Comparison of auditory steady-state response and click-evoked auditory brain response in infants with different types and degrees of hearing loss

Wang, Xiaoli; Cheng, Y.; Shi, J; Sheng, Xiangyun; Wu, Dan; Ya-li, Zhao; Li, Danhui; He, Dinghua; Wang, Hua

doi:10.1080/00016489.2019.1697463

Cited by 3 publications

(3 citation statements)

References 19 publications

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“…ASSR recordings are extensively used to assess hearing thresholds in the pediatric population. The advantages and limitations of the ASSR method for frequency-specific threshold estimations have been amply investigated in individuals with sensorineural hearing loss (Scherf et al 2006; Swanepoel & Erasmus 2007; Wang et al 2019) and central auditory nervous system lesions (Shinn & Musiek 2007; Rabelo & Schochat 2011). The latter works resorted to low modulation rates favoring cortical ASSR generators and showed reduced correlations between electrophysiological and behavioral thresholds indicating sensitivity of cortically-generated ASSRs to central auditory nervous system dysfunctions.…”

Section: Discussionmentioning

confidence: 99%

Preserved Auditory Steady State Response and Envelope-Following Response in Severe Brainstem Dysfunction Highlight the Need for Cross-Checking

Díaz,

Lucchetti,

Avan

et al. 2023

Ear &Amp; Hearing

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Objectives: Commercially available auditory steady state response (ASSR) systems are widely used to obtain hearing thresholds in the pediatric population objectively. Children are often examined during natural or induced sleep so that the recorded ASSRs are of subcortical origin, the inferior colliculus being often designated as the main ASSR contributor in these conditions. This report presents data from a battery of auditory neurophysiological objective tests obtained in 3 cases of severe brainstem dysfunction in sleeping children. In addition to ASSRs, envelope-following response (EFR) recordings designed to distinguish peripheral (cochlear nerve) from central (brainstem) were recorded to document the effect of brainstem dysfunction on the two types of phase-locked responses. Design: Results obtained in the 3 children with severe brainstem dysfunctions were compared with those of age-matched controls. The cases were identified as posterior fossa tumor, undiagnosed (UD), and Pelizaeus–Merzbacher-Like Disease. The standard audiological objective tests comprised tympanograms, distortion product otoacoustic emissions, click-evoked auditory brainstem responses (ABRs), and ASSRs. EFRs were recorded using horizontal (EFR-H) and vertical (EFR-V) channels and a stimulus phase rotation technique allowing isolation of the EFR waveforms in the time domain to obtain direct latency measurements. Results: The brainstem dysfunctions of the 3 children were revealed as abnormal (weak, absent, or delayed) ABRs central waves with a normal wave I. In addition, they all presented a summating and cochlear microphonic potential in their ABRs, coupled with a normal wave I, which implies normal cochlear and cochlear nerve function. EFR-H and EFR-V waveforms were identified in the two cases in whom they were recorded. The EFR-Hs onset latencies, response durations, and phase-locking values did not differ from their respective age-matched control values, indicating normal cochlear nerve EFRs. In contrast, the EFR-V phase-locking value and onset latency varied from their control values. Both patients had abnormal but identifiable and significantly phase-locked brainstem EFRs, even in a case with severely distorted ABR central waves. ASSR objective audiograms were recorded in two cases. They showed normal or slightly elevated (explained by a slight transmission loss) thresholds that do not yield any clue about their brainstem dysfunction, revealing the method’s lack of sensitivity to severe brainstem dysfunction. Conclusions: The present study, performed on 3 sleeping children with severe brainstem dysfunction but normal cochlear responses (cochlear microphonic potential, summating potential, and ABR wave I), revealed the differential sensitivity of three auditory electrophysiological techniques. Estimated thresholds obtained by standard ASSR recordings (cases UD and Pelizaeus–Merzbacher-Like Disease) provided no clue to the brainstem dysfunction clearly revealed by the click-evoked ABR. EFR recordings (cases posterior fossa tumor and UD) showed preserved central responses with abnormal latencies and low phase-locking values, whereas the peripheral EFR attributed to the cochlear nerve was normal. The one case (UD) for which the three techniques could be performed confirms this sensitivity gradient, emphasizing the need for applying the Cross-Check Principle by avoiding resorting to ASSR recording alone. The entirely normal EFR-H recordings observed in two cases further strengthen the hypothesis of its cochlear nerve origin in sleeping children.

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Section: Discussionmentioning

confidence: 99%

Preserved Auditory Steady State Response and Envelope-Following Response in Severe Brainstem Dysfunction Highlight the Need for Cross-Checking

Díaz,

Lucchetti,

Avan

et al. 2023

Ear &Amp; Hearing

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show abstract

“…Both methods are widely discussed, compared to each other, and referenced towards behavioral hearing threshold estimations in the literature. In general, ABR and ASSR show good correlations in hearing threshold estimations [3][4][5][6][7][8][9][10][11][12][13][14]. However, stimuli and methodological setups are partly varying, comparison and validation remains challenging for individual clinical application and will be topic of future research.…”

Section: Introductionmentioning

confidence: 99%

Comparison of ABR and ASSR using narrow-band-chirp-stimuli in children with cochlear malformation and/or cochlear nerve hypoplasia suffering from severe/profound hearing loss

Eder

Polterauer

Semmelbauer

et al. 2021

Eur Arch Otorhinolaryngol

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Objectives In pediatric audiology, objective techniques for hearing threshold estimation in infants and children with profound or severe hearing loss play a key role. Auditory brainstem responses (ABR) and auditory steady-state responses (ASSR) are available for frequency-dependent hearing threshold estimations and both techniques show strong correlations but sometimes with considerable differences. The aim of the study was to compare hearing threshold estimations in children with and without cochlear and cochlear nerve malformations. Methods Two groups with profound or severe hearing loss were retrospectively compared. In 20 ears (15 children) with malformation of the inner ear and/or cochlear nerve hypoplasia and a control group of 20 ears (11 children) without malformation, ABR were measured with the Interacoustics Eclipse EP25 ABR system® (Denmark) with narrow-band CE-chirps® at 500, 1000, 2000 and 4000 Hz and compared to ASSR at the same center frequencies under similar conditions. Results ABR and ASSR correlated significantly in both groups (r = 0.413 in malformation group, r = 0.82 in control group). The malformation group showed a significantly lower percentage of “equal” hearing threshold estimations than the control group. In detail, patients with isolated cochlear malformation did not differ significantly from the control group, whereas patients with cochlear nerve hypoplasia showed significantly greater differences. Conclusion ABR and ASSR should be used jointly in the diagnostic approach in children with suspected profound or severe hearing loss. A great difference in hearing threshold estimation between these techniques could hint at the involvement of cochlear nerve or cochlear nerve hypoplasia itself.

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“…The ABR evoked by click stimulus has been widely applied and regarded as the gold standard for hearing loss assessment clinically (van der Drift et al 1987, Jiang et al 2018). The click is characterized by an abrupt and rapid onset, with a relatively broad spectrum that can theoretically stimulate the entire basilar membrane (Wang et al 2019). However, for the cochlear traveling wave moving down the basilar membrane, it takes a relatively longer time for the low-frequency components to reach the cochlear apical end than the high-frequency components to reach the cochlear base, resulting in asynchrony of the excitation associated with the neural units along the cochlear partition, thus smearing the neural activity across the corresponding nerve fibers (Zirn et al 2014, Samuel et al 2017a.…”

Section: Introductionmentioning

confidence: 99%

Towards effective assessment of normal hearing function from ABR using a time-variant sweep-tone stimulus approach

Jiang¹,

Samuel²,

Zhang³

et al. 2021

Physiol. Meas.

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Objective. The auditory brainstem response (ABR) audiometry is a means of assessing the functional status of the auditory neural pathway in the clinic. The conventional click ABR test lacks good neural synchrony and it mainly evaluates high-frequency hearing while the common tone-burst ABR test only detects hearing loss of a certain frequency at a time. Additionally, the existing chirp stimuli are designed based on average data of cochlear characteristics, ignoring individual differences amongst subjects. Approach. Therefore, this study designed a new stimulus approach based on a sweep-tone concept with a time variant and spectrum characteristics that could be customized based on an individual’s cochlear characteristics. To validate the efficiency of the proposed method, we compared its performance with the click and tone-bursts using ABR recordings from 11 normal-hearing adults. Main results. Experimental results showed that the proposed sweep-tone ABR achieved a higher amplitude compared with those elicited by the click and tone-bursts. When the stimulus level or rate was varied, the sweep-tone ABR consistently elicited a larger response than the corresponding click ABR. Moreover, the sweep-tone ABR appeared earlier than the click ABR under the same conditions. Specifically, the mean wave V peak-to-peak amplitude of the sweep-tone ABR was 1.3 times that of the click ABR at 70 dB nHL (normal hearing level) and a rate of 20 s−1, in which the former saved 40% of test time. Significance. In summary, the proposed sweep-tone approach is found to be more efficient than the traditional click and tone-burst in eliciting ABR.

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Comparison of auditory steady-state response and click-evoked auditory brain response in infants with different types and degrees of hearing loss

Cited by 3 publications

References 19 publications

Preserved Auditory Steady State Response and Envelope-Following Response in Severe Brainstem Dysfunction Highlight the Need for Cross-Checking

Preserved Auditory Steady State Response and Envelope-Following Response in Severe Brainstem Dysfunction Highlight the Need for Cross-Checking

Comparison of ABR and ASSR using narrow-band-chirp-stimuli in children with cochlear malformation and/or cochlear nerve hypoplasia suffering from severe/profound hearing loss

Towards effective assessment of normal hearing function from ABR using a time-variant sweep-tone stimulus approach

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