ORIGINAL RESEARCH article
Front. Neurol.
Sec. Neuro-Otology
Osteoporosis Correlates with Abnormal Ocular Vestibular Evoked Myogenic Potential in Patients with Benign Paroxysmal Positional Vertigo
Chen-Yan Zhou 1
Liang Shu 1
Jing Wu 1
Jie Chen 2
Ying-Xia Bai 2
Ran Yan 1
Xu-Hong Sun 1
Shuai Xu 3,4,5
Jian-Ren Liu 1
Haibin Sheng 3,4,5
Wei Chen 1
1. Department of Neurology, Shanghai Ninth People’s Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
2. Department of Neurology, Shanghai Second People's Hospital, Shanghai, China
3. Department of Otolaryngology‑Head and Neck Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine,, Shanghai, China
4. Ear Institute, Shanghai Jiao Tong University School of Medicine,, Shanghai, China
5. Shanghai Key Laboratory of Translational Medicine on Ear and Nose diseases, Shanghai, China
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Abstract
Background: Osteoporosis may increase the risk of benign paroxysmal positional vertigo (BPPV). However, direct evidence remains elusive. Aims: To analyze the correlation between bone mineral density (BMD) and vestibular function in elderly patients with BPPV. Methods: Two hundred ninety-one idiopathic, unilateral BPPV patients aged 50–80 years were consecutively enrolled in our vertigo outpatient clinic. All the participants underwent BMD, cervical, and ocular vestibular evoked myogenic potential (c/oVEMP) evaluations. The associations between BMD and VEMP results were investigated. Results: Eighty-one patients (27.8%) were diagnosed with osteoporosis, 120 patients (41.2%) had osteopenia, and 90 (30.9%) exhibited normal BMD. Among BPPV patients, abnormal BMD demonstrated a marginal correlation with oVEMP response (p = 0.098), but not with cVEMP response (p = 0.405). Compared to those without osteoporosis, patients with osteoporosis were older (65.9 vs. 62.7 years, p = 0.001), had lower BMI (22.6 vs. 24.3, p<0.001), showed a higher proportion of females (84.0% vs. 72.4%, p = 0.039), and were more likely to present with at least unilateral oVEMP absence (74.1% vs. 57.1%, p = 0.008). Patients exhibiting at least unilateral oVEMP absence also had reduced T-scores and BMD in the lumbar spine. After adjusting for confounding variables, osteoporosis remained independently associated with at least unilateral oVEMP absence in BPPV patients (OR = 2.038, p = 0.019). Conclusion: Our study provides further evidence that osteoporosis may contribute to utricular dysfunction associated with the occurrence of BPPV.
Summary
Keywords
benign paroxysmal positional vertigo, bone mineral density, Osteoporosis, Utricular function, Vestibular evoked myogenic potential
Received
11 January 2026
Accepted
20 February 2026
Copyright
© 2026 Zhou, Shu, Wu, Chen, Bai, Yan, Sun, Xu, Liu, Sheng and Chen. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
*Correspondence: Haibin Sheng; Wei Chen
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