Xiaoxuan Liu1, Shuo Zhang1, Xiao Huang1, Yingshuang Zhang1, Dongsheng Fan2. 1. Department of Neurology, Peking University Third Hospital, Beijing, China. 2. Department of Neurology, Peking University Third Hospital, Beijing, China; Key Laboratory for Neuroscience, National Health Commission/Ministry of Education, Peking University, Beijing, China. Electronic address: dsfan2010@aliyun.com.
Abstract
OBJECTIVE: To evaluate the diagnostic value of vestibular evoked myogenic potentials (VEMPs) in the assessment of brainstem function integrity in patients with amyotrophic lateral sclerosis (ALS). METHODS: This was a prospective case-control study including 30 definite or probable ALS patients divided into two groups (with or without brainstem involvement) and 30 healthy controls. Cervical (c-), masseter (m-) and ocular VEMP (o-VEMP) measurements were obtained for all the participants. RESULTS: The c-VEMP mean p13 and n23 were significantly prolonged in the ALS patients. The interside peak differences in p13 and n23 of c-VEMP and in n10 and p15 of o-VEMP were significantly prolonged. The rates of alteration in c-VEMP, m-VEMP and o-VEMP in the ALS patients were 67%, 40%, and 45%, respectively. The ALS patients with brainstem involvement had a significantly higher percentage of VEMP abnormalities than did those without brainstem involvement (p = 0.027). CONCLUSIONS: c-VEMP is a sensitive tool to detect lower levels of brainstem involvement. Impairments in o-VEMP and m-VEMP indicate involvement of the upper brainstem. The use of combined VEMPs may provide useful insights into the pathophysiological mechanism of ALS. SIGNIFICANCE: VEMPs may be useful in the evaluation of brainstem dysfunction in ALS patients.
OBJECTIVE: To evaluate the diagnostic value of vestibular evoked myogenic potentials (VEMPs) in the assessment of brainstem function integrity in patients with amyotrophic lateral sclerosis (ALS). METHODS: This was a prospective case-control study including 30 definite or probable ALSpatients divided into two groups (with or without brainstem involvement) and 30 healthy controls. Cervical (c-), masseter (m-) and ocular VEMP (o-VEMP) measurements were obtained for all the participants. RESULTS: The c-VEMP mean p13 and n23 were significantly prolonged in the ALSpatients. The interside peak differences in p13 and n23 of c-VEMP and in n10 and p15 of o-VEMP were significantly prolonged. The rates of alteration in c-VEMP, m-VEMP and o-VEMP in the ALSpatients were 67%, 40%, and 45%, respectively. The ALSpatients with brainstem involvement had a significantly higher percentage of VEMP abnormalities than did those without brainstem involvement (p = 0.027). CONCLUSIONS: c-VEMP is a sensitive tool to detect lower levels of brainstem involvement. Impairments in o-VEMP and m-VEMP indicate involvement of the upper brainstem. The use of combined VEMPs may provide useful insights into the pathophysiological mechanism of ALS. SIGNIFICANCE: VEMPs may be useful in the evaluation of brainstem dysfunction in ALSpatients.
Authors: Maria Clara Motta Barbosa Valente; Aline Tenório Lins Carnaúba; Janise Dal Pai; Kelly Cristina Lira de Andrade; Pedro de Lemos Menezes Journal: Clinics (Sao Paulo) Date: 2020-11-11 Impact factor: 2.365