Objective: The purpose of this study was to examine the correlation between auditory steady-state response (ASSR) thresholds and behavioral thresholds in hearing-impaired adults with two common audiometric configurations. A second goal was to compare suprathreshold ASSR growth functions in these two subject groups and to determine whether these growth functions could be used clinically to improve threshold estimation. Design: Thirty adults participated, including 10 subjects with normal hearing, 10 subjects with flat moderately severe sensorineural hearing loss, and 10 subjects with sloping high-frequency sensorineural hearing loss. The accuracy of ASSR threshold estimations for the frequencies of 500, 1000, 2000, and 4000 Hz was compared across groups. In addition, ASSRs were recorded at multiple suprathreshold intensity levels, and the growth of the response was compared across subject groups. Results: ASSR and behavioral thresholds were strongly correlated across all subjects, with no significant difference by audiometric configuration. Slightly poorer correlations were obtained in the normal-hearing subjects than in hearing-impaired subjects and for the 500-Hz test frequency compared with the higher stimulus frequencies. Subtraction and regression methods for predicting behavioral thresholds from ASSR thresholds were equally accurate. Suprathreshold amplitude growth was variable among individuals, but mean growth functions showed steeper slopes in hearing-impaired subjects than in normal-hearing subjects, particularly for the higher frequencies (2000 to 4000 Hz). However, there was not a significant difference in the slopes of amplitude growth functions between subjects with sloping versus flat audiometric configurations for these frequencies, and estimation of threshold from suprathreshold ASSR amplitude growth functions was not advantageous. Conclusions: ASSR thresholds accurately predicted behavioral threshold equally well for flat or sloping audiometric configurations. The accuracy of threshold estimation for either audiometric configuration and the similar growth function slopes may suggest that there is little spread of activation to neighboring regions of the cochlea when using multiple 100% AM stimuli in subjects with moderately sloping losses. The small amplitude of the ASSR response and individual variability may make threshold estimation based on extrapolation from suprathreshold ASSR responses impractical.
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