Background and Aim:  Among all auditory assessment tools, auditory steady state response (ASSR) is a modern test. Modulation frequency for this test is usually 80 Hz. The purpose of this study, was to examined adult subjects with 40 Hz and 80 Hz ASSR and compare the results.
Materials and Methods: Thirty adult (60 ears) were evaluated by ASSR and PTA test, Results were divided into three groups: normal hearing, mild and moderate sensorineural hearing loss.
Results: In all groups, forty hertz ASSR thresholds were relatively closer to behavioral threshold than those of 80 Hz ASSR(p<0.05). Besides, the more severe hearing loss, the lower the difference between those two thresholds. Correlation coefficients were also higher in 40 Hz ASSR(p<0.05).
Conclusion: Frequency modulation thresholds with 40 Hz are more likely to be closer to the behavioral thresholds. Moreover, it has better results than the thresholds with 80 Hz.

Background and Aim: Blocking of the adenosine receptor in central nervous system by caffeine can lead to increasing the level of neurotransmitters like glutamate. As the adenosine receptors are present in almost all brain areas like central auditory pathway, it seems caffeine can change conduction in this way. The purpose of this study was to evaluate the effects of caffeine on latency and amplitude of auditory brainstem response(ABR).
Materials and Methods: In this clinical trial study 43 normal 18-25 years old male students were participated. The subjects consumed 0, 2 and 3 mg/kg BW caffeine in three different sessions. Auditory brainstem responses were recorded before and 30 minute after caffeine consumption. The results were analyzed by Friedman and Wilcoxone test to assess the effects of caffeine on auditory brainstem response.
Results: Compared to control group the latencies of waves III,V and I-V interpeak interval of the cases decreased significantly after 2 and 3mg/kg BW caffeine consumption. Wave I latency significantly decreased after 3mg/kg BW caffeine consumption(p<0.01).
Conclusion: Increasing of the glutamate level resulted from the adenosine receptor blocking brings about changes in conduction in the central auditory pathway.

Background and Aim: Tinnitus is a common symptom among lots of people but little is known about its origins. This study was aimed at comparing the Auditory Steady-State Response (ASSR) thresholds in normal cases and patients with subjective idiopathic tinnitus (SIT) in order to diagnose its real origins.
Materials and Methods: This case-control study was conducted on 19 patients with tinnitus and 24 normal cases aged 18-40 yr.The patients underwent broad medical tests to roll out any background reason for their tinnitus. ASSR thresholds were estimated in both groups at 20 and 40 amplitude modulation. The patients were selected from tinnitus patients in Research Center in Hazrat Rasoul Hospital, Tehran, Iran.
Results: The mean ASSR thresholds at 40HZ modulation were worse in tinnitus patients compared to normal ones (p<0.05) but no significant statistical differences was detected at 20HZ. These results were found in both situations in which we averaged both ears thresholds and when we estimated the thresholds of the ears separately.
Conclusion: It seems that the origin of the responses of the modulation of 40Hz, primary auditory cortex, midbrain regions and subcortical areas, in these patients is involved or the origin of their tinnitus is related to some kind of problems in these areas, although more investigation is needed about 20Hz.

Background and Aim: Tinnitus is an unpleasant sound which can cause some behavioral disorders. According to evidence the origin of tinnitus is not only in peripheral but also in central auditory system. So evaluation of central auditory system function is necessary. In this study Auditory brainstem responses (ABR) were compared in noise induced tinnitus and non-tinnitus control subjects.
Materials and Methods: This cross-sectional, descriptive and analytic study is conducted in 60 cases in two groups including of 30 noise induced tinnitus and 30 non-tinnitus control subjects. ABRs were recorded ipsilateraly and contralateraly and their latencies and amplitudes were analyzed.
Results: Mean interpeak latencies of III-V (p= 0.022), I-V (p=0.033) in ipsilatral electrode array and mean absolute latencies of IV (p=0.015) and V (p=0.048) in contralatral electrode array were significantly increased in noise induced tinnitus group relative to control group.
Conclusion: It can be concluded from that there are some decrease in neural transmission time in brainstem and there are some sign of involvement of medial nuclei in olivery complex in addition to lateral lemniscus.

Background and Aim: Following an early visual deprivation, the neural network involved in processing auditory spatial information undergoes a profound reorganization. In order to investigate this process, event-related potentials provide accurate information about time course neural activation as well as perception and cognitive processes. In this study, the latency and amplitude of auditory P300 were compared in sighted and early blind individuals in age range of 18-25 years old.

Methods: In this cross-sectional study, auditory P300 potential was measured in conventional oddball paradigm by using two tone burst stimuli (1000 and 2000 Hz) on 40 sighted subjects and 19 early blind subjects with mean age 20.94 years old.

Results: The mean latency of P300 in early blind subjects was significantly smaller than sighted subjects (p=0.00.( There was no significant difference in amplitude between two groups (p>0.05).

Conclusion: Reduced latency of P300 in early blind subjects in comparison to sighted subjects probably indicates the rate of automatic processing and information categorization is faster in early blind subjects because of sensory compensation. It seems that neural plasticity increases the rate of auditory processing and attention in early blind subjects.

Background and Aim: Understanding and defining developmental norms of auditory comprehension is a necessity for detecting auditory-verbal comprehension impairments in children. We hereby investigated lexical auditory development of Persian (Farsi) speaking children.
Methods: In this cross-sectional study, auditory comprehension of four 2-5 year old normal children of adult&aposs child-directed utterance at available nurseries was observed by researchers primarily to gain a great number of comprehendible words for the children of the same age. The words were classified into nouns, verbs and adjectives. Auditory-verbal comprehension task items were also considered in 2 sections of subordinates and superordinates auditory comprehension. Colored pictures were provided for each item. Thirty 2-5 year old normal children were randomly selected from nurseries all over Tehran. Children were tested by this task and subsequently, mean of their correct response were analyzed.
Results: The findings revealed that there is a high positive correlation between auditory-verbal comprehension and age (r=0.804, p=0.001). Comparing children in 3 age groups of 2-3, 3-4 and 4-5 year old, showed that subordinate and superordinate auditory comprehension of the former group is significantly lower (p<0.05) than the others . Intra-group comparisons revealed no significant difference between nouns, verbs and adjectives (p>0.05), while the difference between subordinate and superordinate auditory comprehension was significant in all age groups (p<0.05).
Conclusion: Auditory-verbal comprehension develop much faster at lower than older ages and there is no prominent difference between word linguistic classes including nouns, verbs and adjectives. Slower development of superordinate auditory comprehension implies semantic hierarchical evolution of words.

Background and Aim: Evaluation of hearing-impaired children&aposs auditory skills by a valid test is very important before starting auditory training. There are many different tests available for languages other than Persian, and some limited Persian tests for children above 5 year of age as well. Accordingly considering the importance of early intervention, we aimed to design a test for evaluating auditory skills of 3-4 year-old hearing-impaired Persian (Farsi) children, which is not available to date.
Methods: The study method was test (scale) construction. The test named Tavana includes four subtests: detection, discrimination, identification and sentence comprehension. For determining content validity of the test, the vocabulary of 3-4 year-old normal-hearing and hearing-impaired children and also the comments of seven specialists were applied. We classified 10,10,8 and 6 sub skills for 1^st to 4^th subtests, respectively.
Results: The content validity of Tavana test&aposs subskills were 100%, 83%, 96% and 95%, respectively (mean=94%). Mean time for test performance was 82 minutes.
Conclusion: Content validity of Tavana test was 94% which was statistically valid compared to Modarres test (97%) and Mazaheryazdi test (88%).

Background and Aim: Learning disability is a term referes to a group of disorders manifesting listening, reading, writing, or mathematical problems. These children mostly have attention difficulties in classroom that leads to many learning problems. In this study we aimed to compare the auditory attention of 7 to 9 year old children with learning disability to non- learning disability age matched normal group.
Methods: Twenty seven male 7 to 9 year old students with learning disability and 27 age and sex matched normal conrols were selected with unprobable simple sampling. 27 In order to evaluate auditory selective and divided attention, Farsi versions of speech in noise and dichotic digit test were used respectively.
Results: Comparison of mean scores of Farsi versions of speech in noise in both ears of 7 and 8 year-old students in two groups indicated no significant difference (p>0.05) Mean scores of 9 year old controls was significant more than those of the cases only in the right ear (p=0.033). However, no significant difference was observed between mean scores of dichotic digit test assessing the right ear of 9 year-old learning disability and non learning disability students (p>0.05). Moreover, mean scores of 7 and 8 year- old students with learning disability was less than those of their normal peers in the left ear (p>0.05).
Conclusion: Selective auditory attention is not affected in the optimal signal to noise ratio, while divided attention seems to be affected by maturity delay of auditory system or central auditory system disorders.

Background and Aim: Neuroimaging techniques in audiovisual speech processing are innovative approach to neuroscience investigation that steadily influences the deep survey of highly mechanisms involved in this process. The purpose of this study was to evaluate brain activity via functional magnetic resonance imaging throughout audiovisual speech perception in Persian language.
Methods: Functional MRI was used to assess 19 normal 20-30 year old women while they had been presented syllable /ka/ visually and /pa/ auditory using block design method, in which it would provide two series of imaging, functional and T1-weighted. Subsequently, the results were analyzed and compared by FSL software.
Results: The results of this study pointed out that both middle and cortical regions of brain are activated in visual stimuli and its middle regions are activated in response to auditory stimuli. Hence, left anterior supramarginal, some parts of motor speech system including insular and cingulate cortex-precentral cortex were stimulated with visual stimulus and left posterior supramarginal as well as right supramarginal gyrus were stimulated with auditory stimulus. Moreover, in this investigation, McGurk effect was behaviorally proven in fifteen subjects.
Conclusion: It was hypothesized that the activation of unique region, supramarginal gyrus, with both audio and visual stimuli indicated the presence of commonplace region for phonologic processing of sensory inputs. In addition, auditory stimuli develop more intense activity and on the other hand, broaden-maximum voxel-as well as extra regions are demonstrated in response to visual stimuli. These points represent the unfamiliarity of normal individual brain to percept visual speech stimuli.

Background and Aim: High incidence of speech disorders in children with cerebral palsy could be related to a deficiency in processing of auditory stimuli. So it is vital to check out any peripheral or central disorders in auditory system using behavioral and electrophysiological auditory tests.
Methods: In a cross-sectional study, 15 children with spastic diplegia, mean age 5.77, SD 2.26 years, and 15 normal children, mean age 5.33, SD 1.80 years, were tested using pure tone audiometry, immittance and auditory brainstem responses. The results were compared between the two groups.
Results: Hearing thresholds and middle ear status were in normal range in all participants however, contralateral acoustic reflex thresholds were mostly elevated. Comparing absolute latency and interpeak latency intervals of auditory brainstem responses between the two groups, absolute latency interval of later waves, and in specific the V wave, was significantly longer in diplegic children (p=0.04) resulting in a longer III-V interpeak latency intervals (p=0.02).
Conclusion: Neurological disorders in ponto-reticulo-spinal pathway, pontine reticular nuclei and upper pons which are adjacent to auditory nuclei of lateral leminiscus and inferior colliculus result in auditory dys-synchrony and increased latency intervals in latter waves of auditory brainstem responses. This could also attributed to functional disorders in wave-generating sites in these patients.

Background and Aim: The dichotic auditory-verbal memory test (DAVMT) is useful in detecting auditory-verbal memory deficits and differences in memory function between the brain hemispheres. The purpose of this study was to prepare the Persian version of dichotic auditory-verbal memory test and to obtain its results in 18- to 25-year old normal individuals of both genders in Iran.
Methods: The Persian version of dichotic auditory-verbal memory test like the original one consisted of 18 lists of ten words. The lists were arranged such that 10 words were presented to one ear, with the reverse words simultaneously were presented to the other ear, constituting a dichotic test situation. After preparing the 18 lists, content validity was assessed by a panel of eight experts and then, the words of each list were recorded on CD in a dichotic mode. Thereafter, it was performed on one hundred and ten normal individuals with ages ranging from 18 to 25 years (mean age: 21.3 SD 1.9 years) and the scores were recorded on a specially designed scoring sheet.
Results: There was no significant difference between mean scores of 18 lists of the dichotic auditory-verbal memory test. The overall mean of CVI was 96% for the 18 lists and the mean score of dichotic auditory-verbal memory test was 6.5 SD 1.0 in the normal group.
Conclusion: Based on the obtained results, the Persian version of dichotic auditory-verbal memory test has a good content validity and can be used in detecting the auditory-verbal memory deficits.

Background and Aim: To date, the function of auditory efferent system remains unclear. There is evidence that medial olivocochlear bundle receives descending input from the cortex. In this study, the effect of auditory selective attention on stimulus-frequency otoacoustic emissions (SFOAE) was analyzed to investigate the modification of peripheral auditory system by auditory cortex activity in frequency specific mode.
Methods: Thirty-six normal hearing adult subjects with their age ranging from 18 to 30 years (mean age: 21.9 years) participated in this cross-sectional study. Contralateral suppression of stimulus-frequency otoacoustic emissions was recorded in the right ear at 2 KHz. In order to eliminate the auditory attention, subjects were instructed to read a text. Besides, in order to evaluate the effect of auditory attention on contralateral suppression, subjects were instructed to detect target tones in background noise at 1000, 2000, and 4000 KHz.
Results: A significant increase at contralateral suppression of stimulus-frequency otoacoustic emissions was observed in auditory selective attention conditions (p≤0.001). The largest magnitude of stimulus-frequency otoacoustic emissions suppression was seen at 2 KHz.
Conclusion: The results of this study indicated that the activities of medial olivocochlear bundle enhanced by contralateral auditory selective attention increase the magnitude of stimulus-frequency otoacoustic emissions suppression. In fact, these results provided evidence for influence of auditory cortex on the peripheral auditory system via corticofugal pathways in a frequency specific way.

Background and Aim: Although the ability of speech perception has been improved in implanted subjects with recent progress in technology, cochlear implantation alone is not enough and more aural rehabilitation is necessary. The aim of this study was to assess improvement of speech perception in children with cochlear implant.
Methods: Fourteen cochlear implanted children with a mean age of 5.5 years participated in this study. Auditory training was performed in 10 to 43 sessions. Speech recognition and perception were evaluated every 3 months. Third evaluation was done only for 4 patients.
Results: Mean total score of the first evaluation was 43.21%, of the second was 63.76%, and of the third evaluation was 78%. All children obtained complete score for sound awareness at the first evaluation. In environmental sounds discrimination, 71.3%, 84.36%, and 100% answered completely to the questions of three evaluations respectively. In speech sounds discrimination, 34.7% in the first, 57.04% in the second, and 85% in the third evaluation obtained the complete score, and in auditory memory, complete responses were 21% for the first, 57.12% for the second, and 83% for third evaluation. In story rephrasing and comprehension, no one answered to questions completely. However, 12.83% obtained the complete score in the second and third evaluations. There were statistically significant differences between the first and the second evaluation (p=0.002(.
Conclusion: Sound awareness ability seems to be achieved rapidly. Development of speech and environmental sound discrimination abilities, particularly speech comprehension which is the most important skill, need more impressive training.

Background and Aim: In view of improvement in therapeutic outcome of cancer treatment in children resulting in increased survival rates and the importance of hearing in speech and language development, this research project was intended to assess the effects of cisplatin group on hearing ability in children aged 6 months to 12 years.
Methods: In this cross-sectional study, hearing of 10 children on cisplatin group medication for cancer who met the inclusion criteria was examined by recording auditory brainstem responses (ABR) using the three stimulants of click and 4 and 8 kHz tone bursts. All children were examined twice: before drug administration and within 72 hours after receiving the last dose. Then the results were compared with each other.
Results: There was a significant difference between hearing thresholds before and after drug administration (p<0.05). Right and left ear threshold comparison revealed no significant difference.
Conclusion: Ototoxic effects of cisplatin group were confirmed in this study. Insignificant difference observed in comparing right and left ear hearing thresholds could be due to small sample size. auditory brainstem responses test especially with frequency specificity proved to be a useful method in assessing cisplatin ototoxicity.

Background and Aim: Multiple sclerosis (MS) is a neurological disorder that involves central nervous system. Studies have showed that multiple sclerosis affects behavioral central auditory tests, such as masking release or masking level difference (MLD). The purpose of this study is to compare the masking level difference between multiple sclerosis patients and normal subjects.
Methods: This cross sectional and non-interventional study was conducted on 32 multiple sclerosis patients aged between 20-50 years and 32 controls matched for age and gender in Faculty of Rehabilitation, Tehran University of Medical Sciences. masking level difference test was performed on each subject.
Results: The mean masking level difference in the two groups was significantly different (p<0.01) however, gender did not prove to play a role in this difference.
Conclusion: As part of the multiple sclerosis diagnosis panel, masking level difference test is an efficient modality for evaluation of hearing impairment and monitoring of rehabilitation progress.

Background and Aim: Early diagnosis of hearing loss lead to early intervention and improvement of developmental skills of children with hearing loss. The present study aimed to determine the mean age of hearing loss diagnosis and cochlear implantation (CI) in hearing impaired children and to compare the age of performing cochlear implantation in children who were identified by newborn hearing screening with those who were not.
Methods: This cross-sectional study was conducted on 96 children with severe to profound sensorineural hearing loss who received cochlear implantation in Amir-e-Alam cochlear implantation center between the years 2008 and 2010. For data gathering, we assessed subjects&apos medical archives, interviewed with their parents and took medical history including demographic information, birth history and hearing loss history.
Results: Mean age of hearing loss suspicion, diagnosis, hearing aids administration, Initiation of rehabilitation program, performing cochlear implantation and mean age when cochlear implantation was utilized were 6.73 (SD=5.79), 9.35 (SD=5.79), 13.41 (SD=6.10), 16 (SD=6.36), 41.25 (SD=11.12), and 42.15 (SD=11.00) months, respectively. There was statistically significant difference between them (p<0.05). 43.8% of hearing impaired children had been identified by newborn hearing screening. There was statistically significant difference between cochlear implantation operation age of children who were identified by newborn hearing screening with those who were not (p<0.0001).
Conclusion: In spite of notable reduction in the age of hearing loss diagnosis and intervention during recent years, compared to international indices it is still tardy. Conducting newborn hearing screening can significantly reduce these ages.

Background and Aim: Auditory memory plays an important role in developing language skills and learning. The aim of the present study was to assess auditory verbal memory and learning performance of 18-30 year old healthy adults using the Persian version of the Rey Auditory-Verbal Learning Test (RAVLT).
Methods: This descriptive, cross-sectional study was coducted on seventy 18-30 year old healthy females with the mean age of 23.2 years and a standard deviation (SD) of 2.4 years. Different aspects of memory, like immediate recall, delayed recall, recognition, forgetting rate, interference and learning, were assessed using the Persian version of RAVLT.
Results: Mean score increased from 8.94 (SD=1.91) on the first trial to 13.70 (SD=1.18) on the fifth trial. Total learning mean score was 12.19 (SD=1.08), and mean learning rate was 4.76. Mean scores of the participants on the delayed recall and recognition trials were 13.47 (SD=1.2), and 14.72 (SD=0.53), respectively. The proactive and retroactive interference scores were 0.86 and 0.96, respectively. The forgetting rate score was 1.01 and the retrieval score was 0.90.
Conclusion: The auditory-verbal memory and learning performance of healthy Persian-speaking females was similar to the performance of the same population in other countries. Therefore, the Persian version of RAVLT is valid for assessment of memory function in the Persian-speaking female population.

Background and Aim: The temporal processing is one of the critical features in central auditory processing system the gap in noise (GIN) test is the appropriate clinical tool for appraisal of temporal resolution which in people with multiple sclerosis may encounter with complications. Consequently, the aim of this study was to compare the results of gap in noise test in 18 to 40-year-old patients with multiple sclerosis and normal participants.
Methods: This cross-sectional non-invasive cohort study was conducted on 20 patients with relapsing-remitting multiple sclerosis (mean age: 28.9 years) and 26 healthy normal hearing participant (mean age: 27.7 years) in the age range 18 to 40 years. The approximate threshold and percent of corrected responses were obtained and then were analyzed using Student&aposs t-test.
Results: There was an increase in gap detection and decrease in percent of corrected responses in gap in noise test within multiple sclerosis patients in comparison with normal people (p<0.0001). Moreover, there were a correlation of 78% between increasing disease duration and approximate threshold and also a correlation of 82% between increasing disease duration and corrected responses (p<0.0001).
Conclusion: Based on the findings of this study, it seems that people with multiple sclerosis suffer from some degree of disorder in the temporal resolution which might be due to involvement of central nerve system and, somehow, deficit in central auditory processing. Therefore, for evaluating the temporal resolution in people with multiple sclerosis, gap in noise test could be useful.

Background and Aim: Auditory temporal processing reveals an important aspect of auditory performance, in which a deficit can prevent the child from speaking, language learning and reading. Temporal resolution, which is a subgroup of temporal processing, can be evaluated by gap-in-noise detection test. Regarding the relation of auditory temporal processing deficits and phonologic disorder of children with dyslexia-dysgraphia, the aim of this study was to evaluate these children with the gap-in-noise (GIN) test.
Methods: The gap-in-noise test was performed on 28 normal and 24 dyslexic-dysgraphic children, at the age of 11-12 years old. Mean approximate threshold and percent of corrected answers were compared between the groups.
Results: The mean approximate threshold and percent of corrected answers of the right and left ear had no significant difference between the groups (p>0.05). The mean approximate threshold of children with dyslexia-dysgraphia (6.97 ms, SD=1.09) was significantly (p<0.001) more than that of the normal group (5.05 ms, SD=0.92). The mean related frequency of corrected answers (58.05, SD=4.98%) was less than normal group (69.97, SD=7.16%) (p<0.001).
Conclusion: Abnormal temporal resolution was found in children with dyslexia-dysgraphia based on gap-in-noise test. While the brainstem and auditory cortex are responsible for auditory temporal processing, probably the structural and functional differences of these areas in normal and dyslexic-dysgraphic children lead to abnormal coding of auditory temporal information. As a result, auditory temporal processing is inevitable.

Background and Aim: Phonological processing skills include the abilities to restore, retrieve and use memorized phonological codes. The purpose of this research is to compare and evaluate phonological processing skills in 6-7 year old blind and sighted Persian speakers in Tehran, Iran.
Methods: This research is an analysis-comparison study. The subjects were 24 blind and 24 sighted children. The evaluation test of reading and writing disorders in primary school students, linguistic and cognitive abilities test, and the naming subtest of the aphasia evaluation test were used as research tools.
Results: Sighted children were found to perform better on phoneme recognition of nonwords and flower naming subtests and the difference was significant (p<0.001). Blind children performed better in words and sentence memory the difference was significant (p<0.001). There were no significant differences in other subtests.
Conclusion: Blind children&aposs better performance in memory tasks is due to the fact that they have powerful auditory memory.