Hearing loss, which may be due to many different causes, is generally of two types: conductive and sensorineural. Sensorineural hearing loss is due to the absence or destruction of the hair cells in the cochlea that transduce sound signals into nerve impulses. Various hearing prostheses are commercially available to provide individuals suffering from sensorineural hearing loss with the ability to perceive sound. A hearing prosthesis can be a cochlear implant.
Conductive hearing loss occurs when the normal mechanical pathways that provide sound to hair cells in the cochlea are impeded, for example, by damage to the ossicular chain or the ear canal. Individuals suffering from conductive hearing loss may retain some form of residual hearing because the hair cells in the cochlea may remain undamaged.
Individuals suffering from hearing loss typically receive an acoustic hearing aid. Conventional hearing aids rely on principles of air conduction to transmit acoustic signals to the cochlea. In particular, a hearing aid typically uses an arrangement positioned in the recipient's ear canal or on the outer ear to amplify a sound received by the outer ear of the recipient. This amplified sound reaches the cochlea causing motion of the perilymph and stimulation of the auditory nerve. Cases of conductive hearing loss typically are treated by means of bone conduction hearing aids. In contrast to conventional hearing aids, these devices use a mechanical actuator that is coupled to the skull bone to apply the amplified sound.
In contrast to hearing aids, which rely primarily on the principles of air conduction, certain types of hearing prostheses commonly referred to as cochlear implants convert a received sound into electrical stimulation. The electrical stimulation is applied to the cochlea, which results in the perception of the received sound.
Many devices, such as medical devices that interface with a recipient, have structural and/or functional features where there is utilitarian value in adjusting such features for an individual recipient. The process by which a device that interfaces with or otherwise is used by the recipient is tailored or customized or otherwise adjusted for the specific needs or specific wants or specific characteristics of the recipient is commonly referred to as fitting.
In accordance with an exemplary embodiment, there is a method, comprising applying electrical stimulation to a recipient, obtaining from read electrodes read data resulting from the applied stimulation, obtaining an artefact model based at least in part on the read data and obtaining neural response data by comparing the read data to the artefact model.
In accordance with another exemplary embodiment, there is a method that includes developing a recipient-specific electrical stimulation artefact model.
In accordance with an another exemplary embodiment, there is an electrical response stimulation measurement system, comprising an input sub-system configured to receive first data based on a signal response to stimulation applied to a person; and a processor and/or chip assembly configured to develop a model based at least in part on the received first data and to extrapolate a biological signal based on a comparison of the model and the received first data.
Embodiments are described below with reference to the attached drawings, in which:
In view of the above, it is to be understood that at least some embodiments detailed herein and/or variations thereof are directed towards a body-worn sensory supplement medical device (e.g., the hearing prosthesis of
The recipient has an outer ear 101, a middle ear 105, and an inner ear 107. Components of outer ear 101, middle ear 105, and inner ear 107 are described below, followed by a description of cochlear implant 100.
In a fully functional ear, outer ear 101 comprises an auricle 110 and an ear canal 102. An acoustic pressure or sound wave 103 is collected by auricle 110 and channeled into and through ear canal 102. Disposed across the distal end of ear channel 102 is a tympanic membrane 104 which vibrates in response to sound wave 103. This vibration is coupled to oval window or fenestra ovalis 112 through three bones of middle ear 105, collectively referred to as the ossicles 106 and comprising the malleus 108, the incus 109, and the stapes 111. Bones 108, 109, and 111 of middle ear 105 serve to filter and amplify sound wave 103, causing oval window 112 to articulate, or vibrate in response to vibration of tympanic membrane 104. This vibration sets up waves of fluid motion of the perilymph within cochlea 140. Such fluid motion, in turn, activates tiny hair cells (not shown) inside of cochlea 140. Activation of the hair cells causes appropriate nerve impulses to be generated and transferred through the spiral ganglion cells (not shown) and auditory nerve 114 to the brain (also not shown) where they are perceived as sound.
As shown, cochlear implant 100 comprises one or more components which are temporarily or permanently implanted in the recipient. Cochlear implant 100 is shown in
In the illustrative arrangement of
Cochlear implant 100 comprises an internal energy transfer assembly 132 which can be positioned in a recess of the temporal bone adjacent auricle 110 of the recipient. As detailed below, internal energy transfer assembly 132 is a component of the transcutaneous energy transfer link and receives power and/or data from external device 142. In the illustrative embodiment, the energy transfer link comprises an inductive RF link, and internal energy transfer assembly 132 comprises a primary internal coil 136. Internal coil 136 is typically a wire antenna coil comprised of multiple turns of electrically insulated single-strand or multi-strand platinum or gold wire.
Cochlear implant 100 further comprises a main implantable component 120 and an elongate electrode assembly 118. In some embodiments, internal energy transfer assembly 132 and main implantable component 120 are hermetically sealed within a biocompatible housing. In some embodiments, main implantable component 120 includes an implantable microphone assembly (not shown) and a sound processing unit (not shown) to convert the sound signals received by the implantable microphone in internal energy transfer assembly 132 to data signals. That said, in some alternative embodiments, the implantable microphone assembly can be located in a separate implantable component (e.g., that has its own housing assembly, etc.) that is in signal communication with the main implantable component 120 (e.g., via leads or the like between the separate implantable component and the main implantable component 120). In at least some embodiments, the teachings detailed herein and/or variations thereof can be utilized with any type of implantable microphone arrangement.
Main implantable component 120 further includes a stimulator unit (also not shown) which generates electrical stimulation signals based on the data signals. The electrical stimulation signals are delivered to the recipient via elongate electrode assembly 118.
Elongate electrode assembly 118 has a proximal end connected to main implantable component 120, and a distal end implanted in cochlea 140. Electrode assembly 118 extends from main implantable component 120 to cochlea 140 through mastoid bone 119. In some embodiments, electrode assembly 118 may be implanted at least in basal region 116, and sometimes further. For example, electrode assembly 118 may extend towards apical end of cochlea 140, referred to as cochlea apex 134. In certain circumstances, electrode assembly 118 may be inserted into cochlea 140 via a cochleostomy 122. In other circumstances, a cochleostomy may be formed through round window 121, oval window 112, the promontory 123 or through an apical turn 147 of cochlea 140.
Electrode assembly 118 comprises a longitudinally aligned and distally extending array 146 of electrodes 148, disposed along a length thereof. As noted, a stimulator unit generates stimulation signals which are applied by electrodes 148 to cochlea 140, thereby stimulating auditory nerve 114.
Electrode array 146 may be inserted into cochlea 140 with the use of an insertion guide. It is noted that while the embodiments detailed herein are described in terms of utilizing an insertion guide or other type of tool to guide the array into the cochlea, in some alternate insertion embodiments, a tool is not utilized. Instead, the surgeon utilizes his or her fingertips or the like to insert the electrode array into the cochlea. That said, in some embodiments, alternate types of tools can be utilized other than and/or in addition to insertion guides. By way of example only and not by way of limitation, surgical tweezers like can be utilized. Any device, system, and/or method of inserting the electrode array into the cochlea can be utilized according to at least some exemplary embodiments.
Insertion guide tube 210 is mounted on a distal region of an elongate staging section 208 on which the electrode assembly is positioned prior to implantation. A robotic arm adapter 202 is mounted to a proximal end of staging section 208 to facilitate attachment of the guide to a robot, which adapter includes through holes 203 through which bolts can be passed so as to bolt the guide 200 to a robotic arm, as will be detailed below. During use, electrode assembly 145 is advanced from staging section 208 to insertion guide tube 210 via ramp 206. After insertion guide tube 210 is inserted to the appropriate depth in cochlea 140, electrode assembly 145 is advanced through the guide tube to exit distal end 212 as described further below.
As shown in
As noted, electrode assembly 145 is biased to curl and will do so in the absence of forces applied thereto to maintain the straightness. That is, electrode assembly 145 has a memory that causes it to adopt a curved configuration in the absence of external forces. As a result, when electrode assembly 145 is retained in a straight orientation in guide tube 300, the guide tube prevents the electrode assembly from returning to its pre-curved configuration. This induces stress in electrode assembly 145. Pre-curved electrode assembly 145 will tend to twist in insertion guide tube 300 to reduce the induced stress. In the embodiment configured to be implanted in scala tympani of the cochlea, electrode assembly 145 is pre-curved to have a radius of curvature that approximates the curvature of medial side of the scala tympani of the cochlea. Such embodiments of the electrode assembly are referred to as a perimodiolar electrode assembly, and this position within cochlea 140 is commonly referred to as the perimodiolar position. In some embodiments, placing electrode contacts in the perimodiolar position provides utility with respect to the specificity of electrical stimulation, and can reduce the requisite current levels thereby reducing power consumption.
As shown in
Conventional insertion guide tubes typically have a lumen dimensioned to allow the entire tapered electrode assembly to travel through the guide tube. Because the guide tube is able to receive the relatively larger proximal region of the electrode assembly, there will be a gap between the relatively smaller distal region of the electrode assembly and the guide tube lumen wall. Such a gap allows the distal region of the electrode assembly to curve slightly until the assembly can no longer curve due to the lumen wall.
Returning to
It is noted that while the embodiments above disclose the utilization of an insertion tool, in some other embodiments, insertion of the electrode array is not executed utilizing an insertion tool. Moreover, in some embodiments, when an insertion tool is utilized, the insertion tool is not as intrusive as that detailed in the figures. In an exemplary embodiment, there is no distal portion of the tool. That is, the insertion tool stops at the location where the distal portion begins. In an exemplary embodiment, the tool stops at stop 204. In this regard, there is little to no intrusion of the tool into the cochlea. Any device, system, and/or method that can enable the insertion of the electrode array can be utilized in at least some exemplary embodiments.
As can be recognized from the above, the electrode array can be utilized to obtain the data utilized in the methods herein, such as by way of example only and not by way of limitation, the voltages at the read electrodes, and can also be used to provide the stimulating electrode.
Unit 3960 can correspond to an implantable component of an electrode array, as seen in
It is briefly noted that in some embodiments, the arrangement of
Note also that in at least some alternate exemplary embodiments, control unit 8310 can communicate with the so-called “hard ball” reference electrode of the implantable component of the cochlear implant so as to enable communication of data from the receiver/stimulator 8710 to control unit 8310 and/or vice versa.
It is noted that in the embodiment of
Also functionally depicted in
Control unit 8310 can be a signal processor or the like, or a personal computer or the like, or a mainframe computer or the like, etc., that is configured to receive signals from the test unit 3960 and analyze those signals to evaluate the data obtained (it can also be used to control the implant/control the application of current). More particularly, the control unit 8310 can be configured with software or the like to analyze the signals from test unit 3960 in real time and/or in near real time as the electrode array is being advanced into the cochlea by actuator assembly 7720 (if present, and if not present, while the array is being inserted/advanced by hand). The control unit 8310 analyzes the input from test unit 3960, after partial and/or full implantation and/or after the surgery is completed and/or as the electrode array advanced by the actuator assembly 7720 and/or as the electrode array is advanced by the surgeon by hand. The controller/control unit can be programmed to also control the stimulation/control the providing of current to the electrodes during the aforementioned events/situations. The controller 8310 can evaluate the input to determine if there exists a phenomenon according to the teachings detailed herein. The controller can evaluate telemetry, or otherwise receive telemetry, form the implant, via the device that communicates with the implant. That said, in an alternate embodiment, as depicted in
Some exemplary embodiments utilize the receiver/stimulator 8710 as a test unit 3910 that enables the action of obtaining the data and the action of providing current to the electrode, and/or any one or more of the method actions detailed herein. In an exemplary embodiment, the receiver/stimulator 8710 and/or control unit 3810 and/or actuator assembly 7720 and/or input device 8320 are variously utilized to execute one or more or all of the method actions detailed herein, alone or in combination with an external component of a cochlear implant, and/or with the interface 7444, which can be used after the receiver/stimulator 8710 is fully implanted in the recipient and the incision to implant such has been closed (e.g., days, weeks, months, or years after the initial implantation surgery). The interface 7444 can be used to control the receiver/stimulator to execute at least some of the method actions detailed herein (while in some other embodiments, the receiver/stimulator can execute such in an autonomous or semi-autonomous manner, without being in communication with an external component) and/or can be used to obtain data from the receiver/stimulator after execution of such method actions.
In some other embodiments, the cochlear implant by itself controls the stimulation and the reading of the data from the read electrodes. In some embodiments, there is a cochlear implant that is configured to autonomously and/or upon instruction or activation by the recipient or other healthcare professional, execute the stimulation and the reading from the read electrodes. In an exemplary embodiment, the data can be stored in the cochlear implant in the memory, and uploaded to a healthcare professional facility or the like (it can be uploaded to system 1206, as will be detailed below, for example) at a utilitarian time in a utilitarian manner. In an exemplary embodiment, there is a cochlear implant that can implement one or more or all of the method actions detailed herein, such as developing the model and/or obtaining the neural response, etc. In an exemplary embodiment, a so-called remote assistant device, such as that embedded in a cell phone or a smart phone or a smart watch or a dedicated electronic component, etc., can be configured to communicate with the hearing prosthesis to implement some or all of the teachings herein. In this regard, any disclosure of any functional or method action herein can be executed in any device disclosed herein providing that the art enables such.
Embodiments include a multi-contact cochlea electrode array, such as those detailed above, an implant with extra-cochlear electrodes (or another component, such as one that works in conjunction with the implanted portion of the cochlear implant), a receiver stimulator (such as that of the implanted portion), which can be either fully implanted or powered by an external behind the ear (BTE) processor or other external device. The implanted portion can include an in-built amplifier configured to measure electrode voltages concurrent to the delivery of electrical current to either the same or adjacent electrode contacts.
Some exemplary utilizations of the embodiments of
Some embodiments are directed to recording electrically evoked bio-potentials. In some instances, such as those utilizing current technology, there can exist residual artefacts of the electrical stimulation which can be, in some instances, 0.1, 0.2, 0.3, 0.4, 0.5, 0.75, 1, 1.25, 1.5, 1.75, 2, 2.5, 3, 3.5 or 4 or more or any value or range of values therebetween in 0.01 increments (e.g., 0.33, 1.19, 1.28 to 3.37, etc.) orders of magnitude larger than the signal of interest. At least some embodiments, minimize or eliminate this artefact, and can reduce and/or eliminate or otherwise effectively negate or effectively account for any additional noise that results from doing so that results in the measurement procedure.
At least some embodiments include utilizing a mathematical model of the stimulation artefact based on one or more of (i) stimulation parameters, (ii) device configuration (such as the electrode pad size), (iii) device behavioral characteristics, and (iv) interface properties. In at least some embodiments, the model can be used to substantially eliminate the stimulation artefact, without introducing, or at least without introducing or otherwise only introducing minimal additional thermal and/or quantization noise, in addition to potentially providing utilitarian information on the device and the electrode\electrolyte interface.
Some embodiments are based upon the recognition that the stimulation artefact arises predominantly from the electrode-electrolyte interface. For some combinations of biological signals, stimulation paradigms and electrode materials, the stimulation artefact decay rate is substantially different from the biological signal time constant. The present technology can construct mathematical models which adequately model the stimulation artefact, but advantageously retain insufficient flexibility to model the biological signal. This concept is relied upon in at least some embodiments. In this regard, a model may, in some instances at least, if not in all, not be able to model the biological signal. In such a scenario, the biological signal effectively becomes part of the noise in the process. Because the stimulation artefact is usually very large compared to the biological signal of interest, it is expected to have minimal impact on the process.
A brief example will be provided in the context of the Evoked Compound Action Potential (ECAP) response to the stimulus from a cochlear implant. Again, it is noted that in some embodiments, the teachings herein are applicable to other types of response regimes and/or other types of medical devices.
In ECAP, the artefact arising from stimulation requires milliseconds to decay. Conversely, the ECAP biological potential has deviations with a time constant measured in 100's of microseconds. For the purposes of this example, the mathematical model is derived from the Fricke-Warburg model of an electro-tissue interface shown in
Results are shown in
The lower plot frame in
In an exemplary embodiment, the artefact is treated to be in the form y=mx+d (y being voltage, and x being time), so the model is fitted to measured data according to utilitarian data fitting techniques. In some embodiments (advantageously by design), the artefact model that is being used cannot fit the response (which can be quadratic) irrespective of the size of the intercept. Thus, the original (wanted) biological response can be recovered from the mixed measurement data, by subtracting the artefact model from the measurement data. Thus, in some embodiments, this can be a similar process utilized to develop the initial model for the purpose of artefact fitting. In some embodiments, the shapes of the curves/data plots are substantially different so a model can be constructed which fits the artifact but also (advantageously) cannot fit the response. Notably, because the actual artefact can be a non-linear function, there are drawbacks in trying to model or fit the artefact via simple mean squares. Instead, to allow the use of numerical methods to fit or model the artefact, in some embodiments, a guess is initially taken at the model parameters, with the expectation that the guess is sufficiently close to the final parameters, and then numerical methods are used to refine this guess (repeatedly, in some embodiments) and find the model which results in the smallest error (at least that which has an error that is sufficiently small). This can become the model for the stimulation artifact to be used with the present technology. Because, in some embodiments, the model can be based off physical properties, one can be enabled to make a good guess at the likely parameters (or one can measure some of these parameters using impedance spectroscopy, or any other available method and/or system that can enable such) and use this to seed the fit parameters.
Method 1300 also includes method action 1420, which includes measuring one or more electrical properties at one or more locations in the cochlea resulting from the induced current flow. In an exemplary embodiment, the measured electrical properties are at different locations along the electrode array after the electrode after the electrode array is fully inserted. That said, some embodiments include executing the method during insertion.
Method 130 also includes method action 1330, which includes analyzing the data obtained from method action 1320 by accounting for the stimulation artefact present in the data. In some embodiments, the result of method action 1330 is to determine whether a neural response signal is included in the data obtained in method action 1320, and, in some embodiments, what exactly makes up that neural response. Techniques to account for the stimulation artefact will now be described.
In an exemplary embodiment, there is the development of an artefact model, which model is used in method action 1330 to analyze the data. In an exemplary embodiment, the development of the model includes fitting the model to the obtained data obtained in method 1320.
In the curve of
Accordingly, in at least some exemplary embodiments, the methods disclosed herein can further include the action of ignoring the noise and/or accepting the noise as part of the neural response data. Conversely, some embodiments include methods that further include the action of doing something about the noise, such as trying to remove the noise based on a standard or on assumptions based on the overall system that is utilized to obtain the data.
In at least some exemplary embodiments, the action of obtaining the neural response data and for the method actions that are required to obtain the neural response data is executed without introducing additional thermal and/or quantization noise into the signal and/or resulting data.
Method 1500 further includes method action 1520, which includes making an initial model of the artefact based on the data obtained in method action 1510. The initial model can look like curve AM1(t) by way of conceptual example. In an exemplary embodiment, method action 1520 is executed by making one or more guesses for initial values of model parameters and then creating the model response using those parameters. In at least some exemplary embodiments, this initial model may not necessarily be good. However, this is not a problem because the initial model is utilized, in at least some instances, simply to obtain a ballpark concept of how the model should look, from which the model can be further refined.
In this regard, method 1500 further includes method action 1530, which includes evaluating the initial model developed in method action 1520. It is possible that the initial model developed is utilitarian and otherwise can be utilized so that the underlying neural response can be identified in a meaningful or otherwise useful way. If so, no further modeling is executed. That said, in most, if not all scenarios, the initial model developed could be a model that is deemed to be improvable in a meaningful way (more on this below). Accordingly, method 1500 further includes method action 1540, which includes improving upon the initial model developed a method action 1520. Method 1500 further includes method action 1550, which includes evaluating the improved upon model. If it is deemed that the model can be improved upon in a meaningful way, method 1500 then proceeds to method action 1560, which includes improving upon the improved upon model, at which point the method then returned back to method action 1550, which includes evaluating the improved upon model. If it is determined that this second generation of improved upon model can be further improved in a meaningful manner, the method then proceeds to method action 1560, and the cycle is repeated until a determination is made that the improved upon model in a given iteration is utilitarian with respect to implementing the teachings detailed herein to obtain meaningful data related to the neural response. Additional details of this will be described in greater detail below.
It is briefly noted that the action of measuring can be located between any of the method actions, as opposed to only those shown in the figure. Indeed, in an exemplary embodiment, it is noted that any the method actions detailed herein can be practiced in any order providing that such can provide utilitarian value and can enable the teachings detailed herein, all unless otherwise noted.
In view of
Returning back to method action 1330, the action of analyzing the data obtained from method action 1320 by accounting for the stimulation artefact present in the data can be executed in a manner represented by way of example only and not by way of limitation, by
In an exemplary embodiment, the iterations of the models change from iteration to iteration so that the models begin to converge on the curve for the measurement, but never fully converges. The models cannot fully converge because if such is the case, it would not be possible to extract the neural response from the data. Accordingly, in at least some exemplary embodiments, the goal is to develop a model that is good enough or close enough, and then stopping.
Briefly, it is noted that, with respect to
Method 1900 further includes method action 1930, which includes regenerating the model artefact to obtain the n+1th model, which in this embodiment, where n equals 2, would be AM2(t). Method 1900 then returns to method action 1910, where the process is repeated as many times until a determination is made, for example, as a result of method action 1910, that the error determined between the nth model and the recorded signal is sufficiently low that the model can be utilized in a utilitarian manner to determine the neural response/that the error is sufficiently low that the model utilized will provide a utilitarian neural response value.
Thus, it can be seen that method action 1900 is repeated n−1 times, generating artefact models AMn(t) every time, until a model is developed that is deemed satisfactory.
Eventually the best or optimum model is found, such as, for example, when the error cannot be decreased further, or at least decreased further in a meaningful way (there are many methods or algorithms for changing the model parameters in response to the calculated error which can be utilized—any error analysis regime can be utilized to enable the teachings detailed herein can be utilized in at least some exemplary embodiments). In an exemplary embodiment, upon a determination that the overall error has not decreased by more than 10, 9, 8, 7, 6, 5, 4, 3, 2, 1, 0.9, 0.8, 0.7, 0.6, 0.5, 0.4, 0.3, 0.2, 0.1, 0.09, 0.08, 0.07, 0.06, 0.05, 0.04, 0.03, 0.02, 0.01, 0.005, or 0.001% or less, or any value or range of values therebetween in 0.001% increments, for 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 25, 30, 35, 40, 45, or 50 or more, or any value or range of values therebetween in one increment iterations between models (adjacent otherwise), the latest model or one of those models meeting the above-noted criteria can be utilized as the model that will be subtracted or otherwise utilized to remove the artefact from the measured signal.
In an exemplary embodiment, the final artefact model that is utilized is model AMO(t).
It is noted that in at least some embodiments, there is never a perfect fit between the original signal and the artefact model (e.g., error reduced to zero). Some embodiments are directed to avoiding such an occurrence. Indeed, if the artefact model was a perfect fit to the original signal then subtracting the two would yield nothing, and thus the neural response would not be identifiable.
In some embodiments, the artefact models are developed by purposely constraining the artefact model to take the form of a constant phase element (CPE). In an exemplary embodiment, this is done because the shape of the artefact described sufficiently well by a CPE. Conversely, in some embodiments, method actions 1310 and 1320 are executed such that the neural signal that results therefrom is at least effectively or statistically nothing like a CPE. The neural signal of method actions 1310 and 1320 can be somewhat akin to a damped sinusoid. That is, in at least some exemplary body, the action of generating electrical current and/or the action of measuring the resulting electrical properties within the cochlea are executed in a manner that the underlying neural response is as just described, and thus, if a neural signal is present, the model will never be a perfect fit because it is forced to take the form of a CPE. Accordingly, the teachings detailed herein provide, in at least some exemplary embodiments, avoidance of a scenario where the neural signal is “modelled out.” Accordingly, at least some exemplary embodiments provide guarantee that if there is a neural signal present, the neural signal will always show off when the artefact model is removed from the recorded signal.
Briefly, it is noted that the description above refers to and works from a single waveform. However, in at least some exemplary embodiments, the processes detailed above are applied to a series of waveforms. By way of example only and not by way of limitation, different current levels may be used to record each waveform in the series. In such an exemplary embodiment, a series of artefact models are generated, the models respectively likely using the same or related parameters relative to each other. For example, the parameter that scales the overall amplitude of the artefact model may scale linearly with the stimulation current. The model improvement process then calculates the errors for all the waveforms, sums them, and finds the improved parameters which can minimize the summed errors for all the waveforms. In at least some exemplary embodiments, this is more efficient than repeating the process for each individual waveform because the optimum parameter set for one waveform may be the same or very similar to that for the other waveforms in the series.
Some additional details of developing the CPE based model will now be described.
The units of “A” can be Siemens×secondsalpha or 1/omega×secondsalpha (because Farads=S/omega, so when alpha is 1 it will have units in Farads, when it is zero one has units in 1/omega or admittance), the units of S can be J×radians/second, and omega equals resistance. In some instances, alpha thus becomes unitless and effectively a frequency dependent factor.
In some embodiments, such as for a cochlear implant electrode array, the value for A can be around or be actually 10−6. This is based on the fact that equivalent capacitance of an intracochlear electrode measured at around 104 radians per second is around 10−8 Farads. That entails treating it like a capacitor where alpha=1. Also, the same electrode, if thought of as a conductance (=1/resistance), has a conductance of around 10−4 S or 10−4 Ohms−1. That can be based on an assumption that alpha=0. So assuming alpha is typically 0.5, the value of A that gives the equivalent admittance (=1/impedance) will be 10−6 in at least some instances. If alpha is closer to 1 (the interface behaves more like a capacitor), then the value for A will be closer to 10−8. If alpha is closer to 0 (the interface behaves more like a resistor), then the value for A will be closer to 10−4. In practice alpha can vary quite a bit and thus the value of A can also vary a lot (for example, 10−5 to 10−7, by way of example).
Also, alpha (α) works out to around 0.5 as taken from empirical measurements of platinum electrodes in a saline solution (although the range is around 0.3 to 0.7).
In some embodiments, it can be assumed that R is large enough such that the impact thereof to the model can be considered not to matter, the above equation can be expanded to establish an equation for the full model as follows:
The full model would comprise, in some embodiments, two CPE models that would be fitted.
In some embodiments, for triphasic stimulus, allowing for a different value of alpha for Ve and Vf could result in more utilitarian fits.
It is noted that while the above equations are presented in the time domain, this can be done in the frequency domain as well.
In an exemplary embodiment, as will be understood from the above, the actions of applying and obtaining are part of an eCAP measurement method (an electrically evoked compound action potential measurement method). Thus, in an exemplary embodiment, the application of electrical stimulation and the obtaining of the read data occurs at a cochlea of a person. It is noted that the teachings herein are not limited to eCAP. Any measurement regime where artefacts are an issue can be a measurement regime to which the teachings herein can be applied.
As noted above, the constant phase element analysis that is utilized to develop the model can, in some instances, rely on pre-determined or otherwise pre-known initial parameters (which parameters can be assumptions based on empirical or analytical efforts, or can be exacting parameters—any parameters that can enable the teachings detailed herein can be utilized in at least some embodiments. Thus, in an exemplary embodiment, the stimulation applied to the recipient meets certain parameters and the obtained artefact model is based on the certain parameters and based on the read data. In some embodiments, as noted above, stimulation parameters (step function, bipolar, tripolar, etc.), device configuration parameters, such as for example, the electrode pads size or geometry, etc., device behavioral characteristics that can be parameterized, and/or tissue interface property parameters can be utilized in at least some exemplary embodiments.
In a sense, the parameters that are utilized can be considered “seed parameters” which can be utilized to develop “seed parameter estimates” for use in the models, such as to develop the values for the equations detailed above. The key here is that by utilizing devices systems and methods that harness standard parameters, or at least known parameters, the constant phase element-based equations can be developed in a manner that can yield a utilitarian artefact model.
In some embodiments, the artefact model according to the teachings detailed herein is an artefact model that is based on a true constant phase model. In some embodiments, the artefact model does not rely on the results of a double exponential.
As can be seen from the above, the model improvement actions, such as those detailed in method 1900 above, result in an artefact model that is specific to an exact recipient. This as opposed to a model that is based on statistical data for a classification of recipients, etc. accordingly, in an exemplary embodiment, there is a method that comprises developing a recipient-specific electrical stimulation artefact model. In an exemplary embodiment, the developed stimulation artefact model is developed by using predetermined constants and by using data from in-situ electrodes. As noted above, the model can be based on a constant phase model.
It is briefly noted that in an alternate embodiment (it is noted that the embodiment of
It is also briefly noted that while the embodiments herein often focus on temporally based data sets, in alternate embodiments, the teachings herein can be implemented based on frequency based data sets. Any disclosure herein of a temporally based data set corresponds to a disclosure of an alternate embodiment of a frequency based data set (or at least obtaining and/or utilizing one) and vice versa unless otherwise specifically noted. That is, in embodiments herein can be executed utilizing the time domain and/or the frequency domain data.
In an exemplary embodiment of at least some of the methods herein, the action of developing the model includes obtaining a temporally based dataset from sensors attached to the recipient (which includes implanted in the recipient), developing various iterations of embryonic models, all of which are intended to be different from the dataset and using one of the iterations as a basis for the model (in some embodiments, the method includes using one of the iterations as the model, as noted above). As detailed above, the models are purposely designed to be different then the data set that is obtained from the sensors so as to enable a comparison between the two to develop the actual neural response data. In this regard,
In an exemplary embodiment, method action 2720 is executed by utilizing one or more of the iterations individually and/or collectively (by collectively, the models can be averaged, etc.) to compare to the temporally based dataset to determine a neural response based on the comparison.
In view of the above, it can be seen that the actions of developing the model can include obtaining a temporally based dataset from sensors attached to (including implanted in) a recipient and developing the model at least in part based on the obtained dataset. In some embodiments, the method further comprises comparing this developed model, which was developed based on the dataset, to the dataset to identify a neural response.
It is noted that in at least some exemplary embodiments, the teachings detailed herein are directed to artefact suppression and/or elimination and/or artefact accounting techniques utilized in neural response telemetry (NRT). In an exemplary embodiment the teachings detailed herein can provide faster and/or softer NRT relative to that which would be the case if other techniques, such as those detailed below, are utilized. In an exemplary embodiment, this can be because one does not need to utilize more time-consuming techniques and/or one does not need such large signals to deal with imperfections in the artefact suppression and/or the artefact accounting, all other things being equal (note that any comparisons detailed herein are comparisons made, in at least some exemplary embodiments, under the regime of all other things being equal).
At least some exemplary embodiments of the teachings detailed herein provide the best model for an NRT artefact as of Apr. 1, 2019, with respect to those publicly known or utilized in the United States, Canada, the European Union, the United Kingdom, France, Germany, Australia, New Zealand, China, Japan, and/or India. In some embodiments, the just detailed comparison is with respect to methods and systems that are licensed for use in any one or more of the just mentioned jurisdictions as of the just mentioned date, such as, for example, licensed and/or approved by the Food and Drug Administration of the United States of America on Apr. 1, 2019.
In an exemplary embodiment, there is an electrical response stimulation measurement system having functionality according to the method actions detailed herein. In the embodiment illustrated in
System 1206 can comprise a system controller 1212 as well as a user interface 1214. Controller 1212 can be any type of device capable of executing instructions such as, for example, a general or special purpose computer, a handheld computer (e.g., personal digital assistant (PDA)), digital electronic circuitry, integrated circuitry, specially designed ASICs (application specific integrated circuits), firmware, software, and/or combinations thereof. As will be detailed below, in an exemplary embodiment, controller 1212 is a processor. Controller 1212 can further comprise an interface for establishing the data communications link 1208 with the hearing prosthesis 100 (again, which is a proxy for any device that can enable the methods herein—any device with a microphone and/or with an input suite that permits the input data for the methods herein to be captured). In embodiments in which controller 1212 comprises a computer, this interface may be, for example, internal or external to the computer. For example, in an exemplary embodiment, controller 1206 and cochlear implant may each comprise a USB, FireWire, Bluetooth, Wi-Fi, or other communications interface through which data communications link 1208 may be established. Controller 1212 can further comprise a storage device for use in storing information. This storage device can be, for example, volatile or non-volatile storage, such as, for example, random access memory, solid state storage, magnetic storage, holographic storage, etc.
In an exemplary embodiment, input is provided into system 1206 from the implant, which input can correspond to the measurements detailed herein. In an embodiment, the system is configured to execute one or more or all of the method actions detailed herein, or at least control another device to execute such.
The system 1206 includes a processor, represented by block 2920 in
In an exemplary embodiment, device 2920 is a microprocessor or otherwise a system that includes circuitry or microcircuitry, such as transducers, that can be configured or programmed or can access programming from a memory of the system, to execute the teachings herein. In an exemplary embodiment.
In an exemplary embodiment, the aforementioned processor is a general-purpose processor that is configured to execute one or more the functionalities herein. In some embodiments, the processor includes a chip that is based on machine learning/from machine learning. Any device, system, and/or method that can enable the teachings detailed herein can be utilized in at least some exemplary embodiments.
In an exemplary embodiment, system 1206 can be a personal computer that is programmed to implement at least some of the method actions detailed herein.
In an exemplary embodiment, the processor can instead be a chip assembly configured with circuitry configured to implement one or more of the teachings herein.
In an exemplary embodiment, the processor under chip assembly of the system is configured to receive measurements results in the time domain and/or the frequency domain and utilizing those results, develop a model in accordance with the teachings detailed herein.
In an exemplary embodiment, the system is further configured to utilize the model and compare the model to the measurement data to identify the electrical response resulting from the stimulation that was applied to the recipient (whether such was executed under the control of the system or separately).
As will be understood from the above with respect to the teachings directed to ECAP analysis, in an exemplary embodiment, the system is an ECAP measurement analysis system. Also as will be understood from the above, in an exemplary embodiment, the system is configured to develop the model such that the model closely tracks the first data but cannot and/or does not duplicate the first data. Indeed, in this regard, at least some exemplary embodiments are configured so that the model purposely does not duplicate the first data. In at least some exemplary embodiments, this can be utilitarian with respect to the fact that the goal is to identify the neural response from the overall measurement, where the measurement includes the artefact that results from the initial stimulation that was utilized to cause the neural response, and thus the system is removing the artefact in at least some exemplary embodiments.
Corollary to the above, in an exemplary embodiment, the system is configured to develop the model so that it tracks the first data to a statistically insignificant and/or an effectively insignificant improvable difference relative to other models that the system has or can develop with further development. In this regard, by and effectively insignificant improvable difference, it is to be understood that further improvement would not provide any better effective results with respect to efficacy of the underlying method that is executed utilizing the system.
Consistent with the teachings detailed above, in an exemplary embodiment, the system is an artefact removal system and/or an artefact identification system.
In an exemplary embodiment, the system is configured to and/or the methods detailed herein provide at least X % more accuracy with respect to identifying the underlying neural response from input into the system which is based on and/or is the raw signal measurement from the implant than a system that uses/develops a model based on a double exponential, at least 3 out of 4 times, at least 7 our 8 or 9 or 10 times out of 10 times and/or at least 13, 14, 15, 16, 17, 18, 19, or 20 times out of 20 times. (In some embodiments, the methods and system explicitly exclude a model based on a double exponential.) In an exemplary embodiment, X is 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 15, 20, 25, 30, 35, 40, 45, 50, 60, 70, 80, 90, 100, 125, 150, 175, 200, 250, 300, 350, 400, 450, 500, 550, 600, 650, 700, 800, 900, 1000, 1250, 1500, 1750, 2000, 2250, 2500, 2750, 3000, 3500, 4000, 4500, 5000, 6000, 7000, 8000, 9000, or 10000, or more or any value or range of values therebetween in 1% increments.
In an exemplary embodiment, the accuracy is measured by taking the value of the response obtained using the system/method according to the teachings herein and taking the difference between that value and the value from the contrasting system/method and then dividing that value by the value obtained using the system/method and converting such to a percentage.
In an exemplary embodiment, the system is configured to and/or the methods are such that they provide at least X % more accuracy with respect to identifying the underlying neural response from input into the system which is based on and/or is the raw signal measurement from the implant than a system that is based upon the following at least 3 out of 4 times, at least 7 our 8 or 9 or 10 times out of 10 times and/or at least 13, 14, 15, 16, 17, 18, 19, or 20 times out of 20 times: (i) Alternating Stimulation polarity (ii) a regime that relies on the premise that the biological potential being recorded is independent of the polarity of the electrical stimulation, (iii) a regime that utilizes two subsequent stimulations (of opposing polarity) that are summed and the stimulation artefact cancels but the biological potential does not, (iv) forward masking, (v) a regime that relies on the behavior of some bio-potentials known as a refractory period, (vi) a regime that records after a masker-probe pair, (vii) a regime that provides a measurement which includes the stimulation artefact, but without a neural response in response to the probe, (viii) artefact scaling, (ix) a regime that relies on forward masking technique of subtracting a masker only stimulus measurement from a masker-probe stimulus measurement to obtain the probe only stimulation artefact, (x) a regime that utilizes tri phasic stimulation and/or (xi) a regime that seeks to suppress the stimulation artefact, by adding a third phase of stimulation of opposite polarity to the second phase of stimulation, rather than eliminate it via the measurement paradigm.
In an exemplary embodiment, the systems configured and/or the methods detailed herein provides at least X % of a value difference respect to identifying the underlying neural response from input into the system which is based on and/or is the raw signal measurement from the implant than a system that uses/develops the competing models detailed above, at least 3 out of 4 times, at least 7 our 8 or 9 or 10 times out of 10 times and/or at least 13, 14, 15, 16, 17, 18, 19, or 20 times out of 20 times. (In some embodiments, the methods and system explicitly exclude a model based on a double exponential.)
In an exemplary embodiment, difference is measured by taking the value of the response obtained using the system/method according to the teachings herein and taking the difference between that value and the value from the contrasting system/method and then dividing that value by the value obtained using the competing difference and converting such to a percentage.
In an exemplary embodiment, the system is configured such that and/or the methods detailed herein provide, over a time period spanning 0.1, 0.15, 0.2, 0.3, 0.4, 0.5, 0.6, 0.7. 0.8, 0.9, 1.0, 1.1, 1.2, 1.3, 1.4, 1.5, 1.6, 1.7, 1.8, 1.9, 2.0, 2.1, 2.2, 2.3, 2.4, or 2.5 milliseconds or any value or range of values therebetween in 0.01 milliseconds, starting a time T after the stimulus begins and/or ends and/or a medium time, where T is 0.01, 0.02, 0.03, 0.04, 0.05, 0.06, 0.07, 0.08, 0.09, 0.1, 0.11, 0.12, 0.13, 0.14, 0.15, 0.175, 0.2, 0.21, 0.22, 0.23, 0.24, 0.25, 0.26, 0.27, 0.28, 0.29, 0.30, 0.31, 0.32, 0.33, 0.34, 0.35, 0.36, 0.37, 0.38, 0.39, or 0.40 or more milliseconds, or any value or range of values therebetween in 0.01 milliseconds, average deviation (mean, median and/or mode) from the data recorded from the measurements of the artefact model is no more than Z percent, where Z is 0.01, 0.02, 0.03, 0.04, 0.05, 0.06, 0.07, 0.08, 0.09, 0.1, 0.11, 0.12, 0.13, 0.14, 0.15, 0.175, 0.2, 0.21, 0.22, 0.23, 0.24, 0.25, 0.26, 0.27, 0.28, 0.29, 0.30, 0.31, 0.32, 0.33, 0.34, 0.35, 0.36, 0.37, 0.38, 0.39, 0.40, 0.45, 0.50, 0.55, 0.60, 0.65, 0.7, 0.75, 0.8, 0.9, 1, 1.25, 1.5, 1.75, 2, 2.5, 3, 3.5, 4, 4.5, 5, 5.5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 19, 17, 18, 19, or 20, or any value or range of values therebetween in 0.01% increments, where the percentage is measured from the difference of the model to the recorded data divided by the recorded data then converted to a percentage, at least 3 out of 4 times, at least 7 our 8 or 9 or 10 times out of 10 times and/or at least 13, 14, 15, 16, 17, 18, 19 or 20 times out of 20 times.
In an exemplary embodiment, the methods and systems herein do not utilize linearization techniques to develop the model. In this regard, some embodiments explicitly avoid all sequential linear fits. In some embodiments, the teachings detailed herein explicitly avoid utilizing one, two, three, four, five or more sequential linear fits to develop the model and/or the equivalence thereof. In at least some exemplary embodiments, the teachings detailed herein explicitly avoid the utilization of a slew rate, such as that which is limited by the amplifier and/or amplifier system of the implanted component. In at least some exemplary embodiments, any residuals that results from the difference between the model and the recorded data is not merely a smaller exponential.
Again, at least some embodiments involve fitting a true constant phase model, as opposed to successfully fitting more and more exponential decays. In this regard, at least some embodiments avoid the actions of fitting one, two, three, four, five, six, seven, eight, nine, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, or 20 or more exponential decays.
In an exemplary embodiment, some embodiments utilize PCA. In at least some exemplary embodiments, the teachings detailed herein involve a digital technique for estimating and subtracting the stimulation artefact utilizing a mathematical model and numerical methods, with no additional hardware beyond that which is utilized to obtain the measurement data in the first instance and, in embodiments utilizing computers or other processors or chips, etc., the device is to implement those mathematical models and numerical methods to develop the model. Accordingly, in an exemplary embodiment, the system 1206 and the communication regime between the hardware of the system and the implant and the implant are the only components that are utilized to execute at least some methods detailed herein.
It is noted that in at least some exemplary embodiments, there are methods that include evaluating the neural response that is identified utilizing at least some of the teachings detailed herein, and then fitting or otherwise adjusting the prostheses to the recipient based on the evaluation of the neural response. In an exemplary embodiment, the neural response data is utilized in conjunction with threshold and/or comfort levels to develop a map for a cochlear implant. The map is then loaded into the memory of the cochlear implant, and then the cochlear implant evokes hearing percepts based on captured sound based on the map. Accordingly, at least some embodiments include cochlear implants that include map data or otherwise are programmed based at least in part one data that is based on the utilizations of the teachings detailed herein.
Some embodiments include evaluating the neural response data that is obtained according to the teachings detailed herein or variations thereof, and, based on the evaluation, repositioning the electrode array or the electrodes that are utilized to obtain the read data. In an exemplary embodiment, this can correspond to adjusting a cochlear implant electrode array that has been inserted in a cochlea. In an exemplary embodiment, there are methods that include, during surgery, inserting the electrode array into the cochlea, activating the electrode array in accordance with the teachings detailed herein, evaluating the neural response data, repositioning the electrode array, again activating the electrode array, evaluating the new neural response data, and someone, until a desired neural response is achieved, and determining, based on that neural response, that the electrode array is in a position that has utilitarian value or otherwise will not benefit in a meaningful manner from further adjustments with respect to the location thereof. At that point, some exemplary embodiments, or shortly thereafter, the surgery will be commenced and the incision into head is closed and the cochlear implant electrode array is intended to remain at the location of its last position.
That said, as noted above, some embodiments have nothing to do with implantation. Accordingly, at least some exemplary embodiments are directed towards evaluating the neural response after the implant has stabilized, etc. This can correspond to, for example, after the development of any scar tissue that would be present resulting from the implantation.
Any method action detailed herein corresponds to a disclosure of a device and/or a system for executing that method action. Any disclosure of any method of making an apparatus detailed herein corresponds to a resulting apparatus made by that method. Any functionality of any apparatus detailed herein corresponds to a method having a method action associated with that functionality. Any disclosure of any apparatus and/or system detailed herein corresponds to a method of utilizing that apparatus and/or system. Any feature of any embodiment detailed herein can be combined with any other feature of any other embodiment detailed herein providing that the art enables such, unless such is otherwise noted.
Any disclosure herein of a method of making a device herein corresponds to a disclosure of the resulting device. Any disclosure herein of a device corresponds to a disclosure of making such a device.
Any one or more elements or features disclosed herein can be specifically excluded from use with one or more or all of the other features disclosed herein.
While various embodiments of the present invention have been described above, it should be understood that they have been presented by way of example only, and not limitation. It will be apparent to persons skilled in the relevant art that various changes in form and detail can be made therein without departing from the scope of the invention.
This application claims priority to U.S. Provisional Application No. 62/844,079, entitled TECHNIQUES FOR STIMULATION ARTEFACT ELIMINATION, filed on May 6, 2019, naming Ryan Orin MELMAN of Macquarie University, Australia as an inventor, the entire contents of that application being incorporated herein by reference in its entirety.
Filing Document | Filing Date | Country | Kind |
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PCT/IB2020/054266 | 5/5/2020 | WO | 00 |
Number | Date | Country | |
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62844079 | May 2019 | US |