Otoacoustic emissions latency difference between full-term and preterm neonates

Otoacoustic emissions from ears with spontaneous activity behave differently to those without: Stronger responses to tone bursts as well as to clicks

It has been reported that both click-evoked otoacoustic emissions (CEOAEs) and distortion product otoacoustic emissions (DPOAEs) have higher amplitudes in ears that possess spontaneous otoacoustic emissions (SOAEs). The general aim of the present study was to investigate whether the presence of spontaneous activity in the cochlea affected tone-burst evoked otoacoustic emissions (TBOAEs). As a benchmark, the study also measured growth functions of CEOAEs. Spontaneous activity in the cochlea was measured by the level of synchronized spontaneous otoacoustic emissions (SSOAEs), an emission evoked by a click but closely related to spontaneous otoacoustic emissions (SOAEs, which are detectable without any stimulus). Measurements were made on a group of 15 adults whose ears were categorized as either having recordable SSOAEs or no SSOAEs. In each ear, CEOAEs and TBOAEs were registered at frequencies of 0.5, 1, 2, and 4 kHz, and input/output functions were measured at 40, 50, 60, 70, and 80 dB SPL. Global and half-octave-band values of response level and latency were estimated. Our main finding was that in ears with spontaneous activity, TBOAEs had higher levels than in ears without. The difference was more apparent for global values, but were also seen with half-octave-band analysis. Input/output functions had similar growth rates for ears with and without SSOAEs. There were no significant differences in latencies between TBOAEs from ears with and without SSOAEs, although latencies tended to be longer for lower stimulus levels and lower stimulus frequencies. When TBOAE levels were compared to CEOAE levels, the latter showed greater differences between recordings from ears with and without SSOAEs. Although TBOAEs reflect activity from a more restricted cochlear region than CEOAEs, at all stimulus frequencies their behavior still depends on whether SSOAEs are present or not.

Differential Rates of Perinatal Maturation of Human Primary and Nonprimary Auditory Cortex

Primary and nonprimary cerebral cortex mature along different timescales; however, the differences between the rates of maturation of primary and nonprimary cortex are unclear. Cortical maturation can be measured through changes in tissue microstructure detectable by diffusion magnetic resonance imaging (MRI). In this study, diffusion tensor imaging (DTI) was used to characterize the maturation of Heschl's gyrus (HG), which contains both primary auditory cortex (pAC) and nonprimary auditory cortex (nAC), in 90 preterm infants between 26 and 42 weeks postmenstrual age (PMA). The preterm infants were in different acoustical environments during their hospitalization: 46 in open ward beds and 44 in single rooms. A control group consisted of 15 term-born infants. Diffusion parameters revealed that (1) changes in cortical microstructure that accompany cortical maturation had largely already occurred in pAC by 28 weeks PMA, and (2) rapid changes were taking place in nAC between 26 and 42 weeks PMA. At term equivalent PMA, diffusion parameters for auditory cortex were different between preterm infants and term control infants, reflecting either delayed maturation or injury. No effect of room type was observed. For the preterm group, disturbed maturation of nonprimary (but not primary) auditory cortex was associated with poorer language performance at age two years.

Spontaneous otoacoustic emissions in schoolchildren

OBJECTIVE

Spontaneous otoacoustic emissions (SOAEs) are one of the least studied types of otoacoustic emissions (OAEs). The purpose of this study was twofold: first, to determine the prevalence of SOAEs in schoolchildren, and second to test whether there was dependence between the presence or absence of SOAEs in a subject and the corresponding level of their transiently evoked OAEs (TEOAEs).

METHODS

Measurements were made on a group of normally hearing children of age 7-13 years. A technique which detects synchronized SOAEs (SSOAEs) was used in which the response to repetitive clicks (12.5/s) was analyzed in the 60-80 ms time window following each click. The matching pursuit method was used to detect SSOAEs components above the noise in this window. For comparison, TEOAEs evoked by clicks (40/s) were obtained using the standard nonlinear protocol (20 ms time window).

RESULTS

The prevalence of SOAEs was 37%, and higher in females and right ears. There was an average of 2.3 SOAEs per emitting ear. TEOAE levels were higher for ears that had SOAEs and were lower for ears that did not have any SOAEs.

CONCLUSION

Although not all normal human have SOAEs, they appear to reflect an important aspect of cochlear function. Their presence is strongly related to elevated levels of TEOAEs which are routinely used in audiological tests.

Otoacoustic emissions in newborns evoked by 0.5kHz tone bursts

BACKGROUND

Otoacoustic emissions (OAEs) are currently widely used in newborn hearing screening programs. OAEs evoked by transients (TEOAEs) in newborns are usually characterized by large response levels at higher frequencies but lower frequencies are affected by physiological noise. The purpose of the present study was to acquire responses at lower frequencies by measuring OAEs evoked by 0.5kHz tone bursts (TBOAEs).

METHODS

Otoacoustic emissions (OAEs) were recorded from 49 newborns. Measurements were made using the ILO 292 equipment from Otodynamics. In each ear, three measurements were made: first with a standard click stimulus at 80dB pSPL (CEOAEs), a second using a 0.5kHz tone burst at 80dB pSPL (TBOAEs), and a third recording of spontaneous OAEs (SOAEs). Global and half-octave-band values of OAE signal-to-noise ratio (SNR) and response level were used to assess statistical differences between CEOAEs and 0.5kHz TBOAEs. Additionally, time-frequency (TF) analysis of signals was performed using the matching pursuit method.

RESULTS

Global levels were highest for CEOAEs. However, at low frequencies (0.7-1kHz), 0.5kHz TBOAEs had significantly higher levels and SNRs than CEOAEs. At these frequencies, SNRs of CEOAEs were usually below 0dB. At 0.5kHz there were no statistically significant differences between CEOAEs and TBOAEs. In ears with recordable SOAEs, CEOAEs and TBOAEs had higher levels and SNRs than in ears without SOAEs.

CONCLUSIONS

Use of 0.5kHz TBOAEs may be a useful addition to standard CEOAE tests in newborns. They provide information about lower frequencies, a region where CEOAEs are usually prone to noise. The presence of SOAEs affects the magnitudes of both CEOAEs and TBOAEs.

Tone burst evoked otoacoustic emissions in different age-groups of schoolchildren

INTRODUCTION

Otoacoustic emissions (OAEs) are believed to be good predictors of hearing status, particularly in the 1-4kHz range. However both click evoked OAEs (CEOAEs) and distortion product OAEs (DPOAEs) perform poorly at 0.5kHz. The present study investigates OAEs in the lower frequency range of 0.5-1kHz evoked by 0.5kHz tone bursts (TBOAEs) in schoolchildren and compares them with emissions evoked by clicks.

METHODS

Measurements were performed for two groups of normally hearing schoolchildren. Children from 1st grade (age 6-7 years) and children from 6th grade (age 11-12 years). Tympanometry, pure tone audiometry, and OAE measurements of CEAOEs, 0.5kHz TBOAEs, and spontaneous OAEs (SOAEs) were performed. Additionally, analysis by the matching pursuit method was conducted on CEOAEs and TBOAEs to assess their time-frequency (TF) properties.

RESULTS

For all subjects OAEs response levels and signal to noise ratios (SNRs) were calculated. As expected, CEOAE magnitudes were greatest over the range 1-4kHz, with a substantial decrease below 1kHz. Responses from the 0.5kHz TBOAEs were complementary in that the main components occurred between 0.5 and 1.4kHz. In younger children, TBOAEs had SNRs 4-8dB smaller in the 0.5-1.4kHz range. In addition, CEOAEs had lower SNRs in the 0.7-1.4kHz range, by 3-5dB. TBOAEs in younger children had maximum SNRs shifted toward 1-1.4kHz, whereas in older children it was more clearly around 1kHz. The differences in response levels were less evident. The presence of SOAEs appreciably influenced both CEOAEs and TBOAEs, and TF properties of both OAEs did not differ significantly between grades.

CONCLUSION

TBOAEs evoked at 0.5kHz can provide additional information about frequencies below 1kHz, a range over which CEOAEs usually have very low amplitudes. The main difference between the two age groups was that in older children CEOAEs and 0.5kHz TBOAEs had higher SNRs at 0.5-1.4kHz. Additionally, for ears with SOAEs, 0.5kHz TBOAEs had higher response levels and SNRs similar to CEOAEs.

Matching Pursuit with Asymmetric Functions for Signal Decomposition and Parameterization

The method of adaptive approximations by Matching Pursuit makes it possible to decompose signals into basic components (called atoms). The approach relies on fitting, in an iterative way, functions from a large predefined set (called dictionary) to an analyzed signal. Usually, symmetric functions coming from the Gabor family (sine modulated Gaussian) are used. However Gabor functions may not be optimal in describing waveforms present in physiological and medical signals. Many biomedical signals contain asymmetric components, usually with a steep rise and slower decay. For the decomposition of this kind of signal we introduce a dictionary of functions of various degrees of asymmetry – from symmetric Gabor atoms to highly asymmetric waveforms. The application of this enriched dictionary to Otoacoustic Emissions and Steady-State Visually Evoked Potentials demonstrated the advantages of the proposed method. The approach provides more sparse representation, allows for correct determination of the latencies of the components and removes the "energy leakage" effect generated by symmetric waveforms that do not sufficiently match the structures of the analyzed signal. Additionally, we introduced a time-frequency-amplitude distribution that is more adequate for representation of asymmetric atoms than the conventional time-frequency-energy distribution.

Repeatability of transient-evoked otoacoustic emissions in young adults

Background

The aim of this study was to evaluate the repeatability and variability of TEOAE characteristics in hearing screening tests performed under practical conditions on normal subjects.

Material/Methods

A group of 11 young, normal-hearing subjects aged 19–24 years was tested. They were examined otologically and audiologically prior to the tests and no ear pathologies were found. Responses were acquired with a commercially available instrument (Integrity, Vivosonic Inc.) using a standardized OAE protocol. The TEOAE tests were repeated 3 times in each subject at random intervals within 24 h. The analyzed parameters of interest were: (i) whole wave reproducibility (WWR) and; (ii) signal-to-noise ratio (SNR).

Results

WWR and SNR did not differ significantly among the 3 measurement sessions. In most cases the differences in WWR among measurements were around 1–2% and for SNRs they were 1–4 dB SNRs and were highest in the 1–2 kHz range. TEOAE-based tests can be useful tools for hearing screening.

Conclusions

The tests can give reliable results provided that adequate procedures are used and low-noise conditions are ensured. The tests are best complemented with other examinations to widen the range of ear pathologies able to be detected.

Análise das emissões otoacústicas evocadas por produto de distorção em neonatos prematuros

Objetivos: verificar a incidência de alterações nas Emissões Otoacústicas por Produto de Distorção em neonatos prematuros e analisar a amplitude das respostas em função da idade gestacional nessa população.Métodos: trata-se de um estudo transversal observacional, que contou com análise dos resultados do exame de emissões otoacústicas evocadas por produto de distorção dos neonatos pré-termos, triados em um hospital público de Belo Horizonte, no período de agosto de 2010 a fevereiro de 2011. Os neonatos avaliados foram divididos em três grupos de acordo com a idade gestacional, sendo o primeiro grupo constituído por neonatos de 28-30 semanas, o segundo de 31-33 semanas e o terceiro grupo de 34-36 semanas. Este estudo foi aprovado pelo Comitê de Ética da UFG sob parecer número 0210.0.203.000-10.Resultados: dentre as crianças avaliadas 44 (93,62%) apresentaram Emissões Otoacústicas Por Produto de Distorção (EOAPD) presentes e apenas três crianças (6,38%) apresentaram EOAPD ausentes. Com relação à análise das amplitudes das EOAs e suas comparações entre os grupos estudados, não foi encontrada diferença estatisticamente significante entre os grupos gestacionais, entretanto observou-se valores menores de p entre os grupos gestacionais nas frequências altas – 5KHz e 6KHz.Conclusão: observou-se que a prematuridade em si não constitui um fator que influencia no resultado de EOAPD em neonatos prematuros.

Analysis of otoacoustic emissions in neonates at term and preterm

The transient evoked otoacoustic emissions (TEOAEs) have been widely used in neonatal hearing screening.

Objective

To compare the TEOAEs in newborns at term and preterm vis-à-vis the following variables: ear side, gender, frequency spectrum and gestational age.

Method

By means of a cross-sectional cohort of 66 newborns up to the 28^th day of life (41 newborns at term and 25 premature babies), we recorded TEOAEs. All the individuals did not have risk indicators for hearing loss.

Results

There was a signal/noise ratio improvement with frequency increase. No differences were observed between genders and between the ears, but there were differences among the children born at term and preterm in the frequency bands at 3 kHz and 4 kHz.

Conclusion

The TEOAEs test is important for assessing the peripheral auditory system of newborns at term and preterm, making it possible to have responses regardless of gender and gestational age.

Musical ratios in sounds from the human cochlea

The physiological roots of music perception are a matter of long-lasting debate. Recently light on this problem has been shed by the study of otoacoustic emissions (OAEs), which are weak sounds generated by the inner ear following acoustic stimulation and, sometimes, even spontaneously. In the present study, a high-resolution time–frequency method called matching pursuit was applied to the OAEs recorded from the ears of 45 normal volunteers so that the component frequencies, amplitudes, latencies, and time-spans could be accurately determined. The method allowed us to find that, for each ear, the OAEs consisted of characteristic frequency patterns that we call resonant modes. Here we demonstrate that, on average, the frequency ratios of the resonant modes from all the cochleas studied possessed small integer ratios. The ratios are the same as those found by Pythagoras as being most musically pleasant and which form the basis of the Just tuning system. The statistical significance of the results was verified against a random distribution of ratios. As an explanatory model, there are attractive features in a recent theory that represents the cochlea as a surface acoustic wave resonator; in this situation the spacing between the rows of hearing receptors can create resonant cavities of defined lengths. By adjusting the geometry and the lengths of the resonant cavities, it is possible to generate the preferred frequency ratios we have found here. We conclude that musical perception might be related to specific geometrical and physiological properties of the cochlea.

Otoacoustic emissions in neonates measured with different acquisition protocols

OBJECTIVE

The purpose of the study was to investigate the properties of neonatal transiently evoked otoacoustic emissions (TEOAEs) recorded with three most popular stimulation protocols. Differences between the recorded TEOAEs with and without spontaneous otoacoustic emissions (SOAEs), were also assessed. In addition two more issues were addressed: (i) the effect of windowing on the TEOAE responses; and (ii) the contribution of the TEOAE segment from 12.5 to 20 ms to the overall TEOAE response.

METHODS

TEOAEs and SOAEs were recorded from 50 normal hearing neonates using linear, non-linear, QuickScreen and standard synchronized SOAE stimulation protocols. Global and half-octave-band values of TEOAE reproducibility and response level were used to assess statistical differences in the recorded responses. Furthermore protocol differences were evaluated in different recording windows from 2.5 to 12.5 and 12 to 20 ms.

RESULTS

Data from the linear protocol presented TEOAE parameters with the highest values. The differences between recordings with longer and shorter acquisition windows were especially apparent in 1-1.4 kHz frequency range. Furthermore the data have shown that the low frequency TEOAE components are a significant part of the TEOAE response, especially in ears without SOAEs.

CONCLUSIONS

The results suggest that TEOAE protocols using short recording windows (i.e. QuickScreen) can be used only for a fast detection of a valid TEOAE. For more sophisticated clinical analyses the standard 20 ms TEOAE recording window is more appropriate. The presence of SOAEs significantly influences TEOAEs. Ears with SOAEs presented higher values of TEOAE parameters especially in the 2-4 kHz range. On the other hand, in the ears without SOAEs low frequency components contribute more to the signal.

Time-frequency analysis of linear and nonlinear otoacoustic emissions and removal of a short-latency stimulus artifact

Click-evoked otoacoustic emissions (CEOAEs) are commonly recorded as average responses to a repetitive click stimulus. If the click train has constant polarity, a linear average results; if it contains a sequence of clicks of differing polarity and amplitude, a nonlinear average can be calculated. The purpose of this study was to record both protocols from the same set of ears and characterize the differences between them. The major features of CEOAEs were similar under both protocols with the exception of a region spanning 0-5 ms in time and 0-2.2 kHz in frequency. It was assumed that the signal derived from the linear protocol was contaminated by stimulus artifact, and so a simple procedure was used--involving high-pass filtering and time-windowing--to remove components of this artifact. This procedure preserved the short-latency, high-frequency responses; it also produced a marked similarity in the time-frequency plots of recordings made under the two protocols. This result means it is possible to take advantage of the better signal-to-noise ratio of the linear data compared to its nonlinear counterpart. Additionally, it was shown that CEOAEs recorded under the linear protocol appear to be less dependent on the presence of spontaneous otoacoustic emissions (SOAEs).

Frequency shifts with age in click-evoked otoacoustic emissions of preterm infants

A previous study [Brienesse et al. (1997). Pediatr. Res. 42, 478-483] demonstrated a positive shift with increasing postmenstrual age (PMA) in the frequencies of synchronized spontaneous otoacoustic emissions (SSOAEs) in preterm infants. We used a mixed model approach to describe a shift with PMA in the spectra of click-evoked otoacoustic emissions (CEOAEs) measured in a group of 22 preterm infants. The rate in shift in CEOAE spectral components was found to be frequency dependent, with a mean estimate of 10 Hz/week for frequencies around 2 kHz and 30 Hz/week for frequencies around 4.25 kHz. This rate decreased with increasing PMA. Because SSOAEs are often part of the CEOAE response, a comparison was made between the shifts in SSOAEs and CEOAEs in a sub-group of 16 preterm infants. The results indicate that the shifts found for both types of OAE are similar, which supports a common mechanism for this change in OAE-characteristic. At present it is not clear to what extent developmental processes in the cochlea and the middle ear can account for these frequency shifts in the spectra of CEOAEs and SSOAEs during the preterm period.

Use of the matching pursuit algorithm with a dictionary of asymmetric waveforms in the analysis of transient evoked otoacoustic emissions

Transiently evoked otoacoustic emissions (TEOAEs) are normally modeled as the sum of asymmetric waveforms. However, some previous studies of TEOAEs used time-frequency (TF) methods to decompose the signals into symmetric waveforms. This approach was justified mainly as a means to reduce the complexity of the calculations. The present study extended the dictionary of numeric functions to incorporate asymmetric waveforms into the analysis. The necessary calculations were carried out using an adaptive approximation algorithm based on the matching pursuit (MP) numerical technique. The classic MP dictionary uses Gabor functions and consists of waveforms described by five parameters, namely, frequency, latency, time span, amplitude, and phase. In the present investigation, a sixth parameter, the degree of asymmetry, was added in order to enhance the flexibility of this approach. The effects of expanding the available functions were evaluated by means of both simulations using synthetic signals and authentic TEOAEs. The resulting analyses showed that the contributions of asymmetric components in the OAE signal are appreciable. In short, the expanded analysis method brought about important improvements in identifying TEOAE components including the correct detection of components with long decays, which are often related to spontaneous OAE activity, the elimination of a "dark energy" effect in TF distributions, and more reliable estimates of latency-frequency relationships. The latter feature is especially important for correct estimation of latency-frequency data, which is a crucial factor in investigations of OAE-generation mechanisms.

Otoacoustic emissions evoked by 0.5 kHz tone bursts

The aim of this research is to extend previous studies of the time-frequency features of otoacoustic emissions (OAEs) using information about the properties of the signals at low frequencies. Responses to 0.5 kHz tone bursts were compared to OAEs that were evoked by click stimuli and by 1, 2, and 4 kHz tone burst stimuli. The OAEs were measured using 20 and 30 ms intervals between stimuli. The analysis revealed no differences in the time-frequency properties of 1, 2, and 4 kHz bursts measured using these two different acquisition windows. However, at 0.5 kHz the latency of the response was affected significantly if a shorter time window was used. This was caused by the fact that the response reached a maximum after an average time of 15.4 ms, and lasted a few milliseconds longer. Therefore, for this particular stimulus, the use of a 30 ms time window seems more appropriate. In addition, as an example of the possible application of low-frequency OAEs, signals were measured in patients suffering from partial deafness, characterized by steep audiograms with normal thresholds up to 0.5 kHz and almost total deafness above this frequency. Although no response to clicks was observed in these subjects, the use of 0.5 kHz tone bursts did produce OAEs.

Synchronized spontaneous otoacoustic emissions analyzed in a time-frequency domain

A synchronized spontaneous otoacoustic emission paradigm was used to measure the response in time intervals of 80 ms following a click stimulus. The responses obtained were decomposed into basic waveforms by means of adaptive approximations using a matching pursuit algorithm. High-resolution time-frequency distributions of signal energy were calculated and showed three types of component: (1) purely evoked of duration less than 5 ms, (2) longer lasting and decaying, with exponentially decreasing amplitude, and (3) long lasting and stable. The distributions of the frequencies of components of different durations were similar, with most components falling within the 1-2 kHz interval. It is shown that the presence of long-lasting components may influence the estimation of the latency of evoked emissions, especially at higher frequencies where the evoked part has a very short duration.

Transient evoked otoacoustic emission latency and estimates of cochlear tuning in preterm neonates

The latency of transient evoked otoacoustic emissions has been evaluated in a sample of 58 ears from 34 preterm neonates, to understand if the estimates of cochlear tuning based on the otoacoustic emission latency show signs of developmental changes. A previous study on the same otoacoustic emissions analyzed here [Tognola et al. (2005). "Cochlear maturation and otoacoustic emissions in preterm infants: A time-frequency approach," Hear. Res., 199, 71-80] reported indeed a significant change in the otoacoustic emission latency with postconception age. This last result, which would imply a significant decrease of tuning, was partially biased by the presence of spontaneous emissions. In this study, the same neonate data are reanalyzed using a novel time-frequency algorithm, less sensitive to spontaneous emissions. Asymmetry between right and left ears has been found, with the left ears showing no significant change, whereas in the right ears and in the 1.5-2.5 kHz frequency range only, a slow decrease of latency with postconception age (0.1-0.2 ms/week) was observed. The correspondent tuning estimates based on latency decrease by 0.4-0.5/week. Significant differences between neonate and adult latency were confirmed, which could be either cochlear or middle ear in nature. These findings are compared to previous studies on distortion product suppression tuning curves in preterm neonates.

Wavelet and matching pursuit estimates of the transient-evoked otoacoustic emission latency

Different time-frequency techniques may be used to investigate the relation between latency and frequency of transient-evoked otoacoustic emissions. In this work, the optimization of these techniques and the interpretation of the experimental result are discussed. Time-frequency analysis of click-evoked otoacoustic emissions of 42 normal-hearing young subjects has been performed, using both wavelet and matching pursuit algorithms. Wavelet techniques are very effective to provide fast and reliable evaluation of the average latency of large samples of subjects. A major advantage of the matching pursuit technique, as observed by Jedrzejczak et al. [J. Acoust. Soc. Am. 115, 2148-2158 (2004)], is to provide detailed information about the time evolution of the response of single ears at selected frequencies. A hybrid matching pursuit algorithm that includes Fourier spectral information was developed, capable of speeding-up computation times and of identifying "spurious" atoms, whose latency-frequency relation is apparently anomalous. These atoms could be associated with several known phenomena, either intrinsic, such as intermodulation distortion, spontaneous emissions and multiple internal reflections, or extrinsic, such as instrumental noise, linear ringing and the acquisition window onset. A correct interpretation of these phenomena is important to get accurate estimates of the otoacoustic emission latency.