Searching for the optimal stimulus eliciting auditory brainstem responses in humans

Measurement of thresholds using Chirp-ABR in children with auditory neuropathy spectrum disorder and sensorineural hearing loss

AIM

This study explored the value of Chirp-auditory brainstem response (ABR) thresholds in assessing the hearing threshold of children diagnosed with auditory neuropathy spectrum disorder (ANSD).

METHODS

A total of 20 children with ANSD (40 ears, aged 1.5-7.0 years, median age 4.5 years) and 31 children with sensorineural hearing loss (SNHL) (52 ears, aged 0.9-8.0 years, median age 3.7 years) were included. Besides, 25 normal children (50 ears, aged 0.8-7.5 years, median age 4.6 years) were used as controls. Chirp-ABR and behavioral audiometry were performed simultaneously among three groups of children, allowing for a comparison of the thresholds obtained through both methods.

RESULTS

In ANSD children, the correlation (r-values) between the thresholds obtained from Chirp-ABR and behavioral audiometry at 500-4000 Hz were 0.84, 0.67, 0.59, and 0.60, respectively. The average threshold differences between two methods ranged from 9.7 to 13.3 dB at 500-4000 Hz. Notably, 20 % ears (8/40) exhibited considerable discrepancies (>30 dB) in thresholds at certain frequencies. For SNHL children, the r-values between two methods were 0.84, 0.89, 0.92, and 0.93, respectively. The average threshold differences between two methods were 5.7-8.2 dB at 500-4000 Hz. Similarly, in normal children, the average threshold differences between two methods ranged from 6.1 dB to 7.7 dB, the r-values were 0.81, 0.78, 0.80, and 0.80 at 500-4000 Hz, respectively.

CONCLUSION

Chirp-ABR threshold is not suitable to predict the behavioral audiometry threshold in ANSD children. When there is a significant discrepancy (>30 dB) between Chirp-ABR thresholds and behavioral audiometry thresholds in hearing loss, ANSD should be highly suspected.

Auditory Electrophysiological Thresholds With Different Chirps and Their Correlation With Behavioral Thresholds in Hearing-Impaired Children

OBJECTIVES

Research focusing on changes in the clinical practice of audiological diagnosis has become increasingly necessary, particularly in pediatric audiology. The pursuit of accurate and reliable examinations has intensified given the importance of early detection and intervention in cases of childhood hearing loss. Thus, this study aims to investigate the correlation between electrophysiological auditory thresholds, as obtained through frequency-specific auditory brainstem responses with two distinct chirp stimuli (narrow-band CE-Chirp Level Specific and narrow-band iChirp), in children with hearing impairments. In addition, this research set out to correlate these thresholds with behavioral responses while simultaneously comparing the examination durations relative to the type of stimuli and the degree of hearing loss.

DESIGN

A cohort of 20 children (aged 6 months to 12 years) with varying degrees of hearing impairment (ranging from mild to profound) were recruited. The participants underwent bilateral measurement of their electrophysiological thresholds via auditory brainstem responses across different frequencies (500, 1000, 2000, and 4000 Hz), and the timeframe for determining these thresholds was carefully recorded. Subsequently, behavioral thresholds were ascertained using pure-tone audiometry or visual reinforcement audiometry based on the child's age. The data collected was subsequently analyzed using Pearson and Spearman correlation coefficients. To compare examination times, the Student t test and the Kruskal-Wallis test were used.

RESULTS

There was a pronounced correlation between the thresholds obtained through both narrow-band chirp stimuli. Moreover, a substantial correlation was found between electrophysiological and behavioral thresholds at 1000, 2000, and 4000 Hz, especially when compared with pure-tone audiometry. The mean differences between the electrophysiological and behavioral thresholds were below 6 dB nHL, and the exam duration was relatively consistent across both devices, averaging 47.63 (±19.41) min for the narrow-band CE-Chirp Level Specific and 52.42 (±26) min for the narrow-band iChirp. Notably, variations in exam duration did not relate to varying degrees of hearing loss when using the narrow-band CE-Chirp Level Specific. Nevertheless, the narrow-band iChirp indicated significantly shorter durations in instances of profound degree measurements, demonstrating a statistically significant difference.

CONCLUSIONS

The narrow-band CE-Chirp Level Specific and narrow-band iChirp stimuli provided similar estimates of electrophysiological auditory thresholds in children with hearing impairments, giving accurate estimations of behavioral thresholds. The time it took to complete the assessment is comparable between both stimuli. For the narrow-band iChirp, the degree of hearing loss was shown to impact the testing time, and children with profound hearing loss underwent faster exams. Ultimately, this study exhibits significant clinical implications as it reveals that the narrow-band CE-Chirp Level Specific and narrow-band iChirp stimuli could be remarkably promising for clinically exploring electrophysiological thresholds in children with hearing impairments.

Single-unit data for sensory neuroscience: Responses from the auditory nerve of young-adult and aging gerbils

This dataset was collected to study the functional consequences of age-related hearing loss for the auditory nerve, which carries acoustic information from the periphery to the central auditory system. Using high-impedance glass electrodes, raw voltage traces and spike times were recorded from more than one thousand single fibres of the auditory nerve of young-adult, middle-aged, and old Mongolian gerbils raised in a quiet environment. The dataset contains not only responses to simple acoustic stimuli to characterize the fibres, but also to more complex stimuli, such as speech logatomes in background noise and Schroeder-phase stimuli. A software toolbox is provided to search through the dataset, to plot various analysed outcomes, and to give insight into the analyses. This dataset may serve as a valuable resource to test further hypotheses about age-related hearing loss. Additionally, it can aid in optimizing available computational models of the auditory system, which can contribute to, or eventually even fully replace, animal experiments.

Audiogram Estimation by Auditory Brainstem Response with NB CE-Chirp LS stimulus in Normal Hearing Infants

Introduction  NB CE-Chirp LS was developed to improve the audiogram estimation by auditory brainstem response (ABR) thresholds during audiological assessment of infants and difficult to test children. However, before we know how the stimulus behaves in several types of hearing loss, it is important we know how the stimulus behaves in normal hearing infants. Objective  To describe ABR thresholds with NB CE-Chirp LS stimulus for 500, 1,000, 2,000, and 4,000 Hz, as well as the amplitude and absolute latency for ABR thresholds. Methods  Auditory brainstem response thresholds were evaluated with the Eclipse EP25 system. NB CE-Chirp LS was presented using an ER-3A insert earphone. EEG filter was 30 Hz high-pass and 1,500 Hz low-pass. The ABR threshold was defined as the lowest intensity capable of clearly evoke wave V, accompanied by an absent response 5 dB below. Results  Eighteen normal hearing infants were evaluated. The mean and standard deviation (SD) of the ABR threshold (dB nHL) were: 23.8 (±4.2); 14.4 (±5.7); 6.0 (±5.0); and 7.0 (±5.9). The mean and SD of the absolute latency (ms) were: 8.86 (±1.12); 9.21 (±0.95); 9.44 (±0.78); and 9.64 (±0.52). The mean amplitude (nV) and SD were: 0.123 (±0.035); 0.127 (±0.039); 0.141 (±0.052); and 0.105 (±0.028), respectively, for 500, 1,000, 2,000 and 4,000 Hz. Conclusion  Auditory brainstem response threshold with NB CE-Chirp LS reaches low levels, in special for high frequencies. It provides absolute latencies similar between frequencies with robust amplitude. The results obtained brings to the examiner more confidence in the results registered.

Investigating the Effects of Level-Specific CE-Chirp on Auditory Brainstem Response Waves in Normal Hearing Infants

Background

Auditory brainstem response (ABR) to the level-specific (LS) CE-Chirp has been reported to provide optimum neural synchrony along cochlear partitions, theoretically improving ABR waveform resolution. Despite this promising finding, limited studies have been conducted to contrast the results between LS CE-Chirp and Click stimuli. The current study aimed to compare the results of ABR between the two stimuli (Click and LS CE-Chirp).

Method

Sixty-seven normal-hearing infants, both with and without risk factors, aged less than 7 months old, participated in this study. The ABR test was conducted at 70 dBnHL using 33.3 stimulus repetition rates with both Click and LS CE-Chirp stimuli. The signal averaging was stopped at a maximum fixed signal average of 2,500 sweeps. Data were statistically compared between the two stimuli using the Wilcoxon signed-rank test.

Results

The waves I and V ABRs elicited by LS CE-Chirp exhibited significantly larger amplitudes than the Click stimulus. However, the amplitude of wave III and absolute latencies were similar in both stimuli at a supra-threshold level.

Conclusion

LS CE-Chirp has the advantage of larger amplitudes than the ABR from Click at the supra-threshold level (70 dBnHL) in normal-hearing infants.

Predicting early auditory evoked potentials using a computational model of auditory-nerve processing

Non-invasive electrophysiological measures, such as auditory evoked potentials (AEPs), play a crucial role in diagnosing auditory pathology. However, the relationship between AEP morphology and cochlear degeneration remains complex and not well understood. Dau [J. Acoust. Soc. Am. 113, 936-950 (2003)] proposed a computational framework for modeling AEPs that utilized a nonlinear auditory-nerve (AN) model followed by a linear unitary response function. While the model captured some important features of the measured AEPs, it also exhibited several discrepancies in response patterns compared to the actual measurements. In this study, an enhanced AEP modeling framework is presented, incorporating an improved AN model, and the conclusions from the original study were reevaluated. Simulation results with transient and sustained stimuli demonstrated accurate auditory brainstem responses (ABRs) and frequency-following responses (FFRs) as a function of stimulation level, although wave-V latencies remained too short, similar to the original study. When compared to physiological responses in animals, the revised model framework showed a more accurate balance between the contributions of auditory-nerve fibers (ANFs) at on- and off-frequency regions to the predicted FFRs. These findings emphasize the importance of cochlear processing in brainstem potentials. This framework may provide a valuable tool for assessing human AN models and simulating AEPs for various subtypes of peripheral pathologies, offering opportunities for research and clinical applications.

Investigating the optimal stimulus to evoke the binaural interaction component of the auditory brainstem response

Objective assessment of spatial and binaural hearing deficits remains a major clinical challenge. The binaural interaction component (BIC) of the auditory brainstem response (ABR) holds promise as a non-invasive biomarker for diagnosing such deficits. However, while comparative studies have reported robust BIC in animal models, BIC in humans can sometimes be unreliably evoked even in subjects with normal hearing. Here we explore the hypothesis that the standard methodology for collecting monaural ABRs may not be ideal for electrophysiological assessment of binaural hearing. This study aims to improve ABR BIC measurements by determining more optimal stimuli to evoke it. Building on previous methodology demonstrated to enhance peak amplitude of monaural ABRs, we constructed a series of level-dependent chirp stimuli based on empirically derived latencies of monaural-evoked ABR waves I, IV and the binaural-evoked BIC DN1, the most prominent BIC peak, in a cohort of ten chinchillas. We hypothesized that chirps designed based on BIC DN1 latency would specifically enhance across-frequency temporal synchrony in the afferent inputs leading to the binaural circuits that produce the BIC and would thus produce a larger DN1 than either traditional clicks or chirps designed to optimize monaural ABRs. Compared to clicks, we found that level-specific chirp stimuli evoked significantly greater BIC DN1 amplitudes, and that this effect persisted across all stimulation levels tested. However, we found no significant differences between BICs resulting from chirps created using binaural-evoked BIC DN1 latencies and those using monaural-evoked ABR waves I or IV. These data indicate that existing level-specific, monaural-based chirp stimuli may improve BIC detectability and reduce variability in human BIC measurements.

Acoustically Evoked Compound Action Potentials Recorded From Cochlear Implant Users With Preserved Acoustic Hearing

OBJECTIVES

Less traumatic intracochlear electrode design and the introduction of the soft surgery technique allow for the preservation of low-frequency acoustic hearing in many cochlear implant (CI) users. Recently, new electrophysiologic methods have also been developed that allow acoustically evoked peripheral responses to be measured in vivo from an intracochlear electrode. These recordings provide clues to the status of peripheral auditory structures. Unfortunately, responses generated from the auditory nerve (auditory nerve neurophonic [ANN]) are somewhat difficult to record because they are smaller than the hair cell responses (cochlear microphonic). Additionally, it is difficult to completely segregate the ANN from the cochlear microphonic, complicating the interpretation and limiting clinical applications. The compound action potential (CAP) is a synchronous response of multiple auditory nerve fibers and may provide an alternative to ANN where the status of the auditory nerve is of primary interest. This study is a within-subject comparison of CAPs recorded using traditional stimuli (clicks and 500 Hz tone bursts) and a new stimulus (CAP chirp). We hypothesized that the chirp stimulus might result in a more robust CAP than that recorded using traditional stimuli, allowing for a more accurate assessment of the status of the auditory nerve.

DESIGN

Nineteen adult Nucleus L24 Hybrid CI users with residual low-frequency hearing participated in this study. CAP responses were recorded from the most apical intracochlear electrode using a 100 μs click, 500 Hz tone bursts, and chirp stimuli presented via the insert phone to the implanted ear. The chirp stimulus used in this study was CAP chirp generated using parameters from human-derived band CAPs ( Chertoff et al. 2010 ). Additionally, nine custom chirps were created by systematically varying the frequency sweep rate of the power function used to construct the standard CAP chirp stimulus. CAPs were recorded using all acoustic stimuli, allowing for within-subject comparisons of the CAP amplitude, threshold, percentage of measurable CAP responses, and waveform morphology.

RESULTS

Considerable variation in response morphology was apparent across stimuli and stimulation levels. Clicks and CAP chirp significantly evoked identifiable CAP response more compared to 500 Hz tone bursts. At relatively high stimulation levels, the chirp-evoked CAPs were significantly larger in amplitude and less ambiguous in morphology than the click-evoked CAPs. The status of residual acoustic hearing at high frequencies influenced the likelihood that a CAP could be reliably recorded. Subjects with better preserved hearing at high frequencies had significantly larger CAP amplitudes when CAP chirp was used. Customizing the chirp stimulus by varying the frequency sweep rates significantly affected the CAP amplitudes; however, pairwise comparisons did not show significant differences between chirps.

CONCLUSIONS

CAPs can be measured more effectively using broadband acoustic stimuli than 500 Hz tone bursts in CI users with residual low-frequency acoustic hearing. The advantage of using CAP chirp stimulus relative to standard clicks is dependent on the extent of preserved acoustic hearing at high frequencies and the stimulus level. The chirp stimulus may present an attractive alternative to standard clicks or tone bursts for this CI population when the goal is to record robust CAP responses.

Input compensation of dolphin and sea lion auditory brainstem responses using frequency-modulated up-chirps

Frequency-modulated "chirp" stimuli that offset cochlear dispersion (i.e., input compensation) have shown promise for increasing auditory brainstem response (ABR) amplitudes relative to traditional sound stimuli. To enhance ABR methods with marine mammal species known or suspected to have low ABR signal-to-noise ratios, the present study examined the effects of broadband chirp sweep rate and level on ABR amplitude in bottlenose dolphins and California sea lions. "Optimal" chirps were designed based on previous estimates of cochlear traveling wave speeds (using high-pass subtractive masking methods) in these species. Optimal chirps increased ABR peak amplitudes by compensating for cochlear dispersion; however, chirps with similar (or higher) frequency-modulation rates produced comparable results. The optimal chirps generally increased ABR amplitudes relative to noisebursts as threshold was approached, although this was more obvious when sound pressure level was used to equate stimulus levels (as opposed to total energy). Chirps provided progressively less ABR amplitude gain (relative to noisebursts) as stimulus level increased and produced smaller ABRs at the highest levels tested in dolphins. Although it was previously hypothesized that chirps would provide larger gains in sea lions than dolphins-due to the lower traveling wave speed in the former-no such pattern was observed.

Shortened neural conduction time in young adults with tinnitus as revealed by chirp-evoked auditory brainstem response

Tinnitus is generally considered to be caused by neuroplastic changes in the central nervous system, triggered by a loss of input from the damaged peripheral system; however, conflicting results on auditory brainstem responses (ABRs) to clicks have been reported previously in humans with tinnitus. This study aimed to compare the effect of tinnitus on ABRs to chirps with those to clicks in normal-hearing young adults with tinnitus. The results showed that the tinnitus group had no significantly poorer hearing thresholds (0.25-16 kHz), click-evoked otoacoustic emissions (1-16 kHz), and speech perception in noise (SPIN) than the control group. Although chirps evoked significantly larger wave I and V amplitudes than clicks, people with tinnitus had no significantly smaller wave I amplitudes for either stimulus. Nevertheless, adults with tinnitus exhibited significantly smaller interpeak interval (IPI) between waves I and V for chirps (IPI-chirp) but not for clicks. In addition, the IPI-chirp correlated significantly with the SPIN for individuals with tinnitus when the signal-to-noise ratio was low. The present results suggest that the chirp-evoked ABR may be a valuable clinical tool for objectively assessing the SPIN in individuals with tinnitus. Further studies should be conducted to investigate possible etiologies of tinnitus.

Auditory Brainstem response electrophysiological thresholds with narrow band chirps stimuli in hearing infants

OBJECTIVES

to describe reference values for the electrophysiological thresholds obtained in the frequency-specific Auditory Brainstem Response (fsABR) with the NB CE-Chirp® LS and NB iChirp stimuli in hearing infants and to compare the variables: Minimum Levels of Response (MLR), latency, amplitude and examination time.

METHODS

the sample consisted of 74 full-term infants, with a mean age of 23.11 days, 29 females and 45 males. The participants underwent fsABR at the frequencies of 500 Hz, 1000 Hz, 2000 Hz and 4000 Hz, to measure the MLR with the NB CE-Chirp® LS stimulus in the Eclipse equipment, and with the NB iChirp stimulus in the SmartEP, all in natural sleep and performed in the same session. The waveforms were evaluated by judges and later, for the comparison of thresholds and examination time, analyzed with the Wilcoxon test. To compare latency and amplitude, the Student's T Test and ANOVA were used for the same variables, but with the same stimulus. The Kruskal-Wallis test was used to compare the examination time at the different frequencies.

RESULTS

The MLR and latency at 500 Hz and 1000 Hz showed a statistically significant difference between the stimuli, with lower thresholds and higher latencies for the NB iChirp. Higher amplitudes were obtained with the NB iChirp stimulus. The average examination time for the threshold investigation in the four frequencies was 40 min for each ear.

CONCLUSION

it was possible to present reference values for the MLR and latencies for the NB CE-Chirp® LS and NB iChirp stimuli for hearing infants. In addition, with the NB iChirp, the latency of the responses was influenced by the frequency, but it was the stimulus that provided greater amplitudes. With the NB CE-Chirp® LS, the frequency did not influence latency, except at 500 Hz, and the stimulus provided recordings that facilitated the visualization of wave V. There was no difference in the examination time between the stimuli, nor between the test frequencies.

Could Tailored Chirp Stimuli Benefit Measurement of the Supra-threshold Auditory Brainstem Wave-I Response?

Auditory brainstem responses (ABRs) to broadband clicks are strongly affected by dyssynchrony, or "latency dispersion", of their frequency-specific cochlear contributions. Optimized chirp stimuli, designed to compensate for cochlear dispersion, can afford substantial increase in broadband ABR amplitudes, particularly for the prominent wave-V deflection. Reports on the smaller wave I, however, which may be useful for measuring cochlear synaptopathy, have been mixed. This study aimed to test previous claims that ABR latency dispersion differs between waves I and V, and between males and females, and thus that using wave- and/or sex-tailored chirps may provide more reliable wave-I benefit. Using the derived-band technique, we measured responses from frequency-restricted (one-octave-wide) cochlear regions to energy-matched click and chirp stimuli. The derived-band responses' latencies were used to assess any wave- and/or sex-related dispersion differences across bands, and their amplitudes, to evaluate any within-band dispersion differences. Our results suggest that sex-related dispersion difference within the lowest-frequency cochlear regions (< 1 kHz), where dispersion is generally greatest, may be a predominant driver of the often-reported sex difference in broadband ABR amplitude. At the same time, they showed no systematic dispersion difference between waves I and V. Instead, they suggest that reduced chirp benefit on wave I may arise as a result of chirp-induced desynchronization of on- and off-frequency responses generated at the same cochlear places, and resultant reduction in response contributions from higher-frequency cochlear regions, to which wave I is thought to be particularly sensitive.

Evaluating auditory brainstem response to a level-dependent chirp designed based on derived-band latencies

The best cochlear-neural delay model for designing a chirp that can produce the largest auditory brainstem response (ABR) has not been established. This study comprised two experiments. Experiment I aimed to estimate the delay model by measuring derived-band ABR latencies at different levels. The results demonstrated that, as the level decreased, the delay between the center frequencies of 0.7 and 5.7 kHz increased. The aim of experiment II was to compare ABRs generated by three stimuli: (1) a level-dependent derived-band (DB)-Chirp, designed based on the model in experiment I; (2) a level-dependent level specific (LS)-Chirp from Kristensen and Elberling [(2012). J. Am. Acad. Audiol. 23, 712-721]; and (3) a click. The results demonstrated that the DB-Chirp produced significantly larger wave V than the LS-Chirp at 45 dB normal hearing level (nHL); however, no differences were observed at other levels. The wave I generated by the DB-Chirp and LS-Chirp were significantly larger than those evoked by the click at 45 and 60 dB nHL and at 30 and 45 dB nHL, respectively; however, at all levels, no differences between these two chirps were observed. The DB-Chirp may be a valuable stimulus for producing ABRs for clinical applications such as assessing cochlear synaptopathy and estimating hearing sensitivity.

Auditory Brainstem Response with chirp stimuli in newborns: an integrative review

ABSTRACT Purpose: to review the literature available on electrophysiological findings on ABR with chirp stimuli in newborns. Methods: articles were searched in PubMed, MEDLINE, Scopus, Web of Science, LILACS, and SciELO. Papers published in English and Portuguese between 2010 and 2020 were selected, including those that addressed ABR with air-conduction broadband chirp stimuli in newborns, that assessed ABR with a specific frequency, and that compared ABR results with chirp and click stimuli. Articles that assessed only bone-conduction results, duplicates, literature reviews, case reports, letters, and editorials were excluded. Literature review: the search strategy resulted in nine selected articles. Four studies (44.4%) analyzed ABR wave amplitude and latency with chirp stimuli, three studies (33.3%) compared the time of ABR procedures between chirp and click stimuli, two studies (22.2%) analyzed only amplitude, and two (22.2%), verified the specificity of ABR with chirp stimuli in neonatal hearing screening. Conclusion: chirp stimuli elicit responses with greater amplitudes, lower latencies, and shorter examination time than those with click stimuli in newborns.

PEATE por estímulo chirp em recém-nascidos: uma revisão integrativa

RESUMO Objetivo: revisar a literatura disponível sobre os achados eletrofisiológicos do PEATE por estímulo chirp em recém-nascidos. Métodos: a busca dos artigos foi realizada nas bases de dados PubMed, Medline, Scopus, Web of Science, LILACS e Scielo. Foram selecionados artigos publicados em Inglês e Português, entre 2010 e 2020. Foram incluídos artigos que contemplavam o uso do PEATE por estímulo chirp banda larga por via aérea em recém-nascidos; que avaliavam o PEATE por frequência específica e que comparavam os resultados do PEATE por estímulo chirp e clique. Aqueles que avaliavam somente resultados por via óssea, artigos repetidos nas bases de dados, artigos de revisão de literatura, relato de casos, cartas e editoriais foram excluídos. Revisão da Literatura: a estratégia de busca resultou na seleção de nove artigos. Quatro estudos (44,4%) analisaram amplitude e latência das ondas do PEATE por estímulo chirp, três (33,3%) compararam o tempo de realização do PEATE por clique e chirp, dois estudos (22,2%) analisaram somente o parâmetro amplitude e dois (22,2%) verificaram a especificidade do PEATE por chirp na triagem auditiva neonatal. Conclusão: o estímulo chirp possibilita respostas com maiores amplitudes, maiores latências e menor tempo de realização do exame quando comparado ao estímulo clique em recém-nascidos.

Influence of Stimulus Polarity on the Auditory Brainstem Response From Level-Specific Chirp

BACKGROUND AND OBJECTIVES

No known studies have investigated the influence of stimulus polarity on the Auditory Brainstem Response (ABR) elicited from level-specific (LS) chirp. This study is important as it provides a better understanding of the stimulus polarity selection for ABR elicited from LS chirp stimulus. We explored the influence of stimulus polarity on the ABR from LS chirp compared to the ABR from click at 80 dBnHL in normal-hearing adults.

SUBJECTS AND PURPOSE

Nineteen adults with normal hearing participated. The ABRs were acquired using click and LS chirp stimuli using three stimulus polarities (rarefaction, condensation, and alternating) at 80 dBnHL. The ABRs were tested only on the right ear at a stimulus rate of 33.33 Hz. The ABR test was stopped when the recording reached the residual noise level of 0.04 µV. The ABRs amplitudes, absolute latencies, inter-peak latencies (IPLs), and the recorded number of averages were statistically compared among ABRs at different stimulus polarities and stimuli combinations.

RESULTS

Rarefaction polarity had the largest ABR amplitudes and SNRs compared with other stimulus polarities in both stimuli. There were marginal differences in the absolute latencies and IPLs among stimulus polarities. No significant difference in the number of averages required to reach the stopping criteria was found.

CONCLUSIONS

Stimulus polarities have a significant influence on the ABR to LS chirp. Rarefaction polarity is recommended for clinical use because of its larger ABR peak I, III, and V amplitudes than those of the other stimulus polarities.

Auditory brainstem response with click and CE-Chirp® Level Specific stimuli in hearing infants

INTRODUCTION

The assessment of the integrity of the neural responses with ABR, aims to assist in the differential diagnosis of retrocochlear alterations. The gold standard stimulus for this assessment is Click. However, the CE-Chirp® Level Specific was developed to optimize the triggering of neural responses.

OBJECTIVE

to compare neural responses obtained with CE-Chirp® LS stimulus to those obtained with Clicks at 70 dB nHL in hearing infants, in order to analyze advantages in using CE-Chirp® LS.

METHODS

Eighteen infants with normal hearing were evaluated with Eclipse EP25 ABR System. Clicks and CE-Chirp® LS stimuli were presented using ER-3A insert earphones at 70 dB nHL, rate 45.1/s, and alternating polarity. A 30 Hz high-pass and 1500 Hz low-pass filter was applied, and ±40 μV artifact rejection level. Absolute latency of waves I, III and V and their interpeak intervals I-III, III-V and I-V were measured, as well as interaural difference for wave V and interpeak I-V, and wave V amplitude.

RESULTS

Although 18 infants were included in the study, it was possible to collect data only in 30 ears for Click stimulus, and 33 ears for CE-Chirp® LS, according to exclusion criteria. It was possible to record waves I, III, and V for both stimuli at 70 dB nHL in all normal-hearing infants. CE-Chirp® LS stimulus evoked a higher wave V amplitude than Click (p < 0.001). Wave I absolute latency was statistically different between stimuli (p < 0.001), being delayed for CE-Chirp® LS. Wave III absolute latency was statistically different between stimuli only for the right ear (p = 0.021), and wave V absolute latency was similar in both stimuli (p = 0.210). Interpeak intervals I-III and I-V were statistically different between stimuli (p < 0.001), being reduced for CE-Chirp® LS. Interpeak interval III-V was different between the stimuli only for right ears (p = 0.006). There was no difference between stimuli for interaural difference wave V (p = 1.33) and interaural difference interpeak I-V (p = 0.409).

CONCLUSION

It is possible to use CE-Chirp® LS stimulus in order to analyze neural synchrony in infants at 70 dB nHL, since better morphology waveforms were observed, and higher wave V amplitudes could be recorded. We suggest that new studies with infants with neurological disabilities and various hearing status, to observe how CE-Chirp® LS stimulus evokes neural responses in these conditions.

Emotional Arousal and Valence Jointly Modulate the Auditory Response: A 40-Hz ASSR Study

Emotion is defined as a response to external stimuli and internal mental representations. It has been characterized as a multidimensional concept, primarily comprising two dimensions: valence and arousal. Existing studies have demonstrated that emotional experience exerts a powerful impact on auditory processing in terms of valence. However, it has also been shown that while negative emotion can improve auditory perception in healthy subjects, patients with depression show deficits in auditory perception. We thus speculated that both arousal and valence jointly modulate auditory perception. To examine the emotion-driven effects on the auditory response, we induced positive, negative, and neutral emotional states in healthy subjects and collected auditory steady-state response (ASSR) evoked by a 40-Hz chirp sound. We calculated peak-to-peak amplitude (PPA) and event-related spectral perturbation (ERSP) of evoked ASSRs and observed that the positive emotions significantly enhanced brain responses to auditory stimuli (p < 0.001), but that ASSRs in a negative state were not significantly enhanced compared with the neutral state. Subsequently, regression analysis showed a significant positive multiple linear relationship between the PPA and ratings of two emotional dimensions, indicating that arousal and valence jointly regulated the auditory cortex's synchronous oscillation, rather than the valence in isolation, offering the potential to clarify the conflicting results surrounding the role of negative emotions in auditory responses. Because depression is generally characterized by low arousal and low valence in actual life, whereas the negative emotion evoked under laboratory conditions is always with low valence but high arousal.

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

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

Use of an Extra-Tympanic Membrane Electrode to Record Cochlear Microphonics with Click, Tone Burst and Chirp Stimuli

This study determined electrocochleography (ECochG) parameter settings to obtain cochlear microphonics (CM) with less invasive flexible extra-tympanic membrane electrodes. In 24 adult normal-hearing subjects, CMs were elicited by presenting click stimuli at 100 dBnHL, tone bursts (2 kHz) and broadband (BB) CE-chirps^® LS (Interacoustics, Middelfart, Denmark), both at 80 dBnHL. Different high-pass filters (HPFs) (3.3 Hz and 100 Hz, respectively) were used to investigate response quality of the CM. CMs were successfully obtained in 92–100% with click-, 75–83% with 2 kHz tone burst- and 58–63% with CE-chirp^®-LS stimuli. Click stimuli elicited significantly larger CM amplitudes compared to 2 kHz tone bursts and BB CE-chirp^® LS (Interacoustics, Middelfart, Denmark). No significant differences were found between the two different high-pass filter (HPF) settings. The present study shows that it is possible to obtain clear CMs with the flexible extra-tympanic membrane electrodes using click stimuli. In contrast to 2 kHz tone bursts and CE-chirp^® (Interacoustics, Middelfart, Denmark) LS, clicks show a significantly higher success rate and are the preferred stimuli to confirm the presence or absence of CMs.

Neural Representation of Loudness: Cortical Evoked Potentials in an Induced Loudness Reduction Experiment

Loudness context effects comprise differences in judgments of the loudness of a target stimulus depending on the presence of a preceding inducer tone. Interstimulus intervals (ISIs) between inducer tone and target tone of about 200 ms and above cause an induced loudness reduction (ILR) of the target tone. As the ILR increases, respectively, the perceived loudness of the target stimuli decreases with increasing ISI. This in turn means that identical stimuli in a different context have a differently perceived loudness. A correlation between specific characteristics in the electroencephalography responses and perceived loudness in an ILR experiment would therefore provide a neurophysiological indication of loudness processing beyond a neural representation of stimulus intensity only. To examine if such a correlation exists, we investigated cortical electroencephalography responses in a latency range from 75 to 510 ms during a psychoacoustical ILR experiment with different ISIs. With increasing ISI, the strength of the N1-P2 deflection of the respective electroencephalography response decreases similarly to the loudness perception of the target tone pulse. This indicates a representation based on loudness rather than on intensity at the corresponding processing stage.

Diagnostic accuracy of CE Chirp

OBJECTIVE

There has been an increase in the use of the CE-Chirp stimulus in automated auditory brainstem response (AABR) equipment for neonatal hearing screening. The purpose of this study is to evaluate the diagnostic accuracy of the LS CE-Chirp-evoked auditory brainstem response (ABR) compared to the click-evoked ABR for the identification of different degrees and configurations of sensorineural (SNHL) hearing loss.

METHOD

49 ears with mild to moderate SNHL were assessed: 16 ears with rising SNHL and 33 ears with sloping high frequency SNHL. Behavioural pure tone thresholds were obtained at 125-8000 Hz and ABR thresholds were measured using the click and LS CE-Chirp stimuli respectively. Click- and LS CE-Chirp-evoked thresholds were compared with each other and with behavioural pure tone average at 500, 1000, 2000 Hz (PTA), high frequency average at 2000, 4000, 8000 Hz (HFA) and low frequency average at 250, 500, 1000 Hz (LFA). Diagnostic accuracy of the two ABR stimuli was also compared by using ROC curves.

RESULTS

Differences between click- and LS CE Chirp-evoked ABR, and behavioural thresholds were not statistically significant (p > 0.05). The highest significant correlations for ABR using clicks to behavioural thresholds was found at 2000 and 4000 Hz, whereas, the highest correlation for LS CE-Chirp ABRs to behavioural thresholds was found at 1000, 2000 and 4000 Hz (r > 0.7, p < 0.001). A very strong, positive correlation was found between both click (r = 0.805, p < 0.001) and LS CE-Chirp (r = 0.825, p < 0.001) and the behavioural PTA. LS CE-Chirp ABR thresholds were closer to mid and low frequency thresholds than the click ABR while the click-evoked thresholds were in closer proximity to HFA. Sensitivity and specificity and false negative rates were identical. Diagnostic accuracy of the LS CE-Chirp ABR was equal to or better than click for low (area under the curve (AUC) = 0.83), mid (AUC = 0.89) and high frequency hearing losses (AUC = 0.73). However, scatterplots indicated more frequent underestimation of behavioural pure tone thresholds at mid and high frequencies with the LS CE-Chirp than for the click ABR.

CONCLUSION

The diagnostic accuracy of the LS CE Chirp-evoked ABR is equivalent or better than the click-evoked ABR. The importance of ongoing surveillance and consideration of ABR screening protocols is consequently emphasized.

Band-Limited Chirp-Evoked Compound Action Potential in Guinea Pig: Comprehensive Neural Measure for Cochlear Implantation Monitoring

OBJECTIVES

Patients with severely impaired high-frequency hearing and sufficient residual low-frequency hearing can be provided with a cochlear implant (CI), thereby facilitating ipsilateral electric and acoustic stimulation with established advantages over electric stimulation alone. However, partial or complete hearing loss often occurred after implantation due to, inter alia, acute mechanical trauma to cochlear structures during electrode insertion. Possibilities of intraoperative monitoring using electrocochleography (ECochG) have recently been studied in CI patients, primarily using the ongoing response to low-frequency tone bursts consisting of the cochlear microphonic (CM) and the auditory nerve neurophonic. By contrast, the transient neural response to tone bursts, that is, compound action potential (CAP), was generally less detectable or less sensitive as a monitoring measure, thus falling short of providing useful contribution to electrocochleography analysis. In this study, we investigate using chirps to evoke more robust CAP responses in a limited frequency band by synchronizing neural firing, and thereby improving CAP sensitivity to mechanical trauma in a guinea pig model of cochlear implantation.

DESIGN

Stimuli were band-limited between 100 Hz and 10 kHz to investigate their frequency range selectivity as a preliminary model for low-frequency hearing. They were constructed by adding a harmonic series either with zero phase delay (click) or by adjusting the phase delay at a rate that is inversely related to a traveling wave delay model (chirp), with three different parameters to examine level-dependent delay compression. The amplitude spectrum was thus identical between stimuli with differences only in phase. In Experiment 1, we compared input-output functions recorded at the round window in normal-hearing guinea pigs and implemented a high-pass noise masking paradigm to infer neural contribution to the CAP. In Experiment 2, guinea pigs were implanted with a custom-built CI electrode using a motorized micromanipulator. Acute mechanical trauma was simulated during the electrode insertion. At each insertion step, CAP and CM responses were measured at the round window for the following stimuli: broad-band click, band-limited click, and band-limited chirps (3 parameters), and tone bursts at frequencies 1, 2, 4, and 8 kHz.

RESULTS

Chirps compared with the equal-band click showed significantly lower thresholds and steeper slopes of sigmoid-fitted input-output functions. The shorter chirp evoked significantly larger amplitudes than click when compared at equal sensation level. However, the click evoked larger amplitudes than chirps at higher levels and correspondingly achieved larger saturation amplitudes. The results of the high-pass noise masking paradigm suggest that chirps could efficiently synchronize neural firing in their targeted frequency band, while the click recruited more basal fibers outside its limited band. Finally, monitoring sensitivity during electrode insertion, defined as relative amplitude change per unit distance, was higher for chirp-evoked CAP and tone burst-evoked CM, but smaller for CAP responses evoked by clicks or tone bursts.

CONCLUSION

The chirp was shown to be an efficient stimulus in synchronizing neural firing for a limited frequency band in the guinea pig model. This study provides a proof of principle for using chirp-evoked CAP as a comprehensive neural measure in CI patients with residual hearing.

The rat animal model for noise-induced hearing loss

Rats make excellent models for the study of medical, biological, genetic, and behavioral phenomena given their adaptability, robustness, survivability, and intelligence. The rat's general anatomy and physiology of the auditory system is similar to that observed in humans, and this has led to their use for investigating the effect of noise overexposure on the mammalian auditory system. The current paper provides a review of the rat model for studying noise-induced hearing loss and highlights advancements that have been made using the rat, particularly as these pertain to noise dose and the hazardous effects of different experimental noise types. In addition to the traditional loss of auditory function following acoustic trauma, recent findings have indicated the rat as a useful model in observing alterations in neuronal processing within the central nervous system following noise injury. Furthermore, the rat provides a second animal model when investigating noise-induced cochlear synaptopathy, as studies examining this in the rat model resemble the general patterns observed in mice. Together, these findings demonstrate the relevance of this animal model for furthering the authors' understanding of the effects of noise on structural, anatomical, physiological, and perceptual aspects of hearing.

Frequency-modulated up-chirps produce larger evoked responses than down-chirps in the big brown bat auditory brainstem

In many mammals, upward-sweeping frequency-modulated (FM) sounds (up-chirps) evoke larger auditory brainstem responses than downward-sweeping sounds (down-chirps). To determine if similar effects occur in FM echolocating bats, auditory evoked responses (AERs) in big brown bats in response to up-chirps and down-chirps at different chirp durations and levels were recorded. Even though down-chirps are the biologically relevant stimulus for big brown bats, up-chirps typically evoked larger peaks in the AER, but with some exceptions at the shortest chirp durations. The up-chirp duration that produced the largest AERs and the greatest differences between up-chirps and down-chirps varied between individual bats and stimulus levels. Cross-covariance analyses using the entire AER waveform confirmed that amplitudes were typically larger to up-chirps than down-chirps at supra-threshold levels, with optimal durations around 0.5-1 ms. Changes in response latencies with stimulus levels were consistent with previous estimates of amplitude-latency trading. Latencies tended to decrease with increasing up-chirp duration and increase with increasing down-chirp duration. The effects of chirp direction on AER waveforms are generally consistent with those seen in other mammals but with small differences in response patterns that may reflect specializations for FM echolocation.

Frequency-modulated up-chirp stimuli enhance the auditory brainstem response of the killer whale (Orcinus orca)

Previous studies suggested that frequency-modulated tonal stimuli where the frequency sweeps upward (up-chirps) may enhance auditory brainstem response (ABR) amplitudes in mammals. In this study, ABRs were measured in response to up-chirps in three killer whales (Orcinus orca) and compared to ABRs evoked by broadband clicks. Chirp durations ranged from 125 - 2000 μs. Chirp spectral content was either "uncompensated," meaning the spectrum paralleled the transmitting response of the piezoelectric transducer, or "compensated," where the spectral density level was flat (+/-4 dB) across the stimulus bandwidth (10 - 130 kHz). Compensated up-chirps consistently produced higher amplitude ABRs than uncompensated clicks with the same peak equivalent sound pressure level. ABR amplitude increased with up-chirp duration up to 1400 μs, although there was considerable variability between individuals. Results suggest that compensating stimuli for the response of transducers can have a dramatic effect on broadband ABRs, and that compensated up-chirps might be useful for testing whale species where large size makes far-field recording of ABRs at the skin surface difficult.

Rising-frequency chirp stimulus to effectively enhance wave-I amplitude of auditory brainstem response

This study aims to find an effective chirp signal that enhances the amplitude of wave-I of auditory brainstem response (ABR) to diagnose "cochlear synaptopathy." Although several chirp signals have been proposed to enhance the amplitude of wave-V, the effect on wave-I has not been clarified yet. Ten chirp signals, which have shorter group delays than the commonly used "CE-chirp," were produced to measure the amplitudes of wave-I and wave-V of the ABRs. The results show that one of the chirp signals significantly enhanced the amplitude of wave-I, where the group delay is approximately half of the CE-chirp.

Enhanced Auditory Steady-State Response Using an Optimized Chirp Stimulus-Evoked Paradigm

Objectives: It has been reported recently that gamma measures of the electroencephalogram (EEG) might provide information about the candidate biomarker of mental diseases like schizophrenia, Alzheimer's disease, affective disorder and so on, but as we know it is a difficult issue to induce visual and tactile evoked responses at high frequencies. Although a high-frequency response evoked by auditory senses is achievable, the quality of the recording response is not ideal, such as relatively low signal-to-noise ratio (SNR). Recently, auditory steady-state responses (ASSRs) play an essential role in the field of basic auditory studies and clinical uses. However, how to improve the quality of ASSRs is still a challenge which researchers have been working on. This study aims at designing a more comfortable and suitable evoked paradigm and then enhancing the quality of the ASSRs in healthy subjects so as to further apply it in clinical practice. Methods: Chirp and click stimuli with 40 Hz and 60 Hz were employed to evoke the gamma-ASSR respectively, and the sound adjusted to 45 dB sound pressure level (SPL). Twenty healthy subjects with normal-hearing participated, and 64-channel EEGs were simultaneously recorded during the experiment. Event-related spectral perturbation (ERSP) and SNR of the ASSRs were measured and analyzed to verify the feasibility and adaptability of the proposed evoked paradigm. Results: The results showed that the evoked paradigm proposed in this study could enhance ASSRs with strong feasibility and adaptability. 1) ASSR waves in time domain indicated that 40 Hz stimuli could significantly induce larger peak-to-peak values of ASSRs compared to 60 Hz stimuli (p < 0.01**); ERSP showed that obvious ASSRs were obtained at each lead for both 40 Hz and 60 Hz, as well as the click and chirp stimuli. 2) The SNR of the ASSRs were ⁻3.23 ± 1.68, ⁻2.44 ± 2.90, ⁻4.66 ± 2.09, and ⁻3.53 ± 3.49 respectively for 40 Hz click, 40 Hz chirp, 60 Hz click and 60 Hz chirp, indicating the chirp stimuli could induce significantly better ASSR than the click, and 40 Hz ASSRs had the higher SNR than 60 Hz (p < 0.01**). Limitation: In this study, sample size was small and the age span was not large enough. Conclusions: This study verified the feasibility and adaptability of the proposed evoked paradigm to improve the quality of the gamma-ASSR, which is significant in clinical application. The results suggested that 40 Hz ASSR evoked by chirp stimuli had the best performance and was expected to be used in clinical practice, especially in the field of mental diseases such as schizophrenia, Alzheimer's disease, and affective disorder.

Fast acquisition of full-range auditory event-related potentials using an interleaved deconvolution approach

This work relates to recent advances in the field of auditory event-related potentials (ERP), specifically deconvolution-based ERP acquisition and single-trial processing. An efficient stimulus sequence optimization method for ERP deconvolution is proposed, achieving consistent noise attenuation within a broad designated frequency range. Furthermore, a stimulus presentation paradigm for the fast, interleaved acquisition of auditory brainstem, middle-latency and late responses featuring alternating periods of high-rate deconvolution sequences, and subsequent low-rate stimulation is investigated in 20 normal hearing subjects. Deconvolved sequence responses containing early and middle-latency ERP components are fused with subsequent late responses using a time-frequency resolved weighted averaging method based on cross-trial regularity, yielding a uniform signal-to-noise ratio of the full-range auditory ERP across investigated timescales. Obtained average ERP waveforms exhibit morphologies consistent with both literature values and reference recordings acquired in 15 normal hearing subjects using a prior art approach to full-range auditory ERP acquisition, with all prominent waves being visible in the grand average waveforms. Results suggest the proposed interleaved stimulus presentation and associated ERP processing methodology to be suitable for the fast, reliable extraction of full-range auditory processing correlates in future ERP studies.

Free-field evoked auditory brainstem responses in cochlear implant users

The importance of binaural cues in auditory stream formation and sound source segregation is widely accepted. When treating one ear with a cochlear implant (CI) the peripheral auditory system gets partially replaced and processing delays get added potentially, thus important interaural time differences get altered. However, these effects are not fully understood, leaving a lack of systematic binaural fitting strategies with respect to an optimal binaural fusion. To get new insights into such alterations, we suggest a novel method of free-field auditory brainstem evoked responses (ABRs) analysis in CI users. This method does not bypass the technically induced intrinsic delays of the sound processor while leaving the whole electrode array active, thus the most natural way of stimulation is provided. We compared the ABRs collected of 12 CI users and 12 normal hearing listeners using two different stimuli (chirp, click) at four different intensities each. We analyzed the ABRs using the average of 2000 trials as well as a single trial analysis and found consistent results in the ABRs’ amplitudes and latencies, as well as in single trial relationships between both groups. This method provides a new perspective into the natural CI users’ ABRs and can be useful in future research regarding binaural interaction and fusion.

Current audiological diagnostics

Today's audiological functional diagnostics is based on a variety of hearing tests, whose large number takes account of the variety of malfunctions of a complex sensory organ system and the necessity to examine it in a differentiated manner and at any age of life. The objective is to identify nature and origin of the hearing loss and to quantify its extent as far as necessary to dispose of the information needed to initiate the adequate medical (conservative or operational) treatment or the provision with technical hearing aids or prostheses. Moreover, audiometry provides the basis for the assessment of impairment and handicap as well as for the calculation of the degree of disability. In the present overview, the current state of the method inventory available for practical use is described, starting from basic diagnostics over to complex special techniques. The presentation is systematically grouped in subjective procedures, based on psychoacoustic exploration, and objective methods, based on physical measurements: preliminary hearing tests, pure tone threshold, suprathreshold processing of sound intensity, directional hearing, speech understanding in quiet and in noise, dichotic hearing, tympanogram, acoustic reflex, otoacoustic emissions and auditory evoked potentials. Apart from a few still existing gaps, this method inventory covers the whole spectrum of all clinically relevant functional deficits of the auditory system.

Bottlenose dolphin (Tursiops truncatus) auditory brainstem responses to frequency-modulated "chirp" stimuli

Previous studies have demonstrated that increasing-frequency chirp stimuli (up-chirps) can enhance human auditory brainstem response (ABR) amplitudes by compensating for temporal dispersion occurring along the cochlear partition. In this study, ABRs were measured in two bottlenose dolphins (Tursiops truncatus) in response to spectrally white clicks, up-chirps, and decreasing-frequency chirps (down-chirps). Chirp durations varied from 125 to 2000 μs. For all stimuli, frequency bandwidth was constant (10-180 kHz) and peak-equivalent sound pressure levels (peSPLs) were 115, 125, and 135 dB re 1 μPa. Up-chirps with durations less than ∼1000 μs generally increased ABR peak amplitudes compared to clicks with the same peSPL or energy flux spectral density level, while down-chirps with durations from above ∼250 to 500 μs decreased ABR amplitudes relative to clicks. The findings generally mirror those from human studies and suggest that the use of chirp stimuli may be an effective way to enhance broadband ABR amplitudes in larger marine mammals.

Detection of binaural interaction in free-field evoked auditory brainstem responses by time-scale representations

The so called β-wave of the binaural interaction component (BIC) in auditory brainstem responses (ABR) has been shown to be an objective measure for binaural interaction (BI). This component is the arithmetical difference between the sum of the monaurally evoked ABRs and the binaurally evoked ABR. Unfortunately, these neural responses are known to be very fragile and as a result the calculated BIC. An additional issue is, that the findings of this measurement are predominantly needed in people with hearing loss who may use hearing devices like hearing aids (HA) or cochlear implants (CI), thus they are not able to use headphones (like in conventional ABR measurements) during the detection of possible BI. This is a crucial problem, because it is known that factors like the interaural time delay (ITD) between the receiving ears are responsible for solving tasks like sound source localization or sound source separation, but specially designed measurements to coordinate the fitting of HAs or CIs with respect to BI are still missing. In this paper, we introduce a new measurement setup that is able to detect BI depending on different ITDs in free-field evoked responses by using the more reliable instantaneous phase in the time-scale representation. With this pilot study we are able to demonstrate a decreasing BI with an increasing ITD using the wavelet phase synchronization stability analysis in ten normal hearing subjects.

Evaluation of Hearing Sensitivity in Young Adults With Normal Hearing Using a 40-Hz Auditory Steady-State Response With CE-Chirp

PURPOSE

The present study aimed to measure hearing sensitivity in young adults with normal hearing using a 40-Hz auditory steady-state response with CE-Chirp and to evaluate the speed and accuracy of this method.

METHOD

Twelve young adults (1 man, 11 women; mean age = 22.1 ± 3.1 years) each completed two auditory steady-state response measurement sessions with CE-Chirp. The difference score was calculated at each of the four pure-tone frequencies. The measurement time and residual noise level in all stimulus levels were also determined.

RESULTS

The difference scores across the 4 frequencies ranged within ±10 dB (1st: 58% to 71%, 2nd: 54% to 79%), within 20 dB (1st: 79% to 96%, 2nd: 79% to 100%), and ≥ 30 dB (1st: 4% to 17%, 2nd: 0% to 17%). The measurement times for both ears were approximately 20 min in both sessions. There was a significant correlation between the measurement time and the mean residual noise level for pooled frequencies in all stimulus levels (p = .0001249, r = .70). The measurement time was reduced by approximately 50% from conventional auditory steady-state response measurement.

CONCLUSION

The results of this preliminary study support the use of this technology as a rapid and accurate method for behavioral auditory threshold evaluation.

Contralateral Inhibition of Click- and Chirp-Evoked Human Compound Action Potentials

Cochlear outer hair cells (OHC) receive direct efferent feedback from the caudal auditory brainstem via the medial olivocochlear (MOC) bundle. This circuit provides the neural substrate for the MOC reflex, which inhibits cochlear amplifier gain and is believed to play a role in listening in noise and protection from acoustic overexposure. The human MOC reflex has been studied extensively using otoacoustic emissions (OAE) paradigms; however, these measurements are insensitive to subsequent "downstream" efferent effects on the neural ensembles that mediate hearing. In this experiment, click- and chirp-evoked auditory nerve compound action potential (CAP) amplitudes were measured electrocochleographically from the human eardrum without and with MOC reflex activation elicited by contralateral broadband noise. We hypothesized that the chirp would be a more optimal stimulus for measuring neural MOC effects because it synchronizes excitation along the entire length of the basilar membrane and thus evokes a more robust CAP than a click at low to moderate stimulus levels. Chirps produced larger CAPs than clicks at all stimulus intensities (50-80 dB ppeSPL). MOC reflex inhibition of CAPs was larger for chirps than clicks at low stimulus levels when quantified both in terms of amplitude reduction and effective attenuation. Effective attenuation was larger for chirp- and click-evoked CAPs than for click-evoked OAEs measured from the same subjects. Our results suggest that the chirp is an optimal stimulus for evoking CAPs at low stimulus intensities and for assessing MOC reflex effects on the auditory nerve. Further, our work supports previous findings that MOC reflex effects at the level of the auditory nerve are underestimated by measures of OAE inhibition.

A compact representation for the auditory full-range response and its fast denoising using an image filter based on the Radon transform

The Auditory Brainstem, Middle-Latency and Late Responses, a class of event-related potentials (ERPs), are of considerable interest in neuroscience research as robust neural correlates of different processing stages along the auditory pathway. While most research to date centers around one of the responses at a time for practical reasons, recent efforts indicate a paradigm shift towards acquiring them together, enabling the simultaneous monitoring of all auditory processing stages from the brainstem to the cortex. In this paper, we introduce a compact representation for this Auditory Full-Range Response (AFRR) as an ERP map with adaptive sampling rate, making it suitable for computationally inexpencive image filtering. Furthermore, we propose a novel algorithm for the fast denoising of such ERP maps based on the Radon Transform and its inversion by filtered backprojection. Its performance is compared qualitatively to a Gaussian means filter using a real-world chirp-evoked AFRR recording. The algorithm exhibits good noise suppression as well as high preservance of the single-response structure, making it a promising denoising tool for future ERP studies.

A Comparison of Commercially Available Auditory Brainstem Response Stimuli at a Neurodiagnostic Intensity Level

iChirp-evoked auditory brainstem responses (ABRs) yield a larger wave V amplitude at low intensity levels than traditional broadband click stimuli, providing a reliable estimation of hearing sensitivity. However, advantages of iChirp stimulation at high intensity levels are unknown. We tested to see if high-intensity (i.e., 85 dBnHL) iChirp stimulation results in larger and more reliable ABR waveforms than click. Using the commercially available Intelligent Hearing System SmartEP platform, we recorded ABRs from 43 normal hearing young adults. We report that absolute peak latencies were more variable for iChirp and were ~3 ms longer: the latter of which is simply due to the temporal duration of the signal. Interpeak latencies were slightly shorter for iChirp and were most evident between waves I-V. Interestingly, click responses were easier to identify and peak-to-trough amplitudes for waves I, III and V were significantly larger than iChirp. These differences were not due to residual noise levels. We speculate that high intensity iChirp stimulation reduces neural synchrony and conclude that for retrocochlear evaluations, click stimuli should be used as the standard for ABR neurodiagnostic testing.

Rhythm judgments reveal a frequency asymmetry in the perception and neural coding of sound synchrony

In modern Western music, melody is commonly conveyed by pitch changes in the highest-register voice, whereas meter or rhythm is often carried by instruments with lower pitches. An intriguing and recently suggested possibility is that the custom of assigning rhythmic functions to lower-pitch instruments may have emerged because of fundamental properties of the auditory system that result in superior time encoding for low pitches. Here we compare rhythm and synchrony perception between low- and high-frequency tones, using both behavioral and EEG techniques. Both methods were consistent in showing no superiority in time encoding for low over high frequencies. However, listeners were consistently more sensitive to timing differences between two nearly synchronous tones when the high-frequency tone followed the low-frequency tone than vice versa. The results demonstrate no superiority of low frequencies in timing judgments but reveal a robust asymmetry in the perception and neural coding of synchrony that reflects greater tolerance for delays of low- relative to high-frequency sounds than vice versa. We propose that this asymmetry exists to compensate for inherent and variable time delays in cochlear processing, as well as the acoustical properties of sound sources in the natural environment, thereby providing veridical perceptual experiences of simultaneity.

Evaluation of optimal masking levels in place-specific low-frequency chirp-evoked auditory brainstem responses

The aim of the study is the experimental determination of the optimal required masking level for a given stimulus level when using a band limited "low-frequency chirp" in order to improve frequency and place specificity of auditory brainstem responses (ABRs). A low-frequency chirp (100-850 Hz) at stimulation levels between 40 and 80 dB normalized hearing level was presented to 12 normal hearing subjects. During presentation of each stimulus, the level of a high-pass noise with a low cutoff frequency of 1100 Hz was varied between 0 and 25 dB signal-to-noise ratio (SNR) by using 5 dB steps (at 0 dB SNR the same level of both the chirp and the masker in dB sound pressure level was presented). Measurements without masking were used as a reference. In all masking conditions, the latency of wave V was significantly increased compared to unmasked ABRs. The amplitude of wave V decreased when reaching the effective and therefore optimal masking level. Accordingly, in order to ensure place specificity of the ABR, ipsilateral masking is essential. At lower stimulus levels the SNR can be substantially increased (i.e., the masker level decreased) without loss of place specificity.

Neonate Auditory Brainstem Responses to CE-Chirp and CE-Chirp Octave Band Stimuli II: Versus Adult Auditory Brainstem Responses

OBJECTIVES

The purpose of the study was to examine the differences in auditory brainstem response (ABR) latency and amplitude indices to the CE-Chirp stimuli in neonates versus young adults as a function of stimulus level, rate, polarity, frequency and gender.

DESIGN

Participants were 168 healthy neonates and 20 normal-hearing young adults. ABRs were obtained to air- and bone-conducted CE-Chirps and air-conducted CE-Chirp octave band stimuli. The effects of stimulus level, rate, and polarity were examined with air-conducted CE-Chirps. The effect of stimulus level was also examined with bone-conducted CE-Chirps and CE-Chirp octave band stimuli. The effect of gender was examined across all stimulus manipulations.

RESULTS

In general, ABR wave V amplitudes were significantly larger (p < 0.0001) and latencies were significantly shorter (p < 0.0001) for adults versus neonates for all air-conducted CE-Chirp stimuli with all stimulus manipulations. For bone-conducted CE-Chirps, infants had significantly shorter wave V latencies than adults at 15 dB nHL and 45 dB nHL (p = 0.02). Adult wave V amplitude was significantly larger for bone-conducted CE-Chirps only at 30 dB nHL (p = 0.02). The effect of gender was not statistically significant across all measures (p > 0.05).

CONCLUSIONS

Significant differences in ABR latencies and amplitudes exist between newborns and young adults using CE-Chirp stimuli. These differences are consistent with differences to traditional click and tone burst stimuli and reflect maturational differences as a function of age. These findings continue to emphasize the importance of interpreting ABR results using age-based normative data.

Crosscheck Principle in Pediatric Audiology Today: A 40-Year Perspective

The crosscheck principle is just as important in pediatric audiology as it was when first described 40 years ago. That is, no auditory test result should be accepted and used in the diagnosis of hearing loss until it is confirmed or crosschecked by one or more independent measures. Exclusive reliance on only one or two tests, even objective auditory measures, may result in a auditory diagnosis that is not clear or perhaps incorrect. On the other hand, close and careful analysis of findings for a test battery consisting of objective procedures and behavioral tests whenever feasible usually leads to prompt and accurate diagnosis of auditory dysfunction. This paper provides a concise review of the crosscheck principle from its introduction to its clinical application today. The review concludes with a description of a modern test battery for pediatric hearing assessment that supplements traditional behavioral tests with a variety of independent objective procedures including aural immittance measures, otoacoustic emissions, and auditory evoked responses.

The Binaural Interaction Component in Barn Owl (Tyto alba) Presents few Differences to Mammalian Data

The auditory brainstem response (ABR) is an evoked potential that reflects the responses to sound by brainstem neural centers. The binaural interaction component (BIC) is obtained by subtracting the sum of the monaural ABR responses from the binaural response. Its latency and amplitude change in response to variations in binaural cues. The BIC is thus thought to reflect the activity of binaural nuclei and is used to non-invasively test binaural processing. However, any conclusions are limited by a lack of knowledge of the relevant processes at the level of individual neurons. The aim of this study was to characterize the ABR and BIC in the barn owl, an animal where the ITD-processing neural circuits are known in great detail. We recorded ABR responses to chirps and to 1 and 4 kHz tones from anesthetized barn owls. General characteristics of the barn owl ABR were similar to those observed in other bird species. The most prominent peak of the BIC was associated with nucleus laminaris and is thus likely to reflect the known processes of ITD computation in this nucleus. However, the properties of the BIC were very similar to previously published mammalian data and did not reveal any specific diagnostic features. For example, the polarity of the BIC was negative, which indicates a smaller response to binaural stimulation than predicted by the sum of monaural responses. This is contrary to previous predictions for an excitatory-excitatory system such as nucleus laminaris. Similarly, the change in BIC latency with varying ITD was not distinguishable from mammalian data. Contrary to previous predictions, this behavior appears unrelated to the known underlying neural delay-line circuitry. In conclusion, the generation of the BIC is currently inadequately understood and common assumptions about the BIC need to be reconsidered when interpreting such measurements.

LS CE-Chirp® vs. Click in the neuroaudiological diagnosis by ABR

Introduction

The chirp stimulus was developed seeking to counterbalance the delay of the sound wave on its journey through the cochlea, allowing the hair cells to depolarize at the same time. The result is a simultaneous stimulation providing better neural synchrony and, consequently, the recording of responses with greater amplitudes.

Objective

To compare the absolute latency of waves I, III and V, the interpeak intervals I–III, III–V and I–V, amplitude values of wave V and its association with the amplitude of wave I, and the interaural difference V–V in the auditory brainstem response (ABR) using Click and LS CE-Chirp^® stimuli to determine whether the responses evoked by LS CE-Chirp^® could be applied to neuroaudiological diagnosis.

Methods

Cross-sectional study with 30 normal-hearing individuals. The parameters used were: intensity of 85 dBnHL, alternating polarity; 17.1 stimuli/s and 100–3000 Hz filters.

Results

The absolute latencies of waves I, III and V observed with LS CE-Chirp^® and click did not show significant differences. Significantly higher amplitudes of wave V were observed with the LS CE-Chirp^®. The interaural difference between the wave V latencies between stimuli showed no significant difference.

Conclusion

The LS CE-Chirp^® stimulus was shown to be as efficient as the click to capture ABR at high levels of stimulation, with the advantage of producing greater-amplitude V waves.

Impact of monaural frequency compression on binaural fusion at the brainstem level

A classical objective measure for binaural fusion at the brainstem level is the so-called β-wave of the binaural interaction component (BIC) in the auditory brainstem response (ABR). However, in some cases it appeared that a reliable detection of this component still remains a challenge. In this study, we investigate the wavelet phase synchronization stability (WPSS) of ABR data for the analysis of binaural fusion and compare it to the BIC. In particular, we examine the impact of monaural nonlinear frequency compression on binaural fusion. As the auditory system is tonotopically organized, an interaural frequency mismatch caused by monaural frequency compression could negatively effect binaural fusion. In this study, only few subjects showed a detectable β-wave and in most cases only for low ITDs. However, we present a novel objective measure for binaural fusion that outperforms the current state-of-the-art technique (BIC): the WPSS analysis showed a significant difference between the phase stability of the sum of the monaurally evoked responses and the phase stability of the binaurally evoked ABR. This difference could be an indicator for binaural fusion in the brainstem. Furthermore, we observed that monaural frequency compression could indeed effect binaural fusion, as the WPSS results for this condition vary strongly from the results obtained without frequency compression.

Chirp-Evoked Auditory Brainstem Response in Children: A Review

PURPOSE

The aim of this study was to assess the use of the chirp stimulus to record auditory brainstem responses in the pediatric population via a traditional review.

METHOD

An electronic search of the literature and a hand search of the literature were conducted. Studies that utilized chirp stimuli within the pediatric population that met all of the inclusion criteria were included in this review. Qualitative synthesis and interpretation of the data were completed.

RESULTS

Seven studies that met the inclusion criteria were included in the review. Chirp stimuli produce auditory brainstem response (ABR) waveform amplitudes in children similar to those in adults when presented at moderate to low frequency levels. Latency data from chirp stimuli are not consistent when stimulus presentation rates are altered. Test-retest reliability when using the chirp stimulus was found to be good, as were sensitivity and specificity of chirp-evoked ABRs utilized in a newborn hearing screening protocol.

CONCLUSION

Reviewed studies indicated that when presented at 60 dB nHL or lower, broadband chirp-generated ABRs have larger amplitudes than click-generated ABRs in children with normal hearing. Utilization of chirp stimuli decreases test time because waveforms are easier to detect with increased synchronization. Further research should focus on correlating chirp thresholds with behavioral hearing thresholds. Given the variance of results in these select studies, future research should also evaluate latency findings and focus on developing normative data for infants with hearing impairment and normal hearing.

Will diminishing cochlear delay affect speech perception in noise?

OBJECTIVE

Normal auditory systems appear well habituated to time/phase delays inherent to sound encoding along the hearing organ, sending frequency information non-simultaneously to the central auditory system. Eliminating, or simply perturbing, the cochlear delay might be expected to decrease speech recognition ability, especially under demanding listening conditions. Resources of a larger-scale investigation permitted a preliminary examination of this issue, particularly on a relevant timescale of empirically demonstrated cochlear delays.

DESIGN

In a randomized controlled trial study, word recognition was tested for mono-syllabic tokens treated digitally to exacerbate, if not diminish/nullify, such delays. Speech-weighted noise was used to interfere with listening to time-frequency reversed (nominally no delay) versus non-reversed (natural timing) transforms under three treatments of speech tokens: (1) original-digitally recorded; digitally processed to emphasize (2) transient versus (3) quasi-steady-state components.

STUDY SAMPLE

Ten normal-hearing young-adult females.

RESULTS

The findings failed to demonstrate statistically significant differences between delay conditions for any of the three speech-token treatments.

CONCLUSIONS

An algorithm putatively diminishing frequency-dependent cochlear delays failed to systematically deteriorate performance in all subjects for the fixed time-frequency transform, stimulus parameters, and test materials employed. Yet, trends were evident such that some effect of perturbing cochlear delays could not be ruled out completely.