to 52 μs), and was not significantly different for the rates (1 kHz or 4 kHz) tested.