Early Auditory Evoked Potentials Research Articles

Exploring Electrode Placements to Optimize the Identification and Measurement of Early Auditory Evoked Potentials.

Cochlear synaptic loss (termed cochlear synaptopathy) has been suggested to contribute to suprathreshold hearing difficulties. However, its existence and putative effects in humans remain inconclusive, largely due to the heterogeneous methods used across studies to indirectly evaluate the health of cochlear synapses. There is a need to standardize proxies of cochlear synaptopathy to appropriately compare and interpret findings across studies. Early auditory evoked potentials (AEPs), including the compound action potential (AP)/Wave I of the auditory brainstem response are a popular proxy, yet remain variable based on technical considerations. This study evaluated one such consideration-electrode array (i.e., montage)-to optimize the use of early AEP waveforms. In 35 young adults, electrocochleography (ECochG) responses were collected using vertical and horizontal montages. Standard ECochG measures and AP/Wave I and Wave II peak-to-trough amplitudes and latencies were compared between montages. Vertical montage recordings consistently produced significantly larger AP/Wave I peak-to-trough amplitudes compared to horizontal recordings. These findings support the use of a vertical electrode montage for optimal recordings of peripheral cochlear nerve activity. As cochlear synaptopathy continues to be explored in humans, the methods highlighted here should be considered in the development of a standardized assessment.

Speech Perception with Noise Vocoding and Background Noise: An EEG and Behavioral Study.

This study explored the physiological response of the human brain to degraded speech syllables. The degradation was introduced using noise vocoding and/or background noise. The goal was to identify physiological features of auditory-evoked potentials (AEPs) that may explain speech intelligibility. Ten human subjects with normal hearing participated in syllable-detection tasks, while their AEPs were recorded with 32-channel electroencephalography. Subjects were presented with six syllables in the form of consonant-vowel-consonant or vowel-consonant-vowel. Noise vocoding with 22 or 4 frequency channels was applied to the syllables. When examining the peak heights in the AEPs (P1, N1, and P2), vocoding alone showed no consistent effect. P1 was not consistently reduced by background noise, N1 was sometimes reduced by noise, and P2 was almost always highly reduced. Two other physiological metrics were examined: (1) classification accuracy of the syllables based on AEPs, which indicated whether AEPs were distinguishable for different syllables, and (2) cross-condition correlation of AEPs (rcc) between the clean and degraded speech, which indicated the brain's ability to extract speech-related features and suppress response to noise. Both metrics decreased with degraded speech quality. We further tested if the two metrics can explain cross-subject variations in their behavioral performance. A significant correlation existed for rcc, as well as classification based on early AEPs, in the fronto-central areas. Because rcc indicates similarities between clean and degraded speech, our finding suggests that high speech intelligibility may be a result of the brain's ability to ignore noise in the sound carrier and/or background.

Objective frequency-specific measurement of hearing threshold using narrow-band chirp stimuli with level-adaptive simultaneous masking

In the past, various simulation and measurement paradigms have been introduced and evaluated in order to improve frequency-specific measurement of the hearing threshold using early auditory evoked potentials (EAEP). Apromising approach for improvement of detection of stimulus response is the usage of frequency-modulated chirp signals, which optimize the temporal synchrony of neuronal responses along aregion of the basilar membrane. This study validated the performance of three generated narrow-band chirp stimuli in combination with alevel-adaptive simultaneous masker on acollective of normally hearing subjects. In this study 25 normal hearing subjects took part after undergoing pure tone audiometry as well as an objective estimation of the auditory threshold using low, middle and high chirp stimuli. The characteristic EAEP parameters were visually identified before statistical analysis. The characteristic latency level function was conducted using measurements within astimulus level range from 80 to 0 dBHL. Afterwards acomparison of objectively verified auditory threshold and subjective auditory threshold was conducted. All objectively determined thresholds of the frequency-specific evoked EAEP were on average below 10 dBHL: low chirp at 8.2 dBHL, middle chirp at 5.8 dBHL and high chirp at 5.4 dBHL. The mean difference compared to subjectively determined auditory thresholds at all frequencies was below 3 dB and was not significant. Brainstem evoked response audiometry (BERA) using aband-limited and level-specific masked chirp stimulus is an efficient method for the determination of frequency-specific excitation thresholds in the clinical routine. The small, insignificant difference compared to the subjectively determined auditory thresholds makes usage of correction factors mostly redundant. Confirming the study results concerning low chirp stimuli so far, the low chirp BERA currently seems to be the method of choice for estimation of auditory threshold at low frequency ranges around 500 Hz.

Auditory evoked potentials: basics and clinical applications

Auditory evoked potentials (AEPs) are elicited at various levels of the auditory system following acoustic stimulation. Electrocochleography is a technique for recording AEPs of the inner ear. The recording is performed by means of a needle electrode placed on the promontory or non-invasive with tympanic membrane or ear canal electrodes. Clinically, electrocochleography is used for the diagnosis of auditory neuropathy spectrum disorder (ANSD) and endolymphatic hydrops. According to their latencies, AEPs of the central auditory pathway are subdivided into early, middle and late (cortical) AEPs. These AEPs are recorded via surface scalp electrodes. Normally, the larger EEG masks AEPs. For unmasking the AEP, several techniques are applied. Early AEPs or auditory brainstem responses (ABR) are the most widely used AEPs for functional evaluation of the auditory pathway. In contrast to otoacoustic emissions, early AEPs can detect ANSD. Thus, they are more suitable for hearing screening in newborns. For this purpose automated procedures are implemented.

Alterations in early auditory evoked potentials and brainstem transmission time associated with tinnitus residual inhibition induced by auditory electrical stimulation.

Residual inhibition (RI) is the temporary inhibition of tinnitus by use of masking stimuli when the device is turned off. The main aim of this study was to evaluate the effects of RI induced by auditory electrical stimulation (AES) in the primary auditory pathways using early auditory-evoked potentials (AEPs) in subjective idiopathic tinnitus (SIT) subjects. A randomized placebo-controlled study was conducted on forty-four tinnitus subjects. All enrolled subjects based on the responses to AES, were divided into two groups of RI and Non-RI (NRI). The results of the electrocochleography (ECochG), auditory brain stem response (ABR) and brain stem transmission time (BTT) were determined and compared pre- and post-AES in the studied groups. The mean differences in the compound action potential (CAP) amplitudes and III/V and I/V amplitude ratios were significantly different between the RI, NRI and PES controls. BTT was significantly decreased associated with RI. The observed changes in AEP associated with RI suggested some peripheral and central auditory alterations. Synchronized discharges of the auditory nerve fibers and inhibition of the abnormal activity of the cochlear nerve by AES may play important roles associated with RI. Further comprehensive studies are required to determine the mechanisms of RI more precisely.

Alterations in early auditory evoked potentials in multiple sclerosis patients

SummaryAlterations in early auditory evoked potentials (EAEP) in individuals with demyelinating disease are suggestive of lesions in the brainstem.Aimthis study aims to evaluate the prevalence of hearing disorders and altered EAEP in multiple sclerosis (MS) patients.Materials and methodsixteen female and nine male patients with a defined diagnosis of multiple sclerosis took part in this study. All individuals underwent hearing and EAEP tests. The wave forms were categorized according to Jerger (1986).Resultsfifty EAEP tests were carried out; 70% were classified as type I (normal response) according to Jerger's criteria. Altered EAEP results in at least one ear were classified into types II, III, IV or V according to Jerger. Females accounted for 31.25% of alterations, and males 44.44%, adding up to 36% of all cases.Conclusionsthese findings stress the importance of looking at EAEP in cases where there is suspicion of demyelinating disease and in patients with a defined diagnosis for MS.

Frühe akustisch evozierte Potenziale (FAEP)

In this review we address the anatomic and technical aspects of early auditory evoked potentials (EAEPs) as well as their diagnostic criteria. We also present the most relevant neurological diseases which may be associated with abnormal EAEP findings.

Effects of laserneedle stimulation in the external auditory meatus on brainstem and very early auditory evoked potentials in humans

Objectives: For the first time, brainstem auditory evoked potentials (BAEP) and very early auditory evoked potentials (EAEP) were investigated in 23 volunteers (mean age: 26.5 ± 3.6 years) under resting conditions and during continuous and frequency modulated (2 Hz) laser stimulation in the external auditory meatus.Methods: Using a new ear adapter, the outer region of the auditory canal was stimulated with laser light (685 nm, 4 × 30–40 mW, duration: 10 minutes).Results: The EAEPs were significantly changed during continuous (p=0.019), as well as frequency modulated (p=0.014) laser stimulation compared with control measurements.Discussion: Physiologic alterations of inner ear mechanism such as extra-cerebral changes in conductance or stimulation-dependent depolarization processes in extra-cerebral regions of the auditory system could be possible explanations for the significant difference in measurement parameters.

Auditory evoked potentials evaluation of the brain stem in multiple sclerosis

The aim of this study was to evaluate the incidence of auditory and neurotological disorders in multiple sclerosis (MS). Twenty female and 9 male with a definite diagnosis of multiple sclerosis without signs of involvement of the brain stem underwent an audiological and an early auditory evoked potentials (EAEP). The wave forms were classified according to Jerger's (1986) classification. In 58 EAEP it was found 55% of type I (normal response) according to Jerger's classification in both sexes. Considering as an abnormal response the EAEP classified in type II, III, IV or V according to Jerger in at least one side, it was found 60% of abnormalities in females and 56% in males, totalizing 58,62% of all the studied subjects. The authors emphasize the use of EAEP in MS.

Auditory evoked potentials from auditory cortex, medial geniculate nucleus, and inferior colliculus during sleep–wake states and spike-wave discharges in the WAG/Rij rat

Objective: Click auditory evoked potentials (AEP) were simultaneously recorded from the auditory cortex (ACx), the medial geniculate nucleus (MGN), and the inferior colliculus (IC) in the freely moving WAG/Rij rat, to investigate state-dependent changes of the AEP in different anatomical locations along the auditory pathway. Methods: AEPs obtained during active (AW) and passive wakefulness (PW), slow wave sleep (SWS), rapid-eye-movement sleep (REM) and generalized spike-wave discharges (SWD; a specific trait of the WAG/Rij rat, a genetic model for absence epilepsy), were compared. Results: The early components in ACx, MGN and IC were stable throughout the sleep–wake cycle and SWD, apart from a slight increase in the IC during SWD. At all three locations a prominent enlargement of a later component (i.e., N32 in IC, N33 in MGN, and N44 in ACx) was found during SWS and SWD. Conclusions: The early AEP components are not modulated by the normal sleep–wake states, and are not impaired during SWD. A strong state-dependent modulation of a later AEP component occurs at all three anatomical locations investigated. This suggests that apart from the thalamic burst firing mode, additional mechanisms must exist for the enlargement of the AEP during EEG-synchronized states at the prethalamic and cortical level.

Variation of early auditory evoked potentials (EAEP) in severe hyponatremia

Variation of early auditory evoked potentials (EAEP) in severe hyponatremia

Two-dimensional spectral processing of sequential evoked potentials.

The processing of sequential evoked potentials (EPs) is investigated using two-dimensional processing techniques. Two-dimensional EP arrays or images are formed by stacking sequential recordings. Processing is accomplished in the frequency domain by 2-D low-pass filtering using Gaussian filters. Auditory brainstem responses (ABRs), which are the early auditory EPs, are used to investigate the effects of the 2-D filtering on real data. Gaussian filtering improves signal-to-noise ratios by reducing high frequency noise effectively in both intra-EP and inter-EP dimensions. Applications to intra-operative monitoring are simulated with real ABR data.

Forward masking effects on early auditory evoked potential

In early auditory evoked potentials (EAEPs) evoked by click trains, every click had a masking effect on the responses to the clicks following it and the whole response evoked by the click train was the sum of the masked responses to every click in the train. Special attention was paid to the situation when the inter-stimulus interval (ISI) was less than 10 ms and the responses to the individual clicks might be merged to form a continuous wave. The experiments showed that the more the number of the clicks preceding a given click in the train, the stronger the effect on the response to this click until the number was big enough and the effect became saturated; the shorter the ISI when it was less than 10 ms, the stronger the effect; the higher the intensity of the masker, the stronger the effect.

Wave I of early auditory evoked potentials in multiple sclerosis

Early auditory evoked potentials (EAEPs) were recorded in a series of 71 consecutively examined patients suffereing from clinically definite or probable multiple sclerosis (MS). Wave I abnormalities, i.e., delayed latency, with or without reduced amplitude, were observed in 15 such patients and were interpreted as due to MS in 8 of them. As EAEP wave I is identical with the potential N1 in electrocochleography and corresponds to activity of the most distal part of the acoustic nerve or the spiral ganglion, it is concluded that the peripheral part of the acoustic nerve is involved in about 10% of MS patients. In two cases normalization of initially delayed wave I latencies were demonstrated during follow-up recording. The pattern of a late wave I but normal hearing in 3 patients is interpreted in terms of a desynchronized compound nerve activity with fully preserved conductivity, segmental demyelination of a considerable number of acoustic nerve fibres being the most likely cause.

Early auditory evoked potentials (EAEPs) in the rabbit. Normative data and effects of lesions in the cerebello-pontine angle

Early auditory evoked potentials (EAEPs) were measured in rabbits. After establishing normative data an operative method was developed to expose the cerebello-pontine angle. Compression of the VIIIth nerve and a reduction of blood supply to the cochlea via the labyrinthine artery altered the EAEP systematically. In all cases of an VIIIth nerve lesion wave 1 continued to be elicited whereas waves 2–5 disappeared. Circulatory disturbances had an effect upon wave 1. The results indicate that the generator of wave 1 is the unit cochlea/acoustic nerve and of waves 2–5 the auditory pathway within the brain stem. The resultant data help to understand wave alterations in patients with acoustic neuromas.

Acoustic tumour detection with early auditory evoked potentials and neuroradiological methods

A total of 43 patients with surgically identified acoustic neuromas were tested. Results of early auditory evoked potentials (EAEP) and of neuroradiological methods were analysed. Abnormal EAEPs were observed in all patients. In 73% of the cases the EAEP indicated the retrocochlear site of the lesion; in 27%, however, the results did not localize the exact site of the lesion owing to a lack of waves I, II and III due to a pronounced hearing loss. Neuroradiological procedures provided an indication of the site and extent of the tumour. The number of true positives was 21 of 29 cases with polytomography of the petrous bone, 23 of 28 with computed tomography and in all cases when pontine angle cisternography and computed tomography combined with gas cisternography were performed. The EAEPs provide a screening-test for acoustic tumour detection at an early stage. Wave abnormalities indicative of a lesion at the acoustic nerve should lead to a neuroradiological investigation and are particularly valuable in cases with small intracanalicular tumours.

The effect of varying stimulus polarity (rarefaction vs. condensation) on early auditory evoked potentials (EAEPs)

A patient with a vascular brain stem lesion was investigated with EAEP. The results suggest that rarefaction and condensation stimuli produce different responses. The alternating mode is a compromise and helps to suppress stimulus-related artifacts and cochlear microphonics. Wave from alterations and latency shifts must be recognized and taken into account in neurological applications of this test.

The location by early auditory evoked potentials (EAEP) of acoustic nerve and brainstem demyelination in multiple sclerosis (MS).

Tone pips of suprathreshold intensities elicit an acoustic nerve response (I) and six low amplitude brainstem potentials (II-VII) during the initial 10 ms. Seven waves were studied in 40 control subjects and 5 waves (I-V) in 47 patients with MS. The results suggest involvement of the auditory pathway of 24 of 27 patients in the clinically "definite", of 5 of 9 cases in the "probable" and in none of 5 patients in the "possible" MS groups. EAEPs were normal in 6 cases with a spinal form with one exception where changes of potential were indicative of a midbrain lesion. Dysfunction within the acoustic pathway was observed at the level of the acoustic nerve and in the medulla oblongata, pons and midbrain. The significance of the bilateral EAEP abnormalities found in some patients at different levels is discussed with regard to a polytopic location of the underlying lesion.

Early auditory evoked potentials (EAEP) in vertebral basilar insufficiency.

Stimulation with a short tone pip elicits an acoustic nerve compound action potential (I) and different waves (II--VII) in the inital 10 ms. Seven waves have been studied in 40 control subjects and five waves in 12 patients with vertebral-basilar insufficiency. Abnormalities of the different waves were observed at levels such as cochlea and/or acoustic nerve, medulla, caudal pons, rostral pons, and midbrain. The recording of early auditory evoked potentials (EAEP) is a noninvasive method of confirming impairment of the auditory pathway caused by a reduced vascular supply of vertebral and basilar arteries.