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

Abstract Introduction: 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. 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. Objective: To determine if there are significant differences in the latencies of cervical and ocular evoked myogenic potentials between elderly and adult patients. Methods: This 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. Results: The n1 oVEMP latencies had a mean delay in the elderly of 2.32 ms with 95% CI of 0.55-4.10 ms. The overall effect test showed p = 0.01, disclosing that such difference was significant. The heterogeneity found was I 2 = 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 1.34 ms with 95% CI of 0.56-2.11 ms. The overall effect test showed a p < 0.001, with heterogeneity value I 2 = 92% (p < 0.001). For the n23 component, the mean latency delay for the elderly was 2.82 ms with 95% CI of 0.33-5.30 ms. The overall effect test showed p = 0.03. The heterogeneity found was I 2 = 99% (p < 0.001). Conclusion: The 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.

摘要 引言：自然衰老过程可导致前庭系统及传入神经通路的形态学改变，包括毛细胞丢失、前庭神经细胞数量减少以及前庭核神经元丧失。因此，随着年龄增长，前庭诱发肌源性电位（vestibular evoked myogenic potentials, VEMP）的振幅应降低、潜伏期应延长，尤以p13潜伏期延长为著。然而，多项研究并未发现年龄增长带来的潜伏期存在显著差异。研究目的：明确老年患者与成年患者的颈性前庭诱发肌源性电位（cervical VEMP, cVEMP）及眼性前庭诱发肌源性电位（ocular VEMP, oVEMP）潜伏期是否存在显著差异。方法：本研究为一项针对观察性研究的系统综述与荟萃分析，无语言及时间限制，检索了Pubmed、ScienceDirect、SCOPUS、Web of Science、SciELO及LILACS数据库，同时检索灰色文献数据库OpenGrey.eu、DissOnline以及Research Gate，对比老年人群与年轻成人上述电位参数的差异。结果：老年人群的oVEMP n1波潜伏期平均延迟2.32 ms，95%置信区间（95% CI）为0.55~4.10 ms。整体效应检验显示p=0.01，表明该差异具有统计学意义。本次分析的异质性为I²=96%（p<0.001）。由于纳入该指标的文献数量较少，无法对p1潜伏期进行评估。cVEMP分析共纳入13篇文献：对于p13成分，老年人群的潜伏期平均延迟1.34 ms，95% CI为0.56~2.11 ms，整体效应检验显示p<0.001，异质性值I²=92%（p<0.001）；对于n23成分，老年人群的潜伏期平均延迟2.82 ms，95% CI为0.33~5.30 ms，整体效应检验显示p=0.03，异质性为I²=99%（p<0.001）。结论：在年龄大于60岁的老年人群中，oVEMP n1波成分的潜伏期以及cVEMP p13、n23波成分的潜伏期均长于年轻成人。