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Title: Development and significance of the spatial auditory change complex in adult cochlear implant users
Author: Mathew, Rajeev
ISNI:       0000 0004 7660 2374
Awarding Body: UCL (University College London)
Current Institution: University College London (University of London)
Date of Award: 2019
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Despite their great success, cochlear implants (CIs) are associated with a wide range in speech perception outcomes. Interactions of electrode contacts on the CI array, resulting in impaired transmission of the auditory signal, may contribute to poor outcome in certain individuals. The aim of this thesis was to determine whether the spatial auditory change complex (ACC), an electrophysiological measure of electrode discrimination, could be used to objectively assess electrode independence, with a view to using this as a clinical tool for patient assessment. In a series of experiments, the spatial ACC and behavioural electrode discrimination were measured in adult CI users. It was found that it is feasible to measure the spatial ACC in CI devices from different manufacturers and during the early period after switch-on. There was a strong relationship between objective and behavioural measures of electrode discrimination and in several cases, the development of the spatial ACC preceded accurate behavioural discrimination. Longitudinal measurements revealed that the amplitude of the spatial ACC and behavioural discrimination scores increased significantly over the first 6 to 12 months of CI use, providing evidence for auditory plasticity. The time course of adaptation varied substantially, and was slower and more limited in certain individuals. Speech perception was found to be more consistently related to behavioural measures of electrode discrimination than to the spatial ACC. Increasing stimulus intensity led to a significant increase in the spatial ACC amplitude and behavioural discrimination scores. By altering the recording setup and stimulus characteristics, the efficiency and sensitivity of spatial ACC measurements could be improved. These findings show that the spatial ACC provides a useful measure of electrode independence. It is proposed that these measurements could be used to guide clinical interventions that lead to improved hearing outcome in CI users.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available