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Characterizing Polarity Sensitivity in Cochlear Implant Recipients: Demographic Effects and Potential Implications for Estimating Neural Health

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Abstract

Stimulus polarity can affect both physiological and perceptual measures in cochlear-implant recipients. Large differences between polarities for various outcome measures (e.g., eCAP threshold, amplitude, or slope) theoretically reflect poorer neural health, whereas smaller differences reflect better neural health. Therefore, we expect large polarity effects to be correlated with other measures shown to contribute to poor neural health, such as advanced age or prolonged deafness. Our earlier studies using the electrically evoked compound action potential (eCAP) demonstrated differences in polarity effects between users of Cochlear and Advanced Bionics devices when device-specific clinical pulse designs were used. Since the stimuli differed slightly between devices, the first goal of this study was to determine whether small, clinically relevant differences in pulse phase duration (PD) have a significant impact on eCAP polarity effects to potentially explain the device differences observed previously. Polarity effects were quantified as the difference in eCAP thresholds, mean normalized amplitudes, and slope of the amplitude growth function obtained for anodic-first versus cathodic-first biphasic pulses. The results showed that small variations in PD did not explain the observed differences in eCAP polarity effects between devices. Therefore, eCAP polarity sensitivity measures are relatively robust to small differences in pulse parameters. However, it remains unclear what underlies the observed manufacturer differences, which may limit the utility of eCAP polarity sensitivity measures. The second goal was to characterize polarity sensitivity in a large group of CI recipients (65 ears) to relate polarity sensitivity to age and duration of deafness as a proxy for neural health. The same pulse parameters were used for both device groups. The only significant predictors of eCAP polarity effects were age for threshold and amplitude polarity effects for Cochlear recipients and age and duration of deafness for slope for AB recipients. However, three of these four correlations were in the opposite direction of what was expected. These results suggest that eCAP polarity sensitivity measures likely reflect different mechanisms than the effects that age and duration of deafness induce on the peripheral auditory system.

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ACKNOWLEDGEMENTS

This research was supported by NIH/NIDCD grant R01 DC009595. Data collection was completed at Boys Town National Research Hospital in Omaha, NE, and analysis was completed at the University of Nebraska-Lincoln. The content of this project is solely the responsibility of the author and does not necessarily represent the official views of the National Institute on Deafness and Other Communication Disorders or the National Institutes of Health. The author thanks Jenny Goehring, Jacquelyn Baudhuin, Rachel Scheperle, Sangsook Choi, and Josh Sevier for data collection; Elysa Binger and Jamie Petersen for managing data fidelity; Tim Brochier for sharing his Matlab analysis code; and Donna Chen and Lorey Wheeler for assistance with statistical analyses.

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  1. Department of Special Education and Communication Disorders, University of Nebraska-Lincoln, 276 Barkley Memorial Center, Lincoln, NE, 68583, USA

    Michelle L. Hughes

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  1. Michelle L. Hughes
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Correspondence to Michelle L. Hughes.

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This project was approved by the Boys Town National Research Hospital Institutional Review Board under study protocol 03-07-XP. All participants (or parents/guardians for minors) provided written informed consent.

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Hughes, M.L. Characterizing Polarity Sensitivity in Cochlear Implant Recipients: Demographic Effects and Potential Implications for Estimating Neural Health. JARO 23, 301–318 (2022). https://doi.org/10.1007/s10162-021-00824-0

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  • DOI: https://doi.org/10.1007/s10162-021-00824-0

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