Influence of primary frequencies ratio on distortion product otoacoustic emissions amplitude. II. Interrelations between multicomponent DPOAEs, tone-burst-evoked OAEs, and spontaneous OAEs

Distortion product otoacoustic emissions (DPOAEs) are used widely in humans to assess cochlear function. It is well known that 2f1-f2 DPOAE amplitude increases as the f2/f1 ratio increases from 1.0 to about 1.20, and then decreases as the f2/f1 ratio increases above 1.20, showing an amplitude ratio function, which is thought to be related to cochlear filtering properties. Different lower sideband DPOAEs are believed to show the same amplitude ratio functions as the 2f1-f2 DPOAE, with a magnitude peak situated at a constant DPOAE frequency relative to f2. More recently, several studies have suggested the involvement of a DPOAE component coming from its own distortion product place as well as the DPOAE component coming from the f2 place. To investigate DPOAE generation sites and the importance of the DPOAE frequency place, amplitude ratio functions of 2f1-f2, 3f1-2f2, 4f1-3f2 and 2f2-f1, 3f2-2f1, 4f2-3f1 DPOAE components have been systematically studied in 18 normally hearing subjects, using an f2 fixed, f1 sweep method, and an f1 fixed, f2 sweep method, at ten different f2 frequencies. Results show a dependency of the distortion magnitude peak on f2 frequency for each lower sideband DPOAE, and a small frequency shift of the distortion peak for the high order lower sideband DPOAE components. Strong correlation between the different lower sideband DPOAE amplitude were obtained, whether they were recorded with the same f1 (and a different f2) or with the same f2 (and a different f1), suggesting that lower side-band DPOAE amplitude does not depend on small variations in the f2 frequency. Moreover, correlations between DPOAE amplitude and tone-burst evoked otoacoustic emissions (TBOAEs) are highly significant for TBOAEs centered at the f2 frequency and at 1/2 octave below the f2 frequency, suggesting some degree of importance of the cochlear status at frequencies below f2 in DPOAE amplitude. Subjects presenting spontaneous otoacoustic emissions showed a greater lower sideband DPOAE amplitude recorded for low f2/f1 ratios, and a distortion magnitude peak shifted towards higher frequencies. The best correlation between upper sideband DPOAE amplitude and lower sideband DPOAE amplitude occurred for lower sideband DPOAEs generated by an f2 frequency 1/2 octave to 1 octave below the primaries used to generate upper sideband DPOAEs, suggesting a site of generation basal to f2 for the upper sideband DPOAEs. Correlations between TBOAE amplitude and upper sideband DPOAE amplitude agreed with a site of upper sideband DPOAE generation basal to f2, and which would move with the DPOAE frequency itself.     

Mechanisms of generation of the 2f2-f1 distortion product otoacoustic emission in humans

The 2f1-f2 distortion product otoacoustic emission (DPOAE) is considered to consist of two components in normally hearing ears, one having constant phase with changing DP frequency (wave fixed) and one having an increasing phase lag with increasing frequency (place fixed). The aim was to identify the wave-fixed and place-fixed components of both 2f1-f2 and 2f2-f1 DPs, and, in particular, to show whether a wave-fixed 2f2-f1 DP exists in normally hearing adults. DPOAE recordings were made in 20 ears of normally hearing young adults. Four frequency ratios were used and recording entailed fixed frequency-ratio sweeps. A separation into wave-fixed and place-fixed components was carried out using a time-window separation method. A method for estimating the noise floor after data processing was developed. Results confirmed the presence of wave-fixed and place-fixed components for 2f1-f2, consistent with previous studies. Both components were also present for 2f2-f1 in virtually all subjects. This latter finding conflicts with current models of DPOAE generation, and so a modified model is proposed. Unlike the 2f1-f2 emission, which has a wave-fixed component that is strongly dependent on the frequency ratio, neither component of the 2f2-f1 emission showed such a dependence. The proposed model explains these findings in terms of the overlap of the primary frequency traveling waves.     

Amplitude and phase of distortion product otoacoustic emissions in the guinea pig in an (f1 ,f2) area study

Lower sideband distortion product otoacoustic emissions (DPOAEs), measured in the ear canal upon stimulation with two continuous pure tones, are the result of interfering contributions from two different mechanisms, the nonlinear distortion component and the linear reflection component. The two contributors have been shown to have a different amplitude and, in particular, a different phase behavior as a function of the stimulus frequencies. The dominance of either component was investigated in an extensive (f1 ,f2) area study of DPOAE amplitude and phase in the guinea pig, which allows for both qualitative and quantitative analysis of isophase contours. Making a minimum of additional assumptions, simple relations between the direction of constant phase in the (f ,f2) plane and the group delays in f1-sweep, f2-sweep, and fixed f2/f1 paradigms can be derived, both for distortion (wave-fixed) and reflection (place-fixed) components. The experimental data indicate the presence of both components in the lower sideband DPOAEs, with the reflection component as the dominant contributor for low f2/f1 ratios and the distortion component for intermediate ratios. At high ratios the behavior cannot be explained by dominance of either component.     

Characterizing distortion-product otoacoustic emission components across four species

Distortion-product otoacoustic emissions (DPOAEs) were measured as level/phase (L/P) maps in humans, rabbits, chinchillas, and rats with and without an interference tone (IT) placed either near the 2f(1)-f(2) DPOAE frequency place (f(dp)) or at one-third of an octave above the f(2) primary tone (1/3-oct IT). Vector differences between with and without IT conditions were computed to derive a residual composed of the DPOAE components removed by the IT. In humans, a DPOAE component could be extracted with the expected steep phase gradient indicative of reflection emissions by ITs near f(dp). In the laboratory species, ITs near f(dp) failed to produce any conclusive evidence for reflection components. For all species, 1/3-oct ITs extracted large DPOAE components presumably generated at or basal to the IT-frequency place that exhibited both distortion- and reflection-like phase properties. Together, these findings suggested that basal distortion components could assume reflection-like phase behavior when the assumptions of cochlear-scaling symmetry, the basis for shallow phase gradients for constant f(2)/f(1) ratio sweeps, are violated. The present results contradict the common belief that DPOAE components associated with steep or shallow phase slopes are unique signatures for reflection emissions arising from f(dp) or distortion emissions generated near f(2), respectively.     

Sources of distortion product otoacoustic emissions revealed by suppression experiments and inverse fast Fourier transforms in normal ears.

Primary and secondary sources combine to produce the 2f1-f2 distortion product otoacoustic emission (DPOAE) measured in the ear canals of humans. DPOAEs were obtained in nine normal-hearing subjects using a fixed-f2 paradigm in which f1 was varied. The f2 was 2 or 4 kHz, and absolute and relative primary levels were varied. Data were obtained with and without a third tone (f3) placed 15.6 Hz below 2f1-f2. The level of f3 was varied in order to suppress the stimulus frequency otoacoustic emission (SFOAE) coming from the 2f1-f2 place. These data were converted from the complex frequency domain into an equivalent time representation using an inverse fast Fourier transform (IFFT). IFFTs of unsuppressed DPOAE data were characterized by two or more peaks. Relative amplitudes of these peaks depended on overall primary level and on primary-level differences. The suppressor eliminated later peaks, but early peaks remained relatively unaltered. Results are interpreted to mean that the DPOAE measured in humans includes components from the f2 place (intermodulation distortion) and DP place (in the form of a SFOAE). These findings build on previous work by providing evidence that multiple peaks in the IFFT are due to a secondary source at the DP place.     

Distortion product otoacoustic emissions and basilar membrane vibration in the 6-9 kHz region of sensitive chinchilla cochleae

Distortion product otoacoustic emissions (DPOAEs) and basilar membrane (BM) vibration were measured simultaneously in the 6-9 kHz region of chinchilla cochleae. BM-Input-Output functions in a two-tone paradigm behaved similarly to DPOAEs for the 2f1-f2 component, nonmonotonic growth with the intensity of the lower frequency primary and a notch in the functions around 60 dB SPL. Ripples in frequency functions occur in both BM and OAE curves as a function of the distortion frequency. Optimum f2/f1 ratios for DPOAE generation are near 1.2. The slope of phase curves indicates that for low f2f1(<1.1) the emission source is the place location while for f2f1>1.1 the relative constancy of the phase function suggests that the place is the nonlinear region of f2, i.e., the wave location. Magnitudes of the DPOAEs increase rapidly above 60 dB SPL suggesting a different source or mechanism at high levels. This is supported by the observation that the high level DPOAE and BM-DP responses remain for a considerable period postmortem.     

Multiple internal reflections in the cochlea and their effect on DPOAE fine structure

In recent years, evidence has accumulated in support of a two-source model of distortion product otoacoustic emissions (DPOAEs). According to such models DPOAEs recorded in the ear canal are associated with two separate sources of cochlear origin. It is the interference between the contributions from the two sources that gives rise to the DPOAE fine structure (a pseudoperiodic change in DPOAE level or group delay with frequency). Multiple internal reflections between the base of the cochlea (oval window) and the DP tonotopic place can add additional significant components for certain stimulus conditions and thus modify the DPOAE fine structure. DPOAEs, at frequency increments between 4 and 8 Hz, were recorded at fixed f2/f1 ratios of 1.053, 1.065, 1.08, 1.11, 1.14, 1.18, 1.22, 1.26, 1.30, 1.32, 1.34, and 1.36 from four subjects. The resulting patterns of DPOAE amplitude and group delay (the negative of the slope of phase) revealed several previously unreported patterns in addition to the commonly reported log sine variation with frequency. These observed "exotic" patterns are predicted in computational simulations when multiple internal reflections are included. An inverse FFT algorithm was used to convert DPOAE data from the frequency to the "time" domain. Comparison of data in the time and frequency domains confirmed the occurrence of these "exotic" patterns in conjunction with the presence of multiple internal reflections. Multiple internal reflections were observed more commonly for high primary ratios (f2/f1 > or = 1.3). These results indicate that a full interpretation of the DPOAE level and phase (group delay) must include not only the two generation sources, but also multiple internal reflections.     

Evidence for the distortion product frequency place as a source of distortion product otoacoustic emission (DPOAE) fine structure in humans. I. Fine structure and higher-order DPOAE as a function of the frequency ratio f2/f1

Critical experiments were performed in order to validate the two-source hypothesis of distortion product otoacoustic emissions (DPOAE) generation. Measurements of the spectral fine structure of DPOAE in response to stimulation with two sinusoids have been performed with normal-hearing subjects. The dependence of fine-structure patterns on the frequency ratio f2/f1 was investigated by changing f1 or f2 only (fixed f2 or fixed f1 paradigm, respectively), and by changing both primaries at a fixed ratio and looking at different order DPOAE. When f2/f1 is varied in the fixed ratio paradigm, the patterns of 2 f1-f2 fine structure vary considerably more if plotted as a function of f2 than as a function of fDP. Different order distortion products located at the same characteristic place on the basilar membrane (BM) show similar patterns for both, the fixed-f2 and fDP paradigms. Fluctuations in DPOAE level up to 20 dB can be observed. In contrast, the results from a fixed-fDP paradigm do not show any fine structure but only an overall dependence of DP level on the frequency ratio, with a maximum for 2f1-f2 at f2/f1 close to 1.2. Similar stimulus configurations used in the experiments have also been used for computer simulations of DPOAE in a nonlinear and active model of the cochlea. Experimental results and model simulations give strong evidence for a two-source model of DPOAE generation: The first source is the initial nonlinear interaction of the primaries close to the f2 place. The second source is caused by coherent reflection from a re-emission site at the characteristic place of the distortion product frequency. The spectral fine structure of DPOAE observed in the ear canal reflects the interaction of both these sources.     

The effect of stimulus-frequency ratio on distortion product otoacoustic emission components

A detailed measurement of distortion product otoacoustic emission (DPOAE) fine structure was used to extract estimates of the two major components believed to contribute to the overall DPOAE level in the ear canal. A fixed-ratio paradigm was used to record DPOAE fine structure from three normal-hearing ears over a range of 400 Hz for 12 different stimulus-frequency ratios between 1.053 and 1.36 and stimulus levels between 45 and 75 dB SPL. Inverse Fourier transforms of the amplitude and phase data were filtered to extract the early component from the generator region of maximum stimulus overlap and the later component reflected from the characteristic frequency region of the DPOAE. After filtering, the data were returned to the frequency domain to evaluate the impact of the stimulus-frequency ratio and stimulus level on the relative levels of the components. Although there were significant differences between data from different ears some consistent patterns could be detected. The component from the overlap region of the stimulus tones exhibits a bandpass shape, with the maximum occurring at a ratio of 1.2. The mean data from the DPOAE characteristic frequency region also exhibits a bandpass shape but is less sharply tuned and exhibits greater variety across ears and stimulus levels. The component from the DPOAE characteristic frequency region is dominant at ratios narrower than approximately 1.1 (the transition varies between ears). The relative levels of the two components are highly variable at ratios greater than 1.3 and highly dependent on the stimulus level. The reflection component is larger at all ratios at the lowest stimulus level tested (45/45 dB SPL). We discuss the factors shaping DPOAE-component behavior and some cursory implications for the choice of stimulus parameters to be used in clinical protocols.     

Origin of the bell-like dependence of the DPOAE amplitude on primary frequency ratio.

For low and medium sound pressure levels (SPLs), the amplitude of the distortion product otoacoustic emission (DPOAE) recorded from guinea pigs at the 2f1-f2 frequency is maximal when f2/f1 approximately 1.23 and decreases for lower and higher f2/f1 ratios. The high-ratio slope of the DPOAE dependence on the ratio of the primary frequencies might be anticipated since the f1 amplitude at the f2 place is expected to decrease for higher f2/f1 ratios. The low-ratio slope of the dependence at low and medium SPLs of the primaries is actually one slope of a notch. The DPOAE amplitude recovers from the notch when the f2/f1 ratio is further reduced. In two-dimensional space formed by the f2/f1 ratio, and the levels of the primaries, the notch is continuous and has a level-dependent phase transition. The notch is identical to that seen in DPOAE growth functions. Similar notches and phase transitions were observed for high-order and high-frequency DPOAEs. Theoretical analysis reveals that a single saturating nonlinearity is capable of generating similar amplitude notch and phase transition when the f2/f1 ratio is decreased because of the increase in f1 amplitude at the DPOAE generation place (f2 place). The difference between the DPOAE recorded from guinea pigs and humans is discussed in terms of different position of the operating point of the DPOAE generating nonlinearity.     

Group delays of distortion product otoacoustic emissions: relating delays measured with f1- and f2-sweep paradigms

A theoretical analysis is presented of group delays of distortion product otoacoustic emissions (DPOAEs) measured with the phase-gradient method. The aim of the analysis is to clarify the differences in group delays D1 and D2, obtained using the f1- and the f2-sweep paradigms, respectively, and the dependence of group delays on the order of the DPOAE. Two models are considered, the place-fixed and the wave-fixed models. While in the former model the generation place is assumed to be invariant with both f1- and f2-sweeps, in the latter model the shift of generation place is fully accounted for. By making a simple local approximation of the cochlear scale invariance, a mathematical conversion from phase-place to phase-frequency gradients is incorporated in the wave-fixed model. Under the assumption that the DPOAE (as recorded at the best f2/f1 ratio) is dominated by the contribution from the generation site and not by, e.g., reflection components, the analysis leads to simple expressions for the ratio and difference between D1 and D2. Validation of the models against experimental data indicates that lower sideband DPOAEs (2f1-f2, 3f1-2f2, 4f1-3f2) are most consistent with the wave-fixed model. Upper sideband components (2f2-f1), in contrast, are not properly described by either the place-fixed or the wave-fixed model, independent whether DPOAE generation is assumed to originate at the f2 or at the more basally located f(dp) characteristic place.     

Evidence for the distortion product frequency place as a source of distortion product otoacoustic emission (DPOAE) fine structure in humans. II. Fine structure for different shapes of cochlear hearing loss

Distortion product otoacoustic emissions (DPOAE) were recorded from eight human subjects with mild to moderate cochlear hearing loss, using a frequency spacing of 48 primary pairs per octave and at a level L1 = L2 = 60 dBSPL and with a fixed ratio f2/f1. Subjects with different shapes of hearing thresholds were selected. They included subjects with near-normal hearing within only a limited frequency range, subjects with a notch in the audiogram, and subjects with a mild to moderate high-frequency loss. If the primaries were located in a region of normal or near-normal hearing, but DP frequencies were located in a region of raised thresholds, the distortion product 2 f1-f2 was still observable, but the DP fine structure disappeared. If the DP frequencies fell into a region of normal thresholds, fine structure was preserved as long as DPOAE were generated, even in cases of mild hearing loss in the region of the primaries. These experimental results give further strong evidence that, in addition to the initial source in the primary region, there is a second source at the characteristic place of fDP. Simulations in a nonlinear and active computer model for DPOAE generation indicate different generation mechanisms for the two components. The disappearance of DPOAE fine structure might serve as a more sensitive indicator of hearing impairment than the consideration of DP level alone.     

Distortion-product source unmixing: a test of the two-mechanism model for DPOAE generation

This paper tests key predictions of the "two-mechanism model" for the generation of distortion-product otoacoustic emissions (DPOAEs). The two-mechanism model asserts that lower-sideband DPOAEs constitute a mixture of emissions arising not simply from two distinct cochlear locations (as is now well established) but, more importantly, by two fundamentally different mechanisms: nonlinear distortion induced by the traveling wave and linear coherent reflection off pre-existing micromechanical impedance perturbations. The model predicts that (1) DPOAEs evoked by frequency-scaled stimuli (e.g., at fixed f2/f1) can be unmixed into putative distortion- and reflection-source components with the frequency dependence of their phases consistent with the presumed mechanisms of generation; (2) The putative reflection-source component of the total DPOAE closely matches the reflection-source emission (e.g., low level stimulus-frequency emission) measured at the same frequency under similar conditions. These predictions were tested by unmixing DPOAEs into components using two completely different methods: (a) selective suppression of the putative reflection source using a third tone near the distortion-product frequency and (b) spectral smoothing (or, equivalently, time-domain windowing). Although the two methods unmix in very different ways, they yield similar DPOAE components. The properties of the two DPOAE components are consistent with the predictions of the two-mechanism model.     

Breaking away: violation of distortion emission phase-frequency invariance at low frequencies

The phase versus frequency function of the distortion product otoacoustic emission (DPOAE) at 2f(1) - f(2) is approximately invariant at frequencies above 1.5 kHz in human subjects when recorded with a constant f(2)/f(1). However, a secular break from this invariance has been observed at lower frequencies where the phase-gradient becomes markedly steeper. Apical DPOAEs, such as 2f(1)?- f(2), are known to contain contributions from multiple sources. This experiment asked whether the phase behavior of the ear canal DPOAE at low frequencies is driven by the phase of the component from the distortion product (DP) region at 2f(1)?- f(2), which exhibits rapid phase accumulation. Placing a suppressor tone close in the frequency to 2f(1)?- f(2) reduced the contribution of this component to the ear canal DPOAE in normal-hearing adult human ears. When the contribution of this component was reduced, the phase behavior of the ear canal DPOAE was not altered, suggesting that the breaking from DPOAE phase invariance at low frequencies is an outcome of apical-basal differences in cochlear mechanics. The deviation from DPOAE phase invariance appears to be a manifestation of the breaking from approximate scaling symmetry in the human cochlear apex.     

Level dependence of distortion product otoacoustic emission phase is attributed to component mixing

Distortion product otoacoustic emissions (DPOAEs) measured in the ear canal represent the vector sum of components produced at two regions of the basilar membrane by distinct cochlear mechanisms. In this study, the effect of stimulus level on the 2f(1)?- f(2) DPOAE phase was evaluated in 22 adult subjects across a three-octave range. Level effects were examined for the mixed DPOAE signal measured in the ear canal and after unmixing components to assess level effects individually on the distortion (generated at the f(1), f(2) overlap) and reflection (at f(dp)) sources. Results show that ear canal DPOAE phase slope becomes steeper with decreasing level; however, component analysis further explicates this result, indicating that interference between DPOAE components (rather than a shift in mechanics related to distortion generation) drives the level dependence of DPOAE phase measured in the ear canal. The relative contribution from the reflection source increased with decreasing level, producing more component interference and, at times, a reflection-dominated response at the lowest stimulus levels. These results have implications for the use of DPOAE phase to study cochlear mechanics and for the potential application of DPOAE phase for clinical purposes.     

Distortion product otoacoustic emissions provide clues hearing mechanisms in the frog ear

2f1-f2 and 2 f2-f1 distortion product otoacoustic emissions (DPOAEs) were recorded from both ears of male and female Rana pipiens pipiens and Rana catesbeiana. The input-output (I/O) curves obtained from the amphibian papilla (AP) of both frog species are analogous to I/O curves recorded from mammals suggesting that, similarly to the mammalian cochlea, there may be an amplification process present in the frog AP. DPOAE level dependence on L1-L2 is different from that in mammals and consistent with intermodulation distortion expectations. Therefore, if a mechanical structure in the frog inner ear is functioning analogously to the mammalian basilar membrane, it must be more broadly tuned. DPOAE audiograms were obtained for primary frequencies spanning the animals' hearing range and selected stimulus levels. The results confirm that DPOAEs are produced in both papillae, with R. catesbeiana producing stronger emissions than R. p. pipiens. Consistent with previously reported sexual dimorphism in the mammalian and anuran auditory systems, females of both species produce stronger emissions than males. Moreover, it appears that 2 f1-f2 in the frog is generated primarily at the DPOAE frequency place, while 2 f2-f1 is generated primarily at a frequency place around the primaries. Regardless of generation place, both emissions within the AP may be subject to the same filtering mechanism, possibly the tectorial membrane.     

Modifications of a single saturating non-linearity account for post-onset changes in 2f1-f2 distortion product otoacoustic emission

2f1-f2 distortion product otoacoustic emissions (DPOAEs) were recorded from guinea pigs. DPOAEs showed complex time dependence at the onset of stimulation. The DPOAE, measured during the first 500 ms, can either decrease or increase at the onset depending on both the frequencies and levels of the primary tones. These changes are closely associated with amplitude minima (notches) of the DPOAE I/O functions. These notches are characteristic of DPOAE growth functions measured from guinea pigs for primary tones of 50-60-dB sound-pressure level (SPL). Apparent changes in the DPOAE amplitude occur because the notch shifts to higher levels of the primaries during the onset of stimulation. This shift of the notch to higher levels increases for lower f2/f1 ratios but does not exceed about 2 dB. DPOAE amplitude increases for a constant level of the primaries if the onset emission is situated at the low-level, falling slope of the notch. If the onset DPOAE is located on the high-level, rising slope of the notch, then the upward shift of the notch causes the emission either to decrease monotonically, or to decrease initially and then increase. By establishing that the 2f1-f2 onset changes reflect a shift in the growth-function notch, it is possible to predict the temporal behavior of DPOAEs in the two-dimensional space of the amplitude of the primaries and for their different frequency ratios.     

Group delays of distortion product otoacoustic emissions in the guinea pig.

This paper presents a comprehensive set of experimental data on group delays of distortion product otoacoustic emissions (DPOAEs) in the guinea pig. Group delays of the DPOAEs with frequencies 2f1-f2, 3f1-2f2, 4f1-3f2, and 2f2-f1 were measured with the phase gradient method. Both the f1- and the f2-sweep paradigm were used. Differences between the two sweep paradigms were investigated for the four DPOAEs, as well as the group delay differences between the DPOAEs. Analysis revealed larger group delays with the f2-sweep paradigm, but only for the lower sideband DPOAEs (with fdp < f1,f2). For the lower sideband cubic distortion product 2f1-f2, the f2-sweep delays were a factor of 1.17-1.54 larger than the f1-sweep delays, depending on frequency. The upper sideband DPOAE 2f2-f1 showed no significant difference between f1- and f2-sweep group delays, except for the highest and lowest f2 frequencies. Comparing the group delays of the DPOAEs for each sweep paradigm separately, equal group delays were found for all four DPOAEs measured with the f1-sweep. With the f2-sweep paradigm on the other hand, the group delays of the three lower sideband DPOAEs occurred to be larger than the group delays of the upper sideband DPOAE 2f2-f1. A tentative interpretation of the data in the context of proposed explanatory hypotheses on DPOAE group delays is given.     

Hybrid measurement of auditory steady-state responses and distortion product otoacoustic emissions using an amplitude-modulated primary tone

A maximum auditory steady-state response (ASSR) amplitude is yielded when the ASSR is elicited by an amplitude-modulated tone (f(c)) with a fixed modulation frequency (f(m) = 40 Hz), whereas the maximum distortion product otoacoustic emission (DPOAE) level is yielded when the DPOAE is elicited using a fixed frequency ratio of the primary tones (f2/f1 = 1.2). When eliciting the DPOAE and ASSR by the same tone pair, optimal stimulation is present for either DPOAE or ASSR and thus adequate simultaneous DPOAE/ASSR measurement is not possible across test frequency f2 or f(c), respectively. The purpose of the present study was to determine whether the ASSR and DPOAE can be measured simultaneously without notable restrictions using a DPOAE stimulus setting in which one primary tone is amplitude modulated. A DPOAE of frequency 2f1-f2 and ASSR of modulation frequency 41 Hz were measured in ten normal hearing subjects at a test frequency between 0.5 and 8 kHz (f2 = f(c)). The decrease in the DPOAE level and the loss in ASSR amplitude during hybrid mode stimulation amounted, on average, to only 2.60 dB [standard deviation (SD) = 1.38 dB] and 1.83 dB (SD = 2.38 dB), respectively. These findings suggest simultaneous DPOAE and ASSR measurements to be feasible across all test frequencies when using a DPOAE stimulus setting where the primary tone f2 is amplitude modulated.