Department of Neurology, Peking University Third Hospital, Beijing, China.
Department of Neurology, Peking University Third Hospital, Beijing, China; Key Laboratory for Neuroscience, National Health Commission/Ministry of Education, Peking University, Beijing, China.
Clin Neurophysiol. 2019 May;130(5):647-654. doi: 10.1016/j.clinph.2019.01.023. Epub 2019 Feb 21.
To evaluate the diagnostic value of vestibular evoked myogenic potentials (VEMPs) in the assessment of brainstem function integrity in patients with amyotrophic lateral sclerosis (ALS).
This was a prospective case-control study including 30 definite or probable ALS patients divided into two groups (with or without brainstem involvement) and 30 healthy controls. Cervical (c-), masseter (m-) and ocular VEMP (o-VEMP) measurements were obtained for all the participants.
The c-VEMP mean p13 and n23 were significantly prolonged in the ALS patients. The interside peak differences in p13 and n23 of c-VEMP and in n10 and p15 of o-VEMP were significantly prolonged. The rates of alteration in c-VEMP, m-VEMP and o-VEMP in the ALS patients were 67%, 40%, and 45%, respectively. The ALS patients with brainstem involvement had a significantly higher percentage of VEMP abnormalities than did those without brainstem involvement (p = 0.027).
c-VEMP is a sensitive tool to detect lower levels of brainstem involvement. Impairments in o-VEMP and m-VEMP indicate involvement of the upper brainstem. The use of combined VEMPs may provide useful insights into the pathophysiological mechanism of ALS.
VEMPs may be useful in the evaluation of brainstem dysfunction in ALS patients.
评估前庭诱发肌源性电位（VEMPs）在评估肌萎缩侧索硬化症（ALS）患者脑干功能完整性中的诊断价值。
这是一项前瞻性病例对照研究，纳入 30 例明确或可能的 ALS 患者，分为有（无）脑干受累两组，以及 30 例健康对照。所有参与者均进行了颈（c-）、咬肌（m-）和眼肌（o-VEMP）VEMP 测量。
ALS 患者的 c-VEMP 平均 p13 和 n23 显著延长。c-VEMP 中 p13 和 n23 的双侧峰间差异以及 o-VEMP 中 n10 和 p15 的双侧峰间差异均显著延长。c-VEMP、m-VEMP 和 o-VEMP 的改变率分别为 67%、40%和 45%。有脑干受累的 ALS 患者的 VEMP 异常率明显高于无脑干受累者（p=0.027）。
c-VEMP 是检测较低水平脑干受累的敏感工具。o-VEMP 和 m-VEMP 的损害表明上脑干受累。联合使用 VEMPs 可能为 ALS 的病理生理机制提供有用的见解。
VEMPs 可用于评估 ALS 患者的脑干功能障碍。
