Center for Health Policy and Research (CHPR) Publications


Assessment of auditory brainstem function in lead-exposed children using stapedius muscle reflexes

UMMS Affiliation

Department of Pediatrics; Shriver Center; Center for Health Policy and Research; Intellectual and Developmental Disabilities Research Center

Publication Date


Document Type



Acoustic Stimulation; Adolescent; Child; Child, Preschool; Ecuador; Environmental Exposure; Evoked Potentials, Auditory, Brain Stem; Female; Functional Laterality; Humans; Lead; Lead Poisoning; Male; Psychoacoustics; Reflex, Acoustic; Stapedius


Environmental Public Health | Medical Toxicology | Neuroscience and Neurobiology | Otolaryngology | Otorhinolaryngologic Diseases | Pharmacology, Toxicology and Environmental Health | Speech Pathology and Audiology


The purpose of this study was to investigate the neurological integrity and physiological status of the auditory brainstem tracts and nuclei in children with chronic lead (Pb) exposure using non-invasive acoustic stapedius reflex (ASR) measurements of afferent and efferent-neuromuscular auditory function. Following audiological examinations, uncrossed (ipsilateral) and crossed (contralateral) brainstem ASR responses were evoked by pure tone (500, 1000, and 2000 Hz), and broadband noise (bandwidth: 125-4000 Hz) stimulus activators. The ASR threshold (ASRT), amplitude growth, and decay/fatigue were measured by conventional clinical middle ear immittance methods in a group of Andean children (age range: 2-18 years) with a history of chronic environmental Pb exposure from occupational Pb glazing. Blood lead (PbB) levels of the study group (n=117) ranged from 4.0 to 83.7 mug/dL with a mean PbB level of 33.5 mug/dL (SD: 23.6; median: 33.0: CDC III Classification). The PbB distribution data indicated that 77.8% (n=91) of the children had PbB levels greater than the CDC action line of 10 mug/dL. Repeatable, normal ASRTs were elicited for ipsilateral (mean:

DOI of Published Version



Counter SA, Buchanan LH, Ortega F, van der Velde J, Borg E. Assessment of auditory brainstem function in lead-exposed children using stapedius muscle reflexes. J Neurol Sci. 2011 Jul 15;306(1-2):29-37. doi: 10.1016/j.jns.2011.04.003. Epub 2011 May 5. PubMed PMID: 21546039; PubMed Central PMCID: PMC3490493. Link to article on publisher's site

Journal/Book/Conference Title

Journal of the neurological sciences

Related Resources

Link to Article in PubMed