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Germann M, Baker SN. Testing a Novel Wearable Device for Motor Recovery of the Elbow Extensor Triceps Brachii in Chronic Spinal Cord Injury. eNeuro 2023; 10:ENEURO.0077-23.2023. [PMID: 37460228 PMCID: PMC10399611 DOI: 10.1523/eneuro.0077-23.2023] [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: 02/22/2023] [Revised: 05/24/2023] [Accepted: 05/30/2023] [Indexed: 07/29/2023] Open
Abstract
After corticospinal tract damage, reticulospinal connections to motoneurons strengthen preferentially to flexor muscles. This could contribute to the disproportionately poor recovery of extensors often seen after spinal cord injury (SCI) and stroke. In this study, we paired electrical stimulation over the triceps muscle with auditory clicks, using a wearable device to deliver stimuli over a prolonged period of time. Healthy human volunteers wore the stimulation device for ∼6 h and a variety of electrophysiological assessments were used to measure changes in triceps motor output. In contrast to previous results in the biceps muscle, paired stimulation: (1) did not increase the StartReact effect; (2) did not decrease the suppression of responses to transcranial magnetic brain stimulation (TMS) following a loud sound; (3) did not enhance muscle responses elicited by a TMS coil oriented to induce anterior-posterior current. In a second study, chronic cervical SCI survivors wore the stimulation device for ∼4 h every day for four weeks; this was compared with a four-week period without wearing the device. Functional and electrophysiological assessments were repeated at week 0, week 4, and week 8. No significant changes were observed in electrophysiological assessments after paired stimulation. Functional measurements such as maximal force and variability and speed of trajectories made during a planar reaching task also remained unchanged. Our results suggest that the triceps muscle shows less potential for plasticity than biceps; pairing clicks with muscle stimulation does not seem beneficial in enhancing triceps recovery after SCI.
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Affiliation(s)
- Maria Germann
- Institute of Biosciences, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne NE2 4HH, United Kingdom
| | - Stuart N Baker
- Institute of Biosciences, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne NE2 4HH, United Kingdom
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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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Avci NB, Polat Z, Ataş A. Galvanic vestibular evoked myogenic potentials: normative data and the effect of age. Braz J Otorhinolaryngol 2020; 88:556-561. [PMID: 33012701 PMCID: PMC9422467 DOI: 10.1016/j.bjorl.2020.07.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 06/04/2020] [Accepted: 07/30/2020] [Indexed: 11/25/2022] Open
Abstract
Introduction Galvanic vestibular evoked myogenic potentials evaluate vestibular nerve responses using electric stimulation by records collected from the sternocleidomastoid muscle. A normal vestibular evoked myogenic potential response consists of the first positive, P1, and negative, N1, peaks. The response can be affected by factors such as age and gender and is also consequential in the diagnosis of pathologies. Objectives The present study was performed to obtain normative data on healthy adults, to help in diagnosis by establishing clinical norms as well as to investigate changing test parameters with age in galvanic vestibular evoked myogenic potentials. Methods A total of 100 healthy participants were included in the study. Galvanic vestibular evoked myogenic potential (current 3 mA, duration 1 ms) was performed randomly on both ears of each participant. The participants between the ages of 18–65 (mean age 39.7 ± 13.9) were divided into 5 groups according to their ages. Normative data of galvanic vestibular evoked myogenic potentials parameters were calculated in groups and in total, and age-related changes were examined. Results The galvanic vestibular evoked myogenic potential waveform was elicited from all participants (200 ears). The latency of P1 and N1 was 7.82 ± 3.29 ms and 22.06 ± 3.95 ms, respectively. The P1−N1 amplitude value was 66.64 ± 24.5 µV. The percentage of vestibular asymmetry was 16.29 ± 11.99%. The latencies of P1 and N1 and P1−N1 amplitude values demonstrated significant differences among different age groups (p < 0.01). Conclusions The results of this study show that as age increased, latencies were prolonged, and amplitudes gradually decreased. The normative data aids in the diagnosis of retrolabyrinthine lesions and the increase in the clinical use of galvanic vestibular evoked myogenic potentials.
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Affiliation(s)
- Nizamettin Burak Avci
- Hacettepe Üniversitesi, Faculty of Health Sciences, Audiology Department, Ankara, Turkey.
| | - Zahra Polat
- Sağlık Bilimleri Üniversitesi, Faculty of Hamidiye Health Sciences, Audiology Department, Istanbul, Turkey
| | - Ahmet Ataş
- İstanbul Üniversitesi-Cerrahpaşa, Cerrahpasa Faculty of Medicine, Otorhinolaryngology Department, Istanbul, Turkey
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Rajasekaran AK, Arivazhagan A, Yuvaraj P, Shivashankar N. Audiovestibular findings in a 6 year old child with pilocytic astrocytoma - a case report. Int J Audiol 2019; 59:236-241. [PMID: 31790608 DOI: 10.1080/14992027.2019.1697466] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Objective: Pilocytic astrocytoma commonly occurs in children and depending on the extension of the lesion may cause varied audiovestibular dysfunctions. However, audiovestibular findings are scarcely reported in the literature.Design: Audiovestibular testing was performed on a single subject on two occasions pre-surgically.Study sample: A 6 year old girl with pilocytic astrocytoma.Results: All audiological tests revealed normal findings except for the cervical vestibular evoked myogenic potential testing (cVEMP). The amplitude of cVEMP was higher in the lesion side indicating a hypersensitive vestibulocollic reflex pathway functioning.Conclusions: This case study reported a unique finding of hypersensitive cVEMP findings in the lesion side in a patient with pilocytic astrocytoma. The pathophysiological basis for this hypersensitivity is attributed to anatomical connections between the cerebellum and the vestibular nuclei through the inferior cerebellar peduncle.
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Affiliation(s)
- Aravind Kumar Rajasekaran
- Department of speech pathology and audiology, National institute of mental health and neurosciences, Bangalore, India
| | - A Arivazhagan
- Department of neurosurgery, National institute of mental health and neurosciences, Bangalore, India
| | - Pradeep Yuvaraj
- Department of speech pathology and audiology, National institute of mental health and neurosciences, Bangalore, India
| | - N Shivashankar
- Department of speech pathology and audiology, National institute of mental health and neurosciences, Bangalore, India
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Colebatch JG, Rosengren SM. Investigating short latency subcortical vestibular projections in humans: what have we learned? J Neurophysiol 2019; 122:2000-2015. [PMID: 31596627 DOI: 10.1152/jn.00157.2019] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
Vestibular evoked myogenic potentials (VEMPs) are now widely used for the noninvasive assessment of vestibular function and diagnosis in humans. This review focuses on the origin, properties, and mechanisms of cervical VEMPs and ocular VEMPs; how these reflexes relate to reports of vestibular projections to brain stem and cervical targets; and the physiological role of (otolithic) cervical and ocular reflexes. The evidence suggests that both VEMPs are likely to represent the effects of excitation of irregularly firing otolith afferents. While the air-conducted cervical VEMP appears to mainly arise from excitation of saccular receptors, the ocular VEMP evoked by bone-conducted stimulation, including impulsive bone-conducted stimuli, mainly arises from utricular afferents. The surface responses are generated by brief changes in motor unit firing. The effects that have been demonstrated are likely to represent otolith-dependent vestibulocollic and vestibulo-ocular reflexes, both linear and torsional. These observations add to previous reports of short latency otolith projections to the target muscles in the neck (sternocleidomastoid and splenius) and extraocular muscles (the inferior oblique). New insights have been provided by the investigation and application of these techniques.
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Affiliation(s)
- James G Colebatch
- Prince of Wales Hospital Clinical School, University of New South Wales, Sydney, New South Wales, Australia.,Neuroscience Research Australia, University of New South Wales, Sydney, New South Wales, Australia
| | - Sally M Rosengren
- Department of Neurology, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia.,Central Clinical School, The University of Sydney, Sydney, New South Wales, Australia
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Abe C, Yamaoka Y, Maejima Y, Mikami T, Morita H. Hypergravity-induced plastic alteration of the vestibulo-sympathetic reflex involves decrease in responsiveness of CAMK2-expressing neurons in the vestibular nuclear complex. J Physiol Sci 2019; 69:903-917. [PMID: 31435871 PMCID: PMC10942005 DOI: 10.1007/s12576-019-00705-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Accepted: 08/09/2019] [Indexed: 01/18/2023]
Abstract
The vestibular system contributes to not only eye movement and posture but also the sympathetic response. Plastic alteration of the vestibulo-sympathetic reflex is induced by hypergravity load; however, the mechanism remains unknown. Here, we examined 2 g-induced changing in responsiveness of CAMK2-expressing neurons in the vestibular nucleus complex using optogenetic tools. The excitatory photostimulation of the CAMK2-expressing neurons in the unilateral vestibular nuclear complex induced body tilt to the contralateral side, while inhibitory photostimulation showed the opposite response. Photoactivation of either cell body or the axonal terminal in the rostral ventrolateral medulla showed sympathoexcitation followed by the pressor response. Furthermore, this response was significantly attenuated (49.8 ± 4%) after the 1st day of 2 g loading, and this value was further reduced by the 5th day (22.4 ± 3%), suggesting that 2 g-induced attenuation of the vestibulo-sympathetic reflex involves at least decrease in responsiveness of CAMK2-expressing neurons in the vestibular nuclear complex.
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Affiliation(s)
- Chikara Abe
- Department of Physiology, Gifu University Graduate School of Medicine, 1-1 Yanagido, Gifu, 501-1194, Japan.
| | - Yusuke Yamaoka
- Department of Physiology, Gifu University Graduate School of Medicine, 1-1 Yanagido, Gifu, 501-1194, Japan
| | - Yui Maejima
- Department of Physiology, Gifu University Graduate School of Medicine, 1-1 Yanagido, Gifu, 501-1194, Japan
| | - Tomoe Mikami
- Department of Physiology, Gifu University Graduate School of Medicine, 1-1 Yanagido, Gifu, 501-1194, Japan
| | - Hironobu Morita
- Department of Physiology, Gifu University Graduate School of Medicine, 1-1 Yanagido, Gifu, 501-1194, Japan
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MacDougall HG, Holden J, Rosengren SM, Chiarovano E. μVEMP: A Portable Interface to Record Vestibular Evoked Myogenic Potentials (VEMPs) With a Smart Phone or Tablet. Front Neurol 2018; 9:543. [PMID: 30026727 PMCID: PMC6042498 DOI: 10.3389/fneur.2018.00543] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2018] [Accepted: 06/18/2018] [Indexed: 12/28/2022] Open
Abstract
Background: Cervical VEMPs and ocular VEMPs are tests for evaluating otolith function in clinical practice. We developed a simple, portable and affordable device to record VEMP responses on patients, named μVEMP. Our aim was to validate and field test the new μVEMP device. Methods: We recorded cervical VEMPs and ocular VEMPs in response to bone conducted vibration using taps tendon hammer to the forehead (Fz) and to air conducted sounds using clicks. We simultaneously recorded VEMP responses (same subject, same electrode, same stimuli) in three healthy volunteers (2 females, age range: 29-57 years) with the μVEMP device and with a standard research grade commercial (CED) system used in clinics. We also used the μVEMP device to record VEMP responses from six patients (6 females, age mean±SD: 50.3 ± 20.8 years) with classical peripheral audio-vestibular diseases (unilateral vestibular neuritis, unilateral neurectomy, bilateral vestibular loss, unilateral superior canal dehiscence, unilateral otosclerosis). Results: The first part of this paper compared the devices using simultaneous recordings. The average of the concordance correlation coefficient was rc = 0.997 ± 0.003 showing a strong similarity between the measures. VEMP responses recorded with the μVEMP device on patients with audio-vestibular diseases were similar to those typically found in the literature. Conclusions: We developed, validated and field tested a new device to record ocular and cervical VEMPs in response to sound and vibration.This new device is portable (powered by a phone or tablet) with pocket-size dimensions (105 × 66 × 27 mm) and light weight (150 g). Although further studies and normative data are required, our μVEMP device is simpler (easier to use) and potentially more accessible than standard, commercially available equipment.
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Affiliation(s)
| | - John Holden
- School of Psychology, University of Sydney, Sydney, NSW, Australia
| | - Sally M Rosengren
- Neurology Department, Royal Prince Alfred Hospital, Sydney, NSW, Australia.,Central Clinical School, University of Sydney, Sydney, NSW, Australia
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Corneil BD, Camp AJ. Animal Models of Vestibular Evoked Myogenic Potentials: The Past, Present, and Future. Front Neurol 2018; 9:489. [PMID: 29988517 PMCID: PMC6026641 DOI: 10.3389/fneur.2018.00489] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Accepted: 06/05/2018] [Indexed: 11/13/2022] Open
Abstract
Vestibular-evoked myogenic potentials (VEMPs) provide a simple and cost-effective means to assess the patency of vestibular reflexes. VEMP testing constitutes a core screening method in a clinical battery that probes vestibular function. The confidence one has in interpreting the results arising from VEMP testing is linked to a fundamental understanding of the underlying functional anatomy and physiology. In this review, we will summarize the key role that studies across a range of animal models have fulfilled in contributing to this understanding, covering key findings regarding the mechanisms of excitation in the sensory periphery, the processing of sensory information in central networks, and the distribution of reflexive output to the motor periphery. Although VEMPs are often touted for their simplicity, work in animals models have emphasized how vestibular reflexes operate within a broader behavioral and functional context, and as such vestibular reflexes are influenced by multisensory integration, governed by task demands, and follow principles of muscle recruitment. We will conclude with considerations of future questions, and the ways in which studies in current and emerging animal models can contribute to further use and refinement of this test for both basic and clinical research purposes.
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Affiliation(s)
- Brian D. Corneil
- Department of Physiology and Pharmacology, University of Western Ontario, London, ON, Canada
- Department of Psychology, University of Western Ontario, London, ON, Canada
- Robarts Research Institute, University of Western Ontario, London, ON, Canada
| | - Aaron J. Camp
- Discipline of Biomedical Science, Sydney Medical School, University of Sydney, Sydney, NSW, Australia
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Verbecque E, Marijnissen T, De Belder N, Van Rompaey V, Boudewyns A, Van de Heyning P, Vereeck L, Hallemans A. Vestibular (dys)function in children with sensorineural hearing loss: a systematic review. Int J Audiol 2017; 56:361-381. [DOI: 10.1080/14992027.2017.1281444] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Evi Verbecque
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Science, University of Antwerp, Antwerp, Belgium,
- Multidisciplinary Motor Centre Antwerp, University of Antwerp, Wilrijk, Belgium,
| | - Tessa Marijnissen
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Science, University of Antwerp, Antwerp, Belgium,
| | - Niels De Belder
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Science, University of Antwerp, Antwerp, Belgium,
| | - Vincent Van Rompaey
- Department of Otorhinolargynology and Neck & Head Surgery, Antwerp University Hospital, Antwerp, Belgium,
| | - An Boudewyns
- Department of Otorhinolargynology and Neck & Head Surgery, Antwerp University Hospital, Antwerp, Belgium,
| | - Paul Van de Heyning
- Multidisciplinary Motor Centre Antwerp, University of Antwerp, Wilrijk, Belgium,
- Department of Otorhinolargynology and Neck & Head Surgery, Antwerp University Hospital, Antwerp, Belgium,
- Department of Translational Neurosciences, Faculty of Medicine and Health Science, University of Antwerp, Antwerp, Belgium, and
| | - Luc Vereeck
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Science, University of Antwerp, Antwerp, Belgium,
- Multidisciplinary Motor Centre Antwerp, University of Antwerp, Wilrijk, Belgium,
| | - Ann Hallemans
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Science, University of Antwerp, Antwerp, Belgium,
- Multidisciplinary Motor Centre Antwerp, University of Antwerp, Wilrijk, Belgium,
- Department of Functional Morphology, Faculty of Sciences, University of Antwerp, Antwerp, Belgium
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Allena M, Magis D, De Pasqua V, Schoenen J, Bisdorff AR. The Vestibulo-Collic Reflex is Abnormal in Migraine. Cephalalgia 2016; 27:1150-5. [PMID: 17784856 DOI: 10.1111/j.1468-2982.2007.01414.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Interictal evoked central nervous system responses are characterized in migraineurs by a deficit of habituation, at both cortical and subcortical levels. The click-evoked vestibulo-collic reflex (VCR) allows the assessment of otolith function and an oligosynaptic pathway linking receptors in the saccular macula to motoneurons of neck muscles. Three blocks of 75 averaged responses to monaural 95-dB normal hearing level 3-Hz clicks were recorded over the contracted ipsilateral sternocleidomastoid muscle in 25 migraineurs between attacks and 20 healthy subjects, without vestibular symptoms. Amplitudes, raw and corrected for baseline electromyography, were significantly smaller in migraine patients. Whereas in healthy volunteers the VCR habituated during stimulus repetition (-4.96% ± 14.3), potentiation was found in migraineurs (4.34% ± 15.3; P = 0.04). The combination with a reduced mean amplitude does not favour vestibular hyperexcitability as an explanation for the habituation deficit in migraine, but rather an abnormal processing of repeated stimuli in the reflex circuit.
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Affiliation(s)
- M Allena
- Headache Research Unit, Department of Neurology, CHR Citadelle, University of Liège, Boulevard du 12ème de Ligne 1, 4000 Liège, Belgium
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Marinovic W, Tresilian JR. Triggering prepared actions by sudden sounds: reassessing the evidence for a single mechanism. Acta Physiol (Oxf) 2016; 217:13-32. [PMID: 26548462 DOI: 10.1111/apha.12627] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2015] [Revised: 10/13/2015] [Accepted: 11/02/2015] [Indexed: 12/19/2022]
Abstract
Loud acoustic stimuli can unintentionally elicit volitional acts when a person is in a state of readiness to execute them (the StartReact effect). It has been assumed that the same subcortical pathways and brain regions underlie all instances of the StartReact effect. They are proposed to involve the startle reflex pathways, and the eliciting mechanism is distinct from other ways in which sound can affect the motor system. We present an integrative review which shows that there is no evidence to support these assumptions. We argue that motor command generation for learned, volitional orofacial, laryngeal and distal limb movements is cortical and the StartReact effect for such movements involves transcortical pathways. In contrast, command generation for saccades, locomotor corrections and postural adjustments is subcortical and subcortical pathways are implicated in the StartReact effect for these cases. We conclude that the StartReact effect is not a special phenomenon mediated by startle reflex pathways, but rather is a particular manifestation of the excitatory effects of intense stimulation on the central nervous system.
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Affiliation(s)
- W. Marinovic
- School of Health & Rehabilitation Sciences; The University of Queensland; Brisbane Qld Australia
- Centre for Sensorimotor Performance; School of Human Movement and Nutrition Sciences; The University of Queensland; Brisbane Qld Australia
| | - J. R. Tresilian
- Department of Psychology; University of Warwick; Coventry UK
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Vestibular-evoked myogenic potentials in central vestibular disorders. J Neurol 2015; 263:210-220. [DOI: 10.1007/s00415-015-7860-y] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2015] [Revised: 07/13/2015] [Accepted: 07/13/2015] [Indexed: 12/20/2022]
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Young YH. Assessment of functional development of the otolithic system in growing children: a review. Int J Pediatr Otorhinolaryngol 2015; 79:435-42. [PMID: 25650143 DOI: 10.1016/j.ijporl.2015.01.015] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2014] [Revised: 01/12/2015] [Accepted: 01/13/2015] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Although the caloric test, rotational test, and posturography have been used to investigate balance function conventionally, and they are older than tests of otolithic organs, yet it seems that most clinicians are less familiar with the development of otolithic (saccular and utricular) function in children. This study reviewed the electrophysiological testing used to assess the functional development of the otolithic system in growing children. METHODS Based on the literature, studies of cervical vestibular-evoked myogenic potential (cVEMP) and ocular VEMP (oVEMP) tests in children ranging from newborns, small children to adolescents were reviewed. Papers concerning foam posturography in children were also included. RESULTS The cVEMPs can be elicited in newborns at day 5, whereas the oVEMPs are absent in neonatal period. When children grow to 2 years old, the oVEMPs can be induced with eyes closed condition, while the oVEMPs with eyes up condition can be elicited in children aged >3 years old, with the characteristic parameters similar to adult levels. In contrast with cVEMPs, it is until the neck length >15.3cm (aldolesence), one need not account for neck length in evaluating cVEMP latency. Additionally, foam posturography indicated by the Romberg quotient of the sway velocity/area on foam pad is considered to reflect the otolithic function, which reached adult levels when the children at 12 years old. CONCLUSIONS For the functional development of the otolithic system in growing children to approach adult levels, the earliest occurrence is the oVEMP test, followed by the foam posturography, and cVEMP test.
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Affiliation(s)
- Yi-Ho Young
- Department of Otolaryngology, National Taiwan University Hospital, 1 Chang-te St., Taipei 100, Taiwan.
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Abstract
OUTCOME OBJECTIVES To report the case of a contralateral Tullio phenomenon, suggest possible pathophysiology, and give insight into normal vestibular physiology. PATIENTS Twenty-year-old female subject who presented with 8-month symptoms of left-sided Tullio phenomenon after a motor vehicle collision. Testing suggested a right perilymphatic fistula. INTERVENTION(S) Bedrest and a right perilymphatic fistula repair. MAIN OUTCOME MEASURE(S) Cervical vestibular evoked myogenic potentials (cVEMPs), audiometry, and patient symptoms. RESULTS Postoperatively, the patient's symptoms of left-sided Tullio phenomenon abruptly abated, and the patient reported no activity limitations. Vertigo and phonodynia could not be reproduced. Postoperative VEMP demonstrated marked normalization (from abnormally decreased right-sided threshold and increased amplitude preoperatively). The left continued to demonstrate no abnormalities on audiogram, tympanogram, or VEMP. CONCLUSION This is the first known report of symptoms presenting contralateral to the side of perilymph fistula and represents a window of understanding to vestibular physiology. The cause of this unique finding may rest in the failure of commissural inhibition after labyrinth dysfunction. Clinicians should maintain heightened awareness for the possibility of inner ear dysfunction contralateral to symptoms.
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Does the human immunodeficiency virus influence the vestibulocollic reflex pathways? A comparative study. The Journal of Laryngology & Otology 2014; 128:772-9. [PMID: 25166876 DOI: 10.1017/s0022215114001996] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND This study compared vestibulocollic reflex and vestibulo-ocular reflex functioning in subjects with and without human immunodeficiency virus. It also described test results throughout progression of the disease and compared the results of human immunodeficiency virus positive subjects who were receiving antiretroviral therapies with those not receiving this treatment. METHODS Subjects comprised 53 adults with human immunodeficiency virus (mean age 38.5 ± 4.4 years) and 38 without human immunodeficiency virus (mean age 36.9 ± 8.2 years). Clinical examinations included cervical vestibular-evoked myogenic potential and bithermal caloric testing. RESULTS Abnormal cervical vestibular-evoked myogenic potential and caloric results were significantly higher in the human immunodeficiency virus positive group (p = 0.001), with an odds ratio of 10.2. Vestibulocollic reflex and vestibulo-ocular reflex involvement increased with progression of the disease. There were more abnormal test results in subjects receiving antiretroviral therapies (66.7 per cent) than in those not receiving antiretroviral therapies (63.6 per cent), but this difference was insignificant. CONCLUSION Human immunodeficiency virus seems to influence vestibulocollic reflex pathways. Combining cervical vestibular-evoked myogenic potential and caloric testing may be useful to detect early neurological involvement in human immunodeficiency virus positive subjects.
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Wang SJ, Jaw FS, Young YH. Optimizing the bandpass filter for acoustic stimuli in recording ocular vestibular-evoked myogenic potentials. Neurosci Lett 2013; 542:12-6. [DOI: 10.1016/j.neulet.2013.03.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2012] [Revised: 01/23/2013] [Accepted: 03/04/2013] [Indexed: 10/27/2022]
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Tseng CC, Wang SJ, Young YH. Comparison of head elevation versus rotation methods for eliciting cervical vestibular-evoked myogenic potentials via bone-conducted vibration. Int J Audiol 2013; 52:200-6. [DOI: 10.3109/14992027.2012.754108] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Young YH. Potential application of ocular and cervical vestibular-evoked myogenic potentials in meniere's disease: A review. Laryngoscope 2012; 123:484-91. [DOI: 10.1002/lary.23640] [Citation(s) in RCA: 69] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2012] [Revised: 06/25/2012] [Accepted: 07/11/2012] [Indexed: 11/10/2022]
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Vestibular-evoked myogenic potential tests in orthostatic dizziness. Clin Auton Res 2012; 22:281-7. [DOI: 10.1007/s10286-012-0172-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2012] [Accepted: 06/11/2012] [Indexed: 10/28/2022]
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Curthoys IS. The interpretation of clinical tests of peripheral vestibular function. Laryngoscope 2012; 122:1342-52. [DOI: 10.1002/lary.23258] [Citation(s) in RCA: 112] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2011] [Revised: 01/05/2012] [Accepted: 01/30/2012] [Indexed: 11/09/2022]
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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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No effects of anti-motion sickness drugs on vestibular evoked myogenic potentials outcome parameters. Otol Neurotol 2011; 32:497-503. [PMID: 21307816 DOI: 10.1097/mao.0b013e31820d94d0] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To investigate the effects of meclizine (50 mg), baclofen (10 mg), cinnarizine (20 mg) + dimenhydrinate (40 mg), and promethazine (25 mg) + dextro-amphetamine (5 mg) on the parameters of the vestibular evoked myogenic potential (VEMP) test. STUDY DESIGN Double-blind placebo-controlled prospective randomized trial. SETTING University hospital. SUBJECTS Twenty-four (first block: baclofen versus placebo) and 20 healthy male subjects (second block: meclizine, cinnarizine + dimenhydrinate and promethazine + dextro-amphetamine versus placebo). INTERVENTIONS VEMP test. MAIN OUTCOME MEASURES Threshold, p13 and n23 latencies, p13-n23 latency difference, p13-n23 peak-to-peak amplitude, mean rectified voltage of the sternocleidomastoid muscle contraction and the corrected amplitude. RESULTS There were no clinically significant pharmacologic effects on the VEMP outcome parameters. However, there was a statistically significant left-right asymmetry after intake of the combination promethazine + d-amphetamine for the parameters p13 and latency difference. CONCLUSION The absence of clinically significant effects can be explained by the predominant presence of the target receptors for the applied drugs in the medial vestibular nucleus, which receives the lowest grade of saccular projections. It also can be hypothesized that the VEMP methodology and techniques in general do not allow determining pharmacologic effects in a healthy group of subjects because of a too small discriminative power. The left-right asymmetry can be explained by a depressive action of the drugs on the central compensation mechanisms. Because there were no significant differences between the VEMP parameters obtained after intake of the placebos of both blocks, we concluded that there were no training effects.
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Uchino Y, Kushiro K. Differences between otolith- and semicircular canal-activated neural circuitry in the vestibular system. Neurosci Res 2011; 71:315-27. [PMID: 21968226 DOI: 10.1016/j.neures.2011.09.001] [Citation(s) in RCA: 81] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2011] [Revised: 09/09/2011] [Accepted: 09/12/2011] [Indexed: 10/17/2022]
Abstract
In the last two decades, we have focused on establishing a reliable technique for focal stimulation of vestibular receptors to evaluate neural connectivity. Here, we summarize the vestibular-related neuronal circuits for the vestibulo-ocular reflex, vestibulocollic reflex, and vestibulospinal reflex arcs. The focal stimulating technique also uncovered some hidden neural mechanisms. In the otolith system, we identified two hidden neural mechanisms that enhance otolith receptor sensitivity. The first is commissural inhibition, which boosts sensitivity by incorporating inputs from bilateral otolith receptors, the existence of which was in contradiction to the classical understanding of the otolith system but was observed in the utricular system. The second mechanism, cross-striolar inhibition, intensifies the sensitivity of inputs from both sides of receptive cells across the striola in a single otolith sensor. This was an entirely novel finding and is typically observed in the saccular system. We discuss the possible functional meaning of commissural and cross-striolar inhibition. Finally, our focal stimulating technique was applied to elucidate the different constructions of axonal projections from each vestibular receptor to the spinal cord. We also discuss the possible function of the unique neural connectivity observed in each vestibular receptor system.
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Affiliation(s)
- Yoshio Uchino
- Health Service Facility for the Elderly, "Green Village Angyo", Angyo 1145, Kawaguchi-Shi 334-0059, Saitama Prefecture, Japan.
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Sung PH, Cheng PW, Young YH. Effect of gender on ocular vestibular-evoked myogenic potentials via various stimulation modes. Clin Neurophysiol 2011; 122:183-7. [DOI: 10.1016/j.clinph.2010.06.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2010] [Revised: 06/04/2010] [Accepted: 06/05/2010] [Indexed: 10/19/2022]
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Xie SJ. Response to "oVEMP to air-conducted tones reflects functions of different vestibular populations from cVEMP?". Eur Arch Otorhinolaryngol 2010; 268:151-2; author reply 153. [PMID: 21125289 DOI: 10.1007/s00405-010-1444-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2010] [Accepted: 11/19/2010] [Indexed: 11/24/2022]
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Lin CT, Young YH, Cheng PW, Lue JH. Effects of gentamicin on guinea pig vestibular ganglion function and on substance P and neuropeptide Y. J Chem Neuroanat 2010; 40:286-92. [DOI: 10.1016/j.jchemneu.2010.08.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2010] [Revised: 08/05/2010] [Accepted: 08/10/2010] [Indexed: 11/16/2022]
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Comparison of otologic complications between intensity-modulated and two-dimensional radiotherapies in nasopharyngeal carcinoma patients. Otolaryngol Head Neck Surg 2010; 143:662-8. [DOI: 10.1016/j.otohns.2010.07.012] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2010] [Revised: 06/08/2010] [Accepted: 07/19/2010] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To investigate the otologic complications in patients with nasopharyngeal carcinoma (NPC) who were treated by intensity-modulated radiotherapy (IMRT) and compared with those who were treated by two-dimensional radiotherapy (2DRT). STUDY DESIGN A historical cohort study was performed comprising NPC patients who underwent IMRT or 2DRT at Chung Shan Medical University Hospital. SETTING Chung Shan Medical University Hospital. SUBJECTS AND METHODS Twenty-six NPC patients treated by IMRT (group A) and 18 NPC patients treated by 2DRT (group B) were enrolled. All patients underwent otoscopy, audiometry, and a vestibular-evoked myogenic potential (VEMP) test at a mean interval of three years after irradiation. RESULTS Although groups A and B did not significantly differ in the occurrence rate of otitis media with effusion (OME), group B had a significantly greater occurrence rate of chronic otitis media than group A ( P < 0.05, χ2 test). The incidences of high-frequency sensorineural hearing loss were 46 percent in group A and 67 percent in group B, with no significant difference between the two. In terms of VEMPs, group A had a significantly lower abnormal rate (31%) than group B (61%; P < 0.05, χ2 test). In addition, a significant relationship existed between T stages and OME in NPC patients treated by IMRT ( P < 0.01, Fisher-Freeman-Halton test) but not by 2DRT. CONCLUSION The incidence of chronic otitis media and abnormal VEMPs in NPC patients treated by IMRT were significantly lower when compared with those treated by 2DRT, demonstrating the superiority of IMRT in decreasing unwanted otologic complications. However, occurrence of OME, which was related with advanced T stage, cannot be reduced by IMRT.
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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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Eleftheriadou A, Koudounarakis E. Vestibular-evoked myogenic potentials eliciting: an overview. Eur Arch Otorhinolaryngol 2010; 268:331-9. [PMID: 20963599 DOI: 10.1007/s00405-010-1408-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2010] [Accepted: 10/08/2010] [Indexed: 02/07/2023]
Abstract
Recently, the favoured approach for unilateral testing of saccular function is the recently developed method of vestibular-evoked myogenic potentials (VEMPs). VEMP testing is a reliable technique, since it selectively stimulates and investigates each lateral canal in isolation from the other, providing information for the assessment of otolith function and inferior vestibular nerve integrity. The aim of this study was to provide a current review of the different methods used to record VEMPs. We noticed discrepancies in relation to the ways used to record the VEMPs in relation to the following factors: types of stimuli used (clicks or tone bursts) and body muscles tested, patient position at the time of recording, response, type of phone used and way of stimulus presentation (mono or binaural, ipsi or contralateral) and others. As a conclusion, despite the numerous studies in the field, there is no consensus in the literature as to the best recording method for VEMPs. However, the new ocular VEMPs in response to bone conducted vibration seem to be of clinical importance for the evaluation of utricular function. Further research is needed to support its clinical usefulness.
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Affiliation(s)
- Anna Eleftheriadou
- Department of Otolaryngology, General Hospital of Rethymnon, PO Box 269, Rethymnon, 74100 Crete, Greece.
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Test-retest reliability and age-related characteristics of the ocular and cervical vestibular evoked myogenic potential tests. Otol Neurotol 2010; 31:793-802. [PMID: 20517167 DOI: 10.1097/mao.0b013e3181e3d60e] [Citation(s) in RCA: 145] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE To determine the test-retest reliability and age-related trends of the cervical and ocular vestibular evoked myogenic potential (cVEMP and oVEMP, respectively) responses to air-conducted sound and bone-conducted vibration stimulation. STUDY DESIGN Prospective study. SETTING Tertiary referral center. PATIENTS Fifty-three healthy adults with no hearing or vestibular deficits. INTERVENTION(S) All subjects underwent cVEMP and oVEMP testing in response to sounds (0.1-ms clicks and 500-Hz tone bursts) and vibration (midline forehead taps at the hairline, Fz, with a reflex hammer and a Brüel & Kjaer Mini-Shaker Type 4810). Twelve subjects underwent an additional testing session that was conducted at a mean of 10 weeks after the first one. MAIN OUTCOME MEASURE(S) Test-retest reliability for VEMP response parameters (latency, peak-to-peak amplitude, and asymmetry ratio) were assessed using the intraclass correlation coefficient (ICC). RESULTS : oVEMP amplitudes had excellent test-retest reliability (ICC > 0.75) for all 4 stimuli; cVEMP amplitudes had excellent reliability for hammer taps and fair-to-good reliability for other stimuli. oVEMP asymmetry ratios had excellent reliability for clicks and fair-to-good reliability (ICC = 0.4-0.75) for other stimuli; cVEMP asymmetry ratios had fair-to-good reliability for clicks and hammer taps. Older subjects (>50 years old) were found to have significantly decreased cVEMP amplitudes in response to clicks, tones, and taps with a Mini-Shaker and significantly decreased oVEMP amplitudes in response to clicks, tones, and taps with a reflex hammer. No age-related changes were found for latencies or asymmetry ratios. CONCLUSION Overall, oVEMP response parameters demonstrated better test-retest reliability than cVEMP response parameters, but oVEMPs and cVEMPs had similar age-related changes.
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Reflex responses of masseter muscles to sound. Clin Neurophysiol 2010; 121:1690-9. [DOI: 10.1016/j.clinph.2009.11.093] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2009] [Revised: 10/19/2009] [Accepted: 11/09/2009] [Indexed: 11/18/2022]
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Chang CM, Cheng PW, Young YH. Aging effect on galvanic vestibular-evoked myogenic potentials. Otolaryngol Head Neck Surg 2010; 143:418-21. [PMID: 20723781 DOI: 10.1016/j.otohns.2010.04.269] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2010] [Revised: 04/20/2010] [Accepted: 04/27/2010] [Indexed: 11/17/2022]
Abstract
OBJECTIVE This study compared the characteristic parameters of vestibular-evoked myogenic potentials (VEMPs) via galvanic vestibular stimulation (GVS) in healthy subjects of various ages to measure the effect of aging on GVS-VEMPs. STUDY DESIGN Prospective study. SETTING University hospital. SUBJECTS AND METHODS Fifty-two healthy subjects were divided into five groups by age. Each group consisted of 10 subjects in one decade (except 12 subjects in the group of 60 to 69 years). All subjects underwent VEMP testing via GVS with an intensity of 5 mA for 1 ms. RESULTS All 10 subjects (20 ears) in each group aged 20 to 29, 30 to 39, 40 to 49, and 50 to 59 years exhibited clear GVS-VEMPs, whereas 20 (83%) of 24 ears in the group aged 60 to 69 years had clear GVS-VEMPs, exhibiting nonsignificant differences in terms of prevalence between the groups of subjects younger and older than 60 years. The mean p13 and n23 latencies and p13-n23 amplitude of the subjects in the groups aged 20 to 29, 30 to 39, 40 to 49, 50 to 59, and 60 to 69 years differed significantly among the five groups: the p13 and n23 latencies of the group aged older than 60 years was significantly longer than those of subjects younger than 60 years and their p13-n23 amplitude was lower. CONCLUSION The decline of the amplitude and prolongation of the latencies in GVS-VEMPs after the age of 60 may, at least in part, be caused by the decrease in the number of vestibular afferents and their caliber.
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Affiliation(s)
- Chih-Ming Chang
- Department of Otolaryngology, Far Eastern Memorial Hospital, Taipei, Taiwan
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Yang TH, Liu SH, Young YH. Evaluation of guinea pig model for ocular and cervical vestibular-evoked myogenic potentials for vestibular function test. Laryngoscope 2010; 120:1910-7. [DOI: 10.1002/lary.21056] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Yang TH, Liu SH, Young YH. A novel inner ear monitoring system for evaluating ototoxicity of gentamicin eardrops in guinea pigs. Laryngoscope 2010; 120:1220-6. [DOI: 10.1002/lary.20923] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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Vestibular-Evoked Myogenic Potential in the Prediction of Recovery From Acute Low-Tone Sensorineural Hearing Loss. Ear Hear 2010; 31:289-95. [DOI: 10.1097/aud.0b013e3181c5b743] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Lütkenhöner B, Stoll W, Basel T. Modeling the vestibular evoked myogenic potential. J Theor Biol 2010; 263:70-8. [DOI: 10.1016/j.jtbi.2009.10.036] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2009] [Revised: 09/22/2009] [Accepted: 10/29/2009] [Indexed: 12/19/2022]
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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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Assessment of gentamicin-induced vestibulotoxicity by click and galvanic vestibular-evoked myogenic potentials: A guinea pig investigation. Neurotoxicology 2010; 31:121-5. [DOI: 10.1016/j.neuro.2009.10.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2009] [Revised: 10/02/2009] [Accepted: 10/15/2009] [Indexed: 02/07/2023]
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Ocular Vestibular Evoked Myogenic Potentials Via Bone-Conducted Vibrations Applied to Various Midsagittal Cranial Sites. Otol Neurotol 2010; 31:157-61. [DOI: 10.1097/mao.0b013e3181c2a0e1] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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Cheng PW, Chen CC, Wang SJ, Young YH. Acoustic, mechanical and galvanic stimulation modes elicit ocular vestibular-evoked myogenic potentials. Clin Neurophysiol 2009; 120:1841-4. [DOI: 10.1016/j.clinph.2009.08.002] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2009] [Revised: 07/09/2009] [Accepted: 08/03/2009] [Indexed: 11/29/2022]
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Abstract
OBJECTIVE To determine if a sound evoked myogenic potential could be obtained from the triceps with the recording and stimulus parameters routinely used to obtain a vestibular evoked myogenic potential (VEMP) from the sternocleidomastoid. STUDY DESIGN Prospective study of myogenic potentials recorded from the triceps in healthy subjects. We used a monaural acoustic stimulus and measured the unrectified myogenic potential using surface electromyography electrodes, using response-triggered averaging, on the triceps of 18 subjects. SETTING University-affiliated otoneurology clinic. PATIENTS Eighteen healthy adult volunteers (11 women and 7 men), age ranging between 27 and 36 years. MAIN OUTCOME MEASURES Latencies and amplitudes of the first two waves of the evoked response. RESULTS : The P1 latency was 36.83 +/- 8.42 ms (range, 26.34-57.99 ms; 95% confidence interval [CI], 33.53-40.14 ms), the N1 latency was 43.74 +/- 8.80 ms (range, 34.67-66.32 ms; 95% CI, 40.29-47.19 ms), the P1-N1 interlatency was 6.90 +/- 1.23 ms (range, 5.21-9.79 ms; 95% CI, 6.42-7.39 ms), and the P1-N1 interamplitude was 93.23 +/- 51.25 microV (range, 16.33-206.62 microV; 95% CI, 73.14-113.32 V). CONCLUSION A monaural sound stimulus elicits a robust and reproducible surface myogenic potential in triceps muscles.
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Wu CC, Young YH. Ten-year longitudinal study of the effect of impulse noise exposure from gunshot on inner ear function. Int J Audiol 2009; 48:655-60. [DOI: 10.1080/14992020903012481] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Chou CH, Wang SJ, Young YH. Feasibility of the simultaneous ocular and cervical vestibular-evoked myogenic potentials in unilateral vestibular hypofunction. Clin Neurophysiol 2009; 120:1699-705. [DOI: 10.1016/j.clinph.2009.07.036] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2009] [Revised: 06/24/2009] [Accepted: 07/12/2009] [Indexed: 10/20/2022]
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Acoustic clicks activate both the canal and otolith vestibulo-ocular reflex pathways in behaving monkeys. J Assoc Res Otolaryngol 2009; 10:569-77. [PMID: 19626369 DOI: 10.1007/s10162-009-0178-7] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2008] [Accepted: 06/16/2009] [Indexed: 10/20/2022] Open
Abstract
Acoustic activation of the vestibular system has been well documented in humans and animal models. In the past decade, sound-evoked myogenic potentials in the sternocleidomastoid muscle (cVEMP) and the extraocular muscles (oVEMP) have been extensively studied, and their potentials as new tests for vestibular function have been widely recognized. However, the extent to which sound activates the otolith and canal pathways remains controversial. In the present study, we examined this issue in a recently developed nonhuman primate model of acoustic activation of the vestibular system, i.e., sound-evoked vestibulo-ocular reflexes (VOR) in behaving monkeys. To determine whether the canal and otolith VOR pathways are activated by sound, we analyzed abducens neurons' responses to clicks that were delivered into either ear. The main finding was that clicks evoked short-latency excitatory responses in abducens neurons on both sides. The latencies of the two responses, however, were different. The mean latency of the contralateral and ipsilateral abducens neurons was 2.44 +/- 0.4 and 1.65 +/- 0.28 ms, respectively. A further analysis of the excitatory latencies, in combination with the known canal and otolith VOR pathways, suggests that the excitatory responses of the contralateral abducens neurons were mediated by the contralateral disynaptic VOR pathways that connect the lateral canal to the contralateral abducens neurons, and the excitatory responses of the ipsilateral abducens neurons were mediated by the ipsilateral monosynaptic VOR pathways that connect the utricle to the ipsilateral abducens neurons. These results provide new insights into the understanding of the neural basis for sound-evoked vestibular responses, which is essential for developing new tests for both canal and otolith functions in humans.
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Itoh, Young Soon Kim, Katsumi Yoshi A. Clinical Study of Vestibular-evoked Myogenic Potentials and Auditory Brainstem Responses in Patients with Brainstem Lesions. Acta Otolaryngol 2009. [DOI: 10.1080/000164801750388270] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
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Bhagat SP. Properties of binaural vestibular evoked myogenic potentials elicited with air-conducted and bone-conducted tone bursts. Int J Audiol 2009; 45:609-16. [PMID: 17062503 DOI: 10.1080/14992020600937444] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
The purpose of this investigation was to compare the effects of monaural and binaural stimulation on unilaterally-measured vestibular evoked myogenic potential (VEMP) magnitude and latency. The subjects were eighteen normal-hearing adults with no history of vestibular disease. Monaural VEMPs were acquired with air-conducted (AC) and bone-conducted (BC) 500 Hz tone bursts presented at 95 dB nHL and 70 dB nHL, respectively. These stimuli were simultaneously paired with 95 dB nHL contralateral tone bursts at 250, 500, 750, or 1000 Hz during acquisition of binaural VEMPs. Results indicated that AC-VEMP relative magnitudes decreased in each of the binaural conditions compared to the monaural condition. However, no changes in relative magnitude between conditions occurred for BC-VEMPs. Similar latencies were observed for monaural and binaural VEMPs. Differences in bilateral interaction seen between the AC-VEMP and BC-VEMP conditions are consistent with modification of sound transmission through the ear during presentations of binaural sound.
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Affiliation(s)
- Shaum P Bhagat
- The University of Memphis, School of Audiology and Speech-Language Pathology, Memphis, TN 38015, USA.
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Hsu YS, Wang SJ, Young YH. Ocular vestibular-evoked myogenic potentials in children using air conducted sound stimulation. Clin Neurophysiol 2009; 120:1381-5. [DOI: 10.1016/j.clinph.2009.04.009] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2009] [Revised: 03/20/2009] [Accepted: 04/20/2009] [Indexed: 11/24/2022]
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Tseng CL, Young YH. Topographical correlations of lateral medullary infarction with caloric- and vestibular-evoked myogenic potential results. Eur Arch Otorhinolaryngol 2009; 267:191-5. [DOI: 10.1007/s00405-009-1025-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2008] [Accepted: 06/12/2009] [Indexed: 11/24/2022]
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