A dipole localization method in analyzing the auditory brain-stem evoked potential]

The localization of generators of brainstem auditory evoked response (BAER) has been studied in one patient using the method of dipole localization based on the spatial distribution of BAER over the surface of the head. It has been found that in formation of all BAER waves the activity of several generators overlaps. It is especially marked for the peaks I', II', III and III'--their potential distribution can not be described by single-dipole model, thus preventing the defining of their generation site. Distribution of potential for other peaks corresponds to the single-dipole model. The coordinates of the equivalent sources of these peaks are in the vicinity of the auditory structures: I--near the distal part of the auditory nerve, II--near the auditory nerve in the place of its entering the brainstem, V--near contralateral auditory pontine structures, V--near lateral lemniscus while V', VI and VI'--near mesencephalic auditory structures.     

Neuroanatomic correlations with the late waves of the brain-stem auditory evoked potential

The goal of this study was to investigate the neuroanatomic correlations of the late waves (VI–VIII) of the BAEP. Patients (N = 55) with clinical evidence of a CVA were compared to a normal control group (N = 85). Latencies of > 3 S.D. from the means of the normal group were considered abnormal. CT and MRI scans provided evidence of the lesions. For the 14 patients who had normal BAEPs, the sizes of lesions were significantly smaller than for those with abnormal tests. Evidence shows that an abnormal wave VI was related to an ipsilateral cortical lesion and an abnormal wave VIII was related to a lesion in the internal capsule-corpus striatum.     

Correlation between a unilateral midbrain-pontine lesion and abnormalities of brain-stem auditory evoked potential

Brain-stem auditory evoked potentials (BAEPs) were evaluated over a 39 day period in a patient with a unilateral pontine-midbrain lesion verified by CAT scan and autopsy. Waves I, II and III were present on the side of lesion, whereas all 5 waves were present on the side opposite the lesion. The findings suggest that the BAEPs may be obtained with only an intact ipsilateral auditory pathway. Crossing fibers in the trapezoid body also appear to make contributions to the normal generation of wave V.     

Age-dependent amplitude variation of brain-stem auditory evoked potentials

Normative amplitude values of brain-stem auditory evoked potential (BAEP) components are given for normally hearing subjects at 1, 10, 30, 50 and 70 years of age, with an intragroup age variation of only ±6 months. Under these circumstances amplitude standard deviations decreased to less than 20% of the mean values. In contrast with the reduced evolution of latency with age, BAEP amplitude (for components I–V) undergoes a greater oscillation during ontogeny. With the exception of component I, it increased markedly from 1 year to 10 years of age and decreased thereafter constantly up to 50 years, with a mean rate of 10 nV yearly. The decrease slowed down between 50 and 70 years. The amplitude differences between the subgroups are highly significant statistically (P < 0.01). Possible reasons for these changes are discussed.     

Diagnostic role of brain-stem auditory evoked potentials in neurobrucellosis

Evoked potential audiometry and brain-stem auditory evoked potentials were evaluated in 15 patients with systemic brucellosis in whom brucella meningitis was suspected clinically. In 8 patients cerebrospinal fluid (CSF) was abnormal with high brucella titre, and evoked potentials were abnormal in all of them. In 7 patients the CSF was normal and evoked potentials were also normal. Brain-stem auditory evoked potential abnormalities were categorised into 4 types: (1) abnormal wave I, (2) abnormal wave V, both irreversible, (3) prolonged I–III interpeak latencies, and (4) prolonged I–V interpeak latencies, both reversible. These findings are of important diagnostic value and correlate well with the clinical features, aetiopathogenesis and final outcome.     

Effects of localized pontine lesions on auditory brain-stem evoked potentials and binaural processing in humans

Objectives and mehtods: Four sets of measurements were obtained from 11 patients (44–80 years old) with small, localized pontine lesions due to vascular disease: (1) Monaural auditory brain-stem evoked potentials (ABEPs; peaks I to VI); (2) Binaural ABEPs processed for their binaural interaction components (BICs) in the latency range of peaks IV to VI; (3) magnetic resonance imaging (MRI) of the brain-stem; and (4) psychoacoustics of interaural time disparity measures of binaural localization. ABEPs and BICs were analyzed for peak latencies and interpeak latency differences. Three-channel Lissajous' trajectories (3-CLTs) were derived for ABEPs and BICs and the latencies and orientations of the equivalent dipoles of ABEP and BICs were inferred from them.Results: Intercomponent latency measures of monaurally evoked ABEPs were abnormal in only 3 of the 11 patients. Consistent correlations between sites of lesion and neurophysiological abnormality were obtained in 9 of the 11 patients using 3-CLT measures of BICs. Six of the 11 patients had absence of one or more BIC components. Seven of the 11 had BICs orientation abnormality and 3 had latency abnormalities. Trapezoid body (TB) lesions (6 patients) were associated with an absent (two patients with ventral-caudal lesions) or abnormal (one patient with ventral-rostral lesions) dipole orientation of the first component (at the time of ABEPs IV), and sparing of this component with midline ventral TB lesions (two patients). A deviant orientation of the second BICs component (at the time of ABEPs V) was observed with ventral TB lesions. Psychoacoustic lateralization in these patients was biased toward the center. Rostral lateral lemniscus (LL) lesions (3 patients) were associated with absent (one patient) or abnormal (two patients) orientation of the third BICs component (at the time of ABEPs VI); and a side-biased lateralization with behavioral testing.Conclusions: These results indicate that: (1) the BICs component occurring at the time of ABEPs peak IV is dependent on ventral-caudal TB integrity; (2) the ventral TB contributes to the BICs component at the time of ABEPs peak V; and (3) the rostral LL is a contributing generator of the BICs component occurring at the time of ABEP peak VI.     

Chronic effects of phenytoin on brain-stem auditory evoked potentials in man

The effects of phenytoin (PHT) on brain-stem auditory evoked potentials (BAEPs) were studied in 65 epileptic patients who received long-term PHT monotherapy at therapeutic and supra-therapeutic levels with no clinical evidence of brain-stem toxicity. Abnormal BAEPs were found in 7.5% and 33.3% of patients with therapeutic and supra-therapeutic PHT levels respectively. Serum PHT levels had a trend towards a positive relationship with the I–V interpeak latency (IPL), and a significant negative relationship with the amplitudes of waves I and V. at supra-therapeutic levels, both I–V and I–III IPLs were significantly prolonged while at therapeutic evels onl I–III IPLs were prolonged. The absolute latency of wave I was prolonged in both the therapeutic and the supra-therapeutic groups. These results suggest that PHT acts both peripherally on either the auditory nerve or the cochlea, and centrally on brain-stem conduction.     

Classification of brain-stem auditory evoked potentials by syntactic methods

A syntactic pattern recognition procedure for classification of brain-stem auditory evoked potential (BSAEP) is presented. A pre-processing stage of zero-phase bandpass filtering enhances the peaks and suppresses the noise. A finite-state grammar was designed to identify the peaks. Attributes of the peaks (latencies and amplitudes) that are identified are checked for their acceptability. A training run in 70 subjects of known diagnosis was perfomed finr-tune the system and build up necessary acceptance criteria. Peak latency differences are used for the classification rather than absolute peak latencies. Acceptance criteria for peak latency differences were empirically optimized. A data base of normal BSAEPs, created during the training run, was updated and used during the test run. Test of the classifier using 60 subjects yielded a classification accuracy of 83%. The classifier has acceptable accuracy and can be modified for other evoked potentials such as visual and somatosensory by establishing relevant attribute tables.     

Differential impact of hypothermia and pentobarbital on brain-stem auditory evoked responses

Two experiments were conducted to determine the effects of hypothermia and pentobarbital anesthesia, alone and in combination, on the brain-stem auditory evoked responses (BAERs) of rats. In experiment I, unanesthetized rats were cooled to colonic temperatures 0.5 and 1.0°C below normal. In experiment II, 2 groups of rats were cooled and tested at 37.5, 36.0, 34.5 and 31.5°C. One group was anesthetized during testing and the other group was awake. The rat BAER was sensitive to cooling of 1°C or less. Peak latencies were prolonged and peak-to-peak amplitudes were increased by hypothermia alone. The effect on amplitude may be related to the time course of temperature change or to stimulus level. Pentobarbital significantly affected both latencies and amplitudes over and above the effects of cooling. The specific effects of pentobarbital differed by BAER peak and by temperature. The findings point up the importance of the potential confound of anesthetic drugs in most of the evoked potential literature on hypothermia and, for the first time, quantify the complex interactions between pentobarbital and temperature which affect the BAER wave form.     

Binaural interaction in the brain-stem auditory evoked potential: evidence for a delay line coincidence detection mechanism

The binaural interaction component (BIC) of the brain-stem auditory evoked potential (BAEP) was studied in 13 normally hearing adults by subtracting the response to binaural clicks from the algebraic sum of monaural responses. Eight or 16 electrodes on the head and neck were referred to a non-cephalic site, the binaural stimuli were delivered either simultaneously or with an inter-aural time difference (Δt) of 0.2–1.6 msec, and masking noise was presented to the non-stimulated ear.With simultaneous binaural clicks a BIC was identifiable in every subject, the most consistent peaks being a scalp-positive potential (P1) peaking approximately 0.2 msec after wave V and a scalp negativity (N1) 0.7 msec later. Similar potentials were identifiable in 6/7 subjects with Δt fo 0.4 msec, 5/7 at 0.8 msec but only 1/7 at 1.2 msec. This suggests that the BIC may be associated with sound localization mechanisms which are sensitive to a similar range of Δt. On increasing Δt from 0.0 to 0.8 msec, the BIC was progressively delayed by approximately half the inter-aural time difference, with no suggestion of increasing temporal dispersion. This supports the notion of a ‘delay line coincidence detection’ mechanism in which the BIC represents the output of binaurally responsive neurones, probably in the superior olivary complex, which are ‘tuned’ to a particular Δt by the relative lengths of presynaptic axons relaying input from either ear.The distribution of the BIC in sagittal and coronal electrode chains was compared with that of binaural BAEP components I–VI and found to bear the closest resemblance to wave IV. It is suggested that both components may originate largely in the lateral lemnisci.     

Clinical correlates of brain-stem auditory evoked potential variables in multiple sclerosis. Relation to click polarity

The correlations between clinical signs and BAEP latency, amplitude and dispersion variables were investigated in 98 multiple sclerosis patients. A new dispersion variable, the wave IV–V “shape ratio” (SR IV–V), correlated most strongly with brain-stem signs (i.e., nystagmus). Severely reduced wave IV–V amplitude was frequently found in patients with vertical nystagmus or internuclear ophthalmoplegia, and interpeak latency (IPL) III–V correlated most strongly with cerebellar dysfunction (i.e., ataxia). The results may reflect different localizing ability among the various BAEP variables.The association between ataxia and increased IPL III–V was significantly stronger for BAEP to C clicks than to R clicks. Patients with abnormal BAEPs to one polarity (C or R) but not to the other, had significantly more clinical dysfunction than patients with normal BAEPs to both C and R clicks. Hence, C vs. R discordance may be interpreted to indicate possible brain-stem dysfunction.     

Sensorineural hearing loss as evidenced by the auditory brainstem response following prenatal cocaine exposure in the Long-Evans rat

Prenatal cocaine exposure has been associated with a variety of adverse neurological effects. Three recent studies found evidence that prenatal cocaine exposure is associated with abnormal auditory electrophysiology, suggesting abnormal processing of auditory information. The present study used the auditory brainstem response to evaluate the effects of prenatal cocaine exposure on hearing in an animal model (Long-Evans rat). We report that prenatal cocaine exposure can cause elevated ABR thresholds and latency-intensity curves consistent with a recruitment-type sensorineural hearing loss.     

Evaluation of brain-stem auditory evoked potentials using dynamic time warping

Dynamic time warping is a procedure whereby portions of a temporal sequence of values are stretched or shrunk to make it similar to another sequence. This procedure can be used to align the brain-stem auditory evoked potentials recorded from different subjects prior to averaging. The resultant warp-average more closely resembles the wave form of a typical subject than the conventional average. Dynamic time warping can also be used to compare one brain-stem auditory evoked potential to another. This comparison can show the differences that result from changes in a stimulus parameter such as intensity or repetition rate. When a patient's wave form is compared to a normal template, warping can identify the peaks in the patient's wave form that correspond most closely to the peaks in the normal template. Compared to an experienced human interpreter, warping is very accurate in identifying the waves of normal brain-stem auditory evoked potentials (error rate between 0 and 4%) and reasonably accurate in identifying the peaks in abnormal wave forms (error rate between 3 and 18%).     

Pattern-reversal auditory evoked potential

The late auditory evoked potential (AEP) was studied in response to an alternatingly frequency-modulated complex tone. This ‘pattern-reversal’ AEP was found to be a heartier response than the conventional tone-burst evoked potential, albeit longer in latency.     

Methods for determining auditory evoked brain-stem response thresholds in human newborns

Previous investigators have reported that newborn auditory evoked brain-stem responses (ABRs) are 20–30 dB higher than adult psychophysical thresholds to the same stimuli. These investigators reduced the intensity of the stimulus until they no longer reported an ABR to the stimulus. We adapted 2 widely used psychophysical methods, the up-down-transformed response (UDTR) method and the method of constant stimuli, for ABR threshold determination of human newborns. Response judgments were made blindly. ABR thresholds of healthy normal newborns by both procedures were no more than 10–15 dB higher than adult psychophysical thresholds. The differences between the newborn ABR thresholds we reported and those in the literature were probably explained by different procedures including the method used to estimate adult psychophysical thresholds. The correlations between ABR thresholds and suprathreshold ABR latencies and amplitudes and latency and amplitude/intensity functions were modest at best. In normal newborns suprathreshold ABR measurements are of little value in predicting ABR thresholds.     

Fast habituation of the long-latency auditory evoked potential in the awake albino rat

Fast habituation of the long-latency, vertex-recorded auditory evoked potential (AEP) peaks in humans was first described by Callaway (1973) as a reduction in AEP amplitude that occurs to the second of a pair of acoustic stimuli when both stimuli are presented with an interstimulus interval (ISI) of no more than 10 sec. When acoustic stimuli are presented in pairs with an ISI of 2 sec and an interpair interval (IPI) of approximately 10 sec, reduction in amplitude to the second tone occurs by as much as 30–50%. Fast habituation may depend somewhat on a subject's anticipation of the stimulus and on other factors related to attention and orienting. Studies in our laboratory have demonstrated this amplitude decrement to the second tone of a pair in human infants, children and adults and have explored the implications of this finding with respect to attentional processes and the allocation of cerebral resources. In the present investigation we describe an animal model of fast habituation. Here, vertex-recorded AEPs were obtained to paired tone stimuli delivered to awake adult male Sprague-Dawley rats chronically implanted with skull electrodes. Findings showed: (a) an AEP wave form with 8 distinct peaks, (b) for one component there was a marked decrement in amplitude from tone 1 to tone 2 in recordings obtained from an electrode placed slightly to the right of midline, and (c) that there were no significant differences in peak latencies across tones. This methodology may further our understanding of fast habituation in humans and may prove useful for studies of attention, orienting, and resource allocation using techniques that are not possible for use with human subjects.     

Influence of click polarity on the brain-stem auditory evoked response (BAER) revisited

Brain-stem auditory evoked responses (BAERs) were recorded both to rarefaction and condensation click stimulation in 92 normal hearers and 78 patients with varying degrees of cochlear hearing loss (N = 340 ears). Frequency distributions of rarefaction minus condensation (R - C) latency and amplitude differences revealed clinically significant polarity effects in a substantial percentage of the patients studied. Bivariate plots of R - C latency and amplitude differences versus average high frequency hearing loss (PTA 3) demonstrated that the magnitude of the R - C latency and amplitude differences also seemed to be influenced by degree of high frequency hearing loss. Results are discussed relative to the phase-locking properties of the afferent auditory nerve fibers and the possible electrodiagnostic consequences of recording the BAER either to alternating or condensation clicks.     

High-rate sequential sampling of auditory brain-stem and somatosensory evoked responses in hypoxia

We developed a high-rate sequential recording technique that allowed simultaneous measurements of both auditory brain-stem response (ABR) and somatosensory evoked potential (SEP) every 10 sec. Using this method, a transient increase in amplitude of all the ABR and SEP components in response to hypoxia in dogs could be detected. The increase in amplitude preceded the prolongation of latency. Our study showed that there were succesive changes of evoked potentials in response to hypoxia. A transient increase in amplitude is the first to occur, followed by a latency prolongation and an amplitude decrease for both ABRs and SEPs.