Characterizing Simultaneously Recorded Auditory Brainstem and Middle Latency Responses Using the Parallel Auditory Brainstem Response Paradigm

Purpose The auditory brainstem response (ABR) and middle latency response (MLR) are used to characterize hearing but typically require separate recordings due to differing optimal parameters and setups in clinical systems. Advances such as the parallel ABR (pABR) paradigm now allow simultaneous recording of both responses, enabling more comprehensive assessments. We evaluated this simultaneous recording approach by characterizing responses at near- and suprathreshold levels using parameters optimized for pABR. Methods This study used an open dataset [1] of pABR recordings from 20 normal hearing adults to tone-pip stimuli at five frequencies, six presentation rates, and two intensities. ABR (I, III, and V) and MLR (P0, Na, Pa, Nb, Pb) waves were analyzed for presence, latency, and amplitude using linear mixed effect modeling. Results At both levels, ABR wave V and MLR waves Na and Pa were the most consistently identifiable and largest peaks across frequencies, rates, and participants. Frequency and rate changes affected ABR wave V amplitude more than the MLR peaks, whose amplitudes and latencies remained comparatively stable across the moderate and soft levels used in this study. Conclusion ABR wave V and MLR waves Na and Pa are robust and consistently identifiable with pABR-optimized parameters. A simultaneous recording approach that leverages visualization of all three components could both assess auditory function across more areas of the auditory system using a moderate suprathreshold level, and support detection/interpretation of smaller wave Vs for threshold estimation, particularly for broader low frequency responses.