On possible causes of discrepancy between the results of auditory brainstem responses (ABR) and auditory steady-state responses (ASSR) recordings

Auditory brainstem responses (ABR) and auditory steady-state responses (ASSR) are the most widely used tests for objective hearing assessment. These tests are included in clinical guidelines for sensorineural hearing loss and other protocols. The literature sources describe examples of inconsistency between the results of these two tests, which are suggested to be interpreted in favor of ABR as the test with the highest values of sensitivity and specificity. Also, in a number of cases, discrepancy between the results of ABR and ASSR recordings in patients with neurological pathology was revealed. Given the expanding indications for auditory evoked potentials recording in groups of patients with neurological or psychiatric pathologies (for example, ABR and ASSR are recommended for use in clinical guidelines for the management of patients with autism spectrum disorders in 2020), an attempt has been made to assess the diagnostic value of these research methods in relation to conditions unrelated to hearing impairment. Material and methods. A diagnostic search of domestic and foreign literature was conducted on the combined interpretation of the results of ABR and ASSR recording was carried out. Literature on the use of these tests in groups of patients without sensorineural hearing loss was also reviewed. Results. The review includes the results of a literature search that provides a comparative analysis of ABR and ASSR results, including in patients with neurologic/psychiatric pathology. The analysis showed that ASSR recording results may significantly differ from the ABR response, which should be taken into account in patients with comorbidities. © 2025 Elsevier B.V., All rights reserved.