Predicting Pure-Tone Thresholds with Dichotic Multiple Frequency Auditory Steady State Responses

University of Pretoria, South Africa.
Journal of the American Academy of Audiology (Impact Factor: 1.58). 02/2005; 16(1):5-17. DOI: 10.3766/jaaa.16.1.2
Source: PubMed


The accuracy of dichotic multiple frequency auditory steady state in predicting pure-tone thresholds at 0.5, 1, 2, and 4.0 kHz compared to an ABR protocol (click and tone burst at 0.5 kHz) were explored in a group of 25 hearing-impaired subjects across the degree and configuration spectrum. Mean steady state thresholds were within 14, 18, 15, and 14 dB of the pure tones at 0.5, 1, 2, and 4 kHz, compared to the tone-burst ABR at 0.5 kHz pure-tone difference of 24 dB, and a click-evoked pure-tone (2-4 kHz) difference of 9 dB. Recording time for the steady state protocol was 28 minutes (+/- 11) compared to 24 minutes (+/- 9) of the ABR protocol. Degree of loss had a significant effect on steady state; configuration of hearing loss had a limited effect. Mf ASSR predicted thresholds with relative accuracy although some configurations showed discrepancies for low-frequency estimates.

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    ABSTRACT: Objective: To evaluate the audiometric usefulness of the auditory steady-state response (ASSR) using the multiple auditory steady-state response (MASTER®). Design: 1 In normal adults (aged 25-45 years old), comparisons of the behavioral thresholds for pure tones and the ASSR thresholds were compared. 2 In supposedly normal infants (aged 3-45 months old), the click ABR thresholds and ASSR thresholds were compared. 3 In patients (aged 6-81 years old), the behavioral thresholds for pure tones, the ASSR thresholds, and click ABR thresholds were compared. Results: 1 In normal adults, the behavioral thresholds for pure tones of 0.5, 1, 2, and 4 kHz were 9.7 ± 4, 7.8 ± 3.5, 8.9 ± 5, and 6.1 ± 6.3 dB, respectively. In addition, the ASSR thresholds for carrier frequencies of 0.5, 1, 2, and 4 kHz were 40.6 ± 9.4, 33.9 ± 7, 29.4 ± 5.4, and 32.8 ± 4.6 dB, respectively. 2 In the infants, the click ABR thresholds were 20 ± 7.3 dB, while the ASSR thresholds for carrier frequencies of 0.5, 1, 2, and 4 kHz were 55 ± 9.3, 44.4 ± 13.9, 34.8 ± 11.6, and 40.7 ± 14.4 dB, respectively. 3 In the patients, correlation coefficients of behavioral thresholds and ASSR thresholds were 0.65 at 0.5 kHz, 0.85 at 1 kHz, 0.82 at 2 kHz, and 0.77 at 4 kHz. The correlation coefficients of behavioral thresholds and click ABR thresholds were 0.80 at 0.5 kHz, 0.86 at 1 kHz, 0.90 at 2 kHz, and 0.83 at 4 kHz. Conclusion: On average, the thresholds for the ASSR were higher than the behavioral thresholds, and the discrepancies were larger at low frequencies. For a better physiologic audiometry estimation of the lower frequencies, the optimal modulation frequency should be investigated.
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    ABSTRACT: The purpose of the study was to evaluate the effectiveness of a 2-hr initial audiologic assessment appointment for infants referred from area universal newborn hearing screening (UNHS) programs to a clinical audiology department in an urban hospital. A prospective auditory brainstem response (ABR)-based protocol, including clicks, frequency-specific tone bursts, and bone-conducted stimuli, was administered by 10 audiologists to 375 infants. Depending on the ABR findings, additional test options included distortion product otoacoustic emissions (DPOAEs), high-frequency tympanometry, and/or otologic examination. In 88% of the 2-hr test sessions, at least 4 ABR threshold estimates were obtained (i.e., bilateral clicks and either a 500- or 1000-Hz tone burst and a 4000-Hz frequency tone burst for the better ear). The incidence of hearing loss was significantly different across nursery levels: 18% for Level I (well baby), 29% for Level II (special care), and 52% for Level III (neonatal intensive care unit). Hearing loss type was defined at the initial assessment for 35 of the 51 infants with bilateral hearing loss based on bone-conduction ABR, latency measures, DPOAEs, high-frequency tympanometry, and/or otologic examination. Our findings indicate that a 2-hr test appointment is appropriate for all nursery levels to diagnose severity and type of hearing loss in the majority of infants referred from UNHS. Examination by an otolaryngologist within 24-48 hr further defines the hearing loss and facilitates treatment plans.
    No preview · Article · Jul 2006 · American Journal of Audiology
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    ABSTRACT: Reported are the results of meta-analyses of data derived collectively from a sample of 56 published research studies on electric response audiometry (ERA) using auditory steady-state responses (ASSRs). Several specific methodological issues were examined and hypotheses were posited to rigorously test common conclusions drawn from the ASSR literature on the accuracy of ASSR-ERA. Explanatory variables for analyses were type of population (normally hearing and hearing-impaired), type of modulation, number of sweeps acquired during response analysis, electrode montage, and modulation rate (80 vs. 40 Hz). No explanatory variables were found to be significantly related to the degree of disparity between thresholds obtained by ASSR-ERA versus behavioral audiometry in the normally hearing population. Conversely, all but one explanatory variable (i.e. electrode montage) was found to be significantly related to mean threshold differences in the hearing-impaired and combined populations. Results both substantiate some of common conclusions drawn from the literature but call others into question, helping to identify those methodological issues which appear to, or not to, significantly affect the accuracy of estimating threshold using ASSR measurement. In addition to these findings, another practical outcome of this study was the development of various summary tables of the data analysed from the literature sampled.
    No preview · Article · Dec 2007 · International Journal of Audiology
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