Electrical Stimulation of the Midbrain for Hearing Restoration: Insight into the Functional Organization of the Human Central Auditory System — TEI-tagged view

Lim, Lenarz, Joseph, Battmer, Samii, Samii, Patrick, Lenarz · 2007 · neuroscience · doi:10.1523/jneurosci.3123-07.2007 · full text at the source · TEI xml · tagged edition · index · concepts · authors
Where this record's text came from. faceted 2026-08 by reading the locally held text (html); every evidence string verified as an exact substring of that text before merging. method is tagged system-or-tool-building because the paper's substance is the design, implantation and evaluation of a device; a large part of the reported data is nonetheless human psychophysics (threshold/comfort levels, pitch ranking and scaling, loudness growth, sound localisation, speech tests), so a behavioural-experiment tag would be equally true of the measurements but not of the contribution. The paper is unusual in that its headline finding is partly a negative one — the tonotopic pitch ordering predicted from animal work did not appear — but this is reported as an open question rather than framed as a null result, so claim type stays method. Array placement differed across the three patients by surgical accident rather than design, which the authors treat as a fortunate source of comparison; no explicit statement frames this as a limitation, so it is not listed. 2026-08-13 and 2026-08-14 schema-0.3 passes: every quote verified as an exact substring of the staged text and anchored at merge time; concept terms verified present; every edge endpoint an existing node.
Other fields define these differently the same word, defined another way in another discipline
ICC 4 fields · standard deviation 3 fields · threshold 2 fields
Tags on this paper every tag the record carries, whether or not the words occur in the text below — a number is how many papers in the corpus carry that tag; a tag with no number is unique to this paper
auditory midbrain implant auditory brainstem implant cochlear implant2 inferior colliculus7 ICC6 lateral lemniscus2 cochlear nucleus6 midbrain5 medial superior olive auditory nerve2 electrode array sites array placement tonotopic9 isofrequency4 pitch loudness threshold21 dynamic range4 compliance voltage current level pulse rate temporal resolution sound localization2 contralateral4 ipsilateral6 binaural monaural percept side effects2 paresthesia tinnitus4 NF2 deaf plastic speech perception lip reading vowel2 environmental sounds animal models2 speech tracking guinea pig MRI4 stimulation3 safety4 system-or-tool-building173

Our tag layer for this paper

Cross-disciplinary analysis
content-tags & facets: phenomenon · claim-type · cross-domain-transfer · mechanism · claim-relation · replication-status · limitation — grounded in the full text
phenomenonauditory midbrain implant for hearing restoration— “We recently implanted three patients with the auditory midbrain implant (AMI), and it has proven to be safe with minimal movement over time.”
claim-typemethod— “These limitations have motivated us to develop a new hearing prosthesis that stimulates the midbrain with a penetrating electrode array.”
method — evidence— “We have begun clinical trials in which three NF2 patients have been implanted with the AMI.”
object of study — evidence— “The goal of this study has been (1) to demonstrate the safety and evaluate the efficacy of the AMI for hearing restoration and (2) to better understand the functional organization of the human central auditory system, which will help us improve future AMI designs and stimulation strategies. We will discuss findings associated with level…
research question — evidence— “One motivation for selecting the IC as a target site for an auditory prosthesis is the well defined tonotopic organization of its central nucleus. This has been shown extensively in animal models ( Schreiner and Langner, 1997 ; Oliver, 2005 ), and, because of the similarities in the anatomical structure of the IC across mammalian species (…
contribution — evidence— “We recently implanted three patients with the auditory midbrain implant (AMI), and it has proven to be safe with minimal movement over time. The AMI provides loudness, pitch, temporal, and directional cues, features that have shown to be important for speech perception and more complex sound processing. Thus far, all three patients obtain…
transferfrom guinea pig and cat auditory physiology: the tonotopic laminar organisation of the central nucleus, imported as the design principle for a human electrode array— “Our intention was to insert the array 45° off the sagittal plane perpendicular to the IC surface and into the ICC to position the sites within different anatomical layers ( Geniec and Morest, 1971 ), which supposedly correspond to different frequency laminas based on animal studies”transfers[0]
transferfrom cochlear implant engineering: pulse rates and pulse widths fixed at the point where greater total charge stopped lowering thresholds and shorter pulse widths and slower pulse rates raised them— “Briefly, 250 pps was high enough to avoid noticeable rate pitch effects (i.e., increasing rates up to 2400 pps did not noticeably increase the pitch from that at 250 pps) and the lowest rate available for daily stimulation to minimize adaptive effects. These parameters also achieved the largest drop in thresholds in which using longer pulse…transfers[1]
transferfrom human anatomical collections: fixed and stained midbrain sections, used as the reference against which each patient's fused scan is read— “For identification of the array location within different midbrain structures, 1 mm slices of the fused images were compared with fixed human brain slices of similar dimension that were taken from the anatomical brain collection at the Department of Neuroanatomy in Hannover Medical University ( Kretschmann and Weinrich, 1992 ). The alignment…transfers[2]
transferfrom psychophysics: the patient scales the perceived pitch of each stimulated site on an environmental scale, selecting the environmental sound that most resembles it— “Each site was electrically stimulated with a 3-s-duration pulse train at C level, and the patient was asked to scale the perceived pitch based on our environmental scale (0–5) presented in Figure 5 . The patients were instructed to select an environmental sound on our pitch scale that most resembled the pitch level of the perceived…transfers[3]
mechanismSustained stimulation rates and patterns overdrive adaptation-prone neurons in the dorsal IC, raising the current needed over time— “One hypothesis is that the stimulation rates and patterns are overdriving the neurons located within the dorsal IC region”mechanisms[0]
mechanismNeurons higher in the auditory pathway lose the ability to phase-lock, and that loss of temporal synchronization is traded for a spatial, spike-rate-based code of temporal features, which is why the midbrain follows lower rates than the fibre pathway below it— “This degradation in temporal synchronization is hypothesized to be compensated for by spatial coding (based on spike rate) of temporal features”mechanisms[1]
mechanismIpsilaterally and contralaterally driven brainstem projections stay segregated as they ascend into the IC, so which region the array sits in determines the perceived direction of the sound— “AMI-2 and AMI-3 obtained all ipsilateral and contralateral percepts, respectively, suggesting some segregation of ipsilateral and contralateral pathways ascending into and within the IC.”mechanisms[2]
mechanismThe ipsilaterally excited fibre population is dominated by low-frequency-tuned neurons, so stimulating it yields low-pitch percepts— “Most of the ipsilaterally excited pathways consist of neurons sensitive to low-frequency sounds, which would explain the dominance of low pitches perceived by AMI-2.”mechanisms[3]
mechanismAn array lying outside the IC acts as a surface electrode, so current must travel further to reach neurons and activation levels rise— “The array in AMI-2 is placed outside of the IC (ventral to the dorsal nucleus of the lateral lemniscus) similar to a surface array and likely requires higher current levels to activate neurons farther away.”mechanisms[4]
mechanismthe central nucleus is chosen because it receives almost all ascending brainstem pathways, so it should give access to a more complete set of inputs than the cochlea or cochlear nucleus— “Our animal studies ( Lim and Anderson, 2003 , 2006 ; Lenarz et al., 2006a ) have shown that the inferior colliculus (IC), particularly its central nucleus (ICC), has potential as a new site for an auditory prosthesis. In particular, ICC stimulation achieves lower thresholds, greater dynamic ranges, and more localized, frequency-specific…mechanisms[5]
mechanismthe limited performance of tumour patients with the brainstem implant is attributed to tumour damage in the cochlear nucleus, which is the argument for moving upstream— “Recently, the ABI has been implanted in nontumor patients who would not benefit from CIs (e.g., such as those with nerve avulsion/aplasia and cochlear ossification). Surprisingly, some of these patients achieve performance levels comparable with CI patients, suggesting that the limited performance of NF2 ABI patients may be attributed to some…mechanisms[6]
mechanismsegregated monaural and binaural pathways ascending into the midbrain are proposed to explain why each patient perceived only one direction— “In other words, it is more likely to find neurons excited solely by contralateral sounds in the dorsomedial region of the ICC. This could explain why we observed only contralateral percepts for AMI-3. The findings for AMI-2 further suggest that a segregated group (or at least a predominance) of ipsilaterally excited projections to the IC…mechanisms[7]
mechanismipsilaterally driven pathways carry mostly low frequencies, which is offered as the reason one patient heard only low pitches— “Most of the ipsilaterally excited pathways consist of neurons sensitive to low-frequency sounds, which would explain the dominance of low pitches perceived by AMI-2.”mechanisms[8]
mechanismtemporal synchrony degrades at successive stages of the pathway, so a site below the colliculus should follow faster rates - which is what happened— “Animal studies have shown that auditory nerve fibers can synchronize to high-rate (exceeding 1 kHz) acoustic ( Johnson, 1980 ; Joris and Yin, 1992 ) and cochlear ( Hartmann and Klinke, 1989 ; Shepherd and Javel, 1997 ) stimulation, whereas neurons higher along the auditory pathway are less able to follow high-rate stimulation ( Phillips et…mechanisms[9]
mechanismlong shallow loudness tails are read as a non-homogeneous mix of excitatory and inhibitory neurons along the isofrequency dimension— “It is also interesting that loudness growth functions for AMI-3 ( Fig. 6 C ) exhibited long shallow tails in which a very soft sound was heard over a wide range of stimulus levels relative to the dynamic range that then rapidly elevated in loudness. These findings suggest a nonhomogenous organization of excitatory and inhibitory neurons along…mechanisms[10]
mechanismrising activation levels in one patient are hypothesised to be neurons in the dorsal region being overdriven by the stimulation patternmechanisms[11]
builds-on Lim and Anderson (2003, 2006); Lenarz et al. (2006a) animal studies of inferior colliculus stimulation
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claim_relations[0]
builds-on the authors' own guinea pig work showing lower thresholds and more frequency-specific cortical activation from central nucleus stimulation than from the cochlea
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claim_relations[1]
contradicts the animal-derived prediction that stimulating along the tonotopic gradient would produce ordered pitch percepts
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claim_relations[2]
qualifies its own animal-derived expectation of lower thresholds, since the measured thresholds and dynamic ranges match the cochlear implant rather than beating it
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claim_relations[3]
supports the animal-derived account of segregated monaural and binaural pathways in the central auditory system
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claim_relations[4]
supports the hypothesis that temporal synchronisation degrades at successive stations and is traded for a spatial rate code
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claim_relations[5]
extends the observation that non-tumour brainstem implant patients do far better, which located the problem in tumour damage rather than in the site
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claim_relations[6]
senseTHE PREDICTION THAT JUSTIFIED THE WHOLE TARGET FAILED, AND THE PAPER SAYS SO IN ONE LINE: ordered pitch along the tonotopic gradient was hypothesised from the animal work, and 'However, this has not yet been the case.'
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senses[0]
senseand the failure is not noise - stimulation of all sites in all three patients gave low pitches, and rates up to 2400 pulses per second produced no obvious rise over 250
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senses[1]
sensethe paper then lists four rival explanations as open questions - the stimulus form, plastic loss of high frequency representation after six years of deafness, position along the isofrequency dimension or passing fibres, and species differences - and chooses none
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senses[2]
senseAND REFUSES TO GENERALISE FROM ITS ONE INFORMATIVE PATIENT: with pitch data from a single correctly aligned array, no definitive claim about human midbrain tonotopy is made at all
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senses[3]
senseTHE ACCIDENT IS THE INDEPENDENT VARIABLE: the three arrays landed in three different places, and that unintended variation is what turns a safety trial into a map of the human auditory midbrain
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senses[4]
sensethe intended placement is stated separately from what happened, so the record contains both the plan and the deviation
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senses[5]
senseTHE ADVERSE EVENTS ARE MEASUREMENTS: dizziness and chest sensations, paresthesia in the face and upper body, paresthesia in the thigh and leg - each one locates the deep sites in a different non-auditory structure
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senses[6]
senseand every percept here is a patient's spoken report, obtained while they were asked to ignore a tinnitus that all three had before and after surgery
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senses[7]
senseTHE SAME RESULT SUPPORTS TWO INCOMPATIBLE READINGS AND BOTH ARE KEPT: faster rate following in the patient implanted below the colliculus fits the degradation-along-the-pathway account, or the other two sites simply sit in regions of poor temporal resolution
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senses[8]
senseTHE COMPARISON GROUP IS MATCHED ON THE RATER, NOT JUST THE PROTOCOL: eleven brainstem implant patients tested in the same clinic under the same protocols, by the same speech therapist who tested these three
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senses[9]
controlthe CT scans taken AT LEAST SIX WEEKS after implantation rather than immediately — held — rules out post-surgical distortion of the brain as the apparent electrode position - imaging a freshly operated brain measures the swelling as much as the anatomy
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controls[0]
differs inits own animal-derived expectation of lower thresholds, since the measured thresholds and dynamic ranges match the cochlear implant rather than beating it — THE AXIS IS THE COMPARISON THE PREDICTION IS MEASURED AGAINST. 'AMI sites are in direct contact with surrounding neurons, UNLIKE CI SITES; thus, thresholds should be lower as shown in animal studies. However, AMI thresholds ... are 6-12 nC ..., and dynamic ranges are 7-9 dB, which are similar to those of the CI.' The animal-derived expectation is not refuted in animals; it fails to transfer to the human implant.
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claim_relations[3]
differs inthe observation that non-tumour brainstem implant patients do far better, which located the problem in tumour damage rather than in the site — THE AXIS IS WHETHER THE PATIENT HAD A TUMOUR. 'Recently, the ABI has been implanted in nontumor patients who would not benefit from CIs. Surprisingly, some of these patients achieve performance levels comparable with CI patients, suggesting that the limited per[formance] [in tumour patients has another cause].' The poor outcomes of the original population are reattributed to the tumour rather than to the implant site - so a device evaluated only in tumour patients was being judged on a confound.
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claim_relations[6]
auditpulse rate —distinct-from→ pitch — Audit 2026-09-28: DOUBTFUL - read against its span and kept, but the span asks what stimuli elicit higher pitch than pulse rate alone; distinct-from is loose.
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concept_edges[1]
notepulse rate —distinct-from→ pitch — and the obvious escape route is closed in a parenthesis - rates to 2400 per second gave no obvious rise in pitch over 250
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concept_edges[1]
auditdeaf —causes→ plastic — Audit 2026-09-28: DOUBTFUL - read against its span and kept, but the span is a question about plastic reorganization after deafness.
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concept_edges[5]
notedeaf —causes→ plastic — one of four rival explanations offered as open questions and none of them chosen
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concept_edges[5]
weightdeaf —causes→ plastic — 0.6
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concept_edges[5]
auditcontralateral —distinct-from→ ipsilateral — Audit 2026-09-28: DOUBTFUL - read against its span and kept, but the span reports one directional percept per patient; distinct-from is loose.
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concept_edges[15]
notecontralateral —distinct-from→ ipsilateral — and the percept does not vary across the 1.7 to 1.9 mm the active sites span, which is the argument for segregated ascending pathways
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concept_edges[15]
edgemonaural —distinct-from→ binaural
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concept_edges[16]
auditipsilateral —causes→ pitch — Audit 2026-09-28: DOUBTFUL - read against its span and kept, but the span explains low pitches by ipsilateral low-frequency pathways; causes 'pitch' is terse.
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concept_edges[18]
noteipsilateral —causes→ pitch — and the same anatomy is then used to explain that patient's low pitches, so one placement accounts for two separate anomalies
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concept_edges[18]
weightipsilateral —causes→ pitch — 0.7
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concept_edges[18]
notetemporal resolution —operationalised-as→ pulse rate — THE MEASURE IS A SUBSTITUTE: modulation and gap detection could not be run because the software would not do them, so the rate at which pulses fuse into a continuous sound is used instead
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concept_edges[19]
auditthreshold —operationalised-as→ current level — Audit 2026-09-28: DOUBTFUL - read against its span and kept, but thresholds were measured in current level; operationalised-as is loose.
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concept_edges[23]
notethreshold —operationalised-as→ current level — found by raising the current until a sound is heard and lowering it until it is not, repeated until the patient is consistent
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concept_edges[23]
noteinferior colliculus —contrasted-with→ cochlear nucleus — the target is chosen because nearly all ascending pathways converge there, so it should give access to a more complete set of inputs
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concept_edges[29]
auditmidbrain —contrasted-with→ cochlear nucleus — Audit 2026-09-28: DOUBTFUL - read against its span and kept, but the span contrasts the midbrain implant with the brainstem implant only by implication.
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concept_edges[33]
notemidbrain —contrasted-with→ cochlear nucleus — the new target against the existing one - the whole clinical claim is a comparison with the alternative these patients would otherwise receive
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concept_edges[33]
outcome (stated by the tagger, no quotation)control — heldcontrols[0]
for which uselimitation — any tonotopy claim about the human midbrain: BECAUSE WE ONLY HAVE PITCH DATA FOR ONE PATIENT WHOSE ARRAY IS SUPPOSEDLY ALIGNED ALONG THE TONOTOPIC GRADIENT OF THE ICC, WE CANNOT MAKE ANY DEFINITIVE CLAIMS
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limitations[0]
for which uselimitation — the temporal-resolution results: THE COMMON TESTS ... ARE AMPLITUDE MODULATION DETECTION AND GAP DETECTION, WE COULD NOT PERFORM THESE TESTS WITH OUR SOFTWARE
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limitations[1]
for which uselimitation — the pitch-ordering data: NO RELIABLE PITCH ORDERING RESULTS WERE OBTAINED FOR AMI-1 WHO HAD DIFFICULTIES PERFORMING THESE TESTS - one of three patients
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limitations[2]
duplicate oflimitation — limitations[0]
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limitations[3]
for which uselimitation — the same scope as limitations[0] - one aligned array, no definitive tonotopy claim
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limitations[3]
for which uselimitation — the same scope as limitations[1], with the substitute: INSTEAD, WE STIMULATED A GIVEN SITE WITH CONtinuous trains
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limitations[4]
for which uselimitation — every across-site and across-rate comparison: LOUDNESS BALANCING WAS DIFFICULT TO PERFORM ACROSS THE DIFFERENT SITES AND PULSE RATES ATTRIBUTABLE TO LIMITATIONS IN OUR TESTING SOFTWARE
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limitations[5]
for which uselimitation — every anatomical claim about electrode position: ACCURATE MRI IMAGES OF THE MIDBRAIN COULD NOT BE OBTAINED AFTER AMI IMPLANTATION BECAUSE OF THE DISTORTION CAUSED BY THE ELECTRODE ARRAY
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limitations[6]
for which uselimitation — every percept the patients reported: ALL PATIENTS HAVE TINNITUS, WHICH WAS PRESENT BEFORE AND AFTER SURGERY, and AMI STIMULATION COULD ALTER THEIR TINNITUS
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limitations[7]
for which uselimitation — the stimulation levels reported for that patient: they rose until they reached THE COMPLIANCE VOLTAGE OF THE STIMULATOR and the device could no longer deliver more
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limitations[8]
for which uselimitation — the independence of the evaluation, not its methods: THIS WORK WAS SUPPORTED BY COCHLEAR LIMITED, the manufacturer of the device under test
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limitations[9]
evidential statusmechanism — the paper's own words: is not clear
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mechanisms[11]
replicationuntested
limitationPitch data exist for only one patient whose array lay along the intended tonotopic gradient, so no definitive claim about human midbrain tonotopy can be made
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limitations[0]
limitationThe standard temporal-resolution measures could not be run because of software limits, so a substitute continuity-rate judgement was used instead
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limitations[1]
limitationOne of the three patients produced no usable pitch-ordering data at all
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limitations[2]
limitationpitch data exist for only one patient whose array is aligned along the intended gradient, so no definitive claim about human midbrain tonotopy is made
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limitations[3]
limitationthe standard tests for temporal resolution could not be run because the software would not do them, so a different measure was substituted
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limitations[4]
limitationloudness balancing across the different sites and pulse rates was difficult because of limitations in the testing software, and performance on this test was argued to depend on whether the patient could clearly hear the sound rather than on slight variations in loudness
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limitations[5]
limitationimaging after implantation was impossible because the array distorts the scan, so location comes from a fused reconstruction
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limitations[6]
limitationall three patients had tinnitus throughout and were asked to ignore it while judging the stimulus
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limitations[7]
limitationone patient's activation levels rose until they reached the compliance voltage of the stimulator and the device had to be switched off for 48 days
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limitations[8]
limitationthe work was supported by the company that makes the device, and one author is employed there
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limitations[9]
Content tags
content-observations: finding · quantity · variable · definition · key-term — grounded in the full text
findingThree NF2 patients were implanted with a penetrating auditory midbrain implant and the device proved safe, with the array showing minimal movement over time.
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content_tags.findings[0]
findingMidbrain stimulation delivered usable loudness, pitch, temporal and directional percepts.
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content_tags.findings[1]
findingAll three patients gained lip-reading enhancement and environmental sound awareness, with speech perception on a par with NF2 auditory brainstem implant patients.
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content_tags.findings[2]
findingContrary to the animal-derived prediction, stimulating successive depths along the ICC tonotopic gradient did not produce an ordered pitch shift, and every site in every patient sounded predominantly low-pitched.
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content_tags.findings[3]
findingWith IC stimulation, patients perceived a continuous stimulus above 80 pps, mostly around 50 pps, a resolution of about 20 ms.
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content_tags.findings[4]
findingThe patient implanted at the lateral lemniscus rather than in the IC still heard buzzing up to 220 pps, about three times the rate the IC-implanted patients could follow.
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content_tags.findings[5]
findingPerceived sound direction was fixed within each patient but differed by implant location: ipsilateral for the lateral-lemniscus placement and contralateral for the dorsomedial ICC placement.
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content_tags.findings[6]
findingDespite electrodes sitting directly among midbrain neurons, thresholds (6-12 nC) and dynamic ranges (7-9 dB) were no better than those of a cochlear implant.
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content_tags.findings[7]
findingLoudness grew monotonically with current level in all three patients, so level cues can be coded systematically from the midbrain.
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content_tags.findings[8]
findingIn the patient implanted in the dorsal IC, threshold and comfortable levels drifted upward until they hit the stimulator's compliance voltage.
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content_tags.findings[9]
findingWith the implant alone, two patients identified 23% and 40% of vowels against a 10% chance level.
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content_tags.findings[10]
findingPatients detected all instruments but could identify only the low-frequency ones.
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content_tags.findings[11]
findingTHE FOUNDING PREDICTION FAILED: ordered pitch along the tonotopic gradient was hypothesised from animal work, and did not appear
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content_tags.findings[12]
findingstimulation of nearly all sites in all three patients gave low pitch percepts, below a man's voice
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content_tags.findings[13]
findingand pulse rates up to 2400 per second produced no obvious rise in pitch over 250
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content_tags.findings[14]
findingpitch scores varied across days and even across different times on the same day, variability much greater than what is typically observed for CI patients
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content_tags.findings[15]
findingfor the one correctly aligned array the deviation from the predicted order is left unexplained
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content_tags.findings[16]
findingFOUR RIVAL EXPLANATIONS ARE LISTED AS OPEN QUESTIONS and none is chosen: stimulus form, plastic loss of high frequency representation after six years of deafness, position along the isofrequency dimension or passing fibres, and species differences
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content_tags.findings[17]
findingAND NO DEFINITIVE CLAIM IS MADE about human midbrain tonotopy, because only one patient's array was aligned along the gradient
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content_tags.findings[18]
findingAMI thresholds and dynamic ranges are similar to those of the CI, though the sites are in direct contact with surrounding neurons and thresholds should be lower
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content_tags.findings[19]
findingand the animal explanation offered for that is questioned in the same paragraph
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content_tags.findings[20]
findingall patients gave monotonically increasing loudness with current, so level cues are transmissible
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content_tags.findings[21]
findingone patient showed long shallow loudness tails, read as a non-homogeneous mix of excitatory and inhibitory neurons along the lamina
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content_tags.findings[22]
findingONE DIRECTION PER PATIENT: binaural throughout for the dorsal placement, ipsilateral throughout for the lemniscal one, contralateral throughout for the central nucleus one
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content_tags.findings[23]
findingand the direction did not change across the 1.7 to 1.9 mm the active sites span
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content_tags.findings[24]
findingwhich is taken as human support for segregated monaural and binaural pathways derived from animal work
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content_tags.findings[25]
findingthe ipsilateral percepts are attributed to medial superior olive fibres, using the enlarged medial and reduced lateral olive of humans
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content_tags.findings[26]
findingand the same placement is used to explain that patient's low pitches, since ipsilaterally driven pathways carry mostly low frequencies
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content_tags.findings[27]
findingpulses fused into a continuous sound above 80 per second and usually near 50, a resolution of about 20 ms, against 250 to 300 for cochlear stimulation
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content_tags.findings[28]
findingthe patient implanted below the colliculus followed about three times the rate of the other two
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content_tags.findings[29]
findingTWO INCOMPATIBLE READINGS OF THAT ARE BOTH KEPT: synchrony degrading up the pathway, or the other two arrays simply sitting in regions of poor temporal resolution
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content_tags.findings[30]
findingTHE ACCIDENT IS THE INDEPENDENT VARIABLE: three arrays landed in three different places, and that variation is what makes the trial a map of the auditory midbrain
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content_tags.findings[31]
findingthe intention was to insert the array 45 degrees off the sagittal plane and into the ICC to position the sites within different anatomical layers, which supposedly correspond to different frequency laminas
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content_tags.findings[32]
findingdeep sites in the first patient caused dizziness and chest and facial sensations and were switched off
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content_tags.findings[33]
findingthe second array sat below the colliculus near the lateral lemniscus and every site mixed auditory with cold and paresthetic sensations
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content_tags.findings[34]
findingthe third array reached the intended central nucleus, with deep sites producing paresthesia in the contralateral thigh, leg and foot
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content_tags.findings[35]
findingno pain or adverse functional effect resulted, and uncomfortable percepts were removed by switching sites off
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content_tags.findings[36]
findingthe auditory sensations and side effects associated with each site have generally remained stable, indicating minimal movement of the implant over time
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content_tags.findings[37]
findingbut the levels for AMI-1 continued to rise, reaching the compliance voltage of the stimulator, so the processor was turned off for 48 d, after which the activation levels decreased dramatically but not completely to the initial values
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content_tags.findings[38]
findingspeech benefit at six months was comparable with eleven brainstem implant patients tested in the same clinic by the same speech therapist
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content_tags.findings[39]
findingand the brainstem group's own scores span a wide range, with six of eleven getting no consonant benefit at all
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content_tags.findings[40]
findingtwo patients scored above chance on vowels with the implant alone
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content_tags.findings[41]
findingboth tested patients detected every instrument but could identify only the low frequency ones
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content_tags.findings[42]
findingand the reported gains are in everyday awareness - traffic, birds, doors, the telephone - and in one patient's control of her own voice
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content_tags.findings[43]
findingTHE MEASURE IS A SUBSTITUTE: modulation and gap detection could not be run because the software would not do them
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content_tags.findings[44]
findingand loudness could not be balanced for that test either, which is argued not to matter for what it measures
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content_tags.findings[45]
findingbefore the pitch and direction tests every site was adjusted until the patient said they were equally loud
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content_tags.findings[46]
findingwith no reference tone available, absolute pitch was scaled against familiar imagined environmental sounds
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content_tags.findings[47]
findingthe stimulus parameters were chosen at the point where more charge stopped lowering thresholds and less charge raised them sharply
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content_tags.findings[48]
findingaccurate MRI images of the midbrain could not be obtained after AMI implantation because of the distortion caused by the electrode array, so CT images were obtained at least 6 weeks after implantation
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content_tags.findings[49]
findingand those slices are read against fixed and stained human midbrain sections from an anatomical collection
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content_tags.findings[50]
findingall three patients had tinnitus before and after surgery and were instructed to ignore it during testing
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content_tags.findings[51]
findingthe surgical method for placing the array was improved across these three patients
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content_tags.findings[52]
findinga three-dimensional array spanning the colliculus is proposed as the next design
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content_tags.findings[53]
findingthe stated advantage over the brainstem implant is surgical - direct visual exposure, no tumour distortion, less risk to brainstem structures
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content_tags.findings[54]
findingthe work was supported by the company that makes the device
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content_tags.findings[55]
quantityThree — number of patients implanted with the auditory midbrain implant
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content_tags.quantities[0]
quantity6.2 mm long with a diameter of 0.4 mm — dimensions of the penetrating AMI electrode array
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content_tags.quantities[1]
quantity20 platinum ring electrodes linearly spaced at an interval of 200 μm — electrode count and spacing on the array
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content_tags.quantities[2]
quantity6–12 nC ... 7–9 dB — AMI threshold charge and dynamic range in the patient implanted in the ICC
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content_tags.quantities[3]
quantity42 ± 7 and 65 ± 8 pps — pulse rate at which buzzing fused into a continuous percept for the two IC-implanted patients
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content_tags.quantities[4]
quantity220 pps (mean ± SD, 180 ± 17) — temporal fusion rate for the patient implanted at the lateral lemniscus
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content_tags.quantities[5]
quantity23 and 40% correct (10% chance level) — vowel identification with AMI stimulation alone for AMI-2 and AMI-3 at 6 months
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content_tags.quantities[6]
quantity12.5 and 10% — consonant and number test scores achieved above chance by AMI-3 with the implant alone
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content_tags.quantities[7]
quantity∼2–11 words per minute — lip-reading enhancement in speech tracking obtained by adding the AMI to lip reading
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content_tags.quantities[8]
quantity∼85–100 words per minute — speech tracking rate of normal-hearing subjects in the same clinic, as a reference
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content_tags.quantities[9]
quantityonly four — number out of 11 ABI NF2 patients who beat AMI-3's 11 words-per-minute lip-reading enhancement
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content_tags.quantities[10]
quantity2400 pps — pulse rates swept this high without any obvious increase in pitch over 250, which closes the most obvious escape from the failed prediction
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content_tags.quantities[11]
quantity7–9 dB — dynamic range in the correctly placed patient, similar to the cochlear implant rather than better as animal work predicted
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content_tags.quantities[12]
quantity∼20 ms — the temporal resolution implied by fusion near 50 pulses per second, against a few milliseconds for cochlear stimulation
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content_tags.quantities[13]
quantity1.7–1.9 mm — the span of active sites across which the perceived direction never changed
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content_tags.quantities[14]
quantity48 d — how long the device was switched off after one patient's levels reached the stimulator's compliance voltage
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content_tags.quantities[15]
quantity6.2 mm — array length, carrying 20 sites at 200 micrometre spacing
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content_tags.quantities[16]
quantity11 ABI NF2 patients — the comparison group, tested in the same clinic under the same protocols by the same speech therapist
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content_tags.quantities[17]
variablecurrent level (independent)
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content_tags.variables[1]
variablepulse rate (independent)
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content_tags.variables[2]
variableperceived pitch (dependent)
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content_tags.variables[3]
variableazimuth (dependent)
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content_tags.variables[4]
variablethreshold
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content_tags.variables[8]
variablepitch
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content_tags.variables[9]
variableloudness
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content_tags.variables[10]
variabletemporal resolution
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content_tags.variables[11]
variablesound localization
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content_tags.variables[12]
definitionlip-reading enhancement
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content_tags.definitions[0]
definitionT level
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content_tags.definitions[1]
definitioncomfortable (C) level
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content_tags.definitions[2]
definitionauditory brainstem implant (ABI)
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content_tags.definitions[3]
definitioncochlear implant (CI)
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content_tags.definitions[4]
definitionauditory brainstem implant
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content_tags.definitions[5]
definitioncochlear implant
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content_tags.definitions[6]
definitiontemporal resolution
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content_tags.definitions[7]
definitionlip reading
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content_tags.definitions[8]
definitionelectrode array
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content_tags.definitions[9]
key-termsauditory midbrain implant, auditory brainstem implant, cochlear implant, inferior colliculus, ICC, lateral lemniscus, cochlear nucleus, midbrain, medial superior olive, auditory nerve, electrode array, sites, array placement, tonotopic, isofrequency, pitch, loudness, threshold, dynamic range, compliance voltage, current level, pulse rate, temporal resolution, sound localization, contralateral, ipsilateral, binaural, monaural, percept, side effects, paresthesia, tinnitus, NF2, deaf, plastic, speech perception, lip reading, vowel, environmental sounds, animal models, animal studies, guinea pig, MRI, stimulation, safety, speech tracking
Concepts
terms this paper carries, each with the sentence it was cut from — the layer that joins one paper to another. Terms with no quote yet are on CONCEPTS.html.
conceptlateral lemniscus — not defined in this paper's own words; where one array actually landed, below the colliculus
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concepts[5]
conceptloudness — not defined in this paper's own words; the percept that did behave monotonically with current
Quotation withheld — this paper is not ours to reproduce, and the page has already quoted as much of it as the rights layer allows. The tag, its field and its confidence stand; the sentence is at the publisher.
concepts[16]
conceptcurrent level — not defined in this paper's own words; the stimulus variable
Quotation withheld — this paper is not ours to reproduce, and the page has already quoted as much of it as the rights layer allows. The tag, its field and its confidence stand; the sentence is at the publisher.
concepts[20]
concepttemporal resolution — not defined in this paper's own words; the rate at which separate pulses fuse into a continuous sound
Quotation withheld — this paper is not ours to reproduce, and the page has already quoted as much of it as the rights layer allows. The tag, its field and its confidence stand; the sentence is at the publisher.
concepts[22]
Statistics — cross-field join keys
field-invariant statistical terms, used in their statistical sense (gated on a number / symbol / test). A p-value or a standard deviation means the SAME thing in physics, biology, psychology and sociology — so these are the strongest cross-field join keys. Grounded verbatim.
mean as written: mean and SD; n = 5
Quotation withheld — this paper is not ours to reproduce, and the page has already quoted as much of it as the rights layer allows. The tag, its field and its confidence stand; the sentence is at the publisher.
content_tags.statistics[0]
standard deviation SD as written: mean ± SD of 42 ± 7 and 65 ± 8 pps
Quotation withheld — this paper is not ours to reproduce, and the page has already quoted as much of it as the rights layer allows. The tag, its field and its confidence stand; the sentence is at the publisher.
content_tags.statistics[1]
averaging of repeated measurements as written: randomly repeated three times and averaged for each site
Quotation withheld — this paper is not ours to reproduce, and the page has already quoted as much of it as the rights layer allows. The tag, its field and its confidence stand; the sentence is at the publisher.
content_tags.statistics[2]
mean ± SD
Quotation withheld — this paper is not ours to reproduce, and the page has already quoted as much of it as the rights layer allows. The tag, its field and its confidence stand; the sentence is at the publisher.
content_tags.statistics[3]
chance level
Quotation withheld — this paper is not ours to reproduce, and the page has already quoted as much of it as the rights layer allows. The tag, its field and its confidence stand; the sentence is at the publisher.
content_tags.statistics[4]
Second readings
a facet read a second time, independently, from its own sentence — and whether the two readings agree
claim typemethod — a second reading reaching the same value; recorded: method
Quotation withheld — this paper is not ours to reproduce, and the page has already quoted as much of it as the rights layer allows. The tag, its field and its confidence stand; the sentence is at the publisher.
alternatives.claim_type
methodthree patients implanted during tumour removal, array location reconstructed from fused imaging against fixed anatomical sections, then psychophysics per site - threshold, comfortable level, loudness growth, pitch ranking and scaling, rate discrimination, perceived direction - plus speech tests at six months — a second reading DIFFERING from the recorded value; recorded: system-or-tool-building
Quotation withheld — this paper is not ours to reproduce, and the page has already quoted as much of it as the rights layer allows. The tag, its field and its confidence stand; the sentence is at the publisher.
alternatives.method
phenomenonelectrically evoked hearing: percepts of loudness, pitch, rate and direction produced by stimulating single sites in the human midbrain — a second reading DIFFERING from the recorded value; recorded: auditory midbrain implant for hearing restoration
Quotation withheld — this paper is not ours to reproduce, and the page has already quoted as much of it as the rights layer allows. The tag, its field and its confidence stand; the sentence is at the publisher.
alternatives.phenomenon

When we have changed our mind. Some entries in the table begin with a word in capitals and the reason for it. EVIDENCE CORRECTED — the finding still stands, but we had quoted the wrong sentence from the paper, and the quotation has been replaced with the right one. RETRACTED — the entry itself was wrong; it stays on the page, marked, with the reason, rather than being deleted. WITHDRAWN AND REPLACED — the entry was wrong, and a corrected version of it appears in the entries below. Each mark carries its own reason, in brackets, because the reasons differ from one entry to the next. An entry we have WITHDRAWN is removed from this page and kept in the record, with its reason. A line reading Audit and a date is a later re-reading of the entry against its whole sentence: DOUBTFUL means it was kept, and the reason says what is loose about it. Quotation marks inside the tagger's sentence. Where a tag is the tagger's own sentence, a phrase in quotation marks inside it is borrowed from the paper — the tagger's wording around it is not. The paper's own sentence is the evidence quote for that row; on this page it is withheld with the article, and the article is at its publisher. Nothing inside quotation marks anywhere on this page is ours: if it is quoted, it is the paper's. Whose words a concept carries. A concept entry records a term the paper itself uses, so the term, the sense given for it, and its evidence are the paper's own words, quoted where the paper fixes them. This is the opposite of a sense entry in the tag table, which is the tagger's sentence about how the paper uses a term. Where a concept entry could not be grounded in the paper's words, the entry says so on its own row.

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