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      Effect of aging on saccular function

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          Abstract

          Background: Aging can cause loss of balance, which may lead to physical and psychological problems. As the role of the otolith organs in maintaining postural stability has been emphasized in recent years, the present study investigated the effect of aging on saccular function using cervical vestibular evoked myogenic potentials (cVEMP).

          Methods: The participants were assigned into two groups; group one included 31 young adults with a mean age of 22.15 (range: 19-26 yr) and group two consisted of 31 old adults with a mean age of 69.76 years (range: 61-79 yr). All participants hearing sensitivity was normal with no history of balance problems. VEMP was recorded for all subjects using tone burst 500 Hz stimuli at the threshold level and 95 dB nHL intensity level through air-conduction stimulation via an insert receiver.

          Results: There was a significant difference in the cVEMP response threshold (p< 0.001), P1 wave latency (p<0.001), P1/N1 amplitude (p< 0.001), and asymmetry ratio of P1/N1 amplitude (p< 0.05) between the two groups. No significant difference was found between the left and right ears or in N1 wave latency between the two groups.

          Conclusion: VEMP abnormalities observed in healthy older adults showed the sensitivity of this test in identifying early signs of vestibular dysfunction. VEMP is an easy-to-use test that requires a short time to be performed. Therefore, it can be used as a selective objective screening test to detect vestibular disorders

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          Vestibular evoked myogenic potentials: past, present and future.

          S.M. Rosengren, M.S. Welgampola, J.G. Colebatch (2010)
          Since the first description of sound-evoked short-latency myogenic reflexes recorded from neck muscles, vestibular evoked myogenic potentials (VEMPs) have become an important part of the neuro-otological test battery. VEMPs provide a means of assessing otolith function: stimulation of the vestibular system with air-conducted sound activates predominantly saccular afferents, while bone-conducted vibration activates a combination of saccular and utricular afferents. The conventional method for recording the VEMP involves measuring electromyographic (EMG) activity from surface electrodes placed over the tonically-activated sternocleidomastoid (SCM) muscles. The "cervical VEMP" (cVEMP) is thus a manifestation of the vestibulo-collic reflex. However, recent research has shown that VEMPs can also be recorded from the extraocular muscles using surface electrodes placed near the eyes. These "ocular VEMPs" (oVEMPs) are a manifestation of the vestibulo-ocular reflex. Here we describe the historical development and neurophysiological properties of the cVEMP and oVEMP and provide recommendations for recording both reflexes. While the cVEMP has documented diagnostic utility in many disorders affecting vestibular function, relatively little is known as yet about the clinical value of the oVEMP. We therefore outline the known cVEMP and oVEMP characteristics in common central and peripheral disorders encountered in neuro-otology clinics. Copyright 2009 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.
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            Decreasing hair cell counts in aging humans.

            STEVEN RAUCH, LUIS VELAZQUEZ-VILLASEÑOR, PAUL DIMITRI … (2001)
            Deterioration of balance with advancing age is a well-known fact of life. Some investigators have reported a 50% prevalence of dizziness in the elderly. Clinically, progressive dysequilibrium of aging presents as gradually worsening balance due to age-related decline in function of the peripheral vestibular system, central nervous system, vision, and musculoskeletal system. Vestibular function testing has shown clear evidence of age-related changes in peripheral and central sites. Histopathologic changes in the vestibular sensory organs include progressive hair cell degeneration, otoconial degeneration in the otolith organs, and decreasing number of Scarpa's ganglion neurons. Recently, a new quantitative method of assessing vestibular otopathology has been described, utilizing Nomarski differential interference contrast microscopy. This technique has been applied to 67 human temporal bones of individuals from birth to age 100 to create a normative database of total, type I, and type II hair cell counts as a function of age. Results show a highly significant continuous decrease in all counts from birth to age 100, best fit by a linear regression model. Type I hair cell counts in all three semicircular canal cristae decrease at a similar rate, significantly faster than the degeneration observed in type I hair cells of the maculae. Type II hair cell counts decline at the same rate for all 5 sensory epithelia. These normative data provide the basis for comparisons to hair cell counts made in temporal bones from subjects with known vestibular disorders. They also provide a basis for drawing correlations between vestibular function testing and vestibular otopathology.
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              Test-retest reliability and age-related characteristics of the ocular and cervical vestibular evoked myogenic potential tests.

              Miriam S. Welgampola, Jason P Carey, Uyen-Sa D. T. Nguyen (2010)
              To determine the test-retest reliability and age-related trends of the cervical and ocular vestibular evoked myogenic potential (cVEMP and oVEMP, respectively) responses to air-conducted sound and bone-conducted vibration stimulation. Prospective study. Tertiary referral center. Fifty-three healthy adults with no hearing or vestibular deficits. All subjects underwent cVEMP and oVEMP testing in response to sounds (0.1-ms clicks and 500-Hz tone bursts) and vibration (midline forehead taps at the hairline, Fz, with a reflex hammer and a Brüel & Kjaer Mini-Shaker Type 4810). Twelve subjects underwent an additional testing session that was conducted at a mean of 10 weeks after the first one. Test-retest reliability for VEMP response parameters (latency, peak-to-peak amplitude, and asymmetry ratio) were assessed using the intraclass correlation coefficient (ICC). : oVEMP amplitudes had excellent test-retest reliability (ICC > 0.75) for all 4 stimuli; cVEMP amplitudes had excellent reliability for hammer taps and fair-to-good reliability for other stimuli. oVEMP asymmetry ratios had excellent reliability for clicks and fair-to-good reliability (ICC = 0.4-0.75) for other stimuli; cVEMP asymmetry ratios had fair-to-good reliability for clicks and hammer taps. Older subjects (>50 years old) were found to have significantly decreased cVEMP amplitudes in response to clicks, tones, and taps with a Mini-Shaker and significantly decreased oVEMP amplitudes in response to clicks, tones, and taps with a reflex hammer. No age-related changes were found for latencies or asymmetry ratios. Overall, oVEMP response parameters demonstrated better test-retest reliability than cVEMP response parameters, but oVEMPs and cVEMPs had similar age-related changes.
              Article 0 comments Cited 41 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (nlm-ta): Med J Islam Repub Iran
                Journal ID (iso-abbrev): Med J Islam Repub Iran
                Journal ID (publisher-id): MJIRI
                Journal ID (publisher-id): Med J Islam Repub Iran
                Title: Medical Journal of the Islamic Republic of Iran
                Publisher: Iran University of Medical Sciences
                ISSN (Print): 1016-1430
                ISSN (Electronic): 2251-6840
                Publication date Collection: 2014
                Publication date (Electronic): 22 October 2014
                Volume: 28
                Page: 117
                Affiliations
                1. Audiologist, MS, Department of Audiology, School of Rehabilitation Sciences, Shahid Besheshti University of Medical Sciences, Iran. mehri.maleki.a@ 123456gmail.com
                2. Associate Professor, Department of Basic Sciences in Rehabilitation, Rehabilitation Research Center, School of Rehabilitation Sciences, Tehran University of Medical Sciences, Tehran, Iran. jafari.z@ 123456iums.ac.ir
                3. Audiologist, MS, Department of Audiology, School of Rehabilitation Sciences, Shahid Besheshti University of Medical Sciences, Iran. homa_zarrinkoob@ 123456yahoo.com
                4. Associate Professor, Department of Basic Sciences in Rehabilitation, School of Rehabilitation Sciences, Shahid Besheshti University of Medical Sciences, Iran. akbarzad@ 123456sbmu.ac.ir
                Author notes
                (Corresponding author) Associate Professor, Department of Basic Sciences in Rehabilitation, Rehabilitation Research Center, School of Rehabilitation Sciences, Tehran University of Medical Sciences, Tehran, Iran. jafari.z@ 123456iums.ac.ir
                Article
                PMC ID: 4313442
                PubMed ID: 25678996
                SO-VID: 0034f48f-f2ba-4500-900e-96b461850bb6
                Copyright © © 2014 Iran University of Medical Sciences
                License:

                This is an open-access article distributed under the terms of the Creative Commons Attribution NonCommercial 3.0 License (CC BY-NC 3.0), which allows users to read, copy, distribute and make derivative works for non-commercial purposes from the material, as long as the author of the original work is cited properly.

                History
                Date received : 04 October 2013
                Date accepted : 26 April 2014
                Page count
                Figures: 1, Tables: 1, References: 38, Pages: 7
                Categories
                Subject: Original Article

                Keywords: saccular function,vestibular evoked myogenic potentials,aging
                Data availability:
                Keywords: saccular function, vestibular evoked myogenic potentials, aging

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