Cervical vestibular evoked myogenic potential asymmetry, but not amplitude, differentiates vestibular migraine during prolonged unidirectional visual motion
Journal
Frontiers in Neurology
ISSN
1664-2295
Date Issued
2026-03-17
Author(s)
Elvira Cortese
Huseyin Nezih Ozdemir
Anca-Diana Grigore
Nehzat Koohi
Diego Kaski
Type
journal-article
Abstract
<jats:sec>
<jats:title>Introduction</jats:title>
<jats:p>Vestibular migraine (VM) is the leading cause of episodic vestibular complaints. It arises from altered brain states that disrupt sensory processing. A reliance on clinical history for diagnosis highlights the need for bedside biomarkers, particularly in emergency settings where misdiagnosis is common.</jats:p>
</jats:sec>
<jats:sec>
<jats:title>Methods</jats:title>
<jats:p>
In this cross-sectional study, 30 VM patients (median-age = 40.5; 27 females) from University College London vestibular clinics and 30 age-gender matched healthy controls (median-age = 32.5; 27 females) were recruited, between May 2024 and October 2025. Cervical Vestibular Evoked Myogenic Potential (cVEMP) responses were measured before and after a
<jats:italic>Unidirectional Visual Motion Stimuli</jats:italic>
delivered via virtual reality goggles.
</jats:p>
</jats:sec>
<jats:sec>
<jats:title>Results</jats:title>
<jats:p>
Mixed linear modeling (MLM) showed no significant effects of group, condition or ear on cVEMP amplitude (all
<jats:italic>p</jats:italic>
> 0.05). MLM on asymmetry revealed a significant effect of group,
<jats:italic>F</jats:italic>
(1, 57.21) = 11.89,
<jats:italic>p</jats:italic>
= 0.001 and condition,
<jats:italic>F</jats:italic>
(1, 56.53) = 14.47,
<jats:italic>p</jats:italic>
= <0.001; but no significant group × condition interaction,
<jats:italic>F</jats:italic>
(1, 56.53) = 1.57,
<jats:italic>p</jats:italic>
= 0.215. Spearman correlations showed no association between cVEMP delta amplitude and DHI. VM patients scored higher on all symptom’s measures compared with controls (All
<jats:italic>p</jats:italic>
< 0.001).
</jats:p>
</jats:sec>
<jats:sec>
<jats:title>Conclusion</jats:title>
<jats:p>Prolonged unidirectional visual stimulation does not significantly affect cVEMP amplitude responses in VM, limiting its value as a differential diagnostic tool. The need to further explore asymmetry and interaural/interhemispheric sensory integration in VM is underscored.</jats:p>
</jats:sec>
<jats:title>Introduction</jats:title>
<jats:p>Vestibular migraine (VM) is the leading cause of episodic vestibular complaints. It arises from altered brain states that disrupt sensory processing. A reliance on clinical history for diagnosis highlights the need for bedside biomarkers, particularly in emergency settings where misdiagnosis is common.</jats:p>
</jats:sec>
<jats:sec>
<jats:title>Methods</jats:title>
<jats:p>
In this cross-sectional study, 30 VM patients (median-age = 40.5; 27 females) from University College London vestibular clinics and 30 age-gender matched healthy controls (median-age = 32.5; 27 females) were recruited, between May 2024 and October 2025. Cervical Vestibular Evoked Myogenic Potential (cVEMP) responses were measured before and after a
<jats:italic>Unidirectional Visual Motion Stimuli</jats:italic>
delivered via virtual reality goggles.
</jats:p>
</jats:sec>
<jats:sec>
<jats:title>Results</jats:title>
<jats:p>
Mixed linear modeling (MLM) showed no significant effects of group, condition or ear on cVEMP amplitude (all
<jats:italic>p</jats:italic>
> 0.05). MLM on asymmetry revealed a significant effect of group,
<jats:italic>F</jats:italic>
(1, 57.21) = 11.89,
<jats:italic>p</jats:italic>
= 0.001 and condition,
<jats:italic>F</jats:italic>
(1, 56.53) = 14.47,
<jats:italic>p</jats:italic>
= <0.001; but no significant group × condition interaction,
<jats:italic>F</jats:italic>
(1, 56.53) = 1.57,
<jats:italic>p</jats:italic>
= 0.215. Spearman correlations showed no association between cVEMP delta amplitude and DHI. VM patients scored higher on all symptom’s measures compared with controls (All
<jats:italic>p</jats:italic>
< 0.001).
</jats:p>
</jats:sec>
<jats:sec>
<jats:title>Conclusion</jats:title>
<jats:p>Prolonged unidirectional visual stimulation does not significantly affect cVEMP amplitude responses in VM, limiting its value as a differential diagnostic tool. The need to further explore asymmetry and interaural/interhemispheric sensory integration in VM is underscored.</jats:p>
</jats:sec>