Clinical utility of the Vestibular-Evoked-Myogenic-Potentials (VEMPs)
Abstract Introduction and objectives: At the beginning of the 1990s, Colebath and Halmagyi demonstrated that measuring the potential myogenic evoked from an acoustic or vibratory stimulation of the labyrinth is possible, giving name to what since then we call Vestibular-Evoked-Myogenic-Potentials (VEMPs). The objective of this review, aims to meet the anatomic-functional bases of the VEMPs and to describe their current clinical applications. Method: This is a descriptive work from the most relevant bibliography, summarizing the features, obtaining procedures and clinical utility of the VEMPs. Results and conclusion: Using the ocular VEMPs (oVEMPs) and cervical (cVEMPs), we can obtain practical, clinical information on the utricular and saccular functions. Both procedures are specific, simple, fast, reproducible and safe. When these results are combined with other vestibular tests, they provide knowledge of the functional of each one of the sensory receptors of the labyrinth.
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Akin FW, Murnane OD: Vestibular Evoked Myogenic Potentials. En: Jacobson GP, Shepard NT: Balance function assessment and management. Plural Publishing, Inc. 1ª Ed. 2008. Cap. 18; pp. 405-434.
Alpini D, Pugnetti L, Caputo D, Cesarani A. Vestibular evoked myogenic potentials in multiple sclerosis: a comparison between onset and definite cases. Int Tinnitus J. 2005;11(1):48-51. PMid:16419689
Bath AP, Harris N, McEwan J, Yardley MP. Effect of conductive hearing loss on the vestibulo-collic reflex. Clin Otolaryngol Allied Sci. 1999;24(3):181-3. http://dx.doi.org/10.1046/j.1365-2273.1999.00234.x PMid:10384842
Brantberg K, Verrecchia L. Testing vestibular-evoked myogenic potentials with 90-dB clicks is effective in the diagnosis of superior canal dehiscence syndrome. Audiol Neurootol. 2009;14(1):54-8. http://dx.doi.org/10.1159/000153435 PMid:18781064
Chihara Y, Iwasaki S, Ushio M, Fujimoto C, Kashio A, Kondo K, et al. Ocular vestibular-evoked myogenic potentials (oVEMPs) require extraocular muscles but not facial or cochlear nerve activity. Clin Neurophysiol. 2009;120(3):581-7. http://dx.doi.org/10.1016/j.clinph.2008.12.030 PMid:19211302
Colebatch JG, Halmagyi GM. Vestibular evoked potentials in human neck muscles before and after unilateral vestibular deafferentation. Neurology. 1992;42:1635-6. http://dx.doi.org/10.1212/WNL.42.8.1635
Colebatch JG, Rothwell JC. Motor unit excitability changes mediating vestibulocollic reflexes in the sternocleidomastoid muscle. Clin Neurophysiol. 2004;115(11):2567-73. http://dx.doi.org/10.1016/j.clinph.2004.06.012 PMid:15465446
Curthoys IS, Haslwanter T, Black RA, Burgess AM, Halmagyi GM, Topple AN, et al. Off-center yaw rotation: effect of naso-occipital linear acceleration on the nystagmus response of normal human subjects and patients after unilateral vestibular loss. Exp Brain Res. 1998;123(4):425-38. http://dx.doi.org/10.1007/s002210050587 PMid:9870602
Curthoys IS, Manzari L. Otolithic disease: clinical features and the role of vestibular evoked myogenic potentials. Semin Neurol. 2013;33(3):231-7. http://dx.doi.org/10.1055/s-0033-1354595 PMid:24057826
Curthoys IS, Manzari L. Otolithic disease: clinical features and the role of vestibular evoked myogenic potentials. Semin Neurol. 2013;33(3):231-7. http://dx.doi.org/10.1055/s-0033-1354595 PMid:24057826
Curthoys IS. A critical review of the neurophysiological evidence underlying clinical vestibular testing using sound, vibration and galvanic stimuli. Clin Neurophysiol. 2010;121(2):132-44. http://dx.doi.org/10.1016/j.clinph.2009.09.027 PMid:19897412
Curthoys IS. The interpretation of clinical tests of peripheral vestibular function. Laryngoscope. 2012;122(6):1342-52. http://dx.doi.org/10.1002/lary.23258 PMid:22460150
Fujimoto C, Egami N, Kinoshita M, Sugasawa K, Yamasoba T, Iwasaki S. Involvement of vestibular organs in idiopathic sudden hearing loss with vertigo: an analysis using oVEMP and cVEMP testing. Clin Neurophysiol. 2015;126(5):1033-8. http://dx.doi.org/10.1016/j.clinph.2014.07.028 PMid:25200460
Goldberg JM. Afferent diversity and the organization of central vestibular pathways. Exp Brain Res. 2000;130(3):277-97. http://dx.doi.org/10.1007/s002210050033 PMid:10706428 PMCid:PMC3731078
Halmagyi GM, Curthoys IS: Clinical anatomy and physiology of the vestibular system. En: Bronstein AM: Vertigo and Imbalance. Oxford University Press. 1ª Ed. 2013. Cap. 8; pp. 79-91. http://dx.doi.org/10.1093/med/9780199608997.003.0008
Halmagyi GM, Curthoys IS: Otolith function tests. En: Herdmann SJ, Clendaniel RA: Vestibular Rehabilitation. F.A. Davis Company. 4ª Ed. 2014. Cap. 12; pp. 195-226.
Halmagyi GM, Gresty MA, Gibson WP. Ocular tilt reaction with peripheral vestibular lesion. Ann Neurol. 1979;6(1):80-3. http://dx.doi.org/10.1002/ana.410060122 PMid:315752
Helling K, Schönfeld U, Clarke AH. Treatment of Ménière's disease by low-dosage intratympanic gentamicin application: effect on otolith function. Laryngoscope. 2007;117(12):2244-50. http://dx.doi.org/10.1097/MLG.0b013e3181453a3c PMid:17909448
Hong SM, Byun JY, Park CH, Lee JH, Park MS, Cha CI. Saccular damage in patients with idiopathic sudden sensorineural hearing loss without vertigo. Otolaryngol Head Neck Surg. 2008;139(4):541-5. http://dx.doi.org/10.1016/j.otohns.2008.07.003 PMid:18922341
Huang CH, Young YH. Ocular and cervical vestibular-evoked myogenic potentials in Tumarkin falls. Otol Neurotol. 2012;33(7):1251-6. http://dx.doi.org/10.1097/MAO.0b013e31826352e8 PMid:22858713
Iwasaki S, Fujimoto C, Kinoshita M, Kamogashira T, Egami N, Yamasoba T. Clinical characteristics of patients with abnormal ocular/cervical vestibular evoked myogenic potentials in the presence of normal caloric responses. Ann Otol Rhinol Laryngol. 2015;124(6):458-65. http://dx.doi.org/10.1177/0003489414564997 PMid:25533509
Iwasaki S, Smulders YE, Burgess AM, McGarvie LA, Macdougall HG, Halmagyi GM, et al. Ocular vestibular evoked myogenic potentials in response to bone-conducted vibration of the midline forehead at Fz. A new indicator of unilateral otolithic loss. Audiol Neurootol. 2008;13(6):396-404. http://dx.doi.org/10.1159/000148203 PMid:18663292
Janky KL, Nguyen KD, Welgampola M, Zuniga MG, Carey JP. Air-conducted oVEMPs provide the best separation between intact and superior canal dehiscent labyrinths. Otol Neurotol. 2013;34(1):127-34. http://dx.doi.org/10.1097/MAO.0b013e318271c32a PMid:23151775 PMCid:PMC3621128
Kantner C, Gürkov R. Characteristics and clinical applications of ocular vestibular evoked myogenic potentials. Hear Res. 2012;294(1-2):55-63. http://dx.doi.org/10.1016/j.heares.2012.10.008 PMid:23123220
Krause E, Wechtenbruch J, Rader T, Gürkov R. Influence of cochlear implantation on sacculus function. Otolaryngol Head Neck Surg. 2009;140(1):108-113. http://dx.doi.org/10.1016/j.otohns.2008.10.008 PMid:19130972
Kushiro K, Zakir M, Ogawa Y, Sato H, Uchino Y. Saccular and utricular inputs to sternocleidomastoid motoneurons of decerebrate cats. Exp Brain Res. 1999;126(3):410-6. http://dx.doi.org/10.1007/s002210050747 PMid:10382625
Kushiro K, Zakir M, Sato H, Ono S, Ogawa Y, Meng H, et al. Saccular and utricular inputs to single vestibular neurons in cats. Exp Brain Res. 2000;13:406-15. http://dx.doi.org/10.1007/s002219900312
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Li MW, Houlden D, Tomlinson RD. Click evoked EMG responses in sternocleidomastoid muscles: characteristics in normal subjects. J Vestib Res. 1999;9(5):327-34. PMid:10544371
Magliulo G, Gagliardi S, Ciniglio Appiani M, Iannella G, Re M. Vestibular neurolabyrinthitis: a follow-up study with cervical and ocular vestibular evoked myogenic potentials and the video head impulse test. Ann Otol Rhinol Laryngol. 2014;123(3):162-73. http://dx.doi.org/10.1177/0003489414522974 PMid:24633942
Manzari L, Burgess AM, Curthoys IS. Does unilateral utricular dysfunction cause horizontal spontaneous nystagmus?. Eur Arch Otorhinolaryngol. 2012;269(11):2441-5. http://dx.doi.org/10.1007/s00405-012-2127-z PMid:22869020
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Alpini D, Pugnetti L, Caputo D, Cesarani A. Vestibular evoked myogenic potentials in multiple sclerosis: a comparison between onset and definite cases. Int Tinnitus J. 2005;11(1):48-51. PMid:16419689
Bath AP, Harris N, McEwan J, Yardley MP. Effect of conductive hearing loss on the vestibulo-collic reflex. Clin Otolaryngol Allied Sci. 1999;24(3):181-3. http://dx.doi.org/10.1046/j.1365-2273.1999.00234.x PMid:10384842
Brantberg K, Verrecchia L. Testing vestibular-evoked myogenic potentials with 90-dB clicks is effective in the diagnosis of superior canal dehiscence syndrome. Audiol Neurootol. 2009;14(1):54-8. http://dx.doi.org/10.1159/000153435 PMid:18781064
Chihara Y, Iwasaki S, Ushio M, Fujimoto C, Kashio A, Kondo K, et al. Ocular vestibular-evoked myogenic potentials (oVEMPs) require extraocular muscles but not facial or cochlear nerve activity. Clin Neurophysiol. 2009;120(3):581-7. http://dx.doi.org/10.1016/j.clinph.2008.12.030 PMid:19211302
Colebatch JG, Halmagyi GM. Vestibular evoked potentials in human neck muscles before and after unilateral vestibular deafferentation. Neurology. 1992;42:1635-6. http://dx.doi.org/10.1212/WNL.42.8.1635
Colebatch JG, Rothwell JC. Motor unit excitability changes mediating vestibulocollic reflexes in the sternocleidomastoid muscle. Clin Neurophysiol. 2004;115(11):2567-73. http://dx.doi.org/10.1016/j.clinph.2004.06.012 PMid:15465446
Curthoys IS, Haslwanter T, Black RA, Burgess AM, Halmagyi GM, Topple AN, et al. Off-center yaw rotation: effect of naso-occipital linear acceleration on the nystagmus response of normal human subjects and patients after unilateral vestibular loss. Exp Brain Res. 1998;123(4):425-38. http://dx.doi.org/10.1007/s002210050587 PMid:9870602
Curthoys IS, Manzari L. Otolithic disease: clinical features and the role of vestibular evoked myogenic potentials. Semin Neurol. 2013;33(3):231-7. http://dx.doi.org/10.1055/s-0033-1354595 PMid:24057826
Curthoys IS, Manzari L. Otolithic disease: clinical features and the role of vestibular evoked myogenic potentials. Semin Neurol. 2013;33(3):231-7. http://dx.doi.org/10.1055/s-0033-1354595 PMid:24057826
Curthoys IS. A critical review of the neurophysiological evidence underlying clinical vestibular testing using sound, vibration and galvanic stimuli. Clin Neurophysiol. 2010;121(2):132-44. http://dx.doi.org/10.1016/j.clinph.2009.09.027 PMid:19897412
Curthoys IS. The interpretation of clinical tests of peripheral vestibular function. Laryngoscope. 2012;122(6):1342-52. http://dx.doi.org/10.1002/lary.23258 PMid:22460150
Fujimoto C, Egami N, Kinoshita M, Sugasawa K, Yamasoba T, Iwasaki S. Involvement of vestibular organs in idiopathic sudden hearing loss with vertigo: an analysis using oVEMP and cVEMP testing. Clin Neurophysiol. 2015;126(5):1033-8. http://dx.doi.org/10.1016/j.clinph.2014.07.028 PMid:25200460
Goldberg JM. Afferent diversity and the organization of central vestibular pathways. Exp Brain Res. 2000;130(3):277-97. http://dx.doi.org/10.1007/s002210050033 PMid:10706428 PMCid:PMC3731078
Halmagyi GM, Curthoys IS: Clinical anatomy and physiology of the vestibular system. En: Bronstein AM: Vertigo and Imbalance. Oxford University Press. 1ª Ed. 2013. Cap. 8; pp. 79-91. http://dx.doi.org/10.1093/med/9780199608997.003.0008
Halmagyi GM, Curthoys IS: Otolith function tests. En: Herdmann SJ, Clendaniel RA: Vestibular Rehabilitation. F.A. Davis Company. 4ª Ed. 2014. Cap. 12; pp. 195-226.
Halmagyi GM, Gresty MA, Gibson WP. Ocular tilt reaction with peripheral vestibular lesion. Ann Neurol. 1979;6(1):80-3. http://dx.doi.org/10.1002/ana.410060122 PMid:315752
Helling K, Schönfeld U, Clarke AH. Treatment of Ménière's disease by low-dosage intratympanic gentamicin application: effect on otolith function. Laryngoscope. 2007;117(12):2244-50. http://dx.doi.org/10.1097/MLG.0b013e3181453a3c PMid:17909448
Hong SM, Byun JY, Park CH, Lee JH, Park MS, Cha CI. Saccular damage in patients with idiopathic sudden sensorineural hearing loss without vertigo. Otolaryngol Head Neck Surg. 2008;139(4):541-5. http://dx.doi.org/10.1016/j.otohns.2008.07.003 PMid:18922341
Huang CH, Young YH. Ocular and cervical vestibular-evoked myogenic potentials in Tumarkin falls. Otol Neurotol. 2012;33(7):1251-6. http://dx.doi.org/10.1097/MAO.0b013e31826352e8 PMid:22858713
Iwasaki S, Fujimoto C, Kinoshita M, Kamogashira T, Egami N, Yamasoba T. Clinical characteristics of patients with abnormal ocular/cervical vestibular evoked myogenic potentials in the presence of normal caloric responses. Ann Otol Rhinol Laryngol. 2015;124(6):458-65. http://dx.doi.org/10.1177/0003489414564997 PMid:25533509
Iwasaki S, Smulders YE, Burgess AM, McGarvie LA, Macdougall HG, Halmagyi GM, et al. Ocular vestibular evoked myogenic potentials in response to bone-conducted vibration of the midline forehead at Fz. A new indicator of unilateral otolithic loss. Audiol Neurootol. 2008;13(6):396-404. http://dx.doi.org/10.1159/000148203 PMid:18663292
Janky KL, Nguyen KD, Welgampola M, Zuniga MG, Carey JP. Air-conducted oVEMPs provide the best separation between intact and superior canal dehiscent labyrinths. Otol Neurotol. 2013;34(1):127-34. http://dx.doi.org/10.1097/MAO.0b013e318271c32a PMid:23151775 PMCid:PMC3621128
Kantner C, Gürkov R. Characteristics and clinical applications of ocular vestibular evoked myogenic potentials. Hear Res. 2012;294(1-2):55-63. http://dx.doi.org/10.1016/j.heares.2012.10.008 PMid:23123220
Krause E, Wechtenbruch J, Rader T, Gürkov R. Influence of cochlear implantation on sacculus function. Otolaryngol Head Neck Surg. 2009;140(1):108-113. http://dx.doi.org/10.1016/j.otohns.2008.10.008 PMid:19130972
Kushiro K, Zakir M, Ogawa Y, Sato H, Uchino Y. Saccular and utricular inputs to sternocleidomastoid motoneurons of decerebrate cats. Exp Brain Res. 1999;126(3):410-6. http://dx.doi.org/10.1007/s002210050747 PMid:10382625
Kushiro K, Zakir M, Sato H, Ono S, Ogawa Y, Meng H, et al. Saccular and utricular inputs to single vestibular neurons in cats. Exp Brain Res. 2000;13:406-15. http://dx.doi.org/10.1007/s002219900312
Lee KJ, Kim MS, Son EJ, Lim HJ, Bang JH, Kang JG. The Usefulness of Rectified VEMP. Clin Exp Otorhinolaryngol. 2008;1(3):143-7. http://dx.doi.org/10.3342/ceo.2008.1.3.143 PMid:19434246 PMCid:PMC2671751
Li MW, Houlden D, Tomlinson RD. Click evoked EMG responses in sternocleidomastoid muscles: characteristics in normal subjects. J Vestib Res. 1999;9(5):327-34. PMid:10544371
Magliulo G, Gagliardi S, Ciniglio Appiani M, Iannella G, Re M. Vestibular neurolabyrinthitis: a follow-up study with cervical and ocular vestibular evoked myogenic potentials and the video head impulse test. Ann Otol Rhinol Laryngol. 2014;123(3):162-73. http://dx.doi.org/10.1177/0003489414522974 PMid:24633942
Manzari L, Burgess AM, Curthoys IS. Does unilateral utricular dysfunction cause horizontal spontaneous nystagmus?. Eur Arch Otorhinolaryngol. 2012;269(11):2441-5. http://dx.doi.org/10.1007/s00405-012-2127-z PMid:22869020
Manzari L, Burgess AM, Curthoys IS. Ocular and cervical vestibular evoked myogenic potentials in response to bone-conducted vibration in patients with probable inferior vestibular neuritis. J Laryngol Otol. 2012;126(7):683-91. http://dx.doi.org/10.1017/S0022215112000692 PMid:22583739
Manzari L, Burgess AM, McGarvie LA, Curthoys IS. An indicator of probable semicircular canal dehiscence: ocular vestibular evoked myogenic potentials to high frequencies. Otolaryngol Head Neck Surg. 2013;149(1):142-5. http://dx.doi.org/10.1177/0194599813489494 PMid:23674567
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