OBJECTIVE: This study explores the theoretical relation between the psychophysically measured current levels required for sound processor fitting in cochlear implants and the objectively measured compound action potential threshold (as measured by Neural Response Telemetry, NRT). The objective was to gain understanding of the variability across implantees in this relation and determine possible ways (using objective measures) of improving the predictability of NRT thresholds for behavioral levels needed for mapping. DESIGN: A model of how rate of stimulation affects loudness is presented. The model can be used to understand differences among implantees in the way that rate affects loudness and hence explain the disappointing correlation between NRT and psychophysical measures. Suggestions are made, based on the model, for additional information that may improve the usefulness of NRT measurements. One such option (measuring the effect of interphase gap on NRT amplitude) was experimentally explored in eight subjects (26 electrodes). It was hypothesized that the current change required to maintain equal NRT amplitude when interphase gap was changed from 8 to 45 musec would be correlated with the offset between behavioral and NRT thresholds. RESULTS: The above hypothesis was not supported by the data, and several possible reasons for this outcome are discussed. CONCLUSIONS: The loudness model provides useful insights into why NRT thresholds are not good predictors of the behavioral levels needed for mapping and how NRT might be made more useful by additional objective information. These insights should be investigated in further experimental studies.
OBJECTIVE: This study explores the theoretical relation between the psychophysically measured current levels required for sound processor fitting in cochlear implants and the objectively measured compound action potential threshold (as measured by Neural Response Telemetry, NRT). The objective was to gain understanding of the variability across implantees in this relation and determine possible ways (using objective measures) of improving the predictability of NRT thresholds for behavioral levels needed for mapping. DESIGN: A model of how rate of stimulation affects loudness is presented. The model can be used to understand differences among implantees in the way that rate affects loudness and hence explain the disappointing correlation between NRT and psychophysical measures. Suggestions are made, based on the model, for additional information that may improve the usefulness of NRT measurements. One such option (measuring the effect of interphase gap on NRT amplitude) was experimentally explored in eight subjects (26 electrodes). It was hypothesized that the current change required to maintain equal NRT amplitude when interphase gap was changed from 8 to 45 musec would be correlated with the offset between behavioral and NRT thresholds. RESULTS: The above hypothesis was not supported by the data, and several possible reasons for this outcome are discussed. CONCLUSIONS: The loudness model provides useful insights into why NRT thresholds are not good predictors of the behavioral levels needed for mapping and how NRT might be made more useful by additional objective information. These insights should be investigated in further experimental studies.
Authors: Shuman He; Xiuhua Chao; Ruijie Wang; Jianfen Luo; Lei Xu; Holly F B Teagle; Lisa R Park; Kevin D Brown; Michelle Shannon; Cynthia Warner; Angela Pellittieri; William J Riggs Journal: Ear Hear Date: 2020 May/Jun Impact factor: 3.570
Authors: Douglas C Fitzpatrick; Adam P Campbell; Adam T Campbell; Baishakhi Choudhury; Margaret T Dillon; Margaret P Dillon; Mathieu Forgues; Craig A Buchman; Oliver F Adunka Journal: Otol Neurotol Date: 2014-01 Impact factor: 2.311