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On the impact of examiners on latencies and amplitudes in cervical and ocular vestibular-evoked myogenic potentials evaluated over a large sample (N = 1,038)

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

Abstract

Vestibular-evoked myogenic potentials (VEMPs) are frequently used in the clinical diagnosis and research of vertigo syndromes. Altered latencies or amplitudes are typically interpreted as an indication of disturbance in the processing of vestibular stimuli along the otolithic pathways. Correct interpretation, however, can be difficult as VEMP amplitudes can vary greatly across subjects and across laboratories, likely because they are very sensitive to measurement conditions. Here, we attempted to quantify the impact of examiner differences on VEMP data. We collected data from 1,038 people using eight different experimental examiners, and investigated the effect of examiner on VEMP latencies and amplitudes. We found that the examiner collecting the data had a strong effect on outcome measures with significant differences (p < 0.001) in cVEMP and oVEMP latencies and in oVEMP amplitudes. No significant differences between examiners were found for the cVEMP amplitudes. When we compared the healthy and pathological sides of patients with a clinically diagnosed unilateral disease, no significant differences between sides were found. Given our results and the results reported in the literature, we conclude that the signal features of VEMPs are very sensitive to variables that may be influenced by the examiner. The field should therefore work on a better standard for VEMP recordings.

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Acknowledgments

We would like to thank Fern Jaspers-Fayer (UBC, BC, Canada) for critiquing multiple drafts of this manuscript. Part of this work was prepared in the context of Matthias Ertl’s dissertation at the Faculty of Medicine, Ludwig-Maximilians-University, Munich. The work was supported by the BMBF (German Federal Ministry of Education; BMBF 01 EO 0901) and the German Research Foundation (DFG-GRK 1091).

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The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Neurology, University Hospital, Ludwig-Maximilians University, Munich, Germany

    Matthias Ertl, R. Boegle, V. Kirsch & M. Dieterich

  2. Graduate School of Systemic Neuroscience, Ludwig-Maximilians University, Munich, Germany

    Matthias Ertl, R. Boegle, V. Kirsch & M. Dieterich

  3. German Center for Vertigo and Balance Disorders (IFB-LMU), Ludwig-Maximilians University, Munich, Germany

    R. Boegle, V. Kirsch & M. Dieterich

  4. Munich Cluster for Systems Neurology (SyNergy), Munich, Germany

    M. Dieterich

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  1. Matthias Ertl
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Correspondence to Matthias Ertl.

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Ertl, M., Boegle, R., Kirsch, V. et al. On the impact of examiners on latencies and amplitudes in cervical and ocular vestibular-evoked myogenic potentials evaluated over a large sample (N = 1,038). Eur Arch Otorhinolaryngol 273, 317–323 (2016). https://doi.org/10.1007/s00405-015-3510-3

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