Department of Neurology, Tamil Nadu Government Multi Super Speciality Hospital, Chennai, India.
Department of Audiology, All India Institute of Speech and Hearing, Mysuru, Karnataka, India.
Am J Audiol. 2021 Jun 14;30(2):255-265. doi: 10.1044/2020_AJA-20-00155. Epub 2021 Mar 26.
Purpose The brainstem dysfunction in multiple sclerosis (MS) often causes significant functional impairment leading to disability. This study aims to explore modified brainstem auditory evoked potential (BAEP) scores based on the pattern of BAEP abnormalities and relate with brainstem symptoms, brainstem functional system scores (BFSS), brainstem lesions, and disability. Method Forty-five participants with relapsing-remitting MS and 45 age- and gender-matched healthy controls underwent case history assessment, otoscopic examination, pure-tone audiometry, and BAEP testing. Also, neurological examination (Expanded Disability Status Scale, FSS scales) and magnetic resonance imaging were carried out on MS participants. Patterns of BAEP abnormalities were categorized and converted to BAEP scores. Results Out of 45 participants' brainstem symptoms, BFSS > 1, brainstem lesions (magnetic resonance imaging), and BAEP abnormalities were observed in 75.6%, 42.2%, 62.2%, and 55.56% of participants, respectively. Waves V and III abnormalities were more common among MS participants and showed a significant difference from the control group in the Mann-Whitney test. Chi-square test did not show a significant association of BAEP abnormalities with brainstem symptoms and lesions but showed significant association with BFSS. The mean and standard deviation of BAEP scores in MS participants were 1.73 + 2.37. All healthy controls showed BAEP scores of 0. BAEP scores in MS participants showed significant correlation with BFSS scores and predict Expanded Disability Status Scale scores. Conclusion BAEP scores based on the pattern of BAEP abnormality can be a valid and useful measure in evaluating brainstem functions and predicting disability in MS.
目的 多发性硬化症(MS)患者的脑干功能障碍常导致严重的功能损伤,进而导致残疾。本研究旨在探讨基于脑干听觉诱发电位(BAEP)异常模式的改良 BAEP 评分,并与脑干症状、脑干功能系统评分(BFSS)、脑干病变和残疾相关。
方法 45 例复发缓解型 MS 患者和 45 名年龄和性别匹配的健康对照者接受了病史评估、耳镜检查、纯音听阈测试和 BAEP 测试。同时,对 MS 患者进行了神经系统检查(扩展残疾状况量表、FSS 量表)和磁共振成像检查。将 BAEP 异常模式进行分类并转换为 BAEP 评分。
结果 在 45 名患者的脑干症状中,75.6%、42.2%、62.2%和 55.56%的患者分别存在 BFSS > 1、脑干病变(磁共振成像)、BAEP 异常。MS 患者中 V 波和 III 波异常更为常见,与对照组比较差异具有统计学意义(Mann-Whitney 检验)。卡方检验未显示 BAEP 异常与脑干症状和病变之间存在显著相关性,但与 BFSS 显著相关。MS 患者的 BAEP 评分均值和标准差分别为 1.73 ± 2.37。所有健康对照者的 BAEP 评分为 0。MS 患者的 BAEP 评分与 BFSS 评分显著相关,可预测扩展残疾状况量表评分。
结论 基于 BAEP 异常模式的 BAEP 评分可作为评估 MS 患者脑干功能和预测残疾的有效、有用的指标。