60例军校男女学员ASSR测试研究

目的旨在观察正常年轻人多频稳态诱发电位（ASSR）测试的正常值特点。方法对60例第一军医大学学员行ASSR、ABR和电测听测试，比较男．女及左、右耳测试值的差异。结果ASSR0．5kHz、1kHz、2kHz、4kHz测试值均数与纯音听闻均数各频率的差值分别为13．86dBHL、14．63dBHL、13．06dBHL．15．28dBHL；ASSR0．5kHz、1kHz、2kHz、4KHz测试值均数与ABRV波反应阈的差值分别为6．14dBHL、5．37dBHL、6．94dBHL、4．72dBHL；男、女学员ASSR测试值比较无显著性差异（P〉0．05）。结论ASSR正常值不受性别．耳别的影响；用ASSR测试值来推断预估纯音听阈．ABRV波反应阈要综合考虑各频率的差值。     

Establishing normal hearing with the dichotic multiple-frequency auditory steady-state response compared to an auditory brainstem response protocol

OBJECTIVE: To determine the clinical usefulness of the dichotic multiple-frequency (MF) auditory steady-state response (ASSR) technique for estimating normal hearing compared to a 0.5-kHz tone burst and broadband click auditory brainstem response (ABR) protocol in a sample of adults. MATERIAL AND METHODS: A comparative experimental research design was selected in order to compare estimations of normal hearing obtained with the dichotic ASSR technique at 0.5, 1, 2 and 4 kHz with a 0.5-kHz tone burst and broadband click ABR protocol. The recording times required for each procedure were also compared. Normal-hearing subjects (n = 28) were selected according to immittance values within normal limits and pure-tone behavioural thresholds of < 25 dB HL across frequencies. RESULTS: The dichotic MF ASSR estimated normal hearing to be, on average, 30-34 dB HL across the range 0.5-4 kHz. The mean estimate of normal hearing for 0.5 kHz using tone burst ABRs was 30 dB nHL and the mean click ABR threshold was 16 dB nHL, i.e. 14-18 dB better than the ASSR thresholds. The dichotic MFASSR technique recorded 8 thresholds (4 in each ear) in a mean time of 23 min. The ABR protocol recorded 4 thresholds (2 in each ear) in a mean time of 25 min. CONCLUSION: Both the dichotic MF ASSR and ABR protocols provided a time-efficient estimation of normal hearing. There was no significant difference between the tone burst ABR and MF ASSR techniques in terms of estimation of normal hearing at 0.5 kHz. The dichotic MF ASSR technique proved more time-efficient by determining more thresholds in a shorter time compared to the ABR protocol.     

Auditory steady-state response and auditory brainstem response thresholds in children

The inclusion of the auditory steady-state response (ASSR) into test-batteries for objective audiometry has allowed for clinical comparisons with the most widely used procedure, the auditory brainstem response (ABR). The current study describes ASSR and ABR thresholds for a group of infants and young children with various types and degrees of hearing loss. A sample of 48 subjects (23 female) with a mean age of 2.8 ± 1.9 years SD were assessed with a comprehensive test-battery and classified according to type and degree of hearing loss. Thresholds were determined with a broadband click-evoked ABR and single frequency ASSR evoked with continuous tones (0.25–4 kHz) amplitude modulated (67–95 Hz). Mean difference scores (±SD) between the ABR and high frequency ASSR thresholds were 9.8 (±11), 3.6 (±12) and 10.5 (±12) dB at 1, 2 and 4 kHz, respectively. An ASSR mean threshold for 2–4 and 1–4 kHz compared to the ABR threshold revealed an average difference of 7 (±9) and 7.9 (±8) dB, respectively. The overall correlation between the ABR and ASSR thresholds was highest for the mean ASSR thresholds of 2–4 and 1–4 kHz (r = 0.92 for both conditions). Correlations between the ABR and individual ASSR frequencies were slightly less (0.82–0.86). The average of the 2–4 kHz ASSR thresholds correlated best with the click-evoked ABR for all categories of hearing loss except for the sensorineural hearing loss category for which the 1–4 kHz ASSR average was better correlated to ABR thresholds. Findings demonstrate the reliability of verifying high frequency ASSR thresholds with a click-evoked ABR as an important cross-check in infants for whom behavioural audiometry may not be possible.     

68例感音神经性耳聋患者ASSR测试听阈与ABR测试V波反应阈的相关性研究

目的旨在探讨ASSR与ABR在诊断感音神经性耳聋中的相关性。方法68例临床诊断为感音神经性耳聋患者分别行0．5kHz，1kHz，2kHz，4kHzASSR测试及ABR测试，进行不同耳别、不同测试频率ASSR阈值与不同耳别ABRV波反应阈之间的相关分析。结果除了0．5kHz ASSR阈值与ABRV波反应阈的相关系数低而无显著意义外，1kHz，2kHz，4kHz ASSR阈值均与ABRV波反应阈有极显著性相关（P〈0．01），且随着测试频率的递增两者的相关系数随之增加，尤其是4kHz ASSR与ABRV波相关系数达到0．95以上（P〈0．01）。结论ASSR诊断感音神经性耳聋是可靠客观的，具有频率特性，可弥补ABR测试在诊断耳聋疾病中的频率局限性。     

多频稳态诱发电位评估中度感音神经性聋儿童的应用

目的探讨多频稳态听觉诱发电位评估儿童中度感音神经性聋的可靠性。方法所有患者经纯音测听（PTA）检查筛选出中度感音神经性聋30例5～6岁儿童（共40耳），然后口服10％水合氯醛镇静睡眠后，行多频稳态听觉诱发电位（ASSR）检测，其阈值与纯音听阂阈值进行比较，分析不同频率处听力阈值分布情况及其相关性。结果分别比较语言频率ASSR阂值与纯音听闽阈值，结果显示，0．5kHz处相关性较差，其差值为2-18dB，而在4kHz处相关性最好。结论可以应用多频稳态听觉诱发电位评估中度感音神经性聋儿童的听力阈值，但需要注意0．5kHz处的相关性差异。     

感音神经性聋儿童听性稳态反应与行为听阈相关性分析

目的：分析感音神经性聋儿童听性稳态反应（auditory steady－state response,ASSR）与行为听阈的相关性。方法63例（126耳）重度或极重度感音神经性听力损失儿童,年龄0．5～6岁,按年龄分为 A 组（0．5～1．0岁,21例）,B 组（1．1～3．0岁,21例）,C 组（3．1～6．0岁,21例）;分别进行 ASSR 及小儿行为听阈测试,A 组采用行为观察测听（BOA）,B 组采用视觉强化测听（VRA）,C 组采用游戏测听（PA）,采用 SPSS17．0统计软件分析二种检查结果的相关性。结果①ASSR 反应阈与行为听阈在0．5、1、2和4 kHz 处的相关系数分别为0．75、0．76、0．76、0．83,呈极显著相关（P ＜0．01）。②小儿行为听阈值通常比 ASSR 反应阈值低,随着频率的增高,两者间差距缩小。③A 组（相关系数0．70）各频率 ABR 反应阈与行为听阈相关性均较 B（相关系数0．78）、C（相关系数0．83）组低。结论0．5～6．0岁感音神经性聋儿童 ASSR 与行为听阈值均有良好的相关性,ASSR 可预测感音神经性聋儿言语频率的客观听阈,为低龄儿童及难以检测行为听力的患儿验配助听器提供参考。     

Comparison of auditory steady-state responses and auditory brainstem responses in audiometric assessment of adults with sensorineural hearing loss

Objective

Many of the medico-legal patients who claimed compensation may exaggerate hearing loss that varies in degree, nature, and laterality. The purpose of this study was to investigate whether Auditory Steady-State Response (ASSR) could be used to predict the hearing level of adults, and whether ASSR could become a better testing method than Auditory brainstem response (ABR) in audiometric assessment of adults with sensorineural hearing loss.

Methods

This was a prospective study, which was conducted in a tertiary referral hospital. From January to June 2007, 142 subjects (284 ears) with varying degrees of sensori-neural hearing impairment were included in this study. Four commonly used frequencies (500, 1000, 2000, 4000 Hz) were evaluated. All subjects received pure-tone audiometry, multi-channel ASSR, and ABR tests for threshold measurement. The correlation of pure tone thresholds with ASSR and ABR thresholds were assessed.

Results

Between multi-channel ASSR and pure tone thresholds, a difference of less than 15 dB was found in 71% while a difference of less than 25 dB was found in 89% of patients. The correlation coefficient (r) of multi-channel ASSR and pure tone thresholds were 0.89, 0.95, 0.96, and 0.97 at 500, 1000, 2000, and 4000 Hz, respectively. The strength of the relationship increased with increasing frequency. On the other hand, between ABR and pure-tone thresholds, a difference of less than 15 dB was found in 31%; a difference of less than 25 dB was found in 62% of patients. The r correlation value for ABR and pure tone thresholds was 0.83.

Conclusion

ASSR is a more reliable test for the accurate prediction of auditory thresholds than ABR. It can be a powerful and convenient electro-physiologic examination tool for clinically assessing of adults with sensorineural hearing loss.     

短声与短纯音ABR波V阈值的相关性比较

目的研究分别用短声与短纯音作为刺激声的听觉脑干诱发电位（auditory braistem response，ABR）波V阈值测试结果的相关性，以探讨短纯音ABR的临床应用价值。方法分别用短声和短纯音ABR对患者进行波V阈值的测试。结果测试的31耳中，短声与短纯音ABR500Hz～4000Hz的波V阈值的相关系数分别为：0．480、0．583．0．752和0．811。P值均为0。结论短声和短纯音ABR波V阈之间有相关性。其中，2000～4000Hz的相关性优于500～1000Hz；当听力损失大于70dBnHL时的500～1000Hz的相关性好于听力损失小于70dBnHL的时候。提示当短声ABR波V阈值大于70dBnHL时同样可以预测0．5kHz、1kHz短纯音ABR波V阈值。     

Evaluation of residual hearing in cochlear implants candidates using auditory steady-state response

Conclusion: The correlations between behavioral and auditory steady-state response (ASSR) thresholds were significant at 500, 1000, 2000, and 4000 Hz. ASSR presented high sensitivity and specificity in the detection of residual hearing in cochlear implant candidates when compared with warble-tone audiometry. Objectives: To assess residual hearing in cochlear implant candidates by comparing the electrophysiological thresholds obtained in dichotic single-frequency ASSR with behavioral thresholds at 500, 1000, 2000, and 4000 Hz. Methods: This was a comparative study between ASSR and warble-tone audiometry thresholds in 40 cochlear implant candidates (80 ears) before cochlear implantation with bilateral severe-to-profound sensorineural hearing loss. Results: Thresholds were obtained in 62.5% of all frequencies evaluated in warble-tone audiometry and in 63.1% in the ASSR. ASSR sensitivity was 96% and specificity was 91.6%. Mean differences between behavioral and ASSR thresholds did not reach significance at any frequencies. Strong correlations between behavioral and ASSR thresholds were observed in 500, 1000, and 2000 Hz and moderate in 4000 Hz, with correlation coefficients varying from 0.65 to 0.81. On 90% of occasions, ASSR thresholds were acquired within 10 dB of behavioral thresholds.     

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.     

Auditory sensitivity in children using the auditory steady-state response

OBJECTIVE: To determine the effectiveness of auditory steady-state response (ASSR) as a measure of hearing sensitivity in young children suspect for significant hearing loss. DESIGN: Within-subject comparisons of click auditory brainstem response (ABR) thresholds and ASSR thresholds. SUBJECTS: The study population comprised 42 children suspect for hearing loss and subsequently referred for hearing assessment using electrophysiologic techniques. MAIN OUTCOME MEASURES: Electrophysiologic threshold responses for click ABR and ASSR stimuli (0.5, 1, 2, and 4 kHz) for right and left ears. RESULTS: Based on ABR and ASSR thresholds, 50% of the subjects demonstrated significant hearing loss in the severe to profound range. In some subjects, ASSRs were present at higher stimulus levels when click ABRs were absent. Significant correlations (P<.05) were found between high-frequency ASSR and click ABR thresholds for this study sample. For some subjects, ASSR findings suggested differences between ears that were not observable from the no-response click ABR results. CONCLUSIONS: Auditory steady-state response testing may provide additional information for children who demonstrate hearing levels in the severe to profound range. This information may be helpful when selecting the ear for cochlear implantation for a young hearing-impaired child. Multiple objective methods, such as ABR and ASSR testing, may be needed to determine accurate hearing sensitivity for young children being considered for sensory devices, and in particular, cochlear implants.     

Threshold prediction using the auditory steady-state response and the tone burst auditory brain stem response: a within-subject comparison

OBJECTIVE: The purpose of this study was to evaluate the accuracy with which auditory steady-state response (ASSR) and tone burst auditory brain stem response (ABR) thresholds predict behavioral thresholds, using a within-subjects design. Because the spectra of the stimuli used to evoke the ABR and the ASSR differ, it was hypothesized that the predictive accuracy also would differ, particularly in subjects with steeply sloping hearing losses. DESIGN: ASSR and ABR thresholds were recorded in a group of 14 adults with normal hearing, 10 adults with flat, sensorineural hearing losses, and 10 adults with steeply sloping, high-frequency, sensorineural hearing losses. Evoked-potential thresholds were recorded at 1, 1.5, and 2 kHz and were compared with behavioral, pure-tone thresholds. The predictive accuracy of two ABR protocols was evaluated: Blackman-gated tone bursts and linear-gated tone bursts presented in a background of notched noise. Two ASSR stimulation protocols also were evaluated: 100% amplitude-modulated (AM) sinusoids and 100% AM plus 25% frequency-modulated (FM) sinusoids. RESULTS: The results suggested there was no difference in the accuracy with which either ABR protocol predicted behavioral threshold, nor was there any difference in the predictive accuracy of the two ASSR protocols. On average, ABR thresholds were recorded 3 dB closer to behavioral threshold than ASSR thresholds. However, in the subjects with the most steeply sloping hearing losses, ABR thresholds were recorded as much as 25 dB below behavioral threshold, whereas ASSR thresholds were never recorded more than 5 dB below behavioral threshold, which may reflect more spread of excitation for the ABR than for the ASSR. In contrast, the ASSR overestimated behavioral threshold in two subjects with normal hearing, where the ABR provided a more accurate prediction of behavioral threshold. CONCLUSIONS: Both the ABR and the ASSR provided reasonably accurate predictions of behavioral threshold across the three subject groups. There was no evidence that the predictive accuracy of the ABR evoked using Blackman-gated tone bursts differed from the predictive accuracy observed when linear-gated tone bursts were presented in conjunction with notched noise. Similarly, there was no evidence that the predictive accuracy of the AM ASSR differed from the AM/FM ASSR. In general, ABR thresholds were recorded at levels closer to behavioral threshold than the ASSR. For certain individuals with steeply sloping hearing losses, the ASSR may be a more accurate predictor of behavioral thresholds; however, the ABR may be a more appropriate choice when predicting behavioral thresholds in a population where the incidence of normal hearing is expected to be high.     

不同程度感音神经性听力损失儿童ASSR、click-ABR反应阈与行为听阈的相关性

目的 探讨不同程度感音神经性听力损失儿童听性稳态反应(ASSR)、短声听性脑干反应(click-ABR)与行为阈值的相关性及在听障儿童听力评估中的价值.方法 回顾性分析2019年1月至2019年12月确诊的46例(92耳)感音神经性听力损失儿童的ASSR、click-ABR及行为听阈结果,其中,轻度听力损失4耳,中度听...     

正常青年人短纯音ABR和ASSR的相关性研究

目的比较正常青年人短纯音听性脑干反应（auditory brainstem response，ABR）和听性稳态反应（auditory steady-state response，ASSR）反应阈的差异及相关性。方法对10名（20耳）听力正常青年人进行短纯音ABR和ASSR反应阈测试，分别记录0．5．1、2和4 kHz的反应阈，比较这两种不同测试方法所得反应阈的特点及相关性。结果短纯音ABR和ASSR反应阈无显著性差异（P〉O．05），两者在0．5、1、2和4 kHz处的相关系数分别为0．49、0．52．0．64和0．76。结论正常青年人短纯音ABR反应阈和ASSR反应阈存在一定的相关性，高频处的相关性较低频好。     

Predictive value of hearing assessment by the auditory brainstem response following universal newborn hearing screening

Abstract

Objective: This study set out to determine the accuracy with which tone pip ABR and click ABR, carried out in babies referred from universal newborn hearing screening, is able to predict the hearing outcome as determined by follow-up hearing tests. Study sample: The cohort of babies studied were all babies referred for hearing assessment from the universal newborn hearing screen in Sheffield, UK for the period January 2002 to September 2007, who were found to have a significant hearing impairment. Design: The results of hearing assessment following referral from the newborn hearing screen were collected together with those of follow-up tests carried out up to an age when behavioural testing had established ear- and frequency-specific thresholds at 0.5, 1, 2 and 4 kHz. Results: The standard deviation of the difference between the follow up and the tone pip ABR thresholds was 10.5 dB for the 4-kHz tone pip, 16.8 dB for the 1-kHz tone pip, and ranged between 21.7 and 24.7 dB for click ABR. Conclusions: The results of the study show that tone pip ABR following referral from newborn hearing screening has a similar accuracy to that reported in older subjects, and is a much better predictor compared to click ABR.     

Auditory evoked potentials in premature and full-term infants

Accurate information about type, degree, and configuration of hearing loss are necessary for successful audiological early interventions. Auditory brainstem response with tone burst stimuli (TB ABR) and auditory steady-state response (ASSR) exams provide this information.AimTo analyze the clinical applicability of TB ABR and ASSR at 2 kHz in infants, comparing responses in full-term and premature neonates.Material and MethodThe study was cross-sectional, clinical and experimental. Subjects consisted of 17 premature infants and 19 full-term infants. TB ABR and ASSR exams at 2000 Hz were done during natural sleep.ResultsThe electrophysiological minimum response obtained with TB ABR was 32.4 dBnHL (52.4 dBSPL); the ASSR minimum was 13.8 dBHL (26.4 dBSPL). The exams required 21.1 min and 22 min, respectively. Premature and full-term infant responses showed no statistically significant differences, except for auditory steady-state response duration.ConclusionsBoth exams have clinical applicability at 2 kHz in infants, with 20 min of duration, on average. In general, there are no differences between premature and full-term individuals.     

Auditory steady-state responses for children with severe to profound hearing loss

OBJECTIVE: To investigate the clinical usefulness of the dichotic single-frequency auditory steady-state response (ASSR) for estimation of behavioral thresholds in children with severe to profound congenital sensorineural hearing loss. DESIGN: A comparative experimental research design was selected to compare behavioral and ASSR thresholds for the sample. Behavioral pure-tone audiometry served as the criterion standard. SETTING: Hearing Clinic, Department of Communication Pathology, University of Pretoria, Pretoria, South Africa. PATIENTS: A referred sample of 10 patients (20 ears), 5 girls and 5 boys aged 10 to 15 years (mean age, 13 years 4 months), with severe to profound sensorineural hearing impairment. MAIN OUTCOME MEASURES: The difference, and correlation, between 160 pure-tone behavioral and ASSR thresholds at 0.5, 1, 2, and 4 kHz. RESULTS: Mean differences between ASSR and behavioral thresholds were 6 dB for 0.5 kHz and 4 dB for 1, 2, and 4 kHz, with standard deviations varying between 8 and 12 dB. No significant differences (P<.05) were observed between ASSR and behavioral thresholds, except at 0.5 kHz, and Pearson correlation coefficients varied between 0.58 and 0.74 across the evaluated frequencies, with best correlation at 1 kHz and worst at 0.5 kHz. CONCLUSIONS: The ASSR thresholds provided reliable estimations of behavioral thresholds for children with severe to profound hearing loss and indicated an increased sensitivity for more profound hearing loss.     

成人感音神经性聋的听觉稳态反应反应阈与纯音听阈

目的探讨成人感音神经性聋的听觉稳态反应（auditory steady-state responses,ASSR）反应阈与纯音听阈的关系。方法选择中国医科大学附属一院耳鼻咽喉科门诊感音神经性聋的成人患者,分别进行纯音听力测试、ASSR检查,比较ASSR在0.5、1、2、4 kHz频率处的反应阈与纯音听阈的相关性及按听力损失程度比较两者的差值。结果 ASSR反应阈与纯音听阈在各频率处的相关系数分别为0.840、0.905、0.886、0.924;随着感音神经性听力损失的加重二者的差值明显缩小。随着频率的增加,两者的差值明显缩小。结论成人感音神经性聋ASSR反应阈与纯音听阈有显著相关性,随着听力损失的加重,ASSR反应阈愈接近纯音听阈,ASSR作为成人感音神经性聋听力定量诊断的客观方法有很大的临床应用价值。     

正常儿童多频稳态诱发电位与纯音测听测试的相关性

目的：测定正常儿童多频稳态听觉诱发反应（multiple auditory steady-state responses,ASSR）阈值及纯音听阈,探讨两者的相关性。方法：对30例（60耳）正常5～10岁儿童分别行ASSR与纯音测听测试。结果：不同频率ASSR测试值均数与纯音听阈均数差值为11～16.50dB HL;各频率ASSR测试值与纯音听阈均数间差异均有统计学意义（P＜0.05）,在0.25?kHz及0.5?kHz组差异尤为明显（P＜0.01）。除0.25?kHz及0.5?kHz外,其他频率ASSR测试值与纯音听阈相关系数均有统计学意义（P＜0.05）,且随着测试频率的增加,两者的相关关系有增强趋势。结论：正常5～10岁儿童中、高频率ASSR测试值与纯音听阈有良好的相关性,可应用ASSR预测被检查者纯音听阈。     

感音神经性聋儿多频稳态诱发电位及短纯音听性脑干反应与行为测听的相关性

目的 比较多频稳态诱发电位（MASSR）、短纯音听性脑干反应（Tb—ABR）与感音神经性聋儿行为测试听阈的差值．研究MASSR和Tb—ABR反应阈与行为听阈之间是否存在相关性以及在不同听力损失聋儿、不同的频率之间的差异。方法 对60名感音神经性聋儿分别测试MASSR和Tb—ABR反应阈和行为听阈，评价MASSR反应阈、Tb—ABR反应阈与行为听阈的相关性。结果 MASSR反应阈、Tb—ABR反应阈和行为听阈之间均有较高的相关性。二者在频率为2、4kHz时，对行为听阈的预测具有相似的、较高的准确性；但在频率为0．5、1kHz时，MASSR的准确性较Tb—ABR高。结论 MASSR和Tb—ABR均可用作感音神经性聋儿言语频率客观听阈的预测，为低龄儿童及难以检测行为听力的患儿提供诊断依据。