The neural response of the brainstem to brief sounds, known as the auditory brainstem response (ABR), is widely employed in the laboratory and the clinic to diagnose hearing loss. In contrast to behavioral methods that assess hearing using responses to sounds on a trial-by-trial basis, current ABR approaches are limited to analyzing the average ABR over hundreds of trials. Historically, trial-by-trial ABR analysis has not been possible owing to each trial's small signal-to-noise ratio. Here we overcome this limitation and show how to classify individual ABR trials as detected or undetected. We use the distribution of single trial ABRs to assess supra-threshold hearing and to define psychophysics-like thresholds, which we call auditory brainstem detection (ABD) thresholds. ABD thresholds decrease as more of the ABR epoch is taken into account, whereas traditional ABR thresholds do not change. Above the ABD thresholds and below 90 dB SPL, signal detection is significantly improved by utilizing more of the ABR epoch. Our method also allows us to rank the suprathreshold hearing ability of individual subjects. Despite having normal ABR thresholds, some subjects appear to have supra-threshold hearing deficits. The trial-by-trial method demonstrates that signal detection by the ensemble of auditory neurons in the brainstem is intrinsically stochastic not only at low stimulus levels, but also at levels up to 100 dB SPL.
Liu et al. (Tue,) studied this question.