CC BY-NC-ND 4.0 · Semin Hear 2024; 45(01): 110-122
DOI: 10.1055/s-0043-1770137
Review Article

Age-Related Changes in Temporal Binding Involving Auditory and Vestibular Inputs

Alexander K. Malone
1   ENT and Allergy Associates of Florida, Boca Raton, Florida
Michelle E. Hungerford
2   VA RR&D National Center for Rehabilitative Auditory Research, VA Portland Health Care System, Portland, Oregon
3   Department of Otolaryngology—Head and Neck Surgery, Oregon Health and Science University, Portland, Oregon
Spencer B. Smith
4   Department of Speech, Language, and Hearing Sciences, University of Texas, Austin, Texas
Nai-Yuan N. Chang
5   Department of Oral and Maxillofacial Surgery, Oregon Health and Science University, Portland, Oregon
Rosalie M. Uchanski
6   Department of Otolaryngology - Head and Neck Surgery, Washington University in St. Louis, St. Louis, Missouri
Yong-Hee Oh
7   University of Louisville, Louisville, Kentucky
Richard F. Lewis
8   Departments of Otolaryngology and Neurology, Harvard Medical School, Boston, Massachusetts
Timothy E. Hullar
2   VA RR&D National Center for Rehabilitative Auditory Research, VA Portland Health Care System, Portland, Oregon
3   Department of Otolaryngology—Head and Neck Surgery, Oregon Health and Science University, Portland, Oregon
› Author Affiliations
FUNDING/ACKNOWLEDGMENTS This work was supported by NIH R01DC017425 and VA RR&D I50RX002361 (M.E.H., T.E.H.); the Doris Duke Charitable Foundation (A.K.M.); VA RR&D C9230C (M.E.H., T.E.H.), and NIH T35DC008765 (S.B.S.). This material is the result of work supported with resources and the use of facilities at the VA Rehabilitation Research and Development (RR&D) National Center for Rehabilitative Auditory Research (NCRAR) (Center Award #C2361C/I50 RX002361) at the VA Portland Health Care System in Portland, Oregon.


Maintaining balance involves the combination of sensory signals from the visual, vestibular, proprioceptive, and auditory systems. However, physical and biological constraints ensure that these signals are perceived slightly asynchronously. The brain only recognizes them as simultaneous when they occur within a period of time called the temporal binding window (TBW). Aging can prolong the TBW, leading to temporal uncertainty during multisensory integration. This effect might contribute to imbalance in the elderly but has not been examined with respect to vestibular inputs. Here, we compared the vestibular-related TBW in 13 younger and 12 older subjects undergoing 0.5 Hz sinusoidal rotations about the earth-vertical axis. An alternating dichotic auditory stimulus was presented at the same frequency but with the phase varied to determine the temporal range over which the two stimuli were perceived as simultaneous at least 75% of the time, defined as the TBW. The mean TBW among younger subjects was 286 ms (SEM ± 56 ms) and among older subjects was 560 ms (SEM ± 52 ms). TBW was related to vestibular sensitivity among younger but not older subjects, suggesting that a prolonged TBW could be a mechanism for imbalance in the elderly person independent of changes in peripheral vestibular function.

Publication History

Article published online:
22 June 2023

© 2023. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (

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