Sandra Carpinelli1, Philipp O Valko1,2, Daniel Waldvogel1, Elena Buffone1, Christian R Baumann1,2, Dominik Straumann1, Esther Werth1,2, Christopher J Bockisch1,3,4, Konrad P Weber1,3, Yulia Valko1,3. 1. Department of Neurology, Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland. 2. Sleep & Health Zurich, University Hospital Zurich, University of Zurich, Zurich, Switzerland. 3. Department of Ophthalmology, University Hospital Zurich, University of Zurich, Zurich, Switzerland. 4. Department of Otorhinolaryngology, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
Abstract
Background: Early brainstem neurodegeneration is common in Parkinson's disease (PD) and progressive supranuclear palsy (PSP). While previous work showed abnormalities in vestibular evoked myogenic potentials (VEMPs) in patients with either disorder as compared to healthy humans, it remains unclear whether ocular and cervical VEMPs differ between PD and PSP patients. Methods: We prospectively included 12 PD and 11 PSP patients, performed ocular and cervical VEMPs, and calculated specific VEMP scores (0 = normal, 12 = most pathological) based on latencies, amplitude, and absent responses. In addition, we assessed disease duration, presence of imbalance, motor asymmetry, and motor disability using the Movement Disorder Society Unified Parkinson's Disease Rating Scale, part III (MDS-UPDRS III). Moreover, we ascertained various sleep parameters by video-polysomnography. Results: PSP and PD patients had similar oVEMP scores (6 [3-6] vs. 3 [1.3-6], p = 0.06), but PSP patients had higher cVEMP scores (3 [0-6] vs. 0 [0-2.8], p = 0.03) and total VEMP scores (9 [5-12] vs. 4 [2-7.5], p = 0.01). Moreover, total VEMP scores >10 were only observed in PSP patients (45%, p = 0.01). MDS-UPDRS III correlated with cVEMP scores (rho = 0.77, p = 0.01) in PSP, but not in PD. In PD, but not in PSP, polysomnographic markers of disturbed sleep, including decreased rapid eye movement sleep, showed significant correlations with VEMP scores. Conclusions: Our findings suggest that central vestibular pathways are more severely damaged in PSP than in PD, as indicated by higher cervical and total VEMP scores in PSP than PD in a between-groups analysis. Meaningful correlations between VEMPs and motor and non-motor symptoms further encourage its use in neurodegenerative Parkinsonian syndromes.
Background: Early brainstem neurodegeneration is common in Parkinson's disease (PD) and progressive supranuclear palsy (PSP). While previous work showed abnormalities in vestibular evoked myogenic potentials (VEMPs) in patients with either disorder as compared to healthy humans, it remains unclear whether ocular and cervical VEMPs differ between PD and PSPpatients. Methods: We prospectively included 12 PD and 11 PSPpatients, performed ocular and cervical VEMPs, and calculated specific VEMP scores (0 = normal, 12 = most pathological) based on latencies, amplitude, and absent responses. In addition, we assessed disease duration, presence of imbalance, motor asymmetry, and motor disability using the Movement Disorder Society Unified Parkinson's Disease Rating Scale, part III (MDS-UPDRS III). Moreover, we ascertained various sleep parameters by video-polysomnography. Results:PSP and PDpatients had similar oVEMP scores (6 [3-6] vs. 3 [1.3-6], p = 0.06), but PSPpatients had higher cVEMP scores (3 [0-6] vs. 0 [0-2.8], p = 0.03) and total VEMP scores (9 [5-12] vs. 4 [2-7.5], p = 0.01). Moreover, total VEMP scores >10 were only observed in PSPpatients (45%, p = 0.01). MDS-UPDRS III correlated with cVEMP scores (rho = 0.77, p = 0.01) in PSP, but not in PD. In PD, but not in PSP, polysomnographic markers of disturbed sleep, including decreased rapid eye movement sleep, showed significant correlations with VEMP scores. Conclusions: Our findings suggest that central vestibular pathways are more severely damaged in PSP than in PD, as indicated by higher cervical and total VEMP scores in PSP than PD in a between-groups analysis. Meaningful correlations between VEMPs and motor and non-motor symptoms further encourage its use in neurodegenerative Parkinsonian syndromes.
Authors: Ronald B Postuma; Daniela Berg; Matthew Stern; Werner Poewe; C Warren Olanow; Wolfgang Oertel; José Obeso; Kenneth Marek; Irene Litvan; Anthony E Lang; Glenda Halliday; Christopher G Goetz; Thomas Gasser; Bruno Dubois; Piu Chan; Bastiaan R Bloem; Charles H Adler; Günther Deuschl Journal: Mov Disord Date: 2015-10 Impact factor: 10.338
Authors: Ye Zhang; Rong Ren; Larry D Sanford; Linghui Yang; Junying Zhou; Lu Tan; Taomei Li; Jihui Zhang; Yun-Kwok Wing; Jie Shi; Lin Lu; Xiangdong Tang Journal: Sleep Med Rev Date: 2020-02-11 Impact factor: 11.609