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Vestibular reflexes in essential tremor: abnormalities of ocular and cervical vestibular-evoked myogenic potentials are associated with the cerebellum and brainstem involvement

  • Neurology and Preclinical Neurological Studies - Original Article
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Abstract

This study utilized cervical vestibular-evoked myogenic potentials tests (cVEMP) and ocular vestibular-evoked myogenic potentials tests (oVEMP) to investigate the vestibulocollic and vestibuloocular reflex arcs and to evaluate cerebellar and brainstem involvement) in essential tremor (ET). Eighteen cases with ET and 16 age- and gender-matched healthy control subjects (HCS) were included in the present study. Otoscopic and neurologic examinations were performed on all participants, and both cervical and ocular VEMP tests were performed. Pathological cVEMP results were increased in the ET group (64.7%) compared to the HCS (41,2%; p > 0.05). The latencies of P1 and N1 waves were shorter in the ET group than in HCS (p = 0.01 and p = 0.001). Pathological oVEMP responses were significantly higher in the ET group (72.2%) compared to the HCS (37.5%; p = 0.01). There was no statistically significant difference in oVEMP N1-P1 latencies between groups (p > 0.05). Because the ET group had high pathological responses to the oVEMP, but not the cVEMP, the upper brainstem pathways may be more affected by ET.

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Data availability

The data that support the findings of this study are available from the corresponding author, [Nilüfer Bal], upon reasonable request.

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Funding

No funds, grants, or other support was received. The authors have no financial or proprietary interests in any material discussed in this article.

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Authors and Affiliations

  1. Department of Audiology, Faculty of Health Sciences, Bezmialem Vakıf University, Istanbul, Turkey

    Nilüfer Bal & Meliha Başöz Behmen

  2. Subdepartment of Audiology, Department of Otolarygology, Faculty of Medicine, Subdepartment of Audiology, Marmara University, Istanbul, Turkey

    Nilüfer Bal

  3. Department of Neurology, Faculty of Medicine, Çanakkale Onsekiz Mart University, Çanakkale, Turkey

    Yıldızhan Şengül

  4. Department of Neurology, University Texas Southwestern Med. Center, Dallas, Texas, USA

    Allison Powell & Elan D. Louis

Authors
  1. Nilüfer Bal
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  2. Yıldızhan Şengül
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  3. Meliha Başöz Behmen
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  4. Allison Powell
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  5. Elan D. Louis
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by NB, YŞ, and MBB. The first draft of the manuscript was written by NB and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Nilüfer Bal.

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Ethical approval

The study protocol was conducted in accordance with the ethical principles stated in the ‘Declaration of Helsinki’ and approved by the Ethical Committee of Bezmialem Foundation University Hospital.

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Bal, N., Şengül, Y., Behmen, M.B. et al. Vestibular reflexes in essential tremor: abnormalities of ocular and cervical vestibular-evoked myogenic potentials are associated with the cerebellum and brainstem involvement. J Neural Transm 130, 1553–1559 (2023). https://doi.org/10.1007/s00702-023-02652-3

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