Which nerve/otolith correspond to cVEMP and oVEMP, respectively?

• A. Saccular and inferior vestibular nerve function for cVEMP; utricular and superior vestibular nerve function for oVEMP
• B. Inferior vestibular nerve function for cVEMP; Superior vestibular nerve function for oVEMP
• C. Utricular function for cVEMP; Saccular nerve for oVEMP
• D. Semicircular canal function for cVEMP; Cochlear function for oVEMP

Answer: (C)

VEMP tests probe how the otolith organs connect to motor and ocular pathways. Cervical VEMP (cVEMP) mainly reflects the sacculo-collic pathway: sound or vibration stimulates the saccule, travels via the inferior vestibular nerve, and elicits a response from neck muscles (like the sternocleidomastoid). Ocular VEMP (oVEMP) mainly reflects the utriculo-ocular pathway: stimulation of the utricle travels via the superior vestibular nerve to oculomotor pathways, producing a response in extraocular muscles.

So the appropriate pairing is that cVEMP assesses saccular function through the inferior vestibular nerve, while oVEMP assesses utricular function through the superior vestibular nerve. The other options either swap which otolith is involved or point to structures not primarily tested by VEMP.