Neurophysiological effects of simulated auditory prosthesis stimulation

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Neurophysiological effects of simulated auditory prosthesis stimulation 2 th Quarterly Progress Report Neural Prosthesis Program Contract N0-DC-9-207 (no-cost extension period) April 2003 C.A. Miller, S. Nagase, K. Nourski, P.J. Abbas, B.K. Robinson Department of Otolaryngology-Head and Neck Surgery & Department of Speech Pathology and Audiology University of Iowa Iowa City, Iowa, USA File: N0-DC-9-207QPR2.PDF

Effects of Remaining Hair Cells on Cochlear Implant Function N0-DC-9-207QPR2 Neural Prosthesis Program TABLE OF CONTENTS I. Introduction... 3 II. Summary of activities... 3 III. Focus topic: Effect of recording electrode position on the electrically evoked compound action potential... 3 VI. References... 0

N0-DC-9-207QPR2 Neurophysiological effects 3 I. Introduction The purpose of contract N0-DC-9-207 was to explore issues involving the transfer of information from implantable auditory prostheses to the central nervous system. While the contract period has expired, we are continuing investigations in some areas that were begun during the contract period and we deemed of significant interest for follow-up work. This activity is being conducted as a no-cost extension of the contract. Areas of investigation will include: Evaluation of University of Michigan thin-film recording electrode arrays for auditory-nerve studies. Investigation of auditory-nerve adaptation phenomena related to repetitive electrical stimulation. Investigation of the effects of recording electrode position, which is the focus of this report. II. Summary of activities During this reporting period (concluding March 3, 2003) of our no-cost extension to Contract N0-DC-9-207, we have continued the following activities:. In February 2003, we received a new set of Michigan thin-film electrodes. This new set features the three-shank, 6-contact design that has been used before in our nerve-trunk recordings, but features smaller electrode surface areas. Specifically, the 625 µm 2 electrode sites have been replaced with sites with an area of 33 µm 2, which is the smallest that can be fabricated by the Michigan group. It is our hope that smaller pad sites may translate to improved spatial selectivity, which has been a significant limitation for the application of this approach for field-potential recordings (see Final Report for contract N0-DC-9-207). Future experiments will perform frequency-selectivity assessments as well as conduction-velocity measures, which are facilitated by the three-shank design. 2. We have continued investigations of the ECAP adaptation and recovery properties, specifically examining the recovery of ECAP amplitude after pulse train stimulation. Some of our results were presented at the ARO Midwinter Meeting in February 2003 (Abstract # 775). 3. We have conducted a series of preliminary experiments designed to assess the effects of recording electrode position on the electrically evoked compound action potentials acquired from feline subjects. Results were reported at the ARO Midwinter Meeting in February 2003 (Abstract #765) and more information is provided on this topic in the following section.

N0-DC-9-207QPR2 Neurophysiological effects 4 III. Focus topic: Effect of recording electrode position on the electrically evoked compound action potential A. Introduction The electrically evoked compound action potential (ECAP) is routinely recorded from both human implant users (equipped with NRT or NRI systems) and experimental animal subjects. In the case of humans, the ECAP is recorded using the implant s intracochlear electrodes (e.g., Wilson et al., 994; Abbas et al., 999). In contrast, animal studies (Stypulkowski & van den Honert, 984; Killian et al., 994; Miller et al., 998; Haenggeli et al., 998) typically record from extracochlear or nerve-trunk sites. It is possible, however, to use the animal preparations to record intracochlear ECAPs as well, thus providing a means of linking animal and human ECAP findings. Furthermore, Finley et al. (997) reported intracochlear ECAPs from implantees that demonstrated different sensitivities and rates of growth for different intracochlear recording electrodes. This suggested the possibility of using ECAPs from multiple electrode sites to map the base-to-apical extent of neural survival or extent of neural activation. However, interpretation of these intracochlear ECAPs is complicated by unknown degrees of neural survival and poorly understood intracochlear current spread. While animal models provide control over neural survival patterns, the issues of current spread and site-of-excitation remain. We have begun work on this issue by using acute cat preparations to record the ECAP from multiple intracochlear and nerve-trunk recording sites to help interpret the neural contributions to the ECAP. Furthermore, our standard animal ECAP recordings have used electrodes placed on or near the nerve trunk. This placement provides advantageous signal-to-noise conditions, as the stimulus artifact is greatly reduced relative to the intracochlear recordings. For example, we have been able to record animal ECAPs with little or no need for signal averaging, a significant advantage in our recent efforts to characterize adaptation phenomena (see QPR #8). However, it is plausible that the nerve-trunk placement results in some degree of spatial attenuation that is not constant across the population of excited fibers. Knowledge of the extent and nature of this distortion would help us better interpret ECAPs collected in this manner. To address these two areas, we have begun a series of experiments examining the effect of recording electrode placement by varying both the intracochlear electrode location and the extracochlear (nerve-trunk) electrode location. The first two cat experiments conducted (in the fall of 2002) established the need to use the forward-masking method of stimulus-artifact reduction (Abbas et al., 999), as our other method (use of a sub-threshold template ) failed to adequately control stimulus artifacts in the case of intracochlear electrodes. Since then, we have recorded both intra- and extra-cochlear ECAPs from three cats. Data from these cats forming a preliminary understanding are presented here. In analyzing intracochlear ECAPS, we tested two variations of a hypothesis that considers the effect of distance between the neural generators and the recording electrode: () All intracochlear recording electrodes are sufficiently distant from neural generators that the resultant ECAP growth functions will differ by simple constants. (2) Distance effects are not negligible. ECAP growth functions of electrodes closest to the neural generators will show relatively larger potentials for low-level stimuli. Our approach considered a two-part problem: First, we compared the intracochlear ECAP growth functions against that obtained using a nerve-trunk recording electrode -- our standard recording site for animal work. We then examined how nerve-to-electrode distance influences ECAP functions obtained by electrodes positioned over and on the nerve trunk.

N0-DC-9-207QPR2 Neurophysiological effects 5 B. Methods Three adult cats were used in acute experimental sessions. Subjects were deafened by intracochlear infusions of neomycin sulfate (60 ul, 0% w/v) prior to insertion of a Nucleus 8-band electrode array through the round window. Insertion depth was 5-5.5 mm from the round window. The auditory nerve trunk was exposed by a posterior fossa approach and medialization of the overlying cerebellum. Multiple recording electrodes were placed on and dorsal to the nerve trunk to provide recording sites at several distances from the nerve s surface. In one case, a multiple-ball stalk was used; in the remaining two cases, we used a second Nucleus electrode, coupled with a single-ball electrode, to provide the multiple sites. This set-up is schematized in Figure. Stimuli were single 40 µs monophasic pulses presented at a low rate (33 pps) to either a bipolar intracochlear pair I-I2 or a monopolar electrode (I to neck muscle). ECAPs were recorded from either the intracochlear array (electrodes I3 I8) or one of the nine electrodes (N-N9) positioned near the exposed nerve trunk. A gain of either x or 0x was used. Two techniques were used to reduce stimulus artifact: a subthreshold template subtraction technique or a forward-masking subtraction technique. In most instances, the forward-masking technique was needed to acquire the intracochlear ECAPs. N9 Figure Stimulation and ECAP recording scheme. ECAPs could be recorded from either the intracochlear array or the array positioned dorsal to the nerve trunk. The figure depicts bipolar stimulation (electrodes I-I2) and recording from intracochlear electrode I3. I8 I Round window I8 Filtering & ADC I N2 N Auditory nerve trunk C. Results Part : Intracochlear recordings obtained with bipolar stimulation Figure 2 shows examples of ECAPs evoked by bipolar stimulation (electrodes I-I2). The left column shows ECAPs recorded by intracochlear electrode I5, while the right column shows ECAPs from nerve-trunk electrode N. The nerve-trunk waveforms are raw traces. The intracochlear waveforms, which suffer more from stimulus artifact, were processed using the template-subtraction method. In both data sets, a level-dependent shift in ECAP latency is evident, although the low-level, long-latency responses from the nerve-trunk electrode are rather small. We ascribe these jumps to shorter-latency responses as shifts in the site of action-potential initiation along the length of individual fibers (Miller et al., 998: Miller et al., 2003).

N0-DC-9-207QPR2 Neurophysiological effects 6 Figure 2 ECAPs recorded from intracochlear electrode I5 (left column) and electrode Npositioned on the nerve (right column). The block arrows indicate the latency of the negative ECAP peak obtained at relatively low stimulus levels. The prominent negative peak shifts to shorter latencies at the higher stimulus levels. 200 uv Intracochlear Recording (Electrode I5) C98, Ser 0, Stim -2 8.6 db 7.4 6.2 4.9 3.3. -0. -3. -5.2-7.6 -. Nerve-trunk Recording C98, Ser 5, Stim -2 00 uv 0.2 0.4 0.6 0.8.0.2.4 0.2 0.4 0.6 0.8.0.2.4 Time after stimulus onset (ms) The level-dependence of these ECAPs are shown in the plots of Figure 3, in which graph A plots the latency of the negative peak and graph B plots ECAP amplitude (measured from the prominent negative potential to the following positive peak). Latencies of the late, low-level negative peak are plotted using dotted lines, while solid lines delineate the earlier negative peak that occurs at higher levels. The fact that the intracochlear ECAP latencies are shorter than the nerve-trunk latencies suggests that the intracochlear ECAPs arise from generators that are more peripheral than the location of the nerve-trunk recording electrode. Across-electrode comparisons are facilitated by normalizing the amplitude data. In the plots of graph C, the three intracochlear plots are normalized to the ECAP amplitudes obtained by the nerve-trunk electrode. Compared to the nerve-trunk amplitudes, the low-level, long-latency component recorded by the intracochlear electrodes is relatively large, whereas the shorter-latency component is not as large as that recorded by the intracochlear electrodes. Also, the relative amplitudes of the low-level component are Figure 3 Left column: Latency-vslevel functions (A) and amplitude growth functions (B) for 3 intracochlear electrodes and nerve-trunk electrode. Stimulation mode was again bipolar (I-I2). Dotted plots - describe the long-latency ECAP observed at low stimulus levels while plots using solid lines describe the short-latency ECAP response. Right column: Amplitude-vslevel functions normalized in two different ways. In (C), amplitudes are normalized to those obtained with the nervetrunk electrode. In (D), amplitudes are normalized to the amplitude obtained at a high stimulus level (3.4 ma) for each plot. ECAP latency (ms) ECAP amplitude (uv) Recording electrode 0.6 Nerve trunk Intracoch. 3 0.5 Intracoch. 5 Intracoch. 7 0.4 0.3 0.2 0 00 000 A B 0 2 3 4 0 2 3 4 Stimulus level (ma) C D Sub C98, Series 0 & 5 0 0. 0.0 ECAP amplitude (normalized to nerve-trunk data) ECAP amplitude (normalized to high-level response)

N0-DC-9-207QPR2 Neurophysiological effects 7 dependent upon the particular intracochlear electrode. Note that the electrode closest to the stimulating pair (i.e., I3) provides the strongest representation of this ECAP component. These trends are perhaps seen more explicitly in the normalized plots of graph D. Note, in particular, how the relative strength of the ECAP recorded by the nerve-trunk electrode varies with level. We presume this trend relates to changes in the sites of neural excitation with level. We have also noted other ECAP latency-vs-level patterns that vary from those shown in the previous case. Figure 4 shows latency-level plots for a second animal stimulated in the same manner as before (i.e., I-I2 bipolar stimulation) which vary in multiple ways. First, there are no discrete shifts to shorter latencies with increasing level. Second, the intracochlear electrode closest to the stimulating pair (I3, squares) recorded unusually long N latencies. The ECAP amplitudes of this animal exhibit some similarities and differences relative to those of the first subject. Again, electrode I3 produced the largest ECAP amplitudes, but only at relatively low stimulus levels. We do not know what underlies these across-subject differences, but note that small differences in electrode position can result in large changes in fiber recruitment (e.g., Shepherd et al., 993; Miller et al., 993). Although we have observed such variations, we also see a consistent trend of relatively large ECAP amplitudes recorded by intracochlear electrode I3 at low stimulus levels. This is shown for all 3 animals in Figure 5, which plots the normalized ECAP growth functions from three subjects. We speculate that this greater representation by electrode I3 is due to its relative proximity to the subset of fibers excited by the bipolar stimulating pair at those low levels. As fiber recruitment increases at higher levels, this electrode advantage disappears. 0.5 Figure 4 ECAP input-output functions from a second subject with somewhat different level- and electrode dependent trends. N latency (ms) 0.4 0.3 0.2 2 3 4 5 ECAP amplitude (mv) 0. 0.0 Nerve trunk Intracoch. 3 Intracoch. 5 Intracoch. 7 Nerve trunk 2 3 4 5 Stimulus level (ma)

N0-DC-9-207QPR2 Neurophysiological effects 8 0 Recording Electrode I3 I4 I5 I7 Normalized ECAP amplitude 0 Subject C98 0 2 3 4 0. Subject D04 2 3 4 5 Stimulus level (ma) Subject D05 2 3 4 5 Figure 5 Normalized ECAP growth functions from 3 subjects for different intra-cochlear recording electrodes. In all cases, stimuli were presented to intra-cochlear electrodes I and I2. Amplitudes recorded from the other electrodes have been normalized to those obtained from the nerve-trunk electrode (N) Part 2: Intracochlear recordings obtained with monopolar stimulation Given the differences between the way monopolar and bipolar stimulation recruit fibers of the auditory nerve (van den Honert & Stypulkowski, 987; Miller et al., 2003), we hypothesized that monopolar stimulation will produce different patterns than those seen in Figure 5, namely, fewer differences among the intracochlear curves and less dependence upon stimulus level. We have just begun to examine this issue using intracochlear electrode I for monopolar stimulation. We have found it necessary to use the forwardmasking technique to obtain usable ECAP waveforms under this stimulation condition, as stimulus artifacts are much larger. Figure 6 compares the normalized intracochlear ECAP functions obtained with bipolar (left panel) and monopolar (right panel) stimulation. Note that, relative to the bipolar curves, the plots obtained with monopolar stimulation show less systematic variation across electrodes and, particularly at the low stimulus levels where bipolar effects were observed. Bipolar stimulation Monopolar stimulation Figure 6 Normalized ECAP growth functions for 3 intracochlear electrodes for both bipolar stimulation (left panel) and monopolar stimulation (right panel). p 0 0 Recording Electrode I3 I4 I5 I7 2 3 4 5 0.4 0.6 0.8.0.2 Stimulus level (ma)

N0-DC-9-207QPR2 Neurophysiological effects 9 Part 3: Effect of electrode position on the nerve-trunk recordings The above examination of intracochlear electrode recordings was based upon comparisons relative to ECAPs recorded using an electrode positioned directly on the surgically exposed nerve trunk. It is reasonable to assume that such a position will produce a distance-weighted representation of the excited neural population, as the fiber-to-electrode distance varies substantially across the nerve population. To date, we have examined this in one subject using the combination of nerve-trunk electrodes shown in Figure. This consisted of a ball electrode positioned directly above the nerve trunk and a dorsally oriented 8-band array. ECAP growth functions obtained from the four electrodes closest to the nerve trunk are shown in the upper graph of Figure 7. Stimuli were presented through bipolar pair I-I2. The resultant ECAP growth functions are shown in Figure 6. ECAP amplitudes are predictably smaller for the more distant electrode sites. Note that the functions from electrodes N3 and N4 are quite similar. By normalizing the functions of N, N2, and N3 by the N4 data, we can arrive at estimates of how electrode distance results in weighted functions (lower graph). Two observations can be made from these normalized functions. First, the degree of distortion increases as electrode-to-nerve distance decreases. Second, the low-level responses have the greatest weight. These patterns may arise from the fact that, at low stimulus levels, our bipolar stimulation likely excites a basal locus of fibers that are located toward the edge of the nerve trunk s cross section. Figure 7 Upper panel: ECAP growth functions obtained from four recording electrode positions on or near the surgically exposed auditory nerve trunk. Lower panel: Growth functions of electrodes N, N2, and N3 normalized to the amplitudes obtained using electrode N4. Stimulation mode was bipolar, through electrodes I and I2. ECAP amplitude (uv) ECAP amplitude (normalized to N4 amplitudes) 300 250 200 50 00 50 0 0 8 6 4 2 N N2 N3 N4 0 2 3 4 5 Stimulus level (ma)

N0-DC-9-207QPR2 Neurophysiological effects 0 D. Comments The results presented here are preliminary and part of an ongoing investigation. We observed significant across-subject variations that require further scrutiny; however, some trends are evident. The data suggest that intracochlear electrodes can indeed record spatially restricted neural activity. Furthermore, the patterns of normalized recruitment are consistent with the generally accepted notions of restricted excitation with bipolar intracochlear stimulation and wide excitation with monopolar stimulation. Our comparisons of ECAP recordings from electrode positions on and near the nerve trunk indicate the need to account for spatially weighted neural responses, at least when attempting to use the ECAP in a quantitative way to assess fiber recruitment. Finally, although the weighting of intracochlear ECAPs consistently shows spatially restricted measures (Figure 4), analysis of latency patterns suggests that fiber recruitment is strongly affected by the position of the electrode array within the cross-section of the scala tympani. Not only are these results relevant to research with animal models, but also suggest that the choice of the intracochlear electrode used to record human ECAPs (with NRT and NRI systems) may affect results. Specifically, by choosing a recording electrode close to the stimulating electrode(s), one might obtain ECAPs weighted toward a local subpopulation. In contrast, use of a more distant electrode may be the appropriate choice for more global ECAP measures. VI. References Abbas PJ, Brown CJ, Shallop JK, Firszt JB, Hughes ML, Hong SH, Staller SJ 999. Summary of results using the nucleus CI24M implant to record the electrically evoked compound action potential. Ear Hear 20, 45-59.. Finley CC, Wilson BA, van den Honert C 997. Fields and EP responses to electrical stimuli: spatial distributions, electrode interactions and regional differences along the tonotopic axis, 997 Conference on Implantable Auditory Prostheses, Pacific Grove, CA. pp. 32. Haenggeli A, Zhang JS, Vischer MW, Pelizzone M, Rouiller EM 998. Electrically evoked compound action potential (ECAP) of the cochlear nerve in response to pulsatile electrical stimulation of the cochlea in the rat: effects of stimulation at high rates. Audiology 37, 353-7. Killian MJ, Klis SF, Smoorenburg GF 994. Adaptation in the compound action potential response of the guinea pig VIIIth nerve to electric stimulation. Hear Res 8, 66-82. Miller CA, Abbas PJ, Brown CJ 993. Electrically evoked auditory brainstem response to stimulation of different sites in the cochlea. Hear Res 66, 30-42. Miller CA, Abbas PJ, Rubinstein JT, Robinson BK, Matsuoka AJ, Woodworth G 998. Electrically evoked compound action potentials of guinea pig and cat: responses to monopolar, monophasic stimulation. Hear Res 9, 42-54. Miller CA, Abbas PJ, Nourski KV, Hu N, Robinson BK 2003. Electrode configuration influences action potential initiation site and ensemble stochastic response properties. Hear Res 75, 200-24. Shepherd RK, Hatsushika S, Clark GM 993. Electrical stimulation of the auditory nerve: the effect of electrode position on neural excitation. Hear Res 66, 08-20. Stypulkowski PH, van den Honert C 984. Physiological properties of the electrically stimulated auditory nerve. I. Compound action potential recordings. Hear Res 4, 205-23. van den Honert C, Stypulkowski PH (987) Single fiber mapping of spatial excitation patterns in the electrically stimulated auditory nerve. Hear Res 29: 95-206. Wilson BS, Finley CC, Zerbi M, Lawson DT 994. Speech Processors for Auditory Prostheses. Seventh Quarterly Progress Report. NIH Contract N0-DC-2-240 N0-DC-2-240, QPR #7.