Auditory Electrophysiology. A Clinical Guide

Preface to the First Edition
Preface to the Second Edition
Acknowledgments
Contributors
Section I
1 Introduction to Auditory Evoked Potentials
Introduction
What’s in this Text?
Overview of Auditory Evoked Potentials
Classification of Auditory Evoked Potentials
A Brief History of Auditory Evoked Potentials
Competencies in Auditory Evoked Potential Measurement
References
2 Basic Instrumentation, Acquisition, and Recording Considerations
Introduction
Signal versus Noise
Digital Signal Processing
Time and Frequency Domain
Instrumentation
Stimulus Generator
Transducers
Trigger
Acquisition Parameters
Differential Amplification
Filtering
Signal Averaging
Electrodes
Electrode Impedance
Electrode Types
Electrode Placement
Number of Electrodes versus Number of Channels
Recording Considerations for Auditory Evoked Potentials
Electrode Array and Number of Channels
Time Window
Sampling Rate
Number of Sweeps (Stimulus Repetitions)
Stimulation Rate
Filter Settings
Amplification
Artifact Rejection
Electromagnetic Artifacts
General Subject Factors
Age
Gender
Muscle Activity
Attention
Temperature
References
3 Principles of Analysis and Interpretation
Introduction
Transient versus Steady-State Responses
Analyses in the Time Domain
Analysis Techniques Following Signal Averaging
Other Time-Domain Techniques
Collecting Normative Data
Analysis Techniques During Signal Averaging
Analysis in the Frequency Domain: Auditory Steady-State Response
References
4 Fundamental Principles of Neuroanatomy and Neurophysiology Related to Auditory Evoked Potentials
Introduction
Brief Review of the Peripheral and Central Auditory Neural Systems
Cochlear Mechanics
Monaural Contributions to the Auditory System
Binaural Interaction in the Auditory System
General Neurophysiology Concepts
Basic Neuronal Anatomy and Physiology
Potentials at the Source
Dipoles
Near- and Far-Field Potentials
General Principles of the Auditory Nervous System
Synchrony
Phase Locking
Peripheral and Central Auditory System Considerations for AEPs
Exogenous versus Endogenous Potentials
Sonomotor Reflexes
References
Section II
5 Electrocochleography
Overview
Historical Aspects
ECochG Components/Generators
Cochlear Microphonic
Summating Potential
Compound Action Potential
Recording ECochG
Acquisition Parameters
Stimulus Parameters
Electrocochleogram Analyses
Latency
Amplitude
Spectra
Conclusion
References
6 The Auditory Brainstem Response
Introduction
Brief History
Description
Waveform Morphology
Neural Generators
Effects of Various Stimulus and Recording Parameters on the Auditory Brainstem Response
Stimulus Types
Stimulus Polarity
Stimulus Intensity
Stimulation Rate
Transducer Types and Artifact
Monaural versus Binaural Presentation
Contralateral Masking
Typical Setup
Electrode Montage
Measurement Parameters
Overall Waveform Morphology
Latency
Amplitude
Subject Effects
Maturation and Aging Effects
Gender
Hearing Sensitivity
Useful and Promising Applications
Weighted Averaging
Maximum Length Sequence
Objective Detection Techniques
References
7 Frequency-Following Responses
Introduction
Basic Properties of the
Origins of the Frequency-Following Response
Signal Effects on the Frequency-Following Response
Signal Duration
Signal Frequency
Signal Intensity
Recording the Frequency-Following Response
Monaural versus Binaural
Electrode Placement
Recording Parameters
Frequency-Following Response Correlates of Cochlear Nonlinearities
Primary-Tone Frequency
Primary-Tone (
Contralateral Noise
Primary-Tone Level
Recommendations for Recording Distortion Product Frequency-Following Responses
Frequency-Following Responses as Neuronal Indicators of Brainstem Speech Processing
References
8 Auditory Steady-State Responses
Introduction
Historical Overview of ASSR
Terminology
Steady-State Response
Carrier Frequency
Modulation Frequency
Amplitude Modulation
Frequency Modulation
Mixed Modulation
Cosine Stimulus
Frequency (Fourier) Analysis
Phase Coherence
Neural Generators
Stimulus Parameters
Modulation Rate and Depth
Broadband and Narrowband Chirp Stimuli
Intensity
Single versus Multiple-Frequency ASSR
Bone-Conducted ASSR
Measurement Parameters
Equipment and Supplies
Test Setting and Patient
Recording Parameters
Clinical Testing Procedures
Response Detection
Reporting Findings
Subject Effects
Sleep State and Attention
Maturation Effects
Clinical Applications
Threshold Estimation
Suprathreshold Applications
Case Studies
Case 1
Case 2
Case 3
Case 4
Case 5
Conclusion
References
9 Middle Latency Responses
Overview
Components of the MLR
Na Component
Pa Component
Nb Component
Pb Component
Clinical Applications
Behavioral Threshold Estimation
Neurodiagnostic MLRs
Assessing Cochlear Implant
Clinical Considerations for MLR Recording
Recommended Protocol
Number of Electrode Channels Available for Recording
Participant State
Test Environment
References
10 Cortical Event-Related Potentials
Introduction
Late Auditory Evoked Potential
Description of the Waveform
Neural Generators
Stimulus and Recording
Measurement Parameters
Subject Effects
Clinical Applications
Mismatch Negativity
Description of the Waveform
Neural Generators
Stimulus and Recording
Measurement Parameters
Subject Effects
Clinical Applications
P3 Cognitive Potential
Description of the Waveform
Neural Generators
Stimulus/Recording Parameters
Measurement Parameters
Subject Effects
Clinical Applications
Conclusions
References
11 Vestibular Evoked Myogenic Potentials
Background/Historical Information
Myogenic versus Sensory Recordings
Vestibular Evoked Myogenic Potential Pathways
Cervical Vestibular Evoked Myogenic Potential
Ocular Vestibular Evoked Myogenic Potential
Stimulus/Collection Parameters
Stimulus Parameters
Electrode Arrays
Collection Parameters
Waveform Characteristics
Cervical Vestibular Evoked Myogenic Potential Waveform
Ocular Vestibular Evoked Myogenic Potential Waveform
Clinical Considerations
Subject Effects
Clinical Interpretation
Clinical Application
Conclusion
References
Section III
12 Clinical Utility of Electrocochleography
Introduction
ECochG Components
Interpretation of ECochG Results
ECochG in Ménière’s Disease
Dehydration (Glycerol) Test
Overlap Between Ménière’s Disease and Vestibular Migraine
The 3-T Magnetic Resonance Imaging in Ménière’s Disease
ECochG in Third Window Syndrome: Superior Canal Dehiscence Syndrome and Perilymphatic&nbsp
ECochG in Auditory Neuropathy Spectrum Disorder
Cochlear Synaptopathy (Hidden Hearing Loss)
Conclusions
References
13 Automated Auditory Brainstem Response Testing for Newborn Hearing Screening
Introduction
Newborn Hearing Screening Test Performance
Stimulus Parameters
Stimuli
Rate
Polarity
Intensity
Transducers
Transducer Calibration
Recording Parameters
Electrode Types
Electrode Montage
Filters
Noise Reduction Techniques
Sweeps and Replications
Objective Response Detection
Testing in Time Domain
Testing in Frequency Domain
Machine Learning
Patient Considerations
Age
Hearing Loss
Conclusion
References
14 Contemporary Protocol for Frequency-Specific ABR Assessment in Infants and Young Children
Introduction
Setting the Stage
State of Consciousness
A Well-Defined Plan
Tone Burst ABR Test Strategy
Bone Conduction ABR Assessment
Clinical Tips
Waveform Analysis
Three Types of ABR Waveforms
Cross-Check Principle
Click Evoked ABR
Using Tone Burst ABR Threshold Estimations for Hearing Aid Fitting
Case Studies
Case 1
Case 2
Conclusion
References
15 Differential Diagnosis of Auditory Neuropathy Spectrum Disorder
Potential Sites of Lesion
Candidacy for ANSD Testing
Evoked Potentials for Diagnosis of ANSD
Otoacoustic Emissions
Cochlear Microphonic and
Middle Ear Muscle Reflexes
Magnetic Resonance Imaging in ANSD
Case Studies of Auditory Neuropathy Spectrum Disorder
Case 1: Bilateral Auditory Neuropathy Spectrum Disorder
Case 2: ANSD and SNHL
Case 3: Unilateral Auditory Neuropathy Spectrum Disorder
References
16 Evaluation of Balance and Falls Risk Assessment
Introduction
Background
VEMP Clinical Protocol Considerations
Stimulus: Air versus Bone Conduction
Electromyographic Activity
Electrode Location
Typical Presentation
Disease Presentation
Acquired Vestibulopathy
Congenital Vestibulopathy
Central Vestibulopathy
Conclusions
References
17 Evaluating Central Auditory Function
Introduction
Limitations of Auditory Evoked Potentials in the Evaluation of Central Auditory Function
When Should Auditory Evoked Potentials Be Used?
Auditory Brainstem Response
Electrode Montage and Recording Parameters
Response Analysis
Common Central Auditory Function Uses of the Auditory Brainstem Response
Complex Auditory Brainstem
Middle Latency Response
Recording Parameters and Electrode Montage
Response Analysis
Common Central Auditory Function Uses of the Middle Latency Response
Late Latency Response
Recording Parameters and Electrode Montage
Response Analysis
Common Central Auditory Function Uses of the Late Latency Response
P300 Event-Related Potential
Electrode Montage and Recording Parameters
Response Analysis
Common Central Auditory Function Uses of the P300
Other Influences on Central Auditory Function
Case Studies
Vestibular Schwannoma (Case 1)
Traumatic Brain Injury (Case 2)
Type 2 Diabetes Mellitus (Case 3)
References
18 Surgical Applications of Auditory Evoked Potentials
Mechanisms of Change in Intraoperative AEPs
Ischemia/Decreased Perfusion
Stretching the Nerve/Cerebellar Retraction
Anesthesia
Hypothermia
Auditory Monitoring Modalities
Monitoring Applications
Hearing Preservation in CPA tumors
Monitoring Cerebellar Retraction
Monitoring Vertebrobasilar Perfusion and/or Brainstem Function
Monitoring Cochlear Function
The Utility of AEPs in IONM
Improving Outcomes
Outcome Predictions
Pre-„, Peri-„, and Postoperative Considerations for AEP Monitoring
Preoperative Planning
Setting Up the Patient
Running AEP Intraoperatively
When to Alert the Surgeon
Intraoperative Interventions to a Change in Signals
Intraoperative Case Log
Optimizing Signals in the Operating Room
Interpreting Signal Changes
Other Intraoperative Monitoring Modalities
Free Running and Stimulated Electromyography
Somatosensory Evoked Potentials
Transcranial Motor Evoked Potentials
Electroencephalogram Monitoring
References
19 Animal Audiology Applications
Introduction
History of Animal Audiology and FETCHLAB
Who Should Evaluate Animal Hearing?
Canine Evoked Potentials
Canine BAER Screening
Estimation of Hearing Thresholds for Canines
Auditory Middle Latency
Mismatch Negativity
Equine Brainstem Evoked Potentials
Other Animals
References
Section IV
20 Patient Preparation, Data Interpretation, and Documentation
Introduction
Clinician Preparation
Case History Review
Patient Instructions Before Testing
Supplies and Equipment
Patient Preparation
Patient Orientation
Electrode Application
Data Collection
After the Test Session
Documentation and Results
References
21 Stimulation Calibration and Generation
Introduction
Stimuli for Auditory Evoked Potentials
Calibration of Acoustic Stimuli
Methods of Stimulus Calibration
Other Stimulus Parameters for Consideration
Steps for Conducting Behavioral Calibration of Acoustic Transients
Steps for Calibrating Acoustic Transients with Calibration Equipment
Generating Custom Stimuli
Recording and Editing a Speech Stimulus
References
Index

A practical guide to auditory electrophysiology, from the laboratory to the clinic

Auditory Electrophysiology: A Clinical Guide, Second Edition by auditory electrophysiology clinicians, researchers, and educators Samuel R. Atcherson and Tina M. Stoody fills a gap in the literature. The second edition features up-to-date text and references on all aspects of auditory evoked potentials (AEPs). New perspectives include automated newborn hearing screening, frequency-specific auditory brainstem response assessments, differential diagnosis of auditory neuropathy spectrum disorder, evaluation of balance and fall risk assessment, central auditory function testing, surgical applications, and animal audiology.

The first section includes four chapters on the foundational science and instrumentation of AEPs. Section two starts with a chapter on electrocochleography, followed by six chapters discussing various responses and potentials. Section three features eight chapters focused on clinical applications with relevant case studies. The final section provides practical guidance on various aspects, from patient-related management to stimulation calibration and generation.

• New contributions from 20 nationally and internationally recognized experts
• Major updates to the vestibular AEP chapter
• Reader-friendly section organization and tables facilitate acquisition and retention of knowledge
• Boxed pearls, pitfalls, and special considerations provide insightful, easy-to-read references
• An added animal audiology chapter offers the potential for clinicians to expand their scope of practice

This textbook is essential reading for graduate students in audiology and ENT residents, as well as seasoned clinicians who wish to refresh their skills or expand their practice.

This print book includes complimentary access to a digital copy on https://medone.com.