Comparison of Multipole Stimulus Configurations With Respect to Loudness and Spread of Excitation.

Objective: Current spread is a substantial limitation of speech coding strategies in cochlear implants. Multipoles have the potential to reduce current spread and thus generate more discriminable pitch percepts. The difficulty with multipoles is reaching sufficient loudness. The primary goal was to compare the loudness characteristics and spread of excitation (SOE) of three types of phased array stimulation, a novel multipole, with three more conventional configurations. Design: Fifteen postlingually deafened cochlear implant users performed psychophysical experiments addressing SOE, loudness scaling, loudness threshold, loudness balancing, and loudness discrimination. Partial tripolar stimulation (pTP, [sigma] = 0.75), TP, phased array with 16 (PA16) electrodes, and restricted phased array with five (PA5) and three (PA3) electrodes was compared with a reference monopolar stimulus. Results: Despite a similar loudness growth function, there were considerable differences in current expenditure. The most energy efficient multipole was the pTP, followed by PA16 and PA5/PA3. TP clearly stood out as the least efficient one. Although the electric dynamic range was larger with multipolar configurations, the number of discriminable steps in loudness was not significantly increased. The SOE experiment could not demonstrate any difference between the stimulation strategies. Conclusions: The loudness characteristics all five multipolar configurations tested are similar. Because of their higher energy efficiency, pTP and PA16 are the most favorable candidates for future testing in clinical speech coding strategies. Copyright (C) 2017 Wolters Kluwer Health, Inc. All rights reserved.

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