A comparison of commercially available auditory brainstem response stimuli at a neurodiagnostic intensity level | Audiology Research

iChirp-evoked auditory brainstem responses (ABRs) yield a larger wave V amplitude at low intensity levels than traditional broadband click stimuli, providing a reliable estimation of hearing sensitivity. However, advantages of iChirp stimulation at high intensity levels are unknown. We tested to see if high-intensity (i.e., 85 dBnHL) iChirp stimulation results in larger and more reliable ABR waveforms than click. Using the commercially available Intelligent Hearing System SmartEP platform, we recorded ABRs from 43 normal hearing young adults. We report that absolute peak latencies were more variable for iChirp and were ~3 ms longer: the latter of which is simply due to the temporal duration of the signal. Interpeak latencies were slightly shorter for iChirp and were most evident between waves I-V. Interestingly, click responses were easier to identify and peak-to-trough amplitudes for waves I, III and V were significantly larger than iChirp. These differences were not due to residual noise levels. We speculate that high intensity iChirp stimulation reduces neural synchrony and conclude that for retrocochlear evaluations, click stimuli should be used as the standard for ABR neurodiagnostic testing