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A New Auditory Prosthesis Using Deep Brain Stimulation: Development and Implementation

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Implantable Neural Prostheses 1

Part of the book series: Biological and Medical Physics, Biomedical Engineering ((BIOMEDICAL))

Abstract

The auditory midbrain implant (AMI) is a new auditory prosthesis designed for stimulation of the inferior colliculus, particularly its central nucleus (ICC), in deaf patients who cannot sufficiently benefit from current auditory implants (i.e., cochlear and brainstem implants). We have begun clinical trials in which three patients have been successfully implanted with the AMI. Although the intended target was the ICC, the AMI array was implanted into different regions across patients due to our learning experience with the surgical approach. The first patient was implanted into the dorsal cortex of the inferior colliculus, the second patient into the lateral lemniscus, and the third patient into the ICC. Nevertheless, all patients receive hearing benefits on a daily basis with their device, which has been encouraging for the potential of the AMI as a hearing alternative for deaf patients. The greatest improvements have been observed in the patient implanted into the target region of the ICC, indicating the importance of proper placement of the array into the midbrain. Furthermore, we have observed large differences in perceptual effects depending on location of stimulation. This chapter will provide an overview of the different steps that were taken to ensure safe and reliable translation and implementation of a new implant concept to clinical application. The first section of the chapter provides the rationale and issues that needed to be considered in the design of the AMI system. Section 2 covers the safety and feasibility studies performed in vitro and in animals to ensure the device would be safe and functional in humans. Section 3 describes our experience in determining how to implant and implement a new device into patients as well as the overall hearing performance achieved with the device. Finally, the last section provides some future directions for how to improve the AMI based on what we have learned from the human and animal findings. The underlying theme of this chapter is to provide the reader with a complete and realistic overview of the thought process, steps, and obstacles that were involved in translating an idealistic concept to a practical clinical device.

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Acknowledgments

We would like to thank Gert Joseph, Urte Rost, Joerg Pesch, and Rolf-Dieter Battmer for involvement with AMI patient testing and fitting; Madjid Samii, Amir Samii, and the International Neuroscience Institute (Hanover, Germany) for successful AMI surgery; and the engineers and scientists at Cochlear Ltd. (Lane Cove, Australia) for AMI development and technical assistance. We would also like to thank David J. Anderson for providing the scientific pathway for performing the initial AMI feasibility experiments at the University of Michigan; and Günter Reuter, Uta Reich, Gerrit Paasche, and Alexandru C. Stan for involvement with the animal safety studies at Hanover Medical University. We appreciate the contributions by Frank Risi and James F. Patrick from Cochlear Ltd. in the writing of Section 2.1. Funding was mostly provided by Cochlear Ltd. with contributions from the German Research Foundation (SFB 599) and NIH through P41 EB2030, P30 DC05188, T32 DC00011, and F31 DC007009.

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  1. Department of Biomedical Engineering, University of Minnesota, Minnesota, MN, USA

    Hubert H. Lim

  2. Otorhinolaryngology Department, Hannover Medical University, Hannover, Germany

    Minoo Lenarz & Thomas Lenarz

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  1. Hubert H. Lim
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    Lim, H.H., Lenarz, M., Lenarz, T. (2009). A New Auditory Prosthesis Using Deep Brain Stimulation: Development and Implementation. In: Greenbaum, E., Zhou, D. (eds) Implantable Neural Prostheses 1. Biological and Medical Physics, Biomedical Engineering. Springer, New York, NY. https://doi.org/10.1007/978-0-387-77261-5_4

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