Auditory brainstem responses obtained with randomised stimulation level

Objective: To present randomised stimulation level (RSL)–a stimulation paradigm in which the level of the stimuli is randomised, rather than presented sequentially as in the conventional paradigm. Design: The value of RSL was evaluated by (i) comparing the morphology of auditory brainstem responses (ABRs) elicited by the conventional and RSL paradigms, and by (ii) an online survey investigating the hearing comfort of the stimulus sequence. Study sample: ABRs were obtained from 11 normal-hearing adults (8 females, 25–29 years). The online survey was administered to 238 adults from the general community. Results: Results showed that (i) both stimulation paradigms elicit ABR signals of similar morphology, (ii) RSL provides a faster comprehensive representation of the ABR session, and that (iii) the general population found RSL stimuli to be more comfortable. Conclusions: The simultaneous evaluation of all ABR traces of the session provided by RSL has potential to improve the identification of ABR components by enabling clinicians to make use of the response tracking strategy from the start of the test, which is critical in situations where ABRs present an abnormal morphology. New research opportunities and the clinical potential of RSL are discussed.