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

Devan A Keesling,Jason Tait Sanchez,Jordan Paige Parker

doi:10.4081/audiores.2017.161

Devan A Keesling, Jason Tait Sanchez + Show 1 more

Open Access

https://doi.org/10.4081/audiores.2017.161

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Abstract

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.

Highlights

The auditory brainstem response (ABR) is the synchronized firing of neural action potentials in response to acoustic stimulation
We report that absolute peak latencies n were more variable for iChirp and were ~3 ms longer: the latter of which is due to the temporal duration of the signal
Using standard clinical procedures and equipment, we found that the traditional click stimulus produced more reliable latencies and significantly larger amplitudes for all waveform components of the ABR

Summary

Introduction

The auditory brainstem response (ABR) is the synchronized firing of neural action potentials in response to acoustic stimulation. The stimulus used to elicit the ABR has traditionally been brief broadband acoustic click or tone-burst stimuli. These stimuli do not always yield robust waveform amplitudes, especially at low intensity levels.[12,13,14] It has been suggested that the rapid kinetics and frequency spectrum of the broadband click results in a traveling wave that reduces neural synchrony from high-to-low frequency regions of the basilar membrane, producing significant waveform variability.[15]

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