Selective processing of auditory evoked responses with iterative-randomized stimulation and averaging: A strategy for evaluating the time-invariant assumption.

The recording of auditory evoked potentials (AEPs) at fast rates allows the study of neural adaptation, improves accuracy in estimating hearing threshold and may help diagnosing certain pathologies. Stimulation sequences used to record AEPs at fast rates require to be designed with a certain jitter, i.e., not periodical. Some authors believe that stimuli from wide-jittered sequences may evoke auditory responses of different morphology, and therefore, the time-invariant assumption would not be accomplished. This paper describes a methodology that can be used to analyze the time-invariant assumption in jittered stimulation sequences. The proposed method [Split-IRSA] is based on an extended version of the iterative randomized stimulation and averaging (IRSA) technique, including selective processing of sweeps according to a predefined criterion. The fundamentals, the mathematical basis and relevant implementation guidelines of this technique are presented in this paper. The results of this study show that Split-IRSA presents an adequate performance and that both fast and slow mechanisms of adaptation influence the evoked-response morphology, thus both mechanisms should be considered when time-invariance is assumed. The significance of these findings is discussed.

Auditory brainstem and middle latency responses recorded at fast rates with randomized stimulation.

Randomized stimulation and averaging (RSA) allows auditory evoked potentials (AEPs) to be recorded at high stimulation rates. This method does not perform deconvolution and must therefore deal with interference derived from overlapping transient evoked responses. This paper analyzes the effects of this interference on auditory brainstem responses (ABRs) and middle latency responses (MLRs) recorded at rates of up to 300 and 125 Hz, respectively, with randomized stimulation sequences of a jitter both greater and shorter than the dominant period of the ABR/MLR components. Additionally, this paper presents an advanced approach for RSA [iterative-randomized stimulation and averaging (I-RSA)], which includes the removal of the interference associated with overlapping responses through an iterative process in the time domain. Experimental results show that (a) RSA can be efficiently used in the recording of AEPs when the jitter of the stimulation sequence is greater than the dominant period of the AEP components, and (b) I-RSA maintains all the advantages of RSA and is not constrained by the restriction of a minimum jitter. The significance of the results of this study is discussed.

Automatic quality assessment and peak identification of auditory brainstem responses with fitted parametric peaks.

The recording of the auditory brainstem response (ABR) is used worldwide for hearing screening purposes. In this process, a precise estimation of the most relevant components is essential for an accurate interpretation of these signals. This evaluation is usually carried out subjectively by an audiologist. However, the use of automatic methods for this purpose is being encouraged nowadays in order to reduce human evaluation biases and ensure uniformity among test conditions, patients, and screening personnel. This article describes a new method that performs automatic quality assessment and identification of the peaks, the fitted parametric peaks (FPP). This method is based on the use of synthesized peaks that are adjusted to the ABR response. The FPP is validated, on one hand, by an analysis of amplitudes and latencies measured manually by an audiologist and automatically by the FPP method in ABR signals recorded at different stimulation rates; and on the other hand, contrasting the performance of the FPP method with the automatic evaluation techniques based on the correlation coefficient, FSP, and cross correlation with a predefined template waveform by comparing the automatic evaluations of the quality of these methods with subjective evaluations provided by five experienced evaluators on a set of ABR signals of different quality. The results of this study suggest (a) that the FPP method can be used to provide an accurate parameterization of the peaks in terms of amplitude, latency, and width, and (b) that the FPP remains as the method that best approaches the averaged subjective quality evaluation, as well as provides the best results in terms of sensitivity and specificity in ABR signals validation. The significance of these findings and the clinical value of the FPP method are highlighted on this paper.

A study of adaptation mechanisms based on ABR recorded at high stimulation rate.

OBJECTIVE: This paper analyzes the fast and slow mechanisms of adaptation through a study of latencies and amplitudes on ABR recorded at high stimulation rates using the randomized stimulation and averaging (RSA) technique. METHODS: The RSA technique allows a separate processing of auditory responses, and is used, in this study, to categorize responses according to the interstimulus interval (ISI) of their preceding stimulus. The fast and slow mechanisms of adaptation are analyzed by the separated responses methodology, whose underlying principles and mathematical basis are described in detail. RESULTS: The morphology of the ABR is influenced by both fast and slow mechanisms of adaptation. These results are consistent with previous animal studies based on spike rate. CONCLUSIONS: Both fast and slow mechanisms of adaptation are present in all subjects. In addition, the distribution of the jitter and the sequencing of the stimuli may be critical parameters when obtaining reliable ABRs. SIGNIFICANCE: The separated responses methodology enables for the first time the analysis of the fast and slow mechanisms of adaptation in ABR obtained at stimulation rates greater than 100 Hz. The non-invasive nature of this methodology is appropriate for its use in humans.

What is the role of the medial olivocochlear system in speech-in-noise processing?

The medial olivocochlear (MOC) bundle reduces the gain of the cochlear amplifier through reflexive activation by sound. Physiological results indicate that MOC-induced reduction in cochlear gain can enhance the response to signals when presented in masking noise. Some previous studies suggest that this "antimasking" effect of the MOC system plays a role in speech-in-noise perception. The present study set out to reinvestigate this hypothesis by correlating measures of MOC activity and speech-in-noise processing across a group of normal-hearing participants. MOC activity was measured using contralateral suppression of otoacoustic emissions (OAEs), and speech-in-noise processing was measured by measuring the effect of noise masking on performance in a consonant-vowel (CV) discrimination task and on auditory brain stem responses evoked by a CV syllable. Whereas there was a significant correlation between OAE suppression and both measures of speech-in-noise processing, the direction of this correlation was opposite to that predicted by the antimasking hypothesis, in that individuals with stronger OAE suppression tended to show greater noise-masking effects on CV processing. The current results indicate that reflexive MOC activation is not always beneficial to speech-in-noise processing. We propose an alternative to the antimasking hypothesis, whereby the MOC system benefits speech-in-noise processing through dynamic (e.g., attention- and experience-dependent), rather than reflexive, control of cochlear gain.

Neural correlates of perceptual learning in the auditory brainstem: efferent activity predicts and reflects improvement at a speech-in-noise discrimination task.

An extensive corticofugal system extends from the auditory cortex toward subcortical nuclei along the auditory pathway. Corticofugal influences reach even into the inner ear via the efferents of the olivocochlear bundle, the medial branch of which modulates preneural sound amplification gain. This corticofugal system is thought to contribute to neuroplasticity underlying auditory perceptual learning. In the present study, we investigated the involvement of the medial olivocochlear bundle (MOCB) in perceptual learning as a result of auditory training. MOCB activity was monitored in normal-hearing adult listeners during a 5 d training regimen on a consonant-vowel phoneme-in-noise discrimination task. The results show significant group learning, with great inter-individual variability in initial performance and improvement. As observed in previous auditory training studies, poor initial performers tended to show greater learning. Strikingly, MOCB activity measured on the first training day strongly predicted the subsequent amount of improvement, such that weaker initial MOCB activity was associated with greater improvement. Moreover, in listeners that improved significantly, an increase in MOCB activity was observed after training. Thus, as discrimination thresholds of listeners converged over the course of training, differences in MOCB activity between listeners decreased. Additional analysis showed that MOCB activity did not explain variation in performance between listeners on any training day but rather reflected an individual listener's performance relative to their personal optimal range. The findings suggest an MOCB-mediated listening strategy that facilitates speech-in-noise perception. The operation of this strategy is flexible and susceptible to training, presumably because of task-related adaptation of descending control from the cortex.

The effect of stimulus rate and time-separation on Volterra slices of otoacoustic emissions.

Volterra slices (VSs) of otoacoustic emissions are temporal non-linear interaction components which can be measured using the maximum length sequence technique of stimulation. Previous studies have found, but not explained, non-monotonic variations in the amplitude of VSs when stimulus rate is increased. In this study, a simple phenomenological model is investigated which provided possible insights into the effect of rate on VS amplitudes. Resulting theoretical considerations suggest that the effect of rate on VS amplitude is best examined when the time-separation parameter of the VS is held constant. To test these suggestions, data on VSs of order 2 and 3 were measured in 24 normal hearing ears in which the rate is varied while holding constant the time-separation. Under these conditions, the results reveal a monotonic reduction in the amplitude of the VSs with increasing rate. The phenomenological model offers a possible explanation of some of these results in terms of the derivatives of the input-output function of the non-linearity. In addition, measured cross-correlations between waveforms of VS of different order and slice number were obtained, revealing a complex dependence on time-separation that has not been explained.

Evaluation of a technique to measure latency jitter in event-related potentials.

Auditory selective attention results in larger event-related potentials (ERPs) than those recorded to unattended stimuli. Larger ERPs arise from either a greater number of neurons being stimulated or the same number of neurons with better synchrony. The synchrony aspect was studied in an attention experiment recording the N1 response and showed that the latency jitter was significantly less (p=0.002) for the responses to attended stimuli compared with those to unattended stimuli. Here the improved technique to measure latency jitter is the focus of study. Simulated responses were used to evaluate the technique's performance at different signal-to-noise ratios (SNRs) and compare it to the standard technique. Checks that the technique had performed satisfactorily in each case were achieved and a measure of reliability for each result was developed. The parameters defining the technique were varied and the optimum values chosen. This new technique opens the way for researchers to investigate the latency properties of lower SNR ERPs and gives a new insight into auditory selective attention.

Effect of subject task on contralateral suppression of click evoked otoacoustic emissions.

Contralateral suppression of click evoked otoacoustic emissions (CEOAEs) is widely used as a non-invasive measure of the activity of the (uncrossed) medial olivocochlear bundle (MOCB). There is evidence that the uMOCB receives descending input from the cortex, potentially mediating top-down control during higher order processing. This study investigated whether the contralateral suppression measure is affected by top-down influences during different tasks performed by the participants during recording. Suppression of CEOAEs evoked at 50 and 60dB SPL was measured under four different task conditions: (1) no task; (2) passive visual (watching a silent subtitled DVD); (3) active visual (responding to visually presented sums); (4) active auditory (detecting tone pips embedded in the evoking click train). The most significant effect of task was found on the recording noise, with both the passive visual and the active auditory task producing significantly lower noise levels than the no task condition. In the passive visual task, this was associated with a reduced inter-subject variability, which enhanced the effect size relative to the no task condition. A main effect of subject task was also found on the change in CEOAE I/O slope due to contralateral noise. This effect reflected a significantly smaller suppression during the active auditory task compared to the no task condition, leading to a reduced effect size. No significant difference in suppression strength between the no task condition and the two non-auditory tasks was observed, suggesting that the main effect of task reflects a specific effect of auditory attention. The data suggest that MOCB activity is inhibited due to top-down influences when selective attention is focussed on the ipsilateral ear.

Click-evoked otoacoustic emissions (CEOAEs) recorded from neonates under 13 hours old using conventional and maximum length sequence (MLS) stimulation.

Maximum length sequence (MLS) stimulation allows click evoked otoacoustic emissions (CEOAEs) to be averaged at very high stimulation rates. This enables a faster reduction of noise contamination of the response, and has been shown to improve the signal-to-noise ratio (SNR) of CEOAEs recorded from adult subjects. This study set out to investigate whether MLS averaging can enhance the SNR of CEOAEs recorded in newborns within the first day after birth, and so improve the pass rates for OAE screening in this period, when false alarm rates are very high. CEOAEs were recorded in a neonatal ward from 57 ears in 37 newborns ranging from 6 to 13h old, using both conventional (50/s) and high rate (5000/s) MLS averaging. SNR values and pass rates were compared for responses obtained within equal recording times at both rates. MLS averaging produced an SNR improvement of up to 3.8dB, with the greatest improvement found in higher frequency bands. This SNR advantage resulted in pass rate improvement between 5% and 10%, depending on pass criterion. A significant effect of age was found on both SNR and pass rate, with newborns between 6 and 10h old showing significantly lower values than those tested between 10 and 13h after birth, as well as a much greater improvement due to MLS averaging. The findings show that MLS averaging can reduce false alarm rates by up to 15% in very young neonates in a neonatal ward setting.

Selective attention increases the temporal precision of the auditory N100 event-related potential.

Selective attention increases the amplitude of the averaged N100 event-related potential (ERP). This increase may result from more neurons responding to the stimulus or from the same number of neurons better synchronised with the stimulus, or both. We investigated the synchronization mechanism using a new response latency jitter measurement algorithm that performed well for all the signal-to-noise ratios obtained in the experiment. We found that the significantly increased N100 amplitude is accounted for by a significantly decreased latency jitter variance for the attended stimuli.

Effects of maturation on parameters used for pass/fail criteria in neonatal hearing screening programmes using evoked otoacoustic emissions.

We aimed to investigate the incidence of false alarms that occurred with the pass/fail criteria used in a published series of neonatal hearing screening programmes, as a function of age. We analysed the database of 19137 normally hearing babies (38274 ears) tested in the Wessex Universal Neonatal Hearing Screening Project. Otoacoustic emissions were recorded prior to discharge from maternity units, using IL088 equipment. We assessed the pass/fail rate using the Wessex criteria and 10 other pass/fail criteria published in the literature. Using Pearson's correlation coefficient, a statistically significant correlation between signal-to-noise ratio at each of the frequency bands 1, 2, 3, 4 and 5 kHz and babies' age in hours at the 0.01 level was identified. The correlation was also significant (0.01 level) between age and frequency reproducibility in each of the bands at 1, 2, 3, 4 and 5 kHz as well as the whole reproducibility. The number of false alarms reduced significantly after the first 24 h of life with all the criteria examined. We conclude that in the first hours after birth due to insufficient maturation of the otoacoustic emission, there is a high rate of false alarms. This increase in the false alarm rate, whilst dependent on the criteria used, occurs with all criteria. This leads to the consideration of whether the establishment of age-dependent pass/fail criteria could reduce the false alarm rate and the subsequent strain on diagnostic centres.

Volterra Slice otoacoustic emissions recorded using maximum length sequences from patients with sensorineural hearing loss.

When normally hearing ears are stimulated with maximum length sequences (MLS) of clicks, a family of non-linear temporal interaction components of otoacoustic emissions (OAEs) can be derived, which have been named Volterra Slice OAEs (VS OAEs). This study investigates the sensitivity of VS OAEs to sensorineural hearing impairment in adults, compared to that of the widely used derived non-linear click evoked OAE (DNL CEOAE). VS OAEs and DNL CEOAEs were obtained from 24 normally hearing and 24 hearing impaired ears using a custom-built MLS system and a Otodynamics 'ILO88' OAE Analyzer, respectively. The results show that, based on waveform reproducibility, VS OAEs are as successful as DNL CEOAEs at separating normal from impaired ears at the audiometric frequencies of 1 and 2 kHz, where a strong correlation is found between the amplitudes of the two OAE types. At 4 kHz however, VS OAEs are a significantly better indicator of hearing loss than DNL CEOAEs. This difference at 4 kHz appears to be due to the lack of stimulus artefact contamination of VS OAEs in the early, high frequency portion of the response. The findings suggest that VS OAEs may provide a better diagnostic and monitoring tool for hearing loss at high frequencies than the conventional DNL CEOAE.

Transient evoked otoacoustic emissions recorded using maximum length sequences from patients with sensorineural hearing loss.

Much research has shown that transient evoked otoacoustic emissions (TEOAEs) can successfully separate normally hearing and hearing impaired populations. However, this finding comes from TEOAEs recorded using conventional averaging at low stimulation rates. Presenting clicks according to maximum length sequences (MLSs) enables TEOAEs to be recorded at very high stimulation rates. This study compares conventional and MLS TEOAEs in normally hearing and hearing impaired adults. Stimulus presentation rates of 40 clicks/s (conventional) and 5000 clicks/s (MLS) were used. The 'linear' TEOAEs (i.e., the directly recorded waveforms), the 'level nonlinear' (LNL) TEOAEs (i.e., those derived from two linear waveforms separated by a known difference in stimulus level) and the 'rate nonlinear' (RNL) TEOAEs (i.e., obtained by subtracting the emission recorded at 5000 clicks/s from that at 40 clicks/s at a fixed stimulus level) were examined to compare how they separated the normally hearing and hearing impaired subjects. When compared to the results for both conventional and MLS linear or LNL TEOAEs, the present study found that the RNL results best reflected the patients' hearing loss, although the conventional linear and LNL responses performed nearly as well. Only two impaired ears (2%), both with a best threshold of 30 dB HL at 1000 Hz, produced RNL responses with amplitude within the range produced by 95% of the normal group.

The order of testing effect in otoacoustic emissions and its consequences for sex and ear differences in neonates.

The amplitude values of transient-evoked otoacoustic emissions, recorded from a large sample of neonates, were used to examine the asymmetry between ears tested and the differences due to the sex of the subject. Whilst the sex difference, with females having larger responses than males, has been a consistent finding in previous reports, the right/left ear difference, with the right ear giving a larger response than the left, has produced variable results that differed between laboratories. In this study, the sex difference was confirmed with females giving a 1.2 dB greater response than males. It was not affected by the age of the neonate. A significant effect of test order was found. The measured right/left difference was enhanced when the right ear was tested first but was diminished when the left ear was tested first. If the left ear is tested first then the measured right/left difference would be about 0.5 dB whereas, if the right ear is tested first, the measured right/left difference would be about 1.5 dB. When male/female comparisons were made for right and left ears separately and for the same ear tested first, the sex differences were the same for all four conditions. The sex and right/left differences have been confirmed as statistically significant effects and the order effect could explain the discrepancies and variability of the right/left differences reported in the literature.

Methodological factors involved in neonatal screening using transient-evoked otoacoustic emissions and automated auditory brainstem response testing.

The methodological factors involved in screening neonates for hearing loss, using transient-evoked otoacoustic emissions (TEOAEs) and automated auditory brainstem responses, have been evaluated from a large sample of neonates. The risk factors, commonly used to select babies for a targeted screen, have very little correlation with failing TEOAE testing. The parameters used to determine passing or failing the TEOAE test and the false alarm rate change markedly with age in the first few days of life as, of course, did the percentage of babies who failed the test. The stimulus level used was the default setting for the Otodynamics equipment but the stimulus level measured in the ear canal decreased over the first 140 h of life. It is thought that this reflects the impedance changes in outer and middle ears and possible changes in middle ear dynamics. The methodological variables investigated here can illuminate some of the differences in previous reports of neonatal screening, in particular the reported hit and false alarm rates.

The interaction between ear and sex differences and stimulus rate.

Evoked otoacoustic emissions (EOAEs) are produced by the cochlea in response to acoustic stimuli and provide an objective and non-invasive measure of cochlear function. A new technique, based on maximum length sequences (MLSs), enables stimulus rates of up to 5000 clicks/s to be used. Conventional EOAE amplitude differs between ears and sexes, female subjects having responses of greater amplitude than male subjects and right ears larger responses than left ears. As a prerequisite to clinical use it is necessary to establish if these differences occur with the MLS OAE technique and whether they change with stimulus rate. Eighty ears of normally hearing adults between the ages of 18 and 40 years were tested. MLS OAEs were recorded at eight stimulus rates ranging from 40/s to 5000/s. Two stimulus levels and two recordings were made at each stimulus rate. Female subjects were found to have statistically significantly larger MLS OAEs than male subjects and gave larger amplitude responses in the right ears. The difference was not significant between male right and left ears. A rate effect was also demonstrated with the amplitude of the MLS OAEs decreasing with an increase in rate. The study provides normative data for MLS OAE testing and shows that females have MLS OAEs of larger amplitude than males and that as the click stimulus rate increases the significance of this difference decreases. Female right ears also have MLS OAEs of greater amplitude than female left ears.

Temporal nonlinearity revealed by transient evoked otoacoustic emissions recorded to trains of multiple clicks.

A series of detailed experiments is described that investigates how a transient evoked otoacoustic emission (TEOAE) recorded to one-click stimulus is affected by the presence of a variable number of preceding clicks presented over a range of interclick intervals (ICIs). Part of the rationale was to determine if the resulting nonlinear temporal interactions could help explain the amplitude reduction seen when TEOAEs are recorded at very high click rates, as when using maximum length sequence stimulation. Amongst the findings was that the presence of a preceding train of clicks could either suppress or enhance emission amplitude, depending on the number of clicks in the train and the ICI. Results also indicated that the duration of the click trains, rather than the ICI, was the important factor in yielding the most suppressed response and that this seemed to depend on stimulus level. The results recorded at two levels also suggested that the cochlear temporal nonlinearity being monitored was in part related to the nonlinear process that determines the compressive input/output function for stimulus level. It is hypothesised that nonlinear temporal overlap of vibration patterns on the basilar membrane may underlie much of the pattern of results.