Cervical and ocular vestibular-evoked myogenic potentials in acute vestibular neuritis

ObjectivesTo clarify the origin and afferent pathways of short-latency ocular vestibular-evoked myogenic potential (oVEMP) in response to air-conducted sound (ACS), we evaluated cervical (cVEMP) and ocular VEMPs in patients with vestibular neuritis (VN).MethodsIn response to air-conducted tone burst, the oVEMP and cVEMP were measured in 60 healthy controls and in 41 patients with acute VN. The VN selectively involved the superior vestibular nerve (superior VN) in 30 patients, affected the inferior vestibular nerve only (inferior VN) in three and damaged both superior and inferior vestibular nerve branches in eight.ResultsAll 30 patients with superior VN presented normal cVEMPs, indicating preservation of the saccular receptors and their afferents in the inferior vestibular nerve. However, the oVEMP was abnormal in all patients with superior VN. By contrast, the patients with inferior VN showed normal oVEMP and abnormal cVEMP.ConclusionThese dissociations in the abnormalities of cVEMP and oVEMP in patients with VN selectively involving the superior or inferior vestibular nerve suggest that the origin of the vestibular nerve afferents of oVEMP differ from those of cVEMP.SignificanceThe oVEMP in response to ACS may be mediated by the superior vestibular nerve, probably due to an activation of the utricular receptors.     

Cervical and ocular vestibular-evoked myogenic potentials in vestibular neuritis: comparison between air- and bone-conducted stimulation

To clarify the changes of cervical (cVEMP) and ocular (oVEMP) vestibular evoked myogenic potentials induced by air-conducted sound (ACS) and bone-conducted vibration (BCV) in patients with vestibular neuritis (VN), patients with VN (n = 30) and normal controls (n = 45) underwent recording of cVEMP and oVEMP in response to ACS (1,000 Hz, 5 ms, tone bursts) and BCV (500 Hz, short tone burst). Patients with VN showed a high proportion of oVEMP abnormalities in response to both ACS (80.0 %) and BCV at the forehead (Fz, 73.3 %) or the mastoid (76.7 %). In contrast, cVEMPs were mostly normal with both ACS and BCV in the patients. The dissociations in the abnormalities of cVEMP and oVEMP induced by ACS and BCV at the mastoids and at the forehead in patients with VN suggest that oVEMP reflects functions of the superior vestibular nerve and most likely the utricular function. The results of our study suggest that oVEMP induced by either ACS or BCV appears to depend on integrity of the superior vestibular nerve, possibly due to the utricular afferents travelling in it. In contrast, cVEMP elicited by either ACS or BCV may reflect function of the saccular afferents running in the inferior vestibular nerve.     

The n10 component of the ocular vestibular-evoked myogenic potential (oVEMP) is distinct from the R1 component of the blink reflex

ObjectiveBone-conducted vibration (BCV) in the midline at the hairline (Fz), results in short latency potentials recorded by surface electrodes beneath the eyes – the ocular vestibular-evoked myogenic potential (oVEMP). The early negative component of the oVEMP, n10, is due to vestibular stimulation, however it is similar to the early R1 component of the blink reflex. Here we seek to dissociate n10 from R1.MethodsSurface potentials were recorded from the infraorbital electromyogram of 10 healthy subjects, 6 patients with bilateral vestibular loss, 2 with unilateral vestibular loss, 4 with facial palsy and 3 with facial and vestibular nerve lesions on the same side. BCV was delivered at Fz, the inion, the glabella or the supraorbital ridge using a tendon hammer or a bone-conduction vibrator.ResultsOnset latencies of the n10 evoked by taps at Fz or inion were significantly shorter than the R1 components of blink responses to supraorbital and glabellar stimuli. Upward gaze increased the amplitude of n10 but not R1. The n10 was absent bilaterally in patients with bilateral vestibular loss and beneath the contralesional eye in patients with unilateral vestibular loss, but in both these groups of patients R1 was preserved. In severe facial palsy the R1 component was absent or delayed and attenuated ipsilesionally, but n10 was preserved bilaterally. In subjects with unilateral facial and vestibular nerve lesions (Herpes Zoster of the facial and vestibulocochlear nerves) the dissociation was complete – the ipsilesional R1 was absent or attenuated whereas the ipsilesional n10 was preserved.Conclusionsn10 is distinguished from R1 by its earlier onset, laterality, modulation by gaze position and dissociation in patient groups.SignificanceThe n10 component evoked by BCV at Fz is not the R1 component of the blink reflex.     

A critical review of the neurophysiological evidence underlying clinical vestibular testing using sound,vibration and galvanic stimuli

In addition to activating cochlear receptors, air conducted sound (ACS) and bone conducted vibration (BCV) activate vestibular otolithic receptors, as shown by neurophysiological evidence from animal studies – evidence which is the foundation for using ACS and BCV for clinical vestibular testing by means of vestibular-evoked myogenic potentials (VEMPs). Recent research is elaborating the specificity of ACS and BCV on vestibular receptors. The evidence that saccular afferents can be activated by ACS has been mistakenly interpreted as showing that ACS only activates saccular afferents. That is not correct – ACS activates both saccular and utricular afferents, just as BCV activates both saccular and utricular afferents, although the patterns of activation for ACS and BCV do not appear to be identical. The otolithic input to sternocleidomastoid muscle appears to originate predominantly from the saccular macula. The otolithic input to the inferior oblique appears to originate predominantly from the utricular macula. Galvanic stimulation by surface electrodes on the mastoids very generally activates afferents from all vestibular sense organs. This review summarizes the physiological results, the potential artifacts and errors of logic in this area, reconciles apparent disagreements in this field. The neurophysiological results on BCV have led to a new clinical test of utricular function – the n10 of the oVEMP. The cVEMP tests saccular function while the oVEMP tests utricular function.     

Ocular and cervical vestibular-evoked myogenic potentials to bone conducted vibration in Ménière’s disease during quiescence vs during acute attacks

ObjectiveTwo indicators of otolithic function were used to measure dynamic otolith function in the same patients both during an acute attack of Ménière’s disease (MD) and in the quiescent period between attacks.MethodsThe early negative component (n10) of the ocular vestibular-evoked myogenic potential (the oVEMP) to brief 500 Hz bone conducted vibration (BCV) stimulation of the forehead, in the midline at the hairline (Fz) was recorded by surface EMG electrodes just beneath both eyes while the patient looked up. It has been proposed that the n10 component of the oVEMP to 500 Hz Fz BCV indicates utricular function. It has been proposed that the early positive component (p13) of the cervical vestibular-evoked myogenic potential (the cVEMP) recorded by surface electrodes on both tensed SCM neck muscles to 500 Hz Fz BCV indicates saccular function.ResultsSixteen healthy control subjects tested on two occasions showed no detectable change in the symmetry of oVEMPs or cVEMPs to 500 Hz Fz BCV. In response to 500 Hz Fz BCV 15 early MD patients tested at both attack and quiescent phases showed a dissociation: there was a significant increase in contralesional of n10 of the oVEMP during the attack compared to quiescence but a significant decrease in the ipsilesional p13 of the cVEMP during the attack compared to quiescence.ConclusionsDuring an MD attack, dynamic utricular function in the affected ear as measured by the n10 of the oVEMP to 500 Hz Fz BCV is enhanced, whereas dynamic saccular function in the affected ear as measured by the p13 of the cVEMP to 500 Hz Fz BCV is not similarly affected.SignificanceThe MD attack appears to affect different otolithic regions differentially.     

Mastoid and vertex low-frequency vibration-induced oVEMP in relation to medially directed acceleration of the labyrinth

ObjectiveTo explore the stimulus site and stimulus configuration dependency for bone-conducted low-frequency vibration-induced ocular vestibular evoked myogenic potentials (oVEMPs).MethodsoVEMPs were tested in response to 125 Hz single cycle bone-conducted vibration in healthy subjects (n = 12) and in patients with severe unilateral vestibular lesions (n = 10). The stimulus sites were the mastoids and vertex. Both directions of initial stimulus motion were used.ResultsAt mastoid stimulation, the oVEMP to initial laterally directed acceleration of the labyrinth was delayed approximately the length of time of a stimulus half-cycle, as compared with the response to initial medially directed acceleration. At vertex stimulation, the oVEMP to positive initial acceleration was similar to the oVEMP to mastoid stimulation causing lateral initial acceleration. Likewise, the oVEMP to vertex negative initial acceleration was similar to mastoid stimulation causing initial medial acceleration. Further, patients with unilateral vestibular loss had, compared to healthy subjects, similar oVEMP from the healthy labyrinth.ConclusionsA fundamental dependency on medially directed accelerations of the labyrinth, based on the latency differences revealed, may theoretically account for oVEMP in response to low-frequency stimulation.SignificanceLow-frequency bone vibration stimulation at vertex might serve for simultaneous oVEMP testing of both ears.     

Ocular vestibular evoked myogenic potentials to bone conducted vibration of the midline forehead at Fz in healthy subjects.

OBJECTIVE: To provide the empirical basis for using ocular vestibular evoked myogenic potentials (oVEMPS) in response to Fz bone conducted vibration (BCV) stimulation to indicate vestibular function in human subjects. To show the generality of the response by testing a large number of unselected healthy subjects across a wide age range and the repeatability of the response within subjects. To provide evidence that the response depends on otolithic function. METHODS: The early negative component (n10) of the oVEMP to brief BCV of the forehead, in the midline at the hairline (Fz) is recorded by surface EMG electrodes just beneath the eyes. We used a Bruel and Kjaer 4810 Mini-Shaker or a light tap with a tendon hammer to provide adequate BCV stimuli to test a large number (67) of unselected healthy people to quantify the individual differences in n10 magnitude, latency and symmetry to Fz BCV. A Radioear B-71 bone oscillator at Fz is not adequate to elicit a reliable n10 response. RESULTS: The n10 oVEMP response showed substantial differences in amplitude between subjects, but is repeatable within subjects. n10 is of equal magnitude in both eyes with an average asymmetry around 11%. The average n10 amplitude for Mini Tone Burst BCV is 8.47microV+/-4.02 (sd), the average latency is 10.35ms+/-0.63 (sd). The amplitude of n10 decreases and its latency increases with age. CONCLUSIONS: oVEMPs are a new reliable, repeatable test to indicate vestibular and probably otolithic function. SIGNIFICANCE: This study shows the optimum conditions for recording oVEMPs and provides baseline values for individual differences and asymmetry. oVEMPs can be measured in senior subjects without difficulty.     

Feasibility of the simultaneous ocular and cervical vestibular-evoked myogenic potentials in unilateral vestibular hypofunction

ObjectiveThis study compared the results of combined and individual ocular vestibular-evoked myogenic potential (oVEMP) and cervical VEMP (cVEMP) tests in healthy subjects and patients with unilateral vestibular hypofunction to confirm the effectiveness of the combined oVEMP and cVEMP test.MethodsTwenty healthy volunteers and 12 patients with unilateral vestibular hypofunction underwent individual oVEMP and cVEMP tests in a random order, and combined oVEMP and cVEMP test on another day.ResultsTwenty healthy subjects had 100% response rates for oVEMPs and cVEMPs in both individual and combined stimulation modes. Significant positive correlations exist between individual and combined oVEMPs/cVEMPs in terms of latencies and amplitudes. In 12 patients with unilateral vestibular hypofunction, differences in abnormal percentages of oVEMPs or cVEMPs were non-significant. Additionally, the characteristic parameters of oVEMP/cVEMP among ears of healthy subjects, good and pathological ears of patients with unilateral vestibular hypofunction did not differ significantly, regardless of whether the individual or combined mode was used.ConclusionsThe combined oVEMP and cVEMP test generates similar information to that obtained by individual mode, regardless of whether subjects are healthy or have unilateral vestibular hypofunction.SignificanceSimultaneous oVEMP and cVEMP tests may be a convenient screening tool for assessing crossed vestibulo-ocular reflex and ipsilateral sacculo-collic reflex, which definitely shortens the diagnostic test time. Thus, it may favor the large diffusion of these techniques.     

Acoustic, mechanical and galvanic stimulation modes elicit ocular vestibular-evoked myogenic potentials

ObjectiveThis study compared the characteristic parameters of ocular vestibular-evoked myogenic potentials (oVEMPs) elicited by the air-conducted sound (ACS) and bone-conducted vibration (BCV) stimulation modes as well as the galvanic vestibular stimulation (GVS) mode.DesignFifteen healthy subjects underwent oVEMP tests using ACS (127 dBSPL), BCV (142 dB force level), and GVS (5 mA) modes. The response rate, latencies of nI and pI, nI–pI interval and amplitude were measured for each mode and compared among modes.ResultsAll 15 healthy subjects (30 ears) had 100% response rates in both BCV- and GVS–oVEMPs, exhibiting a response rate significantly higher than 80% in ACS–oVEMPs. The mean nI latency was the shortest in the GVS mode, followed by BCV and then ACS modes. The variation among the latencies of the three modes was significant. Likewise, the mean nI–pI amplitudes in ACS-, BCV- and GVS modes varied significantly. However, the mean nI–pI interval did not differ significantly among the three modes.ConclusionsAmong the ACS (127 dBSPL), BCV (142 dB force level), and GVS (5 mA) modes, the BCV mode yields a 100% response rate and the largest nI–pI amplitude of oVEMPs.SignificanceThe oVEMPs in ACS and GVS modes may help to differentiate the saccular from the retro-saccular lesions. If ACS–oVEMPs are normal, then oVEMPs in BCV and GVS modes can distinguish between utricular and retro-utricular disorders. Restated, oVEMPs in ACS, BCV, and GVS modes may promote the topographical delineation of the lesion site of the otolithic–ocular reflex pathway.     

Differing response properties of cervical and ocular vestibular evoked myogenic potentials evoked by air-conducted stimulation

ObjectiveTo determine the amplitude changes of vestibular evoked myogenic potentials (VEMPs) recorded simultaneously from the neck (cVEMPs) and eyes (oVEMPs) in response to 500 Hz, 2 ms air-conducted sound pips over a 30 dB range.MethodsFifteen healthy volunteers (mean age 29, range 18–57 years old) and one patient with unilateral superior canal dehiscence (SCD) were studied. The stimulus was reduced in increments to 105 dB pSPL for the normals (81 dB pSPL for the SCD patient). A statistical criterion was used to detect responses.ResultsIpsilateral (i-p13/n23) and contralateral (c-n12/p24/n30) peaks for the cVEMP montage and contralateral (c-n10/p16/n21) and ipsilateral (i-n13) peaks for the oVEMP montage were present for the baseline intensity. For the lowest intensity, 6/15 subjects had responses for the i-p13 cVEMP potential and 4/15 had c-n10 oVEMP responses. The SCD patient showed larger responses for nearly all intensities. The cVEMP potentials were generally well fitted by a power law relationship, but the oVEMP c-n10, p16 and n21 potentials showed a significant increase in gradient for the higher intensities.ConclusionMost oVEMP and cVEMP responses follow a power law relationship but crossed oVEMP responses showed a change in gradient above a threshold.SignificanceThe pattern of response to AC stimulation may be a property of the pathways underlying the potentials.     

Vestibular evoked myogenic potentials in Bell’s palsy

The aim of the present study was to evaluate vestibular nerve involvement in patients with Bell’s palsy with ocular and cervical vestibular evoked myogenic potentials (oVEMP and cVEMP). Ten patients who were diagnosed with Bell’s palsy and ten healthy controls were included. All patients underwent VEMP recordings within 6 days after their initial presentation. Patients with Bell’s palsy had greater oVEMP asymmetry ratio comparing to healthy controls (?38.4 ± 28.7 % vs ?1.3 ± 19.3 %, p = 0.005). As well N10 latencies of the oVEMP response were prolonged comparing to healthy controls (11.575 vs 9.72 ms). There was no difference in cVEMP asymmetry ratio or latencies between groups. We found no correlation between House–Brackmann grading scale and oVEMP asymmetry ratio (r = 0.003, p = 0.994). There are three possible explanations for increased oVEMP amplitudes on the affected side: (1) oVEMP response on the ipsilateral eye could be contaminated by facial nerve activity (blink reflex); (2) the amplitude of N10-P33 could be affected through the stapedial reflex; and (3) increased oVEMP amplitude could be the consequence of the vestibular nerve dysfunction itself, with prolonged latencies of the N10 oVEMP further supporting this explanation. The results of this study indicate possible involvement of the superior branch of the vestibular nerve in patients with Bell’s palsy.     

Ocular vestibular-evoked myogenic potentials (oVEMPs) require extraocular muscles but not facial or cochlear nerve activity

ObjectivesCervical vestibular evoked myogenic potentials (cVEMPs) have been found to be useful for clinical testing of vestibular function. Recently, investigators showed that short-latency, initially negative surface EMG potentials can be recorded around the extraocular muscles (oVEMPs) in response to air-conducted sound (ACS), bone-conducted vibration (BCV), and head taps. Although these evoked potentials, which are located around the eyes, most likely originate primarily from the otolith-ocular pathway, the possibility of contamination by other nerve activities cannot be completely eliminated. The purpose of the present study was to clarify the origin of oVEMPs by examining these possibilities using clinical findings.MethodsTwelve healthy subjects and 15 patients were enrolled. Of the 15 patients, 3 patients had undergone exenteration of the unilateral intraorbital contents, one had undergone exenteration of the right eyeball with preservation of extraocular muscles, 5 had facial palsy, and 6 had profound hearing loss. ACS and/or BCV were used in these subjects.ResultsExenteration of the unilateral intraorbital contents resulted in absence of myogenic potentials on the affected side. On the other hand, exenteration of the eyeball with preservation of extraocular muscles did not have a major impact on the responses. There were no significant differences in the waveforms between healthy subjects and patients with facial palsy or profound hearing loss.ConclusionsThe results suggested that short-latency, initially negative evoked potentials recorded below the eyes are not affected by cochlear or facial nerve activities and are dependent on the presence of extraocular muscles.SignificanceThis study provides the evidence that oVEMPs originate from exraocular muscles activated through the vestibulo-ocular pathway.     

Recovery of ocular and cervical vestibular evoked myogenic potentials after treatment of inner ear diseases

Abstract

Purpose: This study aimed to assess the clinical value of ocular vestibular evoked myogenic potential (oVEMP) and cervical vestibular evoked myogenic potential (cVEMP) for monitoring the rehabilitation of vestibular function in patients treated for peripheral vertigo.

Materials and methods: Fifteen patients who had been diagnosed with peripheral vertigo and showed no VEMP response on the affected side but exhibited symptom alleviation and VEMP responses after therapies were retrospectively enrolled. We analyzed the restoration and parameters of their VEMP response.

Results: After treatment, six patients with sudden sensorineural hearing loss showed VEMP recovery, including two with both oVEMP and cVEMP recovery, three with oVEMP recovery only, and one with cVEMP recovery only. Two patients with Meniere’s disease (MD) showed cVEMP recovery, while the other three MD patients showed oVEMP recovery. Three patients with herpes zoster oticus exhibited cVEMP recovery. One patient with vestibular neuritis exhibited cVEMP recovery. Among the patients with cVEMP and/or oVEMP restoration, most patients presented normal VEMP parameters; however, some patients showed abnormal VEMP parameters after treatment.

Conclusion: Combined oVEMP and cVEMP are objective tools for assessing vestibular otolithic end organ function during dynamic functional recovery from vestibular diseases.     

Irregular primary otolith afferents from the guinea pig utricular and saccular maculae respond to both bone conducted vibration and to air conducted sound

This study sought to identify in guinea pig the peripheral sense organ of origin of otolith irregular primary vestibular afferent neurons having a very sensitive response to both air-conducted sound (ACS) and bone-conducted vibration (BCV). Neurons responding to both types of stimuli were labelled by juxtacellular labelling by neurobiotin. Whole mounts of the maculae showed that some vestibular afferents activated by both ACS and BCV originate from the utricular macula and some from the saccular macula - there is no "afferent specificity" by one sense organ for ACS and the other for BCV - instead some afferents from both sense organs have sensitive responses to both stimuli. The clinical implication of this result is that differential evaluation of the functional status of the utricular and saccular maculae cannot rely on stimulus type (ACS vs BCV), however the differential motor projections of the utricular and saccular maculae allow for differential evaluation of each sense organ.     

Bone conducted vibration activates the vestibulo-ocular reflex in the guinea pig

The aim of the study was: (a) to test whether short duration (6 ms) 500 Hz bone-conducted vibration (BCV) of the skull in alert head free guinea pigs would elicit eye movements; (b) to test whether these eye movements were vestibular in origin; and (c) to determine whether they corresponded to human eye movements to such stimuli. In this way we sought to establish the guinea pig as an acceptable model for testing the mechanism of the effect BCV on the vestibulo-ocular reflex. Consistent short-latency stimulus-locked responses to BCV were observed. The magnitude of eye displacement was directly related to stimulus intensity as recorded by accelerometers cemented onto the animal's skull. The strongest and most consistent response component was intorsion of both eyes. In lateral-eyed animals intorsion is produced by the combined contraction of the inferior rectus and superior oblique muscles. In humans the same pair of muscles acts to cause depression of the eye. To test whether the movements were vestibular we selectively ablated the vestibular endorgans: 3 of the 8 animals underwent a bilateral intratympanic injection of gentamicin, an ototoxic aminoglycoside antibiotic, to ablate their vestibular receptors. After ablation there was an overall reduction in the magnitude of eye displacement, as well as a reduction in the effectiveness of the BCV stimulus to elicit eye movements. The animals' hearing, as measured by the threshold for auditory brainstem responses, remained unchanged after gentamicin, confirming that the cochlea was not affected. The reduced magnitude of responses after vestibular receptor ablation demonstrates that the eye-movement responses to BCV are probably caused by the stimulation of vestibular receptors, which in turn activate the vestibulo-ocular reflex.     

Vestibular dysfunction in patients with auditory neuropathy detected by vestibular evoked myogenic potentials

ObjectivesThis study aimed to determine vestibular involvement in patients with auditory neuropathy (AN) using ocular vestibular evoked myogenic potential (oVEMP), cervical vestibular evoked myogenic potential (cVEMP), caloric tests, video Head Impulse Tests (vHIT), and Suppression Head Impulse Paradigm (SHIMP) tests.MethodsTwenty-two patients with AN (study group) and 50 age-and-gender-matched healthy subjects (control group) were enrolled. All patients underwent air-conducted sound oVEMP and cVEMP tests. In the study group, 20 patients underwent a caloric test, 10 patients underwent a video Head Impulse Test (vHIT), and nine patients underwent the Suppression Head Impulse Paradigm (SHIMP) test.ResultsSignificant differences in VEMP abnormalities were found between the two groups. Most AN patients showed no VEMP response, while only a few patients showed VEMP responses with normal parameters. Some AN patients presented abnormal VEMP parameters, including thresholds, latencies, and amplitudes. The abnormal rate (including no response and abnormal parameters) was 91% in the cVEMP test and 86% in the oVEMP test. No significant difference was found between oVEMP and cVEMP abnormalities. AN patients exhibited a 70% abnormal rate in the caloric test. Most AN patients showed normal VOR gains. Most patients showed no overt corrective saccades in vHIT, and exhibited normal anticompensatory saccades in the SHIMP test.ConclusionMany AN patients experience vestibular dysfunction, which may be detected by using a vestibular functional test battery.SignificanceVEMP abnormalities might reflect the status and degree of vestibular involvement in AN.     

Afferent innervation of the vestibular nuclei in the chinchilla. I. A method for labeling individual vestibular receptors with horseradish peroxidase

A new method was developed for specific labeling of primary vestibular afferent fibers from selected end-organs with horseradish peroxidase (HRP) applied extracellularly in the inner ear space. In 48 chinchillas, labeling was performed successfully in all animals by scratching the surface of the sensory end-organ of interest with an electrolytically sharpened needle and replacing the fluid in the vestibule with 30% HRP solution. Merely replacing the vestibular fluid (endo- and perilymph) with HRP did not label the ganglion cells or the afferent fibers in the brain stem. The specificity of labeling was verified by histological inspection of the ganglion cells and nerve fibers innervating the damaged and intact receptors. When the posterior semicircular canal and saccular receptors were scratched, labeled fibers and ganglion cells were found in the nerve and ganglion rostrodorsally and caudoventrally, respectively. Labeled ganglion cells from different superior vestibular nerve (SVN) receptors did not show as clear a segregation pattern as did labeled receptors from the inferior vestibular nerve (IVN). Once inside the brain stem, labeled fibers from the SVN receptors were rostral to those from the IVN receptors. The fibers of the vestibular root divided into an ascending and a descending branch which formed the vestibular tract. Labeled fibers from the SVN receptors divided rostrolaterally to those from the IVN receptors. In the vestibular tract, fibers coursed in different locations according to the receptor of origin. Fibers from the utriculus were lateral to those from the horizontal semicircular canal, which were lateral to those from the anterior semicircular canal. Fibers from the sacculus were lateral to those from the posterior semicircular canal.     

Effects of repetition rate of bone-conducted vibration on ocular and cervical vestibular-evoked myogenic potentials

Objective

This study applied bone-conducted vibration (BCV) stimuli at various repetition rates to investigate the effects of repetition rate on both ocular and cervical vestibular-evoked myogenic potentials (oVEMPs and cVEMPs).

Methods

Twenty-five healthy subjects underwent oVEMP tests in BCV mode at repetition rates of 1, 5, 10, 20, 30 and 40 Hz. The optimal repetition rates (5, 10 and 20 Hz) for oVEMPs were also adopted to elicit cVEMPs, and 20 Hz stimuli were further evaluated in pathological ears.

Results

At repetition rates of 1, 5, 10, 20, 30 and 40 Hz, the prevalence of clear oVEMPs were 100% in groups of 5, 10 and 20 Hz, with no significant differences in the mean nI latency, but the mean nI–pI amplitude of the 20 Hz group showed significantly larger. For the BCV–cVEMPs, 5, 10 and 20 Hz stimuli yielded similar information. Clinically, the BCV mode at 20 Hz stimuli was also appropriate for evaluating VEMPs in ears of vestibular schwannoma.

Conclusions

The BCV mode at a repetition rate of 20 Hz is recommended for the mass detection of VEMPs.

Significance

Eliciting VEMPs in BCV mode using 20 Hz stimuli takes a short time and may trigger a high prevalence with large amplitude.     

Why do oVEMPs become larger when you look up? Explaining the effect of gaze elevation on the ocular vestibular evoked myogenic potential

ObjectivesThe ocular vestibular evoked myogenic potential (oVEMP) is a vestibular reflex recorded from the inferior oblique (IO) muscles, which increases in amplitude during eye elevation. We investigated whether this effect of gaze elevation could be explained by movement of the IO closer to the recording electrode.MethodsWe compared oVEMPs recorded with different gaze elevations to those recorded with constant gaze position but electrodes placed at increasing distance from the eyes. oVEMPs were recorded in ten healthy subjects using bursts of skull vibration.ResultsoVEMP amplitude decreased more with decreasing gaze elevation (9 μV from 24° up to neutral) than with increasing electrode distance (2.7 μV from baseline to 6.4 mm; P < 0.005). The oVEMP recorded with gaze 24° down had delayed latency (by 4.5 ms).ConclusionThe effect of gaze elevation on the oVEMP cannot be explained by changes in position of the muscle alone and is likely mainly due to increased tonic contraction of the IO muscle in up-gaze. The oVEMP recorded in down-gaze (when the IO is inactivated, but the IR activated) likely originates in the adjacent IR muscle.SignificanceOur results suggest that oVEMP amplitudes in extraocular muscles scale in response to changing tonic muscle activity.     

Effects of stimulation of the hypothalamic nuclei and treatment with a proline-rich peptide on neurons of the superior vestibular nuclei during exposure to vibration

Vibration impairs functioning of the nervous, cardiovascular, and motor systems. Postvibration disturbances in vestibular function are determined by adaptive changes in neuromediatory processes. We studied the possibility of the regulation of the CNS functions by neurohumoral factors, viz., hypothalamic proline-rich peptides (PRP). We found changes in the spiking activity of single neurons of the superior vestibular nucleus (SVN) in response to high-frequency stimulation (HFS) of the paraventricular (PVN) and supraoptic nuclei (SON) of the hypothalamus in the presence of vibration or systemic treatment with PRP-1. Mathematical analysis of impulse activity showed predominantly tetanic potentiation (TP) in the SVN neurons in response to HFS. Vibration resulted in a decrease in the TP level and an increase in the post-tetanic potentiation. The results of the morphological and histochemical analyses suggest a close relationship between neurons and gliocytes, with both being involved in integral unit formation. An enhanced level of survival of SVN neurons and activation of acidic phosphatase in SVN were also found in the presence of PRP during long-term exposure to vibration.