Decline in Semicircular Canal and Otolith Function With Age
To characterize the physiologic nature of the vestibular dysfunction that occurs with the normative aging process.
Tertiary care academic medical center.
Fifty individuals age 70 years and above.
Head thrust dynamic visual acuity testing and cervical and ocular vestibular-evoked myogenic potential (VEMP) testing.
Semicircular canal function measured by head thrust dynamic visual acuity testing in each of the 3 semicircular canal planes, and saccular and utricular function measured by cervical VEMP and ocular VEMP testing, respectively.
We observed significant declines in semicircular canal function in each of the canal planes as well as otolith function associated with aging. We found that individuals with impaired horizontal and superior semicircular canal function also were likely to have concomitant deficits in utricular but not saccular function. Overall, we noted that the prevalence of semicircular canal dysfunction was highest followed by saccular then utricular impairment, although we did observe individuals with isolated otolith deficits.
These data suggest an overall decline in semicircular canal as well as otolith function associated with aging, although the magnitude of impairment was greater for the semicircular canals than the otoliths in this elderly population. A better understanding of the specific vestibular deficits that occur with aging can inform the development of rational screening, vestibular rehabilitation, and fall risk reduction strategies in older individuals.
Available from: Guo-She Lee
- "The function of VVOR declined 10 years earlier than VOR. The VVOR evaluated by dynamic visual acuity and Gaze Stabilization test also showed a significant decline in participants older than 60.25,26 The results may imply that the vision system helps maintain balance and degenerates earlier than the vestibular system. "
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Imbalance from degeneration of vestibular end organs is a common problem in the elderly. However, the decline of vestibular function with aging was revealed in few vestibular function tests such as vestibular autorotation test (VAT). In the current VAT, there are drawbacks of poor test–retest reliability, slippage of the sensor at high-speed rotations, and limited data about the effect of aging. We developed a correlational-VAT (cVAT) system that included a small, light sensor (less than 20 g) with wireless data transmission technique to evaluate the aging of vestibular function.
Material and methods
We enrolled 53 healthy participants aged between 25 and 75 years and divided them into five age groups. The test conditions were vertical and horizontal head autorotations of frequencies from 0 to 3 Hz with closed eyes or open eyes. The cross-correlation coefficient (CCC) between eye velocity and head velocity was obtained for the head autorotations between 1 Hz and 3 Hz. The mean of the CCCs was used to represent the vestibular function.
Age was significantly and negatively correlated with the mean CCC for all test conditions, including horizontal or vertical autorotations with open eyes or closed eyes (P<0.05). The mean CCC with open eyes declined significantly at 55–65 years old and the mean CCC with closed eyes declined significantly at 65–75 years old.
Vestibular function evaluated using mean CCC revealed a decline with age, and the function of visual-vestibulo-ocular reflex declined 10 years earlier than the function of vestibulo-ocular reflex.
Clinical Interventions in Aging 09/2014; 9:1463-9. DOI:10.2147/CIA.S67720 · 2.08 Impact Factor
Available from: Robert Gurkov
- "Overall, decreased responses in BCV oVEMP testing occur less frequently than in ACS cVEMP and head thrust dynamic acuity testing, indicating that the prevalence of semicircular canal dysfunction in elderly subjects is highest, followed by saccular then utricular impairment (Agrawal et al., 2012). The loss of hair cells in the utricular macula as well as degeneration of vestibular afferent neurons may result in decreased prevalence rates and amplitudes. "
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ABSTRACT: Recently, ocular vestibular evoked myogenic potentials (oVEMPs) have been described and added to the neuro-otologic test battery as a new measure for the vestibulo-ocular reflex. oVEMPs represent extraocular muscle activity in response to otolith stimulation e.g. by air-conducted sound or bone conducted vibration. In response to vestibular stimulation, electromyographic activity of the extraocular muscles can be recorded by means of surface electrodes placed beneath the contralateral eye. oVEMPs are likely to reflect predominantly utricular function, while the widely established cervical vestibular evoked myogenic potentials (cVEMPs) assess saccular function. Thus, measuring oVEMPs and cVEMPs in addition to caloric and head impulse testing provides further evaluation of the vestibular system and enables quick and cost-effective assessment of otolith function. This review summarizes the neurophysiological properties of oVEMPs, gives recommendations for recording conditions and discusses oVEMP alterations in various disorders of the vestibular system. With increasing insight into oVEMP characteristics in vestibular disorders, e.g. Menière's disease and superior semicircular canal dehiscence syndrome, oVEMPs are becoming a promising new diagnostic tool for evaluating utricular function.
Hearing research 10/2012; 294(1-2). DOI:10.1016/j.heares.2012.10.008 · 2.97 Impact Factor
Available from: Leif Erik Walther
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ABSTRACT: Schwindel ist ein häufiges Symptom in der täglichen klinischen Praxis. Störungen des Gleichgewichts beeinträchtigen die Lebensqualität im Alltag und im Beruf. Sie gehen mit der Gefahr von Stürzen einher, führen zur Einschränkung der Fähigkeit zur selbstständigen Fortbewegung und damit auch zu einer Reduktion sozialer Kontakte. Die Ursachen für Störungen mit „Schwindel“ sind im Bereich visueller, somatosensorischer und vestibulärer Sinneseingänge lokalisiert. Der HNO-Arzt ist im interdisziplinären Kontext mit der Aufklärung und Behandlung innenohrbedingter vestibulärer Störungen befasst. Die subjektiv geprägte Symptomatik bei Schwindel kann nur durch eine sorgfältige Anamnese aufgeklärt werden. Mithilfe objektiver Analysen (Ableitung zervikaler vestibulär evozierter myogener Potenziale, okulärer vestibulär evozierter myogener Potenziale, Video-Kopfimpulstest) ist der HNO-Arzt heute in der Lage, die Funktion der 5 Gleichgewichtsrezeptoren selektiv zu analysieren. Damit ist eine topologische Zuordnung bei peripheren Vestibulopathien möglich. Die exakte Diagnostik ist die Voraussetzung für eine spezifische Therapie. Viele Erkrankungen können heute evidenzbasiert, sicher und effektiv behandelt werden.
Der Ophthalmologe 01/2013; 110(1). DOI:10.1007/s00347-012-2575-2 · 0.50 Impact Factor
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