Graeme Clark Collection

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    Physiological and histopathological effects of chronic intracochlear electrical stimulation
    Shepherd, R. K. ; Clark, Graeme M. ; Black, R. C. (Monash University Press, 1983)
    Direct and r.f. currents are known to result in destruction of neural tissue. However, it is now apparent that non-destructive electrical stimulation can be achieved by the use of biphasic pulsatile stimuli (Lilly, 1960; Mortimer et al., 1970; Hughes et al., 1980). Although maximum biologically safe stimulation regimes have yet to be clearly defined, the evidence of a number of investigators suggests that charge density per phase and charge injection per phase are important parameters when establishing biologically safe levels of electrical stimulation (Pudenz et al., 1975; Pudenz et al., 1977; Brown et al., 1977; Babb et al., 1977). Furthermore, considerable attention has been given to ensure that the stimulus is not producing adverse electrochemical reactions that could result in physical or toxic injury to the biological environment. Brummer et al. (1977) have defined the upper limit of electrochemically safe electrical stimulation for platinum electrodes as charge balanced biphasic pulses at a maximum charge density of 300 ?C/cm2 geom./phase.
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    The influence of electrode geometry on the electrically evoked auditory brain stem response
    Shepherd, R. K. ; Hatsushika, S. ; Clark, Graeme M. ( 1988)
    The electrically-evoked auditory brainstem response (EABR) consists of a series of far-field potentials that reflect synchronous neural activity within the auditory brainstem in response to a transient electrical stimulus. The EABR appears relatively simply organized in terms of its amplitude and latency behaviour. The growth in amplitude of wave IV of the EABR, for example, reflects changes in the amplitude of the electrically-evoked VIII nerve compound action potential as a function of stimulus intensity. In addition, single unit population studies have shown a monotonic relationship between the growth in EABR amplitude and the number of nerve fibres being stimulated (Merzenich and White, 1977). The EABR can therefore, provide an insight into the response of the auditory nerve to electrical stimulation. We have used this technique to investigate the efficacy of electrical stimulation of the auditory nerve using a variety of stimulating electrode geometries.
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    Electrical stimulation of the auditory nerve: stimulus induced reductions in neural excitability [Abstract]
    Shepherd, R. K. ; Clark, Graeme M. ( 1987)
    Electrical stimulation of the auditory nerve elicits highly synchronised neural activity (Javel et al., in press). As the stimulus current is increased the neural response becomes highly deterministic with every current pulse eliciting a spike even at stimulus rates of 600-800 pulses per second (pps). Our previous acute experimental studies have shown that high stimulus rates (> 200 pps) and high stimulus currents (> 1.0 mA) can result in temporary and sometimes permanent reductions in the excitability of the auditory nerve (Shepherd and Clark, 1986). The present study was designed to examine the mechanisms underlying these stimulus induced reductions in excitability. These results will have implications for the maximum safe and effective stimulus rates that can be employed in cochlear implants.
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    The histopathology of the human temporal bone following cochlear implantation in a patient: a summary
    Clark, Graeme M. ; Shepherd, R. K. ; Webb, R. L. ; Franz, B. K-H. ( 1987)
    The macroscopic and microscopic evaluation of the implanted and unimplanted temporal bones in a patient who had a cochlear prosthesis for 27 months prior to his death from cardiac disease has shown that the device is biocompatible, and does not lead to any significant adverse effects. The cause of deafness was meningitis.
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    Histopathology following electrode insertion and chronic electrical stimulation
    Shepherd, R. K. ; Clark, Graeme M. ; Pyman, B. C. ; Webb, R. L. ; Murray, M. T. ; Houghton, M. E. (Raven Press, 1985)
    We have examined a number of safety issues associated with cochlear implants. This work has been primarily designed to evaluate the histopathological effects of intracochlear electrode implantation and chronic electrical stimulation. The results of these studies may be summarized as follows: 1) The insertion of the banded free-fit scala tympani array into human cadaver temporal bones produces minimal damage, occurring primarily to a localized region of the spiral ligament. This damage would not result in significant neural degeneration and thus, would not compromise the efficacy of the multiple channel device; 2) chronic intracochlear electrical stimulation for continuous periods of 500 to 2000 hours, using charge balanced biphasic current pulses developing charge densities of 18-32 }?C/cm2. geom./phase, does not adversely affect the spiral ganglion cell population; 3) labyrinthine infection severely reduces the viable spiral ganglion cell population; 4) the formation of new bone present in approximately half of the animals we have implanted --is not associated with electrical stimulation per se; 5) scanning electron microscope studies of electrodes subjected to long periods of intracochlear electrical stimulation reveals minimal platinum dissolution when compared with unstimulated control electrodes, and electrodes that have been stimulated for similar periods in inorganic saline.