"Auditory brainstem response latencies, but not amplitudes, are associated with gray matter volumes across the human auditory pathway in older adults"
Introduction: Auditory brainstem responses (ABRs) are routinely used to assess neural timing and function along the auditory pathway. In older adults, however, peripheral hearing loss, central auditory dysfunction, and broader structural changes in the brain may converge to shape the recorded response. Because ABR waves arise from multiple overlapping neural sources, how their electrophysiological features map onto specific auditory pathway structures in vivo remains poorly understood. Here, we examined the associations between cortical and subcortical gray matter volumes and the latencies and amplitudes of click evoked ABR Waves I and V in older adults. Methods: We evaluated 88 adults aged > 65 years from the Auditory and Dementia Study (ANDES) cohort. Click evoked ABRs were recorded at 80 dB nHL, and the latencies and amplitudes of Waves I and V were measured. High resolution 3T structural MRI data were processed using voxel based morphometry and standardized anatomical masks to estimate bilateral gray matter volumes of the cochlear nucleus, superior olivary complex, inferior colliculus, medial geniculate nucleus, and auditory cortex. Associations were assessed using partial correlations adjusted for age, pure tone hearing thresholds, and intracranial volume, as well as multivariate linear regression models. Results: ABR latencies, rather than amplitudes, showed significant associations with regional gray matter volumes. After adjustment for age, hearing thresholds, and intracranial volume, larger superior olivary complex volume was associated with shorter Wave I latency ({rho}partial = -0.305, p = 0.005), whereas larger medial geniculate nucleus and auditory cortex volumes were associated with shorter Wave V latency ({rho}partial = -0.265, p = 0.014 and {rho}partial = -0.404, p < 0.001, respectively). In multivariate models, superior olivary complex volume remained associated with Wave I latency ({beta} = -0.310, p = 0.007). Medial geniculate nucleus volume was initially associated with Wave V latency ({beta} = -0.247, p = 0.038); however, this relationship was attenuated once auditory cortex volume was included in the model ({beta} = -0.350, p = 0.002), which emerged as the dominant predictor. Inferior colliculus volume was not significantly associated with Wave V latency or amplitude. Conclusions: In older adults, ABR latencies showed selective associations with regional gray matter volumes, whereas amplitudes did not. These associations extended beyond the structures traditionally considered the main generators of Waves I and V, suggesting that interindividual variation in ABR latency may reflect distributed anatomical variation across the auditory pathway rather than a strict one-wave-one-generator correspondence.