Speech perception with interaction-compensated simultaneous stimulation and long pulse durations in cochlear implant users.

Early multi-channel designs in the history of cochlear implant development were based on a vocoder-type processing of frequency channels and presented bands of compressed analog stimulus waveforms simultaneously on multiple tonotopically arranged electrodes. The realization that the direct summation of electrical fields as a result of simultaneous electrode stimulation exacerbates interactions among the stimulation channels and limits cochlear implant outcome led to the breakthrough in the development of cochlear implants, the continuous interleaved (CIS) sampling coding strategy. By interleaving stimulation pulses across electrodes, CIS activates only a single electrode at each point in time, preventing a direct summation of electrical fields and hence the primary component of channel interactions. In this paper we show that a previously presented approach of simultaneous stimulation with channel interaction compensation (CIC) may also ameliorate the deleterious effects of simultaneous channel interaction on speech perception. In an acute study conducted in eleven experienced MED-EL implant users, configurations involving simultaneous stimulation with CIC and doubled pulse phase durations have been investigated. As pairs of electrodes were activated simultaneously and pulse durations were doubled, carrier rates remained the same. Comparison conditions involved both CIS and fine structure (FS) strategies, either with strictly sequential or paired-simultaneous stimulation. Results showed no statistical difference in the perception of sentences in noise and monosyllables for sequential and paired-simultaneous stimulation with doubled phase durations. This suggests that CIC can largely compensate for the effects of simultaneous channel interaction, for both CIS and FS coding strategies. A simultaneous stimulation paradigm has a number of potential advantages over a traditional sequential interleaved design. The flexibility gained when dropping the requirement of interleaving pulses across electrodes may be instrumental in designing coding strategies for a more accurate transmission of stimulus features such as temporal fine structure or interaural time delays to the auditory nerve. Also, longer pulse phase durations may be implemented while maintaining relatively high stimulation pulse rates. Utilizing longer pulse durations may relax requirements on implant compliance and facilitate the design of more energy-efficient implant receivers for a longer battery lifetime or a reduction in implant size. This article is part of a Special Issue entitled .