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

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

PURPOSE

In the present study, a new procedure to perform automatic audiometry using multifrequency Auditory Steady-State Response (ASSR) is proposed.

METHODS

The automatic audiometry procedure consists of detecting the presence of multifrequency ASSR in real-time using the sequential test strategy and by adjusting the stimulus intensity independently. The ASSR audiometric thresholds of 18 adult volunteers with normal hearing were determined by automatically (four simultaneous frequencies per ear) at modulation frequencies in the 80 Hz range. The exam time and the difference between ASSR thresholds and pure-tone behavioural hearing thresholds were estimated as performance measures.

RESULTS

The results showed that automatic audiometry can reduce the number of intensity levels used to obtain the ASSR threshold by up to 58% when compared to audiometry without using the techniques applied in automatic audiometry. In addition, the average of the difference between ASSR thresholds and Pure-Tone Behavioural Hearing thresholds was around 19 dB, which is similar to the results reported in similar studies.

CONCLUSIONS

The audiometric procedure proposed in this study is fully automatic, i.e., does not require any human supervision throughout the exam, and is able to significantly reduce the conventional exam time.

Comparison of Auditory Steady-State Responses With Conventional Audiometry in Older Adults

Behavioral measures, such as pure-tone audiometry (PTA), are commonly used to determine hearing thresholds, however, PTA does not always provide reliable hearing information in difficult to test individuals. Therefore, objective measures of hearing sensitivity that require little-to-no active participation from an individual are needed to facilitate the detection and treatment of hearing loss in difficult to test people. Investigation of the reliability of the auditory steady-state response (ASSR) for measuring hearing thresholds in older adults is limited. This study aimed to investigate if ASSR can be a reliable, objective measure of frequency specific hearing thresholds in older adults. Hearing thresholds were tested at 500 Hz, 1000 Hz, 2000 Hz, and 4000 Hz in 50 participants aged between 60 and 85 years old, using automated PTA and ASSR. Hearing thresholds obtained from PTA and ASSR were found to be significantly correlated (p < .001) in a cohort consisting of participants with normal hearing or mild hearing loss. ASSR thresholds were significantly higher as compared to PTA thresholds, but for the majority of cases the difference remained within the clinically acceptable range (15 dB). This study provides some evidence to suggest that ASSR can be a valuable tool for estimating objective frequency-specific hearing thresholds in older adults and indicate that ASSR could be useful in creating hearing treatment plans for older adults who are unable to complete behavioral PTA. Further research on older adults is required to improve the methodological features of ASSR to increase consistency and reliability, as well as minimize some of the limitations associated with this technique.

Gender and modulation frequency effects on auditory steady state response (ASSR) thresholds

For estimating behavioral hearing thresholds, auditory steady state response (ASSR) can be reliably evoked by stimuli at low and high modulation frequencies (MFs). In this regard, little is known regarding ASSR thresholds evoked by stimuli at different MFs in female and male participants. In fact, recent data suggest that 40-Hz ASSR is influenced by estrogen level in females. Hence, the aim of the present study was to determine the effect of gender and MF on ASSR thresholds in young adults. Twenty-eight normally hearing participants (14 males and 14 females) were enrolled in this study. For each subject, ASSR thresholds were recorded with narrow-band chirps at 500, 1,000, 2,000, and 4,000 Hz carrier frequencies (CFs) and at 40 and 90 Hz MFs. Two-way mixed ANOVA (with gender and MF as the factors) revealed no significant interaction effect between factors at all CFs (p > 0.05). The gender effect was only significant at 500 Hz CF (p < 0.05). At 500 and 1,000 Hz CFs, mean ASSR thresholds were significantly lower at 40 Hz MF than at 90 Hz MF (p < 0.05). Interestingly, at 2,000 and 4,000 Hz CFs, mean ASSR thresholds were significantly lower at 90 Hz MF than at 40 Hz MF (p < 0.05). The lower ASSR thresholds in females might be due to hormonal influence. When recording ASSR thresholds at low MF, we suggest the use of gender-specific normative data so that more valid comparisons can be made, particularly at 500 Hz CF.

Fast hearing-threshold estimation using multiple auditory steady-state responses with narrow-band chirps and adaptive stimulus patterns

This paper describes the estimation of hearing thresholds in normal-hearing and hearing-impaired subjects on the basis of multiple-frequency auditory steady-state responses (ASSRs). The ASSR was measured using two new techniques: (i) adaptive stimulus patterns and (ii) narrow-band chirp stimuli. ASSR thresholds in 16 normal-hearing and 16 hearing-impaired adults were obtained simultaneously at both ears at 500, 1000, 2000, and 4000 Hz, using a multiple-frequency stimulus built up of four one-octave-wide narrow-band chirps with a repetition rate of 40 Hz. A statistical test in the frequency domain was used to detect the response. The recording of the steady-state responses was controlled in eight independent recording channels with an adaptive, semiautomatic algorithm. The average differences between the behavioural hearing thresholds and the ASSR threshold estimate were 10, 8, 13, and 15 dB for test frequencies of 500, 1000, 2000, and 4000 Hz, respectively. The average overall test duration of 18.6 minutes for the threshold estimations at the four frequencies and both ears demonstrates the benefit of an adaptive recording algorithm and the efficiency of optimised narrow-band chirp stimuli.