Increasing the Stimulation Rate Reduces cVEMP Testing Time by More Than Half With No Significant Difference in Threshold

Objective: Assessing the effect of a higher stimulation rate in cervical vestibular evoked myogenic potential (cVEMP) outcome measurements. Study Design: Prospective cohort study. Setting: Large specialty hospital, Department of otolaryngology. Subjects: Eleven healthy subjects were used in this study. Intervention: All subjects underwent a cervical vestibular evoked myogenic potential test at 500, 750, and 1000 Hz using 5 and 13 Hz stimulation rates. Main Outcome Measures: Threshold, peak-to-peak (PP) amplitude, and interaural asymmetry ratio (IAR). Results: PP cVEMP amplitudes were larger at 5/s than at 13/s. The 5/s to 13/s differences were statistically significant at 500 and 750 Hz (p<0.02). The coefficient of variation in PP amplitudes across subjects, was not significantly different at any frequency for 5/s versus 13/s stimuli. No significant difference was found in the IAR at any frequency. The cVEMP thresholds were similar between stimulation rates. Conclusion: In healthy young subjects no significant differences in threshold were found between 5/s and 13/s stimulation rates, though intrasubject PP amplitude was significantly lower at the faster stimulation rate. Increasing stimulation rate reduces test time and burden. Additional studies are needed to verify that these conclusions are also true for patients.