skip to main content

Title: Electrocochleography and Auditory Brainstem Responses in Persons with Non-Optimal Blood Pressure
Abstract Background Numerous cardiometabolic factors may underlie risk of hearing loss. Modifiable risk factors such as non-optimal blood pressure (BP) are of interest. Purpose To investigate early auditory evoked potentials (AEPs) in persons with nonoptimal BP. Research Design A cross-sectional nonexperimental study was performed. Study Sample Fifty-two adults (18–55 years) served as subjects. Individuals were classified as having optimal (systolic [S] BP < 120 and diastolic [D] BP < 80 mm Hg, n = 25) or non-optimal BP (SBP ≥=120 or DBP ≥=80 mm Hg or antihypertensive use, n = 27). Thirteen subjects had hypertension (HTN) (SBP ≥130 or DBP ≥80 mm Hg or use of antihypertensives). Data Collection and Analysis Behavioral thresholds from 0.25 to 16 kHz were collected. Threshold auditory brain stem responses (ABRs) were recorded using rarefaction clicks (17.7/second) from 80 dB nHL to wave V threshold. Electrocochleograms were obtained with 90 dB nHL 7.1/second alternating clicks and assessed for summating and compound action potentials (APs). Outcomes were compared via independent samples t tests. Linear mixed effects models for behavioral thresholds and ABR wave latencies were constructed to account for potential confounders. Results Wave I and III latencies were comparable between optimal and non-optimal BP groups. Wave I was prolonged in hypertensive versus optimal BP subjects at stimulus level 70 dB nHL (p = 0.016). ABR wave V latencies were prolonged in non-optimal BP at stimulus level 80 dB nHL (p = 0.048) and in HTN at levels of 80, 50, and 30 dB nHL (all p < 0.050). DBP was significantly correlated with wave V latency (r = 0.295; p = 0.039). No differences in ABR amplitudes were observed between optimal and non-optimal BP subjects. Electrocochleographic study showed statistically comparable action and summating potential amplitudes between optimal and non-optimal BP subjects. AP latencies were also similar between the groups. Analysis using a set baseline amplitude of 0 μV showed that hypertensive subjects had higher summating (p = 0.038) and AP (p = 0.047) amplitudes versus optimal BP subjects; AP latencies were comparable. Conclusion Elevated BP and more specifically, HTN was associated with subtle AEP abnormalities. This study provides preliminary evidence that nonoptimal BP, and more specifically HTN, may be related to auditory neural dysfunction; larger confirmatory studies are warranted.  more » « less
Award ID(s):
Author(s) / Creator(s):
; ; ;
Date Published:
Journal Name:
Journal of the American Academy of Audiology
Page Range / eLocation ID:
576 to 587
Medium: X
Sponsoring Org:
National Science Foundation
More Like this
  1. null (Ed.)
    Previous studies report prolonged auditory brainstem response (ABR) in children and adults with autism spectrum disorder (ASD). Despite its promise as a biomarker, it is unclear whether healthy newborns who later develop ASD also show ABR abnormalities. In the current study, we extracted ABR data on 139,154 newborns from their Universal Newborn Hearing Screening, including 321 newborns who were later diagnosed with ASD. We found that the ASD newborns had significant prolongations of their ABR phase and V‐negative latency compared with the non‐ASD newborns. Newborns in the ASD group also exhibited greater variance in their latencies compared to previous studies in older ASD samples, likely due in part to the low intensity of the ABR stimulus. These findings suggest that newborns display neurophysiological variation associated with ASD at birth. Future studies with higher‐intensity stimulus ABRs may allow more accurate predictions of ASD risk, which could augment the universal ABR test that currently screens millions of newborns worldwide. 
    more » « less
  2. Abstract Hearing loss has been associated with individual cardiovascular disease (CVD) risk factors and, to a lesser extent, CVD risk metrics. However, these relationships are understudied in clinical populations. We conducted a retrospective study of electronic health records to evaluate the relationship between hearing loss and CVD risk burden. Hearing loss was defined as puretone average (PTA 0.5,1,2,4 ) > 20 dB hearing level (HL). Optimal CVD risk was defined as nondiabetic, nonsmoking, systolic blood pressure (SBP) < 120 and diastolic (D)BP < 80 mm Hg, and total cholesterol < 180 mg/dL. Major CVD risk factors were diabetes, smoking, hypertension, and total cholesterol ≥ 240 mg/dL or statin use. We identified 6332 patients (mean age = 62.96 years; 45.5% male); 64.0% had hearing loss. Sex-stratified logistic regression adjusted for age, noise exposure, hearing aid use, and body mass index examined associations between hearing loss and CVD risk. For males, diabetes, hypertension, smoking, and ≥ 2 major CVD risk factors were associated with hearing loss. For females, diabetes, smoking, and ≥ 2 major CVD risk factors were significant risk factors. Compared to those with no CVD risk factors, there is a higher likelihood of hearing loss in patients with ≥ 2 major CVD risk factors. Future research to better understand sex dependence in the hearing loss-hypertension relationship is indicated. 
    more » « less
  3. Purpose To investigate relationships between blood pressure and the thickness of single retinal layers in the macula. Methods Participants of the population-based Beijing Eye Study, free of retinal or optic nerve disease, underwent medical and ophthalmological examinations including optical coherence tomographic examination of the macula. Applying a multiple-surface segmentation solution, we automatically segmented the retina into its various layers. Results The study included 2237 participants (mean age 61.8±8.4 years, range 50–93 years). Mean thicknesses of the retinal nerve fibre layer (RNFL), ganglion cell layer (GCL), inner plexiform layer, inner nuclear layer (INL), outer plexiform layer, outer nuclear layer/external limiting membrane, ellipsoid zone, photoreceptor outer segments (POS) and retinal pigment epithelium–Bruch membrane were 31.1±2.3 µm, 39.7±3.5 µm, 38.4±3.3 µm, 34.8±2.0 µm, 28.1±3.0 µm, 79.2±7.3 µm, 22.9±0.6 µm, 19.2±3.3 µm and 20.7±1.4 µm, respectively. In multivariable analysis, higher systolic blood pressure (SBP) and diastolic blood pressure (DBP) were associated with thinner GCL and thicker INL, after adjusting for age, sex and axial length (all p<0.0056). Higher SBP was additionally associated with thinner POS and higher DBP with thinner RNFL. For an elevation of SBP/DBP by 10 mm Hg, the RNFL, GCL, INL and POS changed by 2.0, 3.0, 1.5 and 2.0 µm, respectively. Conclusions Thickness of RNFL, GCL and POS was inversely and INL thickness was positively associated with higher blood pressure, while the thickness of the other retinal layers was not significantly correlated with blood pressure. The findings may be helpful for refinement of the morphometric detection of retinal diseases. 
    more » « less
  4. null (Ed.)
    Purpose Miniaturization of digital technologies has created new opportunities for remote health care and neuroscientific fieldwork. The current study assesses comparisons between in-home auditory brainstem response (ABR) recordings and recordings obtained in a traditional lab setting. Method Click-evoked and speech-evoked ABRs were recorded in 12 normal-hearing, young adult participants over three test sessions in (a) a shielded sound booth within a research lab, (b) a simulated home environment, and (c) the research lab once more. The same single-family house was used for all home testing. Results Analyses of ABR latencies, a common clinical metric, showed high repeatability between the home and lab environments across both the click-evoked and speech-evoked ABRs. Like ABR latencies, response consistency and signal-to-noise ratio (SNR) were robust both in the lab and in the home and did not show significant differences between locations, although variability between the home and lab was higher than latencies, with two participants influencing this lower repeatability between locations. Response consistency and SNR also patterned together, with a trend for higher SNRs to pair with more consistent responses in both the home and lab environments. Conclusions Our findings demonstrate the feasibility of obtaining high-quality ABR recordings within a simulated home environment that closely approximate those recorded in a more traditional recording environment. This line of work may open doors to greater accessibility to underserved clinical and research populations. 
    more » « less
  5. Introduction:Current brain-computer interfaces (BCIs) primarily rely on visual feedback. However, visual feedback may not be sufficient for applications such as movement restoration, where somatosensory feedback plays a crucial role. For electrocorticography (ECoG)-based BCIs, somatosensory feedback can be elicited by cortical surface electro-stimulation [1]. However, simultaneous cortical stimulation and recording is challenging due to stimulation artifacts. Depending on the orientation of stimulating electrodes, their distance to the recording site, and the stimulation intensity, these artifacts may overwhelm the neural signals of interest and saturate the recording bioamplifiers, making it impossible to recover the underlying information [2]. To understand how these factors affect artifact propagation, we performed a preliminary characterization of ECoG signals during cortical stimulation.Materials/Methods/ResultsECoG electrodes were implanted in a 39-year old epilepsy patient as shown in Fig. 1. Pairs of adjacent electrodes were stimulated as a part of language cortical mapping. For each stimulating pair, a charge-balanced biphasic square pulse train of current at 50 Hz was delivered for five seconds at 2, 4, 6, 8 and 10 mA. ECoG signals were recorded at 512 Hz. The signals were then high-pass filtered (≥1.5 Hz, zero phase), and the 5-second stimulation epochs were segmented. Within each epoch, artifact-induced peaks were detected for each electrode, except the stimulating pair, where signals were clipped due to amplifier saturation. These peaks were phase-locked across electrodes and were 20 ms apart, thus matching the pulse train frequency. The response was characterized by calculating the median peak within the 5-second epochs. Fig. 1 shows a representative response of the right temporal grid (RTG), with the stimulation channel at RTG electrodes 14 and 15. It also shows a hypothetical amplifier saturation contour of an implantable, bi-directional, ECoG-based BCI prototype [2], assuming the supply voltage of 2.2 V and a gain of 66 dB. Finally, we quantify the worstcase scenario by calculating the largest distance between the saturation contour and the midpoint of each stimulating channel.Discussion:Our results indicate that artifact propagation follows a dipole potential distribution with the extent of the saturation region (the interior of the white contour) proportional to the stimulation amplitude. In general, the artifacts propagated farthest when a 10 mA current was applied with the saturation regions extending from 17 to 32 mm away from the midpoint of the dipole. Consistent with the electric dipole model, this maximum spread happened along the direction of the dipole moment. An exception occurred at stimulation channel RTG11-16, for which an additional saturation contour emerged away from the dipole contour (not shown), extending the saturation region to 41 mm. Also, the worst-case scenario was observed at 6 mA stimulation amplitude. This departure could be a sign of a nonlinear, switch-like behavior, wherein additional conduction pathways could become engaged in response to sufficiently high stimulation.Significance:While ECoG stimulation is routinely performed in the clinical setting, quantitative studies of the resulting signals are lacking. Our preliminary study demonstrates that stimulation artifacts largely obey dipole distributions, suggesting that the dipole model could be used to predict artifact propagation. Further studies are necessary to ascertain whether these results hold across other subjects and combinations of stimulation/recording grids. Once completed, these studies will reveal practical design constraints for future implantable bi-directional ECoG-based BCIs. These include parameters such as the distances between and relative orientations of the stimulating and recording electrodes, the choice of the stimulating electrodes, the optimal placement of the reference electrode, and the maximum stimulation amplitude. These findings would also have important implications for the design of custom, low-power bioamplifiers for implantable bi-directional ECoG-based BCIs.References:[1] Hiremath, S. V., et al. "Human perception of electrical stimulation on the surface of somatosensory cortex." PloS one 12.5 (2017): e0176020.[2] Rouse, A. G., et al. "A chronic generalized bi-directional brain-machine interface." Journal of Neural Engineering 8.3 (2011): 036018 
    more » « less