Subjective visual horizontal correlates better with ocular than with cervical vestibular evoked myogenic potentials

Objective: To examine the relationship between widely used otolith function tests: the Subjective Visual Horizontal (SVH) and Vestibular Evoked Myogenic Potentials (VEMP). Methods: A retrospective analysis was performed on 301 patients who underwent SVH, ocular and cervical VEMP (oVEMP and cVEMP) tests on the same day. Correlations between the mean SVH tilt and amplitude asymmetry ratios for bone-conducted (BC) oVEMP and air-conducted (AC) cVEMP were examined. Diagnoses included vestibular neuritis, stroke, vestibular migraine, Meniere's disease, sudden sensorineural hearing loss (SSNHL) and vestibular schwannoma. Results: SVH results were concordant with the oVEMP in 64% of cases and the cVEMP in 51%. Across all patients, SVH demonstrated a significant moderate correlation with BC oVEMP amplitude asymmetry ratios (r = 0.55, p < 0.001) and a weak correlation with AC cVEMP amplitude asymmetry ratios (r = 0.35, p < 0.001). A stronger correlation between SVH and oVEMPs was observed in patients with vestibular neuritis (r = 0.67, p < 0.001) and SSNHL (r = 0.76, p = 0.001). Conclusions: SVH correlates better with oVEMP than cVEMP symmetry. Significance: This finding reinforces the hypothesis of a common utricular origin for both SVH and oVEMPs which is distinct from the saccular origin of cVEMPs. & COPY; 2023 International Federation of Clinical Neurophysiology. Published by Elsevier B.V. All rights reserved.

Automated summary

This study aimed to investigate the relationship between two widely used otolith function tests, Subjective Visual Horizontal (SVH) and Vestibular Evoked Myogenic Potentials (VEMP). A retrospective analysis of 301 patients showed that SVH had a significant moderate correlation with bone-conducted oVEMP, and a weak correlation with air-conducted cVEMP. This finding supports the hypothesis of a common utricular origin for both SVH and oVEMPs.