N Böttcher1, T Bremova2, K Feil3, C Heinze4, R Schniepp3, M Strupp3. 1. German Center for Vertigo and Balance Disorders, Ludwig-Maximilians University, Munich, Germany; Dept. of Neurology, University Hospital Munich, Munich, Germany. Electronic address: nicolina.boettcher@med.uni-muenchen.de. 2. German Center for Vertigo and Balance Disorders, Ludwig-Maximilians University, Munich, Germany; Graduate School of Systemic Neurosciences, Ludwig-Maximilians University, Munich, Germany. 3. German Center for Vertigo and Balance Disorders, Ludwig-Maximilians University, Munich, Germany; Dept. of Neurology, University Hospital Munich, Munich, Germany. 4. German Center for Vertigo and Balance Disorders, Ludwig-Maximilians University, Munich, Germany.
Abstract
OBJECTIVE: To investigate whether there is a change in ocular (oVEMP) and cervical (cVEMP) vestibular evoked myogenic potentials in patients with normal pressure hydrocephalus (NPH) before and after spinal tap test (STT). METHODS: In 25 patients (6 females, age 62-83years) c/oVEMP were measured before and after STT. Patients with an increase of >20% of walking velocity were classified as responders (n=10). VEMP were also measured in a control group of 13 non-NPH patients. RESULTS: All patients had reproducible oVEMP; 68% had cVEMP. There was a significant increase of the peak-to-peak (pp) oVEMP amplitude after STT in responders (8.5±2.7 to 18.9±7.5μV (p=0.010)). No significant changes were found in non-responders (13.4±7.6 to 15.3±8.6μV) or controls (12.4±7.6 to 12.5±6.8μV). There were no significant differences in cVEMP before and after spinal tap test (STT). CONCLUSION: One third of patients with suspected NPH had impaired otolith function. Responders to STT only had a significant increase of oVEMP and thereby utricular input, probably due to a decrease of pressure. SIGNIFICANCE: Both findings indicate that otolith dysfunction may contribute to imbalance in NPH and that increased utricular function after STT may be relevant for gait improvement.
OBJECTIVE: To investigate whether there is a change in ocular (oVEMP) and cervical (cVEMP) vestibular evoked myogenic potentials in patients with normal pressure hydrocephalus (NPH) before and after spinal tap test (STT). METHODS: In 25 patients (6 females, age 62-83years) c/oVEMP were measured before and after STT. Patients with an increase of >20% of walking velocity were classified as responders (n=10). VEMP were also measured in a control group of 13 non-NPH patients. RESULTS: All patients had reproducible oVEMP; 68% had cVEMP. There was a significant increase of the peak-to-peak (pp) oVEMP amplitude after STT in responders (8.5±2.7 to 18.9±7.5μV (p=0.010)). No significant changes were found in non-responders (13.4±7.6 to 15.3±8.6μV) or controls (12.4±7.6 to 12.5±6.8μV). There were no significant differences in cVEMP before and after spinal tap test (STT). CONCLUSION: One third of patients with suspected NPH had impaired otolith function. Responders to STT only had a significant increase of oVEMP and thereby utricular input, probably due to a decrease of pressure. SIGNIFICANCE: Both findings indicate that otolith dysfunction may contribute to imbalance in NPH and that increased utricular function after STT may be relevant for gait improvement.
Authors: Katrin Abram; Silvia Bohne; Peter Bublak; Panagiota Karvouniari; Carsten M Klingner; Otto W Witte; Orlando Guntinas-Lichius; Hubertus Axer Journal: Dement Geriatr Cogn Dis Extra Date: 2016-09-27