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      LS CE-Chirp ® vs. Click in the neuroaudiological diagnosis by ABR Translated title: LS CE-Chirp ® vs. Clique no diagnóstico neuroaudiológico pelo PEATE

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          Abstract

          Introduction

          The chirp stimulus was developed seeking to counterbalance the delay of the sound wave on its journey through the cochlea, allowing the hair cells to depolarize at the same time. The result is a simultaneous stimulation providing better neural synchrony and, consequently, the recording of responses with greater amplitudes.

          Objective

          To compare the absolute latency of waves I, III and V, the interpeak intervals I–III, III–V and I–V, amplitude values of wave V and its association with the amplitude of wave I, and the interaural difference V–V in the auditory brainstem response (ABR) using Click and LS CE-Chirp ® stimuli to determine whether the responses evoked by LS CE-Chirp ® could be applied to neuroaudiological diagnosis.

          Methods

          Cross-sectional study with 30 normal-hearing individuals. The parameters used were: intensity of 85 dBnHL, alternating polarity; 17.1 stimuli/s and 100–3000 Hz filters.

          Results

          The absolute latencies of waves I, III and V observed with LS CE-Chirp ® and click did not show significant differences. Significantly higher amplitudes of wave V were observed with the LS CE-Chirp ®. The interaural difference between the wave V latencies between stimuli showed no significant difference.

          Conclusion

          The LS CE-Chirp ® stimulus was shown to be as efficient as the click to capture ABR at high levels of stimulation, with the advantage of producing greater-amplitude V waves.

          Resumo

          Introdução

          O chirp foi desenvolvido buscando compensar o atraso da onda sonora em seu trajeto pela cóclea, possibilitando que as células ciliadas despolarizem ao mesmo tempo. O resultado é uma estimulação simultânea proporcionando uma melhor sincronia neural e consequentemente o registro de respostas ocorre com maiores amplitudes.

          Objetivo

          Comparar a latência absoluta das ondas I, III e V, os intervalos interpicos I–III, III–V e I–V, os valores de amplitude da onda V e sua relação com a amplitude da onda I, e a diferença interaural V–V no Potencial Evocado Auditivo de Tronco Encefálico, utilizando os estímulos Clique e LS CE-Chirp ®, a fim de determinar se as respostas evocadas por LS CE-Chirp ® poderiam ter aplicabilidade no diagnóstico neuroaudiólogico.

          Método

          Estudo transversal com 30 indivíduos normo-ouvintes. Os parâmetros utilizados foram: intensidade de 85 dBnNA, polaridade alternada; 17,1 estímulo/s e filtros de 100–3000 Hz.

          Resultado

          As latências absolutas das ondas I, III e V observadas com LS CE-Chirp ® e clique não tiveram diferenças significativas. Amplitudes significativamente maiores da onda V foram observadas com o LS CE-Chirp ®. A diferença interaural entre as latências da onda V entre os estímulos, não mostrou diferença significativa.

          Conclusão

          O estímulo LS CE-Chirp ® mostrou-se ser tão eficiente quanto o clique na captação do Potencial Evocado Auditivo de Tronco Encefálico, em níveis elevados de estimulação, com a vantagem de produzir ondas V de maior amplitude.

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          Most cited references15

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          Auditory brainstem responses with optimized chirp signals compensating basilar-membrane dispersion.

          This study examines auditory brainstem responses (ABR) elicited by rising frequency chirps. The time course of frequency change for the chirp theoretically produces simultaneous displacement maxima by compensating for travel-time differences along the cochlear partition. This broadband chirp was derived on the basis of a linear cochlea model [de Boer, "Auditory physics. Physical principles in hearing theory I," Phys. Rep. 62, 87-174 (1980)]. Responses elicited by the broadband chirp show a larger wave-V amplitude than do click-evoked responses for most stimulation levels tested. This result is in contrast to the general hypothesis that the ABR is an electrophysiological event most effectively evoked by the onset or offset of an acoustic stimulus, and unaffected by further stimulation. The use of this rising frequency chirp enables the inclusion of activity from lower frequency regions, whereas with a click, synchrony is decreased in accordance with decreasing traveling velocity in the apical region. The use of a temporally reversed (falling) chirp leads to a further decrease in synchrony as reflected in ABR responses that are smaller than those from a click. These results are compatible with earlier experimental results from recordings of compound action potentials (CAP) [Shore and Nuttall, "High synchrony compound action potentials evoked by rising frequency-swept tonebursts," J. Acoust. Soc. Am. 78, 1286-1295 (1985)] reflecting activity at the level of the auditory nerve. Since the ABR components considered here presumably reflect neural response from the brainstem, the effect of an optimized synchronization at the peripheral level can also be observed at the brainstem level. The rising chirp may therefore be of clinical use in assessing the integrity of the entire peripheral organ and not just its basal end.
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            Auditory steady-state responses to chirp stimuli based on cochlear traveling wave delay.

            This study investigates the use of chirp stimuli to compensate for the cochlear traveling wave delay. The temporal dispersion in the cochlea is given by the traveling time, which in this study is estimated from latency-frequency functions obtained from (1) a cochlear model, (2) tone-burst auditory brain stem response (ABR) latencies, (3) and narrow-band ABR latencies. These latency-frequency functions are assumed to reflect the group delay of a linear system that modifies the phase spectrum of the applied stimulus. On the basis of this assumption, three chirps are constructed and evaluated in 49 normal-hearing subjects. The auditory steady-state responses to these chirps and to a click stimulus are compared at two levels of stimulation (30 and 50 dB nHL) and a rate of 90s. The chirps give shorter detection time and higher signal-to-noise ratio than the click. The shorter detection time obtained by the chirps is equivalent to an increase in stimulus level of 20 dB or more. The results indicate that a chirp is a more efficient stimulus than a click for the recording of early auditory evoked responses in normal-hearing adults using transient sounds at a high rate of stimulation.
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              A direct approach for the design of chirp stimuli used for the recording of auditory brainstem responses.

              A recent study evaluates auditory brainstem responses (ABRs) evoked by chirps of different durations (sweeping rates) [Elberling et al. (2010). J. Acoust. Soc. Am. 128, 215-223]. The study demonstrates that shorter chirps are most efficient at higher levels of stimulation whereas longer chirps are most efficient at lower levels. Mechanisms other than the traveling wave delay, in particular, upward spread of excitation and changes in cochlear-neural delay with level, are suggested to be responsible for these findings. As a consequence, delay models based on estimates of the traveling wave delay are insufficient for the design of chirp stimuli, and another delay model based on a direct approach is therefore proposed. The direct approach uses ABR-latencies from normal-hearing subjects in response to octave-band chirps over a wide range of levels. The octave-band chirps are constructed by decomposing a broad-band chirp, and constitute a subset of the chirp. The delay compensations of the proposed model are similar to those found in the previous experimental study, which thus verifies the results of the proposed model.
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                Author and article information

                Contributors
                Journal
                Braz J Otorhinolaryngol
                Braz J Otorhinolaryngol
                Brazilian Journal of Otorhinolaryngology
                Elsevier
                1808-8694
                1808-8686
                31 May 2016
                May-Jun 2017
                31 May 2016
                : 83
                : 3
                : 313-317
                Affiliations
                [a ]Universidade Federal de Santa Maria (UFSM), Distúrbios da Comunicação Humana, Santa Maria, RS, Brazil
                [b ]Clinica Coser de Otorrino, Santa Maria, RS, Brazil
                [c ]Universidade Federal de Santa Maria (UFSM), Santa Maria, RS, Brazil
                Author notes
                [* ]Corresponding author. michellecargnelutti@ 123456gmail.com
                Article
                S1808-8694(16)30099-4
                10.1016/j.bjorl.2016.04.018
                9444743
                27297956
                dd2418b5-a45b-4e5d-893f-23e0f289b927
                © 2016 Published by Elsevier Editora Ltda. on behalf of Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial.

                This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).

                History
                : 24 December 2015
                : 6 April 2016
                Categories
                Original Article

                hearing,electrophysiology,auditory brainstem response,audição,eletrofisiologia,potenciais evocados auditivos

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