Frequency and phase effects on cervical vestibular evoked myogenic potentials (cVEMPs) to air-conducted sound.

Few previous studies of tuning using air-conducted (AC) stimuli and the cervical vestibular evoked myogenic potential (cVEMP) have compensated for the effects of middle ear (ME) attenuation. Zhang et al. (Exp Brain Res 213:111-116, 2011a) who did allow for ME effects were able to show a secondary peak around 100 Hz for the ocular VEMP (oVEMP). Recently, it has become clear that the otolith afferents responsible for the cVEMP and oVEMP differ and thus the nature of tuning may be more related to the reflex studied determining which otolith receptors are activated rather than the properties of the stimulus. We wished to reinvestigate the tuning for the cVEMP using AC stimuli, to establish whether the low-frequency peak is specific for the oVEMP or a consequence of the stimulus modality itself. In response to recent evidence using a 500 Hz AC stimulus that there was no effect of stimulus phase, we also investigated whether phase (condensation or rarefaction) had an effect at any frequency. We measured corrected cVEMP amplitudes and latencies in response to stimuli between 50 and 1200 Hz in 10 normal volunteers using an AC stimulus adjusted for ME attenuation. We confirmed earlier reports of the similarity of the tuning for both the cVEMP and oVEMP reflexes but found no separate 100 Hz peak for the cVEMP. AC stimulus phase did not affect either amplitude or latency. Both the tuning pattern and the phase effects contrast with those previously reported for bone-conducted (BC) stimuli. Unlike BC stimulation, which shows tuning consistent with an action on the otolith membrane, AC stimuli are likely to act through a different mechanism, most likely directly at the hair cell level.