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J Am Acad Audiol 2024; 35(09/10): 241-255
DOI: 10.1055/a-2353-2797
Research Article

Development and Standardization of Modified Simultaneous Multifrequency Stimulus for Recording Ocular Vestibular-Evoked Myogenic Potential and Its Interaction with the Alternate Electrode Montages

Rajesh Kumar Raveendran 
1   Department of Audiology, All India Institute of Speech and Hearing, Mysuru, Karnataka, India
,
Niraj Kumar Singh 
2   Department of Audiology, All India Institute of Speech and Hearing, Manasagangothri, Mysuru, Karnataka, India
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Abstract

Background Simultaneous multifrequency (SiMFy) is a time-saving and reliable stimulus to determine the frequency tuning of ocular vestibular-evoked myogenic potential (oVEMP); however, the absence of 4000 Hz in SiMFy potentially makes it a less potent tool for the diagnosis of superior semicircular canal dehiscence, a pathology with an ever-increasing prevalence. Further, SiMFy was validated using only the infraorbital (IO) electrode montage. However, the recordings obtained using the IO montage might be susceptible to reference contamination introduced by a small separation between the recording electrodes and also susceptible to reflex impurity due to the spatially displaced reference electrode from the inferior oblique muscle, rendering it vulnerable to picking up responses from other muscles. Nonetheless, little is known about the similarities/differences between the SiMFy-induced oVEMPs using alternate montages (belly-tendon [BT], chin-reference [CR], and sternum-reference [SR]) and the nonsimultaneous multifrequency oVEMPs (NSM-oVEMPs) using the IO montage.

Purpose of the Study To develop a modified SiMFy stimulus and investigate its effects on frequency tuning of oVEMP using various electrode montages.

Research Design Within-subject experimental design.

Study Sample Thirty-three healthy adults aged 20 to 30 years.

Data Collection and Analysis Tone bursts of octave and mid-octave frequencies from 250 to 4000 Hz were generated and concatenated to create the modified SiMFy stimulus. All participants underwent NSM oVEMPs and modified SiMFy oVEMPs using BT, CR, SR, and IO montages simultaneously. The response rate, peak-to-peak amplitude, and frequency tuning were compared between NSM-oVEMP and modified SiMFy oVEMP and also between the electrode montages.

Results BT montage recorded the largest amplitude among the montages in NSM stimulation and modified SiMFy stimulation. Although the response rates were comparable, the modified SiMFy produced significantly lower oVEMP amplitudes than the NSM stimulation within each electrode montage (p < 0.05). A moderate-to-strong agreement on frequency tuning existed between the NSM stimuli and modified SiMFy stimulus for all the montages, except for the SR montage.

Conclusions Although the modified SiMFy produces smaller amplitude oVEMPs than the NSM stimulation for the respective montages, its use in combination with the BT montage yields higher response rates and larger peak-to-peak amplitudes than the NSM recording using IO montage.

Keywords

frequency tuning - electrode placements - multifrequency - chained stimuli - VEMP

Previous Presentation

An initial draft of this paper was presented at the 54th National Convention of the Indian Speech and Hearing Association, held from Feb 17 - 19, 2023 in New Delhi, India.


Supplementary Material



Publikationsverlauf

Eingereicht: 09. Februar 2024

Angenommen: 21. Juni 2024

Accepted Manuscript online:
26. Juni 2024

Artikel online veröffentlicht:
19. Dezember 2024

© 2024. American Academy of Audiology. This article is published by Thieme.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 

  • References

  • 1 Colebatch JG, Halmagyi GM. Vestibular evoked potentials in human neck muscles before and after unilateral vestibular deafferentation. Neurology 1992; 42 (08) 1635-1636
    CrossrefPubMedSuche in Google Scholar
  • 2 Monobe H, Murofushi T. Vestibular testing by electrical stimulation in patients with unilateral vestibular deafferentation: galvanic evoked myogenic responses testing versus galvanic body sway testing. Clin Neurophysiol 2004; 115 (04) 807-811
    CrossrefPubMedSuche in Google Scholar
  • 3 Rosengren SM, McAngus Todd NP, Colebatch JG. Vestibular-evoked extraocular potentials produced by stimulation with bone-conducted sound. Clin Neurophysiol 2005; 116 (08) 1938-1948
    CrossrefPubMedSuche in Google Scholar
  • 4 Zingler VC, Kryvoshey D, Schneider E, Glasauer S, Brandt T, Strupp M. A clinical test of otolith function: static ocular counterroll with passive head tilt. Neuroreport 2006; 17 (06) 611-615
    CrossrefPubMedSuche in Google Scholar
  • 5 Iwasaki S, McGarvie LA, Halmagyi GM. et al. Head taps evoke a crossed vestibulo-ocular reflex. Neurology 2007; 68 (15) 1227-1229
    CrossrefPubMedSuche in Google Scholar
  • 6 Todd NPM, Rosengren SM, Aw ST, Colebatch JG. Ocular vestibular evoked myogenic potentials (OVEMPs) produced by air- and bone-conducted sound. Clin Neurophysiol 2007; 118 (02) 381-390
    CrossrefPubMedSuche in Google Scholar
  • 7 Akin FW, Murnane OD. Subjective visual vertical test. Semin Hear 2009; 30: 281-286
    Thieme ConnectSuche in Google Scholar
  • 8 Curthoys IS, Iwasaki S, Chihara Y, Ushio M, McGarvie LA, Burgess AM. The ocular vestibular-evoked myogenic potential to air-conducted sound; probable superior vestibular nerve origin. Clin Neurophysiol 2011; 122 (03) 611-616
    CrossrefPubMedSuche in Google Scholar
  • 9 Michelson PL, McCaslin DL, Jacobson GP, Petrak M, English L, Hatton K. Assessment of subjective visual vertical (SVV) using the “Bucket Test” and the virtual SVV system. Am J Audiol 2018; 27 (03) 249-259
    CrossrefPubMedSuche in Google Scholar
  • 10 Weber KP, Rosengren SM, Michels R, Sturm V, Straumann D, Landau K. Single motor unit activity in human extraocular muscles during the vestibulo-ocular reflex. J Physiol 2012; 590 (13) 3091-3101
    CrossrefPubMedSuche in Google Scholar
  • 11 Maheu M, Elblidi A, Saliba I. Investigating performance of cVEMP and oVEMP in the identification of superior canal dehiscence in relation to dehiscence location and size. Audiology Res 2021; 11 (03) 452-462
    CrossrefPubMedSuche in Google Scholar
  • 12 Singh NK, Barman A. Characterizing the frequency tuning properties of air-conduction ocular vestibular evoked myogenic potentials in healthy individuals. Int J Audiol 2013; 52 (12) 849-854
    CrossrefPubMedSuche in Google Scholar
  • 13 Singh NK, Barman A. Utility of the frequency tuning measure of oVEMP in differentiating Meniere's disease from BPPV. J Am Acad Audiol 2016; 27 (09) 764-777
    Thieme ConnectPubMedSuche in Google Scholar
  • 14 Singh NK, Kumar P, Jagadish N, Mendhakar A, Mahajan Y. Utility of inter-frequency amplitude ratio of vestibular-evoked myogenic potentials in identifying Meniere's disease: a systematic review and meta-analysis. Ear Hear 2023; 44 (05) 940-948
    CrossrefPubMedSuche in Google Scholar
  • 15 Sandhu JS, Low R, Rea PA, Saunders NC. Altered frequency dynamics of cervical and ocular vestibular evoked myogenic potentials in patients with Ménière's disease. Otol Neurotol 2012; 33 (03) 444-449
    CrossrefPubMedSuche in Google Scholar
  • 16 Taylor RL, Bradshaw AP, Halmagyi GM, Welgampola MS. Tuning characteristics of ocular and cervical vestibular evoked myogenic potentials in intact and dehiscent ears. Audiol Neurotol 2012; 17 (04) 207-218
    CrossrefPubMedSuche in Google Scholar
  • 17 Winters SM, Berg ITB, Grolman W, Klis SFL. Ocular vestibular evoked myogenic potentials: frequency tuning to air-conducted acoustic stimuli in healthy subjects and Ménière's disease. Audiol Neurotol 2012; 17 (01) 12-19
    CrossrefPubMedSuche in Google Scholar
  • 18 Piker EG, Jacobson GP, Burkard RF, McCaslin DL, Hood LJ. Effects of age on the tuning of the cVEMP and oVEMP. Ear Hear 2013; 34 (06) e65-e73
    CrossrefPubMedSuche in Google Scholar
  • 19 Singh NK, Raul A, Malik G, Sao T. Intersession variations in frequency tuning of ocular vestibular evoked myogenic potentials in healthy individuals. Am J Audiol 2019; 28 (2S): 407-413
    CrossrefPubMedSuche in Google Scholar
  • 20 Singh NK, Firdose H. Characterizing the age and stimulus frequency interaction for ocular vestibular-evoked myogenic potentials. Ear Hear 2018; 39 (02) 251-259
    CrossrefPubMedSuche in Google Scholar
  • 21 Maxwell R, Jerin C, Gürkov R. Utilisation of multi-frequency VEMPs improves diagnostic accuracy for Meniere's disease. Eur Arch Otorhinolaryngol 2017; 274 (01) 85-93
    CrossrefPubMedSuche in Google Scholar
  • 22 Verrecchia L, Glad K, Frisk R, Duan M. Vestibular myogenic potentials evoked by air-conducted stimuli at safe acoustic intensity levels retain optimal diagnostic properties for superior canal dehiscence syndrome. Acta Otolaryngol 2019; 139 (01) 11-17
    CrossrefPubMedSuche in Google Scholar
  • 23 Zhang AS, Govender S, Colebatch JG. Tuning of the ocular vestibular evoked myogenic potential (oVEMP) to air- and bone-conducted sound stimulation in superior canal dehiscence. Exp Brain Res 2012; 223 (01) 51-64
    CrossrefPubMedSuche in Google Scholar
  • 24 Singh NK, Ravikumar MH, Maruthy S. Simultaneous multifrequency (SiMFy) stimulus: a novel and reliable stimulus for frequency tuning of ocular vestibular-evoked myogenic potentials. J Am Acad Audiol 2022; 33 (04) 224-231
    Thieme ConnectPubMedSuche in Google Scholar
  • 25 Curthoys IS, Manzari L. A simple specific functional test for SCD: VEMPs to high frequency (4,000Hz) stimuli-their origin and explanation. Front Neurol 2020; 11: 612075
    CrossrefPubMedSuche in Google Scholar
  • 26 Curthoys IS, Burgess AM, Manzari L, Pastras CJ. A single fast test for semicircular canal dehiscence-oVEMP n10 to 4000 Hz-depends on stimulus rise time. Audiology Res 2022; 12 (05) 457-465
    CrossrefPubMedSuche in Google Scholar
  • 27 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 (01) 142-145
    CrossrefPubMedSuche in Google Scholar
  • 28 Lin K, Lahey R, Beckley R. et al. Validating the utility of high frequency ocular vestibular evoked myogenic potential testing in the diagnosis of superior semicircular canal dehiscence. Otol Neurotol 2019; 40 (10) 1353-1358
    CrossrefPubMedSuche in Google Scholar
  • 29 Tran ED, Swanson A, Sharon JD. et al. Ocular vestibular-evoked myogenic potential amplitudes elicited at 4 kHz optimize detection of superior semicircular canal dehiscence. Front Neurol 2020; 11: 879
    CrossrefPubMedSuche in Google Scholar
  • 30 Leyssens L, Heinze B, Vinck B. et al. 'Standard' versus 'nose reference' electrode placement for measuring oVEMPs with air-conducted sound: test-retest reliability and preliminary patient results. Clin Neurophysiol 2017; 128 (02) 312-322
    CrossrefPubMedSuche in Google Scholar
  • 31 Makowiec K, McCaslin DL, Jacobson GP, Hatton K, Lee J. Effect of electrode montage and head position on air-conducted ocular vestibular evoked myogenic potential. Am J Audiol 2017; 26 (02) 180-188
    CrossrefPubMedSuche in Google Scholar
  • 32 Piker EG, Jacobson GP, McCaslin DL, Hood LJ. Normal characteristics of the ocular vestibular evoked myogenic potential. J Am Acad Audiol 2011; 22 (04) 222-230
    Thieme ConnectPubMedSuche in Google Scholar
  • 33 Piker EG, Jacobson GP, Makowiec KF, Atabek PM, Krolewicz S. The medial canthus reference electrode is not electrically indifferent to the ocular vestibular evoked myogenic potential. Otol Neurotol 2018; 39 (10) e1069-e1077
    CrossrefPubMedSuche in Google Scholar
  • 34 Raveendran RK, Singh NK. Electrode montage induced changes in air-conducted ocular vestibular-evoked myogenic potential. Ear Hear 2024; 45 (01) 227-238
    CrossrefPubMedSuche in Google Scholar
  • 35 Sandhu JS, George SR, Rea PA. The effect of electrode positioning on the ocular vestibular evoked myogenic potential to air-conducted sound. Clin Neurophysiol 2013; 124 (06) 1232-1236
    CrossrefPubMedSuche in Google Scholar
  • 36 Vanspauwen R, Wuyts FL, Krijger S, Maes LK. Comparison of different electrode configurations for the oVEMP with bone-conducted vibration. Ear Hear 2017; 38 (02) 205-211
    CrossrefPubMedSuche in Google Scholar
  • 37 Shahnaz N, David EA. Normal values for cervical and ocular vestibular-evoked myogenic potentials using EMG scaling: effect of body position and electrode montage. Acta Otolaryngol 2021; 141 (05) 440-448
    CrossrefPubMedSuche in Google Scholar
  • 38 Roy SH, De Luca CJ, Schneider J. Effects of electrode location on myoelectric conduction velocity and median frequency estimates. J Appl Physiol 1986; 61 (04) 1510-1517
    CrossrefPubMedSuche in Google Scholar
  • 39 Rainoldi A, Melchiorri G, Caruso I. A method for positioning electrodes during surface EMG recordings in lower limb muscles. J Neurosci Methods 2004; 134 (01) 37-43
    CrossrefPubMedSuche in Google Scholar
  • 40 Rainoldi A, Nazzaro M, Merletti R, Farina D, Caruso I, Gaudenti S. Geometrical factors in surface EMG of the vastus medialis and lateralis muscles. J Electromyogr Kinesiol 2000; 10 (05) 327-336
    CrossrefPubMedSuche in Google Scholar
  • 41 Melaku A, Kumar DK, Bradley A. Influence of inter-electrode distance on EMG. 2001 Conference Proceedings of the 23rd Annual International Conference of the IEEE Engineering in Medicine and Biology Society, vol. 2, 2001: 1082-1085
    Suche in Google Scholar
  • 42 Castroflorio T, Farina D, Bottin A, Piancino MG, Bracco P, Merletti R. Surface EMG of jaw elevator muscles: effect of electrode location and inter-electrode distance. J Oral Rehabil 2005; 32 (06) 411-417
    CrossrefPubMedSuche in Google Scholar
  • 43 De Nooij R, Kallenberg LAC, Hermens HJ. Evaluating the effect of electrode location on surface EMG amplitude of the m. erector spinae p. longissimus dorsi. J Electromyogr Kinesiol 2009; 19 (04) e257-e266
    CrossrefPubMedSuche in Google Scholar
  • 44 Mesin L, Merletti R, Rainoldi A. Surface EMG: the issue of electrode location. J Electromyogr Kinesiol 2009; 19 (05) 719-726
    CrossrefPubMedSuche in Google Scholar
  • 45 Merletti R, Muceli S. Tutorial. Surface EMG detection in space and time: best practices. J Electromyogr Kinesiol 2019; 49: 102363
    CrossrefPubMedSuche in Google Scholar
  • 46 Venkatesan S, Basavaraj V. Ethical Guidelines for Bio-Behavioral Research Involving Human Subjects. All India Institute of Speech and Hearing; 2009
    Suche in Google Scholar
  • 47 Wuyts FL, Van Rompaey V, Maes LK. “SO STONED”: common sense approach of the dizzy patient. Front Surg 2016; 3: 32
    CrossrefPubMedSuche in Google Scholar
  • 48 Singh NK, Govindaswamy R, Jagadish N. Test–retest reliability of video head impulse test in healthy individuals and individuals with dizziness. J Am Acad Audiol 2019; 30 (09) 744-752
    Thieme ConnectPubMedSuche in Google Scholar
  • 49 Singh N, Govindaswamy R, Jagadish N. Efficacy of vestibulo-ocular reflex gain and refixation saccades of video head impulse test in identifying vestibular pathologies. Indian J Otol 2017; 23: 247-251
    CrossrefSuche in Google Scholar
  • 50 Kantner C, Hapfelmeier A, Drexl M, Gürkov R. The effects of rise/fall time and plateau time on ocular vestibular evoked myogenic potentials. Eur Arch Otorhinolaryngol 2014; 271 (09) 2401-2407
    CrossrefPubMedSuche in Google Scholar
  • 51 Joshi MO, Singh NK. Effect of rise/fall and plateau time on ocular vestibular evoked myogenic potential. In: Savithri SR, Narne VK, Kumar P. eds. Student Research at AIISH Mysore (Articles Based on Dissertations Done at AIISH). Mysuru: All India Institute of Speech and Hearing; 2013: 50-63
    Suche in Google Scholar
  • 52 Smith KJ, McCaslin DL, Jacobson GP, Burkard R. The effect of recording montage and tone burst duration on cervical and ocular vestibular evoked myogenic potential latency and amplitude. Am J Audiol 2019; 28 (02) 300-307
    CrossrefPubMedSuche in Google Scholar
  • 53 Singh NK, Kadisonga P, Ashitha P. Optimizing stimulus repetition rate for recording ocular vestibular evoked myogenic potential elicited by air-conduction tone bursts of 500 Hz. Audiology Res 2014; 4 (01) 88
    CrossrefPubMedSuche in Google Scholar
  • 54 Bogle JM, Zapala DA, Burkhardt B. et al. The effect of repetition rate on air-conducted ocular vestibular evoked myogenic potentials (oVEMPs). Am J Audiol 2015; 24 (03) 411-418
    CrossrefPubMedSuche in Google Scholar
  • 55 Nguyen KD, Welgampola MS, Carey JP. Test-retest reliability and age-related characteristics of the ocular and cervical vestibular evoked myogenic potential tests. Otol Neurotol 2010; 31 (05) 793-802
    CrossrefPubMedSuche in Google Scholar
  • 56 McHugh ML. Interrater reliability: the kappa statistic. Biochem Med (Zagreb) 2012; 22 (03) 276-282
    CrossrefPubMedSuche in Google Scholar
  • 57 Murnane OD, Akin FW, Kelly KJ, Byrd S. Effects of stimulus and recording parameters on the air conduction ocular vestibular evoked myogenic potential. J Am Acad Audiol 2011; 22 (07) 469-480
    Thieme ConnectPubMedSuche in Google Scholar
  • 58 Noij KS, Rauch SD. Vestibular evoked myogenic potential (VEMP) testing for diagnosis of superior semicircular canal dehiscence. Front Neurol 2020; 11: 695
    CrossrefPubMedSuche in Google Scholar
  • 59 Mathias SV, Bensalem-Owen M. Artifacts that can be misinterpreted as interictal discharges. J Clin Neurophysiol 2019; 36 (04) 264-274
    CrossrefPubMedSuche in Google Scholar
  • 60 Lapatki BG, Stegeman DF, Jonas IE. A surface EMG electrode for the simultaneous observation of multiple facial muscles. J Neurosci Methods 2003; 123 (02) 117-128
    CrossrefPubMedSuche in Google Scholar
  • 61 Burkard RF, Eggermont JJ, Don M. Auditory Evoked Potentials: Basic Principles and Clinical Application. Lippincott Williams & Wilkins; 2007
    Suche in Google Scholar
  • 62 Zuniga EN, Truong XT, Simons DG. Effects of skin electrode position on averaged electromyographic potentials. Arch Phys Med Rehabil 1970; 51 (05) 264-272
    PubMedSuche in Google Scholar
  • 63 Zuniga J, Housh TJ, Camic CL. et al. The effects of parallel versus perpendicular electrode orientations on EMG amplitude and mean power frequency from the biceps brachii. Electromyogr Clin Neurophysiol 2010; 50 (02) 87-96
    PubMedSuche in Google Scholar
  • 64 Sheykholeslami K. Vestibular-evoked myogenic potentials: do we know all the basics?. Auditory and Vestibular Research 2015; 24: 51-53
    Suche in Google Scholar
  • 65 Todd NPM, Rosengren SM, Colebatch JG. A utricular origin of frequency tuning to low-frequency vibration in the human vestibular system?. Neurosci Lett 2009; 451 (03) 175-180
    CrossrefPubMedSuche in Google Scholar
  • 66 Fettiplace R, Fuchs PA. Mechanisms of hair cell tuning. Annu Rev Physiol 1999; 61: 809-834
    CrossrefPubMedSuche in Google Scholar
  • 67 Welgampola MS, Colebatch JG. Characteristics of tone burst-evoked myogenic potentials in the sternocleidomastoid muscles. Otol Neurotol 2001; 22 (06) 796-802
    CrossrefPubMedSuche in Google Scholar
  • 68 Colletti V. Multifrequency tympanometry. Audiology 1977; 16 (04) 278-287
    CrossrefPubMedSuche in Google Scholar
  • 69 Valvik BR, Johnsen M, Laukli E. Multifrequency tympanometry. Preliminary experiences with a commercially available middle-ear analyzer. Audiology 1994; 33 (05) 245-253
    CrossrefPubMedSuche in Google Scholar
  • 70 Xiao Q, Zhang Q, Wu Q. et al. Effects of acoustic stimulation intensity on air-conducted vestibular evoked myogenic potential in children. Front Neurol 2022; 13: 996246
    CrossrefPubMedSuche in Google Scholar