The Physiological Basis and Clinical Use of the Binaural Interaction Component of the Auditory Brainstem Response.
Geneviève Laumen, Alexander T Ferber, Georg M Klump and 1 others
PMID 27232077WHAT IT FOUND
The binaural interaction component may help identify binaural hearing problems behind difficulty understanding speech in noise, but it is not yet a ready-made clinical test.
Key findings
01The binaural interaction component is obtained by subtracting the sum of left and right monaural auditory brainstem responses from the binaural response.
02The binaural interaction component has been reported as reduced or absent in children with central auditory processing disorder and was detected in 97% of normal-hearing adults versus 20% of patients with profound unilateral hearing loss, though the 20% finding was likely a false positive.
03The exact source of the main binaural interaction peak is not settled; superior olivary complex nuclei are candidates, but the evidence cannot pinpoint one specific nucleus.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
This is a narrative review, not a controlled test of the measure in patients. The binaural interaction component is not present in every normal-hearing person, and its shape varies widely. Different studies use different subtraction conventions, peak labels, amplitude measures, filters, stimulus rates, and electrode placements, so results are hard to compare. Much of the source evidence comes from animal studies, so the exact human generator remains uncertain. The paper states that open questions remain about how pathologies modify the component.
The easy way to misread this
Do not treat the binaural interaction component as a proven clinical test for central auditory processing disorder. The review presents it as a potential objective measure, but its source, recording standards, and diagnostic accuracy are not settled.