scholarly journals Vestibular evoked myogenic potentials evoked by brief interaural head acceleration: properties and possible origin

2009 ◽  
Vol 107 (3) ◽  
pp. 841-852 ◽  
Author(s):  
Sally M. Rosengren ◽  
Neil P. M. Todd ◽  
James G. Colebatch
Keyword(s):  
Positive Response ◽  
Normal Subjects ◽  
Lateral Acceleration ◽  
Vestibular Evoked Myogenic Potentials ◽  
Head Acceleration ◽  
Vestibular Evoked Myogenic Potential ◽  
Side Peak ◽  
Vestibular Loss ◽  
Intact Side ◽  
Late Positivity

The vestibular system responds to head acceleration by producing compensatory reflexes in the eyes and postural muscles. In this study, we investigated the effect of brief interaural acceleration on the vestibular evoked myogenic potential (VEMP) in 10 normal subjects and 10 patients with bilateral (bVL) or unilateral vestibular loss (uVL). The stimuli were delivered with a handheld minishaker and tendon hammer over the mastoid and produced relatively pure interaural head acceleration with little rotation (mean peak acceleration: 0.14 g at 3.3 ms). VEMPs were recorded from the neck muscles and were characterized in normal subjects by a positive/negative potential ipsilateral to the stimulated side (peak latencies: 15.1 and 22.6 ms) and a positive response contralaterally (20.3 ms), which was sometimes preceded by a negativity (14.5 ms). These peaks were absent in patients with bVL, confirming their vestibular dependence. In the patients with uVL, medial acceleration of the intact ear produced bilateral responses, an initial positivity on the intact side, and a negativity on the affected side, whereas lateral acceleration produced only a late positivity on the intact side. As the acceleration was primarily in the horizontal plane, it is likely to have activated utricular receptors. Consistent with this, we found that VEMPs are very sensitive to the direction of head acceleration and have features consistent with the utriculocollic projections demonstrated in animals.

Vestibular evoked myogenic potentials in response to laterally directed skull taps

2002 ◽  
Vol 12 (1) ◽  
pp. 35-45 ◽  
Author(s):  
Krister Brantberg ◽  
Arne Tribukait
Keyword(s):  
Vestibular Function ◽  
Normal Subjects ◽  
Short Latency ◽  
The Other ◽  
Vestibular Evoked Myogenic Potentials ◽  
Vestibular Loss ◽  
Skin Electrodes ◽  
Function Loss ◽  
Relaxation Responses ◽  
Muscular Responses

In recent years it has been demonstrated that loud clicks generate short latency vestibular evoked myogenic potentials (VEMP). It has also been demonstrated that midline forehead skull tap stimulation evokes similar VEMP. In the present study, the influence of skull tap direction on VEMP was studied in 13 normal subjects and in five patients with unilateral vestibular loss. Gentle skull taps were delivered manually above each ear on the side of the skull. The muscular responses were recorded over both sternocleidomastoid muscles using skin electrodes. Among the normals, laterally directed skull taps evoked “coordinated contraction-relaxation responses”, i.e. skull taps on one side evoked a negative-positive “inverted” VEMP on that side and a positive-negative "normal" VEMP on the other side. Among patients with unilateral vestibular function loss, skull taps above the lesioned ear evoked similar coordinated contraction-relaxation responses. However, skull taps above the healthy ear did not evoke that type of response. These findings suggest that laterally directed skull taps activate mainly the contralateral labyrinth.

Cervical Vestibular-Evoked Myogenic Potentials Using Vibration and Sound in Normal Subjects

2011 ◽  
Vol 54 (3) ◽  
pp. 192 ◽  
Author(s):  
Bo Ra Na ◽  
Soo Hee Han ◽  
Eun Jung Ha ◽  
Yeo Jin Lee ◽  
Mun Su Park ◽  
...  
Keyword(s):  
Normal Subjects ◽  
Vestibular Evoked Myogenic Potentials

Quantifying the effects of electrode placement and montage on measures of cVEMP amplitude and muscle contraction

2020 ◽  
pp. 1-13
Author(s):  
Sendhil Govender ◽  
Sally M. Rosengren
Keyword(s):  
Muscle Contraction ◽  
Normal Subjects ◽  
Electrode Placement ◽  
Electrode Position ◽  
Test Results ◽  
Vestibular Evoked Myogenic Potential ◽  
Active Electrode ◽  
Myogenic Potential ◽  
Position Errors ◽  
Test Outcomes

BACKGROUND: The cervical vestibular evoked myogenic potential (cVEMP) can be affected by the recording parameters used to quantify the response. OBJECTIVE: We investigated the effects of electrode placement and montage on the variability and symmetry of sternocleidomastoid (SCM) contraction strength and cVEMP amplitude. METHODS: We used inter-side asymmetries in electrode placement to mimic small clinical errors in twenty normal subjects. cVEMPs were recorded at three active electrode sites and referred to the distal SCM tendon (referential montages: upper, conventional and lower). Additional bipolar montages were constructed offline to measure SCM contraction strength using closely-spaced electrode pairs (bipolar montages: superior, lower and outer). RESULTS: The conventional montage generally produced the largest cVEMP amplitudes (P <  0.001). SCM contraction strength was larger for referential montages than bipolar ones (P <  0.001). Inter-side electrode position errors produced large variations in cVEMP and SCM contraction strength asymmetries in some subjects, producing erroneous abnormal test results. CONCLUSION: Recording locations affect cVEMP amplitude and SCM contraction strength. In most cases, small changes in electrode position had only minor effects but, in a minority of subjects, the different montages produced large changes in cVEMP and contraction amplitudes and asymmetry, potentially affecting test outcomes.

Does Electrode Impedance Affect the Recording of Ocular Vestibular-Evoked Myogenic Potentials?

2014 ◽  
Vol 25 (10) ◽  
pp. 969-974 ◽  
Author(s):  
Rachael L. Taylor ◽  
Mikael Schulin ◽  
Samanthi Goonetilleke ◽  
Miriam S. Welgampola
Keyword(s):  
Repeated Measures ◽  
Isopropyl Alcohol ◽  
Skin Surface ◽  
Estimating Equation ◽  
Vestibular Evoked Myogenic Potentials ◽  
Electrode Impedance ◽  
Vestibular Evoked Myogenic Potential ◽  
Skin Preparation ◽  
Skin Abrasion ◽  
Stimulus Artifact

Background: In evoked potential testing, it is common practice to abrade the skin surface as a means of reducing and balancing electrode impedance. The effects of skin preparation and electrode impedance on ocular vestibular-evoked myogenic potential (oVEMP) prevalence and amplitudes are not known. Purpose: We sought to determine whether comparable oVEMP waveforms could be recorded without excessive skin preparation. Research Design: This was a prospective study with a repeated-measures (within-subjects) design. Study Sample: The study group comprised 20 healthy participants (12 females and 8 males) ages 21–57 yr. Data Collection and Analysis: oVEMP reflexes were recorded in response to air-conducted and bone-conducted (AC and BC) stimuli in three conditions. In the first condition (no skin preparation), electrodes were simply placed over the skin surface. For the second condition (moderate skin preparation), oVEMP testing was repeated after the skin had been prepared with 70% isopropyl alcohol swabs. oVEMPs recorded in these two conditions were then compared with those recorded using a third conventional protocol whereby the skin was abraded with skin preparation gel until electrode impedances were low and balanced. For BC stimuli, reflex amplitudes and latencies were compared using a repeated-measures general linear model. For AC stimuli, rates of reflex detection were analyzed using a generalized estimating equation. Nonparametric Friedman tests were used to compare AC oVEMP amplitudes across the three conditions. Results: There was no significant effect of electrode impedance on reflex amplitudes, latencies, or rates of detection (p > 0.05). The results indicated significant stimulus-related artifact (≥3 μV) in 25 of 40 recordings under the high-impedance condition in response to BC stimulation. The stimulus artifact was detectable in 12 of 40 recordings after moderate skin preparation and in 5 recordings after skin abrasion. Conclusions: Comparable rates of reflex detection and oVEMP amplitudes were recorded in the three conditions, implying that rigorous rubbing of the facial skin is largely unnecessary in clinical oVEMP testing. However, for oVEMPs recorded in response to a single-polarity stimulus, reducing and balancing electrode impedances with either isopropyl alcohol wipes or skin abrasion may help reduce unwanted stimulus artifact.

scholarly journals State-of-the-art assessment allows for improved vestibular evoked myogenic potential test-retest reliability

2018 ◽  
Vol 8 (2) ◽  
Author(s):  
Lydia Behtani ◽  
Maxime Maheu ◽  
Audrey Delcenserie ◽  
Mujda Nooristani ◽  
François Champoux
Keyword(s):  
State Of The Art ◽  
Vestibular Evoked Myogenic Potentials ◽  
Vestibular Evoked Myogenic Potential ◽  
Retest Reliability ◽  
Vestibular Assessment ◽  
Myogenic Responses ◽  
Neurologically Normal ◽  
Test Retest Reliability ◽  
The Impact ◽  
Potential Test

The goal of the present study was to evaluate the test-retest reliability values of myogenic responses using the latest guidelines for vestibular assessment. Twenty-two otologically and neurologically normal adults were assessed twice, on two different days. The analyses were carried out using interclass correlations. The results showed that the latest recommendations for vestibular assessment lead to test-retest reliability values that are as high, or greater, than those reported in previous studies. The results suggest that state-of-the-art testing, using the latest recommendations as well as electromyography control, improves reliability values of myogenic responses, more specifically for the cervical vestibular evoked myogenic potentials. The impact of small differences in experimental procedures on the reliability values of myogenic responses is also addressed.

scholarly journals Chronic Electrical Stimulation of the Otolith Organ: Preliminary Results in Humans with Bilateral Vestibulopathy and Sensorineural Hearing Loss

2019 ◽  
Vol 25 (Suppl. 1-2) ◽  
pp. 79-90 ◽  
Author(s):  
Angel Ramos Macias ◽  
Angel Ramos de Miguel ◽  
Isaura Rodriguez Montesdeoca ◽  
Silvia Borkoski Barreiro ◽  
Juan Carlos Falcón González
Keyword(s):  
Electrical Stimulation ◽  
Vestibular Evoked Myogenic Potentials ◽  
Head Impulse Test ◽  
Clinical Test ◽  
Otolith Organ ◽  
Bilateral Vestibulopathy ◽  
Vestibular Loss ◽  
Bilateral Vestibular Loss ◽  
Chronic Electrical Stimulation ◽  
Stimulation Of

Introduction: Bilateral vestibulopathy is an important cause of imbalance that is misdiagnosed. The clinical management of patients with bilateral vestibular loss remains difficult as there is no clear evidence for an effective treatment. In this paper, we try to analyze the effect of chronic electrical stimulation and adaptation to electrical stimulation of the vestibular system in humans when stimulating the otolith organ with a constant pulse train to mitigate imbalance due to bilateral vestibular dysfunction (BVD). Methods: We included 2 patients in our study with BVD according to Criteria Consensus of the Classification Committee of the Bárány Society. Both cases were implanted by using a full-band straight electrode to stimulate the otoliths organs and simultaneously for the cochlear stimulation we use a perimodiolar electrode. Results: In both cases Vestibular and clinical test (video head impulse test, videonistagmography cervical vestibular evoked myogenic potentials, cVEMP and oVEMP), subjective visual vertical test, computerized dynamic posturography, dynamic gait index, Time UP and Go test and dizziness handicap index) were performed. Posture and gait metrics reveal important improvement if compare with preoperartive situation. Oscillopsia, unsteadiness, independence and quality of life improved to almost normal situation. Discussion/Conclusion: Prosthetic implantation of the otolith organ in humans is technically feasible. Electrical stimulation might have potential effects on balance and this is stable after 1 year follow-up. This research provides new possibilities for the development of vestibular implants to improve gravito-inertial acceleration sensation, in this case by the otoliths stimulation.

scholarly journals Sound-evoked vestibular projections to the splenius capitis in humans: comparison with the sternocleidomastoid muscle

2019 ◽  
Vol 126 (6) ◽  
pp. 1619-1629 ◽  
Author(s):  
Sally M. Rosengren ◽  
Konrad P. Weber ◽  
Sendhil Govender ◽  
Miriam S. Welgampola ◽  
Danielle L. Dennis ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Motor Unit ◽  
Vestibular Function ◽  
Head Rotation ◽  
Neck Muscle ◽  
Vestibular Evoked Myogenic Potential ◽  
Vestibular Loss ◽  
Single Motor Unit ◽  
Single Motor ◽  
Splenius Capitis

The short-latency vestibulo-collic reflex in humans is well defined for only the sternocleidomastoid (SCM) neck muscle. However, other neck muscles also receive input from the balance organs and participate in neck stabilization. We therefore investigated the sound-evoked vestibular projection to the splenius capitis (SC) muscles by comparing surface and single motor unit responses in the SC and SCM muscles in 10 normal volunteers. We also recorded surface responses in patients with unilateral vestibular loss but preserved hearing and hearing loss but preserved vestibular function. The single motor unit responses were predominantly inhibitory, and the strongest responses were recorded in the contralateral SC and ipsilateral SCM. In both cases there was a significant decrease or gap in single motor unit activity, in SC at 11.7 ms for 46/66 units and in SCM at 12.7 ms for 51/58 motor units. There were fewer significant responses in the ipsilateral SC and contralateral SCM muscles, and they consisted primarily of weak increases in activity. Surface responses recorded over the contralateral SC were positive-negative during neck rotation, similar to the ipsilateral cervical vestibular evoked myogenic potential in SCM. Responses in SC were present in the patients with hearing loss and absent in the patient with vestibular loss, confirming their vestibular origin. The results describe a pattern of inhibition consistent with the synergistic relationship between these muscles for axial head rotation, with the crossed vestibular projection to the contralateral SC being weaker than the ipsilateral projection to the SCM. NEW & NOTEWORTHY We used acoustic vestibular stimulation to investigate the saccular projections to the splenius capitis (SC) and sternocleidomastoid (SCM) muscles in humans. Single motor unit recordings from within the muscles demonstrated strong inhibitory projections to the contralateral SC and ipsilateral SCM muscles and weak excitatory projections to the opposite muscle pair. This synergistic pattern of activation is consistent with a role for the reflex in axial rotation of the head.

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.

Vestibular evoked myogenic potentials: review

2010 ◽  
Vol 124 (10) ◽  
pp. 1043-1050 ◽  
Author(s):  
R Mudduwa ◽  
N Kara ◽  
D Whelan ◽  
Anirvan Banerjee
Keyword(s):  
Vestibular Function ◽  
Extensive Study ◽  
Vestibular Evoked Myogenic Potentials ◽  
Vestibular Evoked Myogenic Potential ◽  
Clinical Role ◽  
Myogenic Potential ◽  
Future Developments ◽  
Early Results ◽  
Clinical Conditions ◽  
Based Medicine

AbstractBackground:Disorders of balance often pose a diagnostic conundrum for clinicians, and a multitude of investigations have emerged over the years. Vestibular evoked myogenic potential testing is a diagnostic tool which can be used to assess vestibular function. Over recent years, extensive study has begun to establish a broader clinical role for vestibular evoked myogenic potential testing.Objectives:To provide an overview of vestibular evoked myogenic potential testing, and to present the evidence for its clinical application.Review type:Structured literature search according to evidence-based medicine guidelines, performed between November 2008 and April 2009. No restrictions were applied to the dates searched.Conclusion:The benefits of vestibular evoked myogenic potential testing have already been established as regards the diagnosis and monitoring of several clinical conditions. Researchers continue to delve deeper into potential new clinical applications, with early results suggesting promising future developments.

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