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      Comparison of Chirp Versus Tone Burst– and Click-Evoked Masseteric Vestibular Evoked Myogenic Potentials in Normal-Hearing Adults

      1 , 1 , 1
      American Journal of Audiology
      American Speech Language Hearing Association

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          Abstract

          Purpose:

          This study aimed at comparing narrowband Claus Elberling level-specific chirp (NB CE-Chirp)–, click-, and tone burst–evoked masseteric vestibular evoked myogenic potentials (mVEMPs).

          Method:

          Within-group study design and purposive sampling were performed. A total of 25 normal-hearing individuals participated in the study. The zygomatic electrode montage was used to elicit ipsilateral mVEMP responses using a 500-Hz NB CE-Chirp, a click of 100-μs duration, and a 500-Hz tone burst stimulus. Each of the responses was analyzed based on the absolute peak latency of P11 and N21, the electromyography-scaled peak-to-peak amplitude of the P11–N21 complex, and the interaural asymmetry ratio.

          Results:

          A total of 50 ears were tested and had 100% mVEMP responses. The latencies of click-evoked and 500-Hz NB CE-Chirp–evoked mVEMPs were significantly shorter than those of 500-Hz tone burst–evoked mVEMPs ( p < .05) for both ears. It revealed a significantly superior P11–N21 amplitude of the 500-Hz NB CE-Chirp and tone burst than clicks for both ears. Intraclass correlation coefficient revealed moderate to excellent test–retest reliability for mVEMP parameters across three different stimulations.

          Conclusion:

          The present study supports 500 Hz NB CE-Chirps as effective and reliable stimuli as tone bursts in eliciting mVEMP responses.

          Related collections

          Most cited references48

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          Myogenic potentials generated by a click-evoked vestibulocollic reflex.

          Electromyograms (EMGs) were recorded from surface electrodes over the sternomastoid muscles and averaged in response to brief (0.1 ms) clicks played through headphones. In normal subjects, clicks 85 to 100 dB above our reference (45 dB SPL: close to perceptual threshold for normal subjects for such clicks) evoked reproducible changes in the averaged EMG beginning at a mean latency of 8.2 ms. The earliest potential change, a biphasic positive-negativity (p13-n23), occurred in all subjects and the response recorded from over the muscle on each side was predominantly generated by afferents originating from the ipsilateral ear. Later potentials (n34, p44), present in most but not all subjects, were generated bilaterally after unilateral ear stimulation. The amplitude of the averaged responses increased in direct proportion to the mean level of tonic muscle activation during the recording period. The p13-n23 response was abolished in patients who had undergone selective section of the vestibular nerve but was preserved in subjects with severe sensorineural hearing loss. It is proposed that the p13-n23 response is generated by activation of vestibular afferents, possibly those arising from the saccule, and transmitted via a rapidly conducting oligosynaptic pathway to anterior neck muscles. Conversely, the n34 and p44 potentials do not depend on the integrity of the vestibular nerve and probably originate from cochlear afferents.
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            Vestibular evoked myogenic potentials: past, present and future.

            Since the first description of sound-evoked short-latency myogenic reflexes recorded from neck muscles, vestibular evoked myogenic potentials (VEMPs) have become an important part of the neuro-otological test battery. VEMPs provide a means of assessing otolith function: stimulation of the vestibular system with air-conducted sound activates predominantly saccular afferents, while bone-conducted vibration activates a combination of saccular and utricular afferents. The conventional method for recording the VEMP involves measuring electromyographic (EMG) activity from surface electrodes placed over the tonically-activated sternocleidomastoid (SCM) muscles. The "cervical VEMP" (cVEMP) is thus a manifestation of the vestibulo-collic reflex. However, recent research has shown that VEMPs can also be recorded from the extraocular muscles using surface electrodes placed near the eyes. These "ocular VEMPs" (oVEMPs) are a manifestation of the vestibulo-ocular reflex. Here we describe the historical development and neurophysiological properties of the cVEMP and oVEMP and provide recommendations for recording both reflexes. While the cVEMP has documented diagnostic utility in many disorders affecting vestibular function, relatively little is known as yet about the clinical value of the oVEMP. We therefore outline the known cVEMP and oVEMP characteristics in common central and peripheral disorders encountered in neuro-otology clinics. Copyright 2009 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.
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              Clinical nystagmography. A detailed study of electro-nystagmography in 341 patients with vertigo.

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                Author and article information

                Contributors
                (View ORCID Profile)
                Journal
                American Journal of Audiology
                Am J Audiol
                American Speech Language Hearing Association
                1059-0889
                1558-9137
                June 2023
                June 2023
                : 32
                : 2
                : 303-313
                Affiliations
                [1 ]School of Audiology &amp; Speech-Language Pathology, Bharati Vidyapeeth (Deemed to be University), Pune, India
                Article
                10.1044/2022_AJA-22-00155
                d4be715b-5e5c-49a1-9f73-dce1b4675d7f
                © 2023
                History

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