Graeme Clark Collection
Permanent URI for this collection
Search Results
1 - 10 of 98
-
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.
-
ItemPsychophysical studies with two binaural cochlear implant subjects( 1997)Abstract not available due to copyright.
-
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.
-
ItemPitch and loudness estimation for single and multiple pulse per period electric pulse rates by cochlear implant patients( 1997)Abstract not available due to copyright.
-
ItemVariability of amplitude and area of the auditory nerve compound action potential( 1997)The strength of neural response to sensory stimuli is often estimated by measurement of the amplitude of gross neural potentials. These gross potentials reflect the summed activity of a population of neurons. The amplitude of these potentials is dependent upon the synchrony of the contributing neural responses. We compared the variability of the peak-to-peak amplitude of the auditory nerve compound-action potential (CAP) with that of the area under the peaks. The area under the peaks was significantly less variable than the amplitude for responses to low frequency stimuli. Responses to other stimuli showed differences in the same direction, but these were not significant. We conclude that the area under these peaks is a more precise measure of neural response than measurement of waveform amplitude, at least for responses to low frequency stimuli.
-
ItemSpeech results with a bilateral multi-channel cochlear implant subject for spatially separated signal and noise( 1999)Speech tests in noise were administered to a bilaterally implanted cochlear implant subject. Performance for simultaneous use of two identical implants, with the same speech processing strategy on two independent standard clinical processors, was compared with that of the better performing monaural side alone. Speech was presented at an angle of 45 degrees toward one ear, with noise at 45 degrees toward the contralateral side. Tests were also administered for speech and noise reversed in location. When the speech signal was on the same side as the subject's better performing ear, monaural and binaural tests resulted in similar scores. When the speech was on the opposite side, however, the binaural condition showed significantly better speech scores. The results indicate that binaural implants can provide improved performance in noise when speech and noise arc spatially separated.
-
ItemClinical findings for a group of infants and young children with auditory neuropathy( 1999)Objective: To examine the prevalence of auditory neuropathy in a group of infants at risk for hearing impairment and to present an overview of the clinical findings for affected children. Design: Results for 20 subjects who showed repeatable cochlear microphonic potentials in the absence of click-evoked auditory brain stem responses are included in this study. Behavioral and steady state evoked potential thresholds were established in each case. Where possible, otoacoustic emission and speech perception results (unaided and aided) also were obtained. Results: One in 433 (0.23%) of the children in our series had evidence of auditory neuropathy. The audiometric findings for these subjects varied significantly, with behavioural thresholds ranging from normal to profound levels. Discrimination skills were also variable. Approximately half of the subjects showed little understanding, or even awareness, of speech inputs in both the unaided and aided conditions. There were, however, a number of children who could score at significant levels on speech discrimination tasks and who benefited from the provision of amplification. Conclusion: The results suggest that auditory neuropathy is more common in the infant population than previously suspected. The effects of neuropathy on auditory function appear to be idiosyncratic, producing significant variations in both the detection and discrimination of auditory signals. As such, the management of children with this disorder must allow for individual differences.
-
ItemCochlear implants in the third millennium( 1999)This article discusses the specific challenges facing cochlear implantation in the Third Millennium.
-
ItemIntracellular responses of onset chopper neurons in the ventral cochlear nucleus to tones: evidence for dual-component processing( 1999)The ventral cochlear nucleus (VCN) contains a heterogeneous collection of cell types reflecting the multiple processing tasks undertaken by this nucleus. This in vivo study in the rat used intracellular recordings and dye filling to examine membrane potential changes and firing characteristics of onset chopper (OC) neurons to acoustic stimulation (50 ms pure tones, 5 ms r/f time). Stable impalements were made from 15 OC neurons, 7 identified as multipolar cells. Neurons responded to characteristic frequency (CF) tones with sustained depolarization below spike threshold. With increasing stimulus intensity, the depolarization during the initial 10 ms of the response became peaked, and with further increases in intensity the peak became narrower. Onset spikes were generated during this initial depolarization. Tones presented below CF resulted in a broadening of this initial depolarizing component with high stimulus intensities required to initiate onset spikes. This initial component was followed by a sustained depolarizing component lasting until stimulus cessation. The amplitude of the sustained depolarizing component was greatest when frequencies were presented at high intensities below CF resulting in increased action potential firing during this period when compared with comparable high intensities at CF. During the presentation of tones at or above the high-frequency edge of a cell’s response area, hyperpolarization was evident during the sustained component. The presence of hyperpolarization and the differences seen in the level of sustained depolarization during CF and off CF tones suggests that changes in membrane responsiveness between the initial and sustained components may be attributed to polysynaptic inhibitory mechanisms. The dual-component processing resulting from convergent auditory nerve excitation and polysynaptic inhibition enables OC neurons to respond in a unique fashion to intensity and frequency features contained within an acoustic stimulus.
-
ItemThe effects of stochastic neural activity in a model predicting intensity perception with cochlear implants: low-rate stimulation( 1999)Most models of auditory nerve response to electrical stimulation are deterministic, despite significant physiological evidence for stochastic activity. Furthermore, psychophysical models and analyses of physiological data using deterministic descriptions do not accurately predict many psychophysical phenomena. In this paper we investigate whether inclusion of stochastic activity in neural models improves such predictions. To avoid the complication of interpulse interactions and to enable the use of a simpler and faster auditory nerve model we restrict our investigation to single pulses and low-rate (<200 pulses/s) pulse trains. We apply signal detection theory to produce direct predictions of behavioural threshold, dynamic range and intensity difference limen. Specifically, we investigate threshold versus pulse duration (the strength-duration characteristics), threshold and uncomfortable loudness (and the corresponding dynamic range) versus phase duration, the effects of electrode configuration on dynamic range and on strength-duration, threshold versus number of pulses (the temporal-integration characteristics), intensity difference limen as a function of loudness, and the effects of neural survival on these measures. For all psychophysical measures investigated, the inclusion of stochastic activity in the auditory nerve model was found to produce more accurate predictions.