Evaluating Stimulus Efficacy In Auditory Brainstem Response Testing For Threshold Estimation: A Systematic Review

Authors

  • Amna Awais
  • Nukhbat Ullah Awan
  • Rabia Zulfiqar
  • Uzma Malik
  • Ayesha Aslam
  • Anum Nasrullah
  • Syeda Hamda

DOI:

https://doi.org/10.53555/ks.v12i5.3403

Keywords:

Auditory brainstem response, threshold estimation, amplitude, wave V, intensity

Abstract

Accurate threshold estimation using Auditory Brainstem Response (ABR) is crucial in clinical audiology. This systematic review evaluates various stimulus types for their effectiveness in generating reliable ABR wave V amplitudes, focusing on Chirp stimuli compared to Click and Tone Burst stimuli. To determine which stimulus type—Chirp (Broadband CE Chirp, LS Chirp, Narrowband Chirp), Click, or Tone Burst—provides the most reliable threshold estimation for different intensity levels. A comprehensive review of studies comparing ABR results across different stimulus types was conducted. Emphasis was placed on wave V amplitude reliability, particularly at low intensities (below 60 dB nHL) and high intensities (80 dB nHL and above). Chirp stimuli consistently generated larger wave V amplitudes compared to Clicks, especially at lower intensities. The Broadband CE Chirp and Narrowband Chirp were notably effective in producing larger amplitudes and improving threshold estimation accuracy. Although Chirp stimuli showed reduced effectiveness at higher intensities, they still outperformed Clicks and Tone Bursts in overall amplitude and reliability. Narrowband Chirp was particularly effective for frequency-specific threshold estimation. Some studies indicated a decrease in Chirp amplitude at high intensities, potentially due to the upward spread of excitation. Chirp stimuli, including Broadband CE Chirp, LS Chirp, and Narrowband Chirp, are generally superior to Click stimuli for reliable ABR threshold estimation, particularly at lower intensities. While Chirp stimuli offer robust and consistent results, further research is needed to address their effectiveness at higher intensities and to establish normative data across various populations to refine clinical practices

Author Biographies

Amna Awais

King Edward Medical University/Mayo Hospital, Lahore, Pakistan

 

Nukhbat Ullah Awan

Associate Professor, ENT department, King Edward Medical University/Mayo Hospital, Lahore, Pakistan

Rabia Zulfiqar

Oral & Maxillofacial Surgery Department, King Edward Medical University/Mayo Hospital, Lahore, Pakistan

 

Uzma Malik

Associate Professor, Medicine, King Edward Medical University/Mayo Hospital, Lahore, Pakistan

Ayesha Aslam

Associate Professor, Department of Neurology, King Edward Medical University/Mayo Hospital, Lahore, Pakistan

 

Anum Nasrullah

Clinical Audiologists, King Edward Medical University/Mayo Hospital, Lahore, Pakistan

Syeda Hamda

 King Edward Medical University/Mayo Hospital, Lahore, Pakistan

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Published

2024-09-19

How to Cite

Amna Awais, Nukhbat Ullah Awan, Rabia Zulfiqar, Uzma Malik, Ayesha Aslam, Anum Nasrullah, & Syeda Hamda. (2024). Evaluating Stimulus Efficacy In Auditory Brainstem Response Testing For Threshold Estimation: A Systematic Review. Kurdish Studies, 12(5), 1103–1109. https://doi.org/10.53555/ks.v12i5.3403

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