Can the acoustic change complex be recorded in an individual with a cochlear implant? Separating neural responses from cochlear implant artifact.

The purpose of this case study was to determine whether the P1-N1-P2 acoustic change complex (ACC) could be recorded in an individual with a cochlear implant. In a cochlear implant recipient, stimulus-related artifact from the implant can overlap the evoked potential of interest, making it difficult to determine whether the recorded response is neural or a simple reflection of the artifact. This is an even greater technical challenge for the ACC because stimuli having relatively long durations are used. The subject was a 24-year-old with a diagnosis of auditory neuropathy/auditory dys-synchrony and used a MED-EL Tempo+ cochlear implant in her left ear. The ACC was recorded to synthetic vowels containing a change of F2 at midpoint ranging from 0 (no change) to 1200 Hz (perceived as /ui/). The stimuli were presented randomly at 75 dB SPL via a loudspeaker. In one condition the subject ignored the stimuli and watched a captioned video. In the other, the subject pressed one button on a response pad if she perceived an acoustic change at stimulus midpoint and another if she did not. Cortical auditory evoked potentials were recorded from 32 scalp electrodes. Results indicated that the ACC was present and could be teased apart from the cochlear implant stimulus artifact. ACC thresholds showed good agreement with behavioral discrimination performance, and therefore, results are positive for the potential clinical application of the ACC technique to individuals with cochlear implants.