scholarly journals The Middle Latency Response: A Review of Findings in Various Central Nervous System Lesions

2018 ◽  
Vol 29 (09) ◽  
pp. 855-867 ◽  
Author(s):  
Frank Musiek ◽  
Stephanie Nagle

AbstractThe middle latency response (MLR) first came to light as an auditory evoked potential in 1958. Since then, it has aroused substantial interest and investigation by clinicians and researchers alike. In recent history, its use and popularity have dwindled in tandem with various other auditory evoked potentials in audiology. One area for which MLR research and application has been overlooked is its potential value in measuring the neural integrity of the auditory thalamocortical pathway. In a broader sense, the MLR, when combined with the auditory brain stem response, can provide information concerning the status of much of the central auditory system pathways. This review is intended to provide information concerning the MLR as a measure of central auditory function for the reader to consider.To review and synthesize the scientific literature regarding the potential value of the MLR in assessing the integrity of the central auditory system and to provide the reader an informed perspective on the value of the MLR in this regard. Information is also provided on the MLR generator sites and fundamental characteristics of this evoked potential essential to its clinical and or research application.A systematic review and synthesis of the literature focusing on the MLR and lesions of the central auditory system.Studies and individual cases were reviewed and analyzed that evidenced documented lesions of the central auditory nervous system.The authors searched and reviewed the literature (journal articles, book chapters, and books) pertaining to central auditory system lesion effects on the MLR.Although findings varied from study to study, overall, the MLR was reasonably sensitive and specific to neurological compromise of the central auditory system. This finding is consistent with the generator sites of this evoked potential.The MLR is a valuable tool for assessing the integrity of the central auditory system. It should be of interest to the clinician or researcher who focuses their attention on the function and dysfunction of the higher auditory system.

1988 ◽  
Vol 97 (3) ◽  
pp. 264-271 ◽  
Author(s):  
Kevin T. Kavanagh ◽  
Patricia L. Crews ◽  
William D. Domico ◽  
Virginia A. McCormick

The auditory brain stem response (ABR) and middle latency response (MLR) were studied in 48 young children (96 ears). The responses were elicited using low intensity stimuli (30-dB nHL clicks) and simultaneously were recorded on a dual time base. Both the ABR and MLR were elicited in 70 ears. In 12 ears, just one response was recorded (ABR in eight ears and the MLR in four ears). In 14 ears, neither response was recorded. Test-retest analysis on the same subject demonstrated that the ABR was more repeatable and easier to identify than the MLR. The test-retest difference was determined for the amplitude and latency of the ABR and MLR waveforms. The test-retest latency difference for wave Pa was found to be 3.6 times larger than for wave V. The normalized test-retest amplitude difference for Pø-Na, Na-Pa, and Pa-Nb was found to be two to three times larger than for wave V. These data support the conclusion that the ABR, rather than the MLR, should be used to measure hearing in young children. The authors also advocate using minimal high pass (HP) filtering when recording the ABR in a sedated or sleeping child. Muscle artifact was not found to be a problem. The authors suggest the use of minimal HP filtering so that phase-shift distortion is minimized and a larger response amplitude can be recorded.


1981 ◽  
Vol 89 (1) ◽  
pp. 131-136 ◽  
Author(s):  
Lee A. Harker ◽  
Patricia Backoff

Simultaneous evaluation of auditory brain stem response (ABR) and middle latency response (MLR) in groups of adult subjects with normal hearing, sensorineural hearing loss, and internal auditory canal (IAC) and cerebellopontine angle (CPA) tumors was carried out. Middle latency response delays similar to those described for ABR are seen in patients with IAC and CPA tumors, and such abnormalities are not seen in patients with sensorineural hearing loss from other causes. In comparison with the ABR in tumor patients, the MLR can be evoked more often but the percentage of false negative responses (based on peak latency values) is higher. Using a compound stimulus strengthens the test by allowing examination of more peaks.


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