Graeme Clark Collection
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ItemCochlear implants: a personal scientific journey [Abstract]( 2002)Electrical stimulation of the auditory system to reproduce hearing commenced through academic curiosity, and the hope of helping deaf people. It received direction from neurophysiology, and later psychophysics and speech science. In the 1960s and 1970s there were many questions requiring answers before cochlear implants could become a practical reality. Key concerns were: (1) the cochlea was too complex for electrical stimulation to reproduce the coding of sound; (2) multiple electrodes inserted into the cochlea for the place coding of frequency could damage the auditory nerves to be stimulated; (3) speech was too complex to be reproduced by electrical stimulation; and (4) children born deaf would not develop the appropriate neural connectivity for speech understanding. The first questions were addressed on the experimental animal. Speech research on patients was only possible with the advent of silicon chip technology allowing the development of an implantable receiver-stimulator package. Initial research established proof of principle that connected discourse was possible with multiple electrode stimulation of the auditory nerve in severely and profoundly deaf people. The research has been developed industrially for the benefits to be provided on a widespread basis through clinics worldwide. Further research has resulted in continuing improvements so that the average profoundly deaf person can hear as well as someone with severe hearing loss using a hearing aid. There is still much research required to achieve high fidelity sound, hearing in noise, and totally implantable devices.
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ItemCochlear implants for adults and children(Martin Dunitz, 2002)Cochlear implants which use multiple-electrode speech-processing strategies are now established clinical entity for children and adults, as a result, preoperative selection and (re)habilitation are key issues. It is hard to realize that it was only in the 1960s and 1970s when many scientists and clinicians said that successful cochlear implants were not possible in the foreseeable future. The questions that had to be addressed by a multi disciplinary research effort are discussed, and the solutions achieved from the University of Melbourne's perspective are presented. However, the main aim of this chapter is to focus on preoperative selection, and (re)habilitation, including the results obtained. These issues are discussed primarily with reference to data from the University of Melbourne's Cochlear Implant Clinic at the Royal Victorian Eye and Ear Hospital. As this is a book on audiological medicine only, an overview of surgical principles is presented. The surgical management of the patient is, of course, very important, so for more details the reader is referred elsewhere. Cochlear implantation has also been the subject of quite intense ethical debate, particularly over its use for children. For this reason, a discussion of ethical issues is included. Finally, the chapter concludes with a vision of research in the next Millennium.
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ItemHistopathology of the binaural cochlear implant subject [Abstract]( 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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ItemLateral inhibition in ventral cochlear nucleus chopper neurons: contribution to coding of a speech feature [Abstract]( 2002)Lateral inhibition in the auditory system enhances excitatory responses by suppressing off-best frequency (BF) neural activity. Previous work has suggested that lateral inhibition activated by high frequency frication noise associated with stop consonant plays a role in coding voice onset time (VOT), the period between consonant release and onset of the ensuing vowel.
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ItemPost-implant habilitation for children using cochlear implants: effects on long-term outcome( 2002)Most clinicians working in the cochlear implant field advocate a regular habilitation program for young children receiving implants. The development of auditory skills and the incorporation of these skills into language development are thought to be key areas for such programs. Studies of speech perception and language outcomes demonstrate that an educational approach that emphasises spoken language development appears to enhance the results for implanted children. It remains difficult, however, to demonstrate clearly the effect of habilitation objectively and to determine how much individual attention is desirable for each child. This pilot study considered the long term speech perception and language outcomes for two groups of children who received Nucleus cochlear implants in Melbourne. One group (n=17) was identified as receiving regular habilitation from the Melbourne Cochlear Implant Clinic over a four year post-operative period. Another group (n=l1) was identified as receiving very little regular habilitation over the post-operative period. The language and speech perception results for these two groups showed a significant difference in performance on a wide range of measures with the group receiving regular formal habilitation demonstrating better performance on all measures. These groups included only congenitally, profoundly hearing-impaired children and did not differ significantly on mean age at implant or experience at the time of assessment. Further studies are needed to clarify these results on a larger group of children, and to control for additional confounding variables. Nonetheless, these preliminary results provide support for the incorporation of regular long-term habilitation into cochlear implant programs for children.
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ItemThe relationship between the output synchrony of cochlear nucleus neurons and the site of stimulation in the cochlea( 2001)A model has been developed to determine the relationship between the output synchrony of cochlear nucleus neurons and the site of stimulation in the cochlea. This is an Integrate and Fire Neuron Model in which noisy periodic synaptic inputs to the neuron are summed and a spike is generated when the membrane potential reaches threshold. The model describes the stochastic input that auditory nerve fibres provide to a cochlear nucleus neuron and the corresponding stochastic output. To investigate the relationship between the output synchrony of cochlear nucleus neurons (namely globular bushy cells) and the site of stimulation in the cochlea, phase differences between the periodic inputs of the model were incorporated, in order to mimic how the travelling wave consecutively activates auditory nerve fibres originating over a spatial spread of the basilar membrane. Analysis of the model found that output synchrony decreased with an increase in frequency and spatial spread. Furthermore, enhancement of the output synchrony relative to the input synchrony occurred for small spatial spreads of the basilar membrane over which input primary afferent fibres originate. Adding noise helped to make the model more realistic. As a result enhancement of synchrony occurred with a spatial spread of less than 1.25 mm and 0.75 mm for 0.5 kHz and I kHz respectively, while for the higher frequencies analysed (2 kHz and 5 kHz) enhancement of synchrony did not occur. This research has implications for the design of electrode arrays in cochlear implants. The number and geometry of the electrodes and the stimulus patterns to be used will depend on the degree of convergence of fibres and how phase information is processed by neurons in the brainstem.
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ItemBrainstem encoding of short voice onset times in natural speech( 2001)An auditory nerve study has shown that short voice onset times (VOTs) in synthetic consonant-vowel syllables are not accurately encoded by the fibres' discharge rate. We have re-examined this issue within the ventral Cochlear nucleus (VCN), using natural speech and a fine-grain analysis of single unit responses. We recorded extracellularly from 93 VCN neurons in rats anaesthetised with urethane (2.5 g/kg ip). After identifying a cell's response type and best frequency (BF), 3 syllables spoken by a male were presented at double rate and 3 intensities (/bεt/, /dεt/, and /gεt/, at 45, 65, and 75 dB SPL). These three syllables differ in their VOTs (the interval between consonant release and the onset of glottal pulses associated with voicing) due to the different points of articulation of the three initial stop consonants. In many neurons (particularly onset cells), these syllables evoked a clear response to consonant release, followed by an interval of inactivity or reduced activity before the periodic response to the vowel's voicing frequency commenced. This interval of reduced or no activity corresponded to a given syllable's VOT. The responses of all cells (BFs: 0.9-19 kHz) to the 9 different syllable-SPL combinations were plotted as Grand Average post-stimulus time histograms. In 8/9 combinations, syllable onset was associated with a statistically significant peak in activity and the next significant peak in discharge rate occurred at the time of voice onset (± I ms). These results indicate that the prominent responses to consonant release and voice onset, produced by the synchronous firing of neurons with a wide range of BFs, accurately encode short VOTs.
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ItemThe effects of action potential propagation delay times and an absolute refractory period upon the synchronization index in the integrate and fire neuron model and a comparison with neurons in the auditory pathway( 2000)The effects of action potential (AP) propagation delay times and the absolute refractory period upon the synchronization index are analysed for the integrate and fire neuron model, and the results are compared with recordings from auditory ganglion neurons and cochlear nucleus neurons. In the model the noisy periodic synaptic input to the neuron is summed and an AP is generated when the membrane potential reaches threshold. The output phase distribution (phase histogram) is calculated at the site at which the APs are generated. The AP propagation delay times along an axon are modelled using a periodically wrapped Gaussian distribution, with the width fitted from experimental data. This distribution is convolved with the calculated phase distribution to obtain the phase distribution at the axon terminal.