Vestibular-evoked myogenic potentials in chronic noise-induced hearing loss

Objective To investigate the effect of chronic noise exposure on vestibular-evoked myogenic potentials. Study Design Prospective study. Subjects and Methods Twenty patients with chronic noise-induced hearing loss, presenting as bilateral notched audiogram at 4 kHz, underwent audiometry, caloric, and vestibular-evoked myogenic potential tests. Results Caloric and vestibular-evoked myogenic potential tests revealed abnormal responses in nine (45%) and 10 (50%) patients, respectively. However, when both results were considered together, the abnormal rate reached 70% (14 of 20). The hearing threshold of 4 kHz significantly associated with vestibular-evoked myogenic potential results (ie, vestibular-evoked myogenic potential was abnormal in patients with greater degrees of hearing loss), but not with caloric responses. Conclusion Patients with bilateral 4-kHz notched audiogram and hearing threshold of 4 kHz >40 dB may show abnormal (absent or delayed) vestibular-evoked myogenic potentials, indicating that the vestibular part, especially the sacculocollic reflex pathway, has also been damaged.

Sacculocollic Reflex Arcs in Cats

Uchino, Y., H. Sato, M. Sasaki, M. Imagawa, H. Ikegami, N. Isu, and W. Graf. Sacculocollic reflex arcs in cats. J. Neurophysiol. 77: 3003–3012, 1997. Neuronal connections and pathways underlying sacculocollic reflexes were studied by intracellular recordings from neck extensor and flexor motoneurons in decerebrate cat. Bipolar electrodes were placed within the left saccular nerve, whereas other branches of the vestibular nerve were removed in the inner ear. To prevent spread of stimulus current to other branches of the vestibular nerve, the saccular nerve and the electrodes were covered with warm semisolid paraffin-Vaseline mixture. Saccular nerve stimulation evoked disynaptic (1.8–3.0 ms) excitatory postsynaptic potentials (EPSPs) in ipsilateral neck extensor motoneurons and di- or trisynaptic (1.8–4.0 ms) EPSPs in contralateral neck extensor motoneurons, and di- and trisynaptic (1.7–3.6 ms) inhibitory postsynaptic potentials (IPSPs) in ipsilateral neck flexor motoneurons and trisynaptic (2.7–4.0 ms) IPSPs in contralateral neck flexor motoneurons. Ipsilateral inputs were about twice as strong as contralateral ones to both extensor and flexor motoneurons. To determine the pathways mediating this connectivity, the lateral part of the spinal cord containing the ipsilateral lateral vestibulospinal tract (i-LVST) or the central part of the spinal cord containing the medial vestibulospinal tracts (MVSTs) and possibly reticulospinal fibers (RSTs) were transected at the caudal end of the C1 segment. Subsequent renewed intracellular recordings following sacculus nerve stimulation indicated that the pathway from the saccular nerve to the ipsilateral neck extensor motoneurons projects though the i-LVST, whereas the pathways to the contralateral neck extensors and to the bilateral neck flexor motoneurons descend in the MVSTs/RSTs. Our data show that sacculo-neck reflex connections display a qualitatively bilaterally symmetrical innervation pattern with excitatory connections to both neck extensor motoneuron pools, and inhibitory connections to both neck flexor motoneuron pools. This bilateral organization contrasts with the unilateral innervation scheme of the utriculus system. These results suggest a different symmetry plane along which sacculus postural reflexes are organized, thus supplementing the reference planes of the utriculus system and allowing the gravistatic system to represent all three translational spatial degrees of freedom. We furthermore suggest that the sacculocollic reflex plays an important role in maintaining the relative position of the head and the body against the vertical linear acceleration of gravity.