Discrimination of Schroeder-Phase Harmonic Complexes by Normal-Hearing and Cochlear-Implant Listeners

The temporal fine structure (TFS) of sound contributes significantly to the perception of music and speech in noise. The evaluation of new strategies to improve TFS delivery in cochlear implants (CIs) relies upon the assessment of fine structure encoding. Most modern CI sound processing schemes do not encode within-channel TFS per se, but some TFS information is delivered through temporal envelope cues across multiple channels. Positive and negative Schroeder-phase harmonic complexes differ primarily in acoustic TFS and provide a potential test of TFS discrimination ability in CI users for current and future processing strategies. The ability to discriminate Schroeder-phase stimuli was evaluated in 24 CI users and 7 normal-hearing listeners at four fundamental frequencies: 50, 100, 200, and 400 Hz. The dependent variables were percent correct at each fundamental frequency, average score across all fundamental frequencies, and a maximum-likelihood-predicted threshold fundamental frequency for 75% correct. CI listeners scored better than chance for all fundamental frequencies tested. The 50-Hz, average, and predicted threshold scores correlated significantly with consonant–nucleus–consonant word scores. The 200-Hz score correlated with a measure of speech perception in speech-shaped noise. Pitch-direction sensitivity is predicted jointly by the 400-Hz Schroeder score and a spectral ripple discrimination task. The results demonstrate that the Schroeder test is a potentially useful measure of clinically relevant temporal processing abilities in CI users.     

Reweighting of Binaural Localization Cues in Bilateral Cochlear-Implant Listeners

Normal-hearing (NH) listeners rely on two binaural cues, the interaural time (ITD) and level difference (ILD), for azimuthal sound localization. Cochlear-implant (CI) listeners, however, rely almost entirely on ILDs. One reason is that present-day clinical CI stimulation strategies do not convey salient ITD cues. But even when presenting ITDs under optimal conditions using a research interface, ITD sensitivity is lower in CI compared to NH listeners. Since it has recently been shown that NH listeners change their ITD/ILD weighting when only one of the cues is consistent with visual information, such reweighting might add to CI listeners’ low perceptual contribution of ITDs, given their daily exposure to reliable ILDs but unreliable ITDs. Six bilateral CI listeners completed a multi-day lateralization training visually reinforcing ITDs, flanked by a pre- and post-measurement of ITD/ILD weights without visual reinforcement. Using direct electric stimulation, we presented 100- and 300-pps pulse trains at a single interaurally place-matched electrode pair, conveying ITDs and ILDs in various spatially consistent and inconsistent combinations. The listeners’ task was to lateralize the stimuli in a virtual environment. Additionally, ITD and ILD thresholds were measured before and after training. For 100-pps stimuli, the lateralization training increased the contribution of ITDs slightly, but significantly. Thresholds were neither affected by the training nor correlated with weights. For 300-pps stimuli, ITD weights were lower and ITD thresholds larger, but there was no effect of training. On average across test sessions, adding azimuth-dependent ITDs to stimuli containing ILDs increased the extent of lateralization for both 100- and 300-pps stimuli. The results suggest that low-rate ITD cues, robustly encoded with future CI systems, may be better exploitable for sound localization after increasing their perceptual weight via training.     

Channel Interaction and Current Level Affect Across-Electrode Integration of Interaural Time Differences in Bilateral Cochlear-Implant Listeners

Sensitivity to interaural time differences (ITDs) is important for sound localization. Normal-hearing listeners benefit from across-frequency processing, as seen with improved ITD thresholds when consistent ITD cues are presented over a range of frequency channels compared with when ITD information is only presented in a single frequency channel. This study aimed to clarify whether cochlear-implant (CI) listeners can make use of similar processing when being stimulated with multiple interaural electrode pairs transmitting consistent ITD information. ITD thresholds for unmodulated, 100-pulse-per-second pulse trains were measured in seven bilateral CI listeners using research interfaces. Consistent ITDs were presented at either one or two electrode pairs at different current levels, allowing for comparisons at either constant level per component electrode or equal overall loudness. Different tonotopic distances between the pairs were tested in order to clarify the potential influence of channel interaction. Comparison of ITD thresholds between double pairs and the respective single pairs revealed systematic effects of tonotopic separation and current level. At constant levels, performance with double-pair stimulation improved compared with single-pair stimulation but only for large tonotopic separation. Comparisons at equal overall loudness revealed no benefit from presenting ITD information at two electrode pairs for any tonotopic spacing. Irrespective of electrode-pair configuration, ITD sensitivity improved with increasing current level. Hence, the improved ITD sensitivity for double pairs found for a large tonotopic separation and constant current levels seems to be due to increased loudness. The overall data suggest that CI listeners can benefit from combining consistent ITD information across multiple electrodes, provided sufficient stimulus levels and that stimulating electrode pairs are widely spaced.     

Temporal Acuity in Normal and Hearing-Impaired Listeners

Temporal acuity, defined as the minimum detectable gap in an otherwise continuous noise, was measured with an adaptive version of the two-alternative forced-choice task. For 6 normal listeners, the minimum duration detectable decreased from an average of 20.3 ms at a noise level of 30 dB SPL to 3.2 ms at 80 dB SPL. By comparison, the temporal acuity of 4 listeners with conductive hearing losses, 2 with otosclerosis, and 7 with sensorineural hearing losses, was poorer than that for normal listeners at equal sound pressure levels. At higher sound pressure levels, the acuity of those with conductive hearing losses or otosclerosis approached normal values, but the acuity for listeners with sensorineural hearing losses did not.

Nous avons mesuré l'acuité temporelle, définie comme la durée minimale d'une interruption d'un bruit par ailleurs continu pour qu'elle soit décelable, en appliquant une version particulière de la méthode des choix forcés entre deux alternatives. Chez 6 sujets jouissant d'une audition normale, ce temps passait en moyenne de 20,3 ms pour un bruit de 30 dB SPL à 3,2 ms pour un bruit de 80 dB SPL. Dans 4 cas de surdité de transmission, 2 cas d'otospongiose et 7 cas d'atteinte de l'oreille interne, nous avons trouvé une acuité temporelle moins bonne aux měmes intensités de bruit. Dans les cas de surdité de transmission et d'otospongiose, les valeurs se rapprochaient de la normale à des intensités de son plus élevées, mais il n'en était pas de měme pour les malades souffrant d'atteintes de l'oreille interne.     

The Role of Spectral and Temporal Cues in Voice Gender Discrimination by Normal-Hearing Listeners and Cochlear Implant Users

The present study investigated the relative importance of temporal and spectral cues in voice gender discrimination and vowel recognition by normal-hearing subjects listening to an acoustic simulation of cochlear implant speech processing and by cochlear implant users. In the simulation, the number of speech processing channels ranged from 4 to 32, thereby varying the spectral resolution; the cutoff frequencies of the channels envelope filters ranged from 20 to 320 Hz, thereby manipulating the available temporal cues. For normal-hearing subjects, results showed that both voice gender discrimination and vowel recognition scores improved as the number of spectral channels was increased. When only 4 spectral channels were available, voice gender discrimination significantly improved as the envelope filter cutoff frequency was increased from 20 to 320 Hz. For all spectral conditions, increasing the amount of temporal information had no significant effect on vowel recognition. Both voice gender discrimination and vowel recognition scores were highly variable among implant users. The performance of cochlear implant listeners was similar to that of normal-hearing subjects listening to comparable speech processing (4–8 spectral channels). The results suggest that both spectral and temporal cues contribute to voice gender discrimination and that temporal cues are especially important for cochlear implant users to identify the voice gender when there is reduced spectral resolution.     

Monaural and Binaural Intensity Discrimination in Normal and Cochlear-Impaired Listeners

Monaural and binaural intensity difference limens for 75-dB SPL pure tones were determined for 6 normal subjects and for 6 subjects with cochlear hearing loss. The magnitude of binaural masking level difference (BMLD) was also determined. Both normal and hearing-impaired subjects showed a 0.45-dB binaural advantage for intensity discrimination. In contrast, the BMLD was appreciably reduced with hearing impairment. Results are discussed in terms of specific effects of hearing loss on binaural hearing.     

Acoustic Temporal Modulation Detection in Normal-Hearing and Cochlear Implanted Listeners: Effects of Hearing Mechanism and Development

Temporal modulation detection ability matures over many years after birth and may be particularly sensitive to experience during this period. Profound hearing loss during early childhood might result in greater perceptual deficits than a similar loss beginning in adulthood. We tested this idea by measuring performance in temporal modulation detection in profoundly deaf children and adults fitted with cochlear implants (CIs). At least two independent variables could constrain temporal modulation detection performance in children with CIs: altered encoding of modulation information due to the CI-auditory nerve interface, and atypical development of central processing of sound information provided by CIs. The effect of altered encoding was investigated by testing subjects with one of two different hearing mechanisms (normal hearing vs. CI) and the effect of atypical development was studied by testing two different age groups. All subjects were tested for their ability to detect acoustic temporal modulations of sound amplitude. A comparison of the slope, or cutoff frequency, of the temporal modulation transfer functions (TMTFs) among the four subject groups revealed that temporal resolution was mainly constrained by hearing mechanism: normal-hearing listeners could detect smaller amplitude modulations at high modulation frequencies than CI users. In contrast, a comparison of the height of the TMTFs revealed a significant interaction between hearing mechanism and age group on overall sensitivity to temporal modulation: sensitivity was significantly poorer in children with CIs, relative to the other three groups. Results suggest that there is an age-specific vulnerability of intensity discrimination or non-sensory factors, which subsequently affects sensitivity to temporal modulation in prelingually deaf children who use CIs.     

Discrimination of Time-Reversed Harmonic Complexes by Normal-Hearing and Hearing-Impaired Listeners

Normal-hearing (NH) listeners and hearing-impaired (HI) listeners detected and discriminated time-reversed harmonic complexes constructed of equal-amplitude harmonic components with fundamental frequencies (F0s) ranging from 50 to 800 Hz. Component starting phases were selected according to the positive and negative Schroeder-phase algorithms to produce within-period frequency sweeps with relatively flat temporal envelopes. Detection thresholds were not affected by component starting phases for either group of listeners. At presentation levels of 80 dB SPL, NH listeners could discriminate the two waveforms nearly perfectly when the F0s were less than 300–400 Hz but fell to chance performance for higher F0s. HI listeners performed significantly poorer, with reduced discrimination at several of the F0s. In contrast, at a lower presentation level meant to nearly equate sensation levels for the two groups, NH listeners’ discrimination was poorer than HI listeners at most F0s. Roving presentation levels had little effect on performance by NH listeners but reduced performance by HI listeners. The differential impact of roving level suggests a weaker perception of timbre differences and a greater susceptibility to the detrimental effects of experimental uncertainty in HI listeners.     

Modulation Frequency Discrimination with Modulated and Unmodulated Interference in Normal Hearing and in Cochlear-Implant Users

Differences in fundamental frequency (F0) provide an important cue for segregating simultaneous sounds. Cochlear implants (CIs) transmit F0 information primarily through the periodicity of the temporal envelope of the electrical pulse trains. Successful segregation of sounds with different F0s requires the ability to process multiple F0s simultaneously, but it is unknown whether CI users have this ability. This study measured modulation frequency discrimination thresholds for half-wave rectified sinusoidal envelopes modulated at 115 Hz in CI users and normal-hearing (NH) listeners. The target modulation was presented in isolation or in the presence of an interferer. Discrimination thresholds were strongly affected by the presence of an interferer, even when it was unmodulated and spectrally remote. Interferer modulation increased interference and often led to very high discrimination thresholds, especially when the interfering modulation frequency was lower than that of the target. Introducing a temporal offset between the interferer and the target led to at best modest improvements in performance in CI users and NH listeners. The results suggest no fundamental difference between acoustic and electric hearing in processing single or multiple envelope-based F0s, but confirm that differences in F0 are unlikely to provide a robust cue for perceptual segregation in CI users.     

Electrophysiological and Psychophysical Measures of Temporal Pitch Sensitivity in Normal-hearing Listeners

To obtain combined behavioural and electrophysiological measures of pitch perception, we presented harmonic complexes, bandpass filtered to contain only high-numbered harmonics, to normal-hearing listeners. These stimuli resemble bandlimited pulse trains and convey pitch using a purely temporal code. A core set of conditions consisted of six stimuli with baseline pulse rates of 94, 188 and 280 pps, filtered into a HIGH (3365–4755 Hz) or VHIGH (7800–10,800 Hz) region, alternating with a 36% higher pulse rate. Brainstem and cortical processing were measured using the frequency following response (FFR) and auditory change complex (ACC), respectively. Behavioural rate change difference limens (DLs) were measured by requiring participants to discriminate between a stimulus that changed rate twice (up-down or down-up) during its 750-ms presentation from a constant-rate pulse train. FFRs revealed robust brainstem phase locking whose amplitude decreased with increasing rate. Moderate-sized but reliable ACCs were obtained in response to changes in purely temporal pitch and, like the psychophysical DLs, did not depend consistently on the direction of rate change or on the pulse rate for baseline rates between 94 and 280 pps. ACCs were larger and DLs lower for stimuli in the HIGH than in the VHGH region. We argue that the ACC may be a useful surrogate for behavioural measures of rate discrimination, both for normal-hearing listeners and for cochlear-implant users. We also showed that rate DLs increased markedly when the baseline rate was reduced to 48 pps, and compared the behavioural and electrophysiological findings to recent cat data obtained with similar stimuli and methods.

     

Limitations on Monaural and Binaural Temporal Processing in Bilateral Cochlear Implant Listeners

Monaural rate discrimination and binaural interaural time difference (ITD) discrimination were studied as functions of pulse rate in a group of bilaterally implanted cochlear implant users. Stimuli for the rate discrimination task were pulse trains presented to one electrode, which could be in the apical, middle, or basal part of the array, and in either the left or the right ear. In each two-interval trial, the standard stimulus had a rate of 100, 200, 300, or 500 pulses per second and the signal stimulus had a rate 35 % higher. ITD discrimination between pitch-matched electrode pairs was measured for the same standard rates as in the rate discrimination task and with an ITD of +/− 500 μs. Sensitivity (d′) on both tasks decreased with increasing rate, as has been reported previously. This study tested the hypothesis that deterioration in performance at high rates occurs for the two tasks due to a common neural basis, specific to the stimulation of each electrode. Results show that ITD scores for different pairs of electrodes correlated with the lower rate discrimination scores for those two electrodes. Statistical analysis, which partialed out overall differences between listeners, electrodes, and rates, supports the hypothesis that monaural and binaural temporal processing limitations are at least partly due to a common mechanism.     

Rate Discrimination Training May Partially Restore Temporal Processing Abilities from Age-Related Deficits

Journal of the Association for Research in Otolaryngology - The ability to understand speech in complex environments depends on the brain’s ability to preserve the precise timing...     

Temporal Resolution of the Normal Ear in Listeners with Unilateral Hearing Impairment

Unilateral hearing loss (UHL) leads to an imbalanced input to the brain and results in cortical reorganization. In listeners with unilateral impairments, while the perceptual deficits associated with the impaired ear are well documented, less is known regarding the auditory processing in the unimpaired, clinically normal ear. It is commonly accepted that perceptual consequences are unlikely to occur in the normal ear for listeners with UHL. This study investigated whether the temporal resolution in the normal-hearing (NH) ear of listeners with long-standing UHL is similar to those in listeners with NH. Temporal resolution was assayed via measuring gap detection thresholds (GDTs) in within- and between-channel paradigms. GDTs were assessed in the normal ear of adults with long-standing, severe-to-profound UHL (N = 13) and age-matched, NH listeners (N = 22) at two presentation levels (30 and 55 dB sensation level). Analysis indicated that within-channel GDTs for listeners with UHL were not significantly different than those for the NH subject group, but the between-channel GDTs for listeners with UHL were poorer (by greater than a factor of 2) than those for the listeners with NH. The hearing thresholds in the normal or impaired ears were not associated with the elevated between-channel GDTs for listeners with UHL. Contrary to the common assumption that auditory processing capabilities are preserved for the normal ear in listeners with UHL, the current study demonstrated that a long-standing unilateral hearing impairment may adversely affect auditory perception—temporal resolution—in the clinically normal ear. From a translational perspective, these findings imply that the temporal processing deficits in the unimpaired ear of listeners with unilateral hearing impairments may contribute to their overall auditory perceptual difficulties.     

Detection and Identification of Monaural and Binaural Pitch Contours in Dyslexic Listeners

The use of binaural pitch stimuli to test for the presence of binaural auditory impairment in reading-disabled subjects has so far led to contradictory outcomes. While some studies found that a majority of dyslexic subjects was unable to perceive binaural pitch, others obtained a clear response of dyslexic listeners to Huggins’ pitch (HP). The present study clarified whether impaired binaural pitch perception is found in dyslexia. Results from a pitch contour identification test, performed in 31 dyslexic listeners and 31 matched controls, clearly showed that dyslexics perceived HP as well as the controls. Both groups also showed comparable results with a similar-sounding, but monaurally detectable, pitch-evoking stimulus. However, nine of the dyslexic subjects were found to have difficulty identifying pitch contours both in the binaural and the monaural conditions. The ability of subjects to correctly identify pitch contours was found to be significantly correlated to measures of frequency discrimination. This correlation may be attributed to the similarity of the experimental tasks and probably reflects impaired cognitive mechanisms related to auditory memory or auditory attention rather than impaired low-level auditory processing per se.     

Two Experiments on Subtle Mid-Frequency Hearing Loss and Its Influence on Word Discrimination in Noise-Exposed Listeners

The present study consisted of two experiments. Experiment I was directed toward the detection of subtle mid-frequency cochlear dysfunction and the determination of word discrimination in noise for persons with noise-induced hearing loss. The presence of significantly elevated aural-overload thresholds, consistent with the presence of cochlear pathology in regions of normal pure-tone sensitivity, confirmed previous findings obtained with this subject population by other investigators. In addition, a marked reduction in word discrimination was observed in the presence of a background of competing noise.

For experiment II, normal hearers listened to consonant-nucleus-consonant monosyllables filtered to match the mean audiometric configuration of the noise-exposed subjects in experiment I. Results showed significantly better performance with these filtered words by the normally hearing subjects than that by the noise-exposed group for unfiltered materials. The results of the second experiment were interpreted as providing further support for the presence of subtle auditory dysfunction in the mid-frequencies despite normal threshold sensitivity in this same frequency region.

Dans une première expérience, nous avons utilisé des sujets présentant une baisse de l'acuité auditive à la suite de traumatismes sonores. Nous avons tout d'abord cherché a connaiˇtre l'importance de l'atteinte cochléaire au niveau des fréquences moyennes et nous avons déterminé pour cela les seuils de surcharge auditive (test harmonique); comme certains auteurs précédents, nous nous sommes apençus que ces seuils étaient nettement élevés, témoignant d'une atteinte cochléaire dans une région dont la sensibilité aux sons purs était pourtant normale. Nous avons ensuite noté une baisse importante de la discrimination de mots en présence de bruit.

Dans une seconde expérience, nous avons utilisé des sujets à audition normale. Nous leur avons fait écouter des monosyllabes CNC filtrées de façon à se rapprocher de la configuration audiométrique moyenne des sujets précédents. Leur performance pour ces mots filtrés fut bien meilleure que celle des sujets ayant été exposés au bruit pour les mots non filtrés. Cette deuxième expérience nous semble encore meilleure pour mettre en évidence la présence d'un dysfonctionnement de la cochlée au niveau des fréquences moyennes alors que les seuils de sensation sont normaux pour ces měmes fréquences.     

Effect of Chronic Stimulation and Stimulus Level on Temporal Processing by Cochlear Implant Listeners

A series of experiments investigated potential changes in temporal processing during the months following activation of a cochlear implant (CI) and as a function of stimulus level. Experiment 1 tested patients on the day of implant activation and 2 and 6 months later. All stimuli were presented using direct stimulation of a single apical electrode. The dependent variables were rate discrimination ratios (RDRs) for pulse trains with rates centred on 120 pulses per second (pps), obtained using an adaptive procedure, and a measure of the upper limit of temporal pitch, obtained using a pitch-ranking procedure. All stimuli were presented at their most comfortable level (MCL). RDRs decreased from 1.23 to 1.16 and the upper limit increased from 357 to 485 pps from 0 to 2 months post-activation, with no overall change from 2 to 6 months. Because MCLs and hence the testing level increased across sessions, two further experiments investigated whether the performance changes observed across sessions could be due to level differences. Experiment 2 re-tested a subset of subjects at 9 months post-activation, using current levels similar to those used at 0 months. Although the stimuli sounded softer, some subjects showed lower RDRs and/or higher upper limits at this re-test. Experiment 3 measured RDRs and the upper limit for a separate group of subjects at levels equal to 60 %, 80 % and 100 % of the dynamic range. RDRs decreased with increasing level. The upper limit increased with increasing level for most subjects, with two notable exceptions. Implications of the results for temporal plasticity are discussed, along with possible influences of the effects of level and of across-session learning.

     

Relative Contributions of Temporal Envelope and Fine Structure Cues to Lexical Tone Recognition in Hearing-Impaired Listeners

It has been reported that normal-hearing Chinese speakers base their lexical tone recognition on fine structure regardless of temporal envelope cues. However, a few psychoacoustic and perceptual studies have demonstrated that listeners with sensorineural hearing impairment may have an impaired ability to use fine structure information, whereas their ability to use temporal envelope information is close to normal. The purpose of this study is to investigate the relative contributions of temporal envelope and fine structure cues to lexical tone recognition in normal-hearing and hearing-impaired native Mandarin Chinese speakers. Twenty-two normal-hearing subjects and 31 subjects with various degrees of sensorineural hearing loss participated in the study. Sixteen sets of Mandarin monosyllables with four tone patterns for each were processed through a “chimeric synthesizer” in which temporal envelope from a monosyllabic word of one tone was paired with fine structure from the same monosyllable of other tones. The chimeric tokens were generated in the three channel conditions (4, 8, and 16 channels). Results showed that differences in tone responses among the three channel conditions were minor. On average, 90.9%, 70.9%, 57.5%, and 38.2% of tone responses were consistent with fine structure for normal-hearing, moderate, moderate to severe, and severely hearing-impaired groups respectively, whereas 6.8%, 21.1%, 31.4%, and 44.7% of tone responses were consistent with temporal envelope cues for the above-mentioned groups. Tone responses that were consistent neither with temporal envelope nor fine structure had averages of 2.3%, 8.0%, 11.1%, and 17.1% for the above-mentioned groups of subjects. Pure-tone average thresholds were negatively correlated with tone responses that were consistent with fine structure, but were positively correlated with tone responses that were based on the temporal envelope cues. Consistent with the idea that the spectral resolvability is responsible for fine structure coding, these results demonstrated that, as hearing loss becomes more severe, lexical tone recognition relies increasingly on temporal envelope rather than fine structure cues due to the widened auditory filters.     

Intensity Discrimination,Temporal Integration and Gap Detection by Normally-hearing Subjects with Weak and Strong Otoacoustic Emissions

It is unlikely that the overall status of a cochlea and middle ear which produces strong otoacoustic emissions (OAEs), i.e. high-level evoked emissions (EOAEs) and spontaneous emissions (SOAEs), has a generalized effect on peripheral auditory processing if the sensitivity is normal. Current data do not support the hypothesis that a weak OAE profile (low-level EOAEs and no SOAEs) is indicative of subclinical damage to the cochlea. Nevertheless, the ability of a subject to perform some psychoacoustical tasks may be influenced by the interaction between OAEs and test signals. The present experiments investigated the influence of strong or weak OAEs on: (1) intensity just-noticeable differences for pure tones; (2) temporal integration in the vicinity of SOAEs; (3) gap detection thresholds for broad-band noise bursts. The results show that OAEs can influence performance on these psychoacoustical tasks, especially for low-level stimuli with spectral components in the vicinity of high-level SOAEs.     

Effect of Stimulus Polarity on Detection Thresholds in Cochlear Implant Users: Relationships with Average Threshold,Gap Detection,and Rate Discrimination

Previous psychophysical and modeling studies suggest that cathodic stimulation by a cochlear implant (CI) may preferentially activate the peripheral processes of the auditory nerve, whereas anodic stimulation may preferentially activate the central axons. Because neural degeneration typically starts with loss of the peripheral processes, lower thresholds for cathodic than for anodic stimulation may indicate good local neural survival. We measured thresholds for 99-pulse-per-second trains of triphasic (TP) pulses where the central high-amplitude phase was either anodic (TP-A) or cathodic (TP-C). Thresholds were obtained in monopolar mode from four or five electrodes and a total of eight ears from subjects implanted with the Advanced Bionics CI. When between-subject differences were removed, there was a modest but significant correlation between the polarity effect (TP-C threshold minus TP-A threshold) and the average of TP-C and TP-A thresholds, consistent with the hypothesis that a large polarity effect corresponds to good neural survival. When data were averaged across electrodes for each subject, relatively low thresholds for TP-C correlated with a high “upper limit” (the pulse rate up to which pitch continues to increase) from a previous study (Cosentino et al. J Assoc Otolaryngol 17:371–382). Overall, the results provide modest indirect support for the hypothesis that the polarity effect provides an estimate of local neural survival.