Diagnostic Value of Frequency-Associated Vestibular-Evoked Myogenic Potential Responses in Ménière's Disease

Şalvız, Mehti; Yüce, Turgut; Karataş, Abdullah; Balikci, Hasan Huseyin; Özkul, Murat Haluk

doi:10.1159/000375395

Cited by 11 publications

(21 citation statements)

References 21 publications

(29 reference statements)

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“…Our data suggest that patients with MD have a higher ratio than those presenting with non‐Meniere's vertigo, reflecting a tuning shift to a higher best stimulation frequency in MD. Our results are consistent with others . Sandhu et al consistently noted that MD patients had decreased cVEMP amplitude at 500 Hz when compared to healthy individuals and better responses at higher frequencies (ie, a tuning shift).…”

Section: Discussionsupporting

confidence: 93%

“…Our study aimed to assess the value of cVEMP for the diagnosis of MD, particularly the 1,000/500 Hz amplitude ratio. It has been reported that in healthy individuals, the stimulating frequencies that resulted in the highest amplitude responses are found at 250–500 Hz, and that in healthy individuals the cVEMP 1,000/500 Hz amplitude ratio should be <1 . Our data suggest that patients with MD have a higher ratio than those presenting with non‐Meniere's vertigo, reflecting a tuning shift to a higher best stimulation frequency in MD.…”

Section: Discussionmentioning

confidence: 46%

“…These authors found these changes to be more prominent in ocular VEMP testing. Salviz et al also reported increases of the 1,000/500 Hz amplitude ratio of both cVEMP and ocular VEMP in MD. These authors reported that this test had a fair diagnostic value (AUC of 0.731) and sensitivity and specificity values of 75% and 75%, respectively, when a cutoff value was set at 0.86.…”

Section: Discussionmentioning

confidence: 84%

“…More recently, VEMP has been introduced as diagnostic tools for superior semicircular canal dehiscence and for macular vestibulopathies. However, the diagnostic value of VEMP in MD has not been fully determined . Our study aimed to assess the value of cVEMP for the diagnosis of MD, particularly the 1,000/500 Hz amplitude ratio.…”

Section: Discussionmentioning

confidence: 99%

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Cervical VEMP tuning changes by Meniere's disease stages

Angeli

Goncalves

2019

Laryngoscope Investig Oto

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Objective To determine if changes in cervical vestibular‐evoked myogenic potential (cVEMP) testing reflect the different stages of cochlea‐saccular hydrops in Meniere's disease (MD). Methods This is a case‐control retrospective series. Forty‐seven patients with unilateral MD by American Academy of Otolaryngology–Head and Neck Surgery diagnostic and staging criteria, and 30 with non‐MD vertigo as control. Meniere patients were further classified based on symptoms at the time of testing as active or stable. Subsequently, patients underwent cVEMP testing by tone‐burst stimuli at 500 and 1,000 Hz. The main outcome measure was to compare the cVEMP 1,000 and 500 Hz amplitude ratio in ears with MD and non‐MD vertigo, and in active versus stable MD. Results The cVEMP 1,000/500 Hz amplitude ratio was higher in Meniere's ears (mean = 1.14 μV, SD = 0.25) than in non‐Meniere's ears (mean = 0.96 μV, SD = 0.2) (Student's t test, P = .001), and higher in active (mean = 1.22 μV, SD = 0.25) than in stable MD (mean = 1.00 μV, SD = 0.18) (P = .0035). The diagnostic value of cVEMP 1,000/500 Hz amplitude ratio to differentiate MD versus non‐MD vertigo was evaluated with a receiver‐operating characteristics (ROC) curve and the area under the curve (AUC) was 0.716 (95% confidence interval [CI] [0.591, 0.829]). The ideal cutoff point was 0.9435 with sensitivity and specificity values of 83% and 53%, respectively. The sensitivity and specificity values for this test to differentiate active versus stable MD were 68% and 81%, respectively, with AUC 0.746 (95% CI [0.607, 0.885]) and cutoff value of 1.048. In all ears, the 1,000/500 Hz amplitude ratio increased by a decrease of the 500 Hz amplitude with increasing age. Conclusion The cVEMP 1,000/500 Hz amplitude ratio is elevated in ears with MD but not in those with non‐MD vertigo. After corrected by age, this ratio is higher in active but not in stable MD, probably reflecting dynamic changes in saccular membrane motion mechanics in hydrops, and may be a useful marker of disease progression and the effect of therapy. Level of Evidence IV

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 46%

Section: Discussionmentioning

confidence: 84%

Section: Discussionmentioning

confidence: 99%

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Cervical VEMP tuning changes by Meniere's disease stages

Angeli

Goncalves

2019

Laryngoscope Investig Oto

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“…Because background muscle activities could interfere with the VEMP amplitudes, the interpeak amplitudes were normalized [2,25] . The asymmetry ratio was calculated for comparison between the right and left ears, using the formula described by Murofushi et al [22] .…”

Section: Stimulus Design and Recording Setupmentioning

confidence: 99%

Evaluation of Cervical Vestibular-Evoked Myogenic Potential Findings in Benign Paroxysmal Positional Vertigo

Karataş

Yüce²,

Cebi³

et al. 2016

Int Adv Otol

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OBJECTIVE:Although there has been a wide consensus on the mechanism of nystagmus and clinical presentation of benign paroxysmal positional vertigo (BPPV), the neuroepithelial pathophysiology of BPPV still remains unclear. In this study, we aimed to clarify the pathophysiology of BPPV by evaluating the cervical vestibular-evoked myogenic potential (cVEMP) findings of patients. MATERIALS and METHODS:Thirty-six BPPV patients and 20 healthy volunteers were included. Bilateral cVEMP tests were performed on all participants. The participants were divided into the following three groups: those with a BPPV-affected ear, those with a BPPV-unaffected ear, and the healthy control group. RESULTS:There were no significant differences regarding the latencies of the first positive (p1) and negative (n1) peaks among the three groups. The mean normalized amplitude asymmetry ratio also did not differ between the BPPV and control groups. However, the normalized amplitudes of the BPPV patients (with both affected and unaffected ears) were significantly lower than those of the healthy control group. CONCLUSION:We detected that the cVEMP data of the affected and unaffected ears of the BPPV patients was similar and that their normalized amplitudes significantly differed from those of the healthy controls. Eventually, we concluded that even if the symptoms of BPPV were unilateral, the findings suggest that the bilateral involvement of the macular neuroepithelium is important in understanding the pathophysiology of BPPV. This finding supports the conclusion that the pathophysiological process starts with neuroepithelial membrane degeneration and continues with otoconia separation.

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Utilisation of multi-frequency VEMPs improves diagnostic accuracy for Meniere’s disease

Maxwell

Jerin

Gürkov

2016

Eur Arch Otorhinolaryngol

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To determine whether vestibular evoked myogenic potential (VEMP) measurements that combine the VEMP 500/1000 Hz frequency tuning ratio and the inter-aural asymmetry ratio can reliably detect unilateral Meniere's disease ears as compared to healthy controls. Forty-two consecutive patients with certain unilateral Meniere's disease (as confirmed using a locally enhanced inner ear MRI (LEIM)) were assessed. Cervical vestibular evoked myogenic potentials (cVEMP) and ocular vestibular evoked myogenic potentials (oVEMP) were recorded at 500 and 1000 Hz. The VEMP amplitudes, asymmetry ratios, and the 500/1000 Hz amplitude ratios were compared with those of 21 age-matched healthy controls. A multi-frequency VEMPs score that combined: (1) the cVEMP 500/1000 Hz amplitude ratio, (2) the oVEMP 500/1000 Hz amplitude ratio, (3) the 500 Hz cVEMP asymmetry ratio, (4) the 1000 Hz cVEMP asymmetry ratio, produced a ROC curve with an area under the curve (AUC) of 0.814. The inclusion of audiology data further improved the result to 0.906. This score can be used to discriminate with a good degree of clinical accuracy between Meniere's ears (unilateral) and those of healthy controls. Multi-frequency VEMP analysis offers a simple, cost-effective solution to the diagnostic difficulties presented by Meniere's disease.

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Diagnostic Value of Frequency-Associated Vestibular-Evoked Myogenic Potential Responses in Ménière's Disease

Cited by 11 publications

References 21 publications

Cervical VEMP tuning changes by Meniere's disease stages

Cervical VEMP tuning changes by Meniere's disease stages

Evaluation of Cervical Vestibular-Evoked Myogenic Potential Findings in Benign Paroxysmal Positional Vertigo

Utilisation of multi-frequency VEMPs improves diagnostic accuracy for Meniere’s disease

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