The Impact of Age and Gender on Cervical Vestibular-Evoked Myogenic Potentials Using 500 Hz Tone Bursts Stimuli: A Cross-Sectional Study

Abstract

Background and objective Cervical vestibular-evoked myogenic potential (cVEMP) tests have attracted significant interest as clinical measures of vestibular function recently. A detailed knowledge of the potential individual factors influencing the cVEMP response is, however, essential for the reliability of the test. Hence, we aimed to analyze the trends of different cVEMP parameters with regard to changes in age and gender, under standard recording conditions. Methods cVEMP was conducted on 60 participants aged 18-60 years during the period from April 2023 to March 2024. cVEMP parameters, including response rates, amplitude, interaural amplitude asymmetry, threshold, threshold asymmetry, and latencies, were investigated for the impact of aging and gender differences. One-way ANOVA and Kruskal-Wallis tests were performed for the comparison between the age groups, while unpaired t-test and Kruskal-Wallis test were employed to find the gender differences in cVEMP parameters. Pearson correlation analysis was performed to assess the relationship between age and cVEMP parameters. Statistical significance was set at a p-value of 0.05. Results cVEMP response rate was 100 % in all the age groups. Significant differences were found in terms of p13-n23 amplitude and threshold (both right and left ear) between the age groups (p<0.001) (Kruskal-Wallis test). A significant negative correlation was found between age and both uncorrected and corrected amplitude in both the right ear (r = -0.73, p<0.001) and the left ear (r = -0.75, p<0.001). A significant positive correlation was observed between age and thresholds in both the right ear (r = 0.66, p<0.001) and the left ear (r = 0.75, p<0.001). There were no significant variations regarding p13 and n23 latencies, interaural amplitude asymmetry, and threshold asymmetry among the age groups (p>0.05) (one-way ANOVA) (Kruskal-Wallis test). Gender did not demonstrate variations in the cVEMP parameters tested (p>0.05) (unpaired t test and Kruskal-Wallis test). Conclusions cVEMP had an absolute detection rate in the age groups studied. However, a remarkable age-related decline in p13-n23 amplitude (corrected and uncorrected) and the threshold values highlights the importance of effective consideration of changes in age for optimizing the clinical evaluation. p13 and n23 latencies, and amplitude asymmetry were relatively stable with increasing age. The findings related to cVEMP evoked with 500 Hz short tone burst stimuli in adults (aged 18-60 years) can be utilized in the regional clinical settings.

Keywords: age; amplitude; amplitude asymmetry; cvemp; gender; latency; sternocleidomastoid; threshold; vestibular evoked myogenic potentials.

Figure 1. Comparison of corrected and uncorrected interaural p13-n23 AA in Group 1 (18-34 years)

P-value=0.88 (Wilcoxon signed-rank test) AA: amplitude asymmetry; µv: microvolts

Figure 2. Comparison of corrected and uncorrected interaural p13-n23 AA in Group 2 (35-44 years)

P-value=0.22 (Wilcoxon signed-rank test) AA: amplitude asymmetry; µv: microvolts

Figure 3. Comparison of corrected and uncorrected interaural p13-n23 AA in Group 3 (45-60 years)

P-value=0.95 (Wilcoxon signed-rank test) AA: amplitude asymmetry; µv: microvolts

Figure 4. Scatter plot showing the relationship between age (in years) and right ear p13-n23 amplitude (uncorrected) (µv)

Significant negative correlation observed between the age and right ear uncorrected amplitude (r = -0.73, r² = 0.53, p<0.001) (Pearson correlation analysis) µv: microvolts

Figure 5. Scatter plot showing the relationship between age (in years) and left ear p13-n23 amplitude (uncorrected) (µv)

Significant negative correlation observed between the age and left ear uncorrected amplitude (r = -0.75, r² = 0.56, p<0.001) (Pearson correlation analysis) µv: microvolts

Figure 6. Scatter plot showing the relationship between age (in years) and right ear p13-n23 amplitude (corrected) (µv)

Significant negative correlation observed between the age and right ear corrected amplitude (r = - 0.73, r² = 0.536, p<0.001) (Pearson correlation analysis) µv: microvolts

Figure 7. Scatter plot showing the relationship between age (in years) and left ear p13-n23 amplitude (corrected) (µv)

Significant negative correlation observed between the age and left ear corrected amplitude (r = -0.75, r²=0.56, p = <0.001) (Pearson correlation analysis) µv: microvolts

Figure 8. Scatter plot showing the relationship between age (in years) and right ear cVEMP threshold (dB nHL)

Significant positive correlation was observed between the age of the participants and the stimulus threshold (r = 0.66, r² = 0.44, p<0.001) (Pearson correlation analysis) cVEMP: cervical vestibular-evoked myogenic potential; dB nHL: decibel normalized hearing level

Figure 9. Scatter plot showing the relationship between age (in years) and left ear cVEMP threshold (dB nHL)

Significant positive correlation was observed between the age of the participants and the stimulus threshold (r = 0.75, r² = 0.56, p<0.001) (Pearson correlation analysis) cVEMP: cervical vestibular-evoked myogenic potential; dB nHL: decibel normalized hearing level