Optimizing Parameters for Using the Parallel Auditory Brainstem Response to Quickly Estimate Hearing Thresholds.
Optimizing Parameters for Using the Parallel Auditory Brainstem Response to Quickly Estimate Hearing Thresholds.
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DOI：
10.1097/aud.0000000000001128
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发表时间：
2022
期刊：
影响因子：
3.7
通讯作者：
Maddox RK
中科院分区：
文献类型：
--
作者：
Polonenko MJ;Maddox RK
及时评估对于为听力损失儿童提供早期干预和更好的听力和口语结果至关重要。为了更快地诊断婴儿的听力，作者开发了平行听觉脑干反应（pABR），它以五个频率同时向每只耳朵呈现随机定时的音点序列。该pABR产生高质量的波形，类似于标准，单频串行ABR，但在一小部分的记录时间。虽然对标准abr有充分的记录，但尚不清楚呈现率和级别如何相互作用以影响并行收集的响应。此外，刺激还有待校准到感知阈值。因此，本研究旨在确定ABR的最佳参数范围，并建立ABR刺激的规范刺激水平校正值。两组实验分别由20名听力阈值（≤20 dB HL）在250 ~ 8000 Hz范围内正常的成年人（18 ~ 35岁）组成。首先，记录6种刺激率和2种刺激强度下的pABR脑电图反应。分析了分量波V振幅和延迟的变化，以及所有响应达到标准信噪比为0 dB所需的时间。其次，测量纯音和每一频率的pABR刺激的行为阈值，以确定dB peSPL中刺激水平与dB nHL中知觉阈值之间的校正因子。随着刺激速率的增加，pABR表现出一定的适应性。各种频率在15分钟内产生了强大的反应，但40赫兹是最佳的单一呈现率。扩展分析窗口以包括响应的后期组成部分，为对低频音点的临时更广泛的响应提供了进一步节省时间的优势。对pABR刺激的感知阈值随速率的微妙变化，提供了一组相对相似的校正因子，将pABR刺激水平从dB peSPL转换为dB nHL。pABR的最佳刺激速率为40 Hz，但使用多个速率可能是有用的。感知阈值在不同的速率之间微妙地变化，使得测试范式可以很容易地在速率之间转换，这可能有助于快速估计不同配置的听力损失阈值。这些优化的参数促进了pABR在临床环境中估计听力阈值的方便性和有效性。
Timely assessments are critical to providing early intervention and better hearing and spoken language outcomes for children with hearing loss. To facilitate faster diagnostic hearing assessments in infants, the authors developed the parallel auditory brainstem response (pABR), which presents randomly timed trains of tone pips at five frequencies to each ear simultaneously. The pABR yields high-quality waveforms that are similar to the standard, single-frequency serial ABR but in a fraction of the recording time. While well-documented for standard ABRs, it is yet unknown how presentation rate and level interact to affect responses collected in parallel. Furthermore, the stimuli are yet to be calibrated to perceptual thresholds. Therefore, this study aimed to determine the optimal range of parameters for the pABR and to establish the normative stimulus level correction values for the ABR stimuli. Two experiments were completed, each with a group of 20 adults (18 – 35 years old) with normal hearing thresholds (≤ 20 dB HL) from 250 to 8000 Hz. First, pABR electroencephalographic (EEG) responses were recorded for six stimulation rates and two intensities. The changes in component wave V amplitude and latency were analyzed, as well as the time required for all responses to reach a criterion signal-to-noise ratio of 0 dB. Second, behavioral thresholds were measured for pure tones and for the pABR stimuli at each rate to determine the correction factors that relate the stimulus level in dB peSPL to perceptual thresholds in dB nHL. The pABR showed some adaptation with increased stimulation rate. A wide range of rates yielded robust responses in under 15 minutes, but 40 Hz was the optimal singular presentation rate. Extending the analysis window to include later components of the response offered further time-saving advantages for the temporally broader responses to low frequency tone pips. The perceptual thresholds to pABR stimuli changed subtly with rate, giving a relatively similar set of correction factors to convert the level of the pABR stimuli from dB peSPL to dB nHL. The optimal stimulation rate for the pABR is 40 Hz, but using multiple rates may prove useful. Perceptual thresholds that subtly change across rate allow for a testing paradigm that easily transitions between rates, which may be useful for quickly estimating thresholds for different configurations of hearing loss. These optimized parameters facilitate expediency and effectiveness of the pABR to estimate hearing thresholds in a clinical setting.