WO2017075219A1 - Procédés de désactivation d'électrode d'implant cochléaire guidée par image compatible avec une direction de courant et applications de ceux-ci - Google Patents

Procédés de désactivation d'électrode d'implant cochléaire guidée par image compatible avec une direction de courant et applications de ceux-ci Download PDF

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WO2017075219A1
WO2017075219A1 PCT/US2016/059123 US2016059123W WO2017075219A1 WO 2017075219 A1 WO2017075219 A1 WO 2017075219A1 US 2016059123 W US2016059123 W US 2016059123W WO 2017075219 A1 WO2017075219 A1 WO 2017075219A1
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electrodes
dvf
electrode
curves
plot
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Jack Noble
Rene H. GIFFORD
Robert F. Labadie
Benoit M. Dawant
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Vanderbilt University
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00—Electrotherapy; Circuits therefor
    • A61N1/18—Applying electric currents by contact electrodes
    • A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
    • A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
    • A61N1/36036—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation of the outer, middle or inner ear
    • A61N1/36038—Cochlear stimulation
    • A61N1/36039—Cochlear stimulation fitting procedures
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/12—Audiometering
    • A61B5/121—Audiometering evaluating hearing capacity
    • A61B5/125—Audiometering evaluating hearing capacity objective methods
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00—Electrotherapy; Circuits therefor
    • A61N1/18—Applying electric currents by contact electrodes
    • A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
    • A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
    • A61N1/36036—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation of the outer, middle or inner ear
    • A61N1/36038—Cochlear stimulation
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00—Electrotherapy; Circuits therefor
    • A61N1/02—Details
    • A61N1/04—Electrodes
    • A61N1/05—Electrodes for implantation or insertion into the body, e.g. heart electrode
    • A61N1/0526—Head electrodes
    • A61N1/0541—Cochlear electrodes

Definitions

  • NDC014037 awarded by the National Institute on Deafness and Other Communication Disorders (NIDCD). The government has certain rights in the invention.
  • [11] represents the tenth reference cited in the reference list, namely, Noble JH, Labadie RF, Gifford RH, Davvant BM, "image-guidance enables new methods for customizing cochlear implant stimulation strategies," IEEE Trans Neural Syst Rehabil Eng. vol. 2 1 (5): 820-0, 2013.
  • the present invention relates generally to cochlear implant (CI) image processing technology, and more particularly to systems and methods for performing current steering compatible image-guided CI electrode deactivation, and applications thereof.
  • CI cochlear implant
  • Cochlear implants are neural prosthetics used to treat severe to profound hearing loss. As of 2012, over 320,000 devices have been implanted worldwide [1]. CIs use an array of electrodes implanted into the cochlea to directly stimulate spiral ganglion (SG) neurons to induce hearing sensation. Implants available today produce remarkable results for the vast majority of recipients, with average word recognition of 60% and 70% for unilateral and bilateral recipients, respectively [2-6]. Despite this success, a significant number of users receive marginal benefit, and restoration to normal fidelity is rare even among the best performers.
  • Electrode positioning can influence the neural stimulation pattern overlap across electrodes, which arises due to the non-selective nature of electrical stimulation relative to natural hearing and can affect speech recognition.
  • CF characteristic frequency
  • a nerve pathway is activated when the characteristic frequency (CF) associated with that pathway is present in the incoming sound.
  • CF characteristic frequency
  • Normal-hearing individuals have approximately 30,000 neural fibers.
  • Neural pathways are tonotopically ordered by decreasing CF along the length of the cochlear duct, and this finely tuned spatial organization is well known [10].
  • CIs cannot reproduce the selective activation of specific neural regions that occurs naturally. Rather, electrical stimulation creates broad excitation patterns.
  • excitation patterns When the array is placed farther away from the neural regions, broader excitation patterns are created. Broader excitation patterns create more excitation overlap, or "interference,” with neighboring electrodes. More spectral smearing occurs with greater channel interference, leading to poorer speech recognition in quiet and in noise.
  • One aspect of the present invention relates to a method for performing current steering compatible image-guided cochlear implant (CI) electrode deactivation.
  • the method includes: obtaining, for a plurality of electrodes of an electrode array implanted in a cochlea of a living subject, a plurality of distance-vs- frequency (DVF) curves, where each of the DVF curves corresponds to one of the electrodes; performing an analysis on the DVF curves to identify a plurality of interfering electrodes from the electrodes, where each of the interfering electrodes has an interference with at least one other electrode; and selecting and deactivating, based on a plurality of rules, at least one of the interfering electrodes.
  • DVF distance-vs- frequency
  • the DVF curves are provided on a plot to visualize distances of the electrodes from a modiolus of the living subject, wherein the plot has a horizontal axis showing an angular depth and a characteristic frequency (CF) of the neural regions, and a vertical axis showing a distance from the electrodes to
  • the interfering electrodes are identified from the electrodes based on positions of the electrodes relative to neural regions of the living subject stimulated by the electrodes, and an overlapping degree of each of the corresponding neural regions of the electrodes, where each of the electrodes corresponds to one of the neural regions.
  • the positions of the electrodes relative to the neural regions interfering electrodes are determined by locations of the DVF curves on the vertical axis of the plot, where for each of the electrodes, the position of the electrode is farther from the corresponding neural region when the corresponding DVF curve of the electrode is higher on the plot.
  • the overlapping degree of each of the corresponding neural regions of the electrodes is estimated by depths of concavity between the DVF curves on the plot, wherein for each of the DVF curves, the overlapping degree is high when the DVF curve has little to no depth of concavity with neighboring DVF curves on the plot.
  • the rules include: keeping the electrode having a corresponding DVF curve located at a left-most location on the plot to avoid a resulting sound frequency upshift; avoiding leaving any of the electrodes stranded without a neighboring electrode; and deactivating a minimal number of the interfering electrodes to ensure that high interference is allowed only for each of the electrodes with one of the neighboring electrodes.
  • the system includes: a CI device being implanted in a cochlea of a living subject, the CI device comprising an electrode array having a plurality of electrodes; and at least one computing device having one or more processors and a storage device storing computer executable code.
  • the computer executable code when executed at the one or more processors, is configured to perform functions including: obtaining, for a plurality of electrodes of an electrode array implanted in a cochlea of a living subject, a plurality of distance-vs-frequency (DVF) curves, where each of the DVF curves corresponds to one of the electrodes; performing an analysis on the DVF curves to identify a plurality of interfering electrodes from the electrodes, where each of the interfering electrodes has an interference with at least one other electrode; and selecting and deactivating, based on a plurality of rules, at least one of the interfering electrodes.
  • DVF distance-vs-frequency
  • the functions further include: providing the DVF curves on a plot to visualize distances of the electrodes from a modiolus of the living subject, wherein the plot has a horizontal axis showing an angular depth and a characteristic frequency of the neural regions, and a vertical axis showing a distance from the electrodes to corresponding spiral ganglion stimulation sites.
  • the interfering electrodes are identified from the electrodes based on positions of the electrodes relative to neural regions of the living subject stimulated by the electrodes, and an overlapping degree of each of the corresponding neural regions of the electrodes, where each of the electrodes corresponds to one of the neural regions. In certain embodiments, the positions of the electrodes relative to the neural regions interfering electrodes are determined by locations of the
  • the overlapping degree of each of the corresponding neural regions of the electrodes is estimated by depths of concavity between the DVF curves on the plot, wherein for each of the DVF curves, the overlapping degree is high when the DVF curve has little to no depth of concavity with neighboring DVF curves on the plot.
  • the rules include: keeping the electrode having a corresponding DVF curve located at a left-most location on the plot to avoid a resulting sound frequency upshift; avoiding leaving any of the electrodes stranded without a neighboring electrode; and deactivating a minimal number of the interfering electrodes to ensure that high interference is allowed only for each of the electrodes with one of the neighboring electrodes.
  • the rules are codified into a cost function that permits assigning a quantitative quality score to a given active electrode set.
  • the active electrode set is determined using an exhaustive search scheme where all possible combinations of active electrodes are evaluated to find the active electrode set that satisfies the rules, where the degree to which each possible active electrode set satisfies the rules is quantified using a cost function.
  • a further aspect of the present invention relates to a non-transitory computer- readable medium storing computer executable code.
  • the computer executable code when executed at one or more processors, causes a system to perform functions for performing current steering compatible image-guided cochlear implant (CI) electrode deactivation.
  • CI current steering compatible image-guided cochlear implant
  • the functions include: (a) obtaining, for a plurality of electrodes of an electrode array implanted in a cochlea of a living subject, a plurality of distance-vs-frequency (DVF) curves, where each of the DVF curves corresponds to one of the electrodes; (b) performing an analysis on the DVF curves to identify a plurality of interfering electrodes from the electrodes, where each of the interfering electrodes has an interference with at least one other electrode; and (c) selecting and deactivating, based on a plurality of rules, at least one of the interfering electrodes.
  • DVF distance-vs-frequency
  • Certain aspects of the present invention relate to a method for customizing cochlear implant stimulation of a living subject using a current steering compatible image-guided cochlear implant programming (IGCIP) strategy, which includes: configuring a plurality of electrodes of an electrode array implanted in a cochlea of the living subject using the method or the system as described above.
  • IRCIP current steering compatible image-guided cochlear implant programming
  • FIG. 1 shows a flowchart of a method for performing current steering compatible image-guided CI electrode deactivation according to certain embodiments of the present invention.
  • FIG. 2 schematically shows a plot of raw DVF curves obtained from a patient according to certain embodiments of the present invention.
  • FIG. 3 schematically shows a plot of the DVF curves as shown in FIG. 2 being processed to identify the neighboring electrodes having high interferences according to certain embodiments of the present invention.
  • FIG. 4 schematically shows a plot of the DVF curves as shown in FIG. 2 being processed to select the interfering electrodes to be deactivated according to certain embodiments of the present invention.
  • FIG. 5 schematically shows a plot of the DVF curves after deactivating the selected interfering electrodes as shown in FIG. 4 according to certain embodiments of the present invention.
  • FIG. 6 schematically shows a plot of the DVF curves obtained from a patient processed to select the interfering electrodes to be deactivated according to certain embodiments of the present invention.
  • FIG. 7 schematically shows a plot of the DVF curves after deactivating the selected interfering electrodes as shown in FIG. 6 according to certain embodiments of the present invention.
  • FIG. 8 schematically shows (a) a plot of raw DVF curves obtained from a patient and (b) a plot of the DVF curves after deactivating the selected interfering electrodes according to certain embodiments of the present invention.
  • FIG. 9A schematically shows hearing performance scores of sentence
  • FIG. 9B schematically shows hearing performance scores of monosyllabic words with the experimental steering compatible map vs the baseline map according to certain embodiments of the present invention.
  • FIG. 9C schematically shows hearing performance scores of BKB-SIN with the experimental steering compatible map vs the baseline map according to certain embodiments of the present invention.
  • FIG. 9D schematically shows hearing performance scores of QSMD with the experimental steering compatible map vs the baseline map according to certain embodiments of the present invention.
  • FIG. 10A schematically shows hearing performance scores of sentence understanding with the experimental steering compatible map vs the baseline map according to certain embodiments of the present invention.
  • FIG. 10B schematically shows hearing performance scores of monosyllabic words with the experimental steering compatible map vs the baseline map according to certain embodiments of the present invention.
  • FIG. IOC schematically shows hearing performance scores of BKB-SIN with the experimental steering compatible map vs the baseline map according to certain embodiments of the present invention.
  • FIG. 10D schematically shows hearing performance scores of QSMD with the experimental steering compatible map vs the baseline map according to certain embodiments of the present invention.
  • first, second, third etc. may be used herein to describe various elements, components, regions, layers and/or sections, these elements, components, regions, layers and/or sections should not be limited by these terms. These terms are only used to distinguish one element, component, region, layer or section from another element, component, region, layer or section. Thus, a first element, component, region, layer or section discussed below could be termed a second element, component, region, layer or section without departing from the teachings of the invention.
  • relative terms such as “lower” or “bottom” and “upper” or “top,” may be used herein to describe one element's relationship to another element as illustrated in the Figures. It will be understood that relative terms are intended to encompass different orientations of the device in addition to the orientation depicted in the figures. For example, if the device in one of the figures is turned over, elements described as being on the “lower” side of other elements would then be oriented on “upper” sides of the other elements. The exemplary term “lower”, can therefore, encompasses both an orientation of “lower” and “upper,” depending of the particular orientation of the figure.
  • the phrase "at least one of A, B, and C" should be construed to mean a logical (A or B or C), using a non-exclusive logical OR. It should be understood that one or more operations within a method is executed in different order (or
  • this invention in certain aspects, relates to systems and methods for performing current steering compatible image-guided cochlear implant (CI) electrode deactivation, and applications thereof.
  • CI current steering compatible image-guided cochlear implant
  • CIS continuous interleaved sampling
  • current steering adjacent electrodes are fired simultaneously to attempt to create a peak neural activation region at neural cells that lie between the two electrodes.
  • paired electrode stimulation has been shown to improve battery life and is required for the use of a proprietary noise reduction algorithm (ClearVoiceTM) that has been shown to improve hearing in noise in Advanced Bionics CI users [13].
  • the noise reduction algorithm estimates the signal-to-noise ratio (S R) in each channel. For those channels in which poor SNR is identified, channel gain is reduced. Therefore, certain embodiments of the present invention relate to an image-guided electrode selection strategy that allows for the use of current steering.
  • this invention relates to a method for selection of cochlear implant channels that is compatible with current steering-based cochlear implant stimulation strategies. It is based on a previously disclosed method for image-guided selection of cochlear implant channels.
  • the method includes: (1) using image analysis techniques being developed to accurately locate the position of implanted cochlear implant electrodes relative to the nerves they stimulate; (2) based on the known electrode position, estimating the neural stimulation region for each electrode and the degree of overlap of neural stimulation regions between electrodes; and (3) finding channels that have a high degree of overlap and deactivate them from the patient's map.
  • the method leads to improved hearing outcomes because high channel overlap creates channel interaction artifacts that are known to negatively affect outcomes.
  • the novel invention here is a new method for selecting which channels to deactivate to reduce channel interaction artifacts. The new strategy deactivates channels in patterns that are constrained to be compatible with the "current steering" stimulation strategies.
  • the method for interpreting the position of the electrodes within the cochlea to determine which electrodes should be deactivated for a current steering stimulation strategy is novel.
  • the new method is to evaluate whether the set of steered channels, each of which comprises two neighboring electrodes, is subject to too much stimulation overlap and channel interaction. Channels composed of electrodes that are more distant to the neural stimulation sites are assumed to have greater spread of excitation. All channels composed of electrodes that sit in the immediate vicinity of neural sites are assumed to not create channel interaction and are left active. Other electrodes are selected for deactivation in order to ensure that channels composed of distant electrodes do not interfere. Interference is determined using the electrode distance vs frequency curve analysis technique proposed for the previous invention where steering was not accounted for.
  • One aspect of the present invention relates to a method for performing current steering compatible image-guided cochlear implant (CI) electrode deactivation.
  • the method includes: obtaining, for a plurality of electrodes of an electrode array implanted in a cochlea of a living subject, a plurality of distance-vs- frequency (DVF) curves, where each of the DVF curves corresponds to one of the electrodes; performing an analysis on the DVF curves to identify a plurality of interfering electrodes from the electrodes, where each of the interfering electrodes has an interference with at least one other electrode; and selecting and deactivating, based on a plurality of rules, at least one of the interfering electrodes.
  • DVF distance-vs- frequency
  • the system includes: a CI device being implanted in a cochlea of a living subject, the CI device comprising an electrode array having a plurality of electrodes; and at least one computing device having one or more processors and a storage device storing computer executable code.
  • the computer executable code when executed at the one or more processors, is configured to perform functions including: obtaining, for a plurality of electrodes of an electrode array implanted in a cochlea of a living subject, a plurality of distance-vs-frequency (DVF) curves, where each of the DVF curves corresponds to one of the electrodes; performing an analysis on the DVF curves to identify a plurality of interfering electrodes from the electrodes, where each of the interfering electrodes has an interference with at least one other electrode; and selecting and deactivating, based on a plurality of rules, at least one of the interfering electrodes.
  • DVF distance-vs-frequency
  • the invention relates to software that implements the invention to recommend a current steering electrode configuration for cochlear implant recipients or the know-how of how to interpret the position of the electrodes in the cochlea to determine which electrodes should be deactivated for a current steering stimulation strategy.
  • FIG. 1 shows a flowchart of a method for performing current steering compatible image-guided CI electrode deactivation according to certain embodiments of the present invention. It should be particularly noted that, unless otherwise stated in the present disclosure, the steps of the method may be arranged in a different sequential order, and are thus not limited to the sequential order as shown in FIG. 1.
  • a plurality of distance-vs-frequency (DVF) curves may be obtained for a plurality of electrodes of an electrode array implanted in a cochlea of a living subject.
  • the DVF curves may be obtained using a system having at least one computing devices with necessary software
  • step S120 an analysis is performed on the DVF curves to identify a plurality of interfering electrodes from the electrodes. Then, in step S130, at least one of the interfering electrodes may be selected and deactivated based on a plurality of rules.
  • the rules include: keeping the electrode having a corresponding DVF curve located at a left-most location on the plot to avoid a resulting sound frequency upshift; avoiding leaving any of the electrodes stranded without a neighboring electrode; and deactivating a minimal number of the interfering electrodes to ensure that high interference is allowed only for each of the electrodes with one of the neighboring electrodes.
  • the rules may be codified into a cost function that permits assigning a quantitative quality score to a given active electrode set.
  • the active electrode set may be determined using an exhaustive search scheme where all possible combinations of active electrodes are evaluated to find the active electrode set that satisfies the rules, where the degree to which each possible active electrode set satisfies the rules is quantified using the quantitative quality score assigned by the cost function.
  • a cochlear implant device having an electrode array with 16 electrodes is used to obtain the raw DVF curves, as shown in FIG. 2.
  • FIG. 2 schematically shows a plot of raw DVF curves obtained from a patient according to certain embodiments of the present invention.
  • the plot is used to visualize distances of the electrodes from a modiolus of the living subject.
  • the plot has a horizontal axis showing an angular depth and a characteristic frequency (CF) of the neural regions, and a vertical axis showing a distance from the electrodes to corresponding spiral ganglion stimulation sites of the patient.
  • the DVF curve defines the distance from the electrode to the neural sites on the modiolus of the patient.
  • FIG. 3 schematically shows a plot of the DVF curves as shown in FIG. 2 being processed to identify the neighboring electrodes having high interferences according to certain embodiments of the present invention.
  • interference between neighboring electrodes is identified for electrodes that are farther from the modiolus
  • the neighboring electrodes #6 and #1 may be determined to have high interference, and thus be identified as the interfering electrodes.
  • the rules may be applied to select at least one of the interfering electrodes to be deactivated.
  • FIG. 4 schematically shows a plot of the DVF curves as shown in FIG. 2 being processed to select the interfering electrodes to be deactivated according to certain embodiments of the present invention.
  • the rules may include:
  • the third rule ensures that two neighboring steered channels do not have high interference with each other.
  • the electrodes #4, #7 and #10 were selected to be deactivated. This removes the steered channels shown in red above.
  • FIG. 5
  • FIG. 4 schematically shows a plot of the DVT curves after deactivating the selected interfering electrodes as shown in FIG. 4 according to certain embodiments of the present invention.
  • FIG. 6 schematically shows a plot of the DVF curves obtained from a patient processed to select the interfering electrodes to be deactivated according to certain embodiments of the present invention. As shown in FIG. 6, by applying the rules, the electrodes #3, #6, #9 and #12 were selected to be deactivated. This removes the steered channels shown in red above.
  • FIG. 7 schematically shows a plot of the DVF curves after deactivating the selected interfering electrodes as shown in FIG. 6 according to certain embodiments of the present invention. Results
  • Certain embodiments of the method are further tested in cochlear implant subjects.
  • ten adult (7 postlingual) and 2 pediatric CI recipients implanted with the Advanced Bionics (Valencia, CA) cochlear implant system and using paired stimulation strategies participated in this study.
  • Average age was 49 years (range: 24-63) for the adult group and 7 years (range: 4-10) for the pediatric group.
  • Participants had at least 6-months experience with the device prior to study enrollment.
  • Average device experience was 3.83 years (range: 1.15 to 13 years) for the adult group and 7 years (range: 2-7.9) for the pediatric group.
  • Four bilateral participants participated with their poorer performing ear. A total of 7 females and 5 males participated. All adult participants scored at least 25 on the mini mental state examination (MMSE), indicating no significant risk of cognitive impairment [14].
  • Informed consent was obtained from each participant in accordance with the study protocols approved by the local Institutional Review Board.
  • the challenges with using a conventional post-op CT scans to localize electrodes relative to the sites they stimulate is (1) that the intracochlear structures (e.g., spiral ganglion cells, etc.) are not well contrasted in conventional CT and (2) artifact from the electrode contacts degrade the image.
  • the walls of the cochlea are well defined in pre-op CT [11]
  • the cochlear implant electrode array is well contrasted in post-op CT, which is registered to the pre-op CT scan for analysis of the spatial relationship between the cochlear implant electrode contacts and the spiral ganglion cells. Further information on the image processing techniques can be found in the reference [11].
  • electrode distance-vs-frequency (DVF) curves [11] are used to visualize electrode distance from the modiolus and aid in electrode selection.
  • FIG. 8 schematically shows (a) a plot of raw DVF curves obtained from a patient and (b) a plot of the DVF curves after deactivating the selected interfering electrodes according to certain embodiments of the present invention.
  • the height of each electrode's DVF curve on the vertical axis represents the distance from the corresponding electrode to spiral ganglion stimulation sites, and the horizontal axis shows the angular depth and characteristic frequency (CF) of those stimulation sites.
  • CF characteristic frequency
  • Interference between neighboring electrodes is identified for electrodes that are farther from the modiolus (higher in the plot) and have curves that have a high degree of overlap (little or no depth of concavity) with their neighbors, e.g., between electrodes 7 and 8 as shown in FIG. 8(a). This indicates the two electrodes are equally close to the same neural sites, and thus a high degree of channel interference is occurring and the electrodes are stimulating many of the same neural sites.
  • the rules being used for choosing the interfering electrodes to be deactivated include: (1) keeping the left-most electrode in the plot on to avoid a resulting sound frequency upshift, (2) not leaving any electrode stranded without a neighbor because this would prevent current steering, and (3) deactivating a minimal number of electrodes necessary to ensure that high interference is allowed only with one neighbor of each active electrode. As both neighbors represent a "steered" channel, the last rule ensures that two neighboring steered channels do not have high interference with each other.
  • These rules indicate deactivating electrodes 5, 8, and 11, and as shown in FIG. 8(b), the remaining DVF curves after deactivation are shown.
  • Spectral envelope perception as measured by spectral modulation detection (SMD) serves as a psychoacoustic estimate of spectral resolution that is highly correlated with speech understanding [15, 20, 21].
  • the quick SMD (QSMD) task [15] is used, which utilizes a 3-interval, forced choice procedure based on a modified method of constant stimuli in which the listener is asked to differentiate a spectrally modulated band of noise from that of a flat spectrum noise. There are a fixed number of trials at each modulation depth and frequency.
  • the stimulus was created by applying a logarithmically spaced, sinusoidal modulation to the broadband carrier stimulus with a bandwidth of 125-5600 Hz.
  • FIGS. 9 A to 9D respectively show the hearing performance scores of sentence understanding, monosyllabic words, BKB-SIN and QSMD with the experimental steering compatible map vs the baseline map according to certain embodiments of the present invention.
  • individual hearing performance scores for the baseline program (x-axis) and IGCIP with current steering (y-axis) program are shown in FIGS. 9A-9C.
  • the dashed lines outline the 95% confidence interval for respective test materials. Data points falling outside this region are considered to be significantly different between the two programs for a given participant.
  • the solid diagonal represents no difference between programs.
  • AzBio sentence scores are shown in FIG. 9A for implant ear alone and the best aided condition in quiet and in noise. Sentence scores falling outside the 95% confidence interval for AzBio sentence materials are considered to be significantly different between the two programs for a given participant (Spahr et al., 2012). One individual scored worse in quiet in the best aided condition, however, caution should be used interpreting two of these data points located in the top right of the plot as real differences as the function is compressed at the extremes due to floor and ceiling effects (Spahr et al., 2012). Three individuals scored worse with the IGCIP program in noise with the CI alone. One individual scored worse in quiet and in noise for the CI alone condition.
  • a binomial distribution model for monosyllabic word recognition with 50 words [22] revealed significant differences in word recognition between the two programs for 6 individuals.
  • FIGS. 10A to 10D show individual hearing performance scores for the traditional HiRes IGCIP program are shown on the x-axis and the IGCIP with current steering results are shown on the y-axis.
  • HiRes IGCIP One individual scored significantly better in the CI alone condition in noise with the traditional IGCIP implementation (HiRes IGCIP). This individual has a history of fluctuating performance due to day to day changes in sound quality likely secondary to Meniere's disease diagnosis.
  • the paired electrode IGCIP strategy proposed can yield significant improvements in speech understanding in quiet, in noise, on measures of spectral resolution, as well as improvements in subjective sound quality. Sixty-seven percent of participants (8/12) showed significant improvement on at least one test measure.
  • the paired electrode IGCIP strategy yielded equivalent results when compared to HiRES IGCIP in four individuals who participated in both studies. Eight of 12 participants kept the steered program as their 'everyday' program, and two returned to their HiRes IGCIP program.
  • the present disclosure is related to a non-transitory computer readable medium storing computer executable code.
  • the computer executable code when executed at one or more processer, may perform the method as described above.
  • the non-transitory computer readable medium may include, but not limited to, any physical or virtual storage media.
  • spectral modulation detection for cochlear implant recipients a non-language 480 based measure of performance outcomes. Int. J Audio! 2014;53(3): 159-64.
  • MSTB The New Minimum Speech Test Battery for Adult Cochlear Implant Users. Available at: Accessed

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Abstract

La présente invention concerne des systèmes et des procédés pour effectuer une désactivation d'électrode d'implant cochléaire (IC) guidée par image compatible avec une direction de courant. L'implant cochléaire comprend un ensemble d'électrodes comportant une pluralité d'électrodes implantées dans une cochlée d'un sujet vivant. Pour chaque électrode, une courbe de distance-fréquence (DVF) correspondante est obtenue. Une analyse est effectuée sur les courbes DVF pour identifier les électrodes interférantes, présentant chacune une interférence avec au moins une autre électrode. Ensuite, des règles peuvent s'appliquer aux électrodes interférantes afin de sélectionner une ou plusieurs électrodes interférantes à désactiver. Les règles peuvent comprendre : maintenir l'électrode ayant une courbe DVF correspondante située à un emplacement le plus à gauche sur le graphique afin d'éviter un décalage de fréquence à la hausse du son résultant ; éviter de laisser une électrode bloquée avec une électrode voisine ; et désactiver un nombre minimal des électrodes interférantes afin d'assurer qu'une interférence élevée soit autorisée uniquement pour chaque électrode avec une électrode voisine.
PCT/US2016/059123 2012-04-03 2016-10-27 Procédés de désactivation d'électrode d'implant cochléaire guidée par image compatible avec une direction de courant et applications de ceux-ci WO2017075219A1 (fr)

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US15/770,260 US10821284B2 (en) 2012-04-03 2016-10-27 Current steering compatible image-guided cochlear implant electrode deactivation methods and applications of same

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US62/247,012 2015-10-27

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CN109288521A (zh) * 2018-09-16 2019-02-01 华北理工大学 一种应用于脊柱康复系统的表面肌电检测装置
WO2022232387A1 (fr) * 2021-04-29 2022-11-03 Med-El Elektromedizinische Geraete Gmbh Mesures objectives pour déterminer une interaction de canal d'un implant cochléaire

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Cited By (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN109288521A (zh) * 2018-09-16 2019-02-01 华北理工大学 一种应用于脊柱康复系统的表面肌电检测装置
CN109288521B (zh) * 2018-09-16 2021-06-15 华北理工大学 一种应用于脊柱康复系统的表面肌电检测装置
WO2022232387A1 (fr) * 2021-04-29 2022-11-03 Med-El Elektromedizinische Geraete Gmbh Mesures objectives pour déterminer une interaction de canal d'un implant cochléaire

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