Comparison of the cVEMP and oVEMP Responses with Different Stimuli in Healthy Individuals
Year 2025,
Volume: 15 Issue: 1, 42 - 49, 28.03.2025
Nilüfer Bal
,
Hilal Hüsam
,
Ziya Aydın
,
Büşra Demirci
,
Niyazi Ömer Arslan
,
Özge Gedik
Abstract
Objective: Vestibular evoked myogenic potentials (VEMP) are electromyographic responses induced by auditory, tactile, or electrical stimulation. Electrode placement, intensity, and the type of stimulus applied to influence the amplitude and latency of VEMP responses. The study aims to investigate the effect of differences in stimulus intensities and stimulus types on VEMP results.
Methods: Twenty participants (40 ears) between the ages of 18 and 30 (22.7±1.8) took part in the study. Results from the cervical VEMP (cVEMP) and ocular VEMP (oVEMP) tests were examined using six different characterized stimuli (click, LS CE Chirp, 500 Hz- 1000 Hz Tone Burst, and 500 Hz- 1000 Hz LS CE Chirp) at intensities of 100 dB nHL, 90 dB nHL, and 80 dB nHL.
Results: In cVEMP and oVEMP testing, there was no significant difference between the amplitudes of 500 Hz tone burst (TB) and 500 Hz LS CE chirp stimuli; however, the p1 and n1 latencies of chirp stimuli were found to be significantly shorter. There was no significant difference between p1-n1 latency and the asymmetry ratio of frequency-specific stimuli. No difference was seen between click and chirp stimuli in any of the assessments.
Conclusion: The chirp stimulus is an effective alternative for TB. It is encouraged that each clinic develops its normative data because of the differences in recording parameters.
Ethical Statement
This study was approved by Ethics Committee of Bezmialem Vakıf University (approval date 27.01.2017. and number 71306642-050.01.04)
Supporting Institution
None
Thanks
We thank the study participants and control subjects for their contributions to this study. Niyazi O. Arslan and Ziya Aydin are Scholarship Holders of the Ministry of National Education of the Republic of Türkiye.
References
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- Ocal FCA, Karacayli C, Coban VK, Satar B. Can narrow band chirp stimulus shake the throne of 500 Hz tone burst stimulus for cervical vestibular myogenic potentials? Journal of Audiology & Otology, 2021;25(2): 98. https://doi.org/10.7874/jao.2020.00486
- Özgür A, Çelebi Erdivanlı Ö, Özergin Coşkun Z, Terzi S, Yiğit E, Demirci M, Dursun E. Comparison of tone burst, click and chirp stimulation in vestibular evoked myogenic potential testing in healthy people. International Advanced Otology, 2015;11(1): 33-35 https://doi.org/10.5152/iao.2015.927
- Cebulla M, Stürzebecher E, Don M, Müller-Mazzotta J. Auditory brainstem response recording to multiple interleaved broadband chirps. Ear and Hearing, 2012;33(4): 466-479. https://doi.org/10.1097/AUD.0b013e318241e85a
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- Janky KL, Shepard N. Vestibular evoked myogenic potential (VEMP) testing: normative threshold response curves and effects of age. Journal of the American Academy of Audiology, 2009;20(08): 514-522. https://doi.org/10.3766/jaaa.20.8.6
Year 2025,
Volume: 15 Issue: 1, 42 - 49, 28.03.2025
Nilüfer Bal
,
Hilal Hüsam
,
Ziya Aydın
,
Büşra Demirci
,
Niyazi Ömer Arslan
,
Özge Gedik
References
- Murofushi T. Clinical application of vestibular evoked myogenic potential (VEMP). Auris Nasus Larynx, 2016; 43(4): 367-376. https://doi.org/10.1016/j.anl.2015.12.006
- Rodriguez AI, Marler E, Fitzpatrick D, Creutz T, Cannon SA, Thomas MLA, Janky KL. Optimization of cervical and ocular vestibular evoked myogenic potentialtesting using an impulse hammer in adults, adolescents, and children. Otology & Neurotology, 2020; 41(6):817-827. https://doi.org/10.1097/MAO.0000000000002632
- Seo YJ, Kim J, Choi JY, Lee WS. Visualization of endolymphatic hydrops and correlation with audio-vestibular functional testing in patients with definite Meniere's disease. Auris Nasus Larynx, 2013;40(2):167-172. https://doi.org/10.1016/j.anl.2012.07.009
- Chiarovano E, Cynthia Darlington C, Vidal PP, Lamas G, Waele C. The role of cervical and ocular vestibular evoked myogenic potentials in the assessment of patients with vestibular schwannomas. PLoS One, 2014; 9(8):e105026 https://doi.org/10.1371/journal.pone.0105026
- Noij KS, SD. Rauch, Vestibular evoked myogenic potential (VEMP) testing for diagnosis of superior semicircular canal dehiscence. Frontiers in Neurology, 2020;11:695; 1-8. https://doi.org/10.3389/fneur.2020.00695
- Magliulo A, Iannella G, Gagliardi S, Re M. 1-year follow-up study with C-VEMPs, O-VEMPs and video head impulse testing in vestibular neuritis. European Archives of Oto-Rhino-Laryngology, 2015; 272: 3277-3281. https://doi.org/10.1007/s00405-014-3404-9
- Guo X, Liu X, Ye S, Liu X, Yang X, Fan D. Eye movement abnormalities in amyotrophic lateral sclerosis. Brain Sciences, 2022; 12(4): 489. https://doi.org/10.3390/brainsci12040489
- Eleftheriadou A, Deftereos SN, Zarikas V, Panagopoulos G, Sfetsos S, Karageorgioub CL, Ferekidou E, Kandilorosd D, Korres S. The diagnostic value of earlier and later components of vestibular evoked myogenic potentials (VEMP) in multiple sclerosis. Journal of Vestibular Research, 2009;19(1-2): 59-66. https://doi.org/10.3233/VES-2009-0342
- Bal N, ŞengülY, Behmen MB, Powel A, Louis ED. Vestibular reflexes in essential tremor: abnormalities of ocular and cervical vestibular-evoked myogenic potentials are associated with the cerebellum and brainstem involvement. Journal of Neural Transmission, 2023;1-7. https://doi.org/10.1007/s00702-023-02652-3
- Matsuzaki M, Murofushi T, Mizuno M. Vestibular evoked myogenic potentials in acoustic tumor patients with normal auditory brainstem responses. European archives of oto-rhino-laryngology, 1999; 256: 1-4. https://doi.org/10.1007/s004050050112
- Tsutsumi T, Tsunoda A, Noguchi Y, Komatsuzaki A. Prediction of the nerves of origin of vestibular schwannomas with vestibular evoked myogenic potentials. Otology & Neurotology, 2000;21(5):712-715. https://doi.org/10.1016/b878-0-323-01830-2.50022-5
- Eleftheriadou A, E Koudounarakis. Vestibular-evoked myogenic potentials eliciting: An overview. European archives of oto-rhino-laryngology, 2011;268(3): 331-339. https://doi.org/10.3233/VES-2009-0342
- Curthoys IS. A critical review of the neurophysiological evidence underlying clinical vestibular testing using sound, vibration and galvanic stimuli. Clinical Neurophysiology, 2010;121(2):132-144. https://doi.org/10.1016/j.clinph.2009.09.027
- Mat Q, Duterme JP, Tainmont S, Lelubre C, Manto M. Optimizing ocular vestibular evoked myogenic potentials with narrow band CE-chirps. Ear and Hearing, 2021;42(5):1373-1380. https://doi.org/10.1097/AUD.0000000000001031
- Reddy TM, Heinze B, Biagio-de Jager L, Maes L. Cervical and ocular vestibular evoked myogenic potential: A comparison of narrowband chirp, broadband chirp, tone burst and click stimulation. International Journal of Audiology, 2023; 62(6):579-586. https://doi.org/10.1080/14992027.2022.2064924
- Akin FW, Murnane OD, Proffitt TM. The effects of click and tone-burst stimulus parameters on the vestibular evoked myogenic potential (VEMP). Journal of the American Academy of Audiology, 2003;14(09); 500-509. https://doi.org/10.3766/jaaa.14.9.5
- Karaçaylı C, Karaçaylı C, Öçal FCA, Çoban VK, Satar B. Normative data of ocular vestibular evoked myogenic potentials in response to chirp stimulus. The Journal Of International Advanced Otology, 2020;16(3): 378. https://doi.org/10.5152/iao.2020.6354
- Speidel DP, BeckL. Demystifying the CE-Chirp. Hearing Review, 2016;23(2):28. https://hearingreview.com/hearing-products/accessories/components/demystifying-ce-chirp
- Ocal FCA, Karacayli C, Coban VK, Satar B. Can narrow band chirp stimulus shake the throne of 500 Hz tone burst stimulus for cervical vestibular myogenic potentials? Journal of Audiology & Otology, 2021;25(2): 98. https://doi.org/10.7874/jao.2020.00486
- Özgür A, Çelebi Erdivanlı Ö, Özergin Coşkun Z, Terzi S, Yiğit E, Demirci M, Dursun E. Comparison of tone burst, click and chirp stimulation in vestibular evoked myogenic potential testing in healthy people. International Advanced Otology, 2015;11(1): 33-35 https://doi.org/10.5152/iao.2015.927
- Cebulla M, Stürzebecher E, Don M, Müller-Mazzotta J. Auditory brainstem response recording to multiple interleaved broadband chirps. Ear and Hearing, 2012;33(4): 466-479. https://doi.org/10.1097/AUD.0b013e318241e85a
- Bas B, Keseroglu K, Er S, Ozdek A, Korkmaz MH. Is chirp more effective than click and tone-burst during oVEMP test? Annals of Medical Research, 2021; 27(3): 0819-0824. https://doi.org/10.5455/annalsmedres.2019.11.693
- Isaradisaikul S, Navacharoen N, Hanprasertpong C, Kangsanarak J. Cervical Vestibular‐Evoked Myogenic Potentials: Norms and Protocols. International Journal of Otolaryngology, 2012; 2012(1): 913515. https://doi.org/10.1155/2012/913515
- Janky KL, Shepard N. Vestibular evoked myogenic potential (VEMP) testing: normative threshold response curves and effects of age. Journal of the American Academy of Audiology, 2009;20(08): 514-522. https://doi.org/10.3766/jaaa.20.8.6