European Archives of Oto-Rhino-Laryngology

, Volume 271, Issue 7, pp 1869–1877 | Cite as

Characterization of age-related changes in sacculocolic response parameters assessed by cervical vestibular evoked myogenic potentials

  • Niraj Kumar Singh
  • Ranjitha S. Kashyap
  • L. Supreetha
  • V. Sahana


Age-related changes have been documented in anatomical studies on peripheral as well as central vestibular systems. Similar changes have also been observed for saccular responses evaluated through Cervical vestibular evoked myogenic potential (cVEMP) after the age of 60 years. Nevertheless, most of these studies have either made use of small sample sizes, considered inappropriate for normative studies of such kind, or incorporated wider age groups which might have confounded the conclusions. In order to overcome the above shortcomings, the present study aimed at evaluating the effect of age on cVEMP using larger sample size and distributing the participants to smaller age group divisions. A cross-sectional design was employed to record cVEMPs from 280 healthy volunteers in the age range of 10–85 years who were distributed to seven age groups (10–20, 20–30, 30–40, 40–50, 50–60, 60–70 and above 70 years). The latency, amplitude, inter-aural asymmetry ratio, and threshold were compared using one-way analysis of variance, whereas the response rate was calculated in terms of percentage of ears in which the responses were identifiable. The results revealed a steady decline in response rate and amplitude with advancing age beyond 5th decade (50–60 years). In addition, the latency of P13 and N23 was prolonged, while the thresholds worsened with increasing age also after 50 years. Hence, age-matched norms have to be considered while interpreting the results of cVEMP, especially in individuals above 50 years of age.


Aging cVEMP Saccule Sternocleidomastoid muscle Tone-burst Sacculocolic pathway 


Conflict of interest

The authors declare that they have no conflicts of interest.


  1. 1.
    Honrubia V, Hoffman LF (1997) Handbook of balance function testing. Singuar Publishing Group, San DiegoGoogle Scholar
  2. 2.
    Desmond AL (2011) Vestibular function: clinical and practical management, 2nd edn. Thieme Medical Publishers, New YorkGoogle Scholar
  3. 3.
    Andrade IV, Santos-Perez S, Diz PG, Caballero TL, Soto-Varela A (2012) A Correlation between bithermal caloric test results and vestibular evoked myogenic potentials (VEMPs) in normal subjects. Eur Arch Otorhinolaryngol. doi: 10.1007/s00405-012-2167-4 Google Scholar
  4. 4.
    Helling K, Schonfeld U, Clarke AH (2007) Treatment of Meniere’s disease by low-dosage intratympanic gentamicin application: effect on otolith function. Laryngoscope 117(12):2244–2250PubMedCrossRefGoogle Scholar
  5. 5.
    Beynon GJ, Jani P, Baguley DM (1998) A clinical evaluation of head impulse testing. Clin Otolaryngol Allied Sci 23(2):117–122PubMedCrossRefGoogle Scholar
  6. 6.
    Halmagyi GM, Matthew J, Todd MJ (2005) The active head impulse test in unilateral peripheral vestibulopathy. Arch Neurol 62(2):290–293PubMedCrossRefGoogle Scholar
  7. 7.
    Nguyen KD, Minor LB, Della Santina CC, Carey JP (2009) Vestibular function and vertigo control after intratympanic gentamicin for Meniere’s disease. Audiol Neurotol 14(6):361–372CrossRefGoogle Scholar
  8. 8.
    KoizukaI I, Yamakawa J, Naramura H, Kubo T (1995) Time course of vestibular function in patients with Meniere’s disease following vestibular nerve section. Acta Otolaryngol 115(s519):234–237CrossRefGoogle Scholar
  9. 9.
    Clarke AH (2001) Perspectives for the comprehensive examination of semicircular canal and otolith function. Biol Sci Space 15(4):393–400PubMedCrossRefGoogle Scholar
  10. 10.
    Halmagayi GM, Colebatch JG (1995) Vestibular evoked myogenic potential in the sternomastoid muscle are not of lateral canal origin. Acta Otolaryngol 115:1–3CrossRefGoogle Scholar
  11. 11.
    Welgampola MS, Colebatch JG (2005) Characteristics and clinical applications of vestibular-evoked myogenic potentials. Neurology 64:1682–1688PubMedCrossRefGoogle Scholar
  12. 12.
    Murufoshi T, Shimizu K, Takegoshi H, Cheng PW (2001) Diagnostic value of prolonged latencies in the vestibular evoked myogenic potential. Otolaryngol Head Neck Surg 127(9):1069–1072CrossRefGoogle Scholar
  13. 13.
    Honaker JA, Samy RN (2007) Vestibular evoked myogenic potentials. Curr Opin Otolaryngol Head Neck Surg 15(5):330–334PubMedCrossRefGoogle Scholar
  14. 14.
    Baier B, Stieber N, Dieterich M (2009) Vestibular evoked myogenic potentials in Vestibular migrane. J Neurol 256(9):1447–1454PubMedCrossRefGoogle Scholar
  15. 15.
    Stoody TM, Inverso Y (2012) Development of vestibular evoked myogenic potentials. In: Atcherson SR, Stoody TM (eds) Auditory electrophysiology: a clinical guide. Thieme Medical Publishers, New YorkGoogle Scholar
  16. 16.
    Merchant SN, Velazquez-Villasenor L, Tsuji K, Glynn RJ, Wall C, Rauch SD (2000) Temporal bone studies of the human peripheral vestibular system: normative vestibular hair cell data. Ann Otol Rhinol Laryngol Suppl 181:3–13PubMedGoogle Scholar
  17. 17.
    Velazquez-Villasenor L, Merchant SN, Tsuji K, Glynn RJ, Wall C, Rauch SD (2000) Temporal bone studies of the human peripheral vestibular system: normative scarpa’s ganglion cell data. Ann Otol Rhinol Laryngol Suppl 181:14–19PubMedGoogle Scholar
  18. 18.
    Tang Y, Lopez I, Baloh RW (2001–2002) Age-related change of the neuronal number in the human medial vestibular nucleus: a stereological investigation. J Vestib Res 11: 357-363Google Scholar
  19. 19.
    Su HC, Huang TW, Young YH, Cheng PW (2004) Aging effect on vestibular evoked myogenic potential. Otol Neurotol 25:977–980PubMedCrossRefGoogle Scholar
  20. 20.
    Brantberg K, Granath K, Schart N (2007) Age related changes in vestibular evoked myogenic potential. Audiol Neurotol 12(4):247–253CrossRefGoogle Scholar
  21. 21.
    Janky K, Shepard N (2009) Vestibular evoked myogenic potential (VEMP) testing: normative threshold response curves and effects of age. J Am Acad Audiol 20(8):514–522PubMedCentralPubMedCrossRefGoogle Scholar
  22. 22.
    Kumar K, Bhat JS, Sinha SK (2010) Effect of aging on Vestibular evoked myogenic potential. J Indian Speech Hear Assoc 24:25–28Google Scholar
  23. 23.
    Menzel J (1960) Clinical efficiency in compensation audiometry. J Speech Hear Disord 25:49–54Google Scholar
  24. 24.
    Colebatch JG, Halmagyi GM, Skuse NF (1994) Myogenic potentials generated by a click-evoked vestibulocollic reflex. J Neurol Neurosurg Psychiatry 57:190–197PubMedCentralPubMedCrossRefGoogle Scholar
  25. 25.
    Sazgar AA, Akrami K, Akrami S, Yazdi AR (2006) Recording of vestibular evoked myogenic potentials. Acta Medica Iranica 44(1):13–16Google Scholar
  26. 26.
    Castelein S, Deggouj N, Wuyts F, Gersdorff M (2008) Vestibular evoked myogenic potentials. B-ENT Suppl 4:39–43Google Scholar
  27. 27.
    Engstrom H, Bergstom B, Rosenahll U (1974) Vestibular sensory epithelia. Arch Otolaryngol 100(6):411–418PubMedCrossRefGoogle Scholar
  28. 28.
    Rosenhall U (1973) Degenerative patterns in the aging human vestibular neuro-epithelia. Acta Otolaryngol 76:208–220PubMedCrossRefGoogle Scholar
  29. 29.
    Rosenhall U (1974) Epithelial cysts in the human vestibular apparatus. J Laryngol Otol 88:105–112PubMedCrossRefGoogle Scholar
  30. 30.
    Rosenhall U, Rubin W (1975) Degenerative changes in the human vestibular sensory epithelia. Acta Otolaryngol 79:67–80PubMedCrossRefGoogle Scholar
  31. 31.
    Johnsson LG, Hawkins JE (1972) Sensory and Neural degeneration with aging as seen in microdissection of the human inner ear. Ann Otol Rhinol Laryngol 81(2):179–193PubMedGoogle Scholar
  32. 32.
    Bergstrom B (1973) Morphology of the vestibular nerve I: anatomical studies of the vestibular nerve in man. Acta Otolaryngol 76:162–172PubMedCrossRefGoogle Scholar
  33. 33.
    Bergstrom B (1973) Morphology of the vestibular nerve II: the number of myelinated vestibular nerve fibres in man at various ages. Acta Otolaryngol 76:173–179PubMedCrossRefGoogle Scholar
  34. 34.
    Richter E (1980) Quantitative study of human Scarpa’s ganglion & vestibular sensory epithelia. Acta Otolaryngol 90(2):199–208PubMedCrossRefGoogle Scholar
  35. 35.
    Lopez I, Honrubia V, Baloh RW (1997) Aging & the human vestibular nucleus. J Vestib Res 7(1):77–85PubMedCrossRefGoogle Scholar
  36. 36.
    Alvarez JC, Diaz C, Suarez C, Fernandez JA, Delrey CG, Navarro A et al (1998) Neuronal loss in human medial vestibular nucleus. Anat Rec 251(4):431–438PubMedCrossRefGoogle Scholar
  37. 37.
    Akin FW, Murnane OD, Tampas JW, Clinard CG (2011) The effect of age on the vestibular evoked myogenic potential and sternocleidomastoid muscle tonic electromyogram level. Ear Hear 32(5):617–622PubMedCrossRefGoogle Scholar
  38. 38.
    McCaslin DL, Jacobson GP, Hatton K, Fowler AP, DeLong AP (2013) The effects of amplitude normalization and EMG targets on cVEMP interaural amplitude asymmetry. Ear Hear: doi:  10.1097/AUD.0b013e31827ad792
  39. 39.
    Singh NK, Anoop BJ (2010–2011) Test retest reliability of vestibular evoked myogenic potentials parameters. Student Research at A.I.I.S.H. Mysore (Articles Based on Dissertation Done at AIISH, vol IX:51–60)Google Scholar
  40. 40.
    Ochi K, Ohashi T (2003) Age-related changes in the vestibular evoked myogenic potentials. Otolaryngol Head Neck Sur 129:655–659CrossRefGoogle Scholar
  41. 41.
    Furman JM, Redfern MS (2001) Effect of aging on the otolith-ocular reflex. J Vestib Res 11:91–103PubMedGoogle Scholar
  42. 42.
    Chu NS (1985) Age-related latency changes in the brain-stem auditory evoked potentials. Electroencephalogr Clin Neurophysiol 62:431–436PubMedCrossRefGoogle Scholar
  43. 43.
    Kumar AU, Sangamanatha AV (2011) Temporal processing abilities across different age groups. J Am Acad Audiol 22:5–12PubMedCrossRefGoogle Scholar
  44. 44.
    Konard-Martin D, Dille MF, McMillan G, Griest S, McDermott D, Fausti SA et al (2012) Age-related changes in the auditory brainstem response. J Am Acad Audiol 23:18–35Google Scholar
  45. 45.
    Welgampola MS, Colebatch JG (2001) Vestibulocollic reflexes: normative values and the effect of age. Clin Neurophysiol 112(11):1971–1979PubMedCrossRefGoogle Scholar
  46. 46.
    Davis AC (1990) Epidemiological profile of hearing impairments: the scale and nature of the problem with special reference to the elderly. Acta Otolaryngol Suppl 476:23–31PubMedGoogle Scholar
  47. 47.
    Nash SD, Cruickshanks KJ, Klein R, Klein BE, Nieto FJ, Huang GH et al (2011) The prevalence of hearing impairment and associated risk factors: the Beaver Dam Offspring Study. Arch Otolaryngol Head Neck Surg 137:432–439PubMedCentralPubMedCrossRefGoogle Scholar
  48. 48.
    Mulch G, Petermenn W (1979) Influence of age on results of vestibular function tests. Ann Otol Rhinol Laryngol Suppl 88:1–17PubMedGoogle Scholar
  49. 49.
    Peterka RJ, Black FO, Schoenhoff MB (1990) Age-related changes in human vestibule-ocular reflexes: sinusoidal rotation and caloric tests. J Vestib Res 1:49–59PubMedGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • Niraj Kumar Singh
    • 1
  • Ranjitha S. Kashyap
    • 1
  • L. Supreetha
    • 1
  • V. Sahana
    • 1
  1. 1.All India Institute of Speech and HearingMysoreIndia

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