Macambira Ysa Karen Dos Santos, Carnaúba Aline Tenório Lins, Fernandes Luciana Castelo Branco Camurça, Bueno Nassib Bezerra, Menezes Pedro de Lemos
Universidade Estadual de Ciências da Saúde de Alagoas (UNCISAL), Audiologia, Maceió, AL, Brazil.
Universidade Federal de Alagoas (UFAL), Rede Nordeste de Biotecnologia (RENORBIO), Biotecnologia em Saúde, Maceió, AL, Brazil.
Braz J Otorhinolaryngol. 2017 Jul-Aug;83(4):475-487. doi: 10.1016/j.bjorl.2016.12.006. Epub 2017 Feb 2.
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.
To determine if there are significant differences in the latencies of cervical and ocular evoked myogenic potentials between elderly and adult patients.
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.
The 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 I=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 I=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 I=99% (p<0.001).
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.
自然衰老过程可能导致前庭系统及其传入神经通路发生形态学变化，包括毛细胞丢失、前庭神经细胞数量减少以及前庭核内神经元丧失。因此，随着年龄增长，前庭诱发肌源性电位的波幅应降低，潜伏期应延长，尤其是p13潜伏期延长。此外，许多研究发现潜伏期并未随年龄增长出现显著差异。
确定老年患者与成年患者的颈部和眼部诱发肌源性电位潜伏期是否存在显著差异。
这是一项对观察性研究进行荟萃分析的系统评价，比较老年与年轻成年人之间这些参数的差异，不受语言或日期限制，检索以下数据库：PubMed、ScienceDirect、SCOPUS、Web of Science、SciELO和LILACS，此外还检索灰色文献数据库：OpenGrey.eu和DissOnline，以及ResearchGate。
老年患者的n1 oVEMP潜伏期平均延迟2.32毫秒，95%置信区间为0.55 - 4.10毫秒。总体效应检验显示p = 0.01，表明这种差异具有显著性。发现的异质性为I = 96%（p < 0.001）。由于针对该情况选取的文章数量较少，无法对p1潜伏期进行评估。13篇文章进行了cVEMP分析。对于p13成分，老年患者的平均潜伏期延迟为1.34毫秒，95%置信区间为0.56 - 2.11毫秒。总体效应检验显示p < 0.001，异质性值I = 92%（p < 0.001）。对于n23成分，老年患者的平均潜伏期延迟为2.82毫秒，95%置信区间为0.33 - 5.30毫秒。总体效应检验显示p = 0.03。发现的异质性为I = 99%（p < 0.001）。
60岁以上老年患者的oVEMP n1波成分潜伏期以及cVEMP p13和n23波成分潜伏期比年轻成年人更长。
