Correlation Analysis and Comparison of Adult CE-Chirp ABR Response Threshold and Pure Tone Hearing Threshold.

OBJECTIVES: To study the application of CE-Chirp in the evaluation of hearing impairment in forensic medicine by testing the auditory brainstem response (ABR) in adults using CE-Chirp to analyze the relationship between the V-wave response threshold of CE-Chirp ABR test and the pure tone hearing threshold. METHODS: Subjects (aged 20-77 with a total of 100 ears) who underwent CE-Chirp ABR test in Changzhou De'an Hospital from January 2018 to June 2019 were selected to obtain the V-wave response threshold, and pure tone air conduction hearing threshold tests were conducted at 0.5, 1.0, 2.0 and 4.0 kHz, respectively, to obtain pure tone listening threshold. The differences and statistical differences between the average pure tone hearing threshold and V-wave response threshold were compared in different hearing levels and different age groups. The correlation, differences and statistical differences between the two tests at each frequency were analyzed for all subjects. The linear regression equation for estimating pure tone hearing threshold for all subjects CE-Chirp ABR V-wave response threshold was established, and the feasibility of the equation was tested. RESULTS: There was no statistical significance in the CE-Chirp ABR response threshold and pure tone hearing threshold difference between different hearing level groups and different age groups (P>0.05). There was a good correlation between adult CE-Chirp ABR V-wave response threshold and pure tone hearing threshold with statistical significance (P<0.05), and linear regression analysis showed a significant linear correlation between the two (P<0.05). CONCLUSIONS: The use of CE-Chirp ABR V-wave response threshold can be used to evaluate subjects' pure tone hearing threshold under certain conditions, and can be used as an audiological test method for forensic hearing impairment assessment.

Predictors for estimating subcortical EEG responses to continuous speech.

Perception of sounds and speech involves structures in the auditory brainstem that rapidly process ongoing auditory stimuli. The role of these structures in speech processing can be investigated by measuring their electrical activity using scalp-mounted electrodes. However, typical analysis methods involve averaging neural responses to many short repetitive stimuli that bear little relevance to daily listening environments. Recently, subcortical responses to more ecologically relevant continuous speech were detected using linear encoding models. These methods estimate the temporal response function (TRF), which is a regression model that minimises the error between the measured neural signal and a predictor derived from the stimulus. Using predictors that model the highly non-linear peripheral auditory system may improve linear TRF estimation accuracy and peak detection. Here, we compare predictors from both simple and complex peripheral auditory models for estimating brainstem TRFs on electroencephalography (EEG) data from 24 participants listening to continuous speech. We also investigate the data length required for estimating subcortical TRFs, and find that around 12 minutes of data is sufficient for clear wave V peaks (>3 dB SNR) to be seen in nearly all participants. Interestingly, predictors derived from simple filterbank-based models of the peripheral auditory system yield TRF wave V peak SNRs that are not significantly different from those estimated using a complex model of the auditory nerve, provided that the nonlinear effects of adaptation in the auditory system are appropriately modelled. Crucially, computing predictors from these simpler models is more than 50 times faster compared to the complex model. This work paves the way for efficient modelling and detection of subcortical processing of continuous speech, which may lead to improved diagnosis metrics for hearing impairment and assistive hearing technology.

Gaussian Processes for Hearing Threshold Estimation Using Auditory Brainstem Responses.

The Auditory Brainstem Response (ABR) plays an important role in diagnosing and managing hearing loss, but can be challenging and time-consuming to measure. Test times are especially long when multiple ABR measurements are needed, e.g., when estimating hearing threshold at a range of frequencies. While many detection methods have been developed to reduce ABR test times, the majority were designed to detect the ABR at a single stimulus level and do not consider correlations in ABR waveforms across levels. These correlations hold valuable information, and can be exploited for more efficient hearing threshold estimation. This was achieved in the current work using a Gaussian Process (GP), i.e., a Bayesian approach for non-linear regression. The function to estimate with the GP was the ABR's amplitude across stimulus levels, from which hearing threshold was ultimately inferred. Active learning rules were also designed to automatically adjust the stimulus level and efficiently locate hearing threshold. Simulation results show test time reductions of up to  âˆ¼ 50% for the GP compared to a sequentially applied Hotelling's T2 test, which does not consider correlations across ABR waveforms. A case study was also included to briefly assess the GP approach in ABR data from an adult volunteer.

Investigating the optimal stimulus to evoke the binaural interaction component of the auditory brainstem response.

Objective assessment of spatial and binaural hearing deficits remains a major clinical challenge. The binaural interaction component (BIC) of the auditory brainstem response (ABR) holds promise as a non-invasive biomarker for diagnosing such deficits. However, while comparative studies have reported robust BIC in animal models, BIC in humans can sometimes be unreliably evoked even in subjects with normal hearing. Here we explore the hypothesis that the standard methodology for collecting monaural ABRs may not be ideal for electrophysiological assessment of binaural hearing. This study aims to improve ABR BIC measurements by determining more optimal stimuli to evoke it. Building on previous methodology demonstrated to enhance peak amplitude of monaural ABRs, we constructed a series of level-dependent chirp stimuli based on empirically derived latencies of monaural-evoked ABR waves I, IV and the binaural-evoked BIC DN1, the most prominent BIC peak, in a cohort of ten chinchillas. We hypothesized that chirps designed based on BIC DN1 latency would specifically enhance across-frequency temporal synchrony in the afferent inputs leading to the binaural circuits that produce the BIC and would thus produce a larger DN1 than either traditional clicks or chirps designed to optimize monaural ABRs. Compared to clicks, we found that level-specific chirp stimuli evoked significantly greater BIC DN1 amplitudes, and that this effect persisted across all stimulation levels tested. However, we found no significant differences between BICs resulting from chirps created using binaural-evoked BIC DN1 latencies and those using monaural-evoked ABR waves I or IV. These data indicate that existing level-specific, monaural-based chirp stimuli may improve BIC detectability and reduce variability in human BIC measurements.

Effective networks mediate right hemispheric dominance of human 40 Hz auditory steady-state response.

Auditory steady-state responses (ASSR) are induced from the brainstem to the neocortex when humans hear periodic amplitude-modulated tonal signals. ASSRs have been argued to be a key marker of auditory temporal processing and pathological reorganization of ASSR - a biomarker of neurodegenerative disorders. However, most of the earlier studies reporting the neural basis of ASSRs were focused on looking at individual brain regions. Here, we seek to characterize the large-scale directed information flow among cortical sources of ASSR entrained by 40 Hz external signals. Entrained brain rhythms with power peaking at 40 Hz were generated using both monaural and binaural tonal stimulation. First, we confirm the presence of ASSRs and their well-known right hemispheric dominance during binaural and both monaural conditions. Thereafter, reconstruction of source activity employing individual anatomy of the participant and subsequent network analysis revealed that while the sources are common among different stimulation conditions, differential levels of source activation and differential patterns of directed information flow among sources underlie processing of binaurally and monaurally presented tones. Particularly, we show bidirectional interactions involving the right superior temporal gyrus and inferior frontal gyrus underlie right hemispheric dominance of 40 Hz ASSR during both monaural and binaural conditions. On the other hand, for monaural conditions, the strength of inter-hemispheric flow from left primary auditory areas to right superior temporal areas followed a pattern that comply with the generally observed contralateral dominance of sensory signal processing.

Onset-offset cortical auditory evoked potential amplitude differences indicate auditory cortical hyperactivity and reduced inhibition in people with tinnitus.

OBJECTIVE: The current study investigates evidence of hypothesized reduced central inhibition and/or increased excitation in individuals with tinnitus by evaluating cortical auditory onset versus offset responses. METHODS: Cortical auditory evoked potentials (CAEPs) were recorded to the onset and offset of 3-second white noise stimuli in tinnitus and control groups matched in pairs by age, hearing, and sex (n = 26 total). Independent t-tests and 2-way mixed model ANOVA were used to evaluate onset-offset differences in amplitude, area, and latency of CAEP components by group. The predictive influence of tinnitus presence and associated participant characteristics on CAEP outcomes was assessed by multiple regression proportional reduction in error. RESULTS: The tinnitus group had significantly larger onset minus offset P2 amplitudes (ΔP2 amplitudes) than control group participants. No other component variables differed significantly. ΔP2 amplitude was best predicted by tinnitus status and not significantly influenced by other variables such as hearing loss or age. CONCLUSIONS: Hypothesized reduced central inhibition and/or increased excitation in tinnitus participants was partially supported by a group difference in ΔP2 amplitude. SIGNIFICANCE: This was the first study to evaluate CAEP onset minus offset differences to investigate changes in central excitation/inhibition in individuals with tinnitus versus controls in matched groups.

Comparison of Chirp Versus Tone Burst- and Click-Evoked Masseteric Vestibular Evoked Myogenic Potentials in Normal-Hearing Adults.

PURPOSE: This study aimed at comparing narrowband Claus Elberling level-specific chirp (NB CE-Chirp)-, click-, and tone burst-evoked masseteric vestibular evoked myogenic potentials (mVEMPs). METHOD: Within-group study design and purposive sampling were performed. A total of 25 normal-hearing individuals participated in the study. The zygomatic electrode montage was used to elicit ipsilateral mVEMP responses using a 500-Hz NB CE-Chirp, a click of 100-µs duration, and a 500-Hz tone burst stimulus. Each of the responses was analyzed based on the absolute peak latency of P11 and N21, the electromyography-scaled peak-to-peak amplitude of the P11-N21 complex, and the interaural asymmetry ratio. RESULTS: A total of 50 ears were tested and had 100% mVEMP responses. The latencies of click-evoked and 500-Hz NB CE-Chirp-evoked mVEMPs were significantly shorter than those of 500-Hz tone burst-evoked mVEMPs (p < .05) for both ears. It revealed a significantly superior P11-N21 amplitude of the 500-Hz NB CE-Chirp and tone burst than clicks for both ears. Intraclass correlation coefficient revealed moderate to excellent test-retest reliability for mVEMP parameters across three different stimulations. CONCLUSION: The present study supports 500 Hz NB CE-Chirps as effective and reliable stimuli as tone bursts in eliciting mVEMP responses.

Envelope following responses for hearing diagnosis: Robustness and methodological considerations.

Recent studies have found that envelope following responses (EFRs) are a marker of age-related and noise- or ototoxic-induced cochlear synaptopathy (CS) in research animals. Whereas the cochlear injury can be well controlled in animal research studies, humans may have an unknown mixture of sensorineural hearing loss [SNHL; e.g., inner- or outer-hair-cell (OHC) damage or CS] that cannot be teased apart in a standard hearing evaluation. Hence, a direct translation of EFR markers of CS to a differential CS diagnosis in humans might be compromised by the influence of SNHL subtypes and differences in recording modalities between research animals and humans. To quantify the robustness of EFR markers for use in human studies, this study investigates the impact of methodological considerations related to electrode montage, stimulus characteristics, and presentation, as well as analysis method on human-recorded EFR markers. The main focus is on rectangularly modulated pure-tone stimuli to evoke the EFR based on a recent auditory modelling study that showed that the EFR was least affected by OHC damage and most sensitive to CS in this stimulus configuration. The outcomes of this study can help guide future clinical implementations of electroencephalography-based SNHL diagnostic tests.

Assessing Medial Olivocochlear Reflex Strengths via Auditory Brainstem Response: Measurement and Variability in Normal-Hearing Individuals.

PURPOSE: Optimal measurement settings to measure the medial olivocochlear reflex (MOCR) in humans have not yet been defined. The purpose of this study was to advance the representation of the MOCR in auditory brainstem response (ABR) as an addition to the current diagnostic portfolio. PARTICIPANTS AND METHOD: Twelve female and 14 male normal-hearing adults participated in the study. Potential effects of a contralateral acoustic stimulus (CAS) on amplitude changes were investigated by recording ABR waveform profiles on the left side at click intensities of 50/60/70 dB nHL with and without CAS (60 dB SPL). Secondly, to detect potential chronological order influences, measurement settings were rearranged on the right side and measurements were repeated. Additionally, ABR thresholds were recorded with and without a CAS in 10 patients. RESULTS: When the effect of contralateral suppression was analyzed on the basis of amplitude changes, there was a change under administration of the CAS signal that was statistically significant. Interestingly, the order of recordings affected the degree of amplitude change. In three out of 10 patients, reproducible suppression effects on ABR thresholds were detectable upon CAS presentation. CONCLUSIONS: To our knowledge, this is the largest study dealing with the recording of the MOCR elicited by a contralateral noise via ABR in normal-hearing individuals. Effects of MOCR are measurable via amplitude changes upon CAS administration. Chronological orders influence the impact of this effect on amplitude changes. Optimal measurement settings have not yet been defined. However, experiments such as this study may help to further improve measurements, and thus advance the representation of the MOC reflex in ABR as an addition to the current diagnostic portfolio.

[Evolution of auditory brainstem response in 0-6 years old normal hearing children and characteristics of children with abnormal acoustic conduction].

Objective:To explore the normal reference range of Click-ABR latency and interwave period in 0-6 years old children, and to analyze the clinical characteristics of Click-ABR in children with sound transmission function is abnormal. Methods:A total of 1791（3582 ears） normal hearing children aged 0-6 years and 176（258 ears） conductive hearing loss children were selected for Click-ABR. The differences of Click-ABR parameters in children of different months were analyzed, and the correlation between the degree of conductive hearing loss and Click-ABR parameters was explored. Results:The incubation period of wave Ⅰ was not correlated with the age of month, while the incubation period of wave Ⅲ, wave Ⅴ, waveⅠ-Ⅲ and wave Ⅰ-Ⅴ were highly correlated with the age of month. There was a positive correlation between the latency of wave Ⅰ and hearing threshold in the children with sound transmission function is abnormal under 80 dB nHL stimulation, and there was no difference between the standard values of wave Ⅰ-Ⅲ and Ⅰ-Ⅴ in the children with sound transmission function is abnormal and normal children. Conclusion:The latency of ABR wave Ⅲ and Ⅴ, and the interval between wave Ⅰ-Ⅲ and Ⅰ-Ⅴ shorten with the increase of age in children aged 0-6 years. The normal ABR values of children of different ages should be established in each hearing clinic for children as a reference. Combined with Click-ABR threshold and 80 dB nHL acoustic subwave Ⅰlatency, the abnormal conduction function can be preliminatively screened out, which should be further supplemented with other combinations of hearing diagnosis.

Modified T2 Statistics for Improved Detection of Aided Cortical Auditory Evoked Potentials in Hearing-Impaired Infants.

The cortical auditory evoked potential (CAEP) is a change in neural activity in response to sound, and is of interest for audiological assessment of infants, especially those who use hearing aids. Within this population, CAEP waveforms are known to vary substantially across individuals, which makes detecting the CAEP through visual inspection a challenging task. It also means that some of the best automated CAEP detection methods used in adults are probably not suitable for this population. This study therefore evaluates and optimizes the performance of new and existing methods for aided (i.e., the stimuli are presented through subjects' hearing aid(s)) CAEP detection in infants with hearing loss. Methods include the conventional Hotellings T2 test, various modified q-sample statistics, and two novel variants of T2 statistics, which were designed to exploit the correlation structure underlying the data. Various additional methods from the literature were also evaluated, including the previously best-performing methods for adult CAEP detection. Data for the assessment consisted of aided CAEPs recorded from 59 infant hearing aid users with mild to profound bilateral hearing loss, and simulated signals. The highest test sensitivities were observed for the modified T2 statistics, followed by the modified q-sample statistics, and lastly by the conventional Hotelling's T2 test, which showed low detection rates for ensemble sizes <80 epochs. The high test sensitivities at small ensemble sizes observed for the modified T2 and q-sample statistics are especially relevant for infant testing, as the time available for data collection tends to be limited in this population.

Auditory Brainstem response electrophysiological thresholds with narrow band chirps stimuli in hearing infants.

OBJECTIVES: to describe reference values for the electrophysiological thresholds obtained in the frequency-specific Auditory Brainstem Response (fsABR) with the NB CE-Chirp® LS and NB iChirp stimuli in hearing infants and to compare the variables: Minimum Levels of Response (MLR), latency, amplitude and examination time. METHODS: the sample consisted of 74 full-term infants, with a mean age of 23.11 days, 29 females and 45 males. The participants underwent fsABR at the frequencies of 500 Hz, 1000 Hz, 2000 Hz and 4000 Hz, to measure the MLR with the NB CE-Chirp® LS stimulus in the Eclipse equipment, and with the NB iChirp stimulus in the SmartEP, all in natural sleep and performed in the same session. The waveforms were evaluated by judges and later, for the comparison of thresholds and examination time, analyzed with the Wilcoxon test. To compare latency and amplitude, the Student's T Test and ANOVA were used for the same variables, but with the same stimulus. The Kruskal-Wallis test was used to compare the examination time at the different frequencies. RESULTS: The MLR and latency at 500 Hz and 1000 Hz showed a statistically significant difference between the stimuli, with lower thresholds and higher latencies for the NB iChirp. Higher amplitudes were obtained with the NB iChirp stimulus. The average examination time for the threshold investigation in the four frequencies was 40 min for each ear. CONCLUSION: it was possible to present reference values for the MLR and latencies for the NB CE-Chirp® LS and NB iChirp stimuli for hearing infants. In addition, with the NB iChirp, the latency of the responses was influenced by the frequency, but it was the stimulus that provided greater amplitudes. With the NB CE-Chirp® LS, the frequency did not influence latency, except at 500 Hz, and the stimulus provided recordings that facilitated the visualization of wave V. There was no difference in the examination time between the stimuli, nor between the test frequencies.

Steady-state auditory motion based potentials evoked by intermittent periodic virtual sound source and the effect of auditory noise on EEG enhancement.

Hearing is one of the most important human perception forms, and humans can capture the movement of sound in complex environments. On the basis of this phenomenon, this study explored the possibility of eliciting a steady-state brain response in an intermittent periodic motion sound source. In this study, a novel discrete continuous and orderly change of sound source positions stimulation paradigm was designed based on virtual sound using head-related transfer functions (HRTFs). And then the auditory motion stimulation paradigms with different noise levels were designed by changing the signal-to-noise ratio (SNR). The characteristics of brain response and the effects of different noises on brain response were studied by analyzing electroencephalogram (EEG) signals evoked by the proposed stimulation. Experimental results showed that the proposed paradigm could elicit a novel steady-state auditory evoked potential (AEP), i.e., steady-state motion auditory evoked potential (SSMAEP). And moderate noise could enhance SSMAEP amplitude and corresponding brain connectivity. This study enriches the types of AEPs and provides insights into the mechanism of brain processing of motion sound sources and the impact of noise on brain processing.

Sensory Inhibition and Speech Perception-in-Noise Performance in Children With Normal Hearing.

PURPOSE: This study investigated whether sensory inhibition in children may be associated with speech perception-in-noise performance. Additionally, gating networks associated with sensory inhibition were identified via standardized low-resolution brain electromagnetic tomography (sLORETA), and the detectability of the cortical auditory evoked potential (CAEP) N1 response was enhanced using a 4- to 30-Hz bandpass filter. METHOD: CAEP gating responses, reflective of inhibition, were evoked via click pairs and recorded using high-density electroencephalography in neurotypical 5- to 8-year-olds and 22- to 24-year-olds. Amplitude gating indices were calculated and correlated with speech perception in noise. Gating generators were estimated using sLORETA. A 4- to 30-Hz filter was applied to detect the N1 gating component. RESULTS: Preliminary findings indicate children showed reduced gating, but there was a correlational trend between better speech perception and decreased N2 gating. Commensurate with decreased gating, children presented with incomplete compensatory gating networks. The 4- to 30-Hz filter identified the N1 response in a subset of children. CONCLUSIONS: There was a tenuous relationship between children's speech perception and sensory inhibition. This may suggest that sensory inhibition is only implicated in atypically poor speech perception. Finally, the 4- to 30-Hz filter settings are critical in N1 detectability. SIGNIFICANCE: Gating may help evaluate reduced sensory inhibition in children with clinically poor speech perception using the appropriate methodology. Cortical gating generators in typically developing children are also newly identified.

Do cochlear microphonics evoked by narrow-band chirp stimuli affect the objective detection of auditory steady-state responses?

OBJECTIVE: It has recently been discussed whether hearing screening and hearing threshold assessment can accurately be completed using automated ASSR methods for children with auditory neuropathy spectrum disorder (ANSD). Possible causes for the claimed potential failures were investigated here. DESIGN: The study is based on the analysis of stored ASSR raw data. STUDY SAMPLE: This study reviewed raw ASSR data from 274 patients with a total of 5809 individual recordings. RESULTS: Cochlear microphonics (CM) were found in 18 of the 274 patient records. Four of these 18 were obtained from patients with ANSD. One patient with ANSD without click auditory brainstem responses up to 100 dBnHL demonstrated clear ASSR responses from 65 dBnHL upwards. Where click stimulation suggests an auditory nerve defect, narrow-band chirps were shown to evoke ASSR in certain patients. CMs are elicited by narrow-band chirps in the same way as by broadband stimuli. CM residuals as well as a presumed enlarged wave I with absent neural responses, always accompanied by CM, were found as possible causes of misinterpretation at high stimulus levels. A CM detector was created. CONCLUSIONS: The CM detector, indicating the presence of CM, will prevent misinterpretation of clinical ASSR results.

Auditory brainstem responses obtained with randomised stimulation level.

OBJECTIVE: To present randomised stimulation level (RSL) - a stimulation paradigm in which the level of the stimuli is randomised, rather than presented sequentially as in the conventional paradigm. DESIGN: The value of RSL was evaluated by (i) comparing the morphology of auditory brainstem responses (ABRs) elicited by the conventional and RSL paradigms, and by (ii) an online survey investigating the hearing comfort of the stimulus sequence. STUDY SAMPLE: ABRs were obtained from 11 normal-hearing adults (8 females, 25-29 years). The online survey was administered to 238 adults from the general community. RESULTS: Results showed that (i) both stimulation paradigms elicit ABR signals of similar morphology, (ii) RSL provides a faster comprehensive representation of the ABR session, and that (iii) the general population found RSL stimuli to be more comfortable. CONCLUSIONS: The simultaneous evaluation of all ABR traces of the session provided by RSL has potential to improve the identification of ABR components by enabling clinicians to make use of the response tracking strategy from the start of the test, which is critical in situations where ABRs present an abnormal morphology. New research opportunities and the clinical potential of RSL are discussed.

Auditory nerve phase-locked response recorded from normal hearing adults using electrocochleography.

OBJECTIVE: The auditory nerve overlapped waveform response (ANOW), a new measure that can be recorded non-invasively from humans, holds promise for providing more accurate assessment of low frequency hearing thresholds than currently used objective measures. This research aims to investigate the robustness and the nature of the ANOW response in humans. DESIGN: Repeated within-session recordings of the ANOW response using low-frequency Tone Bursts (TBs) were obtained at multiple stimulus levels. ANOW's absolute amplitude and phase locking value (PLV) measures were analysed to obtain normative data and to test the reliability of the ANOW response. STUDY SAMPLE: Thirteen normal hearing adults within the age range of 25 to 40 years. RESULTS: ANOW response was obtained to both 250 Hz and 500 Hz TBs and was traced down to 30-40 dB nHL. ANOW response showed significantly higher amplitude and stronger phase locking using 250 Hz TB compared to 500 Hz TB. High degree of test retest reliability of the ANOW response was found using 250 Hz TB at presentation levels higher than 40 dB nHL. CONCLUSIONS: ANOW response is recordable noninvasively using low-frequency TBs and shows higher robustness as the stimulus frequency decreases.

Semi-Automated Analysis of Peak Amplitude and Latency for Auditory Brainstem Response Waveforms Using R.

Many reports in the last 15 years have assessed changes in the auditory brainstem response (ABR) waveform after insults such as noise exposure. Common changes include reductions in the peak 1 amplitude and the relative latencies of the later peaks, as well as increased central gain, which is reflected by a relative increase in the amplitudes of the later peaks compared to the amplitude of peak 1. Many experimenters identify the peaks and troughs visually to assess their relative heights and latencies, which is a laborious process when the waveforms are collected in 5 dB increments throughout the hearing range for each frequency and condition. This paper describes free routines that may be executed in the open-source platform R with the RStudio interface to semi-automate the measurements of the peaks and troughs of auditory brainstem response (ABR) waveforms. The routines identify the amplitudes and latencies of peaks and troughs, display these on a generated waveform for inspection, collate and annotate the results into a spreadsheet for statistical analysis, and generate averaged waveforms for figures. In cases when the automated process misidentifies the ABR waveform, there is an additional tool to assist in correction. The goal is to reduce the time and effort needed to analyze the ABR waveform so that more researchers will include these analyses in the future.

Auditory Brainstem Responses at 6 and 8 kHz in Infants With Normal Hearing.

PURPOSE: Normative auditory brainstem response (ABR) data for infants and young children are available for 0.25-4 kHz, limiting clinical assessment to this range. As such, the high-frequency hearing sensitivity of infants and young children remains unknown until behavioral testing can be completed, often not until late preschool or early school ages. The purpose of this study was to obtain normative ABR data at 6 and 8 kHz in young infants. METHOD: Participants were 173 full-term infants seen clinically for ABR testing at 0.4-6.7 months chronological age (M = 1.4 months, SD = 1.0), 97% of whom were ≤ 12 weeks chronological age. Stimuli included 6 and 8 kHz tone bursts presented at a rate of 27.7/s or 30.7/s using Blackman window gating with six cycles (6 kHz) or eight cycles (8 kHz) rise/fall time and no plateau. Presentation levels included 20, 40, and 60 dB nHL. The ABR threshold was estimated in 5- to 10-dB steps. RESULTS: As previously observed with lower frequency stimuli, ABR waveforms obtained in response to 6 and 8 kHz tone bursts decreased in latency with increasing intensity and increasing age. Latency was shorter for 8-kHz tone bursts than 6-kHz tone bursts. Data tables are presented for clinical reference for infants ≤ 4 weeks, 4.1-8 weeks, and 8.1-12 weeks chronological age including median ABR latency for Waves I, III, and V and the upper and lower boundaries of the 90% prediction interval. Interpeak Latencies I-III, III-V, and I-V are also reported. CONCLUSION: The results from this study demonstrate that ABR assessment at 6 and 8 kHz is feasible for young infants within a standard clinical appointment and provide reference data for clinical interpretation of ABR waveforms for frequencies above 4 kHz.

Automatic audiometry using auditory steady-state response and sequential test strategy applied to volunteers with normal hearing.

PURPOSE: In the present study, a new procedure to perform automatic audiometry using multifrequency Auditory Steady-State Response (ASSR) is proposed. METHODS: The automatic audiometry procedure consists of detecting the presence of multifrequency ASSR in real-time using the sequential test strategy and by adjusting the stimulus intensity independently. The ASSR audiometric thresholds of 18 adult volunteers with normal hearing were determined by automatically (four simultaneous frequencies per ear) at modulation frequencies in the 80 Hz range. The exam time and the difference between ASSR thresholds and pure-tone behavioural hearing thresholds were estimated as performance measures. RESULTS: The results showed that automatic audiometry can reduce the number of intensity levels used to obtain the ASSR threshold by up to 58% when compared to audiometry without using the techniques applied in automatic audiometry. In addition, the average of the difference between ASSR thresholds and Pure-Tone Behavioural Hearing thresholds was around 19 dB, which is similar to the results reported in similar studies. CONCLUSIONS: The audiometric procedure proposed in this study is fully automatic, i.e., does not require any human supervision throughout the exam, and is able to significantly reduce the conventional exam time.