The Effects of Click and Tone-Burst Stimulus Parameters on the Vestibular Evoked Myogenic Potential (VEMP)

2003 ◽  
Vol 14 (09) ◽  
pp. 500-509 ◽  
Author(s):  
Faith Wurm Akin ◽  
Owen D. Murnane ◽  
Tina M. Proffitt
Keyword(s):  
Stimulus Frequency ◽  
Tone Burst ◽  
Stimulus Level ◽  
Vestibular Evoked Myogenic Potentials ◽  
Vestibular Evoked Myogenic Potential ◽  
Hearing Sensitivity ◽  
Surface Electrodes ◽  
Acoustic Stimuli ◽  
History Of ◽  
High Level

Vestibular evoked myogenic potentials (VEMP) are short latency electromyograms (EMG) evoked by high-level acoustic stimuli and recorded from surface electrodes over the tonically contracted sternocleidomastoid (SCM) muscle and are presumed to originate in the saccule. The present experiments examined the effects of click and tone-burst level and stimulus frequency on the latency, amplitude, and threshold of the VEMP in subjects with normal hearing sensitivity and no history of vestibular disease. VEMPs were recorded in all subjects using 100 dB nHL click stimuli. Most subjects had VEMPs present at 500, 750, and 1000 Hz, and few subjects had VEMPs present at 2000 Hz. The response amplitude of the VEMP increased with click and tone-burst level, whereas VEMP latency was not influenced by the stimulus level. The largest tone-burst-evoked VEMPs and lowest thresholds were obtained at 500 and 750 Hz. VEMP latency was independent of stimulus frequency when tone-burst duration was held constant.

Comparison of vestibular evoked myogenic potentials elicited by click and short duration tone burst stimuli

2010 ◽  
Vol 125 (4) ◽  
pp. 343-347 ◽  
Author(s):  
K Kumar ◽  
S Kumar Sinha ◽  
A Kumar Bharti ◽  
A Barman
Keyword(s):  
Short Duration ◽  
Clinical Assessment ◽  
Low Frequency ◽  
Tone Burst ◽  
Normal Hearing ◽  
Vestibular Evoked Myogenic Potentials ◽  
Vestibular Evoked Myogenic Potential ◽  
Acoustic Stimuli ◽  
Myogenic Potential ◽  
Electrical Impulses

AbstractIntroduction:Vestibular evoked myogenic potentials are short latency electrical impulses that are produced in response to higher level acoustic stimuli. They are used clinically to diagnose sacculocollic pathway dysfunction.Aim:This study aimed to compare the vestibular evoked myogenic potential responses elicited by click stimuli and short duration tone burst stimuli, in normal hearing individuals.Method:Seventeen subjects participated. In all subjects, we assessed vestibular evoked myogenic potentials elicited by click and short duration tone burst stimuli.Results and conclusion:The latency of the vestibular evoked myogenic potential responses (i.e. the p13 and n23 peaks) was longer for tone burst stimuli compared with click stimuli. The amplitude of the p13–n23 waveform was greater for tone burst stimuli than click stimuli. Thus, the click stimulus may be preferable for clinical assessment and identification of abnormalities as this stimulus has less variability, while a low frequency tone burst stimulus may be preferable when assessing the presence or absence of vestibular evoked myogenic potential responses.

Jendrassik Maneuver Facilitates cVEMP Amplitude: Some Preliminary Observations

2014 ◽  
Vol 25 (03) ◽  
pp. 237-243
Author(s):  
Lauren Roberts ◽  
Anthony T. Cacace
Keyword(s):  
Head Trauma ◽  
Repeated Measures ◽  
Neurological Disease ◽  
Vestibular Evoked Myogenic Potentials ◽  
Vestibular Evoked Myogenic Potential ◽  
Experimental Conditions ◽  
Hearing Sensitivity ◽  
History Of ◽  
Post Hoc ◽  
Jendrassik Maneuver

Background: The cervical vestibular evoked myogenic potential (cVEMP) is an acoustically driven electrophysiological measure of saccular and inferior nerve function that requires tonic sternocleidomastoid muscle (SCM) activity in order to be elicited. The cVEMP is gaining increased interest in the clinical and research communities based on the anatomical specificity it adds to vestibular test batteries, because it is noninvasive, and since it can be performed with instrumentation commonly found in audiology clinics worldwide. Purpose: Because maintaining a constant level of tonic background electromyography (EMG) over the entire course of the recording epoch is a requirement for response elicitation, active participation for some individuals including the elderly and those with cervical problems can be difficult. As a way to facilitate the response for some clinical populations, this study addressed whether cVEMPs could be modulated by remote or local changes in EMG related neural activity by applying various maneuvers during the course of the recording epoch. Research Design: Keeping acoustic stimulation and recording parameters constant, three separate experimental conditions, Jendrassik maneuver, jaw (teeth) clenching, and forced-eye closure, were used to determine whether cVEMP amplitudes could be enhanced from the control condition. Study Sample: Nine adults (2 males; 7 females) ranging in age from 24 to 42 yr with normal pure-tone hearing sensitivity and a negative history of otological disease, neurological disease, and head trauma. Data Collection and Analysis: Cervical vestibular evoked myogenic potentials were recorded from the SCM using surface electrodes in response to suprathreshold 500 Hz Blackman windowed tone bursts under a control and three experimental conditions. Three separate one-way repeated measures analyses of variance (ANOVAs) were used to evaluate the effects of these maneuvers on P1/N1 peak-to-peak amplitudes and P1 and N1 peak latencies. Results: A significant main effect of experimental condition was shown to increase P1/N1 peak-to-peak cVEMP amplitude. Post hoc analysis found that Jendrassik maneuver versus control was the only the condition that produced significantly increased response amplitudes in comparison to all other post hoc contrasts. P1 and N1 peak latencies were unchanged across the various experimental conditions. Conclusions: In adults with normal hearing sensitivity and a negative history of otological disease, neurological disease, and head trauma, Jendrassik maneuver increased cVEMP amplitude by over 39% in comparison to the control condition. Such a simple modulation effect warrants further investigation for application in clinical studies.

scholarly journals Vestibular evoked myogenic potential

2014 ◽  
Vol 67 (suppl. 1) ◽  
pp. 38-45
Author(s):  
Slobodanka Lemajic-Komazec ◽  
Zoran Komazec ◽  
Ljiljana Vlaski ◽  
Slobodan Savovic ◽  
Maja Buljcik-Cupic ◽  
...  
Keyword(s):  
Tone Burst ◽  
Acoustic Stimulation ◽  
Vestibular Evoked Myogenic Potentials ◽  
Vestibular Evoked Myogenic Potential ◽  
Average Value ◽  
Myogenic Potential ◽  
The Difference ◽  
Interaural Differences ◽  
The Right ◽  
A Prospective Study

Introduction. Vestibular evoked myogenic potentials are neurophysiological method for examining of saccular function, the bottom of the vestibular nerve that in nervates the sacculus and central vestibular pathways. Those are inhibitory potentials of the sternocleido mastoid musclein response to ipsilateral acoustic stimulation of the sacculus. Parameters of vestibular evoked myogenic potential testing include threshold, latencies of p1 and n1 wave and interamplitude p13-n23, interaural difference of p13 and n23 latency and interaural amplitude difference ratio. The aim of this study was to compire parameters standardization of vestibular evoked myogenic potentials responses, latency p13 and n23 of waves, the amplitude of responses and interaural differences in the amplitude andto determinewhether there is a difference in values between the sexes. Material and methods. This research was meant to be a prospective study which included 30 normal audiovestibular volunteers of both sexes. The group consisted of 53.3% women and 46.7% men. The saccular function testing by vestibular evoked myogenic potentials was performed monoaurally using air-conductive 500 Hz tone burst auditory stimulation. Results. The average value of the p13 wave latency in healthy subjects of this study was 15.18 ms (?1.24) while the mean latency of n23 waves in the same subjects was 25.00 ms (?2.23). The average value of the amplitude of the p13-n23 waves was 80.28 (34. ?04) microvolts. Conclusion. The difference in the values of the basic parameters of vestibular evoked myogenic potential responses between men and women does not exist. No differences between the right and the left ear in the values of latency and amplitude were observed.

Effects of Stimulus and Recording Parameters on the Air Conduction Ocular Vestibular Evoked Myogenic Potential

2011 ◽  
Vol 22 (07) ◽  
pp. 469-480 ◽  
Author(s):  
Owen D. Murnane ◽  
Faith W. Akin ◽  
J. Kip Kelly ◽  
Stephanie Byrd
Keyword(s):  
Repeated Measures ◽  
Normative Data ◽  
Stimulus Frequency ◽  
Stimulus Level ◽  
Diagnostic Information ◽  
Vestibular Nerve ◽  
Vestibular Evoked Myogenic Potentials ◽  
Repeated Measures Design ◽  
Electrode Location ◽  
Air Conduction

Background: Vestibular evoked myogenic potentials (VEMPs) have been recorded from the sternocleidomastoid muscle (cervical VEMP or cVEMP) and more recently from the eye muscles (ocular VEMP or oVEMP) in response to air conduction and bone conduction stimuli. Both cVEMPs and oVEMPs are mediated by the otoliths and thereby provide diagnostic information that is complementary to videonystagmography and rotational chair tests. In contrast to the air conduction cVEMP, which originates from the saccule/inferior vestibular nerve, recent evidence suggests the possibility that the air conduction oVEMP may be mediated by the utricle/superior vestibular nerve. The oVEMP, therefore, may provide complementary diagnostic information relative to the cVEMP. There are relatively few studies, however, that have quantified the effects of stimulus and recording parameters on the air conduction oVEMP, and there is a paucity of normative data. Purpose: To evaluate the effects of several stimulus and recording parameters on the air conduction oVEMP and to establish normative data for clinical use. Research Design: A prospective repeated measures design was utilized. Study Sample: Forty-seven young adults with no history of neurologic disease, hearing loss, middle ear pathology, open or closed head injury, cervical injury, or audiovestibular disorder participated in the study. Data Collection and Analysis: The effects of stimulus frequency, stimulus level, gaze elevation, and recording electrode location on the amplitude and latency of the oVEMP for monaural air conduction stimuli were assessed using repeated measures analyses of variance in an initial group of 17 participants. The optimal stimulus and recording parameters obtained in the initial group were used subsequently to obtain oVEMPs from 30 additional participants. Results: The effects of stimulus frequency, stimulus level, gaze elevation, and electrode location on the response prevalence, amplitude, and latency of the oVEMP for monaural air conduction stimuli were significant. The maximum N1-P1 amplitude and response prevalence were obtained for contralateral oVEMPs using a 500 Hz tone burst presented at 125 dB peak SPL during upward gaze at an elevation of 30°. Conclusions: The optimal stimulus and recording parameters quantified in this study were used to establish normative data that may be useful for the clinical application of the air conduction oVEMP.

Ocular and cervical vestibular evoked myogenic potentials in response to bone-conducted vibration in patients with probable inferior vestibular neuritis

2012 ◽  
Vol 126 (7) ◽  
pp. 683-691 ◽  
Author(s):  
L Manzari ◽  
A M Burgess ◽  
I S Curthoys
Keyword(s):  
Sense Organ ◽  
Vestibular Neuritis ◽  
Vestibular Evoked Myogenic Potentials ◽  
Detectable Effect ◽  
Vestibular Evoked Myogenic Potential ◽  
Previous Evidence ◽  
Surface Electrodes ◽  
Myogenic Potential ◽  
Function Testing ◽  
Utricular Function

AbstractBackground and aims:Previous evidence shows that the n10 component of the ocular vestibular evoked myogenic potential indicates utricular function, while the p13 component of the cervical vestibular evoked myogenic potential indicates saccular function. This study aimed to assess the possibility of differential utricular and saccular function testing in the clinic, and whether loss of saccular function affects utricular response.Methods:Following vibration conduction from the mid-forehead at the hairline, the ocular n10 component was recorded by surface electromyograph electrodes beneath both eyes, while the cervical p13–n23 component was recorded by surface electrodes over the tensed sternocleidomastoid muscles.Results:Fifty-nine patients were diagnosed with probable inferior vestibular neuritis, as their cervical p13–n23 component was asymmetrical (i.e. reduced or absent on the ipsilesional side), while their ocular n10 component was symmetrical (i.e. normal beneath the contralesional eye).Conclusion:The sense organ responsible for the cervical and the ocular vestibular evoked myogenic potentials cannot be the same, as one response was normal while the other was not. Reduced or absent saccular function has no detectable effect on the ocular n10 component. On vibration stimulation, the ocular n10 component indicates utricular function and the cervical p13–n23 component indicates saccular function.

Tone-induced cervical and ocular vestibular-evoked myogenic potentials: comparing abnormalities in traumatic and non-traumatic vestibular disease

2018 ◽  
Vol 132 (10) ◽  
pp. 906-910 ◽  
Author(s):  
N S Longridge ◽  
A I Mallinson
Keyword(s):  
Companion Paper ◽  
High Rate ◽  
Vestibular Evoked Myogenic Potentials ◽  
Tertiary Referral ◽  
Vestibular Evoked Myogenic Potential ◽  
Vestibular Disease ◽  
Myogenic Potential ◽  
Number Of Patients ◽  
History Of ◽  
Vestibular Assessment

AbstractBackgroundOtolithic function is poorly understood, but vestibular-evoked myogenic potential testing has allowed the documentation of pathology in patients who complain of imbalance.MethodsSeventy-four patients with traumatic and non-traumatic vestibular disease were sequentially assessed at a tertiary referral neuro-otology unit in a teaching hospital. A detailed history of all patients was taken and standard vestibular assessment was conducted using the technique described in the companion paper. The results of both groups of patients were analysed and the rate of abnormalities was assessed.ResultsThere was a high rate of abnormalities, including bilateral pathology, in a significant number of patients. Many patients in both groups inexplicably failed to recover.ConclusionVestibular-evoked myogenic potentials are helpful in documenting pathology, including bilateral pathology, which is outlined in the literature as being exceedingly difficult to compensate for.

The Influence of Caffeine on Calorics and Cervical Vestibular Evoked Myogenic Potentials (cVEMPs)

2014 ◽  
Vol 25 (03) ◽  
pp. 261-267 ◽  
Author(s):  
Kathleen McNerney ◽  
Mary Lou Coad ◽  
Robert Burkard
Keyword(s):  
Data Collection ◽  
Vestibular Function ◽  
Stimulus Presentation ◽  
Vestibular Evoked Myogenic Potentials ◽  
Future Research ◽  
Vestibular Evoked Myogenic Potential ◽  
Moderate Amount ◽  
Potential System ◽  
History Of ◽  
Clinically Significant

Background: Prior to undergoing vestibular function testing, it is not uncommon for clinicians to request that patients abstain from caffeine 24 hr prior to the administration of the tests. However, there is little evidence that caffeine affects vestibular function. Purpose: To evaluate whether the results from two tests commonly used in a clinical setting to assess vestibular function (i.e., calorics and the cervical vestibular evoked myogenic potential [cVEMP]) are affected by caffeine. Research Design: Subjects were tested with and without consuming a moderate amount of caffeine prior to undergoing calorics and cVEMPs. Study Sample: Thirty young healthy controls (mean = 23.28 yr; females = 21). Subjects were excluded if they reported any history of vestibular/balance impairment. Data Collection and Analysis: The Variotherm Plus Caloric Irrigator was used to administer the water, while the I-Portal VNG software was used to collect and analyze subjects’ eye movements. The TECA Evoked Potential System was used for the cVEMP stimulus presentation as well as for the data collection. During cVEMP collection, subjects were asked to monitor their sternocleidomastoid muscle contraction with a Delsys EMG monitor. IBM SPSS Statistics 20 was used to statistically analyze the results via paired t-tests. Results: Analysis of the data revealed that ingestion of caffeine did not significantly influence the results of either test of vestibular function. Conclusions: The results revealed that a moderate amount of caffeine does not have a clinically significant effect on the results from caloric and cVEMP tests in young healthy adults. Future research is necessary to determine whether similar results would be obtained from individuals with a vestibular impairment, as well as older adults.

scholarly journals Tone Burst Masseter Vestibular Evoked Myogenic Potentials: Normative Values and Test–Retest Reliability

2021 ◽  
Author(s):  
Sangu Srinivasan Vignesh ◽  
Niraj Kumar Singh ◽  
Krishna Rajalakshmi
Keyword(s):  
Research Design ◽  
Intraclass Correlation ◽  
Tone Burst ◽  
Peak Amplitude ◽  
Vestibular Evoked Myogenic Potentials ◽  
Normative Values ◽  
Asymmetry Ratio ◽  
Vestibular Evoked Myogenic Potential ◽  
Retest Reliability ◽  
Test Retest Reliability

Abstract Background Masseter vestibular evoked myogenic potential (mVEMP) is a recent tool for the assessment of vestibular and trigeminal pathways. Though a few studies have recorded mVEMP using click stimuli, there are no reports of these potentials using the more conventional VEMP eliciting stimuli, the tone bursts. Purpose The aim of the study is to establish normative values and determine the test–retest reliability of tone burst evoked mVEMP. Research Design The research design type is normative study design. Study Sample Forty-four healthy participants without hearing and vestibular deficits in the age range of 18 to 50 years participated in the study. Data Collection and Analysis All participants underwent mVEMP testing using 500 Hz tone-burst stimuli at 125 dB peSPL. Ten participants underwent second mVEMP testing within 1 month of the initial testing to estimate the test–retest reliability. Results Tone burst mVEMP showed robust responses in all participants. There were no significant ear and sex differences on any mVEMP parameter (p > 0.05); however, males had significantly higher EMG normalized peak-to-peak amplitude than females. Intraclass correlation coefficient (ICC) values of tone burst mVEMP showed excellent test–retest reliability (ICC >0.75) for ipsilateral and contralateral p11 latency, ipsilateral EMG normalized p11-n21 peak to peak amplitude, and amplitude asymmetry ratio. Fair and good test–retest reliability (0.4 < ICC > 0.75) was observed for ipsilateral and contralateral n21 latency, contralateral EMG normalized peak-to-peak amplitude, and amplitude asymmetry ratio. Conclusion Tone burst mVEMP is a robust and reliable test for evaluating the functional integrity of the vestibulomasseteric reflex pathway.

scholarly journals Cervical Vestibular-Evoked Myogenic Potentials: Norms and Protocols

2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
Suwicha Isaradisaikul ◽  
Niramon Navacharoen ◽  
Charuk Hanprasertpong ◽  
Jaran Kangsanarak
Keyword(s):  
Vestibular Function ◽  
Tone Burst ◽  
Contralateral Side ◽  
Vestibular Evoked Myogenic Potentials ◽  
Normative Values ◽  
Vestibular Evoked Myogenic Potential ◽  
Reference Guide ◽  
Inferior Vestibular Nerve ◽  
Set Up ◽  
Vestibular Function Test

Vestibular-evoked myogenic potential (VEMP) testing is a vestibular function test used for evaluating saccular and inferior vestibular nerve function. Parameters of VEMP testing include VEMP threshold, latencies of p1 and n1, and p1-n1 interamplitude. Less commonly used parameters were p1-n1 interlatency, interaural difference of p1 and n1 latency, and interaural amplitude difference (IAD) ratio. This paper recommends using air-conducted 500 Hz tone burst auditory stimulation presented monoaurally via an inserted ear phone while the subject is turning his head to the contralateral side in the sitting position and recording the responses from the ipsilateral sternocleidomastoid muscle. Normative values of VEMP responses in 50 normal audiovestibular volunteers were presented. VEMP testing protocols and normative values in other literature were reviewed and compared. The study is beneficial to clinicians as a reference guide to set up VEMP testing and interpretation of the VEMP responses.

scholarly journals Clinical value of tone burst vestibular evoked myogenic potentials at threshold in acute and stable Ménière's disease

2007 ◽  
Vol 122 (5) ◽  
pp. 452-457 ◽  
Author(s):  
V Osei-Lah ◽  
B Ceranic ◽  
L M Luxon
Keyword(s):  
Standard Deviation ◽  
Tone Burst ◽  
Meniere’S Disease ◽  
Menière’S Disease ◽  
Vestibular Evoked Myogenic Potentials ◽  
Meniere's Disease ◽  
Ménière’S Disease ◽  
Menière's Disease ◽  
Vestibular Evoked Myogenic Potential ◽  
Ménière's Disease

AbstractIntroduction:The objectives of this preliminary, prospective, cohort study were to ascertain the characteristics of vestibular evoked myogenic potentials at threshold levels in two groups of Ménière's disease patients – acute and stable – and to identify whether vestibular evoked myogenic potentials can provide any specific, objective information to distinguish acute from stable Ménière's disease.Subjects and methods:The study was based at a tertiary neuro-otology centre. Twenty adult patients who fulfilled the American Academy of Otolaryngology–Head and Neck Surgery1 criteria for Ménière's disease were divided into two groups: 11 patients with acute Ménière's disease and nine patients with stable Ménière's disease. Eighteen healthy adult volunteers served as controls. All subjects underwent vestibular evoked myogenic potential testing with ipsilateral, short tone burst stimuli at 500 Hz, as well as pure tone audiometry. The patients also underwent caloric testing.Results:Vestibular evoked myogenic potentials were present in all controls, and were present in 65 per cent of patients but absent in 35 per cent. The mean absolute threshold (Tvestibular evoked myogenic potential) ± standard deviation in normal controls was 116 ± 7.7 dBSPL; this did not differ statistically from that in patients, nor did it differ between acute and stable Ménière's disease. The p13/n23 latencies at the threshold levels in the normal, acute and stable groups (mean ± standard deviation) were respectively: 15 ± 2.2 ms/23.0 ± 2.5 ms; 15.7 ± 0.9 ms/23.7 ± 0.9 ms; and 15.3 ± 2.0 ms/24.2 ± 1.9 ms. The mean interaural amplitude difference ratio (IAD) ± standard deviation was significantly higher in the stable group compared with the acute group (0.54 ± 0.33 vs −0.15 ± 0.22; p = 0.007) and with the controls (0.54 ± 0.33 vs 0.1 ± 0.22; p = 0.05).Conclusions:The parameter that best differentiated acute from stable Ménière's disease at threshold was the interaural amplitude difference ratio. Therefore, this parameter may be used to monitor the clinical course of Ménière's disease.

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