Graeme Clark Collection
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ItemA multiple-electrode cochlear implant( 1978)Interest in artificially stimulating the auditory nerve electrically for sensori-neural deafness was first sparked off by Volta in the 18th century. Count Volta, who was the first to develop the electric battery, connected up a number of his batteries to two metal rods which he inserted into his ears. Having placed the rods in his ears he pressed the switch and received "une secousse dans la tete" and perceived a noise like "the boiling of thick soup".
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ItemHearing restoration with the multichannel auditory brainstem implant( 1997)Restoration of useful hearing is now possible in patients with bilateral acoustic neuromas by direct electrical stimulation of the cochlear nucleus. Our first experience with the Multichannel Auditory Brainstem Implant is reported. A forty four year old female with bilateral acoustic neuromas and a strong family history of Neurofibromatosis Type II presented with profound bilateral hearing impairment. Translabyrinthine removal of the right tumour was performed with placement of the Nucleus eight electrode Auditory Brainstem Implant. Intraoperative electrically evoked auditory brainstem response monitoring successfully confirmed placement over the cochlear nucleus. Postoperatively, auditory responses were obtained on stimulation of all electrodes with minimal non-auditory sensations. The patient now receives useful auditory sensations using the "SPEAK" speech processing strategy. Auditory brainstem Implantation should be considered for patients with Neurofibromatosis Type II in whom hearing preservation tumour removal is not possible.
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ItemElectrical stimulation of the auditory nerve with a cochlear implant and the temporal coding of sound frequencies: a brief review( 1997)There is considerable evidence that the brain translates (encodes) the frequency of a sound into both place of excitation (place encoding), and the pattern of intervals between action potentials (temporal encoding). Furthermore, temporal encoding is now thought to be due to a temporal as well as spatial pattern of action potentials in a small group of neurons. This pattern needs to be reproduced with a cochlear implant for improved speech processing. Our recent research has also demonstrated that the timing of excitatory postsynaptic potentials seen with intracellular recordings from brain cells, rather than extracellularly recorded action potentials, correlates better with the frequency of sound. These excitatory postsynaptic potentials are likely to be the link between the patterns of action potentials arriving at nerve cells and the biomolecular activity in the cell. This response also needs to be replicated with improved speech processing strategies.
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ItemEffects of chronic electrical stimulation on spiral ganglion neuron survival and size in deafened kittens( 1998)We have studied spiral ganglion cell (SGC) survival and soma size in neonatally pharmacologically deafened kittens. They were implanted with a four-electrode array in the left cochlea at 100 to 180 or more days of age. Eight animals were chronically stimulated approximately 1000 hours over approximately 60 days with charge-balanced, biphasic current pulses; three were unstimulated controls. Using three-dimensional computer-aided reconstruction of the cochlea, the SGC position and cross-sectional area were stored. SGC position was mapped to the organ of Corti by perpendicular projections, starting from the basal end. The basal region of the cochlea was divided into three 4-mm segments. SGC survival (number per 0.1 mm of the length of the organ of Corti) and soma size for stimulated cochleae were compared statistically with implanted but unstimulated cochleae. There was no evidence of an effect of electrical stimulation on SGC survival under this protocol and with this duration. On the other hand, the cell size on the stimulated side was significantly larger than the control side in the middle segment (4 to 8 mm from the basal end). SGCs undergo a reduction in size after prolonged auditory deprivation; however, these changes may be partially moderated after chronic intracochlear electrical stimulation.
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ItemElectrophonically driven single unit responses of the anteroventral cochlear nucleus in cat [Abstract]( 1996)Electrical stimulation of the cochlea results in both direct and electrophonic excitation of auditory nerve fibres. It has been proposed that electrophonic stimulation results from the creation of a mechanical disturbance on the basilar membrane which has properties similar those resulting from acoustic stimuli. Auditory nerve compound action potential (CAP) forward masking studies1 show the level of frequency specific electrophonic stimulation is highly correlated with the spectral energy of the electrical stimulus waveform. The level of spectral energy in pulsatile biphasic electrical stimuli decreases toward low frequencies suggesting the level of electrophonic stimulation will be diminished in the low frequency region of the cochlea.
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ItemTwo-component hearing sensations produced by two-electrode stimulation in the cochlear of a deaf patient( 1983)http://www.sciencemag.org/cgi/content/abstract/219/4587/993?ijkey=v6jEOhdpzPCxw&keytype=ref&siteid=sci
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ItemThe histopathological effects of chronic electrical stimulation of the cat cochlea(Cambridge University Press, 1983)The success of a cochlear implant depends on stimulating an adequate number of viable spiral ganglion cells. The effect of chronic electrical stimulation on ganglion cells is therefore an important consideration when assessing the effectiveness and safety of such a device. The histopathological assessment of chronic unstimulated intracochlear electrodes is now well documented (Simmons, 1967; Clark, 1973; Clark et al, 1975; Schindler and Merzenich, 1974; Schindler, 1976; Schindler et al, 1977; Sutton et al, 1980). These experimental studies have used a variety of electrode designs, materials and surgical techniques. However, all have shown that chronic implantation has little effect on the peripheral nerves and the spiral ganglion cells adjacent to an implant, provided the insertion procedure is free of trauma and infection.
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ItemChronic electrical stimulation of the auditory nerve in cats: physiological and histopathological results( 1983)The ability of spiral ganglion cells to survive long-term electrical stimulation is a precondition for the success of cochlear prostheses. In this study 10 cats were implanted bilaterally with bipolar scala tympani electrodes and stimulated for periods of up to 2029 hours using charge balanced biphasic current pulses. The status of the auditory nerve was monitored periodically by recording electrically evoked auditory brainstem responses. At the conclusion of the stimulation program, spiral ganglion cell survival was assessed for stimulated and control cochleas; comparison of the two groups showed no statistically significant difference. The results of this study indicate that long-term intracochlear electrical stimulation using carefully controlled biphasic pulses does not adversely affect the spiral ganglion cell population.
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ItemClinical trial of a multiple-channel cochlear prosthesis: an initial study in four patients with profound total hearing loss( 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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ItemCurrent distributions in cochlear stimulation( 1983)The success of a multiple-channel cochlear implant depends, in part, on localizing the electrical current to discrete groups of auditory nerve fibers. A number of studies are described that were performed to investigate this issue. First, a three-dimensional resistance model of the normal cat cochlea was developed to examine general properties of electrically stimulating the cochlea. The distribution of the excited nerve fibers for monopolar and bipolar stimulation of the cat scala tympani were then determined. In addition certain measurements of the current distribution within the human cochlea for a pseudobipolar electrode array were performed. Finally, measurements were made in saline-solution-filled tube models of current distributions for bipolar and pseudobipolar stimulation, with both single-electrode and coincident multi-electrode stimulation. (From Introduction)