Shalash Ali Soliman, Hassan Dalia Mohamed, Elrassas Hanan Hani, Salama Mohamed Mosaad, Méndez-Hernández Edna, Salas-Pacheco José M, Arias-Carrión Oscar
Department of Neurology, Ain Shams University , Cairo , Egypt.
Audiology Unit, Department of Otorhinolaryngology, Ain Shams University , Cairo , Egypt.
Front Neurol. 2017 Feb 27;8:55. doi: 10.3389/fneur.2017.00055. eCollection 2017.
Degeneration of several brainstem nuclei has been long related to motor and non-motor symptoms (NMSs) of Parkinson's disease (PD). Nevertheless, due to technical issues, there are only a few studies that correlate that association. Brainstem auditory-evoked potential (BAEP) and vestibular-evoked myogenic potential (VEMP) responses represent a valuable tool for brainstem assessment. Here, we investigated the abnormalities of BAEPs, ocular VEMPs (oVEMPs), and cervical VEMPs (cVEMPs) in patients with PD and its correlation to the motor and NMSs. Fifteen patients diagnosed as idiopathic PD were evaluated by Unified Parkinson's Disease Rating Scale and its subscores, Hoehn and Yahr scale, Schwab and England scale, and Non-Motor Symptoms Scale. PD patients underwent pure-tone, speech audiometry, tympanometry, BAEP, oVEMPs, and cVEMPs, and compared to 15 age-matched control subjects. PD subjects showed abnormal BAEP wave morphology, prolonged absolute latencies of wave V and I-V interpeak latencies. Absent responses were the marked abnormality seen in oVEMP. Prolonged latencies with reduced amplitudes were seen in cVEMP responses. Rigidity and bradykinesia were correlated to the BAEP and cVEMP responses contralateral to the clinically more affected side. Contralateral and ipsilateral cVEMPs were significantly correlated to sleep ( = 0.03 and 0.001), perception ( = 0.03), memory/cognition ( = 0.025), and urinary scores ( = 0.03). The oVEMP responses showed significant correlations to cardiovascular ( = 0.01) and sexual dysfunctions ( = 0.013). PD is associated with BAEP and VEMP abnormalities that are correlated to the motor and some non-motor clinical characteristics. These abnormalities could be considered as potential electrophysiological biomarkers for brainstem dysfunction and its associated motor and non-motor features.
几个脑干核团的退化长期以来一直与帕金森病(PD)的运动和非运动症状(NMSs)相关。然而,由于技术问题,仅有少数研究将这种关联联系起来。脑干听觉诱发电位(BAEP)和前庭诱发肌源性电位(VEMP)反应是脑干评估的一种有价值的工具。在此,我们研究了PD患者的BAEP、眼VEMP(oVEMP)和颈VEMP(cVEMP)异常及其与运动和NMSs的相关性。通过统一帕金森病评定量表及其子评分、霍恩和雅尔量表、施瓦布和英格兰量表以及非运动症状量表对15例诊断为特发性PD的患者进行评估。PD患者接受了纯音、言语听力测定、鼓室图、BAEP、oVEMP和cVEMP检查,并与15名年龄匹配的对照受试者进行比较。PD受试者表现出BAEP波形态异常,V波绝对潜伏期和I-V峰间潜伏期延长。oVEMP中明显的异常表现为反应缺失。cVEMP反应中可见潜伏期延长且波幅降低。强直和运动迟缓与临床受累更严重一侧对侧的BAEP和cVEMP反应相关。对侧和同侧cVEMP与睡眠(分别为0.03和0.001)、感知(0.03)、记忆/认知(0.025)和排尿评分(0.03)显著相关。oVEMP反应与心血管功能障碍(0.01)和性功能障碍(0.013)显著相关。PD与BAEP和VEMP异常相关,这些异常与运动和一些非运动临床特征相关。这些异常可被视为脑干功能障碍及其相关运动和非运动特征的潜在电生理生物标志物。