Skip to main content

Correlation between blink reflex abnormalities and magnetic resonance imaging findings in patients with multiple sclerosis

Abstract

This study investigates the correlation between brain magnetic resonance imaging findings and blink reflex abnormalities in patients with relapsing remitting multiple sclerosis. Twenty-six patients and 17 healthy subjects were included in this study. Blink reflex test (BRT) results were obtained using right and left stimulations; thus, 52 BRT results were recorded for the patient group, and 34 BRT results were recorded for the control group. The magnetic resonance imaging (MRI) findings were classified based on the existence of brainstem lesions (hyperintense lesion on T2 weighted (W) and fast fluid-attenuated inversion recovery MRI or contrast-enhancing lesion on T1W MRI). Correlation analysis was performed for the BRT and MRI findings. The percentage of individuals with abnormal BRT results (including R1 latency, ipsilateral R2 latency, and contralateral R2 latency) was significantly higher in the patient group as compared to the control group (p values: 0.015, 0.001, and 0.002, respectively). Correlation analysis revealed significant correlations between contralateral R2 latency abnormalities and brainstem lesions (p value: 0.011). Our results showed significant correlation correlations between contralateral R2 latency abnormalities and brainstem lesions and these results may be explained the effects of multiple demyelinating lesions of the brain stem of patients with relapsing remitting multiple sclerosis.

This is a preview of subscription content, access via your institution.

Fig. 1
Fig. 2

References

  1. Adams RD, Victor M, Ropper AH (2001) Multiple sclerosis and allied demyelinative diseases. In: Wonsiewicz MJ, Medina MP, Navzorov M (eds) Principles of neurology, 7th edn. McGraw-Hill, New York, pp 954–982

    Google Scholar 

  2. Zeigelboim BS, Arruda WO, Mangabeira-Albernaz PL, Iorio MC, Jurkiewicz AL, Martins-Bassetto J, Klagenberg KF (2008) Vestibular findings in relapsing, remitting multiple sclerosis: a study of thirty patients. Int Tinnitus J 14:139–145

    PubMed  Google Scholar 

  3. Vucic S (2012) The re-emergence of evoked potentials in multiple sclerosis; from diagnosis to prognostication. Clin Neurophysiol 123:221–222

    PubMed  Article  Google Scholar 

  4. Aghamollaii V, Harirchian MH, Modabbernia A, Ghaffarpour M, Mousavi M, Tafakhori A (2011) Sympathetic skin response (SSR) in multiple sclerosis and clinically isolated syndrome: a case-control study. Neurophysiol Clin 41:161–171

    PubMed  Article  CAS  Google Scholar 

  5. Lori S, Portaccio E, Zipoli V, Giannini M, Scarpelli S, Goretti B, Amato MP (2011) Cognitive impairment and event-related potentials in paediatric multiple sclerosis: 2-year study. Neurol Sci 32:1043–1046

    PubMed  Article  CAS  Google Scholar 

  6. Mikropoulos EH, Papathanasiou AA, Hadjigeorgiou G, Tsironi E, Papadimitriou A (2010) Supratentorial multiple sclerosis lesions affect the blink reflex test. Open Neurol J 4:92–99

    PubMed  Article  Google Scholar 

  7. Nazliel B, Irkec C, Kocer B (2002) The roles of blink reflex and sympathetic skin response in multiple sclerosis diagnosis. Mult Scler 8:500–504

    PubMed  Article  CAS  Google Scholar 

  8. Polman CH, Reingold SC, Banwell B et al (2011) Diagnostic criteria for multiple sclerosis: 2010 revisions to the McDonald criteria. Ann Neurol 69:292–302

    PubMed  Article  Google Scholar 

  9. Kurtzke JF (1983) Rating neurologic impairment in multiple sclerosis: an expended disability status scale (EDSS). Neurology 33:1444–1452

    PubMed  Article  CAS  Google Scholar 

  10. Valls-Sole J (2012) Assessment of excitability in brainstem circuits mediating the blink reflex and the startle reaction. Clin Neurophysiol 123:13–20

    PubMed  Article  Google Scholar 

  11. Rossi B, Buonaguidi R, Muratorio A et al (1979) Blink reflexes in posterior fossa lesions. J Neurol Neurosurg Psychiatry 42:465–469

    PubMed  Article  CAS  Google Scholar 

  12. Xu T, Cui LY, Li BH et al (2007) Clinical value of blink reflex: analysis of 548 patients. Zhonghua Yi Xue Za Zhi 87:1348–1350

    PubMed  Google Scholar 

  13. Walsh JC, Garrick R, Cameron J et al (1982) Evoked potential changes in clinically definite multiple sclerosis. J Neurol Neurosurg Psychiatry 45:494–500

    PubMed  Article  CAS  Google Scholar 

  14. Raffaele R, Vecchio I, Alvano A, Proto G, Nicoletti G, Rampello L (2004) Blink reflex abnormalities in Tourette syndrome. Clin Neurophysiol 115:320–324

    PubMed  Article  Google Scholar 

  15. Aramideh M, Ongerboer de Visser BW, Koelman JH, Majoie CB, Holstege G (1997) The late blink reflex response abnormality due to lesion of the lateral tegmental field. Brain 120:1685–1692

    PubMed  Article  Google Scholar 

  16. Barkhof F (2002) The clinico-radiological paradox in multiple sclerosis revisited. Curr Opin Neurol 15:239–245

    PubMed  Article  Google Scholar 

  17. Klissurski M, Novachkova S, Tzvetanov P, Alexiev F (2009) Orbicularis oculi reflex abnormalities in patients with multiple sclerosis: a clinical, EMG, and MRI investigation. Electromyogr Clin Neurophysiol 49:59–63

    PubMed  CAS  Google Scholar 

Download references

Acknowledgments

We did not utilise any financial support or funding during the patient follow-up period. “The results of this study were presented as a poster presentation in 16th Congress of the European-Federation-of-Neurological-Societies (EFNS) Location: Stockholm, SWEDEN Date: SEP 08-11, 2012”.

Conflict of interest

The authors report no conflicts of interest. The authors alone are responsible for the content and composition of the paper.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Eylem Degirmenci.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Degirmenci, E., Erdogan, C. & Bir, L.S. Correlation between blink reflex abnormalities and magnetic resonance imaging findings in patients with multiple sclerosis. Acta Neurol Belg 113, 265–269 (2013). https://doi.org/10.1007/s13760-012-0175-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s13760-012-0175-1

Keywords

  • Multiple sclerosis
  • Blink reflex test
  • Magnetic resonance imaging
  • Brainstem