Effect of Different References on Auditory-Evoked Potentials in Children with Cochlear Implants

Area of Science:

• Neuroscience
• Audiology
• Biomedical Engineering

Background:

• Auditory event-related potential (AEP) studies commonly use Nose Reference (NR), Mastoid Reference (MR), and Montage Average Reference (MAR).
• A recent Reference Electrode Standardization Technique (REST) may reduce reference effects in AEP analysis.
• Auditory deprivation in children with cochlear implants (CIs) may alter AEPs and reference effects compared to normally developing children.

Purpose of the Study:

• To investigate the impact of different reference strategies on AEPs in children with CIs.
• To compare AEPs between CI users and a control group using various reference techniques.
• To determine the optimal reference for analyzing AEPs in pediatric CI populations.

Main Methods:

• AEPs were recorded from 13 children with right-side CIs (ages 2-5) and 11 age-matched healthy children.
• Data were re-referenced to NR, Left Mastoid Reference (LMR), MAR, and REST.
• CI artifact and P1-N1 complex (latency, amplitude) at Fz were analyzed.

Main Results:

• P1 amplitude was significantly larger with LMR compared to MAR and NR in the CI group; REST showed no significant difference from other references.
• Contralateral MR or MAR was more effective in differentiating CI children from controls for P1 amplitude and N1 amplitude.
• No significant differences were found in P1 latency among references in either group; artifact components were not affected by reference choice.

Conclusions:

• Reference electrode selection does not influence CI artifact detection in AEP studies.
• Contralateral MR is recommended for analyzing P1-N1 components in pediatric CI populations.
• This finding is crucial for both clinical AEP studies and methodological research in CI users.