Effect of contralateral masking on the latency of otoacoustic emissions elicited by acoustic distortion products

Assessment of cochlear and auditory pathways in patients with migraine

PURPOSE

In this study, we aimed to determine the function of the cochlea and peripheral and central auditory pathways with migraine.

MATERIALS AND METHODS

Fifty-eight patients with migraine and 40 healthy subjects were assessed using routine diagnostic audiometry along with transient evoked otoacoustic emissions (TOAEs), distortion product otoacoustic emissions (DPOAEs), and auditory brainstem response (ABR) at high and low repetition rate frequencies.

RESULTS

Nearly two thirds of patients with migraine had one or more abnormalities in electrophysiological testing. Compared with control subjects, patients reported significant lowering of TOAEs amplitude at frequencies of 1 kHz (right: P = .0003; left: P = .002), 3 kHz (right: P = .025), and 4 kHz (right: P = .019); prolonged wave III latency (right: P = .009); and I-V interpeak latency (IPL) (left: P = .024) at high repetition rate frequencies. Significant correlations were identified between age, duration of illness and frequency of migraine and TOAEs total response and at amplitude of 4 kHz, amplitudes of DPOAEs at 1, 1.5, 2, 3, and 5 kHz and I, III and wave latencies and I-V IPL of ABR at high rate frequencies.

CONCLUSIONS

These data suggest that subclinical changes in cochlear function and auditory pathways are associated with chronic migraine. It is possible that migraine could be accompanied by compromise of blood supply of auditory system.

Distortion product otoacoustic emission contralateral suppression functions obtained with ramped stimuli

The purpose of this research was to investigate the changes that occur in human distortion product otoacoustic emission (DPOAE) level functions over continuous frequency bands in response to activation of the medial olivocochlear (MOC) efferent system by contralateral broadband noise. DPOAEs were obtained using continuous upward ramps of the lower frequency tone (f(1)) while the higher frequency tone (f(2)) was fixed. These ramps were designed to change the stimulus frequency ratio f(2)/f(1) over a fixed range for each fixed f(2) value of 2, 3, and 4 kHz. Contralateral noise was presented on alternating ramps and the DPOAEs with and without contralateral noise were averaged separately. Stimulus frequency ratios of 1.10 and 1.22, and noise levels of 60 and 50 dB sound pressure level (SPL) were employed. Changes in DPOAE level were generally suppression (a reduction in DPOAE magnitude), but enhancement was also observed. For most participants, changes were evident for much of the frequency ranges tested. Average absolute changes for 60 dB SPL noise were 0.95, 0.81, and 0.42 dB for the wider stimulus frequency ratios and f(2) of 2, 3, and 4 kHz, respectively. For the narrower ratio and 60 dB SPL noise, the changes were larger with average absolute changes of 1.33, 1.09, and 0.87 dB. For the narrower ratio and 50 dB SPL noise, the changes were 1.08, 0.78, and 0.55 dB with f(2) of 2, 3, and 4 kHz, respectively. DPOAE nulls were observed and a common response pattern was a shift of emission morphology to higher frequencies with contralateral acoustic stimulation. The method appears promising for relatively rapid evaluation of the MOC efferent system in humans and offers information complementary to measurement strategies that explore the effects of stimulus level.

Irreversible cochlear damage in myasthenia gravis -- otoacoustic emission analysis

OBJECTIVE

Acetyl choline (ACh) is the main neurotransmitter of the efferent auditory system. This study is aimed to evaluate cochlear function in myasthenia gravis (MG), a neuromuscular transmission disorder caused by ACh receptor autoantibodies.

METHODS

This prospective study included 16 myasthenic patients, tested audiologically twice, first after improvement from myasthenic crisis or acute oropharyngeal dysfunction (1 week from admission) and then 2 months later. We detected the effect of contralateral acoustic stimulation (CAS) on patients' transient and distortion product otoacoustic emissions (TEOAE and DPOAE).

RESULTS

Compared with controls, patients reported significant reduction in overall echo response and amplitude of TEOAEs at 1-2 kHz and at 1-6 kHz of DPOAE with marked reduction at 5 kHz. In the control group, CAS produced amplitude reduction in TEOAEs and DPOAEs at 1-4 kHz. Utilizing masking effect, patients reported amplitude reduction in TEOAEs at 1.5-4 kHz while DPOAEs did not reach significant level except at 1.5 and 5 kHz. After 2 months, no changes were observed compared with early assessment.

CONCLUSIONS

It is clear that disease progression is associated with irreversible cochlear damage. Lack of improvement in patients' emissions despite partial non-audiometric improvement in relation to receptors needs to be considered.

Latency of DPOAE in milliseconds and waves

The latency of Distortion Product Otoacoustic Emissions is defined as the time interval between the wave onset from initial stimulation and the return to the ear canal.

Aim

The aim of this research was to verify the latency of the distortion product otoacoustic emissions in normal hearing adults, analyzing the influence of the gender, ear, frequencies and measurements.

Study design

clinical prospective.

Material and method

The measurements had been taken in milliseconds and waves. It was an experimental study, conducted at São Paulo City in 2003. The sample consisted of 38 adults, 18 men and 20 women. Significant Differences for interactions between frequency, ear, gender and measurements were not observed in relation to the latency in milliseconds and waves. A high correlation between the latency measurements in milliseconds and waves was observed. It was concluded that the latency of distortion product otoacoustic emission diminishes as increases the frequency in milliseconds and the opposite occurs in waves. Statistical differences in latencies of distortion product otoacoustic emission were not observed between gender, ears and measurements.

Contralateral suppression of DPOAE measured in real time

The aim of this study was to measure contralateral suppression of distortion product otoacoustic emissions (DPOAE) in real time. A total of 10 human subjects were studied with a novel device to record DPOAE without signal time averaging, using digital narrow band pass filtering. Real time DPOAE levels were recorded at 2f1-f2 using primary tone settings of f2/f1 = 1.22 and L1 = 70 dB SPL, L2 = 65 dB SPL, at five values of f2 between 2.2 and 7.7 kHz. An acoustic stimulus was applied intermittently to the contralateral ear to cause DPOAE suppression. Characteristic features of contralateral suppression were identified and distinguished from small spontaneous variations in the real time DPOAE signal. Magnitude of suppression increased with contralateral stimulus intensity. Onset latency of suppression was around 43 ms (31-95 ms). Potential clinical applications are discussed in the light of these findings, including a role in improving the specificity of neonatal hearing screening.