Jane Alaerts

The influence of the detection paradigm in recording auditory steady-state responses

Objectives: The purpose of this study was to evaluate the risks of uncontrolled use of an objective detection criterion in recording auditory steady-state responses (ASSRs). The influence of decisions such as when to accept a response and stop the recording was assessed by analyzing the number of false- and true-detected responses. Design: A large sample of 500 multiple-stimulus ASSR recordings of normal-hearing and hearing-impaired adults and babies was processed offline. Three types of detection paradigms were evaluated. A first type had a fixed recording length with significance testing after the last sweep. A second type allowed a variable recording length and implied sequential application of the statistical decision criterion. The recording was stopped after significance was reached for y consecutive sweeps. The third type was analogous to the second, with the additional requirement of a minimum of eight recorded sweeps. Furthermore, the effect of significance level and averaging procedure were assessed. Error rates were calculated for the different detection paradigms at eight control frequencies. At the signal frequencies, detection rates and recording times were determined, keeping the error rates fixed. Moreover, ASSR thresholds were compared for a selection of detection paradigms. Results: When a variable recording length was allowed and a significance level of p = 0.05 was applied, the error rate increased to unacceptable levels because of the effect of repeated testing. The error rate decreased as the required number of consecutive significant sweeps increased and approximated 5% only when eight consecutive significant sweeps were required (with a maximum of 32 recorded sweeps). With an error rate of 5%, the highest detection rate was associated with a fixed recording length of 32 sweeps combined with weighted averaging. A substantial decrease in detection rate was noted when less than 24 sweeps were recorded per intensity. All paradigms with a variable recording length had rather comparable detection rates and recording times. With an error rate of only 1%, small responses could not be distinguished from the noise. The reduction in recording time using a variable instead of a fixed recording length was very limited when a conventional multiple-stimulus approach was used. Test duration would be reduced considerably when the test set-up would allow an independent presentation and recording of the eight signals and responses. Differences in overall detection rate had a small effect on the ASSR thresholds. Conclusions: The error rate, detection rate, and recording time can improve or deteriorate significantly, even with small adaptations of the detection protocol. When a variable recording length is allowed, the acceptance criterion of the statistical test needs to be adjusted to ensure a tolerable error rate. However, most commercial devices do not offer this option. Then, it is advisable to use a fixed recording length and to judge the significance of the responses at the end of the recording. Although response detection is objective, the measurement protocol has to be well-considered and a critical approach is required when interpreting the responses.

Cortical auditory steady-state responses to low modulation rates

This paper describes low-frequency auditory steady-state responses (ASSRs) to speech-weighted noise stimuli. The effect of modulation frequency was evaluated within the frequency range below 40 Hz. Furthermore, objective ASSR measures were related to speech understanding performance in normal-hearing and hearing-impaired listeners. The variability in ASSR recordings over independent test sessions was larger between subjects than within. Trends of increased responses around 10 and/or 20 Hz were found in all subjects. Obtained latency estimates of the responses pointed to primarily cortical sources involved in ASSR generation at low frequencies. Furthermore, significant differences between normal-hearing and hearing-impaired adults were found for ASSRs to stimuli related to the temporal envelope of speech. Comparing these responses with phoneme identification scores over different stimulus levels showed both measures increased with stimulus level in a similar way (ρ=0.82). At a fixed stimulus level, ASSRs were significantly correlated with speech reception thresholds for phonemes and sentences in noise (ρ from −0.45 to −0.53). These results indicate that objective low-frequency ASSRs are related to behavioral speech understanding, independently of level.

Latencies of Auditory Steady-State Responses Recorded in Early Infancy

Multiple-stimulus auditory steady-state responses (ASSRs) were assessed in 111 ears of 70 infants between –4 and 19 weeks of age at risk for hearing loss. ASSR thresholds obtained in infants with normal hearing (n = 69 ears) were compared with normal adult ASSR thresholds (n = 32 ears), and the linear relation between ASSR thresholds and behavioral thresholds (BHTs) was investigated in normal-hearing and hearing-impaired infants (n = 79 ears). Furthermore, latency estimates of significant responses to stimuli of 50 dB SPL were compared between the normal-hearing infants (n = 171 data points) and adults (n = 124 data points) and developmental changes in latency were evaluated within the infant group. Normal ASSR thresholds were on average 12 dB higher in infants compared with adults. Correlations between ASSR thresholds and BHTs were 0.75, 0.87, 0.87 and 0.79 for 500, 1000, 2000 and 4000 Hz, respectively. There was a significant effect of carrier frequency on ASSR latency, with higher carrier frequencies evoking shorter latencies in both infants and adults. Mean latencies in adults were 24.3 ± 1.5, 22.3 ± 1.1, 19.4 ± 1.0 and 18.0 ± 1.1 ms for 500, 1000, 2000 and 4000 Hz, respectively. Depending on the data fit of the infant latency estimates, mean latencies were 1.0 ms shorter or 9.5 ms longer in infants compared with adults. In infants, latencies were on average 2.0 ms longer in the youngest infant group (≤0 weeks) relative to the oldest infant group (3–8 weeks). These age-related trends, together with other arguments, point to longer latencies in infants compared with adults. The results of this study are valuable as a clinical reference for interpreting ASSR results obtained in high-risk infants within their first months of life and indicate that developmental changes occur regarding ASSR latency.

A flexible research platform for multi-channel auditory steady-state response measurements.

The possibilities of currently commercially available auditory steady-state response (ASSR) devices are mostly limited to avoid unintentional misuse and to guarantuee patient safety as such. Some setups, e.g. do not allow the application of high intensities or the use of own stimuli. Moreover, most devices generally only allow data collection using maximal two EEG channels. The freedom to modify and extend the accompagnying software and hardware is very restricted or inexistent. As a result, these devices are not suited for research and several clinically diagnostic purposes. In this paper, a research platform for multi-channel ASSR measurements is presented, referred to as SOMA (setup ORL for multi-channel ASSR). The setup allows multi-channel measurements and the use of own stimuli. It can be easily extended to facilitate new measurement protocols and real-time signal processing. The mobile setup is based on an inexpensive multi-channel RME soundcard and software is written in C++. Both hardware and software of the setup are described. An evaluation study with nine normal-hearing subjects shows no significant performance differences between a reference and the proposed platform. SOMA presents a flexible and modularly extensible mobile high-end multi-channel ASSR test platform.