Selective effects of ageing on vestibular-dependent lower limb responses following galvanic stimulation

OBJECTIVES To examine the influence of ageing on electromyographic (EMG) responses to galvanic vestibular stimulation (GVS) in the lower limbs and to define normal values. METHODS EMG responses to 4 mA/20 ms transmastoid binaural GVS were recorded from the soleus muscles of 70 healthy adults aged 24-85 years. Short (SL) and medium latency (ML) vestibular-dependent reflex latencies and amplitudes were measured from averaged rectified EMG. Side to side differences were examined in 30 subjects, using monaural stimulation, and expressed as an asymmetry ratio (AR). RESULTS SL reflexes to transmastoid binaural stimulation were absent in 10 of the 25 subjects over the age of 60. ML responses were present in all subjects. SL reflex amplitudes decreased from 24.4+/-12.4% (mean+/-SD) in the 3rd decade to 7.6+/-6.2% in the 8th and 9th decades. The ML reflex amplitudes showed a tendency to increase with age. The mean AR for SL reflex amplitudes increased from 12.1% in the 3rd decade to 80.7% in the 8th and 9th decades but that for ML amplitudes did not change significantly. The average SL and ML response onset latencies were 56.5+/-7.5 and 97.2+/-9.4 ms. SL onset latencies were significantly delayed with age. Both SL and ML responses were highly reproducible between experiments. CONCLUSIONS SL and ML responses behave differently in response to age. The decrease in SL reflex amplitudes correlates well with previously described age-related morphological changes. Preservation of the ML reflex may reflect central adaptation to reduced afferent input. SL and ML responses are potentially useful measures of vestibular-spinal function, which may have a role in the assessment of older subjects with dysequilibrium. These reflexes need to be interpreted in the context of age.