Abstract
Vestibular-evoked myogenic potentials (VEMPs) are short-latency muscle reflexes typically recorded from the neck or eye muscles with surface electrodes. They are used clinically to assess otolith function, but are also interesting as they can provide information about the vestibular system and its activation by sound and vibration. Since the introduction of VEMPs more than 25 years ago, VEMPs have inspired animal and human research on the effects of acoustic vestibular stimulation on the vestibular organs, their projections and the postural muscles involved in vestibular reflexes. Using a combination of recording techniques, including single motor unit recordings, VEMP studies have enhanced our understanding of the excitability changes underlying the sound-evoked vestibulo-collic and vestibulo-ocular reflexes. Studies in patients with diseases of the vestibular system, such as superior canal dehiscence and Meniere's disease, have shown how acoustic vestibular stimulation is affected by physical changes in the vestibule, and how sound-evoked reflexes can detect these changes and their resolution in clinical contexts. This review outlines the advances in our understanding of the vestibular system that have occurred following the renewed interest in sound and vibration as a result of the VEMP.
Highlights
Vestibular-evoked myogenic potentials (VEMPs) are short-latency muscle reflexes typically recorded from the neck or eye muscles with surface electrodes
After its first description in 1992 [1], the vestibular-evoked myogenic potential (VEMP), a soundevoked muscle reflex recorded from the sternocleidomastoid muscle, quickly showed clinical promise as an easy, non-invasive measure of vestibular function
It is sometimes said that sound and vibration are artificial vestibular stimuli, the reflexes evoked by vibration are sensitive to the direction of stimulation [64, 65, 93,94,95,96], suggesting that, the frequency of stimulation is outside what we normally consider the physiological range of vestibular afferents, the vibration-evoked responses are likely to share the same neural mechanisms as vestibular reflexes evoked by perturbations and are special examples of VCR and vestibulo-ocular reflexes (VOR)
Summary
Vestibular-evoked myogenic potentials (VEMPs) are short-latency muscle reflexes typically recorded from the neck or eye muscles with surface electrodes They are used clinically to assess otolith function, but are interesting as they can provide information about the vestibular system and its activation by sound and vibration. Moving the active electrodes away from the midline allowed investigation of the laterality of the reflex, while the use of SCM, a large superficial muscle, provided greater confidence in the origin and polarity of the reflex They recorded a series of sound-evoked potentials from surface electrodes placed over the ipsilateral SCM neck muscles in a patient with Meniere’s disease. Subsequent, systematic investigations confirmed the vestibular-dependence of the early response, which is termed the “cervical VEMP” or cVEMP [8]
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