Optimization of Cervical and Ocular Vestibular Evoked Myogenic Potential Testing Using an Impulse Hammer in Adults, Adolescents, and Children

Rodriguez, Amanda; Marler, Elizabeth; Fitzpatrick, Denis; Creutz, Thomas; Cannon, Shauntelle A; Thomas, Megan L. A.; Janky, Kristen L.

doi:10.1097/mao.0000000000002632

Cited by 7 publications

(10 citation statements)

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“…Caution therefore should be exercised when extending findings for high frequency BCV and ACS from small rodents to humans. Given human utricular morphology and the inertia of the head, clinically relevant short-duration stimuli (e.g., mechanical tap ( 58 , 59 )) likely evoke synchronized neural responses that scale with linear acceleration rather than jerk ( Figure 9 , left).…”

Section: Discussionmentioning

confidence: 99%

A mathematical model for mechanical activation and compound action potential generation by the utricle in response to sound and vibration

et al. 2023

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IntroductionCalyx bearing vestibular afferent neurons innervating type I hair cells in the striolar region of the utricle are exquisitely sensitive to auditory-frequency air conducted sound (ACS) and bone conducted vibration (BCV). Here, we present experimental data and a mathematical model of utricular mechanics and vestibular compound action potential generation (vCAP) in response to clinically relevant levels of ACS and BCV. Vibration of the otoconial layer relative to the sensory epithelium was simulated using a Newtonian two-degree-of-freedom spring-mass-damper system, action potential timing was simulated using an empirical model, and vCAPs were simulated by convolving responses of the population of sensitive neurons with an empirical extracellular voltage kernel. The model was validated by comparison to macular vibration and vCAPs recorded in the guinea pig, in vivo.ResultsTransient stimuli evoked short-latency vCAPs that scaled in magnitude and timing with hair bundle mechanical shear rate for both ACS and BCV. For pulse BCV stimuli with durations <0.8 ms, the vCAP magnitude increased in proportion to temporal bone acceleration, but for pulse durations >0.9 ms the magnitude increased in proportion to temporal bone jerk. Once validated using ACS and BCV data, the model was applied to predict blast-induced hair bundle shear, with results predicting acute mechanical damage to bundles immediately upon exposure.DiscussionResults demonstrate the switch from linear acceleration to linear jerk as the adequate stimulus arises entirely from mechanical factors controlling the dynamics of sensory hair bundle deflection. The model describes the switch in terms of the mechanical natural frequencies of vibration, which vary between species based on morphology and mechanical factors.

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Section: Discussionmentioning

confidence: 99%

A mathematical model for mechanical activation and compound action potential generation by the utricle in response to sound and vibration

et al. 2023

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“…Taps were administered at a bandage used as a target to reduce variability. The data collection program provided simultaneous feedback on appropriate rate and to ensure that only taps between 10 and 30 N were accepted for analysis (Rodriguez et al 2020). The epoch began when the hammer force exceeded a 2.0 N threshold.…”

Section: Methodsmentioning

confidence: 99%

“…The epoch began when the hammer force exceeded a 2.0 N threshold. There is a ~1 ms delay (Rodriguez et al 2020); thus, all IH latencies were adjusted accordingly in the present study.…”

Section: Methodsmentioning

confidence: 99%

“…Participants received verbal feedback from the examiner to indicate if EMG levels were too low or high. For cVEMPs, the root-mean-square EMG was calculated using a prestimulus window, which was rectified and averaged to create an estimated prestimulus tonic EMG level (Rodriguez et al 2020). EMG was limited between 100 and 400 µV for 55 of the total 85 participants.…”

Section: Methodsmentioning

confidence: 99%

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Age Effects of Bone Conduction Vibration Vestibular-evoked Myogenic Potentials (VEMPs) Using B81 and Impulse Hammer Stimuli

et al. 2021

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Objective: Recently developed, the Radioear B81 bone oscillator allows for higher bone conduction vibration output; however, normative data are lacking regarding its use in vestibular-evoked myogenic potential (VEMP) testing. The purpose of this study was to examine the effect of age on cervical and ocular VEMP (c- and oVEMP) responses using the B81 and to compare with air conduction stimuli (ACS) and impulse hammer (IH) VEMP response characteristics. Design: c- and oVEMP were completed with ACS, B81, and IH stimuli in healthy participants (age range = 10 to 87 years, n = 85). Results: Regardless of stimulus type, c- and oVEMP amplitudes and response rates decreased with age. For cVEMP response rates, ACS performed better or equal to B81, which was superior to the IH. For cVEMP corrected amplitude, ACS had significantly higher amplitudes compared with B81 and IH. There was no difference in cVEMP corrected amplitude between B81 and IH. For oVEMP, response rates were comparable between stimuli with the largest disparity in response rates occurring in the oldest groups where IH outperformed both ACS and B81. For oVEMP amplitude, IH had significantly higher amplitudes compared with B81 and ACS. There was no difference in oVEMP amplitude between B81 and ACS. Conclusions: Age significantly affected c- and oVEMP amplitudes regardless of stimulus type (ACS, B81, IH). All stimuli are appropriate for eliciting c- and oVEMP in the young individuals. While ACS resulted in higher cVEMP corrected amplitudes, either ACS or B81 are appropriate for older individuals. However, for oVEMPs, higher response rates and larger amplitudes were noted for IH followed by B81 and ACS. Overall, the B81 performed well across the lifespan for c- and oVEMPs and may be a reasonable bone conduction vibration option for patients with absent ACS VEMPs, but at this time is not recommended as a replacement to ACS.

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“…This equals the force output of the B81 when the frequency is 500 Hz ( 16 , 17 , 28 ). We believe that forehead stimulation may be the best location for the oVEMP response instead of the mastoid ( 17 , 28 , 32 ). Our results showed that the response rate of B81-oVEMP was 100% up to the age group of 40–49 years and progressively declined afterward to only 40% in the group of individuals ≥60 years.…”

Section: Discussionmentioning

confidence: 99%

B81 Bone Vibrator-Induced Vestibular-Evoked Myogenic Potentials: Normal Values and the Effect of Age

et al. 2022

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ObjectiveTo define the normal values and examine the influence of aging on B81 bone vibrator-induced cervical vestibular-evoked myogenic potentials (B81-cVEMPs) and ocular vestibular-evoked myogenic potentials (B81-oVEMPs).MethodsSeventy healthy subjects, divided into seven groups according to their ages, were enrolled in this study. The 4–9-, 10–19-, 20–29-, 30–39-, 40–49-, 50–59-, and 60–70-year-old participants were divided into groups I–VII, respectively. B81-cVEMP and B81-oVEMP were recorded in each group.ResultsThe B81-cVEMP response rates for groups I–VII were 100, 100, 100, 100, 95, 95, and 75%, respectively, with significant differences only between groups I–VI and group VII (p = 0.047, p < 0.05). The B81-oVEMP response rates for groups I–VII were 100, 100, 100, 100, 70, 65, and 40%, respectively, with significant differences only between groups I–IV and groups V–VII (p = 0.020, p = 0.008, p = 0.000; p < 0.05). The threshold, P13, and N23 latencies of B81-cVEMP positively correlated with age (r = 0.756, p = 0.000; r = 0.357, p = 0.003; r = 0.316, p = 0.009; p < 0.05). The raw amplitudes and corrected amplitudes negatively correlated with age (r = −0.641, p = 0.000; r = −0.609, p = 0.000, p < 0.05). For B81-oVEMP, the corrected amplitudes negatively correlated with age (r = −0.638, p = 0.000, p<0.05), but the threshold and N10 latency positively correlated with age (r = 0.768, p = 0.000; r = 0.334, p = 0.009, p < 0.05). Moreover, the interaural asymmetry ratio did not significantly correlate with age for B81-cVEMP and B81-oVEMP.ConclusionAs age increased, the B81-cVEMP response rate decreased, the thresholds increased, P13 and N23 latencies were prolonged, and the raw amplitude and corrected amplitude decreased. The B81-oVEMP response rate and corrected amplitude decreased, the thresholds increased, and N10 latency was prolonged with age. These changes are probably due to the occurrence of morphological and functional changes in the vestibular system with aging. Therefore, we suggest establishing different reference values according to different age groups when evaluating the VEMP results in patients with vestibular diseases.

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Optimization of Cervical and Ocular Vestibular Evoked Myogenic Potential Testing Using an Impulse Hammer in Adults, Adolescents, and Children

Cited by 7 publications

References 40 publications

A mathematical model for mechanical activation and compound action potential generation by the utricle in response to sound and vibration

A mathematical model for mechanical activation and compound action potential generation by the utricle in response to sound and vibration

Age Effects of Bone Conduction Vibration Vestibular-evoked Myogenic Potentials (VEMPs) Using B81 and Impulse Hammer Stimuli

B81 Bone Vibrator-Induced Vestibular-Evoked Myogenic Potentials: Normal Values and the Effect of Age

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