The summating potential in human electrocochleography: Gaussian models and Fourier analysis

A Time-Saving Alternative to "Peak-Picking" Algorithms: A Gaussian Mixture Model Feature Extraction Technique for the Neurodiagnostic Auditory Brainstem Response

OBJECTIVES

The accurate and efficient analysis of neurodiagnostic auditory brainstem responses (ABR) plays a critical role in assessing auditory pathway function in human and animal research and in clinical diagnosis. Traditional analysis of the neurodiagnostic ABR analysis involves visual inspection of the waveform and manually marking peaks and troughs. Visual inspection is a tedious and time-consuming task, especially in research where there may be hundreds or thousands of waveforms to analyze. "Peak-picking" algorithms have made this task faster; however, they are prone to the same errors as visual inspection. A Gaussian mixture model-based feature extraction technique (GMM-FET) is a descriptive model of ABR morphology and an alternative to peak-picking algorithms. The GMM-FET is capable of modeling multiple waves and accounting for wave interactions, compared with other template-matching approaches that fit single waves.

DESIGN

The present study is a secondary analysis applying the GMM-FET to 321 ABRs from adult humans from 2 datasets using different stimuli and recording parameters. Goodness-of-fit of the GMM-FET to waves I and V and surrounding waves, that is, the summating potential and waves IV and VI, was assessed, and latency and amplitude estimations by the GMM-FET were compared with estimations from visual inspection.

RESULTS

The GMM-FET had a similar success rate to visual inspection in extracting peak latency and amplitude, and there was low RMS error and high intraclass correlation between the model and response waveform. Mean peak latency differences between the GMM-FET and visual inspection were small, suggesting the two methods chose the same peak in the majority of waveforms. The GMM-FET estimated wave I amplitudes within 0.12 µV of visual inspection, but estimated larger wave V amplitudes than visual inspection.

CONCLUSIONS

The results suggest the GMM-FET is an appropriate method for extracting peak latencies and amplitudes for neurodiagnostic analysis of ABR waves I and V.

Evidence of cochlear neural degeneration in normal-hearing subjects with tinnitus

Tinnitus, reduced sound-level tolerance, and difficulties hearing in noisy environments are the most common complaints associated with sensorineural hearing loss in adult populations. This study aims to clarify if cochlear neural degeneration estimated in a large pool of participants with normal audiograms is associated with self-report of tinnitus using a test battery probing the different stages of the auditory processing from hair cell responses to the auditory reflexes of the brainstem. Self-report of chronic tinnitus was significantly associated with (1) reduced cochlear nerve responses, (2) weaker middle-ear muscle reflexes, (3) stronger medial olivocochlear efferent reflexes and (4) hyperactivity in the central auditory pathways. These results support the model of tinnitus generation whereby decreased neural activity from a damaged cochlea can elicit hyperactivity from decreased inhibition in the central nervous system.

Characteristics of the Summating Potential Measured Across a Cochlear Implant Array as an Indicator of Cochlear Function

OBJECTIVES

The underlying state of cochlear and neural tissue function is known to affect postoperative speech perception following cochlear implantation. The ability to assess these tissues in patients can be performed using intracochlear electrocochleography (IC ECochG). One component of ECochG is the summating potential (SP) that appears to be generated by multiple cochlear tissues. Its qualities may be able to detect the presence of functional inner hair cells, but evidence for this is limited in human cochleae. This study aimed to examine the IC SP characteristics in cochlear implantation recipients, its relationship to preoperative speech perception and audiometric thresholds, and to other IC ECochG components.

DESIGN

This is a retrospective analysis of 113 patients' IC ECochG recordings across the array in response to a 500 Hz tone burst stimulus. Responses to condensation and rarefaction stimuli were then subtracted from one another to emphasize the cochlear microphonic and added to one another to emphasize the SP, auditory nerve neurophonic, and compound action potential. Patients were grouped based on their maximum SP deflection being large and positive (+SP), large and negative (-SP), or minimal (0 SP) to further investigate these relationships.

RESULTS

Patients in the +SP group had better preoperative speech perception (mean consonant-vowel-consonant phoneme score 46%) compared to the -SP and 0 SP groups (consonant-vowel-consonant phoneme scores 34% and 36%, respectively, difference to +SP: p < 0.05). Audiometric thresholds were lowest for +SP (mean pure-tone average 50 dB HL), then -SP (65 dB HL), and highest for 0 SP patients (70 dB HL), but there was not a statistical significance between +SP and -SP groups ( p > 0.1). There were also distinct differences between SP groups in the qualities of their other ECochG components. These included the +SP patients having larger cochlear microphonic maximum amplitude, more apical SP peak electrode locations, and a more spatially specific SP magnitude growth pattern across the array.

CONCLUSIONS

Patients with large positive SP deflection in IC ECochG have preoperatively better speech perception and lower audiometric thresholds than those without. Patterns in other ECochG components suggest its positive deflection may be an indicator of cochlear function.

Minimum Detectable Differences in Electrocochleography Measurements: Bayesian-Based Predictions

Physiology of the cochlea and auditory nerve can be assessed with electrocochleography (ECochG), a technique that involves measuring auditory evoked potentials from an electrode placed near or within the cochlea. Research, clinical, and operating room applications of ECochG have in part centered on measuring the auditory nerve compound action potential (AP) amplitude, the summating potential (SP) amplitude, and the ratio of the two (SP/AP). Despite the common use of ECochG, the variability of repeated amplitude measurements for individuals and groups is not well understood. We analyzed ECochG measurements made with a tympanic membrane electrode in a group of younger normal-hearing participants to characterize the within-participant and group-level variability for the AP amplitude, SP amplitude, and SP/AP amplitude ratio. Results show that the measurements have substantial variability and that, especially with smaller sample sizes, significant reduction in variability can be obtained by averaging measurements across repeated electrode placements within subjects. Using a Bayesian-based model of the data, we generated simulated data to predict minimum detectable differences in AP and SP amplitudes for experiments with a given number of participants and repeated measurements. Our findings provide evidence-based recommendations for the design and sample size determination of future experiments using ECochG amplitude measurements, and the evaluation of previous publications in terms of sensitivity to detecting experimental effects on ECochG amplitude measurements. Accounting for the variability of ECochG measurements should result in more consistent results in the clinical and basic assessments of hearing and hearing loss, either hidden or overt.

Isolating auditory-nerve contributions to electrocochleography by high-pass filtering: A better biomarker for cochlear nerve degeneration?

In search of biomarkers for cochlear neural degeneration (CND) in electrocochleography from humans with normal thresholds, we high-pass and low-pass filtered the responses to separate contributions of auditory-nerve action potentials (N1) from hair-cell summating potentials (SP). The new N1 measure is better correlated with performance on difficult word-recognition tasks used as a proxy for CND. Furthermore, the paradoxical correlation between larger SPs and worse word scores, observed with classic electrocochleographic analysis, disappears with the new metric. Classic SP is simultaneous with and opposite in phase to an early neural contribution, and filtering separates the sources to eliminate this interference.

Temporal Envelope Coding of the Human Auditory Nerve Inferred from Electrocochleography: Comparison with Envelope Following Responses

Neural coding of the slow amplitude fluctuations of sound (i.e., temporal envelope) is thought to be essential for speech understanding; however, such coding by the human auditory nerve is poorly understood. Here, neural coding of the temporal envelope by the human auditory nerve is inferred from measurements of the compound action potential in response to an amplitude modulated carrier (CAPENV) for modulation frequencies ranging from 20 to 1000 Hz. The envelope following response (EFR) was measured simultaneously with CAPENV from active electrodes placed on the high forehead and tympanic membrane, respectively. Results support the hypothesis that phase locking to higher modulation frequencies (> 80 Hz) will be stronger for CAPENV, compared to EFR, consistent with the upper-frequency limits of phase locking for auditory nerve fibers compared to auditory brainstem/cortex neurons. Future work is needed to determine the extent to which (1) CAPENV is a useful tool for studying how temporal processing of the auditory nerve is affected by aging, hearing loss, and noise-induced cochlear synaptopathy and (2) CAPENV reveals the relationship between auditory nerve temporal processing and perception of the temporal envelope.

Neural Contributions to the Cochlear Summating Potential: Spiking and Dendritic Components

Using electrocochleography, the summating potential (SP) is a deflection from baseline to tones and an early rise in the response to clicks. Here, we use normal hearing gerbils and gerbils with outer hair cells removed with a combination of furosemide and kanamycin to investigate cellular origins of the SP. Round window electrocochleography to tones and clicks was performed before and after application of tetrodotoxin to prevent action potentials, and then again after kainic acid to prevent generation of an EPSP. With appropriate subtractions of the response curves from the different conditions, the contributions to the SP from outer hair cells, inner hair cell, and neural "spiking" and "dendritic" responses were isolated. Like hair cells, the spiking and dendritic components had opposite polarities to tones - the dendritic component had negative polarity and the spiking component had positive polarity. The magnitude of the spiking component was larger than the dendritic across frequencies and intensities. The onset to tones and to clicks followed a similar sequence; the outer hair cells responded first, then inner hair cells, then the dendritic component, and then the compound action potential of the spiking response. These results show the sources of the SP include at least the four components studied, and that these have a mixture of polarities and magnitudes that vary across frequency and intensity. Thus, multiple possible interactions must be considered when interpreting the SP for clinical uses.

Electrocochleography in Auditory Neuropathy Related to Mutations in the OTOF or OPA1 Gene

Auditory Neuropathy (AN) is characterized by disruption of temporal coding of acoustic signals in auditory nerve fibers resulting in alterations of auditory perceptions. Mutations in several genes have been associated to the most forms of AN. Underlying mechanisms include both pre-synaptic and post-synaptic damage involving inner hair cell (IHC) depolarization, neurotransmitter release, spike initiation in auditory nerve terminals, loss of auditory fibers and impaired conduction. In contrast, outer hair cell (OHC) activities (otoacoustic emissions [OAEs] and cochlear microphonic [CM]) are normal. Disordered synchrony of auditory nerve activity has been suggested as the basis of both the alterations of auditory brainstem responses (ABRs) and reduction of speech perception. We will review how electrocochleography (ECochG) recordings provide detailed information to help objectively define the sites of auditory neural dysfunction and their effect on receptor summating potential (SP) and neural compound action potential (CAP), the latter reflecting disorders of ribbon synapses and auditory nerve fibers.