Interaction of Click Polarity, Stimulus Level, and Repetition Rate on the Auditory Brainstem Response

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Abstract
The present study investigated the interaction of click polarity (compression, rarefaction, alternating), repetition rate (2.3 and 9.2 clicks per second), and stimulus level (60, 75, and 90 dB nHL) on auditory brainstem responses. Two tracings (trials) were obtained for each condition using 45 normally hearing subjects. Although no systematic Wave I, III, or V latency or amplitude differences were observed among polarities or repetition rates at the three intensities, statistically significant differences were observed for the following conditions: (1) Wave III latency at 90 dB nHL was longer for the 9.2 repetition rate than for the 2.3 rate, and latencies for compression clicks were shorter than rarefaction clicks; (2) Wave V latencies at 75 dB nHL were longer with compression clicks than with rarefaction clicks; (3) mean Wave V latencies at 60 and 75 dB nHL were slightly longer for the 2.3 click rate than for the 9.2 rate; and (4) Wave V amplitudes at 90 dB nHL were larger for rarefaction clicks than for compression clicks. Because latency and amplitude differences were small and only found in a few conditions, the results indicate that polarity is not a significant variable in normally hearing subjects when using slow repetition rates (≤10 clicks per second) at moderate to high intensities (60 to 90 dB nHL). Because repetition rates of less than 10 clicks per second increases examination time but does not improve wave morphology, rates of 10 per second or faster are recommended for gathering normative data. Absolute amplitudes showed considerable intersubject variability, especially for Waves I and III. Intrasubject variability (test—retest) also was substantial. These findings suggest that absolute amplitudes may be of little use for distinguishing normal from pathologic populations.