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Center at the National Institutes of Health in
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FOR OUR CLINICAL CENTER GRAND
ROUNDS TODAY, WE RECOGNIZE THE
2022 DISTINGUISHED CLINICAL
SCHOLAR AND EDUCATOR IN
RESIDENCE HONORING DR. CHARLES
J. LIMB.
DR. LIMB IS THE FRANCIS A. SOY
OF ISSUE OTOULARIN GOLG, AND
CHIEF DIVISION OF NEUROONTOLOGY
AT THE UNIVERSITY OF CALIFORNIA
SAN FRANCISCO.
UCSF.
HE IS THE DIRECT OF THE DOUGLAS
COCHLEAR IMPLANT CENTER AT UCSF
AND ALSO THE MEDICAL DIRECTOR
THE UCSF CHILDREN'S HOSPITAL IN
OAKLAND, CALIFORNIA.
DR. LIMB EARNED HIS MEDICAL
DEGREE AT YALE UNIVERSITY AND
FOLLOWED BY RESIDENCY AND HEAD
AND NECK SURGERY AT JOHNS
HOPKINS HOSPITAL.
HE COMPLETED HIS POST DOCTORAL
RESEARCH FOR THE SCIENCES AT
HOPKINS WHERE HE STUDY THE
DEVELOPMENT OF THE AUDITORY
BRAIN STEM.
DR. LIMB THEN COMPLETED A SECOND
POST DOCTORAL FELLOWSHIP AT THE
NATIONAL INSTITUTE ON DEAFNESS
AND OTHER COMMUNICATION
DISORDERS, NIDCD WHERE HE
STUDIED MUSIAL AND IMPROVISATION
AND PERCEPTION USING FUNCTIONAL
NEUROIMAGING METHODS.
FROM 1996-2015 HE WAS ASSOCIATE
PROFESSOR OF OTOLAIRIN GOLG AT
HOPKINS AND ALSO A FACULTY
MEMBER OF THE PEABODY
CONSERVATORY OF MUSIC AND
EDUCATION AT SCHOOL AT HOPKINS.
IN 2015 HE JOINED THE DEPARTMENT
OF OTOLYNGOLGY AS EXPERTISE.
HE COVERED THE FULL SCOPE OF
ONTOLOGY, NEURAL ONTOLOGY WITH
THE FOCUS ON HEARING LOSS AND
AUDITORY DISORDERS.
HE SPECIALIZED IN SURGERY OF THE
TEMPORAL BONE WITH EXPERTISE IN
THE COCHLEAR IMPLANT SERGEANTRY,
IMPLANTABLE HEARING AIDS, STAPES
SURGERY, [INDISCERNIBLE] SURGERY
AND CANCERS OF THE EAR.
HIS CURRENT RESEARCH FOCUS ON IS
ON THE STUDY OF THE NEURAL BASIS
OF MUSICAL CREATIVITY AND THE
STUDY OF MUSIC PERCEPTION IN
DEAF INDIVIDUALS WITH COCHLEAR
IMPLANTS WHICH WE WILL BE
TALKING ABOUT TODAY.
DR. LIMB IS A PAST EDITOR AND
CHIEF IN TRANSAND AMPLIFICATION,
NOW CALLED TRANSIN HEARING AND
AN EDITORIAL BOARD MEMBER OF THE
JOURNAL'S NEURAL ONTOLOGY AND
MUSIC AND MEDICINE.
HIS WORK HAS RECEIVED
INTERNATIONAL ATTENTION AND HAS
BEEN FEATURED BY NATIONAL PUBLIC
RADIO, TED, NATIONAL GEOGRAPHIC
AND NUMEROUS OTHER NEWS AND
MEDIA OUTLETS AS WELL AS THE SUN
DANCE FILM FESTIVAL AND THE
BALROOSM SYMPHONY ORCHESTRA.
HE AUTHORED 75 BOOKS AND
CHAPTERS, ON OVER 90 REVIEWED
PEER PUBLICATIONS, HE IS BOARD
CERTIFIED IN OTOLARYNGOLGY, THE
TITLE OF HIS TALK TODAY IS MUSIC
FOR DEAF EARS, COCHLEAR MEDIATED
PERCEPTION OF MUSIC.
PLEASE JOIN ME IN WELCOMING
TODAY'S GREAT TEACHER SPEAKER,
DR. CHARLES LIMB.
>> THANK YOU SO MUCH, IT'S SUCH
A PRIVILEGE TO BE BACK IN HERE
IN PERSON.
IT'S BEEN A FEW YEARS AND I
UNDERSTAND THAT I'M THE FIRST
PERSON TO BE ALLOWED IN PERSON
TO THE NIDCD AS A GUEST SO
THANKS SO MUCH FOR THE
OPPORTUNITY.
BEFORE I BEGIN I WANT TO POINT
OUT THAT YOU KNOW IT'S A PRETTY
FRACTURED WORLD THAT WE'RE
LIVING IN RIGHT NOW.
I THINK THERE ARE SO MANY
REASONS TO FEEL DIVIDED AND 1 OF
MY HOPE SYSTEM THAT SOMETHING
MIGHT SEEM AT FIRST SURVEYS
PERFLEWOUS SUCH AS MUSIC WILL BE
MORE LIKE THE GLUE THAT HOLDS
SOCIETY TOGETHER AND IT'S POWER
TO BRING PEOPLE TOGETHER AND
CLOSER TO 1 ANOTHER IS ACTUALLY
SOMETHING THAT HAS WITH STOOD
THE TEST OF THE TIME PANDEMIC OR
NOT.
SO I HAVE RELEVANT DISCLOSURES.
ADVANCED BIONICS THEY'RE ALL
MANUFACTURES OF DIFFERENT
COCHLEAR IMPLANTS, I WILL NOT
TRY TO AVOID ANY DISCUSSION OF
SPECIFIC PRODUCTS TODAY BUT DO I
RESEARCH WITH THESE COMPANIES.
ALSO YOU DON'T HAVE TO KNOW
ANYTHING ABOUT COCHLEAR IMPLANTS
OR MUSIC OR HEARING FOR THAT
MATTER TO UNDERSTAND THIS TALK.
I UNDERSTAND IT'S A GENERAL
AUDIENCE, I WILL TRY TO GIVE A
LARGE OVERVIEW OF THE TOPIC.
SO FOR THOSE THAT DON'T THINK
ABOUT HOW YOU HEAR THAT OFTEN, I
WANT TO DIRECT YOUR ATTENTION TO
THIS.
SO THIS IS THE TEMPORAL BONE,
BEAUTIFUL DRAWING BY MAX
[INDISCERNIBLE].
IF YOU'VE NEVER CONSIDERED HOW
IT IS POSSIBLE FOR YOU TO HEAR
MY VOICE OR ANY SOUND AT ALL,
THINK ABOUT THE STRUCTURE AND
WHAT IT'S DOING SO HOPEFULLY YOU
HAVE 2 OF THESE IN YOUR HEAD
THAT ARE FUNCTIONAL AND WHAT
THESE THINGS DO IS TAKE
VIBRATIONAL ENERGY IN THE FORM
OF SOUND, TRANSMIT IT TO THE EAR
DRUM, MICROSCOPICALLY DOWN 3
HEARING BONES AND THOSE GET SENT
INTO THE FLUIDS ARE OF THE INNER
EAR AND TRIGGER NEURAL IMPULSES
TO SEND DOWN INTO THE AUDITORY
NERVE.
SO WHAT HAPPENS HERE IS
VIBRATIONAL MOVEMENT BECOME
ELECTRICITY SO IN NORMAL
HEARING, IT IS FUNDAMENTALLY AN
ELECTRICAL PROCESS IN YOUR
BRAIN.
IF YOU HEAR THE SOUND IT'S
ELECTRICITY NOT ACOUSTICS.
SO LET'S LISTEN TO MUSIC
TOGETHER WITH THAT IN MIND.
[* MUSIC ]
SO AS A KIND OF SELF-PROFESSED
MUSIC JUNKIE I'VE ALWAYS BEEN SO
FASCINATED BY THAT PROCESS OF
HOW WE CAN HAVE MUSICAL
EXPERIENCE.
AND SO IT LED ME TO PURSUE A
CAREER IN OTO-LAYNGOLG AND I
JUST WANT TO GET TO THE ROOTS OF
HOW WE HEAR SOMETHING LIKE THAT,
WE CAN BE TRANSFORMED BY A
MOMENT OF MUSIC AND YOU'RE
TRANSFORMED SOMEWHERE ELSE,
ALMOST ANOTHER PERSON, SO I WENT
INTO THIS FIELD SPECIFICALLY TO
FIND THE ANSWER TO THAT AND WHAT
I HEARD WAS A LOT OF THIS ...
[BEEPING ] SO A LOT OF BLIPS AND
BEEPS.
I GOT TO THE FIELD I WAS REALLY
EXCITED AND ALL OF THE SUPPEDDEN
I WAS LISTENING TO BLIPS AND
BEEPS AND I THOUGHT WELL, THAT'S
NOT GOING TO QUITE DO IT FOR ME
SO I FELT LIKE I NEEDED TO GET
TO HIGHER LEVEL HEARING.
AND SO I ACTUALLY CAME TO THE
NIDCD AFTER I DID MY SURGICAL
TRAINING AND IT WAS A PIVOTAL
TIME IN MY CAREER BECAUSE IT
ALLOWED ME TO STOP BEING A
SURGEON AND THINK MORE DEEPLY
ABOUT THE ISSUES THAT WERE
FASCINATING FOR ME AND ALSO I
THINK SCULPTED THE WAY FOR HOW I
COULD HAVE AN ACADEMIC CAREER
AND I'M VERY GRATEFUL TO THIS
PLACE.
NOW I PLAYED YOU THOSE TONES NOT
TO BE DERIVATIVE OF THEM BUT TO
TELL YOU THEY'RE IMPORTANT, IT'S
A SIGNUE SOID, AND OUR ABILITY
TO HEAR SIGN OW SOIDS IS NOT A
TRIVIAL THING AND THE ABILITY TO
TELL 2 SIGNUE SOIDS APART,
SOMETHING LIKE THIS ...
[BEEPING ] THAT'S QUITE A
DIFFICULT FEET FOR THE AUDITORY
SYSTEM AND WE KNOW IT'S A
DIFFICULT FEET FOR THE AUDITORY
SYSTEM BECAUSE WHEN WE TRY TO
RECREATE THAT EXPERIENCE IN A
COCHLEAR IMPLANT USER WE
BASICALLY FAIL.
SO THAT SIMPLE THING, WE HAVE A
VERY HARD TIME DOING, WE CANNOT
GUARANTEE TODAY, WITH TODAY'S
TECHNOLOGY, CANNOT GUARANTEE
THAT THAT PURE TONE WILL SOUND
LIKE A PURE TONE TO A COCHLEAR
IMPLANT USER.
IT'S THAT SIMPLE.
NOW LET'S THINK ABOUT WHAT'S
MORE COMPLIXAITED AND THE
CHALLENGE THAT'S PRESENTED BY
MUSIC.
[* MUSIC ]
SO IF WE CAPTAIN GET THE PURE
TONES RIGHT HOW ARE WE GOING TO
GET THAT RIGHT.
THERE ARE SO MANY DIFFERENT
TAMBERS, DIFFERENT RHYTHMS
ISSUES PITCHES, TONES GOING
TOGETHER.
IN NORMAL HEARING THEY WORK
SEAMLESSLY, YOU DON'T HAVE TO
THINK OR TRY TO HEAR THAT AS A
COHERENT WHOLE, IT JUST HAPPENS.
SO I WANT TO INTRODUCE YOU TO A
CHILD, THIS IS GRACE AND THIS IS
APPROXIMATE GRACE WITH--THIS IS
GRACE WITH HER MOTHER.
>> YEAH.
>> [BABY COOS ]
>> YEAH.
BABY.
SO BEAUTIFUL MOTHER DAUGHTER
RELATIONSHIP, SHE'S DOING
EVERYTHING SHE CAN TO PROVIDE
INPUT TO HER CHILD BECAUSE HER
CHILD IS ABSOLUTELY PROFOUNDLY
DEAF.
NOW, 200 YEARS AGO, THERE WERE
NOT THAT MANY OPTIONS AVAILABLE
FOR DEAFNESS, YOU COULD TAKE A
FUNET AND STICK IT IN YOUR EAR,
YOU COULD TAKE AN EAR SHAPED
OBJECT AND STICK THAT IN YOUR
EARS, NEITHER WORKED VERY WELL
AND FORTUNATELY TODAY WE HAVE
SOMETHING BETTER AND SO IF WE
LOOK AT WHERE WE ARE TODAY IN
THE 2000S THERE ARE STILL NO
APPROVED DRUGS TO TREAT HEARING
LOSS, THINK ABOUT THAT.
IN 2022 THERE ARE NO FDA
APPROVED MEDICATIONS TO TREAT
HEARING LOSS.
BUT WE HAVE DEVICES WE HAVE
HEARING AIDS, WE HAVE THE MODERN
CHANNEL COCHLEAR IMPLANT.
WHICH IS WHAT I WILL FOCUS ON
TODAY, SO THIS CHILD'S MOTHER
DECIDED TO IMPLANT OR DAUGHTER
AT THE AGE OF 1 BY MY MENTOR AND
HERE HE IS ABOUT A DECADE AFTER
GETTING HER SURGERY.
>> SO YOU'VE WRITTEN 2 BOOKS.
>> I HAVE WRITTEN 2 BOOKS, 1 A
BOOK AND THE OTHER LIKE A
JOURNAL ENTRY.
OH, OKAY.
NWELL THIS BOOK HAS 7 CHAPTERS
AND THE LAST--THE LAST CHAPTER
IS ENTITLED THE GOOD THINGS
ABOUT BEING DEAF.
DO YOU REMEMBER WRITE THAGOREAN
CHAPTER.
>> YES I DO, I REMEMBER WRITING
EVERY CHAPTER.
>> WELL SOMETIMES MY SISTER CAN
BE KIND OF ANNOYING AND SO HAD
HELPS TO NOT BE ANNOYED BY HER.
>> AND WHO IS THAT?
>> COLLIE?
>> HER SISTER.
>> MY SISTER.
>> AND HOW CAN YOU AVOID BEING
ANNOYED BY HER.
>> I JUST TAKE OFF MY CI AND I
DON'T HEAR ANYTHING.
[LAUGHTER]
SO IT'S PRETTY--IT COMES IN
HANDY.
>> SO YOU DON'T WANT TO HEAR
EVERYTHING THAT'S OUT THERE.
>> NO.
>> SO SHE'S AMAZING, IF YOU MET
HER YOU WOULD NEVER KNOW SHE'S
DEAF, SHE'S A HUNDRED PERCENT
DEPENDENT ON HER IMPLANTS, SHE
CAN TAKE QUESTIONS FROM THE
STAGE, AUDIENCE AND DOESN'T MISS
A BEAT, BUT WHEN SHE TURNS ON
THE RADIO IT'S A STRUGGLE FOR
HER, RIGHT?
AND SO WHAT WE'RE SEEING IS THAT
EVEN THOUGH THERE WAS NOBODY
BEFORE THE HEARING LOSS, DIDN'T
LIKE TO LISTEN TO MUSIC AFTER
IMPLANTATION, ALMOST 40% OF
MAISHTS ARE SAYING THEY DON'T
LIKE TO LISTEN TO IT.
IT'S NOT THAT THEY DON'T MIND
TTHEY DON'T LIKE IT, IS IT
DOESN'T SOUND GOOD TO THEM.
SO DESPITE THE SUCCESSES WE'RE
HAVING WITH SPOKEN LANGUAGE WITH
COCHLEAR IMPLANTATION, MOST CI
USERS CANNOT HEAR MUSIC WELL, SO
THE FIRST TAKE HOME POINT IS
THAT MUSIC IS A MUCH HARDER,
MUCH MORE SOPHISTICATED AUDITORY
STIMULUS THAN LANGUAGE AND THERE
ARE REASONS FOR THIS THAT HAVE
TO DO WITH THE NATURE OF MUSIC.
YOU HAVE TO ASK YOURSELF WHAT IS
MUSIC, WHAT IS THIS THING WE
CALL MUSIC.
IT'S AN OOB STRACT CONCEPT
BECAUSE MUSIC DOESN'T
NECESSARILY MEAN EVERYTHING, IT
MEANS WHATEVER YOU WANT IT TO
MEAN TO YOURSELF BUT IT'S SOUND,
ORGANIZED SOUND AND ORGANIZED
ACOWARDING TO PERSON PRINCIPLES,
PITCH, RYTH ILLEGALS AND HARMONY
AND THIS IS THE WAY WE CAN
STRUCTURALLY DIVIDE THOSE AND
HOW WE CAN USE THOSE AS A PROBE
FOR THE AUDITORY SYSTEM AND THE
BEAUTY OF MUSIC IS BECAUSE IT'S
SO COMPLEX, BECAUSE IT HAS SO
MANY LAYERS IN A WAY
MATHEMATICAL SOUND, CAN YOU
DECONSTRUCT IT AND USE IT THE
USE OF HEARING.
WHETHER IT'S NORMAL HEARING,
TRAINING HEARING OR IMPOVERISHED
HEARING OR CI USER.
NOW MUSIC IS NOT JUST FOR
ENTERTAINMENT EVEN THOUGH IT'S
ENTERTAINING AND SO THIS IS SOME
EVIDENCE OF THIS.
THIS IS A FOSSIL, BIRD BONE
THOUGHT TO BE RECOVER FRIDAY
35,000 YEARS AGO.
THINK ABOUT HOW LONG AGO THAT
WAS.
WHY ARE THEY MAKING MUSICAL
INSTRUMENTS 35,000 YEARS AGO,
YOU THINK THEY ARE TRYING TO
SURVIVE BUT SOMEHOW MUSIC HAS
PERSIST INDEED ALL CULTURES AND
ALL HISTORICAL AVENUES.
WHENEVER THERE HAVE BEEN HUMANS,
THERE HAS BEEN MUSIC, WHY?
IT MUST HAVE SOMETHING TO DO
WITH ITS ABILITY TO ALLOW US TO
COMMUNICATE WITH 1 ANOTHER THAT
LENDS ITSELF TO A SURVIVAL
ADVANTAGE, IF YOU LOOK AT
ACOUSTIC IMPORTANT PROPERTIES OF
MUSIC, YOU FIND THAT MUSIC IS A
MORE DIFFICULT STIMULUS IN
LANGUAGE NOT JUST IN TERMS OF
THE PRINCIPLES THAT I TALKED
ABOUT EARLIER BUT JUST ON BASIC
SOWBD DYNAMICS AND FREQUENCY
RANGE.
IT'S A MORE EXPANSIVE SOUND AND
AS A RESULT, IF YOU ARE GOING TO
TRY TO TRANSMIT THIS MORE
EXPANSIVE SOUND LIKE SOMETHING
THROUGH AWE COCHLEAR IMPLANT,
HAVE YOU A HARDER ENGINEERING
CHALLENGE FRONT OF YOU.
EVERYBODY ASK WHAT DOES IT SOUND
LIKE IF YOU HAVE A COCHLEAR
IMPLANT AND HEAR MUSIC.
I DON'T KNOW.
I'VE NEVER HAD 1.
BUT WE FOUND THAT IF YOU BREAK
DOWN MUSIC INTO THESE
COMPONENTS, PITCH OTHER RHYTHM,
TAMPER, SOUND, QUALITY,
DYNAMICS, EVERYTHING IN RED IS
OFF FOR A CI USER AND THAT'S A
LOT OF DIFFERENT THINGS.
RHYTHM IS IN GREEN THERE BECAUSE
TIMING RELATIONSHIPS TEBD TO BE
INTACT FOR BASIC RHYTHMIC
PATTERNS FOR COCHLEAR IMPLANT
USERS BECAUSE WE CAN STIMULATE
WITH ELECTRICITY THAT'S PRETTY
HIGH.
NOW THE BIGGEST OBSTACLES ON THE
LEFT THERE WHICH IS PITCH, IT
TURNS OUT IF THERE WAS 1 THING
THAT YOU COULD FIX, IN A
COCHLEAR IMPLANT USER, IS THAT
IT'S BADLY OUT OF TUNE AND ANY
OF THAT YOU PLAY A MUSICAL
INSTRUMENT, YOU KNOW THE FIRST
THING YOU DO WHEN YOU SIT DOWN
TO PLAY IS YOU TUNE AN
INSTRUMENT AND IF YOUR ENTIRE
EAR IS OUT OF TUNE AND CAN'T BE
IN TUNE, NO MATTER WHAT YOU DO,
HOW ARE YOU EVER GOING TO HEAR
PITCHING PROPERLY?
THAT'S THE PROBLEM THAT'S FACED
BY A COCHLEAR IMPLANT USER.
SOLET FIRST OBSTACLE, BECAUSE AS
A CLINICIAN AND SURGEON I HOPE
TO BE ABLE TO TELL A PATIENT, OH
YOU'VE LOST YOUR HEARING, BUT
DON'T WORRY WE CAN RESTORE
PERFECT HEARING BACK TO YOU.
NOW THAT'S RIGHT NOW THE STUFF
OF SCIENCE FICTION, IT DOESN'T
HAPPEN BUT ON THE OTHER HAND
COCHLEAR IMPLANTATION IS THE
STUFF OF SCIENCE FICTION A
HUNDRED YEARS AGO, SO WE CAN
GIVE PEOPLE BACK A LOT OF SPEECH
BUT PITCH HER ACCEPTION IS
REALLY, REALLY VEXING AND THE
REASON IT'S VEXING BECAUSE SO
MANY THINGS HAVE TO GO RIGHT IN
YOUR EAR FOR YOU TO HEAR THOSE
PURE TONES CORRECTLY.
BUT INNER EAR HAS A SPATIAL,
SHAPE IS LIKE A SNAIL AND THAT
SHAPE IS LIKE THAT FOR A REASON
AND PLACE ALONG THAT SNAIL,
WHERE YOU STIMULATE WILL HELP
DETERMINE THE PITCH, NOT JUST
THE PLACE BUT THEERATED, THE
NORMAL HEARING IN THE PLACE AND
RATE STIMULATION, ARE
SYNCHRONIZED THEY'RE SEAMLESSLY
INTEGRATED BUT IN ELECTRICAL
HEARING OR COCHLEAR IMPLANT
HEART ATTACK, THEY'RE BOTH
DISRUPTIVE SO HAVE YOU
ELECTRICITY GOING TO THE WRONG
PLACE AT THE WRONG RATE AND SO
SOMEHOW YOU'RE TRYING TO TAKE
THAT INCORRECT INFORMATION AND
WARP IT, USING NEURAL
PLACENTASISSITY AND OTHER
CONTEXTURAL CUES AND YOUR
ABILITY TO INTERPRET SOUNDS INTO
SOME FRAMEWORK THAT MAKES SENSE
TO YOU.
IF YOU LOOK AT THE KIND OF
STRUCTURE OF A COCHLEAR IMPLANT
ELECTRODE, YOU SEE RIGHT AWAY,
THERE ARE NOT THAT MANY
ELECTRODE CONTACTS IN THERE, HOW
DOES IS THAT DO THE JOB OF
THOUSANDS OF AUDITORY NEURONS?
WELL YOU THINK TO YOURSELF,
WELL, IT PROBABLY CAN'T AND I
WILL TELL YOU IT CAN'T, SO WHAT
CAN IT DO?
IT CAN DO REDUNDANT SIGNALS AS
WELL SO SPEECHES ARE REDUNDANT
SIGNAL SO IF MY VOICE WERE
TRANSPOSED UP OR DOWN, YOU MIGHT
NOT NOTICE OR CARE BECAUSE
THAT'S NOT THE POINT OF YOU
HEARING ME SPEAK, THAT'S WHY WE
CAN ALL TALK TO THE TELEPHONE
DESPITE KNOWING THAT IT DOESN'T
ACTUALLY SOUND LIKE THE PERSON'S
VOICE SOUNDS LIKE IN REAL LIFE
BECAUSE IT'S A IMPOVERISHED
SIGNAL, IT'S ENOUGH, ENOUGH TO
HEAR THE SPEECH BUT WHEN YOU
LOOK AT A PIANO AND YOU LOOK AT
THE NOTES, YOU CAN JUST START
ANALYZING THE FUNDAMENTAL
FREQUENCIES OF THESE TONES AND
YOU REALIZE, HMM, FROM 1 TONE TO
THE NEXT IS A REALLY SMALL DRVES
ABOUT 15-HERTZ AND IF THERE'S
ANY AUDIOLOGIST IN THE GROUP,
YOU KNOW WE'RE NOT TALKING ABOUT
SMALL INCREMENTS WHEN WE TALK
ABOUT PROGRAM BANS, WE TALK
ABOUT HUNDREDS OR THOUSANDS OF
HERTZ THAT WILL FIT INTO 1
ELECTRODE BAN, MEANING
EVERYTHING THAT'S IN THAT
FREQUENCY WILL GET ASSIGNED TO
THAT 1 ELECTRODE CONTACT.
IF YOU HAD TO PICK 1 TARGET TO
STRIVE FOR, YOU WOULD RATHER
HAVE RELATIVE PITCH MORE THAN
ABSOLUTE PITCH SO THE FIRST
TECHNOLOGY TRANSFER I WOULD SAY
IS THAT WE SHOULD PROBABLY
FOREGO FER FECT PITCH.
THE SOUND IS THE 1 SOUND NEXT TO
ITS NEIGHBOR OR WHAT BECAME
BEFORE OR AFTER IS IN THE RIGHT
SORT OF MUSICAL SPATIAL
RELATIONSHIP RATHER THAN BEING
DISTORTED SO HOPEFULLY WHAT WE
CAN DO FIRST AND GET RELATIVE
PITCH TO BE INTACT.
RIGHT NOW WHAT HAPPENS IS RATHER
THAN HAVING THIS KIND OF
ORGANIZED LINEAR ARANKMENT LIKE
A PIANO KEYBOARD, IT'S MORE
SOMETHING LIKE THIS AND IT'S
WORSE THAN THIS, BECAUSE NOT
ONLY ARE ALL THE KEYS THERE IN
CI HEARING, A LOT OF THE KEYS
ARE MISSING OR THE KEYS ARE VERY
WIDE LIKE AN ENTIRE OCTAVE WILL
BE REPRESENTED BY 1 KEY, OR
THERE'S REVERSALS AND DIRECTIONS
WHERE YOU GO UP ON THE KEYBOARD,
THE SOUND IS GOING DOWN, PEOPLE
DESCRIBE A HIGHER TONE PLAYED
AND THE TONE SOUNDS LOWER SO
THERE'S ALL SORTS OF MA HEM
GOING INSIDE THE INNER HERE AND
IT TURNS OUT THAT MUSIC IS NOT
ROBUST TO MAYHEM WHEN IT'S IN
THE PITCH DOMAIN AND JUST AS AN
EXAMPLE OF THAT, I WILL PLAY YOU
A MINIRENDITION OF
[INDISCERNIBLE].
THIS IS THE ORIGINAL VERSION.
[* MUSIC ]
NOW IF YOU TOOK THAT, SAME PIECE
OF MUSIC AND YOU RANDOMIZE IT TO
THE NEAREST SEMITONE OKAY, AND
WE WOULD BE EXSTATTIC IF WE HAD
SEMITONE RESOLUTION IN COCHLEAR
PLANT IMPLANT HEARING, ECSTATIC.
WE DON'T.
THIS IS WHAT IT SOUNDS LIKE TO
THE NEAREST SEMITONE.
SO I WOULD SUBMIT THAT THAT'S A
CLOSER RENDITION OF WHY WHAT IT
SOUNDS LIKE, YOU MATE THINK
THAT'S WHY I DON'T LIKE MUSIC
AFTER MY CI BECAUSE I DON'T WANT
TO HEAR THOSE DANCES ALL THE
TIME.
NOW 1 OF THE KEY QUESTIONS IN
MUSIC AND 1 OF THE MAIN REASONS
WE TEND TO LIKE IT IS BECAUSE IT
GIVES US AN EMOTIONAL RESPONSE
AND IF THERE'S 1 THING MUSIC IS
GOOD AT, IT'S NOT AT
PROPOSITIONAL THOUGHT, SO EVEN
THOUGH WE THINK ABOUT MUSIC AS A
UNIVERSAL LANGUAGE, IT'S NOT
GOOD AT THE THINGS THAT LANGUAGE
IS GOOD AT, I MEAN YOU CAN'T
GIVE A LECTURE USING A PIANO, I
CAN'T JUST LIKE PLAY THIS
LECTURE TO YOU USING A PILOT
PROJECTON O AND HAVE YOU
UNDERSTAND WHAT I'M TALKING
ABOUT, YOU NEED THE SEMANTICS
SPECIFICITY OF SPEECH BUT WHAT
MUSIC DOES BETTER THAN ANYTHING
ELSE IS CONVEY EMOTION, AND SO
WHEN YOU ARE LISTENING TO MUSIC,
THE EMOTIONAL MESSAGE HAS TO BE
THERE FOR YOU.
OTHERWISE IT LOSES ALL ITS
POWER.
SO WHEN WE TRY TO MAKE A MUSICAL
INTERPRETATION OF EMOTION,
MUSICAL EMOTION, WE TEND TO USE
CERTAIN AUDITORY CUES AND THOSE
CUES ARE USUALLY THINGS LIKE
MODE, LIKE WHETHER IT'S A
MEASURE OR MINOR KEY AND THEN
TEMPO WHETHER IT'S FAST OR SLOW.
SO LET'S JUST START A 2 VERY
BASIC CONCEPTS THAT GENERALLY
SPEAK THANKSGIVING IS A CRUDE
OVERRICISM LIAISONIFICATION, BUT
GENERALLY SPEAKS SOMETHING
THAT'S MAJOR SOUNDS BETTER THAN
SOMETHING THAT'S MINOR.
GENERALLY SPEAKING SOMETHING
FASTER IS SOUNDS BETTER THAN
SOMETHING SLOWER.
SO IF YOU TAKE'S MELODY AND MAKE
IT MAJOR AND PLAY IT FAST, IT
SOUNDS LIKE THIS.
[* MUSIC ]
NOW IF YOU TAKE THAT SAME MELODY
AND YOU MAKE IT MINOR AND YOU
PLAY IT SLOW, IT SOUNDS LIKE
THIS ... [* MUSIC ]
OKAY, NOW MOST OF THE PEOPLE
THAT HEAR THOSE 2 THINGS WILL
SAY THE FIRST 1 WAS HAPPY, THE
SECOND 1 WAS SAD IF YOU HAD TO
BE BINARY ABOUT THIS KIND OF
THING.
NOW THERE'S TO AMBIGUOUS
POSSIBILITIES, 1 IS YOU CAN TAKE
SOMETHING MAJOR AND YOU CAN MAKE
IT SLOW.
SO NOW ALL OF A SUDDEN THERE'S
AMBIGUITY IN THE EMOTIONAL
SIGNIFICANCE OF THAT AT LEAST TO
NORMAL HEARING USERS, SAME WITH
SOMEBODY WHO HEARS THIS THAT'S
MINOR AND FAST.
[* MUSIC ]
IS THAT HAPPY OR SAD?
I DON'T KNOW YOU HAVE TO TELL ME
YOUR PERSOAPGZ BUT YOU CAN SEE
HOW THERE'S ATTENTION IN THOSE
AMBIGUOUS 1S.
SO THEN IF YOU RATE THESE IN
TERMS OF VALENCE WHETHER THEY'RE
HAPPY OR SAT, NORMAL HEARING
LISTENERS DO WHAT WE JUST DID,
THEY SAY THE HAPPY, FAST 1 IS
HAPPY, THE MAJOR 1 IS HAPPY AND
THAT THE MINOR SLOW 1 IS SAD AND
THE OTHERS ARE AMBIGUOUS,
THEY'RE CLUSTERED,A ROUND 0.
BUT SEE WHAT CI USERS DO.
IT'S BECAUSE THEY'RE NOT ABLE TO
HEAR THE DIFFERENCES IN MODE.
THE DIFFERENCE BETWEEN MAJOR AND
MINOR IT'S A SEMITONE AT THE
THIRD, THAT'S IT.
AND SO FOR MAJOR AND MINOR MODE
SIGNIFICANCE, THAT'S LOST TO
MOST CI USERS, CAN YOU RIGHT
AWAY FOR EMOTIONAL MUSIC OR
SOMETHING WE MIGHT TAKE FOR
GRANTED ARE EFFORTLESS TO HEAR,
BECOMES QUITE CHALLENGING.
NOW YOU CAN MAKE THAT MORE
COMPLICATED BY LOOKINGA THE
LEVELS OF DISSIDENCE, SO IF YOU
TAKE A MELODY AND PUT A NORMAL
ACCOMPANIMENT TO IT, IT SOUNDS
SOMETHING LIKE THIS ... [* MUSIC
*]
NOW IF YOU MAKE THAT VERY
DISSIDENTOT ACCOMPANYING CHORD
LIKE THIS ... [* MUSIC ]
AGAIN YOU WOULD EXPECT THERE'S
AN EMOTIONAL--THE MORE DISTANT
THE LESS PLEASING IT IS TO YOU,
AND THE NORMAL HEARING, YOU SEE
IT IN THE GRAY BARS THERE, THE
MORE DESDENT, THE LESS PLEASING
IT IS.
IT'S ALL THE SAME.
OKAY, THEY SEE NO DIFFERENCE
DEPENDING ON DEGREE OF DISTANCE,
THEY CAN GET MORE AND MORE
DISTANCE, THEY STILL FEEL LIKE
IT'S MORE THE SAME. AND THAT'S
BECAUSE THEY HEAR DISTANCE ALL
THE TIME.
EVERYTHING IS DISSONANCE.
ANOTHER 1 IS HOW MANY PITCHES
ARE IN TUNE BUT HOW MANY ARE
COMING ON THE YOU AND MOST
PITCHES IT'S NOT 1 NOTE AT A
TIME, YOU ARE HEARING DOZENS OF
NOTES PLAYED AT 1 TIME SO IF YOU
HAD A TASK IF IN FRONT OF YOU
WHERE YOU HAVE THE DISSONANCE
BETWEEN 1 AND, 2, AND 3.
[* MUSIC ]
THAT IS A TASK WHAT WE REFER TO
AS POLYFONNISH PITCH PERCEPTION,
SO YOUR ABILITY TO SAY THAT WAS
1, 2, OR 3.
AND IF YOU LOOK AT THE MATRIXOT
RIGHT, WHEN A NORMAL HEARING
PERSON GETS THAT WRONG, THEY
WILL ALMOST NEVER SAY THAT 3 IS
1.
OKAY?
IF THEY GET IT WRONG, THEY WILL
SEE THE 3 IS 2.
THEY WILL KNOW THERE ARE
MULTIPLE NOTES BUT WHAT DO THE
CI USERS DO ON THE BOTTOM LEFT?
WHEN THEY HEAR THE 3, THEY WILL
FREQUENTLY SAY IT WAS 1.
SO THEY HAVE PERCEPTUAL FUSION
OF MULTIPLE NOTES THAT COMES TO
THEM AS A SINGLE BLOCK AND
THAT'S AGAIN ANOTHER PROBLEM
CONSIDERING MOST MUSIC IS
POLYPHONIC IN NATURE.
SO THE OTHER HUGE OBSTACLE TO
PERFECT HEARING IS SOUND
QUALITY, NOT JUST WHETHER OR
NOT, IT IS RIGHT OR WRONG, BUT
DOES IT SOUND GOOD OR NOT.
IS IT PLEASING?
AND THE ANALOGY I LIKE TO MAKE
IS SOMETHING THAT WAS INSPIRED
BY MY MOVE TO CALIFORNIA, WHEN I
GOT TO CALIFORNIA I DIDN'T
REALIZE HOW SERIOUSLY PEOPLE
TAKE THEIR WINE.
AND YOU KNOW I WAS A LITTLE BIT
CLUELESS AND FOR ME YOU COULD
HAVE HANDED ME A FIVE DOLLARS
BOTTLE OF WINE AND A $50 OF WINE
AND I MIGHT NOT REALLY HAVE
KNOWN THE DIFFERENCE.
AND THE FAULT IS NOT THE WINE'S,
IT WAS MY FAULT, MY PALATE
WASN'T READY FOR IT AND THE
PROBLEM WITH CI USER HEARING IS
NOT IN THE SOUND, IT'S IN THEIR
AUDITORY PALATE.
THEY'RE NOT SOPHISTICATED ENOUGH
TO BE ABLE TO RESOLVE THE
DIFFERENCES THAT ARE PRESENT.
SO YOU COULD PLAY THE FINEST
MUSIC RECORDINGOT BEST SPEAKER
SYSTEM IN THE WORLD TO A CI USER
AND IT MIGHT NOT SOUND THAT MUCH
BETTER THAN PLAYING IT OFF YOUR
LAB TOP BECAUSE THEY HAVE AN
AUDITORY PALATE PROBLEM, SO I
WILL SHOW YOU 2 PATIENTS THAT
EXEMPLIFY THIS.
HERE'S A PATIENT.
>> MUSIC SOUNDS VERY GOOD TO ME
WITH MY COCHLEAR IMPLANT, MUCH,
MUCH BETTER THAN WHEN I HAD
HEARING AIDS.
I THINK I BENEFIT FROM THE FACT
THAT I NEVER HAD THE MUSICIANS
SCHOOLED EAR, LEARNED HERE WHERE
MY SENSE OF PITCH WAS NEVER THAT
GOOD SO I HEARD SOME MUSICIANS
THAT HAVE COCHLEAR IMPLANTS THAT
ARE NOT THAT HAPPY WITH HOW
MUSIC WORKS FOR THEM.
BUT FOR ME I THINK IGNORANCE IS
BLISS BECAUSE IT SOUNDS TERRIFIC
TO ME.
>> HEE CAN'T TELL THE DIFFERENCE
BETWEEN A FIVE DOLLARS BOTTLE OF
WINE AND I A $50 BOTTLE OF WINE.
HE TESTED HIM.
HE'S NOT GOOD BUT HE'S PERFECTLY
HAPPY WITH WHAT HE SIZE'RE HAS.
SO HE WOULD LIKE A FIVE DOLLARS
OF BOTTLE OF WINE, FINE.
NOW HERE'S SOMEBODY ELSE, SHE'S
GOT A DIFFERENT TAKE ON IT?
, SOMETIMES MUSIC IS JUST LIKE
JUST CAR KICKOFF NOWS NOISE AND
I AM TRYING TO HEARING OTHER
THINGS GOING ON OOH ROUND AND
THE MUSIC IS OVERPOWERING, OTHER
TIMES MUSIC IS REALLY SOOTHING
AND HELPFUL IF I'M IN A QUIET
ENVIRONMENT, I CAN PICK UP
POSITIVE ASPECTS OF MUSIC.
A LOT OF TIMES IT SOUNDS LIKE
IT'S IN THE WAY, LIKE SOMETHING
THAT I KNOW THAT OTHER PEOPLE
OBVIOUSLY ENJOY HEARING, I'M
LIKE WHY IS THIS HERE, WHY DOES
THIS NEED TO BE HERE THIS IS
JUST DISTRACTING ME FROM WHAT
I'M ACTUALLY DOING.
>> SHE'S KIND OF CRYSTAL BUT
WHEN YOU TEST HER SHE DOES A LOT
BETTER THAN THE FIRST PERSON.
SO EACH THOUGH SHE HAS A BETTER
PALATE SHE EXPECTS MORE, SHE HAS
A HIGH EXPECTATION OF WHAT
THINGS SOUND LIKE, SHE WANTS THE
FIVE DOLLARS BOTTLE OF WINE TO
TASTE LIKE THE $50 BOTTLE OF
WINE.
SO SOUND QUALITY IS POOR TO
ASSESS.
YOU USUALLY ASSESS IT BY WHETHER
SOMEBODY LIKES SOMETHING.
SO SOUND QUALITY IS NOT ABOUT
WHETHER YOU ARE ENJOYING IT OR
WHETHER CAN YOU RESOLVE THE
DETERIORATION IN THE SOUND
QUALITY.
IT'S NOT WHETHER YOU CAN DIG IT
IT'S THAT YOU'RE LISTENING TO
SOUND ON A TERRIBLE SET OF
SPEAKERS.
SOME OF YOU MAY NOT BE ABLE TO
TELL THE DIFFERENCE BETWEEN
AUDIO FILE SPEAKER ANDS COMPUTER
SPEAKERS AND OTHER PEOPLE ARE
REALLY, REALLY AG.
Q.IVATEED IN THE SOUND
IS NOT EXACTLY RIGHT
WHEN THEY LISTEN TO
SOMETHING LIKE
CLASSICAL MUSIC, SO
THE QUESTION IS CAN WE
USE ASSESSMENTS OF
SOUND QUALITY AS A
PROBE TO AGAIN TEST
YOUR ABILITY TO NOT BE
ABLE TO RECOGNIZE THAT
WE HAVE DETERIORATED
SOUND.
IF YOU CAN'T TELL THE DIFFERENCE
BETWEEN POOR SOUND QUALITY AND
GOOD SOUND QUALITY, YOU DON'T
HAVE GOOD PERCEPTION, SO AN
EXAMPLE OF THIS IS LET'S TRY TO
REMOVE BASE, SO 1 OF THE KEY
PROBLEMS IS THAT THE APEX OF THE
CO CLE ATHIS MEANS SOMETHING
BECAUSE THE BASE FREQUENCY ARE
ALL AT THE APEX AND COCHLEAR
IMPLABT ELECTRONS DON'T REACH
THE APEX, GENERALLY SPEAKING
THEY'RE STIMULATED HIGHER
FREQUENCY PARTS OF THE COCHLEA
RATHER THAN THE LOWER FREQUENCY
PARTS, WHAT THAT MIGHT
SUGSCWHREOF THE IS THAT YOU
CAN'T HEAR BASE IF YOU HAVE A
COCHLEAR IMPLANT AND IT'S ALL
ABOUT THE BASS.
SO WE DID AN EXPERIMENT WHERE WE
TOOK A BUNCH OF MUSE AND I CAN
REMOVED BASS AND WE DID THIS
HIGH PASS FILTERING OF DIFFERENT
MUSE AND I CAN IF YOU LOOK AT
THE SPECTROGRAMS YOU CAN SEE
THIS AND YOU GO LOOK AT EACH
TOKEN AS YOU GO TO THE RIGHT AS
LESS AND LESS FREQUENCY
INFORMATION.
SO IT SOUNDS LIKE THIS.
HERE ARE EMPLOY ANDS.
THIS IS AN EXAMPLE OF USHER
WITHOUT BASE.
[* MUSIC ]
AND WITH BASS ... [* MUSIC ]
THAT MIGHT NOT BE COMING OVER SO
WELL ON THESE SPEAKER SET, BUT
HOPEFULLY CAN YOU HEAR, THERE'S
A DIFFERENCE BETWEEN THOSE 2 AND
IT'S NOT JUST TRUE FOR USHER,
HERE'S JAZZ.
>> [* MUSIC ]
>> AND THEN WITH THE BASS
PRESENCE.
[* MUSIC ]
SO WE'RE NOW COMPARING VERSIONS
OF THESE SOUNDS TO THEMSELVES.
OKAY?
YOU'RE NOT SAYING WHETHER YOU
LIKE THE MUSIC OR YOU LIKE THAT
SONG, YOU ARE SAYING WHETHER OR
NOT YOU CAN TELL THAT 1 VERSION
OF IT SOUNDS BETTER THAN A
DIFFERENT VERSION OF IT WITH
DIFFERENT DEGREES OF BASE AND
WHAT HAPPENS IF YOU HAVE NORMAL
HEARING IN THE DARK GRAY BARS,
AS YOU LOSE BASS, YOU SAY IT
SOUNDS WORSE AND WORSE AND WORSE
AT THAT SLOPE, RIGHT?
CI USERS CAN TELL THAT IT SOUNDS
WORSE BUT IT'S A VERY BLUNTED
RESPONSE, RIGHT?
SO WE'RE AGAIN SEEING NOW THAT
THEY HAVE A LIMITED ABILITY TO
TELL THAT SOUND WAS LOST, IN
FACT AT THE VERY MILD VERSIONS
OF FILTERING THEY CAN'T TELL AT
ALL.
SO JUST OORPGHT EXAMPLE OF HOW
SOUND QUALITY IS POOR IN CI
USERS.
SO I'VE GIIVE YOU SOME SORT OF
DISMAL INFORMATION IN THE FIRST
HALF OF THE TALK AND I WILL NOW
SWITCH GEARS AND TALK ABOUT
REASONS FOR HOPE.
SO THIS IS A VERY FAMOUS PERSON
WHO YOU DON'T USUALLY SEE THE
SKULL OF A FAMOUS PERSON, BUT
THIS IS BEETHOVEN, THE REASON WE
HAVE THE SKULL IS BECAUSE HIS
SKULL WAS STUDIED TWICE TO SEE
WHY HE LOST HIS HEARING, THERE'S
A BULGE THERE ON THE TEMPORAL
BONE, THAT'S NOT THE TEMPORAL
BULGE, THERE WAS A THEORY THAT
ME MIGHT HAVE A DISEASE OF THE
BONE BECAUSE THE BONE WAS
MISSHAKEN, THAT WAS MOLD AND
CLAY USED TO PUT HIS SKULL BACK
TOGETHER AFTER HIS TEMPORAL
BONES WERE LOST, BEETHOVEN'S
TEMPORAL BONES WERE HARVESTED
AND LOST SOMEWHERE AROUND THE
TIME OF WORLD WAR II, IF YOU SEE
A JAR THAT SAYS BEETHOVEN'S
TEMPORAL BONES PLEASE E-MAIL ME,
OKAY?
BECAUSE WE NEVER SAW THE REASON
OF WHY BEETHOVEN LOST HIS
HEARING, WE HAVE ALL THE
THEORIES BUT THE KEY WOULD BE IN
THE TEMPORAL BONES BUT IT TURNS
OUT THAT BEETHOVEN IS 1 OF THE
MOST REMARKABLE EXAMPLES OF
SOMEBODY WHO COMPOSED MUSIC WITH
DEAFNESS AND HE STARTED LOSING
HIS HEARING EARLY, HE ALREADY
KNEW HE WAS USING HEARING.
IT'S RELATED TO WHY HE HAD THIS
VERY FETTERILE PROTECTIVE
PERIOD, HIS FOURTH, FIFTH, AND
SIXTH SYMPHONY CAME OUT QUICKLY,
BUT AT THE NINTH, THE STORY HE
COULDN'T HEAR THE AUDIENCE
CHEERING AFTER THE MUSIC ENDED
AND HE HAD TO BE TURNED AROUND
BY 1 OF THE VOCAL SOLOISTS SO HE
COULD SEE HE WAS GETTING A
STANDING OVATION.
BUT HE WAS ABLE TO COMPOSE THAT
MUSIC BECAUSE HIS AUDITORY BRAIN
WAS INTACT.
SO HIS MUSICAL AND AUDITORY
BRAIN WAS INFACT BEFORE HE LOST
HIS HEARING AND SO THAT'S KIND
OF A CLUE THAT YOU DON'T LOSE
YOUR MUSICALITY OR YOUR ABILITY
TO PERCEIVE MUSIC IN YOUR MIND'S
EAR JUST BECAUSE YOU LOSE YOUR
HEARING, SO IF WE WANT REASONS
FOR HOPE, WE HAVE TO THINK ABOUT
HOW DO WE ACTUALLY, WHAT ARE OUR
STRATEGIES TO TRY TO IMPROVE
SOMETHING LIKE MUSIC FOR USERS
AGAIN, NONAPOPTOTIC THE FOR
ENTERTAINMENT SAKE BUT ARE FOR
THE IDEA OF PERFECT HEARING
RESTORATION, IF YOU COULD LOOK
AT PERFECT HEARING YOU WOULD
TARGET IT FOR SO YOU COULD
TARGET MUSIC, SO YOU MAYBE THE
PROBLEM IS IN THE DEVICE AND SO
THERE'S A LOT OF STRUCTURAL
ENGINEERING ISSUES THAT PERTAIN
TO COCHLEAR IMPLANTS AND A LOT
OF DETAILS ABOUT YOU HO YOU FIRE
THE ELECTRICITY THAT ALL
PROBABLY MATTERED AND SO LET ME
TALK YOU THROUGH A QUICK RUN
THROUGH SOME OF THESE THINGS.
SO RIGHT NOW, CURRENT IS
DELIVERED EITHER IN MONOPOLEAR
FASHION OR BIPOLAR FASHION.
AND WHAT HAPPENS IS THAT
ELECTRICITYS ARE FIRED AT THE
NERVE BUT IT'S KIND OF LIKE
TAKING A GUARDEN HOSE AND TRYING
TO WATER 1 BLADE OF GRASS, YOU
CAN'T.
YOU'RE HITTING ALL THE
NEIGHBORS, OKAY?
AND THAT'S BECAUSE THERE'S
SPRAY, SPREAD OF THE WATER, THAT
SPRAY IS ELECTRICAL, SO YOU CAN
BE THE HIT 1 NEURON, YOU ARE
HITTING ALL OF THE TARGET
NEIGHBORS AND SOME SORT OF
DISTRIBUTED FASHION.
NOW TRI POLEAR STIMULATION IS
SOMETHING THAT IS A WAY TO FOCUS
THE CURRENT BY PUTTING FLANKING
CURRENT THAT'S SORT OF
ENCOURAGES THE ELECTRONS TO STAY
IN A MORE SINGLE FILE WAY RATHER
THAN DISPURSING WIDELY AND YOU
MIGHT THINK THAT IF YOU COULD DO
THAT, KIND OF NARROW THE SPREAD,
YOU MIGHT IMPROVE YOUR ABILITY
TO JUST TARGET SPECIFIC NEURONS
AND YOU MIGHT IMPROVE YOUR
ABILITY FOR EXAMPLE, DO A
POLYFONNISH PITCH PERCEPTION
TASK AND SO IN THE--SORRY, I AM
LOSING THIS SLIDE HERE, SO IN
THE RIGHT SIDE THERE, CAN YOU
SEE THAT THE TRI POLEAR IN THE
GRAY, REDUCES THE SEMITONE
INTERVAL THAT YOU CAN HEAR
BETWEEN SO CAN YOU RESOLVE
SMALLER SEMITONE DIFFERENCES
BETWEEN 1 AND 2 TONES.
SO WE'RE STARTING TO SAY, HUH, A
SIMPLE CHAIMPLE IN OW WE FIRE
ELECTRICITY IS ACTUALLY
IMPROVING OUR ABILITY TO HER
POLARIZEDDIVENY.
NOW YOU CAN FIRE THAT IN A
DIFFERENT DIRECTION, RATHER THAN
FIRING IT IN A MORE NARROW WAY,
YOU COULD PUT A CURRENT THAT
SEND ITS OUT TOWARDS THE APEX,
SO SHOOT THE CURRENT BEYOND THE
PHYSICAL LOCATION OF THE
EXPECTATIONS LECTURE RODE.
SO THIS IS SOMETHING THATY
CALLED PARTIAL BIPOLAR
STIMULATION AND THE PHANTOM IS
THE TERMINOLOGY WE USE TO GIVE A
BASS BOOST SO WHAT YOU'RE DOING
IS LITERALLY DIRECTING
PARENT--CURRENT DIRECTING
ELECTRICITY INTO THE THERE WITH
THE HOPE OF HITTING NEURONS AND
IF YOU DO THAT, AND THEN YOU
COMPARE THAT LOW FREQUENCY HIGH
PASS FILTERING STUDIES WHERE
WE'RE MOVING BASS, IT TURNS OUT
YOU DO BET OR THAT STUDY, HAVE
YOU A MORE NORMAL TEST RESPONSE
IF YOU HAVE THE PHANTOM
ELECTRODE BASS BOOST ON THAN IF
YOU DID.
SO AGAIN, BY STEERING THAT
ELECTRICITY TOWARD THE APEX,
YOU'RE BETTER AT DOING THIS BASE
LO FREQUENCY TASK.
NOW ANECDOTALLY 1 THING THAT WAS
INTERESTING WAS PEOPLE THAT HAD
THIS ELECTRORODE ON SAYING HUH,
I CAN ACTUALLY, MY FAMILY MEMBER
SOUNDS DIFFERENT.
THEIR VOICE SOUNDS DIFFERENT NOW
THAT THEY HAVE THIS NEW
PROCESSING STRATEGY, THEY SOUND
MORE LIKE THEMSELVES.
WHAT DO YOU MEAN?
THEIR VOICE, VOCALIZATIONS THEIR
SPEECH SOUNDS MOAK LINEUP THAT
DID BEFORE THEY HAD THEIR
HEARING LOSS AND YOU PROBABLY
ARE AWARE SPEECH GETS AFFECTED
WHEN YOU LOSE YOUR HEARING AND
THE FEEDBACK LOOP, THAT MAY BE
RELATED TO THE PITCH OF THINGS
SO YOU THINK YOUR VOICE IS OFF
SO YOU MODULATE YOUR VOICE IN A
COMP PENSATORY FASHION IN THE
WRONG DIRECTION.
SO WHEN YOU TURN ON THE PHANTOM
ELECTRODE AND BASS BOOST, YOU
SEE THERE'S A SHIFT IN THE FORM
AND FREQUENCIES OF PEOPLE'S
SPOKEN VOICES MORE TOWARDS THE
FREQUENCY OF THE GENERAL
POPULATION.
SO THERE'S A NORMALIZATION
THAT'S OCCURRING IN THE
FUNDMENTAL FREQUENCY OF THESE
PERFORMANCE FOR VOICES WITH THE
COCHLEAR IMPLANT VERSUS PHANTOM
ON WITH PHANTOM OFF, NOW HEARING
MORE BASE IMPROVINGIOURE ABILITY
TO SPEAK, IN A WAY THAT SOUNDS
MORE LIKE YOUR NATURAL VOICE IF
YOU HAD NORMAL HEARING.
NOW SOME OF YOU MAY HAVE HEARD
ABOUT HEARING PRESERVATION
COCHLEAR IMPLANT SURGERY WHICH
IS A AN OXYMORON, BECAUSE IF YOU
DON'T HAVE OTHER HAD, ITS OUT
WE'RE GETTING BETTER AND BETTER
IN THE SURGICAL COMAIN IN
PUTTING COCHLEAR IMPLANTS IN
PATIENT WHO IS LOST SOME BUT NOT
ALL OF THEIR CRITERIA, THE
CRITERIA, AND WE'RE ABLE TO
PRESERVE LO FREQUENCIES IN
PARTICULAR SO HERE'S PATIENTS
THAT ARE CONSIDERED FOR COCHLEAR
IMPLANT, THEY'RE NOT DEAF AND SO
WHAT KEY CAN DO NOW IS ACTUALLY
PUT AN ELECTRODE IN THIS AND
PRESERVE ITS FUNCTION, HERE'S AN
EXAMPLE OF HOW WE DO THAT, THIS
IS ME DOING COCHLEAR IPT GREATER
PLANT INSERTION, SO HERE'S THE
ELECTRODE.
THIS WILL BE A PLAQUE WHOLE,
WITH THE MEMBRANE, HERE'SLET
IMPLANT BEING THREATED RIGHT
INTO THAT OPENING.
AND I'M GOING TO TRY AS
ATRAUMATICALLY AS POSSIBLE, THAT
TO THREAD THIS INTO THE COCHLEA
AND IT'S ALL DONE FRO HAND,
RIGHT NOW IT'S NOT DONE
ROBOTICALLY ALTHOUGH THAT'S
POSSIBLY THE NEXT PHASE OF
THINGS AND YOU CAN SEE IT'S LIKE
SO EVENTUALLY YOU GET THIS
INSERTED AND YOU CHECK SOMEONE'S
HEARING AND THIS IS THE POST OP
AUDIO GRAM.
THIS IS THE PATIENT AFTER THEY
HAD THE SURGERY AND THIS IS THE
PREOPERATING GLOBALLY AUDIOGRAM,
THE LEFT HERE, THE BLUE LINE IS
THE EAR THAT WAS IMPLANTED SO
THERE'S A SMALL CONDUCTIVE
HEARING LOSS THAT'S PRESENT
AFTER SURGERY FOR TBLU
EDUCATIONAL BUT GENERALLY
SPEAKING THE HEARING NERVE DID
NOT TAKE A HIT SO WHAT DOES THAT
MEAN.
NOW THEY HAVE AN EXTRACTING
LECTURE RODE SITTING INSIDE
THEIRINNER EAR, STIMULATING THE
HIGHER FREQUENCIES WHERE THEY'RE
DEAF BUT THEY HAVE THE ADIG OF
THEIR NATURAL LOW FREQUENCY
HEARING.
THAT COMBINATION, IS REALLY
QUITE GOOD FOR MUSIC BECAUSE IT
TURNS OUT THAT MOST PITCH
PERCEPTION, I DID SAY PITCH IS
THE BIGGEST OBSTACLE, COMES FROM
FUNDAMENTAL FREQUENCY FROM THE
LOWEST FREQUENCIES.
SO IF YOU HAVE ACOUSTIC CORRECT
LOW FREQUENCY INFORMATION AND
ELECTRICAL STIMULATION OF HIGHER
FREQUENCIES, THAT CAN BE A VERY
GREAT WAY TO HEAR SOUND EVEN
THOUGH IT'S THE SORT OF DUAL
MODALITY FORM OF HEARING.
SO, THE QUESTION OF WHETHER WE
CAN ACTUALLY TUNE A COCHLEAR
IMPLANT IS THE THING I'VE BEEN
WRESTLING WITH FOR YEARS NOW AND
I THIS IS SOMETHING THEY THINK
THE ANSWER IS YES TO A LIMITED
DEGREE AND IT'S A LIMITED DEGREE
RIGHT NOW BECAUSE WE JUST DON'T
HAVE THAT MUCH CONTROL OVER WHAT
THAT ELECTRODE IS DOING SO WE'RE
TRYING TO FIGURE OUT HOW TO DO
THIS.
SO IT TURNS OUT THAT RIGHT NOW
IF YOU WERE TO GET A COCHLEAR
IMPLANT, ANY MANUFACTURE, ANY
SITE, YOU GET THAT ACTIVATED
ACCORDING TO A DEFAULT
MANUFACTURE RECOMMENDED MAB IS
NOT PERSONALIZED TO YOU, IF
EVERYONE HERE GOT THE SAME
COCHLEAR IMPLANT DEVICE AND WENT
FOR OUR PROGRAM, WE WOULD ALL
HAVE THE SAME MAP, THAT'S
INDEPENDENT OF WHERE OUR
ELECTRODES ARE SITTING AND WHERE
IT WAS PLACED IN OUR EARS AND OR
THE SIZINGS OF OUR CO COO CLA SO
THINK ABOUT THE VARIABILITY
THERE, SO WE'RE TRYING TO ADJUST
THAT VARIABILITY BY DOING HIGH
RESOLUTION IMAGING WITH FLAT
PANEL CT WHERE WE LOOK AT ALL
THE ANATOMY OF THE INNER HERE IS
SEE WHERE THESE ARE POSITIONED
AND YOU CAN GET SOME EXQUISITELY
DETAILED IMAGE IT IS HERE AND
YOU CAN SEE THAT THE ELECTRODES
HERE ARE NOT ALL THE SAME.
EACH 1 IS NOT SIT NOTHING THE
SAME LOCATION, AND I ALREADY
TALKED ABOUT HOW PLACE MATTERS
IN THE COCHLEA, WHERE YOU ARE IN
THE INNER EAR AFFECTS THE PITCH.
AND SO, ELECTRODE 1 IS ANYTHING
TO BE DIFFERENT FOR EACH OF
THESE INSERTIONS SO YOU WANT
TO,A JUST FOR THAT OR MAYBE YOU
SHOULD ADJUST FOR THAT SO IF IT
WERE ME, WOULD WANT TO TAKE THIS
KIND OF INFORMATION AFTER MY
SURGERY AND I WOULD WANT TO KNOW
THAT THESE EARS ARE NOT THE
SAME.
IF I HAD WOB IN MY RIGHT AND 1
IN MY LEFT, WE WOULD PROGRAM
THEM DIFFERENTLY SO RIGHT NOW
THEY'RE NOT, SOPHISTICATED IT
URNS OUT THERE'S THIS PLACE
RELATIONSHIP CALLED
[INDISCERNIBLE] THAT'S BEEN
FODDIFIED TO SHOW YOU THE YELL
RELATIONSHIP BETWEEN HAIR CELLS
AND THEN FREQUENCY RESPONSE.
NOW IF YOU COMPARE THIS SORT OF
IDEALIZED SPACE ISSUES SPACE TO
PITCH FUNCTION TO WHERE WE ARE
WITH COCHLEAR IMPLANTS YOU CAN
SEE WE'RE QUITE A BIT OFF.
THE BLACK IS KIND OF WHERE YOU
SHOULD BE AND THE ORANGE BARS
ARE WHERE YOU ACTUALLY ARE WITH
YOUR IMPLANTS AND THERE'S A HUGE
MISMATCH AND THAT MISMATCH IS
GREATEST AT THE ENDS, SO THE
APEX AND THE BASE HAS THE
GREATEST MISMATCH AND FREQUENCY
AS YOU MIGHT EXPECT IF YOU JUST
LOOK AT THE MATHEMATICS OF THE
IT IS THE ACTUAL MISMATCH FROM A
MUSCALIPER SPECTIVE CAN BE OFF
BY AS MUCH AS 1 AND HALF ACTIVES
SO THINK ABOUT HOW MUCH IT WOULD
BE OUT OF TUNE IF YOU TOOK A
VIOLIN AND TUNED IT OUT OF TUNE
BY 1 AND HALF ACTIVES AND TRIED
TO PLAY.
SO HOW DO WE FIX THAT, WOO NOW
TAKE CT SCNS AND WETTER MATCH
THEM IN THE PHYSICAL LOCATION OF
THE COCHLEA WHICH IS NOT A
TRIVIAL THING.
SO WE'VE BEEN COLLAB WAITING
WITH I NUMBER OF PEOPLE TO TRY
TO REALLY NAIL DOWN THIS
QUESTION OF WHAT IS THE RIGHT
FREQUENCY AND HOW YOU ARK SESES
THAD YOU MADE SOMEBODY BETTER,
AND YOU CAN GIVE SOMEBODY A
WHOLE ARRAY OF THEM PUT THEM IN
ORDER AND TELL THEM HOW FAR
APART YOU ARE, AND YOU E
ORGANIZE THEM AND LIKE THIS, AND
WHEN YOU DONE REORGANIZING THEM,
WHEN YOU PLAY IT SOWBDS LIKE
IT'S ASCEND NOTHING SOME LINEAR
FASHION IF YOU DO THAT TASK WITH
A FLAT PANEL MAP VERSUS A
CONTROL MAP YOU ACTUALLY GET A
LITTLE BIT BETTER SO YOUR
MISTAKE, YOUR MAJOR PITCHES
VERSES ARE LESS AND THE IN
AAPPROXIMATE EXPECTATIONS AND
THE BASE WHERE YOUR PERFORMANCE
ON THE WORST IS THE RIGHT GRAPH
THERE, CAN YOU SEE THAT THE
PERFOR THE PURPOSANCE IS
SLIGHTLY BETTER.
IS IT ENOUGH TO BE A MAJOR GAME
CHANGER BUT RIGHT NOW ANY PITCH
IN PITCH RESOLUTION MIGHT BE A
HENT THAT THIS IS SOMETHING WE
CAN DO BECAUSE RIGHT NOW WE'RE
SO OFF BASE THAT WE NEED TO FIND
ANYTHING WE CAN TO IMPROVE
THINGS.
SO I SAID WHY WE COULD CHANGE
THE CI, NOW ABOUT WHAT CHANGING
THE BRAIN, SO A LOT OF
MUTESICALLITY HAS TO DO MUSICAL
EXPOSE AND YOU ARE THRAINING SO
I WANT TO INTRODUCE YOU TO THIS
CHILD, TAKE A ELECTRIC AT THIS
KID.
IF YOU HAVE NEVER SEEN HIM, YOU
WILL BE ASTONISHED.
>> ALL RIGHT, DYLAN ROUND 2,
LAST TEST, ROUND 1 WAS MUCH
HARDER.
>> SO MAJOR CORD.
>> [INDISCERNIBLE]
>> TELL ME NOTES IN THIS CHORD.
>> FSHURP KEY, DSHARP F.
>> TELL ME NOTES ON THIS CODE.
>> CAPLAT BFLAT, BPLAT.
>> SING ME AN A.
>> A.
>> CLOSE YOUR EYES AND SING AND
NAME THE NOTES IN THIS CHORD.
>> EAFC-SHARP, F.
>> SING ME G-MINOR.
>> GYB.
>> SING AND NAME THE NOTES IN
THIS CHORD.
>> ACDGA.
>> SING IN AFFLAT.
>> A-FLAT.
>> GREAT.
TELL ME WHAT YOU THINK OF THIS
CHORD?
>> [INDISCERNIBLE]
>> NAME THESE NOTES AND SING
THEM.
>> BFLAT, D, F, AC, C-CHARP B.
>> GREAT.
>> OKAY, LAST CHORD THIS IS A
POLYCHORD, TELL ME THE NAME OF
THIS CHORD.
>> A-FLAT, 7 OVER FMAJOR
[INDISCERNIBLE].
>> WHAT ARE THE NOTES?
>> FA, C-CHARP, G-FLAT, E-FLAT.
>> PERFECT.
>> UNBELIEVABLE RIGHT.
>> NOW IT'S NOT THAT HE AS A
SUPER AUDIO GRAM.
OKAY?
YOU DO AN OWDIO GRAM, THIS IS
PROBABLY VERY SIMILAR TO OURS
FOR BASIC PURE TONES, THE
DIFFERENCE IN HIS BRAIN'S
ABILITY TO INTERPRET COMPLEX
COMBINATIONS OF PITCHES AND HE
PROBABLY WAS EXPOSED TO MUSE
BEINGIC AT A VERY EARLY AGER
BECAUSE IT APPEARS PEOPLE WITH
ABSOLUTE PITCH PERCEPTION HAD
EARLY EXPOSURE TO MUSIC.
WHAT I'M SUGGESTING IS HE'S HAD
BRAIN TRAINING, HIS BRAIN HAS
BEEN DEVELOPED TO UNDERSTAND
PITCHES, NOW IT'S NOT WE CAN GET
EVERYBODY TO BED PITCHING AT
THAT LEVEL.
BUT NOBODY CAN DO THAT THING
ABOUT IF YOU CAN HAVE A NORMAL
HEARING BRAIN AND ELEVATE IT TO
THAT LEVEL THROUGH TRAINING
MAYBE YOU CAN TAKE AN
IMPOVERISHED AUDITORY BRAIN AND
ELEVATE IT A CLOSER NEAR NOARMAL
LEVEL THROUGH TRAINING AND RIGHT
NOW IT TURNS OUT THAT ALL THE
TRAINING THAT'S DONE FOR
COCHLEAR IMPLANT USERS THAT'S
FORMALIZED AND ALL SPEECH BASED.
YOU GET SPEECH TRAINING,
LANGUAGE BASED TRAINING, YOU
DON'T DO MUSIC TRAINING BECAUSE
IT'S FELT THAT THAT'S FOR PEOPLE
THAT LIKE MUSIC BUT I THINK THE
POINT HERE IS THAT IF YOU WANTED
TO PERFECT YOUR ABILITY TO HEAR
FREQUENCIES, YOU SHOULD DO
FREQUENCY BASED TRAINING AND
THAT FREQUENCY BASED TRAINING IS
BETTER DONE THROUGH SOMETHING
LIKE MUSIC THAN IT IS THROUGH
SOMETHING LIKE SPEECH.
SO HERE'S ANOTHER REASON TO
THINK ABOUT CHANGING THE BRAIN,
OKAY?
SO HERE'S A CAT.
NOW IF YOU ANY OF YOU HAVE CATS
YOU MIGHT KNOW, I KNOW RITA
LOVES CATS, YOU MIGHT KNOW THAT
WHITE CATS ARE ACTUALLY NOT
IGNORING YOU BUT THEY'RE OFTEN
DEAF.
SO WITH MY MENTOR DAVID CANNED
WHAT AND OTHER MENTOR JOHN
[INDISCERNIBLE] WE DID THIS
EXPERIMENT AT JOHNS HOPKINS
WHERE WE DID A COCHLEAR IMPLANT
IN THESE DEAF WHITE KITTENS AND
THE ELECTRODE IS LIKE THIS, IT'S
SITTING THERE, CAN YOU SEE IT'S
A CUSTOM 6 CONTACT COCHLEAR
IMPACT DEVICE AND HERE IS A DEAF
WHITE CAT THAT'S BEEN TRAINED
NOW TO RESPOND TO MUSIC FOR
FOOD.
>> [* MUSIC ]
NOW THE TRAINING IS A SPECIFIC
TRUMPET CALL.
[* MUSIC ]
AND IT'S THAT SPECIFIC TRUMPET
CALL, ANOTHER TRUMPET CALL WON'T
WORK, I'M NOT SUGGESTING THE CAT
LIKES TRUMPET OR KNOWS IT, OR IT
HAS BEEN TRAINED TO IMBUE A
MUSICAL ABSTRACT SOUND WITH
MEANING AND THAT'S THE WHOLE
POINT OF LISTENING TO SOME OF
THIS COMPLEX MUSIC SO YOU WE
CHANGED THAT BRAIN'S ABILITY TO
PERCEIVE A SOUND THAT'S CAN A
MUSICAL IMPACT.
THAT'S A DEAF CAT THAT JUST
RESPONDED TO A TRUMPET TO GET
FOOD.
NOW, WHEN WE THINK ABOUT
HEARING, WE CAN'T JUST LOOK AT
THE COCHLEA, WE DIDN'T LOOK AT
THE HERE, WE HAVE TO LOOK AT THE
BRAIN AND THESE ARE THE MAIN
THINGS WE CAN GET OUT OF
LOOKINGA THE BRAIN AND THIS IS
WHY I WANT TO COME TO NIDC AFTER
MY SURGERY TRAINING WITH THE
EAR, LOOKING AT COCHLEA WILL
NEVER GET ME THERE SO I STARTED
LOOKING FOR A WAY TO ABLE TO DO
THIS IN A REAL PERSON ALIVE, AND
I FOUND THAT WE COULD DO PET
SCANNING HERE AT THE NIDCD, AND
SO PET SCANNING IS POSITRONNIC
EMISSION TOMOGRAPHY, YOU CAN PUT
A COCHLEAR IMPLANT DEVICE IF
THERE UNLIKE FUNCTIONAL MRI
STANING SO THE WAY IT WORKS IT
YOU GET INJECTED WITH 15 WATER
WHICH EMITS POS TRANS, TOAZ ARE
FLOOTING NOTHING BLOOD, HAY
ANIALATE WITH LOCAL NEUTRONS IN
THE BRAIN AND THEN THEY'RE
LOCALIZED TO PART OF YOUR BRAIN
AND YOU CAN GET A MAP OF
ACTIVITY.
SO THE FIRST QUESTION WOULD BE
IS COCHLEAR IMPLANT SIMILAR TO
LISTENING IN THE BRAIN, AND YOU
LOOK AT NORMAL LISTENERS
LISTENING TO SPEECH, YOU SEE
THIS AND THEN LET'S LOOK AT THE
MAP OF CI LISTENERS AND IF YOU
GO SLICE BY SLICE, THAT IS
STRIKINGLY CLOSE, YOU THINK WOW,
LOAMACY BEING AT THAT, THE MAN
IS ALMOST IDENTICAL AND YOU FEEL
LIKE YOU JUST CLOSE AND STOP
RIGHT THERE, LOOK IT'S GREAT, WE
RESTORED BRIN FUNCTION BUT YOU
STARTED DO A COMPARISON MAP, YOU
DO A CONTRAST AND YOU SAY HMM,
IT'S NOT ALL THE SAME, THE
COCHLEAR IMPLANT ACTIVITY IS
HIGHER IN THE AUDITORY CO TEX
AND IF DO A SUBTRACTION FOR AN
EQUIVALENT STIMULUS, THE CI
USERS NEED OR DEMONSTRATE MORE
BRAIN ACTIVITY TO LISTEN TO THAT
SOUND AND IF YOU HAVE DIFFERENT
KINDS OF STIMULI, WHETHER
THEY'RE LANGUAGE OR RHYTHM OR
MELODY YOU CAN SEE THE MAPS
CHANGE.
SO FOR LANGUAGE WHICH I DID WELL
ON, THERE'S PRETTY GOOD
STIMULATION RELATIVE TO NORMALS,
IN THE AUDITORY COURSES, BUT
LOOK WHAT HAPPENS IN MELODY,
THERE'S VERY LITTLE RELATIVE
ADVANTAGE FOR MELODY SO IT SEEMS
THAT FOR WHATEVER REASON,
THEY'RE NOT STIMULATING THE
CORTEX OF THESE COCHLEAR IMPLANT
USERS THE WAY SPEECH IS AND THIS
IS SOMETHING AGAIN THAT WE MIGHT
HAVE TO TARGET WHEN WE THINK
ABOUT HOW TO GET A CI BRAIN TO
LOOK MORE LIKE A NORMAL HEARING
BRAIN IN RESPONSE TO SOMETHING
THAT IS DIFFICULT FOR THEM NOT
SOMETHING THAT GOOD FOR THEM.
ANOTHER THINK BY TRAINING OR
EDUCATING THE BRAIN, THIS IS A
GIRL WITH A BILATERAL COCHLEAR
IMPLANT AND WHEN I WAS AT
PEABODY WE HAD MUSICAL EDUCATION
PROGRAM FOR KIDS THAT WERE DEAF
AND THIS GIRL WAS PLAYING THE
XYLOPHONE FOR THE FIRST TIME.
AND WE HAD BASICALLY A BINARY
TASK, SAME OR DIFFERENT FOR
DIFFERENT PITCH, AND TAMBER AND
IT TURN OUT THESE CHILDREN DID
PRETTY WELL.
THESE ARE AGAIN, REALLY YOUNG
KIDS, VERY ENGAGED AND THEY'RE
PERFORMING CERTAINLY BETTER THAN
CHANCE ON THIS TASK AND NOT AS
QUITE AS GOOD AS NORMAL HEARING
CONTROLS BUT NOT THAT BAD, SO
AGAIN, REASONS TO HOPE THAT
ACTUALLY THE EARLIER YOU GO, WE
KNOW THAT IMPLANTING CHILDREN
EARLY HELPS SPEECH BUT MAYBE
TEACHING CHILDREN WITH DEAFNESS
EARLY WITH COCHLEAR I AM NOT
PLANTS WILL ALSO HELP LEAD TO
MORE NORMAL OUTCOMES IN TERMS OF
HEARING.
NOW TONAL LANGUAGE ISS ARE
INTERESTING BECAUSE IN TONAL
LANGUAGE PERCEPTION, YOU HAVE TO
USE THAT PITCH INFORMATION TO
GET THE MEANING OF TONES OR ELSE
YOU CAN BE WRONG.
SO IN CHILDREN, THAT ARE ALWAYS
EXPOSED TO TONAL CUES, THIS IS A
TASK WHERE YOU HAVE TO TELL THE
DIRECTION OF A [INDISCERNIBLE],
AND THE RANGE OF DIFFERENT SPEED
IS DIFFERENT.
ALL THE BLUES ARE NORMAL HEARING
FOR TIARAS 1 EASE CHILDREN, AND
ALL THE REDS ARE CHILDREN FROM
THE U.S., AND YOU CAN SEE THE
PERFORMANCE BETTER IN THE
TAIWANESE CHILDREN?
WHY IS THAT NOT BECAUSE THE
COCHLEAR IMPLANTS ARE BETTER OR
BETTER AUDIOGRAMS IT'S BECAUSE
THEY ARE LIVING IN A TONAL THINK
ABOUT BASED SOCIETY WHERE THEY
MUST GIVE MEANING TO THESE TONE
SWEEPS AND THEY'RE BETTER ABLE
TO DO THIS SO AGAIN, IT'S SORT
OF ECOLOGICALLY RELEVANT
EVIDENCE THAT TRAINING MATTERS
AND THE EARLIER YOU CAN DO THAT
DRAINING, THE BETTER YOU WILL BE
AT DOING THIS PITCH TASK, YOU
CAN FORMALIZE CONFORT TRAINING
BY GIVING A KEYBOARD AND MAKING
IT LINK TO MOTOR MOVEMENTS SO
YOU HAVE TO PLAY THE
[INDISCERNIBLE] AND WHEN YOU DO
THAT OUR ABILITY TO DETECT DOES
IMPROVE AS SHOWN BY THE GREEN
BARS SO AFTER YOU HAD TRAINING
WITH A MOTEAR BASED BAR, YOUR
ABILITY TO HEAR THE TASK ALONE
GETS BETTER AND LASTLY I WANT TO
SHOW YOU A VIDEO OF A WOMAN WHO
CONTACTED ME AFTER HER SURGERY
AND I SAID HOW'S IT GOING WITH
YOUR IMPLANT, IT WAS JUST
ACTIVATED.
SHE SAID IT'S GREAT, I CAN TUNE
MY GUITAR, I'M LIKE WHAT ARE
TALKING ABOUT?
NO YOU CAN'T, AND I THOUGHT SHE
MEANT WITH A TUNER WITH A
DEVICE, JUST USING MY IMPLANTS,
I SAID SHOW ME, AND SO I HAD HER
BRING HER GUITAR TO CLINIC
BECAUSE I DIDN'T BELIEVE HER AND
SHE BROUGHT IT AND SHE DID THIS
TEST WHICH I RECREATED HERE FOR
YOU ON VIDEO.
>> THIS IS AN ADVANCED BIONICS
COCHLEAR IMPLANT WITH A HIGH
REZONING 120 AND A HARMONY
PROCESSOR.
I'M GOING TO START WITH MY
GUITAR IN TUNE.
[* MUSIC ]
NOW I'M GOING TO TAKE OUT OF
TUNE AND RETUNE IT.
*
SHE HAS NO HEARING AID AND NO
HEARING--
>> I WILL START AGAIN.
[* MUSIC ]
OKAY, WE HAVE A PERSON IN HERE
WHO WILL UNTUNE THE GUITAR AGAIN
AND I WILL RETURN IT AND I WILL
INDICATE WITH MY EYES CLOSED
THAT I WILL RETUNE IT.
SO I THOUGHT SHE WAS CHEATING
SOMEHOW, SO HISOMEONE ELSE DO IT
FOR HEHER, I THOUGHT MAYBE SHE
COULD FEEL THE VIBRATIONINGS OR
ANYTHING LIKE THAT GOING ON.
SO IMI SHE WILL GO THROUGH AND
SHE AGAIN GETS IT RIGHT.
NOW IN THE END I THINK SHE'S
USING TEMPORAL CUES TO BE ABLE
TO DO THIS PITCH TASK, IF I HAD
TO GUESS, ABOUT YOU THAT'S OKAY,
SHE'S USING OTHER INFORMATION TO
DO A VERY COMPLEX PITCH MASKING
TASK THAT'S BEYOND THE LIMITS OF
HER COCHLEAR IPT GREATER PLANT
TO RESOLVE.
SO SHE WILL TELL HIM WHEN IT'S
IN TUNE.
[* MUSIC ]
NTHAT'S --
>> THAT'S IN TUNE NOW.
>> OKAY, SO I'M HOPEFUL--
>> I WILL LET HER FINISH HER
MELODY.
SO AS YOU CAN SEE MY IMPLANT HAS
HELPED ME TO BE ABLE TO
DISCRIMINATE PITCHES MUCH BETTER
AND ENJOY MUSIC ONCE AGAIN.
THANK YOU.
>> SO I THINK SHE GOT LUCKY AND
HAS A BRAIN THAT WORKS HER
IMPLANT INSERTION HAPPENS TO BE
A CERTAIN WAY AND HER MAP WORKED
FOR HER AND SHE CARED ENOUGH TO
TRY TO DO THIS AND KEEPING ON
WORKING ON IT AND BUT AGAIN,
IT'S A CLUE, THERE'S REASONS FOR
HOPE HERE.
NOW IN THE LAST FEW MINUTES I
WANT TO SHIFT GEARS A BIT TO
SOMETHING THAT I THINK THE NIH
HAS BEEN PIVOTAL FOR AND EVERY
TIME IT COMES LIKE WHY MUSIC?
SO 1 OF THE THINGS IS TO POSE A
QUESTION OF SOMETHING LIKE MUSIC
POTENTIALLY SERVINGAs A FORM
OF MEDICINE OR AS A FORM OF
THERAPY.
AND THERE'S AN EFFORT THAT'S NOW
UNDERWAY CALLED THE SOUND HEALTH
NETWORK, WHICH I WANT TO
INTRODUCE YOU TO SOME OF YOU MAY
RECOGNIZE AND MISS THIS PERSON
QUITE A BIT.
SO FRANCIS COLLINS AS MANY OF
YOU KNOW IS A MUSICIAN, HE MET
WITH RENE FLEMMING THE OPERA
SINGER AND A FEW YEARS AGO
PREPANDEMIC HELD THE FIRST EVER
NIH WORKSHOP ON MUSIC AND THE
BRAIN WHICH WAS THE PROCEEDINGS
WERE PUBLISH INDEED NEURON AND I
WAS LUCKY TO BE PART OF THIS
GROUP HERE AND WHAT WOUND OF
HAPPENING WAS A REMARKABLE
COLLABORATION CALLED SOUND
HEALTH AND SOUND HEALTH WAS AN
NIH AND KENNEDY CENTER LARGELY
FOCUSED INITIATIVE AND I WANT TO
SHOW YOU A VIDEO OF WHAT THAT
WAS LIKE.
>> SOUND HEALTH IS A NEW
INITIATIVE WE'RE EXPLORING WITH
THE NIH UNDER THE LEADERSHIP OF
RENE FLEMMING WHO BEGAN THIS
DIALOGUE WITH DR. COLLINS WE ARE
LOOKING TO AT HOW IS A KRETTIVE
LIFE A MORE HEALTHY LIFE.
>> IT'S AN EXCITING TIME IN
NEUROSCIENCE, WE ARE STARTING TO
LEARN WAYS IN WHICH MIEWIC CAN
INFLUENCE ALL OTHER ASPECTS OF
1'S BRAIN FUNCTION AND
ESPECIALLY HOW WE COULD USE THAT
INFORMATION TO USE MUSIC
THERAPEUTICALLY.
>> WHEN I MET FRANCIS COLLYNN
WHO IS I DISCOVERED WAS A REALLY
TERRIFIC MUSICIAN, THIS MIGHT BE
AN OPPORTUNITY.
IF PEOPLE ARE THROUGH MUSIC
THERAPY SUCCEEDING IN HELPING
PATIENTS, CHILDREN WITH AUTISM,
PATIENTS WITH PARKINSONS, STROKE
VICTIM WHO IS CAN THEN
COMMUNICATE BECAUSE THEY CAN
SING BUT THEY CAN'T SPEAK, THE
SCIENCE OF HEALING IN THE ARTS,
IT'S ANOTHER AREA OF EXPLODING
RESEARCH.
>> THIS HAS A RESEARCH COMPONENT
TO IT.
IT HAS A PRESENTATION COMPONENT
TO IT.
IT HAS AN ADVOCACY COMPONENT TO
IT AS WELL IN TERMS OF WHERE
CULT NUR AMERICA TODAY IS GOING.
>> THROUGH THIS INITIATIVE WE
CAN ALL LEARN FROM EACH OTHER
AND WE CAN MOVE INTO A NEW SPACE
OF INTEGRATION, OF DEEP
INTELLECTUAL AND SCIENTIFIC
THOUGHT.
>> THE FACT THAT THIS IS COMING
TOGETHER, THAT THE NIH AND
KENNEDY IS CENTER ARE
COLLABORATING IT MAKES THE ARTS
MORE RELEVANT, IT EXALTS THE
IMPORTANCE OF ARTS IN OUR LIVES.
[* MUSIC ]
>> SO FRANCIS AND RENE CAME DOWN
TO THE CANCER CENTER WHERE WE
DID A DEEP DIVE INTO THESE
TOPICS AND IT'S POSTED ON
DR. COLLINS' BLOG SITE, THIS IS
A PUBLIC CONVERSATION IN FRONT
OF AN AUDIENCE AND THEN THE
FOLLOWING WEEK NIH ANNOUNCED
FIRST EVER ASHES WARDS FOR MUSIC
SPECIFIC RESEARCH.
SO THEY PUT $20 MILLION TO
SUPPORT THIS RESEARCH AND WHILE
THIS IS NOT A HUGE AMOUNT OF
MONEY BY NIH STANDARDS IT'S A
HUGE AMOUNT OF MONEY BY MUSIC
STANDARDS AND THE MUSIC
COMMUNITY WAS ECSTATIC THIS
HAPPENED.
THE NATIONAL ENDOWMENT FOR
THEARS JOINED THE PICTURE AND
DECIDED TO FORMALIZE THIS WITH A
NETWORK THAT INVOLVED NEA AND
THE KENNEDY CENTER, I'VE BEEN
FORTUNATE TO BE THE CO DIRECTOR
TOGETHER WITH JULIAN JOHNSON AT
UCSF AND THIS IS OUR MISSION IS
TO PROMOTE RESEARCH AND PUBLIC
AWARENESS ABOUT THE IMPACT OF
MUSE AND I CAN WELLNESS ON THIS,
TKPHRASZS,--TKPHRASZS IF YOU ARE
INTERESTED IN THIS, JOIN THE
NETWORK, IT'S FREE, WE'RE
PUTTING ON WEBINARS, CONFERENCES
AND TRYING TO KEEP THE COMMUNITY
AND GATHERING SPACE IN A WAY THE
FACE OF THE FIELD FOR PEOPLE
THAT ARE INTERESTED IN IT AND
WE'RE NOT--WE'RE REALLY
WELCOMING ANYBODY THRA'S
INTERESTED IN MUSIC FROM ANY
DIFFERENT ANGLE THAT HAS A
SCIENTIFIC COMPONENT.
SO FIRST OF ALL THANK YOU FOR
THE INVITATION TO SPEAK AND I
KNOW DURING A PANDEMIC, WE'RE
ALL USED TO JUST BEING IN OUR
OWN ROOMS AND NOT SEEING EACH
OTHER IN A WAY THAT'S EASY AND I
APPRECIATE YOU COMING OUT TO
HEAR ME SPEAK AND JUST FOR
CARING ENOUGH ABOUT THE TOPIC TO
SHOW UP.
I WANT TO THANK THE NIH, NIDCD
FOR ALL MY YEARS HERE, CARTER IF
ARE YOUR MENTORING BUT ALSO ON A
BRILLIANT CAREER HERE AND
CONGRATULATIONS ON YOUR UPCOMING
RETIREMENT, YOU WILL BE MISSED
HERE SORELY BUT THANK YOU VERY
MUCH FOR EVERYTHING.
I HAVE A LOT OF INSTITUTIONS TO
THANK, MOST SPECIFICALLY I WOULD
LIKE TO THANK COLLEAGUES AND
THEN MEMBERS OF MY LAB AND SO,
THESE ARE PEOPLE THAT HAVE ALL
BEEN VERY INSTRUMENTAL IN MY
BEING ABLE TO DO THIS WORK AND
EXTREMELY GRATEFUL FOR THEIR
PARTICIPATION FOR YEARS OF
COLLABORATION AND FRIENDSHIP AND
WITH THAT I WANT TO THANK AND
YOU I'M HAPPY TO TAKE ANYY
REQUESTS AT ALL.
THANKS SO MUCH [ APPLAUSE ]
SHOULD I REMASK, IS THAT THE
PROTOCOL?
>> WE WILL TAKE QUESTIONS INSIDE
AND THEN I HAVE SOME QUESTIONS
THAT WERE SENT THAT WE'LL DO
AFTERWARDS.
>> CHARLES, I WANT TO THANK YOU
FOR A WOBDERFUL, WONDERFUL
PRESENTATION.
I GET THE FEELING THAT OBVIOUSLY
SPEECH AND SPEECH UNDERSTANDING
AND MUSIC ARE THEY SHARE
COMPONENTS BUT THEY'RE NOT
ALWAYS HARMONIOUS.
>> PUN INTENDED.
>> YEAH.
IF YOU HAD THE ABILITY TO
PROGRAM A COCHLEAR IMPLANT TO
MUSIC, WHAT HAPPENS TO SPEECH?
>> GENERALLY SPEAKING, NOW YOU
HAVE TO PROVE THIS YOU CAN'T
ASSUME THIS BUT GENERALLY
SPEAKING IT SHOULD IMPROVE
ANOTHER WAY IS IF YOU CAN HEAR
MUSIC LYOU SHOULD HEAR ANYTHING
WELL, THAT'S NOT TRUE WITH
SPEECH, IF YOU CAN HEAR MUSIC
WELL, YOU SHOULD HEAR ANYTHING
WELL.
>> O IF THE PROGRAM IS TARGETING
FOR BETTER MUSIC PERCEPTION, YOU
COULD POSSIBLY THEN DEDUCE THE
FACT THAT MATE MIGHT HAVE BETTER
SPEECH.
>> YES, WITH A LOT OF SPEECH
PEOPLE ARE SEALING, YOU'RE
ALREADY AT 98%, YOU WILL NOT
SHOW A BENEFIT NOW YOU MAKE THE
TESTS INCREASINGLY HARDER TO
SHOW THAT YOU'RE ACTUALLY
GETTING MORE PERFORMANCE OUT OF
THE DEVICE, BUT IN A WAY, THE
FIELD HAS--WE DON'T FEEL LIKE
ACHIEVING HIGH LEVEL OPEN SET
SPEECH IS A REAL ACCOMPLISHMENT
ANYMORE, PATIENTS ARE DOING THAT
RETEENLY NOWADAYS.
>> APPRECIATE IT.
>> THANK YOU.
GREAT TO SEE YOU.
>> THANK YOU FOR YOUR PATIENCE
AS I CLIMB THE STAIRS.
THANK YOU SO MUCH FOR YOUR TALK
I LEARNED SO MUCH AND THIS IS
REALLY EXCITING.
I'M CURIOUS ARE YOU SEEING ANY
DIFFERENCES WHEN IT COMES TO
HEARING FOR DIFFERENT GENRES OF
MUSIC BECAUSE I KNOW WE PLAY
CLASSICAL, JAZZ, WHAT ABOUT LIKE
DEFINITE TYPES OF MUSIC FROM
DIFFERENT CULTURES?
HOW IS THAT BEING LIKE
INTERPRETED BY PATIENTS?
>> GREAT QUESTION.
IT'S ACTUALLY NOT A SIMPLE
ANSWER BUT LET ME TELL YOU THIS
WAY, THERE'S ALWAYS PEOPLE WHO
HAVE PREFERENCES AND THOSE
PREFERENCES SHOULD REMAIN IN
TACT, IT TURNS OUT THOUGH THAT
IF YOU HAVE NO, HAVE NEVER HAD
ANY MUSICAL EXPERIENCE, THE
THINGS THAT ARE EASIEST FOR YOU
TO PICK UP ARE RHYTHM AND SO
IT'S INTERESTING, NOW THIS MAY
BE A GENERATIONAL THING BUT A
LOT OF CHILDREN WITH COCHLEAR
IMPLANTS REALLY ENJOY HIP HOP
AND RAP AND PART OF THAT MIGHT
BE BECAUSE IT'S HEAVY DRUMS AND
HEAVY LYRIC AND THEY DID DO
THOSE PRETTY WELL, THINGS LIKE
CLASSICAL MUSIC AND SLOW
SECTIONS THAT ARE VERY, VERY
GNAWANCED ARE HARDER TO GET
RIGHT WITH THE COCHLEAR IMPLANT
BUT THAT'S THE MUSIC YOU LOVE
AND GREW UP ON, THAT WILL BE
WHAT YOU PREFER TO LISTEN TO AND
I HAVE HAD MANY, THERE'S A
COCHLEAR IMPLANT USER THAT'S A
PROFESSIONAL MUSIC CRITIC AND
WRITES CONCERT REVIEWS ABOUT
HEARING MUSIC WITH THE COCHLEAR
IMPLANT AND THE WRITING YOU
WOULD NEVER KNOW HE HAS A
HEARING IMPAIRMENT.
AND THEN OTHER CULTURES THAT
THEREYA A LOT OF THINGS LIKE
MICROPHONES AND DIFFERENT SCALE
SYSTEMS SOPHISTICATEDY WE HAVE
THIS WESTERN BASE BIAS WHEN WE
DO A LOT OF TESTING BE,
MICROTONAL IS ALMOST UNHEARD OF
WITH A CI USER SO 1 THING I TRY
TO LOOK AT RYE NOW IS WHETHER
YOU CAN USE MICROTONES AS A
PROBE WHETHER YOU GET THINGS IN
TUNE.
SO IT'S NOT CLEAR THAT YOU HEAR
AN ACTIVE IN TUNE.
>> THANK YOU VERY MUCH.
>> THANK YOU GOOD QUESTION.
>> THANKS FOR A WONDERFUL TALK.
I HAVE A QUESTION ABOUT IF YOU
WERE--YOU HAVE A CHILD WITH A
COO CLEAR IMPLANT, LIKE WHICH
INSTRUMENT WOULD YOU RECOMMEND?
YOU THINK PIANO MIGHT BE MORE
COMPLEX?
>> THANKS, GOT GOOD TO SEE YOU,
I WOULD RECOMMEND A TRIEWMENT
THAT'S IN TUNE, THAT YOU DON'T
HAVE TO INTONATE BY EAR, SO
SEVERAL INSTRUMENTS THAT YOU
MUST INTONATE BY EAR TO PLAC IT
CORRECTLY, CELLO, SO I HAVE
VIOLIN,
TROMBONE IS A ANOTHER TRIEWMENT
WHERE YOU INTERNATIONAL
CLASSIFICATION TONNATE BY EAR,
AND SINGING, WHEREAS THE PIANO
JUST PRESS THE RIGHT NOTE AND
IT'S IN TUNE IF YOU PRESS THE
RIGHT NOTE.
SO PICK AN INSTRUMENT THAT AS
DISCREAM TUNING, SOMETHING
THAT'S THREADED LIKE A GUITAR IS
SAY DISAIFER BET THAN SOMETHING
COMPLETELY TUNED BY EAR.
NOT SO MUCH TAKEN--THEY THAT THE
CHARACTERISTICS WILL DETERMINE
AND HAD SUCCESS IN MUSICAL
INSTRUMENT PERFORMANCE, THEY
WERE DRAWN TO THE SOUND OF THE
INSTRUMENT THAT THEY HEARD AND
THAT'S KIND OF WHAT LED THEM TO
WANT TO KEEP PLAYING IT.
SO I WOULD SAY THAT IF A CHILD
WITH COCHLEAR IMPLANT FEELS THAT
WAY, THEY SHOULD GO WITH THAT
INSTINCT BUT THEN RECOGNIZE THAT
THEY HAVE TUNING CHALLENGES AND
STEER THEM TOWARDS SOMETHING
WHERE THEY DON'T HAVE TO TUNE BY
EAR.
THANKS.
>> SO WE HAVE 2 AUDIENCE
SUBMITTED QUESTIONS SO THE FIRST
IS HOW DO YOU THINK BEETHOVEN
WAS ABLE TO COMPOSE SOME OF HIS
GREATEST MUSIC AFTER HE LOST HIS
HEARING?
>> THAT'S A QUESTION I WISH I
COULD ANSWER.
I WILL TELL YOU THIS, IF YOU GO
BACK AND LISTEN TO THE NINTH SIM
PROJECTION NEURONS OR PIONS FONY
START TO FINISH NOW THAT YOU
REELZ IT WAS PROFOUNDLY DEAF, IT
WILL PLOA YOUR MIND, YOU CANNOT
COMPREHEND HOW THAT'S POSSIBLE
BUT IF YOU THINK ABOUT IT, RIGHT
NOW ALL OF YOU STOP AND THINK
ABOUT YOUR FAVORITE SONG, PLAY
IT IN YOUR HEAD.
YOU CAN HEAR IT.
AND IT SOUNDS PRETTY GOOD, LIKE
IT'S INTACT IN YOUR BRAIN.
YOUR AUDIDENTITIORY MUSIC WAS
PRETTY GOOD.
SO SOMEHOW HE WAS ABLE TO HAVE A
CONCEPTUALIZATION OF SOUND THAT
WAS NOT REALIZE AND PUT IT OUT
ON PAPER AND THAT I THINK IS
SOMETHING YOU COULD IMAGINE
DOING BUT IT'S STILL ASTONISH,
NOW THERE'S A REASON WHY HE'S
UNIQUE EXEMPLAR IN THE HISTORY
OF MUSIC I DON'T KNOW THAT
ANYONE WILL BE ABLE TO DO WHAT
HE DID AGAIN, ON THE OTHER HAND
IT'S A TESTAMENT THAT OUR
AUDITORY BRAINS REMAIN INTACT NO
MATTER WHAT HAPPENS TO OUR
HEARING.
>> NEXT QUESTION, IS, IS THERE
AN UPPER AGE LIMIT FOR COCHLEAR
IMPLANT SURGERY.
>> THE OLDEST PERSON I IMPLANTED
WAS 97 YEARS YOUNG.
AND I WOULD SAY IF YOU CAN
TOLERATE SURGERY FOR ABOUT 2
HOURS, YOU'RE GOOD TO GO AND
THIS IS AN OUTPATIENT PROCEDURE
WITH MINIMAL BLOOD LOSS SO IT'S
A VERY, VERY SAFE PROCEDURE.
THANK YOU.
>> THANK YOU AGAIN FOR AN
OUTSTANDING LECTURE.
>> THANK YOU FOR HAVING ME.