Normative Ranges for Auditory Brainstem Response Wave I Amplitude: A Potential Diagnostic Indicator of Cochlear Deafferentation

While cochlear synaptopathy has limited impact on auditory thresholds, there is increasing evidence that cochlear deafferentation is associated with auditory perceptual deficits. However, there is currently no means for diagnosing synaptopathy or deafferentation in individual patients....

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✦ The floor

Discussion

Signed responses from readers of the wire.

✦ Clinical Takeaway ✦

These normative ranges for ABR Wave I amplitude could support clinical identification of cochlear synaptopathy in patients with normal audiograms but auditory complaints; audiologists should consider this as a supplementary diagnostic tool pending further validation in diverse clinical populations.

✦ Why It Matters ✦

Establishing normative ABR Wave I amplitude ranges is a critical step toward clinically detecting cochlear synaptopathy — a condition currently invisible to standard audiometry — which may underlie listening difficulties in millions of people with "normal" hearing.

✦ Key Points ✦

01Study in American Journal of Audiology establishes normative ABR Wave I amplitude ranges for the first time as a deafferentation marker.
02Cochlear deafferentation/synaptopathy (damage to nerve connections in the inner ear) causes hearing difficulty despite near-normal pure-tone thresholds.
03Reduced ABR Wave I amplitude is proposed as a diagnostic indicator of this "hidden" hearing loss.
04Normative data are foundational for future clinical screening protocols targeting synaptopathy.
05Further clinical validation across age groups and populations is needed before routine adoption.

✦ Claims & Evidence ✦

ClaimEvidenceSupport

ABR Wave I amplitude can serve as a diagnostic indicator of cochlear deafferentation/synaptopathy.

studypartially supported

Cochlear deafferentation causes auditory perceptual deficits despite near-normal hearing thresholds.

studysupported

✦ Research metadata ✦

PMID: 42635501
DOI: 10.1044/2026_AJA-25-00296.
Journal: American Journal of Audiology
Publication type: research_article
Evidence level: 2b
Population: Participants with near-normal audiometric thresholds assessed for cochlear deafferentation/synaptopathy
Intervention: ABR Wave I amplitude measurement as a diagnostic marker
Comparator: Normative reference ranges established in the study

Primary outcomes

Normative ranges for ABR Wave I amplitude; Validity of ABR Wave I amplitude as a diagnostic indicator of cochlear deafferentation

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