Comparison of Signal and Gap-Detection Thresholds for Focused and Broad Cochlear Implant Electrode Configurations

摘要

Cochlear implant (CI) users usually exhibit marked across-electrode differences in detection thresholds with “focused” modes of stimulation, such as partial-tripolar (pTP) mode. This may reflect differences either in local neural survival or in the distance of the electrodes from the modiolus. To shed light on these two explanations, we compared stimulus-detection thresholds and gap-detection thresholds (GDTs) at comfortably loud levels for at least four electrodes in each of ten Advanced Bionics CI users, using 1031-pps pulse trains. The electrodes selected for each user had a wide range of stimulus-detection thresholds in pTP mode. We also measured across-electrode variations in both stimulus-detection and gap-detection tasks in monopolar (MP) mode. Both stimulus-detection and gap-detection thresholds correlated across modes. However, there was no significant correlation between stimulus-detection and gap-detection thresholds in either mode. Hence, gap-detection thresholds likely tap a source of across-electrode variation additional to, or different from, that revealed by stimulus-detection thresholds. Stimulus-detection thresholds were significantly lower for apical than for basal electrodes in both modes; this was only true for gap detection in pTP mode. Finally, although the across-electrode standard deviation in stimulus-detection thresholds was greater in pTP than in MP mode, the reliability of these differences—assessed by dividing the across-electrode standard deviation by the standard deviation across adaptive runs for each electrode—was similar for the two modes; this metric was also similar across modes for gap detection. Hence across-electrode differences can be revealed using clinically available MP stimulation, with a reliability comparable to that observed with focused stimulation.