Auditory steady-state response and auditory brainstem response thresholds in children

Abstract

The inclusion of the auditory steady-state response (ASSR) into test-batteries for objective audiometry has allowed for clinical comparisons with the most widely used procedure, the auditory brainstem response (ABR). The current study describes ASSR and ABR thresholds for a group of infants and young children with various types and degrees of hearing loss. A sample of 48 subjects (23 female) with a mean age of 2.8+/-1.9 years SD were assessed with a comprehensive test-battery and classified according to type and degree of hearing loss. Thresholds were determined with a broadband click-evoked ABR and single frequency ASSR evoked with continuous tones (0.25-4 kHz) amplitude modulated (67-95 Hz). Mean difference scores (+/-SD) between the ABR and high frequency ASSR thresholds were 9.8 (+/-11), 3.6 (+/-12) and 10.5 (+/-12) dB at 1, 2 and 4 kHz, respectively. An ASSR mean threshold for 2-4 and 1-4 kHz compared to the ABR threshold revealed an average difference of 7 (+/-9) and 7.9 (+/-8) dB, respectively. The overall correlation between the ABR and ASSR thresholds was highest for the mean ASSR thresholds of 2-4 and 1-4 kHz (r=0.92 for both conditions). Correlations between the ABR and individual ASSR frequencies were slightly less (0.82-0.86). The average of the 2-4 kHz ASSR thresholds correlated best with the click-evoked ABR for all categories of hearing loss except for the sensorineural hearing loss category for which the 1-4 kHz ASSR average was better correlated to ABR thresholds. Findings demonstrate the reliability of verifying high frequency ASSR thresholds with a click-evoked ABR as an important cross-check in infants for whom behavioural audiometry may not be possible.

A Comparison of Thresholds of Auditory Steady-State Response and Auditory Brainstem Response in Healthy Term Babies

“…Vander Werff et al [16] found strong correlations between the 2-kHz threshold and the mean values of the 2-4 kHz ASSR responses and click-ABR results (r=0.96 and r=0.97, respectively). Similarly, Swanepoel and Ebrahim [17] reported that the mean values of 1-4 and 2-4 kHz had the best correlations between ASSR and ABR; however, strong correlations were found among other frequencies as well (r 1kHz =0.82, r 2kHz =0.86, r 4kHz =0.85, r average1-4kHz =0.92, and r average2-4kHz =0.92). The possible reason for the difference could be the mean age of our subjects (2.98 ±2.58 months), which was much lower than that in previous clinical studies.…”

“…The values of correlation coefficients in babies with hearing loss showed that the best and strongest correlation was between the ABR and ASSR thresholds at 4 kHz. On the other hand, Swanepoel and Ebrahim [17] found the poorest correlation at 4 kHz in patients with sensorineural hearing loss. This situation could be explained as follows: In that study, the subjects were subdivided into two groups, those with conductive hearing loss and those with sensorineural hearing loss.…”

Potenciais Evocados Auditivos de Estado Estável no diagnóstico audiológico infantil: uma comparação com os Potenciais Evocados Auditivos de Tronco Encefálico

“…Since the click-BERA can correspond to the best response between 1 and 4 kHz, a sample made up of a larger number of hearing loss with descending configurations, for instance, may present a better correlation with the SSEAP for the frequency of 1 kHz. 12,18 Swanepoel and Ebrahim 12 found a better click-BERA and SSEAP for the 2-4 kHz frequencies in subjects with normal hearing and conductive hearing loss. Notwithstanding, in the subjects with sensorineural hearing loss, the best correlation was with the mean value of 1-4 kHz.…”

“…[5][6][7] Studies have compared BERA and click-BERA responses showing reasonable correlations among the techniques. [8][9][10][11][12] The few studies comparing click-BERA and SSEAP in the frequencies of 2 and 4 kHz, and with the SSEAP mean values in the high frequencies (1-4 and 2-4 kHz), in children with ages equal to or lower than 36 months indicated significant correlations between the techniques. 10,11,13 In this paper we will discuss the first clinical experiences with the SSEAP in a highly complex hearing health service in São Paulo.…”

Potencial evocado auditivo de estado estável em crianças e adolescentes com perda auditiva neurossensorial de grau severo e profundo e descendente

“…Thus, the applicability of the ASSR in early audiological diagnosis has been emphasized in the literature (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11) . The easy and practical registrations in identifying the ASSR responses, using statistical analysis, are important aspects of this procedure (1) .…”