Graeme Clark Collection

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    Speech perception as a function of electrical stimulation rate: using the nucleus 24 cochlear implant system
    Vandali, Andrew E. ; Whitford, Lesley A. ; Plant, Kerrie L. ; Clark, Graeme M. ( 2000)
    Objective: To investigate the effect of varying electrical stimulation rate on speech comprehension by cochlear implant users, while keeping the number of stimulated channels constant. Design: Three average rates of electrical stimulation,250, 807, and 1615 pulses per second per channel (pps/ch), were compared using a speech processing strategy that employed an electrode selection technique similar to that used in the Spectral Maxima Sound Processor strategy (McDermott, McKay,& Vandali, 1992; McDermott & Vandali, Reference Note 1; McKay, McDermott, Vandali, & Clark, 1991)and the Spectral Peak strategy (Skinner et al., 1994;Whitford et al., 1995). Speech perception tests with five users of the Nucleus 24 cochlear implant system were conducted over a 21-wk period. Subjects were given take-home experience with each rate condition. A repeated ABC evaluation protocol with alternating order was employed so as to account for learning effects and to minimize order effects. Perception of open-set monosyllabic words in quiet and open-set sentences at signal to noise ratios ranging from +20 to 0 dB, depending on the subject’s ability, were tested. A comparative performance questionnaire was also administered. Results: No statistical differences in group performance between the 250 and 807 pps/ch rates were observed in any of the speech perception tests. However, significantly poorer group performance was observed for the 1615 pps/ch rate for some tests due predominantly to the results of one subject. Analysis of individual scores showed considerable variation across subjects. For some subjects, one or more of the three rate conditions evaluated provided benefits on some speech perception tasks. The results of the comparative performance questionnaire indicated a preference for the 250 and 807pps/ch rates over the 1615 pps/ch rate for most listening situations. Conclusions: For the speech processing strategy, implant system, and subjects evaluated in this study, the group results indicated that the use of electrical stimulation rates higher than 250 pps/ch (up to 1615 pps/ch) generally provided no significant improvement to speech comprehension. However, individual results indicated that perceptual.
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    Cochlear implants: future research directions
    Clark, Graeme M. ( 1995)
    The future of cochlear implants for profoundly deaf people now seems assured, and further research should improve its benefits. The present benefits of cochlear implants have now been clearly demonstrated. The results have shown that many postlingually deaf adults get significant open-set speech recognition using electrical stimulation alone, and that profoundly deaf children with a cochlear implant get better speech perception than similar children who use hearing aids or tactile vocoders.
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    Signal processing for multichannel cochlear implants: past, present and future [Abstract]
    DOWELL, RICHARD ; SELIGMAN, PETER ; MCDERMOTT, HUGH ; Whitford, Lesley ; BLAMEY, PETER ; Clark, Graeme M. ( 1994)
    Since the late 1970's, many groups have worked on developing effective signal processing for multichannel cochlear implants. The main aim of such schemes has been to provide the best possible speech perception for those using the device. Secondary aims of providing awareness and discrimination of environmental sounds and appreciation of music have also been considered. Early designs included some that attempted to simulate the normal cochlea. The application of such complex processing schemes was limited by the technology of the times. In some cases, researchers reverted to the use of single channel systems which could be controlled reliably with the existing technology. In other cases, as with the Australian implant, a simple multichannel processing scheme was devised that allowed a reliable implementation with available electronics. Over the next 15 years, largely due to the improvements in integrated circuit technology, the signal processors have slowly become more complex. Further psychophysical research has shown how additional information can be transferred effectively to implant users via electrical stimulation of the cochlea. This has lead to rapid improvement in the speech perception abilities of adults using cochlear implants. Some of the main developments in signal processing over the last 15 years will be discussed along with the latest speech perception results obtained with the new SPEAK processing scheme for the Australian 22-channel cochlear implant. Initial results for SPEAK show mean scores of 70% (equivalent to 85-90% phoneme scores) for open set monosyllabic word testing for experienced adult users. Although there remains a large range of performance for all users of cochlear implants, average speech perception scores for all implanted adults have also improved significantly with the developments in signal processing. It appears likely that multichannel cochlear implants will be a viable alternative for the treatment of severe hearing loss in the future.
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    Speech processing for cochlear implants
    Tong, Y. C. ; Millar, J. B. ; Blamey, P. J. ; Clark, Graeme M. ; Dowell, R. C. ; Patrick, J. F. ; Seligman, P. M. (JAI Press Ltd, 1992)
    The cochlear implant is a hearing prosthesis designed to replace the function of the ear. The operation of the prosthesis can be described as a sequence of four functions: the processing of the acoustic signal received by a microphone; the transfer of the processed signal through the skin; the creation of neural activity in the auditory nerve; and the integration of the experience of this neural activity into the perceptual and cognitive processing of the implantee.
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    The development of speech processing strategies for the University of Melbourne/cochlear multiple channel implantable hearing prosthesis.
    Clark, Graeme M. ( 1992)
    The speech processing strategies that have been used with the University of Melbourne/Cochlear multiple channel implantable hearing prosthesis have been developed systematically from the inaugural one that extracted the second formant and presented this on a place coding basis and the voicing frequency which determined the rate of stimulation. Speech processing has also depended heavily on biological research to ensure that the stimulus parameters used or the operative approach did not damage the spiral ganglion cells it was hoped to stimulate. The advances in speech processing from Melbourne primarily have been to extract more features and spectral information and present this on a place coding basis. This has led to a progressive improvement in speech perception, and a small number of patients can achieve nearly 100% correct scores for open sets of phonetically-balanced words using electrical stimulation alone.
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    Clinical trial of a multiple-channel cochlear prosthesis: an initial study in four patients with profound total hearing loss
    Bailey, Quentin R. ; Seligman, Peter M. ; Tong, Yit. C. ; Clark, Graeme M. ; Dowell, R. C. ; Brown, Alison M. ; Luscombe, Susan M. ; Pyman, Brian C. ; Webb, Robert L. ( 1983)
    The clinical trial of a multiple-channel cochlear prosthesis was undertaken in four patients with postlingual deafness and profound total hearing loss. The results of open-set speech tests confirmed that, using electrical stimulation alone, one patient could have a meaningful conversation with resorting to lipreading (for example, this patient uses the prosthesis to converse with her husband on the telephone). The results of closed-set speech tests also suggested that a multiple-channel stimulator is more effective than a single-channel one in conveying speech information. The cochlear prosthesis was especially effective in all four patients when it was used in conjunction with lipreading, and speech-tracking tests showed that the patients could combine the information obtained from both electrical stimulation and lipreading.
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    Prediction of variance in neural response to cochlear implant stimulation and its implications for perception [Abstract]
    O'LEARY, STEPHEN ; Irlicht, Lawrence S. ; BRUCE, IAN ; White, Mark ; Clark, Graeme M. ( 1997)
    Cochlear implant patients' perception of sound is derived via electrical pulses arising from an electrode array. Chosen aspects of the acoustic spectrum are coded via a stimulation pattern designed according to some sound coding algorithm. Thus, a patients' ability to discriminate between sounds, and in turn their understanding, is directly related to their ability to differentiate between the patterns of electrical stimulation which code various sounds.
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    High rate electrical stimulation of the auditory nerve: physiological and pathological results [Abstract]
    Shepherd, Robert K. ; XU, JIN ; TYKOCINSKI, MICHAEL ; Millard, Rodney, E. ; Clark, Graeme M. ( 1995)
    Previous experimental studies have shown that chronic electrical stimulation of the auditory nerve using charge balanced biphasic current pulses at rates of up to 500 pulses per second (pps) do not adversely affect the adjacent spiral ganglion population. More recently, a number of clinical trials have indicated that speech processing strategies based on high pulse rates (1000 pps and more), can further improve speech perception. In this paper we summarize our results following acute and chronic electrical stimulation of the auditory nerve using high pulse rates.
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    Physiological and histopathological response of the cochlea to chronic electrical stimulation of the auditory nerve at high stimulus rates [Abstract]
    Shepherd, R. K. ; Xu, J. ; Clark, Graeme M. ( 1994)
    Previous research has shown that chronic electrical stimulation of the auditory nerve using charge balanced biphasic current pulses at rates of up to 500 pulses per second (pps) does not adversely affect the adjacent spiral ganglion population. More recently, a number of clinical trials have suggested that speech processing strategies based on high pulse rates (e.g. 1000 pps), can further improve speech perception. In the present study we evaluated the physiological and histopathological response of the cochlea following long-term stimulation using rates of 1000 pps. Thirteen normal hearing cats were bilaterally implanted with scala tympani electrodes and unilaterally stimulated using 25-50 �s per phase charge balanced biphasic current pulses presented at 1000 pps. Additional charge balance was achieved by shorting the electrodes between current pulses. Each animal was stimulated for periods ranging from 700 - 2100 hours at current levels within its dynamic range. Auditory brainstem responses to both acoustic (ABR) and electrical (EABR) stimuli were periodically recorded throughout the chronic stimulation program. At completion of the program the cochleas were prepared for histological examination. While all animals exhibited an increase in acoustic thresholds following surgery, click evoked ABR's returned to near normal levels in half the animals. Frequency specific stimuli indicated that the most extensive hearing loss occurred adjacent to the array (>12 kHz) while lower frequency thresholds appeared at or near normal Our EABR data showed that the majority of animals exhibited slight increases in threshold, although response amplitudes remained very stable for the duration of the stimulus program. The physiological data reported here will be correlated with cochlear histopathology. These initial findings suggest that chronic intracochlear electrical stimulation at high pulse rates, using a carefully designed charge balanced stimulator, does not appear to adversely affect the implanted cochlea.