Abstract
The effects of rise-fall and plateau times for the Pa component of the middle-latency response (MLR) were investigated in normally hearing subjects, and an objective MLR threshold was measured in patients with low- and middle-tone hearing losses, using a selected stimulus-envelope time. Our results showed that the stimulus-envelope time (the rise-fall time and plateau time groups) affected the Pa component of the MLR (quality was determined by the (χ2-test and amplitude by the F-test). The 4-2-4 tone-pips produced good Pa quality by visual inspection. However, our data revealed no statistically significant Na-Pa amplitude differences between the two subgroups studied when comparing the 2- and 4-ms rise-fall times and the 0- and 2-ms plateau times. In contrast, Na-Pa became significantly smaller from the 4-ms to the 6-ms rise-fall time and from the 2-ms to the 4-ms plateau time (paired t-test). This result allowed us to select the 2- or 4-ms rise-fall time and the 0- or 2-ms plateau time without influencing amplitude. Analysis of the stimulus spectral characteristics demonstrated that a rise-fall time of at least 2ms could prevent spectral splatter and indicated that a stimulus with a 5-ms rise-fall time had a greater frequency-specificity than a stimulus of 2-ms rise-fall time. When considering the synchronous discharge and frequency-specificity of MLR, our findings show that a rise-fall time of four periods with a plateau of two periods is an acceptable compromise for estimating the objective MLR threshold. The correspondence between MLR and pure-tone audiometric (PTA) thresholds was high, with a correlation coefficient around 0.92–0.96 in these cases with rising low- and middle-tone sensorineural hearing losses. The MLR and PTA thresholds were within 10 dB for all cases. A comparison of the mean difference (MLRt-PTAt) at 0.5, 1 and 2 kHz revealed no significant differences (F-test). The MLR threshold in the present study approximated the psychoacoustic threshold in the hearing-impaired subjects, while the MLR using 4-2-4 tone-pips was able to measure objective thresholds across low and middle frequencies. This study has again demonstrated the clinical usefulness of the MLR for estimating low- to middle-frequency auditory thresholds.
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Xu, Z.M., De Vel, E., Vinck, B. et al. Selecting the best tone-pip stimulus-envelope time for estimating an objective middle-latency response threshold for low- and middle-tone sensorineural hearing losses. Eur Arch Otorhinolaryngol 252, 275–279 (1995). https://doi.org/10.1007/BF00185389
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DOI: https://doi.org/10.1007/BF00185389