The impact of stimulation rates in vestibular evoked myogenic potential testing

Aline Tenório Lins Carnaúba, Otávio Gomes Lins, Ilka do Amaral Soares, Kelly Cristina Lira de Andrade, Pedro de Lemos Menezes, Aline Tenório Lins Carnaúba, Otávio Gomes Lins, Ilka do Amaral Soares, Kelly Cristina Lira de Andrade, Pedro de Lemos Menezes

Abstract

Vestibular evoked myogenic potentials (VEMP) have been used in complementary otoneurological assessment, but the use of VEMP in clinical settings is limited. VEMPs can be used to assess vestibular function, particularly of the saccule, the inferior vestibular nerve, and/or the vestibular nucleus.

Objective: To verify the highest possible - and reliable - stimulation rate to obtain VEMPs.

Method: The VEMPs of 18 subjects were acquired using stimulation rates ranging between 5.1 and 40.8 stimuli per second.

Study design: cross-sectional contemporary cohort study.

Results: Latencies were kept unaltered and amplitudes were progressively reduced as stimulation rates were increased. However, ANOVA and the Kruskal-Wallis test failed to find statistically significant differences between the tested parameters. The study further indicated that when stimulation rates of 5.1 and 10.2 stimuli per second were compared, no statistically significant differences were observed in latency.

Conclusion: The highest reliable stimulation rate observed in the group of young adults with normal hearing included in this study was 10.2 stimuli per second.

Figures

Graph 1
Graph 1
Comparison between amplitudes according to stimulation rate.

References

    1. Damen MMJ. Clinical application of the threshold. Medical Engineering. Technische Universiteit Eindhoven; Eindhoven: 2007. Vestibular evoked myogenic potential (VEMP)
    1. Pollak L, Kushnir M, Stryjer R. Diagnostic value of vestibular evoked myogenic potentials in cerebellar and lower-brainstem strokes. Neurophysiol Clin. 2006;36(4):227–233. doi: 10.1016/j.neucli.2006.08.014. DOI:
    1. Rauch SD. Vestibular evoked myogenic potentials. Curr Opin Otolaryngol Head Neck Surg. 2006;14(5):299–304. doi: 10.1097/01.moo.0000244185.65022.01. DOI:
    1. Sazgar AA, Dortaj V, Akrami K, Akrami S, Karimi Yazdi AR. Saccular damage in patients with high-frequency sensorineural hearing loss. Eur Arch Otorhinolaryngol. 2006;263(7):608–613. doi: 10.1007/s00405-006-0038-6. PMID: 16625399 DOI:
    1. Lütkenhöner B, Stoll W, Basel T. Modeling the vestibular evoked myogenic potential. J Theor Biol. 2010;263(1):70–78. doi: 10.1016/j.jtbi.2009.10.036. PMID: 19896953 DOI:
    1. Akin FW, Murnane OD, Panus PC, Caruthers SK, Wilkinson AE, Proffitt TM. The influence of voluntary tonic EMG level on the vestibular-evoked myogenic potential. J Rehabil Res Dev. 2004;41(3B):473–480. PMID: 15543465.
    1. Halmagyi GM, Colebatch JG, Curthoys IS. New tests of vestibular function. Baillieres Clin Neurol. 1994;3(3):485–500.
    1. Hong SM, Park DC, Yeo SG, Cha CI. Vestibular evoked myogenic potentials in patients with benign paroxysmal positional vertigo involving each semicircular canal. Am J Otolaryngol. 2008;29(3):184–187. doi: 10.1016/j.amjoto.2007.07.004. DOI:
    1. Pérez Guillén V, González García E, García Piñero A, Piqueras Del Rey A, Morera Pérez C, Pérez Garrigues H. Vestibular evoked myogenic potential: a contribution to the vestibular physiology and pathology knowledge. Quantitative patterns in healthy subjects. Acta Otorrinolaringol Esp. 2005;56(8):349–353. PMID: 16285433.
    1. Shimizu K, Murofushi T, Sakurai M, Halmagyi M. Vestibular evoked myogenic potentials in multiple sclerosis. J Neurol Neurosurg Psychiatry. 2000;69(2):276–277. doi: 10.1136/jnnp.69.2.276. PMID: 10960289 DOI:
    1. Colebatch JG, Halmagyi GM. Vestibular evoked potentials in human neck muscles before and after unilateral vestibular deafferentation. Neurology. 1992;42(8):1635–1636. doi: 10.1212/WNL.42.8.1635. DOI:
    1. Burkard RF, Eggermont JJ, Don M. Auditory evoked potentials: Basic principles and Clinical Application. Lippincott Williams & Wilkins; Philadelphia: 2007.
    1. Timmer FC, Zhou G, Guinan JJ, Kujawa SG, Herrmann BS, Rauch SD. Vestibular evoked myogenic potential (VEMP) in patients with Ménière's disease with drop attacks. Laryngoscope. 2006;116(5):776–779. doi: 10.1097/01.mlg.0000205129.78600.27. PMID: 16652086 DOI:
    1. Basta D, Todt I, Ernst A. Normative data for P1/N1-latencies of vestibular evoked myogenic potentials induced by air- or bone-conducted tone bursts. Clin Neurophysiol. 2005;116(9):2216–2219. doi: 10.1016/j.clinph.2005.06.010. PMID: 16043396 DOI:
    1. Sheykholeslami K, Habiby Kermany M, Kaga K. Frequency sensitivity range of the saccule to bone-conducted stimuli measured by vestibular evoked myogenic potentials. Hear Res. 2001;160(1-2):58–62. PMID: 11591491.
    1. Kelsch TA, Schaefer LA, Esquivel CR. Vestibular evoked myogenic potentials in young children: test parameters and normative data. Laryngoscope. 2006;116(6):895–900. doi: 10.1097/01.mlg.0000214664.97049.3e. PMID: 16735887 DOI:
    1. Huang TW, Su HC, Cheng PW. Effect of click duration on vestibular-evoked myogenic potentials. Acta Otolaryngol. 2005;125(2):141–144. doi: 10.1080/00016480410016900. PMID: 15880943 DOI:
    1. Cheng PW, Murofushi T. The effects of plateau time on vestibular-evoked myogenic potentials triggered by tone bursts. Acta Otolaryngol. 2001;121(8):935–938. doi: 10.1080/00016480127377. PMID: 11813898 DOI:
    1. Cheng PW, Murofushi T. The effect of rise/fall time on vestibular-evoked myogenic potential triggered by short tone bursts. Acta Otolaryngol. 2001;121(6):696–699. doi: 10.1080/00016480152583638. PMID: 11678168 DOI:
    1. Murofushi T, Matsuzaki M, Wu CH. Short tone burst-evoked myogenic potentials on the sternocleidomastoid muscle: are these potentials also of vestibular origin? Arch Otolaryngol Head Neck Surg. 1999;125(6):660–664. doi: 10.1001/archotol.125.6.660. PMID: 10367923 DOI:
    1. Stapells DR. In: A sound foundation through early amplification. Seewald RC, Bamford J., editors. Ponak; Chicago: 2005. Current status of the auditory steady-state responser for estimating an infant's audiogram; pp. 43–59.
    1. Picton TW, John MS, Dimitrijevic A, Purcell D. Human auditory steady-state responses. Int J Audiol. 2003;42(4):177–219. doi: 10.3109/14992020309101316. PMID: 12790346 DOI:
    1. Felipe L, Kigman H. Gonçalves DH. Potencial evocado miogênico vestibular. Arq Int Otorrinolaringol. 2012;16(1):103–107. doi: 10.7162/S1809-48722012000100015. DOI:
    1. Lins OG. Audiometria fisiológica tonal utilizando respostas de estado estável auditivas do tronco cerebral [Tese de Doutorado] Universidade Federal de São Paulo, Escola Paulista de Medicina; São Paulo: 2002.
    1. Pauli-Magnus D, Hoch G, Strenzke N, Anderson S, Jentsch TJ, Moser T. Detection and differentiation of sensorineural hearing loss in mice using auditory steady-state responses and transient auditory brainstem responses. Neuroscience. 2007;149(3):673–684. doi: 10.1016/j.neuroscience.2007.08.010. PMID: 17869440 DOI:
    1. Wu CH, Murofushi T. The effect of click repetition rate on vestibular evoked myogenic potential. Acta Otolaryngol. 1999;119(1):29–32. doi: 10.1080/00016489950181891. DOI:
    1. Oliveira AC. Estudo dos potenciais evocados miogênicos vestibulares de estado estável [Tese de doutorado] Universidade de São Paulo: Faculdade de Medicina de Ribeirão Preto; Ribeirão Preto: 2010.
    1. Murofushi T, Curthoys IS. Physiological and anatomical study of click-sensitive primary vestibular afferents in the guinea pig. Acta Otolaryngol. 1997;117(1):66–72. doi: 10.3109/00016489709117994. PMID: 9039484 DOI:
    1. Murofushi T, Curthoys IS, Topple AN, Colebatch JG, Halmagyi GM. Responses of guinea pig primary vestibular neurons to clicks. Exp Brain Res. 1995;103(1):174–178. doi: 10.1007/BF00241975. PMID: 7615033 DOI:
    1. Murofushi T, Curthoys IS, Gilchrist DP. Response of guinea pig vestibular nucleus neurons to clicks. Exp Brain Res. 1996;111(1):149–152. doi: 10.1007/BF00229565. PMID: 8891646 DOI:

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