Evaluation of vestibular evoked myogenic potentials with different stimulus models i̇n i̇ndividuals diagnosed with vestibular migraine

In this study, it was aimed to compare the effect on latency and amplitude by using different stimulus models (tone burst, click and chirp) in sVEMP and oVEMP tests in VM patients with the control group. 26 individuals (52 ears) and 26 healthy individuals (52 ears) diagnosed with Vestibular migraine in Ondokuz Mayıs University Neurology Department between February 2022 and September 2022 were included in the study. All participants underwent 500 Hz tone burst (TB) and 500 Hz Frequency-specific chirp and click stimulus and vestibular evoked myogenic potentials (sVEMP, oVEMP) tests. In the sVEMP and oVEMP test, threshold values for all stimuli (chirp, TB and click) responses were found to be statistically significantly higher in the VM group than in the control group (p<0.00). Chirp stimulus responses compared to TB stimulus responses; There was no statistically significant difference in P1, N1 latency, P1-N1 amplitude and threshold values in the sVEMP and oVEMP test in the VM group and in the oVEMP test in the control group (p> 0.05). There was no statistically significant difference in P1, N1 wave latency, P1-N1 amplitude and threshold (p> 0.05). Chirp stimulus responses were compared to click stimulus responses; P1-N1 amplitude and response rate values in sVEMP and oVEMP tests were found to be statistically significantly higher in VM patients and control groups (p<0.05). VEMP threshold values for chirp stimulus responses compared to click stimulus responses were found to be statistically significantly lower (p<0.05). In the VEMP test performed with 500 Hz frequency-specific chirp stimulus, the sVEMP P1-N1 amplitude value and the oVEMP N1 latency value were found to be statistically significantly higher than the VM group in the control group (p<0.05). In the test performed with 500 Hz TB stimulus, sVEMP P1-N1 amplitude and asymmetry ratio, and oVEMP P1, N1 latency and asymmetry ratio were found to be statistically significantly higher than the control group in the VM group (p<0.05). In the sVEMP test performed with click stimulus, N1 latency, P1-N1 amplitude and statistically significantly lower values were found in the VM patient group compared to the control group (p<0.05). In the sVEMP test, the rate of asymmetry in the VM group was found to be statistically significantly higher than the control group (p<0.05). In vestibular migraine patients and control group, sVEMP and oVEMP responses were 100% obtained at 500 Hz TB stimulus. In the sVEMP and oVEMP test, the least response rate was obtained with click stimulus in both groups. The highest response rate was found in 500 Hz tone burst stimulus. Due to the high response rates and amplitude values of the 500Hz frequency-specific chirp stimulus, low threshold values and smoother wave morphology, it was concluded that VEMP test is an effective stimulus in the evaluation of the vestibular system in VM patients.