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

Eur Arch Otorhinolaryngol. 2019 Nov;276(11):2991-3003. doi: 10.1007/s00405-019-05582-7. Epub 2019 Jul 29.

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.

Keywords: Cervical vestibular evoked myogenic potential; Splenius capitis; Sternocleidomastoid.

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Case-Control Studies
  • Electromyography
  • Female
  • Humans
  • Male
  • Middle Aged
  • Neck Muscles / physiology*
  • Paraspinal Muscles / physiology*
  • Parkinson Disease / physiopathology*
  • Vestibular Evoked Myogenic Potentials / physiology*
  • Young Adult