The Effect of Stimulus Polarity on the Relation Between Pitch Ranking and ECAP Spread of Excitation in Cochlear Implant Users

  • Emily R. Spitzer
  • Sangsook Choi
  • Michelle L. HughesEmail author
Research Article


Although modern cochlear implants (CIs) use cathodic-leading symmetrical biphasic pulses to stimulate the auditory nerve, a growing body of evidence suggests that anodic-leading pulses may be more effective. The positive polarity has been shown to produce larger electrically evoked compound action potential (ECAP) amplitudes, steeper slope of the amplitude growth function, and broader spread of excitation (SOE) patterns. Polarity has also been shown to influence pitch perception. It remains unclear how polarity affects the relation between physiological SOE and psychophysical pitch perception. Using a within-subject design, we examined the correlation between performance on a pitch-ranking task and spatial separation between SOE patterns for anodic and cathodic-leading symmetric biphasic pulses for 14 CI ears. Overall, there was no effect of polarity on either ECAP SOE patterns, pitch ranking performance, or the relation between the two. This result is likely due the use of symmetric biphasic pulses, which may have reduced the size of the effect previously observed for pseudomonophasic pulses. Further research is needed to determine if a pseudomonophasic stimulus might further improve the relation between physiology and pitch perception.


electrical stimulation biphasic stimuli electrically evoked compound action potential 


Funding Information

This study was funded by the National Institutes of Health. This research was supported by NIH/NIDCD grants R01 DC009595 and T35 DC008757 and NIGMS P20 GM109023. The content of this project is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Compliance with Ethical Standards

This study was approved by the Boys Town National Research Hospital Institutional Review Board under protocol 03-07-XP. Written informed consent was obtained from all participants.

Conflict of Interest

The authors declare that they have no conflict of interest.


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Copyright information

© Association for Research in Otolaryngology 2019

Authors and Affiliations

  • Emily R. Spitzer
    • 1
    • 2
  • Sangsook Choi
    • 1
  • Michelle L. Hughes
    • 1
    • 3
    Email author
  1. 1.Boys Town National Research HospitalOmahaUSA
  2. 2.Dept. of Otolaryngology—Head & Neck SurgeryNYU School of MedicineNew YorkUSA
  3. 3.Dept. of Special Education and Communication DisordersUniversity of Nebraska-LincolnLincolnUSA

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