ORIGINAL RESEARCH article
Front. Neurosci.
Sec. Auditory Cognitive Neuroscience
This article is part of the Research TopicFactors impacting outcomes in adult cochlear implant usersView all 4 articles
Rhythm increases perceptual tolerance when measuring electrically evoked compound action potentials in cochlear implant recipients
Provisionally accepted
- 1Hannover Medical School, Hanover, Germany
- 2MED-EL Medical Electronics, Innsbruck, Austria
- 3MED-EL Elektromedizinische Geräte GmbH, Hannover, Germany
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In cochlear implant (CI) recipients, measurement of the electrically evoked compound action potential (ECAP) is used in clinical routine to prove the electrode-nerve interface and to support fitting, especially in very young children. To record an ECAP amplitude growth function (AGF), electrical stimuli are presented at increasing intensities up to the maximum acceptable loudness (MAL). However, a continuously monotonically rising sound can quickly be perceived as unpleasant and thus impair the success rate of ECAP threshold (TECAP) determination. The present study investigates whether perceptual and objective parameters, which are involved in ECAP measurements, depend on the type of stimulus presentation. In 27 subjects with a CI (28 implants), stimuli of five different AGF patterns were presented ten times in random order at a medial electrode contact, resulting in a total of 50 AGFs per implant. One pattern (Pclin) in which the stimuli increase strictly monotonically is already implemented in the clinical software (MAESTRO). The present study also employed rhythmic patterns and patterns with pauses.In addition to the pattern already implemented in the clinical software (Pclin), in which the stimuli increase strictly monotonically, rhythmic patterns and patterns with pauses were also employed. The behavioral threshold (THR), the maximum comfortable level (MCL), the MAL, and objective TECAP threshold were analyzed. TECAP threshold values did not change significantly when different stimulus paradigms were applied. Rhythmic AGF patterns were perceived as less unpleasant and enabled a higher MAL compared to Pclin. This in turn led to improved TECAP threshold determination, with the success rate rising to 86.7%, compared to 79.1% for Pclin.
Keywords: auditory looming, cochlear implant, Electrically evoked compound action potential (ECAP), Fine-grain, Loudness Perception
Received: 23 Sep 2025; Accepted: 30 Nov 2025.
Copyright: © 2025 Gärtner, Schwarz, Bräcker, Lamping, Lenarz and Büchner. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Lutz Gärtner
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