Optimal Electrode Configuration for Masseter Vestibular-Evoked Myogenic Potential: A Comparison Between Zygomatic and Forehead Electrode Montages

<b>Background:</b> The masseter vestibular-evoked myogenic potential (mVEMP) is a short-latency electromyographic potential that assesses the integrity of the vestibule-masseteric reflex pathway. Due to limited normative studies, there is no optimal mVEMP protocol to be implemented clinically. Apart from the conventional electrode configuration, a naïve montage referred to as the forehead reference has been used in recent studies. <b>Purpose:</b> This study compared latency and amplitude parameters of mVEMP between the zygomatic and forehead electrode configurations to address the optimal electrode montage to elicit mVEMP. <b>Research Design:</b> Cross-sectional research study. <b>Study Sample:</b> Thirty healthy participants (mean age: 23.3 years; 14 males and 16 females). <b>Data Collection and Analysis:</b> Participants underwent mVEMP testing under two-electrode montage conditions (zygomatic and forehead reference electrode montages). <b>Results:</b> Statistically significant increases in P1 latency, decrease in N1 latency, reduction of P1-N1 interpeak interval, enlargement of both unrectified and electromyography-rectified amplitudes, and lower interaural amplitude asymmetry ratio were observed for the forehead electrode montage compared to the conventional zygomatic montage. <b>Conclusions:</b> mVEMP response waveforms obtained using forehead reference electrode montage are superior to the zygomatic montage. Hence, the forehead montage is suggested for further research on mVEMP.