MASTER: a Windows program for recording multiple auditory steady-state responses

Prognostic validity of dichotic multiple frequencies auditory steady-state responses versus distortion product otoacoustic emissions in hearing screening of high risk neonates

OBJECTIVE

To determine the validity of dichotic multiple frequencies auditory steady-state responses (ASSR) as a hearing screening technique versus using distortion product otoacoustic emissions (DPOAEs) among high-risk neonates.

METHODS

A cross sectional study was performed on 118 high-risk neonates by means of dichotic multiple frequencies ASSR and DPOAE for hearing screening. DPOAE results were used as the standard for hearing screening in parallel with ASSR. Dichotic multiple frequencies ASSR results were analyzed by means of F-value of less or greater than 0.05 criteria as a pass-fail for the responses. Dichotic multiple ASSR hearing screening technique was considered in two intensity levels at 40 and 70 dB HL. The ASSRs thresholds were measured in high risk neonates with and without hearing deficits as determined by DPOAES. The results of ASSR and DPOAE were compared to be gathered by contingency table in order to obtain sensitivity, specificity and other different statistical values. Average performing times for the tests were analyzed.

RESULTS

The specificity of dichotic multiple ASSR was 92.6%, 93.8% and the sensitivity was 71.6%, 62.2% at the 70 and 40 dB hearing levels, respectively. Mean ASSR thresholds for normal-hearing infants at an average corrected age of 6 days were 32.2 ± 12.2, 29.8 ± 10.2, 26.2 ± 11.4 and 30.4 ± 10.8 dB HL for 0.5, 1, 2 and 4 kHz, respectively. The average times for performing the tests were 18.7 and 32.9 min respectively.

CONCLUSIONS

ASSR with this special paradigm is a fairly desirable method for hearing screening of high-risk neonates. There is good concordance between ASSRs and DOPAEs results among high risk neonates referred for hearing screening. The sensitivity and specificity of this test is sufficient for hearing screening in high risk neonates. This test could be valuable for rapid confirmation of normal thresholds. As long as further research have not been conducted on ASSR, great caution should be made to interpret the results of ASSR as a hearing screening technique in young infants and also additional techniques such as the tone-evoked ABRs should be used to cross-check results. It's still too soon to recommend ASSRs as a standalone electrophysiologic measure of hearing thresholds in infants.

The efficiency of the single- versus multiple-stimulus auditory steady state responses in infants

OBJECTIVES

Multiple auditory steady state responses (ASSRs) will likely be included in the diagnostic test battery for estimating infant auditory thresholds in the near future; however, the effects of single- versus multiple-stimulus presentation in infants has never been investigated. In adults, there are no interactions (reduced amplitudes) between responses to multiple simultaneous stimuli presented at 60 dB SPL or lower. Maturational differences, however, may lead to greater interactions in infants; thus, it is unknown whether the single-stimulus technique or the multiple-stimulus technique is more efficient for testing infants. Two studies were carried out to address this issue.

DESIGN

All infants in study A participated in three stimulus conditions, which differed in the number of stimuli presented simultaneously. The monotic single (MS) condition consisted of 500, 1000, 2000, and 4000 Hz tones, which were presented singly to one ear. The monotic multiple (MM) condition was composed of four tones (500, 1000, 2000, and 4000 Hz) presented to one ear simultaneously. The dichotic multiple (DM) condition consisted of eight tones presented simultaneously to both ears (four tones to each ear). ASSR amplitudes were obtained from 15 normal infants (mean age: 23.1 wks) in response to multiple (MM, DM) and single (MS) air conduction amplitude-modulated (AM) tones (77 to 105 Hz modulation rates; 60 dB SPL). In study B, ASSR thresholds were determined for 500-Hz stimuli in the single- and DM-stimulus conditions (14 infants; mean age: 20.2 wks).

RESULTS

Mean single-stimulus ASSR amplitudes for 500, 1000, 2000, and 4000 Hz were 30, 39, 45 and 43 nV, respectively. Presentation of multiple AM tones (i.e., four octave-spaced frequencies) to one ear resulted in ASSR amplitudes that were 97%, 87%, 82%, and 70% (for 500, 1000, 2000, and 4000 Hz, respectively) of the single-stimulus ASSR amplitudes. Results for the dichotic presentation of eight AM tones show ASSR amplitudes that were 70%, 77%, 67%, and 67% relative to the MS condition. Although decreases in amplitude occurred using multiple stimuli in infants, the multiple ASSR remained more efficient than the single-stimulus ASSR (i.e., multiple-stimulus amplitudes were greater than single-stimulus amplitudes divided by √K, where K is the number of stimuli). Results from study B indicate that ASSR thresholds for 500 Hz presented in the DM condition were elevated 3 dB compared with that obtained in the 500-Hz single-stimulus condition. This statistically nonsignificant difference is within the range of acceptable test-retest variability and is thus not of clinical significance.

CONCLUSIONS

The amplitude reductions seen in the multiple-stimulus conditions in infants, not seen in adults, could be related to maturational differences in the ear canal, middle ear, cochlea, and/or brain stem. Because greater interactions occur in the DM-stimulus condition compared with the monotic multiple-stimulus condition and baseline single-stimulus condition, brain stem origins of these interactions are likely. Study B revealed statistically nonsignificant differences between threshold for 500 Hz when presented in the single- and DM-stimulus conditions. In summary, as with adults, multiple-stimulus presentation in infants is more efficient than single AM tones, at least for 60 dB SPL stimuli.

Multiple auditory steady state response thresholds to bone conduction stimuli in adults with normal and elevated thresholds

OBJECTIVE

Auditory steady state responses (ASSRs) to multiple air conduction (AC) stimuli modulated at ∼80 Hz have been shown to provide reasonable estimates of the behavioral audiogram. To distinguish the type of hearing loss (i.e., conductive, sensorineural, or mixed), bone conduction (BC) results are necessary. There are few BC-ASSR data, especially for individuals with hearing loss. The present studies aimed to (1) determine multiple ASSR thresholds to BC stimuli in adults with normal hearing, masker-simulated hearing loss, and sensorineural hearing loss (SNHL) and (2) determine how well BC-ASSR distinguishes normal versus elevated thresholds to BC stimuli in adults with normal hearing or SNHL.

DESIGN

Multiple ASSR and behavioral thresholds for BC stimuli were determined in two studies. Study A assessed 16 normal-hearing adults with relatively flat threshold elevations produced by 50, 60, and 70 dB SPL AC masking noise, as well as no masking. Study B assessed 10 adults with normal hearing and 40 adults with SNHL. In both studies, the multiple (500 to 4000 Hz) ASSR stimuli were modulated between 77 and 101 Hz and varied in intensity from 0 to 50 dB HL in 10-dB steps. Stimuli were presented using a B71 bone oscillator held on the temporal bone by an elastic band while participants relaxed or slept.

RESULTS

Study A: Correlations (r) between behavioral and ASSR thresholds for all conditions combined were 0.77, 0.87, 0.90, and 0.87 for 500, 1000, 2000, and 4000 Hz, respectively. ASSR minus behavioral threshold difference scores for all frequencies combined for the no-masker, 50, 60, and 70 dB SPL masker conditions were 14.3 ± 9.2, 12.1 ± 10.4, 12.7 ± 7.7, and 11.4 ± 8.1 dB, respectively. Study B: The difference scores for 500, 1000, 2000, and 4000 Hz were, on average, 15.7 ± 12.3, 10.3 ± 10.7, 9.7 ± 10.3, and 5.7 ± 7.9 dB, respectively, with correlations of 0.73, 0.84, 0.87, and 0.94 for the normal-hearing and SNHL groups combined. The ASSR minus behavioral difference scores were significantly larger for 500 Hz and significantly smaller for 4000 Hz compared with 1000 and 2000 Hz. Across all frequencies, the BC-ASSR correctly classified 89% of thresholds as "normal" or "elevated" (92% correct for 1000, 2000, and 4000 Hz).

CONCLUSIONS

The threshold difference scores and correlations in individuals with SNHL are similar to those in normal listeners with simulated SNHL. These difference scores are also similar to those shown by previous studies for the AC-ASSR in individuals with SNHL, at least for 1000 to 4000 Hz. The BC-ASSR provides a reasonably good estimate of BC behavioral threshold in adults, especially between 1000 and 4000 Hz. Further research is required in infants with hearing loss.

Frequency characteristics of contralateral sound suppression of 40-Hz auditory steady-state response

Sound presented to the contralateral ear suppresses the amplitude of the 40-Hz auditory steady-state response (ASSR). The frequency characteristics of this suppression of the 40-Hz ASSR for amplitude modulated (AM) tones at 1,000 Hz (79-dB SPL) were examined in 12 healthy volunteers (10 males and 2 females, mean age 32.3 years) using contralateral AM tones (500, 1,000, 2,000, and 4,000 Hz) and 1/3 octave-band noise (500, 1,000, 2,000, and 4,000 Hz). The 40-Hz ASSR at 1,000 Hz was suppressed by a relatively wide frequency range of contralateral sound than expected from the known characteristics of psychophysical central masking by contralateral sound: the greatest suppression was obtained with 500- and 1,000-Hz sounds, but considerable suppression was also obtained with 2,000- and 4,000-Hz sounds. Substantial differences in the suppression pattern were not observed between two types of contra-suppressors; i.e., AM tones and 1/3 octave-band noise. Therefore, any sound presented to the contralateral ear, regardless of the frequency, can suppress the 40-Hz ASSR. Moreover, the different frequency characteristics of the contralateral sound effects between the psychophysical central masking and the 40-Hz ASSR would support the idea that the 40-Hz ASSR has an additive role in the processing of auditory signals to simple threshold judgment. Investigation of the type of psychophysical measurement using the AM signal showing similar suppression patterns by the presentation of contralateral sound would be helpful to reveal the functional relevance of ASSRs.

Real-time detection of auditory steady-state responses

Detection of the auditory steady-state responses (ASSRs) is a difficult task, its main technical impediment is no other than the excessively lengthy recording time required for the estimation process due to the extremely low signal-to-noise ratio (SNR). To improve the detection rate of ASSRs, a new observer-based real-time ASSR detector is derived as an alternate solution to the existing methods. The ASSR detector has a simple structure, and provides fast and reliable signal detection. Simulation and experimental recorded data were used to evaluate the performances of the proposed approach. Compared with the conventional methods, the proposed method requires shorter recording time which could be proven as a valuable hearing screening or diagnostic tool.

Hearing status in children with congenital cytomegalovirus: up-to-6-years audiological follow-up

OBJECTIVE

To evaluate the audiological outcome of children with congenital cytomegalovirus infection.

METHODS

In a prospective study, the hearing of ninety seven congenitally cytomegalovirus-infected children, born between January 2003 and July 2009, was systematically evaluated until the age of six, applying the Flemish CMV protocol. Depending on the age of the child, the protocol provides hearing evaluation by objective-, play- or conventional audiometry. Symptomatic children with hearing loss at birth were treated with ganciclovir, if parents consented.

RESULTS

Seventy children had a pass on initial screening, 27 had unilateral or bilateral hearing loss. Within the normal hearing group, one asymptomatic and two symptomatic children developed late-onset hearing loss. Within the group with hearing loss, 8 children received ganciclovir, while 8 symptomatic and 11 asymptomatic children did not receive ganciclovir. As for the treated group, 37.5% of the children had stable hearing loss, one child had progressive and one child had fluctuating hearing loss. Improvement of hearing threshold occurred in 37.5% of the children. Among the untreated symptomatic children, hearing loss remained stable in 50%, while progression occurred in 37.5%. In the group of asymptomatic children with hearing loss, hearing loss was most commonly stable (72.7%). Within the group of normal hearing ears at birth (n=156), there is a significant better progression in pure tone average for ears of asymptomatic subjects in comparison to ears of symptomatic subjects (p≤0.0001). As for the group of ears with hearing loss at birth (n=38), analysis shows no evidence for a difference in pure tone average progression between the different groups (p=0.38).

CONCLUSIONS

Cytomegalovirus infection may cause hearing loss, in both symptomatic and asymptomatic children. Our data show a significant difference, between both groups, in the progression of pure tone average of normal hearing ears at birth, in favor of the asymptomatic children. This is not the case for ears with hearing loss at birth. However, this may be due to the small number of ears in this group. Our data show the tendency that treatment with ganciclovir increases the likelihood of improvement and reduces the likelihood of deterioration of the hearing.

The effects of a second stimulus on the auditory steady state response (ASSR) from the inferior colliculus of the chinchilla

The auditory steady-state response (ASSR) is an auditory evoked potential which follows the envelope of the stimulus. One of the advantages of the ASSR is that multiple stimulation frequencies can be tested simultaneously. In experiment 1, we evaluated the effects of simultaneously presenting two separate stimuli on ASSR response amplitude. In experiment 2, we evaluated the effects of presenting two ASSR-generating stimuli monotically vs. dichotically, either ipsilaterally or contralaterally to the recording electrode. Recordings were made from the chinchilla inferior colliculi, in response to tonebursts, two-tones, or sinusoidally-amplitude modulated tones. We found that the addition of a second stimulus resulted in a reduction in ASSR response amplitude at moderate to high stimulus levels. The amount of amplitude reduction was typically larger in the monotic (e.g. approximately 50%) vs. dichotic condition (e.g. approximately 10-20%), regardless of whether the responses were recorded ipsilaterally or contralaterally to the ear of stimulus presentation. In conclusion, central as well as peripheral interactions contribute to the reduction in ASSR amplitude in response to the simultaneous presentation of multiple stimuli.

Threshold prediction in children with sensorioneural hearing loss using the auditory steady-state responses and tone-evoked auditory brain stem response

OBJECTIVE

The purpose of this study was to compare ASSRs to tone-evoked ABR and to behavioral thresholds obtained on follow-up audiometry at 500, 1000, 2000, and 4000 Hz in infants and young children.

METHODS

The study included 17 infants and young children ages between 2 months and 3 years old, with sensorineural hearing loss. The ASSRs thresholds were compared with the tone-evoked ABR thresholds, and with the behavioral thresholds obtained on follow-up audiometry.

RESULTS

The correlation of tone-evoked ABR and ASSRs thresholds at 500, 1000, 2000 and 4000 Hz was 0.91, 0.76, 0.81, 0.89, respectively. ASSRs and behavioral hearing thresholds obtained on follow-up were highly correlated, with Pearson r values exceeding 0.94 at each of the test frequencies.

CONCLUSIONS

Multiple ASSRs have strong correlations to tone-evoked ABR and to behavioral thresholds obtained during follow-up in hearing impaired infants and young children. These results might be useful in order to provide further evidence for the use of multiple ASSRs, as an alternative tool to tone-evoked ABR, although further data are still required.

Age effects in temporal envelope processing: speech unmasking and auditory steady state responses

OBJECTIVE

The purpose of this study was to determine whether temporal envelope processing is reduced in older listeners. Experiment 1 tested the hypothesis that older listeners exhibit reduced speech unmasking at higher modulation rates. Experiment 2 tested the hypothesis that auditory steady state response (ASSR) amplitudes are reduced in older listeners at high modulation rates.

DESIGN

Two groups of observers with relatively normal hearing (younger, mean age = 25.0 years and older, mean age = 68.7 years) participated in two experiments. Experiment 1 examined speech unmasking in modulated noise as a function of masker modulation rate (16 and 32 Hz) and target speech rate (normal and 33% time compressed). Experiment 2 measured ASSR amplitudes as a function of modulation rate (32 and 128 Hz) and carrier frequency (500 and 2000 Hz).

RESULTS

Experiment 1 indicated that older listeners show reduced speech unmasking for normal-rate speech and reduced recognition of rapid speech in steady noise. However, for rapid speech, there is no age effect for speech unmasking and no difference in the magnitude of masking release as a function of modulation rate. In general, effects of listener age and masker modulation rate on the magnitude of masking release are observed only for normal-rate speech. Experiment 2 showed that the ASSR amplitudes of older listeners are reduced for a 128-Hz modulation rate but not for a 32-Hz modulation rate, irrespective of carrier frequency.

CONCLUSION

These results suggest that the reduced speech unmasking seen in older listeners for relatively slow modulation rates is not caused by deficits in envelope processing but rather is associated with the more constrained redundancy of the speech material available during the masker minima. Deficits in temporal envelope processing are evident in advanced age but only for relatively high envelope frequencies.

Validity and accuracy of electric response audiometry using the auditory steady-state response: Evaluation in an empirical design

The validity and accuracy of the application of the auditory steady-state response (ASSR) to electric response audiometry (ERA) was tested further in a study permitting subjects to be their own controls for hearing loss. Simulated sensorineural hearing loss (SSHL) of complex configuration and varying degrees was effected using filtered masking noise. Thresholds estimated via ASSR-ERA were compared to those measured via conventional pure-tone audiometry. Further, the slow vertex potential N1-P2 was recorded to permit a comparison with an evoked-response test of common content validity and known accuracy. Results in a homogeneous subject sample demonstrated strong interest correlation and agreement within 10 dB at 1000 to 4000 Hz (on average), but not at 500 Hz. The configurations determined by ASSR-ERA followed behavioral audiometric patterns well, except for the mildest degree of SSHL tested. Consequently, limitations of ERA remain, although ASSR-ERA appears to be quite valid overall and promises (justifiably) broad clinical applicability.

Neural representations of complex temporal modulations in the human auditory cortex

Natural sounds such as speech contain multiple levels and multiple types of temporal modulations. Because of nonlinearities of the auditory system, however, the neural response to multiple, simultaneous temporal modulations cannot be predicted from the neural responses to single modulations. Here we show the cortical neural representation of an auditory stimulus simultaneously frequency modulated (FM) at a high rate, f(FM) approximately 40 Hz, and amplitude modulation (AM) at a slow rate, f(AM) <15 Hz. Magnetoencephalography recordings show fast FM and slow AM stimulus features evoke two separate but not independent auditory steady-state responses (aSSR) at f(FM) and f(AM), respectively. The power, rather than phase locking, of the aSSR of both decreases with increasing stimulus f(AM). The aSSR at f(FM) is itself simultaneously amplitude modulated and phase modulated with fundamental frequency f(AM), showing that the slow stimulus AM is not only encoded in the neural response at f(AM) but also encoded in the instantaneous amplitude and phase of the neural response at f(FM). Both the amplitude modulation and phase modulation of the aSSR at f(FM) are most salient for low stimulus f(AM) but remain observable at the highest tested f(AM) (13.8 Hz). The instantaneous amplitude of the aSSR at f(FM) is successfully predicted by a model containing temporal integration on two time scales, approximately 25 and approximately 200 ms, followed by a static compression nonlinearity.

Frequency-specific objective audiometry: Tone-evoked brainstem responses and steady-state responses to 40 Hz and 90 Hz amplitude modulated stimuli

Tone-evoked Auditory Brainstem Responses (tone-burst ABRs) and Auditory Steady-State Responses (ASSRs) with 40 or 90 Hz amplitude modulation (AM) were compared, using the same equipment and recording parameters, to determine which of these three methods most accurately approached the behavioural hearing thresholds in response to 500 Hz and 2000 Hz stimuli in eleven awake adults with normal hearing. Estimates of the thresholds obtained with the three methods were 10, 18, and 26 dB SL at 500 Hz; and 10, 12, and 22 dB SL at 2000 Hz; using 40 Hz ASSR, 90 Hz ASSR, and tone-burst ABR, respectively. ASSRs with 40 Hz AM stimuli produced significantly better results (lowest thresholds with SD=0), whereas the wave-V analysis on the tone-burst ABR produced the poorest results. In the averaged ABRs, a robust steady-state potential was also visible. Analysis of those steady-state responses showed estimated thresholds of 13 and 14 dB SL (at 500 and 2000 Hz, respectively), thus considerably better than the estimated thresholds from the wave-V analysis. It is concluded that the 40 Hz ASSR showed superior results, especially at 500 Hz.

Automated auditory response detection: Statistical problems with repeated testing Evaluación repetida en la detección de respuestas auditivas

Sequential application of a statistical test is usually applied in an automated auditory response detection algorithm. The sequential test strategy is very time-efficient but increases the probability of a false rejection of the null-hypothesis. For this reason, it is necessary to correct the critical test value. However, the well-known Bonferroni correction leads to an over-correction when dealing with dependent or partly dependent data. The objective of the study reported here was to develop a method to determine the critical test value for the sequential testing of dependent data. Extensive Monte Carlo simulations were used to develop this method. The simulation results were reviewed and the benefit of the suggested method, in comparison to the Bonferroni correction, was shown using a large sample of real amplitude modulation following response data. The detection rate determined for these data and the ROC curve demonstrate the advantage of using the method suggested here.

Comparison of MASTER and AUDERA for measurement of auditory steady-state responses Comparación de MASTER y AUDERA para la medición de las respuestas auditivas de estado estable

Two approaches to assess auditory steady-state responses (ASSR) are compared under similar test conditions: a monaural single-frequency technique with a detection method based on phase coherence (AUDERA), and a binaural multiple-frequency technique using the F-test (MASTER). ASSR thresholds at four frequencies were assessed with both methods in both ears of ten normal-hearing and ten hearing-impaired adult subjects, within a test duration of one hour. The test-retest reliability and the influence of prolonging the test duration are assessed. For the total subject group the multiple-frequency technique outperforms the single-frequency technique. In hearing-impaired subjects, however, both techniques perform equally well. Hearing thresholds can be estimated with a standard error of the estimate between 7 and 12 dB dependent on frequency. About 55% of the estimates are within 5 dB of the behavioral hearing threshold, and 94% within 15 dB. Prolonging the test duration improves the performance of both techniques.

Auditory steady-state responses (ASSR): effects of modulation and carrier frequencies

Presented are results relevant to extending the utility of the auditory steady-state response (ASSR) in threshold estimation at high-frequency carriers and to the accuracy of thresholds estimated using modulation frequencies near 40 versus 80 Hz. Initially, efforts were directed at confirming various findings reported in the literature apropos effects of several basic ASSR parameters. Results supplement others' observations suggesting that ASSR detection limits overestimate behavioral thresholds for conventional audiometric (carrier) frequencies from 500 to 4000 Hz. Further investigation revealed even greater errors of threshold estimates for 8000 and 12000 Hz, by about 14 and 22 dB on average, respectively. Although suggesting high-frequency ASSR testing to be efficacious, technical advances and additional work is needed to establish clinical utility. Comparison of effects of modulation frequency suggested ASSR thresholds with 40 Hz modulation to fall closer to behavioral threshold than those estimated at 80 Hz. Consequently, when circumstances permit, 40 Hz ASSR testing may be the method of choice (e.g. in the assessment of malingers, who may be tested awake/alert).

Auditory steady-state responses to MM and exponential envelope AM2/FM stimuli in normal-hearing adults

The present study utilized a commercially available multiple auditory steady-state response (ASSR) system to test normal hearing adults (n=55). The primary objective was to evaluate the impact of the mixed modulation (MM) and the novel proposed exponential AM(2)/FM stimuli on the signal-to-noise ratio (SNR) and threshold estimation accuracy, through a within-subject comparison. The second aim was to establish a normative database for both stimulus types. The results demonstrated that the AM(2)/FM and MM stimulus had a similar effect on the SNR, whereas the ASSR threshold results revealed that the AM(2)/FM produced better thresholds than the MM stimulus for the 500, 1000, and 4000 Hz carrier frequency. The mean difference scores to tones of 500, 1000, 2000, and 4000 Hz were for the MM stimulus: 20+/-12, 14+/-9, 10+/-8, and 12+/-8 dB; and for the AM(2)/FM stimulus: 18+/-13, 12+/-8, 11+/-8, and 10+/-8 dB, respectively. The current research confirms that the AM(2)/FM stimulus can be used efficiently to test normal hearing adults.

Hearing assessment by recording multiple auditory steady-state responses: the influence of test duration

The influence of test duration on the precision of hearing thresholds estimated by recording multiple auditory steady-state responses (ASSRs) was investigated. ASSR thresholds at four frequencies in both ears were assessed in 10 normal-hearing and 10 hearing-impaired subjects. The precision of the estimated hearing thresholds was compared for ASSR recordings of 5, 10 and 15 min per intensity level, corresponding to total test durations of approximately 30, 55 and 70 min for hearing-impaired ears. Furthermore, an intensity step size of 10 dB was compared to a step size of 5 dB. The mean difference scores averaged over the four frequencies were 15 +/- 10, 12 +/- 9 and 11 +/- 8 dB after recordings of 5, 10 and 15 min respectively. The corresponding Pearson correlation coefficients were 0.93, 0.95 and 0.96. Increasing the length of the separate recordings increases the precision of the estimates, independent of tested frequency. A compromise between both will have to be made. With a total test duration of approximately 1 h, four hearing thresholds in both ears can be estimated with a standard error of the estimate of 8 dB.

Optimal electrode selection for multi-channel electroencephalogram based detection of auditory steady-state responses

Auditory steady-state responses (ASSRs) are used for hearing threshold estimation at audiometric frequencies. Hearing impaired newborns, in particular, benefit from this technique as it allows for a more precise diagnosis than traditional techniques, and a hearing aid can be better fitted at an early age. However, measurement duration of current single-channel techniques is still too long for clinical widespread use. This paper evaluates the practical performance of a multi-channel electroencephalogram (EEG) processing strategy based on a detection theory approach. A minimum electrode set is determined for ASSRs with frequencies between 80 and 110 Hz using eight-channel EEG measurements of ten normal-hearing adults. This set provides a near-optimal hearing threshold estimate for all subjects and improves response detection significantly for EEG data with numerous artifacts. Multi-channel processing does not significantly improve response detection for EEG data with few artifacts. In this case, best response detection is obtained when noise-weighted averaging is applied on single-channel data. The same test setup (eight channels, ten normal-hearing subjects) is also used to determine a minimum electrode setup for 10-Hz ASSRs. This configuration allows to record near-optimal signal-to-noise ratios for 80% of subjects.

Envelope and spectral frequency-following responses to vowel sounds

Frequency-following responses (FFRs) were recorded to two naturally produced vowels (/a/ and /i/) in normal hearing subjects. A digitally implemented Fourier analyzer was used to measure response amplitude at the fundamental frequency and at 23 higher harmonics. Response components related to the stimulus envelope ("envelope FFR") were distinguished from components related to the stimulus spectrum ("spectral FFR") by adding or subtracting responses to opposite polarity stimuli. Significant envelope FFRs were detected at the fundamental frequency of both vowels, for all of the subjects. Significant spectral FFRs were detected at harmonics close to formant peaks, and at harmonics corresponding to cochlear intermodulation distortion products, but these were not significant in all subjects, and were not detected above 1500 Hz. These findings indicate that speech-evoked FFRs follow both the glottal pitch envelope as well as spectral stimulus components.

The effect of brief-tone stimulus duration on the brain stem auditory steady-state response

OBJECTIVE

To investigate the effect of brief-tone stimulus duration on the amplitude of the brain stem auditory steady-state response (ASSR), both in single- and multiple-stimulus conditions.

DESIGN

In Experiment 1, the primary stimuli were Blackman-windowed 500- and 2000-Hz brief tones presented using repetition rates of 79 and 83 Hz, respectively. Stimuli had durations ranging from 0.5 to 12 msec. In the single-stimulus condition, these two stimuli were presented dichotically, whereas in the four-stimulus multiple-stimulus condition, instead of being presented alone, each stimulus was combined with three interfering stimuli, which were also Blackman-windowed brief tones spaced one octave apart, and presented at rates of 77 to 96 Hz. In Experiment 2, the effect of brief-tone duration and the effect of interfering stimuli were further studied by systematically removing interfering stimuli from the multiple stimuli, with the goal of determining which specific stimuli in the multiple stimuli were responsible for the interference. In both experiments, stimuli were presented at 75 ppe dB SPL. The subjects were normal-hearing adults, who relaxed or slept during the recording sessions.

RESULTS

Experiment 1: ASSR amplitudes increased as stimulus duration decreased in the single-stimulus condition, for both 500 and 2000 Hz. However, amplitudes did not significantly increase until stimuli were quite brief (2 msec for 2000 Hz; 6 msec for 500 Hz). In the four-stimulus multiple-stimulus condition, the pattern of amplitude increase with decreasing stimulus duration at 2000 Hz was similar to that in the single-stimulus condition, although amplitudes at all durations were reduced. However, for 500-Hz stimuli in the four-stimulus multiple-stimulus condition, ASSR amplitudes showed no change as stimulus duration decreased. Experiment 2: for 2000-Hz stimuli, the 4000-Hz interfering stimuli resulted in the largest change in amplitude, the 1000-Hz interfering stimuli had a small effect, and the 500-Hz interfering stimuli had no effect. For 500-Hz stimuli, the 1000-Hz interfering stimuli had the greatest effect, the 2000-Hz interfering stimuli the next largest, and the 4000-Hz interfering stimuli a small effect. The interference effects for 500-Hz stimuli occurred only for brief (< or =6 msec) stimuli, with no effects of the interfering stimuli when the 500-Hz stimuli were 8 or 12 msec in duration.

CONCLUSION

Although brief tones may result in larger-amplitude ASSRs, their duration must be quite brief (not more than three to four cycles) to show a significant amplitude increase. Moreover, when presented together with other stimuli in the multiple-stimulus technique, response interference reduces the amplitudes of ASSRs, and for 500 Hz removes the amplitude gain normally seen with decreasing duration. Brief-tone stimuli, therefore, may not be optimal for ASSR threshold estimation, especially because of the compromise in frequency specificity accompanying the use of very brief tones.

A flexible research platform for multi-channel auditory steady-state response measurements

The possibilities of currently commercially available auditory steady-state response (ASSR) devices are mostly limited to avoid unintentional misuse and to guarantuee patient safety as such. Some setups, e.g. do not allow the application of high intensities or the use of own stimuli. Moreover, most devices generally only allow data collection using maximal two EEG channels. The freedom to modify and extend the accompagnying software and hardware is very restricted or inexistent. As a result, these devices are not suited for research and several clinically diagnostic purposes. In this paper, a research platform for multi-channel ASSR measurements is presented, referred to as SOMA (setup ORL for multi-channel ASSR). The setup allows multi-channel measurements and the use of own stimuli. It can be easily extended to facilitate new measurement protocols and real-time signal processing. The mobile setup is based on an inexpensive multi-channel RME soundcard and software is written in C++. Both hardware and software of the setup are described. An evaluation study with nine normal-hearing subjects shows no significant performance differences between a reference and the proposed platform. SOMA presents a flexible and modularly extensible mobile high-end multi-channel ASSR test platform.

Cortical Steady-State Responses to Central and Peripheral Auditory Beats

Different types of generation mechanisms of 40-Hz auditory steady-state response (ASSR) were investigated using diotic and dichotic stimulation with 500- and 540-Hz pure tones of 1.0-s duration and 2.0-s stimulus onset asynchrony. When the sum of both tones was presented to both ears simultaneously, they interacted at cochlear level and resulted in perception of a 40-Hz beat termed "peripheral beat." Dichotic presentation of the 500-Hz tone to one ear and the 540-Hz tone to the other one resulted in beat perception as the effect of central interaction, most likely in the superior olivary nuclei and was termed "central beat." ASSR and transient N1m responses were found in the averaged 151-channel whole-head magnetoencephalographic recordings under both stimulus conditions and were modeled with single spatiotemporal equivalent current dipoles in both hemispheres. The ASSR sources in both conditions were more anterior, more inferior, and more medial compared with N1m sources. Right hemispheric lateralization of the magnetic field strength was found for the ASSR in both stimulus conditions. Although the central and peripheral beat interacted at different levels of the auditory system, the initial responses were projected along the afferent auditory pathway and activated common cortical sources.

Cortical responses to the 2f1-f2 combination tone measured indirectly using magnetoencephalography

The simultaneous presentation of two tones with frequencies f(1) and f(2) causes the perception of several combination tones in addition to the original tones. The most prominent of these are at frequencies f(2)-f(1) and 2f(1)-f(2). This study measured human physiological responses to the 2f(1)-f(2) combination tone at 500 Hz caused by tones of 750 and 1000 Hz with intensities of 65 and 55 dB SPL, respectively. Responses were measured from the cochlea using the distortion product otoacoustic emission (DPOAE), and from the auditory cortex using the 40-Hz steady-state magnetoencephalographic (MEG) response. The perceptual response was assessed by having the participant adjust a probe tone to cause maximal beating ("best-beats") with the perceived combination tone. The cortical response to the combination tone was evaluated in two ways: first by presenting a probe tone with a frequency of 460 Hz at the perceptual best-beats level, resulting in a 40-Hz response because of interaction with the combination tone at 500 Hz, and second by simultaneously presenting two f(1) and f(2) pairs that caused combination tones that would themselves beat at 40 Hz. The 2f(1)-f(2) DPOAE in the external auditory canal had a level of 2.6 (s.d. 12.1) dB SPL. The 40-Hz MEG response in the contralateral cortex had a magnitude of 0.39 (s.d. 0.1) nA m. The perceived level of the combination tone was 44.8 (s.d. 11.3) dB SPL. There were no significant correlations between these measurements. These results indicate that physiological responses to the 2f(1)-f(2) combination tone occur in the human auditory system all the way from the cochlea to the primary auditory cortex. The perceived magnitude of the combination tone is not determined by the measured physiological response at either the cochlea or the cortex.

Human Auditory Steady-State Responses During Sweeps of Intensity

OBJECTIVE

To record steady-state responses to amplitude-modulated tones that change their intensity over time and to see how well behavioral thresholds can be estimated from such responses.

DESIGN

The intensity of the stimuli used in this experiment increased from 25 to 75 dB SPL for 8 sec and then decreased back to 25 dB HL during the subsequent 8 sec. Responses to this intensity sweep were averaged and then analyzed using a short-time Fast-Fourier Transform to measure how the amplitude and phase of the responses changed with intensity. One experimental condition presented single 2-kHz tones to the left ear; a second condition examined the use of simultaneously presented multiple tones (0.5, 1, 2, and 4 kHz) to the left ear; a third condition used multiple tones presented dichotically; and a fourth condition presented the multiple dichotic tones in masking noise to simulate either low-frequency (less than 1400 Hz) or high-frequency (greater than 1400 Hz) hearing loss. Physiological thresholds were determined using six different algorithms and the relations between physiological and behavioral thresholds were evaluated to see how well behavioral thresholds could be estimated.

RESULTS

The amplitude-intensity functions for the 1 and 2 kHz responses both demonstrated a plateau at higher intensities in the multiple-stimulus conditions but not in the single-stimulus condition. The slope of the amplitude-intensity functions varied significantly with the carrier frequency of the stimulus: 1.30 at 500 Hz, 0.87 at 1000 Hz, 0.75 at 2000 Hz, and 1.40 at 4000 Hz. The slope of the phase-intensity function averaged 1.16 degrees per dB and did not vary with carrier frequency. Estimates of latency, however, indicated that latency increased with decreasing carrier frequency and with decreasing intensity. The performance of the threshold estimating algorithms differed between normal hearing and simulated hearing loss, since the amplitude- and phase-intensity functions in the latter condition were not linear. Physiological-behavioral threshold differences were generally greater for normal hearing than for simulated hearing loss. Linear regression provided the least physiological-behavioral difference but was quite variable during simulated hearing loss. Simply defining threshold as the lowest intensity above which all responses were significantly different from residual EEG noise was the most accurate method in terms of yielding the least standard deviation of the physiological-behavioral difference with an average standard deviation of 10 dB, provided EEG noise levels were low enough in the normal hearing condition.

CONCLUSIONS

Thresholds can be estimated using intensity sweeps with about the same accuracy as recording separate responses to discrete intensities. Sweep recordings provide additional information about the responses at suprathreshold intensities by clearly determining amplitude- and phase- intensity functions at these intensities.

Improving Auditory Steady-State Response Detection Using Independent Component Analysis on Multichannel EEG Data

Over the last decade, the detection of auditory steady-state responses (ASSR) has been developed for reliable hearing threshold estimation at audiometric frequencies. Unfortunately, the duration of ASSR measurement can be long, which is unpractical for wide scale clinical application. In this paper, we propose independent component analysis (ICA) as a tool to improve the ASSR detection in recorded single-channel as well as multichannel electroencephalogram (EEG) data. We conclude that ICA is able to reduce measurement duration significantly. For a multichannel implementation, near-optimal performance is obtained with five-channel recordings.

Reliability of electric response audiometry using 80 Hz auditory steady-state responses

The reliability of the Auditory Steady State Response (ASSR) has not been thoroughly evaluated despite its recent application as a clinical tool for threshold estimation. The purpose of this study was to examine test-retest (TR) reliability of ASSR threshold estimates in an empirical research design. The ASSR, tested using modulation frequencies approximately 80 Hz and above, was evaluated against pure tone audiometry (PTA), and the slow vertex potential (SVP, N1-P2). Sixteen normal-hearing young female adults were tested twice, one week apart. Varying degrees of sensorineural hearing loss of a notched configuration were simulated with filtered masking noise. Test-retest reliability was assessed using Pearson-product moment correlation analysis, supplemented by other post-hoc analyses. Results demonstrated moderately strong TR reliability for ASSR at 1000, 2000 and 4000 Hz (r = 0.83-0.93); however, the reliability of ASSR at 500 Hz was weaker (r = 0.75). Results suggest that ASSR-ERA is a reliable test at mid-high frequencies, at least with the configuration and degrees of simulated sensorineural hearing loss examined in this study.

Effects of Bone Oscillator Coupling Method, Placement Location, and Occlusion on Bone-Conduction Auditory Steady-State Responses in Infants

OBJECTIVE

The aim of these experiments was to investigate procedures used when estimating bone-conduction thresholds in infants. The objectives were: (i) to investigate the variability in force applied using two common bone-oscillator coupling methods and to determine whether coupling method affects threshold estimation, (ii) to examine effects of bone-oscillator placement on bone-conduction ASSR thresholds, and (iii) to determine whether the occlusion effect is present in infants by comparing bone-conduction ASSR thresholds for unoccluded and occluded ears.

DESIGN

Experiment 1A: The variability in the amount of force applied to the bone oscillator by trained assistants (n = 4) for elastic-band and hand-held coupling methods was measured. Experiment 1B: Bone-conduction behavioral thresholds in 10 adults were compared for two coupling methods. Experiment 1C: ASSR thresholds and amplitudes to multiple bone-conduction stimuli were compared in 10 infants (mean age: 17 wk) using two coupling methods. Experiment 2: Bone-conduction ASSR thresholds and amplitudes were compared for temporal, mastoid and forehead oscillator placements in 15 preterm infants (mean age: 35 wk postconceptual age (PCA)). Experiment 3: Bone-conduction ASSR thresholds, amplitudes and phase delays were compared in 13 infants (mean age: 15 wk) for an unoccluded and occluded test ear. All infants that participated had passed a hearing screening test.

RESULTS

Experiment 1A: Coupling method did not significantly affect the variability in force applied to the oscillator. Experiment 1B: There were no differences in adult bone-conduction behavioural thresholds between coupling methods. Experiment 1C: There was no significant difference between oscillator coupling method or significant frequency x coupling method interaction for ASSR thresholds or amplitudes in the young infants tested. However, there was a nonsignificant 9-dB better threshold at 4000 Hz for the elastic-band method. Experiment 2: Mean bone-conduction ASSR thresholds for the preterm infants were not significantly different for the temporal and mastoid placements. Mean ASSR thresholds for the forehead placement were significantly higher compared to the other two placements (12-18 dB higher on average). Mean ASSR amplitudes were significantly larger for the temporal and mastoid placements compared to the forehead placement. Experiment 3: There was no difference in mean ASSR thresholds, amplitudes or phase delays for the unoccluded versus occluded conditions.

CONCLUSIONS

Trained assistants can apply an appropriate amount of force to the bone oscillator using either the elastic-band or hand-held method. Coupling method has no significant effect on estimation of bone-conduction thresholds; therefore, either may be used clinically provided assistants are appropriately trained. For preterm infants, there are no differences in ASSRs when the oscillator is positioned at the temporal or mastoid placement. However, thresholds are higher and amplitudes are smaller for the forehead placement, consequently, a forehead placement should be avoided for clinical testing. There does not appear to be a significant occlusion effect in young infants; therefore, it may be possible to do bone-conduction testing with ears unoccluded or occluded without applying a correction factor, although further research is needed to confirm this finding.

Human auditory steady-state responses to changes in interaural correlation

Steady-state responses were evoked by noise stimuli that alternated between two levels of interaural correlation rho at a frequency fm. With rho alternating between +1 and 0, responses at fm dropped steeply above 4 Hz, but persisted up to 64 Hz. Two time constants of 47 and 4.4 ms with delays of 198 and 36 ms, respectively, were obtained by fitting responses to a transfer function based on symmetric exponential windows. The longer time constant, possibly reflecting cortical integration, is consistent with perceptual binaural "sluggishness". The shorter time constant may reflect running cross-correlation in the high brainstem or primary auditory cortex. Responses at 2fm peaked with an amplitude of 848+/-479 nV (fm=4 Hz). Investigation of this robust response revealed that: (1) changes in rho and lateralization evoked similar responses, suggesting a common neural origin, (2) response was most dependent on stimulus frequencies below 1000 Hz, but frequencies up to 4000 Hz also contributed, and (3) when rho alternated between [0.2-1] and 0, response amplitude varied linearly with rho, and the physiological response threshold was close to the average behavioral threshold (rho=0.31). This steady-state response may prove useful in the objective investigation of binaural hearing.

Age-related changes in transient and oscillatory brain responses to auditory stimulation in healthy adults 19-45 years old

The capacity of the human cerebral cortex to track fast temporal changes in auditory stimuli is related to the development of language in children and to deficits in speech perception in the elderly. Although maturation of temporal processing in children and its deterioration in the elderly has been investigated previously, little is known about naturally occurring changes in auditory temporal processing between these limits. The present study examined age-related (19-45 years) changes in 3 electrophysiological measures of auditory processing: 1) the late transient auditory evoked potentials to tone onset, 2) the auditory steady-state response (ASSR) to a 40-Hz frequency-modulated tone, and 3) the envelope following response (EFR) to sweeps of amplitude-modulated white noise from 10 to 100 Hz. With increasing age, the latency of the auditory P1-N1 complex decreased, the oscillatory (ASSR) response became larger and more stable, and the resonant peak of the EFR increased from 38 Hz at 19 years to 46 Hz at 45 years. Source analysis localized these changes to the auditory regions of the temporal lobe. These results indicate persistent adaptation of cortical auditory processes into middle adulthood. We speculate that experience-driven myelination and/or refinement of inhibitory circuits may underlie these changes.

Envelope Following Responses to Natural Vowels

Envelope following responses to natural vowels were recorded in 10 normal hearing people. Responses were recorded to individual vowels (/a/, /i/, /u/) with a relatively steady pitch, to /[symbol: see text]/ with a variable and steady pitch, and to a multivowel stimulus (/[symbol: see text]ui/) with a steady pitch. Responses were analyzed using a Fourier analyzer, so that recorded responses could follow the changes in the pitch. Significant responses were detected for all subjects to /a/, /i/ and /u/ with the time required to detect a significant response ranging from 6 to 66 s (average time: 19 s). Responses to /[symbol: see text]/ and /[symbol: see text]ui/ were detected in all subjects, but took longer to demonstrate (average time: 73 s). These results support the use of a Fourier analyzer to measure envelope following responses to natural speech.

High frequency oscillations in the somatosensory evoked potentials (SSEP's) are mainly due to phase-resetting phenomena

A small series of high frequency oscillations (HFOs) overlapping the earliest part of the N20 wave can be observed in the somatosensory evoked potentials (SSEPs) of normal subjects. We tried to elucidate whether these high frequency components are mainly due to phase-resetting phenomena, to the emergence of new oscillations related to the stimuli, or to a combination of both. Averaged median-nerve SSEPs from seven healthy subjects were studied by means of time-frequency analysis. The presence of new oscillatory activities was evaluated by averaging the energy of the single-trial time-frequency transforms in the HFOs range (400-1000 Hz). To study phase-resetting phenomena, we measured inter-trial coherence (ITC) in the same frequency range. A marked inter-trial coherence related to the HFOs was found, whereas energy changes (related to the emergence of new oscillations) were minimal. The combination of these three different approaches suggests that the HFOs are mainly due to resettings of the ongoing EEG activity originated in response to the stimuli. The emergence of new activities does not seem to be a relevant mechanism in the formation of these components.

Multiple Auditory Steady-State Response Thresholds to Bone-Conduction Stimuli in Young Infants with Normal Hearing

OBJECTIVE

Multiple auditory steady-state responses (ASSRs) probably will be incorporated into the diagnostic test battery for estimating hearing thresholds in young infants in the near future. Limiting this, however, is the fact that there are no published bone-conduction ASSR threshold data for infants with normal or impaired hearing. The objective of this study was to investigate bone-conduction ASSR thresholds in infants from a Neonatal Intensive Care Unit (NICU) and in young infants with normal hearing and to compare these with adult ASSR thresholds.

DESIGN

ASSR thresholds to multiple bone-conduction stimuli (carrier frequencies: 500 to 4000 Hz; 77 to 101-Hz modulation rates; amplitude/frequency modulated; single-polarity stimulus) were obtained in two infant groups [N = 29 preterm (32 to 43 wk PCA), tested in NICU; N = 14 postterm (0 to 8 mo), tested in sound booth]. All infants had passed a hearing screening test. ASSR thresholds, amplitudes, and phase delays for preterm and postterm infants were compared with previously collected adult data.

RESULTS

Mean (+/-1 SD) ASSR thresholds were 16 (11), 16 (10), 37 (10), and 33 (13) dB HL for the preterm infants and 14 (13), 2 (7), 26 (6), and 22 (8) dB HL for the postterm infants at 500, 1000, 2000, and 4000 Hz, respectively. Both infant groups had significantly better thresholds for 500 and 1000 Hz compared with 2000 and 4000 Hz, in contrast to adults who have similar thresholds across frequency (22, 26, 18, and 18 dB HL). When 500- and 1000-Hz thresholds were pooled, pre- and postterm infants had better low-frequency thresholds than adults. When 2000- and 4000-Hz thresholds were pooled, pre- and postterm infants had poorer thresholds than adults. ASSR amplitudes were significantly larger for low frequencies compared with high frequencies for both infant groups, in contrast to adults, who show little difference across frequency. ASSR phase delays were later for lower frequencies compared with higher frequencies for infants and adults, except for 500 Hz in the preterm group. ASSR phase delays were later for infants compared with adults across frequency.

CONCLUSIONS

Infant bone-conduction ASSR thresholds are very different from those of adults. Overall, these results indicate that low-frequency bone-conduction thresholds worsen and high-frequency bone-conduction thresholds improve with maturation. Bone-conduction ASSR threshold differences between the postterm infants and adults probably are due to skull maturation. Differences between preterm and older infants may be explained both by skull changes and a masking effect of high ambient noise levels in the NICU (and possibly to other issues due to prematurity).