Acoustically Evoked Auditory Change Complex in Children With Auditory Neuropathy Spectrum Disorder

Abstract

Objective: The overall aim of the study was to evaluate the feasibility of using electrophysiological measures of the auditory change complex (ACC) to identify candidates for cochlear implantation in children with auditory neuropathy spectrum disorder (ANSD). In order to achieve this overall aim, this study 1) assessed the feasibility of measuring the ACC evoked by temporal gaps in a group of children with ANSD across a wide age range; and 2) investigated the association between gap detection thresholds (GDTs) measured by the ACC recordings and open-set speech-perception performance in these subjects. Design: Nineteen children with bilateral ANSD ranging in age between 1.9 to 14.9 yrs (mean: 7.8 yrs) participated in this study. Electrophysiological recordings of the auditory event-related potential (ERP), including the onset ERP response and the ACC, were completed in all subjects and open-set speech perception was evaluated for a subgroup of sixteen subjects. For the ERP recordings, the stimulus was a Gaussian noise presented through ER-3A insert earphones to the test ear. Two stimulation conditions were used. In the “control condition,” the stimulus was an 800-ms Gaussian noise. In the “gapped condition”, the stimuli were two noise segments, each being 400 ms in duration, separated by one of five gaps (i.e. 5, 10, 20, 50, or 100 ms). The inter-stimulation interval was 1200 ms. The aided open-set speech perception ability was assessed using the Phonetically Balanced Kindergarten (PBK) word lists presented at 60 dB SPL using recorded testing material in a sound booth. For speech perception tests, subjects wore their hearing aids at the settings recommended by their clinical audiologists. For a subgroup of five subjects, psychophysical gap detection thresholds for the Gaussian noise were also assessed using a three-interval, three-alternative forced-choice procedure. Results: Responses evoked by the onset of the Gaussian noise (i.e. onset responses) were recorded in all stimulation conditions from all subjects tested in this study. The presence/absence, peak latency and amplitude, and response width of the onset response did not correlate with aided PBK word scores. The objective GDTs measured with the ACC recordings from seventeen subjects ranged from 10 to 100 ms. The ACC was not recorded from two subjects for any gap durations tested in this study. There was a robust negative correlation between objective GDTs and aided PBK word scores. In general, subjects with prolonged objective GDTs showed low aided PBK word scores. GDTs measured using electrophysiological recordings of the ACC correlated well with those measured using psychophysical procedures in four of five subjects who were evaluated using both procedures. Conclusions: The clinical application of the onset response in predicting open-set speech-perception ability is relatively limited in children with ANSD. The ACC recordings can be used to objectively evaluate temporal resolution abilities in children with ANSD having no severe comorbidities, a...

The Electrically Evoked Auditory Change Complex Evoked by Temporal Gaps Using Cochlear Implants or Auditory Brainstem Implants in Children With Cochlear Nerve Deficiency

“…These data support the idea that the eACC can be used to objectively evaluate temporal resolution acuity in the central auditory system, which is consistent with previously published studies (e.g. He et al, 2013, 2015b; Lister et al, 2007; Martin et al, 2008).…”

Electrically Evoked Auditory Event-Related Responses in Patients with Auditory Brainstem Implants: Morphological Characteristics, Test–Retest Reliability, Effects of Stimulation Level, and Association with Auditory Detection

“…Previous results have established an association between auditory perception and ERPs evoked by acoustic and electrical stimulation in human listeners (e.g. Chang et al, 2012; Cone & Whitaker, 2013; He et al, 2012; 2013, 2015a; Lightfoot & Kennedy, 2006; Visram et al, 2015). Additionally, morphological characteristics of onset eERPs that are associated with non-auditory sensations are different from those evoked by auditory stimulation in CI patients (He et al, 2012).…”

Acoustic Change Complex: Clinical Implications

“…Some researchers have also examined the relationship between the ACC and behavioral measures in individuals with auditory neuropathy spectrum disorder (ANSD) [ 10 16 27 ]. ANSD is characterized by an absent or severely abnormal auditory brainstem response with preservation of cochlear microphonics and/or otoacoustic emissions [ 28 ].…”

“…In addition, they revealed a close association between gap detection thresholds measured psychophysically and electrophysiologically in both the normal and ANSD groups. He, et al [ 27 ] also recorded the ACC evoked by temporal gaps in children with ANSD. They investigated the relationship between gap detection thresholds measured by the ACC and speech perception in these subjects.…”