Crnošija Luka, Krbot Skorić Magdalena, Gabelić Tereza, Adamec Ivan, Habek Mario
School of Medicine, University of Zagreb, Zagreb, Croatia.
University Hospital Center Zagreb, Department of Neurology, Referral Center for Autonomic Nervous System Disorders, Zagreb, Croatia.
J Neurol Sci. 2017 Jan 15;372:28-32. doi: 10.1016/j.jns.2016.11.028. Epub 2016 Nov 14.
To validate the VEMP score as a measure of brainstem dysfunction in patients with the first symptom of multiple sclerosis (MS) (clinically isolated syndrome (CIS)) and to investigate the correlation between VEMP and brainstem MRI results.
121 consecutive CIS patients were enrolled and brainstem functional system score (BSFS) was determined. Ocular VEMP (oVEMP) and cervical VEMP (cVEMP) were analyzed for latencies, conduction block and amplitude asymmetry ratio and the VEMP score was calculated. MRI was analyzed for the presence of brainstem lesions as a whole and separately for the presence of pontine, midbrain and medulla oblongata lesions.
Patients with signs of brainstem involvement during the neurological examination (with BSFS ≥1) had a higher oVEMP score compared to patients with no signs of brainstem involvement. A binary logistic regression model showed that patients with brainstem lesion on the MRI are 6.780 times more likely to have BSFS ≥1 (p=0.001); and also, a higher VEMP score is associated with BSFS ≥1 (p=0.042). Furthermore, significant correlations were found between clinical brainstem involvement and brainstem and pontine MRI lesions, and prolonged latencies and/or absent VEMP responses.
The VEMP score is a valuable tool in evaluation of brainstem involvement in patients with early MS.
验证前庭诱发肌源性电位（VEMP）评分作为首发症状为多发性硬化（MS）（临床孤立综合征（CIS））患者脑干功能障碍的一项指标，并研究VEMP与脑干磁共振成像（MRI）结果之间的相关性。
纳入121例连续的CIS患者，测定脑干功能系统评分（BSFS）。分析眼VEMP（oVEMP）和颈VEMP（cVEMP）的潜伏期、传导阻滞及波幅不对称率，并计算VEMP评分。对MRI进行分析，观察脑干整体病变情况以及脑桥、中脑和延髓的病变情况。
神经系统检查时有脑干受累体征（BSFS≥1）的患者，其oVEMP评分高于无脑干受累体征的患者。二元逻辑回归模型显示，MRI上有脑干病变的患者BSFS≥1的可能性高6.780倍（p=0.001）；而且，较高的VEMP评分与BSFS≥1相关（p=0.042）。此外，临床脑干受累与脑干及脑桥MRI病变、潜伏期延长和/或VEMP反应缺失之间存在显著相关性。
VEMP评分是评估早期MS患者脑干受累情况的一项有价值的工具。
