Multiple auditory steady-state response (MASSR) is recommended to estimate hearing thresholds in difficult-to-test individuals. The multiple stimuli that evoke MASSR may present an interstimulus interaction (ISI) that is able to distort the generation of responses. No consensus exists on the effects of the ISI in MASSR when dealing with high sound level stimuli or cases of sensorineural hearing loss. This study investigated the effects of ISI on the amplitude and detectability of auditory steady-state responses, with a focus at and above 65 dB sound pressure level (SPL). Normal hearing (NH) and sensorineural hearing impaired (SNHI) adults were tested with different stimulus types [amplitude modulation (AM) One octave chirp (OC), and a weighted OC (WOC)], stimulus levels, and modalities (single or multiple stimuli). ISI typically attenuated response amplitude of a control stimulus caused by an interference stimulus one octave above the control stimulus. At and above 80 dB SPL, attenuations of around 50% decreased the number of detectable responses near SNHI thresholds, especially for OC and WOC. AM stimuli obtained a higher detection rate than OC and WOC when presented 10 dB above the behavioral hearing threshold of SNHI participants. Using OC in MASSR when assessing elevated thresholds might diminish accuracy on threshold estimation, and extend test duration.
Bibliographical noteFunding Information:
The authors declare that they have no conflict interests. The authors are grateful for the financial support of Brazilian institutions of CAPES, CNPq, FINEP, and the Ecuadorian institution SENESCYT. Also, the Salesian Polytechnic University (UPS - Ecuador) supported the work of the author, P.F.C.-L. The authors acknowledge the support provided by the Speech Therapy Department of the University Hospital Clementino Fraga Filho Hospital of the Federal University of Rio de Janeiro for their assistance in subject recruitment and audiological tests. To Professor Antonio Fernando Catelli Infantosi in memoriam.
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