Vestibular-Evoked Myogenic Potential Outcomes Associated with Pediatric Sports-Related Concussion

Amanda I Rodriguez; Jonathan Chiao; Gretchen Spencer

doi:10.1002/lary.29803

Vestibular-Evoked Myogenic Potential Outcomes Associated with Pediatric Sports-Related Concussion

Laryngoscope. 2022 Feb;132(2):436-442. doi: 10.1002/lary.29803. Epub 2021 Aug 7.

Authors

Amanda I Rodriguez¹, Jonathan Chiao^{2

3

4}, Gretchen Spencer¹

Affiliations

¹ Department of Special Education and Communication Disorders, University of Nebraska-Lincoln, Lincoln, Nebraska, U.S.A.
² Department of Otolaryngology - Head and Neck Surgery, University of Nebraska Medical Center, Omaha, Nebraska, U.S.A.
³ Bobby R. Alford Department of Otolaryngology - Head and Neck Surgery, Baylor College of Medicine, Houston, Texas, U.S.A.
⁴ Division of Pediatric Otolaryngology, Texas Children's Hospital, Houston, Texas, U.S.A.

PMID: 34363397
DOI: 10.1002/lary.29803

Abstract

Objectives/hypothesis: To 1) characterize vestibular-evoked myogenic potential responses in children and young adults with sports-related concussion (SRC) histories as compared with a normal healthy control group, and 2) correlate VEMP characteristics to SRC/sport history outcomes.

Study design: Prospective cohort study.

Methods: Seventy-six children and young adults with and without a history of SRC received cervical and ocular VEMP testing using a 500 Hz tone burst air conduction stimuli. VEMP response parameters (response rates, peak latencies, and peak-to-peak amplitudes) were assessed. Other clinical vestibular measures were performed. In the SRC group, sport history outcomes including number of SRC sustained over a lifetime, years of playing contact sports, and length of time playing contact sports were collected via in-person questionnaire.

Results: Children and young adults with SRC had significantly reduced oVEMP responses and peak-to-peak amplitudes and greater amplitude response asymmetries between left and right ear. There was no effect of group on cVEMP findings. A greater frequency of SRCs sustained throughout a lifetime, a greater number of contact sports played, and a longer duration of playing a contact sport correlated with significantly poorer VEMP response characteristics.

Conclusions: Our results suggest that SRC and repeated subclinical head impact events have an effect on oVEMP outcomes. SRC may affect the utricle, superior vestibular nerve, and/or brainstem-mediated vestibular-ocular-reflex pathway. The prevalence of post-concussion-related dizziness is becoming increasingly common in a pediatric-otology clinic, thus performing VEMP testing in youth post-SRC provides an objective, noninvasive, and cost-effective method for monitoring the effects of sports-related impact on the vestibular system and related neural pathways.

Level of evidence: 3 Laryngoscope, 132:436-442, 2022.

Keywords: Concussion; VEMP; dizziness; otoliths; pediatrics.

MeSH terms

Adolescent
Adult
Athletic Injuries / physiopathology*
Brain Concussion / physiopathology*
Child
Female
Humans
Male
Prospective Studies
Vestibular Evoked Myogenic Potentials*
Young Adult