Hacettepe University, Faculty of Health Sciences, Department of Audiology, Ankara, Turkey.
Hacettepe University, Faculty of Health Sciences, Department of Audiology, Ankara, Turkey; Hacettepe University, Dizziness and Balance Disorders Research and Application Center, Ankara, Turkey.
Clin Neurophysiol. 2021 Aug;132(8):1813-1819. doi: 10.1016/j.clinph.2021.04.014. Epub 2021 May 24.
This study aimed to examine the vestibulo-collic reflex (VCR) and linear vestibulo-ocular reflex (lVOR) and their correlation with brain lesions in pediatric-onset multiple sclerosis (POMS).
The study group consisted of 17 patients (34 ears) with POMS (mean age 18.73 ± 2.02, mean age at disease onset 14.64 ± 1.36 years), and the control group included 11 age-matched healthy subjects (22 ears). Ocular and cervical Vestibular Evoked Myogenic Potentials (oVEMP and cVEMP) were performed to assess IVOR and VCR pathways. Magnetic Resonance Imaging was evaluated in the study group.
In the POMS group, 47.05 % of oVEMPs and 17.64 % of the cVEMPs were abnormal, while all VEMPs were normal in the control group. The oVEMP amplitude was associated with infratentorial lesion volume (r = -0.459, p = 0.01) and total lesion volume of the brainstem and cerebellum (r = -0.450, p = 0.01). The cVEMP asymmetry ratio was correlated with the deep white matter lesion volume (r = 0.683, p < 0.001). The MVEMP scores were found to correlate only with lesion volumes in the cerebellum (r = 0.488, p = 0.04) and infratentorial region (r = 0.573, p = 0.01).
Ocular and cervical VEMP abnormalities confirm that lVOR and VCR pathways may be affected in early POMS.
Routine use of the VEMP test, especially the oVEMP test is recommended as a useful tool in the follow-up of POMS patients.
本研究旨在探讨儿童发病多发性硬化症（POMS）患者的前庭眼反射（VOR）和前庭脊髓反射（VCR）及其与脑损伤的相关性。
研究组由 17 例 POMS 患者（34 耳，平均年龄 18.73±2.02 岁，发病平均年龄 14.64±1.36 岁）组成，对照组为 11 例年龄匹配的健康受试者（22 耳）。采用眼肌和颈肌前庭诱发肌源性电位（oVEMP 和 cVEMP）评估 lVOR 和 VCR 通路。对研究组进行磁共振成像评估。
在 POMS 组中，47.05%的 oVEMP 和 17.64%的 cVEMP 异常，而对照组所有 VEMP 均正常。oVEMP 振幅与小脑幕下病变体积（r=−0.459，p=0.01）和脑桥与小脑的总病变体积（r=−0.450，p=0.01）相关。cVEMP 不对称比与深部白质病变体积（r=0.683，p<0.001）相关。MVEMP 评分仅与小脑（r=0.488，p=0.04）和小脑幕下（r=0.573，p=0.01）病变体积相关。
眼肌和颈肌 VEMP 异常证实 lVOR 和 VCR 通路可能在早期 POMS 中受到影响。
建议常规使用 VEMP 测试，特别是 oVEMP 测试，作为 POMS 患者随访的有用工具。
