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Use of Envelope Following Response Normative Ranges for Diagnosing Cochlear Deafferentation.

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Related Experiment Video

Updated: May 15, 2026

Morphological and Functional Evaluation of Ribbon Synapses at Specific Frequency Regions of the Mouse Cochlea
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Normative Ranges for Wideband Middle Ear Muscle Reflex Magnitude: Limited Potential for Diagnosing Cochlear

Naomi F Bramhall1,2, Garnett P McMillan1, Sean D Kampel1

  • 1VA Rehabilitation Research & Development, National Center for Rehabilitative Auditory Research, VA Portland Health Care System, OR.

American Journal of Audiology
|February 24, 2026
PubMed
Summary

This study aimed to establish normative ranges for wideband middle ear muscle reflexes (MEMRs) to detect cochlear synaptopathy. However, the developed ranges were ineffective as a standalone diagnostic tool for cochlear deafferentation.

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Area of Science:

  • Auditory Neuroscience
  • Otoacoustic Emissions
  • Audiology

Background:

  • Cochlear synaptopathy, the loss of synapses between inner hair cells and auditory nerve fibers, is a common auditory deficit linked to noise exposure and aging.
  • Current diagnostic methods for cochlear synaptopathy and deafferentation are lacking.
  • Wideband middle ear muscle reflexes (MEMRs) show potential for diagnosing cochlear deafferentation, but normative data is needed.

Purpose of the Study:

  • To establish normative ranges for wideband MEMR magnitude.
  • To identify patients with abnormally weak MEMRs.
  • To assess the utility of MEMR ranges in diagnosing cochlear deafferentation.

Main Methods:

  • Generated normative ranges for ipsilateral and contralateral wideband MEMR magnitude in a low-risk population.
  • Statistically adjusted MEMR ranges for distortion product otoacoustic emission (DPOAE) levels.
  • Collected measurements from military Veterans at high risk for synaptopathy.

Main Results:

  • Normative ranges were established, accounting for outer hair cell function via DPOAE levels.
  • Few high-risk individuals fell below the established MEMR normative ranges.
  • The normative ranges did not effectively identify significant cochlear deafferentation as hypothesized.

Conclusions:

  • Wideband MEMR magnitude normative ranges alone are insufficient for diagnosing cochlear deafferentation.
  • Further research is needed to develop reliable diagnostic tools for cochlear synaptopathy.