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Effect of age on ocular vestibular-evoked myogenic potentials using air-conducted sound




Diagnostic testing of the vestibular system is an essential component for the correct treatment and rehabilitation of patients with balance dysfunction. Stimulus-related electromyogenic changes can be recorded from the extraocular muscles and is termed ocular vestibular-evoked myogenic potential (oVEMP). These changes are a reflection of the otolith organ functionality. The purpose of this study was to investigate the effect of age on the amplitude, threshold, and latency of the oVEMP, to establish age-appropriate norms that will help in the correct diagnosis of balance dysfunction accordingly

Participants and methods

This study was carried out in the Audiology Unit of Alexandria Petrol Hospital (Egypt). Participants with no medical history, normal hearing, and who were neurologically free participated in this study. The study was carried out on 50 ears (50 individuals) divided into five groups according to age: the first group from 10 to 25 years, the second group from 25 to 35 years, the third group from 35 to 45 years, the fourth group from 45 to 55 years, and the fifth group over 55 years of age. Each group contained 10 participants

Results and conclusion

The main outcome measures are amplitude, latency, and threshold of the oVEMP. In this study, oVEMP was present contralaterally in 88% of healthy participants (44 of 50 ears), and the percentage of the presence of oVEMP decreased with age stratification to 60% in the oldest age group (>55 years). When we examined the younger groups in this study, we found 100% response rate for participants under the age of 45 years, whereas the response rate was only 80% in the fourth group (age range, 45–55 years) and 60% in the fifth group (age > 55 years). In the current study, an age effect on oVEMP N1-P1 amplitude and threshold was observed. Significantly reduced amplitude and a significantly increased threshold were observed in the two oldest age groups (>45 years) compared with other age groups. However, oVEMP N1 latency was stable for all age groups less than 55 years but significantly increased in the oldest age group above 55 years. The well-documented neuroanatomic age-related changes that occur in the peripheral vestibular system may explain the commonly reported decrease in the response rate and a decrease in the amplitude with age. However, oVEMP N1 latency represents the function of the time required for the afferent limb of reflex, central transmission and the efferent limb of reflex, and muscle activation. Therefore, the age-dependent increase in N1 latency may occur as a result of degradation of central vestibular system processing, rather than as a result of diminished peripheral vestibular system function


  1. Colebatch J, Halmagyi G. Vestibular evoked potentials in human neck muscles before and after unilateral vestibular deafferentation. Neurology 1992; 42: 1635–1636.

    Article  CAS  Google Scholar 

  2. Colebatch J, Halmagyi G, Skuse, N. Myogenic potentials generated by a click-evoked vestibulocollic reflex. J Neurol Neurosurg Psychiatry 1994; 57: 190–197.

    Article  CAS  Google Scholar 

  3. Rosengren S, McAngus Todd N, Colebatch J. Vestibular-evoked extraocular potentials produced by stimulation with bone-conducted sound. Clin Neurophysiol 2005; 116: 1938–1948.

    Article  CAS  Google Scholar 

  4. Todd N, Rosengren S, Aw S, Colebatch J. Ocular vestibular evoked myogenic potentials (OVEMPs) produced by air- and bone-conducted sound. Clin Neurophysiol 2007; 118: 381–390.

    Article  Google Scholar 

  5. 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: 2745–2751.

    Article  Google Scholar 

  6. Govender S, Rosengren S, Colebatch J. The effect of gaze direction on the ocular vestibular evoked myogenic potential produced by air-conducted sound. Clin Neurophysiol 2009; 120: 1386–1391.

    Article  Google Scholar 

  7. Iwasaki S, Smulders YE, Burgess AM, McGarvie LA, MacDougall HG, Halmagyi GM, et al. Ocular vestibular evoked myogenic potentials in response to bone-conducted vibration of the midline forehead at fz: a new indicator of unilateral otolithic loss. Audiol Neurotol 2008; 13: 396–404.

    Article  CAS  Google Scholar 

  8. Wang S, Jaw F, Young Y. Ocular vestibular-evoked myogenic potentials elicited from monaural versus binaural acoustic stimulations. Clin Neurophysiol 2009; 120: 420–423.

    Article  Google Scholar 

  9. Chihara Y, Iwasaki S, Ushio M, Fujimoto C, Kashio A, Kondo K, et al. Ocular vestibular-evoked myogenic potentials (oVEMPs) require extraocular muscles but not facial or cochlear nerve activity. Clin Neurophysiol 2009; 120: 581–587.

    Article  Google Scholar 

  10. Welgampola M, Migliaccio A, Myrie O, Minor L, Carey J. The human sound-evoked vestibulo-ocular reflex and its electromyographic correlate. Clin Neurophysiol 2009; 120:158–166.

    Article  Google Scholar 

  11. Colebatch J, Rothwell J. Motor unit excitability changes mediating vestibulocollic reflexes in the sternocleidomastoid muscle. Clin Neurophysiol 2004; 115:2567–2573.

    Article  CAS  Google Scholar 

  12. Rosengren S, Welgampola M, Colebatch J. 2010; Vestibular evoked myogenic potentials: past, present and future. Clin Neurophysiol 121:636–651.

    Article  CAS  Google Scholar 

  13. Chou CH, Wang SJ, Young YH. Feasibility of the simultaneous ocular and cervical vestibular-evoked myogenic potentials in unilateral vestibular hypofunction. Clin Neurophysiol 2009; 120:1699–1705.

    Article  Google Scholar 

  14. Hsu YS, Wang SJ, Young YH. Ocular vestibular-evoked myogenic potentials in children using air conducted sound stimulation. Clin Neurophysiol 2009; 120:1381–1385.

    Article  Google Scholar 

  15. Su HC, Huang TW, Young YH, Cheng PW. Aging affect on vestibular evoked myogenic potential. Otol Neurotol 2004; 25:977–980.

    Article  Google Scholar 

  16. 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; 31:793–802.

    Article  Google Scholar 

  17. Tseng CL, Chou CH, Young YH. Aging effect on the ocular vestibular-evoked myogenic potentials. Otol Neurotol 2010; 31:959–963.

    Article  Google Scholar 

  18. Rosenhall U. Degenerative patterns in the aging human vestibular neuro-potentials. Acta Otolaryngol 1973; 76:208–220.

    Article  CAS  Google Scholar 

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Correspondence to Samir Asal MD.

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Asal, S. Effect of age on ocular vestibular-evoked myogenic potentials using air-conducted sound. Egypt J Otolaryngol 30, 166–170 (2014).

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