Reduction in excitability of the auditory nerve following electrical stimulation at high stimulus rates. IV. Effects of stimulus intensity.

High rate intracochlear electrical stimulation using stimulus intensities well above clinical limits can induce a significant reduction in the excitability of the auditory nerve as measured by a reduction in the amplitude of the electrically evoked auditory brainstem response (EABR). The purpose of the present study was to assess the effect of stimulus intensity on these stimulus induced changes by comparing the effects of acute stimulation using stimulus intensities within normal clinical levels (6 dB and 12 dB above EABR threshold) and significantly above normal clinical levels (> 20 dB above EABR threshold; 0.34 microC/phase). Stimulus rates of 200, 400, or 1000 pulses/s (pps) were delivered to bipolar scala tympani electrodes. EABRs were recorded before and periodically following 2 h of continuous stimulation. No reduction in EABR amplitude was observed following stimulation at 6 dB above EABR threshold for the three stimulus rates examined. However, EABRs were reduced when stimulated at 12 dB above EABR threshold at 400 pps, and significantly reduced when stimulated at a rate of 1000 pps. Immediate post-stimulus response amplitudes of wave III were 63% and 35% of the pre-stimulus amplitude at 400 and 1000 pps respectively. More significant reductions in EABR amplitude were observed following stimulation at levels more than 20 dB above EABR threshold for both 400 and 1000 pps stimuli. Our findings indicate that stimulus induced changes in EABR amplitude are related to both stimulus rate and stimulus intensity. Moreover, stimulation using intensities within the normal clinical range show little evidence of prolonged reductions in auditory nerve excitability at stimulus rates of up to 1000 pps.