Cervical VEMP Threshold Response Curve in the Identification of Ménière’s Disease

Zhu, Yi; McPherson, James H.; Beatty, Charles W.; Driscoll, Colin L. W.; Neff, Brian A.; Eggers, Scott D.Z.; Shepard, Neil T.

doi:10.3766/jaaa.25.3.7

Cited by 10 publications

(12 citation statements)

References 10 publications

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“…Since age is known to affect frequency tuning ( 46 ), these differences could instead be due to normal aging, instead of EH. Nevertheless, studies that controlled for age showed that it could influence frequency tuning in controls and in the unaffected ear of individuals with MD, but not in ears affected by MD ( 41 – 44 ).…”

Section: Frequency Tuning Curvementioning

confidence: 99%

The Clinical Utility of Vestibular-Evoked Myogenic Potentials in the Diagnosis of Ménière’s Disease

et al. 2017

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Ménière’s disease (MD) is a condition that has been proposed over 150 years ago, which involves audiological and vestibular manifestations, such as aural fullness, tinnitus, vertigo, and fluctuating hearing thresholds. Over the past few years, many researchers have assessed different techniques to help diagnose this pathology. Vestibular-evoked myogenic potential (VEMP) is an electrophysiological method assessing the saccule (cVEMP) and the utricule (oVEMP). Its clinical utility in the diagnosis of multiple pathologies, such as superior canal dehiscence, has made this tool a common method used in otologic clinics. The main objective of the present review is to determine the current state of knowledge of the VEMP in the identification of MD, such as the type of stimuli, the frequency tuning, and the interaural asymmetry ratio of the cVEMP and the oVEMP. Results show that the type of stimulation, the frequency sensitivity shift and the interaural asymmetry ratio (IAR) could be useful tool to diagnose and describe the evolution of MD. It is, however, important to emphasize that further studies are needed to confirm the utility of VEMP in the identification of MD in its early stage, using either bone-conduction vibration or air-conduction stimulation, which is of clinical importance when it comes to early intervention.

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Section: Frequency Tuning Curvementioning

confidence: 99%

The Clinical Utility of Vestibular-Evoked Myogenic Potentials in the Diagnosis of Ménière’s Disease

et al. 2017

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“…71 -Vestibular evoked myogenic potentials (VEMPs): This is a test that uses cervical or ocular muscles reflexes evoked by a loud noise in the ear or high-frequency vibration, which helps to evaluate the function of the saccule (cVEMP) and utricle (oVEMP). 72,73 Its role for MD diagnosis is so far unestablished (sensitivity: 50%; specificity: 49%). 74 -Video head impulse test: This is an objective measure of the VOR for each semicircular canal.…”

Section: Vestibular Function Testsmentioning

confidence: 99%

Current Understanding and Clinical Management of Meniere's Disease: A Systematic Review

Pérez-Carpena

Lopez-Escamez

2019

Semin Neurol

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Meniere's disease (MD) is a set of uncommon disorders with core phenotype of tinnitus, episodic vertigo, and sensorineural hearing loss. MD shows a genetic predisposition and a family history is found in 10% cases, with an autosomal dominant inheritance pattern. It is a multifactorial condition whose onset and development are triggered by the combined effect of genetic and environmental factors. Histopathological studies have associated MD with the accumulation of endolymph in the cochlea and the vestibular organs. However, endolymphatic hydrops does not fully explain the persistence of tinnitus, hearing loss progression, or the frequency of vertigo attacks.There are several comorbidities associated with MD, such as migraine, anxiety, autoimmune, and autoinflammatory disorders, adding more complexity to the phenotype. This “extended phenotype” can make the diagnosis and clinical management more complex, but it could also lead to a better characterization, understanding, and treatment of MD patients.We have conducted a systematic review on MD to update current knowledge, focusing on its mechanisms, diagnosis, comorbidities, and practical management.

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“…Another limitation of the μVEMP device is that ACS clicks stimulus amplitude cannot be adjusted by the operator (an intentional safety feature). In consequence, a threshold of response, often assessed in SCD or Meniere's patients ( 34 , 35 ), cannot be evaluated with this device. These limitations have been intentionally imposed for hearing safety reasons, to minimize stimulus generation hardware and for our goal to produce a device that is as easy to use as possible (no frequencies or amplitudes to set).…”

Section: Discussionmentioning

confidence: 99%

μVEMP: A Portable Interface to Record Vestibular Evoked Myogenic Potentials (VEMPs) With a Smart Phone or Tablet

et al. 2018

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Background: Cervical VEMPs and ocular VEMPs are tests for evaluating otolith function in clinical practice. We developed a simple, portable and affordable device to record VEMP responses on patients, named μVEMP. Our aim was to validate and field test the new μVEMP device.Methods: We recorded cervical VEMPs and ocular VEMPs in response to bone conducted vibration using taps tendon hammer to the forehead (Fz) and to air conducted sounds using clicks. We simultaneously recorded VEMP responses (same subject, same electrode, same stimuli) in three healthy volunteers (2 females, age range: 29–57 years) with the μVEMP device and with a standard research grade commercial (CED) system used in clinics. We also used the μVEMP device to record VEMP responses from six patients (6 females, age mean±SD: 50.3 ± 20.8 years) with classical peripheral audio-vestibular diseases (unilateral vestibular neuritis, unilateral neurectomy, bilateral vestibular loss, unilateral superior canal dehiscence, unilateral otosclerosis).Results: The first part of this paper compared the devices using simultaneous recordings. The average of the concordance correlation coefficient was rc = 0.997 ± 0.003 showing a strong similarity between the measures. VEMP responses recorded with the μVEMP device on patients with audio-vestibular diseases were similar to those typically found in the literature.Conclusions: We developed, validated and field tested a new device to record ocular and cervical VEMPs in response to sound and vibration.This new device is portable (powered by a phone or tablet) with pocket-size dimensions (105 × 66 × 27 mm) and light weight (150 g). Although further studies and normative data are required, our μVEMP device is simpler (easier to use) and potentially more accessible than standard, commercially available equipment.

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Cervical VEMP Threshold Response Curve in the Identification of Ménière’s Disease

Cited by 10 publications

References 10 publications

The Clinical Utility of Vestibular-Evoked Myogenic Potentials in the Diagnosis of Ménière’s Disease

The Clinical Utility of Vestibular-Evoked Myogenic Potentials in the Diagnosis of Ménière’s Disease

Current Understanding and Clinical Management of Meniere's Disease: A Systematic Review

μVEMP: A Portable Interface to Record Vestibular Evoked Myogenic Potentials (VEMPs) With a Smart Phone or Tablet

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