Applicability of subcortical EEG metrics of synaptopathy to older listeners with impaired audiograms.

Emerging evidence suggests that cochlear synaptopathy is a common feature of sensorineural hearing loss, but it is not known to what extent electrophysiological metrics targeting synaptopathy in animals can be applied to people, such as those with impaired audiograms. This study investigates the applicability of subcortical electrophysiological measures associated with synaptopathy, i.e., auditory brainstem responses (ABRs) and envelope following responses (EFRs), to older participants with high-frequency sloping audiograms. The outcomes of this study are important for the development of reliable and sensitive synaptopathy diagnostics in people with normal or impaired outer-hair-cell function. Click-ABRs at different sound pressure levels and EFRs to amplitude-modulated stimuli were recorded, as well as relative EFR and ABR metrics which reduce the influence of individual factors such as head size and noise floor level on the measures. Most tested metrics showed significant differences between the groups and did not always follow the trends expected from synaptopathy. Age was not a reliable predictor for the electrophysiological metrics in the older hearing-impaired group or young normal-hearing control group. This study contributes to a better understanding of how electrophysiological synaptopathy metrics differ in ears with healthy and impaired audiograms, which is an important first step towards unravelling the perceptual consequences of synaptopathy.