BACKGROUND: The measurement of ocular Vestibular Evoked Myogenic Potentials (oVEMP) is a novel method for investigating vestibular function. Stimulus and recording techniques vary in the literature. A standardized test procedure is desirable in order to ensure repeatable results.
OBJECTIVE: To investigate the magnitude and repeatability of the asymmetry ratio (AR) of oVEMPs in response to low-frequency bone conducted vibration (BCV) applied to the forehead and vertex in a healthy population.
METHODS: 20 healthy subjects were tested three times by stimulating with 125 Hz BCV at the forehead and the vertex. The first two tests were performed with the subject remaining in the examining room and the electrodes in place. After a short break, a third test was performed with a new set of electrodes. The AR was calculated for each test based on the evoked oVEMPs responses from the left and the right side. The AR magnitude, variance and repeatability coefficients were evaluated to determine which of the two stimulus sites is best suited in clinical use.
RESULTS: Stimulation at the forehead resulted in a statistically significant lower median AR compared to the vertex. The forehead had lower repeatability coefficients, and statistically significantly lower variances.
CONCLUSIONS: This study indicates that the forehead is a better stimulation site than the vertex for low-frequency BCV in clinical use.
ChiharaY., IwasakiS., FujimotoC., UshioM., YamasobaT. and MurofushiT., Frequency tuning properties of ocular vestibular evoked myogenic potentials, Neuroreport20 (2009), 1491–1495.
2.
ChiharaY., IwasakiS., UshioM. and MurofushiT., Vestibular-evoked extraocular potentials by air-conducted sound: Another clinical test for vestibular function, Clinical Neurophysiology118 (2007), 2745–2751.
3.
ColebatchJ.G., GovenderS. and RosengrenS.M., Two distinct patterns of VEMP changes with age, Clinical Neurophysiology124 (2013), 2066–2068.
4.
ColebatchJ.G., HalmagyiG.M. and SkuseN.F., Myogenic potentials generated by a click-evoked vestibulocollic reflex, Journal of Neurology, Neurosurgery and Psychiatry57 (1994), 190–197.
5.
CurthoysI.S., ManzariL., SmuldersY.E. and BurgessA.M., A review of the scientific basis and practical application of a new test of utricular function – ocular vestibular-evoked myogenic potentials to bone-conducted vibration, Acta Otorhinolaryngologica Italica29 (2009), 179–186.
6.
ErtlM., BoegleR., KirschV. and DieterichM., On the impact of examiners on latencies and amplitudes in cervical and ocular vestibular-evoked myogenic potentials evaluated over a large sample (N=1,038), European Archives ofOto-Rhino-Laryngology273 (2016), 317–323.
7.
GovenderS., RosengrenS.M. and ColebatchJ.G., The effect of gaze direction on the ocular vestibular evoked myogenic potential produced by air-conducted sound, Clinical Neurophysiology120 (2009), 1386–1391.
8.
GovenderS., RosengrenS.M. and ColebatchJ.G., Vestibular neuritis has selective effects on air- and bone-conducted cervical and ocular vestibular evoked myogenic potentials, Clinical Neurophysiology122 (2011), 1246–1255.
9.
HolmesletB., FossO., BugtenV. and BrantbergK., Ocular vestibular-evoked myogenic potentials (oVEMPs) in response to bone-conducted vertex vibration, Clinical Neurophysiology14 (2014), 6.
10.
HolmesletB., WestinM. and BrantbergK., Ocular vestibular evoked myogenic potentials: Skull taps can cause a stimulus direction dependent double-peak, Clinical Neurophysiology122 (2011), 391–397.
11.
IwasakiS., ChiharaY., SmuldersY.E., BurgessA.M., HalmagyiG.M., CurthoysI.S. and MurofushiT., The role of the superior vestibular nerve in generating ocular vestibular-evoked myogenic potentials to bone conducted vibration at Fz, Clinical Neurophysiology120 (2009), 588–593.
12.
IwasakiS., McGarvieL.A., HalmagyiG.M., BurgessA.M., KimJ., ColebatchJ.G. and CurthoysI.S., Head taps evoke a crossed vestibulo-ocular reflex, Neurology68 (2007), 1227–1229.
13.
IwasakiS., SmuldersY.E., BurgessA.M., McGarvieL.A., MacdougallH.G., HalmagyiG.M. and CurthoysI.S., Ocular vestibular evoked myogenic potentials in response to bone-conducted vibration of the midline forehead at Fz. A new indicator of unilateral otolithic loss, Audiology and Neuro-Otology13 (2008), 396–404.
14.
IwasakiS., SmuldersY.E., BurgessA.M., McGarvieL.A., MacdougallH.G., HalmagyiG.M. and CurthoysI.S., Ocular vestibular evoked myogenic potentials to bone conducted vibration of the midline forehead at Fz in healthy subjects, Clinical Neurophysiology119 (2008), 2135–2147.
15.
KantnerC. and GurkovR., The effects of commonly used upward gaze angles on ocular vestibular evoked myogenic potentials, Otology & Neurotology35 (2014), 289–293.
16.
LinC.M., WangS.J. and YoungY.H., Ocular vestibular evoked myogenic potentials via bone-conducted vibrations applied to various midsagittal cranial sites, Otology & Neurotology31 (2010), 157–161.
17.
LinK.Y., WangS.J. and YoungY.H., Influence of head acceleration on ocular vestibular-evoked myogenic potentials via skull vibration at Fz versus Fpz sites, International Journal of Audiology51 (2012), 551–556.
18.
ManzariL., TedescoA., BurgessA.M. and CurthoysI.S., Ocular vestibular-evoked myogenic potentials to bone-conducted vibration in superior vestibular neuritis show utricular function, Otolaryngology and Head and Neck Surgery143 (2010), 274–280.
19.
NguyenK.D., WelgampolaM.S. and CareyJ.P., Test-retest reliability and age-related characteristics of the ocular and cervical vestibular evoked myogenic potential tests, Otology & Neurotology31 (2010), 793–802.
20.
RosengrenS.M., GovenderS. and ColebatchJ.G., Ocular and cervical vestibular evoked myogenic potentials produced by air- and bone-conducted stimuli: Comparative properties and effects of age, Clinical Neurophysiology122 (2011), 2282–2289.
21.
RosengrenS.M., McAngus ToddN.P. and
ColebatchJ.G., Vestibular-evoked extraocular potentials produced by stimulation with bone-conducted sound, ClinicalNeurophysiology116 (2005), 1938–1948.
22.
TaylorR.L., BlaivieC., BomA.P., HolmesletB., PansellT., BrantbergK. and WelgampolaM.S., Ocular vestibular-evoked myogenic potentials (oVEMP) to skull taps in normal and dehiscent ears: Mechanisms and markers of superior canal dehiscence, Experimental Brain Research (2014).
23.
TaylorR.L., SchulinM., GoonetillekeS. and WelgampolaM.S., Does electrode impedance affect the recording of ocular vestibular-evoked myogenic potentials?, Journal of the American Academy of Audiology25 (2014), 969–974.
24.
ToddN.P., RosengrenS.M., AwS.T. and ColebatchJ.G., Ocular vestibular evoked myogenic potentials (OVEMPs) produced by air- and bone-conducted sound, ClinicalNeurophysiology118 (2007), 381–390.
25.
ToddN.P., RosengrenS.M. and ColebatchJ.G., Tuning and sensitivity of the human vestibular system to low-frequency vibration, Neuroscience Letters444 (2008), 36–41.
26.
ToddN.P., RosengrenS.M. and ColebatchJ.G., A utricular origin of frequency tuning to low-frequency vibration in the human vestibular system?Neuroscience Letters451 (2009), 175–180.
27.
WestinM. and BrantbergK., Mastoid and vertex low-frequency vibration-induced oVEMP in relation to medially directed acceleration of the labyrinth, Clinical Neurophysiology125 (2014), 615–620.
28.
ZhangA.S., GovenderS. and ColebatchJ.G., Tuning of the ocular vestibular evoked myogenic potential to bone-conducted sound stimulation, Journal of Applied Physiology112 (2012), 1279–1290.
