I want to know about the clinical implication of ACC. Thanking You!
The acoustic change complex (P1-N1-P2) is a cortical auditory evoked potential elicited in response to a change in an ongoing sound. So, it can be used for clinical assessment of speech perception capacity. ACC shows good agreement with behavioral measures of intensity discrimination (∼3 dB) and frequency discrimination (∼10 Hz). It differs from From MMN where ACC is elicited by an acoustic change within a sound stimulus. For MMN, the response is elicited by an acoustic difference between different stimuli or stimulus patterns.
In my view, the so-called ACC is simply a P1-N1-P2 complex (in adults) elicited to the second stimulus (the change stimulus) in a 2-stimulus sound. ALL P1-N1-P2 responses are CAEPs to a change in an "ongoing" sound. Under more-typical situations, the ongoing sound is the background silence or noise. However, there are many studies showing P1-N1-P2 response to a frequency change or intensity change, for example, in an ongoing tone.
The "ACC" paradigm is typically one where a change is introduced in the middle of an initial stimulus. Really not so different from the above, except that the "ongoing" sound, the initial stimulus, is a transient stimulus that also elicits a P1-N1-P2.
As for clinical applicability: The presence of an "ACC" response indicates the brain has the capacity (i.e., information) to detect the changed stimulus. This does not mean it actually detects (signals) that a change has occurred. The ABSENCE of an "ACC" response is not useful clinically. Thus, the clinical usefulness of the "ACC" is currently very limited.
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