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. 2022 Aug 26:13:921133.
doi: 10.3389/fneur.2022.921133. eCollection 2022.

Bilateral Dysfunction of Otolith Pathway in Patients With Unilateral Idiopathic BPPV Detected by ACS-VEMPs

Xiaorong Niu  1 , Peng Han  1 , Maoli Duan  2 , Zichen Chen  1 , Juan Hu  3 , Yanfei Chen  3 , Min Xu  3 , Pengyu Ren  3 , Qing Zhang  3   4
Affiliations

Bilateral Dysfunction of Otolith Pathway in Patients With Unilateral Idiopathic BPPV Detected by ACS-VEMPs

Xiaorong Niu et al. Front Neurol. .

Abstract

Objective: To observe the functional status of the otolith pathway in patients with unilateral idiopathic benign paroxysmal positional vertigo (BPPV) by combining air-conducted sound elicited cervical vestibular-evoked myogenic potential (ACS-cVEMP) and ocular vestibular-evoked myogenic potential (ACS-oVEMP).

Methods: One hundred and eighty patients with BPPV were recruited for conventional cVEMP and oVEMP tests. The abnormal rates of VEMPs were compared between BPPV patients and control participants.

Results: The abnormal rates of cVEMP and oVEMP in BPPV patients were 46.7% (84/180) and 57.2% (103/180) in affected ears, respectively, and 45.0% (81/180) and 56.7% (102/180) in unaffected ears, respectively; both were significantly higher than the abnormal rates of cVEMP and oVEMP in normal control ears. Compared with normal subjects, the cVEMP response rate was lower in affected and unaffected ears in BPPV patients. The abnormal rates of cVEMP and oVEMP were 48.1% (76/158) and 57.6% (91/158) in patients with posterior semicircular canal BPPV, and 36.4% (8/22) and 54.5% (12/22) in lateral semicircular canal BPPV. There was no significant difference in VEMP abnormalities between posterior semicircular canal BPPV and lateral semicircular canal BPPV.

Conclusion: The prevalence of abnormal cVEMPs and oVEMPs in both affected and unaffected ears of patients with BPPV was significantly higher than that observed in the control group. The pathological mechanism of unilateral idiopathic BPPV may be associated with bilateral degeneration of otolith pathways.

Keywords: air-conducted sound; benign paroxysmal positional vertigo; cervical vestibular-evoked myogenic potential; ocular vestibular-evoked myogenic potential; vestibular function.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Comparison of abnormal rates of cervical vestibular-evoked myogenic potential (cVEMP) and ocular vestibular-evoked myogenic potential (oVEMP) among affected ears and unaffected ears in the benign paroxysmal positional vertigo (BPPV) group and normal control ears; *p < 0.01, #p < 0.05, compared with normal control ears. p affected, cVEMP < 0.001, p unaffected, cVEMP < 0.001; p affected, oVEMP = 0.17, p unaffected, oVEMP = 0.22.
Figure 2
Figure 2
Cervical vestibular-evoked myogenic potential (cVEMP) waves of patients with benign paroxysmal positional vertigo (BPPV). The top picture shows the cVEMP response of a normal subject. The bottom picture shows the cVEMP response of a patient with BPPV.
Figure 3
Figure 3
Ocular vestibular-evoked myogenic potential (oVEMP) in affected ears with benign paroxysmal positional vertigo (BPPV). The top picture shows the oVEMP response of a normal subject. The bottom picture shows the oVEMP response of a patient with BPPV.
See this image and copyright information in PMC

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