Graeme Clark Collection

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    Effects of intracochlear factors on spiral ganglion cells and auditory brain stem response after long-term electrical stimulation in deafened kittens
    Araki, Susumu ; Kawano, Atsushi ; Seldon, H. Lee ; Shepherd, Robert K. ; Funasaka, Sotaro ; Clark, Graeme M. ( 2000)
    Using an animal model, we have studied the response of the auditory brain stem to cochlear implantation and the effect of intracochlear factors on this response. Neonatally, pharmacologically deafened cats (100 to more than 180 days old) were implanted with a 4-electrode array in both cochleas. Then, the left cochlea of each cat was electrically stimulated for total periods of up to 1000 hours. After a terminal 14C-2-deoxyglucose (2DG) experiment, the fraction of the right inferior colliculus with a significant accumulation of 2DG label was calculated. Using 3-dimensional computer-aided reconstruction, we examined the cochleas of these animals for spiral ganglion cell (SGC) survival and intracochlear factors such as electrode positions, degeneration of the organ of Corti, and the degree of fibrosis of the scala tympani. The distribution of each parameter was calculated along the organ of Corti from the basal end. There was a positive correlation between SGC survival and the level of fibrosis in the scala tympani, and a negative correlation between SGC survival and the degree of organ of Corti degeneration. Finally, there was a negative correlation between the 2DG-labeled inferior colliculus volume fraction and the degree of fibrosis, particularly in the 1-mm region nearest the pair of electrodes, and presumably in the basal turn.
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    Electrode discrimination by early-deafened subjects using the Cochlear Limited multiple electrode cochlear implant
    Busby, P. A. ; Clark, Graeme M. ( 2000)
    Objective: The aims of this study were to determine whether electrode discrimination by early-deafened subjects using the Cochlear Limited prosthesis varied at different locations on the electrode array, was influenced by the effects of auditory deprivation and experience with electric stimulation, and was related to speech perception. Design: Difference limens for electrode discrimination were measured in 16 early-deafened subjects at three positions on the array: electrodes 18 (apical), 14 (mid), and 8 (basal). Electrodes were stimulated using random variations in current level to minimize the influence of loudness cues. Assessed were correlations between the difference limens, subject variables related to auditory deprivation (age at onset of deafness, duration of deafness, and age at implantation) and auditory experience (duration of implant use and the total time period of auditory experience), and speech perception scores from two closed-set and two open-set tests. Results: The average difference limens across the three positions were less than two electrodes for 75%, of subjects, with average limens between 2 and 6.5 electrodes for the remaining 25% of subjects. Significant differences across the three positions were found for 69% of subjects. The average limens and those at the basal position positively correlated with variables related to auditory deprivation, with larger limens for subjects implanted at a later age and with a longer duration of deafness. The average limens and those at the apical position negatively correlated with closed-set speech perception scores, with lower scores for subjects with larger limens, but not with open-set scores. Speech scores also negatively correlated with variables related to auditory deprivation. Conclusions: These findings showed that early-deafened subjects were generally successful in electrode discrimination although performance varied across the array for over half the subjects. Discrimination performance was influenced by the effects of auditory deprivation, and both electrode discrimination and variables related to auditory deprivation influenced closed-set speech perception.
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    Pitch estimation by early-deafened subjects using a multiple-electrode cochlear implant
    Busby, P. A. ; Clark, Graeme M. ( 2000)
    Abstract not available due to copyright.
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    Calculation of interspike intervals for integrate-and-fire neurons with Poisson distribution of synaptic inputs
    Burkitt, A. N. ; Clark, Graeme M. ( 2000)
    We present a new technique for calculating the interspike intervals of integrate-and-fire neurons. There are two new components to this technique. First, the probability density of the summed potential is calculated by integrating over the distribution of arrival times of the afferent postsynaptic potentials (PSPs), rather than using conventional stochastic differential equation techniques. A general formulation of this technique is given in terms of the probability distribution of the inputs and the time course of the postsynaptic response. The expressions are evaluated in the gaussian approximation, which gives results that become more accurate for large numbers of small-amplitude PSPs. Second, the probability density of output spikes, which are generated when the potential reaches threshold, is given in terms of an integral involving a conditional probability density. A.N. Burkitt and G.M. Clark, 'Calculation of Interspike Intervals for Integrate and Fire Neurons with Poisson Distribution of Synaptic Inputs ', Neural Computation, 12:8 (August, 2000), pp. 1789-1820. © 2000 by the Massachusetts Institute of Technology. http://www.mitpressjournals.org.ezp.lib.unimelb.edu.au/toc/neco/12/8
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    Analysis of synchronization in response of neurons to noisy periodic synaptic input
    Burkitt, A. N. ; Clark, Graeme M. ( 2000)
    Unavailable due to copyright.
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    Renewal-process approximation of a stochastic threshold model for electrical neural stimulation
    Bruce, Ian C. ; Irlicht, Laurence S. ; White, Mark W. ; O'Leary, Stephen J. ; Clark, Graeme M. ( 2000)
    In a recent set of modelling studies we have developed a stochastic threshold model of auditory nerveresponse to single biphasic electrical pulses (Bruce et al., 1999c) and moderate rate (less than 800 pulses per second) pulse trains (Bruce et al., 1999a). In this article we derive an analytical approximation for the single-pulse model, which is then extended to describe the pulse-train model in the case of evenly timed, uniform pulses. This renewal process description provides an accurate and computationally efficient model of electrical stimulation of single auditory nerve fibers by a cochlear implant that may be extended to other forms of electrical neural stimulation.
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    Multichannel auditory brainstem implantation: the Australian experience
    Briggs, R. J. S. ; Fagan, P. ; Atlas, M. ; Kaye, A. H. ; Sheehy, J. ; Hollow, R. ; Shaw. S. ; Clark, Graeme M. (Cambridge University Press, 2000)
    The multichannel auditory brainstem implant (ABI) provides the potential for hearing restoration in patients with neuro bromatosis type 2 (NF2). Programmes for auditory brainstem implantation have been established in two Australian centres. Eight patients have been implanted under the protocol of an international multi-centre clinical trial. Three patients had ABI insertion at the time of first side tumour removal, four at second side tumour removal and one after previous bilateral surgery where there was some residual tumour. The translabyrinthine approach was used in all cases. Successful positioning of the electrode array was achieved in seven of eight patients, all of whom achieved auditory perception with electrical stimulation. Intra-operative electrically evoked auditory brainstem response testing was successful in four patients and was useful in confirming correct electrode position. In six cases postoperative psychophysical and auditory perception testing demonstrated that useful auditory sensations were achieved. Five of these patients regularly used the implant. In one patient electrode placement was unsuccessful and only non-auditory sensations occurred on stimulation. In the remaining patients nonauditory sensations were minimal and avoidable by selective electrode programming. Auditory brainstem implantation should be considered in patients with NF2. The greatest benefit is seen in patients without debilitating disease who have non-aidable hearing in the contralateral ear.
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    Histopathology of the binaural cochlear implant subject [Abstract]
    Yukawa, K. ; O'Leary, S. J. ; Clark, Graeme M. ( 2001)
    Binaural hearing improves speech reception in noise, and is necessary for sound localisation. Normal hearing subjects use both interaural time, and intensity, differences to localise sound. This study investigates why sound localisation in bilateral cochlear implantees is insensitive to interaural time differences (Hoesel 1993). We looked for evidence of neural degeneration in the auditory brainstem involved in binaural sound localisation, since this may have degraded the neural circuitry required to accurately code interaural time delays. Method: The brainstem of a bilateral cochlear implantee was prepared for light microscopy by embedding it in paraffin, sectioning at 10 mm and staining sections with thionine or Luxol fast blue (LFB). The histological sections were digitised with NIH Image and 3-dimensional reconstructions made of the cochlear nucleus (CN) and superior olivary complex (SOC) with AnalysePC. Within the CN and the SOC, cell number and size were estimated by the physical dissector technique following thionine staining, and myelination of the nerve fibres was estimated using the optical density method following LFB staining. Results: A reduction in cell size (from thionine staining) and myelination (from LFB staining) was seen in both the CN and the SOC. Conclusions: These finding are consistent with neural degeneration within the auditory pathways. This may have lead to a degradation of the neural circuitry required to accurately detect interaural time delays.
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    The role of radiographic phase-contrast imaging in the development of intracochlear electrode arrays
    XU, JIN ; Stevenson, Andrew W. ; Gao, Dachao ; TYKOCINSKI, MICHAEL ; LAWRENCE, DAVID ; Wilkins, Stephen W. ; Clark, Graeme M. ; Saunders, Elaine ; Cowan, Robert S. ( 2001)
    Objective: This study describes the application of a new radiographic imaging modality, phase-contrast radiography, to in vitro human temporal bone imaging and investigates it use in the development of new electrode arrays for cochlear implants. Background: The development of perimodiolar electrode arrays for cochlear implants requires detailed information from postoperative radiologic assessment on the position of the array in relation to the cochlear structures. Current standard radiographic techniques provide only limited details. Materials and Methods: Nucleus standard electrode arrays and perimodiolar Contour electrode arrays were implanted into the scala tympani of 11 human temporal bones. Both conventional and phase-contrast radiographs were taken of each temporal bone for comparative purposes. Results: Phase-contrast imaging provides better visulization of anatomic details of the inner ear and of the structure of the intracochlear electrode array, and better definition of electrode location in relation to cochlear walls. Conclusion: Phase-contrast radiography offers significant improvement over conventional radiography in images of in vitro human temporal bones. It seems to be a valuable tool in the development of intracochlear electrode arrays and cochlear implant research. However, this new radiographic technique still requires certain computational and physics challenges to be addressed before its clinical use can be established.
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    The Contour electrode array: Safety study and initial patient trials of a new perimodiolar design
    Tykocinski, M ; Saunders, E ; Cohen, LT ; Treaba, C ; Briggs, RJS ; Gibson, P ; Clark, GM ; Cowan, RSC (LIPPINCOTT WILLIAMS & WILKINS, 2001-01)
    OBJECTIVE: The aim of these studies was to investigate the insertion properties and safety of a new intracochlear perimodiolar electrode array design (Contour). BACKGROUND: An electrode array positioned close to the neural elements could be expected to reduce stimulation thresholds and might potentially reduce channel interaction. METHODS: Two sequential studies were conducted. In study 1, the Contour electrode array was inserted in 12 human temporal bones. After cochlear surface preparation, the position of the array was noted and the basilar membrane was examined for insertion damage. On the basis of the outcome of this temporal bone study, study 2 investigated the Contour array, mounted on a Nucleus CI-24 M device and implanted in three adult patients. RESULTS: Study I showed that in 10 temporal bones, the Contour array was positioned close to the modiolus, and the basilar membrane was intact. In the two remaining bones, the arrays had pierced the basilar membrane and were positioned in the scala vestibuli apical to the penetration. Statistical analysis showed an equivalent probability of insertion-induced damage of the two array designs. In study 2, image analysis indicated that the Contour electrodes were positioned closer to the modiolus than the standard Nucleus straight array. Lower T and C levels, but higher impedance values, were recorded from electrodes close to the modiolus. Initial speech perception data showed that all patients gained useful open-set speech perception, two patients achieving scores of 100% on sentence material 3 months postoperatively. CONCLUSIONS: The temporal bone studies showed the Contour electrode array to be generally positioned closer to the modiolus than the standard Nucleus straight array, and to have an equivalent probability of causing insertion-induced damage.