Vestibular Evoked Myogenic Potentials in Newborns

Abstract

This study presents a novel method for recording vestibular evoked myogenic potential (VEMP) in newborns, used to investigate the maturation of sacculocollic reflex at birth.Twenty full-term newborns aged 2–5 days old were enrolled in this study. During natural sleep, each newborn underwent distortion product otoacoustic emission test, and VEMP test using the head rotation method. For comparison, 20 healthy adults also underwent VEMP test using the same method. Based on adult criteria, 40 newborn ears revealed normal VEMPs in 40%, prolonged VEMPs in 35%, and absent VEMPs in 25%, indicating that great variation exists in the maturation of the sacculocollic reflex at birth. Comparison of VEMP characteristics between healthy newborns and adults revealed nonsignificant difference in the response rate and the latency of n23. However, significant differences existed in the latency of p13, interpeak p13-n23 interval and p13-n23 amplitude between newborns and adults. In conclusion, VEMPs in newborns can be easily recorded by the head rotation method. Prolonged or absent VEMPs in newborns may reflect incomplete maturity of the sacculocollic reflex pathway, especially the myelination. A further large number of newborns receiving MRI scan for other reasons may undergo VEMP test to verify this hypothesis.

Clinical application of vestibular evoked myogenic potentials in healthy newborns

“…In our study, short-tone bursts were used to evoke VEMPs, and the mean latencies of n23 were short, whereas the mean latencies of p13 were similar to defined adult values. Chen et al [16] found the mean latency of p13 increased (17.7 ms) in newborns, whereas they found the mean latency of n23 to be similar (23.9 ms) to that in adults. These authors also used short-tone burst stimulation, but they performed VEMP recordings during early days after birth.…”

Development of Vestibular Evoked Myogenic Potentials in Preterm Neonates

“…Generation of VEMP response is via a disynaptic pathway, from the saccular macula to the SCM muscle via the inferior vestibular nerve, lateral vestibular nucleus, medial vestibulospinal tract, motor neurons and endplates of the SCM muscle. Since VEMP response is typically in proportion to the level of tonic muscle activity, inadequate SCM muscle contraction in newborns may produce false-negative VEMP responses [Chen et al, 2007]. In this study, preterm neonates had a significantly lower VEMP response rate (26%) than full-term neonates (72%), implying that the sacculocollic reflex system was immature in preterm neonates ( table 2 ).…”

“…A recent study by the authors successfully recorded vestibular evoked myogenic potential (VEMP) responses in full-term newborns, setting the stage for assessing the development of the sacculocollic reflex in full-term neonates [Chen et al, 2007]. However, when VEMP responses are elicited in preterm neonates remains unclear.…”

Vestibular Evoked Myogenic Potentials in Preterm Infants

“…In light of our results, we conclude that incomplete damage to sacculocollic pathways causing prolonged peak p13 latencies rather than total deterioration of vestibule function leading to absent VEMP waves is associated with asphyxiated infants. Chen et al [2007] found great variation in the maturation of the sacculocollic reflex at birth. However, in a recent study, we elicited VEMP recordings in 4-week-old term infants [Erbek et al, 2007].…”