Reduced digit spans and ear dominance using dichotic digits in bimodal cochlear-implant users.

Bimodal stimulation, a cochlear implant (CI) in one ear and a hearing aid (HA) in the other, provides highly asymmetrical inputs. To understand how asymmetry affects perception and memory, forward and backward digit spans were measured in nine bimodal listeners. Spans were unchanged from monotic to diotic presentation; there was an average two-digit decrease for dichotic presentation with some extreme cases of decreases to zero spans.

The Relationship Between Interaural Insertion-Depth Differences, Scalar Location, and Interaural Time-Difference Processing in Adult Bilateral Cochlear-Implant Listeners.

Sensitivity to interaural time differences (ITDs) in acoustic hearing involves comparison of interaurally frequency-matched inputs. Bilateral cochlear-implant arrays are, however, only approximately aligned in angular insertion depth and scalar location across the cochleae. Interaural place-of-stimulation mismatch therefore has the potential to impact binaural perception.

Computed-Tomography Estimates of Interaural Mismatch in Insertion Depth and Scalar Location in Bilateral Cochlear-Implant Users.

Hypothesis: Bilateral cochlear-implant (BI-CI) users will have a range of interaural insertion-depth mismatch because of different array placement or characteristics. Mismatch will be larger for electrodes located near the apex or outside scala tympani, or for arrays that are a mix of precurved and straight types.

Background: Brainstem superior olivary-complex neurons are exquisitely sensitive to interaural-difference cues for sound localization.

Interaural Place-of-Stimulation Mismatch Estimates Using CT Scans and Binaural Perception, But Not Pitch, Are Consistent in Cochlear-Implant Users.

Bilateral cochlear implants (BI-CIs) or a CI for single-sided deafness (SSD-CI; one normally functioning acoustic ear) can partially restore spatial-hearing abilities, including sound localization and speech understanding in noise. For these populations, however, interaural place-of-stimulation mismatch can occur and thus diminish binaural sensitivity that relies on interaurally frequency-matched neurons. This study examined whether plasticity-reorganization of central neural pathways over time-can compensate for peripheral interaural place mismatch.

Dichotic listening performance and effort as a function of spectral resolution and interaural symmetry.

One potential benefit of bilateral cochlear implants is reduced listening effort in speech-on-speech masking situations. However, the symmetry of the input across ears, possibly related to spectral resolution, could impact binaural benefits. Fifteen young adults with normal hearing performed digit recall with target and interfering digits presented to separate ears and attention directed to the target ear.

Single-Sided Deafness Cochlear Implant Sound-Localization Behavior With Multiple Concurrent Sources.

Objectives: For listeners with one deaf ear and the other ear with normal/near-normal hearing (single-sided deafness [SSD]) or moderate hearing loss (asymmetric hearing loss), cochlear implants (CIs) can improve speech understanding in noise and sound-source localization. Previous SSD-CI localization studies have used a single source with artificial sounds such as clicks or random noise. While this approach provides insights regarding the auditory cues that facilitate localization, it does not capture the complex nature of localization behavior in real-world environments.

Aging Effects on Cortical Responses to Tones and Speech in Adult Cochlear-Implant Users.

Age-related declines in auditory temporal processing contribute to speech understanding difficulties of older adults. These temporal processing deficits have been established primarily among acoustic-hearing listeners, but the peripheral and central contributions are difficult to separate. This study recorded cortical auditory evoked potentials from younger to middle-aged (< 65 years) and older (≥ 65 years) cochlear-implant (CI) listeners to assess age-related changes in temporal processing, where cochlear processing is bypassed in this population.

A Comparison of Place-Pitch-Based Interaural Electrode Matching Methods for Bilateral Cochlear-Implant Users.

Interaural place-of-stimulation mismatch for bilateral cochlear-implant (BI-CI) listeners is often evaluated using pitch-comparison tasks that can be susceptible to procedural biases. Bias effects were compared for three sequential interaural pitch-comparison tasks in six BI-CI listeners using single-electrode direct stimulation. The reference (right ear) was a single basal, middle, or apical electrode.

Acoustic Hearing Can Interfere With Single-Sided Deafness Cochlear-Implant Speech Perception.

Objectives: Cochlear implants (CIs) restore some spatial advantages for speech understanding in noise to individuals with single-sided deafness (SSD). In addition to a head-shadow advantage when the CI ear has a better signal-to-noise ratio, a CI can also provide a binaural advantage in certain situations, facilitating the perceptual separation of spatially separated concurrent voices. While some bilateral-CI listeners show a similar binaural advantage, bilateral-CI listeners with relatively large asymmetries in monaural speech understanding can instead experience contralateral speech interference.

Binaural Optimization of Cochlear Implants: Discarding Frequency Content Without Sacrificing Head-Shadow Benefit.

Objectives: Single-sided deafness cochlear-implant (SSD-CI) listeners and bilateral cochlear-implant (BI-CI) listeners gain near-normal levels of head-shadow benefit but limited binaural benefits. One possible reason for these limited binaural benefits is that cochlear places of stimulation tend to be mismatched between the ears. SSD-CI and BI-CI patients might benefit from a binaural fitting that reallocates frequencies to reduce interaural place mismatch.

The effect of envelope modulations on binaural processing.

An experiment was performed with 10 young normal-hearing listeners that attempted to determine if envelope modulations affected binaural processing in bandlimited pulse trains. Listeners detected an interaurally out-of-phase carrier pulse train in the presence of different amplitude modulations. The peaks of the pulses were constant (called "flat" or F), followed envelope modulations from an interaurally correlated 50-Hz bandwidth noise (called CM), or followed modulations from an interaurally uncorrelated noise (called UM).

Across-frequency processing of interaural time and level differences in perceived lateralization.

Interaural time and level differences (ITDs and ILDs) contribute to the localization of sound sources; however, reverberation or use of cochlear implants diminishes the role of ITDs. Intracranial lateralization was investigated in normal-hearing listeners using correlated or uncorrelated narrowband noises, where ITDs and/or ILDs from a typical headrelated transfer function were applied. Results showed that ITDs and ILDs contributed to lateralization for correlated noises.

Interaural Pitch-Discrimination Range Effects for Bilateral and Single-Sided-Deafness Cochlear-Implant Users.

By allowing bilateral access to sound, bilateral cochlear implants (BI-CIs) or unilateral CIs for individuals with single-sided deafness (SSD; i.e., normal or near-normal hearing in one ear) can improve sound localization and speech understanding in noise.

Interaural Time-Difference Discrimination as a Measure of Place of Stimulation for Cochlear-Implant Users With Single-Sided Deafness.

Current clinical practice in programming a cochlear implant (CI) for individuals with single-sided deafness (SSD) is to maximize the transmission of speech information via the implant, with the implicit assumption that this will also result in improved spatial-hearing abilities. However, binaural sensitivity is reduced by interaural place-of-stimulation mismatch, a likely occurrence with a standard CI frequency-to-electrode allocation table (FAT). As a step toward reducing interaural mismatch, this study investigated whether a test of interaural-time-difference (ITD) discrimination could be used to estimate the acoustic frequency yielding the best place match for a given CI electrode.

Across-channel interaural-level-difference processing demonstrates frequency dependence.

Accurate localization of complex sounds involves combining interaural information across frequencies to produce a single location percept. Interaural level differences (ILDs) are highly frequency dependent and it is unclear how the auditory system combines differing ILDs across frequency. Therefore, ILD just noticeable differences (JNDs) and intracranial lateralization were measured in young normal-hearing listeners using single- and multi-band stimuli.

Contralateral Interference Caused by Binaurally Presented Competing Speech in Adult Bilateral Cochlear-Implant Users.

Objectives: Bilateral cochlear implants (BI-CIs) are intended to improve sound localization and speech understanding in the presence of interfering sounds. For normal-hearing listeners, improved speech understanding in the presence of interfering sounds can be achieved with monaural head shadow and binaural unmasking. While some BI-CI listeners experience binaural unmasking under certain testing conditions, others appear to not.

Auditory and otologic profile of Alström syndrome: Comprehensive single center data on 38 patients.

Alström syndrome (AS) is a rare autosomal recessive ciliopathy caused by mutations in the ALMS1 gene. Hallmark characteristics include childhood onset of severe retinal degeneration, sensorineural hearing loss, obesity, insulin-resistant diabetes, and cardiomyopathy. Here we comprehensively characterize the auditory and otologic manifestations in a prospective case series of 38 individuals, aged 1.

Effects of brain-derived neurotrophic factor (BDNF) on the cochlear nucleus in cats deafened as neonates.

Many previous studies have shown significant neurotrophic effects of intracochlear delivery of BDNF in preventing degeneration of cochlear spiral ganglion (SG) neurons after deafness in rodents and our laboratory has shown similar results in developing cats deafened prior to hearing onset. This study examined the morphology of the cochlear nucleus (CN) in a group of neonatally deafened cats from a previous study in which infusion of BDNF elicited a significant improvement in survival of the SG neurons. Five cats were deafened by systemic injections of neomycin sulfate (60 mg/kg, SQ, SID) starting one day after birth, and continuing for 16-18 days until auditory brainstem response (ABR) testing demonstrated profound bilateral hearing loss.

Lateralization of Interaural Level Differences with Multiple Electrode Stimulation in Bilateral Cochlear-Implant Listeners.

Objective: There is currently no accepted method of mapping bilateral cochlear-implant (BiCI) users to maximize binaural performance, but the current approach of mapping one ear at a time could produce spatial perceptions that are not consistent with a sound's physical location in space. The goal of this study was to investigate the perceived intracranial lateralization of bilaterally synchronized electrical stimulation with a range of interaural level differences (ILDs) and to determine a method to produce relatively more centered auditory images when provided multielectrode stimulation.

Design: Using direct stimulation, lateralization curves were measured in nine BiCI listeners using 1000-pulses per second (pps), 500-msec constant-amplitude pulse trains with ILDs that ranged from -20 to +20 clinical current units (CUs).

Effects of brain-derived neurotrophic factor (BDNF) and electrical stimulation on survival and function of cochlear spiral ganglion neurons in deafened, developing cats.

Both neurotrophic support and neural activity are required for normal postnatal development and survival of cochlear spiral ganglion (SG) neurons. Previous studies in neonatally deafened cats demonstrated that electrical stimulation (ES) from a cochlear implant can promote improved SG survival but does not completely prevent progressive neural degeneration. Neurotrophic agents combined with an implant may further improve neural survival.

Monopolar intracochlear pulse trains selectively activate the inferior colliculus.

Previous cochlear implant studies using isolated electrical stimulus pulses in animal models have reported that intracochlear monopolar stimulus configurations elicit broad extents of neuronal activation within the central auditory system-much broader than the activation patterns produced by bipolar electrode pairs or acoustic tones. However, psychophysical and speech reception studies that use sustained pulse trains do not show clear performance differences for monopolar versus bipolar configurations. To test whether monopolar intracochlear stimulation can produce selective activation of the inferior colliculus, we measured activation widths along the tonotopic axis of the inferior colliculus for acoustic tones and 1,000-pulse/s electrical pulse trains in guinea pigs and cats.

Brain-derived neurotrophic factor promotes cochlear spiral ganglion cell survival and function in deafened, developing cats.

Postnatal development and survival of spiral ganglion (SG) neurons depend on both neural activity and neurotrophic support. Our previous studies showed that electrical stimulation from a cochlear implant only partially prevents SG degeneration after early deafness. Thus, neurotrophic agents that might be combined with an implant to improve neural survival are of interest.

Effects of age at onset of deafness and electrical stimulation on the developing cochlear nucleus in cats.

This study examined the effects of deafness and intracochlear electrical stimulation on the anatomy of the cochlear nucleus (CN) after a brief period of normal auditory development early in life. Kittens were deafened by systemic ototoxic drug injections either as neonates or starting at postnatal day 30. Total CN volume, individual CN subdivision volumes, and cross-sectional areas of spherical cell somata in the anteroventral CN (AVCN) were compared in neonatally deafened and 30-day deafened groups at 8 weeks of age and in young adults after approximately 6 months of electrical stimulation initiated at 8 weeks of age.

Factors influencing neurotrophic effects of electrical stimulation in the deafened developing auditory system.

Research in animal models has demonstrated that electrical stimulation from a cochlear implant (CI) may help prevent degeneration of the cochlear spiral ganglion (SG) neurons after deafness. In cats deafened early in life, effective stimulation of the auditory nerve with complex signals for several months preserves a greater density of SG neurons in the stimulated cochleae as compared to the contralateral deafened ear. However, SG survival is still far from normal even with early intervention with an implant.

Spontaneous discharge patterns in cochlear spiral ganglion cells before the onset of hearing in cats.

Spontaneous neural activity has been recorded in the auditory nerve of cats as early as 2 days postnatal (P2), yet individual auditory neurons do not respond to ambient sound levels <90-100 dB SPL until about P10. Significant refinement of the central projections from the spiral ganglion to the cochlear nucleus occurs during this neonatal period. This refinement may be dependent on peripheral spontaneous discharge activity.