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Auditory-Nerve Responses to Varied Inter-Phase Gap and Phase Duration of the Electric Pulse Stimulus as Predictors for Neuronal Degeneration

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Abstract

After severe hair cell loss, secondary degeneration of spiral ganglion cells (SGCs) is observed—a gradual process that spans years in humans but only takes weeks in guinea pigs. Being the target for cochlear implants (CIs), the physiological state of the SGCs is important for the effectiveness of a CI. For assessment of the nerve’s state, focus has generally been on its response threshold. Our goal was to add a more detailed characterization of SGC functionality. To this end, the electrically evoked compound action potential (eCAP) was recorded in normal-hearing guinea pigs and guinea pigs that were deafened 2 or 6 weeks prior to the experiments. We evaluated changes in eCAP characteristics when the phase duration (PD) and inter-phase gap (IPG) of a biphasic current pulse were varied. We correlated the magnitude of these changes to quantified histological measures of neurodegeneration (SGC packing density and SGC size). The maximum eCAP amplitude, derived from the input–output function, decreased after deafening, and increased with both PD and IPG. The eCAP threshold did not change after deafening, and decreased with increasing PD and IPG. The dynamic range was wider for the 6-weeks-deaf animals than for the other two groups. Excitability increased with IPG (steeper slope of the input–output function and lower stimulation level at the half-maximum eCAP amplitude), but to a lesser extent for the deafened animals than for normal-hearing controls. The latency was shorter for the 6-weeks-deaf animals than for the other two groups. For several of these eCAP characteristics, the effect size of IPG correlated well with histological measures of degeneration, whereas effect size of PD did not. These correlations depend on the use of high current levels, which could limit clinical application. Nevertheless, their potential of these correlations towards assessment of the condition of the auditory nerve may be of great benefit to clinical diagnostics and prognosis in cochlear implant recipients.

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Acknowledgments

The authors would like to thank Ferry Hendriksen for histological processing, René van de Vosse for technical support, and Roland Hessler at MED-EL, Innsbruck, for the electrode arrays. This work was supported by MED-EL GmbH, Innsbruck, Austria.

Conflict of Interest Disclosure Statement

Wilko Grolman received unrestrictive research grants from Cochlear Ltd., MED-EL GmbH, and Advanced Bionics. No competing interests declared by the other authors.

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Authors and Affiliations

  1. Department of Otorhinolaryngology and Head & Neck Surgery, University Medical Center Utrecht, Room G.02.531, P.O. Box 85500, 3508 GA, Utrecht, The Netherlands

    Dyan Ramekers, Huib Versnel, Emma M. Smeets, Sjaak F.L. Klis & Wilko Grolman

  2. Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands

    Dyan Ramekers, Huib Versnel, Sjaak F.L. Klis & Wilko Grolman

  3. Research and Development, MED-EL Medical Electronics, Fürstenweg 77a, 6020, Innsbruck, Austria

    Stefan B. Strahl

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  1. Dyan Ramekers
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  2. Huib Versnel
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  6. Wilko Grolman
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Correspondence to Huib Versnel.

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Ramekers, D., Versnel, H., Strahl, S.B. et al. Auditory-Nerve Responses to Varied Inter-Phase Gap and Phase Duration of the Electric Pulse Stimulus as Predictors for Neuronal Degeneration. JARO 15, 187–202 (2014). https://doi.org/10.1007/s10162-013-0440-x

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  • DOI: https://doi.org/10.1007/s10162-013-0440-x

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