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medRxiv PreprintsInternational9 November 2026

Optimisation of and mechanisms behind neural distortion responses obtained with cochlear-implant stimulation by interleaved pulse trains

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Purpose: We investigated the mechanisms behind the generation of Neural Distortion Responses (NDRs) measured with electroencephalography when interleaving amplitude-modulated (AM) pulse trains in cochlear implant (CI) users. Methods: Previous experiments measured NDRs using interleaved pulse trains in which odd- and even-numbered pulses were respectively modulated at F1 and F2 Hz, where F1=2*F2/3 and F1{approx}80Hz. Experiment 1 separated quadratic and cubic distortion products using a relationship of F1 and F2 such that F1 = (2*F2/3)+2. Experiment 2 retained the original F1=2*F2/3 relationshi
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