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Introduction: Expanding cochlear implant (CI) candidacy criteria and advances in electrode arrays and soft surgical techniques have increased the number of CI recipients who have residual low-frequency hearing. Objective measures such as obligatory cortical auditory-evoked potentials (CAEPs) may help clinicians make more tailored recommendations to recipients regarding optimal listening mode. As a step toward this goal, this study investigated how CAEPs measured from hybrid CI users differ in two listening modes: acoustic alone (A-alone) versus acoustic plus electric (A + E). Methods: Eight successful hybrid CI users participated in this study. Two CAEPs, the P1-N1-P2 and the acoustic change complex (ACC), were measured simultaneously in response to the onset and change of a series of different and spectrally complex acoustic signals, in each of the two listening modes (A-alone and A + E). We examined the effects of listening mode and stimulus type on the onset and ACC N1-P2 amplitudes and peak latencies. Results: ACC amplitudes in hybrid CI users significantly differed as a function of listening mode and stimulus type. ACC responses in A + E were larger than those in the A-alone mode. This was most evident for stimuli involving a change from low to high frequency. Conclusions: Results of this study showed that the ACC varies as a function of listening mode and stimulus type. This finding suggests that the ACC can be used as a physiologic, objective measure of the benefit of hybrid CIs, potentially supporting clinicians in making clinical recommendations on individualized listening mode, or to document subjective preference for a given listening mode. Further research into this potential clinical application in a range of hybrid recipients and/or long electrode users who have residual low-frequency hearing is warranted. [ABSTRACT FROM AUTHOR]

The Hodgkin-Huxley (HH) model does not simulate the significant changes in auditory nerve fiber (ANF) responses to sustained stimulation that are associated with neural adaptation. Given that the electric stimuli used by cochlear prostheses can result in adapted responses, a computational model incorporating an adaptation process is warranted if such models are to remain relevant and contribute to related research efforts. In this paper, we describe the development of a modified HH single-node model that includes potassium ion ([K.sup.+]) concentration changes in response to each action potential. This activity-related change results in an altered resting potential, and hence, excitability. Our implementation of [K.sup.+]-related changes uses a phenomenological approach based upon [K.sup.+] accumulation and dissipation time constants. Modeled spike times were computed using repeated presentations of modeled pulse-train stimuli. Spike-rate adaptation was characterized by rate decrements and time constants and compared against ANF data from animal experiments. Responses to relatively low (250 pulse/s) and high rate (5000 pulse/s) trains were evaluated and the novel adaptation model results were compared against model results obtained without the adaptation mechanism. In addition to spike-rate changes, jitter and spike intervals were evaluated and found to change with the addition of modeled adaptation. These results provide one means of incorporating a heretofore neglected (although important) aspect of ANF responses to electric stimuli. Future studies could include evaluation of alternative versions of the adaptation model elements and broadening the model to simulate a complete axon, and eventually, a spatially realistic model of the electrically stimulated nerve within extracochlear tissues. Index Terms--Adaptation, auditory nerve, cochlear implant, computer modeling, electric stimulation, neural modeling, potassium ion, pulse train.

This paper presents an analysis of the effects of the electrode-to-fiber distance on the temporal response properties of an auditory nerve fiber stimulated by electric current pulses. This analysis was based upon results from a computational model of a mammalian auditory nerve fiber axon having 50 nodes of Ranvier, each consisting of 130 stochastic sodium channels and 50 stochastic potassium channels, making it possible to represent the temporal fluctuations of action potential initiation and conduction. A monopolar stimulus electrode was located above a central (26th) node at electrode-to-fiber distances of 1, 4, and 7 mm, while the recording electrode was located at the 36th node. Action potentials (spikes) were generated by the biophysical model using the Crank-Nicholson method to solve a diffusive partial differential equation. By observing the occurrence times of spikes in response to 2000 cathodic monophasic stimulus pulses, temporal jitter (i.e., the standard deviation of spike times) was calculated and the poststimulus time (PST) histogram was generated as well. Furthermore, by computing the PST histogram for each initiation node as functions of space (node number) and time (PST), it was shown that spike initiation was distributed not only spatially but also temporally for stimulus levels producing firing efficiencies (FEs) near 0.5. However, at levels producing FEs near 0.99, while temporal variations approached zero, the spatial distribution of initiating nodes was comparable to that observed for the FE near 0.5. As temporal fluctuations are important for speech coding in cochlear implants, we conclude that spatial characteristics of the electrode-auditory nerve fiber interface may play a significant role in influencing these stochastic temporal processes. Index Terms--Action potential, auditory nerve fiber, cochlear implants, computer simulation, electrical stimulation, fluctuations, information transfer, neural encoding, neural prosthesis, spike, spike initiation, stochastic ion channels, temporal jitter.

Electrically evoked whole nerve action potentials (EAP) have been recorded from 20 Ineraid cochlear implant users in response to bipolar and/or monopolar electrical stimulation of the cochlea. EAP growth functions and refractory recovery functions were obtained for a variety of different stimulating conditions. Where possible, parallel psychophysical experiments were conducted that measured the just detectable increment in stimulus current level (JND), forward-masking functions, and detection thresholds for a range of different stimuli. Variations in EAP threshold, slope of the EAP growth function, and the rate of recovery of the EAP from the refractory state were observed both across subjects for a given place and by mode of stimulation (bipolar versus monopolar), as well as across electrodes within a subject. A poor correlation between slope of the EAP growth functions and current JNDs was obtained. However, good correlations were observed between EAP threshold and psychophysical detection threshold and between the EAP refractory recovery functions and the psychophysical forward-masking functions. Our interpretation of these findings is that these particular physiological measures are related to the excitability of the auditory nerve to electrical stimulation and further that these measures are related to performance of cochlear implant patients on listening tasks. Consequently, such information may prove to be useful in adjusting the stimulation parameters of the cochlear implant speech processor in order to maximize an individual's performance with the device. KEY WORDS: cochlear implants, auditory evoked potentials, whole-nerve action potentials, electrical stimulation, electrophysiologic measures