Jessie N Patterson, Nour El Hidek, Kristen L Janky
{"title":"Electrode Montage for Bilateral Cervical Vestibular Evoked Myogenic Potential (cVEMP) Testing.","authors":"Jessie N Patterson, Nour El Hidek, Kristen L Janky","doi":"10.1055/a-2250-3096","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Cervical vestibular evoked myogenic potentials (cVEMPs) are predominantly ipsilateral, myogenic responses originating from saccular activation. Some individuals have contralateral-crossed cVEMP responses with monaural air-conducted stimulation (ACS) which can contaminate cVEMP responses with bilateral stimulation. While the origin of the contralateral-crossed response is under debate, its presence has implications for cVEMP testing with midline bone conduction vibration (BCV).</p><p><strong>Purpose: </strong>The purpose of this study was to determine the origin of the contralateral-crossed cVEMP response. It was hypothesized that the crossed response is due to electrode contamination and would disappear with a modified electrode montage.</p><p><strong>Research design: </strong>Cross-sectional research study.</p><p><strong>Study sample: </strong>Fifteen healthy participants (30 ears; mean age: 27.4 19-39; 10 females).</p><p><strong>Data collection and analysis: </strong>Participants completed cVEMP testing using three stimulation methods (monoaural ACS, binaural ACS, and midline BCV) and two electrode montages (sternum reference and Fp reference).</p><p><strong>Results: </strong>In the monoaural ACS with sternum reference condition, 53.3% ears had contralateral-crossed cVEMP responses that were in-phase with the ipsilateral response for all but 3 ears. Whereas in the monoaural ACS with Fp reference condition, 3% had a contralateral-crossed cVEMP response. ACS and BCV cVEMP corrected amplitudes were significantly larger in the sternum reference conditions, which is attributed to artificial enhancement from the in-phase contralateral-crossed responses.</p><p><strong>Conclusions: </strong>The significant reduction of contralateral-crossed responses in the Fp reference condition suggests that the contralateral-crossed cVEMP response is due to reference electrode contamination and may be a more appropriate reference placement when completing cVEMPs with midline BCV.</p><p><strong>Purpose: </strong>The purpose of this study was to determine the origin of the contralateral-crossed cVEMP response. It was hypothesized that the crossed response is due to electrode contamination and would disappear with a modified electrode montage.</p><p><strong>Research design: </strong>Cross-sectional research study.</p><p><strong>Study sample: </strong>Fifteen healthy participants (30 ears; mean age: 27.4 19-39; 10 females).</p><p><strong>Data collection and analysis: </strong>Participants completed cVEMP testing using three stimulation methods (monoaural ACS, binaural ACS, and midline BCV) and three electrode montages (sternum reference, Fp reference, and active on Fp).</p><p><strong>Results: </strong>In the monoaural ACS with sternum reference condition, 53.3% ears had contralateral-crossed cVEMP responses that were in-phase with the ipsilateral response for all but 3 ears. Whereas in the monoaural ACS with Fp reference condition, 3% had a contralateral-crossed cVEMP response. No participants demonstrated responses using Fp for the active electrode suggesting this is a neutral site. ACS and BCV cVEMP corrected amplitudes were significantly larger in the sternum reference conditions, which is attributed to artificial enhancement from the in-phase contralateral-crossed responses.</p><p><strong>Conclusions: </strong>The significant reduction of contralateral-crossed responses in the Fp reference condition suggests that the contralateral-crossed cVEMP response is due to reference electrode contamination and may be a more appropriate reference placement when completing cVEMPs with midline BCV.</p>","PeriodicalId":50021,"journal":{"name":"Journal of the American Academy of Audiology","volume":null,"pages":null},"PeriodicalIF":1.0000,"publicationDate":"2024-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of the American Academy of Audiology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1055/a-2250-3096","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"AUDIOLOGY & SPEECH-LANGUAGE PATHOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Cervical vestibular evoked myogenic potentials (cVEMPs) are predominantly ipsilateral, myogenic responses originating from saccular activation. Some individuals have contralateral-crossed cVEMP responses with monaural air-conducted stimulation (ACS) which can contaminate cVEMP responses with bilateral stimulation. While the origin of the contralateral-crossed response is under debate, its presence has implications for cVEMP testing with midline bone conduction vibration (BCV).
Purpose: The purpose of this study was to determine the origin of the contralateral-crossed cVEMP response. It was hypothesized that the crossed response is due to electrode contamination and would disappear with a modified electrode montage.
Research design: Cross-sectional research study.
Study sample: Fifteen healthy participants (30 ears; mean age: 27.4 19-39; 10 females).
Data collection and analysis: Participants completed cVEMP testing using three stimulation methods (monoaural ACS, binaural ACS, and midline BCV) and two electrode montages (sternum reference and Fp reference).
Results: In the monoaural ACS with sternum reference condition, 53.3% ears had contralateral-crossed cVEMP responses that were in-phase with the ipsilateral response for all but 3 ears. Whereas in the monoaural ACS with Fp reference condition, 3% had a contralateral-crossed cVEMP response. ACS and BCV cVEMP corrected amplitudes were significantly larger in the sternum reference conditions, which is attributed to artificial enhancement from the in-phase contralateral-crossed responses.
Conclusions: The significant reduction of contralateral-crossed responses in the Fp reference condition suggests that the contralateral-crossed cVEMP response is due to reference electrode contamination and may be a more appropriate reference placement when completing cVEMPs with midline BCV.
Purpose: The purpose of this study was to determine the origin of the contralateral-crossed cVEMP response. It was hypothesized that the crossed response is due to electrode contamination and would disappear with a modified electrode montage.
Research design: Cross-sectional research study.
Study sample: Fifteen healthy participants (30 ears; mean age: 27.4 19-39; 10 females).
Data collection and analysis: Participants completed cVEMP testing using three stimulation methods (monoaural ACS, binaural ACS, and midline BCV) and three electrode montages (sternum reference, Fp reference, and active on Fp).
Results: In the monoaural ACS with sternum reference condition, 53.3% ears had contralateral-crossed cVEMP responses that were in-phase with the ipsilateral response for all but 3 ears. Whereas in the monoaural ACS with Fp reference condition, 3% had a contralateral-crossed cVEMP response. No participants demonstrated responses using Fp for the active electrode suggesting this is a neutral site. ACS and BCV cVEMP corrected amplitudes were significantly larger in the sternum reference conditions, which is attributed to artificial enhancement from the in-phase contralateral-crossed responses.
Conclusions: The significant reduction of contralateral-crossed responses in the Fp reference condition suggests that the contralateral-crossed cVEMP response is due to reference electrode contamination and may be a more appropriate reference placement when completing cVEMPs with midline BCV.
期刊介绍:
The Journal of the American Academy of Audiology (JAAA) is the Academy''s scholarly peer-reviewed publication, issued 10 times per year and available to Academy members as a benefit of membership. The JAAA publishes articles and clinical reports in all areas of audiology, including audiological assessment, amplification, aural habilitation and rehabilitation, auditory electrophysiology, vestibular assessment, and hearing science.