title: The vestibular evoked myogenic potentials (VEMP) score: a promising tool for evaluation of brainstem involvement in multiple sclerosis.
abstract: OBJECTIVE
  Concerning the great importance of brainstem involvement in multiple sclerosis (MS), the aim of this study was to explore the role of the newly developed vestibular evoked myogenic potentials (VEMP) score as a possible marker of brainstem involvement in MS patients.
  
  
  METHODS
  This was a prospective case-control study which included 100 MS patients divided into two groups (without and with clinical signs of brainstem involvement) and 50 healthy controls. Ocular VEMP (oVEMP) and cervical VEMP (cVEMP) measurements were performed in all participants and analyzed for latencies, conduction block and amplitude asymmetry ratio. Based on this the VEMP score was calculated and compared with Expanded Disability Status Scale (EDSS), disease duration and magnetic resonance imaging data.
  
  
  RESULTS
  Multiple sclerosis patients with clinical signs of brainstem involvement (group 2) had a statistically significant higher percentage of VEMP conduction blocks compared with patients without clinical signs of brainstem involvement (group 1) and healthy controls (P = 0.027 and P < 0.0001, respectively). Similarly, the VEMP score was significantly higher in group 2 compared with group 1 (P = 0.018) and correlated with EDSS and disease duration (P = 0.011 and P = 0.032, respectively). Multivariate linear regression analysis showed that the VEMP score has a statistically significant influence on the EDSS score (P < 0.001, R(2) = 0.239).
  
  
  CONCLUSIONS
  Interpretation of the oVEMP and cVEMP results in the form of the VEMP score enables better evaluation of brainstem involvement than either of these evoked potentials alone and correlates well with disability.
authors.affiliation: Department of Neurology, Referral Center for Demyelinating Diseases of the Central Nervous System, University Hospital Center Zagreb, Zagreb, Croatia.
authors.forename: T
authors.initials: T
authors.lastname: Gabelić
authors.forename: M
authors.initials: M
authors.lastname: Krbot Skorić
authors.forename: I
authors.initials: I
authors.lastname: Adamec
authors.forename: B
authors.initials: B
authors.lastname: Barun
authors.forename: I
authors.initials: I
authors.lastname: Zadro
authors.forename: M
authors.initials: M
authors.lastname: Habek
mesh_terms: D000293:Adolescent; D000328:Adult; D001933:Brain Stem / Q000473:pathology / Q000503:physiopathology*; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008297:Male; D009103:Multiple Sclerosis / Q000175:diagnosis / Q000473:pathology / Q000503:physiopathology*; D011446:Prospective Studies; D058585:Vestibular Evoked Myogenic Potentials / Q000502:physiology*; D055815:Young Adult
keywords: VEMP score; brainstem; multiple sclerosis; ocular and cervical vestibular evoked myogenic potentials