Abstract
By allowing bilateral access to sound, bilateral cochlear implants (BI-CIs) or unilateral CIs for individuals with single-sided deafness (SSD; i.e., normal or near-normal hearing in one ear) can improve sound localization and speech understanding in noise. Spatial hearing in the horizontal plane is primarily conveyed by interaural time and level differences computed from neurons in the superior olivary complex that receive frequency-matched inputs. Because BI-CIs and SSD-CIs do not necessarily convey frequency-matched information, it is critical to understand how to align the inputs to CI users. Previous studies show that interaural pitch discrimination for SSD-CI listeners is highly susceptible to contextual biases, questioning its utility for establishing interaural frequency alignment. Here, we replicate this finding for SSD-CI listeners and show that these biases also extend to BI-CI listeners. To assess the testing-range bias, three ranges of comparison electrodes (BI-CI) or pure-tone frequencies (SSD-CI) were tested: full range, apical/lower half, or basal/upper half. To assess the reference bias, the reference electrode was either held fixed throughout a testing block or randomly chosen from three electrodes (basal end, middle, or apical end of the array). Results showed no effect of reference electrode randomization, but a large testing range bias; changing the center of the testing-range shifted the pitch match by an average 63 % (BI-CI) or 43 % (SSD-CI) of the change magnitude. This bias diminished pitch-match accuracy, with a change in reference electrode shifting the pitch match only an average 34 % (BI-CI) or 40 % (SSD-CI) of the expected amount. Because these effects extended to the relatively more symmetric BI-CI listeners, the results suggest that the bias cannot be attributed to interaural asymmetry. Unless the range effect can be minimized or accounted for, a pitch-discrimination task will produce interaural place-of-stimulation estimates that are highly influenced by the conditions tested, rather than reflecting a true interaural place-pitch comparison.
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Notes
We performed pilot tests using a very low rate, 25 pps, for several BI-CI listeners, because Carlyon et al. (2010) suggested that 25 pps might yield less biased results than 1000 pps. The main reason for using very low-rate pulse trains around 25 pps is to reduce the influence of temporal pitch cues on the pitch perception, because some electrodes have a different upper limit of temporal pitch than others (e.g., Kong and Carlyon 2010). We found no apparent difference in using 25 or 1000 pps in our pilot tests for listeners who could perform the task. For a few of our BI-CI listeners, the low rate was so distracting that they had substantial difficulty or could not perform the interaural pitch-discrimination task. Changing to the higher rate allowed them to better attend to the pitch of the pulse train. We therefore opted for the higher stimulation rate for this study. Note, that this finding is in contrast to other studies where BI-CI listeners appeared to have no problem with interaural pitch discrimination using 25-pps pulse trains (e.g., Ihlefeld et al. 2015). The reason for the discrepancy is unclear and motivates further investigation on the use of very low rates in interaural pitch-discrimination tasks.
The Latin square design applied to listeners BCI1, 2, 4, 5, 6 and 7. We recruited one extra BI-CI listener for the study, BCI3, who was tested on the same order of conditions as listener BCI5. Listener BCI6, who was tested with the reference electrodes in both the right and left ears, was assigned a unique order for the left ear, but the same order as BCI1 for the right ear.
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Acknowledgements
We thank Cochlear Ltd. and Med-El for providing the testing equipment and technical support. We thank Danielle King, Emily Waddington, and Tori Levi who helped collect data for this study. We thank the Department of Hearing and Speech Sciences at University of Maryland, College Park (Dr. Nicole Nguyen), the Cochlear Implant Center at Greater Baltimore Medical Center (Dr. Regina Presley), the University of Maryland Medical School (Dr. David Eisenman and Dr. Ronna Hertzano), and Walter Reed National Military Medical Center (Dr. Gerald Schuchman) for their assistance with recruiting listeners. We thank Ginny Alexander for the managerial help and Kenneth Jensen for helpful comments on a previous version of this paper. The views expressed in this article are those of the authors and do not reflect the official policy of the Department of Army/Navy/Air Force, Department of Defense, or U.S. Government. The identification of specific products or scientific instrumentation does not constitute endorsement or implied endorsement on the part of the author, DoD, or any component agency.
Funding
The research reported in this publication was supported by the National Institute On Deafness And Other Communication Disorders of the National Institutes of Health under Award Number R01 DC015798 (M.J.G. and J.G.W.B.). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
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Goupell, M.J., Cosentino, S., Stakhovskaya, O.A. et al. Interaural Pitch-Discrimination Range Effects for Bilateral and Single-Sided-Deafness Cochlear-Implant Users. JARO 20, 187–203 (2019). https://doi.org/10.1007/s10162-018-00707-x
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DOI: https://doi.org/10.1007/s10162-018-00707-x