Abstract
IntroductionThe natural aging process may result in morphological changes in the vestibular system and in the afferent neural pathway, including loss of hair cells, decreased numbers of vestibular nerve cells, and loss of neurons in the vestibular nucleus. Thus, with advancing age, there should be a decrease in amplitudes and an increase in latencies of the vestibular evoked myogenic potentials, especially the prolongation of p13 latency. Moreover, many investigations have found no significant differences in latencies with advancing age. ObjectiveTo determine if there are significant differences in the latencies of cervical and ocular evoked myogenic potentials between elderly and adult patients. MethodsThis is a systematic review with meta-analysis of observational studies, comparing the differences of these parameters between elderly and young adults, without language or date restrictions, in the following databases: Pubmed, ScienceDirect, SCOPUS, Web of Science, SciELO and LILACS, in addition to the gray literature databases: OpenGrey.eu and DissOnline, as well as Research Gate. ResultsThe n1 oVEMP latencies had a mean delay in the elderly of 2.32ms with 95% CI of 0.55–4.10ms. The overall effect test showed p=0.01, disclosing that such difference was significant. The heterogeneity found was I2=96% (p<0.001). Evaluation of p1 latency was not possible due to the low number of articles selected for this condition. cVEMP analysis was performed in 13 articles. For the p13 component, the mean latency delay in the elderly was 1.34ms with 95% CI of 0.56–2.11ms. The overall effect test showed a p<0.001, with heterogeneity value I2=92% (p<0.001). For the n23 component, the mean latency delay for the elderly was 2.82ms with 95% CI of 0.33–5.30ms. The overall effect test showed p=0.03. The heterogeneity found was I2=99% (p<0.001). ConclusionThe latency of oVEMP n1 wave component and latencies of cVEMP p13 and n23 wave components are longer in the elderly aged >60 years than in young adults.
Highlights
The natural aging process may result in morphological changes in the vestibular system and in the afferent neural pathway, including loss of hair cells, decreased numbers of vestibular nerve cells, and loss of neurons in the vestibular nucleus
The vestibular evoked myogenic potential (VEMP) evaluates the final reflex; it cannot be used for the topographical diagnosis, but confirms or rules out the involvement of the affected pathway.7---10
The devising of this systematic review sought to answer the following question: Do the elderly have different latency values of cervical and ocular vestibular evoked myogenic potentials than adults? Based on this question, the review is reported according to the items of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement (PRISMA)
Summary
The natural aging process may result in morphological changes in the vestibular system and in the afferent neural pathway, including loss of hair cells, decreased numbers of vestibular nerve cells, and loss of neurons in the vestibular nucleus. With advancing age, there should be a decrease in amplitudes and an increase in latencies of the vestibular evoked myogenic potentials, especially the prolongation of p13 latency. Many investigations have found no significant differences in latencies with advancing age. Objective: To determine if there are significant differences in the latencies of cervical and ocular evoked myogenic potentials between elderly and adult patients. Aging and wave-component latency delays in oVEMP and cVEMP: a systematic review with meta-analysis. The vestibular evoked myogenic potential (VEMP) is an objective, non-invasive examination with high-intensity auditory stimuli that assesses vestibular function integrity through the muscle reflex response.1---3. Recent advances in technology have allowed clinicians to assess the vestibular function capacity through the ocular (oVEMP) and cervical vestibular evoked myogenic potential (cVEMP).[1,2]. As a basic evaluation principle of any evoked potential, the time between the stimulus and the response is measured, classifying it as normal or altered based on the duration time and the morphology of the generated electric waves.11---13
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