Aging and wave-component latency delays in oVEMP and cVEMP: a systematic review with meta-analysis

Publication date: Available online 2 February 2017
Source:Brazilian Journal of Otorhinolaryngology
Author(s): Ysa Karen dos Santos Macambira, Aline Tenório Lins Carnaúba, Luciana Castelo Branco Camurça Fernandes, Nassib Bezerra Bueno, Pedro de Lemos Menezes
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 (VEMP), especially the prolongation of p13 latency. Moreover, many investigations have found no significant differences in VEMP latencies with advancing age.ObjectiveTo determine if there are significant differences in the latencies of cervical VEMP (cVEMP) and ocular VEMP (oVEMP) 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.



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