Association of cervical vestibular-evoked myogenic potential tuning property test results with MRI findings of endolymph
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OTOLOGY
Association of cervical vestibular‑evoked myogenic potential tuning property test results with MRI findings of endolymphatic hydrops in Meniere’s disease Toshihisa Murofushi1 · Masahito Tsubota1 · Yasuhisa Kanai2 · Hideho Endo2 · Munetaka Ushio3 Received: 5 August 2020 / Accepted: 28 September 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Purpose To examine the concordance between cervical vestibular-evoked myogenic potential (cVEMP) tuning property test results and MRI findings of endolymphatic hydrops (EH). Methods Fourteen subjects (age 24–76 years) that had been diagnosed with unilateral definite Meniere’s disease (MD) (N = 8) or unilateral probable MD (N = 6) were enrolled. All of the subjects underwent cVEMP tests (using 500 Hz and 1000 Hz tone bursts), pure-tone audiometry, and gadolinium-enhanced 3 T-MRI. To examine tuning properties of cVEMP, the 500–1000 Hz amplitude ratio was calculated as the SLOPE. The results of the cVEMP tuning property test results were compared with EH-related MRI findings. Results EH positivity in both the cochlea and vestibule on MRI was observed in 7 of the 8 affected ears of definite MD and 3 of the 6 affected ears of probable MD, although it was only in one of the 14 unaffected ears. EH(+) or no response (NR) in cVEMP tuning property test was significantly associated with EH positivity on MRI, while EH(-) in the cVEMP tuning property test was significantly associated with EH-negativity on MRI (p = 0.0016 Fisher’s exact test test). Conclusion EH(+) or NR in the cVEMP tuning property test correspond well to EH positivity in the MRI findings. The cVEMP tuning property test is useful for screening and following up EH. Keywords Meniere’s disease · Endolymphatic hydrops · cVEMP · Saccule · Tuning · MRI
Introduction Meniere’s disease (MD) is a representative peripheral vestibular disease, which is characterized by episodic vertigo attacks accompanied by fluctuating auditory symptoms/signs [1, 2]. Endolymphatic hydrops (EH) is one of the histopathological features of MD [3, 4], and clinical neurophysiological tests, such as cervical vestibular-evoked myogenic potential (cVEMP) testing, electrocochleography (ECoG), etc., * Toshihisa Murofushi toshi‑[email protected] 1
Department of Otolaryngology, Teikyo University School of Medicine Mizonokuchi Hospital, 5‑1‑1 Futago, Takatsu‑ku, Kawasaki 213‑8507, Japan
2
Department of Radiology, Ochanomizu Surugadai Clinic, Tokyo, Japan
3
Department of Otolaryngology, Toho University School of Medicine Sakura Medical Center, Sakura, Japan
are used to detect EH [5–8]. Magnetic resonance imaging (MRI) can also be used to detect EH [9, 10]. However, the concordance between the results of the neurophysiological tests used to detect EH and MRI findings of EH has not been fully elucidated. Gürkov et al. studied the relationship between ECoG findings and MRI findings obtained with locally injected contrast medium (gadolinium, Gd) in patients with overlapping of MD and vestibular migraine [11]. In t
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