Temporal processing in the auditory system: Insights from cochlear and auditory midbrain implantees

Central auditory processing in humans was investigated by comparing the perceptual effects of temporal parameters of electrical stimulation in auditory midbrain implant (AMI) and cochlear implant (CI) users. Four experiments were conducted to measure the following: effect of interpulse intervals on detection thresholds and loudness; temporal modulation transfer functions (TMTFs); effect of duration on detection thresholds; and forward masking decay. The CI data were consistent with a phenomenological model that based detection or loudness decisions on the output of a sliding temporal integration window, the input to which was the hypothetical auditory nerve response to each stimulus pulse. To predict the AMI data, the model required changes to both the neural response input (i.e., midbrain activity to AMI stimuli, compared to auditory nerve activity to CI stimuli) and the shape of the integration window. AMI data were consistent with a neural response that decreased more steeply compared to CI stimulation as the pulse rate increased or interpulse interval decreased. For one AMI subject, the data were consistent with a significant adaptation of the neural response for rates above 200 Hz. The AMI model required an integration window that was significantly wider (i.e., decreased temporal resolution) than that for CI data, the latter being well fit using the same integration window shape as derived from normal-hearing data. These models provide a useful way to conceptualize how stimulation of central auditory structures differs from stimulation of the auditory nerve and to better understand why AMI users have difficulty processing temporal cues important for speech understanding

Electrophysiological Validation of a Human Prototype Auditory Midbrain Implant in a Guinea Pig Model

The auditory midbrain implant (AMI) is a new treatment for hearing restoration in patients with neural deafness or surgically inaccessible cochleae who cannot benefit from cochlear implants (CI). This includes neurofibromatosis type II (NF2) patients who, due to development and/or removal of vestibular schwannomas, usually experience complete damage of their auditory nerves. Although the auditory brainstem implant (ABI) provides sound awareness and aids lip-reading capabilities for these NF2 patients, it generally only achieves hearing performance levels comparable with a single-channel CI. In collaboration with Cochlear Ltd. (Lane Cove, Australia), we developed a human prototype AMI, which is designed for electrical stimulation along the well-defined tonotopic gradient of the inferior colliculus central nucleus (ICC). Considering that better speech perception and hearing performance has been correlated with a greater number of discriminable frequency channels of information available, the ability of the AMI to effectively activate discrete frequency regions within the ICC may enable better hearing performance than achieved by the ABI. Therefore, the goal of this study was to investigate if our AMI array could achieve low-threshold, frequency-specific activation within the ICC, and whether the levels for ICC activation via AMI stimulation were within safe limits for human application. We electrically stimulated different frequency regions within the ICC via the AMI array and recorded the corresponding neural activity in the primary auditory cortex (A1) using a multisite silicon probe in ketamine-anesthetized guinea pigs. Based on our results, AMI stimulation achieves lower thresholds and more localized, frequency-specific activation than CI stimulation. Furthermore, AMI stimulation achieves cortical activation with current levels that are within safe limits for central nervous system stimulation. This study confirms that our AMI design is sufficient for ensuring safe and effective activation of the ICC, and warrants further studies to translate the AMI into clinical application