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

• Published in: European archives of oto-rhino-laryngology 2019-11, Vol.276 (11), p.2991-3003
• Main Authors: Mohammed Ali, Fatema, Westling, Martin, Zhao, Luke Hong Lu, Corneil, Brian D., Camp, Aaron J.
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Age Factors; Aged; Aged, 80 and over; Case-Control Studies; Electromyography; Female; Head and Neck Surgery; Humans; Male; Medicine; Medicine & Public Health; Middle Aged; Neck Muscles - physiology; Neurosurgery; Otology; Otorhinolaryngology; Paraspinal Muscles - physiology; Parkinson Disease - physiopathology; Vestibular Evoked Myogenic Potentials - physiology; Young Adult
• ISSN: 0937-4477; 1434-4726; 1434-4726
• DOI: 10.1007/s00405-019-05582-7

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.