Age Effects of Bone Conduction Vibration Vestibular-evoked Myogenic Potentials (VEMPs) Using B81 and Impulse Hammer Stimuli.
Jessie N Patterson, Amanda I Rodriguez, Katherine R Gordon and 2 others
PMID 33735908WHAT IT FOUND
Bone conduction VEMPs did not escape age-related decline; responses dropped with age regardless of stimulus.
Air conduction remained superior for cervical VEMPs in older adults, while impulse hammer taps produced the strongest ocular VEMPs. Neither method replaced air conduction, but bone conduction avoids middle ear interference.
Key findings
01VEMP response rates and amplitudes decreased with age for all stimuli, including bone conduction, contradicting the hypothesis that bone conduction is less susceptible to aging.
02For cervical VEMPs, air conduction produced larger amplitudes and equal or better response rates than bone conduction in most age groups, though bone conduction was superior in the 50-69 year range.
03For ocular VEMPs, the impulse hammer produced larger amplitudes and higher response rates than air conduction and the B81 oscillator in older adults (70+ years).
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The B81 bone oscillator was not placed at a standardized location on the mastoid, relying instead on where it felt most stable, which may introduce variability. The B81 was driven at levels (136-138 dB pFL) that may exceed its linear range, potentially causing harmonic distortion, though the authors note this may not affect low-frequency VEMPs. Cervical VEMPs were recorded with bilateral SCM contraction during bone conduction stimulation, which may cause crossed pathway interference and reduce amplitude accuracy compared to unilateral protocols. The study included only healthy participants with normal hearing or symmetric sensorineural hearing loss, so results may not apply to patients with significant vestibular or auditory pathology.
Declared interests
The study was supported by the National Institute on Deafness and Other Communication Disorders (N.I.H., Extramural). The authors declared no conflicts of interest.
The easy way to misread this
Do not assume bone conduction VEMPs are a reliable alternative to air conduction for detecting vestibular function in older adults. The study found that bone conduction responses also decline with age and do not consistently outperform air conduction, particularly for cervical VEMPs.