Semin Hear 2022; 43(03): 149-161
DOI: 10.1055/s-0042-1756161
Review Article

Neuroaudiological Considerations for the Auditory Brainstem Response and Middle Latency Response Revisited: Back to the Future

Frank E. Musiek
1   Department of Speech, Language and Hearing Sciences, University of Arizona, Tucson, Arizona
,
Jane A. Baran
2   Department of Communication Disorders, University of Massachusetts Amherst, Amherst, Massachusetts
› Author Affiliations

Abstract

The auditory brainstem response (ABR) and middle latency response (MLR) are two sets of evoked potentials that have made major contributions to the field of diagnostic audiology. Many of these contributions were guided by clinical research audiologists. Though many of these auditory evoked potentials (AEPs) are still being used diagnostically by audiologists, there has been a steep decline in their popularity both clinically and in the research laboratory. This is indeed most unfortunate because these AEPs could and should be advancing our field and benefitting many patients. In this article, some critical research is overviewed that addresses some of the reasons why these AEPs (ABR and MLR) are not being utilized as frequently as they should be for neuroauditory assessments. Reflecting on our past when ABR and MLR were more commonly used can serve as a model for our future. Multiple applications and the diagnostic value of these AEPs are presented in an effort to convince audiologists that these electrophysiologic procedures should be revisited and reapplied in the clinic and research settings. It is argued that the dwindling use of ABR and MLR (and AEPs in general) in the field of audiology is not only remarkably premature but also lacks good scientific grounding. While on the other hand, if applied clinically, the value of these AEPs is both substantial and promising.



Publication History

Article published online:
26 October 2022

© 2022. Thieme. All rights reserved.

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

 
  • References

  • 1 Part B National Summary Data File (Previously known as BESS) [Internet]. Medicare (US). 2017. Accessed July 28, 2022 at: https://www.cms.gov/Research-Statistics-Data-and-Systems/Downloadable-Public-Use-Files/Part-B-National-Summary-Data-File/Overview.html
  • 2 Musiek FE, Shinn JB, Jirsa R. The auditory brainstem response in auditory nerve and brainstem dysfunction. In: Burkard RF, Eggermont JJ, Don M. eds Auditory Evoked Potentials: Basic Principles and Clinical Application. Philadelphia: Lippincott Williams & Wilkins; 2007: 291-312
  • 3 Koors PD, Thacker LR, Coelho DH. ABR in the diagnosis of vestibular schwannomas: a meta-analysis. Am J Otolaryngol 2013; 34 (03) 195-204
  • 4 Musiek FE, Baran JA. The Auditory System, Anatomy, Physiology and Clinical Correlates. 2nd ed. San Diego: Plural Publishing; 2018
  • 5 Musiek F, Nagle S. The middle latency response: a review of findings in various central nervous system lesions. J Am Acad Audiol 2018; 29 (09) 855-867
  • 6 Musiek FE. Auditory Evoked Responses in Site of Lesion Assessment. In: Rintelmann WF. ed. Hearing Assessment. 2nd ed. Austin, TX: : Pro Ed; 1991: 383-428
  • 7 Ivey RG, Cheek D, Musiek F. ABR heralds the initial diagnosis of neurofibromatosis type II. Hear J 2021; 74 (02) 8-9
  • 8 Fortnum H, O'Neill C, Taylor R. et al. The role of magnetic resonance imaging in the identification of suspected acoustic neuroma: a systematic review of clinical and cost effectiveness and natural history. Health Technol Assess 2009; 13 (18) ):iii–iv, ix–xi, 1-154
  • 9 Vandervelde C, Connor SE. Diagnostic yield of MRI for audiovestibular dysfunction using contemporary referral criteria: correlation with presenting symptoms and impact on clinical management. Clin Radiol 2009; 64 (02) 156-163
  • 10 Versaw N. How much does an MRI cost? Compare.com. Published 8/16/2021. Updated 12/14/2021. Accessed December 14, 2021 at: https://www.compare.com/health/healthcare-resources/how-much-does-an-mri-cost
  • 11 Kalamarides M, Bouccara D, El Garem H. et al. Small acoustic neuroma: Observation or treatment? A review of 207 cases. [Article in French] Neurochir 2001; 47 (04) 403-412
  • 12 Chiappa KH, Ropper AH. Evoked potentials in clinical medicine (first of two parts). N Engl J Med 1982; 306 (19) 1140-1150
  • 13 Musiek FE, Lee WW. The auditory brain stem response in patients with brain stem or cochlear pathology. Ear Hear 1995; 16 (06) 631-636
  • 14 Marrie RA, Elliott L, Marriott J. et al. Effect of comorbidity on mortality in multiple sclerosis. Neurology 2015; 85 (03) 240-247
  • 15 Luxon LM. Hearing loss in brainstem disorders. J Neurol Neurosurg Psychiatry 1980; 43 (06) 510-515
  • 16 Musiek FE, Gollegly KM, Kibbe KS, Reeves AG. Electrophysiologic and behavioral auditory findings in multiple sclerosis. Am J Otol 1989; 10 (05) 343-350
  • 17 National Multiple Sclerosis Society. . Updated 2022. Accessed December 14, 2021 at: https://www.nationalmssociety.org/
  • 18 Woo D, Frohman T, Frohman E. Vestibular testing and multiple sclerosis. In: Vertigo and Imbalance: Clinical Neurophysiology of the Vestibular System. Amsterdam: Elsevier Publishers; 2010: 478-486
  • 19 Celebisoy N, Aydoğdu I, Ekmekçi O, Akürekli O. Middle latency auditory evoked potentials (MLAEPs) in (MS). Acta Neurol Scand 1996; 93 (05) 318-321
  • 20 Delalande I, Thomas D, Forzy G, Hautecoeur P, Gallois P. Diagnostic importance of middle latency auditory evoked potentials (MLAEP) in multiple sclerosis. Neurophysiol Clin 1997; 27 (04) 293-299
  • 21 Hendler T, Squires NK, Emmerich DS. Psychophysical measures of central auditory dysfunction in multiple sclerosis: neurophysiological and neuroanatomical correlates. Ear Hear 1990; 11 (06) 403-416
  • 22 Japaridze G, Shakarishvili R, Kevanishvili Z. Auditory brainstem, middle-latency, and slow cortical responses in multiple sclerosis. Acta Neurol Scand 2002; 106 (01) 47-53
  • 23 Matas CG, Matas SL, Oliveira CR, Gonçalves IC. Auditory evoked potentials and multiple sclerosis. Arq Neuropsiquiatr 2010; 68 (04) 528-534
  • 24 Robinson K, Rudge P. Abnormalities of the auditory evoked potentials in patients with multiple sclerosis. Brain 1977; 100 (Pt 1): 19-40
  • 25 Versino M, Bergamaschi R, Romani A. et al. Middle latency auditory evoked potentials improve the detection of abnormalities along auditory pathways in multiple sclerosis patients. Electroencephalogr Clin Neurophysiol 1992; 84 (03) 296-299
  • 26 Di Stadio A, Dipietro L, Ralli M. et al. Sudden hearing loss as an early detector of multiple sclerosis: a systematic review. Eur Rev Med Pharmacol Sci 2018; 22 (14) 4611-4624
  • 27 Musiek FE, Shinn JB, Baran JA, Jones RO. Disorders of the Auditory System. 2nd ed. San Diego: Plural Publishing; 2021: 284-296
  • 28 Cone-Wesson B, Rance G. Auditory neuropathy: a brief review. Curr Opin Otolaryngol Head Neck Surg 2000; 8 (05) 421-425
  • 29 Rapin I, Gravel J. “Auditory neuropathy”: physiologic and pathologic evidence calls for more diagnostic specificity. Int J Pediatr Otorhinolaryngol 2003; 67 (07) 707-728
  • 30 Dublin WB. The cochlear nuclei–pathology. Otolaryngol Head Neck Surg 1985; 93 (04) 448-463
  • 31 Akinpelu OV, Waissbluth S, Daniel SJ. Auditory risk of hyperbilirubinemia in term newborns: a systematic review. Int J Pediatr Otorhinolaryngol 2013; 77 (06) 898-905
  • 32 Jiang ZD, Wilkinson AR. Impaired function of the auditory brainstem in term neonates with hyperbilirubinemia. Brain Dev 2014; 36 (03) 212-218
  • 33 Salehi N, Bagheri F, Ramezani Farkhani H. Effects of hyperbilirubinemia on auditory brainstem response of neonates treated with phototherapy. Iran J Otorhinolaryngol 2016; 28 (84) 23-29
  • 34 Smith CM, Barnes GP, Jacobson CA, Oelberg DG. Auditory brainstem response detects early bilirubin neurotoxicity at low indirect bilirubin values. J Perinatol 2004; 24 (11) 730-732
  • 35 Perlman M, Fainmesser P, Sohmer H, Tamari H, Wax Y, Pevsmer B. Auditory nerve-brainstem evoked responses in hyperbilirubinemic neonates. Pediatrics 1983; 72 (05) 658-664
  • 36 Castellanos MJ, Fuente A. The adverse effects of heavy metals with and without noise exposure on the human peripheral and central auditory system: a literature review. Int J Environ Res Public Health 2016; 13 (12) 1223-1247
  • 37 Discalzi GL, Capellaro F, Bottalo L, Fabbro D, Mocellini A. Auditory brainstem evoked potentials (BAEPs) in lead-exposed workers. Neurotoxicology 1992; 13 (01) 207-209
  • 38 Bleecker ML, Ford DP, Lindgren KN, Scheetz K, Tiburzi MJ. Association of chronic and current measures of lead exposure with different components of brainstem auditory evoked potentials. Neurotoxicology 2003; 24 (4-5): 625-631
  • 39 Lanphear BP, Dietrich K, Auinger P, Cox C. Cognitive deficits associated with blood lead concentrations <10 microg/dL in US children and adolescents. Public Health Rep 2000; 115 (06) 521-529
  • 40 Otto D, Robinson G, Baumann S. et al 5-year follow-up study of children with low-to-moderate lead absorption: electrophysiological evaluation. Environ Res 1985; 38 (01) 168-186
  • 41 Discalzi G, Fabbro D, Meliga F, Mocellini A, Capellaro F. Effects of occupational exposure to mercury and lead on brainstem auditory evoked potentials. Int J Psychophysiol 1993; 14 (01) 21-25
  • 42 Musiek FE, Hanlon DP. Neuroaudiological effects in a case of fatal dimethylmercury poisoning. Ear Hear 1999; 20 (03) 271-275
  • 43 14 Amazing Phenylketonuria Statistics. Health Research Funding. Published November 27, 2014. Accessed December, 2021 at: https://healthresearchfunding.org/14-amazing-phenylketonuria-statistics
  • 44 Cleary MA, Walter JH, Wraith JE. et al Magnetic resonance imaging of the brain in phenylketonuria. Lancet 1994; 344 (8915): 87-90
  • 45 Cardona F, Leuzzi V, Antonozzi I, Benedetti P, Loizzo A. The development of auditory and visual evoked potentials in early treated phenylketonuric children. Electroencephalogr Clin Neurophysiol 1991; 80 (01) 8-15
  • 46 Korinthenberg R, Ullrich K, Füllenkemper F. Evoked potentials and electroencephalography in adolescents with phenylketonuria. Neuropediatrics 1988; 19 (04) 175-178
  • 47 Mancini PC, Durrant JD, Starling ALP, Iório MCM. Children with phenylketonuria treated early: basic audiological and electrophysiological evaluation. Ear Hear 2013; 34 (02) 236-244
  • 48 Langer L, Levy C, Bayley M. Increasing incidence of concussion: true epidemic or better recognition?. J Head Trauma Rehabil 2020; 35 (01) E60-E66
  • 49 Bergemalm PO, Borg E. Long-term objective and subjective audiologic consequences of closed head injury. Acta Otolaryngol 2001; 121 (06) 724-734
  • 50 Taber KH, Warden DL, Hurley RA. Blast-related traumatic brain injury: what is known?. J Neuropsychiatry Clin Neurosci 2006; 18 (02) 141-145
  • 51 Bonow RH, Friedman SD, Perez FA. et al Prevalence of abnormal magnetic resonance imaging findings in children with persistent symptoms after pediatric sports-related concussion. J Neurotrauma 2017; 34 (19) 2706-2712
  • 52 Gaetz M, Bernstein DM. The current status of electrophysiologic procedures for the assessment of mild traumatic brain injury. J Head Trauma Rehabil 2001; 16 (04) 386-405
  • 53 Rowe III MJ, Carlson C. Brainstem auditory evoked potentials in postconcussion dizziness. Arch Neurol 1980; 37 (11) 679-683
  • 54 Schoenhuber R, Gentilini M. Auditory brain stem responses in the prognosis of late postconcussional symptoms and neuropsychological dysfunction after minor head injury. Neurosurgery 1986; 19 (04) 532-534
  • 55 Musiek F, Chermak G. Diagnosis of (central) auditory processing disorder in traumatic brain injury: psychophysical and electrophysiological approaches. ASHA Lead 2009; 14 (15) 1-26
  • 56 Munjal SK, Panda NK, Pathak A. Audiological deficits after closed head injury. J Trauma 2010; 68 (01) 13-18 , discussion 18
  • 57 Kraus N, Thompson EC, Krizman J, Cook K, White-Schwoch T, LaBella CR. Auditory biological marker of concussion in children. Sci Rep 2016; 6 (01) 39009
  • 58 Musacchia G, Hu J, Bhutani VK. et al Frequency-following response among neonates with progressive moderate hyperbilirubinemia. J Perinatol 2020; 40 (02) 203-211
  • 59 Drake Jr ME, Weate SJ, Newell SA. Auditory evoked potentials in postconcussive syndrome. Electromyogr Clin Neurophysiol 1996; 36 (08) 457-462
  • 60 Soustiel JF, Hafner H, Chistyakov AV, Barzilai A, Feinsod M. Trigeminal and auditory evoked responses in minor head injuries and post-concussion syndrome. Brain Inj 1995; 9 (08) 805-813
  • 61 Møller A. Intraoperative Neurophysiological Monitoring, 3rd ed. Secaucus, NJ: Springer; 2010
  • 62 Schochat E, Musiek FE, Alonso R, Ogata J. Effect of auditory training on the middle latency response in children with (central) auditory processing disorder. Braz J Med Biol Res 2010; 43 (08) 777-785
  • 63 Jerger J. Is it time to panic?. Semin Hear 2016; 37 (04) 291-292
  • 64 Munn Z, Moola SK, Lisy K. et al Claustrophobia in magnetic resonance imaging: a systematic review and meta-analysis. Radiography 2015; 21 (02) e59-e63
  • 65 Do D, Boyle N. MRI in patients with implantable devices: current controversies [Expert analysis]. J Am Coll Cardiol 2016. Accessed December 14, 2021 at: https://www.acc.org/latest-in-cardiology/articles/2016/08/01/07/15/mri-in-patients-with-implanted-devices
  • 66 Martin ET, Coman JA, Shellock FG, Pulling CC, Fair R, Jenkins K. Magnetic resonance imaging and cardiac pacemaker safety at 1.5-Tesla. J Am Coll Cardiol 2004; 43 (07) 1315-1324
  • 67 Farling PA, Corry RC. Perioperative challenges during diagnostic and perioperative magnetic resonance imaging (MRI). In: Brambrink A, Kirsch J. eds Essentials of Neurosurgical Anesthesia & Critical Care: Strategies for Prevention, Early Detection, and Successful Management of Perioperative Complications. New York, NY: Springer; 2012: 319-330