Vestibular evoked myogenic potentials induced by intraoperative electrical stimulation of the human inferior vestibular nerve

Vestibular evoked myogenic potentials (VEMPs) can be recorded from sternocleidomastoid muscle (SCM) in clinical practice. The aim of the present study was to investigate VEMPs upon direct electrical stimulation of the human inferior vestibular nerve to evidence the vestibulocollic reflex arch and their saccular origin, respectively. Seven subjects were stimulated at the inferior (IVN) and superior (SVN) vestibular nerve. The EMG signals of the SCM were recorded. These recordings were compared to air- and bone-conduction evoked VEMPs with respect to latency and shape. All subjects showed normal VEMPs upon acoustic stimulation with a latency of 12.8+/-1.4 ms for P13, and 22.7+/-2.0 ms for the N23 pre-operatively. Upon direct electrical stimulation of the IVN, the mean latency of the positive peak was 9.1+/-2.2 and 13.2+/-2.3 ms for the negative one. No contralateral SCM response was found. Electrical stimulation of the SVN did not result in any EMG response of the SCM. The study shows experimental evidence of the vestibulocollic reflex by direct electrical stimulation of the human IVN for the first time. The method can be utilized to map VIIIth nerve subdivisions and to intraoperatively monitor IVN integrity in a real-time mode.

[1]  Nina Kraus,et al.  Neurophysiology of Cochlear Implant Users I: Effects of Stimulus Current Level and Electrode Site on the Electrical ABR, MLR, and N1-P2 Response , 2002, Ear and hearing.

[2]  J. Colebatch,et al.  Galvanic stimulation evokes short-latency EMG responses in sternocleidomastoid which are abolished by selective vestibular nerve section. , 1998, Electroencephalography and clinical neurophysiology.

[3]  Charles A. Miller,et al.  Electrically evoked auditory brainstem response to stimulation of different sites in the cochlea , 1993, Hearing Research.

[4]  J. Colebatch,et al.  Vestibulocollic reflexes evoked by short‐duration galvanic stimulation in man , 1998, The Journal of physiology.

[5]  J. Guinan,et al.  Sound-evoked activity in primary afferent neurons of a mammalian vestibular system. , 1997, The American journal of otology.

[6]  R. A. Yavor,et al.  Tapping the head activates the vestibular system , 1995, Neurology.

[7]  A R Møller,et al.  Intraoperative Neurophysiologic Monitoring , 2011 .

[8]  T. Murofushi,et al.  Click-evoked potentials on the neck of the guinea pig , 2002, Hearing Research.

[9]  T. Lenarz,et al.  Intraoperative facial nerve monitoring in the surgery of cerebellopontine angle tumors: improved preservation of nerve function. , 1994, ORL; journal for oto-rhino-laryngology and its related specialties.

[10]  U. Grouven,et al.  Intraoperative Electrically Elicited Stapedius Reflex Threshold is Related to the Dosage of Hypnotic Drugs in General Anesthesia , 2003, The Annals of otology, rhinology, and laryngology.

[11]  O. Murnane,et al.  Vestibular evoked myogenic potentials: preliminary report. , 2001, Journal of the American Academy of Audiology.

[12]  G M Halmagyi,et al.  Myogenic potentials generated by a click-evoked vestibulocollic reflex. , 1994, Journal of neurology, neurosurgery, and psychiatry.

[13]  D. Basta,et al.  Management of Posttraumatic Vertigo , 2003, Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery.

[14]  G. Magliulo,et al.  Preservation of the Saccular Nerve and of the Vestibular Evoked Myogenic Potential During Vestibular Schwannoma Surgery , 2003, Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology.

[15]  A. Ernst,et al.  Galvanic testing in neuro-otological diagnostics. , 1989, Acta oto-laryngologica. Supplementum.

[16]  T. Murofushi,et al.  Vestibular testing by electrical stimulation in patients with unilateral vestibular deafferentation: galvanic evoked myogenic responses testing versus galvanic body sway testing , 2004, Clinical Neurophysiology.

[17]  I. Curthoys,et al.  Responses of guinea pig primary vestibular neurons to clicks , 2004, Experimental Brain Research.

[18]  Robert K Shepherd,et al.  Electrical stimulation of the auditory nerve. I. Correlation of physiological responses with cochlear status , 1997, Hearing Research.

[19]  Y. Cazals,et al.  Otoconia and neural junctions of type I hair cells in amikacin-treated guinea pigs presenting saccular acoustic responses , 2004, Archives of oto-rhino-laryngology.

[20]  J. Colebatch,et al.  Vestibular evoked potentials in human neck muscles before and after unilateral vestibular deafferentation , 1992, Neurology.

[21]  G M Halmagyi,et al.  Vestibular activation by bone conducted sound , 2003, Journal of neurology, neurosurgery, and psychiatry.

[22]  I. Curthoys,et al.  Clinical Testing of Otolith Function , 1999, Annals of the New York Academy of Sciences.

[23]  P. Vidal,et al.  Vestibular evoked myogenic potentials in patients suffering from an unilateral acoustic neuroma: a study of 170 patients , 2003, Clinical Neurophysiology.

[24]  J. Colebatch,et al.  Vestibular evoked myogenic potentials in the sternomastoid muscle are not of lateral canal origin. , 1995, Acta oto-laryngologica. Supplementum.

[25]  M Dieterich,et al.  Galvanic stimulation in bilateral vestibular failure: 3-D ocular motor effects. , 1999, Neuroreport.

[26]  M. McCue,et al.  Acoustically responsive fibers in the vestibular nerve of the cat , 1994, The Journal of neuroscience : the official journal of the Society for Neuroscience.

[27]  A. Clarke,et al.  Unilateral testing of utricular function , 1998, Experimental Brain Research.

[28]  M. Ohki,et al.  Galvanic-evoked myogenic responses in patients with an absence of click-evoked vestibulo-collic reflexes , 2002, Clinical Neurophysiology.