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ORIGINAL ARTICLE
COMPARISON OF N1P2 CORTICAL AUDITORY EVOKED POTENTIAL AND NARROW-BAND CHIRP AUDITORY STEADY STATE POTENTIAL IN HEARING THRESHOLD DETECTION IN ADULTS
1
Audio-Vestibular Unit, Department of Otolaryngology,, Kasr-Al-Ainy Faculty of Medicine, Cairo University, Egypt., Egypt
2
Audio-Vestibular Unit, Department of Otolaryngology,, Naser Institute Hospital, Cairo, Egypt., Egypt
A - Research concept and design; B - Collection and/or assembly of data; C - Data analysis and interpretation; D - Writing the article; E - Critical revision of the article; F - Final approval of article;
Submission date: 2020-05-31
Final revision date: 2020-10-11
Acceptance date: 2020-11-27
Publication date: 2020-12-31
Corresponding author
Abeir Osman Dabbous
Audio-Vestibular Unit, Department of Otolaryngology,, Kasr-Al-Ainy Faculty of Medicine, Cairo University, Egypt., 5 Cairo University Street, 12211, Cairo, Egypt
Audio-Vestibular Unit, Department of Otolaryngology,, Kasr-Al-Ainy Faculty of Medicine, Cairo University, Egypt., 5 Cairo University Street, 12211, Cairo, Egypt
J Hear Sci 2020;10(4):48-68
KEYWORDS
TOPICS
ABSTRACT
Background:
Various auditory evoked potential techniques have been explored as a means of objectively predicting the behavioral audiogram in groups of subjects who cannot provide reliable or accurate behavioral results. The tone-evoked auditory brainstem response (ABR) cannot differentiate between severe and profound SNHL, whereas the auditory steady state response (ASSR) can provide threshold information in a frequency-specific manner at intensity levels of 120 dBSPL. The cortical auditory evoked potential (N1P2 CAEP) has shown advantages over the ABR and ASSR.
Objectives:
To assess the ability of the N1P2 cortical auditory evoked potential (CAEP) to estimate the hearing threshold level at different frequencies, in normal hearing adults and adults with different degrees of sensorineural hearing loss (SNHL); and to compare it to the auditory steady state response (ASSR).
Methods:
This study included 90 subjects (180 ears), grouped into 6 groups according to the degree of hearing obtained by pure tone audiometry (PTA). Hearing threshold was then measured using N1P2 CAEP and ASSR.
Results:
N1P2 CAEP and ASSR were highly correlated to PTA at all frequencies. However, N1P2 CAEP predicted behavioral thresholds more accurately than ASSR at all frequencies, especially at 500 and 1000 Hz in the normal hearing group and for all degrees of SNHL. N1P2 CAEP was equally accurate at all frequencies and predicted behavioral thresholds better at more severe degrees of SNHL at 1, 2, and 4 kHz.
Conclusions:
The N1P2 CAEP can be reliably used as an objective method for estimating the behavioral hearing threshold, yielding more accurate results than the ASSR, especially at lower frequencies and with more severe degrees of hearing loss. We therefore recommend using the N1P2 CAEP in estimating the behavioral threshold in difficult-to-test adults.
Various auditory evoked potential techniques have been explored as a means of objectively predicting the behavioral audiogram in groups of subjects who cannot provide reliable or accurate behavioral results. The tone-evoked auditory brainstem response (ABR) cannot differentiate between severe and profound SNHL, whereas the auditory steady state response (ASSR) can provide threshold information in a frequency-specific manner at intensity levels of 120 dBSPL. The cortical auditory evoked potential (N1P2 CAEP) has shown advantages over the ABR and ASSR.
Objectives:
To assess the ability of the N1P2 cortical auditory evoked potential (CAEP) to estimate the hearing threshold level at different frequencies, in normal hearing adults and adults with different degrees of sensorineural hearing loss (SNHL); and to compare it to the auditory steady state response (ASSR).
Methods:
This study included 90 subjects (180 ears), grouped into 6 groups according to the degree of hearing obtained by pure tone audiometry (PTA). Hearing threshold was then measured using N1P2 CAEP and ASSR.
Results:
N1P2 CAEP and ASSR were highly correlated to PTA at all frequencies. However, N1P2 CAEP predicted behavioral thresholds more accurately than ASSR at all frequencies, especially at 500 and 1000 Hz in the normal hearing group and for all degrees of SNHL. N1P2 CAEP was equally accurate at all frequencies and predicted behavioral thresholds better at more severe degrees of SNHL at 1, 2, and 4 kHz.
Conclusions:
The N1P2 CAEP can be reliably used as an objective method for estimating the behavioral hearing threshold, yielding more accurate results than the ASSR, especially at lower frequencies and with more severe degrees of hearing loss. We therefore recommend using the N1P2 CAEP in estimating the behavioral threshold in difficult-to-test adults.
REFERENCES (43)
1.
Tomlin D, Rance G, Graydon K and Tsialios I. A comparison of 40 Hz auditory steady-state response (ASSR) and cortical auditory evoked potential (CAEP) thresholds in awake adult subjects. Int J of Audiol, 2006; 45(10): 580–8.
2.
Lightfoot G and Kennedy V. Cortical electric response audiometry hearing threshold estimation: accuracy, speed, and the effects of stimulus presentation features. Ear Hear, 2006; 27(5): 443–56.
3.
Hall, James W. eHandbook of Auditory Evoked Responses (Kindle Locations 15216–15219). Kindle Edition.
4.
Lightfoot, G. The N1–P2 cortical auditory evoked potential in threshold estimation. Insights in practice for clinical audiology. 2010 https://www.audiologyonline.co....
5.
Stapells D. Cortical event-related potentials to auditory stimuli. Handbook of Clinical Audiology. In J. Katz (ed.), 5th Edition, Baltimore: Lippincott, Williams & Wilkins, 2002; vol. 5, pp. 378–406.
6.
Hyde M. The N1 response and its applications. Audiol Neuro Otol, 1997; 2(5): 281–307.
7.
Prasher D, Mula M, Luxon L. Cortical evoked potential criteria in the objective assessment of auditory threshold: a comparison of noise induced hearing loss with Meniere’s disease. J Laryngol Otol, 1993; 107(9): 780–86.
8.
Lightfoot, G. The effect of short-term auditory training on speech in noise perception and cortical auditory evoked potentials in adults with cochlear implants. Semin Hear, 2016; 37(01): 84–98.
9.
Venail F, Astraud JP, Blanchet C, Uzeil A, Mondain M. Refining the audiological assessment in children using the narrow-band CE chirp-evoked auditory steady state response. Int J Audiol, 2015; 54(2): 106–13.
10.
John MS, Picton TW. MASTER: a windows program for recording multiple auditory steady-state responses. Comput Methods Programs Biomed, 2000; 61(2): 125–50.
12.
D’Haenens W, Dhooge I, Maes L, Bockstael A, Keppler H, Philips B, Swinnen F, Vinck B. The clinical value of the multiple-frequency 80-Hz auditory steady-state response in adults with normal hearing and hearing loss. Arch Otolaryngol Head Neck Surg, 2009; 135(5): 496–506.
13.
Hossein Abadi R, Jafarzadeh S. Auditory steady-state response thresholds in adults with conductive and mild to moderate sensorineural hearing loss. Iran Red Crescent Med J, 2015; 17(1): e18029.
14.
Clark J. Uses and abuses of hearing loss classification. ASHA, 1981; 23(7): 493–500.
15.
Soliman S, FathAllah A, Shehata W. Development of the Arabic Staggered Spondaic Words (SSW) test. In: Proceedings of the 8th AinShams Medical Congress, 1985: 1220–46.
16.
Soliman S. Speech discrimination audiometry using Arabic phonetically balanced words. Ain Shams Med J, 1976; 27: 27–30.
18.
Chan YH. Biostatistics: Quantitative data: parametric and nonparametric tests. Singapore Med J, 2003; 44(8): 391–6.
19.
Chan YH. Biostatistics: Qualitative data: tests of independence. Singapore Med J, 2003; 44(10): 498–503.
20.
Chan YH Biostatistics: correlational analysis. Singapore Med J, 2003; 44(12): 614–9.
21.
Hulley SB, Cummings SR, Browner WS, Grady D, Newman TB. Designing clinical research: an epidemiologic approach. 4th ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2013. Appendix 6C, p.79.
22.
Machin D, Campbell MJ, Tan SB, Tan SH. Sample Size Tables for Clinical Studies. 3rd ed. (2009), Chichester: Wiley-Blackwell.
23.
Yeung KN, Wong LL. Prediction of hearing thresholds: comparison of cortical evoked response audiometry and auditory steady state response audiometry techniques. Int J Audiol, 2007; 46(1): 17–25.
24.
Dabbous AO, El-Shennawy AM, Medhat MM, Abdel-Latief DF. Narrow band CE-Chirp stimulus in auditory steady state response threshold estimation in normal hearers and patients with various degrees of sensorineural hearing loss. Hearing, Balance and Communication, 2017; 15(4), 199–213.
25.
Wunderlich JL and Cone-Wesson BK. Effects of stimulus frequency and complexity on the mismatch negativity and other components of the cortical auditory-evoked potential. J Acoust Soc Am, 2001; 109(4): 1526–37.
26.
Jacobson GP, Lombardi DM, Gibbens ND, Ahmad BK, Newman CW. The effects of stimulus frequency and recording site on the amplitude and latency of multichannel cortical auditory evoked potential (CAEP) component N1. Ear Hear, 1992; 13(5): 300–306.
27.
Ghannoum T, El-Khousht M, El-Abd S, Dabbous A, Soliman R. Comparison of auditory steady state response among normal hearers and patients with different degrees of sensorineural hearing loss. Med J Cairo Univ, 2008; 76: 349–58.
28.
Herdman AT, Stapells DR. Auditory steady-state response thresholds of adults with sensorineural hearing impairments. Int J Audiol, 2003; 42(5): 237–48.
29.
Hsu WC, Wu HP, Liu TC. Objective assessment of auditory thresholds in noise-induced hearing loss using steady-state evoked potentials. Clin Otolaryngol, 2003; 28: 195–8.
30.
Ishida I, Cuthbert B, Stapells D. Multiple auditory steady state response thresholds to bone conduction stimuli in adults with normal and elevated thresholds. Ear Hear, 2011; 32(3): 373–81.
31.
John M, Brown D, Muir P, Picton T. Recording auditory steadystate responses in young infants. Ear Hear, 2004; 25(6): 539–53.
32.
Tlumak AI, Rubinstein E, Durrant JD. Meta-analysis of variables that affect accuracy of threshold estimation via measurement of the auditory steady-state response (ASSR). Int J Audiol, 2007; 46(11): 692–710.
33.
Biagio L, Swanepoel DW, Soer ME. Objective assessment of noiseinduced hearing loss: a comparison of methods. Occupational Health Southern Africa, 2009; 26–32.
34.
Tsui B, Wong L, Wong E. Accuracy of cortical evoked response audiometry in the identification of non-organic hearing loss. Int J Audiol, 2002; 41(6): 330–33.
35.
Hari R, Lounasmaa OV. Recording and interpretation of cerebral magnetic fields. Science, 1989; 244(4903): 432–7.
36.
Herdman AT, Picton TW, Stapells DR. Place specificity of multiple auditory steady-state responses. J Acoust Soc Am, 2002; 112(4): 1569–82.
37.
Mäkelä J, Karmos G, Molnar M, Csepe V, Winkler I. Steady-state responses from the cat auditory cortex. Hear Res, 1990; 45(1): 41–50.
38.
Johnson B, Weinberg H, Ribary U, Cheyne D, Ancill R. Topographic distribution of the 40 Hz auditory evoked-related potential in normal and aged subjects. Brain Topogr, 1988; 1(2): 117–21.
39.
Kiren T, Aoyagi M, Furuse H, Koike Y. An experimental study on the generator of amplitude-modulation following response. Acta Otolaryngol Suppl, 1994; 511: 28–33.
40.
Cone-Wesson B, Dowell RC, Tomlin D, Rance G, Jia-Ming W. The auditory steady-state response: comparisons with the auditory brainstem response. J Am Acad Audiol, 2002; 13(4):173–87.
41.
Picton TW, John MS, Dimitrijevic A, Purcell D. Human auditory steady-state responses. Int J Audiol, 2003; 42(4): 177–219.
42.
Rance G, Rickards FW, Cohen LT, De Vidi S, Clark GM. Automated prediction of hearing thresholds in sleeping subjects using auditory steady-state evoked potentials. Ear Hear, 1995; 16(5): 499–507.
43.
Van Dun B, Dillon H, Seeto M. Estimating hearing thresholds in hearing-impaired adults through objective detection of cortical auditory evoked potentials. J Am Acad Audiol, 2015; 26(4): 370–83.
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