Practical model description of peripheral neural excitation in cochlear implant recipients: 1. Growth of loudness and ECAP amplitude with current.

This is the first in a series of five papers, presenting the development of a practical mathematical model that describes excitation of the auditory nerve by electrical stimulation from a cochlear implant. Here are presented methods and basic data for the subjects, who were implanted with the Nucleus 24 cochlear implant system (three with straight and three with Contour electrode arrays), required as background for all papers. The growth of subjective loudness with stimulus current was studied, for low-rate pulse bursts and for single pulses. The growth of the amplitude of the compound action potential (ECAP) was recorded using the Neural Response Telemetry (NRT) system. An approximately linear relationship was demonstrated between ECAP amplitude and burst loudness, although this failed at the lower end of the dynamic range, to an extent that varied with subject and stimulated electrode. Single-pulse stimuli were audible below ECAP threshold, demonstrating that the audibility of burst stimuli at such low currents was not due solely to temporal loudness summation. An approximate function was established relating the curvature of the burst loudness growth function to the maximum comfortable level (MCL). Loudness at threshold was quantified, as a percentage of loudness at MCL. The relationship between loudness and ECAP growth functions, the curvature versus MCL function and the loudness associated with threshold are relevant to the development of a mathematical model of electrically evoked auditory nerve excitation.