Trial-By-Trial Auditory Brainstem Response Detection

The neural response of the brainstem to brief sounds, known as the auditory brainstem response (ABR), is widely employed in the laboratory and the clinic to diagnose hearing loss. In contrast to behavioral methods that assess hearing using responses to sounds on a trial-by-trial basis, current ABR approaches are limited to analyzing the average ABR over hundreds of trials. Historically, trial-by-trial ABR analysis has not been possible owing to each trials small signal-to-noise ratio. Here we overcome this limitation and show how to classify individual ABR trials as detected or undetected. We use the distribution of single-trial ABRs to assess supra-threshold hearing and to define psychophysics-like thresholds, which we call auditory brainstem detection (ABD) thresholds. ABD thresholds decrease as more of the ABR epoch is taken into account, whereas traditional ABR thresholds do not change. Above the ABD thresholds and below 90 dB SPL, signal detection is significantly improved by utilizing more of the ABR epoch. Our method also allows us to rank the supra-threshold hearing ability of individual subjects. Despite having normal ABR thresholds, some subjects appear to have supra-threshold hearing deficits. The trial-by-trial method demonstrates that signal detection by the ensemble of auditory neurons in the brainstem is intrinsically stochastic not only at low stimulus levels, but also at levels up to 100 dB SPL. Significance StatementNeural responses to sound can be measured by electrodes placed on a subjects head and are commonly used in the laboratory and the clinic to assess hearing. Although the auditory system must distinguish each sound stimulus from intrinsic noise, current methods for ana-lyzing the response of the brainstem to sound only utilize the average response to hundreds of stimuli. Here we overcome this constraint by showing how to classify an individual sound stimulus as detected or undetected based on each auditory brainstem response. This ap-proach can assess hearing at all stimulus levels, indicates that subjects with normal hearing thresholds can exhibit supra-threshold hearing loss, and potentially extends the types of hearing deficits that can be diagnosed using auditory evoked potentials.