Comparison of Multifrequency Narrow-Band CE-Chirp and Tone Burst Evoked Cervical Vestibular Evoked Myogenic Potentials

Abstract

Background: Cervical Vestibular Evoked Myogenic Potentials (cVEMPs) are inhibitory myogenic responses that have commonly been elicited using a variety of stimuli. Yet, the comparison of the effects of multi-frequency tone bursts and narrowband Claus Elberling chirps (NB CE-chirps) on cVEMPs has never been studied in homogeneous age groups. Purpose: The present study focused on comparing the effect of multi-frequency NB CE-chirps and tone bursts on the various parameters of cVEMP responses in normal-hearing younger adults. Research Design: A within-group study design was applied, and purposive sampling was utilized for the collection of the data sample. Study Sample: The present study involved the elicitation of NB CE-chirps and tone bursts evoked cVEMPs across four-octave frequencies in 25 normal-hearing younger adults. Results: NB CE-chirps and tone bursts evoked cVEMPs were found to have a 100% response rate for all frequencies except 4000 Hz. Across frequencies, P1 and N1 latencies were seen to be significantly shorter for NB CE-chirps than tone bursts at 500 Hz and 1000 Hz stimulation. No differences were seen in the P1N1 amplitudes and inter-aural asymmetry ratio (IAAR) between the two stimuli across all four-octave frequencies. Further, it was found to have a significantly higher number of ears tuned to NB CE-chirps than tone bursts at 500 Hz. Conclusions: Comparative differences in the latencies of cVEMP responses between and within stimuli could be due to the variation in stimuli duration. Also, the difference in amplitudes across stimulation frequencies might have resulted due to the predominance of saccular responses at lower mechanical resonance frequencies. Thus, the tuning was also seen at 500 Hz and was relatively higher for NB CE-chirps than tone bursts.

A meta-analysis comparing the performance of narrowband CE-Chirp and 500 Hz tone burst stimuli in recording cervical vestibular evoked myogenic potential (cVEMP)

“…In particular, relative to the 500 Hz tone burst, several studies found the P1–N1 amplitude to be larger for the chirp stimulus 18 , 20 , 22 , 23 . On the contrary, in other studies, the P1–N1 amplitude was found to be comparable between the two stimuli 24 – 26 , as well as lower for the chirp stimulus 17 . Owing to the conflicting findings in the literature, the aim of this meta-analysis is to provide more plausible evidence as to whether the NB CE-Chirp stimulus is superior to the conventional 500 Hz tone burst in the cVEMP testing.…”

“…Subsequently, two articles were excluded due to ineligible study outcomes. In particular, studies conducted by Mat et al 22 and Neupane and Lodha 26 did not provide the respective mean and standard deviation values of cVEMP parameters. Additionally, an article authored by Moinudeen et al 20 was retrieved using the citation search method (Fig.…”

“…Nevertheless, contradictory outcomes have been reported in the literature. While the majority of studies found P1 and N1 latencies to be statistically shorter for the chirp stimulus 17 , 18 , 20 – 26 , inconsistent findings were reported regarding P1–N1 amplitude. In particular, relative to the 500 Hz tone burst, several studies found the P1–N1 amplitude to be larger for the chirp stimulus 18 , 20 , 22 , 23 .…”

“…As such, the low frequency tone such as a 500 Hz burst has been the stimulus of choice for clinical and research applications 3 , 4 , 13 – 15 . In recent years, there has been a surge of interest in researching the usefulness of chirp stimuli in the cVEMP testing 16 – 26 . It is worth mentioning that the chirp stimuli were specifically developed with the aim of producing enhanced amplitudes of auditory evoked potentials (AEPs), such as the auditory brainstem response (ABR) and the auditory steady state response (ASSR) 27 – 30 .…”

“…Even though there are many types of chirp stimuli 17 – 21 , a narrowband (NB) CE-Chirp stimulus (frequencies from 360 to 720 Hz and centred at 500 Hz) has been commonly employed in the cVEMP studies 18 , 20 , 22 – 26 . The purpose of applying this chirp stimulus, which is commercially accessible in many types of AEP devices, is to ascertain whether it would produce more robust cVEMP responses than the conventional 500 Hz tone burst.…”