A smart cochlear implant electode array
August 23rd, 2008I haven’t been posting a lot of neuroscience content lately, despite my aim to steer this blog in that direction. After spending 10 hours a day on neuroscience, writing about it isn’t usually the first thing that comes to mind upon returning home. But I’m going to try! And I’m going to cheat by writing about things that happen to be in my field.
So, without further ado: When hearing loss is caused by some fault of the machinery that converts sound energy into neural impulses within the cochlea, a spiral shaped structure within the inner ear, a cochlear implant (CI) is usually the only option in restoring hearing. It works by electrically activating remaining neurons, using an electrode array placed in the scala tympani, one of three fluid filled chambers of the cochlea (the coiled structure, below).

Now, the cochlea has what is known as a frequency-place code. Different regions of the cochlea are tuned to particular frequencies, with high frequency sounds down at the base, and low frequency sounds at the tip. So, by stimulating different regions, you can create the perception of different pitches. A CI, in essence, pulls out the dominant frequencies of the received auditory signal, and stimulates the corresponding region of the cochlea. In the very best patients, this gives near perfect speech perception — which is a fascinating phenomenon given how much information is stripped out by the CI.
There are a few limitations of the CI that researchers are trying to address. The most oft-stated are poor speech recognition in noisy environments (such as a busy restaurant), and poor music perception. It’s suggested that if you can deliver more detailed pitch information, it will allow the brain to filter out some noise, or recognize complex melodies.
Given what I’ve just said, you might imagine that if you can stimulate more regions of the cochlea, you can represent more pitches. Unfortunately, this is a difficult proposition. Unlike the normal mechanical fine tuning of the cochlea, the electrical stimulation from a CI spreads over a broad area, activating neurons that represent a range of frequencies. If you put electrodes too close together, there will be so much overlap in the groups of activated neurons that the brain won’t be able to tell the difference. In the case of speech perception, it’s been found that stimulating anything more than about eight electrodes yields no improvement (a typical human CI has about 22 electrodes to choose from).
Part of the problem is that the electrode array lies in the fluid of the scala tympani, often with a layers of protein and cell encapsulation, at some distance from the neurons it’s trying to stimulate. Therefore, you’re unlikely to get greater frequency selectivity with increased numbers of electrodes, unless you can somehow get the electrodes nice and close to those neurons.
There’s been a couple of approaches on that one. The first is trying to skewer the cochlea with an electrode array right down the middle of the cochlea, in the auditory nerve itself. Two problems with this are that it is (a) invasive, and (b) now difficult to determine which neurons correspond to which frequencies. But you do get lower thresholds (i.e. less power is required, which is very exciting to engineers like myself), and access to a broader frequency range (current clinical electrode arrays can’t reach the upper turns of the cochlea). Middlebrooks & Snyder (2008) recently provided a review of this approach. Another approach has been to insert an electrode array into the scala tympani, but get it to hug the wall against the modiolus, as close as possible to the neurons (there are also efforts afoot to get the neurons to grow onto the electrode array, but that’s another story).
The latter has been in clinical use for a while, but a clear benefit to auditory performance has yet to fully emerge, suggesting it isn’t the silver bullet some were hoping for. The means by which the curved electrode array is inserted is clever, but by no means advanced. During surgery, a stylette sits inside the electrode array, keeping it straight. As the array is inserted into the cochlea, the stylette is incrementally removed, allowing the tip to curl around the cochlea, eventually hugging the wall of the modiolus once fully removed. In short, it relies on the skill of the surgeon, knowing where the electrode tip is, and how it is situated. Pull the stylette out too slowly, and the electrode could bang against the wall of the cochlea instead of following the turns of the cochlea. Too quickly, and the tip could wrap back on itself.
I’m overstating the danger a bit; the array design has been optimized to reduce the risk of such hiccups. But wouldn’t it be nice to know where the electrode array is in the cochlea, how it is oriented, and if it is about the crash into something important, rather than just going by feel? That’s what Wise and colleagues (2008) set out to do at The University of Michigan. They built a pre-curved silicon electrode array with sensors along it’s length, and at its tip. Combined with some onboard processing, this permits the shape of the electrode array, and forces exerted upon it, to be monitored during insertion.

Photo showing the smart electrode array, with the inset showing a stimulation electrode (black circle) and position/contact sensors (the orange squiggly things).
The authors hope that this system will eventually be integrated with an automated insertion tool, allowing electrode arrays to be positioned with precision and repeatability. And, being silicon based, more electrode sites can be integrated than clinical (hand-made) electrode arrays, like the Contour. Though, as I’ve mentioned, it’s unclear whether this will provide added benefit to most patients. Lack of cochlear trauma, and preservation of any existing hearing, however, certainly provides benefit. In those with residual hearing, the best outcomes are achieved when a cochlear implant is combined with a hearing aid (usually used for low frequencies, where the electrode array can’t reach) — an approach called bimodal hearing.







