UNASSIGNED: To investigate the effects of acoustic stimulation intensity on ocular and cervical vestibular evoked myogenic potential (oVEMP and cVEMP) responses elicited by air-conducted sound (ACS) in healthy children.
UNASSIGNED: Thirteen healthy children aged 4-10 years and 20 healthy adults aged 20-40 years with normal hearing and tympanometry were enrolled in this study. All subjects received oVEMP and cVEMP tests under different acoustic stimulation intensities (131, 126, 121, 116, 111 and 106 dB SPL). Mean n1 latency, p1 latency, interpeak latency, amplitude and response rate were investigated and analyzed.
UNASSIGNED: As the acoustic stimulation intensity decreased, for oVEMP, the response rate of children decreased from 100% (131, 126 and 121 dB SPL) to 57.69% (116 dB SPL), 26.92% (111 dB SPL) and 11.54% (106 dB SPL). The response rate of adults decreased from 100% (131 and 126 dB SPL) to 95% (121 dB SPL), 55% (116 dB SPL), 12.5% (111 dB SPL) and 2.5% (106 dB SPL). There were lower n1 latency, p1 latency and higher amplitude in children when comparing by acoustic stimulation intensities (p < 0.05). Regarding cVEMP, the response rate of children decreased from 100% (131, 126 and 121 dB SPL) to 88.46% (116 dB SPL), 53.85% (111 dB SPL) and 26.92% (106 dB SPL). The response rate of adults decreased from 100% (131 and 126 dB SPL) to 95% (121 dB SPL), 85% (116 dB SPL), 37.5% (111 dB SPL) and 7.5% (106 dB SPL). A statistically significant difference was found in amplitude at different acoustic stimulation intensities in both children and adults (p < 0.05). When stimulated by 131 dB SPL acoustic stimulation, there were lower n1 latency, p1 latency and higher amplitude in children in oVEMP and cVEMP compared with adults (p < 0.05).
UNASSIGNED: The response rate and amplitude of oVEMP and cVEMP in children and adults presented significant differences with a decrease in acoustic stimulation intensity. In this study, using 121 dB SPL for children and 126 dB SPL for adults during VEMP test could be regarded as safer stimulation intensities and thus reduced sound exposure.

UNASSIGNED: The vestibular evoked myogenic potentials (VEMPs) response characteristics depend on age, stimulus and individual anatomical differences. Therefore, normative data are required for accurate VEMPs interpretations. This cross-sectional study investigates VEMPs age-related changes among healthy adults using 750 Hz short alternating tone burst (TB) stimuli.
UNASSIGNED: Fifty adults aged between 23 years old and 76 years old with a mean of 51.56 (SD = 16.44) years old underwent air-conducted (AC) cervical VEMP (cVEMP) and head taps ocular VEMPs (oVEMPs) testing.
UNASSIGNED: The cVEMPs and oVEMPs response rates reduced significantly at the age of 50-year-old and above. No significant age trends were observed for both cVEMPs and oVEMPs latencies and asymmetry ratios. However, amplitude reduced with increasing age for both cVEMPs, P < 0.001 and oVEMPs, P = 0.01. No significant differences in cVEMPs and oVEMPs latencies, amplitude or asymmetry ratios were identified between gender.
UNASSIGNED: To the best of our knowledge, this is the first published normative data for cVEMPs and oVEMPS in Malaysia and Southeast Asia, obtained among healthy adults aged between 23 years old and 76 years old. Health professionals in the region can use these findings as VEMPs normative references in their clinical settings.

OBJECTIVE: To explore the usefulness of vestibular tests including \"vestibular evoked myogenic potentials\" (VEMPs) and the video head impulse test (vHIT) in the early diagnosis of \"idiopathic Parkinson\'s disease\" (PD).
METHODS: The study involved 80 participants including 40 patients (24 males, 16 females; age average 63.20 ± 7.94 years) with PD and 40 healthy individuals (18 males and 22 females; age average of 60.36 ± 7.68 years). The Modified Hoehn and Yahr (H&Y) scale was used to measure how Parkinson\'s symptoms progress and the level of disability. Patients with PD underwent cVEMPs, oVEMPs, and vHIT and the results were compared with those of 40 age-matched healthy control (HC) subjects. vHIT results and VEMP responses were registered in all patients and HCs.
RESULTS: One-sided absent cVEMP responses were found in 6 (15%) patients with PD and 8 (20%) patients had bilaterally absent responses. Five (12.5%) patients had 1-sided absent oVEMP responses and it was bilateral in 6 (15%). Patients with PD had significantly shorter cVEMP P1, N1 latency, lower cVEMP amplitudes, and oVEMP amplitudes than the HC group. The cVEMP and oVEMP amplitude asymmetry ratio was significantly higher in the PD group (P < .05). Evaluation of vHIT results and vestibular-ocular reflex (VOR) gain between the groups revealed that anterior canal and posterior canal VOR gains results were remarkably lower in the PD group than in the HCs (P < .05). There was no difference in right and left lateral canal VOR gains between the groups (P > .05).
CONCLUSIONS: The results of this study suggest that cVEMP and vHIT can be used to evaluate the vestibular system in patients with early-stage Parkinson\'s disease.

Objective:This study aimed to assess the clinical practice value of ocular vestibular evoked myogenic potential（oVEMP） and cervical vestibular evoked myogenic potential（cVEMP） in monitoring the rehabilitation of vestibular function in patients with suddensen sorineural hearing loss（SSHL）. Method:Twenty-four patients with SSHL were retrospectively enrolled， showing no VEMP response on the affected side but exhibiting VEMP responses after therapies We analyzed the improvement and the restoration of hearing and the parameters of VEMP response. Result:After treatment, seven patients showed VEMP recovery, including three cases with both oVEMP and cVEMP recovery, three cases with oVEMP recovery, and one case with cVEMP recovery. Between VEMP recoved group and VEMP unrecoved group, before treatment, no significant difference was found in the thresholds of pure-tone audiometry（PTA）. However, after treatment, VEMP recoved group exhibited lower PTA thresholds and better PTA shift （P<0.01）. Multivariate analysis revealed that recovery of VEMP was the independent risk factor for the therapeutic effect of SSHL. Conclusion:The Combination of oVEMP and cVEMP is an objective tool for assessing vestibular otolithic end organ function during dynamic functional recovery in SSHL and the recovery of VEMP could predict the auditory improvement.
目的：探讨突发性聋（突聋）治疗后耳石器功能转归情况，以明确突聋患者治疗后内耳病损的恢复情况及预后判断指标。 方法：随访24例突聋患者的听力及眼肌前庭诱发肌源性电位（oVEMP）和颈肌前庭诱发肌源性电位（cVEMP）恢复情况。 结果：24例患者，治疗前oVEMP无反应5例，cVEMP无反应8例，oVEMP及cVEMP均无反应11例。治疗后共7例患者表现出oVEMP和/或cVEMP波形恢复，其中3例oVEMP恢复反应，1例cVEMP恢复反应，3例oVEMP及cVEMP均恢复反应。根据治疗后VEMP是否恢复分为恢复组和未恢复组，两组间治疗后听力水平及听力改善程度的差异均有统计学意义（P<0.01）。多元Logistic回归分析显示，VEMP恢复是影响突聋预后的独立危险因素。 结论：VEMP能够检测部分突聋患者的耳石器功能损伤并动态监测其转归，VEMP恢复是影响突聋预后的独立危险因素，对判断预后及确定治疗周期具有重要意义。.

Verso un nuovo staging della malattia di Ménière: un approccio vestibolare.
UNASSIGNED: La malattia di Ménière (MD) è caratterizzata da episodi intermittenti di vertigine, ipoacusia neurosensoriale fluttuante, tinnito e sensazione di ovattamento auricolare. L’idrope endolinfatica è inizialmente osservata a livello istopatologico nel dotto cocleare e nel sacculo, ma con la progressione della malattia anche l’utricolo e i canali semicircolari possono venire interessati. Lo scopo dello studio è duplice: 1) definire la funzione del sacculo, dell’utricolo e dei tre canali semicircolari per mezzo di potenziali evocati vestibolari miogeni cervicali e oculari (cVEMP, oVEMP) e del video-Head Impulse Test (vHIT) nei pazienti affetti da MD; 2) correlare i risultati ottenuti con i diversi stadi di malattia. Quaranta pazienti con diagnosi di MD monolaterale secondo i criteri dell’AAO-HNS (1995) sono stati inclusi nello studio. I pazienti sono stati suddivisi in quattro sottogruppi, in base allo stadio di malattia e della soglia uditiva (definita dalla media delle frequenze 500, 1000, 2000, 3000 Hz) ottenuta al peggiore esame audiometrico tonale osservato negli ultimi 6 mesi. Un gruppo di controllo di 40 soggetti adulti sani, equivalenti per età, è stato distribuito in modo uniforme in altrettanti quattro sottogruppi sulla base della soglia audiometrica. In entrambi i gruppi sono state ottenute le risposte di cVEMP, oVEMP, test calorico a stimolazione bitermica, vHIT per ciascuno dei canali semicircolari. I risultati mostrano nei pazienti affetti da MD una maggior prevalenza di alterazioni nel PTA (85%), a seguire cVEMP (72,5%) e oVEMP (67,5%). Minor prevalenza di alterazioni sono state osservate per la stimolazione calorica (32,5%) e il vHIT con 20% per il canale semicircolare laterale, 7,5% per il superiore, 5% per il posteriore. Tale distribuzione di alterazioni funzionali rispecchia il pattern di danno istopatologico nel sistema vestibolare. In conclusione, con il progredire della MD si ottengono risposte patologiche ai test cVEMP, oVEMP, calorici e vHIT che riflettono la progressione istopatologica di malattia dal sacculo ai canali semicircolari. Sulla base di tali rilievi, gli autori propongono un aggiornato sistema classificativo per la MD.
Ménière’s disease (MD) is characterised by intermittent episodes of vertigo, fluctuating sensorineural hearing loss, tinnitus and aural pressure. Histopathologically, endolymphatic hydrops are seen initially in the cochlear duct and saccule, and with progression of the disease subsequent involvement of the utricle and semicircular canals occurs. The aims of this study are: 1) to assess the function of the saccule, utricle and three semicircular canals using cervical vestibular evoked myogenic potential (cVEMP), ocular VEMP (oVEMP) and video head impulse test (vHIT) in Ménière’s patients, and 2) to correlate the findings with the different stages of MD. Forty patients diagnosed with unilateral definite MD according to the AAO-HNS (1995) criteria were tested. They were divided into four subgroups according to the stage of MD using the average of 500, 1000, 2000 and 3000 Hz pure tone thresholds of the worst documented audiogram during the 6-month interval before examination. A control group of 40 healthy age-matched adults was equally divided into four corresponding subgroups according to their pure tone average. 500 and 1000 Hz tone burst air conduction cVEMP and oVEMP tests, bithermal caloric test and video HIT for all semicircular canals were recorded for both groups. The results of this study showed that the highest prevalence of abnormalities in Ménière’s patients were seen in the PTA (85%), followed by cVEMP (72.5%) and oVEMP (67.5%). Caloric test abnormalities followed with a lower prevalence of 32.5%. The vHIT presented the lowest prevalence of abnormalities with 20% in the lateral canal, 7.5% in the anterior and 5% in the posterior. This pattern of abnormality agrees with the histopathological pattern of hydrops formation in the vestibular system. The findings of the current study suggest that with the advancement in the stage of MD, abnormal cVEMP, oVEMP, caloric and vHIT responses occur following the histopathological evidence of progression of the disease from the saccule up to the semicircular canals. Based on these findings, the authors suggest a new staging scheme for MD.

Currently, it is possible to assess in vivo the morphology of each compartment of the endolymphatic spaces 4 hours after an intravenous administration of gadolinium on magnetic resonance imaging (MRI). The aim of this study was to assess the correlation between otolithic and ampullar functions (cervical vestibular evoked myogenic potential [cVEMP], ocular vestibular evoked myogenic potential [oVEMP], video head impulse test [VHIT]) and delayed inner ear MRI based on a compartmental, anatomically based classification that included the cochlea, the saccule, the utricle, and the ampullas.
Retrospective case-control study.
In this retrospective study, we performed three-dimensional fluid-attenuated inversion recovery sequences with delayed acquisition in 26 healthy subjects and 31 definite Menière\'s disease (MD) patients. Each subject was then graded on MRI on the basis on cochlear, saccular, utricular, and ampullar hydrops in MD patients. All patients underwent pure-tone audiometry, VHIT, cVEMP, and oVEMP testing.
Cochlear, saccular, utricular, and ampullar hydrops were found on MRI in 88%, 91%, 50%, and 8.5% respectively. We found no significant correlation between the presence of saccular hydrops versus cVEMP, utricular hydrops versus oVEMP, and ampullar hydrops versus VHIT. However, the severity of endolymphatic hydrops on MRI was correlated to the degree of hearing loss.
We proposed a compartmental, anatomically based classification for endolymphatic hydrops on MRI, which included the whole vestibular compartment. Using this classification, we observed increasing morphological changes as the disease evolved, affecting first the saccule, then the utricle, and finally the ampullas. The severity of vestibular endolymphatic hydrops is only correlated to hearing loss severity.
3 Laryngoscope, 130:E444-E452, 2020.

UNASSIGNED: To compare the amplitude of potentials by acoustic stimulation at 500 Hz versus 1000 Hz in healthy subjects.
UNASSIGNED: 25 subjects; potentials were performed with acoustic stimuli burst-type at 500 and 1000 Hz with a stimulation rate of 5.1 at 100 dB in both ears. Descriptive statistics tests were performed, confidence intervals were calculated for the mean with 95% reliability, standard error graphs and t-test for related samples.
UNASSIGNED: The values obtained in amplitude when performing an acoustic stimulus at 1000 Hz show a faster response compared to that obtained in the frequency of 500 Hz. The t-test showed a significant difference in the amplitude in the 1000 Hz frequency between ears with a significance value of p < 0.025.
UNASSIGNED: It is strengthened the hypothesis that in the amplitude of potentials by aerial acoustic stimulation in the frequency of 1000 Hz a greater amplitude is generated in relation to the one generated in the frequency of 500 Hz.
UNASSIGNED: Comparar la amplitud de los potenciales miogénicos vestibulooculares por estimulación acústica a 500 y 1000 Hz en sujetos sanos.
UNASSIGNED: Se estudiaron 25 sujetos y se realizaron potenciales con estímulos acústicos tipo burst a 500 y 1000 Hz con una tasa de estimulación de 5.1 a 100 dB en ambos oídos. Se realizaron pruebas de estadística descriptiva y se calcularon los intervalos de confianza para la media con un 95% de confiabilidad, las gráficas de error estándar y la prueba t para muestras relacionadas.
UNASSIGNED: Los valores obtenidos en amplitud al realizar estímulo acústico a 1000 Hz muestran una respuesta más rápida en comparación con la obtenida en la frecuencia de 500 Hz. La prueba t mostró una diferencia significativa en la amplitud en la frecuencia 1000 Hz entre oídos, con un valor de significancia p < 0.025.
UNASSIGNED: Se fortalece la hipótesis de que en los potenciales por estimulación acústica aérea en la frecuencia de 1000 Hz se genera una mayor amplitud en relación con la generada en la frecuencia de 500 Hz.

BACKGROUND: Characteristics of vestibular evoked myogenic potentials (VEMPs) depend on stimulus conditions.
OBJECTIVE: To determine the optimal stimulus conditions for cervical and ocular VEMPs.
METHODS: Participants were 23 healthy subjects. We compared air-conducted cervical and ocular VEMPs elicited by various tone-burst conditions (frequencies 500-1,000 Hz, rise/fall times 1-2 ms, and plateau times 0-6 ms) with an intensity of 105 dB normal hearing level. Effects of simultaneous contralateral masking noise on VEMPs were also evaluated.
RESULTS: The largest cervical VEMP amplitudes were elicited by 500-750 Hz and 2-6 ms plateau time-tone-bursts, and the largest ocular VEMP amplitudes by 750 Hz and 2-4 ms plateau time-tone-bursts. Repeatability of the latency was better at 1 ms than at 2 ms rise/fall time in both VEMPs. In both VEMPs, masking noise reduced amplitude, and in ocular VEMP, amplitudes were significantly larger at the left ear stimulation than the right.
CONCLUSIONS: Optimal tone-burst stimulation for both VEMPs seemed to be 500-750 Hz frequency and 1/2/1 ms rise/plateau/fall time without contralateral masking noise. Ocular VEMP amplitudes from left ear stimulation were originally larger than those from right ear stimulation.

OBJECTIVE: Benign paroxysmal positioning vertigo (BPPV) is the most common peripheral vestibular disorder. Canalolithiasis in the posterior semi-circular canal is the most common underlying pathology that can be treated effectively by repositioning maneuvers. Our hypothesis suggested that successful maneuvers can lead to repositioning of dislodged otoconia to the utricle.
METHODS: Air conducted oVEMP, which is thought to originate from the contra-lateral utricular organ was measured in twenty patients with unilateral BPPV and we compared n1-p1 peak to peak amplitude of the affected ears in 3 separate intervals: on pre-treatment when typical nystagmus was confirmed, immediately after, and 1 week after repositioning maneuvers to assess change, if any, in amplitude.
RESULTS: This study showed significant increase of oVEMP amplitude in the affected ears after successful repositioning maneuver that was more significant after 1 week.
CONCLUSIONS: oVEMP can be used as a reliable objective test for ensuring a successful maneuver rather than subjective dependence on the patient\'s symptoms, which may be misleading due to a remission.