Graeme Clark Collection
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ItemReduction in excitability of the auditory nerve in guinea pigs following acute high rate electrical stimulation [Abstract]( 1996)Electrical stimulation of neural tissue involves the transfer of charge to tissue via electrodes. Safe charge transfer can be achieved using biphasic current pulses designed to reduce the generation of direct current (DC) or the production of electrochemical products. However, neural stimulators must also use capacitors in series with electrodes, or electrode shorting between current pulses, to further minimize DC due to electrode polarization.
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ItemA "Combionic Aid": Combined speech processing for a cochlear implant in one ear and speech processing hearing aid in the other ear [Abstract]( 1993)Independent use of a cochlear implant in one ear and a hearing aid in the other is not acceptable for many implant users with some residual hearing. Psychophysical evidence suggests that there are substantial interactions between acoustic and electrical signals including masking and loudness summation. These effects may contribute to the difficulty in using two independent devices and it is desirable to control the parameters of the electrical and acoustical signals far more accurately than is possible with two independent devices with separate microphones. In order to achieve this control we have developed a Combionic aid incorporating an implant and an 'in1planlcompatible' hearing aid controlled from the same speech processor. The new processor is particularly flexible and can implement a wide variety of speech processing strategies for combined acoustic and electrical stimulation. A benchtop prototype has been tested with five patients using a range of different speech tests. In general, patients do better when they use acoustic and electrical information simultaneously than they do with either alone. Some patients on some tests perform significantly better with the bimodal aid than they do with independent hearing aids and implant processors worn together. Wearable devices have now been built and evaluations of these devices are continuing.
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ItemChanges in excitability of the auditory nerve following electrical stimulation using large surface area electrodes [Abstract]( 1998)High rate intracochlear electrical stimulation at intensities well above clinical limits can induce significant reductions in the excitability of the auditory nerve. Such changes are primarily associated with stimulus induced neuronal activity, although direct current (DC) can also contribute. In the present study we examined the extent of stimulus induced change in auditory nerve excitability using large surface area platinum (Pt) electrodes (high-Q). These electrodes have an effective surface area 10-20 times larger than standard Pt electrodes, resulting in lower DC and charge density for a common stimulus. Twenty-three guinea pigs anaesthetized with ketamine (40 mg/kg i.p.) and xylazine (4 mg/kg i.p.), were bilaterally implanted with either high-Q or standard Pt electrodes, and unilaterally stimulated for two hours using a stimulus intensity of 0.34 μC/phase at stimulus rates of 200,400, or 1000 pulses/s (pps). Electrically evoked auditory brainstem responses (EABRs) were recorded before and periodically following the acute stimulation. No reduction in EABR amplitude was observed at 200 pps for both stimulating electrodes. However, EABRs were reduced significantly at 400 and 1000 pps. At 200 pps there was no significant difference (p>0.05 ANOVA) in the post-stimulus recovery of EABR amplitudes following stimulation with either high-Q or standard Pt electrodes. There was, however, significantly greater EABR recovery following stimulation with the high-Q electrode compared with the standard Pt electrode at 400 (p<0.05) and 1000 pps (p<0.05). These data indicate that large surface area high-Q electrodes can significantly reduce stimulus induced changes in auditory nerve excitability, and may therefore have important clinical application.
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ItemElectrical stimulus induced changes in excitability of the auditory nerve( 1997)High rate electrical stimulation of the auditory nerve using stimulus intensities well above the clinical limits can induce a significant reduction in the excitability of the auditory nerve as measured by a decrement in the amplitude of the electrically evoked auditory brainstem response (EABR). Two potential mechanisms may be associated with this stimulus induced reduction in activity: 1) stimulus induced prolonged neuronal hyperactivity; and 2) the generation of adverse electrochemical productions from the electrode surface. The purpose of the present study was to assess the extent to which adverse electrochemical damage contributes to the stimulus induced reduction in auditory nerve excitability. Twenty-six adult guinea pigs anaesthetized with ketamine (40 mg/kg i.p.) and xylazine (4 mglkg i.p.), were bilaterally implanted and unilaterally stimulated for two hours using a stimulus intensity of two or four times EABR threshold. Stimulus rates of 200, 400, or 1000 pulses/s (pps) were delivered via a standard platinum scala tympani electrode or large surface area ("high Q") platinum electrode.
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ItemCochlear implants: high rate stimulation studies and the effect of electrode position [Abstract]( 1996)This paper summarizes our recent findings investigating the safety of high rate electrical stimulation, and reviews the effects of electrode position on auditory excitability. These studies used charge balanced biphasic pulses and electrode shorting between stimuli to minimize any residual charge or direct current. High rate (400-1000 pulses/s) electrical stimulation of the auditory nerve can result in significant stimulus induced reductions in auditory nerve excitability at stimulus levels well above those used clinically (1). The extent of this reduction was dependent on stimulus rate, intensity and duty cycle, implying that such changes were related to the degree of evoked activity.
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ItemSpeech perception results for children changing from multipeak to SPEAK speech processing strategy [Abstract]( 1996)In mid-1994, a new speech processing strategy termed SPEAK was introduced for the Nucleus Spectra-22 cochlear prostheses. To compare benefits in implanted children changing to the SPEAK strategy, speech perception in a group of twelve children from Melbourne and Sydney was evaluated. The children were assessed in quiet and in background noise.
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ItemLatest results and future directions in speech processing for the Nucleus multichannel cochlear prosthesis [Abstract]( 1995)The past two years has seen the introduction of the Speak speech encoding scheme for most patients using the Nucleus 22-channel cochlear prosthesis. This scheme, based on the Spectral Maxima Speech Processor (SMSP) developed at the University of Melbourne, uses a bank of 20 band-pass filters to present detailed spectral information to the intracochlear electrode array. Clinical trials of this speech processor have shown highly significant improvements over the previous Multipeak scheme in English, German, French and Japanese speaking patients. The largest improvements were evident for open-set testing in background noise, which represents a more realistic measure of everyday benefit than testing in quiet. The latest results for adults who have changed from Multipeak to Speak will be presented, along with results over time for newly-implanted patients using the Speak scheme. New research aimed at improving the speech processing in both the spectral and temporal domains will also be discussed.
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ItemClinical comparison of open-set speech perception with MSP and WSPIII speech processors and preliminary results for the new SPEAK processor [Abstracts]( 1993)There are several studies which compare the WSP III (FOIF11F2) and MSP (Multipeak) speech processors for the Nucleus multiple-channel cochlear implant in small, controlled groups of patients. In the present study we were interested in the benefits of open set speech perception provided by the MSP over the prior WSP III speech processor in a large, unselected clinical population.