Objective: to examine the functioning of the brain stem and to gain insight into the irregularities of cervical vestibular-evoked myogenic potentials (cVEMPs) in patients with Parkinson’s disease (PD).

Background:

Although postural stability is based on the integration of somatosensory, motor, vestibular, and cognitive circuits,  the function of the vestibular otolith and its central linkages are still somewhat unknown and sometimes ignored.

Method:

This study is an observational prospective case-control study that was conducted at Audiology unit, Al Hussein University Hospital from January 2022 to November 2022. The study was conducted on 62 subjects, and they were equally subdivided into two groups; Group I (Cases) included patients diagnosed with idiopathic PD and Group II (Controls) included age and gender healthy matched subjects. In addition, full clinical evaluation including otological examination and hearing assessment were performed. The duration of illness, most affected side, and history of recurrent falls were reported. The Pull test was performed for all patients for assessment of postural instability. Cervical Vestibular-Evoked Myogenic Potentials (cVEMP) testing was carried out for all subjects to assess the saccular function and inferior branch of the vestibular nerve.

Results:

The included subjects were equally subdivided (31 participant in each group) with mean age 63.10 and 63.65 years in group I and group II respectively. The mean overall Unified Parkinson’s Disease Rating Scale section III (UPDRS-III) score was 14.10 ± 8.42 and ranging from 3 to 30 while the mean Hoehn and Yahr (H&Y) scale was 1.77 ± 0.62 and ranging from stage I- stage III. However, the prolonged latencies of P13 and N23 were positively correlated with UPDRS-III and H&Y Scale; the P13-N23 amplitude didn’t show significant correlation. Having the identification of cVEMP, the response was present in about two-third of the case group with a statistically significant difference between the two groups (P<0.001). Among the case group, the mean P13 latency and N23 latency was significantly prolonged, while the mean P13-N23 amplitude was significantly reduced with a statistically significant difference between the two groups (P<0.001).

Conclusion:

We have shown the physiological changes in the saccular section of the otolith and its participation in the central connections of individuals with Parkinson’s disease.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/cervical-vestibular-evoked-myogenic-potentials-in-patients-with-parkinsons-disease/