August 15, 2025

Evaluating vestibulo-ocular reflex gain characteristics with monocular video head impulse test across different age groups in a healthy population

Key Points

Average VOR gain was significantly higher for left anterior-right posterior canals than for right anterior-left posterior and horizontal canals.
Statistical significance was noted with P values below 0.001 for the differences in VOR gains among semicircular canals.
Participants from 19 to 69 years old were included, with no major variation in VOR gain across different age groups.
Gender analysis indicated higher LARP gain for females, suggesting a need for tailored normative values based on specific testing protocols.

Abstract

Objective The study aims to assess the high-frequency Vestibulo-Ocular Reflex (VOR) gain across three pairs of semicircular canals using the EyeSeeCam device and to determine normative values. Methods A total of 105 volunteers, aged 19 to 69 years with no history of vestibular disorders, were enrolled. This cohort included 50 males (mean age 41.11 ± 15.98) and 55 females (mean age 35.52 ± 15.07), with no statistically significant age difference between the genders ( P = 0.078). Participants were categorized into six age brackets: 11–20, 21–30, 31–40, 41–50, 51–60, and 61–70. For each test, the recording device was consistently positioned on the left side of the goggles, and the tests were conducted by a right-handed operator. Results The average regression gain for left anterior-right posterior canals (LARP) was 1.44 ± 0.19, significantly surpassing that of right anterior-left posterior canals (RALP) at 1.09 ± 0.13 ( p < 0.001) and horizontal semicircular canals (HSC) at 1.11 ± 0.07 ( p < 0.001). No significant difference was observed between the VOR gains of RALP and HSC ( p = 0.1077). Additionally, VOR gain values did not show significant variation across different age groups. In a gender-based analysis, a marginally higher HSC gain was observed in females (1.13 ± 0.07) compared to males (1.11 ± 0.07; p = 0.042), while no significant gender disparity was noted for RALP gains (females: 1.09 ± 0.11; males: 1.10 ± 0.14; p = 0.641). Females exhibited significantly higher LARP gain values (1.49 ± 0.18) than males (1.41 ± 0.20; p = 0.002). Conclusion This study underscores the stability of high-frequency VOR gain values across ages. However, it also reveals a significant asymmetry in vertical canal gains (LARP vs RALP), suggesting a possible vertical canals monocular directional preponderance. This finding highlights that normative values can be highly specific to the recording and testing protocol. Thus, laboratories should develop their own normative values, customized to their equipment and testing protocols.

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