Test -Retest Reliability of Cervical Vestibular Evoked Myogenic Potential for Different Stimuli in Healthy Adults

Abstract

Background: Vestibular evoked myogenic potentials (VEMP) are short-latency electromyograms (EMG) triggered by high-intensity acoustic stimuli. These potentials are recorded from surface electrodes placed over the tonically contracted sternocleidomastoid (SCM) muscle and are believed to originate from the saccule. There is a dearth of studies evaluating the test-retest reliability of cVEMP recorded with different stimuli. Aim of the study: The study aimed to investigate the Test-retest reliability of cVEMP using different acoustic stimuli (Tone burst of 500 Hz and 1000 Hz, level-specific chirp of 500 Hz and 1000 Hz, and click stimuli). Method: A total of 32 subjects were included in the study (age range: 18 to 30 years). All the participant underwent cervical VEMP using 500Hz tone burst,1000Hz tone burst,500Hz Level specific CE-chirp and 1000Hz Level specific CE-chirp and click stimuli. VEMP was recorded for all the participants for three sessions with an inter-session interval of seven days. Result: The result showed that moderate to good reliability for P1 and N1 latency and P1-N1 amplitude for 5000Hz tone burst.1000Hz showed poor reliability for P1 latency and good reliability for P1-N1 amplitude. 500Hz level-specific CE-chirp showed very poor reliability for P1 latency and good reliability for P1-N1 amplitude, whereas 1000Hz level-specific CE-chirp showed moderate to good reliability. Click showed moderate reliability for P1 and N1 latency and good reliability for P1-N1 amplitude. Conclusion: The study's results suggest a very poor reliability of the P1 peak recorded with the level-specific chirp stimulus. The P1 peak of cVEMP is very important in diagnosing various vestibular disorders. Hence, the level-specific chirp stimulus should be used cautiously when recording cVEMP. However, further studies should explore the reliability of the different stimuli in recording cVEMP among various vestibular pathologies.