Epidemiology of Vestibulo-Ocular Reflex Function

Li, Carol; Layman, Andrew J.; Geary, Robert; Anson, Eric; Carey, John P.; Ferrucci, Luigi; Agrawal, Yuri

doi:10.1097/mao.0000000000000610

Cited by 92 publications

(48 citation statements)

References 33 publications

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“…Notably, this decline was not associated with any symptoms or signs of disequilibrium (47). By contrast, the patients, whose VOR responses were depressed at the start of testing, did not show any significant decline (48). Carol et al analyzed 109 subjects using data from the Baltimore Longitudinal Study of Aging and found that VOR gain remained stable from ages 26 to 79, after which it significantly declined at a rate of 0.012/year; the prevalence of VOR gain less than 0.8 was 13% in individuals aged ≥80 compared with 2.8% in those aged under 80 (48).…”

Section: The Peripheral Vestibular Systemmentioning

confidence: 99%

Age-Related Vestibular Loss: Current Understanding and Future Research Directions

et al. 2016

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The vestibular system sub-serves a number of reflex and perceptual functions, comprising the peripheral apparatus, the vestibular nerve, the brainstem and cerebellar processing circuits, the thalamic relays, and the vestibular cerebral cortical network. This system provides signals of self-motion, important for gaze and postural control, and signals of traveled distance, for spatial orientation, especially in the dark. Current evidence suggests that certain aspects of this multi-faceted system may deteriorate with age and sometimes with severe consequences, such as falls. Often the deterioration in vestibular functioning relates to how the signal is processed by brain circuits rather than an impairment in the sensory transduction process. We review current data concerning age-related changes in the vestibular system, and how this may be important for clinicians dealing with balance disorders.

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Section: The Peripheral Vestibular Systemmentioning

confidence: 99%

Age-Related Vestibular Loss: Current Understanding and Future Research Directions

et al. 2016

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“…A normal, compensatory VOR gain should equal 1.0. VOR gains less than 0.8, 39 along with compensatory refixation saccades, suggested a loss of peripheral vestibular function. 40 Six individuals from the dementia case group had missing VOR data (two individuals were unable to follow testing instructions, MMSE of 12 and 12, and the equipment was unavailable for testing for the remaining four individuals).…”

Section: Methodsmentioning

confidence: 96%

“…For vHIT testing, a 0.05 difference in VOR gain (standard deviation around 0.1) was chosen as clinically significant. 39 The calculated sample size for the VOR gain analyses was 48 individuals.…”

Section: Methodsmentioning

confidence: 99%

Vestibular Impairment in Dementia

Harun¹,

Oh²,

Bigelow³

et al. 2016

Otology &Amp; Neurotology

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104

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Objective Recent studies suggest an association between vestibular and cognitive function. The goal of the study was to investigate whether vestibular function was impaired in individuals with mild cognitive impairment (MCI) and Alzheimer’s disease (AD) compared to cognitively normal individuals. Study Design Cross-sectional study. Setting Outpatient memory clinic and longitudinal observational study unit. Patients Older individuals ≥ 55 years with MCI or AD. Age, gender and education-matched normal controls were drawn from the Baltimore Longitudinal Study of Aging (BLSA). Intervention Saccular and utricular function was assessed with cervical and ocular vestibular-evoked myogenic potentials (c- and oVEMPs) respectively, and horizontal semicircular canal function was assessed with video head impulse testing. Main Outcome Measures Presence or absence of VEMP responses, VEMP amplitude and vestibular ocular reflex (VOR) gain were measured. Results Forty-seven individuals with cognitive impairment (MCI N=15 and AD N=32) underwent testing and were matched with 94 controls. In adjusted analyses, bilaterally absent cVEMPs were associated with an over three-fold odds of AD (OR 3.42, 95% CI 1.33–8.91, p=0.011). One microvolt increases in both cVEMP and oVEMP amplitudes were associated with decreased odds of AD (OR 0.28, 95% CI 0.09–0.93, p=0.038 and OR 0.92, 95% CI 0.85–0.99, p=0.036, respectively). There was no significant difference in VOR gain between the groups. Conclusions These findings confirm and extend emerging evidence of an association between vestibular dysfunction and cognitive impairment. Further investigation is needed to determine the causal direction for the link between peripheral vestibular loss and cognitive impairment.

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“…We have previously documented an association between vestibular loss and aging in this population (4, 5). In this study, we specifically examined whether VOR gain, compensatory saccade amplitude, and latency were associated with performance on the Short Physical Performance Battery (SPPB).…”

Section: Introductionmentioning

confidence: 88%

Compensatory Saccades Are Associated With Physical Performance in Older Adults: Data From the Baltimore Longitudinal Study of Aging

Xie

Anson

Simonsick

et al. 2017

Otology &Amp; Neurotology

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Objective To determine whether compensatory saccade metrics observed in the video head impulse test, specifically saccade amplitude and latency, predict physical performance. Study Design Cross-sectional analysis of the Baltimore Longitudinal Study of Aging (BLSA), a prospective cohort study. Setting National Institute on Aging Intramural Research Program Clinical Research Unit in Baltimore, Maryland Patients Community-dwelling older adults Intervention(s) Video head impulse testing was performed, and compensatory saccades and horizontal vestibulo-ocular reflex (VOR) gain were measured. Physical performance was assessed using the Short Physical Performance Battery (SPPB), which included the feet side-by-side, semi-tandem, tandem, and single-leg stance; repeated chair stands; and usual gait speed measurements. Main Outcome Measure(s) Compensatory saccade amplitude and latency, VOR gain, and SPPB performance. Results In 183 participants who underwent vestibular and SPPB testing (mean age 71.8 years; 53% females), both higher mean saccade amplitude (odds ratio [OR] =1.62, p=0.010) and shorter mean saccade latency (OR=0.88, p=0.004) were associated with a higher odds of failing the tandem stand task. In contrast, VOR gain was not associated with any physical performance measure. Conclusions We observed in a cohort of healthy older adults that compensatory saccade amplitude and latency were associated with tandem stance performance. Compensatory saccade metrics may provide insights into capturing the impact of vestibular loss on physical function in older adults.

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Epidemiology of Vestibulo-Ocular Reflex Function

Cited by 92 publications

References 33 publications

Age-Related Vestibular Loss: Current Understanding and Future Research Directions

Age-Related Vestibular Loss: Current Understanding and Future Research Directions

Vestibular Impairment in Dementia

Compensatory Saccades Are Associated With Physical Performance in Older Adults: Data From the Baltimore Longitudinal Study of Aging

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