Graeme Clark Collection
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ItemTraining place pitch perception in cochlear implant users [Abstract]( 1997)The study has aimed at determining whether the ability to use place coded vowel formant information could be enhanced with analytical vowel training in a group of -congenitally deafened patients, who showed limited speech perception skills after cochlear implant experience ranging from 1y8m to 6y11m. It has investigated whether improvements in vowel perception after training can carry over to word recognition. A further objective was to see whether poorer vowel perception was associated with poorer electrode position difference limens. Three children, one adolescent and one young adult were assessed with synthesized versions of the words /hid, head, had, hud, hod, hood/ and a natural version of these words as well as with a closed-set monosyllabic word task. The change in performance after 10 training sessions was compared to the change in performance during a non-training period. Four of the five patients showed a significant gain in synthetic vowel perception post-training on at least one assessment, but only two patients showed gains across a number of tests post-training. For one of these 2 children improvements in vowel perception generalized to word perception. Patients’ electrode limens ranged from 1 to 3 electrodes except for 1 adolescent whose minimal progress post-training could be partly explained by poorer apical electrode discrimination. The findings are discussed with reference to a number of factors, including the notion of a "critical period" for neural plasticity.
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ItemChronic electrical stimulation of the auditory nerve at high rates: I. Effect on residual hearing [Abstract]( 1996)In addition to direct excitation of auditory nerve fibres, cochlear implant patients with small amounts of residual hearing may receive important additional auditory cues via electrophonic activation of hair cells 1. Before incorporating electrophonic hearing into speech processing strategies, the extent of hair cell survival following cochlear implantation must first be determined. We have recently demonstrated widespread survival of hair cells apical to electrode arrays implanted for periods of up to three years, the present report describes the effects of chronic electrical stimulation on hair cell survival.
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ItemChronic electrical stimulation of the auditory nerve at high rates: II. Cochlear pathophysiology [Abstract]( 1996)A major factor in the improved performance of cochlear implant patients has been the use of high stimulus rate speech processing strategies. While these strategies show clear clinical advantage, we know little of their long-term safety. Indeed, recent studies have indicated that high stimulus rates at intensities above clinical limits, can result in neural damage as a result of prolonged neuronal hyperactivity. The present study was designed to evaluate the effects of chronic electrical stimulation of the auditory nerve at high rates, using intensities within clinical limits.
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ItemSpatial representation of the cochlea within the inferior colliculus of neonatally deafened kittens following chronic electrical stimulation of the auditory nerve [Abstract]( 1995)The orderly tonotopic representation of the cochlea is accurately reproduced within the central auditory system of normal hearing animals. Any degradation of this representation as a result of a neonatal hearing loss or chronic electrical stimulation during development could have important implications for the use of multichannel cochlear implants in young children. In the present study we have used 2-deoxyglucose autoradiography (2-00) to examine the topographic representation of the cochlea within the inferior colliculus (IC) of neonatally deafened kittens following periods of chronic intracochlear electrical stimulation.
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ItemPost mortem study of the intracochlear position of the nucleus standard 22 electrode array( 2000)The final position of an intracochlear cochlear implant electrode array can vary depending on the pathology, the insertion technique used and the type of electrode array used. The distance of the electrodes from the target neural elements and the presence of intracochlear fibrous tissue or new bone formation are believed to affect the performance of the device. A post mortem study was conducted to assess these factors.
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ItemPhysiological and histopathological effects of chronic monopolar high rate stimulation on the auditory nerve( 2000)Speech processing strategies based on high rate electrical stimulation have been associated with improvements in speech perception among cochlear implant users. The present study was designed to evaluate the electrophysiological and histopathological effects of long-term intracochlear monopolar stimulation at the maximum stimulus rate of the current Nucleus Cochlear implant system (14493 pulses/s) as part of our ongoing investigations of safety issues associated with cochlear implants
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ItemSafety studies and preliminary patient trails with a new perimodiolar electrode array( 2000)A new perimodiolar electrode array, the curly-with stylet (CwS), has been developed and undergone safety trials in human cadaver temporal bones. The array was developed as a result of animal and modelling studies which indicated that there are potential advantages in situating the electrode array in closer proximity to the neural elements. Preliminary studies with four patients in Melbourne implanted with a developmental pre-curved array had supported the predictions of lower current requirements and possibly more focussed spread of excitation.
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ItemEffects of sensorineural hearing loss on the refractory properties of auditory nerve fibers( 2000)We hypothesised that the loss of the peripheral processes and the partial demyelination of auditory nerve fibres (ANFs) following a sensorineural hearing loss would increase their refractory properties. Normal control, and long-term (2.5 months) systemically deafened rats were anaesthetised (urethane, 1.3 g/kg i.p.), a bipolar stimulating electrode was implanted into the scala tympani and glass microelectrodes (30-80 MΩ) used to record single ANF activity. Stimuli (pairs of 100 µs/phase charge balanced biphasic pulses with interpulse intervals (IPIs) of 0.34-10 ms) were presented at 6 dB above threshold using a repetition interval of 250 ms. Absolute refractory period (ARP) was defined as the IPI at which the probability of eliciting a spike to the second stimulus was 0.1. In the present results, based on recordings from 62 fibres, ANFs were distinguished from cochlear nucleus (CN) neurones by their significantly shorter median latencies (AN: 0.575ms vs CN: 1.137ms; Whitney-Mann Rank Sum, p<0.0001). There were no significant differences between minimum ANF latencies from normal and deafened animals. Although the median ARP was greater in deafened versus normal animals, this difference was not statistically significant (normals: median0.658ms, interquartile range 0.554-0.913ms; deafened: 0.772ms and 0.616-1.073ms; p=0.16). Finally, the spike latency associated with the second pulse of a pair systematically increased with decreasing IPI, contrasting with the stable latency of the response to the leading pulse. Although pathological changes to ANFs may increase their refractory properties, at this duration of deafness these changes were not significant.
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ItemPre-operative hearing assessment in young cochlear implant candidates( 2000)Early implantation of congenitally deaf candidates is now a goal of most cochlear implant clinics. This objective can only be achieved through the use of audiological tests that are able to identify and quantify hearing loss in infancy. Behavioural conditioning techniques provide the most accurate indication of hearing acuity in older subjects, but these procedures are unreliable in young (6 months) or developmentally delayed children. This paper investigates the degree of accuracy with which two electrophysiological test techniques (click-ABR & steady-state evoked potential [SSEPD can be used to assess auditory function in infants with significant hearing loss. ABR and SSEP findings from 108 children were compared with hearing levels obtained behaviourally.
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ItemResponses of bushy cells to tones: implications for place and temporal sound coding( 2000)The coding of sound requires both temporal and spatial information. The relative importance of temporal and place coding in the ventral cochlear nucleus (YCN) has not been well established. In male rats anaesthetised with urethane (1.3g/kg i.p), microelectrodes containing 1M KAc, were inserted into the YCN. Intracellular recordings were made in 26 neurons which had an intracellular response to pure tones typical of spherical bushy neurons. In response to tones at characteristic frequency (CF) these neurons responded in a primary-like (PL) fashion. The intracellular response was associated with sustained depolarisation to tones presented at CF. Action potentials were usually followed by hyperpolarisation, although hyperpolarisation was still present in their absence.
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