Inter-frequency amplitude ratio of oVEMP for differentiating Meniere’s disease from BPPV: clinical validation using a double-blind approach

Abstract

Objective: The study aimed at examining the usefulness of inter-frequency amplitude ratio (IFAR) of ocular vestibular evoked myogenic potential (oVEMP) in identifying Meniere’s disease (MD) and differentiating it from benign paroxysmal positional vertigo (BPPV).

Design: A case-control design was used with a double blind approach. Phase 1 included 70 healthy individuals and 36 individuals each with MD and BPPV and Phase 2 included 20 individuals each with MD and BPPV. The age range of the participants in both phases was 15–50 years. All participants underwent oVEMP testing using 500 and 1000 Hz tone bursts and IFAR was obtained.

Results: The results in phase 1 revealed significantly higher IFARs in Meniere’s disease than BPPV and healthy individuals (p < 0.001). An optimum criterion point of IFAR ≥1.11 for diagnosing MD was found which yielded 80% sensitivity and 98% specificity. The results in phase 2 demonstrated 85% correct identification of MD and 95% correct rejection of BPPV as non-MD.

Conclusions: IFAR of oVEMP appears highly sensitive and specific parameter for identifying MD and a clinically valid tool for differentiating MD from BPPV.

Keywords:

• Frequency-amplitude ratio
• oVEMP
• Meniere’s disease
• BPPV
• double-blind study
• clinical validation

Acknowledgements

The data for the study was collected at Department of Audiology, All India Institute of Speech and Hearing, Mysore as part of a doctoral thesis. The authors would like to thank the Director of the institute and the HOD Audiology for granting permission to conduct the study and allow the use of equipments of the department. A heartfelt gratitude is also expressed towards the participants of the study for their kind cooperation during the study.

Disclosure statement

No potential conflict of interest was reported by the authors.