Variance of Vestibular‐Evoked Myogenic Potentials

Ochi, Kentaro; Ohashi, Toru; Nishino, Hirohito

doi:10.1097/00005537-200103000-00025

Cited by 97 publications

(95 citation statements)

References 7 publications

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“…Alternatively, the muscle tone may be quantified in terms of the pre-stimulus root-mean-square (RMS) value of the sEMG, which was reported to be linearly related to the VEMP amplitude as well (Lim et al, 1995). Subsequent studies corroborated these findings (Ochi et al, 2001;Welgampola et al, 2003;Akin et al, 2004). Nowadays, the prevailing idea seems to be that the VEMP amplitude is proportional to the sEMG level.…”

Section: Introductionmentioning

confidence: 68%

Modeling the vestibular evoked myogenic potential

Lütkenhöner¹,

Stoll²,

Basel³

2010

Journal of Theoretical Biology

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Measuring the vestibular evoked myogenic potential (VEMP) promises to become a routine method for assessing vestibular function, although the technique is not yet standardized. To overcome the problem that the VEMP amplitude depends not only on the inhibition triggered by the acoustic stimulation of the vestibular end organs in the inner ear, but also on the tone of the muscle from which the potential is recorded, the VEMP is often normalized by dividing through a measure of the electromyogram (EMG) activity. The underlying idea is that VEMP amplitude and EMG activity are proportional. But this would imply that the muscle tone is irrelevant for a successful VEMP recording, contradicting experimental evidence. Here, an analytical model is presented that allows to resolve the contradiction. The EMG is modeled as the sum of motor unit action potentials (MUAPs). A brief inhibition can be characterized by its equivalent rectangular duration (ERD), irrespective of the actual time course of the inhibition. The VEMP resembles a polarity-inverted MUAP under such circumstances. Its amplitude is proportional to both the ERD and the MUAP rate. The EMG activity, by contrast, is proportional to the square root of the MUAP rate. Thus, the normalized VEMP still depends on the muscle tone. To avoid confounding effects of the muscle tone, the standard deviation of the EMG could be considered. But the inhibition effect on the standard deviation is small so that the measuring time would have to be much longer than usual today.

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Section: Introductionmentioning

confidence: 68%

Modeling the vestibular evoked myogenic potential

Lütkenhöner¹,

Stoll²,

Basel³

2010

Journal of Theoretical Biology

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“…Latency has been found to be stable in a variety of peripheral vestibular disorders, including Mé niè re's disease. 11,24,25 Murofushi et al 24 also reported prolonged p13 latency both in patients with multiple sclerosis and in those with a large vestibular schwannoma compressing the brainstem. They concluded that lesions within the brainstem pathway of the vestibulospinal tract are a prerequisite for the prolongation of p13.…”

Section: Discussionmentioning

confidence: 97%

Clinical value of tone burst vestibular evoked myogenic potentials at threshold in acute and stable Ménière's disease

2007

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Introduction:The objectives of this preliminary, prospective, cohort study were to ascertain the characteristics of vestibular evoked myogenic potentials at threshold levels in two groups of Ménière's disease patients – acute and stable – and to identify whether vestibular evoked myogenic potentials can provide any specific, objective information to distinguish acute from stable Ménière's disease.Subjects and methods:The study was based at a tertiary neuro-otology centre. Twenty adult patients who fulfilled the American Academy of Otolaryngology–Head and Neck Surgery1 criteria for Ménière's disease were divided into two groups: 11 patients with acute Ménière's disease and nine patients with stable Ménière's disease. Eighteen healthy adult volunteers served as controls. All subjects underwent vestibular evoked myogenic potential testing with ipsilateral, short tone burst stimuli at 500 Hz, as well as pure tone audiometry. The patients also underwent caloric testing.Results:Vestibular evoked myogenic potentials were present in all controls, and were present in 65 per cent of patients but absent in 35 per cent. The mean absolute threshold (Tvestibular evoked myogenic potential) ± standard deviation in normal controls was 116 ± 7.7 dBSPL; this did not differ statistically from that in patients, nor did it differ between acute and stable Ménière's disease. The p13/n23 latencies at the threshold levels in the normal, acute and stable groups (mean ± standard deviation) were respectively: 15 ± 2.2 ms/23.0 ± 2.5 ms; 15.7 ± 0.9 ms/23.7 ± 0.9 ms; and 15.3 ± 2.0 ms/24.2 ± 1.9 ms. The mean interaural amplitude difference ratio (IAD) ± standard deviation was significantly higher in the stable group compared with the acute group (0.54 ± 0.33 vs −0.15 ± 0.22; p = 0.007) and with the controls (0.54 ± 0.33 vs 0.1 ± 0.22; p = 0.05).Conclusions:The parameter that best differentiated acute from stable Ménière's disease at threshold was the interaural amplitude difference ratio. Therefore, this parameter may be used to monitor the clinical course of Ménière's disease.

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“…Even if its structure is yet to be completely understood, given the little time since the scientific world has gotten an interest in this topic, the analysis of this reflex has brought about growing support to the diagnosis of severe pathologic conditions, such as tumors in the acoustic nerve (vestibular neuritis), Meniere's disease, multiple sclerosis and sensorineural hearing loss [41][42][43][44][45] .…”

Section: Discussionmentioning

confidence: 99%

Potenciais miogênicos evocados vestibulares: metodologias de registro em homens e cobaias

Oliveira

David

Colafêmina

2008

Rev. Bras. Otorrinolaringol.

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The vestibular evoked myogenic potential (VEMP) is a clinical test that assess the vestibular function by means of an inhibitory vestibulo-neck reflex, recorded in body muscles in response to high intensity acoustic stimuli. Aim: To check and analyze the different methods used to record VEMPs in humans and in guinea pigs. Materials and Methods: We researched the following databases: MEDLINE, LILACS, SCIELO and COCHRANE. Results: we noticed discrepancies in relation to the ways used to record the vestibular evoked myogenic potentials in relation to the following factors: patient position at the time of recording, type of sound stimulus used (clicks or tone bursts), parameters for stimuli mediation (intensity, frequency, duration of presentation, filters, response amplification gain and windows for stimulus recording), type of phone used and way of stimulus presentation (mono or binaural, ipsi or contralateral). Conclusion: There is no consensus in the literature as to the best recording method for vestibular evoked myogenic potentials. We need more specific studies in order to compare these recordings and establish a standard model to use it in the clinical practice.

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Variance of Vestibular‐Evoked Myogenic Potentials

Abstract: Interaural difference of thresholds might be the most useful parameters. Adjustment using average muscle tonus is not necessary when the subject is able to get sufficient muscle tonus.

Cited by 97 publications

References 7 publications

Modeling the vestibular evoked myogenic potential

Modeling the vestibular evoked myogenic potential

Clinical value of tone burst vestibular evoked myogenic potentials at threshold in acute and stable Ménière's disease

Potenciais miogênicos evocados vestibulares: metodologias de registro em homens e cobaias

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