Ertugrul Gorkem, Konuskan Bahadır, Solmaz Ismail, Anlar Banu, Aksoy Songul
Hacettepe University, Faculty of Health Sciences, Department of Audiology, Ankara, Turkey.
Hacettepe University, Faculty of Medicine, Department of Pediatric Neurology, Ankara, Turkey.
Mult Scler Relat Disord. 2020 Sep;44:102329. doi: 10.1016/j.msard.2020.102329. Epub 2020 Jun 22.
Multiple Sclerosis (MS), an autoimmune demyelinating disease of the central nervous system, is an important cause of disability in young adults. The purpose of this cross-sectional study was to evaluate the vestibular system with video Head Impulse Test (vHIT) and determine the impairment of the Vestibulo-ocular Reflex (VOR) in childhood-onset MS.
The study group, 20 persons with MS (pwMS) with onset before 18 years of age (6 M, 14 F; mean age 19.06 ± 1.66) and the control group, 20 healthy, age- and sex-matched individuals were retrieved from vHIT recordings. The mean age of MS onset in the study group was 14.60 ± 1.53 years. The VOR pathway was evaluated using vHIT.
The median VOR gains of right anterior (1.00), left lateral (0.96) and left posterior (0.91) semicircular canals were significantly lower in the pwMS group than those of the healthy control group (1.05, 1.00, 0.98 respectively, p < 0.05). Four of pwMS (20%) had abnormal VOR gains. The pwMS with dizziness had significantly lower VOR gains (median 0.91) compared with pwMS without dizziness (median 1.01, p < 0.05).
This study demonstrates vestibulo-ocular system can be affected in patients with childhood-onset MS and suggests using vHIT especially in the follow-up of pwMS with dizziness.
多发性硬化症(MS)是中枢神经系统的一种自身免疫性脱髓鞘疾病,是年轻成年人残疾的重要原因。本横断面研究的目的是通过视频头脉冲试验(vHIT)评估前庭系统,并确定儿童期发病的MS患者的前庭眼反射(VOR)损害情况。
从vHIT记录中选取研究组,20例18岁前发病的多发性硬化症患者(pwMS)(6例男性,14例女性;平均年龄19.06±1.66岁)和对照组,20名年龄、性别匹配的健康个体。研究组MS发病的平均年龄为14.60±1.53岁。使用vHIT评估VOR通路。
pwMS组右前半规管(1.00)、左外侧半规管(0.96)和左后半规管(0.91)的VOR增益中位数显著低于健康对照组(分别为1.05、1.00、0.98,p<0.05)。4例pwMS(20%)的VOR增益异常。与无头晕的pwMS相比,有头晕的pwMS的VOR增益显著更低(中位数0.91)(中位数1.01,p<0.05)。
本研究表明儿童期发病的MS患者的前庭眼系统可能会受到影响,并建议尤其在对有头晕症状的pwMS进行随访时使用vHIT。