The Effect of Recording Montage and Tone Burst Duration on Cervical and Ocular Vestibular Evoked Myogenic Potential Latency and Amplitude

Electrode Montage Induced Changes in Air-Conducted Ocular Vestibular-Evoked Myogenic Potential

OBJECTIVES

Stimulus and recording parameters are pivotal for shaping the ocular vestibular-evoked myogenic potential (oVEMP). In the last decade, several attempts were made to identify the optimum electrode placement site to improve the oVEMP responses. A vast majority of these found larger response amplitudes for alternate electrode montages like belly-tendon (BT), chin-referenced (CR), and/or sternum-referenced montages than the clinically used infra-orbital montage. However, no study has yet compared all alternate electrode montages in a simultaneous recording paradigm to eliminate other confounding factors. Also, no study has compared all of them for their test-retest reliability, waveform morphology, and signal-to-noise ratio. Therefore, the decision on which among these electrode montages is best suited for oVEMP acquisition remains opaque. The present study aimed to investigate the effects of various electrode montages on oVEMP's response parameters and to determine the test-retest reliability of each of these in clinically healthy individuals using a simultaneous recording paradigm.

DESIGN

This study had a within-subject experimental design. Fifty-five young healthy adults (age range: 20-30 years) underwent contralateral oVEMP recording using infra-orbital, BT, chin-referenced, and sternum-referenced electrode montages simultaneously using a four-channel evoked potential system.

RESULTS

BT montage had a significantly shorter latency, larger amplitude, higher signal-to-noise ratio, and better morphology than other alternate montages ( p < 0.008). Further, all electrode montages of the current study showed fair/moderate to excellent test-retest reliability.

CONCLUSIONS

By virtue of producing significantly better response parameters than the other electrode montages, BT montage seems better suited to the recording of oVEMP than the known electrode montages thus far.

Age Effects of Bone Conduction Vibration Vestibular-evoked Myogenic Potentials (VEMPs) Using B81 and Impulse Hammer Stimuli

OBJECTIVE

Recently developed, the Radioear B81 bone oscillator allows for higher bone conduction vibration output; however, normative data are lacking regarding its use in vestibular-evoked myogenic potential (VEMP) testing. The purpose of this study was to examine the effect of age on cervical and ocular VEMP (c- and oVEMP) responses using the B81 and to compare with air conduction stimuli (ACS) and impulse hammer (IH) VEMP response characteristics.

DESIGN

c- and oVEMP were completed with ACS, B81, and IH stimuli in healthy participants (age range = 10 to 87 years, n = 85).

RESULTS

Regardless of stimulus type, c- and oVEMP amplitudes and response rates decreased with age. For cVEMP response rates, ACS performed better or equal to B81, which was superior to the IH. For cVEMP corrected amplitude, ACS had significantly higher amplitudes compared with B81 and IH. There was no difference in cVEMP corrected amplitude between B81 and IH. For oVEMP, response rates were comparable between stimuli with the largest disparity in response rates occurring in the oldest groups where IH outperformed both ACS and B81. For oVEMP amplitude, IH had significantly higher amplitudes compared with B81 and ACS. There was no difference in oVEMP amplitude between B81 and ACS.

CONCLUSIONS

Age significantly affected c- and oVEMP amplitudes regardless of stimulus type (ACS, B81, IH). All stimuli are appropriate for eliciting c- and oVEMP in the young individuals. While ACS resulted in higher cVEMP corrected amplitudes, either ACS or B81 are appropriate for older individuals. However, for oVEMPs, higher response rates and larger amplitudes were noted for IH followed by B81 and ACS. Overall, the B81 performed well across the lifespan for c- and oVEMPs and may be a reasonable bone conduction vibration option for patients with absent ACS VEMPs, but at this time is not recommended as a replacement to ACS.

Effects of Tonic Muscle Activation on Amplitude-Modulated Cervical Vestibular Evoked Myogenic Potentials (AMcVEMPs) in Young Females: Preliminary Findings

Cervical vestibular evoked myogenic potentials (cVEMPs) are usually elicited by transient tonebursts, but when elicited by amplitude-modulated (AM) tones, they can provide new information about cVEMPs. Previous reports of cVEMPs elicited by AM tones, or AMcVEMPs, have not systematically examined the effects of tonic EMG activation on their response properties. Fourteen young, healthy female adults (ages 20-24) with clinically normal audiograms participated in this study. AMcVEMPs were elicited with bone-conducted 500 Hz tones amplitude modulated at a rate of 37 Hz and recorded for five different EMG targets ranging from 0 to 90 μV. Amplitude increased linearly as tonic EMG activation increased. Signal-to-noise ratio (SNR) was minimal at 0 μV, but robust and with equivalent values from 30 to 90 μV; phase coherence and EMG-corrected amplitude had findings similar to SNR across EMG target levels. Interaural asymmetry ratios for SNR and phase coherence were substantially lower than those for raw or corrected amplitude. AMcVEMP amplitude scaled with tonic EMG activation similar to transient cVEMPs. Signal-to-noise ratio, phase coherence, and EMG-corrected amplitude plateaued across a range of EMG values, suggesting that these properties of the response reach their maximum values at relatively low levels of EMG activation and that higher levels of EMG activation are not necessary to record robust AMcVEMPs.