title: Otolith Dysfunction in Persons With Both Diabetes and Benign Paroxysmal Positional Vertigo.
abstract: Vestibular dysfunction is a well-recognized complication of type 2 diabetes (DM) that may contribute to increased fall risk. The prevalence of benign paroxysmal positional vertigo (BPPV) is higher in people with DM. The impact of DM on the otolith organs of the vestibular system in people with BPPV is unknown. The purpose of this study was to analyze otolith function using vestibular-evoked myogenic potential (VEMP) tests in people with DM and concurrent BPPV (BPPV + DM), and to examine the relationships between VEMP variables and diabetes-related variables.
  
  
  
  Prospective, cross-sectional study.
  
  
  
  Tertiary academic medical center.
  
  
  
  Participants 40 to 65 years were recruited in four groups: controls (n = 20), people with DM (n = 19), BPPV (n = 18), and BPPV + DM (n = 14). Saccule and utricle function were examined using cervical VEMP (cVEMP) and ocular VEMP (oVEMP), respectively. Diabetes-related variables such as HbA1c, duration of diabetes, and presence of sensory impairment due to diabetes were collected.
  
  
  
  The frequency of abnormal cVEMP responses was higher in the DM (p = 0.005), BPPV (p = 0.003), and BPPV + DM (p <0.001) groups compared with controls. In the participants with diabetes, higher HbA1c levels were correlated with prolonged P1 (p = 0.03) and N1 latencies (p = 0.03). The frequency of abnormal oVEMP responses was not different between groups (p = 0.2).
  
  
  
  Although BPPV and DM may independently affect utricle and saccule function, they do not seem to have a distinct cumulative effect.
authors.affiliation: *Department of Physical Therapy Education, Rockhurst University, Kansas City, Missouri †Department of Otolaryngology, Head and Neck Surgery ‡Department of Hearing and Speech, University of Kansas Medical Center, Kansas City, Kansas §Health Services and Outcomes Research, Children's Mercy Hospital, Kansas City, Missouri ||Department of Physical Therapy and Rehabilitation Science, University of Kansas Medical Center, Kansas City, Kansas.
authors.forename: Linda J
authors.initials: LJ
authors.lastname: DʼSilva
authors.forename: Hinrich
authors.initials: H
authors.lastname: Staecker
authors.forename: James
authors.initials: J
authors.lastname: Lin
authors.forename: Christy
authors.initials: C
authors.lastname: Maddux
authors.forename: John
authors.initials: J
authors.lastname: Ferraro
authors.forename: Hongying
authors.initials: H
authors.lastname: Dai
authors.forename: Patricia M
authors.initials: PM
authors.lastname: Kluding
mesh_terms: D000328:Adult; D000368:Aged; D065635:Benign Paroxysmal Positional Vertigo / Q000150:complications*; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010037:Otolithic Membrane / Q000503:physiopathology*; D011446:Prospective Studies; D058585:Vestibular Evoked Myogenic Potentials / Q000502:physiology