{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T03:30:16Z","timestamp":1788492616710,"version":"build-2803163510"},"reference-count":45,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,7,7]],"date-time":"2025-07-07T00:00:00Z","timestamp":1751846400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,7,7]],"date-time":"2025-07-07T00:00:00Z","timestamp":1751846400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"University of Tomorrow project"},{"DOI":"10.13039\/100014653","name":"Manchester Biomedical Research Centre","doi-asserted-by":"publisher","award":["IS-BRC-1215-20007"],"award-info":[{"award-number":["IS-BRC-1215-20007"]}],"id":[{"id":"10.13039\/100014653","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100014653","name":"Manchester Biomedical Research Centre","doi-asserted-by":"publisher","award":["IS-BRC-1215-20007"],"award-info":[{"award-number":["IS-BRC-1215-20007"]}],"id":[{"id":"10.13039\/100014653","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:p>The loss of inner hair cells and\/or neurons in the cochlea leads to cochlear dead regions (DRs). One of the consequences of DRs is noisy transmission of information from the cochlea to the brain, which results in poorer than expected perception of speech in noise. DRs can be detected using behavioural masking techniques such as the threshold-equalizing noise (TEN) test. However, the TEN test, although fast and easy to perform, requires participants\u2019 active cooperation and thus is not suitable for use with infants, young children and adults who cannot provide behavioural responses. Recently, Kang et al. (2018) proposed the electrophysiological Acoustic Change Complex (ACC) as an objective test for diagnosing cochlear DRs, but with limited evidence supporting their proposed approach. Thus, the first step towards addressing this gap is to develop and assess an objective ACC detection method. Here, we evaluated three methods of detecting the ACC based on: i) the root mean square of N1-P2 amplitude as reported in Kang et al. (2018); ii) Signal-to-Noise Ratio (SNR) as recommended by the British Society of Audiology; and iii) bootstrap by multiple resampling of the original data in a random manner and calculating a measure of variance in the N1-P2 amplitude to noise floor ratio from the resampled data. We have also examined the relationship between ACC amplitude, threshold, and stimulus frequency\/intensity. Twenty-three normally hearing adults were tested. The ACC was evoked by either a 1-kHz or 4-kHz pure tone presented simultaneously with the TEN at SNRs between 0 and 15\u00a0dB, in 3\u00a0dB steps relative to the TEN level. We found that the bootstrap method was most efficient at detecting ACC and was two times faster to administer than the commonly used British Society of Audiology method. We also found that the threshold of ACC detection is frequency dependent, i.e., the higher the frequency, the higher the signal level needed to evoke ACC. Thus, frequency-dependent ACC norms need to be established before this method can be used for detection of cochlear DRs in children and adults who cannot provide behavioural responses.<\/jats:p>","DOI":"10.1038\/s41598-025-02093-w","type":"journal-article","created":{"date-parts":[[2025,7,7]],"date-time":"2025-07-07T02:44:54Z","timestamp":1751856294000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["The acoustic change complex as a diagnostic tool for cochlear dead regions evaluated in normally hearing adults"],"prefix":"10.1038","volume":"15","author":[{"given":"Anna","family":"Schelenz","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4392-6933","authenticated-orcid":false,"given":"Emanuele","family":"Perugia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lin","family":"Wu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8479-4009","authenticated-orcid":false,"given":"Ewa","family":"Skrodzka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3638-2787","authenticated-orcid":false,"given":"Karolina","family":"Kluk","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,7,7]]},"reference":[{"key":"2093_CR1","unstructured":"British Society of Audiology. Recommended Procedure: Cortical Auditory Evoked Potential (CAEP) Testing. https:\/\/www.thebsa.org.uk\/wp-content\/uploads\/2016\/05\/OD104-40-Recommended-Procedure-Cortical-ERA.pdf (2016)."},{"key":"2093_CR2","unstructured":"Hall, J. W. I. (2015). eHandbook of Auditory Evoked Responses: Principles, Procedures & Protocols."},{"issue":"5","key":"2093_CR3","doi-asserted-by":"publisher","first-page":"433","DOI":"10.1001\/archotol.1970.00770040627007","volume":"91","author":"J Jerger","year":"1970","unstructured":"Jerger, J. & Jerger, S. Evoked response to intensity and frequency change. Arch. Otolaryngol. (Chicago, Ill.: 1960) 91(5), 433\u2013436. https:\/\/doi.org\/10.1001\/archotol.1970.00770040627007 (1970).","journal-title":"Arch. Otolaryngol. (Chicago, Ill.: 1960)"},{"issue":"3","key":"2093_CR4","doi-asserted-by":"publisher","first-page":"624","DOI":"10.1044\/jshr.1303.624","volume":"13","author":"GA McCandless","year":"1970","unstructured":"McCandless, G. A. & Rose, D. E. Evoked cortical responses to stimulus change. J. Speech Hear. Res. 13(3), 624\u2013634. https:\/\/doi.org\/10.1044\/jshr.1303.624 (1970).","journal-title":"J. Speech Hear. Res."},{"issue":"4","key":"2093_CR5","doi-asserted-by":"publisher","first-page":"375","DOI":"10.1111\/j.1469-8986.1987.tb00311.x","volume":"24","author":"R N\u00e4\u00e4t\u00e4nen","year":"1987","unstructured":"N\u00e4\u00e4t\u00e4nen, R. & Picton, T. The N1 wave of the human electric and magnetic response to sound: A review and an analysis of the component structure. Psychophysiology 24(4), 375\u2013425. https:\/\/doi.org\/10.1111\/j.1469-8986.1987.tb00311.x (1987).","journal-title":"Psychophysiology"},{"issue":"6","key":"2093_CR6","doi-asserted-by":"publisher","first-page":"609","DOI":"10.1016\/0013-4694(75)90073-5","volume":"39","author":"JR Wolpaw","year":"1975","unstructured":"Wolpaw, J. R. & Penry, J. K. A temporal component of the auditory evoked response. Electroencephalogr. Clin. Neurophysiol. 39(6), 609\u2013620. https:\/\/doi.org\/10.1016\/0013-4694(75)90073-5 (1975).","journal-title":"Electroencephalogr. Clin. Neurophysiol."},{"issue":"1","key":"2093_CR7","doi-asserted-by":"publisher","first-page":"33","DOI":"10.1097\/00003446-199902000-00004","volume":"20","author":"BA Martin","year":"1999","unstructured":"Martin, B. A. & Boothroyd, A. Cortical, auditory, event-related potentials in response to periodic and aperiodic stimuli with the same spectral envelope. Ear Hear. 20(1), 33\u201344. https:\/\/doi.org\/10.1097\/00003446-199902000-00004 (1999).","journal-title":"Ear Hear."},{"issue":"4","key":"2093_CR8","doi-asserted-by":"publisher","first-page":"2155","DOI":"10.1121\/1.428556","volume":"107","author":"BA Martin","year":"2000","unstructured":"Martin, B. A. & Boothroyd, A. Cortical, auditory, evoked potentials in response to changes of spectrum and amplitude. J. Acous. Soc. Am. 107(4), 2155\u20132161. https:\/\/doi.org\/10.1121\/1.428556 (2000).","journal-title":"J. Acous. Soc. Am."},{"issue":"9","key":"2093_CR9","doi-asserted-by":"publisher","first-page":"2111","DOI":"10.1016\/j.clinph.2008.06.002","volume":"119","author":"A Dimitrijevic","year":"2008","unstructured":"Dimitrijevic, A., Michalewski, H. J., Zeng, F.-G., Pratt, H. & Starr, A. Frequency changes in a continuous tone: Auditory cortical potentials. Clin. Neurophysiol.: Offic. J. Int. Fed. Clin. Neurophysiol. 119(9), 2111\u20132124. https:\/\/doi.org\/10.1016\/j.clinph.2008.06.002 (2008).","journal-title":"Clin. Neurophysiol.: Offic. J. Int. Fed. Clin. Neurophysiol."},{"issue":"10","key":"2093_CR10","doi-asserted-by":"publisher","first-page":"771","DOI":"10.3109\/14992027.2012.699198","volume":"51","author":"S He","year":"2012","unstructured":"He, S., Grose, J. H. & Buchman, C. A. Auditory discrimination: The relationship between psychophysical and electrophysiological measures. Int. J. Audiol. 51(10), 771\u2013782. https:\/\/doi.org\/10.3109\/14992027.2012.699198 (2012).","journal-title":"Int. J. Audiol."},{"issue":"2","key":"2093_CR11","doi-asserted-by":"publisher","first-page":"374","DOI":"10.1016\/j.clinph.2008.11.009","volume":"120","author":"A Dimitrijevic","year":"2009","unstructured":"Dimitrijevic, A. et al. Intensity changes in a continuous tone: Auditory cortical potentials comparison with frequency changes. Clin. Neurophysiol.: Offic. J. Int. Fed. Clin. Neurophysiol. 120(2), 374\u2013383. https:\/\/doi.org\/10.1016\/j.clinph.2008.11.009 (2009).","journal-title":"Clin. Neurophysiol.: Offic. J. Int. Fed. Clin. Neurophysiol."},{"key":"2093_CR12","doi-asserted-by":"publisher","first-page":"233121651773741","DOI":"10.1177\/2331216517737417","volume":"21","author":"JH Grose","year":"2017","unstructured":"Grose, J. H., Buss, E. & Hall, J. W. Loud music exposure and cochlear synaptopathy in young adults: Isolated auditory brainstem response effects but no perceptual consequences. Trends Hearing 21, 2331216517737417. https:\/\/doi.org\/10.1177\/2331216517737417 (2017).","journal-title":"Trends Hearing"},{"issue":"1\u20132","key":"2093_CR13","doi-asserted-by":"publisher","first-page":"15","DOI":"10.1016\/j.heares.2009.04.002","volume":"254","author":"CJ Billings","year":"2009","unstructured":"Billings, C. J., Tremblay, K. L., Stecker, G. C. & Tolin, W. M. Human evoked cortical activity to signal-to-noise ratio and absolute signal level. Hear. Res. 254(1\u20132), 15\u201324. https:\/\/doi.org\/10.1016\/j.heares.2009.04.002 (2009).","journal-title":"Hear. Res."},{"issue":"4","key":"2093_CR14","doi-asserted-by":"publisher","first-page":"278","DOI":"10.1055\/s-0033-1356640","volume":"34","author":"AS Martinez","year":"2013","unstructured":"Martinez, A. S., Eisenberg, L. S. & Boothroyd, A. The acoustic change complex in young children with hearing loss: A preliminary study. Semin. Hear. 34(4), 278\u2013287. https:\/\/doi.org\/10.1055\/s-0033-1356640 (2013).","journal-title":"Semin. Hear."},{"issue":"1","key":"2093_CR15","doi-asserted-by":"publisher","first-page":"779","DOI":"10.1016\/j.clinph.2015.04.002","volume":"127","author":"AK Mathew","year":"2016","unstructured":"Mathew, A. K., Purdy, S. C., Welch, D., Pontoppidan, N. H. & R\u00f8nne, F. M. Electrophysiological and behavioural processing of complex acoustic cues. Clin. Neurophysiol. 127(1), 779\u2013789. https:\/\/doi.org\/10.1016\/j.clinph.2015.04.002 (2016).","journal-title":"Clin. Neurophysiol."},{"issue":"1","key":"2093_CR16","doi-asserted-by":"publisher","first-page":"3645","DOI":"10.1038\/s41598-018-21754-7","volume":"8","author":"S Kang","year":"2018","unstructured":"Kang, S. et al. Objective test of cochlear dead region: Electrophysiologic approach using acoustic change complex. Sci. Rep. 8(1), 3645. https:\/\/doi.org\/10.1038\/s41598-018-21754-7 (2018).","journal-title":"Sci. Rep."},{"issue":"2","key":"2093_CR17","doi-asserted-by":"publisher","first-page":"98","DOI":"10.1097\/01.AUD.0000120359.49711.D7","volume":"25","author":"BCJ Moore","year":"2004","unstructured":"Moore, B. C. J. Dead regions in the cochlea: Conceptual foundations, diagnosis, and clinical applications. Ear Hear. 25(2), 98\u2013116 (2004).","journal-title":"Ear Hear."},{"issue":"4","key":"2093_CR18","doi-asserted-by":"publisher","first-page":"205","DOI":"10.3109\/03005364000000131","volume":"34","author":"BCJ Moore","year":"2000","unstructured":"Moore, B. C. J., Huss, M., Vickers, D. A., Glasberg, B. R. & Alc\u00e1ntara, J. I. A test for the diagnosis of dead regions in the cochlea. Br. J. Audiol. 34(4), 205\u2013224. https:\/\/doi.org\/10.3109\/03005364000000131 (2000).","journal-title":"Br. J. Audiol."},{"issue":"3","key":"2093_CR19","doi-asserted-by":"publisher","first-page":"339","DOI":"10.1097\/AUD.0b013e318202e982","volume":"32","author":"RM Cox","year":"2011","unstructured":"Cox, R. M., Alexander, G. C., Johnson, J. & Rivera, I. Cochlear dead regions in typical hearing aid candidates: Prevalence and implications for use of high-frequency speech cues. Ear Hear. 32(3), 339\u2013348. https:\/\/doi.org\/10.1097\/AUD.0b013e318202e982 (2011).","journal-title":"Ear Hear."},{"issue":"8","key":"2093_CR20","doi-asserted-by":"publisher","first-page":"600","DOI":"10.3766\/jaaa.16.8.9","volume":"16","author":"JE Preminger","year":"2005","unstructured":"Preminger, J. E., Carpenter, R. & Ziegler, C. H. A clinical perspective on cochlear dead regions: Intelligibility of speech and subjective hearing aid benefit. J. Am. Acad. Audiol. 16(8), 600\u2013613 (2005).","journal-title":"J. Am. Acad. Audiol."},{"issue":"3 Pt 1","key":"2093_CR21","doi-asserted-by":"publisher","first-page":"1133","DOI":"10.1121\/1.1498853","volume":"112","author":"T Baer","year":"2002","unstructured":"Baer, T., Moore, B. C. J. & Kluk, K. Effects of low pass filtering on the intelligibility of speech in noise for people with and without dead regions at high frequencies. J. Acous. Soc. Am. 112(3 Pt 1), 1133\u20131144 (2002).","journal-title":"J. Acous. Soc. Am."},{"issue":"2","key":"2093_CR22","doi-asserted-by":"publisher","first-page":"1164","DOI":"10.1121\/1.1381534","volume":"110","author":"DA Vickers","year":"2001","unstructured":"Vickers, D. A., Moore, B. C. & Baer, T. Effects of low-pass filtering on the intelligibility of speech in quiet for people with and without dead regions at high frequencies. J. Acous. Soc. Am. 110(2), 1164\u20131175 (2001).","journal-title":"J. Acous. Soc. Am."},{"issue":"5","key":"2093_CR23","doi-asserted-by":"publisher","first-page":"573","DOI":"10.1097\/AUD.0b013e31824d8ef3","volume":"33","author":"RM Cox","year":"2012","unstructured":"Cox, R. M., Johnson, J. A. & Alexander, G. C. Implications of high-frequency cochlear dead regions for fitting hearing aids to adults with mild to moderately severe hearing loss. Ear Hear. 33(5), 573\u2013587. https:\/\/doi.org\/10.1097\/AUD.0b013e31824d8ef3 (2012).","journal-title":"Ear Hear."},{"issue":"1","key":"2093_CR24","doi-asserted-by":"publisher","first-page":"20","DOI":"10.3109\/14992027.2015.1074294","volume":"55","author":"A Pepler","year":"2016","unstructured":"Pepler, A., Lewis, K. & Munro, K. J. Adult hearing-aid users with cochlear dead regions restricted to high frequencies: Implications for amplification. Int. J. Audiol. 55(1), 20\u201329. https:\/\/doi.org\/10.3109\/14992027.2015.1074294 (2016).","journal-title":"Int. J. Audiol."},{"issue":"8","key":"2093_CR25","doi-asserted-by":"publisher","first-page":"463","DOI":"10.1080\/14992020600753189","volume":"45","author":"K Kluk","year":"2006","unstructured":"Kluk, K. & Moore, B. C. J. Detecting dead regions using psychophysical tuning curves: A comparison of simultaneous and forward masking. Int. J. Audiol. 45(8), 463\u2013476. https:\/\/doi.org\/10.1080\/14992020600753189 (2006).","journal-title":"Int. J. Audiol."},{"issue":"5","key":"2093_CR26","doi-asserted-by":"publisher","first-page":"478","DOI":"10.1097\/01.aud.0000145992.31135.89","volume":"25","author":"BCJ Moore","year":"2004","unstructured":"Moore, B. C. J., Glasberg, B. R. & Stone, M. A. New version of the TEN test with calibrations in dB HL. Ear Hear. 25(5), 478\u2013487. https:\/\/doi.org\/10.1097\/01.aud.0000145992.31135.89 (2004).","journal-title":"Ear Hear."},{"issue":"7","key":"2093_CR27","doi-asserted-by":"publisher","first-page":"408","DOI":"10.1080\/14992020500060800","volume":"44","author":"A S\u0119k","year":"2005","unstructured":"S\u0119k, A., Alc\u00e1ntara, J., Moore, B. C. J., Kluk, K. & Wicher, A. Development of a fast method for determining psychophysical tuning curves. Int. J. Audiol. 44(7), 408\u2013420. https:\/\/doi.org\/10.1080\/14992020500060800 (2005).","journal-title":"Int. J. Audiol."},{"issue":"1","key":"2093_CR28","doi-asserted-by":"publisher","first-page":"43","DOI":"10.1097\/AUD.0b013e31818fbb7a","volume":"30","author":"E Markessis","year":"2009","unstructured":"Markessis, E. et al. Frequency tuning curves derived from auditory steady state evoked potentials: A proof-of-concept study. Ear Hear. 30(1), 43\u201353. https:\/\/doi.org\/10.1097\/AUD.0b013e31818fbb7a (2009).","journal-title":"Ear Hear."},{"key":"2093_CR29","doi-asserted-by":"publisher","first-page":"233121652311732","DOI":"10.1177\/23312165231173234","volume":"27","author":"E Perugia","year":"2023","unstructured":"Perugia, E., Marmel, F. & Kluk, K. Feasibility of diagnosing dead regions using auditory steady-state responses to an exponentially amplitude modulated tone in threshold equalizing notched noise, assessed using normal-hearing participants. Trends Hearing 27, 23312165231173230. https:\/\/doi.org\/10.1177\/23312165231173234 (2023).","journal-title":"Trends Hearing"},{"key":"2093_CR30","doi-asserted-by":"publisher","first-page":"485","DOI":"10.1097\/AUD.0b013e31820a77e2","volume":"32","author":"T Wilding","year":"2011","unstructured":"Wilding, T., McKay, C., Baker, R., Picton, T. W. & Kluk, K. Using the auditory steady state response to record response amplitude curves. A possible fast objective method for diagnosing dead regions. Ear Hearing 32, 485\u2013497. https:\/\/doi.org\/10.1097\/AUD.0b013e31820a77e2 (2011).","journal-title":"Ear Hearing"},{"issue":"4","key":"2093_CR31","doi-asserted-by":"publisher","first-page":"554","DOI":"10.1097\/AUD.0b013e31824b9e43","volume":"33","author":"BCJ Moore","year":"2012","unstructured":"Moore, B. C. J., Creeke, S., Glasberg, B. R., Stone, M. A. & Sek, A. A version of the TEN Test for use with ER-3A insert earphones. Ear Hear. 33(4), 554\u2013557. https:\/\/doi.org\/10.1097\/AUD.0b013e31824b9e43 (2012).","journal-title":"Ear Hear."},{"issue":"2","key":"2093_CR32","doi-asserted-by":"publisher","first-page":"191","DOI":"10.1016\/j.medengphy.2006.03.001","volume":"29","author":"J Lv","year":"2007","unstructured":"Lv, J., Simpson, D. M. & Bell, S. L. Objective detection of evoked potentials using a bootstrap technique. Med. Eng. Phys. 29(2), 191\u2013198. https:\/\/doi.org\/10.1016\/j.medengphy.2006.03.001 (2007).","journal-title":"Med. Eng. Phys."},{"key":"2093_CR33","unstructured":"British Society of Audiology. Recommended Procedure: Pure-tone air-conduction and bone-conduction threshold audiometry with and without masking. https:\/\/www.thebsa.org.uk\/wp-content\/uploads\/2018\/11\/Recommended-Procedure-Pure-Tone-Audiometry-August-2018-FINAL.pdf (2018)."},{"key":"2093_CR34","doi-asserted-by":"publisher","first-page":"68","DOI":"10.1016\/j.heares.2016.10.028","volume":"344","author":"G Prendergast","year":"2017","unstructured":"Prendergast, G. et al. Effects of noise exposure on young adults with normal audiograms I: Electrophysiology. Hear. Res. 344, 68\u201381. https:\/\/doi.org\/10.1016\/j.heares.2016.10.028 (2017).","journal-title":"Hear. Res."},{"issue":"6","key":"2093_CR35","doi-asserted-by":"publisher","first-page":"857","DOI":"10.1111\/psyp.12406","volume":"52","author":"M-A Schulz","year":"2015","unstructured":"Schulz, M.-A. et al. On utilizing uncertainty information in template-based EEG-fMRI ballistocardiogram artifact removal. Psychophysiology 52(6), 857\u2013863. https:\/\/doi.org\/10.1111\/psyp.12406 (2015).","journal-title":"Psychophysiology"},{"issue":"8476","key":"2093_CR36","doi-asserted-by":"publisher","first-page":"307","DOI":"10.1016\/S0140-6736(86)90837-8","volume":"1","author":"JM Bland","year":"1986","unstructured":"Bland, J. M. & Altman, D. G. Statistical methods for assessing agreement between two methods of clinical measurement. Lancet 1(8476), 307\u2013310. https:\/\/doi.org\/10.1016\/S0140-6736(86)90837-8 (1986).","journal-title":"Lancet"},{"issue":"4","key":"2093_CR37","doi-asserted-by":"publisher","first-page":"571","DOI":"10.1080\/10543400701329422","volume":"17","author":"JM Bland","year":"2007","unstructured":"Bland, J. M. & Altman, D. G. Agreement between methods of measurement with multiple observations per individual. J. Biopharm. Stat. 17(4), 571\u2013582. https:\/\/doi.org\/10.1080\/10543400701329422 (2007).","journal-title":"J. Biopharm. Stat."},{"issue":"1","key":"2093_CR38","doi-asserted-by":"publisher","first-page":"255","DOI":"10.2307\/2532051","volume":"45","author":"LI Lin","year":"1989","unstructured":"Lin, L. I. A concordance correlation coefficient to evaluate reproducibility. Biometrics 45(1), 255\u2013268 (1989).","journal-title":"Biometrics"},{"issue":"1","key":"2093_CR39","doi-asserted-by":"crossref","first-page":"324","DOI":"10.1111\/j.0006-341X.2000.00324.x","volume":"56","author":"LI Lin","year":"2000","unstructured":"Lin, L. I. A note on the concordance correlation coefficient. Biometrics 56(1), 324\u2013235 (2000).","journal-title":"Biometrics"},{"key":"2093_CR40","unstructured":"Stevenson, M., Sergeant, E., & Firestone, S. epiR: Tools for the Analysis of Epidemiological Data [R package version 2.0.67]. https:\/\/CRAN.R-project.org\/package=epiR (2024)."},{"issue":"9","key":"2093_CR41","doi-asserted-by":"publisher","first-page":"672","DOI":"10.1080\/14992027.2017.1307531","volume":"56","author":"N Vinay","year":"2017","unstructured":"Vinay, N., Raen, \u00d8. & Moore, B. C. J. Reference thresholds for the TEN(HL) test for people with normal hearing. Int. J. Audiol. 56(9), 672\u2013676. https:\/\/doi.org\/10.1080\/14992027.2017.1307531 (2017).","journal-title":"Int. J. Audiol."},{"issue":"1\u20134","key":"2093_CR42","doi-asserted-by":"publisher","first-page":"87","DOI":"10.3109\/00207450009003268","volume":"105","author":"\u00c7 \u00d6zesmio","year":"2000","unstructured":"\u00d6zesmio, \u00c7., Dolu, N., S\u00fcer, C., G\u00f6lgelio, A. & A\u015f\u00e7ioglu, M. Habituation of the auditory evoked potential in a short interstimulus interval paradigm. Int. J. Neurosci. 105(1\u20134), 87\u201395. https:\/\/doi.org\/10.3109\/00207450009003268 (2000).","journal-title":"Int. J. Neurosci."},{"key":"2093_CR43","unstructured":"British Society of Audiology. Recommended Procedure: Auditory Brainstem Response (ABR) Testing in Newborns. https:\/\/www.thebsa.org.uk\/wp-content\/uploads\/2025\/02\/100_ABR-Testing-in-Babies-26-Feb-2025.pdf (2025)."},{"key":"2093_CR44","doi-asserted-by":"publisher","DOI":"10.1016\/j.heares.2024.109090","volume":"451","author":"S Meehan","year":"2024","unstructured":"Meehan, S., Adank, M. L., van der Schroeff, M. P. & Vroegop, J. L. A systematic review of acoustic change complex (ACC) measurements and applicability in children for the assessment of the neural capacity for sound and speech discrimination. Hear. Res. 451, 109090. https:\/\/doi.org\/10.1016\/j.heares.2024.109090 (2024).","journal-title":"Hear. Res."},{"key":"2093_CR45","doi-asserted-by":"publisher","DOI":"10.1155\/2012\/365752","volume":"2012","author":"CJ Billings","year":"2012","unstructured":"Billings, C. J., Papesh, M. A., Penman, T. M., Baltzell, L. S. & Gallun, F. J. Clinical use of aided cortical auditory evoked potentials as a measure of physiological detection or physiological discrimination. Int. J. Otolaryngology 2012, 365752. https:\/\/doi.org\/10.1155\/2012\/365752 (2012).","journal-title":"Int. J. Otolaryngology"}],"container-title":["Scientific Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41598-025-02093-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-025-02093-w","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-025-02093-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,7,7]],"date-time":"2025-07-07T02:45:04Z","timestamp":1751856304000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41598-025-02093-w"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,7]]},"references-count":45,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["2093"],"URL":"https:\/\/doi.org\/10.1038\/s41598-025-02093-w","relation":{},"ISSN":["2045-2322"],"issn-type":[{"value":"2045-2322","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7,7]]},"assertion":[{"value":"19 December 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"12 May 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"7 July 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declaration"}},{"value":"The authors declare no competing interests.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"24160"}}