Effect of Electrode Montage on Frequency Tuning Properties of Air-Conducted Ocular Vestibular-Evoked Myogenic Potential.

OBJECTIVES The use of a 500 Hz tone burst over other frequencies was adopted for the clinical recording of ocular vestibular-evoked myogenic potential (oVEMP) on the basis that this stimulus frequency produces larger response amplitudes (frequency tuning) than the other frequencies. However, the possibility of reflex contamination due to a spatially displaced reference electrode from the muscle of the response origin raises questions about using an infraorbital (IO) montage. Nonetheless, the belly-tendon (BT) montage, which places both the recording electrodes over the inferior oblique muscle, increases the chances of obtaining a response with greater contribution from the inferior oblique muscle. However, whether this response continues to show the frequency tuning to 500 Hz is not known. Therefore, the present study aimed to examine the frequency tuning of oVEMP using various electrode montages. DESIGN Thirty-eight young adults underwent simultaneous oVEMP recording from IO, BT, chin-referenced, and sternum-referenced electrode montages in response to 250, 500, 750, 1000, 1500, 2000, 3000, and 4000 Hz tone bursts. RESULTS The frequency tuning most often coincided with a 750-Hz tone burst irrespective of the montage, with the BT montage exhibiting significantly higher response rates and larger peak to peak amplitudes than other montages (p < 0.008). Further, there was a "substantial" agreement on frequency tuning between BT and IO montages. CONCLUSIONS With better response rates and response amplitudes yet similar frequency tuning to the IO montage, the BT montage can be a better option for the clinical recording of oVEMP across frequencies.