title: Paired neurophysiological and clinical study of the brainstem at different stages of Parkinson's Disease.
abstract: OBJECTIVE
  To study brainstem function in Parkinson's Disease (PD) at different stages, through a battery of vestibular-evoked myogenic potentials (VEMPs) and compare the results with scores on clinical scales assessing the presence of symptoms linked to brainstem involvement.
  
  
  METHODS
  Cervical, masseter and ocular VEMPs were recorded in patients with early PD (n=14, disease duration 1.42±0.7years), advanced PD (n=19, disease duration 7.26±2.9years) and in 27 age-matched controls. In PD, the following clinical scales were administered: Mini-BESTest, REM sleep Behavior Disorder Screening Questionnaire (RBD-SQ), PD Sleep Scale, Epworth Sleepiness Scale and Geriatric Depression Scale.
  
  
  RESULTS
  Rate of VEMPs alterations was higher (p<0.001) in PD than controls, but similar within PD groups. However, early and advanced PD showed a different pattern of abnormalities (p=0.02), being latency delay prevalent in the former and absence in the latter. VEMP impairment correlated directly with RBD-SQ scores in both PD cohorts and inversely with Mini-BESTest scores in advanced PD.
  
  
  CONCLUSIONS
  VEMPs displayed progressive severity of alterations at different stages of PD, with remarkable correlations with presence of postural instability and RBD.
  
  
  CONCLUSIONS
  The combined use of VEMPs may provide interesting insights into the pathophysiological mechanisms of PD at the earliest and prodromal stage of the disease.
authors.affiliation: Department of Biomedical Sciences, University of Sassari, Italy.
authors.forename: E R
authors.initials: ER
authors.lastname: de Natale
authors.affiliation: Department of Biomedical Sciences, University of Sassari, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Ginatempo
authors.affiliation: Department of Clinical and Experimental Medicine, University of Sassari, Sassari, Italy.
authors.forename: K S
authors.initials: KS
authors.lastname: Paulus
authors.affiliation: Department of Biomedical Sciences, University of Sassari, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Manca
authors.affiliation: Department of Biomedical Sciences, University of Sassari, Italy.
authors.forename: B
authors.initials: B
authors.lastname: Mercante
authors.affiliation: Department of Clinical and Experimental Medicine, University of Sassari, Sassari, Italy.
authors.forename: G M
authors.initials: GM
authors.lastname: Pes
authors.affiliation: Department of Clinical and Experimental Medicine, University of Sassari, Sassari, Italy.
authors.forename: V
authors.initials: V
authors.lastname: Agnetti
authors.affiliation: Department of Biomedical Sciences, University of Sassari, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Tolu
authors.affiliation: Department of Biomedical Sciences, University of Sassari, Italy. Electronic address: deriuf@uniss.it.
authors.forename: F
authors.initials: F
authors.lastname: Deriu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001933:Brain Stem / Q000503:physiopathology*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000175:diagnosis* / Q000503:physiopathology*; D020187:REM Sleep Behavior Disorder / Q000175:diagnosis* / Q000503:physiopathology*; D058585:Vestibular Evoked Myogenic Potentials / Q000502:physiology
keywords: Brainstem; Parkinson’s Disease; Vestibular-evoked myogenic potentials; Vestibulo-collic reflex; Vestibulo-masseteric reflex; Vestibulo-ocular reflex