Rise Time and Center-Frequency Effects on Auditory Brainstem

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J Am Acad Audiol 2: 24-31 (1991)
Rise Time and Center-Frequency Effects on
Auditory Brainstem Responses to
High-Frequency Tone Bursts
Stephen A . Fausti'
Pamela S . Grayt
Richard H .Freyt
Curt R. Mitchell=
Abstract
The effects of rise time and center frequency on the auditory brainstem response (ABR)
elicited by high-frequency tone bursts were examined in six normal-hearing adults . Tone
bursts with rise times of 0 .1, 0.25, 0.5, and 1 .0 msec, duration of 2 msec, and center frequencies of 8, 10, and 12 kHz were used in this study. The absolute latencies of waves I,
III, and V were obtained in all subjects, and interpeak intervals of I-III, III-V, and I-V were
calculated . As would be expected, rise time significantly affected the absolute latencies of
waves I, III, and V, i .e ., faster rise times shortened the absolute latencies, but did not affect
the interpeak latencies. The tone-burst frequency significantly affected the latency of wave
I but not the later waves . No significant differences were found in reliability of the response
at different rise times or frequencies, within or across sessions . An estimate of the effective
bandwidth of the stimulus suggests that frequency specificity of the response is maintained
with fast rise time tone-burst stimuli .
Key Words: Reliability, high-frequency, tone burst, auditory brainstem response (ABR), rise
time, serial monitoring, ototoxicity
T
he development and use of frequencyspecific stimuli in the measurement of
early auditory evoked potentials is important for an accurate estimation of hearing sensitivity in infants, comatose patients, and others
not able to respond to conventional hearing testing techniques . Most investigations dealing with
stimulus parameters for frequency-specific
auditory brainstem responses (ABR) have utilized
stimuli having center frequencies within the conventionally tested range of hearing ( .125-8 kHz) .
These studies reported that latency decreases as
`Director of Auditory Research, Chief of Audiology,
Veterans Affairs Medical Center (PVAMC), and Associate
Professor, Oregon Health Sciences University, Portland,
Oregon
tPVAMC Auditory Research Laboratory
$Oregon Hearing Research Center and Assistant
Professor, Oregon Health Sciences University, Portland,
Oregon
Reprint requests : Stephen A . Fausti, Ph .D ., VA Medical Center (151J), P .O . Box 1034, Portland, OR 97207
24
intensity increases (Stapells and Picton, 1981),
and as center frequency increases (Terkildsen et
al, 1975 ; Davis and Hirsh, 1976 ; Kodera et al,
1977 ; Suzuki et al, 1977 ; Gorga et al, 1987) . Latency also decreases as the rise time is shortened
(Hecox et al, 1976 ; Stapells and Picton, 1981 ;
Weber and Folsom, 1977) .
Improvements in equipment and techniques
have made ABR testing above 8 kHz feasible
(Fausti et al, 1984 ; Rappaport et al, 1985 ; Gray,
1987) . Gorga et al (1987) reported wave V data on
auditory evoked potentials using tone bursts at
frequencies from 9 to 16 kHz . This high-frequency
study also reported shorter latencies at higher frequencies and at higher presentation intensities .
Among the several unresolved issues are : the
effect of rise time on high-frequency tone-burst
evoked responses in humans, and the effect of
these frequencies on waves I and 111 . Therefore,
the purpose of this study is to determine the effect
of rise time and frequency of high-frequency
stimuli (8 kHz and above) on the response laten-
High-Frequency Tone Burst ABR Rise Time/Fausti et al
ties of waves I, III, and V in humans with normal
hearing .
METHOD
Subjects
Data were collected from six subjects, two
males and four females, ranging in age from 25 to
33 years . All subjects met the following criteria :
negative history of ear pathology ; audiometric
thresholds of 15 dB HL or less (re : ANSI, 1989) at
conventional test frequencies (0 .25-8 kHz) ; highfrequency pure-tone sensitivity within one standard deviation of the mean for age-categorized data
reported previously (Schechter et al, 1986) for fre-
quencies 8 to 12 kHz ; normal acoustic-immittance
measures (Wiley et al, 1987 ; Shanks et al, 1988)
and identifiable waves I, 111, and V of the ABR to
an alternating click stimulus . High-frequency
tone-burst evoked responses were obtained from
one ear of each subject .
Means and standard deviations for pure-tone
behavioral threshold responses for all subjects are
plotted in Figure 1 . Thresholds for some subjects
exceeded the maximum output of the testing system for the highest test frequencies . Only those
individuals who responded are included in this
statistic . All six subjects responded through 14
kHz ; five at 16 kHz, and three at 18 kHz .
Equipment
Tone bursts were controlled by Grason-Stadler (G-S) 1200 Series analog logic modules . A G-S
1287B Electronic Switch module was modified to
provide faster rise-fall times utilized in this study .
,00
N=6
60
J 60
d
m
m
40
20
0
26
5
1
2
4
e
10
12
14
,6
18
Frequency in kHz
Figure 1 Mean pure-tone threshold responses for study
subjects .
Stimulus polarity was alternated to reduce stimulus artifact . An active amplifier/filter network
(Fausti et al, 1979) was utilized to match the Koss
HV/lA earphone input impedance, improve the
signal-to-noise ratio, lower the sidebands, and
narrow the bandwidth in order to provide a signal
with exceptionally sharp slopes and low background noise . This equipment was synchronized
with a Nicolet 1170 signal averager . The bioamplifier filter settings were 150 and 1500 Hz .
A single-channel differential electrode recording montage was utilized . The noninverting
electrode was placed on the vertex with the inverting and common electrodes at the ipsilateral and
contralateral mastoids, respectively. Absolute impedance did not exceed 2 kS2, and the interelectrode
impedance differences were at or below 1 kQ .
Stimuli
Tone bursts centered at frequencies of 8, 10,
and 12 kHz were gated with rise and fall times of
0 .1, 0 .25, 0 .5, and 1 .0 msec . Rise and fall times
were linear between the 10 percent and 90 percent
on-condition . The duration between zero voltage
points was 2 .0 msec . Stimuli were presented at a
60 dB sensation level (SL), at a rate of 11 .1 per
second . Band-pass masking (7 .5-25 kHz) was
presented contralaterally at an intensity 30 dB
less than the tone-burst signal level (S/N=+30) to
prevent potential intracranial interference .
The acoustic spectra of the tone-burst stimuli
shown in Figure 2 were measured with a HewlettPackard #3561A Dynamic Signal Analyzer (Fast
Fourier Transform), using a rectangular window
(0-20 kHz) and peak hold mode . Signal output was
measured through the high-frequency transducer
(Koss HV/1A) centered on a flat-plate coupler with
a Bruel & Kjaer (B&K) #4134, 1/2 inch pressure
condenser microphone as reported by Fausti et al
(1979) . Although these stimuli were not generated
by digital methods, the acoustic spectra are comparable to those reported by others (Gorga et al,
1988 ; Dolan and Klein, 1987) . The roll-off, the
high- and low-frequency bandwidths measured at
20, 40, and 60 dB down, and the noise floor were
all comparable to, or more sharply defined than,
reported digitally generated signals .
The acoustic output for each tone burst was
displayed on a Tektronix #7633 digital oscilloscope . A continuous pure-tone set at the center frequency of the tone burst was matched to the scope
displacement value (peak-peak) of the tone burst .
A Hewlett-Packard #3400A True RMS Voltmeter,
Journal of the American Academy of Audiology/Volume 2, Number 1, January 1991
Rise time
100
Table 1 Means of Differences (in dB) between ToneBurst and Pure-Tone Thresholds
90
80
70
60
kHz
0 . 1 msec
0.25 msec
0 .5 msec
1 .0 msec
8
5.9
10
4.5
7 .6
6.8
7.6
6 .3
5 .4
6 .3
12
50
40
START: OH .
x: eo00Hz
STOP- 20 000 Hz
4 .6
4.3
4.7
5.5
'Tone-burst peak equivalent SPLs were determined by
comparison to continous pure-tone stimuli at matched frequencies .
100
90
J
QU)
m
v
Single Subject Response as a Function of Rise Time
80
70
60
01
50
025
40
START OHz
x IOOOOHZ
STOP ; 20000Hz
05
L0
8 kHz
0 .1
025
START OHz
%- 12000 Hz
05
STOP 2000011:
Frequency
1 .0
Figure 2 Acoustic spectra for tone bursts with center
frequencies of 8, 10, and 12 kHz are shown for the fastest
(0 .1 msec) and slowest (1 .0 msec) rise times. Decibel (dB)
levels used in this study are an average of 60 dB SL .
calibrated at 94 dB sound pressure level (SPL) via
a B&K #4930 1 kHz microphone calibrator, was
used to determine dB SPL .
Spectra in Figure 2 are shown at mean (across
subjects) output levels for 60 dB SL presentations
at each frequency for the shortest (0 .1 msec) and
longest (1 .0 msec) rise times used in this study .
These spectra illustrate the well known spread of
acoustic energy as a function of rise time .
10 kHz
Response Latency (ms)
Test Procedure
Responses were obtained from each subject in
two sessions of approximately 60 minutes each .
26
Figure 3 Auditory brainstem responses obtained for
each of the rise times and frequencies used in this study
(60 dB SL).
High-Frequency Tone Burst ABR Rise Time/Fausti et al
Table 2 Mean Latency, SD, and Range across Sessions for Wave I, III, and V
F
(kHz)
Rise time
1
Wa ve
111
V
(ms)
Mean
SD
Range
Mean
SD
Range
Mean
SD
Range
8
0 .10
0 .25
0 .50
1 .00
2 .10
2 .15
2 .24
2 .47
0 .30
0 .17
0 .18
0 .26
0 .76
0 .40
0 .51
0 .68
4 .35
4 .36
4 .46
4 .72
0 .28
0 .31
0 .27
0 .27
0 .75
0 .82
0 .70
0 .61
6 .22
6 .36
6 .48
6 .53
0 .46
0 .29
0 .36
0 .37
1 .30
0 .77
0 .84
0 .83
10
0 .10
0 .25
0 .50
1 .00
1 .95
1 .97
2 .13
2 .32
0 .23
0 .13
0 .20
0 .20
0 .64
0 .37
0 .54
0 .56
4 .28
4 .30
4 .44
4 .66
0 .18
0 .24
0 .16
0 .21
0 .52
0 .66
0 .47
0 .62
6 .24
6 .32
6 .33
6 .60
0 .38
0 .33
0 .24
0 .29
1 .00
0 .89
0 .61
0 .83
12
0 .10
0 .25
0 .50
1 .00
1 .90
1 .95
2 .04
2 .18
0 .23
0 .24
0 .22
0 .20
0 .63
0 .68
0 .60
0 .53
4 .22
4 .31
4 .44
4 .56
0 .27
0 .20
0 .25
0 .16
0 .72
0 .51
0 .61
0 .38
6 .12
6 .22
6 .42
6 .56
0 .31
0 .37
0 .31
0 .20
0 .95
1 .03
0 .87
0 .52
.N=6 subjects ; data collapsed across sessions .
During each session, behavioral thresholds to
pure tones as well as tone bursts were obtained .
Table 1 demonstrates the mean differences in absolute value between the tone-burst (8, 10, and 12
kHz) and pure-tone stimuli behavioral thresholds
at each of the rise times studied . Thresholds for
tone bursts were greater than for corresponding
pure tones . Differences in tone-burst thresholds
as a function of rise time were minimal .
For each stimulus condition, two ABR averages were obtained per session . Each average was
the sum of 1024 stimulus presentations within a
response window of 10 .24 msec . Each of the twelve
stimulus conditions (three frequencies and four
rise times) was presented in the two sessions .
Thus, a total of four averages were obtained for
each stimulus condition . This test format allowed
within-session as well as across-session reliability
to be determined . To prevent an order effect, the
stimuli were presented in a counter-balanced,
pseudorandom order .
Wave Scoring Procedure
Wave identification techniques used with
standard ABR click stimuli (Chiappa et al, 1979;
Beattie et al, 1986 ; Picton et al, 1988) were employed as a guideline for peak picking with highfrequency tone-burst stimuli . To facilitate peak
identification, additional information was obtained by comparing the ipsilateral and added ip-
silateral waveforms from repeated runs for each
of the stimulus parameters . Absolute latencies
were measured for waves I, III, and V .
RESULTS
R
epresentative responses for the twelve
stimulus conditions are shown in Figure 3 .
In all subjects, waves 1, III, and V could be identified . Mean latencies of waves I, III, and V at each
frequency and rise time for all subjects are shown
in Table 2, and graphically demonstrated in Figure 4 . As rise time was shortened from 1 .0 to 0 .1
msec, the absolute latency of all waves was significantly shortened . There was a trend for rise
time to have a slightly greater effect on waves III
and V than on wave I . However, this trend was
not enough for rise time to significantly change
interpeak latencies (I-III, III-V, or I-V) (Table 3) .
Repeated measures analyses of variance
(ANOVAs) were performed using within- and
across-session responses to determine the
stability of the response . Since no significant differences 'were found either within or across sessions for any of the three waves, the data were
collapsed over sessions and two-way repeated
measures ANOVAs (frequency and rise time) were
calculated on the latencies for each wave .
Significant differences were found between
frequencies (p < 0 .05) and between rise times (p <
0 .01) for wave I ; the frequency x rise-time interaction was not significant (Table 4) . An analysis
Journal of the American Academy of Audiology/Volume 2, Number 1, January 1991
of simple effects was performed at each of the rise
times to determine if there were differences between the frequencies at each rise time . Each of
these was significant (p < 0 .05), so Newman-Keuls
paired comparison tests were done . At each of the
four rise times, the latency of the 8-kHz tone burst
was significantly longer than that for the 12-kHz
tone burst . At rise times of 0 .1, 0 .25, and 1 .0 msec,
the latency of 8 kHz also was significantly longer
than the 10-kHz tone burst . The latency of the 10kHz tone burst did not differ from 12 kHz at any
of the rise times .
A significant rise-time effect was also found for
waves III and V (p < 0.01). There were no significant
latency differences between frequencies at any of
the rise times for these two waves (Table 4) .
DISCUSSION
n this study, waves I, III, and V were obtained
at 60 dB SL with four rise times for tone-burst
stimuli at 8, 10, and 12 kHz . The four rise times
in this study produced significantly shorter latencies with faster rise times for waves I, III, and V
as shown in Table 2 and Figure 4 . Additionally,
wave I latencies produced by tone bursts at 8, 10,
and 12 kHz were found to be significantly shorter
with respect to increased frequency . Waves III
and V, while demonstrating a slight trend for
shorter latencies with increased frequency, did
not show significant latency differences as a function of frequency .
Wave V
7
6
4
3
Wave I
2
A 8 kHz
0 10 kHz
o 12 kHz
0 .1
0 .25
0 .5
1 .0
Rise time (ms)
Figure 4 Mean latency at each of the rise times and
frequencies for waves 1,111, and V.
28
Frequency
F = 1 .71
F = 0 .13
Rise time
Frequency X rise time F = 0 .23
df = 2,10
df = 3,15
df = 6,30
III-V
F = 0 .10
Frequency
F = 1 .41
Rise time
Frequency X rise time F = 1 .28
df = 2,10
df = 3,15
df = 6,30
I -V
Frequency
F = 2 .40
F = 1 .01
Rise time
Frequency X rise time F = 1 .24
df = 2,10
df = 3,15
df = 6,30
The changes in latency of waves I, III, and V
with changing rise times observed in the present
study were as expected . Absolute latencies of wave
V are comparable to those reported by Gorga et al
(1987) for the same rise time, frequency, and intensity . As would be expected, latencies from highfrequency tone bursts were faster than those
produced by lower frequency stimuli (Suzuki et al,
1977 ; Neely et al, 1988) .
The latency of wave I was found to be significantly affected by tone-burst frequency while
waves III and V were not . Usually, when wave I
changes, waves III and V change also . This effect
is found when the intensity level of a click is
varied, the rise time is changed, or derived bands
are determined .
In other cases, latencies of waves III and V
may change differently than wave I, such as by
increased rates of stimulation, masking, or click
polarity (Terkildsen et al, 1975 ; Rosenhammer et
Wave III
5
d
m
J
I-III
Table 4 Summary Table of Wave ANOVAs
N
E
a
Table 3 Summary Table of Interwave Interval
ANOVAs
Wave I
Frequency
F = 7 .25' df = 2,10
F =38 .291 df = 3,15
Rise time
Frequency X rise time F = 0 .88 df = 6,30
Wave III
Frequency
F = 0 .48
df = 2,10
F
=34
.591
df = 3,15
Rise time
Frequency X rise time F = 0 .74 df = 6,30
Wave V
Frequency
F = 0 .25 df = 2,10
F =27 .891 df = 3,15
Rise time
df = 6,30
Frequency X rise time F = 1 .04
p<0 .05 ; tp<0 .01
High-Frequency Tone Burst ABR Rise Time/Fausti et al
al, 1978 ; Stockard et al, 1978 ; Ornitz et a), 1980 ;
Beattie, 1988) . In the current study we attribute
the significant wave I change with frequency,
without significant wave III and V changes, to the
larger standard deviations of waves III and V, the
narrow range of frequencies used, and the number
of subjects tested . Using a larger frequency range
and a greater number of subjects may allow the
detection of significant changes in III and V with
frequency . Also, the interwave intervals, 1-111 and
I-V were not significantly affected by frequency,
which suggests that waves III and V do indeed follow wave I .
To obtain ABRs, it is desirable to have the
largest biologic response at the lowest presentation level . This approach would dictate using the
fastest rise-time stimulus possible (Goldstein and
Kiang, 1958 ; Mitchell, 1976) . However, if frequency-specific responses are desired, as in serial
monitoring of ototoxic effects, this presents a problem . As the rise time of a tone burst is shortened,
frequency specificity may be compromised due to
the concomitant spectral broadening.
Thus, estimation of the effective spectrum for
different rise-time stimuli would be desirable to
evaluate this trade-off. Waves I, 111, and V are all
affected by rise-time changes . As mentioned, if the
latency of wave I is delayed, the latencies of waves
III and V are also delayed (Table 2 and Fig . 4). In
this context, it is important to understand how
spectral changes associated with rise-time changes can affect the latency of these waves .
The latency of wave I of the ABR depends on
at least five variables :
1.
2.
3.
4.
Travel time of the acoustic stimulus from the
transducer to the cochlea . This includes
travel time in air from the transducer to the
tympanic membrane and through the middle
ear to the cochlea . This travel time is assumed to be the same for all frequencies and
intensities of a stimulus, and under headphones is on the order of 0 .1 msec .
Travel time of the stimulus within the cochlea . Traveling wave time varies with both intensity and frequency, from about 1 .3 to as
much as 10 msec (Neely et al, 1988) .
Synaptic delay between the cochlear hair
cells and the peripheral axons of the auditory
nerve . This delay is a constant 0 .5 to 0 .7 msec
(Moller, 1981) .
Temporal summation of nerve firing, which
produces neural synchrony . Neural synchrony is greatly affected by stimulus rise
time (Goldstein and Kiang, 1958), as well as
5.
by frequency and intensity . A stimulus with
a fast rise time reaches threshold sooner than
a slow rise-time stimulus, thus resulting in a
shorter response latency for each fiber and
greater synchrony among the fibers .
Conduction time in the axons of the auditory
nerve . This is primarily a function of fiber
diameter and is assumed to be independent
of stimulus parameters .
As rise time of the stimulus is shortened, the
latency of wave I decreases as a result of more
rapid summation of nerve fibers . However, with
faster rise times and the concomitant spectral
broadening, the traveling wave could be broader,
thus producing a more dispersed stimulation of
nerve fibers . Thus, with faster rise times, frequency specificity as well as synchrony may be compromised . The net effect of rise time on latency
can thus be complex .
Mang et al (1965), Mitchell (1976), Elberling
and Hoke (1978), Kodera et al (1983) and others
have attempted to relate the spectrum of a stimulus to the population of nerve fibers activated by
that stimulus . An estimate of the spectral area,
which is related to the peak latency of wave I, can
be obtained using the stimulus spectrum and the
threshold of hearing .
The acoustic spectrum of an 8-kHz tone burst
with 0 .1 msec rise time, as used in this study, is
shown (in dB SPL) in Figure 5 . Also plotted in this
figure is the average of hearing thresholds for all
subjects who participated in this study ("-" ) .
The portion of the 8-kHz spectrum above the
threshold of hearing could be expected to activate
auditory nerve fibers . However, not all of this area
contributes to, or is encoded into, wave I . For ex-
----~ 1 .6 ms Estimate
"-0 8 Pure-tone Threshold (N=6)
J
N
a
START OHz
X 8000 Hz
Frequency
Figure 5 Estimate of the spectral area of an 8-kHz tone
burst, which contributes to the peak latency of wave 1.
Journal of the American Academy of Audiology/Volume 2, Number 1, January 1991
ample, single auditory fibers whose latencies are
longer than the peak of wave I would not be expected to contribute to the latency of wave I . That
is, they would fire too late to be represented in the
peak of wave 1 . Thus the observed latency of wave
I sets a cutoff in this case mainly on the low-frequency side of the spectrum . In short, the hearing
threshold in the high frequencies provides an estimate of high-frequency cutoff, while the latency
of wave 1 determines low-frequency cutoff.
Cochlear travel time, synaptic delay, and rise
time must be considered to determine this low-frequency cutoff. The 8-kHz tone burst shown in Figure 5 produced a wave 1 latency of 2 .1 msec (Table
2) . Synaptic delay, 0 .5 msec, subtracted from wave
I latency, leaves 1 .6 msec as the travel time of the
stimulus within the cochlea . Thus, in order for a
nerve fiber to be represented in the peak of wave
I, the stimulus must have a travel time of 1 .6 msec
or less in the cochlea . From Neely et al (1988, Fig.
2, page 654), the frequencies and intensities for
which cochlear travel time is 1 .6 msec or less can
be determined . Adjusting the travel time to 0 .1
msec rise time at each frequency, and extrapolating beyond 8 kHz is necessary for this calculation.
The intensity at each frequency with a cochlear
travel time of 1 .6 msec is plotted in Figure 5 (A-A) .
The area above this line is an estimate of spectral
area, which would be expected to contribute to
wave I (based on the peak latency) . Thus, Figure
5 displays an estimate of the effective spectra that
is represented in the latency of wave I when a 0 .1msec rise-time tone burst is presented at 60 dB
SL . The stimulus bandwidth can be obtained from
this estimate about 18 dB below the peak and is
an indication of the frequency specificity .
It should be noted that the estimate of the ef-
fective spectrum in Figure 5 is primarily determined by the cochlear travel time described by
Neely et al (1988), and as additional data becomes
available, this estimate may be improved . It should
also be noted that, upon entering the cochlea the
spectrum will not have this same shape, and that
the cochlear activation and neural response patterns will also have different shapes . However, relative differences between spectra is the important
variable. It would be expected that small differences between two spectra would produce small differences in the final neural activation pattern .
A comparison of the spectra of the 0 .1-msec
and the 1 .0-msec rise-time tone bursts shown in
Figure 2 demonstrates minimal differences in the
bandwidth 20 dB down from the peak . This suggests that the fastest rise time, 0 .1 msec, may be
used without unduly sacrificing frequency
specificity, a conclusion similar to that reached by
Mitchell (1976) . This suggestion, along with findings in the current study that there are no significant differences in response reliability with
different rise times, is another indication that fast
rise-time tone bursts may be used in obtaining
high-frequency ABRs, such as in serial monitoring
for detection of ototoxicity .
CONCLUSION
T
he four tone-burst rise times, 0 .1, 0 .25, 0 .5,
and 1 .0 msec, produced different wave 1, 111,
and V latencies, but did not change the interpeak
latencies (I-I11, I-V, and III-V) . An estimate of
the effective bandwidth of the stimulus for wave
I suggests that fast-rise stimuli can be used to
evoke frequency-specific responses . At each rise
time, the absolute latency of wave I was affected
by tone-burst frequency such that 8 kHz had a
longer latency than 10 kHz and 12 kHz, as would
be expected from different locations in the cochlea .
Waves III and V, or the interpeak latencies, did
not show significant differences with frequency .
The reliability of the peak latencies did not vary
either within-session or across-sessions . New information is thus provided on waves I and III at
these high frequencies, as well as on the effects
of rise time on waves 1, 111, and V .
The auditory brainstem responses to toneburst stimuli with rise times of 0 .1, 0 .25, 0 .5, and
1 .0 msec were not significantly different in the
reliability of the response . However, faster rise
times produce greater synchrony in nerve responses, which were seen in this study as better definition of wave morphology, especially of Wave I . The
faster rise-time tone burst stimuli contained more
side-band energy . This, however, did not interfere
with obtaining significant differences between frequencies . With careful attention to the spectrum
of the high-frequency tone-burst acoustic stimulus, rise times as short as 0.1 msec can be used
to obtain frequency-specific ABRs .
Acknowledgments. The authors wish to acknowledge
significant contributions to this manuscript made by Drs.
Robert Burkard, Thomas Dolan, Cynthia Fowler, David
Lilly and David Phillips . Thanks also go to doctoral student James Henry and to Research Associate Deanna
Olson for invaluable assistance in manuscript preparation .
Fundingfor this study provided by Medical Research Service, Department of Veterans Affairs.
High-Frequency Tone Burst ABR Rise Time/Fausti et al
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