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J Pethe

Publications and source records attributed to J Pethe.

14 recordsLinked to original sources

[Amplitude modulation following responses in audiological diagnostics].

The registration of brainstem potentials currently represents one of the most common methods in objective audiological diagnostics. However, regardless of their use, they are still known to possess important disadvantages, such as low specificity and validity in the lower frequency range due to broadband stimuli, or uncertainties due to the need for subjective evaluation. One potential solution to these problems could involve the registration of amplitude modulation following responses (AMFR). These potentials are being discussed much more regularly within the anglo-american literature due to their known frequency specificity within the high frequency range (resulting from a very narrow frequency band of stimulation), and also their ability to permit assessment of the hearing threshold at lower frequencies. Another additional advantage of AMFR results from the simple statistical verification of its presence.Extensive studies on the influence of both stimulating and recording parameters have also shown that the registration of AMFR could prove to be a very promising audiological tool, with past interest being focussed primarily on the optimal modulation frequency, the influence of vigilance of the generation of potentials, and the precise assessment of an objective threshold.

Acoustic Stimulation↗

[Dependence of "amplitude modulation following response" on attention].

BACKGROUND AND OBJECTIVE: Amplitude modulation following responses (AMFR) allows good estimation of the hearing threshold due to the very narrow band excitation of the cochlea. Audiological use of AMFR requires knowledge of the relationship of these responses to the state of vigilance. The few studies published compared only qualitatively the amplitude of AMFR recorded in awake subjects to that recorded in sleeping subjects. A quantitative determination of the level of vigilance on the basis of recorded physiological parameters has not yet been carried out. In the present study, the relationship between the amplitude of AMFR and the level of vigilance was investigated quantitatively. PATIENTS/METHODS: In eight adults with normal hearing, the relationship between the AMFR amplitude and EEG amplitude in the delta- and theta-band was determined. The amplitude in both frequency bands was used to indicate the state of vigilance. The subjects were studied during natural and drug-induced sleep. A 1-kHz carrier tone with a sinusoidally modulated amplitude of 40 Hz or 80 Hz was used as stimulus. RESULTS: At 40-Hz modulation frequency, the AMFR amplitude correlates with the EEG amplitude both in natural and drug-induced sleep. An increase in EEG activity is paralleled by a significant reduction of AMFR amplitude. At 80-Hz modulation frequency, no relationship between AMFR amplitude and EEG activity could be detected. Under all conditions, the amplitudes of AMFR evoked by a modulation frequency of 80 Hz were significantly lower than those evoked by 40 Hz. CONCLUSIONS: These results suggest that for an audiological use of the 40-Hz AMFR the state of vigilance should be stabilised at a constantly high level. In spite of the lower influence of vigilance on the 80-Hz AMFR, this response appears less ideal for threshold estimation in adults due to the significantly smaller amplitudes.

Adult↗

Linear versus non-linear recordings of transiently-evoked otoacoustic emissions--methodological considerations.

A non-linear technique is predominantly used for the recording of transiently-evoked otoacoustic emissions (TEOAEs). The aim of this study was to compare linear and non-linear TEOAE recordings. TEOAEs were recorded in 22 normal hearing subjects to clicks from 90 to 30 dB SPL in 10 dB steps with the ILO88 system using both linear and non-linear recording techniques. The non-linear recording technique reduces stimulus artifacts for early latencies, but total elimination could not be proved. Both artifact reduction and significant differences between the two kinds of TEOAE recordings were reduced for longer latencies and lower stimulus intensities. For longer latencies (>10 ms) there was no significant difference between "linear" and "non-linear" TEOAEs. A higher signal-to-noise ratio was found for "linear" TEOAEs, resulting in better identification and a higher test-retest correlation. The linear recording technique, which includes new methods of artifact cancellation in comparison to the mainly utilized non-linear recording technique, should be used especially in hearing screening.

Female↗

Amplitude modulation following responses in awake and sleeping humans--a comparison for 40 Hz and 80 Hz modulation frequency.

There have been several studies, which suggest that the amplitude of amplitude modulation following responses (AMFR) is correlated to the state of vigilance, similar to the 40 Hz event-related potentials. The aim of the present study was to compare the dependency of the AMFR-amplitude from the state of sleep for 40 Hz and 80 Hz modulation frequency. Eight normal hearing adults were investigated during natural and drug-induced sleep. The stimuli used were sinusoidally amplitude-modulated tones of 1 kHz carried frequency and 40 or 80 Hz modulation frequency at 60 dB nH stimulation level. For 40 Hz modulation frequency an increase of EEG-activity in the Delta-and Theta-band during periods of sleep correlates significantly with a decreased AMFR-amplitude whereas for 80 Hz no significant relation between stage of sleep and AMFR-amplitude could be found. The results suggest that in audiological use of 40 Hz-AMFR the state of vigilance should be monitored and stabilized at a high level.

Adult↗

On the frequency spectrum of Amplitude Modulation Following Responses.

Objective detection of Amplitude Modulation Following Responses (AMFR) is based on statistics applied after signal transformation from the time to the frequency domain by means of Discrete Fourier Transformation. In theory the frequency resolution of such transformation depends only on the analysed time window. In practise frequency resolution is also limited by the error caused by minimal difference between the clocks used for stimulus generation and Analogue/Digital-conversion. Small differences in clock frequencies may cause a spread of energy to neighbouring bins. In order to avoid this error we derived the sample clock for the A/D-conversion from the stimulator clock. By means of this technique the frequency structure of the AMFR was investigated. It is shown that if technical induced errors are excluded, the energy of the AMFR-response is limited to a very narrow frequency band. No physiologically induced disturbances of the phase locking of the AMFR to the modulation frequency could be observed. Additionally it is demonstrated that an increase of frequency resolution leads to an improved signal to noise ratio similar to the increase of averages in the time domain.

Adult↗

[An optimal electrode position for recording auditory evoked brain stem potentials within the scope of pediatric audiology].

BACKGROUND: Estimation of hearing threshold in children is based on reliable identification of a response to a stimulus in the near-threshold range. It is well known that only wave V can be detected in brainstem potentials evoked by near-threshold stimuli. So the question arises as to whether or not a noncephalic reference electrode compared to the common lateral postition of the reference electrode on the ipsilateral mastoid produces a more stable wave V of increased amplitude. METHOD: Thirty-three normal hearing children in three age groups (< 6 years, 6-10 years, > 10 years) were investigated. For a near-threshold stimulation with 100-microsecond-clicks (10, 20, 30 dB nHL), bioactivity was simultaneously recorded with the reference electrode in four different locations (ipsilateral mastoid, contralateral mastoid, ipsilateral earlobe, and noncephalic electrode). RESULTS: The noncephalic reference produced the highest absolute and scaled amplitudes. This finding was statistically significant. For all investigated intensities, recording with the noncephalic reference electrode yielded the highest number of reliable detectable potentials. Evaluation of the residual noise in the four recording locations revealed a significantly increased noise level for the noncephalic electrode at the nape of the neck. CONCLUSIONS: Even if the residual noise is increased, the use of noncephalic reference results in a more reliable detection of wave V compared to the conventional locations of the reference electrode.

Adult↗

[Effect of stimulus rise time and high-pass masking on early auditory evoked potentials].

BACKGROUND: Problems of frequency-specific objective assessment of hearing threshold by means of auditory brainstem response (ABR) have been discussed recently. While a number of workers have recommended methods of selective masking to improve the frequency specificity, others believe that frequency-specific potentials can also be obtained without masking. In this context, the effects of rise-decay time and high-pass masking on ABRs were investigated. METHOD: ABRs were recorded in normal-hearing subjects and patients with high and low frequency hearing loss by means of surface electrodes between the vertex and the ipsilateral mastoid. The frequency of the stimulus was 1 kHz, and the rise-decay time 1 ms (1-0-1) or 2 ms (2-0-2). High-pass filtered noise (cutoff frequency 1.5 kHz; filter slope 250 dB/octave) was employed for masking. Particular attention was paid to the problem of efficient masking. RESULTS: In normal-hearing subjects under the influence of high-pass masking compared to non-masked ABRs, longer mean latencies and diminished means of the amplitudes of wave V were found, with differences in the near-threshold domain being less pronounced. Similar results were observed in patients with high frequency hearing loss. In patients with low frequency hearing loss, the influence of high-pass masking was especially marked distinctly near to threshold. Furthermore, latency and amplitude differences of wave V of the 1-0-1 and the 2-0-2 stimuli were determined from the ABRs obtained with and without high-pass masking. The differences between the latency differences of both stimuli in the suprathreshold range (70 dB nHL) only were statistically significant. CONCLUSIONS: The results are suggestive of an inadequate frequency specificity of unmasked stimuli in the suprathreshold range. Evaluation of the latencies revealed for both rise-decay times a similar frequency specificity near the threshold and a higher frequency specificity of the longer stimulus in the suprathreshold range.

Acoustic Stimulation↗

[Comparison of methods for reducing residual noise in suprathreshold early auditory evoked potential registration].

BACKGROUND: The level of residual noise in auditory brainstem responses (ABR) depends not only on the number of averages but also on the amplitude of background noise and on the frequency of artifacts. This paper describes the influence of digital filtering and of different methods of artifact suppression on the residual noise of ABRs. METHOD: Amplitude of background noise was estimated for 1033 ABRs recorded under suprathreshold stimulation (70 and 90 dB nHL) in 251 subjects. In 45 ABR recordings in 15 subjects, all 4000 individual sweeps were stored for off-line simulation. The power spectrum of background noise was investigated using an FFT analyzer. RESULTS: A great variability of mean noise amplitude was found both between subjects and in the recordings for each subject. Depending on the slope of the analogue 100-Hz high-pass filter, mean RMS values of background noise of 4.2 microV (6 dB/Oct.) and 2.5 microV (12 dB/Oct.), respectively, were found. Digital high pass filtering before averaging was found to increase the signal-to-noise ratio (SNR) considerably. CONCLUSIONS: Results indicate that (i) effective suppression of low-frequency noise components can only be achieved by zero phase digital filtering and (ii) if clipping of noise amplitude to 25 microV is used, optimized artifact rejection as weighted averaging or adopted artifact rejection levels have only small effect on the SNR.

Adolescent↗

Influence of electrode position on near-threshold recording of auditory evoked brainstem potentials.

Use of brainstem potentials in audiology is based on identifying a response in the near-threshold range. Wave V has turned out to be the component of the brainstem potentials that can be detected with a great deal of reliability when assessment of the threshold for the particular stimulus is desirable. As the detection of Wave I can be dispensed within audiologic diagnosis, the question arises as to whether or not a non-cephalic reference electrode compared to the common lateral position of the reference electrode on the ipsilateral mastoid produces a more stable Wave V of increased amplitude. In a group of 20 normal-hearing adults, near-threshold stimulation with clicks was conducted and the brainstem potentials recorded simultaneously with the reference electrode placed in four different locations (ipsilateral mastoid, contralateral mastoid, non-cephalic electrode, and ipsilateral earlobe). At all of the three intensities studied (10 dB nHL, 20 dB nHL and 30 dB nHL), recording with the non-cephalic reference yielded the highest amplitudes, the finding being statistically significant.

Adolescent↗

[Amplitude modulation following response (AMFR)--a method for objective frequency specific audiologic diagnosis].

BACKGROUND: The objective evaluation of the hearing threshold below 1kHz by means of early auditory potentials leads to problems caused by the discrepancy between the required steep rise edge of stimulus and the frequency specificity of the potentials. Therefore the aim of this study was to evaluate the potential role of the AMFR as a diagnostic tool for the assessment of hearing below 1 kHz. METHOD: The threshold of the AMFR was compared to the behavioral threshold in 13 normal hearing subjects and 46 patients with hearing loss. The stimulus used was an amplitude-modulated tone at the carrier frequencies of 0.5 and 1 kHz, a modulation frequency of 40 Hz; the modulation depth was 80%. The introduction of an empiric detectibility criterion based on spectral analysis of the response curve allowed the investigator to minimize the examination time and objectify the interpretation of the response. Additional investigations by means of highpass-masking took place to estimate the frequency specificity of the AMFR. RESULTS: The results show a good correspondence of the AMFR threshold to the behavioral threshold. Depending on hearing loss the mean values of differences between AMFR threshold and behavioral threshold are 3 dB - 13 dB. The degree of correspondence was highest in the patients with the most severe hearing loss. An influence of underlying cause of the hearing loss could not be found. Additionally the frequency specificity of the response potential was proven with high-pass masking in normal hearing subjects. Masking with cut-off frequencies above the carrier frequencies had no influence on the response while masking at the carrier frequency resulted in a strong reduction of the response curve. CONCLUSIONS: The results show that the 40 Hz-AMFR is a suitable method for the objective frequency-specific assessment of hearing in adults. Problems in the clinical use of the AMFR are caused by the long investigation time and the dependence of the potentials on the state of wakeness.

Adolescent↗

[Diagnosis of hearing disorders in premature infants].

In cases of severe hearing loss in babies an early rehabilitation should prevent a delay in development. More than a half of all hearing disorders in children are acquired; to a large extend these hearing disorders are caused by premature birth and can be detected by suitable screening. Two methods are used for testing: (1) reflex audiometry with a standardized stimulus generator; and (2) bedside recording of brainstem potentials. Having tested the method of bedside recording of brainstem potentials a group of 60 premature infants of varied body weights and no additional diseases was examined as "normal" control group. Only premature birth with all signs of maturation adequate for gestational age is not a greater risk for hearing disorders. In premature infants with birth weights less than 1500 g, having marked hyperbilirubinemia and extensive intracranial bleeding always increased wave V latencies has been observed. In about 10% of these children severe hearing disorders were diagnosed and after leaving the premature department were sent to a paedaudiological dispensaire.

Audiometry, Evoked Response↗

[Systematic hearing diagnosis in the premature infant. The Magdeburg model].

Almost 50% of all hearing disorders found in children are acquired. To a large extent these hearing disorders are caused by premature birth and can be detected by suitable screening. Two methods have proved useful for such testing: (1) Reflex audiometry with a standardized stimulus generator; and (2) bedside recording of brainstem potentials. Having tested the method of bedside recording of brainstem potentials we examined a group of 60 infants of varied body weights and otherwise normal findings as a "normal" control group. At all click intensities measured, premature infants weighing from 1500 to 2000 g showed a latency increase by about 0.7 ms when compared to infants weighing in excess of 2000 g. Premature infants showing signs of maturation adequate for gestational age were not at greater risk for hearing disorders. In contrast, premature infants weighing less than 1500 g and having marked hyperbilirubinemia as week as extensive intracranial bleeding always showed increased wave V latencies. Ten percent of these infants had severe hearing disorders requiring special pecaudiological training. Overall findings showed the great usefulness of audiometric screening in a pediatric hospital center for detecting hearing disorders in premature infants.

Audiometry, Evoked Response↗

Resonant frequency pattern in multifrequency tympanograms: results in normally-hearing subjects.

This paper presents experimental data on the evaluation of middle ear resonances by multifrequency tympanometry. Multifrequency tympanograms (MFTs) of 18 normally-hearing subjects were recorded with a frequency resolution of 15 Hz. The fine structure found in the MFT patterns was compared with findings in literature. A first approach for the evaluation of this fine structure was made explaining the great variability of the main ossicular resonance frequencies described in previous publications. The consequence of the present investigation is that the concept of the main ossicular resonance has to be revised critically.

Acoustic Impedance Tests↗