Graeme Clark Collection
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ItemChronic electrical stimulation of the auditory nerve using non-charge-balanced stimuli( 1999)This study was designed to evaluate the pathophysiological response of the cochlea following long-term intracochlear electrical stimulation using a poorly charge-balanced stimulus regime, leading to direct current (DC) levels >0.1 µA. Four normal-hearing adult cats were bilaterally implanted with scala tympani electrode arrays and unilaterally stimulated for periods up to 2200 h. Stimuli consisted of 50 µs monophasic current pulses presented at 2000 pulses per second (pps) per channel, and resulted in DC levels of 0.4-2.8 µA. Both acoustic and electrical (EABR) evoked potentials were periodically recorded during the stimulation program. Frequency-specific stimuli indicated that an extensive and widespread hearing loss occurred over the 4-24 KHz region in all stimulated cochleae, although the 2 KHz region exhibited thresholds close to normal in some animals, despite long-term implantation and chronic stimulation. Longitudinal EABRs showed a statistically significant increase in threshold for three of the four animals. Histopathological evaluation of the cochleae revealed a highly significant reduction in ganglion cell density in stimulated cochleae compared with their controls. Spiral ganglion cell loss was significantly correlated with the degree of inflammation, duration of electrical stimulation, and the level of DC. In conclusion, the present study highlights the potential for neural damage following stimulation using poorly charge-balanced stimuli.
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ItemControl strategies for neurons modeled by self-exciting point processes( 1996)Abstract not available due to copyright.
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ItemElectrical stimulation of the auditory nerve: the coding of frequency, the perception of pitch and the development of cochlear implant speech processing strategies for profoundly deaf people( 1996)1. The development of speech processing strategies for multiple-channel cochlear implants has depended on encoding sound frequencies and intensities as temporal and spatial patterns of electrical stimulation of the auditory nerve fibres so that speech information of most importance for intelligibility could be transmitted. 2. Initial physiological studies showed that rate encoding of electrical stimulation above 200 pulses/s could not reproduce the normal response patterns in auditory neurons for acoustic stimulation in the speech frequency range above 200 Hz and suggested that place coding was appropriate for the higher frequencies. 3. Rate difference limens in the experimental animal were only similar to those for sound up to 200 Hz. 4. Rate difference limens in implant patients were similar to those obtained in the experimental animal. 5. Satisfactory rate discrimination could be made for durations of 50 and 100 ms, but not 25 ms. This made rate suitable for encoding longer duration suprasegmental speech information, but not segmental information, such as consonants. The rate of stimulation could also be perceived as pitch, discriminated at different electrode sites along the cochlea and discriminated for stimuli across electrodes. 6. Place pitch could be scaled according to the site of stimulation in the cochlea so that a frequency scale was preserved and it also had a different quality from rate pitch and was described as tonality. Place pitch could also be discriminated for the shorter durations (25 ms) required for identifying consonants. 8. As additional speech frequencies have been encoded as place of stimulation, the mean speech perception scores have continued to increase and are now better than the average scores that severely-profoundly deaf adults and children with some residual hearing obtain with a hearing aid.
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ItemAcute effects of high-rate stimulation on auditory nerve function in guinea pigs( 1995)Cochlear implants have been shown to successfully provide profoundly deaf patients with auditory cues for speech discrimination. Furthermore, a number of safety studies using the Melbourne/Cochlear electrode array indicated that chronic electrical stimulation using charge-balanced biphasic current pulses and stimulus rates between 100 and 500 pulses per second (pps) do not result in additional spiral ganglion loss or general cochlear pathology.1-3 However, safe maximum levels for stimulus parameters (stimulus rate, charge per phase, charge density) have not yet been adequately defined.
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ItemCochlear implants: future research directions( 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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ItemCross-fiber interspike interval probability distribution in acoustic stimulation: a computer modeling study( 1995)Electrical stimulation strategies for cochlear implants may be improved by studying temporal frequency coding in single auditory fibers and across fibers in acoustic stimulation (Clark et al, this suppl, section 5). In single nerve fibers, phase locking between action potentials and the acoustic stimulus can only be maintained at frequencies below about 600 Hz. At these frequencies, the time interval between successive action potentials, called the interspike interval (lSI), is distributed around the period of the stimulus, and it can therefore be used to code frequency within single fibers. At higher frequencies, the phase locking of individual nerve fibers diminishes, but it may still be possible to retain phase-locking properties by combining the action potentials in an ensemble of nerve fibers. In an ensemble of fibers, the lSI in each nerve is affected by factors such as the spectral shape of the stimulus, the characteristic frequency, and the firing characteristics of the nerve. The lSI between the fibers, however, is further affected by the propagation or phase delay of the traveling wave. It is therefore uncertain how these factors would affect frequency coding across fibers. It is possible that the propagation delay between the fibers may lower the phase locking in an ensemble of nerves -because the probability that the majority of nerves in an ensemble will fire simultaneously may be low. It is also possible that the combined firing statistics of the fibers in an ensemble may result in a higher degree of synchrony such that the predominant intervals in an ensemble are preserved over a wider frequency range than in a single fiber. Are these accurate postulations of the physical system? In a future electrical stimulation strategy that incorporates temporal frequency coding, is it necessary to mimic the spatial-temporal delay in the firing patterns caused by the traveling wave? These are important questions that need to be studied and answered. (From Introduction)
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ItemCochlear pathology following chronic electrical stimulation of the auditory nerve: II Deafened kittens( 1994)The present study examines the effects of long-term electrical stimulation of the auditory nerve on cochlear histopathology and spiral ganglion cell survival in young sensorineural deafened cats. Eight kittens were deafened using kanamycin and ethacrynic acid, and implanted with bipolar or monopolar scala tympani electrodes. Following recovery from surgery the animals were unilaterally stimulated using charge balanced biphasic current pulses for 450-1730 hours over implant periods of up to four months. Charge densities varied from 0.6-0.9 µC.cm ^-2 geom. per phase for monopolar electrodes to 12-26 µC.cm ^-2 geom. per phase for the bipolar electrodes. Electrically-evoked auditory brainstem responses (EABRs) were periodically monitored during stimulation to confirm that the stimulus levels were above threshold, and to monitor any change in the response of the auditory nerve. Following completion of the stimulation program cochleae were prepared for histological examination. EABRs exhibited relatively stable thresholds for both stimulated and implanted, unstimulated control cochleae for the stimulus duration. While the growth in response amplitude as a function of stimulus current remained stable for the bipolar control and monopolar stimulated cochleae, the five cochleae chronically stimulated using bipolar electrodes exhibited a moderate to large increase in response amplitude. These increases were associated with a more widespread fibrous tissue response which may have altered the current distribution within these cochleae. Implanted control cochleae exhibited significantly less tissue response within the scala tympani. Importantly, we observed no statistically significant difference in the spiral ganglion cell density associated with chronic electrical stimulation when compared with unstimulated control cochleae. While the present study supports the safe application of cochlear implants in young profoundly deafened children, it does not corroborate previous studies that have reported electrical stimulation providing a trophic effect on degenerating auditory nerve fibres.
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ItemCochlear pathology following chronic electrical stimulation using non charge balanced stimuli( 1991)During the course of a chronic intracochlear electrical stimulation study using charge balanced biphasic current pulses, one animal inadvertently received a short period of direct current (DC) stimulation at a level of approximately 1 µA. Subsequent, the animal was chronically stimulated using a poorly charge balanced waveform that produced a DC level of approximately 2 µA. Extensive pathological changes were observed within the cochlea. These changes included widespread spiral ganglion cell loss and new bone growth that extended throughout all turns of the cochlea. Significant changes in the morphology of the electrically evoked auditory brainstem response (EABR) were associated with these pathological changes. EABRs recorded prior to the DC stimulation exhibited a normal waveform morphology. However, responses recorded during the course of the DC stimulation were dominated by a short latency response believed to be vestibular in origin. The response thresholds were also significantly higher than levels recorded before the DC stimulation. In contrast, the contralateral cochlea, stimulated using charge balanced stimuli, showed no evidence of adverse pathological changes. Furthermore, EABRs evoked from this cochlea remained stable throughout the chronic stimulation period. Although preliminary, the present results illustrate the adverse nature of poorly charge balanced electrical stimuli. These results have important implications for both the design of neural prostheses and the use of DC stimuli to suppress tinnitus in patients.
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ItemElectrical stimulation of the auditory nerve in deaf kittens: effects on cochlear nucleus morphology( 1991)The present study examines the effects of long-term electrical stimulation of the auditory nerve on the morphology of neurons in the cochlear nucleus in young, sensorineural deaf animals. Kittens, systemically deafened using kanamycin and ethacrynic acid, received bilateral cochlear implants and were stimulated unilaterally for periods of up to four months. After sacrifice, cross-sectional areas of neuron somata were measured with an image-analysis system and compared using nonparametric statistics. The areas of cell somata within the anteroventral cochlear nucleus (AVCN) on the stimulated side were significantly larger than those of corresponding somata on the control, unstimulated side (P < 0.001). However, there was no statistically significant difference among dorsal cochlear nucleus (DCN) neurons. These results indicate that long-term electrical stimulation of the auditory nerve can at least partially negate some effects of early postnatal auditory deprivation at the level of the cochlear nucleus.