Comparison of Auditory Brainstem Responses Recorded from Three Different Clinical Systems.

Abstract

Background: The auditory brainstem response (ABR) test is used to estimate hearing thresholds and for neurodiagnostic purposes. ABRs can be recorded for traditional stimuli such as broadband clicks and frequency-specific tone bursts (0.5, 1, 2, and 4 kHz). Recently, chirp stimuli (broadband and narrowband chirps [0.5, 1, 2, and 4 kHz]) have been recommended to be used to record ABRs.

Purpose: There is a lack of comparative studies of ABR latency, amplitude, and thresholds obtained from these systems for both traditional and chirp stimuli.

Research design: Repeated measure design.

Study sample: Fifteen adults whose hearing thresholds were ≤25 dB HL participated in this study.

Data collection and analysis: The Interacoustics Eclipse-25 (EP-25), the Intelligent Hearing System (IHS), and the Vivosonic Integrity V500 systems were used. Peak-to-peak voltage was examined for traditional and chirp stimuli across all three systems. Behavioral and ABR thresholds were obtained for all stimuli. Also, peak V latencies and peak-to-peak amplitudes for all stimuli recorded at 80 dBnHL were examined.

Results: Peak-to-peak voltage differed between systems, especially for chirp stimuli. The EP-25 and the IHS systems showed significantly lower behavioral thresholds for some chirp stimuli compared with traditional, comparable stimuli, whereas the Integrity V500 system showed significantly lower behavioral thresholds for broadband click and 4-kHz tone burst stimuli compared with comparable chirp stimuli. Significant differences in behavioral thresholds between systems were observed. The EP-25 (broadband chirp, 1-, 2-, and 4-kHz narrowband chirp) and the IHS (2-kHz narrowband chirp) showed significantly lower ABR thresholds for comparable stimuli, whereas the Integrity V500 system showed lower ABR thresholds for broadband click and 0.5-kHz tone burst stimuli compared with comparable chirp stimuli. ABR thresholds for 2-kHz tone burst and 0.5- and 2-kHz narrowband chirp stimuli were significantly different between systems. The peak V latencies of the IHS system were significantly longer for most of the stimuli compared with other systems. The Integrity V500 system showed significantly lower peak-to-peak amplitudes of peak V for most of the stimuli when compared with other systems.

Conclusions: The ABR latencies, amplitudes, and thresholds may differ between ABR recording systems, and clinicians should be aware of these differences to avoid misdiagnosis.

Clinical relevance statement: The differences in ABR latencies, amplitudes, and thresholds between systems may lead to inconsistencies in diagnostic accuracy. Audiologists should use system-specific normative data.