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Test-Retest of Long Latency Auditory Evoked Potentials (P300) with Pure Tone and Speech Stimuli

Abstract

Introduction

Long latency auditory evoked potentials, especially P300, have been used for clinical evaluation of mental processing. Many factors can interfere with Auditory Evoked Potential - P300 results, suggesting large intra and inter-subject variations.

Objective

The objective of the study was to identify the reliability of P3 components (latency and amplitude) over 4-6 weeks and the most stable auditory stimulus with the best test-retest agreement.

Methods

Ten normal-hearing women participated in the study. Only subjects without auditory processing problems were included. To determine the P3 components, we elicited long latency auditory evoked potential (P300) by pure tone and speech stimuli, and retested after 4-6 weeks using the same parameters. We identified P300 latency and amplitude by waveform subtraction.

Results

We found lower coefficient of variation values in latency than in amplitude, with less variability analysis when speech stimulus was used. There was no significant correlation in latency measures between pure tone and speech stimuli, and sessions. There was a significant intrasubject correlation between measures of latency and amplitude.

Conclusion

These findings show that amplitude responses are more robust for the speech stimulus when compared with its pure tone counterpart. The P300 indicated stability for latency and amplitudemeasures when the test-retest was applied. Reliability was higher for amplitude than for latency, with better agreement when the pure tone stimulus was used. However, further research with speech stimulus is needed to clarify how these stimuli are processed by the nervous system.

Keywords:
event-related; potentials; auditory perception; reliability; evoked potentials

Introduction

Long latency auditory evoked potentials (LLAEP) have been used to monitor neurophysiological changes that compromise the cortical regions of the auditory pathway, in relation to skills such as cognitive processing, memory, attention, and auditory discrimination.

The P300 is considered an endogenous potential, since it reflects the individual's functional use of the stimulus and does not depend directly on their physical characteristics.11 Sutton S, BrarenM, Zubin J, John ER. Evoked-potential correlates of stimulus uncertainty. Science 1965;150(3700):1187-1188 It is related to cognitive skills, perception, and attention. The P3 component occurs when individuals consciously recognize a change in auditory stimulus.22 Musiek FE, Baran JA, Pinheiro ML. Neuro-Audiology: Case Studies. San Diego: Singular Publishing Company; 1994:20-21 33 McPherson DL. Late potentials of the auditory system. San Diego: Singular Publishing Group, Inc.; 1996

The exact location of the origin of the P300 wave remains unknown. The possible neural generators of N200 and P300 waves result from the joint participation of several neural structures, that is, multiple generators. They involve areas of the supratemporal auditory cortex (N2), frontal cortex, and hippocampus (P300).33 McPherson DL. Late potentials of the auditory system. San Diego: Singular Publishing Group, Inc.; 1996 44 Hall JW. Handbook of auditory evoked responses. 3nd ed. Massachusetts (Boston): Allyn and Bacon; 1990 LLAEPs evaluate the cortical activity involved in discrimination, integration, and attention skills.33 McPherson DL. Late potentials of the auditory system. San Diego: Singular Publishing Group, Inc.; 1996 55 Kraus N, McGee T. Potenciais auditivos de longa latência. In: Katz J. Tratado de audiologia clínica. São Paulo: Manole; 1999:403-20

To elicit the P300, a wide variety of paradigms have been used, of which the “oddball” paradigm is the most utilized. In a process of active attention, different stimuli, with the same modality and different characteristics,66 Duarte JL, Alvarenga KdeF, Banhara MR, Melo AD, Sás RM, Costa Filho OA. P300-long-latency auditory evoked potential in normal hearing subjects: simultaneous recording value in Fz and Cz. Braz J Otorhinolaryngol 2009;75(2):231-236 are presented in a series such that one of them occurs relatively infrequently, that is, the oddball.77 Squires NK, Squires KC, Hillyard SA. Two varieties of long-latency positive waves evoked by unpredictable auditory stimuli in man. Electroencephalogr Clin Neurophysiol 1975;38(4):387-401

The amplitude of the P300 wave is highly influenced by individual characteristics and latency over the time neural activity takes to travel along the auditory pathway, including time spent in synaptic transmission and neural conduction.88 Eggermont JJ. Electric and magnetic fields of synchronous neural activity. In: Burkard RF, Don M, Eggermont JJ (Eds.). Auditory evoked potentials. Baltimore: Lippincott William & Wilkins; 2006:2-21

Several authors99 Polich J, Howard L, Starr A. P300 latency correlates with digit span. Psychophysiology 1983;20(6):665-669 1010 Sklare DA, Lynn GE. Latency of the P3 event-related potential: normative aspects andwithin-subject variability. Electroencephalogr Clin Neurophysiol 1984;59(5):420-424 1111 Polich J. Normal variation of P300 from auditory stimuli. Electroencephalogr Clin Neurophysiol 1986;65(3):236-240 1212 Kileny PR, Kripal JP. Test-retest variability of auditory eventrelated potentials. Ear Hear 1987;8(2):110-114 1313 Segalowitz SJ, Barnes KL. The reliability of ERP components in the auditory oddball paradigm. Psychophysiology 1993;30(5): 451-459 1414 Kinoshita S, Maeda H, Nakamura J, Kodama E, Morita K. Reliability of the probability effect on event-related potentials during repeated testing. Kurume Med J 1995;42(4):199-210 1515 Kinoshita S, Inoue M, Maeda H, Nakamura J, Morita K. Long-term patterns of change in ERPs across repeated measurements. Physiol Behav 1996;60(4):1087-1092 1616 Sandman CA, Patterson JV. The auditory event-related potential is a stable and reliable measure in elderly subjects over a 3 year period. Clin Neurophysiol 2000;111(8):1427-1437 1717 Walhovd KB, Fjell AM. One-year test-retest reliability of auditory ERPs in young and old adults. Int J Psychophysiol 2002;46(1): 29-40 have demonstrated that P300 latency and/or amplitude values in normal adults are replicable and stable, with no statistically significant test-retest differences at different time intervals. By contrast, other studies1818 Matas CG, Hataiama NM, Gonçalves IC. Estabilidade dos potenciais evocados auditivos em indivíduos adultos com audição normal. Rev Soc Bras Fonoaudiol. 2011;16:37-41 1919 Reis ACMB, Frizzo ACF, Lozano AC, Santos FR, Anastasio ART, Hyppolito MA. Variability of registration latency and amplitude of the auditory evoked potential long latency (P3) in the condition test and retest. Audiol. Communic Res 2014;19(3):293-298 have exhibited test-retest variability in the P300 wave.

Studies have reported that a large number of factors can interfere in P300 results, although without reaching consensus. Primarily the attention component,33 McPherson DL. Late potentials of the auditory system. San Diego: Singular Publishing Group, Inc.; 1996 44 Hall JW. Handbook of auditory evoked responses. 3nd ed. Massachusetts (Boston): Allyn and Bacon; 1990 stimulus intensity interferes directly in measures of wave amplitude and latency.2020 Covington JW, Polich J. P300, stimulus intensity, and modality. Electroencephalogr Clin Neurophysiol 1996;100(6):579-584 Advancing age leads to variations in P300 values such as increased latency,2121 Goodin DS, Squires KC, Henderson BH, Starr A. Age-related variations in evoked potentials to auditory stimuli in normal human subjects. Electroencephalogr Clin Neurophysiol 1978;44(4):447-458 2222 Polich J. P300 in clinical applications: meaning, method, and measurement. Am J EEG Technol 1991;31(3):201-231 decreased amplitude,2323 Verleger R, Neukäter W, Kömpf D, Vieregge P. On the reasons for the delay of P3 latency in healthy elderly subjects. Electroencephalogr Clin Neurophysiol 1991;79(6):488-502 and cognitive development.2424 Polich J, Ladish C, Burns T. Normal variation of P300 in children: age, memory span, and head size. Int J Psychophysiol 1990;9(3):237-248 In children, the development changes observed in AEPs are related not only to anatomical and functional elements, but also to organizational patterns that occur with behavior and learning.2424 Polich J, Ladish C, Burns T. Normal variation of P300 in children: age, memory span, and head size. Int J Psychophysiol 1990;9(3):237-248 Normal variation results from the association between age and cognitive maturity.33 McPherson DL. Late potentials of the auditory system. San Diego: Singular Publishing Group, Inc.; 1996 2424 Polich J, Ladish C, Burns T. Normal variation of P300 in children: age, memory span, and head size. Int J Psychophysiol 1990;9(3):237-248 2525 Squires K, Goodin D, Starr A. Event-related potentials in development, aging and dementia. In: Lehman D, Callaway E, eds. Human evoked potentials. New York: Plenum Publishing Co; 1979 2626 Musiek FE. Probing brain function with acoustic stimuli. ASHA 1989;31(8):100-106, 55 There are also reports of sex and menstrual cycle interference.1919 Reis ACMB, Frizzo ACF, Lozano AC, Santos FR, Anastasio ART, Hyppolito MA. Variability of registration latency and amplitude of the auditory evoked potential long latency (P3) in the condition test and retest. Audiol. Communic Res 2014;19(3):293-298 2727 Machado CSS, Carvalho ACO, Silva PLG. Standard characterization of P300 in young adults. Rev Soc Bras Fonoaudiol. 2009;14(1):83-90

In light of the vast clinical applications of LLAEPs and the significant intra and interindividual variation, the test-retest stability of the P300 wave should be investigated.

Objective

The aim of the present study was to analyze test-retest (4–6 weeks apart) amplitude and latency variability of the P300 wave, using different auditory stimuli (pure tone and speech) in young adult women, without auditory processing disorders (APD).

Methods

The study was approved under protocol number 1376/11, and all participants gave their informed consent.

Participants

We selected the sample by convenience and was justified by the profile of students in the speech therapy course. Ten women, non-smoking, ranging in age between 17 and 30 years participated in the study.

As for some studies' conclusion that menstrual cycle and use of oral contraceptives do not affect the P300 wave or other ERP components,2828 Fleck KM, Polich J. P300 and the menstrual cycle. Electroencephalogr Clin Neurophysiol 1988;71(2):157-160 2929 Fagan PL, Church GT. Effect of the menstrual cycle on the auditory brainstem response. Audiology 1986;25(6):321-328 3030 Howard R, Mason P, Taghavi E, Spears G. Brainstem auditory evoked responses (BAERs) during the menstrual cycle in women with and without premenstrual syndrome. Biol Psychiatry 1992; 32(8):682-690 we decided against controlling this variable.

Inclusion criteria were having a normal peripheral auditory system and auditory processing. Exclusion criteria were the presence of hearing loss, history of neurological and/or cognitive disorders, and the use of drugs acting on the central nervous system. Subjects received orientation for testing of AEPs as follows: avoid taking tea, coffee, and chocolate in the preceding 24 hours.

Procedures

The individuals underwent a basic audiological assessment consisting of tonal audiometry, vocal audiometry, and imitanciometry. Next, auditory processing behavior was assessed as a diagnostic criterion and only individuals with no auditory processing disorders were included in the present study.

LLAEP- P300 was recorded with a two-channel Smart EP USB Jr system (Intelligent Hearing System, Miami, USA), in a quiet setting. We placed electrodes on the vertex (Cz) and on each side of the ear (A1 for the left ear and A2 for the right ear), with the ground electrode (Fpz) on the forehead, in accordance with the international 10–20 system.3131 Jasper HH. Report of the committee on methods of clinical examination in electroencephalography. Eletroenceph Clin Neurophysiol. 1958;10:370-375 We assessed the right and left ears separately, using ER-3A insert earphones. Skin was cleansed with gauze and abrasive paste. Surface electrodes were then placed over electrolytic paste (for optimizing electrical conductivity) and fixed with microporous adhesive tape. Accepted electrode impedance was up to five ohms, with a difference of up to two ohms between electrodes.

We used the following parameters to acquire P300: 300 monaural acoustic stimuli at frequencies of 1000 Hz for the frequent (85%) and 2000 Hz for the rare (15%), intensity of 75 dB SPL; recording window of 510 milliseconds; filter between 1 (high-pass) and 30 Hz (low-pass); speed presentation of 1.1 stimuli per second. Rare and frequent stimuli were randomly presented (oddball paradigm).77 Squires NK, Squires KC, Hillyard SA. Two varieties of long-latency positive waves evoked by unpredictable auditory stimuli in man. Electroencephalogr Clin Neurophysiol 1975;38(4):387-401 Individuals remained seated and were instructed to pay attention and count out loud the number of occurrences of the rare stimulus, and to avoid artifact contamination caused by eye movement, subjects were asked to keep their eyes fixed on a target.3232 Vaughan HG Jr, Ritter W. The sources of auditory evoked responses recorded from the human scalp. Electroencephalogr Clin Neurophysiol 1970;28(4):360-367 After we recorded P300 results with the pure tone, we elicited P300 by speech, using the same parameters. The /DA/ and /BA/ syllables were used for the rare and frequent acoustic stimulus, respectively.

We performed the analysis of P300 by waveform subtraction. The third waveform resulted from subtracting the frequent from the rare waveform, and we selected the wave with the highest positive peak after the N1-P2-N2 complex.55 Kraus N, McGee T. Potenciais auditivos de longa latência. In: Katz J. Tratado de audiologia clínica. São Paulo: Manole; 1999:403-20 2424 Polich J, Ladish C, Burns T. Normal variation of P300 in children: age, memory span, and head size. Int J Psychophysiol 1990;9(3):237-248 We marked the latency and amplitude of P300 on this curve. To obtain amplitude values of the P300 wave, the cursor was placed on the positive polarity wave (P300) as far as the negative polarity (N2). The latency reference values used were 225 to 365msec,33 McPherson DL. Late potentials of the auditory system. San Diego: Singular Publishing Group, Inc.; 1996 while those for amplitude ranged between 5 and 20 micro V.44 Hall JW. Handbook of auditory evoked responses. 3nd ed. Massachusetts (Boston): Allyn and Bacon; 1990

Statistical Analysis

Data obtained in descriptive analysis and presented in tabular form are expressed as mean, standard deviation, median, minimum, and maximum.

Pearson's coefficient of variation, a measure of relative dispersion used to estimate the accuracy of experiments, represents the standard deviation expressed in percentage of the mean. Inferential analysis involved the following methods: Intra-subject agreement regarding measures of latency and amplitude was assessed by the intraclass correlation coefficient (ICC),3333 Bartko JJ, Carpenter WT Jr. On the methods and theory of reliability. J Nerv Ment Dis 1976;163(5):307-317 and we analyzed the variation in these measures between stimuli (pure tone and speech) or between the left and right ears using the Wilcoxon signed-rank test.

We evaluated the normal distribution of latency and amplitude measures by the Shapiro-Wilks test. We adopted a 5% significance level, and processed the statistical analysis using SAS 6.11 software (SAS Institute, Inc., Cary, North Carolina).

Results

We studied latency (msec) and amplitude (μV) of the P300 wave in response to right and left ear stimulation for each variable (acoustic stimulus) and between sessions. We found no statistically significant differences between the right and left ears, in the electrophysiological assessment of AEP-P300. Thus, we grouped the ears (n= 20) for analyses.

Lower coefficient of variation values was found for latency, indicating that this is a more accurate measure, that is, with less response variability. The coefficient of variation of latency with speech stimulus was lower than that using pure tone (Table 1). The values obtained were similar at the two assessment sessions, with a lower mean for speech stimulus than pure tone. The variation in latency between pure tone and speech stimuli exhibited a descriptive level of p= 0.75 at test and p= 0.17 at retest, that is, no significant variation between assessments.

Table 1
Measures of P300 latency with pure tone and speech stimuli, at test and retest

Table 2 shows that measures of amplitude were similar between sessions, and that the mean values found for the pure tone stimulus were lower than those obtained for the speech stimulus. The coefficient of variation was more accurate using the speech than the pure tone stimulus. At the 5% level, there was a significant increase in amplitude using the speech stimulus compared with the pure tone, for p= 0.0003 at test and p= 0.004 at retest.

Table 2
Measures of P300 amplitude with pure tone and speech stimuli, at test and retest

The intraclass correlation coefficient (ICC) was used to determine intrasubject agreement on the test-retest with measures of latency and amplitude using pure tone and speech stimuli. Table 3 contains the intraclass correlation coefficient (ICC), its respective 95% confidence interval (CI) and p-value for the measures of latency and amplitude. A significance value of 1% was considered to obtain more robust interpretations.

Table 3
Intra-subject agreement in measures of latency and amplitude with pure tone and speech stimuli

There was statistical significance for intra-subject test-retest, in measures of latency and amplitude. Agreement for latency was moderate, using both auditory stimuli. For amplitude, agreement was excellent for pure tone and good for speech.

Figs. 1 and 2 illustrate the distribution of P300 amplitude and latency, for pure tone and speech stimuli between sessions.

Fig. 1
Box Plot Amplitudes.

Fig. 2
Box Plot Latencies.

Discussion

Normative data collected during the present study reflect that the P300 wave was significantly stable between sessions. The reliabilities found generally correspond well to those reported by others.

Ears were grouped (n= 20) since between the ears P300 latency and amplitude showed no statistically significant difference.

Mean latency of the P300 wave in the test-retest for the pure tone was 279.6msec and 287.3msec, respectively, and for the speech stimulus 276.7msec and 278.9msec. The mean values obtained were lower than in other studies with normal adults, all of which reported a mean of more than 300msec.1010 Sklare DA, Lynn GE. Latency of the P3 event-related potential: normative aspects andwithin-subject variability. Electroencephalogr Clin Neurophysiol 1984;59(5):420-424 1111 Polich J. Normal variation of P300 from auditory stimuli. Electroencephalogr Clin Neurophysiol 1986;65(3):236-240 1717 Walhovd KB, Fjell AM. One-year test-retest reliability of auditory ERPs in young and old adults. Int J Psychophysiol 2002;46(1): 29-40 1919 Reis ACMB, Frizzo ACF, Lozano AC, Santos FR, Anastasio ART, Hyppolito MA. Variability of registration latency and amplitude of the auditory evoked potential long latency (P3) in the condition test and retest. Audiol. Communic Res 2014;19(3):293-298 2727 Machado CSS, Carvalho ACO, Silva PLG. Standard characterization of P300 in young adults. Rev Soc Bras Fonoaudiol. 2009;14(1):83-90 3434 Schochat E, Matas CG, Samelli AG, Mamede Carvallo RM. From otoacoustic emission to late auditory potentials P300: the inhibitory effect. Acta Neurobiol Exp (Warsz) 2012;72(3):296-308 This disagreement may have occurred in the present study because auditory processing behavior was assessed, thereby reducing the interference of difficulties in the perceptual processing of auditory information in the nervous system.

The variation in latency was between 241msec and 327msec with the pure tone and 248msec and 324msec with speech. The values obtained are within the range proposed in the literature33 McPherson DL. Late potentials of the auditory system. San Diego: Singular Publishing Group, Inc.; 1996 for adolescents and adults (17 to 30 years). There was a slight increase in the general latency mean in the retest for both stimuli, which also occurred in another study that analyzed test-retest using the pure tone stimulus.1919 Reis ACMB, Frizzo ACF, Lozano AC, Santos FR, Anastasio ART, Hyppolito MA. Variability of registration latency and amplitude of the auditory evoked potential long latency (P3) in the condition test and retest. Audiol. Communic Res 2014;19(3):293-298 The results suggest that there was no learning effect in the second assessment, the task did not become easier, and non-auditory factors such as attention and lack of motivation may have influenced the response. These data disagree with several findings that showed a slight decline in latency in the second assessment.1010 Sklare DA, Lynn GE. Latency of the P3 event-related potential: normative aspects andwithin-subject variability. Electroencephalogr Clin Neurophysiol 1984;59(5):420-424 1212 Kileny PR, Kripal JP. Test-retest variability of auditory eventrelated potentials. Ear Hear 1987;8(2):110-114 1414 Kinoshita S, Maeda H, Nakamura J, Kodama E, Morita K. Reliability of the probability effect on event-related potentials during repeated testing. Kurume Med J 1995;42(4):199-210 1717 Walhovd KB, Fjell AM. One-year test-retest reliability of auditory ERPs in young and old adults. Int J Psychophysiol 2002;46(1): 29-40 The authors put forward several factors to explain the changes observed, such as the learning effect or a decrease in task difficulty due to previous experience, reduced anxiety, and greater fatigue control.1010 Sklare DA, Lynn GE. Latency of the P3 event-related potential: normative aspects andwithin-subject variability. Electroencephalogr Clin Neurophysiol 1984;59(5):420-424 1212 Kileny PR, Kripal JP. Test-retest variability of auditory eventrelated potentials. Ear Hear 1987;8(2):110-114

Pure tone amplitude exhibited mean values of 9.8µV and 9.3µV in the test-retest, respectively, with a minimum value of 3.0µV and maximum of 25.8µV. For the speech stimulus the means were 13.8µV (test) and 13.4µV (retest), with a minimum of 5.9µV and maximum of 23.8µV. The minimum and maximum amplitude values obtained in the sample are outside the ranges between 10 and 20µV22 Musiek FE, Baran JA, Pinheiro ML. Neuro-Audiology: Case Studies. San Diego: Singular Publishing Company; 1994:20-21 and between 5 and 20µV44 Hall JW. Handbook of auditory evoked responses. 3nd ed. Massachusetts (Boston): Allyn and Bacon; 1990 suggested in the literature. However, they agree with another study2727 Machado CSS, Carvalho ACO, Silva PLG. Standard characterization of P300 in young adults. Rev Soc Bras Fonoaudiol. 2009;14(1):83-90 that used a pure tone stimulus to assess adult women, where amplitude ranges were between 3.24µV and 24.9µV. This greater variability in responses may be due to interference from the menstrual cycle, which was not controlled in the present study and, according to the authors, can influence amplitude values.1919 Reis ACMB, Frizzo ACF, Lozano AC, Santos FR, Anastasio ART, Hyppolito MA. Variability of registration latency and amplitude of the auditory evoked potential long latency (P3) in the condition test and retest. Audiol. Communic Res 2014;19(3):293-298 2727 Machado CSS, Carvalho ACO, Silva PLG. Standard characterization of P300 in young adults. Rev Soc Bras Fonoaudiol. 2009;14(1):83-90

The auditory stimuli used exhibited a statistically significant difference in response values, with higher speech amplitudes. Test-retest analysis showed no statistical difference between-session, indicating that the wave exhibited no habituation process.1414 Kinoshita S, Maeda H, Nakamura J, Kodama E, Morita K. Reliability of the probability effect on event-related potentials during repeated testing. Kurume Med J 1995;42(4):199-210 The physiology of the P300 wave is controversial, but there are literature reports that P300 amplitude is correlated with the number of neural sources that the attention system needs to perform the task, and can be used to infer the difficulty in detecting and discriminating the stimulus.3535 Polich J. Task difficulty, probability, and inter-stimulus interval as determinants of P300 from auditory stimuli. Electroencephalogr Clin Neurophysiol 1987;68(4):311-320 3636 Kok A. On the utility of P3 amplitude as a measure of processing capacity. Psychophysiology 2001;38(3):557-577 In relation to task difficulty, it is suggested that amplitudes be higher for easier discrimination tasks, and lower for more difficult tasks. Likewise, latency declines when the discrimination task is easier and rises for more difficult tasks.3535 Polich J. Task difficulty, probability, and inter-stimulus interval as determinants of P300 from auditory stimuli. Electroencephalogr Clin Neurophysiol 1987;68(4):311-320

The data show that the speech stimulus generates a more robust response than a pure tone. Following the assumption of task complexity, this study exhibited greater facility with speech stimulus, showing lower latencies and higher amplitudes for the P300 wave. Our findings corroborate those of authors3737 Lew HL, Slimp J, Price R, Massagli TL, Robinson LR. Comparison of speech-evoked v tone-evoked P300 response: implications for predicting outcomes in patients with traumatic brain injury. Am J Phys Med Rehabil 1999;78(4):367-371 that compared nonverbal and verbal stimuli. They used one word (mommy) as rare stimulus and a 1000 Hz tone as frequent stimulus. There was no statistically significant difference for P300 latency and P300 amplitudes were higher with verbal stimulus, with a statistically significant difference. These results differ from those of another study3838 Massa CG, Rabelo CM,Matas CG, Schochat E, Samelli AG. P300with verbal and nonverbal stimuli in normal hearing adults. Braz J Otorhinolaryngol 2011;77(6):686-690 showing a statistically significant difference with higher latency and lower P300 amplitude, when the verbal stimulus is used.

The use of speech stimulus showed a lower SD for both test sessions, as well as lower coefficient of variation values when compared with pure tones. These data suggest that the speech stimulus exhibits lower response variability for the P300 wave. Since most studies performed with LLAEP prioritized the use of nonverbal (pure tones) stimulus to capture the P300 wave, it is important that further studies be conducted to compare how these stimuli are processed by the nervous system, thereby contributing to understanding the different changes that can involve the auditory system.

The AEP-P300 indicated stable latency and amplitude measures on the test-retest, with statistically significant agreement. Reliability of P300 amplitude was higher than latency in the present study, as well as in earlier investigations.1010 Sklare DA, Lynn GE. Latency of the P3 event-related potential: normative aspects andwithin-subject variability. Electroencephalogr Clin Neurophysiol 1984;59(5):420-424 1111 Polich J. Normal variation of P300 from auditory stimuli. Electroencephalogr Clin Neurophysiol 1986;65(3):236-240 1414 Kinoshita S, Maeda H, Nakamura J, Kodama E, Morita K. Reliability of the probability effect on event-related potentials during repeated testing. Kurume Med J 1995;42(4):199-210 1515 Kinoshita S, Inoue M, Maeda H, Nakamura J, Morita K. Long-term patterns of change in ERPs across repeated measurements. Physiol Behav 1996;60(4):1087-1092 1717 Walhovd KB, Fjell AM. One-year test-retest reliability of auditory ERPs in young and old adults. Int J Psychophysiol 2002;46(1): 29-40 P300 reliability was assessed in other studies and considered satisfactory at different time intervals, such as intrasession,1313 Segalowitz SJ, Barnes KL. The reliability of ERP components in the auditory oddball paradigm. Psychophysiology 1993;30(5): 451-459 1414 Kinoshita S, Maeda H, Nakamura J, Kodama E, Morita K. Reliability of the probability effect on event-related potentials during repeated testing. Kurume Med J 1995;42(4):199-210 1515 Kinoshita S, Inoue M, Maeda H, Nakamura J, Morita K. Long-term patterns of change in ERPs across repeated measurements. Physiol Behav 1996;60(4):1087-1092 days,1010 Sklare DA, Lynn GE. Latency of the P3 event-related potential: normative aspects andwithin-subject variability. Electroencephalogr Clin Neurophysiol 1984;59(5):420-424 1414 Kinoshita S, Maeda H, Nakamura J, Kodama E, Morita K. Reliability of the probability effect on event-related potentials during repeated testing. Kurume Med J 1995;42(4):199-210 1515 Kinoshita S, Inoue M, Maeda H, Nakamura J, Morita K. Long-term patterns of change in ERPs across repeated measurements. Physiol Behav 1996;60(4):1087-1092 months,1414 Kinoshita S, Maeda H, Nakamura J, Kodama E, Morita K. Reliability of the probability effect on event-related potentials during repeated testing. Kurume Med J 1995;42(4):199-210 and years.1313 Segalowitz SJ, Barnes KL. The reliability of ERP components in the auditory oddball paradigm. Psychophysiology 1993;30(5): 451-459 1616 Sandman CA, Patterson JV. The auditory event-related potential is a stable and reliable measure in elderly subjects over a 3 year period. Clin Neurophysiol 2000;111(8):1427-1437 1717 Walhovd KB, Fjell AM. One-year test-retest reliability of auditory ERPs in young and old adults. Int J Psychophysiol 2002;46(1): 29-40 The results indicate that P300 amplitude, calculated based on the difference between waves, is a stable marker for assessment between sessions, with better reproducibility for the pure tone stimulus. The greater reliability and methodological advantages of amplitude in relation to latency should encourage future efforts to clarify its functional significance.

Several studies1111 Polich J. Normal variation of P300 from auditory stimuli. Electroencephalogr Clin Neurophysiol 1986;65(3):236-240 1313 Segalowitz SJ, Barnes KL. The reliability of ERP components in the auditory oddball paradigm. Psychophysiology 1993;30(5): 451-459 1414 Kinoshita S, Maeda H, Nakamura J, Kodama E, Morita K. Reliability of the probability effect on event-related potentials during repeated testing. Kurume Med J 1995;42(4):199-210 1515 Kinoshita S, Inoue M, Maeda H, Nakamura J, Morita K. Long-term patterns of change in ERPs across repeated measurements. Physiol Behav 1996;60(4):1087-1092 1717 Walhovd KB, Fjell AM. One-year test-retest reliability of auditory ERPs in young and old adults. Int J Psychophysiol 2002;46(1): 29-40 have investigated P300 reliability, using the auditory oddball paradigm, with recordings at the Cz site, and reported intersession reliability (Pearson's correlation coefficient) for P300 latency ranging from 0.48 to 0.73, and amplitude between 0.51 and 0.62.1313 Segalowitz SJ, Barnes KL. The reliability of ERP components in the auditory oddball paradigm. Psychophysiology 1993;30(5): 451-459 1414 Kinoshita S, Maeda H, Nakamura J, Kodama E, Morita K. Reliability of the probability effect on event-related potentials during repeated testing. Kurume Med J 1995;42(4):199-210 1515 Kinoshita S, Inoue M, Maeda H, Nakamura J, Morita K. Long-term patterns of change in ERPs across repeated measurements. Physiol Behav 1996;60(4):1087-1092 1717 Walhovd KB, Fjell AM. One-year test-retest reliability of auditory ERPs in young and old adults. Int J Psychophysiol 2002;46(1): 29-40 Studies that conduct a retest at the same session, with recordings at Cz, obtained values ranging between 0.43 and 0.93 for latency1010 Sklare DA, Lynn GE. Latency of the P3 event-related potential: normative aspects andwithin-subject variability. Electroencephalogr Clin Neurophysiol 1984;59(5):420-424 1111 Polich J. Normal variation of P300 from auditory stimuli. Electroencephalogr Clin Neurophysiol 1986;65(3):236-240 1313 Segalowitz SJ, Barnes KL. The reliability of ERP components in the auditory oddball paradigm. Psychophysiology 1993;30(5): 451-459 1414 Kinoshita S, Maeda H, Nakamura J, Kodama E, Morita K. Reliability of the probability effect on event-related potentials during repeated testing. Kurume Med J 1995;42(4):199-210 1515 Kinoshita S, Inoue M, Maeda H, Nakamura J, Morita K. Long-term patterns of change in ERPs across repeated measurements. Physiol Behav 1996;60(4):1087-1092 1717 Walhovd KB, Fjell AM. One-year test-retest reliability of auditory ERPs in young and old adults. Int J Psychophysiol 2002;46(1): 29-40 and 0.50 and 0.89 for amplitude.1111 Polich J. Normal variation of P300 from auditory stimuli. Electroencephalogr Clin Neurophysiol 1986;65(3):236-240 1313 Segalowitz SJ, Barnes KL. The reliability of ERP components in the auditory oddball paradigm. Psychophysiology 1993;30(5): 451-459 1414 Kinoshita S, Maeda H, Nakamura J, Kodama E, Morita K. Reliability of the probability effect on event-related potentials during repeated testing. Kurume Med J 1995;42(4):199-210 1515 Kinoshita S, Inoue M, Maeda H, Nakamura J, Morita K. Long-term patterns of change in ERPs across repeated measurements. Physiol Behav 1996;60(4):1087-1092 1717 Walhovd KB, Fjell AM. One-year test-retest reliability of auditory ERPs in young and old adults. Int J Psychophysiol 2002;46(1): 29-40 For young adults, studies have shown satisfactory correlation for the retest at the same session or with intervals. However, correlations were slightly higher when they were retested at the same session than with intervals of years. It is believed that when participants return to a new session after a period of time, they may be in another state, that is, more or less tired, alert, healthy, among others, which suggests lower correlation with higher time intervals.1717 Walhovd KB, Fjell AM. One-year test-retest reliability of auditory ERPs in young and old adults. Int J Psychophysiol 2002;46(1): 29-40

The correlation coefficients for latency using both auditory stimuli in the present study are within the range reported in the literature,1515 Kinoshita S, Inoue M, Maeda H, Nakamura J, Morita K. Long-term patterns of change in ERPs across repeated measurements. Physiol Behav 1996;60(4):1087-1092 indicating moderate agreement. For analysis of amplitude, agreement was excellent for pure tones and good for speech. This study obtained high response reproducibility, confirming that the P300 wave is a reliable measure, with significant stability in repetition measures, as well as for observing differences caused by physiological changes.1010 Sklare DA, Lynn GE. Latency of the P3 event-related potential: normative aspects andwithin-subject variability. Electroencephalogr Clin Neurophysiol 1984;59(5):420-424 These findings are in agreement with the literature, which indicates good reliability in P300 measures, in normal young adults, when test-retest is conducted, and favor its application for the study of normal and altered cognitive processes.

Conclusion

In conclusion, the present study provided data indicating more robust amplitude responses for the speech stimulus when compared with pure tones, with a statistically significant difference. The LLAEP-P300 exhibited stability in latency and amplitude measures when the test-retest is applied, and statistically significant agreement. Amplitude reliability was higher than that of latency, with excellent agreement when the pure tone stimulus was used.

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Publication Dates

  • Publication in this collection
    Apr-Jun 2017

History

  • Received
    16 Mar 2016
  • Accepted
    28 Mar 2016
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