Sensitivity and specificity of auditory steady-state response testing

Rabelo, Camila Maia; Schochat, Eliane

doi:10.1590/s1807-59322011000100016

Cited by 5 publications

(5 citation statements)

References 17 publications

(43 reference statements)

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“…ASSR recordings are extensively used to assess hearing thresholds in the pediatric population. The advantages and limitations of the ASSR method for frequency-specific threshold estimations have been amply investigated in individuals with sensorineural hearing loss (Scherf et al 2006; Swanepoel & Erasmus 2007; Wang et al 2019) and central auditory nervous system lesions (Shinn & Musiek 2007; Rabelo & Schochat 2011). The latter works resorted to low modulation rates favoring cortical ASSR generators and showed reduced correlations between electrophysiological and behavioral thresholds indicating sensitivity of cortically-generated ASSRs to central auditory nervous system dysfunctions.…”

Section: Discussionmentioning

confidence: 99%

Preserved Auditory Steady State Response and Envelope-Following Response in Severe Brainstem Dysfunction Highlight the Need for Cross-Checking

Díaz,

Lucchetti,

Avan

et al. 2023

Ear &Amp; Hearing

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Objectives: Commercially available auditory steady state response (ASSR) systems are widely used to obtain hearing thresholds in the pediatric population objectively. Children are often examined during natural or induced sleep so that the recorded ASSRs are of subcortical origin, the inferior colliculus being often designated as the main ASSR contributor in these conditions. This report presents data from a battery of auditory neurophysiological objective tests obtained in 3 cases of severe brainstem dysfunction in sleeping children. In addition to ASSRs, envelope-following response (EFR) recordings designed to distinguish peripheral (cochlear nerve) from central (brainstem) were recorded to document the effect of brainstem dysfunction on the two types of phase-locked responses. Design: Results obtained in the 3 children with severe brainstem dysfunctions were compared with those of age-matched controls. The cases were identified as posterior fossa tumor, undiagnosed (UD), and Pelizaeus–Merzbacher-Like Disease. The standard audiological objective tests comprised tympanograms, distortion product otoacoustic emissions, click-evoked auditory brainstem responses (ABRs), and ASSRs. EFRs were recorded using horizontal (EFR-H) and vertical (EFR-V) channels and a stimulus phase rotation technique allowing isolation of the EFR waveforms in the time domain to obtain direct latency measurements. Results: The brainstem dysfunctions of the 3 children were revealed as abnormal (weak, absent, or delayed) ABRs central waves with a normal wave I. In addition, they all presented a summating and cochlear microphonic potential in their ABRs, coupled with a normal wave I, which implies normal cochlear and cochlear nerve function. EFR-H and EFR-V waveforms were identified in the two cases in whom they were recorded. The EFR-Hs onset latencies, response durations, and phase-locking values did not differ from their respective age-matched control values, indicating normal cochlear nerve EFRs. In contrast, the EFR-V phase-locking value and onset latency varied from their control values. Both patients had abnormal but identifiable and significantly phase-locked brainstem EFRs, even in a case with severely distorted ABR central waves. ASSR objective audiograms were recorded in two cases. They showed normal or slightly elevated (explained by a slight transmission loss) thresholds that do not yield any clue about their brainstem dysfunction, revealing the method’s lack of sensitivity to severe brainstem dysfunction. Conclusions: The present study, performed on 3 sleeping children with severe brainstem dysfunction but normal cochlear responses (cochlear microphonic potential, summating potential, and ABR wave I), revealed the differential sensitivity of three auditory electrophysiological techniques. Estimated thresholds obtained by standard ASSR recordings (cases UD and Pelizaeus–Merzbacher-Like Disease) provided no clue to the brainstem dysfunction clearly revealed by the click-evoked ABR. EFR recordings (cases posterior fossa tumor and UD) showed preserved central responses with abnormal latencies and low phase-locking values, whereas the peripheral EFR attributed to the cochlear nerve was normal. The one case (UD) for which the three techniques could be performed confirms this sensitivity gradient, emphasizing the need for applying the Cross-Check Principle by avoiding resorting to ASSR recording alone. The entirely normal EFR-H recordings observed in two cases further strengthen the hypothesis of its cochlear nerve origin in sleeping children.

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Section: Discussionmentioning

confidence: 99%

Preserved Auditory Steady State Response and Envelope-Following Response in Severe Brainstem Dysfunction Highlight the Need for Cross-Checking

Díaz,

Lucchetti,

Avan

et al. 2023

Ear &Amp; Hearing

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“…Despite the diffuse nature of these lesions, multiple studies, including the present investigation, have noted poor performance on auditory measures in patients with MTS. In 2011, one study showed that individuals with MTS exhibited significantly elevated auditory electrophysiological thresholds, as measured based on the auditory steady-state response compared with controls, even though the two groups had similar behavioral thresholds 28 . This result suggests that the neural function of MTS patients does not contribute the neural synchrony necessary for the detection of subtle electrophysiological events.…”

Section: Discussionmentioning

confidence: 99%

Temporal resolution in individuals with neurological disorders

Rabelo

Weihing

Schochat

2015

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OBJECTIVE:Temporal processing refers to the ability of the central auditory nervous system to encode and detect subtle changes in acoustic signals. This study aims to investigate the temporal resolution ability of individuals with mesial temporal sclerosis and to determine the sensitivity and specificity of the gaps-in-noise test in identifying this type of lesion.METHOD:This prospective study investigated differences in temporal resolution between 30 individuals with normal hearing and without neurological lesions (G1) and 16 individuals with both normal hearing and mesial temporal sclerosis (G2). Test performances were compared, and the sensitivity and specificity were calculated.RESULTS:There was no difference in gap detection thresholds between the two groups, although G1 revealed better average thresholds than G2 did. The sensitivity and specificity of the gaps-in-noise test for neurological lesions were 68% and 98%, respectively.CONCLUSIONS:Temporal resolution ability is compromised in individuals with neurological lesions caused by mesial temporal sclerosis. The gaps-in-noise test was shown to be a sensitive and specific measure of central auditory dysfunction in these patients.

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“…The correlation differences between the two protocols were statistically significant in the frequencies of 1000 Hz and 2000 Hz in both ears, and 4000 Hz in the left ear. Interaural differences may be attributed to internal jittering caused by neurologic asynchronicity, and have also been described in the past 5 , 6 .…”

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confidence: 89%