Otorhinolaryngology Department, Hannover Medical University, 30625, Hannover, Germany.
J Assoc Res Otolaryngol. 2010 Dec;11(4):689-708. doi: 10.1007/s10162-010-0229-0. Epub 2010 Aug 18.
The auditory midbrain implant (AMI), which consists of a single shank array designed for stimulation within the central nucleus of the inferior colliculus (ICC), has been developed for deaf patients who cannot benefit from a cochlear implant. Currently, performance levels in clinical trials for the AMI are far from those achieved by the cochlear implant and vary dramatically across patients, in part due to stimulation location effects. As an initial step towards improving the AMI, we investigated how stimulation of different regions along the isofrequency domain of the ICC as well as varying pulse phase durations and levels affected auditory cortical activity in anesthetized guinea pigs. This study was motivated by the need to determine in which region to implant the single shank array within a three-dimensional ICC structure and what stimulus parameters to use in patients. Our findings indicate that complex and unfavorable cortical activation properties are elicited by stimulation of caudal-dorsal ICC regions with the AMI array. Our results also confirm the existence of different functional regions along the isofrequency domain of the ICC (i.e., a caudal-dorsal and a rostral-ventral region), which has been traditionally unclassified. Based on our study as well as previous animal and human AMI findings, we may need to deliver more complex stimuli than currently used in the AMI patients to effectively activate the caudal ICC or ensure that the single shank AMI is only implanted into a rostral-ventral ICC region in future patients.
听觉中脑植入物(AMI)由一个用于刺激下丘中央核(ICC)的单针阵列组成,专为不能从耳蜗植入物中受益的失聪患者开发。目前,AMI 的临床试验中的性能水平远低于耳蜗植入物的水平,并且在患者之间差异很大,部分原因是刺激位置的影响。作为改善 AMI 的初步步骤,我们研究了刺激 ICC 同频域的不同区域以及变化的脉冲相位持续时间和水平如何影响麻醉豚鼠的听觉皮层活动。这项研究的动机是需要确定在三维 ICC 结构中在哪个区域植入单针阵列以及在患者中使用什么刺激参数。我们的研究结果表明,AMI 阵列刺激 ICC 的尾背区域会引起复杂且不利的皮层激活特性。我们的结果还证实了 ICC 同频域存在不同的功能区域(即尾背和头腹区域),这在传统上是未分类的。基于我们的研究以及之前的动物和人类 AMI 发现,我们可能需要传递比目前在 AMI 患者中使用的更复杂的刺激,以有效地激活 ICC 的尾部,或确保未来的患者仅将单针 AMI 植入头腹 ICC 区域。