title: Determining the upper limits of stimulation for auditory steady-state response measurements.
abstract: OBJECTIVE
  To determine the maximum stimulus levels at which a measured auditory steady-state response (ASSR) can be assumed to be a reliable measure of auditory thresholds.
  
  
  METHODS
  ASSR thresholds were measured at octave frequencies from 500 to 4000 Hz in 10 subjects with profound hearing loss. These subjects provided no behavioral responses to sound at the limits of pure-tone audiometers and at the limits of the stimulus levels produced by the ASSR device. Subjects were divided into two groups of five, with repeated measures obtained within the same session in one group and repeated measures obtained in a separate session on a different day in the other group.
  
  
  RESULTS
  ASSR thresholds were observed in all 10 subjects at each of four frequencies and in both trials. On average, these ASSR thresholds were observed at 100 dB HL (SD = 5 dB). Because these responses were at least 18 to 22 dB below the limits of the equipment where all subjects had no behavioral responses, it is reasonable to conclude that the ASSRs were not generated by the auditory system.
  
  
  CONCLUSIONS
  An artifact or distortion may be present in the recording of ASSRs at high levels. These data bring into question the view that there is a wider dynamic range for ASSR measurements compared with auditory brain stem response measurements, at least with current implementation.
authors.affiliation: Boys Town National Research Hospital, Omaha, Nebraska 68131, USA. gorga@boystown.org
authors.forename: Michael P
authors.initials: MP
authors.lastname: Gorga
authors.forename: Stephen T
authors.initials: ST
authors.lastname: Neely
authors.forename: Brenda M
authors.initials: BM
authors.lastname: Hoover
authors.forename: Darcia M
authors.initials: DM
authors.lastname: Dierking
authors.forename: Kathryn L
authors.initials: KL
authors.lastname: Beauchaine
authors.forename: Carol
authors.initials: C
authors.lastname: Manning
mesh_terms: D000328:Adult; D000368:Aged; D001309:Auditory Threshold / Q000502:physiology*; D003054:Cochlear Implants; D005072:Evoked Potentials, Auditory / Q000502:physiology*; D034381:Hearing Loss / Q000503:physiopathology* / Q000628:therapy; D006801:Humans; D008875:Middle Aged; D015203:Reproducibility of Results