Objectives
The ability to perceive speech is related to the listener’s ability to
differentiate among frequencies (i.e., spectral resolution). Cochlear implant (CI) users
exhibit variable speech-perception and spectral-resolution abilities, which can be
attributed in part to the extent of electrode interactions at the periphery (i.e.,
spatial selectivity). However, electrophysiological measures of peripheral spatial
selectivity have not been found to correlate with speech perception. The purpose of this
study was to evaluate auditory processing at the periphery and cortex using both simple
and spectrally complex stimuli to better understand the stages of neural processing
underlying speech perception. The hypotheses were that (1) by more completely
characterizing peripheral excitation patterns than in previous studies, significant
correlations with measures of spectral selectivity and speech perception would be
observed, (2) adding information about processing at a level central to the auditory
nerve would account for additional variability in speech perception, and (3) responses
elicited with spectrally complex stimuli would be more strongly correlated with speech
perception than responses elicited with spectrally simple stimuli.
Design
Eleven adult CI users participated. Three experimental processor programs
(MAPs) were created to vary the likelihood of electrode interactions within each
participant. For each MAP, a subset of 7 of 22 intracochlear electrodes was activated:
adjacent (MAP 1), every-other (MAP 2), or every third (MAP 3). Peripheral spatial
selectivity was assessed using the electrically evoked compound action potential (ECAP)
to obtain channel-interaction functions for all activated electrodes (13 functions
total). Central processing was assessed by eliciting the auditory change complex (ACC)
with both spatial (electrode pairs) and spectral (rippled noise) stimulus changes.
Speech-perception measures included vowel-discrimination and the Bamford-Kowal-Bench
Sentence-in-Noise (BKB-SIN) test. Spatial and spectral selectivity and speech perception
were expected to be poorest with MAP 1 (closest electrode spacing) and best with MAP 3
(widest electrode spacing). Relationships among the electrophysiological and
speech-perception measures were evaluated using mixed-model and simple linear regression
analyses.
Results
All electrophysiological measures were significantly correlated with each other
and with speech perception for the mixed-model analysis, which takes into account
multiple measures per person (i.e. experimental MAPs). The ECAP measures were the
best predictor of speech perception. In the simple linear regression
analysis on MAP 3 data, only the cortical measures were significantly correlated with
speech; spectral ACC amplitude was the strongest predictor.
Conclusions
The results suggest that both peripheral and central electrophysiological
measures of spatial and spectral selectivity provide valuable information about speech
perception. Clinically, it is often desirable to optimize pe...