Graeme Clark Collection
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ItemChronic monopolar high rate simulation of the auditory nerve: physiological and histopathological effects(Kugler Publications, 2001)There is clinical interest in the development of high rate speech processing strategies, since there are indications that these might enhance speech perception due to an improved representation of the rapid variations in amplitude of speech. Significant improvement in speech perception using high rate stimulation has been demonstrated in cochlear implant recipients. However, it is important that the long-term safety of high rate stimulation is clearly established prior to its general clinical application. This is especially important, since acute animal studies have shown that high rate stimulation can induce a reduction in the excitability of the auditory nerve. This was also associated with an increase in both threshold and latency of the electrically evoked auditory brainstem response (EABR). However, while a chronic stimulation study indicated that monopolar electrical stimulation of the auditory nerve at rates of 1000 pulses per second (pps)/channel (three channels) had no adverse effects on the spiral ganglion cell density (SGCO),5 there is limited data concerning higher rates. In the present study, we evaluated the electrophysiological and histopathological effects of chronic monopolar electrical stimulation of the auditory nerve using considerably higher stimulus rates than have been used in previous studies.
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ItemDirect current measurements in cochlear implants: an in vivo and in vitro study( 1998)Direct current (DC) was measured both in vivo and in vitro in cochlear implant electrodes with stimulation at moderate to high pulse rates in monopolar and bipolar modes. In vivo DC was approximately 2-3 times higher than that measured in vitro. In vivo DC levels were <100 nA even at very high rates, although DC levels increased as a function of stimulus rate and charge intensity. DC levels were lower: in the monopolar than in the bipolar stimulation condition. Stimulation with a monopolar capacitively coupled extracochlear electrode showed even lower DC levels in the intracochlear .electrodes. Our results indicated that the Nucleus electrode shorting system is able to maintain a low level of DC during very high rate stimulation for both monopolar and bipolar modes.
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ItemPeri-modiolar electrode arrays: a comparison of electrode position n the human temporal bone(Monduzzi Editore, 1997)This paper describes a radiologic evaluation of three types of peri-modiolar arrays, comparing their trajectory within the scala tympani with a standard Mini-22 electrode. All peri-modiolar arrays were found to lie closer to the modiolus for much of their insertion length compared with the standard array. While one design showed evidence for the potential of increased insertion trauma, two designs produced satisfactory results. Although further electrode development, temporal bone and histopathologic studies arE required, it would appear that the benefits of peri-modiolar electrode arrays will be realised clinically.
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ItemElectrical stimulation of the auditory nerve: stimulus induced reductions in neural excitability [Abstract]( 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.