ABR in patients with congenital/early acquired sensorineural hearing loss, abnormal stapedius reflex thresholds and speech retardation

Auditory function in adrenomyeloneuropathy

Auditory brainstem responses (ABR), ipsilateral and contralateral acoustic reflexes and the masking level difference for speech (MLD) were studied in 29 patients with adrenomyeloneuropathy (AMN). Abnormalities were seen for all ABR components with Waves V and III affected to the greatest degree. For male patients with AMN, the I-III, III-V and I-V interpeak latency intervals were abnormal for a majority of patients. For female patients with AMN, the I-V and III-V interpeak latency intervals were abnormal for a majority of patients with the I-III interval less affected. Contralateral acoustic reflexes were elevated or absent for approximately 50% of ears. Ipsilateral acoustic reflexes were abnormal for 25% of ears. MLDs were significantly reduced in 72% of patients. When considered in terms of the earliest ABR wave abnormality, the earlier components of the ABR (i.e., Waves III and I) were the initial components impaired for the majority of ears. Word recognition in quiet was relatively unimpaired for all subjects. Despite the presence of marked ABR abnormalities, patients with AMN denied the presence of significant difficulty hearing.

Auditory stimulation brain map

The topography of auditory evoked potentials (AEPs) was studied in 12 neurologically normal, adult, right-handed subjects of either sex. The AEPs were recorded with seventeen active electrodes in response to 500 Hz tone bursts with a level of 75 dB HL presented either to the left or the right ear. AEP brain maps were obtained with the BRAIN ATLAS III system. A region of maximum negativity was obtained corresponding to N1 at vertex and defined as focus of N1 (FN1). The reproducibility within and between sessions of FN1 was studied and found to be good for most of the subjects. The interindividual variability was moderate and the centre of FN1 on the map was localized 7 mm in front of the vertex electrode and 8.4 and 8.0 mm to the contralateral side of the vertex electrode upon stimulation of the left and the right ear, respectively. The approximate position of the skull surface is obtained by multiplication by a factor of 3. It was concluded that a standardized test session including six single maps based on 50 stimuli each gives an average map with identifiable and reproducible focus. The basis seems to be fulfilled to use the brain map in further analysis on clinical material.