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Stimulus-specific Cortical Visual Evoked Potential Morphological Patterns
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The detection of infant cortical auditory evoked potentials (CAEPs) using statistical and visual detection techniques
Lyndal Carter1, Maryanne Golding, Harvey Dillon
1National Acoustic Laboratories, Chatswood, NSW, Australia. Lyndal.Carter@nal.gov.au
Journal of the American Academy of Audiology
|June 24, 2010
Summary
An automated statistic, Hotelling's T(2), demonstrated equal sensitivity to experienced examiners in detecting cortical auditory evoked potentials (CAEPs) in infants. This offers objective assessment for hearing aid fitting in newborns.
Area of Science:
- Audiology
- Neuroscience
- Biomedical Engineering
Background:
- Newborn hearing screening necessitates accurate hearing aid fitting verification in infants.
- Cortical auditory evoked potentials (CAEPs) are feasible for this but challenging due to infant development and noise.
- Subjective interpretation of CAEPs can be difficult for clinicians.
Purpose of the Study:
- To compare the effectiveness of an automated statistic (Hotelling's T(2)) against experienced examiners for detecting infant CAEPs.
- To assess the ability of both methods to identify the presence or absence of CAEPs when stimuli are presented or omitted.
- To evaluate the reliability of objective vs. subjective CAEP detection in pediatric audiology.
Main Methods:
- A repeated-measures design was employed, analyzing 87 infant CAEPs from 14 infants (9 male, 5 female; mean age 12 months).
- CAEPs were recorded at three sensation levels (10, 20, 30 dB) and during non-stimulus trials.
- Examiners and Hotelling's T(2) analyzed waveforms presented in series and randomized order; signal detection theory (d', ROC curve) and ANOVA were used for analysis.
Main Results:
- Sensitivity (d') increased with stimulus level for both automated and examiner detection.
- Experienced examiners and Hotelling's T(2) showed equal sensitivity in distinguishing CAEPs from noise.
- Neither method achieved maximum sensitivity at the highest tested sensation level (30 dB).
Conclusions:
- Hotelling's T(2) provides an objective method for CAEP detection in infants, performing comparably to experienced clinicians.
- An on-line clinical instrument utilizing Hotelling's T(2) could enhance diagnostic accuracy, particularly for less experienced examiners.
- Objective assessment of CAEPs can improve the reliability of hearing aid fitting verification in infants.
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