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Volume 8 Issue 1 (pdf) - Andrew John Publishing Inc

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Psarros (2010) examined ECAP recovery<br />

functions with the hypothesis that ECAP<br />

recovery is heavily influenced both by<br />

neural survival as well as the size of the<br />

neural population that can be recruited<br />

to respond to a pulse-train stimulus. The<br />

popular understanding of the recovery<br />

function has been that faster recovery<br />

indicates a more efficient response to the<br />

individual pulses within a sequence. 3<br />

However, psychophysical data have not<br />

supported this view and, in fact, the<br />

opposite has been observed; faster<br />

recovery has been found to lead to<br />

poorer psychophysical thresholds. 3 The<br />

researchers attempted to investigate this<br />

counterintuitive finding by postulating<br />

that the size of the neural population<br />

available to respond would heavily<br />

influence the refractoriness and<br />

operating status of the whole nerve. As<br />

it is not possible to count neural<br />

populations in human subjects, their<br />

study relied on a computational model<br />

of the cat auditory nerve and human<br />

ECAP measurements. Their findings<br />

demonstrated that slower ECAP<br />

recovery was related to better temporal<br />

synchrony with increasing stimulation<br />

rate. 3 Based on these findings they<br />

propose that the size of the neural<br />

population, in addition to neural<br />

survival, influences the whole nerve<br />

refractoriness: large neural populations<br />

operate near threshold and are more<br />

susceptible to masking, leading to<br />

slower ECAP recovery; however, they<br />

maintain temporal responsiveness<br />

through greater numbers of nonrefractory<br />

neurons. 3,6 It is known that<br />

auditory nerve degeneration advances<br />

with duration of hearing impairment<br />

and another major finding of this study<br />

was that longer durations of hearing loss<br />

were associated with faster ECAP<br />

recovery. 2–4<br />

Overall, studies such as the one<br />

described highlight the complexity of<br />

the auditory system and the changes that<br />

occur in the brain when auditory input<br />

changes due to hearing loss. Studies that<br />

allow us to investigate brain-related<br />

changes are our gateway into<br />

discovering the underlying causes of<br />

patient variability, and ultimately in the<br />

long term, can help us provide the best<br />

clinical care for our patients.<br />

referenCes<br />

1. Abbas P and Brown C.<br />

Electrocochleography. In Katz J,<br />

Medwetsky L, Burkard R, and Hood<br />

L, Handbook of Clinical Audiology,<br />

Sixth Edition. Baltimore, MD:<br />

Lippincott Williams & Wilkins;<br />

2009.<br />

2. Nadol JB, Young YS, Glynn RJ.<br />

Survival of spiral ganglion cells in<br />

profound sensorineural hearing loss:<br />

Implications for cochlear<br />

implantation. Ann Otol Rhinol<br />

Laryngol 1989;98:411–16.<br />

3. Botros A, Psarros C. Neural response<br />

telemetry reconsidered: II. The<br />

influence of neural population on<br />

the ECAP Recovery function and<br />

refractoriness. Ear and Hearing<br />

2010;380–91.<br />

4. Prado-Guitierrez P, Fewster LM,<br />

Heasman JM. Effect of interphase<br />

gap and phase duration on<br />

electrically evoked potentials is<br />

correlated with auditory nerve<br />

survival. Hear Res 2006;215:47–55.<br />

5. Gil-Loyzaga P. Biological bases of<br />

neuroplasticity- in vivo and in vitro<br />

studies: interest for the auditory<br />

system. Audiological Medicine<br />

2009;7:3–10.<br />

6. Miller CA, Abbas PJ, Rubinstein JT.<br />

Response properties of the refractory<br />

auditory nerve fiber. J Assoc Res<br />

Otolaryngol 2001;2:216–32.<br />

Canadian Hearing Report 2013;8(1):23-24.<br />

CANADIAN ACADEMY OF AUDIOLOGY<br />

PO Box 62117 777 Guelph Line, Burlington ON, L7R 4K2 T: 905-633-7114/1-800-264-5106 F: 905-633-9113 E: caa@canadianaudiology.ca<br />

BOARDOFDIRECTORS / CONSEIL DE DIRECTION<br />

Steve Aiken<br />

President/Présidente<br />

Dalhousie University<br />

Halifax, NS<br />

Rex Banks<br />

Director/Directeur<br />

Canadian Hearing Society<br />

Toronto, ON<br />

Salima Jiwani<br />

Director/Directeur<br />

University of Toronto<br />

Toronto, ON<br />

Maxine Armstrong<br />

Director/Directeur<br />

Toronto General Hospital<br />

Toronto, ON<br />

Susan Nelson-Oxford<br />

President-Elect /Présidente-Désignée<br />

Vancouver Island Health Authority<br />

Victoria, BC<br />

MJ Desousa<br />

Director/Directeur<br />

Connect Hearing<br />

Toronto, ON<br />

Gurjit singh<br />

Director/Directeur<br />

University of Toronto<br />

Toronto, ON<br />

Victoria Lee<br />

Past President/Présidente-Sortant<br />

Auditory Outreach Provincial<br />

Program Burnaby, BC<br />

Susan English-Thompson<br />

Director/Directeur<br />

Sackville Hearing Centre<br />

Sackville, NS<br />

Glynnis Tidball<br />

Director/Directeur<br />

St. Paul’s Hospital<br />

Vancouver, BC<br />

Petra Smith<br />

Treasurer/Trésorière<br />

Hastings Hearing Centres<br />

Steinbach, MB<br />

Joy Gauvreau<br />

Director/Directeur<br />

Costco<br />

Saskatoon, SK<br />

Erica Wong<br />

Director/Directeur<br />

Mount Sinai Hospital<br />

Toronto, ON<br />

24 CANADIAN HEARING REPORT | REVUE CANADIENNE D’AUDITION

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