Loudness perception and late auditory evoked potentials in adult cochlear implant users

In clinical routine the adjustment of speech processors in cochlear implant users is based on the patients' subjective statements about the loudness of specific electrical stimuli. From hearing patients it is known that the latencies and amplitudes of late auditory evoked potentials (LAEP) which are generated within the auditory cortex correlate with the loudness perception of acoustical stimuli. The aim of this study was to investigate the correlation between LAEP and loudness perception in adult cochlear implant users. We investigated 8 adult subjects who had been provided with a 22 electrode Cochlear Implant (nucleus CI24M) at least 6 months prior to the investigation. All subjects showed open speech understanding. Electrical pulse trains of 300 ms duration presented at a single electrode served as stimuli. Electrically LAEP morphologies were similar to normal hearing subjects. In all subjects and each intracochlear electrode position LAEP were well identifiable down to low loudness sensations. Both amplitudes and latencies depended on the loudness perception. The best correlation was observed for the N1 deflection. The results show that LAEP can be used for estimation of both hearing thresholds and most comfortable levels.