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A Comparison of Auditory Brain Stem Responses Elicited by Click and Chirp Stimuli in Adults With Normal Hearing and Sensory Hearing Loss

Objectives: The aim of this study was to compare the human auditory brain stem response (ABR) elicited by clicks and chirps with overall behavioral hearing thresholds in participants with normal hearing and with sensory hearing loss. The authors hypothesized that ABRs to chirps would be more robust and that thresholds would be more similar to overall behavioral hearing thresholds compared with ABRs to clicks. Design: Twenty-five adults with normal hearing and 25 adults with sensory hearing loss were recruited. Subjects were without middle ear or neurological pathologies at the time of testing. Subjects with sensory hearing loss were separated into mild to moderate hearing loss and mild to severe hearing loss groups. Behavioral hearing thresholds for pure tones were obtained at nine octave and interoctave frequencies ranging from 250 to 8000 Hz; an average of these nine frequencies was calculated for each participant. Evoked potential thresholds were measured by ABRs to click and chirp stimuli. Analyses included wave V absolute latencies and wave V peak-to-peak amplitudes. Thresholds for ABRs to clicks and chirps were compared with each other and with overall behavioral hearing thresholds. Results: ABR thresholds to chirp and click stimuli did not differ significantly for either the normal-hearing or the hearing loss groups. Wave V peak-to-peak amplitude was higher for chirps than clicks, particularly at lower intensities, for all groups. ABR thresholds to chirps were closer to overall behavioral thresholds than clicks in all groups. Moreover, ABR thresholds to chirps did not differ significantly from behavioral thresholds in the two hearing loss groups. Conclusions: ABRs obtained with chirp stimuli provide an efficient method for estimating hearing thresholds in individuals with normal hearing and sensory hearing loss where broadband signals are selected for testing. ABRs to chirps display higher peak-to-peak amplitudes than those obtained with clicks and may provide responses closer to behavioral thresholds. This information could result in improved accuracy in identifying hearing loss and estimating hearing sensitivity for broadband signals in infants, children, and difficult-to-test older populations.