Graeme Clark Collection
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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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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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ItemPhysiological and histopathological effects of chronic monopolar high rate stimulation of the auditory nerve [Abstract]( 1999)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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ItemPhysiological and histopathological effects of chronic monopolar stimulation on the auditory nerve using very high stimulus rates [Abstract]( 1999)Speech-processing strategies using high stimulus rates are used in some cochlear implant systems. While some data suggests that electrical stimulation of the auditory nerve at rates of 2000 pps per channel is safe, there is little data concerning higher rates. The present study was designed to evaluate the safety of a rate of 5000 pps per channel. Under anaesthesia, (ketamine (20 mg/kg. i.v.) and xylazine (3.8 mg/kg. i.v.)), four normal hearing cats were bilaterally implanted with a three channel platinum (Pt) scala tympani electrode array and a return Pt-electrode placed within the temporalis muscle. Each animal was stimulated unilaterally for durations of up to 2700 h using 25μגs per phase charge-balanced biphasic current pulses. The stimuli were delivered at 5000 pps per channel at mid-dynamic range intensities. Acoustically-evoked auditory brainstem responses (ABRs) were recorded during the stimulation regime to monitor the animals' residual hearing. Electrically-evoked auditory brainstem responses (EABRs) were periodically recorded to monitor the status of the auditory nerve and to ensure stimulus intensity remained above threshold. ABRs typically showed poor recovery in the stimulated ear. Longitudinal EABRs recorded from all animals remained relatively stable for the duration of stimulation. Electrode impedances were calculated from daily monitoring of current and voltage waveforms. Two animals that exhibited the highest electrode impedance throughout the duration of stimulation were found to have significant amounts of new bone growth and fibrous tissue in the basal region of the cochlea. However, as one of these animals showed a similar response in the contralateral, unstimulated, implanted cochlea, this response can not be attributed to electrical stimulation per se. There was no statistically significant difference in spiral ganglion cell density in the stimulated cochleae when compared to corresponding regions in controls (p?0.2, Mann-Whitney Rank. Sum Test). These initial results indicate that chronic monopolar stimulation of the cochlea at a rate of 5000 pps per channel does not have an adverse effect on spiral ganglion cell density.
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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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ItemChronic electrical stimulation of the auditory nerve using non-charge balanced stimuli [Abstract]( 1998)Cochear implants use charge balanced biphasic current pulses and electrode shorting between current pulses to minimise potentially damaging direct current (DC). In the present study we evaluated the effectiveness of the electrode shorting technique using a non-charge balanced stimulus regime. Under general anaesthesia (ketamine (20 mg/kg. i.m.) and xylazine (3.8 mg/kg. i.m)), eight normal hearing cats were bilaterally implanted with two channel platinum scala tympani electrodes. Each animal was stimulated unilaterally for 500 to 2200 h using 50 μs monophasic current pulses. The stimuli were delivered at rates of 500 or 2000 pulses per channel continuously at mid-dynamic range intensities. Electrically-evoked auditory brainstem responses (EABR) were periodically recorded to monitor the status of the auditory nerve and to ensure stimulus intensity remained above threshold. At a stimulus rate of 500 pulses/s, electrode shorting effectively reduced DC levels to ≤ 0.3µA. Longitudinal EABR's recorded from these animals , remained relatively stable over the stimulus duration. These cochleae showed minimal tissue response and there was no statistically significant difference in spiral ganglion cell density when compared with controls (p=0.21, Mann-Whitney U-test). Chronic stimulation at 2000 pulses/s resulted in increased DC levels (0.6-2.8µA). These cochleae exhibited a highly significant reduction in spiral ganglion cell density when compared with controls (p<0.0001), and their EABR's typically displayed an elevation in threshold as a function of stimulus duration. The present findings indicate that continuous non-charge balanced stimuli at rates of 2000 pulses/s can result in significant loss of spiral ganglion cells, presumably as a result of increased DC levels.
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ItemElectrical stimulation of the auditory nerve: chronic monopolar stimulation using very high stimulus rates [Abstract]( 1998)Speech processing strategies based on high rate electrical stimulation have been associated with recent improvements of speech perception among cochlear implant users. In the present study we investigated the effects of chronic monopolar stimulation using very high rates (14493 pulses\s). Under general anaesthesia (ketamine (20 mg/kg) and xylazine (3.8 mg/kg) i.p.) six normal hearing cats were implanted bilaterally with a three channel platinum (Pt) scala tympani electrode array, while a return Pt-electrode was placed outside the bulla. Chronic electrical stimulation using charge-balanced biphasic current pulses was delivered unilaterally via a transcutaneous leadwire connected to a backpack-stimulator for up to 2000 h. The animals hearing status was periodically monitored using acoustically evoked compound action potentials (CAP's) and brainstem responses (ABR's). In addition the electrically evoked ABR (EABR) was also recorded to ensure that the chronic stimulus was above threshold. Stimulus current and electrode voltage waveforms were monitored twice daily and access resistance (Ra) and electrode impedance (Zc) calculated. ABR and CAP thresholds were elevated immediately following implantation, but generally showed evidence of partial recovery (0-40 dB). Further deterioration of thresholds on the stimulated side (10-30 dB) was subsequently observed, while control-thresholds remained more stable. Ra (1.3-1.8 kΩ) and Zc (2.2-3.8Ω) typically increased in the first few weeks of electrical stimulation up to Ra:5.6 kΩ and Zc:8.1 kΩ, before decreasing slightly to a constant plateau. These initial results indicate changes in the electrode-tissue interface and tissue growth within the cochlea. They also indicate that chronic stimulation at these high rates may decrease residual hearing.
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ItemComparison and alternate designs for peri-modiolar electrode arrays: insertion trauma and position [Abstract]( 1997)While it has been shown that the straight but flexible banded electrode array can be safely inserted into the scala tympani of the human cochlea, histological studies have revealed that the array lies along the outer walll.2. Since a profound total hearing loss is generally associated with a moderate to complete degeneration of the spiral ganglion peripheral process, these electrodes lie some distance from their target neural population -the spiral ganglion soma -located within Rosenthal's canal.
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