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Ceylan S, Gümüşgün A, Kumbul YÇ, Feratlar F, Özcan Ulubeli P. Investigation of Pathogenesis and Otolithic Organ Responses in Sailors with Seasickness Using cVEMP. Indian J Otolaryngol Head Neck Surg 2024; 76:2690-2697. [PMID: 38883522 PMCID: PMC11169141 DOI: 10.1007/s12070-023-04472-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Accepted: 12/27/2023] [Indexed: 06/18/2024] Open
Abstract
There are different theories cited as the cause of Motion Sickness. Asymmetrical otolithic organ function is one of the etiology theories of motion sickness. In our study, the aim was to reveal whether there is a cause originating from the sacculocolic reflex pathway in the physiopathology of seasickness. The patient group included 15 man sailors with diagnosis of seasickness and the control group included 15 man sailors without seasickness in our study. Cervical evoked myogenic vestibular potential (cVEMP) findings were compared between the groups. In the right and left ears of sailors with seasickness, the mean latencies of the p13 and n23 waves at 100, 95, and 90 dB normal hearing level (nHL) levels were found significantly shorter than in the control group (p < 0.05, for all). In the seasickness group, cVEMP interaural wave amplitude asymmetry ratio at 100 nHL level were found significantly higher than the control group (p = 0.001). The findings of our study indicated that there may be reasons arising rom the sacculocolic reflex pathway in the pathophysiology of seasickness.
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Affiliation(s)
- Seval Ceylan
- Audiology Department, Izmir Tınaztepe University, Aydoğdu, 1267/,Streeet Number:4, 35400 Buca/Izmir, Turkey
| | - Atilla Gümüşgün
- Department of Otorhinololaryngology, Izmir Katip Çelebi University Atatürk Training and Research Hospital, Izmir, Turkey
| | - Yusuf Çağdaş Kumbul
- Department of Otorhinolaryngology, Faculty of Medicine, Suleyman Demirel University, Isparta, Turkey
| | - Ferhan Feratlar
- Department of Otorhinololaryngology, Izmir Katip Çelebi University Atatürk Training and Research Hospital, Izmir, Turkey
| | - Pelin Özcan Ulubeli
- Department of Speech and Language Therapy, Faculty of Health Sciences, Çukurova University, Adana, Turkey
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Hançer Arslan G, Arslan M, Aran OT, Özberk EH, Baydan Aran M. Effectiveness of the sternocleidomastoid muscle contraction asymmetry and filter: cervical vestibular evoked myogenic potential. J Laryngol Otol 2024; 138:410-415. [PMID: 37581001 DOI: 10.1017/s0022215123001366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/16/2023]
Abstract
OBJECTIVE This study aimed to determine the precautions that can be taken to increase the reliability of the vestibular evoked myogenic potentials test without being affected by the asymmetry of the sternocleidomastoid muscle and the issues that should be considered in the interpretation of vestibular evoked myogenic potential results if these precautions are not taken. METHOD Individuals with sternocleidomastoid muscle activity of less than 30 μV in cervical vestibular evoked myogenic potential testing and an asymmetry ratio of more than 0.35 were excluded. In our study, individuals were divided into different groups according to sternocleidomastoid muscle asymetry. RESULTS A total of 53 individuals were included in the study. Intergroup comparisons were made to determine the effect of electromyogram scaling and filter use on amplitude asymmetry ratio according to sternocleidomastoid muscle asymmetry. CONCLUSION Keeping the sternocleidomastoid muscle asymmetry not exceeding 10 μV maximises the reliability of cervical vestibular evoked myogenic potentials. As a result of our study, it can be concluded that in clinical applications the asymmetry should not exceed 20 μV.
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Affiliation(s)
- G Hançer Arslan
- Department of Audiometry, Vocational School of Health Services, Trakya University, Edirne, Turkey
| | - M Arslan
- Department of Audiology, Faculty of Health Sciences, Trakya University, Edirne, Turkey
| | - O T Aran
- Department of Occupational Therapy, Faculty of Health Sciences, Hacettepe University, Ankara, Turkey
| | - E H Özberk
- National Foundation for Educational Research, London, UK
| | - M Baydan Aran
- Department of Audiology, Faculty of Health Sciences, Ankara University, Ankara, Turkey
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Peng Y, Xiang M, Fan T, Zhong X, Dai A, Feng J, Guan P, Gong J, Li J, Wang Y. A Novel COCH p.D544Vfs*3 Variant Associated with DFNA9 Sensorineural Hearing Loss Causes Pathological Multimeric Cochlin Formation. Life (Basel) 2023; 14:33. [PMID: 38255649 PMCID: PMC10817332 DOI: 10.3390/life14010033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 12/16/2023] [Accepted: 12/19/2023] [Indexed: 01/24/2024] Open
Abstract
COCH (coagulation factor C homology) is one of the most frequently mutated genes of autosomal dominant non-syndromic hearing loss. Variants in COCH could cause DFNA9, which is characterized by late-onset hearing loss with variable degrees of vestibular dysfunction. In this study, we report a Chinese family with a novel COCH variant (c.1687delA) causing p.D544Vfs*3 in the cochlin. Comprehensive audiometric tests and vestibular function assessments were taken to acquire the phenotypic profile of the subjects. Next-generation sequencing was conducted and segregation analysis was carried out using Sanger sequencing. The proband presented mild vestibular symptoms and normal functional assessment results in almost every test, while the variant co-segregated with hearing impairment in the pedigree. The variant was located beyond the vWFA2 domain, which was predicted to affect the post-translational cleavage of the cochlin via molecular modeling analysis. Notably, in the overexpressing study, by transient transfecting the HEK 293T cells, we found that the p.D544Vfs*3 variant increased the formation of multimeric cochlin. Our result enriched the spectrum of DFNA9-linked pathological COCH variants and suggested that variants, causative of cochlin multimerization, could be related to DFNA9 with sensorineural hearing loss rather than serious vestibular symptoms.
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Affiliation(s)
- Yingqiu Peng
- ENT Institute and Department of Otorhinolaryngology, EYE & ENT Hospital, Fudan University, Shanghai 200031, China
- NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai 200031, China
| | - Mengya Xiang
- ENT Institute and Department of Otorhinolaryngology, EYE & ENT Hospital, Fudan University, Shanghai 200031, China
- NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai 200031, China
| | - Ting Fan
- ENT Institute and Department of Otorhinolaryngology, EYE & ENT Hospital, Fudan University, Shanghai 200031, China
- NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai 200031, China
| | - Xiaofang Zhong
- Clinical Laboratory Center, Children’s Hospital of Fudan University, Shanghai 201102, China
| | - Aqiang Dai
- ENT Institute and Department of Otorhinolaryngology, EYE & ENT Hospital, Fudan University, Shanghai 200031, China
| | - Jialing Feng
- ENT Institute and Department of Otorhinolaryngology, EYE & ENT Hospital, Fudan University, Shanghai 200031, China
| | - Pengfei Guan
- ENT Institute and Department of Otorhinolaryngology, EYE & ENT Hospital, Fudan University, Shanghai 200031, China
- NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai 200031, China
| | - Jiamin Gong
- ENT Institute and Department of Otorhinolaryngology, EYE & ENT Hospital, Fudan University, Shanghai 200031, China
| | - Jian Li
- Clinical Laboratory Center, Children’s Hospital of Fudan University, Shanghai 201102, China
| | - Yunfeng Wang
- ENT Institute and Department of Otorhinolaryngology, EYE & ENT Hospital, Fudan University, Shanghai 200031, China
- NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai 200031, China
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Lim VWM, Dela Roca Serafico II, Kek TL. Establishing cervical vestibular evoked myogenic potential (cVEMP) normative data in Singapore school-aged children. Int J Pediatr Otorhinolaryngol 2023; 172:111686. [PMID: 37517141 DOI: 10.1016/j.ijporl.2023.111686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Accepted: 07/20/2023] [Indexed: 08/01/2023]
Abstract
OBJECTIVES The Cervical Vestibular Evoked Myogenic Potential (cVEMP) is often employed in routine clinical practice as part of the vestibular test battery assessments. However, there is currently no well-established paediatric cVEMP normative data in Singapore. Additionally, limited literature has examined the relationship between neck length and cVEMP parameters. The main aims of this study are to 1) establish cVEMP normative data from Singaporean school-aged children aged 6-12 years old, and 2) examine if there is a significant correlation between neck length and cVEMP parameters. METHODS 31 healthy children participated in this study. Every participant was screened to ensure that they had normal auditory and vestibular profiles before completing the cVEMP procedure, which involved 500 Hz tone burst through insertphones and head elevation from supine position as the method of neck contraction. RESULTS The response rate in 62 ears was 98.4% at 95 dBnHL and 100% at 100 dBnHL. The mean P1 and N1 latencies were 13.96 ± 1.17 m s and 21.50 ± 1.66 m s, with a mean corrected P1-N1 amplitude of 0.88 ± 0.34, and mean asymmetry ratio of 13 ± 10%. Median threshold was 80 dBnHL. Significant positive correlation between neck length and both P1, N1 latencies, and significant negative correlation between neck length and corrected P1-N1 amplitude were observed. CONCLUSIONS cVEMP paediatric normative data has been established for Singaporean school-aged children. The study also confirmed that neck length did have a significant influence on both latencies and corrected amplitude.
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Affiliation(s)
- Vernice Wen Min Lim
- Audiology Program, Yong Loo Lin School of Medicine, National University of Singapore, Block MD 7, #03-12, 8 Medical Drive, 117596, Singapore
| | | | - Tze Ling Kek
- Otolaryngology - Head & Neck Surgery Department, National University Hospital, 119074, Singapore.
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Kunelskaya NL, Guseva AL, Manaenkova EA, Chugunova MA, Zaoeva ZO. [Vestibular evoked myogenic potentials in patients with recurrent benign paroxysmal positional vertigo]. Vestn Otorinolaringol 2023; 88:4-9. [PMID: 37184547 DOI: 10.17116/otorino2022880214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
Registration of ocular and cervical vestibular evoked myogenic potentials (oVEMPs and cVEMPs) reflects the function of otolith receptors: sacculus and utriculus. Benign paroxysmal positional vertigo (BPPV) is a disease of the inner ear as a result of the utriculus disfunction and migration of otoliths into semicircular channels. OBJECTIVE To study the function of otolith receptors (sacculus and utriculus) with using VEMPs registration in patients with first-time and recurrent posterior semicircular canal BPPV before and after repositional maneuvers. MATERIAL AND METHODS Registration and comparison of the results of oVEMPs and cVEMPs were performed in 50 patients with first-time posterior semicircular canal idiopathic BPPV and 26 patients with recurrent posterior semicircular canal BPPV before and after repositional treatment. RESULTS AND DISCUSSION Clinically significant asymmetry of the amplitude of oVEMPs before treatment was recorded in 14 (38%) of patients with first-time BPPV and in 15 (57.7%) of patients with recurrent BPPV; cVEMPs - in 6 (12%) of patients with first-time BPPV and in 6 (23.1%) of patients with recurrent BPPV. Successful repositional treatment did not affect the amplitude of cVEMPs in any of the groups of patients, but led to a significant increase in the amplitude of oVEMPs on the affected side in patients with first-time BPPV. In patients with recurrent BPPV, despite the absence of symptoms of otolithiasis, the asymmetry of the amplitude of oVEMPs persisted during remission (p<0.05), which can be considered as a prognostically unfavorable factor of disease recurrence.
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Affiliation(s)
- N L Kunelskaya
- Sverzhevky Research Clinical Institute of Otorhinolaryngology, Moscow, Russia
- Pirogov Russian National Research Medical University, Moscow, Russia
| | - A L Guseva
- Pirogov Russian National Research Medical University, Moscow, Russia
| | - E A Manaenkova
- Sverzhevky Research Clinical Institute of Otorhinolaryngology, Moscow, Russia
| | - M A Chugunova
- Sverzhevky Research Clinical Institute of Otorhinolaryngology, Moscow, Russia
| | - Z O Zaoeva
- Sverzhevky Research Clinical Institute of Otorhinolaryngology, Moscow, Russia
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Kumar L, Kairo A, Thakar A. Normative and Pathological Ranges of Cervical Vestibular Evoked Myogenic Potentials in Normal Subjects and Patients with Complete Compensated Unilateral Vestibular Loss: A Cross Sectional Study. Indian J Otolaryngol Head Neck Surg 2022; 74:4020-4027. [PMID: 36742940 PMCID: PMC9895149 DOI: 10.1007/s12070-021-02723-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Accepted: 06/27/2021] [Indexed: 02/07/2023] Open
Abstract
To know the normative ranges of VEMP response metrics in healthy young adults. To know the pathological cutoff of VEMP metrics in unilateral vestibular loss patients. To compare our VEMP metrics with the normative values of other studies from the western world. Prospective cross-sectional study. Tertiary care audiovestibular laboratory. 30 healthy subjects and 15 cases with a unilateral complete compensated loss. Various VEMP parameters-p1 latency, n1 latency, p1-n1 amplitude and Interaural asymmetry ratio (IAR) were entered into databases and analyzed. We compared our parameters with the most cited scientific data on VEMP available in the PubMed database, and we analyzed the results. 90% of controls and 80% of cases got VEMP responses at 95 dB HL threshold, 500 Hz with subject/patient placed in sitting upright with head turned to opposite side position. The normative data of VEMP response metrics in young adults for p1, n1 latencies, p1-n1 amplitude, and IAR are 13 ± 2 ms, 21 ± 2 ms, 91 ± 33 uV, and 9.25 ± 7.3, respectively. As the VEMP test has 100% sensitivity and 100% (95% CI 87-100%) negative predictive value in detecting the saccular dysfunction, we recommend the VEMP test as a mandatory tool in the vestibular test battery. There is no statistically significant difference in various VEMP parameters between the control and normal sides of the case group.
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Affiliation(s)
- Lokesh Kumar
- Departments of Otolaryngology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, 605010 India
| | - Arvind Kairo
- Department of Otolaryngology, All India Institute of Medical Sciences, New Delhi, 110029 India
| | - Alok Thakar
- Department of Otolaryngology, All India Institute of Medical Sciences, New Delhi, 110029 India
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Mat Q, Deggouj N, Duterme JP, Tainmont S, Lelubre C, Manto M. Using Narrow Band CE-Chirps to Elicit Cervical Vestibular Evoked Myogenic Potentials. Ear Hear 2021; 43:941-948. [PMID: 34611119 PMCID: PMC9007088 DOI: 10.1097/aud.0000000000001146] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Objectives: To compare the effects of Narrow band CE-Chirps (NB CE-Chirps) and tone bursts (TBs) at 500 Hz and 1000 Hz on the amplitudes and latencies in cervical vestibular evoked myogenic potentials (cVEMPs). Design: Thirty-one healthy adult volunteers of varying ages were tested by air conduction at 95 dB nHL. Recording conditions were randomized for each participant and each modality was tested twice. Results: NB CE-Chirps showed larger corrected amplitudes than TBs at 500 Hz (p < 0.001) which were themselves larger than NB CE-Chirps and TBs at 1000 Hz (p < 0.001). In older volunteers, NB CE-Chirps 500 and 1000 Hz had significantly higher response rates than TBs 500 Hz (p = 0.039). A negative correlation was observed between the corrected amplitudes and the age of the participants regardless of the stimulus and the frequency studied. The p13 and n23 latencies were not correlated with the age of the subjects. Conclusions: NB CE-Chirps at 500 Hz improved the corrected amplitudes of waveforms in cVEMPs as a result of a better frequency specificity compared with TBs. In the elderly, eliciting cVEMPs at a frequency of 1000 Hz might not be necessary to improve response rates with NB CE-Chirps. Additional studies including a higher number of healthy participants and patients with vestibular disorders are required to confirm these observations.
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Affiliation(s)
- Quentin Mat
- Department of Otorhinolaryngology, C.H.U. Charleroi, Charleroi, Belgium Faculty of Medicine and Pharmacy, University of Mons (UMons), Mons, Belgium Department of Otorhinolaryngology and Head and Neck Surgery, Cliniques Universitaires Saint-Luc, UCLouvain (UCL), Brussels, Belgium Department of Internal Medicine, C.H.U. Charleroi, Charleroi, Belgium Department of Neurology, Médiathèque Jean Jacquy, C.H.U. Charleroi, Charleroi, Belgium
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Nakul E, Bartolomei F, Lopez C. Vestibular-Evoked Cerebral Potentials. Front Neurol 2021; 12:674100. [PMID: 34621231 PMCID: PMC8490637 DOI: 10.3389/fneur.2021.674100] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Accepted: 08/20/2021] [Indexed: 11/30/2022] Open
Abstract
The human vestibular cortex has mostly been approached using functional magnetic resonance imaging and positron emission tomography combined with artificial stimulation of the vestibular receptors or nerve. Few studies have used electroencephalography and benefited from its high temporal resolution to describe the spatiotemporal dynamics of vestibular information processing from the first milliseconds following vestibular stimulation. Evoked potentials (EPs) are largely used to describe neural processing of other sensory signals, but they remain poorly developed and standardized in vestibular neuroscience and neuro-otology. Yet, vestibular EPs of brainstem, cerebellar, and cortical origin have been reported as early as the 1960s. This review article summarizes and compares results from studies that have used a large range of vestibular stimulation, including natural vestibular stimulation on rotating chairs and motion platforms, as well as artificial vestibular stimulation (e.g., sounds, impulsive acceleration stimulation, galvanic stimulation). These studies identified vestibular EPs with short latency (<20 ms), middle latency (from 20 to 50 ms), and late latency (>50 ms). Analysis of the generators (source analysis) of these responses offers new insights into the neuroimaging of the vestibular system. Generators were consistently found in the parieto-insular and temporo-parietal junction-the core of the vestibular cortex-as well as in the prefrontal and frontal areas, superior parietal, and temporal areas. We discuss the relevance of vestibular EPs for basic research and clinical neuroscience and highlight their limitations.
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Affiliation(s)
- Estelle Nakul
- Centre National de la Recherche Scientifique (CNRS), Laboratoire de Neurosciences Cognitives (LNC), FR3C, Aix Marseille Univ, Marseille, France
| | - Fabrice Bartolomei
- Institut de Neurosciences des Systèmes, Inserm, Aix Marseille Univ, Marseille, France
- Service de Neurophysiologie Clinique, Hôpital Timone, Aix Marseille Univ, Marseille, France
| | - Christophe Lopez
- Centre National de la Recherche Scientifique (CNRS), Laboratoire de Neurosciences Cognitives (LNC), FR3C, Aix Marseille Univ, Marseille, France
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Bayramoglu B, Emre U, Erdal Y, Demirhan H, Yasak I, Yalin OO. Cervical vestibular-evoked myogenic potentials in patients with essential tremor. J Clin Neurosci 2021; 91:365-368. [PMID: 34373053 DOI: 10.1016/j.jocn.2021.07.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 07/06/2021] [Accepted: 07/10/2021] [Indexed: 10/20/2022]
Abstract
Although different neuroanatomical structures and pathways are emphasized as possible explanations for essential tremor (ET), there is still an ongoing debate. This study aimed to assess the role of brainstem and reflex pathways with cervical vestibular-evoked myogenic potentials (VEMP) in patients with ET. This prospective study included 34 patients with ET and 25 healthy controls. Cervical VEMP was performed in both groups and latencies, inter-peak latency intervals, peak-to-peak amplitudes and asymmetry ratios were recorded. There was statistically no significant difference between the groups in terms of age (38.9 ± 14.9 years vs. 38.9 ± 14.9 years, p = 0.673) and gender (female to male ratio: 14/11 vs. 20/14, p = 0.828). Right N1 latency and right N1-P1 interval were significantly longer in the patient group (p < 0.05). There was a significant positive correlation between the duration of disease and the right N1-P1 interval (p < 0.05). There was no significant difference between the patient and control groups in terms of bilateral P1 latency, left N1 latency, left N1-P1 interval, and bilateral N1 and P1 amplitudes (p˃0.05). Cervical VEMP may reveal the involvement of brainstem and associated reflex pathways in ET.
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Affiliation(s)
- Banu Bayramoglu
- Health Sciences University, Bakirkoy Prof. Dr. Mazhar Osman Training and Research Hospital for Psychiatric and Neurologic Diseases, Neurology Department, Istanbul, Turkey.
| | - Ufuk Emre
- Health Sciences University, Istanbul Training and Research Hospital, Neurology Department, Istanbul, Turkey
| | - Yuksel Erdal
- Health Sciences University, Istanbul Training and Research Hospital, Neurology Department, Istanbul, Turkey
| | - Hasan Demirhan
- Istanbul Medipol University, Otorhinolaryngology Department, Istanbul, Turkey
| | - Ilknur Yasak
- Health Sciences University, Istanbul Training and Research Hospital, Neurology Department, Istanbul, Turkey
| | - Osman Ozgur Yalin
- Health Sciences University, Istanbul Training and Research Hospital, Neurology Department, Istanbul, Turkey
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Ahmad SA, Abdul Wahat NH, Zakaria MN, Wiener-Vacher SR, Abdullah NA. cVEMPs and oVEMPs normative data in Malaysian preschool and primary school-aged children. Int J Pediatr Otorhinolaryngol 2020; 135:110132. [PMID: 32502914 DOI: 10.1016/j.ijporl.2020.110132] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/01/2020] [Revised: 05/20/2020] [Accepted: 05/20/2020] [Indexed: 02/07/2023]
Abstract
OBJECTIVE Vestibular assessments in children are essential for the early identification of vestibular and balance dysfunctions. Vestibular evoked myogenic potentials, cervical (cVEMPs) and ocular (oVEMPs) have been reported to be feasible and effective when assessing otolith function in children. The main aim of the study was to obtain normative data for cVEMPs and oVEMPs from preschool and primary school-aged Malaysian children. METHODS A group of 33 healthy children, aged from 5 years 9 months-12 years 4 months (mean ± SD = 8.83 ± 1.92 years), was recruited. Their otolith saccular function was assessed using 750 Hz tone burst for cVEMPs (with ER3A insert phone), while their utricular function was assessed using Brüel & Kjaer Mini-shaker Type 4810 (Naerum, Denmark) for oVEMPs. RESULTS For cVEMPs, the mean value of P13 latency, N23 latency, P13-N23 interamplitude and asymmetry ratio were 12.62 ± 1.38 ms, 19.85 ± 1.95 ms, 92.47 ± 50.35 μV and 14.03 ± 9.75%, respectively. For oVEMPs, the mean value of N10 latency, P15 latency, N10-P15 interamplitude and asymmetry ratio were 9.23 ± 1.07 ms, 14.41 ± 1.04 ms, 10.32 ± 5.65 μV and 15.84 ± 11.49%, respectively. Two-way ANOVA analysis found that ear laterality and gender had no significant effect on all cVEMPs and oVEMPs parameters. No significant correlation was found between age and all VEMPs parameters. CONCLUSIONS The normative data for cVEMPs and oVEMPs obtained in this study can be used as a guide by health professionals to assess saccular and utricular functions among children age from 5 to 12 years of age.
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Affiliation(s)
- Siti Aisyah Ahmad
- Audiology Program, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, 50300, Kuala Lumpur, Malaysia
| | - Nor Haniza Abdul Wahat
- Audiology Program, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, 50300, Kuala Lumpur, Malaysia.
| | - Mohd Normani Zakaria
- Audiology and Speech Pathology Programme, School of Health Sciences, Universiti Sains Malaysia, 16150, Kubang Kerian, Kelantan, Malaysia
| | - Sylvette R Wiener-Vacher
- Center for Evaluation of Balance Disorders in Children (EFEE), Robert Debré University Hospital, Paris, France
| | - Nurul Ain Abdullah
- Audiology Unit, Hospital Sungai Buloh, 47000, Sungai Buloh, Selangor, Malaysia
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Birk R, Dietz M, Sommer JU, Stuck BA, Hörmann K, Rotter N, Maurer JT, Kramer B, Hülse R, Schell A. Nightly Hypoxia Does Not Seem to Lead to Otolith Dysfunction in Patients With Obstructive Sleep Apnea. EAR, NOSE & THROAT JOURNAL 2020; 100:667-672. [PMID: 32339052 DOI: 10.1177/0145561320922126] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVES Obstructive sleep apnea (OSA) is a common sleep disorder, which is associated with recurrent oxygen desaturation during sleep. It has already been shown that nocturnal hypoxia may lead to cochlear dysfunction in patients with OSA. Less is known whether hypoxia during sleep also impacts vestibular function in those patients. Thus, the aim of the presented study was to assess a potential vestibulotoxic effect of nightly desaturations with hypoxia in patients with OSA by investigating a possible correlation between respiratory parameters and vestibular function tests. METHODS A total of 56 patients were included in the study and underwent a fully attended cardiorespiratory polysomnography (PSG). Vestibular function was assessed using video head impulse test to evaluate horizontal semicircular canal function and cervical vestibular evoked myogenic potentials (cVEMPs) and ocular vestibular evoked myogenic potentials (oVEMPs) to measure otolith function. Descriptive data analysis was conducted and correlation analysis between selected PSG parameters and the results of vestibular testing was performed using Kendall τ coefficient. RESULTS A significant correlation between vestibular function and respiratory polysomnographic parameters could not be demonstrated in the study (P > .05) but cVEMP and oVEMP results showed a trend toward a correlation with oxygen desaturation indices and apnea-hypopnea index. Additionally, otolith hypofunction was more prevalent in patients with hypertension as well as OSA. CONCLUSION The results of our study show that there is no significant correlation between vestibular function and sleep apnea parameters, although otolith dysfunction might be more prevalent in patients with OSA and hypertension.
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Affiliation(s)
- Richard Birk
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Marburg, Philipps-Universität Marburg, Germany
| | - Miriam Dietz
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Mannheim, Germany
| | - Jörg Ulrich Sommer
- Department of Otorhinolaryngology, Head and Neck Surgery, Helios University Clinic Wuppertal, Germany
| | - Boris A Stuck
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Marburg, Philipps-Universität Marburg, Germany
| | - Karl Hörmann
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Mannheim, Germany
| | - Nicole Rotter
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Mannheim, Germany
| | - Joachim T Maurer
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Mannheim, Germany
| | - Benedikt Kramer
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Mannheim, Germany
| | - Roland Hülse
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Mannheim, Germany
| | - Angela Schell
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Mannheim, Germany
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Abstract
OBJECTIVES To determine the most effective method for normalizing cervical vestibular evoked myogenic potentials (cVEMPs). DESIGN cVEMP data from 20 subjects with normal hearing and vestibular function were normalized using 16 combinations of methods, each using one of the 4 modes of electromyogram (EMG) quantification described below. All methods used the peak to peak value of an averaged cVEMP waveform (VEMPpp) and obtained a normalized cVEMP by dividing VEMPpp by a measure of the EMG amplitude. EMG metrics were obtained from the EMG within short- and long-duration time windows. EMG amplitude was quantified by its root-mean-square (RMS) or average full-wave-rectified (RECT) value. The EMG amplitude was used by (a) dividing each individual trace by the EMG of this specific trace, (b) dividing VEMPpp by the average RMS or RECT of the individual trace EMG, (c) dividing the VEMPpp by an EMG metric obtained from the average cVEMP waveform, or (d) dividing the VEMPpp by an EMG metric obtained from an average cVEMP "noise" waveform. Normalization methods were compared by the normalized cVEMP coefficient of variation across subjects and by the area under the curve from a receiver-operating-characteristic analysis. A separate analysis of the effect of EMG-window duration was done. RESULTS There were large disparities in the results from different normalization methods. The best methods used EMG metrics from individual-trace EMG measurements, not from part of the average cVEMP waveform. EMG quantification by RMS or RECT produced similar results. For most EMG quantifications, longer window durations were better in producing receiver-operating-characteristic with high areas under the curve. However, even short window durations worked well when the EMG metric was calculated from the average RMS or RECT of the individual-trace EMGs. Calculating the EMG from a long-duration window of a cVEMP "noise" average waveform was almost as good as the individual-trace-EMG methods. CONCLUSIONS The best cVEMP normalizations use EMG quantification from individual-trace EMGs. To have the normalized cVEMPs accurately reflect the vestibular activation, a good normalization method needs to be used.
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Chen G, Zhao X, Yu G, Jian H, Li Y, Xu G. Otolith dysfunction in recurrent benign paroxysmal positional vertigo after mild traumatic brain injury. Acta Otolaryngol 2019; 139:18-21. [PMID: 30714506 DOI: 10.1080/00016489.2018.1562214] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
BACKGROUND The pathogenesis of recurrence of traumatic benign paroxysmal positional vertigo (BPPV) is poorly understood by far. OBJECTIVES To evaluate the value of secondary otolith dysfunction using vestibular evoked myogenic potential (VEMP) test in the pathogenesis of recurrence of BPPV after mild traumatic brain injury (mTBI). MATERIAL AND METHODS We reviewed 42 patients with BPPV after mTBI. According to recurrence, patients were divided into two groups. Both cervical VEMP (cVEMP) and ocular VEMP (oVEMP) tests were performed on all of them. RESULTS We detected abnormal cVEMP responses in four (26.7%) patients in the recurrent BPPV group after mTBI and five (18.5%) patients in the non-recurrent BPPV group after mTBI, and there was no significant difference between both groups. We detected abnormal oVMEP responses in nine (60.0%) patients in the recurrent BPPV group after mTBI and six (22.2%) patients in the non-recurrent BPPV group after mTBI, and there was a significant difference between both groups. CONCLUSIONS AND SIGNIFICANCE Our study shows that oVEMP abnormalities in recurrent BPPV group after mTBI are significantly higher than those in non-recurrent BPPV group after mTBI. Therefore, we can conclude that secondary utricular dysfunction may be a potential pathogenesis of recurrence of traumatic BPPV.
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Affiliation(s)
- Gang Chen
- Department of Otolaryngology – Head and Neck Surgery, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, China
| | - Xuening Zhao
- Department of Otolaryngology – Head and Neck Surgery, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, China
| | - Gang Yu
- Department of Otolaryngology – Head and Neck Surgery, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, China
| | - Huirong Jian
- Department of Otolaryngology – Head and Neck Surgery, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, China
| | - Yun Li
- Department of Otolaryngology – Head and Neck Surgery, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, China
| | - Guangming Xu
- Department of Neurosurgery, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, China
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Brix GS, Ovesen T, Devantier L. Vestibular evoked myogenic potential in healthy adolescents. Int J Pediatr Otorhinolaryngol 2019; 116:49-57. [PMID: 30554707 DOI: 10.1016/j.ijporl.2018.10.019] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2018] [Revised: 09/16/2018] [Accepted: 10/11/2018] [Indexed: 12/25/2022]
Abstract
OBJECTIVE Vestibular dysfunction, which may lead to delayed motor development and reduced quality of life, is an overlooked entity among children and adolescents. Vestibular evoked myogenic potential (VEMP) is a common, safe diagnostic tool in adults with vestibular disorders. No normative data exist for children and adolescents. Our objective was to collect and assess normative VEMP data for adolescents. METHODS Cervical VEMP (cVEMP) with air-conducted sound. Endpoints were peak latencies after 13 and 23 ms (P13 and N23) and amplitude. Ocular VEMP (oVEMP) with bone-conducted vibration on the mastoid. Endpoints were latencies (N10 and P15) and amplitude. A meta-analysis of existing cVEMP data in children. RESULTS cVEMP response rate (RR) was 85%, mean P13 and N23 latencies were 15.44 and 25.55 ms, respectively, and the asymmetry ratio (AR) was 14%. oVEMP RR was 100%, mean N10 and P15 were 10.61 and 16.58 ms, respectively, and the AR was 12%. In the meta-analysis, the pooled mean P13 and N23 were 12.75 and 21.8 ms, respectively. Head elevation (HE) gave shorter latencies than head rotation (HR). CONCLUSION The oVEMP data represents normal values for adolescents aged 13-16 years. Height should be considered more important than age when interpreting cVEMP in adolescents. Separate normative cVEMP data should be established for HE and HR.
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Affiliation(s)
- Gitte Stokvad Brix
- Department of Clinical Medicine, Aarhus University, Nørrebrogade 44, 8000, Aarhus C, Denmark.
| | - Therese Ovesen
- Department of Clinical Medicine, Aarhus University, Nørrebrogade 44, 8000, Aarhus C, Denmark; Department of Otorhinolaryngology, Region Hospital Holstebro, Lægårdvej 12, 7500, Holstebro, Denmark.
| | - Louise Devantier
- Department of Clinical Medicine, Aarhus University, Nørrebrogade 44, 8000, Aarhus C, Denmark; Department of Otorhinolaryngology, Region Hospital Holstebro, Lægårdvej 12, 7500, Holstebro, Denmark.
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Burns JC, Stone JS. Development and regeneration of vestibular hair cells in mammals. Semin Cell Dev Biol 2017; 65:96-105. [PMID: 27864084 PMCID: PMC5423856 DOI: 10.1016/j.semcdb.2016.11.001] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2016] [Accepted: 11/03/2016] [Indexed: 10/20/2022]
Abstract
Vestibular sensation is essential for gaze stabilization, balance, and perception of gravity. The vestibular receptors in mammals, Type I and Type II hair cells, are located in five small organs in the inner ear. Damage to hair cells and their innervating neurons can cause crippling symptoms such as vertigo, visual field oscillation, and imbalance. In adult rodents, some Type II hair cells are regenerated and become re-innervated after damage, presenting opportunities for restoring vestibular function after hair cell damage. This article reviews features of vestibular sensory cells in mammals, including their basic properties, how they develop, and how they are replaced after damage. We discuss molecules that control vestibular hair cell regeneration and highlight areas in which our understanding of development and regeneration needs to be deepened.
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Affiliation(s)
- Joseph C Burns
- Decibel Therapeutics, 215 First St., Suite 430, Cambridge, MA 02142, USA.
| | - Jennifer S Stone
- Department of Otolaryngology/Head and Neck Surgery and The Virginia Merrill Bloedel Hearing Research Center, University of Washington School of Medicine, Box 357923, Seattle, WA 98195-7923, USA.
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Macambira YKDS, Carnaúba ATL, Fernandes LCBC, Bueno NB, Menezes PDL. Aging and wave-component latency delays in oVEMP and cVEMP: a systematic review with meta-analysis. Braz J Otorhinolaryngol 2017; 83:475-487. [PMID: 28237301 PMCID: PMC9442875 DOI: 10.1016/j.bjorl.2016.12.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2016] [Revised: 11/30/2016] [Accepted: 12/07/2016] [Indexed: 10/26/2022] Open
Abstract
INTRODUCTION The natural aging process may result in morphological changes in the vestibular system and in the afferent neural pathway, including loss of hair cells, decreased numbers of vestibular nerve cells, and loss of neurons in the vestibular nucleus. Thus, with advancing age, there should be a decrease in amplitudes and an increase in latencies of the vestibular evoked myogenic potentials, especially the prolongation of p13 latency. Moreover, many investigations have found no significant differences in latencies with advancing age. OBJECTIVE To determine if there are significant differences in the latencies of cervical and ocular evoked myogenic potentials between elderly and adult patients. METHODS This is a systematic review with meta-analysis of observational studies, comparing the differences of these parameters between elderly and young adults, without language or date restrictions, in the following databases: Pubmed, ScienceDirect, SCOPUS, Web of Science, SciELO and LILACS, in addition to the gray literature databases: OpenGrey.eu and DissOnline, as well as Research Gate. RESULTS The n1 oVEMP latencies had a mean delay in the elderly of 2.32ms with 95% CI of 0.55-4.10ms. The overall effect test showed p=0.01, disclosing that such difference was significant. The heterogeneity found was I2=96% (p<0.001). Evaluation of p1 latency was not possible due to the low number of articles selected for this condition. cVEMP analysis was performed in 13 articles. For the p13 component, the mean latency delay in the elderly was 1.34ms with 95% CI of 0.56-2.11ms. The overall effect test showed a p<0.001, with heterogeneity value I2=92% (p<0.001). For the n23 component, the mean latency delay for the elderly was 2.82ms with 95% CI of 0.33-5.30ms. The overall effect test showed p=0.03. The heterogeneity found was I2=99% (p<0.001). CONCLUSION The latency of oVEMP n1 wave component and latencies of cVEMP p13 and n23 wave components are longer in the elderly aged >60 years than in young adults.
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Affiliation(s)
| | - Aline Tenório Lins Carnaúba
- Universidade Federal de Alagoas (UFAL), Rede Nordeste de Biotecnologia (RENORBIO), Biotecnologia em Saúde, Maceió, AL, Brazil
| | - Luciana Castelo Branco Camurça Fernandes
- Universidade Estadual de Ciências da Saúde de Alagoas (UNCISAL), Maceió, AL, Brazil; Universidade Federal de São Paulo (UNIFESP), Distúrbio da Comunicação, São Paulo, SP, Brazil
| | - Nassib Bezerra Bueno
- Universidade Federal de Alagoas (UFAL), Maceió, AL, Brazil; Universidade Federal de São Paulo (UNIFESP), Ciências, São Paulo, SP, Brazil
| | - Pedro de Lemos Menezes
- Universidade Estadual de Ciências da Saúde de Alagoas (UNCISAL), Maceió, AL, Brazil; Universidade de São Paulo (USP), Física aplicada à Medicina, São Paulo, SP, Brazil.
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Singh NK, Apeksha K. Efficacy of cervical and ocular vestibular-evoked myogenic potentials in evaluation of benign paroxysmal positional vertigo of posterior semicircular canal. Eur Arch Otorhinolaryngol 2015; 273:2523-32. [DOI: 10.1007/s00405-015-3867-3] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2015] [Accepted: 12/16/2015] [Indexed: 10/22/2022]
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Abstract
Aging affects every sensory system in the body, including the vestibular system. Although its impact is often difficult to quantify, the deleterious impact of aging on the vestibular system is serious both medically and economically. The deterioration of the vestibular sensory end organs has been known since the 1970s; however, the measurable impact from these anatomical changes remains elusive. Tests of vestibular function either fall short in their ability to quantify such anatomical deterioration, or they are insensitive to the associated physiologic decline and/or central compensatory mechanisms that accompany the vestibular aging process. When compared with healthy younger individuals, a paucity of subtle differences in test results has been reported in the healthy older population, and those differences are often observed only in response to nontraditional and/or more robust stimuli. In addition, the reported differences are often clinically insignificant insomuch that the recorded physiologic responses from the elderly often fall within the wide normative response ranges identified for normal healthy adults. The damaging economic impact of such vestibular sensory decline manifests itself in an exponential increase in geriatric dizziness and a subsequent higher prevalence of injurious falls. An estimated $10 to $20 billion dollar annual cost has been reported to be associated with falls-related injuries and is the sixth leading cause of death in the elderly population, with a 20% mortality rate. With an estimated 115% increase in the geriatric population over 65 years of age by the year 2050, the number of balanced-disordered patients with a declining vestibular system is certain to reach near epidemic proportions. An understanding of the effects of age on the vestibular system is imperative if clinicians are to better manage elderly patients with balance disorders, dizziness, and vestibular disease.
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Affiliation(s)
- Christopher K. Zalewski
- Otolaryngology Branch, Audiology Unit, National Institute on Deafness and Other Communication Disorders (NIDCD), National Institutes of Health (NIH), Bethesda, Maryland
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Pereira AB, Silva GSDM, Assunção ARM, Atherino CCT, Volpe FM, Felipe L. Cervical vestibular evoked myogenic potentials in children. Braz J Otorhinolaryngol 2015; 81:358-62. [PMID: 26163229 PMCID: PMC9442738 DOI: 10.1016/j.bjorl.2014.08.019] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2014] [Accepted: 08/12/2014] [Indexed: 12/01/2022] Open
Abstract
Introduction Cervical vestibular evoked myogenic potential is a test used in neurotological examination. It verifies the integrity of vestibular function through a muscular response evoked by an acoustic stimulation which activates the saccular macula. Normal standards in adults have been established, however, there are few published data on the normal responses in children. Objective To establish normal standards for vestibular myogenic responses in children without neurotological complaints. Methods This study's design is a cohort with cross-sectional analysis. The sample consisted of 30 subjects, 15 females (50%) and 15 males (50%). Results The age of the subjects ranged between 8 and 13 years, with a mean of 10.2 (± 1.7). P1 peak showed an average latency of 17.26 (± 1.78) ms and a mean amplitude of 49.34 (± 23.07) μV, and the N2 peak showed an average latency of 24.78 (± 2.18) ms and mean amplitude of 66.23 (± 36.18) μV. P1–N2 mean amplitude was 115.6 (± 55.7) μV. There were no statistically significant differences when comparing by gender or by laterality. Conclusion We established normal values of cervical myogenic vestibular responses in children between 8 and 13 years without neurotological complaints.
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Affiliation(s)
| | | | | | | | - Fernando Madalena Volpe
- Teaching and Research Management, Fundação Hospitalar do Estado de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Lilian Felipe
- Universidade Federal Fluminense (UFF), Niterói, RJ, Brazil
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Kammermeier S, Singh A, Noachtar S, Krotofil I, Bötzel K. Intermediate latency evoked potentials of cortical multimodal vestibular areas: Acoustic stimulation. Clin Neurophysiol 2015; 126:614-25. [DOI: 10.1016/j.clinph.2014.06.036] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2013] [Revised: 05/19/2014] [Accepted: 06/22/2014] [Indexed: 10/25/2022]
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Abstract
OBJECTIVE A systematic literature review and meta-analysis was performed to determine the effect of stimulus type, SCM muscle activation method, transducer type, and method to control SCM muscle EMG level on response parameter values for 0.1-ms click-evoked and 500-Hz tone burst cVEMPs. A description of normative response values was attempted. DESIGN An electronic systematic literature review was performed to obtain normative cVEMP response data. Subsequently a meta-analysis was conducted to determine significant effects on cVEMP response parameters and to obtain norms. STUDY SAMPLE Scopus was used to identify reports containing normative data. Reports were selected based on inclusion and exclusion criteria determined beforehand. Weighted means were calculated and compared to identify significant effects and normative data. RESULTS Sixty-six reports were included in the systematic review. Stimulus type, SCM muscle activation method, transducer type, and method to control SCM muscle EMG level had significant effects on all response parameters. CONCLUSIONS Optimal stimulus and recording parameters suggested by previous research are confirmed by the current systematic review and meta-analysis and are suggested for clinical use. Response parameter values are influenced by variations in stimulus and recording parameters and normative response values are suggested as guideline for cVEMP interpretation.
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Affiliation(s)
- Nathalie Meyer
- Department of Speech-Language Pathology and Audiology, University of Pretoria , Pretoria , South Africa
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Kim JH, Park JM, Yong SY, Kim JH, Kim H, Park SY. Difference of diagnostic rates and analytical methods in the test positions of vestibular evoked myogenic potentials. Ann Rehabil Med 2014; 38:226-33. [PMID: 24855617 PMCID: PMC4026609 DOI: 10.5535/arm.2014.38.2.226] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2013] [Accepted: 10/07/2013] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE To compare the differences of diagnostic rates, of the two widely used test positions, in measuring vestibular evoked myogenic potentials (VEMP) and selecting the most appropriate analytical method for diagnostic criteria for the patients with vertigo. METHODS Thirty-two patients with vertigo were tested in two comparative testing positions: turning the head to the opposite side of the evaluating side and bowing while in seated position, and bowing while in supine positions. Abnormalities were determined by prolonged latency of p13 or n23, shortening of the interpeak latency, and absence of VEMP formation. RESULTS Using the three criteria above for determining abnormalities, both the seated and supine positions showed no significant differences in diagnostic rates, however, the concordance correlation of the two positions was low. When using only the prolonged latency of p13 or n23 in the two positions, diagnostic rates were not significantly different and their concordance correlation was high. On the other hand, using only the shortened interpeak latency in both positions showed no significant difference of diagnostic rates, and the degree of agreement between two positions was low. CONCLUSION Bowing while in seated position with the head turned in the opposite direction to the area being evaluated is found to be the best VEMP test position due to the consistent level of sternocleidomastoid muscle tension and the high level of compliance. Also, among other diagnostic analysis methods, using prolonged latency of p13 or n23 as the criterion is found to be the most appropriate method of analysis for the VEMP test.
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Affiliation(s)
- Ji Hyun Kim
- Department of Rehabilitation Medicine, Wonju Severance Christian Hospital, Wonju, Korea
| | - Jeong Mee Park
- Department of Rehabilitation Medicine, Wonju Severance Christian Hospital, Wonju, Korea
| | - Sang Yeol Yong
- Department of Rehabilitation Medicine, Wonju Severance Christian Hospital, Wonju, Korea
| | - Jong Heon Kim
- Department of Rehabilitation Medicine, Wonju Severance Christian Hospital, Wonju, Korea
| | - Hee Kim
- Department of Occupational Therapy, Graduate School, Yonsei University; Department of Occupational Therapy, Wonju Medical Center, Wonju, Korea
| | - Sang-Yoo Park
- Department of Otolaryngology-Head and Neck Surgery, Yonsei University Wonju College of Medicine, Wonju, Korea
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Yetiser S, Ince D, Gul M. An Analysis of Vestibular Evoked Myogenic Potentials in Patients With Benign Paroxysmal Positional Vertigo. Ann Otol Rhinol Laryngol 2014; 123:686-95. [DOI: 10.1177/0003489414532778] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective: Vestibular evoked myogenic potentials (VEMPs) selectively test the vestibular end-organ. The aim of this study was to analyze how the site of the diseased canal, type of particulate deposition, duration of symptoms, severity of nystagmus, recurrence, and age affect the VEMP in patients with benign paroxysmal positional vertigo (BPPV). Methods: One hundred two patients were enrolled in the study between 2009 and 2012. There were 36 men and 66 women with ages ranging from 16 to 71 years (mean age, 42.28 ± 11.29 years). Patients with BPPV were tested with roll-on and head-hanging maneuvers under video-electronystagmography monitoring and with air conduction cervical VEMP testing. Patients were grouped for duration, severity, recurrence, age, site of canal involvement, and so on, and the results were compared in each subgroup. Kruskal–Wallis and Mann–Whitney U tests were used for the comparative analysis. Results: Twenty-four patients (23.5%) had a gross VEMP abnormality (absence of VEMP in 6 and greater than 25% depression of the amplitude in 18). Abnormality of VEMPs was not correlated with factors including age, severity of nystagmus, number of maneuvers applied, and the site of canal involvement ( P < .05). However, persistence or recurrence of symptoms has an effect on VEMP results ( P = .016). Conclusion: Vestibular evoked myogenic potential is a useful tool to study the otolithic function in patients with BPPV and should be included in the test battery.
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Affiliation(s)
- Sertac Yetiser
- Department of Otorhinolaryngology–Head and Neck Surgery, Anadolu Medical Center, Kocaeli, Turkey
| | - Dilay Ince
- Department of Otorhinolaryngology–Head and Neck Surgery, Anadolu Medical Center, Kocaeli, Turkey
| | - Murat Gul
- Department of Statistics, University of Giresun, Giresun, Turkey
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Singh NK, Sinha SK, Govindaswamy R, Kumari A. Are cervical vestibular evoked myogenic potentials sensitive to changes in the vestibular system associated with benign paroxysmal positional vertigo? HEARING BALANCE AND COMMUNICATION 2014. [DOI: 10.3109/21695717.2014.883208] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Lee JS, Lee SK, Shin IH, Yeo SG, Park MS, Byun JY. Vestibular evoked myogenic potential according to middle ear condition in chronic otitis media with tympanic membrane perforation. Acta Otolaryngol 2014; 134:34-40. [PMID: 24102226 DOI: 10.3109/00016489.2013.836756] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
CONCLUSION Vestibular evoked myogenic potential (VEMP) function results can vary between individuals with different middle ear conditions. Therefore, by analyzing VEMP results after paper patching, we can predict the condition of the middle ear in chronic otitis media (COM) patients. OBJECTIVES VEMP responses decrease with impairment of sound transmission, such as in conductive hearing loss (CHL). COM with tympanic membrane (TM) perforation is a common disorder that causes various degrees of CHL. The aim of this study was to evaluate and clarify the VEMP responses in patients with COM with different middle ear pathology. METHODS This study included 50 patients with unilateral COM with TM perforation. Initial pure-tone audiometry (PTA) and VEMP responses were recorded. After paper patching, PTA and VEMP were re-performed. Each VEMP response was compared with those of the healthy controls. Moreover, VEMP responses between pre- and post-paper patching were compared. RESULTS There was a positive correlation between normalizing of VEMP parameters, such as p13 and VEMP asymmetry ratio (VAR), and reduction of air-bone gap in patients with COM after paper patching. The VEMP response in patients with COM with intact ossicle and clean mucosa was more normalized compared with those in patients with COM with different middle ear conditions.
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Affiliation(s)
- Jun Seok Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, School of Medicine, Kyung Hee University , Seoul , Korea
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Khan FK, Balraj A, Lepcha A. Normative data for vestibular evoked myogenic potential in different age groups among a heterogeneous Indian population. Indian J Otolaryngol Head Neck Surg 2013; 66:149-54. [PMID: 24822153 DOI: 10.1007/s12070-013-0685-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2013] [Accepted: 10/21/2013] [Indexed: 11/25/2022] Open
Abstract
To establish normative data of vestibular evoked myogenic potential in different age groups among a heterogeneous Indian population. Prospective study design using a sample of convenience. Eighty five normal controls ranging between the ages 7 and 71 years were asked to provide a written signed consent for the study. Demographic characteristics of the patients were summarized using descriptive statistical methods using SPSS-17 analysing software. The outcome variable (VEMP recording) was expressed in percentiles as function of age. In all patients the stimulus which gave the best response was 95 dB (97.7 %) and 100 dB (95 %). The mean of wave latencies (p1 & n1) for 95-VEMP were, 11.2 ± 3.2 and 17.3 ± 4.7 ms on the right and 11.0 ± 2.8 and 17.0 ± 4.2 ms on the left respectively. The amplitude was 45.1 ± 54 mV on right and 46.9 ± 61.6 mV on the left. The mean of latency difference was 0.87 ms. The VEMP is a relatively simple test. The VEMP response rate was maximum in the younger age group; the optimum intensity was 95 dB. The asymmetry ratio interpretation should be done according to the age specific values.
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Affiliation(s)
- Feroze K Khan
- Department of ENT, Dr SMCSI Medical College, Karakkonam, Trivandrum, 695504 Kerala India
| | - Achamma Balraj
- Audiovestibular Unit, Christian Medical College, Vellore, India
| | - Anjali Lepcha
- Audiovestibular Unit, Christian Medical College, Vellore, India
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Talaat HS, Metwaly MA, Khafagy AH, Abdelraouf HR, Moussa Isak HA. Vestibular evoked myogenic potentials in idiopathic posterior canal benign paroxysmal positional vertigo. HEARING, BALANCE AND COMMUNICATION 2013. [DOI: 10.3109/21695717.2013.834577] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Lee JD, Park MK, Lee BD, Lee TK, Sung KB, Park JY. Abnormality of cervical vestibular-evoked myogenic potentials and ocular vestibular-evoked myogenic potentials in patients with recurrent benign paroxysmal postitional vertigo. Acta Otolaryngol 2013; 133:150-3. [PMID: 22953719 DOI: 10.3109/00016489.2012.723823] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
CONCLUSION Our results show that cervical vestibular-evoked myogenic potential (cVEMP) or ocular VEMP (oVEMP) abnormalities in the recurrent benign paroxysmal positional vertigo (BPPV) group were significantly higher than those in the non-recurrent BPPV group. Therefore, we can infer that VEMP abnormality is one of risk factors for BPPV recurrence. OBJECTIVE This prospective study aimed to test the hypothesis that otolith dysfunction using the VEMP test is a cause of recurrence of BPPV. METHODS cVEMP and oVEMP tests using 500 Hz tone-burst stimuli were performed on 16 patients with recurrent BPPV between March 2010 and December 2011. Both VEMP tests were performed in 20 patients with non-recurrent BPPV. RESULTS The differences in age, sex, and involved canal between the recurrent and non-recurrent BPPV groups were not significant. Abnormal cVEMP responses were detected in 5 of 16 (31.3%) subjects in the recurrent BPPV group and abnormal oVMEP responses were detected in 4 of 16 (25%) subjects in the recurrent BPPV group. When we defined VEMP abnormality as an abnormal cVEMP or abnormal oVEMP, VEMP abnormalities were detected in eight (50%) subjects in the recurrent BPPV group and in three (15%) subjects in the non-recurrent BPPV group; the difference between groups was significant.
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Affiliation(s)
- Jong Dae Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, Soonchunhyang University College of Medicine, Bucheon, Korea
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Abstract
OBJECTIVE To examine the association between dehiscence length in patients with superior semicircular canal dehiscence syndrome and their clinical findings, including objective audiometric and vestibular testing results. STUDY DESIGN Retrospective study. SETTING Tertiary referral center. PATIENTS Patients included in this study were diagnosed with superior semicircular canal dehiscence syndrome and underwent surgical repair of the dehiscence through middle fossa craniotomy. The dehiscence length was measured intraoperatively in all cases. MAIN OUTCOME MEASURES Correlation between dehiscence length with pure-tone average (PTA), average bone-conduction threshold, maximal air-bone gap, cervical vestibular evoked myogenic potential thresholds, and presenting signs and symptoms. RESULTS The correlation between dehiscence length and maximal air-bone gap was statistically significant on both univariate and multivariate regression analyses. The correlations between dehiscence length and PTA, average bone-conduction threshold, cervical vestibular evoked myogenic potential threshold, and presenting signs and symptoms were not statistically significant. CONCLUSION The dehiscence length correlated positively with the maximal air-bone gap in patients with superior semicircular canal dehiscence. The correlation was statistically significant. The dehiscence length did not correlate with the other variables examined in this study.
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Viciana D, Lopez-Escamez JA. Short tone bursts are better than clicks for cervical vestibular-evoked myogenic potentials in clinical practice. Eur Arch Otorhinolaryngol 2012; 269:1857-63. [PMID: 22237760 DOI: 10.1007/s00405-011-1912-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2011] [Accepted: 12/27/2011] [Indexed: 10/14/2022]
Abstract
Our aim is to compare short tone burst (STB)--and clicks--stimuli to evoke vestibular-evoked myogenic potentials (VEMPs) in healthy controls. A cross-sectional study in which VEMPs were measured in two sets of 185 and 55 normal volunteers by an air-conducted 500 Hz STBs and clicks, respectively. The test-retest reliability between different sessions was assessed in two subsets of 35 individuals. Moreover, 53 individuals were examined with both stimuli within the same session. Intraclass correlation coefficients (ICC) were used to assess reliability for P1 and N1 latencies, corrected amplitude and asymmetry ratio (AR). The results included that STBs produced a reliable response between different sessions (N = 35; [ICC] = 0.61-0.94, all p < 0.0001). Although clicks produced a reliable response for P1 and N1 latencies and corrected amplitudes (ICC = 0.62-0.74, all p < 0.0001), the amplitude ratio showed a lower reliability [ICC = 0.32 (-0.10 to 0.59)]. The amplitude of VEMP was consistently larger with 500 Hz STBs than clicks for a given sound pressure level. Within the same session, STBs evoked a response in 52/53 subjects (98%) whereas clicks evoked VEMPs only in 44/53 individuals (83%). Conclusions revealed that a 500 Hz STBs elicited consistently larger amplitudes, better reliability across recording sessions and fewer missing responses compared with click-induced VEMPs.
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Affiliation(s)
- David Viciana
- Otology & Neurotology Group CTS495, Department of Otolaryngology, Hospital de Poniente, Ctra de Almerimar, El Ejido, 04700 Almería, Spain
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Abnormal cervical vestibular-evoked myogenic potential in anterior inferior cerebellar artery territory infarction: Frequency, pattern, and a determinant. J Neurol Sci 2011; 307:114-9. [DOI: 10.1016/j.jns.2011.04.027] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2011] [Revised: 03/29/2011] [Accepted: 04/26/2011] [Indexed: 01/31/2023]
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Walther LE, Hörmann K, Pfaar O. [Recording cervical and ocular vestibular evoked myogenic potentials. Part 2: influencing factors, evaluation of findings and clinical significance]. HNO 2011; 58:1129-42; quiz 1143. [PMID: 20963394 DOI: 10.1007/s00106-010-2184-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
VEMP measurements are subject to various influencing factors: patient age, threshold, sound intensity and frequency. Using air (AC) and bone conduction (BC) the vestibular receptors and afferents of the otolith organs can be activated to varying degrees. Recordings of cervical (cVEMP) and ocular VEMP (oVEMP) are clinically possible. AC-cVEMP are primarily an indicator of the sacculocollic reflex pathway. Together with findings on the vestibuloocular reflex (VOR) and complimentary otolith tests, VEMP enable otolith function analysis of each side separately. In addition, the distinction between combined or isolated canal and otolith dysfunction in terms of subtyping and patterns of damage in mono- and bilateral disorders, such as vestibular neuritis or bilateral vestibulopathy, is possible. Moreover, VEMP is relevant in terms of prognostic and therapeutic considerations as well as expert assessments.
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Affiliation(s)
- L E Walther
- HNO-Gemeinschaftspraxis, Main-Taunus-Zentrum, 65843, Sulzbach (Taunus), Deutschland.
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Tourtillott BM, Ferraro JA, Bani-Ahmed A, Almquist E, Deshpande N. Age-related changes in vestibular evoked myogenic potentials using a modified blood pressure manometer feedback method. Am J Audiol 2010; 19:100-8. [PMID: 20966352 DOI: 10.1044/1059-0889(2010/10-0021)] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
PURPOSE To collect age-specific vestibular evoked myogenic potential (VEMP) data and to characterize age-related differences in VEMP parameters using a modified blood pressure manometer (BPM) method of sternocleidomastoid (SCM) muscle monitoring. METHODS VEMPs were recorded on healthy adults ranging in age from 23 to 84 years with no history of dizziness, neuromuscular pathologies, or cervical complaints. Participants were assigned to 3 groups using a nonprobability static group assignment based on their age. VEMP P1 and N1 latency, threshold, peak-to-peak amplitude, and interamplitude difference (IAD) ratios were obtained at 130 dB SPL. RESULTS Statistical differences were detected in peak-to-peak mean amplitude and threshold measures among groups. Post hoc analysis revealed that differences shown were between the young group and both older groups. No significant differences were noted in P1 and N1 latencies or IAD ratios. CONCLUSIONS This study confirmed a significant decline in VEMP amplitude and increase in VEMP thresholds in healthy older persons. Normative age-related data may be necessary to properly interpret VEMP recordings in a clinical setting when evaluating aging populations. The BPM method utilized for controlling SCM muscle may be a valuable alternative to control SCM muscle contraction when electromyography equipment is not available.
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Brainstem representation of vestibular evoked myogenic potentials. Clin Neurophysiol 2010; 121:1102-8. [DOI: 10.1016/j.clinph.2010.02.007] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2009] [Revised: 01/25/2010] [Accepted: 02/07/2010] [Indexed: 11/19/2022]
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Vestibular evoked myogenic potentials: review. The Journal of Laryngology & Otology 2010; 124:1043-50. [DOI: 10.1017/s0022215110001234] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
AbstractBackground:Disorders of balance often pose a diagnostic conundrum for clinicians, and a multitude of investigations have emerged over the years. Vestibular evoked myogenic potential testing is a diagnostic tool which can be used to assess vestibular function. Over recent years, extensive study has begun to establish a broader clinical role for vestibular evoked myogenic potential testing.Objectives:To provide an overview of vestibular evoked myogenic potential testing, and to present the evidence for its clinical application.Review type:Structured literature search according to evidence-based medicine guidelines, performed between November 2008 and April 2009. No restrictions were applied to the dates searched.Conclusion:The benefits of vestibular evoked myogenic potential testing have already been established as regards the diagnosis and monitoring of several clinical conditions. Researchers continue to delve deeper into potential new clinical applications, with early results suggesting promising future developments.
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The effect of age on the sinusoidal harmonic acceleration test, pseudorandom rotation test, velocity step test, caloric test, and vestibular-evoked myogenic potential test. Ear Hear 2010; 31:84-94. [PMID: 19779351 DOI: 10.1097/aud.0b013e3181b9640e] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Age-related anatomical and morphologic vestibular deterioration has already been elaborated. Demonstrating a corresponding degradation in physiologic function, however, entails a much higher challenge. The objective of this study was to investigate age-related changes using rotational tests, caloric tests, and the vestibular-evoked myogenic potentials (VEMP) test. DESIGN Eighty healthy human subjects (38 men and 42 women) ranging in age from 18 to 80 yrs participated in this study and were subjected to an extensive vestibular test battery. Function tests included sinusoidal harmonic acceleration tests, a pseudorandom rotation test, velocity step tests, a caloric test, and a VEMP test. RESULTS No significant age trends were noted for the sinusoidal harmonic acceleration test and velocity step tests response parameters, in contrast to subtle decreasing gain values with advancing age for the pseudorandom rotation test. Increasing slow-component velocity values were measured with the caloric test, whereas the frequency parameter showed no relevant age changes. The largest age trends were detected with the VEMP, with decreasing amplitudes, increasing thresholds, and decreasing N1 latencies. All asymmetry parameters remained stable across the different age categories. CONCLUSIONS Only subtle age changes could be demonstrated with the rotational and caloric tests, in contrast to more pronounced age trends with the VEMP.
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Vestibular evoked myogenic potentials in patients with fibromyalgia syndrome. The Journal of Laryngology & Otology 2010; 124:610-5. [DOI: 10.1017/s0022215110000010] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
AbstractObjective:To assess vestibular evoked myogenic potentials in patients with fibromyalgia syndrome.Methods:Twenty-four patients with fibromyalgia syndrome (two men and 22 women) and 21 female controls were included in the study. All patients underwent vestibular evoked myogenic potential testing.Results:Statistical comparison of fibromyalgia patients with control subjects showed a significant difference with respect to n23 latencies and interpeak latencies (p < 0.05). There was no significant difference in p13 latencies, nor in p13 amplitudes, n23 amplitudes or interpeak amplitudes (p > 0.05).Conclusions:Although patients with fibromyalgia syndrome generally have subjective neurotological symptoms, clinical and laboratory assessments usually fail to detect any objective abnormality. However, it is possible to detect abnormalities on vestibular evoked myogenic potential testing in such patients, indicating dysfunction in the vestibulospinal pathway, possibly in the saccule. Elongation of the n23 latency and of the interpeak latency of waves p13–n23, during vestibular evoked myogenic potential testing, may be a useful, objective indicator demonstrating neurotological involvement in fibromyalgia syndrome patients. Future research investigating the mechanisms of this latency elongation may help increase understanding of the pathogenesis of fibromyalgia syndrome.
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Kim S, Lee HS, Kim JS. Medial vestibulospinal tract lesions impair sacculo-collic reflexes. J Neurol 2010; 257:825-32. [DOI: 10.1007/s00415-009-5427-5] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2009] [Revised: 12/10/2009] [Accepted: 12/14/2009] [Indexed: 12/19/2022]
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Fujimoto C, Murofushi T, Chihara Y, Suzuki M, Yamasoba T, Iwasaki S. Novel subtype of idiopathic bilateral vestibulopathy: bilateral absence of vestibular evoked myogenic potentials in the presence of normal caloric responses. J Neurol 2009; 256:1488-92. [DOI: 10.1007/s00415-009-5147-x] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2009] [Revised: 03/30/2009] [Accepted: 04/17/2009] [Indexed: 11/28/2022]
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Ozdek A, Tulgar M, Saylam G, Tatar E, Korkmaz H. Comparison of head rotation versus head elevation methods for vestibular evoked myogenic potentials by using logon stimulus. Int J Pediatr Otorhinolaryngol 2009; 73:645-9. [PMID: 19168231 DOI: 10.1016/j.ijporl.2008.12.023] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2008] [Revised: 12/14/2008] [Accepted: 12/15/2008] [Indexed: 11/20/2022]
Abstract
OBJECTIVES To compare vestibular evoked myogenic potentials (VEMP) between two different methods, head rotation (HR) with unilateral recording and head elevation (HE) with bilateral simultaneous recording. SUBJECTS AND METHODS Twenty-eight healthy children (56 ears) were involved in the study. The subjects were tested in two different positions: head rotation (HR) method and head elevation (HE) method. Right- and left-side recordings were made separately in HR method and simultaneously in HE method. Logon type stimulus with 120dB Hl intensity was used to trigger VEMPs in both methods. RESULTS The response rate was 80.4% for HR method and 89.3% for HE method (p>0.05). There was no significant difference between the two groups with respect to P1 latency, N1 latency, and P1-N1 interval. The mean P1-N1 amplitude of HE method was higher than HR method (p<0.05). There were very strong positive correlations between two methods regarding N1 latency and P1-N1 interval (r: 0.849 and 0.841, respectively). CONCLUSION Bilateral simultaneous VEMP recording in head elevation position by using logon stimulus is a practical way to evaluate vestibulocollic reflex in children and it gives superior results than unilateral recording with head rotation position.
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Affiliation(s)
- Ali Ozdek
- S.B. Diskapi Egitim hastanesi, KBB Klinigi, Ankara, Turkey.
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