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Semin Hear 2025; 46(04): 253-265
DOI: 10.1055/s-0045-1812878
Review Article

Agreement Between Evoked Potentials and Behavioral Thresholds Using LS-Chirp and 1 kHz Tone Burst in Normal-Hearing Adults: A Pilot Study

Autor*innen

  • Wan Madihah W. Embong

    1   Department of Audiology and Speech-Language Pathology, Kulliyyah of Allied Health Sciences, International Islamic University Malaysia
    2   Bahagian Perkembangan Latihan, Kementerian Kesihatan, Malaysia

  • Sarah Rahmat

    1   Department of Audiology and Speech-Language Pathology, Kulliyyah of Allied Health Sciences, International Islamic University Malaysia
    3   Children Health and Wellbeing Research Group, Kulliyyah of Allied Health Sciences, International Islamic University Malaysia

  • Ahmad Aidil Arafat Dzulkarnain

    1   Department of Audiology and Speech-Language Pathology, Kulliyyah of Allied Health Sciences, International Islamic University Malaysia
    3   Children Health and Wellbeing Research Group, Kulliyyah of Allied Health Sciences, International Islamic University Malaysia

  • Mohd Normani Zakaria

    4   Program Audiologi, Pusat Pengajian Sains Kesihatan, Universiti Sains Malaysia

  • Juliana Aminah Marhaban

    1   Department of Audiology and Speech-Language Pathology, Kulliyyah of Allied Health Sciences, International Islamic University Malaysia
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Abstract

Background

Auditory evoked potentials (AEPs), including the auditory brainstem response (ABR) and cortical auditory evoked potential (CAEP), are widely used to estimate hearing thresholds in individuals unable to provide behavioral responses. However, it remains unclear whether brainstem or cortical activity better reflects perceptual thresholds, and how stimulus characteristics influence this relationship. This study investigated the agreement between evoked potentials and behavioral thresholds using different stimuli and presentation rates.

Methods

Two experiments examined agreement between AEPs and behavioral thresholds. Experiment 1 (n = 8 ears) used LS CE-Chirp stimuli at 33.3 stimuli/second. Experiment 2 (n = 12 ears) used 1 kHz tone burst stimuli and examined three conditions: behavioral thresholds at 33.3 stimuli/second (Experiment 2a), behavioral thresholds at 1.0 stimuli/second (Experiment 2b), and standard 1 kHz pure tone audiometry (Experiment 2c). Different adult groups (≥18 years) were recruited for each experiment. Behavioral thresholds were obtained via the Hughson–Westlake method. Thresholds were compared using Wilcoxon signed-rank tests.

Results

Agreement patterns varied systematically with stimulus characteristics. For LS CE-Chirp stimuli at 33.3 stimuli/second, ABR thresholds showed significantly better agreement with behavioral thresholds than CAEP thresholds (p < 0.05). For 1 kHz tone burst stimuli at 33.3 stimuli/second, no significant difference was observed between ABR and CAEP agreement with behavioral thresholds (p > 0.05). However, at 1.0 stimuli/second, CAEP thresholds demonstrated significantly better agreement with behavioral thresholds than ABR thresholds (p < 0.05). Both ABR and CAEP thresholds showed comparable agreement with clinical 1 kHz pure tone audiometry thresholds (p > 0.05).

Conclusion

These preliminary findings demonstrate that both stimulus type and presentation rate influence threshold estimation, with slower rates favoring cortical-behavioral agreement and faster rates favoring brainstem-behavioral agreement. These context-dependent patterns may guide measurement strategies and support their use in the identification of auditory dysfunction. Further research with larger samples is needed to validate these findings and establish their clinical applicability.

Keywords

ABR - CAEP - LS CE-chirp - 1 kHz tone burst - behavioral hearing thresholds

Short Blurb

This study explores the agreement between ABR, CAEP, and behavioral thresholds using LS CE-Chirp and 1 kHz tone burst stimuli in normal-hearing adults. Findings highlight the effect of stimulus duration and rate on threshold estimation and neural contributions at the brainstem and cortical levels.


Ethical Approval

Ethical approval was obtained from the International Islamic University of Malaysia (IIUM) Institutional Research Ethics Committee (reference number: IIUM/504/14/11/2/IREC-2025–131).


AI Use in Manuscript

Language editing was assisted using AI tools such as ChatGPT. All content and interpretations remain the sole responsibility of the authors.




Publikationsverlauf

Artikel online veröffentlicht:
06. November 2025

© 2025. Thieme. All rights reserved.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 

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