Neural response measurement

Abstract

Presented herein are techniques for measuring an evoked response to stimulation. One or more electrical stimulation signals are delivered to first ear of a recipient via a first hearing device implanted at the first ear of the recipient. One or more evoked potential evoked by the one or more electrical stimulation signals are measured with a second hearing device implanted at a second ear of the recipient.

Description

Atty. Docket No. 3065.0863i Client Ref. No. CID03815WOPC1NEURAL RESPONSE MEASUREMENTBACKGROUNDField of the Invention[oooi] The present invention relates generally to measuring neural responses in a medical device system.Related Art

[0002] Medical devices have provided a wide range of therapeutic benefits to recipients over recent decades. Medical devices can include internal or implantable components / devices, external or wearable components / devices, or combinations thereof (e.g., a device having an external component communicating with an implantable component). Medical devices, such as traditional hearing aids, partially or fully-implantable hearing prostheses (e.g., bone conduction devices, mechanical stimulators, cochlear implants, etc.), pacemakers, defibrillators, functional electrical stimulation devices, and other medical devices have been successful in performing lifesaving and / or lifestyle enhancement functions and / or recipient monitoring for a number of years.

[0003] The types of medical devices and the ranges of functions performed thereby have increased over the years. For example, many medical devices, sometimes referred to as “implantable medical devices,” now often include one or more instruments, apparatus, sensors, processors, controllers or other functional mechanical or electrical components that are permanently or temporarily implanted in a recipient. These functional devices are typically used to diagnose, prevent, monitor, treat, or manage a disease / injury or symptom thereof, or to investigate, replace or modify the anatomy or a physiological process. Many of these functional devices utilize power and / or data received from external devices that are part of, or operate in conjunction with, implantable components.SUMMARY

[0004] In one aspect, a method is provided. The method comprises: delivering one or more electrical stimulation signals to first ear of a recipient via a first hearing device implanted at the first ear of the recipient; and measuring, with a second hearing device implanted or placed intra- aurally at a second ear of the recipient, at least one evoked potential evoked by the one or more electrical stimulation signals.Atty. Docket No. 3065.0863i Client Ref. No. CID03815WOPC1

[0005] In another aspect, another method is provided. The method comprises: recording, on a first recording channel of a first hearing device implanted in a first ear of a recipient, a first neural response to a stimulus; recording, on a second recording channel of a second hearing device implanted in a second ear of the recipient, a second neural response to the stimulus; and performing one or more actions based on the first neural response and the second neural response.

[0006] In another aspect, an apparatus is provided. The apparatus comprises: a first hearing device implanted in a first ear of a recipient, the first hearing device delivering a stimulus for evoking a response from an auditory path; and a second hearing device implanted in a second ear of the recipient, the second hearing device measuring the response to the stimulus.

[0007] In another aspect, another apparatus is provided. The apparatus comprises a first hearing device implanted in a first ear of a recipient, the first hearing device recording a first neural response to a stimulus; and a second hearing device implanted in a second ear of the recipient, the second hearing device recording a second neural response to the stimulus.BRIEF DESCRIPTION OF THE DRAWINGS

[0008] Embodiments of the present invention are described herein in conjunction with the accompanying drawings, in which:

[0009] FIG. 1 A is a schematic view of a cochlear implant system in which embodiments presented herein can be implemented;[ooio] FIG. IB is a side view of a recipient wearing the cochlear implant system of FIG. 1A;[ooii] FIG. 1C is a schematic view of the components of the cochlear implant system of FIG. 1 A;

[0012] FIGs. ID and IE are block diagrams of sound processing units forming part of the cochlear implant system of FIG. 1A;

[0013] FIG. 2 is a diagram of a system for delivering a stimulus with a first hearing device and measuring a response to the stimulus with a second hearing device, according to embodiments presented herein;

[0014] FIG. 3 is a diagram of a system for delivering a stimulus and recording a response to the stimulus at a first hearing device and a second hearing device, according to embodiments presented herein;Atty. Docket No. 3065.0863i Client Ref. No. CID03815WOPC1

[0015] FIG. 4 is a diagram of a system for determining adjustments for a hearing device, according to embodiments presented herein;

[0016] FIG. 5 is a flow diagram of a method of measuring, at a second hearing device, potential evoked by one or more electrical stimulation signals delivered by a first hearing device, according to embodiments presented herein;

[0017] FIG. 6 is a flow diagram of a method of performing one or more actions based on a first neural response measured at a first hearing device and a second neural response measured at a second hearing device, according to embodiments presented herein;

[0018] FIG. 7 is a schematic diagram illustrating an example system that can be configured to perform certain aspects of the embodiments presented herein; and.

[0019] FIG. 8 is a schematic diagram illustrating another example system that can be configured to perform certain aspects of the embodiments presented herein.DETAILED DESCRIPTION

[0020] Presented herein are techniques for performing measurements of neural response (evoked potentials) using implantable medical devices, such as hearing / auditory prostheses, outside of a clinical environment. In particular, the techniques presented herein deliver one or more stimulation signals (e.g., electrical stimulation signals) to first location (e.g., a first ear) of a recipient via / using a first implantable medical device implanted / positioned at the first location. A second implantable medical device positioned / implanted at a second location (e.g., a second ear) of the recipient measures at least one neural response evoked by the one or more electrical stimulation signals.

[0021] It is to be appreciated that the techniques presented herein can be implemented with any of a number of systems, including in conjunction with cochlear implants or other hearing devices, balance prostheses (e.g., vestibular implants), retinal or other visual prostheses, cardiac devices (e.g., implantable pacemakers, defibrillators, etc.), seizure devices, sleep apnea devices, electroporation devices, spinal cord stimulators, deep brain stimulators, motor cortex stimulators, sacral nerve stimulators, pudendal nerve stimulators, vagus / vagal nerve stimulators, trigeminalAtty. Docket No. 3065.0863i Client Ref. No. CID03815WOPC1 nerve stimulators, diaphragm (phrenic) pacers, pain relief stimulators, other neural, neuromuscular, or functional stimulators, etc.

[0022] In certain examples, the techniques presented herein can be implemented by hearing device systems that comprise of at least two devices that operate to convert sound signals into one or more acoustic, mechanical, and / or electrical stimulation signals for delivery to a user / recipient. One specific type of hearing device system, referred to herein as a “binaural hearing device system” or more simply as a “binaural system,” includes two hearing devices, where one of the two hearing prosthesis is positioned at each ear of the recipient. More specifically, in a binaural system each of the two hearing devices can deliver stimulation to one of the two ears of the recipient (i.e., either the right or the left ear of the recipient). The binaural system can include any combination of one or more personal sound amplification products (PSAPs), hearing aids, middle ear auditory prostheses, bone conduction devices, direct acoustic stimulators, electro-acoustic prostheses, auditory brain stimulators, cochlear implants, combinations or variations thereof, etc.,

[0023] Merely for ease of description, aspects of the techniques will be generally described with reference to a specific binaural hearing device system, namely a bilateral cochlear implant system. As used herein, a “bilateral cochlear implant system” is a specific type of binaural system that includes first and second cochlear implants located at first and second ears, respectively, of a recipient. In such systems, each of the two cochlear implant system can deliver electrical stimulation signals (current pulses) to one of the two ears of the recipient (i.e., either the right or the left ear of the recipient). In a bilateral cochlear implant system, one or more of the two cochlear implants can also deliver acoustic stimulation to the ears of the recipient (e.g., an electro-acoustic cochlear implant) and / or the two cochlear implants need not be identical with respect to, for example, the number of electrodes used to electrically stimulate the cochlea, the type of stimulation delivered, etc.

[0024] FIGs. 1A-1E are diagrams illustrating one example bilateral cochlear implant system 100 configured to implement the techniques presented herein. More specifically, FIGs. 1A-1E illustrate an example bilateral system 100 comprising left and right cochlear implants, referred to as cochlear implant 102L and cochlear implant 102R. FIGs. 1A and IB are schematic drawings of a recipient wearing the left cochlear implant 102L at a left ear 14 IL and the right cochlear implant 102R at a right ear 141R, while FIG. 1C is a schematic view of each of the left and rightAtty. Docket No. 3065.0863i Client Ref. No. CID03815WOPC1 cochlear implants. FIGs. ID and IE are block diagrams illustrating further details of the left cochlear implant 102L and the right cochlear implant 102R, respectively.

[0025] Referring specifically to FIG. 1 C, cochlear implant 102L includes an external component 104L that is configured to be directly or indirectly attached to the body of the recipient and an implantable component 112L configured to be implanted in the recipient. The external component 104L comprises a sound processing unit 106L, while the implantable component 112L includes an internal coil 114L, a stimulator unit 142L and an elongate stimulating assembly (electrode array) 116L implanted in the recipient’s left cochlea (not shown in FIG. 1C).

[0026] The cochlear implant 102R is substantially similar to cochlear implant 102L. In particular, cochlear implant 102R includes an external component 104R comprising a sound processing unit 106R, and an implantable component 112R comprising internal coil 114R, stimulator unit 142R, and elongate stimulating assembly 116R.

[0027] FIG. ID is a block diagram illustrating further details of cochlear implant 102L, while FIG. IE is a block diagram illustrating further details of cochlear implant 102R. As noted, cochlear implant 102R is substantially similar to cochlear implant 102L and includes like elements as that described below with reference to cochlear implant 102L. For ease of description, further details of cochlear implant 102R have been omitted from the description.

[0028] As noted, the external component 104L of cochlear implant 102L includes a sound processing unit 106L. The sound processing unit 106L comprises one or more input devices 113L that are configured to receive input signals (e.g., sound or data signals). In the example of FIG. ID, the one or more input devices 113L include one or more sound input devices 118L (e.g., microphones, audio input ports, telecoils, etc.), one or more auxiliary input devices 119L (e.g., audio ports, such as a Direct Audio Input (DAI), data ports, such as a Universal Serial Bus (USB) port, cable port, etc.), and a wireless transmitter / receiver (transceiver) 120L. However, it is to be appreciated that one or more input devices 113L can include additional types of input devices and / or less input devices (e.g., one or more auxiliary input devices 119L could be omitted).

[0029] The sound processing unit 106L also comprises one type of a closely-coupled transmitter / receiver (transceiver) 122L, referred to as radio-frequency (RF) transceiver 122L, a power source 123L, and a processing module 124L. The processing module 124L comprises oneAtty. Docket No. 3065.0863i Client Ref. No. CID03815WOPC1 or more processors 125L and a memory 126L that includes sound processing logic 127L and measurement logic 128L.

[0030] In the examples of FIGs. 1 A-1E, the sound processing unit 106L and the sound processing unit 106R are off-the-ear (OTE) sound processing units (i.e., components having a generally cylindrical shape and which is configured to be magnetically coupled to the recipient’s head), etc. However, it is to be appreciated that embodiments of the present invention can be implemented by sound processing units having other arrangements, such as by a behind-the-ear (BTE) sound processing unit configured to be attached to and worn adjacent to the recipient’s ear, including a mini or micro-BTE unit, an in-the-canal unit that is configured to be located in the recipient’s ear canal, a body-worn sound processing unit, etc.

[0031] The implantable component 112L comprises an implant body (main module) 134L, a lead region 136L, and the intra-cochlear stimulating assembly 116L, all configured to be implanted under the skin / tissue (tissue) 115 of the recipient. The implant body 134L generally comprises a hermetically-sealed housing 138L in which RF interface circuitry 140L and a stimulator unit 142L are disposed. The implant body 134L also includes the internal / implantable coil 114L that is generally external to the housing 138L, but which is connected to the RF interface circuitry 140L via a hermetic feedthrough (not shown in FIG. ID).

[0032] As noted, stimulating assembly 116L is configured to be at least partially implanted in the recipient’s cochlea. Stimulating assembly 116L includes a plurality of longitudinally spaced intra- cochlear electrical stimulating contacts (electrodes) 144L that collectively form a contact or electrode array 146L for delivery of electrical stimulation (current) to the recipient’s cochlea.

[0033] Stimulating assembly 116L extends through an opening in the recipient’s cochlea (e.g., cochleostomy, the round window, etc. and has a proximal end connected to stimulator unit 142L via lead region 136L and a hermetic feedthrough (not shown in FIG. ID). Lead region 136L includes a plurality of conductors (wires) that electrically couple the electrodes 144L to the stimulator unit 142L.

[0034] As noted, the cochlear implant 102L includes the external coil 108L and the implantable coil 114L. The coils 108L and 114L are typically wire antenna coils each comprised of multiple turns of electrically insulated single-strand or multi-strand platinum or gold wire. Generally, a magnet is fixed relative to each of the external coil 108L and the implantable coil 114L. TheAtty. Docket No. 3065.0863i Client Ref. No. CID03815WOPC1 magnets fixed relative to the external coil 108L and the implantable coil 114L facilitate the operational alignment of the external coil 108L with the implantable coil 114L. This operational alignment of the coils enables the external component 104L to transmit data, as well as possibly power, to the implantable component 112L via a closely-coupled wireless link formed between the external coil 108L with the implantable coil 114L. In certain examples, the closely-coupled wireless link is a radio frequency (RF) link. However, various other types of energy transfer, such as infrared (IR), electromagnetic, capacitive and inductive transfer, can be used to transfer the power and / or data from an external component to an implantable component and, as such, FIG. ID illustrates only one example arrangement.

[0035] As noted above, sound processing unit 106L includes the processing module 124L. The processing module 124L is configured to convert received input signals (received at one or more of the input devices 113L) into output signals 145L for use in stimulating a first ear of a recipient (i.e., the processing module 124L is configured to perform sound processing on input signals received at the sound processing unit 106L). Stated differently, in the sound processing mode, the one or more processors 125L are configured to execute sound processing logic stored, for example, in in memory 126L to convert the received input signals into output signals 145L that represent electrical stimulation for delivery to the recipient.

[0036] In the embodiment of FIG. ID, the output signals 145L are provided to the RF transceiver 122L, which transcutaneously transfers the output signals 145L (e.g., in an encoded manner) to the implantable component 112L via external coil 108L and implantable coil 114L. That is, the output signals 145L are received at the RF interface circuitry 140L via implantable coil 114L and provided to the stimulator unit 142L. The stimulator unit 142L is configured to utilize the output signals 145L to generate electrical stimulation signals (e.g., current signals) for delivery to the recipient’ s cochlea via one or more stimulating contacts 144L. In this way, cochlear implant 102L electrically stimulates the recipient’s auditory nerve cells, bypassing absent or defective hair cells that normally transduce acoustic vibrations into neural activity, in a manner that causes the recipient to perceive one or more components of the received sound signals.

[0037] As noted, cochlear implant 102R is substantially similar to cochlear implant 102L and comprises external component 104R and implantable component 112R. External component 104R includes a sound processing unit 106Rthat comprises external coil 108R, input devices 113R (i.e., one or more sound input devices 118R, one or more auxiliary input devices 119R, and wirelessAtty. Docket No. 3065.0863i Client Ref. No. CID03815WOPC1 transceiver 120R), closely-coupled transceiver (RF transceiver) 122R, power source 123R, and processing module 124R. The processing module 124R includes one or more processors 125R and a memory 126R that includes sound processing logic 127R and measurement logic 128R. The implantable component 112R includes an implant body (main module) 134R, a lead region 136R, and the intra-cochlear stimulating assembly 116R, all configured to be implanted under the skin / tissue (tissue) 115 of the recipient. The implant body 134R generally comprises a hermetically-sealed housing 138R in which RF interface circuitry 140L and a stimulator unit 142R are disposed. The implant body 134R also includes the internal / implantable coil 114R that is generally external to the housing 138R, but which is connected to the RF interface circuitry 140R via a hermetic feedthrough (not shown in FIG. IE). The stimulating assembly 116R includes a plurality of longitudinally spaced intra-cochlear electrical stimulating contacts (electrodes) 144R that collectively form a contact or electrode array 146R for delivery of electrical stimulation (current) to the recipient’s cochlea. Each of the elements of cochlear implant 102R shown in FIG. IE are similar to like-numbered elements of cochlear implant 102L shown in FIG. ID.

[0038] It is to be appreciated that the arrangements of cochlear implants 102L and 102R, as shown in FIGs. 1A-1E, are merely illustrative and that the cochlear implants 102L and 102R could have different arrangements. For example, in certain embodiments, the implantable components 112L and 112R could each include a wireless transceiver that is similar to the wireless transceivers 120L and 120R. In the same or other embodiments, the implantable components 112L and 112R could each include processing modules that are similar to the processing modules 124L and 124R. The implantable components 112L and 112R could also include processing modules that are not necessarily the same as the processing modules 124L and 124R, for example, in terms of functional capabilities.

[0039] The cochlear implants 102L and 102R are configured to establish a binaural wireless communication link / channel 162 (binaural wireless link) that enables the cochlear implants 102L and 102R (e.g., the sound processing units 104L / 104R and / or the implantable components 1121 / 122, if equipped with wireless transceivers) to wirelessly communicate with one another. The binaural wireless link 162 can be, for example, a magnetic induction (MI) link, a standardized wireless channel, such as a Bluetooth®, Bluetooth® Low Energy (BLE) or other channel interface making use of any number of standard wireless streaming protocols, a proprietary protocol forAtty. Docket No. 3065.0863i Client Ref. No. CID03815WOPC1 wireless exchange of data, etc. Bluetooth® is a registered trademark owned by the Bluetooth® SIG. The binaural wireless link 162 is enabled by the wireless transceivers 120L and 120R.

[0040] In certain conventional arrangements, the objective assessment of the function of acoustic hearing by means of neural responses (evoked potentials) requires the use of scalp electrodes and external recording equipment. These measurements need to be done in a clinical setup and require extra preparation. Presented herein are techniques for performing these measurements with hearing devices themselves to enable monitoring outside of the clinical environment.

[0041] The present inventors have determined that ipsilateral objective measurements of neural responses (e.g., measurements made by the same device that delivers the electrical stimulus) are frequently contaminated by a large electrical artifact that masks a target response. Moreover, certain objective measurements, particularly cortical responses, are lateralized to the contralateral side and are harder to detect on the ipsilateral side. The present inventors have determined that neural response measurements taken at a contralateral hearing device in response to stimulation by an ipsilateral hearing device can be easier to detect and have a smaller artifact than neural response measurements taken at the ipsilateral hearing device. Currently, for neural response measurements taken during ongoing stimulation (e.g., neural tracking of electroencephalogram (EEG) signals or other continuous monitoring), background noise and brain activity cannot be reduced by means of averaging.

[0042] According to some embodiments described herein, neural response measurements at a contralateral hearing device of a recipient can be taken in response to stimulation delivered by an ipsilateral hearing device of the recipient. For example, a first (ipsilateral) cochlear implant can deliver electrical stimulation signals, and a second (contralateral) cochlear implant can measure the neural response (evoked potentials) evoked by the electrical stimulation signals. In certain examples, no additional devices are needed for the measurements and measurements can be done at home or in another location outside of a clinic. This allows for monitoring of a recipient’s hearing performance, to adjust settings, detect issues to be treated by the clinician or to provide input for pre-processing or noise cancelling algorithms (e.g., detect focus and adjust directionality, enhance target speaker focus, etc.), etc.

[0043] According to additional embodiments described herein, a recording channel can be provided on each one of two auditory bilaterally arranged hearing devices. Each recording channelAtty. Docket No. 3065.0863i Client Ref. No. CID03815WOPC1 can record a higher order response that can be correlated with acoustic or electric stimulus received by one or both ears. In other words, the measured response from each of two separate recording channels (one on each side of the head) can be combined to improve the signal extraction from the background activity. In an embodiment, each hearing device can be a cochlear implant that measures EEG from each of the intracochlear electrodes to understand how speech is being comprehended.

[0044] As noted, embodiments described herein provide for recording or measuring neural responses (e.g., neural responses evoked in response to an electrical stimulus) at one or more locations, such as first and second ears of a recipient of a medical device system. For example, referred specifically to a binaural hearing device system comprising first and second hearing devices implanted at first and second ears, respectively, of a recipient, the embodiments described herein relate to recording or measuring neural responses at / by one or both hearing devices.

[0045] Reference is now made to FIG. 2, which is a diagram illustrating an example in which an ipsilateral hearing device 202 delivers stimulation to a first ear of a recipient and a contralateral hearing device 204 measures the evoked response to the stimulation. In one embodiment, ipsilateral hearing device 202 and contralateral hearing device 204 are each cochlear implants.

[0046] As illustrated in FIG. 2, a recipient of the hearing devices (or another user) can initiate a test using an external device 208. In some embodiments, the test can be automatically initiated without input from the recipient. When the test is initiated, ipsilateral hearing device 202 can deliver an electrical stimulus (one or more electrical stimulation signals) 206 to the first ear of the recipient. As described above, ipsilateral objective measurements of neural responses can be contaminated by a large electrical artifact that masks the target response. In addition, some neural responses, particular cortical responses, are lateralized to the contralateral side and are the responses are more difficult to detect on the ipsilateral or stimulating side. Therefore, in accordance with embodiments presented herein and as illustrated in FIG. 2, a response to the stimulus 206 can be measured at contralateral hearing device 204.

[0047] Contralateral hearing device 204 can have a recording channel for measuring the neural response(s). A cochlear implant, in particular, can use a combination of electrodes to record the response to the stimulus. For example, recording using a combination of an intracochlear electrode and an extracochlear electrode can yield the best signals for some responses (e.g., brainstem orAtty. Docket No. 3065.0863i Client Ref. No. CID03815WOPC1 cortical responses). In other examples, different electrodes or different combinations of electrodes can be used to record the responses.

[0048] In certain examples, the delivered stimulus and / or the contralateral hearing device 204 are configured to evoke / record higher order responses, such as cortical responses and brainstem responses. For example, a stimulus can be provided to measure an electrically-evoked auditory brainstem response (E-ABR), which measures how well the auditory nerve responds to electrical stimulation. As another example, the delivered stimulus and / or the contralateral hearing device 204 are configured to evoke / record an electroencephalography (EEG) response that indicates electrical activity of the brain. In some embodiments, other responses can be recorded.

[0049] Advantageously, there is reduced artifact noise in the signal that is measured using the recording channel of contralateral hearing device 204 compared to using a recording channel of ipsilateral hearing device 202. Another advantage to recording the neural responses at contralateral hearing device 204 is that some potentials, such as cortical potentials, are generated at the contralateral auditory cortex and are easier to be detected from the contralateral side than from the ipsilateral or stimulating side.

[0050] For contralateral hearing device 204 to properly record a neural response evoked by stimulus delivered via ipsilateral hearing device 202, ipsilateral hearing device 202 and contralateral hearing device 204 are synchronized to ensure that the stimulation and recording are aligned. For example, the hearing devices can be synchronized or phase locked to a reference signal in a case in which a synthetic test stimulus, such as a pulse or pulse train, is used. In some embodiments, a synthetic stimulus can be used because the same test can be performed repeatedly with the same synthetic stimulus and the results can be averaged to remove background noise and provide a meaningful result.

[0051] In certain examples, a wireless link can be provided between ipsilateral hearing device 202 and contralateral hearing device 204, and this wireless link could be used to synchronize the recording of a neural response with the stimulus. For example, the ipsilateral hearing device 202 can transmit a signal or message to contralateral hearing device 204 so that contralateral hearing device 204 knows when to start recording the response and for how long to record the neural response. In one embodiment, ipsilateral hearing device 202 can transmit a signal, such as a sync signal or trigger pulse, to contralateral hearing device 204 indicating when the stimulus will beAtty. Docket No. 3065.0863i Client Ref. No. CID03815WOPC1 delivered so that the contralateral hearing device 204 knows when to record the response to the stimulus.

[0052] Reference is now made to FIG. 3, which is a diagram illustrating an example in which a hearing device 302 and a hearing device 304 record a neural response in response to stimulation delivered by one or both of the hearing devices. In some embodiments, hearing device 302 and hearing device 304 are each cochlear implants. In other embodiments, hearing device 302 or hearing device 304 can be another type of hearing device, such as a hearing aid or other type of hearing device.

[0053] As illustrated in FIG. 3, a recipient of hearing device 302 and hearing device 304 (or another person) can initiate a test using, for example, an external device 308. In some embodiments, the test can be automatically initiated without input from the recipient. When the test is initiated, hearing device 302, hearing device 304, or both hearing devices 302 and 304 can deliver a stimulus 306 suitable for evoking a measurable potential from an auditory path. The stimulus can be an electrical stimulus, a mechanical stimulus, an auditory stimulus, or another type of stimulus that evokes a neural response in the auditory nerve that can be recorded by recording channels of hearing device 302 and hearing device 304. In some embodiments, the stimulus can be a synthetic stimulus or speech (e.g., ongoing speech in a free field or ambient environment).

[0054] Hearing devices 302 and 304 can record a neural response to the stimulus. For example, hearing devices 302 and 304 can have recording channels for recording the neural response. In some embodiments, the neural response can be a higher order response that can be correlated with the stimulus received by one or both ears of the recipient of the hearing devices. For example, the response can include EEG, E-ABR, etc.

[0055] In the example illustrated in FIG. 3, both hearing devices 302 and 304 record neural responses to the stimulus. Although FIG. 3 illustrates the stimulus being delivered by both hearing devices 302 and 304, in some embodiments, the stimulus can be delivered by hearing device 302 only, hearing device 304 only, or both hearing devices.

[0056] The measured neural responses recorded at the recording channels of hearing devices 302 and 304 can be combined to improve the extraction of the signal produced by the stimulus from the background activity. In one embodiment, each hearing device is a cochlear implant that measures EEG from each of the intracochlear electrodes to understand how speech is beingAtty. Docket No. 3065.0863i Client Ref. No. CID03815WOPC1 comprehended. Current EEG recordings are done with multichannel EEGs that have, for example, 24 or 64 channels. Because cochlear implants have only one channel, combining the recorded responses from each cochlear implant of a bilateral cochlear implant system provides the ability to analyze the signal from two sides.

[0057] Similar to the situation described above with respect to FIG. 2, data associated with the stimulation and measurements can be exchanged between hearing device 302 and hearing device 304 via a communication link. For example, data can be exchanged between the hearing devices to configure the measurements, start the recording, stop the recording, etc. In addition, data can be exchanged between the hearing devices to read and / or combine the measurements recorded on the recording channels of the two hearing devices.

[0058] In the case in which ongoing speech in free field is used as a stimulus, the speech signal itself can be used as reference as it is picked up by the microphones of both hearing devices. In this case, when the free field speech signal is detected by each microphone of hearing devices 302 and 304, the hearing devices can be triggered to record the neural responses to the speech stimulus. In this scenario, both hearing devices 302 and 304 can detect the free field signal, deliver stimulation, and record a neural response. Since both hearing devices are recording the neural response, the neural responses can be combined to filter the signal (e.g., an EEG signal) from artifacts and background noise to produce a meaningful ‘combined’ neural response.

[0059] Reference is now made to FIG. 4, which is a diagram of a closed loop system in which adjustments to a hearing device can be determined based on measurement data taken using the techniques described with respect to FIGs. 2 and 3. As discussed above, currently, acoustic hearing is tested in a clinical setting using scalp electrodes and dedicated equipment. However, by implementing the techniques described herein, acoustic and electric hearing can be tested in environments outside of a clinic and without additional equipment. Therefore, neural response measurements can be taken more frequently, and additional testing can be performed. The results of the testing can be used, for example, to make adjustments to hearing devices, identify changes in a recipient’s hearing, recommend additional hearing devices, etc.

[0060] For example, in one scenario, a recipient of a cochlear implant and a hearing aid can perform neural response measurements using the techniques described herein. In this case, an acoustic input can be used to record a reference response, such as an ABR amplitude. Over time,Atty. Docket No. 3065.0863i Client Ref. No. CID03815WOPC1 the measurements can be repeated. Since the neural response measurements can be taken outside of a clinic, the neural response measurements can easily be performed, for example, on a regular, continuous, or periodic basis. In this example, if it is determined that the ABR response becomes lower over time, it can be determined that either the “fit” of the hearing device to the recipient is sub-optimal (e.g., because residual hearing has gone down, or the recipient’s hearing loss has gotten to the point where a second cochlear second implant is recommended, etc.). Because the measurements can be taken outside of a clinical environment, a larger number of measurements can be taken, and doctors or clinicians can identify problems with a recipient’s hearing that may not have been identified previously. In this example, the patient can receive a second cochlear implant or adjustments can be made to the hearing aid to improve the patient’s hearing.

[0061] In certain examples presented, the neural response measurement results can be used to adjust operation of the hearing device system (e.g., due to changes in the recipient’s hearing and / or other factors). For example, the neural response measurement results can be used to set / adjust preprocessing parameters, signal processing programs, stimulation parameters, etc. In certain embodiments, changes to the operation of the hearing device system can be implemented automatically or semi-automatically (e.g., as a form of closed loop feedback with or without involvement of the recipient, clinician or other user).

[0062] In another embodiment, measurements, such as higher order brainstem or cortical measurements, can be taken over time and adjustments can be made to electrical hearing based on the results of the measurements. In this embodiment, a closed loop system can be used in which measurements are performed (e.g., continuously, periodically, etc.) and, based on changes to the measurements, adjustments can be made to a hearing device.

[0063] Referring to FIG. 4, a machine learning model 402 can be used to recommend adjustments to a hearing device based on test data 404, device settings 406, and cloud data 408. Machine learning model 402 can include a machine learning system or a different type of artificial intelligence system (e.g., that uses a different type of model) that can be used for recommending adjustments to a hearing device based on different inputs. The machine learning model 402 can be located at a user’s external device (e.g., smartphone, tablet, laptop computer, etc.) or can be on a cloud and accessed by an external device.Atty. Docket No. 3065.0863i Client Ref. No. CID03815WOPC1

[0064] Machine learning model 402 can receive test data 404 associated with a recipient of hearing devices. The test data 404 can be obtained using the techniques described above with respect to FIGs. 2 and 3. In one embodiment, the test data 404 can include measurements or responses taken from tests performed over a period of time. In this way, a pattern can be detected over the period of time that can indicate a problem with the recipient’s hearing. The machine learning model 402 can additionally receive device settings 406. The device settings 406 can be associated with the recipient’s hearing device (e.g., cochlear implant, hearing aid, etc.). The device settings 406 can include, for example, stimulation parameters, sound processing parameters, preprocessing parameters, or other types of parameters. Although not shown in FIG. 4, machine learning model 402 can receive additional inputs, such as patient information, (e.g., information associated with the patient, the patient’s history, patient demographics, etc.), device data (e.g., type of hearing device, model of hearing device, etc.), and / or other information.

[0065] Machine learning model 402 can additionally receive cloud data 408. Cloud data 408 can include information associated with other recipients of hearing devices and information associated with the hearing devices of the other recipients. This information can include, for example, patient demographics, settings associated with the patients’ hearing devices, measurement results associated with the other recipients, and / or additional data.

[0066] Machine learning model 402 can analyze the received test data 404, device settings 406, cloud data 408, and any additional data and output recommended updated settings 410 to be made to the user’s hearing device. In one embodiment, the updated settings or adjustments can be made automatically to the hearing device. For example, adjustments to the settings of the hearing device can be performed automatically based on receiving an indication of the updated settings. In another embodiment, the updated settings can be output to the user or clinician. In yet another embodiment, the updated settings 410 can include recommendations, such a recommendation to switch from a hearing aid to a cochlear implant.

[0067] After the settings adjustments have been made, additional measurements can be taken and the test data 404 and updated device settings 406 can be inputted to the machine learning model 402. In this way, a closed loop system is provided to continuously perform tests and ensure that the recipient’s device has optimal settings for the recipient. The settings adjustments can be made to the ipsilateral hearing device, the contralateral hearing device, or both hearing devices.Atty. Docket No. 3065.0863i Client Ref. No. CID03815WOPC1

[0068] In some embodiments, the adjustments to the hearing device can include adjustments to stimulation levels. For example, when the measurements indicate that higher order responses are weaker, stimulation levels can be updated. In other embodiments, the adjustments can include changing the focusing of channels. For example, for new cochlear implants, if continuous ongoing envelope tracking is performed and it is determined that the envelope tracking gets worse, changing the focusing of channels focused multipolar stimulation can be performed.

[0069] In some embodiments, the dynamic use of the closed loop feedback illustrated in FIG. 4 can be used for tuning preprocessing parameters, such as attention decoding. If envelope matching or neuro tracking is performed, there are techniques in which a hearing device can detect which of two or more speakers a recipient is trying to focus on and can change the focus directionality or tune a Deep Neural Network (DNN) noise canceler to cancel other speakers. Using these techniques, the DNN needs some input to know which speaker to focus on and EEG measurements can be used to provide this input. Performing the EEG measurements using two channels, as described in FIG. 3, increases the chances of identifying the focus information. In this example, the results of the EEG measurements, which indicate the speaker the recipient is trying to focus on, can be provided to the machine learning model 402. The machine learning model 402 can identify settings adjustments to make to the hearing device to allow the recipient to focus on the correct speaker and the settings adjustments can be automatically made. In this way, techniques described herein can provide for real time changing of directionality (or other parameters / settings) to increase a recipient’s hearing capabilities.

[0070] Reference is now made to FIG. 5, which is a flow diagram illustrating a method 500 of measuring, at a second hearing device, neural responses (evoked potentials) evoked by one or more electrical stimulation signals delivered by a first hearing device. More specifically, at 502, one or more electrical stimulation signals are delivered to a first ear of a recipient via a first hearing device that is implanted at the first ear of the recipient. At 504, at least one evoked potential evoked by the one or more electrical stimulation signals is measured with a second hearing device that is implanted or placed intra-aurally at a second ear of the recipient. In this way, the evoked potential measured at the second hearing device can include a reduced artifact noise compared an evoked potential measured at the first hearing device that delivers the one or more electrical stimulation signals.Atty. Docket No. 3065.0863i Client Ref. No. CID03815WOPC1

[0071] As noted, the second device could be implanted in the recipient or could be an an in-the- ear (ITE) device (e.g., in the ear canal of the recipient). In certain such examples, the first and second hearing devices could be referred to as a ‘bimodal’ system (e.g., cochlear implant at the first ear and an ITE canal acoustic amplification hearing aid at the second ear). In one such bimodal system, the second hearing device can include any kind of acoustic hearing device so long as there is an intra-aural component having electrode / s for measuring the neural response (e.g., ITE canal hearing aid, a BTE hearing aid with an electrical lead that is connected to an in the ear canal receiver / speaker which has electrodes on the receiver / speaker for taking the evoked measurements, etc.).

[0072] Reference is now made to FIG. 6, which is a flow diagram illustrating a method 600 of performing one or more actions based on recording of one or more neural responses to a stimulus at a first hearing device and a second hearing device. More specifically, at 602, a first neural response to a stimulus is recorded on a first recording channel of a first hearing device implanted in a first ear of a recipient. At 604, a second neural response to the stimulus is recorded on a second recording channel of a second hearing device implanted in a second ear of the recipient. At 606, one or more actions are performed based on the first neural response and the second neural response. For example, the recorded first neural response and the recorded second neural response can be combined to improve signal extraction from background activity. In certain examples of FIG. 6, the first device, the second device, or both, can be implanted or placed inter-aurally (e.g., a device having at least one component placed in the ear canal of the recipient).

[0073] As previously described, the technology disclosed herein can be applied in any of a variety of circumstances and with a variety of different devices. Merely for ease of description, the techniques presented herein have primarily described herein with reference to an illustrative medical device system, namely a cochlear implant system that delivers electrical stimulation to both ears of a recipient. However, it is to be appreciated that the techniques presented herein can also be used with a variety of other medical devices that, while providing a wide range of therapeutic benefits to recipients, patients, or other users, can benefit from the techniques presented. For example, a cochlear implant system in accordance with embodiments presented herein can also deliver acoustic stimulation to one or both ears of the recipient (e.g., one or more of the cochlear implants is an electro-acoustic cochlear implant). It is also to be appreciated that the two cochlear implants of a cochlear implant system in accordance with embodiments presentedAtty. Docket No. 3065.0863i Client Ref. No. CID03815WOPC1 need not be identical with respect to, for example, the number of electrodes used to electrically stimulate the cochlea, the type of stimulation delivered, etc.

[0074] Furthermore, it is to be appreciated that the techniques presented herein can be used with other systems including two or more devices, such as systems including one or more personal sound amplification products (PSAPs), one or more acoustic hearing aids, one or more bone conduction devices, one or more middle ear auditory prostheses, one or more direct acoustic stimulators, one or more other electrically simulating auditory prostheses (e.g., auditory brain stimulators), one or more vestibular devices (e.g., vestibular implants), one or more visual devices (i.e., bionic eyes), one or more sensors, one or more pacemakers, one or more drug delivery systems, one or more defibrillators, one or more functional electrical stimulation devices, one or more catheters, one or more seizure devices (e.g., devices for monitoring and / or treating epileptic events), one or more sleep apnea devices, one or more electroporation devices, one or more remote microphone devices, one or more consumer electronic devices, etc. For example, FIGs. 7 and 8 are schematic diagrams of alternative systems that can implement aspects of the techniques presented herein.

[0075] More specifically, FIG. 7 is a schematic diagram illustrating an example vestibular system 800, in accordance with certain embodiments presented herein. In this example, the vestibular system 700 comprises a first vestibular stimulator 702(A) and a second vestibular stimulator 702(B). The first vestibular stimulator 702(A) comprises an external device 704(A) and an implantable component 712(A), while the second vestibular stimulator 702(B) comprises an external device 704(B) and an implantable component 712(B). In accordance with certain embodiments presented herein, the first vestibular stimulator 702(A) (e.g., external device 704(A) and / or implantable component 712(A)) and / or the second vestibular stimulator 702(B) (e.g., external device 704(B) and / or implantable component 712(B)) are configured to implement aspects of the techniques presented herein to perform contralateral measurement of neural responses.

[0076] FIG. 8 is a schematic diagram illustrating an example retinal prosthesis system 800 that can be configured to perform contralateral measurement of neural responses., in accordance with certain embodiments presented herein. In this example, the retinal prosthesis system 800 comprises a first retinal prosthesis 802(A) and a second retinal prosthesis 802(B). In accordanceAtty. Docket No. 3065.0863i Client Ref. No. CID03815WOPC1 with certain embodiments presented herein, the first retinal prosthesis 802(A) and / or the second retinal prosthesis 802(B) are configured to implement aspects of the techniques presented herein.

[0077] As should be appreciated, while particular uses of the technology have been illustrated and discussed above, the disclosed technology can be used with a variety of devices in accordance with many examples of the technology. The above discussion is not meant to suggest that the disclosed technology is only suitable for implementation within systems akin to that illustrated in the figures. In general, additional configurations can be used to practice the processes and systems herein and / or some aspects described can be excluded without departing from the processes and systems disclosed herein.

[0078] This disclosure described some aspects of the present technology with reference to the accompanying drawings, in which only some of the possible aspects were shown. Other aspects can, however, be embodied in many different forms and should not be construed as limited to the aspects set forth herein. Rather, these aspects were provided so that this disclosure was thorough and complete and fully conveyed the scope of the possible aspects to those skilled in the art.

[0079] As should be appreciated, the various aspects (e.g., portions, components, etc.) described with respect to the figures herein are not intended to limit the systems and processes to the particular aspects described. Accordingly, additional configurations can be used to practice the methods and systems herein and / or some aspects described can be excluded without departing from the methods and systems disclosed herein.

[0080] According to certain aspects, systems and non-transitory computer readable storage media are provided. The systems are configured with hardware configured to execute operations analogous to the methods of the present disclosure. The one or more non-transitory computer readable storage media comprise instructions that, when executed by one or more processors, cause the one or more processors to execute operations analogous to the methods of the present disclosure.

[0081] Similarly, where steps of a process are disclosed, those steps are described for purposes of illustrating the present methods and systems and are not intended to limit the disclosure to a particular sequence of steps. For example, the steps can be performed in differing order, two or more steps can be performed concurrently, additional steps can be performed, and disclosed stepsAtty. Docket No. 3065.0863i Client Ref. No. CID03815WOPC1 can be excluded without departing from the present disclosure. Further, the disclosed processes can be repeated.

[0082] Although specific aspects were described herein, the scope of the technology is not limited to those specific aspects. One skilled in the art will recognize other aspects or improvements that are within the scope of the present technology. Therefore, the specific structure, acts, or media are disclosed only as illustrative aspects. The scope of the technology is defined by the following claims and any equivalents therein.

[0083] It is also to be appreciated that the embodiments presented herein are not mutually exclusive and that the various embodiments can be combined with another in any of a number of different manners.

Claims

Atty. Docket No. 3065.0863i Client Ref. No. CID03815WOPC1CLAIMSWhat is claimed is:

1. A method comprising: delivering one or more electrical stimulation signals to first ear of a recipient via a first hearing device implanted at the first ear of the recipient; and measuring, with a second hearing device implanted or placed intra-aurally at a second ear of the recipient, at least one evoked potential evoked by the one or more electrical stimulation signals.

2. The method of claim 1, wherein measuring the at least one evoked potential includes: synchronizing the first hearing device and the second hearing device to a reference signal.

3. The method of claim 1, wherein delivering the one or more electrical stimulation signals comprises: processing a synthetic test input; and generating the one or more electrical stimulation signals based on the synthetic test input.

4. The method of claim 1 , wherein delivering the one or more electrical stimulation signals comprises: processing one or more signals from an ambient environment of the recipient; and generating the one or more electrical stimulation signals based on the one or more signals from the ambient environment.

5. The method of claim 1, 2, 3, or 4, further comprising: adjusting one or more settings of the first hearing device or the second hearing device based on the at least one evoked potential.

6. The method of claim 5, further comprising: identifying a problem with the first hearing device or the second hearing device based on the at least one evoked potential; andAtty. Docket No. 3065.0863i Client Ref. No. CID03815WOPC1 adjusting the one or more settings based on identifying the problem.

7. The method of claim 5, wherein adjusting the one or more settings further comprises: adjusting one or more operations for pre-processing audio signals at the first hearing device or the second hearing device.

8. The method of claim 1, 2, 3, or 4, wherein the at least one evoked potential is an electrically-evoked auditory brainstem response (E-ABR).

9. The method of claim 1, 2, 3, or 4, wherein the at least one evoked potential is a cortical response.

10. The method of claim 1, 2, 3, or 4, wherein the at least one evoked potential is an electroencephalography (EEG) response.

11. The method of claim 1, 2, 3, or 4, further comprising: measuring, with the first hearing device, one or more evoked potentials evoked by the one or more electrical stimulation signals; and adjusting one or more settings of the first hearing device or the second hearing device based on the at least one evoked potential and the one or more evoked potentials.

12. The method of claim 1, 2, 3, or 4, wherein the first hearing device is a cochlear implant, and the second hearing device is a cochlear implant.

13. A method comprising: recording, on a first recording channel of a first hearing device implanted in a first ear of a recipient, a first neural response to a stimulus; recording, on a second recording channel of a second hearing device implanted in a second ear of the recipient, a second neural response to the stimulus; and performing one or more actions based on the first neural response and the second neural response.Atty. Docket No. 3065.0863i Client Ref. No. CID03815WOPC114. The method of claim 13, wherein performing the one or more actions includes: combining the first neural response and the second neural response to determine a combined response.

15. The method of claim 13, wherein the stimulus is received at the first ear.

16. The method of claim 13, wherein the stimulus is received at the first ear and the second ear.

17. The method of claim 13, wherein the stimulus is an electric stimulus.

18. The method of claim 13, wherein the stimulus is an acoustic stimulus.

19. The method of claim 13, 14, 15, 16, 17, or 18, wherein the first neural response and the second neural response are higher order responses.

20. The method of claim 19, wherein the first neural response and the second neural response are electrically-evoked auditory brainstem responses (E-ABR).

21. The method of claim 19, wherein the first neural response and the second neural response are electroencephalography (EEG) responses.

22. The method of claim 21, wherein the first hearing device and the second hearing device are cochlear implants that measure EEG responses from intracochlear electrodes to determine how speech is being comprehended by the recipient.

23. A system comprising: a first hearing device implanted in a first ear of a recipient, the first hearing device delivering a stimulus for evoking a response from an auditory path; and a second hearing device implanted in a second ear of the recipient, the second hearing device measuring the response to the stimulus.Atty. Docket No. 3065.0863i Client Ref. No. CID03815WOPC124. The system of claim 23, wherein, when measuring the response to the stimulus, the second device synchronizes the first hearing device and the second hearing device to a reference signal.

25. The system of claim 23, wherein, when delivering the stimulus, the first hearing device processes a synthetic test input and generates the stimulus based on the synthetic test input.

26. The system of claim 23, wherein, when delivering the stimulus, the first hearing device processes one or more signals from an ambient environment of the recipient and generates the stimulus based on the one or more signals from the ambient environment.

27. The system of claim 23, 24, 25, or 26, further comprising: one or more processors configured to adjust one or more settings of the first hearing device or the second hearing device based on the response.

28. The system of claim 27, wherein the one or more processors are further configured to: identify a problem with the first hearing device or the second hearing device based on the response; and adjust the one or more settings based on identifying the problem.

29. The system of claim 28, wherein, adjusting the one or more settings, the one or more processors are further configured to: adjust one or more operations for pre-processing audio signals at the first hearing device or the second hearing device.

30. The system of claim 23, 24, 25, or 26, wherein the response is an electrically-evoked auditory brainstem response (E-ABR).

31. The system of claim 23, 24, 25, or 26, wherein the response is a cortical response.Atty. Docket No. 3065.0863i Client Ref. No. CID03815WOPC132. The system of claim 23, 24, 25, or 26, wherein the response is an electroencephalography (EEG) responses.

33. The system of claim 23, 24, 25, or 26, wherein the first hearing device measures a second response evoked by the stimulus.

34. The system of claim 23, 24, 25, or 26, wherein the first hearing device is a cochlear implant, and the second hearing device is a cochlear implant.

35. A system comprising: a first hearing device implanted in a first ear of a recipient, the first hearing device recording a first neural response to a stimulus; and a second hearing device implanted in a second ear of the recipient, the second hearing device recording a second neural response to the stimulus.

36. The system of claim 35, wherein the system further comprises one or more processors to combine the first neural response and the second neural response to determine a combined response.

37. The system of claim 35, wherein the stimulus is received at the first ear.

38. The system of claim 35, wherein the stimulus is received at the first ear and the second ear.

39. The system of claim 35, wherein the stimulus is an electric stimulus.

40. The system of claim 35, wherein the stimulus is an acoustic stimulus.

41. The system of claim 35, 36, 37, 38, or 39, wherein the first neural response and the second neural response are higher order responses.

42. The system of claim 41, wherein the first neural response and the second neural response are electrically-evoked auditory brainstem responses (E-ABR).Atty. Docket No. 3065.0863i Client Ref. No. CID03815WOPC143. The system of claim 41, wherein the first neural response and the second neural response are electroencephalography (EEG) responses.

44. The system of claim 43, wherein the first hearing device and the second hearing device are cochlear implants that measure EEG responses from intracochlear electrodes to determine how speech is being comprehended by the recipient.

45. One or more non-transitory storage media comprising instructions that, when executed by one or more processors, are configured to: obtain data associated with a first neural response to a stimulus, wherein the first neural response was recorded via a first recording channel of a first hearing device implanted in a first ear of a recipient; obtain data associated with a second neural response to the stimulus, wherein the second neural response was recorded via a second recording channel of a second hearing device implanted in a second ear of the recipient; and analyze the first neural response relative to the second neural response; adjust operation of the first hearing device based on the analyzing of the first neural response relative to the second neural response.

46. The one or more non-transitory storage media of claim 45, further comprising instructions that, when executed by the one or more processors, are configured to: combine the first neural response and the second neural response to determine a combined response.

47. The one or more non-transitory storage media of claim 45, wherein the stimulus is received at the first ear.

48. The one or more non-transitory storage media of claim 45, wherein the stimulus is received at the first ear and the second ear.

49. The one or more non-transitory storage media of claim 45, wherein the stimulus is an electric stimulus.Atty. Docket No. 3065.0863i Client Ref. No. CID03815WOPC150. The one or more non-transitory storage media of claim 45, wherein the stimulus is an acoustic stimulus.

51. The one or more non-transitory storage media of claim 45, 46, 47, 48 49, or 50, wherein the first neural response and the second neural response are higher order responses.

52. The method of claim 51, wherein the first neural response and the second neural response are electrically-evoked auditory brainstem responses (E-ABR).

53. The method of claim 51, wherein the first neural response and the second neural response are electroencephalography (EEG) responses.

54. The method of claim 53, wherein the first hearing device and the second hearing device are cochlear implants that measure EEG responses from intracochlear electrodes to determine how speech is being comprehended by the recipient.

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