Auditory

Brainstem
Response
 ACCOMPLISHMENTS IN THE PAST

In 1967, Sohmer and Feinmesser were the first to publish ABRs recorded

with surface electrodes in humans which showed that cochlear potentials
could be obtained non-invasively. In 1971, Jewett and Williston gave a clear
description of the human ABR and correctly interpreted the later waves as
arriving from the brainstem. In 1974, Hecox and Galambos showed that the
ABR could be used for threshold estimation in adults and infants.

USE OF ABR

The ABR is used for newborn hearing screening, auditory threshold

estimation, intraoperative monitoring, determining hearing loss type and
degree, and auditory nerve and brainstem lesion detection.

HISTORY OF AUDITORY STEADY STATE RESPONSE (ASSR)

In 1981, Galambos and colleagues reported on the “40 Hz auditory potential”

which is a continuous 400 Hz tone sinusoidally ‘amplitude modulated’ at
40 Hz and at 70 dB SPL. This produced a very frequency specific response,
but the response was very susceptible to state of arousal. In 1991, Cohen
and colleagues learned that by presenting at a higher rate of stimulation than
40 Hz (>70 Hz), the response was smaller but less affected by sleep. In
1994, Rickarts and colleagues showed that it was possible to obtain
responses in newborns. In 1995, Lins and Picton found that simultaneous
stimuli presented at rates in the 80 to 100 Hz range made it possible to
obtain auditory thresholds

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 HISTORY OF STACKED ABR

. In 1997, Dr. Manuel Don and colleagues published on the Stacked ABR as
a way to enhance the sensitivity of the ABR in detecting smaller tumors.
Their hypothesis was that the new ABR-stacked derived-band ABR
amplitude could detect small acoustic tumors missed by standard ABR
measures.In 2005, he stated that it would be clinically valuable to have
available an ABR test to screen for small tumors. In a 2005 interview in
Audiology Online, Dr. Don of House Ear Institute defined the Stacked ABR as
“..an attempt to record the sum of the neural activity across the entire
frequency region of the cochlea in response to a click stimuli.”

HISTORY OF BC ABR
ASHA (1991) recommended BCABR tests for assessment of newborns,
infants and toddlers. BC-ABR tests were first reported in the 1970s with
the inception of ABR as a clinical tool and have received considerable
attention during the past 15 years, with a flurry of papers published on the
topic since 1987. There is no consensus, yet, about what constitutes a
sensitive and specific BC-ABR test protocol.

RECENT ABR INSTRUMENTS

GSI AuderA

AEP Software Features:

• Click, tone pip and tone
burst stimuli with contralateral masking available
• No predefined limits on number of waveforms displayed

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 • Multiple panels of waveforms displayed simultaneously
• Continuous live display of ongoing input signals
• Display results for different tests, recorded with different time bases,
in a single chart
• Unlimited number of user-defined test protocols
• Built-in, one-button electrode impedance measurement
• Data collected with different protocols can be displayed in the same
chart or different charts
• User-definable marker/measurement tables

ASSR Software Features:

• Clinically-validated protocols - University of Melbourne
• All ASSR information is shown in a single display
• Continuous live display allows easy monitoring of ongoing EEG signals
• Electrode attachment integrity can be assessed with a one-button, on-
screen impedance measurement
• Evoke the ASSR with AM/FM modulated tonal stimuli for the 250
-8,000 Hz frequency range

SMART EP

AUDITORY EVOKED POTENTIALS

SmartEP, is the most complete and flexible platform for

the acquisition of Evoked Potentials. A straightforward
Control Panel allows for fast data acquisition, while the

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 great variety of controls allow you to perform tests the
way you want them.

BASE SOFTWARE FUNCTIONALITY INCLUDES:

 Electrocochleography (ECochG) using TM-Wick or other

electrodes.
 Click and Tone Auditory Brainstem Response (ABR).
 Bone Conduction ABR.
 Middle Latency Response (MLR).
 Late Latency Response (LLR).

OPTIONAL ADD-ON MODULES

 P300/MMN software module

for the acquisition of P300 and Mismatched Negativity.
 eABR software module and hardware
for acquisition in patients with Cochlear Implants.
 Chained Stimulus software module
for concurrent acquisition of multiple stimulus levels.
 Notched Masking software module and hardware
for ipsilateral masking using notched noise.

SmartEP-ASSR

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 AUDITORY STEADY STATE EVOKED RESPONSES

ASSR takes the guesswork out of audiometric evaluation

by providing accurate threshold detection using statistical
analysis, greatly reducing the potential for human error.

SMARTEP-ASSR FEATURES INCLUDE:

 Dual ear stimulation and dual channel acquisition.

 Simultaneous multi-frequency testing.
 Test at the four main audiometric frequencies or create your
own protocol.
 “Response” or “No Response” evaluation result for each
frequency and intensity level tested
 Automatically generated estimated audiogram.

The ASSR Advantage

ASSR speeds up audiometric evaluation by providing accurate
threshold detection using automated statistical analysis, which
also greatly reduces the potential for human error.
 • Automatically generates an estimated audiogram for user selected
frequencies.
Simultaneous, dual-ear stimulation technique reduces test
time.
 • Simultaneous, multi-frequency testing.
 • Two channel option for both ipsilateral and contralateral
analysis and bone conduction testing.
 • Detection of mild, moderate, or profound hearing losses.
 • “Response” or “No Response” evaluation result for each
frequency and intensity level tested.
 • Easy selection of test frequencies.
 • Responses displayed in Audiogram, Spectral Analysis, and
 Phasor graphs.

PETSCREENER

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 PetScreener is an ABR acquisition system with the purpose
of screening the pet population for hearing problems. It's
response detection algorithm is especially tailored to the
morphology of animal responses.

BASE FUNCTIONALITY INCLUDES:

 Use Click or 500, 1k, 2k, 4k Hz tones.

 Up to 10 intensities in a single protocol.
 Standard and Chain acquisition modes.
 Automatic "No-Response" or "Probable Response"
interpretation

MB 11 BERAphone

 Fast and automatic ABR-screening, reliable

results within seconds
 Unique BERAphone® with integrated electrodes saving costs for
disposables
 CE-Chirp™ stimulus evoking a higher ABR than a Click stimulus
(Elberling et. al. 2007)
 Automatic impedance check of the electrode skin contact
 Tracking data export functionality
 Stimulation level of 35 dBnHL
 USB-connection for power supply and data transfer

MB 11 Classic

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  Fast and automatic ABR-screening, reliable results within seconds
 Simultaneous binaural hearing screening for all ages
 CE-Chirp™ stimulus evoking a higher ABR than a Click stimulus
(Elberling et. al. 2007)
 Advanced ABR detection algorithm provides “PASS” or “REFER”
result
 Automatic impedance check ensuring precise and clear signal
conditions
 Automatic data export for easy tracking
 Using Sanibel Infant EarCups™ and snap electrodes

easyScreen

 Fast and easy AABR hearing screening using the CE-Chirp® stimulus

 Powerful ABR detection algorithm for short test time

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  Intuitive user interface with easy-to-learn operation
 Advanced database system with tracking capabilities
 Configurable patient and tracking information fields
 Large multicolour Touch Screen for comfortable navigation
 Multifunctional docking station for fast and safe data transfer and
battery charging

Interacoustics EP 15

 Threshold & neurological ABR testing & eABR

 Bayesian weighting
 Residual noise calculator
 Fmp calculator
 SNR 3:1 ratio calculator
 CR, RA, INC waveform markers
 Normative latency data for click, CE-Chirp® & NB CE-Chirp®
 Single/split screen
 CE-Chirp® & NB CE-Chirps® for optimized threshold assessment (optional)
 CM & ECochG testing (optional)

Interacoustics EP 25
EP25 – all the features of EP15 and more...

 AMLR & ALLR testing

 EcochG Area Ratio Calculation by John Ferraro
 CE-Chirp® & NB CE-Chirp® for optimized threshold assessment (*optional for
EP15)
 Comprehensive editing/analysis tools
 Fully customizable protocols
 Normative latency data for click, CE-Chirp® & NB CE-Chirp

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 Madsen AccuScreen OAE/ABR Screener

Grason-Stadler AudioScreener+

 Available as OAE, ABR, or combo unit

 - Offers both TEOAE and DPOAE testing
 - Lightweight, handheld design
 - View summary results or detailed results on 
    screen.
 - Included tracking software compatible with
   OZ and HiTrack