{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T16:41:07Z","timestamp":1792428067041,"version":"4.5.0"},"reference-count":34,"publisher":"S. Karger AG","license":[{"start":{"date-parts":[[2026,9,5]],"date-time":"2026-09-05T00:00:00Z","timestamp":1788566400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/karger.com\/pages\/terms-and-conditions"},{"start":{"date-parts":[[2026,9,5]],"date-time":"2026-09-05T00:00:00Z","timestamp":1788566400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/karger.com\/pages\/terms-and-conditions"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Audiol Neurotol"],"abstract":"<jats:p>Background: High-frequency bone-conducted vibration (BCV; here referring primarily to the vibratory range of approximately 60\u2013100 Hz and above) and skull vibration-induced nystagmus (SVIN) are widely used to probe vestibular function, yet their physical nature and physiological targets remain incompletely defined. In particular, the relationship between vibration physics, jerk as the time derivative of acceleration, hair bundle shear-rate dynamics, and vestibular activation requires an integrated biomechanical and physiological framework. Summary: This narrative review develops an engineering-informed framework for high-frequency vestibular stimulation, distinguishing the upper physiological frequency range of head movements and video head impulse test, approximately 5\u201310 Hz, from the vibratory clinical range used for BCV, vestibular-evoked myogenic potential (VEMPs), and SVIN, approximately 60\u2013100 Hz and above. It integrates mechanical analysis of sinusoidal motion, contemporary vestibular physiology of Type I hair cells, calyx synapses and irregular afferents, and experimental and clinical evidence from BCV, high-frequency sound, ocular VEMPs (oVEMPs), cervical VEMPs (cVEMPs), and SVIN. For a sinusoid of fixed displacement amplitude, velocity scales with angular frequency, acceleration with its square and jerk with its cube. At 60\u2013100 Hz, jerk becomes a useful macroscopic descriptor of rapid temporal transients, although it is not the proximal encoded neural variable. The biologically relevant effect is the generation of rapid hair bundle shear-rate transients at the sensory epithelium. Type I hair cells, calyx endings, and irregular afferents form a transient, high-bandwidth vestibular pathway characterized by high gain, phase lead, and strong phase locking to high-frequency BCV and sound. Animal and human data indicate that BCV and high-frequency sound preferentially activate irregular otolithic and canal afferents. Accordingly, BCV-evoked oVEMPs, cVEMPs, and SVIN provide complementary clinical readouts of this rapid-transient vestibular pathway. Key Message: High-frequency BCV should not be interpreted simply as very high-frequency rotation, but as a rapid-transient mechanical stimulus shaped by otolithic biomechanics and high-bandwidth afferent pathways. Jerk is useful as a macroscopic descriptor of vibratory stimulation, whereas hair bundle shear rate represents the more proximal mechanical variable at the sensory epithelium. Incorporating this dual-channel, biomechanics-informed perspective may improve the interpretation of VEMPs and SVIN in unilateral vestibular loss, M\u00e9ni\u00e8re\u2019s disease, third-window syndromes and other vestibular disorders.<\/jats:p>","DOI":"10.1159\/aud\/abnag008","type":"journal-article","created":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T11:31:28Z","timestamp":1788521488000},"page":"1-1","source":"Crossref","is-referenced-by-count":0,"title":["High-Frequency Vibration as a Vestibular Stimulus: From Jerk-Rich Physiology to Clinical Applications \u2013 Emphasis on Type I Hair Cells and Irregular Afferents"],"prefix":"10.1159","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7126-2719","authenticated-orcid":false,"given":"Leonardo","family":"Manzari","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"127","published-online":{"date-parts":[[2026,9,5]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2017.00117"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1016\/s0194-5998(98)70052-x"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1016\/bs.ctdb.2025.07.001"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1007\/s002210050033"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2015.00154"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.3390\/jcm13237236"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.3390\/audiolres14040047"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.3390\/jcm13092454"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.14639\/0392-100X-N2152"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1007\/s00221-006-0544-1"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1016\/j.brainresbull.2012.07.007"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1016\/j.heares.2015.10.019"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.3390\/audiolres11040050"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0000000000002791"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2017.00041"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.1016\/j.anorl.2020.11.014"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.3390\/audiolres14010009"},{"key":"ref18","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinph.2008.05.028"},{"key":"ref19","doi-asserted-by":"publisher","DOI":"10.3390\/audiolres12020016"},{"key":"ref20","doi-asserted-by":"publisher","DOI":"10.3390\/audiolres12010002"},{"key":"ref21","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0000000000003022"},{"key":"ref22","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2022.891536"},{"key":"ref23","doi-asserted-by":"publisher","DOI":"10.1152\/jn.1999.82.4.2000"},{"key":"ref24","doi-asserted-by":"publisher","DOI":"10.1038\/s41583-019-0153-1"},{"key":"ref25","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2023.1159242"},{"key":"ref26","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2024.1434026"},{"key":"ref27","doi-asserted-by":"publisher","DOI":"10.1113\/JP273060"},{"key":"ref28","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuroscience.2012.09.051"},{"key":"ref29","doi-asserted-by":"publisher","DOI":"10.3389\/fncel.2017.00356"},{"key":"ref30","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2025.1533842"},{"key":"ref31","doi-asserted-by":"publisher","DOI":"10.1097\/WCO.0000000000000770"},{"key":"ref32","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2020.612075"},{"key":"ref33","doi-asserted-by":"publisher","DOI":"10.3390\/audiolres13060079"},{"key":"ref34","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2023.1109506"}],"container-title":["Audiology and Neurotology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/karger.com\/article-pdf\/doi\/10.1159\/aud\/abnag008","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T16:01:00Z","timestamp":1792425660000},"score":1,"resource":{"primary":{"URL":"https:\/\/karger.com\/article\/doi\/10.1159\/aud\/abnag008"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,5]]},"references-count":34,"URL":"https:\/\/doi.org\/10.1159\/aud\/abnag008","archive":["Portico"],"relation":{},"ISSN":["1420-3030","1421-9700"],"issn-type":[{"value":"1420-3030","type":"print"},{"value":"1421-9700","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,5]]}}}