Use of Envelope Following Response Normative Ranges for Diagnosing Cochlear Deafferentation

The lack of a means to diagnose cochlear synaptopathy, a type of cochlear deafferentation, prevents clinicians from identifying patients with this auditory deficit and providing them with appropriate treatments. The envelope following response (EFR) has potential as a diagnostic indicator of deafferentation. However, it is not clear what constitutes an abnormal EFR....

If normative EFR ranges are validated for diagnosing cochlear synaptopathy in clinical populations, audiologists should consider integrating EFR testing into their hidden hearing loss diagnostic workflow, but adoption should await full review of sensitivity and specificity data from this study.

Cochlear synaptopathy ("hidden hearing loss") remains difficult to diagnose with standard audiometry, and a validated clinical EFR normative tool could meaningfully close that diagnostic gap.

1. 01Study evaluates Envelope Following Response (EFR) normative ranges as a clinical diagnostic tool for cochlear synaptopathy.
2. 02Cochlear synaptopathy causes hearing difficulty despite normal audiograms — a major unmet diagnostic need.
3. 03Published in American Journal of Audiology, a clinically focused peer-reviewed journal.
4. 04Use of normative ranges could provide a practical, accessible path to diagnosing hidden hearing loss.
5. 05Sensitivity and specificity of EFR normative cutoffs in clinical populations remain to be fully established.

PMID

42215036

DOI

10.1044/2026_AJA-25-00277.

Journal

American Journal of Audiology

Publication type

research_article

Evidence level

2b

Population

Clinical populations being evaluated for cochlear synaptopathy/cochlear deafferentation

Intervention

Envelope Following Response (EFR) testing using normative reference ranges

Comparator

Standard normative reference ranges or alternative diagnostic methods