Ocular vestibular evoked myogenic potentials induced by air-conducted sound in patients with acute brainstem lesions

Oh, Sun-Young; Kim, Ji Soo; Lee, Jongmin; Shin, Byoung‐Soo; Hwang, Seung Bae; Kwak, Kichang; Kim, Chanmi; Jeong, Seul-Ki; Kim, Tae Woo

doi:10.1016/j.clinph.2012.09.026

Cited by 41 publications

(46 citation statements)

References 40 publications

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“…More than a half (27/52, 52 %) of the patients with acute brainstem lesions showed abnormal oVEMPs induced by air-conducted tone burst sounds (ACS) ( Table 1) [5]. Four of the five patients with acute midbrain lesions (80 %) also showed abnormal oVEMPs during contralesional ear stimulation, mostly in combination with a contraversive ocular tilt reaction (OTR) and contraversive tilt of the subjective visual vertical (Fig.…”

Section: Ovempsmentioning

confidence: 97%

“…The contralesional or bilateral abnormalities of cVEMPs in patients with unilateral LMI were ascribed to disruption of commissural modulation between the vestibular nuclei [23]. Of the 19 patients with medullary lesions, patients with lateral medullary lesions (n = 14) showed abnormal oVEMPs less frequently than those with medial medullary lesions (4/14, 28.5 % vs. 5/5, 100 %) [5].…”

Section: Lateral Medullary Infarction (Wallenberg Syndrome)mentioning

confidence: 98%

“…In contrary to the cVEMPs which are an uncrossed inhibitory vestibulospinal response, the oVEMPs represent a crossed excitatory vestibulo-ocular reflex (VOR) (Fig. 1) [5][6][7]. The VOR is mediated by the vestibular end organ receptors, the neurons in the vestibular nuclei, and the ocular motoneurons.…”

Section: Introductionmentioning

confidence: 96%

“…The VOR is mediated by the vestibular end organ receptors, the neurons in the vestibular nuclei, and the ocular motoneurons. Pathways carrying these signals mostly run in the MLF in the upper medulla and pons, but also in other ascending otolithic pathways such as the central ventral tegmental tract, ascending tract of Deiters and the ipsilateral vestibulo-thalamic tract from the vestibular nuclei to the upper brainstem and thalamus [5,8].…”

Section: Introductionmentioning

confidence: 99%

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Vestibular-evoked myogenic potentials in central vestibular disorders

Kim

2015

J Neurol

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Vestibular-evoked myogenic potentials (VEMPs) are short latency manifestations of vestibuloocular and vestibulocollic reflexes that originate from the utricle and saccule. Although cervical and ocular VEMPs have mostly been applied to peripheral vestibular disorders, the characteristics and the diagnostic values of VEMPs have been expanded to assess the function of the central otolithic pathways. In the central nervous system, the cervical VEMPs (cVEMPs) are mediated by the vestibular nuclei and uncrossed medial vestibulospinal tract descending in the lower brainstem and spinal cord. In contrast, the ocular VEMPs (oVEMPs) reflect the function of the vestibular nuclei and the crossed vestibulo-ocular reflex (VOR) pathways, mostly contained in the medial longitudinal fasciculus (MLF). Therefore, lesions involving the vestibular nuclei can present abnormalities of both cVEMPs and oVEMPs. The medullary lesions involving the descending MLF or the spinal accessory nucleus impair cVEMPs. In contrast, the lesions involving the MLF, the crossed ventral tegmental tract, oculomotor nuclei and the interstitial nucleus of Cajal can impair oVEMPs. Patients with unilateral cerebellar infarctions may show abnormal VEMPs especially when they have the ocular tilt reaction. Delayed responses of VEMPs are characteristic of multiple sclerosis (MS). Reduced VEMP responses can be observed in patients with vestibular migraine. VEMPs are useful in evaluating central as well as peripheral otolithic function that are not readily defined by conventional vestibular function tests, and can aid in detecting and localizing central lesions, especially silent brainstem lesions such as tiny infarctions or MS plaques.

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Section: Ovempsmentioning

confidence: 97%

Section: Lateral Medullary Infarction (Wallenberg Syndrome)mentioning

confidence: 98%

Section: Introductionmentioning

confidence: 96%

Section: Introductionmentioning

confidence: 99%

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Vestibular-evoked myogenic potentials in central vestibular disorders

Kim

2015

J Neurol

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“…Studies in patients with acute brainstem lesions [86] and internuclear ophthalmoplegia (INO) [87,88,86] caused by stroke and multiple sclerosis (MS) suggest that the oVEMP pathways course along the medial longitudinal fasciculus (MLF) through the dorsomedial brainstem. The circuit remains functional independent of the cerebellum, as oVEMPs and cVEMPs tend to be preserved in isolated cerebellar lesions, but are often abolished in cerebellar lesions involving the brainstem [89].…”

Section: Central Vestibular Disordersmentioning

confidence: 99%

Clinical Utility of Ocular Vestibular-Evoked Myogenic Potentials (oVEMPs)

Weber

Rosengren

2015

Curr Neurol Neurosci Rep

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Ocular vestibular-evoked myogenic potentials (oVEMP) to skull taps in normal and dehiscent ears: mechanisms and markers of superior canal dehiscence

Taylor

Blaivie²,

Bom

et al. 2014

Exp Brain Res

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The site of stimulus delivery modulates the waveforms of cervical- and ocular vestibular-evoked myogenic potentials (cVEMP and oVEMP) to skull taps in healthy controls. We examine the influence of stimulus location on the oVEMP waveforms of 18 patients (24 ears) with superior canal dehiscence (SCD) and compare these with the results of 16 healthy control subjects (32 ears). oVEMPs were recorded in response to taps delivered with a triggered tendon-hammer and a hand-held minishaker at three midline locations; the hairline (Fz), vertex (Cz) and occiput (Oz). In controls, Fz stimulation evoked a consistent oVEMP waveform with a negative peak (n1) at 9.5 ± 0.5 ms. In SCD, stimulation at Fz produced large oVEMP waveforms with delayed n1 peaks (tendon-hammer = 13.2 ± 1.0 ms and minitap = 11.5 ± 1.1 ms). Vertex taps produced diverse low-amplitude waveforms in controls with n1 peaks at 15.5 ± 1.2 and 13.2 ± 1.3 ms for tendon-hammer taps and minitaps, respectively; in SCD, they produced large amplitude oVEMP waveforms with n1 peaks at 12.9 ± 0.8 ms (tendon-hammer) and 12.1 ± 0.5 ms (minitap). Occiput stimulation evoked oVEMPs with similar n1 latencies in both groups (tendon-hammer = 11.3 ± 1.3 and 10.7 ± 0.8; minitap = 10.3 ± 0.9 and 11.1 ± 0.4 for control and SCD ears, respectively). Compared to reflex amplitudes, n1 peak latencies to Fz taps provided clearer separation between SCD and control ears. The distinctly different effects of Fz and vertex taps on the oVEMP waveforms may represent an additional non-osseous mechanism of stimulus transmission in SCD. For skull taps at Fz, a prolonged n1 latency is an indicator of SCD.

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Ocular vestibular evoked myogenic potentials induced by air-conducted sound in patients with acute brainstem lesions

Cited by 41 publications

References 40 publications

Vestibular-evoked myogenic potentials in central vestibular disorders

Vestibular-evoked myogenic potentials in central vestibular disorders

Clinical Utility of Ocular Vestibular-Evoked Myogenic Potentials (oVEMPs)

Ocular vestibular-evoked myogenic potentials (oVEMP) to skull taps in normal and dehiscent ears: mechanisms and markers of superior canal dehiscence

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