Neonatal auditory brainstem responses recorded from four electrode montages

Area of Science:

• Neuroscience
• Audiology
• Pediatric Medicine

Background:

• Auditory brainstem responses (ABRs) are crucial for assessing auditory pathway function in neonates.
• Standardization of ABR recording techniques, particularly electrode montages, is essential for reliable interpretation.

Purpose of the Study:

• To compare the waveform expression of simultaneous ABRs across four electrode arrays in neonates.
• To determine the optimal electrode montage for neonatal ABR recordings in different clinical applications.

Main Methods:

• Simultaneous ABRs were recorded from 16 full-term neonates using click stimuli at 30 and 60 dB nHL.
• Four electrode arrays were utilized: vertical (Cz-Nape), ipsilateral (Cz-Mi), contralateral (Cz-Mc), and horizontal (Mc-Mi).
• Waveform morphology, polarity, and component identification were analyzed across the different montages.

Main Results:

• ABR waveforms in neonates were morphologically similar to adult recordings, with clear identification of Waves I, III, and V at 60 dB nHL in most subjects.
• Waveform expression varied significantly depending on the electrode montage used.
• The ipsilateral recording array demonstrated the highest expression of ABR wave components.

Conclusions:

• The ipsilateral electrode montage is recommended for neonatal ABRs in high-intensity neurodiagnostic evaluations due to superior wave component expression.
• For screening or threshold searching at lower stimulus levels, ipsilateral or vertical montages are acceptable.
• Clinicians should exercise caution when interpreting neonatal ABRs from unconventional montages due to potential waveform variability.