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Abnormalities of vestibular-evoked myogenic potentials in idiopathic Parkinson’s disease are associated with clinical evidence of brainstem involvement

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Abstract

Brainstem degeneration in Parkinson’s disease (PD) may explain the occurrence of many non-motor symptoms in this condition. Purposes of the present work were to investigate brainstem function in PD through a battery of vestibular-evoked myogenic potentials (VEMP) allowing a comprehensive brainstem exploration and to correlate VEMP findings with symptoms related to brainstem involvement. Cervical (cVEMP), masseter (mVEMP) and ocular (oVEMP) VEMPs were investigated in 24 PD patients and compared with those recorded in 24 age-matched controls. Presence of symptoms ascribable to brainstem dysfunction, such as daytime sleepiness, REM sleep behavior disorder and depression, was investigated through Epworth Sleepiness Scale, Parkinson’s Disease Sleep Scale, REM Sleep Disorder Screening Questionnaire (RBD-SQ) and Geriatric Depression Scale. Postural instability was additionally assessed through mini-BESTest. The frequency of alteration of VEMPs in patients was 83.3 % when considering the whole set and 41.7 % for cVEMP, 66.7 % for mVEMP and 45.8 % for oVEMP. This was significantly different from controls, with absence being the prevalent alteration in PD. A significant inverse correlation between the number of altered VEMPs and mini-BESTest and a direct correlation with RBD-SQ were found. The VEMP battery under study allowed the identification of brainstem dysfunctions in PD patients, which correlated with clinical tests suggestive of postural and REM sleep disorders. VEMPs might represent a valuable tool of brainstem assessment in PD.

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Acknowledgments

The authors are thankful to Prof. J.C. Rothwell for his helpful suggestions and Mr. Paul Gottlieb for language revision. Dr Francesca Ginatempo was supported by Fondazione Banco di Sardegna Sassari (Italy).

Conflict of interest

The authors report no conflicts.

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Authors and Affiliations

  1. Department of Biomedical Sciences, University of Sassari, Viale San Pietro 43/b, 07100, Sassari, Italy

    Edoardo R. de Natale, Francesca Ginatempo, Andrea Manca, Eusebio Tolu & Franca Deriu

  2. Department of Clinical and Experimental Medicine, University of Sassari, Sassari, Italy

    Kai S. Paulus, Giovanni M. Pes & Virgilio Agnetti

Authors
  1. Edoardo R. de Natale
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  2. Francesca Ginatempo
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  3. Kai S. Paulus
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  4. Giovanni M. Pes
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  5. Andrea Manca
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  6. Eusebio Tolu
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  7. Virgilio Agnetti
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  8. Franca Deriu
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Correspondence to Franca Deriu.

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de Natale, E.R., Ginatempo, F., Paulus, K.S. et al. Abnormalities of vestibular-evoked myogenic potentials in idiopathic Parkinson’s disease are associated with clinical evidence of brainstem involvement. Neurol Sci 36, 995–1001 (2015). https://doi.org/10.1007/s10072-014-2054-4

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  • DOI: https://doi.org/10.1007/s10072-014-2054-4

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