Leyssens Laura, Heinze Barbara, Vinck Bart, Van Ombergen Angelique, Vanspauwen Robby, Wuyts Floris L, Maes Leen K
Faculty of Medicine and Health Sciences, Department of Speech, Language and Hearing Sciences, Ghent University, Ghent, Belgium.
Faculty of Humanities, Department of Speech-Language Pathology and Audiology, Pretoria University, Pretoria, South Africa.
Clin Neurophysiol. 2017 Feb;128(2):312-322. doi: 10.1016/j.clinph.2016.11.023. Epub 2016 Dec 5.
This study compared two electrode placements ('standard' versus 'nose reference' placement) for measuring oVEMPs, elicited by air-conducted 500Hz tone bursts. The test-retest reliability of both positions was evaluated and additionally both electrode placements were applied on a group of vestibular patients.
Eighteen healthy volunteers (range of 20-25years) participated in the first part and were retested after one week for evaluation of the test-retest reliability. Eleven patients (range of 41-74years) with a variety of vestibular pathologies were tested once.
In the normal group, the nose reference electrode placement resulted in significantly larger peak-to-peak amplitudes (p<0.001), shorter n10 (p=0.001) and p15 (p<0.001) latencies and smaller 95% prediction intervals for the Inter-Ocular Ratio (IOR) ([-68, 68] for the standard position versus [-32, 32] for the nose reference position). Furthermore, an excellent amplitude and IOR test-retest reliability was observed with the nose reference configuration, as shown by the intraclass correlation coefficient (ICC), the coefficient of variation of the method error (CV) and the minimal detectable differences (MDD). In the patient group, the same significant amplitude difference was found. Moreover, three patients presented with absent oVEMPs when recorded with the standard placement, whereas the nose reference placement could evoke a detectable oVEMP response.
This study demonstrated that a nose reference electrode position results in larger oVEMP amplitudes and achieves a better reliability for the most important clinical parameters (amplitude and IOR). Our patient data substantiate the possible clinical benefit of this position, but further systematic patient verification is required.
The nose reference electrode position facilitates the detection of generally very small oVEMP responses and shows a high test-retest reliability, showing promising potential for future use in the vestibular clinic.
本研究比较了两种电极放置方式（“标准”与“鼻参考”放置）用于测量由气导500Hz短纯音诱发的眼震电图（oVEMP）。评估了两种位置的重测信度，此外，还将两种电极放置方式应用于一组前庭疾病患者。
18名健康志愿者（年龄在20 - 25岁之间）参与了第一部分研究，并在一周后进行重新测试以评估重测信度。对11名患有各种前庭疾病的患者（年龄在41 - 74岁之间）进行了一次测试。
在正常组中，鼻参考电极放置方式导致峰峰值幅度显著更大（p<0.001），n10潜伏期更短（p = 0.001）和p15潜伏期更短（p<0.001），并且眼间比率（IOR）的95%预测区间更小（标准位置为[-68, 68]，鼻参考位置为[-32, 32]）。此外，鼻参考配置观察到了出色的幅度和IOR重测信度，如组内相关系数（ICC）、方法误差变异系数（CV）和最小可检测差异（MDD）所示。在患者组中，发现了相同的显著幅度差异。此外，三名患者在采用标准放置记录时未引出oVEMP，而鼻参考放置可引出可检测到的oVEMP反应。
本研究表明，鼻参考电极位置可导致更大的oVEMP幅度，并在最重要的临床参数（幅度和IOR）方面实现更好的信度。我们的患者数据证实了该位置可能具有的临床益处，但需要进一步进行系统的患者验证。
鼻参考电极位置有助于检测通常非常小的oVEMP反应，并显示出高重测信度，在前庭临床未来应用中显示出有前景的潜力。
