Age-related decline in vestibulo-ocular reflex gain is associated with an increased sway response to electrical vestibular stimulation

Despite considerable loss of peripheral vestibular input with age, there is relatively little change in function. This has led to speculation that increasing central neural gain mitigates such losses. Here we test this hypothesis by comparing the gain of the vestibulo-ocular reflex (VOR) with the response to electrical vestibular stimulation (EVS) across the lifespan....

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No immediate practice change is warranted, but findings deepen understanding of how aging alters central vestibular compensation — relevant context for interpreting vestibular test results in older patients.

Understanding the neural compensation mechanisms underlying age-related vestibular decline may inform future rehabilitation targets and help explain why fall risk increases disproportionately in some older adults.

1. 01Age-related decline in vestibulo-ocular reflex (VOR) gain was correlated with greater postural sway during electrical vestibular stimulation (EVS).
2. 02Findings suggest the central nervous system upregulates reliance on vestibular spinal pathways as VOR gain declines with age.
3. 03Electrical vestibular stimulation was used as a research tool to probe vestibular-to-postural signal weighting.
4. 04Study published in Journal of Neurophysiology, a high-quality basic science journal.
5. 05Results contribute to fall-risk mechanistic research in aging populations.

PMID

42716030

DOI

10.1152/jn.00110.2026.

Journal

Journal of Neurophysiology

Publication type

research_article

Evidence level

2b

Population

Adults across age groups examined for vestibulo-ocular reflex gain and postural responses

Intervention

Electrical vestibular stimulation (EVS) combined with vestibulo-ocular reflex gain measurement

Comparator

Within-subject comparison across age groups; younger adults as implicit reference