Objectives This goal of this study was to create and validate a new set of sentence lists that could be used to evaluate the speech perception abilities of hearing impaired listeners and cochlear implant users. Our intention was to generate a large number of sentence lists with an equivalent level of difficulty for the evaluation of performance over time and across conditions. Design The AzBio sentence corpus includes 1000 sentences recorded from 2 female and 2 male talkers. The mean intelligibility of each sentence was estimated by processing each sentence through a 5-channel cochlear implant simulation and calculating the mean percent correct score achieved by 15 normal-hearing listeners. Sentences from each talker were sorted by percent correct score and 165 sentences were selected from each talker and were then sequentially assigned to 33 lists, each containing 20 sentences (5 sentences from each talker). List equivalency was validated by presenting all lists, in random order, to 15 cochlear implant users. Results Using sentence scores from the cochlear implant simulation study produced 33 lists of sentences with a mean score of 85% correct. The results of the validation study with cochlear implant users revealed no significant differences in percent correct scores for 29 of the 33 sentence lists. However, individual listeners demonstrated considerable variability in performance on the 29 lists. The binomial distribution model was used to account for the inherent variability observed in the lists. This model was also used to generate 95% confidence intervals for one and two list comparisons. A retrospective analysis of 172 instances where research subjects had been tested on two lists within a single condition revealed that 94% of results were accurately contained within these confidence intervals. Conclusions The use of a 5-channel cochlear implant simulation to estimate the intelligibility of individual sentences allowed for the creation of a large number of sentence lists with an equivalent level of difficulty. The results of the validation procedure with cochlear implant users found that 29 of 33 lists allowed scores that were not statistically different. However, individual listeners demonstrated considerable variability in performance across lists. This variability was accurately described by the binomial distribution model and was used to estimate the magnitude of change required to achieve statistical significance when comparing scores from one and two lists per condition. Fifteen sentence lists have been included in the AzBio Sentence Test, for use in the clinical evaluation of hearing impaired listeners and cochlear implant users. An additional 8 sentence lists have been included in the Minimum Speech Test Battery to be distributed by the cochlear implant manufacturers for the evaluation of cochlear implant candidates.

Spectral resolution has been reported to be closely related to vowel and consonant recognition in cochlear implant (CI) listeners. One measure of spectral resolution is spectral modulation threshold (SMT), which is defined as the smallest detectable spectral contrast in the spectral ripple stimulus. SMT may be determined by the activation pattern associated with electrical stimulation. In the present study, broad activation patterns were simulated using a multi-band vocoder to determine if similar impairments in speech understanding scores could be produced in normal-hearing listeners. Tokens were first decomposed into 15 logarithmically spaced bands and then re-synthesized by multiplying the envelope of each band by matched filtered noise. Various amounts of current spread were simulated by adjusting the drop-off of the noise spectrum away from the peak (40-5 dBoctave). The average SMT (0.25 and 0.5 cyclesoctave) increased from 6.3 to 22.5 dB, while average vowel identification scores dropped from 86% to 19% and consonant identification scores dropped from 93% to 59%. In each condition, the impairments in speech understanding were generally similar to those found in CI listeners with similar SMTs, suggesting that variability in spread of neural activation largely accounts for the variability in speech perception of CI listeners.

Most cochlear implant strategies utilize monopolar stimulation, likely inducing relatively broad activation of the auditory neurons. The spread of activity may be narrowed with a tripolar stimulation scheme, wherein compensating current of opposite polarity is simultaneously delivered to two adjacent electrodes. In this study, a model and cochlear implant subjects were used to examine loudness growth for varying amounts of tripolar compensation, parameterized by a coefficient sigma, ranging from 0 (monopolar) to 1 (full tripolar). In both the model and the subjects, current required for threshold activation could be approximated by I(sigma)=Ithr(0)(1-sigmaK), with fitted constants Ithr(0) and K. Three of the subjects had a "positioner," intended to place their electrode arrays closer to their neural tissue. The values of K were smaller for the positioner users and for a "close" electrode-to-tissue distance in the model. Above threshold, equal-loudness contours for some subjects deviated significantly from a linear scale-up of the threshold approximations. The patterns of deviation were similar to those observed in the model for conditions in which most of the neurons near the center electrode were excited.

Current steering and current focusing are stimulation techniques designed to increase the number of distinct perceptual channels available to cochlear implant (CI) users by adjusting currents applied simultaneously to multiple CI electrodes. Previous studies exploring current steering and current focusing stimulation strategies are reviewed, including results of research using computational models, animal neurophysiology, and human psychophysics. Preliminary results of additional neurophysiological and human psychophysical studies are presented that demonstrate the success of current steering strategies in stimulating auditory nerve regions lying between physical CI electrodes, as well as current focusing strategies that excite regions narrower than those stimulated using monopolar configurations. These results are interpreted in the context of perception and speech reception by CI users. Disparities between results of physiological and psychophysical studies are discussed. The differences in stimulation used for physiological and psychophysical studies are hypothesized to contribute to these disparities. Finally, application of current steering and focusing strategies to other types of auditory prostheses is also discussed.

Speech understanding by cochlear implant listeners may be limited by their ability to perceive complex spectral envelopes. Here, spectral envelope perception was characterized by spectral modulation transfer functions in which modulation detection thresholds became poorer with increasing spectral modulation frequency (SMF). Thresholds at low SMFs, less likely to be influenced by spectral resolution, were correlated with vowel and consonant identifications [Litvak, L. M. et al. (2008). J. Acoust. Soc. Am. 122, 982-991] for the same listeners; while thresholds at higher SMFs, more likely to be affected by spectral resolution, were not. Results indicate that the perception of broadly spaced spectral features is important for speech perception.

Many modern cochlear implants use sound processing strategies that stimulate the cochlea with modulated pulse trains. Rubinstein et al. [Hear. Res. 127, 108 (1999)] suggested that representation of the modulator in auditory nerve responses might be improved by the addition of a sustained, high-rate, desynchronizing pulse train (DPT). In addition, activity in response to the DPT may mimic the spontaneous activity (SA) in a healthy ear. The goals of this study were to compare responses of auditory nerve fibers in acutely deafened, anesthetized cats elicited by high-rate electric pulse trains delivered through an intracochlear electrode with SA, and to measure responses of these fibers to amplitude-modulated pulse trains superimposed upon a DPT. Responses to pulse trains showed variability from presentation to presentation, but differed from SA in the shape of the envelope of the interval histogram (IH) for pulse rates above 4.8 kpps (kilo pulses per second). These IHs had a prominent mode near 5 ms that was followed by a long tail. Responses to modulated biphasic pulse trains resembled responses to tones in intact ears for small (<10%) modulation depths, suggesting that acousticlike responses to sinusoidal stimuli might be obtained with a DPT. However, realistic responses were only observed over a narrow range of levels and modulation depths. Improved coding of complex stimulus waveforms may be achieved by signal processing strategies for cochlear implants that properly incorporate a DPT.

Rubinstein et al. [Hear. Res. 127, 108-118 (1999)] suggested that the neural representation of the waveforms of electric stimuli might be improved by introducing an ongoing, high-rate, desynchronizing pulse train (DPT). A DPT may desynchronize neural responses to electric stimulation in a manner similar to spontaneous activity in a healthy ear. To test this hypothesis, responses of auditory-nerve fibers (ANFs) to 10-min-long electric pulse trains (5 kpps) were recorded from acutely deafened, anesthetized cats. Stimuli were delivered via an intracochlear electrode, and their amplitude was chosen to elicit a response in most ANFs. Responses to pulse trains showed pronounced adaptation during the first 1-2 min, followed by either a sustained response or cessation of spike discharges for the remainder of the stimulus. The adapted discharge rates showed a broad distribution across the ANF population like spontaneous activity. However, a higher proportion of fibers (46%) responded to the DPT at rates below 5 spikes/s than for spontaneous activity, and 12% of the fibers responded at higher rates than any spontaneously active fiber. Interspike interval histograms of sustained responses for some fibers had Poisson-like (exponential) shapes, resembling spontaneous activity, while others exhibited preferred intervals and, occasionally, bursting. Simultaneous recordings from pairs of fibers revealed no evidence of correlated activity, suggesting that the DPT does desynchronize the auditory nerve activity. Overall, these results suggest that responses to an ongoing DPT resemble spontaneous activity in a normal ear for a substantial fraction of the ANFs.

Simultaneous or near-simultaneous activation of adjacent cochlear implant electrodes can produce pitch percepts intermediate to those produced by each electrode separately, thereby increasing the number of place-pitch steps available to cochlear implant listeners. To estimate how many distinct pitches could be generated with simultaneous dual-electrode stimulation, the present study measured place-pitch discrimination thresholds for single- versus dual-electrode stimuli in users of the Clarion CII device. Discrimination thresholds were expressed as the proportion of current directed to the secondary electrode of the dual-electrode pair. For 16 of 17 electrode pairs tested in six subjects, thresholds ranged from 0.11 to 0.64, suggesting that dual-electrode stimuli can produce 2-9 discriminable pitches between the pitches of single electrodes. Some subjects demonstrated a level effect, with better place-pitch discrimination at higher stimulus levels. Equal loudness was achieved with dual-electrode stimuli at net current levels that were similar to or slightly higher than those for single-electrode stimuli.