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      Comparación de las amplitudes y latencias de la onda V del potencial evocado auditivo de tronco cerebral obtenidas a través de estímulos clic y CE-Chirp® Translated title: Comparison of brainstem auditory evoked potential wave V amplitudes and latencies obtained through click and CE-Chirp® stimuli

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          Introducción: El potencial evocado auditivo de tronco cerebral (PEATC) se ha convertido en un procedimiento estándar dentro de la evaluación audiológica. Durante décadas, el estímulo más utilizado ha sido el clic, sin embargo, últimamente se ha propuesto la utilización de estímulos de frecuencia modulada (chirp) para obtener resultados más eficientes. Objetivo: Comparar las amplitudes y las latencias de la onda V del PEATC obtenidas a través de estímulos clic y CE-Chirp® a distintas intensidades. Material y método: Se realizó un estudio de tipo cuantitativo, no experimental, transversal y descriptivo en 17 sujetos a los que se evaluó con un PEATC utilizando estímulos clic y CE-Chirp®. Resultados: Se obtuvieron mayores amplitudes de onda Vpara estímulos CE-Chirp® que para clic, en todas las intensidades evaluadas (80, 60, 40,30 y 20 dBnHL). Se obtuvieron menores latencias en la onda Vpara estímulos CE-Chirp® solo a 80 y 60 dBnHL, mientras que en el resto de las intensidades se obtuvo menores latencias con estímulos clic. Conclusiones: Existen diferencias significativas entre las latencias y amplitudes de la onda V obtenidas con estímulos clic y CE-Chirp®. Mientras los estímulos CE-Chirp® aportan en rapidez en el examen y en la búsqueda del umbral electrofisiológico más preciso, los estímulos clic serían los adecuados al momento de realizar un estudio de topodiagnóstico.

          Translated abstract

          Introduction: The auditory brainstem response (ABR) has become a standard procedure in the audiological evaluation. For decades the most widely used stimulus was the click, but recently the use of chirp stimulus has been proposed for obtain more efficient results. Aim: To compare the amplitudes and latencies of wave V of ABR obtained through click and CE-Chirp® stimuli at different intensities. Material and method: A quantitative, not experimental, transversal and descriptive study was conducted with 17 subjects who were evaluated with ABR using click and CE-Chirp® stimuli. Results: Wave V larger amplitudes were verified for stimulus CE-Chirp®, in all the evaluated intensities (80, 60, 40, 30 and 20 dBnHL). Shorter latencies of wave V were obtained for CE-Chirp® stimuli only at 80 and 60 dBnHL, while it was found that the remaining intensities showed lower latencies with click stimuli. Conclusions: There are significant differences between latencies and amplitudes of the wave V obtained with CE-Chirp® and click stimuli. While the CE-Chirp® stimuli provides faster results for most accurate electrophysiological threshold, click stimuli would be appropriate to conduct site of the lesion testing.

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          Most cited references 19

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            Auditory brainstem responses with optimized chirp signals compensating basilar-membrane dispersion.

            This study examines auditory brainstem responses (ABR) elicited by rising frequency chirps. The time course of frequency change for the chirp theoretically produces simultaneous displacement maxima by compensating for travel-time differences along the cochlear partition. This broadband chirp was derived on the basis of a linear cochlea model [de Boer, "Auditory physics. Physical principles in hearing theory I," Phys. Rep. 62, 87-174 (1980)]. Responses elicited by the broadband chirp show a larger wave-V amplitude than do click-evoked responses for most stimulation levels tested. This result is in contrast to the general hypothesis that the ABR is an electrophysiological event most effectively evoked by the onset or offset of an acoustic stimulus, and unaffected by further stimulation. The use of this rising frequency chirp enables the inclusion of activity from lower frequency regions, whereas with a click, synchrony is decreased in accordance with decreasing traveling velocity in the apical region. The use of a temporally reversed (falling) chirp leads to a further decrease in synchrony as reflected in ABR responses that are smaller than those from a click. These results are compatible with earlier experimental results from recordings of compound action potentials (CAP) [Shore and Nuttall, "High synchrony compound action potentials evoked by rising frequency-swept tonebursts," J. Acoust. Soc. Am. 78, 1286-1295 (1985)] reflecting activity at the level of the auditory nerve. Since the ABR components considered here presumably reflect neural response from the brainstem, the effect of an optimized synchronization at the peripheral level can also be observed at the brainstem level. The rising chirp may therefore be of clinical use in assessing the integrity of the entire peripheral organ and not just its basal end.
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              Human auditory evoked potentials: possible brain stem components detected on the scalp.

              Auditory potentials recorded from the vertex of humans by a modified averaging technique have very short latencies and are probably generated by brain stem structures located at a considerable distance from the recording point. The evoked waves, which shOW considerable detail and consistency within and across subjects, may be clinically useful in evaluating subcortical function.

                Author and article information

                Role: ND
                Role: ND
                Revista de otorrinolaringología y cirugía de cabeza y cuello
                Rev. Otorrinolaringol. Cir. Cabeza Cuello
                Sociedad Chilena de Otorrinolaringología, Medicina y Cirugía de Cabeza y Cuello (Santiago, , Chile )
                December 2016
                : 76
                : 3
                : 272-279
                orgnameUniversidad Santo Tomás orgdiv1Facultad de Salud orgdiv2Escuela de Fonoaudiología Chile
                orgnameUniversidad UCINF orgdiv1Facultad de Ciencias de la Salud Chile

                This work is licensed under a Creative Commons Attribution 4.0 International License.

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