Age-adjusted analysis of cVEMP frequency tuning using spline approximation for diagnosis of endolymphatic hydrops.

BACKGROUND

Although the cervical vestibular-evoked myogenic potential (cVEMP) frequency response has diagnostic value in Ménière's disease (MD), a method that accounts for age-related changes is needed.

AIMS/

OBJECTIVE

To develop an age-independent diagnostic approach for MD using cVEMP.

SUBJECTS AND

METHODS

cVEMP frequency responses were recorded at six stimulus frequencies (250-2000 Hz) in 35 definite unilateral MD ears and 55 control ears. The discrete peak frequencies were converted into a continuous variable by spline approximation. This spline peak was normalized age-adjusted Z (AAZ) scores which were from a linear regression model using data for controls.

RESULTS

The spline peak frequency was significantly higher in MD ears (1171 ± 395 Hz) than in controls (707 ± 270 Hz). A receiver operating characteristic analysis identified a cutoff value of 0.866 for AAZ score, yielding a sensitivity of 0.771, specificity of 0.825, and area under the curve of 0.858 for distinguishing MD from controls. The AAZ score achieved stable diagnostic performance across age groups.

CONCLUSIONS AND SIGNIFICANCE: Spline approximation enables the physiologically meaningful estimation of cVEMP peaks, and AAZ scoring eliminates age-related effects. This novel approach may serve as a practical diagnostic tool for MD in aging populations.