The Auditory Brain Stem Response in Patients with Brain Stem or Cochlear Pathology

In Brief Objective The purpose of this study was to determine the value, based on true-positive and false-positive rates, of various auditory brain stem response (ABR) indices in discriminating patients with brain stem lesions from patients with cochlear lesions. Design A factorial design was used in this retrospective study. Receiver operating characteristics (ROC) curves were constructed to analyze the performance of 32 patients with brain stem lesions and 33 patients with cochlear involvement for the absolute latency of wave V; the 1-111, 111-V, and I-V interwave intervals; the interaural latency difference and 'the V/I amplitude ratio. Analyzed in the same manner were four combinations of ABR indices. Results Based on the ROC curves, the clinically most valuable index was the I-V interval, but overall the individual indices showed only moderate sensitivity to brain stem pathology. By combining several indices, the sensitivity to brain stem involvement was improved. However, as expected, the overall false-positive rate also increased. Conclusions There is a diagnostic advantage to using more than one ABR index in evaluating patients suspected of having brain stem involvement. We assessed the true positive and false positive rates of the auditory brain stem response (ABR)in terms of identifying patients with brain stem disorders, observing that the most efficacious ABR index in this regard is the I-V interval. The true positive rate for brain stem disorders is lower than that reported for eighth nerve disorders. Our results stress the value of using more than one ABR index for the audiological evaluation of patients suspected of brain stem disorders. Frank E.