Advertisement

Band limited chirp stimulation in vestibular evoked myogenic potentials

Abstract

Air conducted vestibular evoked myogenic potentials (VEMP) can be elicited by various low frequency and intense sound stimuli, mainly clicks or short tone bursts (STB). Chirp stimuli are increasingly used in diagnostic audiological evaluations as an effective means to obtain acoustically evoked responses in narrowed or extended frequency ranges. We hypothesized in this study that band limited chirp stimulation, which covers the main sensitivity range of sound sensitive otolithic afferents (around 500 Hz), might be useful for application in cervical and ocular VEMP to air conduction. For this purpose we designed a chirp stimulus ranging 250–1000 Hz (up chirp). The chirp stimulus was delivered with a stimulus intensity of 100 dB nHL in normal subjects (n = 10) and patients with otolith involvement (vestibular neuritis) (n = 6). Amplitudes of the designed chirp (“CW-VEMP-chirp, 250–1000 Hz”) were compared with amplitudes of VEMPs evoked by click stimuli (0.1 ms) and a short tone burst (STB, 1-2-1, 8 ms, 500 Hz). CVEMPs and oVEMPs were detectable in 9 of 10 normal individuals. Statistical evaluation in healthy patients revealed significantly larger cVEMP and oVEMP amplitudes for CW-VEMP-chirp (250–1000 Hz) stimuli. CVEMP amplitudes evoked by CW-VEMP-chirp (250–1000 Hz) showed a high stability in comparison with click and STB stimulation. CW-VEMP-chirp (250–1000 Hz) showed abnormal cVEMP and oVEMP amplitudes in patients with vestibular neuritis, with the same properties as click and STB stimulated VEMPs. We conclude that the designed CW-VEMP-chirp (250–1000 Hz) is an effective stimulus which can be further used in VEMP diagnostic. Since a chirp stimulus can be easily varied in its properties, in particular with regard to frequency, this might be a promising tool for further investigations.

This is a preview of subscription content, log in to check access.

Access options

Buy single article

Instant unlimited access to the full article PDF.

US$ 39.95

Price includes VAT for USA

Subscribe to journal

Immediate online access to all issues from 2019. Subscription will auto renew annually.

US$ 199

This is the net price. Taxes to be calculated in checkout.

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7

References

  1. 1.

    Todd NP, Curthoys IS, Aw ST, Todd MJ, McGarvie LA, Rosengren SM et al (2004) Vestibular evoked ocular responses to air- (AC) and bone-conducted (BC) sound I: eye movements and timing in relation to vestibular evoked peri-ocular potentials (VEPP). J Vestib Res 14:123–124

  2. 2.

    Todd NP, Rosengren SM, Colebatch JG (2004) Vestibular evoked ocular responses to air-(AC) and bone-conducted (BC) sound II: a neuroanatomical and physiological interpretation of AC-OVEMPs. J Vestib Res 14:215–216

  3. 3.

    Colebatch JG, Halmagyi GM (1992) Vestibular evoked potentials in human neck muscles before and after unilateral vestibular deafferentation. Neurology 42:1635–1636

  4. 4.

    Colebatch JG, Halmagyi GM, Skuse NF (1994) Myogenic potentials generated by a click-evoked vestibulocollic reflex. J Neurol Neurosurg Psychiatry 57:190–197

  5. 5.

    Rosengren SM, Welgampola MS, Colebatch JG (2010) Vestibular evoked myogenic potentials: past, present and future. Clin Neurophysiol 121:636–651

  6. 6.

    Papathanasiou ES, Murofushi T, Akin FW, Colebatch JG (2014) International guidelines for the clinical application of cervical vestibular evoked myogenic potentials: an expert consensus report. Clin Neurophysiol 125:658–666

  7. 7.

    Curthoys IS, Vulovic V, Burgess AM, Manzari L, Sokolic L, Pogson J, Robins M, Mezey LE, Goonetilleke S, Cornell ED, MacDougall HG (2014) Neural basis of new clinical vestibular tests: otolithic neural responses to sound and vibration. Clin Exp Pharmacol Physiol 41:371–380

  8. 8.

    Singh NK, Barman A (2013) Characterizing the frequency tuning properties of air-conduction ocular vestibular evoked myogenic potentials in healthy individuals. Int J Audiol 52:849–854

  9. 9.

    Rosengren SM, Kingma H (2013) New perspectives on vestibular evoked myogenic potentials. Curr Opin Neurol 26:74–80

  10. 10.

    Rauch SD, Zhou G, Kujawa SG, Guinan JJ, Herrmann BS (2004) Vestibular evoked myogenic potentials show altered tuning in patients with Ménière’s disease. Otol Neurotol 25:333–338

  11. 11.

    Node M, Seo T, Miyamoto A, Adachi A, Hashimoto M, Sakagami M (2005) Frequency dynamics shift of vestibular evoked myogenic potentials in patients with endolymphatic hydrops. Otol Neurotol 26:1208–1213

  12. 12.

    Murofushi T, Komiyama S, Hayashi Y, Yoshimura E (2015) Frequency preference in cervical vestibular evoked myogenic potential of idiopathic otolithic vertigo patients. Does it reflect otolithic endolymphatic hydrops? Acta Otolaryngol 135:995–999

  13. 13.

    Kim-Lee Y, Ahn JH, Kim YK, Yoon TH (2009) Tone burst vestibular evoked myogenic potentials: diagnostic criteria in patients with Ménière`s disease. Acta Otolaryngol 129:924–928

  14. 14.

    Sandhu JS, Low R, Rea PA, Saunders NC (2012) Altered frequency dynamics of cervical and ocular vestibular evoked myogenic potentials in patients with Ménière’s disease. Otol Neurotol 33:444–449

  15. 15.

    Winters SM, Berg IT, Grolman W, Klis SF (2012) Ocular vestibular evoked myogenic potentials: frequency tuning to air-conducted acoustic stimuli in healthy subjects and Ménière’s disease. Audiol Neurootol 17:12–19

  16. 16.

    Zhang AS, Govender S, Colebatch JG (2012) Tuning of the ocular vestibular evoked myogenic potential (oVEMP) to air- and bone-conducted sound stimulation in superior canal dehiscence. Exp Brain Res 223:51–64

  17. 17.

    Manzari L, Burgess AM, McGarvie LA, Curthoys IS (2013) An indicator of probable semicircular canal dehiscence: ocular vestibular evoked myogenic potentials to high frequencies. Otolaryngol Head Neck Surg 149:142–145

  18. 18.

    Murofushi T, Ozeki H, Inoue A, Sakata A (2009) Does migraine-associated vertigo share a common pathophysiology with Meniere’s disease? Study with vestibular-evoked myogenic potential. Cephalalgia 29:1259–1266

  19. 19.

    Janky KL, Shepard N (2009) Vestibular evoked myogenic potential (VEMP) testing: normative threshold response curves and effects of age. J Am Acad Audiol 20:514–522

  20. 20.

    Piker EG, Jacobson GP, Burkard RF, McCaslin DL, Hood LJ (2013) Effects of age on the tuning of the cVEMP and oVEMP. Ear Hear 34:e65–e73

  21. 21.

    Rosengren SM, Govender S, Colebatch JG (2011) Ocular and cervical vestibular evoked myogenic potentials produced by air- and bone-conducted stimuli: comparative properties and effects of age. Clin Neurophysiol 122:2282–2289

  22. 22.

    Colebatch JG, Govender S, Rosengren SM (2013) Two distinct patterns of VEMP changes with age. Clin Neurophysiol 124:2066–2068

  23. 23.

    Papathanasiou ES, Papacostas SS (2013) Vestibular evoked myogenic potentials: the fuzzy picture of different stimulation types is beginning to come into focus. Clin Neurophysiol 124:1926–1927

  24. 24.

    Stürzebecher E, Cebulla M, Elberling C, Berger T (2006) New efficient stimuli for evoking frequency-specific auditory steady-state responses. J Am Acad Audiol 17:448–461

  25. 25.

    Elberling C, Don M, Cebulla M, Stürzebecher E (2007) Auditory steady-state responses to chirp stimuli based on cochlear traveling wave delay. J Acoust Soc Am 122:2772–2785

  26. 26.

    Cebulla M, Stürzebecher E, Elberling C, Müller J (2007) New clicklike stimuli for hearing testing. J Am Acad Audiol 18:725–738

  27. 27.

    Elberling C, Don M (2008) Auditory brainstem responses to a chirp stimulus designed from derived-band latencies in normal-hearing subjects. J Acoust Soc Am 124:3022–3037

  28. 28.

    Elberling C, Don M (2010) A direct approach for the design of chirp stimuli used for the recording of auditory brainstem responses. J Acoust Soc Am 128:2955–2964

  29. 29.

    Kristensen SG, Elberling C (2012) Auditory brainstem responses to level-specific chirps in normal-hearing adults. J Am Acad Audiol 23:712–721

  30. 30.

    Wang BC, Liang Y, Liu XL, Zhao J, Liu YL, Li YF, Zhang W, Li Q (2014) Comparison of chirp versus click and tone pip stimulation for cervical vestibular evoked myogenic potentials. Eur Arch Otorhinolaryngol 271:3139–3146

  31. 31.

    Özgür A, Çelebi Erdivanl Ö, Özergin Coşkun Z, Terzi S, Yiğit E, Demirci M, Dursun E (2015) Comparison of tone burst, Click and chirp stimulation in vestibular evoked myogenic potential testing in healthy people. J Int Adv Otol 11:33–35

  32. 32.

    Basta D, Todt I, Ernst A (2005) Normative data for P1/N1-latencies of vestibular evoked myogenic potentials induced by air- or bone-conducted tone bursts. Clin Neurophysiol 116:2216–2219

  33. 33.

    Siegel S (1956) Nonparametric statistics for the behavioral sciences. McGraw-Hill, London

  34. 34.

    Hochberg Y, Tamhane AC (1987) Multiple Comparison Procedures. Wiley and Sons, New York

  35. 35.

    Dancey C, Reidy J (2004) Statistics without Maths for Psychology: using SPSS for Windows. Prentice Hall, London

  36. 36.

    Park HJ, Lee IS, Shin JE, Lee YJ, Park MS (2010) Frequency-tuning characteristics of cervical and ocular vestibular evoked myogenic potentials induced by air-conducted tone bursts. Clin Neurophysiol 121:85–89

  37. 37.

    Viciana D, Lopez-Escamez JA (2012) Short tone bursts are better than clicks for cervical vestibular-evoked myogenic potentials in clinical practice. Eur Arch Otorhinolaryngol 269:1857–1863

  38. 38.

    Rosengren SM, Govender S, Colebatch JG (2009) The relative effectiveness of different stimulus waveforms in evoking VEMPs: significance of stimulus energy and frequency. J Vestib Res 19:33–40

  39. 39.

    Cheng PW, Huang TW, Young YH (2003) The influence of clicks versus short tone bursts on the vestibular evoked myogenic potentials. Ear Hear 24:195–197

  40. 40.

    Huang TW, Su HC, Cheng PW (2005) Effect of click duration on vestibular-evoked myogenic potentials. Acta Otolaryngol (Stockh) 125:141–144

  41. 41.

    Cheng YL, Wu HJ, Lee GS (2012) Effects of plateau time and ramp time on ocular vestibular evoked myogenic potentials. J Vestib Res 22:33–39

  42. 42.

    Kantner C, Hapfelmeier A, Drexl M, Gürkov R (2014) The effects of rise/fall time and plateau time on ocular vestibular evoked myogenic potentials. Eur Arch Otorhinolaryngol 271:2401–2407

  43. 43.

    Krause E, Mayerhofer A, Gürkov R, Drexl M, Braun T, Olzowy B, Boetzel K (2013) Effects of acoustic stimuli used for vestibular evoked myogenic potential studies on the cochlear function. Otol Neurotol 34:1186–1192

  44. 44.

    Colebatch JG, Rosengren SM (2014) Safe levels of acoustic stimulation: comment on “effects of acoustic stimuli used for vestibular evoked myogenic potential studies on the cochlear function”. Otol Neurotol 35:932–934

  45. 45.

    McCue MP, Guinan JJ Jr (1994) Acoustically responsive fibers in the vestibular nerve of the cat. J Neurosci 14:6058–6070

  46. 46.

    McCue MP, Guinan JJ Jr (1994) Influence of efferent stimulation on acoustically responsive vestibular afferents in the cat. J Neurosci 14:6071–6083

  47. 47.

    Curthoys IS, Vulovic V, Sokoloic L, Pogson J, Burgess AM (2012) Irregular primary otolith afferents from the guinea pig utricular and saccular maculae respond to both bone conducted vibration and air conducted sound. Brain Res Bull 89:16–21

  48. 48.

    Sohmer H (2006) Sound induced fluid pressures directly activate vestibular hair cells: implications for activation of the cochlea. Clin Neurophysiol 117:933–934

Download references

Author information

Correspondence to Leif Erik Walther.

Ethics declarations

Financial disclosure

The authors report no conflict of interest, financial or otherwise.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary material 1 (MP4 10622 kb)

Supplementary material 5 (MP4 13503 kb)

Supplementary material 1 (MP4 10622 kb)

Supplementary material 2 (PNG 239 kb)

Supplementary material 3 (PNG 217 kb)

Supplementary material 4 (PNG 230 kb)

Supplementary material 5 (MP4 13503 kb)

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Walther, L.E., Cebulla, M. Band limited chirp stimulation in vestibular evoked myogenic potentials. Eur Arch Otorhinolaryngol 273, 2983–2991 (2016) doi:10.1007/s00405-015-3888-y

Download citation

Keywords

  • VEMP
  • Chirp
  • Ocular VEMP
  • Cervical VEMP
  • oVEMP
  • cVEMP