Contributions from the auditory nerve to the brain-stem auditory evoked potentials (BAEPs): results of intracranial recording in man

doi:10.1016/0168-5597(88)90005-6

Electroencephalography and Clinical Neurophysiology/Evoked Potentials Section

Volume 71, Issue 3, May–June 1988, Pages 198-211

https://doi.org/10.1016/0168-5597(88)90005-6 Get rights and content

Abstract

Intraoperative recordings obtained from electrodes placed on the scalp (vertex and earlobe or ear canal) in response to click stimulation were compared with recordings made directly from the auditory nerve in patients undergoing microvascular decompression (MVD) operations to relieve hemifacial spasm (HFS) and disabling positional vertigo (DPV). The results support earlier findings that show that the auditory nerve is the generator of both peak I and peak II in man, and that it is the intracranial portion of the auditory nerve that generates peak II. The results indicate that the second negative peak in the potentials recorded from the earlobe is generated by the auditory nerve where it passes through the porus acusticus into the skull cavity, and that the proximal portion of the intracranial portion of the auditory nerve generates a positive peak in the potentials that are recorded from the vertex. This peak appears with a latency that is slightly longer than that of the second negative peak in the potentials recorded from the earlobe (or ear canal). The second negative peak in the recording from the ear canal and the positive peak in the vertex recording contribute to peak II in the differentially recorded BAEP. Since our results indicate that the difference in the latency of the second negative peak in the recording from the earlobe and that of the positive peak in the vertex recording represents the neural travel time in the intracranial portion of the auditory nerve, this measure may be valuable in the differential diagnosis of eighth nerve disorders such as vascular compression syndrome.

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Auditory nerve (AN) fibers that innervate inner hair cells in the cochlea degenerate with advancing age. It has been proposed that age-related reductions in brainstem frequency-following responses (FFR) to the carrier of low-frequency, high-intensity pure tones may partially reflect this neural loss in the cochlea (Märcher-Rørsted et al., 2022). If the loss of AN fibers is the primary factor contributing to age-related changes in the brainstem FFR, then the FFR could serve as an indicator of cochlear neural degeneration. In this study, we employed electrocochleography (ECochG) to investigate the effects of age on frequency-following neurophonic potentials, i.e., neural responses phase-locked to the carrier frequency of the tone stimulus. We compared these findings to the brainstem-generated FFRs obtained simultaneously using the same stimulation. We conducted recordings in young and older individuals with normal hearing. Responses to pure tones (250 ms, 516 and 1086 Hz, 85 dB SPL) and clicks were recorded using both ECochG at the tympanic membrane and traditional scalp electroencephalographic (EEG) recordings of the FFR. Distortion product otoacoustic emissions (DPOAE) were also collected. In the ECochG recordings, sustained AN neurophonic (ANN) responses to tonal stimulation, as well as the click-evoked compound action potential (CAP) of the AN, were significantly reduced in the older listeners compared to young controls, despite normal audiometric thresholds. In the EEG recordings, brainstem FFRs to the same tone stimulation were also diminished in the older participants. Unlike the reduced AN CAP response, the transient-evoked wave-V remained unaffected. These findings could indicate that a decreased number of AN fibers contributes to the response in the older participants. The results suggest that the scalp-recorded FFR, as opposed to the clinical standard wave-V of the auditory brainstem response, may serve as a more reliable indicator of age-related cochlear neural degeneration.
Microvascular Decompression: A Bibliometric Analysis of the 100 Most Cited Articles
2022, World Neurosurgery
Bibliometric analyses assess the impact and influence of articles in the academic community. There is no previous work that has used bibliometric analysis of microvascular decompression (MVD). This study aims to identify and characterize the 100 most cited articles on MVD.
Highly cited articles were identified assessing the Scopus library by using the keywords “microvascular decompression,” “MVD,” “nerve decompression,” “nerve root decompression,” and “microvascular surgery.” Data were further processed by sampling techniques with defined inclusion and exclusion criteria. The number of citations, country of origin, institutions of origin, year of publication, type of cranial nerve disorder, type of article, and the publishing journal were analyzed. Further, article categories and the type of studies were investigated.
The 100 most cited articles on MVD ranged from 951 to 76 total citations, and from 38.04 to 1.88 citations per year. Publication dates spanned a period from 1959 to 2015. The most frequently studied cranial nerve disorder was trigeminal neuralgia (n = 54). Articles were published in 29 journals, with Neurosurgery (n = 33) topping the list. The articles came from 14 different countries, with most contributions from the United States (n = 55). Authors of the highly cited articles who received most citations were Peter J. Jannetta (n = 26), followed by Aage Møller (n = 13), and Marc Sindou (n = 11).
This work provides a detailed evaluation of the 100 most cited articles on MVD, thus allowing recognition and selected reading of the most influential academic contributions related to this surgical technique in a variety of cranial nerve disorders.
Auditory brainstem responses in adults with autism spectrum disorder
2021, Clinical Neurophysiology Practice
Citation Excerpt :
Waves with numbers from III up to and including wave V are generated in the auditory brainstem. Wave III is believed to originate from the cochlear nucleus; wave IV from the SOC; and wave V from the lateral lemniscus and the inferior colliculus (Eggermont., 2019; Møller and Jannetta, 1983; Møller et al., 1988; Parkkonen et al., 2009). A large number of studies have focused on the latencies of waves I, III, and V in infants and children with ASD, and have reported prolonged absolute wave III and V latencies and interpeak latencies (IPLs) I–V, I–III, and III–V (Azouz et al., 2014; Cohen et al., 2013; Kwon et al., 2007; Magliaro et al., 2010; Maziade et al., 2000; Miron et al., 2016; Rosenblum et al., 1980; Rosenhall et al., 2003; Roth et al., 2012; Skoff et al., 1980; Taylor et al., 1982; Ververi et al., 2015).
To investigate possible differences in the auditory peripheral and brainstem functions between adults with autism spectrum disorder (ASD) and neurotypical (NT) adults.
Click-evoked auditory brainstem responses (ABRs) were obtained from 17 high-functioning ASD adults (aged 21–38 years) and 20 NT adults (aged 22–36 years). A relatively large number of stimulus presentations (6000) were adopted, and ABRs by horizontal and vertical electrode montages were evaluated, in order to allow precise evaluations of early ABR components.
Waves I, II, III, and V were identified in the vertical electrode montage, and wave I and the summating potential (SP) in electrocochleograms were identified in the horizontal electrode montage. There were no significant group differences in the wave I, II, III, and V latencies or the interpeak latencies (IPLs) in the vertical electrode montage. In the horizontal montage, the ASD adults exhibited significantly shortened SP latencies compared with the NT adults, whereas there was no significant group difference in the wave I latency.
The ASD adults may have the abnormalities of processing more in the peripheral auditory system than in the brainstem.
The current study suggests that the peripheral abnormality is associated with ASD.
Intraoperative Erb's Point-Vertex recording increases brainstem auditory evoked potential wave V amplitude
2020, Clinical Neurophysiology
Citation Excerpt :
An alternative explanation of our findings could be obtained by taking into account physiological theories on active input and differential amplifiers: Cz is conventionally the reference (inverting input) of a differential amplifier so that peaks I, III and V are up-going in the displayed traces. The electrode at Cz is the physiologically active input, and EP may simply be a better differential reference compared to a mastoid site (Moller and Jannetta, 1984; Moller et al., 1988). Corroborating our findings, an amplitude increase of up to 50% could also be observed using non-cephalic electrode in healthy adults and children (Katbamna et al., 1995; McPherson et al., 1985; Pethe et al., 1998).
Recording derivations for intraoperative brainstem auditory evoked potential (BAEP) monitoring consist of a preauricular electrode referenced to Cz′. These derivations are prone to unfavorable signal amplitude. This study analyses whether an alternative noncephalic electrode positioned over ipsilateral Erb’s point, thereby generating a new Erb’s point-vertex recording derivation, improves BAEP recordings.
Electrodes were placed preauricularly (A1/A2) and at left and right Erb’s point (EP1/EP2). They were referenced to Cz′. Click sound stimulation (80–95 dB above hearing level) was applied. At intraoperative baseline conditions, latencies and amplitudes of waves I–V of all derivations were analyzed.
Data of 30 patients (54 ± 15 years/17 females) with normal hearing or mild symmetrical presbycusis undergoing infratentorial surgeries (15 microvascular decompressions) were analyzed. Using EP1-Cz′/EP2-Cz′ derivations compared to A1-Cz′/A2-Cz′, amplitudes for wave IV (left +65%, p < 0.001; right +43%, p = 0.002) and wave V (left +54%, p < 0.001; right +48%, p < 0.001) were significantly increased. Only in the left (EP1) derivation, there was a tendency towards less reproducibility of wave I, resulting in a decrease of amplitude (−35%, p = 0.005).
Adding an Erb’s point electrode derivation resulted in larger amplitudes of waves IV to V. whereas conventional preauricular or mastoid derivation is preferential for wave I assessment.
Increased wave amplitudes facilitate detection of pathologically reduced wave forms (wave V in particular) which represents a significant advancement.
Neurophysiology of the auditory system: basics and ION techniques
2020, Neurophysiology in Neurosurgery: A Modern Approach
This chapter reviews the historical perspective of brainstem auditory-evoked potentials (BAEPs) recordings and its intraoperative use. It describes the neurophysiologic basis for the generation of far-field BAEP and methods for monitoring the neural conduction in the auditory pathways using BAEPs and evoked potentials recorded directly from the VIIIth nerve. Monitoring BAEPs is beneficial in operations of large acoustic tumors, posterior fossa procedures, procedures that can compress the brainstem, and other related procedures. BAEPs have improved the outcomes in these complex procedures by giving the surgical team information on the functional status of the auditory pathway from the cochlea through the brainstem.
Auditory brainstem response
2019, Handbook of Clinical Neurology
Citation Excerpt :
Originally it was thought that each component resulted from different sections of the brainstem and, because each was separated from the others by about 0.8 ms (approximately one synaptic delay), it was assumed that wave II originated from the cochlear nucleus, wave III from the olivary complex, and so on. Several important findings, one from correlating surface activity with depth recordings during surgery (Møller and Jannetta, 1982; Moller et al., 1988) and one from modeling experiments (Stegeman et al., 1987), have changed our interpretation considerably. Vlllth nerve recordings during surgery showed potentials corresponding in latency to scalp-recorded waves I and II.
The auditory brainstem response (ABR), consisting of five to six vertex-positive peaks with separation of about 0.8 ms, is very sensitive to factors that affect conduction velocity and hence ABR wave latencies in the brainstem auditory pathways. In addition, disorders causing dissynchronization of neural activity result in an amplitude decrease or disappearance of ABR peaks. The opposite effects occur in the maturation process, which takes about 2 years postterm; here conduction velocity increases quickly to its adult value, but synaptic delays being sensitive to synchronous release of transmitter substance take considerably longer. In neurological disorders, those that cause dissynchrony, such as auditory neuropathy and vestibular schwannoma, Gaucher disease, and Krabbe disease, the (longer latency) ABR peaks are reduced or absent. Effects on neural conduction, resulting in increased ABR interwave latencies, are found in vestibular schwannomas, Bell's palsy, Duane retraction syndrome, Marcus Gunn ptosis, and various encephalomyopathies. These measures allow an assessment of the parts of the brainstem that are involved.

View all citing articles on Scopus

^☆: This study was supported by a grant from the National Institutes of Health No. 1 R01 NS21378-03).

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Contributions from the auditory nerve to the brain-stem auditory evoked potentials (BAEPs): results of intracranial recording in man☆

Abstract

Electroenceph. clin. Neurophysiol.

Electroenceph. clin. Neurophysiol.

Brain Res.

Electroenceph. clin. Neurophysiol.

Electroenceph. clin. Neurophysiol.

J. Exp. Neurol.

Electroenceph. clin. Neurophysiol.

Electroenceph. clin. Neurophysiol.

Far-field acoustic response: origins in the cat

Science

Normative evoked potential data

Über die Kaliberverhältnisse der Nervenfasern im N. stato-acusticus des Menschen

Z. Mikrosk. Anat. Forsch.

Brainstem auditory evoked responses in hereditary motor-sensory neuropathy: site of origin of wave II

Neurology (NY)

Simultaneous recordings of human auditory potentials: transtympanic electrocochleography (ECoG) and brainstem evoked potentials (ABR)

Arch. Otolaryngol.

Auditory evoked potentials recorded directly from the human VIIIth nerve and brain stem: origins of their fast and slow components

Brain-stem auditory evoked potentials recorded directly from human brain-stem and thalamus

Brain

Vascular decompression in trigeminal neuralgia

Hemifacial spasm

Neurovascular cross-compression of the eighth cranial nerve in patients with vertigo and tinnitus

Disabling positional vertigo

New Engl. J. Med.

Auditory-evoked far fields averaged from scalp of humans

Brain