Characterization and application of a novel auditory brainstem response grading scale

Authors

  • AS Le
  • C Zalewski
  • A Mahurkar
  • V Kamath
  • T Oh
  • C Brewer
  • N Allemang
  • J Chisholm
  • J Christensen
  • T Wafa
  • A Tran
  • S Avenilla
  • R Hertzano
  • GL Poling

Abstract

Auditory Brainstem Response (ABR) testing is a widely used diagnostic tool that measures synchronous neural activity from the auditory nerve and brainstem, represented by a physiologic waveform with distinct, clinically relevant neural peaks. Absolute and interpeak latencies are used for ABR interpretation. ABR peaks can be prolonged or absent in the presence of retrocochlear pathology. In the case of absent peaks, it is impossible to quantify latency when performing statistical analyses. It is possible to overcome this limitation through a severity grading scale. To this end, we evaluated an ABR grading system designed to facilitate statistical analyses and ensure consistent interpretation.
We investigated the veracity of our ABR severity grading system by applying it to data from 2767 ABRs obtained from patients with predicted retrocochlear and non-retrocochlear pathologies. We also facilitated the merging of ABR grades and latencies against an existing NIDCD audiometric (nHEAR) database to investigate the relationship between hearing sensitivity (pure-tone average of 2, 3, and 4kHz) and ABR severity grade (0-4). The ABR grading scale was then applied to a known retrocochlear cohort with neurofibromatosis type II (NF2) to demonstrate the clinical efficacy of the ABR grading system.
The proposed ABR grading scale correctly classifies a retrocochlear versus non-retrocochlear pathology with an odds ratio of 30.05 (X2=907.87; p<0.001). Moreover, there is a moderate positive correlation between ABR severity and hearing sensitivity for both the entire study population (n=2005; p=<0.001; R2=0.12) and the NF2 cohort (n=175, p=<0.001, R2=0.29). Limitations of the grading scale will be discussed.

Scientific Focus Area: Clinical Research

This page was last updated on Tuesday, August 6, 2024

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