Test-retest reliability and age-related characteristics of the ocular and cervical vestibular evoked myogenic potential tests

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.

Figures

Figure 1

Cervical VEMP traces from each subject (averaged from 100 sweeps), in response to clicks, tones, and taps with a reflex hammer and Mini-Shaker. Traces on the left correspond to the first testing session; traces on the right correspond to the second testing session.

Figure 2

Ocular VEMP traces from each subject (averaged from 100 sweeps), in response to clicks, tones, and taps with a reflex hammer and Mini-Shaker. Traces on the left correspond to the first testing session; traces on the right correspond to the second testing session.

Figure 3

Mean corrected peak-to-peak cVEMP amplitudes in response to clicks, tones, and taps with a reflex hammer and Mini-Shaker. Error bars represent 1 SD above and below the mean. Asterisks indicate significantly decreased amplitudes (p

Figure 4

Mean peak-to-peak oVEMP amplitudes in response to clicks, tones, and taps with a reflex hammer and Mini-Shaker. Error bars represent 1 SD above and below the mean. Asterisks indicate significantly decreased amplitudes (p

Figure 5

Mean n10 oVEMP amplitudes in response to clicks, tones, and taps with a reflex hammer and Mini-Shaker. Error bars represent 1 SD above and below the mean. Asterisks indicate significantly decreased amplitudes (p