Inconsistency of auditory middle latency and steady-state responses in infants

Amplitude Modulation Perception and Cortical Evoked Potentials in Children With Listening Difficulties and Their Typically Developing Peers

PURPOSE

Amplitude modulations (AMs) are important for speech intelligibility, and deficits in speech intelligibility are a leading source of impairment in childhood listening difficulties (LiD). The present study aimed to explore the relationships between AM perception and speech-in-noise (SiN) comprehension in children and to determine whether deficits in AM processing contribute to childhood LiD. Evoked responses were used to parse the neural origins of AM processing.

METHOD

Forty-one children with LiD and 44 typically developing children, ages 8-16 years, participated in the study. Behavioral AM depth thresholds were measured at 4 and 40 Hz. SiN tasks included the Listening in Spatialized Noise-Sentences Test (LiSN-S) and a coordinate response measure (CRM)-based task. Evoked responses were obtained during an AM change detection task using alternations between 4 and 40 Hz, including the N1 of the acoustic change complex, auditory steady-state response (ASSR), P300, and a late positive response (late potential [LP]). Maturational effects were explored via age correlations.

RESULTS

Age correlated with 4-Hz AM thresholds, CRM separated talker scores, and N1 amplitude. Age-normed LiSN-S scores obtained without spatial or talker cues correlated with age-corrected 4-Hz AM thresholds and area under the LP curve. CRM separated talker scores correlated with AM thresholds and area under the LP curve. Most behavioral measures of AM perception correlated with the signal-to-noise ratio and phase coherence of the 40-Hz ASSR. AM change response time also correlated with area under the LP curve. Children with LiD exhibited deficits with respect to 4-Hz thresholds, AM change accuracy, and area under the LP curve.

CONCLUSIONS

The observed relationships between AM perception and SiN performance extend the evidence that modulation perception is important for understanding SiN in childhood. In line with this finding, children with LiD demonstrated poorer performance on some measures of AM perception, but their evoked responses implicated a primarily cognitive deficit.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.25009103.

Amplitude modulation perception and cortical evoked potentials in children with listening difficulties and their typically-developing peers

Purpose

Amplitude modulations (AM) are important for speech intelligibility, and deficits in speech intelligibility are a leading source of impairment in childhood listening difficulties (LiD). The present study aimed to explore the relationships between AM perception and speech-in-noise (SiN) comprehension in children and to determine whether deficits in AM processing contribute to childhood LiD. Evoked responses were used to parse the neural origin of AM processing.

Method

Forty-one children with LiD and forty-four typically-developing children, ages 8-16 y.o., participated in the study. Behavioral AM depth thresholds were measured at 4 and 40 Hz. SiN tasks included the LiSN-S and a Coordinate Response Measure (CRM)-based task. Evoked responses were obtained during an AM Change detection task using alternations between 4 and 40 Hz, including the N1 of the acoustic change complex, auditory steady-state response (ASSR), P300, and a late positive response (LP). Maturational effects were explored via age correlations.

Results

Age correlated with 4 Hz AM thresholds, CRM Separated Talker scores, and N1 amplitude. Age-normed LiSN-S scores obtained without spatial or talker cues correlated with age-corrected 4 Hz AM thresholds and area under the LP curve. CRM Separated Talker scores correlated with AM thresholds and area under the LP curve. Most behavioral measures of AM perception correlated with the SNR and phase coherence of the 40 Hz ASSR. AM Change RT also correlated with area under the LP curve. Children with LiD exhibited deficits with respect to 4 Hz thresholds, AM Change accuracy, and area under the LP curve.

Conclusions

The observed relationships between AM perception and SiN performance extend the evidence that modulation perception is important for understanding SiN in childhood. In line with this finding, children with LiD demonstrated poorer performance on some measures of AM perception, but their evoked responses implicated a primarily cognitive deficit.

Neuromagnetic 40 Hz Auditory Steady-State Response in the left auditory cortex is related to language comprehension in children with Autism Spectrum Disorder

Language impairment is comorbid in most children with Autism Spectrum Disorder (ASD), but its neural mechanisms are still poorly understood. Some studies hypothesize that the atypical low-level sensory perception in the auditory cortex accounts for the abnormal language development in these children. One of the potential non-invasive measures of such low-level perception can be the cortical gamma-band oscillations registered with magnetoencephalography (MEG), and 40 Hz Auditory Steady-State Response (40 Hz ASSR) is a reliable paradigm for eliciting auditory gamma response. Although there is research in children with and without ASD using 40 Hz ASSR, nothing is known about the relationship between this auditory response in children with ASD and their language abilities measured directly in formal assessment. In the present study, we used MEG and individual brain models to investigate 40 Hz ASSR in primary-school-aged children with and without ASD. It was also used to assess how the strength of the auditory response is related to language abilities of children with ASD, their non-verbal IQ, and social functioning. A total of 40 children were included in the study. The results demonstrated that 40 Hz ASSR was reduced in the right auditory cortex in children with ASD when comparing them to typically developing controls. Importantly, our study provides the first evidence of the association between 40 Hz ASSR in the language-dominant left auditory cortex and language comprehension in children with ASD. This link was domain-specific because the other brain-behavior correlations were non-significant.

The age-related changes in 40 Hz Auditory Steady-State Response and sustained Event-Related Fields to the same amplitude-modulated tones in typically developing children: A magnetoencephalography study

Recent studies have revealed that gamma-band oscillatory and transient evoked potentials may change with age during childhood. It is hypothesized that these changes can be associated with a maturation of GABAergic neurotransmission and, subsequently, the age-related changes of excitation-inhibition balance in the neural circuits. One of the reliable paradigms for investigating these effects in the auditory cortex is 40 Hz Auditory Steady-State Response (ASSR), where participants are presented with the periodic auditory stimuli. It is known that such stimuli evoke two types of responses in magnetoencephalography (MEG)-40 Hz steady-state gamma response (or 40 Hz ASSR) and auditory evoked response called sustained Event-Related Field (ERF). Although several studies have been conducted in children, focusing on the changes of 40 Hz ASSR with age, almost nothing is known about the age-related changes of the sustained ERF to the same periodic stimuli and their relationships with changes in the gamma strength. Using MEG, we investigated the association between 40 Hz steady-state gamma response and sustained ERF response to the same stimuli and also their age-related changes in the group of 30 typically developing 7-to-12-year-old children. The results revealed a tight relationship between 40 Hz ASSR and ERF, indicating that the age-related increase in strength of 40 Hz ASSR was associated with the age-related decrease of the amplitude of ERF. These effects were discussed in the light of the maturation of the GABAergic system and excitation-inhibition balance development, which may contribute to the changes in ASSR and ERF.

Comparison of Auditory Steady-State Responses With Conventional Audiometry in Older Adults

Behavioral measures, such as pure-tone audiometry (PTA), are commonly used to determine hearing thresholds, however, PTA does not always provide reliable hearing information in difficult to test individuals. Therefore, objective measures of hearing sensitivity that require little-to-no active participation from an individual are needed to facilitate the detection and treatment of hearing loss in difficult to test people. Investigation of the reliability of the auditory steady-state response (ASSR) for measuring hearing thresholds in older adults is limited. This study aimed to investigate if ASSR can be a reliable, objective measure of frequency specific hearing thresholds in older adults. Hearing thresholds were tested at 500 Hz, 1000 Hz, 2000 Hz, and 4000 Hz in 50 participants aged between 60 and 85 years old, using automated PTA and ASSR. Hearing thresholds obtained from PTA and ASSR were found to be significantly correlated (p < .001) in a cohort consisting of participants with normal hearing or mild hearing loss. ASSR thresholds were significantly higher as compared to PTA thresholds, but for the majority of cases the difference remained within the clinically acceptable range (15 dB). This study provides some evidence to suggest that ASSR can be a valuable tool for estimating objective frequency-specific hearing thresholds in older adults and indicate that ASSR could be useful in creating hearing treatment plans for older adults who are unable to complete behavioral PTA. Further research on older adults is required to improve the methodological features of ASSR to increase consistency and reliability, as well as minimize some of the limitations associated with this technique.

The power of rhythms: how steady-state evoked responses reveal early neurocognitive development

Electroencephalography (EEG) is a non-invasive and painless recording of cerebral activity, particularly well-suited for studying young infants, allowing the inspection of cerebral responses in a constellation of different ways. Of particular interest for developmental cognitive neuroscientists is the use of rhythmic stimulation, and the analysis of steady-state evoked potentials (SS-EPs) - an approach also known as frequency tagging. In this paper we rely on the existing SS-EP early developmental literature to illustrate the important advantages of SS-EPs for studying the developing brain. We argue that (1) the technique is both objective and predictive: the response is expected at the stimulation frequency (and/or higher harmonics), (2) its high spectral specificity makes the computed responses particularly robust to artifacts, and (3) the technique allows for short and efficient recordings, compatible with infants' limited attentional spans. We additionally provide an overview of some recent inspiring use of the SS-EP technique in adult research, in order to argue that (4) the SS-EP approach can be implemented creatively to target a wide range of cognitive and neural processes. For all these reasons, we expect SS-EPs to play an increasing role in the understanding of early cognitive processes. Finally, we provide practical guidelines for implementing and analyzing SS-EP studies.

A pilot study: Auditory steady-state responses (ASSR) can be measured in human fetuses using fetal magnetoencephalography (fMEG)

Background

Auditory steady-state responses (ASSRs) are ongoing evoked brain responses to continuous auditory stimuli that play a role for auditory processing of complex sounds and speech perception. Transient auditory event-related responses (AERRs) have previously been recorded using fetal magnetoencephalography (fMEG) but involve different neurological pathways. Previous studies in children and adults demonstrated that the cortical components of the ASSR are significantly affected by state of consciousness and by maturational changes in neonates and young infants. To our knowledge, this is the first study to investigate ASSRs in human fetuses.

Methods

47 fMEG sessions were conducted with 24 healthy pregnant women in three gestational age groups (30–32 weeks, 33–35 weeks and 36–39 weeks). The stimulation consisted of amplitude-modulated (AM) tones with a duration of one second, a carrier frequency (CF) of 500 Hz and a modulation frequency (MF) of 27 Hz or 42 Hz. Both tones were presented in a random order with equal probability adding up to 80–100 repetitions per tone. The ASSR across trials was quantified by assessing phase synchrony in the cortical signals at the stimulation frequency.

Results and conclusion

Ten out of 47 recordings were excluded due to technical problems or maternal movements. Analysis of the included 37 fetal recordings revealed a statistically significant response for the phase coherence between trials for the MF of 27 Hz but not for 42 Hz. An exploratory subgroup analysis moreover suggested an advantage in detectability for fetal behavioral state 2F (active asleep) compared to 1F (quiet asleep) detected using fetal heart rate. In conclusion, this pilot study is the first description of a method to detect human ASSRs in fetuses. The findings warrant further investigations of the developing fetal brain.

Current audiological diagnostics

Today's audiological functional diagnostics is based on a variety of hearing tests, whose large number takes account of the variety of malfunctions of a complex sensory organ system and the necessity to examine it in a differentiated manner and at any age of life. The objective is to identify nature and origin of the hearing loss and to quantify its extent as far as necessary to dispose of the information needed to initiate the adequate medical (conservative or operational) treatment or the provision with technical hearing aids or prostheses. Moreover, audiometry provides the basis for the assessment of impairment and handicap as well as for the calculation of the degree of disability. In the present overview, the current state of the method inventory available for practical use is described, starting from basic diagnostics over to complex special techniques. The presentation is systematically grouped in subjective procedures, based on psychoacoustic exploration, and objective methods, based on physical measurements: preliminary hearing tests, pure tone threshold, suprathreshold processing of sound intensity, directional hearing, speech understanding in quiet and in noise, dichotic hearing, tympanogram, acoustic reflex, otoacoustic emissions and auditory evoked potentials. Apart from a few still existing gaps, this method inventory covers the whole spectrum of all clinically relevant functional deficits of the auditory system.

The accuracy of objective threshold determination at low frequencies: comparison of different auditory brainstem response (ABR) and auditory steady state response (ASSR) methods

OBJECTIVE

The hearing threshold at 500 Hz was estimated using five methods which are suitable for the low frequency range: Low-Chirp BERA (LCBERA), Notched-noise BERA (NNBERA), Narrow band CE-Chirp BERA (NBCBERA) and Narrow band CE-Chirp ASSR (NBCASSR) (40/90 Hz). The slope of the discrimination function of each method was used for determination of the most efficient method. The threshold values were compared and the corresponding odds ratios (OR) were calculated.

DESIGN

All methods were applied to each subject. Stimulus levels were arranged individually. Response detection was carried out by visual inspection of the records in case of BERA and automatically in case of ASSR. Each individual series of recordings was converted to a dichotomous function indicating whether or not a response was discernible and a continuous method-specific discrimination function was constructed. This function was realised by a Boltzmann function whose slope in the inflection point serves as quality measure. Additionally, an OR evaluation was carried out in order to validate the significance of results.

STUDY SAMPLE

Twenty five normal hearing adults (aged 18-30 years) were tested.

RESULTS

LCBERA proved to have the highest reliability according to the slope of the Boltzmann function, the comparison of threshold values and OR.

CONCLUSIONS

The LCBERA is recommended for use in routine clinical practice.

Comparing pure-tone audiometry and auditory steady state response for the measurement of hearing loss

Objective

To compare pure-tone audiometry and auditory steady state response (ASSR) to measure hearing loss based on the severity of hearing loss in frequencies.

Study Design and Setting

A total of 105 subjects (168 ears, 64 male and 41 female) were enrolled in this study. We determined hearing level by measurement of pure-tone audiometry and ASSR on the same day for each subject.

Results

Pure-tone audiometry and ASSR were highly correlated (r = 0.96). The relationship is described by the equation PTA = 1.05 × mean ASSR − 7.6. When analyzed according to the frequencies, the correlation coefficients were 0.94, 0.95, 0.94, and 0.92 for 0.5, 1, 2, and 4 kHz, respectively.

Conclusion

From this study, authors could conclude that pure-tone audiometry and ASSR showed very similar results and indicated that ASSR may be a good alternative method for the measurement of hearing level in infants and children, for whom pure-tone audiometry is not appropriate. © 2007 American Academy of Otolaryngology-Head and Neck Surgery Foundation. All rights reserved.

Translating Adult Electrophysiology Findings to Younger Patient Populations: Difficulty Measuring 40-Hz Auditory Steady-State Responses in Typically Developing Children and Children with Autism Spectrum Disorder

BACKGROUND

x03B3; (∼30-80 Hz) brain rhythms are thought to be abnormal in neurodevelopmental disorders such as schizophrenia and autism spectrum disorder (ASD). In adult populations, auditory 40-Hz click trains or 40-Hz amplitude-modulated tones are used to assess the integrity of superior temporal gyrus (STG) 40-Hz x03B3;-band circuits. As STG 40-Hz auditory steady-state responses (ASSRs) are not fully developed in children, tasks using these stimuli may not be optimal in younger patient populations. The present study examined this issue in typically developing (TD) children as well as in children with ASD, using source localization to directly assess activity in the principal generators of the 40-Hz ASSR in the left and right primary/secondary auditory cortices.

METHODS

40-Hz amplitude-modulated tones of 1 s duration were binaurally presented while magnetoencephalography data were obtained from 48 TD children (45 males; 7-14 years old) and 42 ASD children (38 males; 8-14 years old). T1-weighted structural MRI was obtained. Using single dipoles anatomically constrained to each participant's left and right Heschl's Gyrus, left and right 40-Hz ASSR total power (TP) and intertrial coherence (ITC) measures were obtained. Associations between 40-Hz ASSR TP, ITC and age as well as STG gray matter cortical thickness (CT) were assessed. Group STG function and structure differences were also examined.

RESULTS

TD and ASD did not differ in 40-Hz ASSR TP or ITC. In TD and ASD, age was associated with left and right 40-Hz ASSR ITC (p < 0.01). The interaction term was not significant, indicating in both groups a ∼0.01/year increase in ITC. 40-Hz ASSR TP and ITC were greater in the right than left STG. Groups did not differ in STG CT, and no associations were observed between 40-Hz ASSR activity and STG CT. Finally, right STG transient x03B3; (50-100 ms and 30-50 Hz) was greater in TD versus ASD (significant for TP, trend for ITC).

CONCLUSIONS

The 40-Hz ASSR develops, in part, via an age-related increase in neural synchrony. Greater right than left 40-Hz ASSRs (ITC and TP) suggested earlier maturation of right versus left STG neural network(s). Given a ∼0.01/year increase in ITC, 40-Hz ASSRs were weak or absent in many of the younger participants, suggesting that 40-Hz driving stimuli are not optimal for examining STG 40-Hz auditory neural circuits in younger populations. Given the caveat that 40-Hz auditory steady-state neural networks are poorly assessed in children, the present analyses did not point to atypical development of STG 40-Hz ASSRs in higher-functioning children with ASD. Although groups did not differ in 40-Hz auditory steady-state activity, replicating previous studies, there was evidence for greater right STG transient x03B3; activity in TD versus ASD.

Refining the audiological assessment in children using narrow-band CE-Chirp-evoked auditory steady state responses

OBJECTIVE

To demonstrate the feasibility and reliability of simultaneous binaural recording of auditory steady-state responses (ASSR) in young children using narrow-band CE-Chirps as stimuli.

DESIGN

Prospective cohort study comparing ASSR thresholds to four frequency stimuli (0.5, 1, 2, and 4 kHz), with click-evoked auditory brainstem responses (ABR) and behavioral response audiometry.

STUDY SAMPLE

Thirty-two young children (mean age 7.4 ± 5.2 months) referred for auditory assessment were evaluated.

RESULTS

The mean duration for ABR recordings was 13.3 ± 7.2 min versus 22.9 ± 15.8 min for ASSR (p < 0.01). ASSR (means of 2 and 4 kHz thresholds) were highly correlated with ABR thresholds (R2 = 0.935, p < 0.001), though significantly different (3 ± 10.7 dB, p = 0.02). ASSR (means of 0.5, 1, 2, and 4 kHz thresholds) were highly correlated with mean behavioral response audiometry thresholds (R2 = 0.968, p < 0.001). ASSRs were highly and significantly correlated with behavioral response audiometry at 0.5, 1, 2, and 4 kHz (R2 = 0.845, 0.907, 0.929, and 0.859 respectively, p < 0.001). 87.5% and 90.7% ASSR thresholds were within a ± 10 dB range around their corresponding ABR and mean behavioral response audiometry thresholds.

CONCLUSIONS

Narrow-band CE-Chirps allow a fast and reliable assessment of auditory thresholds in children, especially in the low-frequency range, by comparison with other stimuli.

40-Hz multiple auditory steady-state responses to narrow-band chirps in sedated and anaesthetized infants

OBJECTIVE

The general consensus to date has been that a stimulus repetition rate of 40Hz is not appropriate for the recording of auditory steady-state responses (ASSR) in sedated or anaesthetized infants. The aim of this study was to investigate whether reliable 40-Hz ASSR thresholds can be obtained in sedated infants using narrow-band chirp stimuli in the clinical routine.

METHODS

40-Hz auditory brainstem responses (ABR) and 40-Hz ASSR were recorded in 34 infants below the age of 48 months under sedation or under general anaesthesia. ABR were evoked by broad-band chirp stimuli with a flat amplitude spectrum. ASSR were recorded simultaneously from both ears with an adaptive multiple stimulus paradigm using four narrow-band chirps centred at 500, 1000, 2000 and 4000Hz. ABR and ASSR thresholds were evaluated to determine differences between the estimates from the two methods.

RESULTS

Despite of sedation and anaesthesia, large wave V amplitudes of the chirp evoked 40-Hz ABR were found at levels as low as 10dB above the individual ABR threshold. ASSR thresholds for stimulus repetition rates of 40Hz could be consistently estimated in all 34 infants. Thresholds estimated from the ASSR for the four frequencies of the narrow-band chirps and the threshold derived from the broad-band chirp ABR differ, on average by 3.7dB for the frequency range of 1000-2000Hz and 7.1dB for the frequency range from 2000 to 4000Hz.

CONCLUSION

In contrast to the general assumption that 40-Hz ASSR are not appropriate for threshold estimation in infants our results demonstrate that multiple ASSR with a stimulus repetition rate of 40Hz can be recorded in sedated and anaesthetized infants using narrow-band chirps. Threshold estimates obtained with 40-Hz ASSR are, on average, slightly higher than those obtained with chirp evoked ABR but allow for a frequency specific characterisation of the hearing ability.

Development of sensory gamma oscillations and cross-frequency coupling from childhood to early adulthood

Given the importance of gamma oscillations in normal and disturbed cognition, there has been growing interest in their developmental trajectory. In the current study, age-related changes in sensory cortical gamma were studied using the auditory steady-state response (ASSR), indexing cortical activity entrained to a periodic auditory stimulus. A large sample (n = 188) aged 8-22 years had electroencephalography recording of ASSR during 20-, 30-, and 40-Hz click trains, analyzed for evoked amplitude, phase-locking factor (PLF) and cross-frequency coupling (CFC) with lower frequency oscillations. Both 40-Hz evoked power and PLF increased monotonically from 8 through 16 years, and subsequently decreased toward ages 20-22 years. CFC followed a similar pattern, with strongest age-related modulation of 40-Hz amplitude by the phase of delta oscillations. In contrast, the evoked power, PLF and CFC for the 20- and 30-Hz stimulation were distinct from the 40-Hz condition, with flat or decreasing profiles from childhood to early adulthood. The inverted U-shaped developmental trajectory of gamma oscillations may be consistent with interacting maturational processes-such as increasing fast GABA inhibition that enhances gamma activity and synaptic pruning that decreases gamma activity-that may continue from childhood through to adulthood.

Multiple-ASSR Interactions in Adults with Sensorineural Hearing Loss

The multiple auditory steady-state response (multiple-ASSR) technique, where thresholds for up to 8 frequencies (4 in each ear) are obtained simultaneously, is currently of great interest for audiometric assessment of infants. Although threshold estimates using the multiple-ASSR appear to be reasonably accurate, it is not currently known whether it is more efficient to use multiple stimuli or single stimuli when testing individuals with sensorineural hearing loss (SNHL). The current study investigated the effect of single versus multiple simultaneous stimuli on the 80- and 40-Hz ASSRs in adults with normal hearing or SNHL. Results showed significant interactions (i.e., decreased amplitudes) for both ASSRs going from single to multiple stimuli in one ear. Going from multiple one ear to multiple two ears did not further reduce the amplitude of the 80-Hz ASSR. At the 40-Hz rate, however, there was a further amplitude decrease going from one-ear multiple to two-ear multiple stimuli. Importantly, these interactions did not differ between the normal-hearing and SNHL groups. Although supportive of the multiple-ASSR technique, there are likely situations where it is more efficient to use single stimuli. Future studies are required to assess these interactions in infants with varying degrees and configurations of hearing loss.

Steady-state analysis of auditory evoked potentials over a wide range of stimulus repetition rates in awake vs. natural sleep

OBJECTIVE

Auditory steady-state responses (ASSR) evoked by recurrent tones were assessed over a wide range of stimulus repetition rates embracing well the traditionally measured transient AEPs. Repetition rates of ≤ 10 Hz have received little attention in the context of the ASSR stimulus-response analysis approach which is speculated to provide technical advantages, if not additional/supplemental information, over more traditional transient stimulus-response paradigms.

DESIGN

Magnitudes were measured at repetition rates from 0.75 to 80 Hz, using trains of recurrent tone-burst stimuli.

STUDY SAMPLE

Twenty-five normal-hearing adults during sleep and awake.

RESULTS

Results show that response magnitudes for adults tested during sleep were significantly larger than those for adults while awake at repetition rates <5 Hz. Magnitudes were largest at the two lowest repetition rates, as expected from corresponding results obtained using conventional methods.

CONCLUSIONS

The analysis methods used in this paper may give information that will have applications for clinical testing. Results confirm and extend knowledge of the effects of repetition rate on AEPs over a range embracing the gamut of responses as traditionally classified, specifically at the beginning stages of natural sleep.

Steady-state visual evoked potentials can be explained by temporal superposition of transient event-related responses

BACKGROUND

One common criterion for classifying electrophysiological brain responses is based on the distinction between transient (i.e. event-related potentials, ERPs) and steady-state responses (SSRs). The generation of SSRs is usually attributed to the entrainment of a neural rhythm driven by the stimulus train. However, a more parsimonious account suggests that SSRs might result from the linear addition of the transient responses elicited by each stimulus. This study aimed to investigate this possibility.

METHODOLOGY/PRINCIPAL FINDINGS

We recorded brain potentials elicited by a checkerboard stimulus reversing at different rates. We modeled SSRs by sequentially shifting and linearly adding rate-specific ERPs. Our results show a strong resemblance between recorded and synthetic SSRs, supporting the superposition hypothesis. Furthermore, we did not find evidence of entrainment of a neural oscillation at the stimulation frequency.

CONCLUSIONS/SIGNIFICANCE

This study provides evidence that visual SSRs can be explained as a superposition of transient ERPs. These findings have critical implications in our current understanding of brain oscillations. Contrary to the idea that neural networks can be tuned to a wide range of frequencies, our findings rather suggest that the oscillatory response of a given neural network is constrained within its natural frequency range.

Auditory steady-state responses (ASSR): effects of modulation and carrier frequencies

Presented are results relevant to extending the utility of the auditory steady-state response (ASSR) in threshold estimation at high-frequency carriers and to the accuracy of thresholds estimated using modulation frequencies near 40 versus 80 Hz. Initially, efforts were directed at confirming various findings reported in the literature apropos effects of several basic ASSR parameters. Results supplement others' observations suggesting that ASSR detection limits overestimate behavioral thresholds for conventional audiometric (carrier) frequencies from 500 to 4000 Hz. Further investigation revealed even greater errors of threshold estimates for 8000 and 12000 Hz, by about 14 and 22 dB on average, respectively. Although suggesting high-frequency ASSR testing to be efficacious, technical advances and additional work is needed to establish clinical utility. Comparison of effects of modulation frequency suggested ASSR thresholds with 40 Hz modulation to fall closer to behavioral threshold than those estimated at 80 Hz. Consequently, when circumstances permit, 40 Hz ASSR testing may be the method of choice (e.g. in the assessment of malingers, who may be tested awake/alert).

Auditory brainstem and middle latency responses to 1 kHz tones in noise-masked normally-hearing and sensorineurally hearing-impaired adults

The present study provides comparative evaluation of the ABR and MLR to 1 kHz brief tones in two groups of hearing-impaired subjects (noise-masked normally-hearing; and sensorineurally hearing-impaired adults), as well as a normally-hearing control group. Tones were presented at intensities from threshold to 80-90 dB nHL. The results of this study show that: (1) the ABR and MLR to these low-frequency (1 kHz) tones are equally accurate in estimating hearing threshold, (2) at supra-threshold levels, there are differences in the ABRs and MLRs for subjects with decreased hearing sensitivity resulting from cochlear pathology, compared to those obtained from adults with simulated hearing loss due to broadband masking, and (3) supra-threshold stimuli produce differential effects on the latency and amplitude characteristics of the ABR and MLR in listeners with true sensorineural hearing impairments. Possible physiologic explanations are offered for this differential pattern of results.

Hearing assessment by recording multiple auditory steady-state responses: the influence of test duration

The influence of test duration on the precision of hearing thresholds estimated by recording multiple auditory steady-state responses (ASSRs) was investigated. ASSR thresholds at four frequencies in both ears were assessed in 10 normal-hearing and 10 hearing-impaired subjects. The precision of the estimated hearing thresholds was compared for ASSR recordings of 5, 10 and 15 min per intensity level, corresponding to total test durations of approximately 30, 55 and 70 min for hearing-impaired ears. Furthermore, an intensity step size of 10 dB was compared to a step size of 5 dB. The mean difference scores averaged over the four frequencies were 15 +/- 10, 12 +/- 9 and 11 +/- 8 dB after recordings of 5, 10 and 15 min respectively. The corresponding Pearson correlation coefficients were 0.93, 0.95 and 0.96. Increasing the length of the separate recordings increases the precision of the estimates, independent of tested frequency. A compromise between both will have to be made. With a total test duration of approximately 1 h, four hearing thresholds in both ears can be estimated with a standard error of the estimate of 8 dB.

Optimizing the stimuli to evoke the amplitude modulation following response (AMFR) in neonates

OBJECTIVE

The goal was to identify stimulus features that enhance the detection of the amplitude modulation following response (AMFR) in neonates. The features explored were (1) envelope type, sinusoidal versus a half-wave rectified sinusoid (transposed); (2) best modulation frequency; and (3) spectral content, i.e., tone versus band-pass noise.

DESIGN

Results are based on recordings from 149 babies (80 babies in the neonatal intensive care unit and 69 newborn infants). All had passed hearing screening based on the click-evoked ABR. Babies were not sedated. We used carrier frequencies of approximately 500, 1000, 2000, and 4000 Hz and modulation frequencies between approximately 25 and 98 Hz. For the noise stimuli, we used band-pass noise at center frequencies of 500, 1000, 2000, and 4000 Hz. All stimuli were presented through insert earphones delivered simultaneously to both ears, at intensities ranging from 20 to 70 dB SPL. Magnitude squared coherence, phase coherence, and spectral criteria were used to detect criterion AMFRs. We analyzed four measures: (1) percent of satisfied runs; (2) the amplitude of criterion AMFR; (3) time to detect a criterion AMFR; and (4) response strength (e.g., the value of the magnitude squared coherence when it reached criterion minus the critical value it had to exceed for that number of averages all divided by the critical value).

RESULTS

(1) The AMFRs evoked by transposed tones were larger and detected faster than those to sinusoidal amplitude modulated tones. Consequently, remaining protocols all used the transposed envelopes. (2) The range of effective modulation frequencies was broad (41 to 88 Hz) across carrier frequencies. (3) The AMFRs evoked by transposed noise were faster and more efficient than those to transposed tones.

CONCLUSIONS

In neonates, transposed tones are more effective than sinusoidal amplitude modulated tones in evoking the AMFR, modulation frequencies between 41 to 88 Hz are almost equally effective in evoking the AMFR, and band-pass noises are more effective in evoking the AMFR than tones. These three stimulus factors all add incrementally to the efficiency of evoking the AMFR. The short detection times indicate that the AMFR could be an effective tool for hearing screening.

Modulation of steady-state auditory evoked potentials by cerebellar rTMS

Steady-state auditory evoked responses (SSAER) obtained via electroencephalography (EEG) co-vary in amplitude with blood flow changes in the auditory area of the cerebellum. The aim of the present EEG study was to probe the cerebellar role in the control of such SSAER. For this purpose, we investigated changes in SSAERs due to transient disruption of the cerebellar hemisphere by repetitive transcranial magnetic stimulation (rTMS). SSAERs to click-trains of three different frequencies in the gamma-band (32, 40 and 47 Hz) were recorded from 45 scalp electrodes in six healthy volunteers immediately after 1-Hz rTMS and compared to baseline SSAERs assessed prior to magnetic stimulation. Cerebellar rTMS contralateral to the stimulated ear significantly reduced the amplitude of steady-state responses to 40-Hz click-trains and showed a tendency to reduce the amplitude to 32-Hz click-trains. No effects were observed for 47-Hz click-trains, nor for magnetic stimulation of the cerebellum ipsilateral to auditory stimulation or after sham stimulation. Our results suggest that interference with cerebellar output by rTMS modifies functional activity associated with cortical auditory processing. The finding of maximum effects on 40-Hz SSAERs provides support to the notion that the cerebellum is part of a distributed network involved in the regulation of cortical oscillatory activity and points at some frequency-specificity for the control of auditory-driven neuronal oscillations.

Comparison of multiple auditory steady-state responses (80 versus 40 Hz) and slow cortical potentials for threshold estimation in hearing-impaired adults

This study evaluated the use of multiple auditory steady-state responses (ASSRs) and slow cortical potentials (SCPs) to estimate behavioural audiograms in adults for compensation cases. Two groups of 23 subjects were assessed using either 80 Hz or 40 Hz multiple simultaneous tones with carrier frequencies of 0.5, 1.0, 2.0, and 4.0 kHz. SCP thresholds for 0.5, 1.0, and 2.0 kHz were obtained for both groups. Mean evoked potential thresholds (dB HL) minus behavioural pure-tone thresholds (dB HL) difference scores were 5-17 dB for the 80 Hz group, 1-14 dB for the 40 Hz group, and 20-22 dB for the SCPs. Thresholds for 40 Hz ASSR were significantly closer to behavioural thresholds than were 80 Hz or SCP thresholds. SCP and 40 Hz ASSR audiogram estimates were obtained more quickly than the 80 Hz ASSR. Multiple 40 Hz ASSR is the method of choice for evoked potential threshold estimation in adults.

Tonfrequenzevozierte Potenziale

Auditory evoked responses to tone-pips in notched-noise provide frequency specific estimations of thresholds. Most often, test frequencies are 0.5-4 kHz. Thresholds are expected to match with a high degree to behavioral thresholds. However, only few studies are available containing data on stimulus and averaging parameters, especially at a test frequency of 0.25 kHz. In order to find "optimal" parameters for a widely used device (Nicolet Spirit Version 1.6), we designed five experiments on stimulus polarity (Exp.I), sweep frequency (Exp.II), stimulus duration (Exp.III), notched noise level (Exp.IV), and threshold estimation (Exp.V). The experiments also included a low test frequency of 0.25 kHz. These experiments were applied to 29 healthy volunteers (n=29, aged 20-41 years with normal hearing and no history of illness of the ear). We found that alternating stimulus polarity and a sweep frequency of 43.5/s evoked responses that were highest with respect to amplitudes (0.2-0.4 mV) and correlations (0.49-0.91). A novel finding of the study was that the highest amplitudes and correlations could be achieved if stimulus durations and notched-noise-levels were specifically adjusted to the test frequencies (stimulus durations 0.25 kHz: 4 ms, 0.5 Hz: 2 ms, 1-4 kHz: 1 ms, notched-noise-levels 0.25-0.5 Hz: +10 dB, 1-4 kHz: +/-0 dB). Deviations from behavioral thresholds did not exceed +/-5 dB in 93% of the measures. The results indicate that frequency specific auditory evoked responses provide reliable threshold estimations. Future experiments are required to confirm the threshold deviations for hard of hearing individuals.

Clinical application of dichotic multiple-stimulus auditory steady-state responses in high-risk newborns and young children

Experience with dichotic multiple-stimulus auditory steady-state responses (ASSRs) in clinical practice is described. ASSR thresholds were assessed in a sample of 60 high-risk newborns and young children between birth and 4 years of age. Amplitudes and signal-to-noise ratios (SNRs) of the ASSR were compared between normal-hearing infants and adults. Age-related changes within a group of infants younger than 3 months of age were investigated. A comparison was made between ASSR, the click-evoked auditory brainstem response and behavioral hearing thresholds in infants with a wide range of hearing threshold levels. Mean ASSR thresholds for normal-hearing infants at an average corrected age of 12 days were 42 +/- 10, 35 +/- 10, 32 +/- 10 and 36 +/- 9 dB SPL for 0.5, 1, 2 and 4 kHz, respectively. Compared to adults, these thresholds were elevated by on average 11 dB and SNRs were 1.7 times smaller. However, based on ASSRs, reasonably accurate estimations could be made of behavioral hearing thresholds obtained at a later age (median delay of 7 months). The predicted thresholds were in 61% of the cases within 10 dB of the corresponding behavioral thresholds, and in 83% of the cases within 15 dB. In less than 1 h, thresholds at four frequencies per ear could be obtained. The optimal age of testing is between 1 week and 3 months corrected age. The dichotic multiple-stimulus ASSR technique is a valuable extension of the clinical test battery for hearing-impaired children, as a follow-up diagnostic after the neonatal hearing screening.

EEG Derivations Providing Auditory Steady-State Responses With High Signal-to-Noise Ratios in Infants

OBJECTIVE

To identify EEG derivations that yield high signal-to-noise ratios (SNRs) of the auditory steady-state response (ASSR) in infants aged 0 to 5 months.

DESIGN

The ASSR was recorded simultaneously from 10 EEG derivations in a monopolar montage in 20 sleeping infants. Stimuli were tones of 0.5 or 2 kHz that were 100% amplitude modulated and 20% frequency modulated, presented at 65 dB SPL for 4.4 minutes in either the right or the left ear. An amplitude modulation frequency of 90 Hz (left ear) or 94 Hz (right ear) was used. From the 10 measured monopolar derivations, all 45 bipolar derivations were calculated mounting up to 55 EEG derivations. EEG derivations were selected in the preferred set if they had the largest SNRs within subjects and if they were obtained significantly more frequently across subjects than was expected by chance (Monte Carlo simulation and Wilcoxon signed ranks test).

RESULTS

The preferred derivations are both mastoids ipsilateral to the stimulated ear with Cz as common reference. These derivations improved SNRs compared with each of several conventional EEG derivations (excluding the preferred derivations) between 16 and 69% (500 Hz, left ear), 9 and 132% (500 Hz, right ear), 31 and 193% (2 kHz, left ear), and 3 and 105% (2 kHz, right ear). In contrast to results reported earlier for adults, high SNRs were not found at the inion-Cz derivation in these infants.

CONCLUSIONS

High SNRs were obtained in infants aged younger than 6 months if the ASSR was recorded from the mastoids ipsilateral to the ear of stimulation referenced to Cz.

Human auditory steady state responses to binaural and monaural beats

OBJECTIVE

Binaural beat sensations depend upon a central combination of two different temporally encoded tones, separately presented to the two ears. We tested the feasibility to record an auditory steady state evoked response (ASSR) at the binaural beat frequency in order to find a measure for temporal coding of sound in the human EEG.

METHODS

We stimulated each ear with a distinct tone, both differing in frequency by 40Hz, to record a binaural beat ASSR. As control, we evoked a beat ASSR in response to both tones in the same ear. We band-pass filtered the EEG at 40Hz, averaged with respect to stimulus onset and compared ASSR amplitudes and phases, extracted from a sinusoidal non-linear regression fit to a 40Hz period average.

RESULTS

A 40Hz binaural beat ASSR was evoked at a low mean stimulus frequency (400Hz) but became undetectable beyond 3kHz. Its amplitude was smaller than that of the acoustic beat ASSR, which was evoked at low and high frequencies. Both ASSR types had maxima at fronto-central leads and displayed a fronto-occipital phase delay of several ms.

CONCLUSIONS

The dependence of the 40Hz binaural beat ASSR on stimuli at low, temporally coded tone frequencies suggests that it may objectively assess temporal sound coding ability. The phase shift across the electrode array is evidence for more than one origin of the 40Hz oscillations.

SIGNIFICANCE

The binaural beat ASSR is an evoked response, with novel diagnostic potential, to a signal that is not present in the stimulus, but generated within the brain.

Objective assessment of frequency-specific hearing thresholds in babies

OBJECTIVE

To report on clinical experience using dichotic multiple-stimulus auditory steady-state responses (ASSRs) as an objective technique to estimate frequency-specific hearing thresholds in hearing-impaired infants.

METHODS

A comparison was made between the click-evoked auditory brainstem response (ABR), auditory steady-state responses and behavioral hearing thresholds (BHTs). Both ears of 10 infants between 3 and 14 months of age were tested. ABR and ASSRs were recorded during the same test session. ABR was evoked by 100 micros clicks. ASSRs were evoked by amplitude- and frequency-modulated tones with carrier frequencies of 0.5, 1, 2 and 4 kHz and modulation frequencies ranging from 82 to 110 Hz. Eight signals (four to each ear) were presented simultaneously. ASSR thresholds were derived after separate recordings of approximately 5, 7.5 and 10 min to compare the influence of test duration. BHTs were defined in later test sessions as soon as possible after the ASSR test, dependent on medical and developmental factors.

RESULTS

For the subjects tested in this study 60% of ABR thresholds and 95% of ASSR thresholds for 1, 2 and 4 kHz were found at an average age of 7 months. Only 51% of frequency-specific BHTs could be obtained but on average 5 months later. The correlation of ABR thresholds and ASSR thresholds at 2 kHz was 0.77. The correlation of ASSRs and BHTs was 0.92. The mean differences and associated standard deviations were 4 +/- 14, 4 +/- 11, -2 +/- 14 and -1 +/- 13 dB for 0.5, 1, 2 and 4 kHz, respectively. The average test duration was 45 min for ABR (one threshold in both ears) and 58 min for ASSR (four thresholds in both ears). By reducing the duration of the separate recordings of ASSR, the precision of the hearing threshold estimate decreased and the number of outlying and missing values increased. Correlation coefficients were 0.92, 0.89 and 0.83 for recordings of maximum 10, 7.5 and 5 min, respectively. A compromise between test duration and precision has to be sought.

CONCLUSIONS

Multiple-frequency ASSRs offer the possibility to estimate frequency-specific hearing thresholds in babies in a time-efficient way.

Auditory Steady-State Responses and Word Recognition Scores in Normal-Hearing and Hearing-Impaired Adults

OBJECTIVE

The number of steady-state responses evoked by the independent amplitude and frequency modulation (IAFM) of tones has been related to the ability to discriminate speech sounds as measured by word recognition scores (WRS). In the present study IAFM stimulus parameters were adjusted to resemble the acoustic properties of everyday speech to see how well responses to these speech-modeled stimuli were related to WRS.

DESIGN

We separately measured WRS and IAFM responses at a stimulus intensity of 70 dB SPL in three groups of subjects: young normal-hearing, elderly normal-hearing, and elderly hearing-impaired. We used two series of IAFM stimuli, one with modulation frequencies near 40 Hz and the other with modulation frequencies near 80 Hz. The IAFM stimuli, consisting of four carrier frequencies each independently modulated in frequency and amplitude, could evoke up to eight separate responses in one ear. We recorded IAFM responses and WRS measurements in quiet and in the presence of speech-masking noise at 67 dB SPL or 70 dB SPL. We then evaluated the hearing-impaired subjects with and without their hearing aids to see whether an improvement in WRS would be reflected in an increased number of responses to the IAFM stimulus.

RESULTS

The correlations between WRS and the number of IAFM responses recognized as significantly different from the background were between 0.70 and 0.81 for the 40 Hz stimuli, between 0.73 and 0.82 for the 80 Hz stimuli, and between 0.76 and 0.85 for the combined assessment of 40 and 80 Hz responses. Response amplitudes at 80 Hz were smaller in the hearing-impaired than in the normal-hearing subjects. Response amplitudes for the 40 Hz stimuli varied with the state of arousal and this effect made it impossible to compare amplitudes across the different groups. Hearing aids increased both the WRS and the number of significant IAFM responses at 40 Hz and 80 Hz. Masking decreased the WRS and the number of significant responses.

CONCLUSIONS

IAFM responses are significantly correlated with WRS and may provide an objective tool for examining the brain's ability to process the auditory information needed to perceive speech.

A whole head MEG study of the amplitude-modulation-following response: phase coherence, group delay and dipole source analysis

OBJECTIVE

The amplitude-modulation-following response (AMFR) is the frequency component detectable in the electroencephalogram (EEG) or magnetoencephalography (MEG) corresponding to the modulation frequency of an amplitude modulated tone used as a continuous acoustic stimulus. Various properties of the AMFR depend on modulation frequency, suggesting that different generators along the auditory pathway are involved. The present study addresses these issues on the basis of a whole head MEG experiment.

METHODS

AM tones with modulators in the 40 Hz and 80 Hz range were presented unilaterally to 10 normal hearing subjects. Biomagnetic responses were recorded with a 151 channel MEG system. The data analysis concentrated on the phase coherence of the responses, group delays and the estimated location of underlying equivalent dipole sources.

RESULTS

MEG AMFR is more reliably detected in the 40 Hz than in the 80 Hz range. Both response amplitude and phase coherence indicate clear bilateral activation over the parietal/temporal region. Dipole source analysis confirms that sources are located in or near the auditory cortex. Group delays at 80 Hz are shorter than at 40 Hz.

CONCLUSIONS

In both modulation frequency ranges MEG responses are dominated by activity in the auditory cortex, in apparent contrast with EEG data in the literature, pointing to dominant contributions of thalamic sources to the 80 Hz AMFR.

Human auditory steady-state responses

Steady-state evoked potentials can be recorded from the human scalp in response to auditory stimuli presented at rates between 1 and 200 Hz or by periodic modulations of the amplitude and/or frequency of a continuous tone. Responses can be objectively detected using frequency-based analyses. In waking subjects, the responses are particularly prominent at rates near 40 Hz. Responses evoked by more rapidly presented stimuli are less affected by changes in arousal and can be evoked by multiple simultaneous stimuli without significant loss of amplitude. Response amplitude increases as the depth of modulation or the intensity increases. The phase delay of the response increases as the intensity or the carrier frequency decreases. Auditory steady-state responses are generated throughout the auditory nervous system, with cortical regions contributing more than brainstem generators to responses at lower modulation frequencies. These responses are useful for objectively evaluating auditory thresholds, assessing suprathreshold hearing, and monitoring the state of arousal during anesthesia.

Place specificity of multiple auditory steady-state responses

Auditory steady-state responses (ASSRs) were elicited by simultaneously presenting multiple AM (amplitude-modulated) tones with carrier frequencies of 500, 1000, 2000, and 4000 Hz and modulation frequencies of 77, 85, 93, and 102 Hz, respectively. Responses were also evoked by separately presenting single 500- or 2000-Hz AM tones. The objectives of this study were (i) to determine the cochlear place specificity of single and multiple ASSRs using high-pass noise masking and derived-band responses, and (ii) to determine if there were any differences between single- and multiple-stimulus conditions. For all carrier frequencies, derived-band ASSRs for 1-octave-wide derived bands ranging in center frequency from 0.25 to 8 kHz had maximum amplitudes within a 1/2 octave of the carrier frequency. For simultaneously presented AM tones of 500, 1000, 2000, and 4000 Hz, bandwidths for the function of derived-band ASSR amplitude by derived-band center frequency were 476, 737, 1177, and 3039 Hz, respectively. There were no significant differences when compared to bandwidths of 486 and 1371 for ASSRs to AM tones of 500 or 2000 Hz presented separately. Results indicate that ASSRs to moderately intense stimuli (60 dB SPL) reflect activation of reasonably narrow cochlear regions, regardless of presenting AM tones simultaneously or separately.

Multiple auditory steady-state responses

Steady-state responses are evoked potentials that maintain a stable frequency content over time. In the frequency domain, responses to rapidly presented stimuli show a spectrum with peaks at the rate of stimulation and its harmonics. Auditory steady-state responses can be reliably evoked by tones that have been amplitude-modulated at rates between 75 and 110 Hz. These responses show great promise for objective audiometry, because they can be readily recorded in infants and are unaffected by sleep. Responses to multiple tones presented simultaneously can be independently assessed if each tone is modulated at a different modulation frequency. This ability makes it possible to estimate thresholds at several audiometric frequencies in both ears at the same time. Because amplitude-modulated tones are not significantly distorted by free-field speakers or microphones, they can also be used to evaluate the performance of hearing aids. Responses to amplitude and frequency modulation may also become helpful in assessing suprathreshold auditory processes, such as those necessary for speech perception.

Frequency specificity of the human auditory brainstem and middle latency responses using notched noise masking

This study investigated the frequency specificity of the auditory brainstem and middle latency responses to 80 and 90 dB ppe SPL 500-Hz and 90 dB ppe SPL 2000-Hz tonebursts. The stimuli were brief (2-1-2 cycle) linear-gated tonebursts. ABR/MLRs were recorded using two electrode montages: (1) Cz-nape of neck and (2) Cz-ipsilateral earlobe. Cochlear contributions to ABR wave V-Na and MLR waves Na-Pa and Pa-Nb were assessed by plotting notched noise tuning curves which showed amplitudes and latencies as a function of center frequency of the noise masker [Abdala and Folsom, J. Acoust. Soc. Am. 97, 2394 (1995); ibid. 98, 921 (1995)]. Maxima in the response amplitude profiles for the ABR and MLR to 80 dB ppe SPL tonebursts occurred within one-half octave of the nominal stimulus frequency, with minimal contributions to the responses from frequencies greater than one octave away. At 90 dB ppe SPL, contributions came from a slightly broader frequency region for both stimulus frequencies. Thus, the ABR/MLR to 80 dB ppe SPL tonebursts shows good frequency specificity which decreases at 90 dB ppe SPL. No significant differences exist in frequency specificity of: (1) ABR wave V-Na versus MLR waves Na-Pa and Pa-Nb at either stimulus frequency or intensity; and (2) ABR/MLRs recorded using the two electrode montages.

Clinical findings for a group of infants and young children with auditory neuropathy

OBJECTIVE

To examine the prevalence of auditory neuropathy in a group of infants at risk for hearing impairment and to present an overview of the clinical findings for affected children.

DESIGN

Results for 20 subjects who showed repeatable cochlear microphonic potentials in the absence of click-evoked auditory brain stem responses are included in this study. Behavioral and steady state evoked potential thresholds were established in each case. Where possible, otoacoustic emission and speech perception results (unaided and aided) also were obtained.

RESULTS

One in 433 (0.23%) of the children in our series had evidence of auditory neuropathy. The audiometric findings for these subjects varied significantly, with behavioral thresholds ranging from normal to profound levels. Discrimination skills were also variable. Approximately half of the subjects showed little understanding, or even awareness, of speech inputs in both the unaided and aided conditions. There were, however, a number of children who could score at significant levels on speech discrimination tasks and who benefited from the provision of amplification.

CONCLUSION

The results suggest that auditory neuropathy is more common in the infant population than previously suspected. The effects of neuropathy on auditory function appear to be idiosyncratic, producing significant variations in both the detection and discrimination of auditory signals. As such, the management of children with this disorder must allow for individual differences.

Deconvolution of 40 Hz steady-state fields reveals two overlapping source activities of the human auditory cortex

Steady-state auditory evoked fields were recorded from 15 subjects using a whole head MEG system. Stimuli were 800 ms trains of binaural clicks with constant stimulus onset asynchrony (SOA). Seven different SOA settings (19, 21, 23, 25, 27, 29 and 31 ms) were used to give click rates near 40 Hz. Transient responses to each click were reconstructed using a new algorithm that deconvoluted the averaged responses to the different trains. Spatio-temporal multiple dipole modelling in relation to 3D MRI scans revealed two overlapping source components in both the left and right auditory cortex. The primary sources in the medial part of Heschl's gyrus exhibited a N19-P30-N40 m pattern. The secondary, weaker sources at more lateral sites on Heschl's gyrus showed a N24-P36-N46 m pattern. When applied to transient middle latency auditory evoked fields (MAEFs) recorded at SOAs of 95-135 ms, the primary sources imaged activities similar to the deconvoluted steady-state responses, but the secondary source activities were inconsistent. Linear summation of the deconvoluted source waveforms accounted for more than 96% of the steady-state variance. This indicates that the primary activity of the auditory cortex remains constant up to high stimulation rates and is not specifically enhanced around 40 Hz.

Forward masking among infant and adult listeners

Psychophysical forward-masked thresholds were estimated for 3- and 6-month-old infants and for adults. Listeners detected a repeated 1000-Hz probe, with 16-ms rise time, no steady-state duration, and 16-ms fall time. Unmasked thresholds were determined for one group of listeners who were trained to respond when they heard the probe but not at other times. In the masking conditions, each tone burst was preceded by a 100-ms broadband noise masker at 65 dB SPL. Listeners were trained to respond when they heard the probe and masker, but not when they heard the masker alone. The masker-probe interval, delta t, was either 5, 10, 25, or 200 ms. Four groups of subjects listened in the masked conditions, each at one value of delta t. Each listener attempted to complete a block of 32 trials including four probe levels chosen to span the range of expected thresholds. "Group" thresholds, based on average psychometric functions, as well as thresholds for individual listeners, were estimated. Both group and individual thresholds declined with delta t, as expected, for both infants and adults. Infants' masked thresholds were higher than those of adults, and comparison of masked to unmasked thresholds suggested that infants demonstrate more forward masking than adults, particularly at short delta t. Forward masking appeared to have greater effects on 3-month-olds' detection than on either 6-month-olds' or adults'. Compared to adults, 6-month-olds demonstrated more forward masking only for delta t of 5 ms. Thus, susceptibility to forward masking may be nearly mature by 6 months of age.

Anesthesia and the electrophysiology of auditory consciousness

Empirical work is reviewed which correlates the presence or absence of various parts of the auditory evoked potential with the disappearance and reemergence of auditory sensation during induction of and recovery from anesthesia. As a result, the hypothesis is generated that the electrophysiological correlate of auditory sensation is whatever neural activity generates the middle latency waves of the auditory evoked potential. This activity occurs from 20 to 80 ms poststimulus in the primary and secondary areas of the auditory cortex. Evidence is presented suggesting that earlier or later waves in the auditory evoked potential do not covary with auditory sensation (as opposed to auditory perception) and it is therefore suggested that they are possibly not the electrophysiological correlates of sensation.

Multiple auditory steady-state responses (MASTER): stimulus and recording parameters

Steady-state responses evoked by simultaneously presented amplitude-modulated tones were measured by examining the spectral components in the recording that corresponded to the different modulation frequencies. When using modulation frequencies between 70 and 110 Hz and an intensity of 60 dB SPL, there were significant interactions between two stimuli when the carrier frequencies were closer than one half of an octave apart, with attenuation of the response to the lower carrier frequency. However, there were no significant decreases in response amplitude with four simultaneous stimuli provided the carrier frequencies differed by one octave or more. Higher intensities (70 dB SPL) resulted in greater interactions between the stimuli than when low intensities (35 dB SPL) were used. Modulation frequencies could be as closely spaced as 1.3 Hz without affecting the responses. Using broad-band noise as a carrier instead of a pure tone resulted in a significantly larger response when the stimuli were presented at the same sound pressure level. At modulation frequencies between 30 and 50 Hz, there were greater interactions between stimuli than at faster modulation frequencies. These results support the following recommendations for using multiple stimuli in evoked potential audiometry: (1) The multiple stimulus technique works well for steady state responses at frequencies between 70 and 110 Hz. (2) Up to four stimuli can be simultaneously presented to an ear without significant loss in amplitude of the response, provided the carrier frequencies are separated by an octave and the intensities are 60 dB SPL or less. (3) Bandpass noise might serve as a better carrier signal than pure tones.

Auditory development reflected by middle latency response

The auditory middle latency response (MLR) seems to have a relatively long developmental time course, extending through the first decade of life. Characteristics of each MLR component change developmentally not only with respect to waveform morphology but also with respect to response reliability, dependence on awareness state, and stimulus rate. Both human and animal studies indicate that these complex changes may be a result of multiple generating systems that show multiple time courses of development. This framework has practical ramifications in that clinical and research studies of MLR in young children must take into account the development sequence. Furthermore, it cannot be assumed a priori that research results obtained from adults will apply to young children. The complexity of the process raises intriguing questions regarding the functional development of auditory perception.

Generation of human auditory steady-state responses (SSRs). I: Stimulus rate effects

Auditory evoked responses were recorded in 16 normally hearing subjects in order to investigate the mechanisms underlying the generation of the 40 Hz steady-state response (SSR). In the first part of our study, auditory potentials were evoked by 0.1 ms clicks presented at 105 dB p.e. SPL with repetition rates of 7.9 (to obtain middle latency response, MLR), 20, 30, 40, 50, 60 Hz. In each subject predictions of the responses recorded at stimulus repetition rates of 30, 40, 50, 60 Hz were synthesized by superimposing MLRs at suitable time intervals. The calculated mean amplitude/rate and phase/rate functions behaved similarly for the recorded and predicted curves, showing the highest amplitude at 40 Hz and a linear increase of phase values when increasing the stimulus rate. Nevertheless the synthetic curves closely predicted amplitude and phase values of the recorded responses only at 40 Hz. At frequencies below 40 Hz, the mean amplitude of the predicted curve was lower than that of the recorded one while at frequencies above 40 Hz the mean amplitude was higher. Predicted phase values were found lagging at 30 Hz, and leading at 50 Hz and 60 Hz in comparison to phase values calculated on the recorded responses. Our findings suggest that a model based on the linear addition of transient MLRs is not able to adequately predict steady-state responses at stimulus rates other than at 40 Hz. Other mechanisms related to the recovery cycle of the activated system come into play in the steady-state response generation causing a decrease in amplitude and an increase in phase lag when increasing the stimulus repetition rate.

Generation of human auditory steady-state responses (SSRs). II: Addition of responses to individual stimuli

In order to investigate the generation of the 40 Hz steady-state response (SSR), auditory potentials evoked by clicks were recorded in 16 healthy subjects in two stimulating conditions. Firstly, repetition rates of 7.9 and 40 Hz were used to obtain individual middle latency responses (MLRs) and 40 Hz-SSRs, respectively. In the second condition, eight click trains were presented at a 40 Hz repetition rate and an inter-train interval of 126 ms. We extracted from the whole train response: (1) the response-segment taking place after the last click of the train (last click response, LCR), (2) a modified LCR (mLCR) obtained by clearing the LCR from the amplitude enhancement due to the overlapping of the responses to the clicks preceding the last within the stimulus train. In comparison to MLRs, the most relevant feature of the evoked activity following the last click of the train (LCRs, mLCRs) was the appearance in the 50-110 ms latency range of one (in 11 subjects) or two (in 2 subjects) additional positive-negative deflections having the same periodicity as that of MLR waves. The grand average (GA) of the 40 Hz-SSRs was compared with three predictions synthesized by superimposing: (1) the GA of MLRs, (2) the GA of LCRs, (3) the GA of mLCRs. Both the MLR and mLCR predictions reproduced the recorded signal in amplitude while the LCR prediction amplitude resulted almost twice that of the 40 Hz-SSR. With regard to the phase, the MLR, LCR and mLCR closely predicted the recorded signal. Our findings confirm the effectiveness of the linear addition mechanism in the generation of the 40 Hz-SSR. However the responses to individual stimuli within the 40 Hz-SSR differ from MLRs because of additional periodic activity. These results suggest that phenomena related to the resonant frequency of the activated system may play a role in the mechanisms which interact to generate the 40 Hz-SSR.

Auditory steady-state evoked potential in newborns

Steady-state evoked potential responses were recorded from 337 normal full-term sleeping newborns to combined amplitude and frequency modulated tones. Responses were automatically detected by statistical analysis of the response phase. Responses were most easily and consistently recorded at carrier frequencies of 500 Hz, 1500 Hz and 4000 Hz when the modulation frequency was between 60 Hz and 100 Hz. In this modulation frequency range, the response latencies were found to be between 11 ms and 15 ms, depending on carrier frequency, and the mean response thresholds for the three carrier frequencies were found to be 41.36 dB HL, 24.41 dB HL and 34.51 dB HL respectively. The results of this study suggest that steady-state evoked potentials at modulation rates in excess of 60 Hz may be useful for frequency specific, automated hearing screening in newborns.

Effect of natural sleep on auditory steady state responses in adult subjects with normal hearing

Auditory 40-Hz steady state response (SSR), auditory brainstem response (ABR), and middle-latency response (MLR) were recorded in 12 healthy adult females with normal hearing while awake and asleep. The responses were recorded with 500-Hz tone pips at 55 dBnHL. Synthesized SSR were made by superimposing the recorded ABR and MLR waveforms (ABR-MLR), and their amplitudes were compared with those of the actually recorded SSR. In the waking state, the ratio of the mean amplitude of recorded SSR to that of synthesized SSR was 0.819, whereas in the sleeping state it decreased to 0.522, a statistically significant difference. The results indicate that the SSR can be predicted from the linear superimposition of ABR and MLR in the waking state, but not in the sleeping state.