Research in Vestibular Science

Original Article

Difference of Cervical Vestibular Evoked Myogenic Potentials between Bone-Conduction and Air-Conduction in Patients with Nonspecific Dizziness: Yong-Hwi An, Jung Ho Choi, Seung Yeon Jeon, Hyun Joon Shim; Res Vestib Sci. 2022;21(4):93-98. Published online December 15, 2022; DOI: https://doi.org/10.21790/rvs.2022.21.4.93

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Abstract PDF: Objectives
This study was performed to evaluate the difference of the cervical vestibular evoked myogenic potentials (cVEMP) stimulated by bone-conduction (BC) and air-conduction (AC) in patients with nonspecific dizziness.
Methods
Twenty-eight dizzy patients (56 ears) and 15 subjects (30 ears) as normal control was enrolled. Responses of BC- and AC-cVEMP were recorded sequentially in both groups. cVEMP parameters including latencies, inter-latencies intervals, amplitudes, and interaural amplitude asymmetry were analyzed and compared.
Results
Among the patients with nonspecific dizziness, AC-cVEMP responses were clearly detected in all 56 ears while BC-cVEMP responses were detected in 32 ears (57.1%). Amplitudes of BC-cVEMP were significantly smaller than those of AC-cVEMP in all patients with BC-cVEMP response. There was no difference in latencies, inter-latencies intervals, and interaural amplitude asymmetry ratios between BC- and AC-cVEMP. There was no significant difference in BCand AC-cVEMP between the dizzy and control groups.
Conclusions
BC-cVEMP is not clinically useful in comparison to AC-cVEMP for the evaluation of nonspecific dizziness. An effective stimulation tool for BC is necessary to provoke more reliable responses of BC-cVEMP.

Review

Clinical Application and Updates on Vestibular Evoked Myogenic Potential: Proposal for Future Development in Vestibulopathy: Myung-Whan Suh, Jinil Kim; Res Vestib Sci. 2018;17(3):71-78. Published online September 18, 2018; DOI: https://doi.org/10.21790/rvs.2018.17.3.71

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2 Crossref

Both cervical vestibular evoked myogenic potential (cVEMP) and ocular VEMP (oVEMP) are irreplaceable tools in the current vestibular science, but they have many drawbacks. For example, the test-retest reliability of the asymmetry ratio is inadequate for both tests. The American Academy of Neurology noted that there is insufficient evidence to determine whether cVEMP and oVEMP can accurately identify vestibular function specifically related to the saccule/utricle. One of the most important factors underlying the variability of cVEMP seems to be the control of, and compensation for, baseline muscle contraction power. Reasons for variability in oVEMP include a poor signal to noise ratio, the angle of superior gaze, effective and controlled presentation of stimuli, intracranial pressure, and electrode location. Many of these shortcomings could be improved by further development of recording methods and devices. This article examines the reasons for the insufficient reliability of VEMP and proposes avenues for improvement of VEMP recording systems.

Citations

Citations to this article as recorded by

Difference of Cervical Vestibular Evoked Myogenic Potentials between Bone-Conduction and Air-Conduction in Patients with Nonspecific Dizziness
Yong-Hwi An, Jung Ho Choi, Seung Yeon Jeon, Hyun Joon Shim
Research in Vestibular Science.2022; 21(4): 93. CrossRef
A Case of Patient with Acute Peripheral Vestibulopathy Involving Isolated Posterior Semicircular Canal
Sang Kwon Im, Mee Hyun Song, Ja Won Gu, Dae Bo Shim
Research in Vestibular Science.2019; 18(4): 128. CrossRef

Original Articles

Cervical Vestibular Evoked Myogenic Potential as a Prognostic Indicator of Benign Paroxysmal Positional Vertigo Recurrence: Min Su Kang, Hyun Ju Han, Min Young Lee, Jae Yung Jung; Res Vestib Sci. 2017;16(2):53-56. Published online June 15, 2017; DOI: https://doi.org/10.21790/rvs.2017.16.2.53

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Abstract PDF: Objectives
Recently there was hypothesis that relates the otolith dysfunction to the recurrence of benign paroxysmal positional vertigo (BPPV). Therefore in the present study, we assessed relationship between cervical vestibular evoked myogenic potential (cVEMP) and BPPV recurrence and raise the possibility of cVEMP as a recurrence indicator of BPPV. Methods: A retrospective review of patient from November 2009 to June 2014 was carried out. Ninety-four patients who suffered from BPPV were enrolled. Medical record review and telephone survey was done to check BPPV recurrence. Results: In medical record review, normal cVEMP group showed 18.9% recurrence rate and abnormal cVEMP group showed 25%. In telephone survey, normal cVEMP group showed 39.19% recurrence rate and abnormal cVEMP group showed 60%. There was no significant statistical difference. Conclusions: cVEMP abnormality was not a risk factor of BPPV recurrence. Further study with larger number of enrolled subjects is necessary.

Comparison of Video Head Impulse Test with Posterior Semicircular Canal Plane and Cervical Vestibular Evoked Myogenic Potential: Jin Su Park, Yong Woo Lee, Jung Yup Lee, Jae Ho Ban, Sun O Chang, Min-Beom Kim; Res Vestib Sci. 2016;15(3):74-79. Published online September 15, 2016; DOI: https://doi.org/10.21790/rvs.2016.15.3.74

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1 Crossref

Abstract PDF

Objective: Cervical vestibular evoked myogenic potential (cVEMP) is thought to be assessing the function of the saccule and inferior vestibular nerve. Therefore, cVEMP indirectly reflects the function of the posterior semicircular canal. Recently, the video head impulse test (vHIT) is considered as useful clinical tool to detect each semicircular canal dysfunction. Goal of this study was to evaluate and compare the results of cVEMP with posterior canal plane of vHIT (p-vHIT).
Methods
Retrospectively, we compared the results of cVEMP with p-vHIT in 43 patients who visited with dizziness. We analyzed the inter-test agreement of cVEMP with p-vHIT.
Results
Positive asymmetry of cVEMP was present in 37.2% (16/43), and no responses of both ears were identified in 16.3% (7/43). In p-vHIT analysis, unilateral positive was 27.9% (12/43), bilateral positive was 11.6% (5/43) and negative in both sides was 60.5% (26/43). The inter-test agreement between cVEMP and p-vHIT was 75.8% (25/33) as we considered even in lesion side. And, Fleiss’s kappa value showed a fair to good agreement (kappa value=0.559). In bilateral no response group (7 patients) in cVEMP, variable additional information could be obtained using p-vHIT.
Conclusion
cVEMP and p-vHIT showed relatively lower inter-test agreement than expected. But, p-vHIT could be easily performed, and give additional information for differential diagnosis.

Citations

Citations to this article as recorded by

Clinical Characteristics of the Patients with Dizziness after Car Accidents
Young Min Hah, Chul Won Yang, Sang Hoon Kim, Seung Geun Yeo, Moon Suh Park, Jae Yong Byun
Korean Journal of Otorhinolaryngology-Head and Nec.2017; 60(8): 390. CrossRef

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