Affiliations: [a]
Department of Neurological Sciences, Prince of Wales Hospital, Randwick, Sydney, Australia
| [b]
Department of Neurology, Royal Prince Alfred Hospital, Sydney, NSW, Australia
| [c]
Central Clinical School, The University of Sydney, Sydney, NSW, Australia
Correspondence:
[*]
Corresponding author: Dr Sally Rosengren, Royal Prince Alfred Hospital, Department of Neurology, Level 8, Missenden Rd, Camperdown NSW 2050, Australia. Tel.: +61 295157565; E-mail: sally@srosengren.org.
Abstract: BACKGROUND:The cervical vestibular evoked myogenic potential (cVEMP) can be affected by the recording parameters used to quantify the response. OBJECTIVE:We investigated the effects of electrode placement and montage on the variability and symmetry of sternocleidomastoid (SCM) contraction strength and cVEMP amplitude. METHODS:We used inter-side asymmetries in electrode placement to mimic small clinical errors in twenty normal subjects. cVEMPs were recorded at three active electrode sites and referred to the distal SCM tendon (referential montages: upper, conventional and lower). Additional bipolar montages were constructed offline to measure SCM contraction strength using closely-spaced electrode pairs (bipolar montages: superior, lower and outer). RESULTS:The conventional montage generally produced the largest cVEMP amplitudes (P < 0.001). SCM contraction strength was larger for referential montages than bipolar ones (P < 0.001). Inter-side electrode position errors produced large variations in cVEMP and SCM contraction strength asymmetries in some subjects, producing erroneous abnormal test results. CONCLUSION:Recording locations affect cVEMP amplitude and SCM contraction strength. In most cases, small changes in electrode position had only minor effects but, in a minority of subjects, the different montages produced large changes in cVEMP and contraction amplitudes and asymmetry, potentially affecting test outcomes.
