Auditory Steady-state Responses at multiple frequencies and their value in the objective assessment of hearing


  • María Cecilia Pérez Ábalo Centro de Neurociencias de Cuba. La Habana. Cuba.
  • Alejandro Torres Fortuny Centro de Neurociencias de Cuba. La Habana. Cuba.
  • Guillermo Savio López Centro de Neurociencias de Cuba. La Habana. Cuba.
  • Eduardo Eimil Suarez Centro de Neurociencias de Cuba. La Habana. Cuba.



Auditory steady state responses, multi-frequency stimulation, objective audiometry, frequency-specific audiometry


One of the main objectives in conducting an electroaudiometric examination is to obtain a specific frequency evaluation of the audibility thresholds. In recent decades, multiple technical proposals have been made based on the recording of Auditory Evoked Potentials (AEP). They are not affected by sedation or sleep and can be detected at stimulation intensities very close to the threshold of audibility. The aforementioned advantages have made it a useful tool for objective hearing evaluation. However, this technique has certain limitations from the electroaudiometric point of view, mainly due to the lack of specified frequency of said response.
Auditory Steady State  Responses (ASSR) by isolated tonal stimuli and at stimulation frequencies between 75 and 110 Hz have been proposed as a valid alternative for performing a specific frequency audiometry. This type of response represents the synchronous discharge of the brain stem neurons, which follow the modulation frequency of the stimulus that gives rise to them.
There have been multiple authors who in recent years and using this type of response have obtained reliable estimates of the tonal audibility threshold, both in healthy children and adults and in hard of hearing subjects. This technique has multiple advantages over transient PEAs in determining specific thresholds in frequency: 1) Given the periodicity of the response, it can be represented in the frequency domain, thus minimizing the complexity of its measurement, 2) The acoustic stimulus used is more specific in frequency, 3) Due to the rectification properties of the cochlea, the response caused by an amplitude modulated tone is represented as a spectral peak at the modulation frequency, 4) These peaks Spectrals can be detected using different frequency domain statistics.
Despite the advantages described above, obtaining a complete audiogram using PEAee triggered by isolated tonal stimuli can be time consuming. More recently, an optimized variant of the ASSR between 75 and 110 Hz has been proposed with the simultaneous use of multiple tones modulated in amplitude. Given the fact that each carrier tone is modulated with a different frequency, multiple tones can then be added together, forming a complex tone composed of multiple tones modulated in amplitude. Using then as a stimulus, a mix composed of tones of 500, 1000, 2000 and 4000 Hz we can simultaneously activate and evaluate these four frequency regions of the cochlea. On the other hand, these complex stimuli can be presented binaurally, evaluating both ears simultaneously.
PEAee caused by multiple amplitude-modulated tones have been used with encouraging results in the objective determination of audibility thresholds in children and adults, hearing-impaired patients, and in the early detection of hearing defects. This article summarizes some basic concepts, as well as their clinical applications.


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Kemp, D. (1978). Stimulated acoustic emissions from within the human auditory system. J Acoust Soc Am; 64: 1386.

Jewett, D. L; Romano, M. N; Wilson, J. S.(1970): Human auditory evoked potentials; Possible brainstem components detected on the scalp. Science 167: 1517-1518.

Davis, A. y cols. (1997). A critical review of the role of neonatal hearing screening in the detection of congenital hearing impairment. Health Technology Assessment; Vol I: No.10.

Valdés, M. (1985). Pesquisaje de defectos auditivos en lactantes mediante potenciales evocados auditivos de tallo cerebral. Tesis para optar por el grado de Candidato a Doctor en Ciencias Médicas. CNIC, La Habana, Cuba.

Pérez M.C.; Savío G.; Torres A. Martín V.; Rodríguez E.; Galán L.(2001): An optimized method to test frequency specific thresholds in heraing impaired children and normal subjects. Ear & Hearing, 22:200-11.

Hyde, M.L., Riko, K., Malizia, K. (1990). Audiometric accuracy of de click ABR in infants at risk for hearing loss. J. Am. Acad. Audiol., 1: 59-66.

Durieux-Smith, A., Picton. T.W., Bernard, P., MacMurray, B., Goodman, J.T. (1991). Prognostic validity of brain-stem electrical response audiometry in infants of neonatal intensive care unit. Audiology, 30: 249-265.

Galambos, R., Makeig, S., Talmachoff, P.J. (1981). A 40 Hz auditory potential recorded from the human scalp. Proc. Nat. Acad. Sci., 78: 2643-2647.

Stapells DR, Gravel JS, Martin BA: Thresholds for auditory brainstem responses to tones in notched noise from infants and young children with normal hearing or sensorineural hearing loss. Ear & Hearing 1995; 16: 361-371.

Regan, D. (1989). Human brain electrophysiology: Evoked potentials and evoked magnetic fields in science and medicine. NY, Elsevier.

Maiste, A., Picton, T.W. (1989). Human auditory evoked potentials to frequency-modulated tones. Ear Hear, 10: 153-160.

Lins, O.G., y Picton, T.W. (1995). Auditory steady-state responses to multiple simultaneous stimuli. Electroencephalography and Clinical Neurophysiology, 96, 420-432.

Plourde, G., Picton, T.W. (1990). Human auditory steady-state response during general anesthesia. Anesth. Analg., 71: 460-468.

Plourde, G., Stapells, D.R., Picton, T.W. (1991). The human auditory steady-state evoked potentials. Acta Otolaryngol. (Stockh), Suppl. 491: 153-160.

Cohen, L.T., Rickards, F.W., Clark, G.M. (1991). A comparison of steady-state evoked potentials to modulated tones in awake and sleeping humans. J. Acoust. Soc. Am., 90: 2467-2479.

Aoyagi, M., Kiren, T., Kim, Y., Suzuki, Y., Fuse, T., Koike, Y. (1993). Optimal modulation frequency for amplitude-modulation following response in young children during sleep. Hear. Res., 65: 253-261.

Levi, E.C., Folsom, R.C., Dobie, R.A. (1993). Amplitude-modulation following response (AMFR): effects of modulation rate, carrier frequency, age, and state. Hear. Res., 68: 42-52.

Lins OG, Picton TW, Boucher BL, Durieux-Smith A, Champagne SC, Moran LM, Perez-Abalo MC, Martin V, Savio G: Frequency-specific audiometry using steady-state responses. Ear and Hearing 1996; 17: 81-96.

Rickards, F.W., Tan, L.E., Cohen, L.T., Wilson, O.J., Drew, J.H., & Clark, G.M. (1994). Auditory steady state evoked potentials in newborns. British Journal of Audiology, 28, 327-337.

Rance, G., Rickards, F.W., Cohen L.T., De Vidi S. & Clark, G.M. (1995). The automated prediction of hearing thresholds in sleeping subjects using auditory steady-state evoked potentials. Ear & Hearing, 16, 499-507.

Lins, O.G., Picton, T.W., Boucher, B.L., Durieux-Smith, A., Champagne, S.C., Moran, L.M., Perez-Abalo, M.C., Martin, V., Savio, G. (1996). Frequency-specific audiometry using steady-state responses. Ear Hear.

Moore, E.J. (1983). Bases of Auditory Brain-Stem Evoked Responses. NY, Grune & Stratton.

Suzuki, T., Kobayashi, K., Tagaki, N. (1986). Effects of stimulus repetition rate on slow and fast components of auditory brain-stem responses. Electroenceph. Clin. Neurophysiol., 65: 150-156.

Pratt, H., Bleich, N., Feingold, K. (1990). Three-channel Lissajous' trajectories of auditory brainstem evoked potentials: Contribution of fast and slow components to planar segment formation. Hear. Res., 43: 159-170.

Lins, O.G.; Picton, P.E.; Picton, T.W.; Champagne, S.C.; Durieux-Smith, A. (1995). Auditory steady-state responses to tones amplitude-modulated at 80 to 110 Hz. J. Acoust. Soc. Am., 97: 3051-3063.

Pickles, J. O. An introduction to the physiology of hearing. (ed. Academic Press) 1982.

Valdés J.L, Pérez-Abalo, M.C., Martín, V., Savio, G., Sierra, C., Rodríguez, E., & Lins, O. (1997). Comparison of statistical indicators for the automatic detection of 80 Hz auditory steady state response. Ear & Hearing, 18, 420-429

Pérez, M.C., Perera, M., Bobes, M.A., Valdés, M., Sanchez, M. (1988). Ensayo de pesquisaje de defectos auditivos en la Ciudad de la Habana. Revista Cubana de Investigaciones Biomédicas, 7: 60-74.

Savio G, Perez-Abalo MC, Valdes JL, Martin V, Sierra C, Rodriguez E, Eimil E, Torres A: Potenciales evocados auditivos de estado estable a múltiples frecuencias: Una nueva alternativa para evaluar la audición en forma objetiva. Acta de Otorrinolaringología and Cirugía de Cabeza y Cuello 1997; 25: 87-97.

Picton, T.W., Durieux-Smith A., Champagne S., Whittingham J., Moran L., Giguére C., & Beauregard Y. (1998). Objective evaluation of aided thresholds using auditory steady-state responses. J. Am. Acad. Audiol., 9, 315-331.

Rance, G., Dowell, R.C., Rickards, F.W., Beer, D.E., & Clark, G.M. (1998). Steady state evoked potential and behavioral hearing thresholds in a group of children with absent click evoked auditory brain stem response. Ear & Hearing, 19, 48-61.

John, M.S.; Picton, T.W. Human auditory steady-state responses to amplitude-modulated tones: phase and latency measurements. Hearing Research 141 (2000) 57-79.

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2003-11-01 — Updated on 2021-09-15


How to Cite

Pérez Ábalo, M. C., Torres Fortuny, A., Savio López, G., & Eimil Suarez, E. (2021). Auditory Steady-state Responses at multiple frequencies and their value in the objective assessment of hearing. Auditio, 2(2), 41–49. (Original work published November 1, 2003)



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