Age-dependent mechanical stress underlies unexpected vestibular differentiation and regeneration patterns

Loss of inner-ear sensory hair cells (HCs) is a major cause of hearing and balance disorders. Promoting HC regeneration offers a potential therapeutic strategy, but regenerative capacity is limited in adult mammals and declines rapidly during early postnatal development in mice. HCs can regenerate through trans-differentiation of neighboring supporting cells in a process controlled by Notch mediated lateral inhibition. However, the factors underlying the decrease in regeneration capacity are poorly understood. Here, we combine live imaging with single-HC ablation in mouse vestibular explants to track the dynamics of HC development and regeneration. We reveal unexpected age-dependent deviations from the classical lateral inhibition model, in which new HCs differentiate adjacent to existing HCs. We find that mechanical stress changes with age and that perturbing it alters the observed differentiation patterns. A mathematical model incorporating local mechanical regulation of Notch signaling captures both HC differentiation and regeneration patterns across ages. Together, these findings identify mechanical stress as a crucial regulator of HC differentiation and support an underlying mechanism in which the interplay between local mechanics and Notch signaling shapes regenerative responses. This coupling offers a framework for understanding the age-dependent decline in HC regeneration and motivates investigation of mechanical regulation as a potential therapeutic target.