The auditory brain stem response interaural latency difference (ILD) in patients with brain stem lesions

Optimizing Auditory Brainstem Response Acquisition Using Interleaved Frequencies

Auditory brainstem responses (ABRs) require averaging responses to hundreds or thousands of repetitions of a stimulus (e.g., tone pip) to obtain a measurable evoked response at the scalp. Fast repetition rates lead to changes in ABR amplitude and latency due to adaptation. To minimize the effect of adaptation, stimulus rates are sometimes as low as 10 to 13.3 stimuli per second, requiring long acquisition times. The trade-off between reducing acquisition time and minimizing the effect of adaptation on ABRs is an especially important consideration for studies of cochlear synaptopathy, which use the amplitude of short latency responses (wave 1) to assess auditory nerve survival. It has been proposed that adaptation during ABR acquisition can be reduced by interleaving tones at different frequencies, rather than testing each frequency serially. With careful ordering of frequencies and levels in the stimulus train, adaptation in the auditory nerve can be minimized, thereby permitting an increase in the rate at which tone bursts are presented. However, widespread adoption of this stimulus design has been hindered by lack of available software. Here, we develop and validate an interleaved stimulus design to optimize the rate of ABR measurement while minimizing adaptation. We implement this method in an open-source data acquisition software tool that permits either serial or interleaved ABR measurements. The open-source software library, psiexperiment, is compatible with widely used ABR hardware. Consistent with previous studies, careful design of an interleaved stimulus train can reduce ABR acquisition time by more than half, with minimal effect on ABR thresholds and wave 1 latency, while improving measures of wave 1 amplitude.

The effects of cochlear hearing loss, age and sex on the auditory brainstem response

This study analyzed the effects of auditory impairment, age and sex on the auditory brainstem response (ABR) wave latencies. ABR wave I, wave V and I-V interval measures were extracted from the clinical records of 201 patients with cochlear hearing loss. Females had consistently earlier wave V latencies and shorter I-V intervals than males. No age effects were observed. Degree of impairment had a systematic effect on ABR wave latencies and I-V intervals. Wave I displayed latency extension with increasing levels of high-frequency hearing loss, whilst for wave V increases in latency were dependent upon both degree and slope of the hearing loss. Present results suggest that many of the previously reported sex differences and variable interactions seen for the ABR can be accounted for by differences in the underlying distribution of audiogram shapes within and between study populations. Different audiometric configurations were found to produce consistent differential effects on both wave I and wave V latency and thus influence the I-V interval. This study underlines the need to develop a more detailed model of impairment effects if correction factors are to be employed more effectively in ABR testing for retrocochlear pathology.

ABR Indices

ABR absolute latencies and interpeak intervals were reviewed for 684 non-tumor ears and 75 eighth-nerve tumor ears having various degrees of high frequency hearing loss. For non-tumor ears, the percentage of abnormal absolute latencies for waves I, III, and V increased rather systematically as hearing loss increased, whereas absolute latencies for eighth-nerve tumor ears were largely abnormal regardless of hearing loss. Interpeak intervals were normal for most of the non-tumor ears, but the I–III and I–V intervals were abnormal for most of the tumor ears. The most sensitive index for otoneurologic assessment was a combination of abnormal wave V interaural latency differences or I–V interpeak interval, and the most specific criterion was the I–V interpeak interval. Tumor size influenced sensitivity of most ABR indices.

Neuroaudiologic Correlates to Anatomical Changes of the Brain

1. There appears to be a relationship among the improved overall behavior of this patient, anatomical changes in the brain, and enhanced performance of both psychophysical and electrophysiological central auditory tests.2. The right-sided peripheral hearing loss was one of the primary indicators for further diagnostic workup, but probably is unrelated to the lesion that was later discovered.3. In demonstrating structural as well as functional improvement, this case demonstrates the plasticity of the young human brain.