J Am Acad Audiol 2019; 30(05): 396-405
DOI: 10.3766/jaaa.18014
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Middle Latency Responses to Optimized Chirps in Adult Cochlear Implant Users

Razieh Alemi
*   Department of Otolaryngology, Faculty of Medicine, McGill University, Montreal, QC, Canada
†   Centre for Research on Brain, Language and Music (CRBLM), Montreal, QC, Canada
‡   International Laboratory for Brain, Music and Sound Research (BRAMS), Montreal, QC, Canada
Alexandre Lehmann
*   Department of Otolaryngology, Faculty of Medicine, McGill University, Montreal, QC, Canada
†   Centre for Research on Brain, Language and Music (CRBLM), Montreal, QC, Canada
‡   International Laboratory for Brain, Music and Sound Research (BRAMS), Montreal, QC, Canada
› Author Affiliations
Further Information

Publication History

22 October 2018

04 December 2018

Publication Date:
26 May 2020 (online)



Cochlear implant (CI) outcomes can be assessed using objective measures that reflect the integrity of the auditory pathway. One such measure is the middle latency response (MLR), which can provide valuable information for clinicians.


Traditional stimuli for evoking MLRs, that is, clicks or tone bursts, do not stimulate all parts of the cochlea simultaneously, whereas chirp stimuli compensate for the cochlear neural delay and, therefore, produce more synchronous responses from the different neural elements of the cochlea. The purpose of the present study was to determine whether chirp stimuli can elicit reliable MLRs in CI users and whether those responses correlate with clinical outcomes and with deprivation-related factors.

Research Design:

We presented 2,000 free-field optimized chirp stimuli to CI and control participants while their electroencephalography (EEG) was being recorded.

Study Sample:

Twenty-four adult CI users and 24 matched normal-hearing (NH) individuals (age range from 18 to 63 years) participated in this study.

Data Collections and Analysis:

The EEG was recorded from 64 active electrodes placed on the scalp. EEG signals were processed using EEGLAB and ERPLAB toolboxes. We characterized the latencies and amplitudes of the different MLR components in both groups.


Chirp stimuli reliably evoked qualitatively similar MLRs across all NH and CI participants with a couple of differences observed between the NH and CI group. Among the different MLR components, the Na latency was significantly shorter for the CI group. A significant amplitude difference was also found between groups for the Pa–Nb complex, with higher amplitudes observed in the NH group. Finally, there were no significant correlations between MLR latencies (or amplitudes) and clinical outcomes or deprivation-related measures.


Free-field–presented optimized chirp stimuli were shown to evoke measurable and reliable MLRs in CI users. In this experiment, the MLR morphology in CI users was similar to those observed in NH participants. Even though we did not replicate here a significant relationship between MLR and speech perception measures, we were able to successfully collect acoustically evoked MLRs, which could constitute an important supplemental measure to the standard behavioral tests presently being used in postoperative clinical evaluation settings.

This work was funded by an Incubator Award from the Centre for Research on Brain, Language and Music (CRBLM).


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