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DOI: 10.1055/s-0042-1747910
Effects of Age and Middle Ear on the Frequency Tuning of the cVEMP and oVEMP
Funding Student investigator research grant in hearing and American Academy of Audiology Foundation.![](https://www.thieme-connect.de/media/10.1055-s-00046128/202205/lookinside/thumbnails/10-1055-s-0042-1747910_21112-1.jpg)
Abstract
Background Upward shift in the air conducted (AC) frequency tuning of vestibular evoked myogenic potentials (VEMPs) as an effect of aging is hypothesized to be due to the microstructural stiffening changes in the inner ear. However, with an AC stimulus, it may be possible that the shift in the frequency tuning of VEMPs as an effect of aging may also be due to contributions from the middle ear.
Purpose The main aim of this study was to examine the effects of age on the frequency tuning of the cervical VEMP (cVEMP) and ocular VEMP (oVEMP) and determine the role of middle ear transmission characteristics in shaping these effects.
Research Design Standard group comparison.
Study Sample One-hundred seven participants divided in three groups: young adult, middle-age, and older adults with “normal” middle ear and negative history of neurological or vestibular complaints.
Data Collection and Analyses Middle ear measures included static admittance and middle ear resonant frequency. cVEMP and oVEMPs were elicited with AC tone bursts at 500, 750, and 1,000 Hz.
Results No significant effect of age was observed on any of the middle ear measures. There was a significant effect of age on the amplitude of the cVEMP, but this effect was frequency specific. The age-related reduction in cVEMP corrected amplitude was only observed when the eliciting stimulus was 500 or 750 Hz, with no significant effect observed with a 1,000 Hz stimulus. For the oVEMP, the effects of age were apparent at all stimulus frequencies. We also observed a general upward shift in the frequency tuning of both the cVEMP and oVEMP for middle-age and older adults, with 750 and 1,000 Hz yielding higher response rates and larger amplitudes among middle-aged and older adults. Measurements of middle ear did not significantly contribute to the observed findings.
Conclusions The upward shift in frequency tuning of VEMPs among middle age and older adults could be due to the changes in the vestibular system and not from the middle ear. These results support the use of different frequency stimuli (i.e., 750 or 1,000 Hz) to elicit a VEMP if a response is absent using a 500 Hz stimulus, especially in patients over the age of 40.
Disclaimer
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Publication History
Received: 16 November 2021
Accepted: 04 March 2022
Article published online:
07 November 2022
© 2022. American Academy of Audiology. This article is published by Thieme.
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References
- 1 Richter E. Quantitative study of human Scarpa's ganglion and vestibular sensory epithelia. Acta Otolaryngol 1980; 90 (3-4): 199-208
- 2 Velázquez-Villaseñor L, Merchant SN, Tsuji K, Glynn RJ, Wall III C, Rauch SD. Temporal bone studies of the human peripheral vestibular system. Normative Scarpa's ganglion cell data. Ann Otol Rhinol Laryngol Suppl 2000; 181: 14-19
- 3 Smith PF. Age-related neurochemical changes in the vestibular nuclei. Front Neurol 2016; 7 (MAR): 20
- 4 Yeo SS, Kwon JW, Cho IH. Associations between age-related changes in the core vestibular projection pathway and balance ability: a diffusion tensor imaging study. Behav Neurol 2020; 2020: 2825108
- 5 Colebatch JG, Halmagyi GM, Skuse NF. Myogenic potentials generated by a click-evoked vestibulocollic reflex. J Neurol Neurosurg Psychiatry 1994; 57 (02) 190-197
- 6 Todd NPMA, Rosengren SM, Aw ST, Colebatch JG. Ocular vestibular evoked myogenic potentials (OVEMPs) produced by air- and bone-conducted sound. Clin Neurophysiol 2007; 118 (02) 381-390
- 7 Chihara Y, Iwasaki S, Ushio M, Murofushi T. Vestibular-evoked extraocular potentials by air-conducted sound: another clinical test for vestibular function. Clin Neurophysiol 2007; 118 (12) 2745-2751
- 8 Welgampola MS, Colebatch JG. Vestibulocollic reflexes: normal values and the effect of age. Clin Neurophysiol 2001; 112 (11) 1971-1979
- 9 Ochi K, Ohashi T. Age-related changes in the vestibular-evoked myogenic potentials. Otolaryngol Head Neck Surg 2003; 129 (06) 655-659
- 10 Su HC, Huang TW, Young YH, Cheng PW. Aging effect on vestibular evoked myogenic potential. Otol Neurotol 2004; 25 (06) 977-980
- 11 Basta D, Todt I, Ernst A. Characterization of age-related changes in vestibular evoked myogenic potentials. J Vestib Res 2007; 17 (2-3): 93-98
- 12 Brantberg K, Granath K, Schart N. Age-related changes in vestibular evoked myogenic potentials. Audiol Neurotol 2007; 12 (04) 247-253
- 13 Nguyen KD, Welgampola MS, Carey JP. Test-retest reliability and age-related characteristics of the ocular and cervical vestibular evoked myogenic potential tests. Otol Neurotol 2010; 31 (05) 793-802
- 14 Singh NK, Firdose H. Characterizing the impact of advancing age on 500 Hz tone-burst evoked ocular-vestibular evoked myogenic potentials. Eur Arch Otorhinolaryngol 2021; 278 (11) 4259-4268
- 15 Singh NK, Firdose H. Characterizing the age and stimulus frequency interaction for ocular vestibular-Evoked myogenic potentials. Ear Hear 2018; 39 (02) 251-259
- 16 Piker EG, Jacobson GP, Burkard RF, McCaslin DL, Hood LJ. Effects of age on the tuning of the cVEMP and oVEMP. Ear Hear 2013; 34 (06) e65-e73
- 17 Papathanasiou ES, Murofushi T, Akin FW, Colebatch JG. International guidelines for the clinical application of cervical vestibular evoked myogenic potentials: an expert consensus report. Clin Neurophysiol 2014; 125 (04) 658-666
- 18 Rosengren SM, Colebatch JG, Young AS, Govender S, Welgampola MS. Vestibular evoked myogenic potentials in practice: methods, pitfalls and clinical applications. Clin Neurophysiol Pract 2019; 4: 47-68
- 19 Piker EG, Baloh RW, Witsell DL, Garrison DB, Lee WT. Assessment of the clinical utility of cervical and ocular vestibular evoked myogenic potential testing in elderly patients. Otol Neurotol 2015; 36 (07) 1238-1244
- 20 Todd NPM, Rosengren SM, Colebatch JG. A utricular origin of frequency tuning to low-frequency vibration in the human vestibular system?. Neurosci Lett 2009; 451 (03) 175-180
- 21 Colletti V. Multifrequency tympanometry. Audiology 1977; 16 (04) 278-287
- 22 Valvik BR, Johnsen M, Laukli E. Multifrequency tympanometry. Preliminary experiences with a commercially available middle-ear analyzer. Audiology 1994; 33 (05) 245-253
- 23 Williams C. Rout 2016. Wideband Acoustic Immittance and DPOAE Changes in Older Adults Mandy Marie Williams A dissertation submitted to the Graduate Faculty of JAMES MADISON UNIVERSITY In Partial Fulfillment of the Requirements for the degree of Doctor of Audiology Department of. 2016;(May).
- 24 Akin FW, Murnane OD, Proffitt TM. The effects of click and tone-burst stimulus parameters on the vestibular evoked myogenic potential (VEMP). J Am Acad Audiol 2003; 14 (09) 500-509 , quiz 534–535
- 25 van Tilburg MJ, Herrmann BS, Guinan Jr JJ, Rauch SD. Normalization reduces intersubject variability in cervical vestibular evoked myogenic potentials. Otol Neurotol 2014; 35 (08) e222-e227
- 26 Kanzaki S, Ito M, Takada Y, Ogawa K, Matsuo K. Resorption of auditory ossicles and hearing loss in mice lacking osteoprotegerin. Bone 2006; 39 (02) 414-419
- 27 Kumar P, Singh NK, Gargeshwari A, S R, Jha R. Changes in middle ear transmission characteristics secondary to altered bone remodelling. Osteoporos Int 2019; 30 (04) 863-870
- 28 Zhou L, Shen N, Feng M, Liu H, Duan M, Huang X. Study of age-related changes in Middle ear transfer function. Comput Methods Biomech Biomed Engin 2019; 22 (13) 1093-1102 [Internet]
- 29 Blood IM, Greenberg HJ. Low level acoustic reflex thresholds. J Acoust Soc Am 1979; 65 (S1): S10-S11
- 30 Wiley TL, Cruickshanks KJ, Nondahl DM, Tweed TS, Klein R, Klein BE. Tympanometric measures in older adults. J Am Acad Audiol 1996; 7 (04) 260-268
- 31 Feeney MP, Sanford CA. Age effects in the human middle ear: wideband acoustical measures. J Acoust Soc Am 2004; 116 (06) 3546-3558
- 32 Wiley TL, Cruickshanks KJ, Nondahl DM, Tweed TS. Aging and middle ear resonance. J Am Acad Audiol 1999; 10 (04) 173-179
- 33 Uchida Y, Nomura H, Itoh A. et al. The effects of age on hearing and middle ear function. J Epidemiol 2000; 10 (1, Suppl): S26-S32
- 34 Torre III P, Lasky RE, Fowler CG. Aging and middle ear function in rhesus monkeys (Macaca mulatta). Audiology 2000; 39 (06) 300-304
- 35 Rosengren SM, Govender S, Colebatch JG. Ocular and cervical vestibular evoked myogenic potentials produced by air- and bone-conducted stimuli: comparative properties and effects of age. Clin Neurophysiol 2011; 122 (11) 2282-2289
- 36 Singh NK, Kashyap RS, Supreetha L, Sahana V. Characterization of age-related changes in sacculocolic response parameters assessed by cervical vestibular evoked myogenic potentials. Eur Arch Otorhinolaryngol 2014; 271 (07) 1869-1877
- 37 Li C, Layman AJ, Carey JP, Agrawal Y. Epidemiology of vestibular evoked myogenic potentials: data from the Baltimore Longitudinal Study of Aging. Clin Neurophysiol 2015; 126 (11) 2207-2215
- 38 Singh NK, Firdose H, Barman A. Effect of advancing age on inter-frequency amplitude ratio of ocular vestibular evoked myogenic potentials. Int J Audiol 2021; 60 (12) 995-999
- 39 Taylor RL, Bradshaw AP, Halmagyi GM, Welgampola MS. Tuning characteristics of ocular and cervical vestibular evoked myogenic potentials in intact and dehiscent ears. Audiol Neurotol 2012; 17 (04) 207-218
- 40 Singh NK, Barman A. Characterizing the frequency tuning properties of air-conduction ocular vestibular evoked myogenic potentials in healthy individuals. Int J Audiol 2013; 52 (12) 849-854
- 41 Todd NPMA, Cody FWJ, Banks JR. A saccular origin of frequency tuning in myogenic vestibular evoked potentials?: implications for human responses to loud sounds. Hear Res 2000; 141 (1-2): 180-188
- 42 Johnsson LG, Hawkins Jr JE. Vascular changes in the human inner ear associated with aging. Ann Otol Rhinol Laryngol 1972; 81 (03) 364-376
- 43 Jang YS, Hwang CH, Shin JY, Bae WY, Kim LS. Age-related changes on the morphology of the otoconia. Laryngoscope 2006; 116 (06) 996-1001
- 44 Walther LE, Westhofen M. Presbyvertigo-aging of otoconia and vestibular sensory cells. J Vestib Res 2007; 17 (2-3): 89-92
- 45 Rauch SD, Zhou G, Kujawa SG, Guinan JJ, Herrmann BS. Vestibular evoked myogenic potentials show altered tuning in patients with Ménière's disease. Otol Neurotol 2004; 25 (03) 333-338
- 46 Node M, Seo T, Miyamoto A, Adachi A, Hashimoto M, Sakagami M. Frequency dynamics shift of vestibular evoked myogenic potentials in patients with endolymphatic hydrops. Otol Neurotol 2005; 26 (06) 1208-1213
- 47 Kim-Lee Y, Ahn JH, Kim YK, Yoon TH. Tone burst vestibular evoked myogenic potentials: diagnostic criteria in patients with Ménière's disease. Acta Otolaryngol 2009; 129 (09) 924-928
- 48 Sandhu JS, Low R, Rea PA, Saunders NC. Altered frequency dynamics of cervical and ocular vestibular evoked myogenic potentials in patients with Ménière's disease. Otol Neurotol 2012; 33 (03) 444-449
- 49 Salviz M, Yuce T, Acar H, Taylan I, Yuceant GA, Karatas A. Diagnostic value of vestibular-evoked myogenic potentials in Ménière's disease and vestibular migraine. J Vestib Res 2016; 25 (5-6): 261-266
- 50 Maxwell R, Jerin C, Gürkov R. Utilisation of multi-frequency VEMPs improves diagnostic accuracy for Meniere's disease. Eur Arch Otorhinolaryngol 2017; 274 (01) 85-93
- 51 Singh NK, Barman A. Utility of the frequency tuning measure of oVEMP in differentiating Meniere's disease from BPPV. J Am Acad Audiol 2016; 27 (09) 764-777
- 52 Manzari L, Burgess AM, McGarvie LA, Curthoys IS. An indicator of probable semicircular canal dehiscence: ocular vestibular evoked myogenic potentials to high frequencies. Otolaryngol Head Neck Surg 2013; 149 (01) 142-145
- 53 Noij KS, Rauch SD. Vestibular evoked myogenic potential (VEMP) testing for diagnosis of superior semicircular canal dehiscence. Front Neurol 2020; 11 (July): 695
- 54 Curthoys IS, Manzari L. A simple specific functional test for SCD: VEMPs to high frequency (4,000Hz) stimuli-their origin and explanation. Front Neurol 2020; 11 (November): 612075