By Marcello Cherchi, MD PhD
For clinicians
Optokinetic testing in the elderly
Hajioff and colleagues (Hajioff et al. 2000) studied 96 healthy subjects (56 men) age 66 – 89 years (median age 76 years) using electronystagmography. For horizontal bidirectional optokinetic testing at a constant velocity of 20˚/sec they reported gain with a lower reference range of 0.550 (95% CI 0.30 – 0.64) and an upper reference range of 1.20 (95% CI 1.05 – 1.30).
Optokinetic testing over a broad age range
Lynch and colleagues (Lynch, Nayak, Isaacs 1985) studied 10 healthy subjects age 20 – 35 years, and 10 healthy subjects (4 male) age 69 – 76 years, using electronystagmography. Of the younger group (age 20 – 35 years) they reported that, “None showed asymmetry of the optokinetic response,” whereas in the older group (age 69 – 76 years) they reported that “Four… subjects [40%] showed asymmetry of the optokinetic response” (although the table indicates that 5 subjects [50%] had optokinetic asymmetry).
Seferlis and colleagues (Seferlis et al. 2015) studied 250 healthy subjects (87 male) age 18 – 70 years using videonystagmography. They utilized a horizontal optokinetic stimulus moving at 15 deg/sec and reported the optokinetic slow phase velocities stratified by age:
|
Age range (years) |
Number of subjects |
Mean (95% CI) slow phase velocity, degrees/second |
Mean (95% CI) gain (percent) |
|
|
Optokinetic nystagmus leftwards |
Group A, 18 – 30 |
50 |
12.77 (10.91 – 14.62) |
77.64 (72.93 – 82.34) |
|
Group B, 31 – 40 |
50 |
11.32 (10.38 – 12.25) |
72.91 (68.89 – 76.92) |
|
|
Group C, 41 – 50 |
50 |
11.20 (10.49 – 11.90) |
73.09 (69.08 – 77.09) |
|
|
Group D, 51 – 60 |
50 |
10.72 (9.74 – 11.69) |
65.91 (60.31 – 71.51) |
|
|
Group E, 61 – 70 |
50 |
10.26 (9.24 – 11.27) |
61.53 (56.59 – 66.47) |
|
|
Total |
250 |
11.25 (10.73 – 11.77) |
70.21 (68.05 – 72.37) |
|
|
Optokinetic nystagmus rightwards |
Group A, 18 – 30 |
50 |
12.53 (11.54 – 13.51) |
80.33 (76.12 – 84.53) |
|
Group B, 31 – 40 |
50 |
12.41 (11.52 – 13.30) |
79.39 (75.17 – 83.61) |
|
|
Group C, 41 – 50 |
50 |
11.77 (11.05 – 12.49) |
75.79 (71.92 – 79.67) |
|
|
Group D, 51 – 60 |
50 |
11.41 (10.31 – 12.51) |
67.11 (62.04 – 72.18) |
|
|
Group E, 61 – 70 |
50 |
7.90 (7.37 – 8.43) |
61.04 (56.37 – 65.71) |
|
|
Total |
250 |
11.20 (10.77 – 11.64) |
72.73 (70.59 – 74.87) |
Spooner and colleagues (Spooner, Sakala, Baloh 1980) studied 25 healthy subjects aged 22 – 64 years (mean 42 years), and 14 healthy subjects age 50 – 85 years (mean 65 years) with electronystagmography. The overlap in age between the groups is apparently because the first group “had served as normal controls in our laboratory for several years.” They used a horizontal optokinetic protocol with “the subject seated inside a large drum with alternating black and white stripes. The drum rotated at a fixed velocity of 30˚/s for 30 s in clockwise and counter-clockwise directions. Average slow component velocity over the 30-s period of stimulation was calculated for each group of subjects.” They reported that in the group age 22 – 64 years the slow component velocity was 25.6 (± SD of 2.8) deg/sec, and in the group age 50 – 85 years the slow component velocity was 19.6 (± SD of 4.6) deg/sec.
References
Hajioff D, Barr-Hamilton RM, Colledge NR, Lewis SJ, Wilson JA (2000) Re-evaluation of normative electronystagmography data in healthy ageing. Clin Otolaryngol Allied Sci 25: 249-52. doi: coa361 [pii]
Lynch SJ, Nayak US, Isaacs B (1985) Positional and optokinetic nystagmus in healthy old people. Age Ageing 14: 122-4. doi: 10.1093/ageing/14.2.122
Seferlis F, Chimona TS, Papadakis CE, Bizakis J, Triaridis S, Skoulakis C (2015) Age related changes in ocular motor testing in healthy subjects. J Vestib Res 25: 57-66. doi: 10.3233/VES-150548
Spooner JW, Sakala SM, Baloh RW (1980) Effect of aging on eye tracking. Arch Neurol 37: 575-6. doi: 10.1001/archneur.1980.00500580071012
