Pg.

174
2000Hz stimulus and 1 to 10 ms for
the tone burst stimulus at 500Hz.
Stimuli had linear envelope shapes
and, importantly, constant-onset
slopes. Only the initial past of the
stimulus was involved in eliciting
the ABR, except at very low
intensity levels at which later
portions were involved. For the
2000Hz stimulus, the response was
completely generated by the first
0.5 ms portion of a higher intensity
(50db) stimulus, and longer stimuli
had no effect on the response.
However, at lower intensity levels,
signals with a rise time of 0,1 ms
generated a completely developed
response (minimal latency and
maximum amplitude). Results at
500Hz were less consistent, perhaps
because neural units, according to
the authors, begin to respond to
individual
components
of
the
stimulus.
STIMULUS OFFSET ABR. | Basic
studies of the auditory CNS have
provided evidence of a variety of
functional neuron types (Tsuchitani,
1983). Two of these types are onset
neurons, which fire only at the onset
of a stimulus, and offset neurons,
which fire only at the offset of a
stimulus (when the stimulus is
turned off). As typically recorded,
ABR
is
thought
to
reflect
synchronous firing of onset neurons.
For a click stimulus with the
conventional
duration
of
0,1
milliseconds, stimulus onset and
offset occur almost simultaneously,
and identification of any offset
contribution to the response is
impossible. Over the ears, papers
have
sporadically
appeared
describing AERs generated by the
offset portion of stimuli. Early work
in this area was conducted with the
ALR (Rose & Malone, 1965). An

offset ALR resembling the onset ALR

was recorded in all subjects showing
an onset response and it was not
systematically affected by stimulus
frequency
or
rise/fall
time.
Prolonged stimulus duration of 850
to 1500 ms was required to elicit the
offset response (Rose & Malone,
1965).
Studies of ABR measurement
with offset stimuli are not conclusive
and, in fact, the existence of a true
offset
ABR
is
somewhat
controversial (Antonelli & Grandori,
1984; Brinkmann & Scherg, 1979;
Grandori, 1979; Kodera, Yamane,
Yamada, & Suzuki, 1977; Laukli &
Mair, 1985; Perez-Abalo, ValdesSosa, Bobes, Galan, & Biscay, 1988;
Radionova, 1989). The offset ABR is
generally less distinct than the
onset response. A long- duration
stimulus (tone burst or noise burst)
is necessary to separate in time the
offset response from the onset
response, yet with a tone burst of
15 to 20 ms, the offset ABR may be
obscured by the AMLR generated by
stimulus onset.
Clinical studies, conducted
with modest numbers of normalhearing subjects, suggest that in
comparison to onset responses, the
offset responses (a) are not as
robust
(70
to
80%
smaller
amplitude) or as reliably recorded,
(b) have a higher (poorer) threshold
(by 10 to 20db), and (c) may be
reversed
in
polarity
(showing
downward peaks) with whitenoiseburst stimuli (Brinkmann & Scherg,
1979; Kodera et al., 1977). The
offset response is recorded with a
stimulus of extended duration (e.g.,
10 ms duration or longer) to prevent

FIGURE 6.2. Diagram of

auditory
brainstem
responses evoked by onset
and offset portions of a
2000Hz tone-brst signal.
Overlapping with the invariable
onset response. The problem with
this method, at least when rise/fall
time are very brief (less than 5 ms)
is
interference
of
offset
identification by AMLR activity.
There is also some concern in
human investigations hat what is
thought to be an offset response is,
in fact, produced by acoustic
transducer ringing that follows
stimulus
onset
(Brinkmann
&
scherg, 1979). In short, offset ABRs
are poorly understood, at best. More
normal descriptive research is
needed on the relationship of
stimulus
parameters,
such
as
intensity, duration (rise/fall time,
plateau), presentation rate, the type
of stimulus (noise versus tone
burst), and response acquisition
parameters (e.g., filtering) to offset
ABRs. Nonetheless, with careful
stimulus selection, including stimuli
characterized by no ringing artifact,
it is possible to record a reliable ABR
for the offset of tonal stimulation, as
illustrated in Figure 6.2 (Van
Campen, Hall & Grantham, 1997).
The stimulus depicted in this figure
is a 2000Hz tone burst with onsetoffset times of 0,5 ms and a
duration of 10 ms. An ABR appears
at the onset of the stimulus and also
following the offset.
SUMMARY. | Click duration does
not have a marked influence on ABR
latency or amplitude. There is no
latency
change
for
stimulus
durations ranging from 0,25 to 100
sec, and an increase in latency 0,2
ms, at most, can be excepted for
durations ranging from 100 through

400
sec.
Nonetheless,
click
duration
should
be
routinely
specified and used in a consistent
manner
in
clinical
ABR
measurement.
A
complete
discussion of stimulus duration,
although seemingly straightforward,
actually leads to concerns about the
possible effects of related stimulus
characteristics.
For
example,
duration
directly
influences
frequency content of the stimulus
and to the audibility of the stimulus.
Duration effects also interact with
the envelope of the rising portion of
the stimulus and whether the onset
slope is constant or variable. Finally,
current understanding of stimulus
duration effects is limited to data
obtained from young, normalhearing subjects. There is published
study of click duration in older
subjects and/or in those with
hearing impairment, even though
these and perhaps other subject
characteristics might be expected to
interact with duration.
Other stimulus Types
FILTERED CLICKS. | In addition to
clicks
and
tone
bursts,
miscellaneous additional types of
acoustic stimuli have been reported
in ABR measurement, often in
animal models rather than in
patients (e.g., Mller & Jho, 1989).
Although none of these stimuli enjoy
widespread clinical application yet,
some are worth nothing. For
example,
filtered
clicks
are
produced when a wide-spectrum
click (e.g., the usual unfiltered or
raw click resulting from delivering a
rectangular electric pulse to a
transducer) is passed through a set
or series of filters to produce
transient
stimuli,
with
energy
centered at desired frequencies
(Arlinger, 1981; Davis & Hirsh,

1976; Klein & Teas, 1978). ABRs

(Lehnhardt, 1982) and later latency
AERs (Arlinger, 1977; Lehnhardt,
1971; Spoor, Timmer & Odenthal,
1969) have been elicited with chirps
or linear frequency ramps. These
stimuli consist of a sweep through a
defined frequency range (e.g., 1200
to 1700 or 4200 to 4700Hz) over a
defined period of time (e.g., 10 ms).
The sweep frequencies can be rising
or
falling.
Intensity
level
is
determined at the center frequency
of the ramp.
PAIRED CLICKS. | Ernest Moore
and
colleagues
(Davis-Gunter,
Lowenheim, Gopal, & Moore, 2001;
Moore et al., 1992) describe another
component of the ABRa I potential
evoked by presentation of two
closely spaced click stimuli (0,1 ms
duration). As the reader may recall
from the historical overview in
Chapter 1. Dr. Moore was one of the
first investigators to report the
identification of reliably recorded
auditory evoked responses in the
time period immediately following
the ECochG, what we now clearly
recognize as the ABR. With the
paired-click stimulus paradigm, the
presentation of a standard click is
followed soon by a second click. The
time difference (delta t) between
the two clicks in the pair is
manipulated,
with
interstimulus
intervals ranging from 4.0 ms down
to only 0.1 ms. As stated by DavisGunter et al. (2001), These time
intervals were chosen to be shorter
than, encompass, as well as exceed
the duration of the absolute (1.0
ms) and relative (4 to 5 ms)
refractory periods of the VIIIth
nerve (p. 53), and then the authors
cite the experimental findings on
auditory physiology of Eggermont
and Odenthal (1974b). The first
click, of course, generates combined

(ensemble) action potentials (AP) in

the distal portion of the auditory
nerve, the ABR wave I. If the second
click is presented before the
auditory nerve fibers have fully
recovered from firing (during their
refractory period), it presumably will
not generate an AP. The second click
will, however, produce excitatory
postsynaptic potentials (EPSPs) that
are reflected within the activity
measured as an ABR. To isolate and
identify the EPSP activity, the
authors utilize a derived response
technique i.e., the waveform for the
first (standard) click is subtracted
from the waveform for pair of clicks.
In theory, the derived response (the
difference wave) consists of only
EPSP activity. When Davis-Gunter et
al. (2001) performed the paired
stimulus and derived response
analysis
technique
with
three
normal-hearing adult subjects, the
authors identified two wavesI 0 and
Ilappearing
before
the
conventional wave I. As reported
previously (Moore et al., 1992), the
average latency for wave I i was 0,97
ms, whereas conventional wave I
latency was 1,83 ms. The authors
speculate that peaks I0 and Il
represent the summating potential
and
the
generator
potential,
generated by the cochlea and VIIIth
nerve
dendrites,
respectively
(Davis-Gunter et al., 2001, p, 50).
PLOPS. | In a study of novel
stimulation and analysis techniques,
Scherg and Speulda (1982) recorded
ABRs with conventional clicks (100
sec square-wave pulses) and with
Gaussian-shaped impulses centered
around 1000Hz, referred to by the
authors as plops. Stimuli were
presented separately for three
polarity
modes
(alternating,
rarefaction, and condensation), via a
TDH-39 earphone. The envelope of

the acoustic waveform for the plop,

as depicted in a figure in the paper,
resembled that of a click, but it
lacked the ringing (and added
frequency components) of the click
waveform. It appeared, from data
presented in a table, that absolute
latency values for wave I, wave III,
and wave V were greater for the
plop versus the click, while other
ABR
parameters
(absolute
amplitude of wave V and interwave
latencies) were similar for the two
stimuli types. A latency delay for a
stimulus with center frequency of
1000Hz versus click is excepted
because the click activates a more
basal region of the cochlea.
CHIRPS. | There is consensus that
the ABR evoked by conventional
click stimulation is dominated by
activation of the basal region of the
cochlea, mostly frequencies above
2000Hz. Attempts to enhance the
contribution of other regions of the
cochlea to ABR generation include
the generation of rather unique
types of stimuli, such as chirps
and
sophisticated
recording
techniques, such as stacked ABR.
The chirp stimulus is designed
mathematically
to
produce
simultaneous displacement maxima
along the cochlear partition by
compensating for the frequencydependent
traveling
time
differences (Fobel & Dau, 2004).
Several groups of authors since
2000
have
reported
detailed
technical
descriptions
and
mathematical models for chirp
stimuli (e.g., Dau, Wagner, Mellert,
& Kollmeier, 2000; Fobel & Dau,
2004; Wegner & Dau, 2002). In
theory, the chirp will optimize
synchronization across a broad
frequency region at high and low
intensity levels, yielding a more
robust ABR than the conventional

click
stimulus.
A
detailed
explanation of the model of cochlear
biomechanics and the mathematical
functions important in the rationale
for and generation of chirps is far
beyond the scope of this discussion.
The article authored by Fobel
and Dau (2004) provides a useful
source of information on the topic.
Fobel and Dau (2004) designed two
chirp stimuli for elicitation of the
ABR. Onereferred to as the O-chirp
was derived from previously
pusblished group-delay data (Shera
& Guinan, 2000) from stimulus
frequency OAEs (the term O chirp
refers to the derivation from an OAE
stimulus). The other stimulus
referred to as the A-chirpwas
designed with reference to data
(Gorga, Kaminski, Beauchaine, &
Jesteadt, 1988) demonstrating the
relationship between tone burst
frequency and ABR latency (the
term A chirp refers to the
derivation from ABR data). ABRs
generated by these two chirp stimuli
were compared also to a previously
developed type of chirp (Dau et al.,
2000)the M-chirpbased on a
model (the M refers to Model)
for
producing
a
flat-spectrum
stimulus. Fobel and Dau (2004)
recorded ABRs from 9 normalhearing adult subjects with the
different chirp stimuli, and with
conventional click stimuli. Since the
frequency composition of the chirp
stimuli covered a range from 0.1 to
10000Hz, durations for the chirp
stimuli were remarkably long in
comparison to clicks. Duration for
the O-chirp was 13.52 ms, whereas
duration for the M-chirp was 10-32.
For the A-chirp, however, duration
varied as a function of stimulus
intensity, from 12.72 ms at 10dB SL
(sensation level) to 5.72 ms at 60
dB SL. Fobel and Dau (2004)
reported no difference in the ABRs

evoked with O- and M-chirp stimuli

at any of the intensity levels. Each
of the chirp stimuli, however,
evoked ABRs with larger amplitude
values than those elicited by
conventional click stimuli. Among
the three types of chirps, the A-chirp
produced the most robust ABR
waveforms, and it is particularly
effective at very low [intensity]
levels where wave-V amplitude is
about three times as large as for the
click (Fobel & Dau, 2004, p. 2221).
The authors speculate on the
potential benefits of the A-chirps for
clinical
application
of
ABR,
especially for estimation of auditory
thresholds.
TONE BURSTS. | Tone bursts are
now regularly used in clinical ABR
measurement for estimation of
auditory sensitivity for discrete
frequency regions, especially in
infants and young children. The
minimum response level for the
wave V component of the ABR
evoked by tone-burst stimuli is
recorded within 10 dB or the
behavioral
threshold
for
a
comparable pure-tone frequency for
the majority of patients with sensory
hearing loss, with over 90 percent of
patients yielding a difference within
20 dB (e.g., Balfour, Pillion, &
Gaskin, 1999; Gorga, Kaminski,
Beauchaine, & Jesteadt, 1988;
Stapells, Gravel, & Martin, 1955;
Stapells, Picton, & Durieux, 1994).
The clinical application of tone-burst
stimuli
for
electrophysiological
estimation of pure-tone hearing
thresholds is discussed in Chapter 8.
What follows here is a brief mention
of other, primarily research, uses of
tone-burst stimulation of the ABR.
As noted in the section below on
stimulus polarity, differences in the
ABRs evoked by tone-burst stimuli
in different frequency regions shed

light on the mechanisms of cochlear

physiology and, in particular, the
cochlear response to rarefaction
versus
condensation
stimulus
polarity. A number of investigators
have examined with ABR the
forward masking phenomenon (e.g.,
Burkard & Hecox, 1987; Kramer &
Teas, 1982; Lasky & Rupert, 1982).
Walton, Orlando, and Burkard (1999)
utilized tone-burst maskers and
probe signals in an investigation of
the recovery from forward masking
as a function of age in adults. Using
the forward masking paradigm, the
authors found an age difference in
the latency shift of wave V with
short intervals (e.g., 16 ms)
between the masker and the probe
for higher tone-burst frequencies
(e.g., 4000 and 8000Hz), but not for
a
lower
frequency
(1000Hz).
Recovery from masking, that is,
baseline latency values for the ABR,
was always complete under all
stimulus conditions and age groups
with an interval of at least 64 ms
between masker and probe signal.
MODULATED TONES. | There are
also descriptions of AER generation
with stimuli that are frequency
modulated (Eggermont & Odenthal,
1974b; Lehnhardt, 1971) and with
stimuli
that
are
amplitude
modulated (Eggermont & Odenthal
1974b; Kuwada, Batra & Maher,
1986; Milford & Birchall, 1989;
Mller, 1987b; Rees, Green. & Kay,
1986). Amplitude modulated (AM)
and frequency modulated (FM)
sinusoidal signals are discussed
further in reference to the auditory
steady-state response (ASSR) in
Chapter 8. Legendre sewuences and
maximum length sewuences (MLS)
of pulse trains have also been
described in stimulation of ABR
(Burkard, Shi, & Hecox, 1990a, b;
Eysholdt
&
Schreiner,
1982).

Although
the
techniques
may
potentially increase efficiency of
ABR data collection and reduce test
time, clinical confirmation is lacking.
STIMULUS TRAINS. | Tietze (1980)
reported two clever techniques for
simultaneous
stimulation
and
recording of the ABR and ALR. The
methodological
problem
in
simultaneously recording these two
AERs is that the ABR requires stimuli
with rather abrupt onset (e.g., 2 to 4
cycles), a similarly brief duration,
and short interstimulus intervals
(e.g., 25 ms), whereas the ALR is
best elicited with stimuli having
relatively leisurely rise/fall times

e.g., 8 to 30ms), plateau durations

(30 to 500 ms) and interstimulus
intervals of approximately 2.5
seconds. With one technique, trains
of tone pips are presented with an
interval of 2.5 seconds between
each train. Each train has the effect
of a single stimulus unit in eliciting
the ALR. However, within each train,
individual tone pips at intervals of
25 ms serve as the stimuli for the
ABR. The second technique is
similar. The individual tone pips
continue to serve as the ABR
stimuli, and between each group of
tone pips, a tone burst of a slightly
lower intensity level is inserted, to
evoke the ALR.