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Cutoff points for ocular vestibular evoked myogenic potentials in unilateral vestibulopathy: a cross-sectional diagnostic accuracy study
Cutoff points for ocular vestibular evoked myogenic potentials in unilateral vestibulopathy: a cross-sectional diagnostic accuracy study
Adriana L. Benavides-Estrada 1 
, Daniel Ramos-Maldonado 2 , Ivonne Calderón-Leyva 2 , Annel Gómez-Coello 3 , Victoria Sosa-Romo 2
1 Subdirección de Otoneurología, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Ciudad de México, México; 2 Otoneurology Service, National Institute of Rehabilitation, México City, Mexico; 3 Subdirección de Audiología, Foniatría y Patología de Lenguaje, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Ciudad de México, México
*Correspondence: Daniel Ramos-Maldonado. Email: dmaldonado@inr.gob.mx
Abstract
Introduction: Ocular vestibular evoked myogenic potentials (oVEMP) assess utricular function, but standardized cutoff points for unilateral peripheral vestibulopathy (UPV) are lacking. Objective: To establish diagnostic cutoff points for P1 and N1 latencies, interval, and amplitude in oVEMP of patients with UPV. Method: Retrospective, cross-sectional diagnostic accuracy study in adults diagnosed with UPV (Bárány criteria) confirmed by caloric testing. A total of 100 ears (49 pathological, 51 controls) were analyzed at 500 Hz and 63 at 1,000 Hz using t-tests and ROC curves. Results: At 500 Hz, a significant difference in amplitude was found (p = 0.032), but discriminatory capacity was insufficient (AUC = 0.606), preventing the establishment of clinically valid cutoff points for latencies or amplitude. At 1,000 Hz, no measures showed significant differences (p > 0.05; AUC = 0.598). In this cohort, oVEMP did not allow for adequate discrimination of UPV. Conclusions: oVEMP at 500 and 1,000 Hz do not adequately discriminate unilateral UPV in this study population. Larger samples or optimized protocols are required to validate their clinical diagnostic utility.
Keywords: Vestibular evoked myogenic potentials. Vestibular diseases. ROC curve. Reference values. Vestibular function tests.
