Graeme Clark Collection
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ItemSpeech processor design for a multiple-channel cochlear implant( 1980)This paper outlines the strategy adopted for a laboratory-based speech processor used to provide speech information to patients with a multiple-channel cochlear implant It also presents the results of vowel and consonant recognition studies and speech test using open sets of words and sentences.
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ItemDelayed neurotrophin treatment supports auditory neuron survival in deaf guinea pigs [Abstract]( nd)The cochlear implant provides auditory cues to patients with a severe profound hearing loss by direct electrical stimulation of the auditory nerve. As such, the total number and integrity of the surviving auditory neuron population may govern the benefits that patients can derive from the implants. Therefore, the rescue of auditory neurons from degeneration following the loss of hair cells is of great therapeutic significance. Neurotrophic factors are known to be important for the development and maintenance of the auditory system I, and have also been rep6rted to act as survival factors for auditory neurons in animal models of deafness. However, while studies have demonstrated that the application of neurotrophins into the inner ear shortly following deafening can prevent auditory neuron degeneration2,3, much less is known about the survival effects of delayed neurotrophin treatment, which is a clinically more realistic model. This study therefore examined the effects of delayed neurotrophin treatment on auditory neuron survival following deafening. Specifically, we aimed to determine if any or all of the neurotrophins -BDNF, NT -3, NT-4/5 and NGF -could rescue neurons from degeneration after a period of two weeks of deafuess. Normal hearing guinea pigs were bilaterally deafened J using a combination of the aminoglycoside kanamycin and the loop diuretic frusemide. Two weeks later the left cochleae were implanted with a cannula attached to a mini-osmotic pump, which delivered 10Ilg of neurotrophin over a period of 28 days. The right cochleae acted as deafened and untreated controls. Despite the delayed treatments, each of the four neurotrophins prevented the degeneration of auditory neurons that is normally seen following loss of hair cells. When compared to normal hearing animals, the neuronal survival rates of deafened, neurotrophin-treated animals ranged between 79 87%; in contrast, deafened, untreated controls displayed only 52% neuronal survival. Current work is also investigating the expression patterns of the neurotrophin Trk receptors in relation to these findings, and these results will also be discussed. The results of this study provide further support to the theory that neurotrophic factors may be able to be used as therapeutic agents for the benefit of the hearing impaired community.
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ItemElectrophonically driven single unit responses of the anteroventral cochlear nucleus in cat [Abstract]( 1996)Electrical stimulation of the cochlea results in both direct and electrophonic excitation of auditory nerve fibres. It has been proposed that electrophonic stimulation results from the creation of a mechanical disturbance on the basilar membrane which has properties similar those resulting from acoustic stimuli. Auditory nerve compound action potential (CAP) forward masking studies1 show the level of frequency specific electrophonic stimulation is highly correlated with the spectral energy of the electrical stimulus waveform. The level of spectral energy in pulsatile biphasic electrical stimuli decreases toward low frequencies suggesting the level of electrophonic stimulation will be diminished in the low frequency region of the cochlea.
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ItemA "Combionic Aid": Combined speech processing for a cochlear implant in one ear and speech processing hearing aid in the other ear [Abstract]( 1993)Independent use of a cochlear implant in one ear and a hearing aid in the other is not acceptable for many implant users with some residual hearing. Psychophysical evidence suggests that there are substantial interactions between acoustic and electrical signals including masking and loudness summation. These effects may contribute to the difficulty in using two independent devices and it is desirable to control the parameters of the electrical and acoustical signals far more accurately than is possible with two independent devices with separate microphones. In order to achieve this control we have developed a Combionic aid incorporating an implant and an 'in1planlcompatible' hearing aid controlled from the same speech processor. The new processor is particularly flexible and can implement a wide variety of speech processing strategies for combined acoustic and electrical stimulation. A benchtop prototype has been tested with five patients using a range of different speech tests. In general, patients do better when they use acoustic and electrical information simultaneously than they do with either alone. Some patients on some tests perform significantly better with the bimodal aid than they do with independent hearing aids and implant processors worn together. Wearable devices have now been built and evaluations of these devices are continuing.
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ItemPsychophysical matching of sensations produced by acoustic and electrical stimulation of the auditory nerve [Abstract](Monash University Press, 1983)The aim of this study was to establish an acoustic model of a multiple-channel cochlear implant that could be used in the development of speech coding strategies. Identical psychophysical tests were carried out with electrical stimuli for two cochlear implant patients and with acoustic stimuli for three normally hearing listeners. Each electrical stimulus was a train of biphasic pulses at a constant rate between 50 and 100 pps directed to one of the 10 electrodes spaced at 1.5mm intervals around the basal turn of the cochlea (Clark et al. 1977). The corresponding acoustic stimulus was a train of noise bursts at a rate equal to the electrical pulse rate. The noise bursts were passed through one of 8 bandpass filters with centre frequencies equally spaced on a logarithmic scale from 1140 to 10880 Hz representing 8 different electrodes.
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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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ItemPredicting speech perception outcomes for children using multichannel cochlear implants [Abstract]( 2002)The ability to predict outcomes for children who are cochlear implant candidates is most helpful in counselling families and making clinical recommendations. Open-set speech perception results have been collected for all children implanted with the Nucleus device in Melbourne. Speech perception as assessed at six month intervals following implantation. Information wascollected for each child regarding type of hearing loss, duration and age at onset of profound hearing loss, age at implantation, pre and post-implant communication mode, developmental delay, speech coding scheme and implant experience.
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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.