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PubMed2000

Comparison of EAP thresholds with MAP levels in the nucleus 24 cochlear implant: data from children.

OBJECTIVE: The purpose of this study is to examine the relationship between the electrically evoked compound action potential (EAP) thresholds and the MAP thresholds (T-levels) and maximum comfort levels (C-levels) in children implanted with the Nucleus 24 device. DESIGN: EAP thresholds were measured using the Neural Response Telemetry system of the Nucleus 24 device. Twenty children implanted with the Nucleus 24 cochlear implant participated in this study. EAP thresholds were compared with the behavioral measures of T- and C-level used to construct the MAP these children used on a daily basis. For these subjects, both EAP and MAP T- and C-levels were obtained the same visit, which occurred at 3 to 5 mo postconnection. RESULTS: EAP thresholds were shown to fall between MAP T- and C-level for 18 of 20 subjects tested; however, considerable variability across subjects was noted. On average, EAP thresholds fell at 53% of the MAP dynamic range. Correlations between EAP threshold and MAP T- and C-level improved substantially when combined with behavioral measures obtained from one electrode in the array. CONCLUSIONS: Moderate correlations were found between EAP thresholds and MAP T- and C-levels for the children participating in this study. However, a technique is described for improving the accuracy of predictions of MAP T- and C-levels based on EAP data combined with a small amount of behavioral information.

Acoustic Stimulation↗
PubMed2001

PMCA2 mutation causes structural changes in the auditory system in deafwaddler mice.

Homozygous deafwaddler mice (dfw/dfw) have a mutation in the gene encoding plasma membrane Ca2+ATPase isoform 2 (Pmca2). They walk with a hesitant and wobbly gait, display head bobbing and are deaf. Light microscopy and transmission electron microscopy were used to evaluate the nature and relationship of morphological changes in the cochlea, spiral ganglion cells and spherical cells of the cochlear nucleus in homozygous and heterozygous mice of different ages and controls. Ultrastructural findings showed that in 7 week old homozygous (dfw) mice, inner hair cells and their afferent terminals were present although outer hair cells appeared apoptotic. Stereocilia were absent from the second and third rows of outer hair cells. Ganglion cells were also present although abnormal in appearance. In older homozygous mutants there was a loss of hair cells and spiral ganglion cells. Remaining ganglion cells in this group contained very few cytoplasmic organelles apart from a few hypertrophied mitochondria. In the anteroventral cochlear nucleus, spherical cell soma size was smaller in all homozygous (dfw) mutants than in heterozygous mice and controls. The ultrastructural appearance of the end bulbs of Held in homozygous mutants was abnormal compared with controls, and in the younger group were seen to be swollen, with less distinct synaptic densities and containing large numbers of small synaptic vesicles arranged in clumps. In the older group these synapses were distorted and contained hypertrophied mitochondria and no synaptic densities could be seen, suggesting that these synapses may be non-functional. This study has shown that in homozygous (dfw) mice structural abnormalities occurred not only in cochlear hair cells but also in the spiral ganglion neurones and spherical cells in the cochlear nucleus. It seems likely that these changes are the result of the Pmca2 mutation and the subsequent accumulation of toxic levels of calcium that may lead to alterations in their functional integrity.

Animals↗
PubMed2005

Influence of ionizing radiation on nucleus 24 cochlear implants.

HYPOTHESIS: To evaluate the influence of conventional or hyperfractionated radiotherapy on Nucleus CI24M or CI24R(CS) implant systems. BACKGROUND: As a consequence of more than 70,000 cochlear implant recipients worldwide, the potential need for radiotherapy is an issue requiring consideration by both implantees and implantation centers. Conditions requiring radiotherapy of the head may include head, neck, or brain tumors. METHODS: The study examines the effect of ionizing radiation on cochlear implant function. The implanted devices examined were the Nucleus CI24M and Nucleus CI24R(CS). In a modeled study, two implants of each type were treated with fraction schemes most frequently used in clinical routine (e.g., conventional fractionation [total dose, 120 Gy] and hyperfractionation [total dose, 116 Gy]). Parameters quantified were the implant output amplitude changes at high and low current level (current levels 255 and 100, respectively), the charge balance of the biphasic pulse, and the accuracy of the impedance telemetry function. RESULTS: Within the clinically relevant dose range (< 80 Gy), implant function in all four devices was normal. Failure occurred in one Nucleus CI24R(CS) device treated with hyperfractionation. A dramatic drop in the output amplitude at 106 Gy was observed, and the impedance measurement failed at a total dose of 111 Gy. CONCLUSION: The results suggest that conventional or hyperfractionated radiotherapy can be applied safely at Nucleus CI24M or CI24R(CS) implant systems in a patient-like setting. Therefore, the authors propose that the results of the study can be applicable in clinical practice.

Cochlear Implants↗
PubMed1988

Aging and presbycusis: effects on 2-deoxy-D-glucose uptake in the mouse auditory brain stem in quiet.

Autoradiography was used to assess the incorporation of [2-14C]deoxy-D-glucose by the auditory brain stem of young and aging mice of the C57BL/6 strain (which demonstrates progressive chronic sensorineural hearing loss) and the CBA strain (which maintains good hearing until late in life). Animals were injected with labeled 2-deoxyglucose and placed in quiet for 45 min; brain stem sections were prepared for autoradiography. The amounts of 2-deoxyglucose incorporated into the anterior ventral cochlear nucleus (AVCN), inferior colliculus (IC), and trigeminal nerve (TN) were densitometrically analyzed. Within each subject, the densities of the three structures were statistically compared. In every mouse, inferior colliculus density was greater than that of the anterior ventral cochlear nucleus, which was greater than trigeminal nerve density. To compare subject groups, relative densities (inferior colliculus and anterior ventral cochlear nucleus re: trigeminal nerve) were used; no significant differences were found between groups. Thus, aging, with or without severe loss of hearing, is not associated with altered incorporation of 2-deoxyglucose (and presumably glucose) in quiet.

Aging↗
PubMed2006

The auditory midbrain implant: a new auditory prosthesis for neural deafness-concept and device description.

The auditory midbrain implant (AMI) is a new central auditory prosthesis designed for penetrating stimulation of the human inferior colliculus. The major group of candidates for the AMI consists of neurofibromatosis type 2 (NF2) patients who develop neural deafness because of growth and/or surgical removal of bilateral acoustic neuromas. Because of the absence of a viable auditory nerve, these patients cannot benefit from cochlear implants. An alternative solution has been the auditory brainstem implant (ABI), which stimulates the cochlear nucleus. However, speech perception performance in NF2 ABI patients has been limited. The fact that the ABI is able to produce high levels of speech perception in nontumor patients (with inaccessible cochleae or posttraumatic damage to the cochlear nerve) suggests that limitations in ABI performance in NF2 patients may be associated with cochlear nucleus damage caused by the tumors or the tumor removal process. Thus, stimulation of the auditory midbrain proximal to the damaged cochlear nucleus may be a better alternative for hearing restoration in NF2 patients. We propose the central nucleus of the inferior colliculus (ICC) as the potential site. A penetrating electrode array aligned along the well-defined tonotopic gradient of the ICC should selectively activate different frequency regions, which is an important elementfor supporting good speech understanding. The goal of this article is to present the ICC as an alternative site for an auditory implant for NF2 patients and to describe the design of the first human prototype AMI. Practical considerations for implementation of the AMI will also be discussed.

Algorithms↗
PubMed1993

Effects of noise and noise reduction processing on the operation of the Nucleus-22 cochlear implant processor.

Cochlear implants, like other types of auditory sensory aids, become increasingly ineffective with increasing ambient noise levels. One method of signal processing to reduce additive random wideband noise, the INTEL method, has been used to good effect as an input preprocessor for the Nucleus-22 cochlear implant. The implant's own signal processor estimates and encodes pitch frequency and the frequencies of Formants 1 and 2. The study reported here shows that additive noise results in substantial deviations in formant frequency estimates from those that would be observed in the absence of noise. When noisy speech is preprocessed by the INTEL method to reduce noise intensity, the deviations in the frequency estimates for Formant 2 are substantially reduced.

Acoustic Stimulation↗
PubMed1990

Delayed, frequency-specific inhibition in the cochlear nuclei of mice: a mechanism for monaural echo suppression.

To understand how auditory information is processed in the cochlear nuclei, it is crucial to know what circuitry exists and how it functions. Previous anatomical experiments have shown that neurons in the deep layer of the dorsal cochlear nucleus (DCN) project topographically to the anteroventral cochlear nucleus (AVCN) (Wickesberg and Oertel, 1988). Because interneurons in the DCN and their targets in AVCN are excited by the same group of auditory nerve fibers, the projection is frequency-specific. Here we report that microinjections of glutamate in the DCN evoke trains of IPSPs in individual, impaled AVCN neurons in brain slices of the cochlear nuclear complex. Only injections along a rostrocaudal band in the DCN, matching the anatomical projection of tuberculoventral neurons, evoke IPSPs; elsewhere, there were no responses to the glutamate. The inhibition is blocked by 0.5 microM strychnine. Both bushy and stellate cells are targets of the inhibitory projection. Inhibition in the AVCN is delayed by an additional synaptic delay with respect to the excitation. Delayed, frequency-specific inhibition allows the first wavefront to be transmitted to higher auditory centers by bushy and stellate cells, while following inputs encoding signals of similar frequencies are attenuated at least for the duration of an IPSP. These findings are consistent with results from psychoacoustic experiments and suggest that this circuit provides a source of monaural echo suppression.

Animals↗
PubMed1992

[Intracochlear electrical stimulation of the auditory nerve in deaf kittens--brainstem response audiometric and histopathologic studies].

The effects of long-term electrical stimulation of the auditory nerve on the morphology of the cochlear nucleus were investigated in young pharmacologically deafened kittens. Comparing the amplitude of EABR with the soma area, there was a strong positive correlation between the amplitude of EABR and the soma area of neurons within the anterior ventral cochlear nucleus on the stimulated side. However, there was no correlation between the amplitude of EABR and the soma area of neurons within the unstimulated anterior ventral cochlear nucleus. In addition, there was no correlation between the amplitude of EABR and the survival rate of spiral ganglion cells. This showed that EABR may be affected not only by the survival rate of the spiral ganglion cell, but also by the development of the central auditory nervous system in kittens, which were deafened under the development of the central auditory nervous system.

Animals↗
PubMed2003

Ultrastructural examination of the somatic innervation of ventrotubercular cells in the rat.

Ventrotubercular cells are multipolar cells in the ventral cochlear nucleus (VCN) that project a collateral axon to the ipsilateral dorsal cochlear nucleus (DCN). These cells are thought to be involved in sensitizing DCN output neurons to spectral shapes that represent the location of a sound source in space. The present report focused on the neuronal composition of this pathway. Intracellular labeling studies in cats and mice have described two types of ventrotubercular cells (Smith and Rhode [1989] J Comp Neurol. 282:595-626; Oertel et al. [1990] J Comp Neurol. 295:136-154). In cats, one difference between the two classes is that type I multipolar neurons have fewer than 35% of their somata apposed by terminals, whereas type II cells have greater than 70% apposition values. Intracellular recordings from single cells, however, are difficult and thus limit the yield of data. We investigated whether a two-component description of the ventrotubercular pathway was representative of a larger population. This issue was addressed by retrogradely labeling ventrotubercular neurons with an extracellular injection of biotinylated dextran amine into the DCN of rats. These injections labeled many VCN neurons, thus providing a more complete view of the pathway than previous studies. Thirty-eight labeled cells were selected for electron microscopic analysis with respect to their location, cell body size, and ultrastructural morphology. We observed labeled type I and type II neurons, but unlike ventrotubercular cells in cats, many of these neurons in rats (17 of 38 cells) had appositions between 35% and 70%. On the basis of this analysis, a third class of ventrotubercular cell, called the adendritic neuron, was revealed. Adendritic neurons have small somata with many filopodial appendages, no observable dendrites, and high percentage of terminal appositions (>80%). The results demonstrated that the ventrotubercular pathway in the rat is diverse.

Animals↗
PubMed1996

Regional distribution of neurotrophin receptors in the developing auditory brainstem.

Neuron survival and axonal regeneration become severely limited during early postnatal development. In conjunction with our recent organotypic analysis of regeneration in the auditory midbrain, we wished to determine whether neurotrophins could serve as a trophic substance during the postnatal period. Therefore, the current study examines the development of three neurotrophin receptor tyrosine kinases (TrkA, TrkB, and TrkC) in the gerbil auditory brainstem. Immunoreactivity to TrkA, the nerve growth-factor receptor, was observed in nonneuronal cells during the first two postnatal weeks. In the cochlear nucleus of mature animals, however, there was a TrkA-positive neuronal subpopulation. In contrast, immunoreactivity to TrkB and TrkC (the receptors for brain-derived neurotrophic factor and neurotrophin-3, respectively) displayed a widespread distribution in the auditory brainstem. At postnatal day 0, TrkB and TrkC staining was virtually absent from auditory nuclei, although immunopositive neurons were present in the mesencephalic trigeminal nucleus. By postnatal day 7, TrkB- and TrkC-positive neurons were present in most brainstem auditory nuclei. At postnatal day 15, TrkB immunoreactivity was observed throughout the inferior colliculus (IC), the cochlear nucleus, the medial and lateral nuclei of the trapezoid body, and the lateral superior olive, whereas TrkC labeled only a subpopulation of neurons within the central nucleus of the IC. The TrkB immunoreactivity was present on both neuronal somata and dendrites, whereas TrkC was generally restricted to cell bodies. At postnatal day 30, TrkB immunostaining was observed on most neurons of the IC. The medial and lateral nuclei of the trapezoid body displayed extremely strong TrkB staining, followed by the cochlear nucleus. In contrast, the TrkC immunostaining was decreased dramatically by postnatal day 21. Observations at the ultrastructural level confirmed a neuronal localization of TrkB and TrkC. Immunostaining for both receptors was restricted largely to the postsynaptic density of synaptic profiles in both dendrites and somata. In summary, this study illustrates a differential pattern of immunoreactivity between three neurotrophin receptors during development. The general increase of TrkB expression is well correlated with the onset of sound-evoked activity in this system, and its synaptic localization suggests that it may be involved in the modulation or maintenance of postsynaptic physiology.

Animals↗
PubMed2001

[The intraoperative application of neural response telemetry with the nucleus CI24M cochlear implant].

OBJECTIVE: To test device integrity and objective auditory reaction for cochlear implant patients intraoperatively. METHODS: Our protocol for intraoperative testing of the implant device includes device electrode impedance test and neural response telemetry (NRT), which measures the electrically evoked auditory nerve compound action potentials (ECAP). RESULTS: We completed electrode integrity tests and NRT intraoperatively on 40 patients with the Nucleus CI24M cochlear implant. We have measured normal implant function on all 40 patients and obtained ECAP results from 39 patients. Out of 33 patients with normal inner ear, typical ECAPs were recorded in 195 electrodes in all 198 testing electrodes(98.5%). In 7 patients with inner ear Mondini dysphasia, affirmative ECAP waveforms were recorded in 26 electrodes in all 42 testing electrodes. The basal electrode ECAP threshold was higher than that of the epical one. CONCLUSIONS: The intraoperative measurements of device function and NRT are quite simple, quick and with high accuracy. Inner ear malformation is an important factor that may affect NRT results.

Action Potentials↗
PubMed1999

Effects of electrode configuration and frequency allocation on vowel recognition with the Nucleus-22 cochlear implant.

OBJECTIVE: This study was conducted to understand vowel recognition in cochlear implants as a function of the cochlear location and separation of the stimulated electrode pairs and as a function of the matching between speech spectral information and the location of the stimulated electrodes. DESIGN: Four-electrode speech processors with a continuous interleaved sampling speech processing strategy were implemented through a custom interface in five subjects implanted with the Nucleus-22 cochlear implant. The temporal envelopes from four broad frequency bands were used to modulate 500 pps, 100 microsec/phase interleaved pulse trains delivered to four electrode pairs. Ten different frequency allocations and five sets of four-electrode configurations were tested. Each frequency allocation represented the same cochlear extent but different cochlear locations based on Greenwood's frequency-to-place formula. Recognition of multi-talker medial vowels was measured for each combination of parameters with no period of practice or adjustment. RESULTS: Results showed that recognition of multi-talker vowels was highly dependent on frequency allocation for all electrode configurations. For a given electrode configuration maximum vowel recognition was observed with a specific frequency allocation. When the stimulated electrodes were shifted basally by 3 mm, the frequency allocation that produced the best performance also shifted basally by 3 mm. A similar pattern of vowel recognition was observed as a function of frequency allocation for electrode configurations that had the same apical-most electrode in each pair, regardless of location of the basal-most electrode in the pair. Subjects with different electrode insertion depths had similar trends in vowel recognition for each frequency allocation. CONCLUSIONS: For a given electrode configuration, the best performance was obtained with processors with a specific frequency allocation. In addition, the apical-most member of each electrode pair had a much stronger influence on vowel recognition in electric hearing. Finally, results from this study also suggest that over time, patients with implants can partially adapt to a basal shift in place of stimulation.

Adult↗
PubMed2001

Zinc inhibition of group I mGluR-mediated calcium homeostasis in auditory neurons.

Zinc is widely distributed in the central nervous system (CNS), it functions normally as a synaptic modulator, and it contributes to neuronal death under pathologic conditions. Zinc colocalizes with glutamate in excitatory synapses, and the presence of zinc is well characterized in the synapses of the auditory system. Since chick cochlear nucleus neurons depend upon synaptic activation of metabotropic glutamate receptors (mGluRs) for maintenance and survival, the goal of this study was to determine (1) if zinc is released from the eighth nerve calyces onto nucleus magnocellularis (NM) neurons in the chick cochlear nucleus, and, if so, (2) what effect it has on group I mGluR-mediated calcium homeostasis of these neurons. Using in vitro slices and a fluorescent dye relatively specific to vesicularized zinc, we show that zinc is indeed localized to the presynaptic calyces and is released upon nerve stimulation or KCl depolarization. Experiments employing fura-2 calcium imaging show that zinc inhibits group I mGluR release of calcium from internal stores of NM neurons and disrupts activity-dependent calcium homeostasis in a manner identical to the mGluR5-specific antagonist 2-methyl-6-(phenylethynyl)pyridine. The mGluR1-specific antagonist 7-hydroxyiminocyclopropan-[b]chromen-la-carboxylic acid ethyl ester did not affect release of calcium from stores by the nonspecific mGluR agonist aminocyclopentane dicarboxylic acid, nor did it affect activity-dependent calcium homeostasis. We conclude that zinc is present in and released from the glutamatergic eighth nerve calcyes. The presence of zinc inhibits mGluR5, a major component of calcium homeostasis of NM neurons, and plays a modulatory role in the activity-dependent, mGluR-mediated calcium homeostasis of auditory neurons.

Animals↗
PubMed1999

Acoustic brainstem nuclei express Fos after flurothyl-induced generalized seizures in rats.

The inferior colliculus (IC) plays a key role in modulating audiogenic seizures (AS) in rats. We investigated whether acoustic brainstem nuclei express Fos-like immunoreactivity (FLI) after flurothyl-induced generalized seizures in rats. Compared to controls, experimental animals showed significantly (P<0.05) more FLI in the dorsal and external cortex of the IC, as well as in the medial part of the medial geniculate body (MGB), perigeniculate area, and dorsal cochlear nucleus. No significant increase of FLI was observed in the central nucleus of the IC, ventral and dorsal parts of the MGB, dorsal nucleus of the lateral lemniscus, or ventral cochlear nucleus. Because this pattern of FLI closely resembles that observed after AS in previous studies, these results suggest that Fos expression in acoustic brainstem nuclei is not specific for AS.

Animals↗
PubMed1988

Initial experience with children using the Nucleus 22 Channel cochlear implant.

The Nucleus 22 Channel cochlear prosthesis developed by the University of Melbourne and Cochlear Pty Ltd is now being used in over 90 clinics worldwide, in fourteen countries and fifteen languages. A total of thirty adolescents and thirty-nine children have now been implanted in Australia, America and more recently Germany. There have been no significant postoperative complications, and the device has been successfully programmed in children as young as two years nine months. Comprehensive evaluation and training programs are being undertaken with each implanted child to assess long term development of speech perception and communication skills. The average postoperative stimulation time for most of the children implanted is around 3 months, so as yet, little data has been recorded on these patients. However, the two original children implanted in Melbourne have now been using their speech processors in excess of 18 months. The focus of this paper will be on the performance of these two children.

Child↗
PubMed2003

C-Fos immunoreactivity mapping of the auditory system after electrical stimulation of the cochlear nerve in rats.

The aim of this study was to establish the use of c-Fos immunoreactivity as a marker for functional mapping in the auditory system in response to direct electrical stimulation of the cochlear nerve in the cerebellopontine angle. In rats the cochlear nerve was electrically stimulated with a biphasic current (120-250 microA, 5 Hz) for 30 min using a bipolar concentric Tungsten electrode. Bilateral cochlectomy was performed in a control group in order to investigate basal expression of c-Fos in the auditory brainstem nuclei. The response of auditory brainstem nuclei to electrical stimulation and the completeness of cochlear ablations were electrophysiologically verified. After the experiments, the animals were prepared for cryotomy and c-Fos immunohistochemistry. The results were morphologically analyzed and statistically compared among groups. In anesthetized animals with unilateral electrical stimulation of the cochlear nerve increased expression of c-Fos was detected in the ipsilateral ventral (VCN) and bilateral dorsal cochlear nucleus (DCN), whereas the VCN of the contralateral side revealed only few immunoreactive cells. In animals with bilateral cochlear ablation the number of c-Fos reactive cell nuclei representing basal expression was generally low in the VCN and DCN of both sides. Our data show that electrical stimulation of the cochlear nerve leads to increased expression of c-Fos in the cochlear nucleus. It also confirms bilateral connections between the cochlear nuclei. These experimental results suggest that c-Fos immunoreactivity mapping provides a powerful tool for functional investigations on the cellular level after direct electrical stimulation of the cochlear nerve. Future functional studies analyzing the effect of electrical stimulation of the central auditory system as performed by auditory brainstem implants could be investigated in detail by mapping c-Fos expression on cellular level.

Animals↗
PubMed1992

GAD- and GABA-immunoreactivity in the ascending auditory pathway of horseshoe and mustached bats.

A comparative study of the immunostain to antibodies directed against glutamic acid decarboxylase (GAD) and gamma-aminobutyric acid (GABA) in the ascending auditory pathway was carried out in horseshoe bats (Rhinolophus rouxi) and mustached bats (Pteronotus parnellii). In both species GAD/GABA-positive puncta (presumed axonal boutons) and GAD/GABA-positive cells were found in the cochlear nucleus, the superior olivary complex, the nuclei of the lateral lemniscus the inferior colliculus, and the medial geniculate body. General features of the immunostaining pattern in the auditory pathway agree with observations in other mammals. Quantitative analysis of puncta distribution shows that many auditory centers are characterized by subregional differences in puncta density and distribution. This indicates local differences in putatively inhibitory input related to connectivity and tonotopic organization. The following species characteristic features were found: 1) The dorsal non-laminated portion of the dorsal cochlear nucleus in horseshoe bats lacks the GAD/GABA-immunoreactive cells typical for the ventral laminated portion and the dorsal cochlear nucleus of other species. Clearly, a cytoarchitectonic specialization is accompanied by a loss of putatively GABAergic local inhibitory circuits. 2) The ventral division of the medial geniculate body of the mustached bat lacks GAD/GABA-immunopositive cells. Such cells are present in the horseshoe bat and other mammals. This finding implies functional differences in the organization of the medial geniculate body within the same mammalian order.

Animals↗
PubMed1993

Partial insertion of the nucleus multichannel cochlear implant: technique and results.

The goal of cochlear implant surgery is to insert the entire electrode array into the scala tympani. Incomplete insertion is usually attributable to the presence of new bone formation as a result of meningitis. Surgical techniques for dealing with obstruction include various degrees of drilling of the cochlea or alternative placement of the electrode array. We evaluated the postoperative performance of eight such patients implanted with the Nucleus multichannel cochlear implant at NYU Medical Center as well as data from adults and children nationwide. Scores ranging from marginal closed-set speech discrimination to 40 percent on open-set speech recognition tests were obtained. Surgical procedure, placement, and number of electrodes as well as number of channels in use affect the ultimate performance of these patients.

Adolescent↗