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AbstractObjectiveDesignStudy sampleResultsConclusionTo evaluate whether a 500 pulses per second per channel (pps/ch) rate would provide non-inferior hearing performance compared to the 900 pps/ch rate in the Advanced Combination Encoder (ACE™) sound coding strategy.A repeated measures single-subject design was employed, wherein each subject served as their own control. All except one subject used 900 pps/ch at enrolment. After three weeks of using the alternative rate program, both programs were loaded into the sound processor for two more weeks of take-home use. Subjective performance, preference, words in quiet, sentences in babble, music quality, and fundamental frequency (F0) discrimination were assessed using a balanced design.Data from 18 subjects were analysed, with complete datasets available for 17 subjects.Non-inferior performance on all clinical measures was shown for the lower rate program. Subjects’ preference ratings were comparable for the programs, with 53% reporting no difference overall. When a preference was expressed, the 900 pps/ch condition was preferred more often.Reducing the stimulation rate from 900 pps/ch to 500 pps/ch did not compromise the hearing outcomes evaluated in this study. A lower pulse rate in future cochlear implants could reduce power consumption, allowing for smaller batteries and processors. [ABSTRACT FROM AUTHOR]

The stimulation rate in cochlear implant (CI) sound coding, or the "carrier" rate in pulses per second (pps), is known to influence pitch perception, as well as loudness perception and sound quality. Our main objective was to investigate the effects of reduced carrier rate on the loudness and pitch of coded speech samples. We describe two experiments with 16 Nucleus® CI users, where we controlled modulation characteristics and carrier rate using Spectral and Temporal Enhanced Processing (STEP), a novel experimental multichannel sound coder. We used a fixed set of threshold and comfortable stimulation levels for each subject, obtained from clinical MAPs. In the first experiment, we determined equivalence for voice pitch ranking and voice gender categorization between the Advanced Combination Encoder (ACE), a widely used clinical strategy in Nucleus® recipients, and STEP for fundamental frequencies (F0) 120–250 Hz. In the second experiment, loudness was determined as a function of the input amplitude of speech samples for carrier rates of 1000, 500, and 250 pps per channel. Then, using equally loud sound coder programs, we evaluated the effect of carrier rate on voice pitch perception. Although nearly all subjects could categorize voice gender significantly above chance, pitch ranking varied across subjects. Overall, carrier rate did not substantially affect voice pitch ranking or voice gender categorization: as long as the carrier rate was at least twice the fundamental frequency, or when stimulation pulses for the lowest, 250 pps carrier were aligned to F0 peaks. These results indicate that carrier rates as low as 250 pps per channel are sufficient to support functional voice pitch perception for those CI users sensitive to temporal pitch cues; at least when temporal modulations and pulse timings in the coder output are well controlled by novel strategies such as STEP. [ABSTRACT FROM AUTHOR]

The traditional method of recording electrically evoked compound action potentials (ECAPs), as implemented in the MAESTRO clinical software (standard ART), requires manual adjustments during threshold determination through a specialist. The "FineGrain" research tool (FineGrain RT) uses a continuous stimulation paradigm combined with automatic ECAP threshold determination. The aim of this study was to compare the FineGrain RT with standard ART. ECAPs were recorded with standard ART and the FineGrain RT in paediatric cochlear implant recipients. Different stimulation rates were used for FineGrain ECAP recordings (40, 60, and 76 Hz). Thirteen children (6 − 19 years) participated in this study - nine were bilaterally and four unilaterally implanted, resulting in a total of twenty-two implanted ears. ECAP threshold determination success rates were similar between the two approaches (92% and 89%) and ECAP thresholds correlated well (r: 0.94, p < 2.2e–16) with average ART thresholds being lower than FineGrain RT thresholds. FineGrain stimulation with different stimulation rates did not have a significant effect on ECAP thresholds but ECAP thresholds at medial and apical contacts were lower compared to basal contacts. TheFineGrain research approach is a reliable replacement for standard ART in clinical practice. [ABSTRACT FROM AUTHOR]

BackgroundAmplitude modulation (AM) detection is a measure of temporal processing that has been correlated with cochlear implant (CI) users' speech understanding. For CI users, AM stimuli have been shown to be louder than steady-state (non-AM) stimuli presented at the same reference current level, suggesting that unwanted loudness cues might contribute to CI users' AM sensitivity as measured in a modulation detection task. In this paper, a new method is introduced to dynamically control unwanted AM loudness cues when adaptively measuring modulation detection thresholds (MDTs) in CI users.MethodsMDTs were adaptively measured in 9 CI subjects using a three-alternative, forced-choice procedure, with and without dynamic control of unwanted AM loudness cues. To control for AM loudness cues during the MDT task, the level of the steady-state (non-AM) stimuli was increased to match the loudness of the AM stimulus using a non-linear amplitude scaling function, which was obtained by first loudness-balancing non-AM stimuli to AM stimuli at various modulation depths. To further protect against unwanted loudness cues, ±0.75dB of level roving was also applied to all stimuli during the MDT task.ResultsAbsolute MDTs were generally poorer when unwanted AM loudness cues were controlled. However, the effects of modulation frequency and presentation level on modulation sensitivity were fundamentally unchanged by the availability of AM loudness cues.ConclusionsThe data suggest that the present method controlling for unwanted AM loudness cues might better represent CI users' MDTs, without changing fundamental effects of modulation frequency and presentation level on CI users' modulation sensitivity.

Objective: To evaluate whether a 500 pulses per second per channel (pps/ch) rate would provide non-inferior hearing performance compared to the 900 pps/ch rate in the Advanced Combination Encoder (ACE™) sound coding strategy., Design: A repeated measures single-subject design was employed, wherein each subject served as their own control. All except one subject used 900 pps/ch at enrolment. After three weeks of using the alternative rate program, both programs were loaded into the sound processor for two more weeks of take-home use. Subjective performance, preference, words in quiet, sentences in babble, music quality, and fundamental frequency (F0) discrimination were assessed using a balanced design., Study Sample: Data from 18 subjects were analysed, with complete datasets available for 17 subjects., Results: Non-inferior performance on all clinical measures was shown for the lower rate program. Subjects' preference ratings were comparable for the programs, with 53% reporting no difference overall. When a preference was expressed, the 900 pps/ch condition was preferred more often., Conclusion: Reducing the stimulation rate from 900 pps/ch to 500 pps/ch did not compromise the hearing outcomes evaluated in this study. A lower pulse rate in future cochlear implants could reduce power consumption, allowing for smaller batteries and processors.

Objective: To systematically review the evidence of how adjustments of the electrical threshold (T) level, input dynamic range (IDR) and electrical stimulation rate impact on speech perception for cochlear implant (CI) users. Design: Systematic review. Study sample: A search of two electronic data sources yielded 32 studies, which met the inclusion criteria. A quality assessment and two evidence-based practice (EBP) review rating schemes were used to grade studies. Results: Due to the heterogeneity of speech perception measures, CI device type and study design, comparisons were made by structured review. Conclusion: The quality of studies was found to be moderate to poor. Increasing T levels above behavioural threshold, or as a proportion of electrical dynamic range (EDR), has been demonstrated to improve perception of monosyllables in quiet and sentences in both quiet and in noise. Specific IIDR and IDR setting may improve perception of monosyllables in quiet and sentences in noise. However, no recommendation could be determined for setting rate of stimulation as speech perception varied significantly across rates examined. To optimise speech perception, a bespoke approach to parameter setting providing an individualised CI fitting is recommended; however, detail of how to optimise settings and the interactions between parameters is as yet unknown. [ABSTRACT FROM AUTHOR]

Insect and vertebrate hearts share the ability to generate spontaneously their rhythmic electrical activity, which triggers the fluid-propelling mechanical activity. Although insects have been used as models in studies on the impact of genetic alterations on cardiac function, there is surprisingly little information on the generation of the inotropic activity in their hearts. The main goal of this study was to investigate the sources of Ca2+ for contraction in Tenebrio molitor hearts perfused in situ, in which inotropic activity was assessed by the systolic variation of the cardiac luminal diameter. Increasing the pacing rate from 1.0 to 2.5 Hz depressed contraction amplitude and accelerated relaxation. To avoid inotropic interference of variations in spontaneous rate, which have been shown to occur in insect heart during maneuvers that affect Ca2+ cycling, experiments were performed under electrical pacing at near-physiological rates. Raising the extracellular Ca2+ concentration from 0.5 to 8 mM increased contraction amplitude in a manner sensitive to L-type Ca2+ channel blockade by D600. Inotropic depression was observed after treatment with caffeine or thapsigargin, which impair Ca2+ accumulation by the sarcoplasmic reticulum (SR). D600, but not inhibition of the sarcolemmal Na+/Ca2+ exchanger by KB-R7943, further depressed inotropic activity in thapsigargin-treated hearts. From these results, it is possible to conclude that in T. molitor heart, as in vertebrates: (a) inotropic and lusitropic activities are modulated by the heart rate; and (b) Ca2+ availability for contraction depends on both Ca2+ influx via L-type channels and Ca2+ release from the SR. [ABSTRACT FROM AUTHOR]

Prior research has shown that in electrical hearing, cochlear implant (CI) users' speech recognition performance is related in part to their ability to detect temporal modulation (i.e., modulation sensitivity). Previous studies have also shown better speech recognition when selectively stimulating sites with good modulation sensitivity rather than all stimulation sites. Site selection based on channel interaction measures, such as those using imaging or psychophysical estimates of spread of neural excitation, has also been shown to improve speech recognition. This led to the question of whether temporal modulation sensitivity and spatial selectivity of neural excitation are two related variables. In the present study, CI users' modulation sensitivity was compared for sites with relatively broad or narrow neural excitation patterns. This was achieved by measuring temporal modulation detection thresholds (MDTs) at stimulation sites that were significantly different in their sharpness of the psychophysical spatial tuning curves (PTCs) and measuring MDTs at the same sites in monopolar (MP) and bipolar (BP) stimulation modes. Nine postlingually deafened subjects implanted with Cochlear Nucleus® device took part in the study. Results showed a significant correlation between the sharpness of PTCs and MDTs, indicating that modulation detection benefits from a more spatially restricted neural activation pattern. There was a significant interaction between stimulation site and mode. That is, using BP stimulation only improved MDTs at stimulation sites with broad PTCs but had no effect or sometimes a detrimental effect on MDTs at stimulation sites with sharp PTCs. This interaction could suggest that a criterion number of nerve fibers is needed to achieve optimal temporal resolution, and, to achieve optimized speech recognition outcomes, individualized selection of site-specific current focusing strategies may be necessary. These results also suggest that the removal of stimulation sites measured with poor MDTs might improve both temporal and spectral resolution. [ABSTRACT FROM AUTHOR]

Previous psychophysical studies have shown that a steep detection-threshold-versus-stimulation-rate function (multipulse integration; MPI) is associated with laterally positioned electrodes producing a broad neural excitation pattern. These findings are consistent with steep MPI depending on either a certain width of neural excitation allowing a large population of neurons operating at a low point on their dynamic range to respond to an increase in stimulation rate or a certain slope of excitation pattern that allows recruitment of neurons at the excitation periphery. Results of the current study provide additional support for these mechanisms by demonstrating significantly flattened MPI functions in narrow bipolar than monopolar stimulation. The study further examined the relationship between the steepness of the psychometric functions for detection (d' versus log current level) and MPI. In contrast to findings in monopolar stimulation, current data measured in bipolar stimulation suggest that steepness of the psychometric functions explained a moderate amount of the across-site variance in MPI. Steepness of the psychometric functions, however, cannot explain why MPI flattened in bipolar stimulation, since slopes of the psychometric functions were comparable in the two stimulation modes. Lastly, our results show that across-site mean MPI measured in monopolar and bipolar stimulation correlated with speech recognition in opposite signs, with steeper monopolar MPI being associated with poorer performance but steeper bipolar MPI being associated with better performance. If steeper MPI requires broad stimulation of the cochlea, the correlation between monopolar MPI and speech recognition can be interpreted as the detrimental effect of poor spectral resolution on speech recognition. Assuming bipolar stimulation produces narrow excitation, and MPI measured in bipolar stimulation reflects primarily responses of the on-site neurons, the correlation between bipolar MPI and speech recognition can be understood in light of the importance of neural survival for speech recognition. [ABSTRACT FROM AUTHOR]

Electrical stimulation of auditory nerve fibers using cochlear implants (CI) shows psychophysical forward masking (pFM) up to several hundreds of milliseconds. By contrast, recovery of electrically evoked compound action potentials (eCAPs) from forward masking (eFM) was shown to be more rapid, with time constants no greater than a few milliseconds. These discrepancies suggested two main contributors to pFM: a rapid-recovery process due to refractory properties of the auditory nerve and a slow-recovery process arising from more central structures. In the present study, we investigate whether the use of different maskers between eCAP and psychophysical measures, specifically single-pulse versus pulse train maskers, may have been a source of confound.In experiment 1, we measured eFM using the following: a single-pulse masker, a 300-ms low-rate pulse train masker (LTM, 250 pps), and a 300-ms high-rate pulse train masker (HTM, 5000 pps). The maskers were presented either at same physical current (Φ) or at same perceptual (Ψ) level corresponding to comfortable loudness. Responses to a single-pulse probe were measured for masker-probe intervals ranging from 1 to 512 ms. Recovery from masking was much slower for pulse trains than for the single-pulse masker. When presented at Φ level, HTM produced more and longer-lasting masking than LTM. However, results were inconsistent when LTM and HTM were compared at Ψ level. In experiment 2, masked detection thresholds of single-pulse probes were measured using the same pulse train masker conditions. In line with our eFM findings, masked thresholds for HTM were higher than those for LTM at Φ level. However, the opposite result was found when the pulse trains were presented at Ψ level.Our results confirm the presence of slow-recovery phenomena at the level of the auditory nerve in CI users, as previously shown in animal studies. Inconsistencies between eFM and pFM results, despite using the same masking conditions, further underline the importance of comparing electrophysiological and psychophysical measures with identical stimulation paradigms. [ABSTRACT FROM AUTHOR]

In the present study, we investigated an impact of the stimulation rate on the detection of the proarrhythmic potential of 10 reference compounds with effects on different cardiac ion channels in the isolated arterially-perfused rabbit left ventricular wedge preparation. The compounds were tested in the wedge model using two distinct protocols; including baseline stimulation at 1-Hz followed by a brief period at 0.5-Hz, either without an additional brief period of 2-Hz stimulation (i.e. Protocol 1) or with 2-Hz stimulation (i.e. Protocol 2). As expected, QT-prolonging drugs (ibutilide and quinidine) prolonged the QT interval, similarly increased the Torsades de Pointes (TdP) score, and elicited early afterdepolarizations (EADs) in both protocols. HMR1556 and JNJ-303 (I Ks blockers) also prolonged the QT interval up to 1 μM similarly in both protocols. Nifedipine (Ca 2 + antagonist) shortened the QT interval, and reduced force of contraction similarly in both protocols. However, Na + channel blockers (Ia, Ib, Ic) widened the QRS duration more in Protocol 2 than in Protocol 1. Furthermore, it was only possible to detect non-TdP-like ventricular tachycardia/fibrillation (VT/VF) induced by Na + blockers and by QT-shortening drugs (levcromakalim and mallotoxin) using the 2-Hz stimulation (Protocol 2). Our data suggest that the inclusion of a brief period of fast stimulation at 2 Hz is critical for detecting drug-induced slowing of conduction (QRS widening), QT shortening and associated (non-TdP-like) VT/VF, which are distinct from the QT prolongation/TdP proarrhythmia in isolated, arterially-perfused rabbit left ventricular wedges. [ABSTRACT FROM AUTHOR]

Goal: Auditory middle-latency responses (MLRs) are reported to be particularly susceptible to stimulation rate. Deconvolution methods are necessary to unwrap the overlapping responses at a high rate under the linear superposition assumption. This study aims to investigate and compare the MLR characteristics at high and conventional stimulation rates. Methods: The characteristics were examined in healthy adults by using two closely related deconvolution paradigms, namely continuous-loop averaging deconvolution and multirate steady-state averaging deconvolution at a mean rate of 40 Hz, and a conventional low rate of 5 Hz. Results: The morphology and stability of the MLRs can benefit from a high-rate stimulation. It appears that stimulation sequencing strategies of deconvolution methods exerted divergent rate effects on MLR characteristics, which might be associated with different adaptation mechanisms. Conclusion: MLRs obtained by two deconvolution methods and the conventional reference feature differently from one another. Significance: These findings have critical implications in our current understanding of the rate effects on MLR characteristics which may inspire further studies to explore the characteristics of evoked responses at high rates and deconvolution paradigms. [ABSTRACT FROM PUBLISHER]

Objective To investigate brain asymmetry of the temporal auditory evoked potentials (T-complex) in response to monaural stimulation in children compared to adults. Methods Ten children (7 to 9 years) and ten young adults participated in the study. All were right-handed. The auditory stimuli used were tones (1100 Hz, 70 dB SPL, 50 ms duration) delivered monaurally (right, left ear) at four different levels of stimulus onset asynchrony (700–1100–1500–3000 ms). Latency and amplitude of responses were measured at left and right temporal sites according to the ear stimulated. Results Peaks of the three successive deflections (Na–Ta–Tb) of the T-complex were greater in amplitude and better defined in children than in adults. Amplitude measurements in children indicated that Na culminates on the left hemisphere whatever the ear stimulated whereas Ta and Tb culminate on the right hemisphere but for left ear stimuli only. Peak latency displayed different patterns of asymmetry. Na and Ta displayed shorter latencies for contralateral stimulation. The original finding was that Tb peak latency was the shortest at the left temporal site for right ear stimulation in children. Amplitude increased and/or peak latency decreased with increasing SOA, however no interaction effect was found with recording site or with ear stimulated. Conclusion Our main original result indicates a right ear–left hemisphere timing advantage for Tb peak in children. The Tb peak would therefore be a good candidate as an electrophysiological marker of ear advantage effects during dichotic stimulation and of functional inter-hemisphere interactions and connectivity in children. [ABSTRACT FROM AUTHOR]

Objectives Determine ipsilateral acoustic electric pitch place match in a patient with preserved residual hearing across a broad frequency range. Methods Case report. Patient with up-sloping sensorineural hearing loss underwent implantation with a 680° insertion angle with preserved residual hearing. Pitch matching with variance of pulse rate was carried out. Results Electrical pitch percepts closely approximated the Greenwood map when compared to the acoustical pitch percepts and electrode position as determined by post-operative computed tomographic scan. The pitch matching results achieved from the deeply inserted electrodes, in the apical portion of the cochlea, suggest that the electrical stimulation may activate the dendritic extensions from the ganglion cell bodies that radiate from the terminal bulb. Stimulation rate influenced pitch perception in the apical turn but not in the mid- and basilar regions. Discussion Frequency to pitch allocation can potentially be improved by cochlear implants that access the apical third of the spiral ganglion. The ultimate goal of stimulating the apical third of the cochlea is to provide the maximum amount of spectral information to the user. We had the unique opportunity to work with a patient who presented with a severe sensorineural hearing loss rising to within normal limits and poor speech discrimination scores. Data from this study may aid our ability to give patients a broader spectrum of sound perception. [ABSTRACT FROM AUTHOR]

Highlights: [•] Unwanted loudness cues may contribute to cochlear implant (CI) users’ modulation detection thresholds (MDTs). [•] A method to control for amplitude-modulated (AM) loudness cues was used in an adaptive modulation detection task. [•] The level of non-AM stimuli was adjusted to match the loudness of AM stimuli, followed by roving the level of all stimuli. [•] Absolute MDTs were poorer after controlling for AM loudness cues. [•] Effects of presentation level and modulation rate were unchanged by the new method, with an interaction with carrier rate. [ABSTRACT FROM AUTHOR]

The stimulation rate in cochlear implant (CI) sound coding, or the "carrier" rate in pulses per second (pps), is known to influence pitch perception, as well as loudness perception and sound quality. Our main objective was to investigate the effects of reduced carrier rate on the loudness and pitch of coded speech samples. We describe two experiments with 16 Nucleus® CI users, where we controlled modulation characteristics and carrier rate using Spectral and Temporal Enhanced Processing (STEP), a novel experimental multichannel sound coder. We used a fixed set of threshold and comfortable stimulation levels for each subject, obtained from clinical MAPs. In the first experiment, we determined equivalence for voice pitch ranking and voice gender categorization between the Advanced Combination Encoder (ACE), a widely used clinical strategy in Nucleus® recipients, and STEP for fundamental frequencies (F0) 120-250 Hz. In the second experiment, loudness was determined as a function of the input amplitude of speech samples for carrier rates of 1000, 500, and 250 pps per channel. Then, using equally loud sound coder programs, we evaluated the effect of carrier rate on voice pitch perception. Although nearly all subjects could categorize voice gender significantly above chance, pitch ranking varied across subjects. Overall, carrier rate did not substantially affect voice pitch ranking or voice gender categorization: as long as the carrier rate was at least twice the fundamental frequency, or when stimulation pulses for the lowest, 250 pps carrier were aligned to F0 peaks. These results indicate that carrier rates as low as 250 pps per channel are sufficient to support functional voice pitch perception for those CI users sensitive to temporal pitch cues; at least when temporal modulations and pulse timings in the coder output are well controlled by novel strategies such as STEP., (© 2022. The Author(s) under exclusive licence to Association for Research in Otolaryngology.)

Abstract: Objective: It has recently been demonstrated in the cat and in healthy subjects that the effects of repetitive afferent fibre stimulation depends on the target spinal neurones. The purpose of this series of experiments was therefore to determine whether central nervous system lesions modify the behaviour of the inhibitory spinal pathways in response to repetitive activation of afferent fibres. Methods: The H-reflex technique was used to study the effect of increasing the conditioning stimulus rate from 0.16 to 1Hz on disynaptic inhibition and on presynaptic Ia inhibition on the affected side of 36 hemiplegic patients. Results: The major finding was that, similar to results previously obtained in healthy subjects, increasing the conditioning stimulus rate in hemiplegic patients leads to an increase in the synaptic efficiency of inhibitory spinal circuits. Furthermore, a significant correlation was found between the severity of flexor carpi radialis muscle spasticity and the amount of disynaptic inhibition. Conclusions: The reinforcement of inhibitory spinal networks induced by repetitive stimulation of afferent fibres is preserved in spastic patients, whereas the mechanisms underlying this phenomena might be altered. Significance: The results of these experiments open up a number of possibilities for novel spasticity therapies based on non-invasive techniques. [Copyright &y& Elsevier]

Abstract: Presbycusis, as the deterioration of hearing ability occurring with aging, can be manifested not only in a shift of hearing thresholds, but also in a deterioration of the temporal processing of acoustical signals, which may in elderly people result in degraded speech comprehension. In this study we assessed the age-related changes in the temporal processing of acoustical signals in the auditory system of pigmented rats (Long Evans strain). The temporal resolution was investigated in young adult (3–4months) and old (30–34months) rats by behavioral and electrophysiological methods: the rats'' ability to detect and discriminate gaps in a continuous noise was examined behaviorally, and the amplitude-rate function was assessed for the middle latency response (MLR) to clicks. A worsening of the temporal resolution with aging was observed in the results of all tests. The values of the gap detection threshold (GDT) and the gap duration difference limen (GDDL) in old rats increased about two-fold in comparison with young adult rats. The MLR to a click train in old rats exhibited a significantly faster reduction in amplitude with an increasing stimulation rate in comparison with young adult rats. None of the age-related changes in the parameters characterizing temporal resolution (GDT, GDDL and MLR to a click train) correlated with the degree of the age-related hearing loss. However, the age-related changes in MLR amplitude-rate function correlated with the age-related changes in GDDL, but not with the changes in GDT. The behavioral and electrophysiological data clearly show that aging in rats is accompanied with a pronounced deficit in the temporal processing of acoustical signals that is associated with the deteriorated function of the central auditory system. [Copyright &y& Elsevier]

High stimulation rates in cochlear implants (CI) offer better temporal sampling, can induce stochastic-like firing of auditory neurons and can increase the electric dynamic range, all of which could improve CI speech performance. While commercial CI have employed increasingly high stimulation rates, no clear or consistent advantage has been shown for high rates. In this study, speech recognition was acutely measured with experimental processors in 7 CI subjects (Clarion CII users). The stimulation rate varied between (approx.) 600 and 4800 pulses per second per electrode (ppse) and the number of active electrodes varied between 4 and 16. Vowel, consonant, consonant-nucleus-consonant word and IEEE sentence recognition was acutely measured in quiet and in steady noise (+10 dB signal-to-noise ratio). Subjective quality ratings were obtained for each of the experimental processors in quiet and in noise. Except for a small difference for vowel recognition in quiet, there were no significant differences in performance among the experimental stimulation rates for any of the speech measures. There was also a small but significant increase in subjective quality rating as stimulation rates increased from 1200 to 2400 ppse in noise. Consistent with previous studies, performance significantly improved as the number of electrodes was increased from 4 to 8, but no significant difference showed between 8, 12 and 16 electrodes. Altogether, there was little-to-no advantage of high stimulation rates in quiet or in noise, at least for the present speech tests and conditions. Copyright © 2010 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Abstract The Nucleus CI24RE 'Freedom' device offers higher stimulation rates and lower noise levels in action potential measurements (ECAPs) than previous devices. A study including ten European implant teams showed that the effect of changes in rate from 250 to 3500 pulses per second on tilt and curvature of the T and C profiles is insignificant. When changing rate one may change the levels at all electrodes by the same amount. Using an automated procedure ECAPs could be measured quickly and reliably at a noise level of only 1 μV. However, this did not result in improved correlations between the tilt and curvature parameters of the ECAP profiles and those of the T and C profiles. Average C levels appear to differ markedly among implant centers; a better assessment protocol is required. When increasing stimulus rate one should take into account that this requires higher pulse charges per second and more power consumption. Sumario El dispositivo Nucleus CI24RE 'Freedom' ofrece tasas de estimulación mayores, y menores niveles de ruido en las mediciones del potencial de acción (ECAPs) que los dispositivos anteriores. Un estudio que incluyó diez grupos europeos de implantes, mostró que el efecto de los cambios en la tasa de 250 a 3500 pulsos por segundo en la inclinación y la curvatura de los perfiles T y C es insignificante. Cuando se cambian las tasas, uno puede cambiar los niveles de todos los electrodos en la misma medida. Utilizando un procedimiento automatizado, los ECAPs pueden medirse en forma rápida y confiable a un nivel de ruido de solo 1mV. Sin embargo, esto no conlleva (a) una mejoría en las correlaciones entre los parámetros de inclinación y de curvatura de los perfiles ECAP y aquellos de los perfiles de T y C. Los niveles C promedio parecen diferir marcadamente entre los centros de implante; se requiere un mejor protocolo de evaluación. Cuando se incrementa la tasa de estimulación uno debe tomar en cuenta que eso requiere una mayor carga de pulsos por segundo y mayor poder de consumo. [ABSTRACT FROM AUTHOR]

Abstract Current cochlear implants can operate at high pulse rates. The effect of increasing pulse rate on speech performance is not yet clear. Habituation to low rates may affect the outcome. This paper presents the results of three subsequent studies using different experimental paradigms, applying the Nucleus CI24RE device, and conducted by ten European implant teams. Pulse rate per channel varied from 500 to 3500 pulses per second with ACE and from 1200 to 3500 pps with CIS strategy. The results showed that the first rate presented had little effect on the finally preferred rate. Lower rates were preferred. The effect of pulse rate on word scores of post-linguistic implantees was small; high rates tended to give lower scores. However, there were no significant differences between the word scores across subjects if collected at the individually preferred pulse rate. High pulse rates were preferred when the post-implantation threshold was low. Sumario Los implantes cocleares actuales puede operara a tasas de pulso altas. El efecto de la tasa de pulso en aumento sobre el desempeño en el lenguaje aún no es claro. La habituación a tasas bajas puede afectar el resultado. Este trabajo presenta los resultados de tres estudios subsiguientes que usaron diferentes paradigmas experimentales, utilizando el dispositivo Nucleus CI24RE, y llevado a cabo por diez equipos europeos de implante. La tasa de pulso por canal varió entre 500 a 3500 pulsos por segundo con la estrategia ACE y de 1200 a 3500 pps con la estrategia CIS. Los resultados mostraron que la primera tasa presentada tenía poco efecto sobre la tasa preferida final. Se prefirieron tasas más bajas. El efecto de la tasa de pulso sobre los puntajes de reconocimiento de palabras en implantados post-lingüísticos fue pequeño; tasas más altas tendieron a dar puntajes más bajos. Sin embargo, no existieron diferencias significativas entre los puntajes de reconocimiento de palabras en los diferentes sujetos si se recogían a la tasa preferida individual de pulso. Se prefirieron tasas de pulso más altas cuando el umbral post-implantación era bajo. [ABSTRACT FROM AUTHOR]

Many sounds in the environment, including speech, are temporally dynamic. The auditory brainstem is exquisitely sensitive to temporal features of the incoming acoustic stream, and by varying the speed of presentation of these auditory signals it is possible to investigate the precision with which temporal cues are represented at a subcortical level. Therefore, to determine the effects of stimulation rate on the auditory brainstem response (ABR), we recorded evoked responses to both a click and a consonant-vowel speech syllable (/da/) presented at three rates (15.4, 10.9 and 6.9 Hz). We hypothesized that stimulus rate affects the onset to speech-evoked responses to a greater extent than click-evoked responses and that subcomponents of the speech- ABR are distinctively affected. While the click response was invariant with changes in stimulus rate, timing of the onset response to /da/ varied systematically, increasing in peak latency as presentation rate increased. Contrasts between the click- and speech-evoked onset responses likely reflect acoustic differences, where the speech stimulus onset is more gradual, has more delineated spectral information, and is more susceptible to backward masking by the subsequent formant transition. The frequency-following response (FFR) was also rate dependent, with response magnitude of the higher frequencies (>400 Hz), but not the frequencies corresponding to the fundamental frequency, diminishing with increasing rate. The selective impact of rate on high-frequency components of the FFR implicates the involvement of distinct underlying neural mechanisms for high- versus low-frequency components of the response. Furthermore, the different rate sensitivities of the speech-evoked onset response and subcomponents of the FFR support the involvement of different neural streams for these two responses. Taken together, these differential effects of rate on the ABR components likely reflect distinct aspects of auditory function such that varying rate of presentation of complex stimuli may be expected to elicit unique patterns of abnormality, depending on the clinical population. Copyright © 2010 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

The article discusses a study of median nerve somatosensory evoked potential (SEP) responses at three hertz (Hz) stimulation in comatose patients. The study involved 639 patients at Harborview Medical Center in Washington from January 1, 1999 to April 30, 2008. One of the three who had a response present on both sides with 1.11 Hz stimulation was a 16-year-old patient with traumatic brain injury (TBI) who awoke at six months post SEP. Also cited are the key limitations of the study, one of which is the small number of patients with absent responses.

Conclusion: The technology of stimulation rates between 1500 and 5000 pulses per second per channel (pps/ch) brings a benefit for all users. However, the fastest possible rate does not necessarily lead to best hearing performance in each individual subject. Individual optimization of stimulation rate is recommended. Objectives: The aim of this study was to investigate the effect of high stimulation rates on speech perception ability. Subjects and methods: Thirteen subjects with at least 3 months of experience with conventional Clarion speech coding strategies were recruited into cross-over studies. The first study investigated stimulation rates of 1500, 2000 and 3000 pps/ch, the second study investigated rates of 2500 and 5000 pps/ch. Speech perception data were collected for testing in quiet and in competing noise . Results: On average, speech perception performance increased significantly when changing from conventional speech coding strategies to High Resolution Mode. Subjects who preferred continous interleaved sampling (CIS) in standard mode appeared to obtain better results with rates of 2500 or 3000 pps/ch than with 5000 pps/ch. The stimulation rate that led to best performance provided the highest stimulation current efficiency in the majority of subjects. [ABSTRACT FROM AUTHOR]

Abstract An n-of-m speech coding strategy has been developed for the Clarion Cochlear Implant Series 1.x (1.0 & 1.2). The basic principle is to reduce the number of stimuli per cycle, by neglecting the less significant spectral components, and to concentrate on the more dominant frequency bands. In this study 20 subjects, implanted with a Clarion device, used an n-of-m strategy at 1666 pps per channel. The outcomes using this strategy were compared with the outcomes using conventional processing (CIS at 833 pps/channel). Eight of the 20 subjects underwent additional testing with the n-of-m strategy with the rate set at 833 pps/channel. Using the n-of-m strategy at 1666 pps showed statistically significant improvement in performance over the CIS strategy, with 16 of the 20 subjects achieving better results. However, there was no statistically meaningful difference in performance between n-of-m at 833 pps and the CIS strategy running at the same rate. Results therefore suggest that n-of-m strategy can be an alternative to CIS, particularly when the implant hardware limits the overall stimulation rate. Sumario Se ha desarrollado una estrategia n-of-m de codificación del lenguaje para el implante coclear Clarion en sus series 1 × (1.0 & 1.2). El principio básico es reducir el número de estímulos por ciclo, abandonando los componentes espectrales menos significativos y concentrándose en las bandas de frecuencia más dominantes. En este estudio 20 sujetos implantados con un Clarion, usaron una estrategia n-of-m a 1666 pps por canal. Los resultados con el uso de esta estrategia se compararon con los obtenidos al usar procesamiento convencional (CIS a 833 pps/ canal).Ocho de los 20 sujetos realizaron pruebas adicionales con la estrategia n-of-m a una tasa de 833 pps/canal. El uso de la estrategia n-of-m a 1666 pps mostró una mejoría estadísticamente significativa en el rendimiento, en comparación con la estrategia CIS, en 16 de los 20 sujetos que obtuvieron mejores resultados. No obstante, no hubo una diferencia estadísticamente significativa en el rendimiento entre la condición de 833 pps y la estrategia CIS, practicadas a la misma tasa. Los resultados sugieren por consiguiente que la estrategia n-of-m puede ser una alternativa de la CIS, particularmente cuando el equipo limita la tasa total de estimulación. [ABSTRACT FROM AUTHOR]

Abstract: The P300 is an easily recorded component of the event-related potential (ERP). Yet, it is desirable to reduce the recording duration, for instance in patient examinations. A limiting factor is the time between stimuli that is necessary for the ERP to return to baseline. We explored whether this time could be reduced, despite an overlap of responses to successive stimuli, by presenting visual stimuli at a fast rate of 4.7s−1using a standard oddball paradigm. Rare stimuli occurred at a probability of 14%. The P300 was isolated by subtracting the responses to the frequent stimuli from those to the rare stimuli, thereby eliminating the influence of response overlap. We compared the efficiency of fast stimulation to that of conventionally slow stimulation by assessing the signal-to-noise ratio of the P300 amplitude. Two presentation durations of individual stimuli, namely 53ms and 93ms, were tested. Not unexpectedly, P300 amplitudes were smaller for the fast sequence. However, the signal-to-noise ratio improved significantly by more than 50% due to the larger number of trials within a given time interval. When targeting a given signal-to-noise ratio, fast stimulation allows for a reduction in recording time of around 35%. Median peak times were 16–56ms shorter for the fast stimulus sequence. Topography was comparable for fast and slow stimulation, suggesting a similar functional composition of the respective responses. Fast stimulation may thus be used to replace less efficient slow stimulation schemes in clinical diagnosis and for certain experimental questions. [Copyright &y& Elsevier]

Background: Optimization of cardiac resynchronization therapy (CRT) with respect to the interventricular (V-V) interval is mainly limited to pacing at a resting heart rate. We studied the effect of higher stimulation rates with univentricular and biventricular (BiV) pacing modes including the effect of the V-V interval optimization. Methods: In 36 patients with heart failure and chronic atrial fibrillation (AF), the effects of right ventricular (RV), left ventricular (LV), simultaneous BiV, and optimized sequential BiV (BiVopt) pacing were measured. The effect of the pacing mode and the optimal V-V interval was determined at stimulation rates of 70, 90, and 110 ppm using invasive measurement of the maximum rate of left ventricular pressure rise (LV dP/dtmax). Results: The average LV dP/dt max for all pacing modalities at stimulation rates of 70, 90, and 110 ppm was 781 ± 176, 833 ± 197, and 884 ± 223 mmHg/s for RV pacing; 893 ± 178, 942 ± 186, and 981 ± 194 mmHg/s for LV pacing; 904 ± 179, 973 ± 187, and 1052 ± 206 mmHg/s for simultaneous BiV pacing; and 941 ± 186, 1010 ± 198, and 1081 ± 206 mmHg/s for BiVopt pacing, respectively. In BiVopt pacing, the corresponding optimal V-V interval decreased from 34 ± 29, 28 ± 28, and 21 ± 27 ms at stimulation rates of 70, 90, and 110 ppm, respectively . In two individuals, LV dP/dtmax decreased when the pacing rate was increased from 90 to 110 ppm. Conclusion: In patients with AF and heart failure, LV dP/dtmax increases for all pacing modalities at increasing stimulation rates in most, but not all, patients. The rise in LV dP/dtmax with increasing stimulation rates is higher in biventricular (BiV and BiVopt) than in univentricular (LV and RV) pacing. The optimal V-V interval at sequential biventricular pacing decreases with increasing stimulation rates. [ABSTRACT FROM AUTHOR]