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Threshold levels of dual electrode stimulation in cochlear implants.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Snel-Bongers, Jorien Briaire, Jeroen J. Van Der Veen, Erika H. Kalkman, Randy K. Frijns, Johan H. M.
Description	Author Affiliation: Snel-Bongers J ( ENT-department, Leiden University Medical Centre, PO box 9600, 2300, RC, Leiden, The Netherlands, j.snel-bongers@lumc.nl.)
Abstract	Simultaneous stimulation on two contacts (current steering) creates intermediate pitches between the physical contacts in cochlear implants. All recent studies on current steering have focused on Most Comfortable Loudness levels and not at low stimulation levels. This study investigates the efficacy of dual electrode stimulation at lower levels, thereby focusing on the requirements to correct for threshold variations. With a current steered signal, threshold levels were determined on 4 different electrode pairs for 7 different current steering coefficients ( ). This was done psychophysically in twelve postlingually deafened cochlear implant (HiRes90K, HiFocus1J) users and, in a computer model, which made use of three different neural morphologies. The analysis on the psychophysical data taking all subjects into account showed that in all conditions there was no significant difference between the threshold level of the physical contacts and the intermediate created percepts, eliminating the need for current corrections at these very low levels. The model data showed unexpected drops in threshold in the middle of the two physical contacts (both contacts equal current). Results consistent with this prediction were obtained for a subset of 5 subjects for the apical pair with wider spacing (2.2 mm). Further analysis showed that this decrease was only observed in subjects with a long duration of deafness. For current steering on adjacent contacts, the results from the psychophysical experiments were in line with the results from computational modelling. However, the dip in the threshold profile could only be replicated in the computational model with surviving peripheral processes without an unmyelinated terminal. On the basis of this result, we put forward that the majority of the surviving spiral ganglion cells in the cochlea in humans with a long duration of deafness still retain peripheral processes, but have lost their unmyelinated terminals.
File Format	HTM / HTML
ISSN	15253961
e-ISSN	14387573
DOI	10.1007/s10162-013-0395-y
Journal	Journal of the Association for Research in Otolaryngology
Issue Number	5
Volume Number	14
Language	English
Publisher	Springer
Publisher Date	2013-10-01
Publisher Place	United States
Access Restriction	Open
Subject Keyword	Discipline Otolaryngology Auditory Threshold Physiology Cochlear Implantation Cochlear Implants Computer Simulation Deafness Physiopathology Models, Biological Therapy Electrodes, Implanted Loudness Perception Pitch Perception Psychoacoustics Research Support, Non-u.s. Gov't
Content Type	Text
Resource Type	Article
Subject	Otorhinolaryngology Sensory Systems

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