Murnane Owen D, Akin Faith W, Kelly Kip J, Byrd Stephanie
James H. Quillen VA Medical Center, Mountain Home, TN, USA.
J Am Acad Audiol. 2011 Jul-Aug;22(7):469-80. doi: 10.3766/jaaa.22.7.7.
Vestibular evoked myogenic potentials (VEMPs) have been recorded from the sternocleidomastoid muscle (cervical VEMP or cVEMP) and more recently from the eye muscles (ocular VEMP or oVEMP) in response to air conduction and bone conduction stimuli. Both cVEMPs and oVEMPs are mediated by the otoliths and thereby provide diagnostic information that is complementary to videonystagmography and rotational chair tests. In contrast to the air conduction cVEMP, which originates from the saccule/inferior vestibular nerve, recent evidence suggests the possibility that the air conduction oVEMP may be mediated by the utricle/superior vestibular nerve. The oVEMP, therefore, may provide complementary diagnostic information relative to the cVEMP. There are relatively few studies, however, that have quantified the effects of stimulus and recording parameters on the air conduction oVEMP, and there is a paucity of normative data.
To evaluate the effects of several stimulus and recording parameters on the air conduction oVEMP and to establish normative data for clinical use.
A prospective repeated measures design was utilized.
Forty-seven young adults with no history of neurologic disease, hearing loss, middle ear pathology, open or closed head injury, cervical injury, or audiovestibular disorder participated in the study.
The effects of stimulus frequency, stimulus level, gaze elevation, and recording electrode location on the amplitude and latency of the oVEMP for monaural air conduction stimuli were assessed using repeated measures analyses of variance in an initial group of 17 participants. The optimal stimulus and recording parameters obtained in the initial group were used subsequently to obtain oVEMPs from 30 additional participants.
The effects of stimulus frequency, stimulus level, gaze elevation, and electrode location on the response prevalence, amplitude, and latency of the oVEMP for monaural air conduction stimuli were significant. The maximum N1-P1 amplitude and response prevalence were obtained for contralateral oVEMPs using a 500 Hz tone burst presented at 125 dB peak SPL during upward gaze at an elevation of 30°.
The optimal stimulus and recording parameters quantified in this study were used to establish normative data that may be useful for the clinical application of the air conduction oVEMP.
前庭诱发肌源性电位（VEMPs）已从胸锁乳突肌记录到（颈VEMP或cVEMP），最近也从眼肌记录到（眼VEMP或oVEMP），以响应气导和骨导刺激。cVEMPs和oVEMPs均由耳石介导，从而提供与视频眼震图和转椅试验互补的诊断信息。与起源于球囊/下前庭神经的气导cVEMP不同，最近的证据表明气导oVEMP可能由椭圆囊/上前庭神经介导。因此，oVEMP可能提供相对于cVEMP的互补诊断信息。然而，相对较少的研究对刺激和记录参数对气导oVEMP的影响进行了量化，并且缺乏规范数据。
评估几种刺激和记录参数对气导oVEMP的影响，并建立临床使用的规范数据。
采用前瞻性重复测量设计。
47名无神经疾病、听力损失、中耳病变、开放性或闭合性头部损伤、颈部损伤或听觉前庭障碍病史的年轻成年人参与了研究。
在最初的17名参与者中，使用重复测量方差分析评估刺激频率、刺激强度、注视高度和记录电极位置对单耳气导刺激的oVEMP振幅和潜伏期的影响。随后，使用在最初组中获得的最佳刺激和记录参数，从另外30名参与者中获取oVEMPs。
刺激频率、刺激强度、注视高度和电极位置对单耳气导刺激的oVEMP反应发生率、振幅和潜伏期的影响具有显著性。在向上注视30°时，使用125 dB峰值声压级呈现的500 Hz短纯音，对侧oVEMPs获得最大N1-P1振幅和反应发生率。
本研究中量化的最佳刺激和记录参数用于建立规范数据，这可能对气导oVEMP的临床应用有用。
