Objective: To explore the brainstem lesion reflected by means of vestibular-evoked myogenic potentials(VEMPs) and its association with REM sleep without atonia(RSWA) and other clinical assessments in early Parkinson’s disease(PD) and idiopathic REM sleep behavior disorder(iRBD) patients.

Background: Brainstem dysfunction accounts for many clinical manifestations in early PD and iRBD patients. Furthermore, asymmetrical pathology of brainstem may underlie the lateral onset of motor and non-motor features in PD.

Method: We recruited 82 early PD, 24 iRBD patients and 41 controls. All PD and iRBD patients underwent one-night polysomnography(PSG) and clinical motor and non-motor scales. We used the Mann-Whitney U test for comparing the whole battery of cervical(cVEMP), ocular(oVEMP) and masseter VEMP(mVEMP) parameters between patients and controls. The correlations between VEMP parameters and RSWA and other clinical measures were evaluated by means of the nonparametric Spearman’s ρ.

Results: Compared with controls, PD and iRBD patients exhibited prolonged latencies in cVEMP and oVEMP. Furthermore, the total cVEMP scores correlated with phasic RSWA in PD patients(p=0.015, r=0.268). In left-onset PD, the tonic RSWA was associated with left oVEMP scores(p=0.003, r=0.488). In iRBD, phasic RSWA correlated with total cVEMP scores(p=0.003, r=0.574) and oVEMP scores(p=0.008, r=0.527). Simultaneously, the prolonged latencites of cVEMP and oVEMP were associated with Unified Parkinson’s Disease Rating Scale part three(UPDRS-III), REM sleep Behavior Disorder Questionnaire HongKong(RBDQ-HK), Scales for Outcomes in Parkinson’s disease-Autonomic(SCOPA-AUT) and Hamilton Depression Scale(HAMD) in PD and iRBD patients(p<0.05).

Conclusion: Our findings demonstrated the VEMP as a valuable tool to evaluate brainstem dysfunction in early PD and iRBD patients. Furthermore, the asymmetrical lesion to brainstem in PD patients reflected by altered VEMPs was associated with RSWA severity and various clinical evidence, highlighting the meaningfulness of detecting the brainstem dysfunction in the early stage of disease.

« Back to MDS Virtual Congress 2021

MDS Abstracts - https://www.mdsabstracts.org/abstract/abnormalities-of-vestibular-evoked-myogenic-potentials-are-associated-with-rem-sleep-without-atonia-in-early-parkinsons-disease-and-idiopathic-rem-sleep-behavior-disorder/