title: The multi-channel cochlear implant: multi-disciplinary development of electrical stimulation of the cochlea and the resulting clinical benefit.
abstract: This multi-disciplinary research showed sound could be coded by electrical stimulation of the cochlea and peripheral auditory nervous system. But the temporal coding of frequency as seen in the experimental animal, was inadequate for the important speech frequencies. The data indicated the limitation was due in particular to deterministic firing of neurons and failure to reproduce the normal fine temporo-spatial pattern of neural responses seen with sound. However, the data also showed the need for the place coding of frequency, and this meant multi-electrodes inserted into the cochlea. Nevertheless, before this was evaluated on people we undertook biological safety studies to determine the effects of surgical trauma and electrical stimuli, and how to prevent infection. Then our research demonstrated place of stimulation had timbre and was perceived as vowels. This led to our discovery in 1978 of the formant-extraction speech code that first enabled severely-profoundly deaf people to understand running speech. This result in people who had hearing before becoming severely deaf was an outcome not previously considered possible. In 1985 it was the first multi-channel implant to be approved by the US Food and Drug Administration (FDA). It was also the fore runner of our advanced formant and fixed filter strategies When these codes were used from 1985 for those born deaf or deafened early in life we discovered there was a critical period when brain plasticity would allow speech perception and language to be developed near- normally, and this required in particular the acquisition of place coding. In 1990 this led to the first cochlear implant to be approved by the FDA for use in children. Finally, we achieved binaural hearing in 1989 with bilateral cochlear implants, followed by bimodal speech processing in 1990 with a hearing aid in one ear and implant in the other. The above research has been developed industrially, with for example 250,000 people worldwide receiving the Cochlear device in 2013, and as of December 2012 the NIH estimated that approximately 324,200 people worldwide had received this and other implants (NIH Publication No. 11-4798). This article is part of a Special Issue entitled <Lasker Award>.
authors.affiliation: Centre for Neural Engineering, The University of Melbourne, 3010, Australia. Electronic address: gclark@unimelb.edu.au.
authors.forename: Graeme M
authors.initials: GM
authors.lastname: Clark
mesh_terms: D000161:Acoustic Stimulation; D000818:Animals; D019929:Cochlear Implantation / Q000295:instrumentation*; D003054:Cochlear Implants; D032882:Comprehension; D003299:Cooperative Behavior; D004558:Electric Stimulation; D006801:Humans; D033183:Interdisciplinary Communication; D019986:Persons with Hearing Disabilities / Q000523:psychology / Q000534:rehabilitation*; D011474:Prosthesis Design; D012815:Signal Processing, Computer-Assisted; D013065:Speech Intelligibility; D013067:Speech Perception