Normal values for cervical and ocular vestibular-evoked myogenic potentials using EMG scaling: effect of body position and electrode montage

Abstract

Background The clinical utility of cervical and ocular vestibular-evoked myogenic potential (cVEMP and oVEMP) is limited by variability of testing protocols and a dearth of normative data using contemporary methods for amplitude scaling. Aims/objectives To investigate the effect of body position and electrode montage on VEMP responses and to establish normative values. Material and Methods This is a repeated measures study of 44 healthy young adult subjects (22 men and 22 women). Results The highest response rate (99%) for cVEMP was achieved in the supine position with the head elevated and turned. For oVEMP, the highest response rate (90%) was achieved using nasal alar electrode montage with the subject in a sitting position. Scaled peak-to-peak amplitude was higher in males than in females for both cVEMP and oVEMP. Conclusion Normative data for 44 young healthy adults was successfully collected for two body positions for cVEMP and two head positions and two electrode montages for oVEMP. Significance Our findings describe VEMP protocols that efficiently detect VEMP responses, and we provide normative VEMP response data for young healthy subjects. We describe a potential difference in response between males and females, which may be clinically important.