The evidence is finally here: Ocular vestibular evoked myogenic potentials are mainly dependent on utricular pathway function

Papathanasiou, Eleftherios S.

doi:10.1016/j.clinph.2015.01.007

Cited by 11 publications

(4 citation statements)

References 14 publications

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“…Since the utricular afferents travel in the superior nerve and project to contralateral inferior oblique, it is most likely the utricular afferents which are affected. In light of these results, the Curthoys ( 71 , 74 ) suggestion is now accepted: “Ocular vestibular evoked potentials are mainly dependent on utricular pathway function” [( 78 ), p. 1843] and “The oVEMP originates predominantly from utricular afferents” [( 79 ), p. 1051].…”

Section: Physiology Relevant For Clinical Testingmentioning

confidence: 99%

Otolithic Receptor Mechanisms for Vestibular-Evoked Myogenic Potentials: A Review

et al. 2018

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Air-conducted sound and bone-conduced vibration activate otolithic receptors and afferent neurons in both the utricular and saccular maculae, and trigger small electromyographic (EMG) responses [called vestibular-evoked myogenic potentials (VEMPs)] in various muscle groups throughout the body. The use of these VEMPs for clinical assessment of human otolithic function is built on the following logical steps: (1) that high-frequency sound and vibration at clinically effective stimulus levels activate otolithic receptors and afferents, rather than semicircular canal afferents, (2) that there is differential anatomical projection of otolith afferents to eye muscles and neck muscles, and (3) that isolated stimulation of the utricular macula induces short latency responses in eye muscles, and that isolated stimulation of the saccular macula induces short latency responses in neck motoneurons. Evidence supports these logical steps, and so VEMPs are increasingly being used for clinical assessment of otolith function, even differential evaluation of utricular and saccular function. The proposal, originally put forward by Curthoys in 2010, is now accepted: that the ocular vestibular-evoked myogenic potential reflects predominantly contralateral utricular function and the cervical vestibular-evoked myogenic potential reflects predominantly ipsilateral saccular function. So VEMPs can provide differential tests of utricular and saccular function, not because of stimulus selectivity for either of the two maculae, but by measuring responses which are predominantly determined by the differential neural projection of utricular as opposed to saccular neural information to various muscle groups. The major question which this review addresses is how the otolithic sensory system, with such a high density otoconial layer, can be activated by individual cycles of sound and vibration and show such tight locking of the timing of action potentials of single primary otolithic afferents to a particular phase angle of the stimulus cycle even at frequencies far above 1,000 Hz. The new explanation is that it is due to the otoliths acting as seismometers at high frequencies and accelerometers at low frequencies. VEMPs are an otolith-dominated response, but in a particular clinical condition, semicircular canal dehiscence, semicircular canal receptors are also activated by sound and vibration, and act to enhance the otolith-dominated VEMP responses.

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Section: Physiology Relevant For Clinical Testingmentioning

confidence: 99%

Otolithic Receptor Mechanisms for Vestibular-Evoked Myogenic Potentials: A Review

et al. 2018

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“…Fig. 1f; [12,33,44,51,52,56,61,64,82]). This "double dissociation" of o-and c-VEMPs in superior versus infe-…”

Section: Vestibular Neuritismentioning

confidence: 99%

“…On the other hand, reduced ipsilateral cVEMP p13n23 amplitudes and symmetrical oVEMP n10 responses are a hallmark of inferior vestibular neuritis (Fig. 1 f; [ 12 , 33 , 44 , 51 , 52 , 56 , 61 , 64 , 82 ]). This “double dissociation” of o‑ and c‑VEMPs in superior versus inferior vestibular neuritis has two important implications.…”

Section: Clinical Applicationsmentioning

confidence: 99%

Evidence-based diagnostic use of VEMPs

Dlugaiczyk¹

2020

HNO

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“…For a thorough understanding of the effects of low-frequency sounds on humans, the vestibular organ should be included in any investigation. As cVEMPs and oVEMPs evoked with AC sound are now widely considered to selectively reflect activity of the saccule and utricle [8,9,13,40], respectively, we assessed cVEMP and oVEMP thresholds in the range between 40 and 120 Hz in order to gain selective information from the two otolith organs. In a second step, the relation between the stimulus carrier phase and cVEMP characteristics was established, based on earlier indications that VEMP waveforms may lock onto AC sound carrier waveforms at low frequencies [48].…”

Section: Introductionmentioning

confidence: 99%

Ocular and cervical vestibular evoked myogenic potentials elicited by air-conducted, low-frequency sound

Luecke¹,

Buchwieser²,

Eulenburg

et al. 2020

VES

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BACKGROUND: Sound is not only detected by the cochlea, but also, at high intensities, by the vestibular system. Acoustic activation of the vestibular system can manifest itself in vestibular evoked myogenic potentials (VEMPs). In a clinical setting, VEMPs are usually evoked with rather high-frequency sound (500 Hz and higher), despite the fact that only a fraction of saccular and utricular hair cells in the striolar region is available for high-frequency stimulation. OBJECTIVE: As a growing proportion of the population complains about low-frequency environmental noise, including reports on vestibular symptoms, the activation of the vestibular system by low-frequency sound deserves better understanding. METHODS: We recorded growth functions of oVEMPs and cVEMPs evoked with air-conducted sound at 120 Hz and below. We estimated VEMP thresholds and tested whether phase changes of the stimulus carrier result in changes of VEMP amplitude and latency. RESULTS: The VEMP response of the otholith organs to low-frequency sound is uniform and not tuned when corrected for middle ear attenuation by A-weighting the stimulus level. Different stimulus carrier phases result in phase-correlated changes of cVEMP latencies and amplitudes. CONCLUSIONS: VEMPs can be evoked with rather low-frequency sound, but high thresholds suggest that they are unlikely to be triggered by environmental sounds.

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The evidence is finally here: Ocular vestibular evoked myogenic potentials are mainly dependent on utricular pathway function

Cited by 11 publications

References 14 publications

Otolithic Receptor Mechanisms for Vestibular-Evoked Myogenic Potentials: A Review

Otolithic Receptor Mechanisms for Vestibular-Evoked Myogenic Potentials: A Review

Evidence-based diagnostic use of VEMPs

Ocular and cervical vestibular evoked myogenic potentials elicited by air-conducted, low-frequency sound

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