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Splenius capitis: sensitive target for the cVEMP in older and neurodegenerative patients

  • Otology
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

Background

The vestibular evoked myogenic potential (VEMP) is a technique used to assess vestibular function. Cervical VEMPs (cVEMPs) are obtained conventionally from the sternocleidomastoid (SCM) muscle; however, the dorsal neck muscle splenius capitis (SPL) has also been shown to be a reliable target alongside the SCM in young subjects.

Objective

This study aimed to compare cVEMPs from the SCM and SPL in two positions across young, older, and Parkinson’s disease (PD) patients.

Method

Experiments were carried out using surface EMG electrodes placed over the SCM and SPL. cVEMPs were measured using a 30 s, 126 dB sound stimulus with 222 individual tone bursts, while subjects were in a supine and head-turned posture (also known as the head elevation method), and in a seated head-turned posture.

Results

When comparing cVEMPs across positions, the incidence of supine and seated SCM-cVEMPs diminished significantly in older and PD patients in comparison with young subjects. However, no statistically significant differences in incidences were found in seated SPL-cVEMPs when comparing young, older and PD patients. SPL-cVEMPs were present significantly more often than seated SCM-cVEMPs in PD patients.

Conclusions

SPL-cVEMPs are not altered to the same extent that SCM-cVEMPs are by aging and disease and its addition to cVEMP testing may reduce false-positive tests for vestibulopathy.

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Abbreviations

VEMPs:

Vestibular evoked myogenic potentials

SCM:

Sternocleidomastoid

cVEMPs:

Cervical vestibular evoked myogenic potentials

SPL:

Splenius capitis

MG:

Medial gastrocnemius

TIB:

Tibialis anterior

SCM-cVEMP:

Cervical vestibular evoked myogenic potential measured from the sternocleidomastoid

PD:

Parkinson’s disease

SPL-cVEMP:

Cervical vestibular evoked myogenic potentials measured from the splenius capitis

EMG:

Electromyography

MD:

Meniere’s disease

PSP:

Progressive supranuclear palsy

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Acknowledgements

The authors would like to acknowledge Ms Miranda Mathews and Mr Max Mo for assistance with data collection, and Dr. Ala Ali for sourcing of subjects and patients.

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Authors and Affiliations

  1. Discipline of Biomedical Science, Sydney Medical School, University of Sydney, Sydney, NSW, Australia

    Fatema Mohammed Ali, Luke Hong Lu Zhao & Aaron J. Camp

  2. The Faculty of Medicine and Health Sciences, Linkoping University, Linköping, Sweden

    Martin Westling

  3. Department of Physiology and Pharmacology, University of Western Ontario, London, ON, Canada

    Brian D. Corneil

  4. Robarts Research Institute, University of Western Ontario, London, ON, Canada

    Brian D. Corneil

Authors
  1. Fatema Mohammed Ali
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  2. Martin Westling
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Correspondence to Aaron J. Camp.

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Research involving humans and animal rights

This study was carried out in accordance with the recommendations of the National Health and Medical Research Council of Australia’s statement on ethical conduct in research (2015) with approval from the Human Research Ethics Committee of the University of Sydney (2017/082).

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All subjects gave written informed consent in accordance with the Declaration of Helsinki.

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Mohammed Ali, F., Westling, M., Zhao, L.H.L. et al. Splenius capitis: sensitive target for the cVEMP in older and neurodegenerative patients. Eur Arch Otorhinolaryngol 276, 2991–3003 (2019). https://doi.org/10.1007/s00405-019-05582-7

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