Biomedical subjects

Michael F Dorman

Publications and source records attributed to Michael F Dorman.

13 recordsLinked to original sources

PubMed2006

Central auditory development in children with cochlear implants: clinical implications.

A common finding in developmental neurobiology is that stimulation must be delivered to a sensory system within a narrow window of time (a sensitive period) during development in order for that sensory system to develop normally. Experiments with congenitally deaf children have allowed us to establish the existence and time limits of a sensitive period for the development of central auditory pathways in humans. Using the latency of cortical auditory evoked potentials (CAEPs) as a measure we have found that central auditory pathways are maximally plastic for a period of about 3.5 years. If the stimulation is delivered within that period CAEP latencies reach age-normal values within 3-6 months after stimulation. However, if stimulation is withheld for more than 7 years, CAEP latencies decrease significantly over a period of approximately 1 month following the onset of stimulation. They then remain constant or change very slowly over months or years. The lack of development of the central auditory system in congenitally deaf children implanted after 7 years is correlated with relatively poor development of speech and language skills [Geers, this vol, pp 50-65]. Animal models suggest that the primary auditory cortex may be functionally decoupled from higher order auditory cortex due to restricted development of inter- and intracortical connections in late-implanted children [Kral and Tillein, this vol, pp 89-108]. Another aspect of plasticity that works against late-implanted children is the reorganization of higher order cortex by other sensory modalities (e.g. vision). The hypothesis of decoupling of primary auditory cortex from higher order auditory cortex in children deprived of sound for a long time may explain the speech perception and oral language learning difficulties of children who receive an implant after the end of the sensitive period.

Auditory Cortex↗

PubMed2005

The influence of a sensitive period on central auditory development in children with unilateral and bilateral cochlear implants.

We examined the longitudinal development of the cortical auditory evoked potential (CAEP) in 21 children who were fitted with unilateral cochlear implants and in two children who were fitted with bilateral cochlear implants either before age 3.5 years or after age 7 years. The age cut-offs (<3.5 years for early-implanted and >7 years for late-implanted) were based on the sensitive period for central auditory development described in [Ear Hear. 23 (6), 532.] Our results showed a fundamentally different pattern of development of CAEP morphology and P1 cortical response latency for early- and late-implanted children. Early-implanted children and one child who received bilateral implants by age 3.5 years showed rapid development in CAEP waveform morphology and P1 latency. Late-implanted children showed aberrant waveform morphology and significantly slower decreases in P1 latency postimplantation. In the case of a child who received his first implant by age 3.5 years and his second implant after age 7 years, CAEP responses elicited by the second implant were similar to late-implanted children. Our results are consistent with animal models of central auditory development after implantation and confirm the presence of a relatively brief sensitive period for central auditory development in young children.

Acoustic Stimulation↗

PubMed2005

Acoustic simulations of combined electric and acoustic hearing (EAS).

OBJECTIVE: Our aim was to explore the consequences for speech understanding of leaving a gap in frequency between a region of acoustic hearing and a region stimulated electrically. Our studies were conducted with normal-hearing listeners, using an acoustic simulation of combined electric and acoustic (EAS) stimulation. DESIGN: Simulations of EAS were created by low-pass filtering speech at 0.5 kHz (90 dB octave roll-off) and adding amplitude-modulated sine waves at higher frequencies. The gap in frequency between acoustic and simulated electric hearing was varied over the range 0.5 kHz to 3.2 kHz. Stimuli included sentences in quiet, sentences in noise, and consonants and vowels. Three experiments were conducted with sample sizes of 12 listeners. RESULTS: Scores were highest in conditions that minimized the frequency gap between acoustic and electric stimulation. In quiet, vowels and consonant place of articulation showed the most sensitivity to the frequency gap. In noise, scores in the simulated EAS condition were higher than the sum of the scores from the acoustic-only and simulated electric-only conditions. CONCLUSIONS: Our results suggest that both deep and shallow insertions of electrodes could improve the speech understanding abilities of patients with residual hearing to 500 Hz. However, performance levels will be maximized if the gap between acoustic and electric stimulation is minimized.

Acoustic Stimulation↗

PubMed2005

Effects of minimum stimulation settings for the Med El Tempo+ speech processor on speech understanding.

OBJECTIVE: The aim of this study was to assess the effects of variations in the settings for minimum stimulation levels on speech understanding for adult cochlear implant recipients using the Med El Tempo+ speech processor. DESIGN: Fifteen patients served as listeners. The test material included sentences presented at a conversational level in noise (74 dB SPL at +10 dB signal-to-noise ratio), sentences presented at a soft level in a quiet background (54 dB SPL), consonants in "vCv" environment (74 dB SPL re: vowel peaks), and synthetic vowels in "bVt" environment (54 dB SPL re: vowel peaks). The patients' speech processors were programmed with minimum stimulation levels set to behavioral threshold, set to 10% of most comfortable loudness, and set to 0 muA. RESULTS: The level of speech understanding achieved in the behavioral threshold condition was not significantly different from that achieved in either the 10% of most comfortable loudness or 0 muA conditions for any test material. Only 2 of the 15 patients demonstrated performance differences of greater than 10 percentage points between the 0 muA condition and the behavioral threshold condition on more than a single test. CONCLUSIONS: Our results demonstrate that there are no grievous consequences, in terms of speech understanding, for setting minimum stimulation levels below behavioral thresholds. The time savings from setting thresholds to 10% of MCL or 0 muA may be especially useful during the initial device fitting.

Acoustic Stimulation↗

PubMed2004

Performance of subjects fit with the Advanced Bionics CII and Nucleus 3G cochlear implant devices.

OBJECTIVE: To determine if subjects who used different cochlear implant devices and who were matched on consonant-vowel-consonant (CNC) identification in quiet would show differences in performance on speech-based tests of spectral and temporal resolution, speech understanding in noise, or speech understanding at low sound levels. DESIGN: The performance of 15 subjects fit with the CII Bionic Ear System (CII Bionic Ear behind-the-ear speech processor with the Hi-Resolution sound processing strategy; Advanced Bionics Corporation) was compared with the performance of 15 subjects fit with the Nucleus 24 electrode array and ESPrit 3G behind-the-ear speech processor with the advanced combination encoder speech coding strategy (cochlear corporation). SUBJECTS: Thirty adults with late-onset deafness and above-average speech perception abilities who used cochlear implants. MAIN OUTCOME MEASURES: Vowel recognition, consonant recognition, sentences in quiet (74, 64, and 54 dB SPL [sound pressure level]) and in noise (+10 and +5 dB SNR [signal-to-noise ratio]), voice discrimination, and melody recognition. RESULTS: Group differences in performance were significant in 4 conditions: vowel identification, difficult sentence material at +5 dB and +10 dB SNR, and a measure that quantified performance in noise and low input levels relative to performance in quiet. CONCLUSIONS: We have identified tasks on which there are between-group differences in performance for subjects matched on CNC word scores in quiet. We suspect that the differences in performance are due to differences in signal processing. Our next goal is to uncover the signal processing attributes of the speech processors that are responsible for the differences in performance.

Adult↗

PubMed2004

Speech understanding by cochlear-implant patients with different left- and right-ear electrode arrays.

Electrode-pitch rankings and monaural and binaural speech perception scores were obtained from two patients fit with a Med El CIS-Link processor and Ineraid electrode array in one ear and a Clarion processor and Hi-Focus electrode array in the other ear. The results of the electrode-ranking task indicated that current from the Hi-Focus electrodes extended more apically than current from the Ineraid array, i.e., the two most apical Hi-Focus electrodes were ranked lower in pitch than the most apical Ineraid electrode. Because of this and because of the different number of active electrodes in the two arrays, it is likely that the two cochleae presented different representations of the same signal to more central stages of information processing. In spite of this, both patients achieved better scores when both implants were activated than when the implants were activated one at a time.

Adult↗

PubMed2003

Adaptation by a cochlear-implant patient to upward shifts in the frequency representation of speech.

The purpose of this project was to assess the degree to which a patient, after 1 wk of experience, could adapt to 3.2-mm and 6.8-mm basal shifts in the representation of speech. Only small deficits in performance were found after practice after the 3.2-mm shift. After practice after the 6.9-mm shift, scores on tests that emphasized amplitude envelope cues returned to baseline levels. Scores on vowel and sentence tests that emphasized frequency-based cues remained poor. Scores for "place," however, showed some recovery. Vowel recognition may be the limiting factor in recognizing basally shifted speech.

Adaptation, Physiological↗

PubMed2003

A phone-assistive device based on Bluetooth technology for cochlear implant users.

Hearing-impaired people, and particularly hearing-aid and cochlear-implant users, often have difficulty communicating over the telephone. The intelligibility of telephone speech is considerably lower than the intelligibility of face-to-face speech. This is partly because of lack of visual cues, limited telephone bandwidth, and background noise. In addition, cellphones may cause interference with the hearing aid or cochlear implant. To address these problems that hearing-impaired people experience with telephones, this paper proposes a wireless phone adapter that can be used to route the audio signal directly to the hearing aid or cochlear implant processor. This adapter is based on Bluetooth technology. The favorable features of this new wireless technology make the adapter superior to traditional assistive listening devices. A hardware prototype was built and software programs were written to implement the headset profile in the Bluetooth specification. Three cochlear implant users were tested with the proposed phone-adapter and reported good speech quality.

Cochlear Implants↗

PubMed2003

Dichotic speech recognition in noise using reduced spectral cues.

It is generally accepted that the fusion of two speech signals presented dichotically is affected by the relative onset time. This study investigated the hypothesis that spectral resolution might be an additional factor influencing spectral fusion when the spectral information is split and presented dichotically to the two ears. To produce speech with varying degrees of spectral resolution, speech materials embedded in +5 dB S/N speech-shaped noise were processed through 6-12 channels and synthesized as a sum of sine waves. Two different methods of splitting the spectral information were investigated. In the first method, the odd-index channels were presented to one ear and the even-index channels to the other ear. In the second method the lower frequency channels were presented to one ear and the high-frequency channels to the other ear. Results indicated that spectral resolution did affect spectral fusion, and the effect differed across speech materials, with the sentences being affected the most. Sentences, processed through six or eight channels and presented dichotically in the low-high frequency condition were not fused as accurately as when presented monaurally. Sentences presented dichotically in the odd-even frequency condition were identified more accurately than when presented in the low-high condition.

Acoustic Stimulation↗

PubMed2002

Rapid development of cortical auditory evoked potentials after early cochlear implantation.

The aim of our research was to estimate the time course of development and plasticity of the human central auditory pathways following cochlear implantation. We recorded cortical auditory-evoked potentials in 3-year-old congenitally deaf children after they were fitted with cochlear implants. Immediately after implantation cortical response latencies resembled those of normal-hearing newborns. Over the next few months, the cortical evoked responses showed rapid changes in morphology and latency that resulted in age-appropriate latencies by 8 months after implantation. Overall, the development of cortical response latencies for the implanted children was more rapid than for their normal-hearing age-matched peers. Our results demonstrate a high degree of central auditory system plasticity during early human development.

Analysis of Variance↗

PubMed2002

Factors that allow a high level of speech understanding by patients fit with cochlear implants.

Three factors account for the high level of speech understanding in quiet enjoyed by many patients fit with cochlear implants. First, some information about speech exists in the time/amplitude envelope of speech. This information is sufficient to narrow the number of word candidates for a given signal. Second, if information from the envelope of speech is available to listeners, then only minimal information from the frequency domain is necessary for high levels of speech recognition in quiet. Third, perceiving strategies for speech are inherently flexible in terms of the mapping between signal frequencies (i.e., the locations of the formants) and phonetic identity.

Cochlear Implantation↗

PubMed2002

A comparison of the speech understanding provided by acoustic models of fixed-channel and channel-picking signal processors for cochlear implants.

Vowels, consonants, and sentences were processed by two cochlear-implant signal-processing strategies-a fixed-channel strategy and a channel-picking strategy-and the resulting signals were presented to listeners with normal hearing for identification. At issue was the number of channels of stimulation needed in each strategy to achieve an equivalent level of speech recognition in quiet and in noise. In quiet, 8 fixed channels allowed a performance maximum for the most difficult stimulus material. A similar level of performance was reached with a 6-of-20 channel-picking strategy. In noise, 10 fixed channels allowed a performance maximum for the most difficult stimulus material. A similar level of performance was reached with a 9-of-20 strategy. Both strategies are capable of providing a very high level of speech recognition. Choosing between the two strategies may, ultimately, depend on issues that are independent of speech recognition-such as ease of device programming.

Acoustic Stimulation↗

PubMed2002

A sensitive period for the development of the central auditory system in children with cochlear implants: implications for age of implantation.

OBJECTIVE: The aim of the present experiment was to assess the consequences of cochlear implantation at different ages on the development of the human central auditory system. DESIGN: Our measure of the maturity of central auditory pathways was the latency of the P1 cortical auditory evoked potential. Because P1 latencies vary as a function of chronological age, they can be used to infer the maturational status of auditory pathways in congenitally deafened children who regain hearing after being fit with a cochlear implant. We examined the development of P1 response latencies in 104 congenitally deaf children who had been fit with cochlear implants at ages ranging from 1.3 yr to 17.5 yr and three congenitally deaf adults. The independent variable was the duration of deafness before cochlear implantation. The dependent variable was the latency of the P1 cortical auditory evoked potential. RESULTS: A comparison of P1 latencies in implanted children with those of age-matched normal-hearing peers revealed that implanted children with the longest period of auditory deprivation before implantation-7 or more yr-had abnormal cortical response latencies to speech. Implanted children with the shortest period of auditory deprivation-approximately 3.5 yr or less-evidenced age-appropriate latency responses within 6 mo after the onset of electrical stimulation. CONCLUSIONS: Our data suggest that in the absence of normal stimulation there is a sensitive period of about 3.5 yr during which the human central auditory system remains maximally plastic. Plasticity remains in some, but not all children until approximately age 7. After age 7, plasticity is greatly reduced. These data may be relevant to the issue of when best to place a cochlear implant in a congenitally deaf child.

Adolescent↗