Tripolar Configuration Research Articles

A novel method for real-time skin impedance measurement during radiofrequency skin tightening treatments

The thermal effects of monopolar and bipolar radiofrequency (RF) have been proven to be beneficial in skin tightening. Nevertheless, these effects were frequently partial or unpredictable because of the uncontrolled nature of monopolar or unipolar RF and the superficial nature of energy flow for bipolar or tripolar configurations. One of the hypotheses for lack or predictability of efficacy of the first-generation RF therapy skin tightening systems is lack of adaptation of delivered power to differences in individual skin impedance. A novel multisource phase-controlled system was used (1 MHz, power range 0-65 W) for treatment and real-time skin impedance measurements in 24 patients (EndyMed PRO™; EndyMed, Cesarea, Israel). This system allows continuous real-time measurement of skin impedance delivering constant energy to the patient skin independent of changes in its impedance. More than 6000 unique skin impedance measurements on 22 patients showed an average session impedance range was 215-584 Ohm with an average of 369 Ohm (standard deviation of 49 Ohm). Analyzing individual pulses (total of 600 readings) showed a significant decrease in impedance during the pulse. These findings validate the expected differences in skin impedance between individual patients and in the same patients during the treatment pulse. Clinical study on 30 patients with facial skin aging using the device has shown high predictability of efficacy (86.7% of patients had good results or better at 3 months' follow-up [decrease of 2 or more grades in Fitzpatrick's wrinkle scale]). The real-time customization of energy according to skin impedance allows a significantly more accurate and safe method of nonablative skin tightening with more consistent and predictable results.

Electrode alignment of transverse tripoles using a percutaneous triple-lead approach in spinal cord stimulation

The aim of this modeling study is to determine the influence of electrode alignment of transverse tripoles on the paresthesia coverage of the pain area in spinal cord stimulation, using a percutaneous triple-lead approach. Transverse tripoles, comprising a central cathode and two lateral anodes, were modeled on the low-thoracic vertebral region (T10–T12) using percutaneous triple-lead configurations, with the center lead on the spinal cord midline. The triple leads were oriented both aligned and staggered. In the staggered configuration, the anodes were offset either caudally (caudally staggered) or rostrally (rostrally staggered) with respect to the midline cathode. The transverse tripolar field steering with the aligned and staggered configurations enabled the estimation of dorsal column fiber thresholds (IDC) and dorsal root fiber thresholds (IDR) at various anodal current ratios. IDC and IDR were considerably higher for the aligned transverse tripoles as compared to the staggered transverse tripoles. The aligned transverse tripoles facilitated deeper penetration into the medial dorsal columns (DCs). The staggered transverse tripoles always enabled broad and bilateral DC activation, at the expense of mediolateral steerability. The largest DC recruited area was obtained with the rostrally staggered transverse tripole. Transverse tripolar geometries, using percutaneous leads, allow for selective targeting of either medial or lateral DC fibers, if and only if the transverse tripole is aligned. Steering of anodal currents between the lateral leads of the staggered transverse tripoles cannot target medially confined populations of DC fibers in the spinal cord. An aligned transverse tripolar configuration is strongly recommended, because of its ability to provide more post-operative flexibility than other configurations.

Electrical field imaging as a means to predict the loudness of monopolar and tripolar stimuli in cochlear implant patients

Tripolar and other electrode configurations that use simultaneous stimulation inside the cochlea have been tested to reduce channel interactions compared to the monopolar stimulation conventionally used in cochlear implant systems. However, these “focused” configurations require increased current levels to achieve sufficient loudness. In this study, we investigate whether highly accurate recordings of the intracochlear electrical field set up by monopolar and tripolar configurations correlate to their effect on loudness. We related the intra-scalar potential distribution to behavioral loudness, by introducing a free parameter ( α) which parameterizes the degree to which the potential field peak set up inside the scala tympani is still present at the location of the targeted neural tissue. Loudness balancing was performed on four levels between behavioral threshold and the most comfortable loudness level in a group of 10 experienced Advanced Bionics cochlear implant users. The effect of the amount of focusing on loudness was well explained by α per subject location along the basilar membrane. We found that α was unaffected by presentation level. Moreover, the ratios between the monopolar and tripolar currents, balanced for equal loudness, were approximately the same for all presentation levels. This suggests a linear loudness growth with increasing current level and that the equal peak hypothesis may predict the loudness of threshold as well as at supra-threshold levels. These results suggest that advanced electrical field imaging, complemented with limited psychophysical testing, more specifically at only one presentation level, enables estimation of the loudness growth of complex electrode configurations.

Partial tripolar cochlear implant stimulation: Spread of excitation and forward masking in the inferior colliculus

This study examines patterns of neural activity in response to single biphasic electrical pulses, presented alone or following a forward masking pulse train, delivered by a cochlear implant. Recordings were made along the tonotopic axis of the central nucleus of the inferior colliculus (ICC) in ketamine/xylazine anesthetized guinea pigs. The partial tripolar electrode configuration was used, which provided a systematic way to vary the tonotopic extent of ICC activation between monopolar (broad) and tripolar (narrow) extremes while maintaining the same peak of activation. The forward masking paradigm consisted of a 200 ms masker pulse train (1017 pulses per second) followed 10 ms later by a single-pulse probe stimulus; the current fraction of the probe was set to 0 (monopolar), 1 (tripolar), or 0.5 (hybrid), and the fraction of the masker was fixed at 0.5. Forward masking tuning profiles were derived from the amount of masking current required to just suppress the activity produced by a fixed-level probe. These profiles were sharper for more focused probe configurations, approximating the pattern of neural activity elicited by single (non-masked) pulses. The result helps to bridge the gap between previous findings in animals and recent psychophysical data.

Probing the Electrode-Neuron Interface With Focused Cochlear Implant Stimulation

Cochlear implants are highly successful neural prostheses for persons with severe or profound hearing loss who gain little benefit from hearing aid amplification. Although implants are capable of providing important spectral and temporal cues for speech perception, performance on speech tests is variable across listeners. Psychophysical measures obtained from individual implant subjects can also be highly variable across implant channels. This review discusses evidence that such variability reflects deviations in the electrode-neuron interface, which refers to an implant channel's ability to effectively stimulate the auditory nerve. It is proposed that focused electrical stimulation is ideally suited to assess channel-to-channel irregularities in the electrode-neuron interface. In implant listeners, it is demonstrated that channels with relatively high thresholds, as measured with the tripolar configuration, exhibit broader psychophysical tuning curves and smaller dynamic ranges than channels with relatively low thresholds. Broader tuning implies that frequency-specific information intended for one population of neurons in the cochlea may activate more distant neurons, and a compressed dynamic range could make it more difficult to resolve intensity-based information, particularly in the presence of competing noise. Degradation of both types of cues would negatively affect speech perception.

Modeling the electrode–neuron interface of cochlear implants: Effects of neural survival, electrode placement, and the partial tripolar configuration

The partial tripolar electrode configuration is a relatively novel stimulation strategy that can generate more spatially focused electric fields than the commonly used monopolar configuration. Focused stimulation strategies should improve spectral resolution in cochlear implant users, but may also be more sensitive to local irregularities in the electrode–neuron interface. In this study, we develop a practical computer model of cochlear implant stimulation that can simulate neural activation in a simplified cochlear geometry and we relate the resulting patterns of neural activity to basic psychophysical measures. We examine how two types of local irregularities in the electrode–neuron interface, variations in spiral ganglion nerve density and electrode position within the scala tympani, affect the simulated neural activation patterns and how these patterns change with electrode configuration. The model shows that higher partial tripolar fractions activate more spatially restricted populations of neurons at all current levels and require higher current levels to excite a given number of neurons. We find that threshold levels are more sensitive at high partial tripolar fractions to both types of irregularities, but these effects are not independent. In particular, at close electrode–neuron distances, activation is typically more spatially localized which leads to a greater influence of neural dead regions.

Identifying Cochlear Implant Channels with Poor Electrode-Neuron Interface: Partial Tripolar, Single-Channel Thresholds and Psychophysical Tuning Curves

The goal of this study was to evaluate the ability of a threshold measure, made with a restricted electrode configuration, to identify channels exhibiting relatively poor spatial selectivity. With a restricted electrode configuration, channel-to-channel variability in threshold may reflect variations in the interface between the electrodes and auditory neurons (i.e., nerve survival, electrode placement, and tissue impedance). These variations in the electrode-neuron interface should also be reflected in psychophysical tuning curve (PTC) measurements. Specifically, it is hypothesized that high single-channel thresholds obtained with the spatially focused partial tripolar (pTP) electrode configuration are predictive of wide or tip-shifted PTCs. Data were collected from five cochlear implant listeners implanted with the HiRes90k cochlear implant (Advanced Bionics Corp., Sylmar, CA). Single-channel thresholds and most comfortable listening levels were obtained for stimuli that varied in presumed electrical field size by using the pTP configuration for which a fraction of current (sigma) from a center-active electrode returns through two neighboring electrodes and the remainder through a distant indifferent electrode. Forward-masked PTCs were obtained for channels with the highest, lowest, and median tripolar (sigma = 1 or 0.9) thresholds. The probe channel and level were fixed and presented with either the monopolar (sigma = 0) or a more focused pTP (sigma > or = 0.55) configuration. The masker channel and level were varied, whereas the configuration was fixed to sigma = 0.5. A standard, three-interval, two-alternative forced choice procedure was used for thresholds and masked levels. Single-channel threshold and variability in threshold across channels systematically increased as the compensating current, sigma, increased and the presumed electrical field became more focused. Across subjects, channels with the highest single-channel thresholds, when measured with a narrow, pTP stimulus, had significantly broader PTCs than the lowest threshold channels. In two subjects, the tips of the tuning curves were shifted away from the probe channel. Tuning curves were also wider for the monopolar probes than with pTP probes for both the highest and lowest threshold channels. These results suggest that single-channel thresholds measured with a restricted stimulus can be used to identify cochlear implant channels with poor spatial selectivity. Channels having wide or tip-shifted tuning characteristics would likely not deliver the appropriate spectral information to the intended auditory neurons, leading to suboptimal perception. As a clinical tool, quick identification of impaired channels could lead to patient-specific mapping strategies and result in improved speech and music perception.

Experimental validation of the nerve conduction velocity selective recording technique using a multi-contact cuff electrode

The earthworm ( Lumbricus terrestris) is presented as an in vitro model of a peripheral nerve containing only two fibers each with distinctly different conduction velocities, the median and lateral giant fibers (MGF and LGF). The worm model is used with a multi-contact cuff electrode to validate the spatial–temporal filtering effect of different electrode contact configurations and the effect of applying a delay adder and matched filter tuned to either the MGF or LGF action potential (AP) to extract conduction direction and velocity from the recording. The results confirmed the known effect of inter-electrode spacing and bipolar and tripolar recording configuration on the AP amplitude. It also demonstrates a crossover point where the amplitude of the tripolar recording is larger than the monopolar recording, an effect of the slower action potential conduction velocities in the worm. The delay adder was found to be an effective velocity sensitive filter, able to discriminate units based on conduction velocity. The matched filter to be an effective means to eliminate artifact and increase signal to noise ratios, however was not found to improve selectivity.

Non-linear dielectric spectroscopy of microbiological suspensions

BackgroundNon-linear dielectric spectroscopy (NLDS) of microorganism was characterized by the generation of harmonics in the polarization current when a microorganism suspension was exposed to a sinusoidal electric field. The biological nonlinear response initially described was not well verified by other authors and the results were susceptible to ambiguous interpretation. In this paper NLDS was performed to yeast suspension in tripolar and tetrapolar configuration with a recently developed analyzer.MethodsTripolar analysis was carried out by applying sinusoidal voltages up to 1 V at the electrode interface. Tetrapolar analysis was carried on with sinusoidal field strengths from 0.1 V cm-1 to 70 V cm-1. Both analyses were performed within a frequency range from 1 Hz through 100 Hz. The harmonic amplitudes were Fourier-analyzed and expressed in dB. The third harmonic, as reported previously, was investigated. Statistical analysis (ANOVA) was used to test the effect of inhibitor an activator of the plasma membrane enzyme in the measured response.ResultsNo significant non-linearities were observed in tetrapolar analysis, and no observable changes occurred when inhibitor and activator were added to the suspension. Statistical analysis confirmed these results.When a pure sinus voltage was applied to an electrode-yeast suspension interface, variations higher than 25 dB for the 3rd harmonic were observed. Variation higher than 20 dB in the 3rd harmonics has also been found when adding an inhibitor or activator of the membrane-bounded enzymes. These variations did not occur when the suspension was boiled.DiscussionThe lack of result in tetrapolar cells suggest that there is no, if any, harmonic generation in microbiological bulk suspension. The non-linear response observed was originated in the electrode-electrolyte interface. The frequency and voltage windows observed in previous tetrapolar analysis were repeated in the tripolar measurements, but maximum were not observed at the same values.ConclusionContrary to previous assertions, no repeatable dielectric non-linearity was exhibited in the bulk suspensions tested under the field and frequency condition reported with this recently designed analyzer. Indeed, interface related harmonics were observed and monitored during biochemical stimuli. The changes were coherent with the expected biological response.

Efficacy of Transverse Tripolar Spinal Cord Stimulator for the Relief of Chronic Low Back Pain from Failed Back Surgery

Failed back surgery syndrome is a common clinical entity for which spinal cord stimulation has been found to be an effective mode of analgesia, but with variable success rates. To determine if focal stimulation of the dorsal columns with a transverse tripolar lead might achieve deeper penetration of the electrical stimulus into the spinal cord and therefore provide greater analgesia to the back. Case report. We describe a 42-year-old female with failed back surgery syndrome that had greater back pain than leg pain. The tripolar lead configuration was achieved by placing percutaneously an octapolar lead in the spinal midline followed by 2 adjacent quadripolar leads, advanced to the T7-T10 vertebral bodies. Tripolar stimulation pattern resulted in more than 70% pain relief in this patient during the screening trial, while stimulation of one or 2 electrodes only provided 20% pain relief. After implantation of a permanent tripolar electrode system with a single rechargeable battery, the pain relief was maintained for one year. This is case report describing a case of a patient with chronic low back pain with a diagnosis of failed back surgery syndrome in which transverse tripolar stimulation using an octapolar and 2 quadripolar leads appeared to be beneficial. The transverse tripolar system consists of a central cathode surrounded by anodes, using 3 leads. This arrangement may contribute to maximum dorsal column stimulation with minimal dorsal root stimulation and provide analgesia to the lower back.

Current Steering and Current Focusing in Cochlear Implants: Comparison of Monopolar, Tripolar, and Virtual Channel Electrode Configurations

To compare the effects of Monopole (Mono), Tripole (Tri), and "Virtual channel" (Vchan) electrode configurations on spectral resolution and speech perception in a crossover design. Nine experienced adults who received an Advanced Bionics CII/90K cochlear implant participated in a crossover design using three experimental strategies for 2 wk each. Three strategies were compared: (1) Mono; (2) Tri with current partly returning to adjacent electrodes and partly (25 or 75%) to the extracochlear reference; and (3) a monopolar "Vchan" strategy creating seven intermediate channels between two contacts. Each strategy was a variant of the standard "HiRes" processing strategy using 14 channels and 1105 pulses/sec/ channel, and a pulse duration of 32 microsec/phase. Spectral resolution was measured using broadband noise with a sinusoidally rippled spectral envelope with peaks evenly spaced on a logarithmic frequency scale. Speech perception was measured for monosyllables in quiet and in steady-state and fluctuating noises. Subjective comments on music experience and preferences in everyday use were assessed through questionnaires. Thresholds and most comfortable levels with Mono and Vchan were both significantly lower than levels with Tri. Spectral resolution was significantly higher with Tri than with Mono; spectral resolution with Vchan did not differ significantly from the other configurations. Moderate but significant correlations between word recognition and spectral resolution were found in speech in quiet and fluctuating noise. For speech in quiet, word recognition was best with Mono and worst with Vchan; Tri did not significantly differ from the other configurations. Pooled across the noise conditions, word recognition was best with Tri and worst with Vchan (Mono did not significantly differ from the other configurations). These differences were small and insufficient to result in a clear increase in performance across subjects if the result from the best configuration per subject was compared with the result from Mono. Across all subjects, music appreciation and satisfaction in everyday use did not clearly differ between configurations. (1) Although spectral resolution was improved with the tripolar configuration, differences in speech performance were too small in this limited group of subjects to justify clinical introduction. (2) Overall spectral resolution remained extremely poor compared with normal hearing; it remains to be seen whether further manipulations of the electrical field will be more effective.

Cochlear implant electrode configuration effects on activation threshold and tonotopic selectivity

The multichannel design of contemporary cochlear implants (CIs) is predicated on the assumption that each channel activates a relatively restricted and independent sector of the deaf auditory nerve array, just as a sound within a restricted frequency band activates a restricted region of the normal cochlea The independence of CI channels, however, is limited; and the factors that determine their independence, the relative overlap of the activity patterns that they evoke, are poorly understood. In this study, we evaluate the spread of activity evoked by cochlear implant channels by monitoring activity at 16 sites along the tonotopic axis of the guinea pig inferior colliculus (IC). “Spatial tuning curves” (STCs) measured in this way serve as an estimate of activation spread within the cochlea and the ascending auditory pathways. We contrast natural stimulation using acoustic tones with two kinds of electrical stimulation either (1) a loose fitting banded array consisting of a cylindrical silicone elastomer carrier with a linear series of ring contacts; or (2) a space-filling array consisting of a tapered silicone elastomer carrier that is designed to fit snugly into the guinea pig scala tympani with a linear series of ball contacts positioned along it Spatial tuning curves evoked by individual acoustic tones, and by activation of each contact of each array as a monopole, bipole or tripole were recorded. Several channel configurations and a wide range of electrode separations were tested for each array, and their thresholds and selectivity were estimated. The results indicate that the tapered space-filling arrays evoked more restricted activity patterns at lower thresholds than did the banded arrays. Monopolar stimulation (one intracochlear contact activated with an extracochlear return) using either array evoked broad activation patterns that involved the entire recording array at current levels <6 dB SL, but at relatively low thresholds. Bi- and tri-polar configurations of both array types evoked more restricted activity patterns, but their thresholds were higher than those of monopolar configurations. Bipolar and tripolar configurations with closely spaced contacts evoked activity patterns that were comparable to those evoked by pure tones. As the spacing of bipolar electrodes was increased (separations >1 mm), the activity patterns became broader and evoked patterns with two distinct threshold minima, one associated with each contact.

Threshold and channel interaction in cochlear implant users: Evaluation of the tripolar electrode configuration

The efficacy of cochlear implants is limited by spatial and temporal interactions among channels. This study explores the spatially restricted tripolar electrode configuration and compares it to bipolar and monopolar stimulation. Measures of threshold and channel interaction were obtained from nine subjects implanted with the Clarion HiFocus-I electrode array. Stimuli were biphasic pulses delivered at 1020 pulses/s. Threshold increased from monopolar to bipolar to tripolar stimulation and was most variable across channels with the tripolar configuration. Channel interaction, quantified by the shift in threshold between single- and two-channel stimulation, occurred for all three configurations but was largest for the monopolar and simultaneous conditions. The threshold shifts with simultaneous tripolar stimulation were slightly smaller than with bipolar and were not as strongly affected by the timing of the two channel stimulation as was monopolar. The subjects' performances on clinical speech tests were correlated with channel-to-channel variability in tripolar threshold, such that greater variability was related to poorer performance. The data suggest that tripolar channels with high thresholds may reveal cochlear regions of low neuron survival or poor electrode placement.

Tri-polar concentric ring electrode development for Laplacian electroencephalography

Brain activity generates electrical potentials that are spatio-temporal in nature. Electroencephalography (EEG) is the least costly and most widely used noninvasive technique for diagnosing many brain problems. It has high temporal resolution, but lacks high spatial resolution. In an attempt to increase the spatial selectivity, researchers introduced a bipolar electrode configuration utilizing a five-point finite difference method (FPM) and others applied a quasi-bipolar (tri-polar with two elements shorted) concentric electrode configuration. To further increase the spatial resolution, the authors report on a tri-polar concentric electrode configuration for approximating the analytical Laplacian based on a nine-point finite difference method (NPM). For direct comparison, the FPM, quasi-bipolar method (a hybrid NPM), and NPM were calculated over a 400 x 400 mesh with 1/400 spacing using a computer model. A closed-form analytical computer model was also developed to evaluate and compare the properties of concentric bipolar, quasi-bipolar, and tri-polar electrode configurations, and the results were verified with tank experiments. The tri-polar configuration and the NPM were found to have significantly improved accuracy in Laplacian estimation and localization. Movement-related potential (MRP) signals were recorded from the left prefrontal lobes on the scalp of human subjects while they performed fast repetitive movements. Disc, bipolar, quasi-bipolar, and tri-polar electrodes were used. MRP signals were plotted for all four electrode configurations. The signal-to-noise ratio and spatial selectivity of the MRP signals acquired with the tri-polar electrode configuration were significantly better than the other configurations.

Model-based evaluation of the short-circuited tripolar cuff configuration

Recordings of neural information for use as feedback in functional electrical stimulation are often contaminated with interfering signals from muscles and from stimulus pulses. The cuff electrode used for the neural recording can be optimized to improve the S/I ratio. In this work, we evaluate a model of both the nerve signal and the interfering signals recorded by a cuff, and subsequently use this model to study the signal to interference ratio of different cuff designs and to evaluate a recently introduced short-circuited tripolar cuff configuration. The results of the model showed good agreement with results from measurements in rabbits and confirmed the superior performance of the short-circuited tripolar configuration as compared with the traditionally used tripolar configuration.

Development of a Tri-polar Concentric Ring Electrode for Acquiring Accurate Laplacian Body Surface Potentials

Potentials recorded on the body surface from the heart are of a spatial and temporal function. The 12-lead electrocardiogram (ECG) provides a useful means of global temporal assessment; however, it yields limited spatial information due to the smoothing effect caused by the volume conductor. In an attempt to circumvent the smoothing problem, researchers have used the five-point method (FPM) to numerically estimate the analytical solution of the Laplacian with an array of monopolar electrodes. Researchers have also developed a bipolar concentric ring electrode system to estimate the analytical Laplacian, and others have used a quasi-bipolar electrode configuration. In a search to find an electrode configuration with a close approximation to the analytical Laplacian, development of a tri-polar concentric ring electrode based on the nine-point method (NPM) was conducted. A comparison of the NPM, FPM, and discrete form of the quasi-bipolar configuration was performed over a 400 x 400 mesh with 1/400 spacing by computer modeling. Different properties of bipolar, quasi-bipolar and tri-polar concentric ring electrodes were evaluated and compared, and verified with tank experiments. One-way analysis of variance (ANOVA) with post hoc t-test and Bonferroni corrections were performed to compare the performance of the various methods and electrode configurations. It was found that the tri-polar electrode has significantly improved accuracy and local sensitivity. This paper also discusses the development of an active sensor using the tri-polar electrode configuration. A 1-cm active Laplacian tri-polar sensor based on the NPM was tested and deemed feasible for acquiring Laplacian cardiac surface potentials.

Observational Characteristics of Radio Emission Related to Multi-polar Magnetic Configuration

We present a large complex radio burst and its associated fast time structures observed on 2001 April 10 in the frequency range of 0.65–7.6 GHz. The NoRH radio image observation shows very complex radio source structures which include preexisting, newly emerging, submerging/cancelling polarities and a bipolar, a tripolar (a `bipolar + remote unipolar'), and a quadrupolar structure. This suggests that the radio burst is generated from a very complicated loop structure. According to the spectral and image observations, we assume that the beginning of this flare was caused by a single bipolar loop configuration with a `Y-type' reconnection structure. A composite of radio continuum and fast time structures is contained in this flare. The various fast radio emission phenomena include normal and reverse drifting type III bursts, and slowly drifting and no-drift structures. The tripolar configurations may form a double-loop with a `three-legged' structure, which is an important source of the various types of fast time structures. The two-loop reconnection model can lead simultaneously to electron acceleration and corona heating. We have also analyzed the behaviors of coronal magnetic polarities and the emission processes of different types radio emission qualitatively. Interactions of a bipolar or multi-polar loop are consistent with our observational results. Our observations favor the magnetic reconnection configurations of the `inverted Y-type' (bipolar) and the `three-legged' structures (tripolar or quadrupolar).

Artefact reduction with alternative cuff configurations

In nerve cuff electrode recordings of neural signals, the pick-up of interfering signals can be reduced by choosing appropriate cuff configurations. In the traditionally used tripolar configuration, short circuiting of the end electrodes is expected to reduce the field inside the cuff from interfering signals. A model study suggests that moving the end electrodes toward the center of the cuff reduces the pick-up of interfering signals. In this paper, these properties are studied in more detail using a rabbit model. In addition, a new cuff configuration is suggested, which has an additional set of short circuited end electrodes. The total improvement of signal-to-noise ratio in the new configuration as compared with the traditionally used tripolar configuration was 73% for muscle signals and 127% for the stimulus pulse.

Auditory cortical images of cochlear-implant stimuli: coding of stimulus channel and current level.

This study quantified the accuracy with which populations of neurons in the auditory cortex can represent aspects of electrical cochlear stimuli presented through a cochlear implant. We tested the accuracy of coding of the place of stimulation (i.e., identification of the active stimulation channel) and of the stimulus current level. Physiological data came from the companion study, which recorded spike activity of neurons simultaneously from 16 sites along the tonotopic axis of the guinea pig's auditory cortex. In that study, cochlear electrical stimuli were presented to acutely deafened animals through a 6-electrode animal version of the 22-electrode Nucleus banded electrode array (Cochlear). Cochlear electrode configurations consisted of monopolar (MP), bipolar (BP + N) with N inactive electrodes between the active and return electrodes (0 < or = N < or = 3), tripolar (TP) with one active electrode and two flanking return electrodes, and common ground (CG) with one active electrode and as many as five return electrodes. In the present analysis, an artificial neural network was trained to recognize spatiotemporal patterns of cortical activity in response to single presentations of particular stimuli and, thereby, to identify those stimuli. The accuracy of pair-wise discrimination of stimulation channels or of current levels was represented by the discrimination index, d', where d' = 1 was taken as threshold. In many cases, the threshold for discrimination of place of cochlear stimulation was < 0.75 mm, and the threshold for discrimination of current levels was < 1 dB. Cochlear electrode configurations varied in the accuracy with which they signaled to the auditory cortex the place of cochlear stimulation. The BP + N and TP configurations provided considerably greater sensitivity to place of stimulation than did the MP configuration. The TP configuration maintained accurate signaling of place of stimulation up to the highest current levels, whereas sensitivity was degraded at high current levels in BP + N configurations. Electrode configurations also varied in the dynamic range over which they signaled stimulus current level. Dynamic ranges were widest for the BP + 0 configuration and narrowest for the TP configuration. That is, the configuration that showed the most accurate signaling of cochlear place of stimulation (TP) showed the most restricted dynamic range for signaling of current level. These results suggest that the choice of the optimal electrode configuration for use by human cochlear-prosthesis users would depend on the particular demands of the speech-processing strategy that is to be employed.

RELATIVE VENTRICULAR VOLUME MEASUREMENTS BY INTRACARDIAC IMPEDANCE

The purpose of this study was to investigate whether changes of the right ventricular end-diastolic and end-systolic volumes can be detected by the DC-coupled electrical intracardiac impedance signal. Measurements were conducted in 13 patients with an implanted or external pacemaker, testing various measurement configurations. Volume changes were induced by incremental overpacing and by postural changes. The pulse contour systolic integral from the peripheral blood pressure was used as a marker of stroke volume changes. The results show, that DC-coupled impedance can detect volume changes of the right ventricle. The quadrupolar impedance measurement configurations offer better amplitude resolution, but the tripolar and intraventricular bipolar configurations are better hemodynamic markers.