title: Abnormalities of vestibular-evoked myogenic potentials in idiopathic Parkinson's disease are associated with clinical evidence of brainstem involvement.
abstract: Brainstem degeneration in Parkinson's disease (PD) may explain the occurrence of many non-motor symptoms in this condition. Purposes of the present work were to investigate brainstem function in PD through a battery of vestibular-evoked myogenic potentials (VEMP) allowing a comprehensive brainstem exploration and to correlate VEMP findings with symptoms related to brainstem involvement. Cervical (cVEMP), masseter (mVEMP) and ocular (oVEMP) VEMPs were investigated in 24 PD patients and compared with those recorded in 24 age-matched controls. Presence of symptoms ascribable to brainstem dysfunction, such as daytime sleepiness, REM sleep behavior disorder and depression, was investigated through Epworth Sleepiness Scale, Parkinson's Disease Sleep Scale, REM Sleep Disorder Screening Questionnaire (RBD-SQ) and Geriatric Depression Scale. Postural instability was additionally assessed through mini-BESTest. The frequency of alteration of VEMPs in patients was 83.3 % when considering the whole set and 41.7 % for cVEMP, 66.7 % for mVEMP and 45.8 % for oVEMP. This was significantly different from controls, with absence being the prevalent alteration in PD. A significant inverse correlation between the number of altered VEMPs and mini-BESTest and a direct correlation with RBD-SQ were found. The VEMP battery under study allowed the identification of brainstem dysfunctions in PD patients, which correlated with clinical tests suggestive of postural and REM sleep disorders. VEMPs might represent a valuable tool of brainstem assessment in PD.
authors.affiliation: Department of Biomedical Sciences, University of Sassari, Viale San Pietro 43/b, 07100, Sassari, Italy.
authors.forename: Edoardo R
authors.initials: ER
authors.lastname: de Natale
authors.forename: Francesca
authors.initials: F
authors.lastname: Ginatempo
authors.forename: Kai S
authors.initials: KS
authors.lastname: Paulus
authors.forename: Giovanni M
authors.initials: GM
authors.lastname: Pes
authors.forename: Andrea
authors.initials: A
authors.lastname: Manca
authors.forename: Eusebio
authors.initials: E
authors.lastname: Tolu
authors.forename: Virgilio
authors.initials: V
authors.lastname: Agnetti
authors.forename: Franca
authors.initials: F
authors.lastname: Deriu
mesh_terms: D000368:Aged; D001933:Brain Stem / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000503:physiopathology*; D020187:REM Sleep Behavior Disorder / Q000503:physiopathology*; D058585:Vestibular Evoked Myogenic Potentials / Q000502:physiology*