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OBJECTIVES: The cortical auditory evoked potential (CAEP) test is a candidate for supplementing clinical practice for infant hearing aid users and others who are not developmentally ready for behavioral testing. Sensitivity of the test for given sensation levels (SLs) has been reported to some degree, but further data are needed from large numbers of infants within the target age range, including repeat data where CAEPs were not detected initially. This study aims to assess sensitivity, repeatability, acceptability, and feasibility of CAEPs as a clinical measure of aided audibility in infants. DESIGN: One hundred and three infant hearing aid users were recruited from 53 pediatric audiology centers across the UK. Infants underwent aided CAEP testing at age 3 to 7 months to a mid-frequency (MF) and (mid-)high-frequency (HF) synthetic speech stimulus. CAEP testing was repeated within 7 days. When developmentally ready (aged 7-21 months), the infants underwent aided behavioral hearing testing using the same stimuli, to estimate the decibel (dB) SL (i.e., level above threshold) of those stimuli when presented at the CAEP test sessions. Percentage of CAEP detections for different dB SLs are reported using an objective detection method (Hotellings T 2 ). Acceptability was assessed using caregiver interviews and a questionnaire, and feasibility by recording test duration and completion rate. RESULTS: The overall sensitivity for a single CAEP test when the stimuli were ≥0 dB SL (i.e., audible) was 70% for the MF stimulus and 54% for the HF stimulus. After repeat testing, this increased to 84% and 72%, respectively. For SL >10 dB, the respective MF and HF test sensitivities were 80% and 60% for a single test, increasing to 94% and 79% for the two tests combined. Clinical feasibility was demonstrated by an excellent >99% completion rate, and acceptable median test duration of 24 minutes, including preparation time. Caregivers reported overall positive experiences of the test. CONCLUSIONS: By addressing the clinical need to provide data in the target age group at different SLs, we have demonstrated that aided CAEP testing can supplement existing clinical practice when infants with hearing loss are not developmentally ready for traditional behavioral assessment. Repeat testing is valuable to increase test sensitivity. For clinical application, it is important to be aware of CAEP response variability in this age group.
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Pérdida Auditiva Sensorineural , Percepción del Habla , Niño , Humanos , Lactante , Estimulación Acústica/métodos , Habla , Estudios de Factibilidad , Pérdida Auditiva Sensorineural/rehabilitación , Potenciales Evocados Auditivos/fisiología , Percepción del Habla/fisiologíaRESUMEN
OBJECTIVES: The primary objective of this study was to train and test machine learning algorithms to be able to detect accurately whether EEG data contains an auditory brainstem response (ABR) or not and recommend suitable machine learning methods. In addition, the performance of the best machine learning algorithm was compared with that of prominent statistical detection methods. DESIGN: Four machine learning algorithms were trained and evaluated using nested k-fold cross-validation: a random forest, a convolutional long short-term memory network, a stacked ensemble, and a multilayer perceptron. The best method was evaluated on a separate test set and compared with conventional detection methods: Fsp, Fmp, q-sample uniform scores test, and Hotelling's T2 test. The models were trained and tested on simulated data that were generated based on recorded ABRs collected from 12 normal-hearing participants and no-stimulus EEG data from 15 participants. Simulation allowed the ground truth of the data ("response present" or "response absent") to be known. RESULTS: The sensitivity of the best machine learning algorithm, a stacked ensemble, was significantly greater than that of the conventional detection methods evaluated. The stacked ensemble, evaluated using a bootstrap approach, consistently achieved a high and stable level of specificity across ensemble sizes. CONCLUSIONS: The stacked ensemble model presented was more effective than conventional statistical ABR detection methods and the alternative machine learning approaches tested. The stacked ensemble detection method may have potential both in automated ABR screening devices as well as in evoked potential software, assisting clinicians in making decisions regarding a patient's ABR threshold. Further assessment of the model's generalizability using a large cohort of subject recorded data, including participants of different ages and hearing status, is a recommended next step.
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Potenciales Evocados Auditivos del Tronco Encefálico , Pruebas Auditivas , Algoritmos , Potenciales Evocados Auditivos del Tronco Encefálico/fisiología , Humanos , Aprendizaje AutomáticoRESUMEN
OBJECTIVES: Objective detection of brainstem responses to natural speech stimuli is an important tool for the evaluation of hearing aid fitting, especially in people who may not be able to respond reliably in behavioral tests. Of particular interest is the envelope frequency following response (eFFR), which refers to the EEG response at the stimulus' fundamental frequency (and its harmonics), and here in particular to the response to natural spoken vowel sounds. This article introduces the frequency-domain Hotelling's T (HT2) method for eFFR detection. This method was compared, in terms of sensitivity in detecting eFFRs at the fundamental frequency (HT2_F0), to two different single-channel frequency domain methods (F test on Fourier analyzer (FA) amplitude spectra [FA-F-Test] and magnitude-squared coherence [MSC]) in detecting envelope following responses to natural vowel stimuli in simulated data and EEG data from normal-hearing subjects. Sensitivity was assessed based on the number of detections and the time needed to detect a response for a false-positive rate of 5%. The study also explored whether a single-channel, multifrequency HT2 (HT2_3F) and a multichannel, multifrequency HT2 (HT2_MC) could further improve response detection. DESIGN: Four repeated words were presented sequentially at 70 dB SPL LAeq through ER-2 insert earphones. The stimuli consisted of a prolonged vowel in a /hVd/ structure (where V represents different vowel sounds). Each stimulus was presented over 440 sweeps (220 condensation and 220 rarefaction). EEG data were collected from 12 normal-hearing adult participants. After preprocessing and artifact removal, eFFR detection was compared between the algorithms. For the simulation study, simulated EEG signals were generated by adding random noise at multiple signal to noise ratios (SNRs; 0 to -60dB) to the auditory stimuli as well as to a single sinusoid at the fluctuating and flattened fundamental frequency (f0). For each SNR, 1000 sets of 440 simulated epochs were generated. Performance of the algorithms was assessed based on the number of sets for which a response could be detected at each SNR. RESULTS: In simulation studies, HT2_3F significantly outperformed the other algorithms when detecting a vowel stimulus in noise. For simulations containing responses only at a single frequency, HT2_3F performs worse compared with other approaches applied in this study as the additional frequencies included do not contain additional information. For recorded EEG data, HT2_MC showed a significantly higher response detection rate compared with MSC and FA-F-Test. Both HT2_MC and HT2_F0 also showed a significant reduction in detection time compared with the FA-F-Test algorithm. Comparisons between different electrode locations confirmed a higher number of detections for electrodes close to Cz compared to more peripheral locations. CONCLUSION: The HT2 method is more sensitive than FA-F-Test and MSC in detecting responses to complex stimuli because it allows detection of multiple frequencies (HT2_F3) and multiple EEG channels (HT2_MC) simultaneously. This effect was shown in simulation studies for HT2_3F and in EEG data for the HT2_MC algorithm. The spread in detection time across subjects is also lower for the HT2 algorithm, with decision on the presence of an eFFR possible within 5 min.
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Potenciales Evocados Auditivos del Tronco Encefálico/fisiología , Fonética , Percepción del Habla/fisiología , Adulto , Electroencefalografía/métodos , Femenino , Audífonos , Pérdida Auditiva/rehabilitación , Humanos , Masculino , Persona de Mediana Edad , Relación Señal-Ruido , Adulto JovenRESUMEN
OBJECTIVES: The aims of this study were to systematically explore the effects of stimulus duration, background (quiet versus noise), and three consonant-vowels on speech-auditory brainstem responses (ABRs). Additionally, the minimum number of epochs required to record speech-ABRs with clearly identifiable waveform components was assessed. The purpose was to evaluate whether shorter duration stimuli could be reliably used to record speech-ABRs both in quiet and in background noise to the three consonant-vowels, as opposed to longer duration stimuli that are commonly used in the literature. Shorter duration stimuli and a smaller number of epochs would require shorter test sessions and thus encourage the transition of the speech-ABR from research to clinical practice. DESIGN: Speech-ABRs in response to 40 msec [da], 50 msec [ba] [da] [ga], and 170 msec [ba] [da] [ga] stimuli were collected from 12 normal-hearing adults with confirmed normal click-ABRs. Monaural (right-ear) speech-ABRs were recorded to all stimuli in quiet and to 40 msec [da], 50 msec [ba] [da] [ga], and 170 msec [da] in a background of two-talker babble at +10 dB signal to noise ratio using a 2-channel electrode montage (Cz-Active, A1 and A2-reference, Fz-ground). Twelve thousand epochs (6000 per polarity) were collected for each stimulus and background from all participants. Latencies and amplitudes of speech-ABR peaks (V, A, D, E, F, O) were compared across backgrounds (quiet and noise) for all stimulus durations, across stimulus durations (50 and 170 msec) and across consonant-vowels ([ba], [da], and [ga]). Additionally, degree of phase locking to the stimulus fundamental frequency (in quiet versus noise) was evaluated for the frequency following response in speech-ABRs to the 170 msec [da]. Finally, the number of epochs required for a robust response was evaluated using Fsp statistic and bootstrap analysis at different epoch iterations. RESULTS: Background effect: the addition of background noise resulted in speech-ABRs with longer peak latencies and smaller peak amplitudes compared with speech-ABRs in quiet, irrespective of stimulus duration. However, there was no effect of background noise on the degree of phase locking of the frequency following response to the stimulus fundamental frequency in speech-ABRs to the 170 msec [da]. Duration effect: speech-ABR peak latencies and amplitudes did not differ in response to the 50 and 170 msec stimuli. Consonant-vowel effect: different consonant-vowels did not have an effect on speech-ABR peak latencies regardless of stimulus duration. Number of epochs: a larger number of epochs was required to record speech-ABRs in noise compared with in quiet, and a smaller number of epochs was required to record speech-ABRs to the 40 msec [da] compared with the 170 msec [da]. CONCLUSIONS: This is the first study that systematically investigated the clinical feasibility of speech-ABRs in terms of stimulus duration, background noise, and number of epochs. Speech-ABRs can be reliably recorded to the 40 msec [da] without compromising response quality even when presented in background noise. Because fewer epochs were needed for the 40 msec [da], this would be the optimal stimulus for clinical use. Finally, given that there was no effect of consonant-vowel on speech-ABR peak latencies, there is no evidence that speech-ABRs are suitable for assessing auditory discrimination of the stimuli used.
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Estimulación Acústica/métodos , Potenciales Evocados Auditivos del Tronco Encefálico , Ruido , Habla , Adulto , Femenino , Voluntarios Sanos , Humanos , Masculino , Persona de Mediana Edad , Adulto JovenRESUMEN
BACKGROUND: To assess hearing in response to speech, the envelope frequency following response (FFR) can be observed at the fundamental frequency of a vowel stimulus and its harmonics. FFRs are complex non-linear phenomena, which require better understanding for allowing robust inferences on the assessment of hearing and hearing aid fitting. OBJECTIVES: To evaluate the effect of stimulus bandwidth on FFR detection rates using filtered vowel stimuli with equal sound levels. DESIGN: FFRs were collected whilst presenting repeated vowels (in consonant-vowel-consonant format) filtered into different bandwidths. Eighty stimuli per word were presented at 70 dB SPL LAeq through insert earphones with an inter-stimulus interval of 1 s. Responses were detected using frequency-domain Hotelling's T2 (HT2) tests for individual multiples of the fundamental frequency (F0) and for combinations of F0 multiples. STUDY SAMPLE: A total of 11 native English-speaking subjects with normal hearing thresholds. RESULTS: Average detection rates are highest (69%) with stimuli high-pass filtered >1000 Hz, and significantly lower for low-pass filtered stimuli (40%). CONCLUSIONS: High-pass filtered vowels therefore appear to elicit stronger FFRs than low-pass filtered vowels at the same dB SPL LAeq. For testing hearing using band-limited speech, filtering effects (due to hearing loss, hearing aid setting or stimulus choice) on responses must be considered.
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Pruebas Auditivas , Acústica del Lenguaje , Percepción del Habla , Adulto , Femenino , Audición , Humanos , Lenguaje , Masculino , Persona de Mediana Edad , Adulto JovenRESUMEN
BACKGROUND: The technique of measuring ocular vestibular evoked myogenic potentials (oVEMP) in response to Mini-shaker vibration is relatively new, there is a limited normative data to define the presence or absence of a response in the literature. OBJECTIVE: To determine the test-retest reliability of cervical and ocular VEMPs (cVEMP and oVEMP, respectively) to air-conducted sound (ACS) and bone-conducted vibration (BCV) stimulation and to determine normative ranges for the responses. METHODS: Twenty normal-hearing individuals (40 ears) and 20 hearing impaired volunteers with normal balance function (40 ears) were examined in this study. ACS cVEMP and BCV oVEMP (using a Mini-shaker) were recorded from both groups to assess the test-retest reliability and to collect normative VEMP data for P1/N1 latencies and amplitudes from 20 normal hearing individuals. To test reliability, VEMP recordings were repeated within the same session. RESULTS: The test-retest reliability for all the cVEMP parameters showed excellent reliability whereas oVEMP parameters showed between fair and excellent reliability depending on the parameter tested. Normative data for VEMP P1/N1 latencies and amplitudes were established. CONCLUSIONS: Normative data and test-retest reliability for BCV oVEMP using the Mini-shaker at 100âHz were established in our study for the first time in the literature. Responses appear reliable.
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Potenciales Vestibulares Miogénicos Evocados , Vestíbulo del Laberinto , Adulto , Humanos , Potenciales Vestibulares Miogénicos Evocados/fisiología , Reproducibilidad de los Resultados , VibraciónRESUMEN
The decoding multivariate Temporal Response Function (decoder) or speech envelope reconstruction approach is a well-known tool for assessing the cortical tracking of speech envelope. It is used to analyse the correlation between the speech stimulus and the neural response. It is known that auditory late responses are enhanced with longer gaps between stimuli, but it is not clear if this applies to the decoder, and whether the addition of gaps/pauses in continuous speech could be used to increase the envelope reconstruction accuracy. We investigated this in normal hearing participants who listened to continuous speech with no added pauses (natural speech), and then with short (250 ms) or long (500 ms) silent pauses inserted between each word. The total duration for continuous speech stimulus with no, short, and long pauses were approximately, 10 minutes, 16 minutes, and 21 minutes, respectively. EEG and speech envelope were simultaneously acquired and then filtered into delta (1-4 Hz) and theta (4-8 Hz) frequency bands. In addition to analysing responses to the whole speech envelope, speech envelope was also segmented to focus response analysis on onset and non-onset regions of speech separately. Our results show that continuous speech with additional pauses inserted between words significantly increases the speech envelope reconstruction correlations compared to using natural speech, in both the delta and theta frequency bands. It also appears that these increase in speech envelope reconstruction are dominated by the onset regions in the speech envelope. Introducing pauses in speech stimuli has potential clinical benefit for increasing auditory evoked response detectability, though with the disadvantage of speech sounding less natural. The strong effect of pauses and onsets on the decoder should be considered when comparing results from different speech corpora. Whether the increased cortical response, when longer pauses are introduced, reflect improved intelligibility requires further investigation.
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Percepción del Habla , Habla , Humanos , Habla/fisiología , Electroencefalografía/métodos , Estimulación Acústica/métodos , Potenciales Evocados Auditivos , Percepción del Habla/fisiologíaRESUMEN
Auditory steady state responses (ASSR) allow objective assessment of hearing thresholds. At high stimulation levels artifactual responses have been reported in subjects with severe to profound deafness. Relatively large amplitude 'steady state' responses to amplitude modulated tones were measured from the Sternocleidomastoid muscle at 500 Hz. Response thresholds were similar to those of vestibular evoked myogenic potentials and scaled with neck muscle tension. 'Steady-state' myogenic responses showed broad tuning to modulation frequency. Reduced amplitude responses were measured at the inion indicating volume conduction from the SCM. While dependant on neck tension, such responses are a potential source of artifacts when recording ASSR.
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Umbral Auditivo , Electromiografía , Músculos del Cuello/fisiología , Potenciales Vestibulares Miogénicos Evocados , Estimulación Acústica , Artefactos , Audiometría de Tonos Puros , HumanosRESUMEN
Due to individual characteristics such as head size, earmould type, and earmould venting, the directional benefit that an individual will obtain from a hearing aid cannot be predicted from average data. It is therefore desirable to measure real ear directional benefit. This paper demonstrates a method to measure real ear hearing aid directivity based on a general approach to measure the broadband output signal-to-noise ratio of a hearing aid. Errors arising from non-linearity were tested in simulation and found to be low for typical hearing aid compression ratios. Next, the efficacy of the method to estimate directional benefit was demonstrated on KEMAR. Finally the variability of directional benefit was explored in real-ears. Significant differences in signal-to-noise ratio between directional and omnidirectional microphone settings were demonstrated at most azimuths. Articulation-Index-weighted directional benefit varied by more than 7 dB across ears at some azimuths. Such individual variation in directional benefit has implications when fitting hearing aids: it should not be assumed that all users will receive similar directional benefit from the same hearing aid.
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Audífonos , Audición , Ruido , Acústica , Adolescente , Adulto , Simulación por Computador , Femenino , Humanos , Masculino , Percepción del Habla , Adulto JovenRESUMEN
When using a statistical test for automatically detecting evoked potentials, the number of stimuli presented to the subject (the sample size for the statistical test) should be specified at the outset. For evoked response detection, this may be inefficient, i.e., because the signal-to-noise ratio (SNR) of the response is not known in advance, the user would usually err on the cautious side and use a relatively high number of stimuli to ensure adequate statistical power. A more efficient approach is to apply the statistical test repeatedly to the accumulating data over time, as this allows the test to be stopped early for the high SNR responses (thus reducing test time), or later for the low SNR responses. The caveat is that the critical decision boundaries for rejecting the null hypothesis need to be adjusted if the intended type-I error rate is to be obtained. This study presents an intuitive and flexible method for controlling the type-I error rate for sequentially applied statistical tests. The method is built around the discrete convolution of truncated probability density functions, which allows the null distribution for the test statistic to be constructed at each stage of the sequential analysis. Because the null distribution remains tractable, the procedure for finding the stage-wise critical decision boundaries is greatly simplified. The method also permits data-driven adaptations (using data from previous stages) to both the sample size and the statistical test, which offers new opportunities to speed up testing for evoked response detection.
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Potenciales Evocados/fisiología , Proyectos de Investigación , Relación Señal-Ruido , Electroencefalografía , Humanos , Tamaño de la MuestraRESUMEN
BACKGROUND: Cortical entrainment to speech correlates with speech intelligibility and attention to a speech stream in noisy environments. However, there is a lack of data on whether cortical entrainment can help in evaluating hearing aid fittings for subjects with mild to moderate hearing loss. One particular problem that may arise is that hearing aids may alter the speech stimulus during (pre-)processing steps, which might alter cortical entrainment to the speech. Here, the effect of hearing aid processing on cortical entrainment to running speech in hearing impaired subjects was investigated. METHODOLOGY: Seventeen native English-speaking subjects with mild-to-moderate hearing loss participated in the study. Hearing function and hearing aid fitting were evaluated using standard clinical procedures. Participants then listened to a 25-min audiobook under aided and unaided conditions at 70 dBA sound pressure level (SPL) in quiet conditions. EEG data were collected using a 32-channel system. Cortical entrainment to speech was evaluated using decoders reconstructing the speech envelope from the EEG data. Null decoders, obtained from EEG and the time-reversed speech envelope, were used to assess the chance level reconstructions. Entrainment in the delta- (1-4 Hz) and theta- (4-8 Hz) band, as well as wideband (1-20 Hz) EEG data was investigated. RESULTS: Significant cortical responses could be detected for all but one subject in all three frequency bands under both aided and unaided conditions. However, no significant differences could be found between the two conditions in the number of responses detected, nor in the strength of cortical entrainment. The results show that the relatively small change in speech input provided by the hearing aid was not sufficient to elicit a detectable change in cortical entrainment. CONCLUSION: For subjects with mild to moderate hearing loss, cortical entrainment to speech in quiet at an audible level is not affected by hearing aids. These results clear the pathway for exploring the potential to use cortical entrainment to running speech for evaluating hearing aid fitting at lower speech intensities (which could be inaudible when unaided), or using speech in noise conditions.
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When hearing aid gain is prescribed by software, gain is calculated based on the average acoustics for the age of patient, gender, mold type, and so on. The acoustics of the individual's ear often vary from the average values, so there will be a mismatch between the prescribed gain and the real-ear gain. Real-ear measurement can be used to verify the gain and adjust it to meet targets, but the quality of the match will be limited by the number of channels and the flexibility of the hearing aid. A potential way to improve this process is to generate a filter that compensates for variations in real-ear insertion gain due to individual ear acoustics. Such a filter could be included in the processing path of a digital hearing aid. This article describes how such a filter can be generated using the windowing method, and the principle is demonstrated in a real ear. The approach requires communication between the real-ear measurement and hearing aid programming software. A finite impulse response filter with group delay just over 2 ms matched insertion gain to target values within the acceptable tolerance defined by British Society of Audiology guidelines.
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Acústica , Oído/anatomía & histología , Audífonos , Selección de Paciente , Ajuste de Prótesis , Procesamiento de Señales Asistido por Computador , Análisis de Fourier , Humanos , Diseño de Prótesis , Espectrografía del Sonido , Factores de TiempoRESUMEN
The European multicenter project named GUARD involved nine centers and aimed to assess potential changes in auditory function as a consequence of exposure to low-intensity electromagnetic fields (EMFs) produced by GSM cellular phones. Participants were healthy young adults without any evidence of hearing or ear disorders. Auditory function was assessed immediately before and after exposure to EMFs, and only the exposed ear was tested. The procedure was conducted twice in a double blinded design, once with a genuine EMF exposure and once with a sham exposure (at least 24 h apart). Tests for assessment of auditory function were hearing threshold level (HTL), transient otoacoustic emissions (TEOAE), distortion product otoacoustic emissions (DPOAE), and auditory brainstem response (ABR). The exposure consisted of speech at a typical conversational level delivered via an earphone to one ear, plus genuine or sham EMF exposure. The EMF exposure used the output of a software-controlled consumer cellular phone at full power for 10 min. A system of phone positioning that allowed participants to freely move their heads without affecting exposure was used. Analysis of the data showed there were no effects of exposure to GSM mobile phone signals on the main measures of the status of the auditory system.
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Percepción Auditiva/fisiología , Percepción Auditiva/efectos de la radiación , Teléfono Celular , Pruebas Auditivas , Microondas , Adolescente , Adulto , Relación Dosis-Respuesta en la Radiación , Europa (Continente) , Femenino , Humanos , Masculino , Dosis de RadiaciónRESUMEN
Evoked potentials are usually evaluated subjectively, by visual inspection, and considerable differences between interpretations can occur. Objective, automated methods are normally based on calculating one (or more) parameters from the data, but only some of these techniques can provide statistical significance (p-values) for the presence of a response. In this work, we propose a bootstrap technique to provide such p-values, which can be applied to a wide variety of parameters. The bootstrap method is based on randomly resampling (with replacement) the original data and gives an estimate of the probability that the response obtained is due to random variation in the data rather than a physiological response. The method is illustrated using auditory brainstem responses (ABRs) to detecting hearing thresholds. The flexibility of the approach is illustrated, showing how it can be used with different parameters, numbers of stimuli and with user-defined false-positive rates. The bootstrap method provides a new, simple and yet powerful means of detecting evoked potentials, which is very flexible and readily adapted to a wide variety of signal parameters.
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Algoritmos , Inteligencia Artificial , Diagnóstico por Computador/métodos , Electroencefalografía/métodos , Potenciales Evocados Auditivos del Tronco Encefálico/fisiología , Reconocimiento de Normas Patrones Automatizadas/métodos , Adolescente , Adulto , Femenino , Humanos , Masculino , Reproducibilidad de los Resultados , Sensibilidad y EspecificidadRESUMEN
Mobile phones have become very commonly used worldwide within a short period of time. To date there is only limited knowledge about interaction between electromagnetic fields (EMFs) emitted by mobile phones and the auditory function. Moreover, there is widespread concern that there may be potential for harm. The aim of this study was to assess potential subtle changes in cochlear function by measuring the temporal and spectral fine structure of transiently evoked otoacoustic emissions (TEOAE) in normal hearing subjects after exposure to EMFs emitted by Global System for Mobile Communication (GSM) mobile phones. TEOAEs were recorded in 27 healthy young adults before and after 10 min of real or sham exposure in a double-blind design. TEOAE data were analyzed both globally (broadband analysis) and using the Wavelet Transform (analysis of the time-frequency fine structure). The broadband analysis revealed no significant effect on TEOAEs related to exposure, confirming results of previous studies; in addition, no significant change was detected in the analysis of the elementary wavelet components, suggesting that the temporal and spectral fine structure of TEOAEs is not affected by 10 min exposure to low-intensity EMFs emitted by GSM mobile phones.
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Teléfono Celular , Emisiones Otoacústicas Espontáneas/fisiología , Adulto , Método Doble Ciego , Oído Medio/fisiopatología , Campos Electromagnéticos , Femenino , Células Ciliadas Auditivas Externas/fisiología , Humanos , Masculino , Tiempo de Reacción/fisiología , Procesamiento de Señales Asistido por Computador , Espectrografía del SonidoRESUMEN
The auditory evoked potential known as the middle latency response (MLR), evoked with regular click stimulation at around 5 Hz, has been suggested as an indicator of adequacy of anesthesia. The MLR is a very small signal embedded in high levels of background noise, so it can take a long time to acquire. However, using a stimulus paradigm of chirps presented in a maximum length sequence, the acquisition of the MLR can be improved compared to using conventional click stimulation. In this pilot study, we investigated this new technique in a clinical environment. Significant changes in MLR amplitude, but not latency, were measured for six of seven subjects in association with changes in responsiveness to command using the isolated forearm technique. The absence of any latency shift differs from other studies of the MLR during anesthesia and highlights the limited understanding of the relationship between anesthesia and the MLR.
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Estimulación Acústica/métodos , Anestesia , Potenciales Evocados Auditivos , Tiempo de Reacción , Estado de Conciencia , Electroencefalografía , Humanos , Masculino , Persona de Mediana Edad , Sensibilidad y EspecificidadRESUMEN
OBJECTIVES: This study investigated whether the method for eliciting vibration-induced oVEMPs could be improved by applying vibration directly to the teeth, and how vibration-induced oVEMP responses depend on the duration of the applied vibration. METHODS: In 10 participants, a hand-held shaker was used to present 100-Hz vibration tone pips to the teeth via a customised bite-bar or to other parts of the head. oVEMP potentials were recorded in response to vibration in three orthogonal directions and five stimulus durations (10-180 ms). The oVEMP responses were analysed in terms of the peak latency onset, peak-to-peak amplitude, and the quality of the trace. RESULTS: Vibration applied to the teeth via the bite-bar produced oVEMPs that were more consistent, of higher quality and of greater amplitude than those evoked by vibration applied to the head. Longer duration stimuli produced longer duration oVEMP responses. One cycle duration stimuli produced responses that were smaller in amplitude and lower quality than the longer stimulus durations. CONCLUSIONS: Application of vibration via the teeth using a bite-bar is an effective means of producing oVEMPs. A 1-cycle stimulus is not optimal to evoke an oVEMP because it produces less robust responses than those of longer stimulus duration. A positive relationship between the duration of the stimulus and the response is consistent with the notion that the vibration-induced oVEMP is an oscillatory response to the motion of the head, rather than being a simple reflex response that occurs when the stimulus exceeds a threshold level of stimulation. SIGNIFICANCE: Applying acceleration to the teeth through a bite-bar elicits clearer oVEMP responses than direct application to other parts of the head and has potential to improve clinical measurements. A 100-Hz 1-cycle stimulus produces less robust oVEMP responses than longer 100-Hz stimuli.
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Conducción Ósea/fisiología , Diente/fisiología , Potenciales Vestibulares Miogénicos Evocados/fisiología , Vibración , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Adulto JovenRESUMEN
In this paper we report the results of an experiment to investigate the emergence of ocular vestibular evoked myogenic potentials (OVEMPs) during the linear vestibular ocular reflex (LVOR) evoked by whole-body vibration (WBV). OVEMP and electrooculogram (EOG) montages were employed to record periocular potentials (POPs) from six subjects during WBV in the nasooccipital (NO) axis over a range of frequencies from 0.5 to 64 Hz with approximately constant peak head acceleration of 1.0 ms(-2) (i.e., 0.1 g). Measurements were made in two context conditions: a fixation context to examine the effect of gaze eccentricity (0 vs. 20°), and a visual context, where a target was either head-fixed or earth-fixed. The principal results are that from 0.5 to 2 Hz POP magnitude in the earth-fixed condition is related to head displacement, so with constant acceleration at all frequencies it reduces with increasing frequency, but at frequencies greater than 2 Hz both POP magnitude and POP gain, defined as the ratio of POP magnitude at 20 and 0°, increase with increasing frequency. By exhibiting this high-pass characteristic, a property shared with the LVOR, the results are consistent with the hypothesis that the OVEMP, as commonly employed in the clinical setting, is a high-frequency manifestation of the LVOR. However, we also observed low-frequency acceleration following POPs in head-fixed conditions, consistent with a low-frequency OVEMP, and found evidence of a high-frequency visual context effect, which is also consistent with the OVEMP being a manifestation of the LVOR.
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Electrooculografía , Movimientos Oculares , Movimientos de la Cabeza , Músculos Oculomotores/inervación , Reflejo Vestibuloocular , Potenciales Vestibulares Miogénicos Evocados , Vestíbulo del Laberinto/inervación , Vibración , Aceleración , Análisis de Varianza , Electromiografía , Humanos , Masculino , Visión OcularRESUMEN
UNLABELLED: The set of extreme pathways, a generating set for all possible steady-state flux maps in a biochemical reaction network, can be computed from the stoichiometric matrix, an incidence-like matrix reflecting the network topology. Here, we describe the implementation of a well-known algorithm to compute these pathways and give a summary of the features of the available software. AVAILABILITY: The C-code, along with a Windows executable and sample network reaction files, are available at http://systemsbiology.ucsd.edu CONTACT: palsson@ucsd.edu.