Neurofeedback-controlled comparison of the head elevation versus head rotation and head-hand methods in eliciting cervical vestibular evoked myogenic potentials.

A constant tension of the sternocleidomastoid muscles is a prerequisite to a reliable recording of cervical vestibular evoked myogenic potentials (cVEMP). Therefore, the head elevation method, the head rotation method, and the head-hand method are used in clinical practice. So far, no method has been shown to achieve the best stability and validity of the cVEMP responses. We performed a prospective study to compare the cVEMP responses in a within-subject design. With 40 healthy subjects, cVEMP amplitudes, latencies, asymmetry ratios and thresholds were measured. The muscle tension was kept constant by using acoustic feedback. The individual subjective comfort and preference of a method were evaluated by a questionnaire. The cVEMP threshold and asymmetry ratios were lowest with the head rotation method. This method was also rated as the most comfortable and thus preferred one. The cVEMP latencies were not different between the methods. Our results show that the head rotation method appears to be superior to the compared head elevation and head-hand methods.