Singh Niraj Kumar, Apeksha Kumari
All India Institute of Speech and Hearing, Mysore, India.
J Vestib Res. 2014;24(1):25-31. doi: 10.3233/VES-130503.
Cervical vestibular evoked myogenic potential (cVEMP) is a biphasic potential recorded from the Sternocleidomastoid muscle in response to loud acoustic stimulation and assesses the intactness of the Sacculocolic pathway. The literature on clinical utility of cVEMP has been growing rapidly, though not without inconsistencies despite involving alike population. A close scrutiny of the methods across such studies revealed an inconsistent use of stimulus parameters; especially rise/fall times (RFTs). However the effect of RFTs on cVEMP has been largely unexplored.
The study aimed at exploring the effect of varying RFTs on cVEMP and obtaining optimum RFT to enable reliable recording of cVEMPs.
The cVEMPs were recorded from both ears of 30 healthy individuals with normal audio-vestibular system using 500 Hz short tone-bursts (STBs) at 95 dB nHL and varying the RFTs from 1 to 8 ms at all integer values.
There was significant prolongation of latencies with increasing RFTs (p< 0.05). The largest amplitudes were obtained for 2 to 3 ms RFTs, though significantly smaller amplitude was obtained only for 8 ms RFT (p< 0.05), thereby rendering 8 ms RFT unfit for cVEMP recording. The 1 ms RFT produced smallest variability across individuals and would also result in lesser duration of exposure to loud sound.
The RFT of 1 ms of 500 Hz STBs are optimum for recording cVEMPs. This is owing to large amplitudes and least variability demonstrated for this RFT.
颈前庭诱发肌源性电位(cVEMP)是在对高声刺激做出反应时从胸锁乳突肌记录到的双相电位,用于评估球囊结肠通路的完整性。关于cVEMP临床应用的文献增长迅速,尽管研究对象相似,但仍存在不一致之处。对这些研究中的方法进行仔细审查后发现,刺激参数的使用不一致;尤其是上升/下降时间(RFTs)。然而,RFTs对cVEMP的影响在很大程度上尚未得到探索。
本研究旨在探讨不同RFTs对cVEMP的影响,并获得最佳RFT,以实现cVEMPs的可靠记录。
使用95 dB nHL的500 Hz短纯音脉冲(STBs),对30名听觉前庭系统正常的健康个体的双耳记录cVEMPs,并将RFTs在1至8 ms的所有整数值上进行变化。
随着RFTs增加,潜伏期显著延长(p<0.05)。RFT为2至3 ms时获得最大振幅,不过仅在RFT为8 ms时获得的振幅显著较小(p<0.05),因此8 ms的RFT不适合用于cVEMP记录。1 ms的RFT在个体间产生的变异性最小,并且暴露于高声的持续时间也较短。
500 Hz STBs的1 ms RFT最适合记录cVEMPs。这是因为该RFT表现出大振幅和最小变异性。