Electrophysiologic vestibular evaluation in type 2 diabetic and prediabetic patients: Air conduction ocular and cervical vestibular evoked myogenic potentials

Konukseven, Özlem; Polat, Şefika Burçak; Karahan, Sevilay; Konukseven, E.; Ersoy, Reyhan; Çakır, Bekir; Kutluhan, Ahmet; Aksoy, Songül

doi:10.3109/14992027.2014.971887

Cited by 29 publications

(41 citation statements)

References 28 publications

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“…Recent studies have shown that otolith organ function is impaired in people with type 2 diabetes, particularly in those with a longer duration of diabetes [6, 13]. Animal studies have shown morphological changes in the saccule of rats in experimentally induced diabetes due to metabolic stress [14].…”

Section: Discussionmentioning

confidence: 99%

“…The cause of this displacement has been postulated to be due to underlying degeneration of the macula of the otolith organs [12]. Diabetes, by increasing metabolic stress, has been shown to contribute to the degeneration of the otolith organs [6, 13, 14]. In fact, otolith dysfunction has been shown in people with diabetes, particularly in those with prolonged duration of diabetes and in those with poor glycemic control [13].…”

Section: Introductionmentioning

confidence: 99%

“…Diabetes, by increasing metabolic stress, has been shown to contribute to the degeneration of the otolith organs [6, 13, 14]. In fact, otolith dysfunction has been shown in people with diabetes, particularly in those with prolonged duration of diabetes and in those with poor glycemic control [13]. BPPV causes transient vertigo that is provoked by change in head position, and is associated with loss of balance and frequent falls [12].…”

Section: Introductionmentioning

confidence: 99%

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Postural sway in individuals with type 2 diabetes and concurrent benign paroxysmal positional vertigo

D’Silva

Kluding

Whitney

et al. 2017

International Journal of Neuroscience

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Background and Purpose Diabetes has been shown to affect the peripheral vestibular end organs and is associated with an increase in the frequency of benign paroxysmal positional vertigo (BPPV). People with diabetes have higher postural sway; however, the impact of symptomatic BPPV on postural sway in individuals with diabetes is unclear. The purpose of this cross-sectional study was to examine postural sway in people with type 2 diabetes who have symptomatic, untreated BPPV (BPPVDM). Methods Fifty-two participants (mean age 56.9 ± 5.6 years) were enrolled: controls (n=14), diabetes (n=14), BPPV only (n=13) and BPPVDM (n=11). An inertial motion sensor was used to detect pelvic acceleration across five standing conditions with eyes open/closed on firm/foam surfaces. Range of acceleration (cm/s2), peak velocity (cm/s), and variability of sway (RMS) in the anterior-posterior (AP) and medial-lateral (ML) directions were used to compare postural sway between groups across conditions. Results Participants with BPPVDM had higher ranges of acceleration in the AP (p=0.02) and ML (p=0.02) directions, as well as higher peak velocity (p<0.001) and RMS values (p=0.006) in the AP direction compared to the control and diabetes groups. Standing on foam with eyes closed and tandem stance were challenging conditions for people with BPPVDM. Conclusion Clinicians may consider using standing on foam with eyes closed and tandem standing with eyes open to assess postural control in people with BPPVDM to identify postural instability.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Postural sway in individuals with type 2 diabetes and concurrent benign paroxysmal positional vertigo

D’Silva

Kluding

Whitney

et al. 2017

International Journal of Neuroscience

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“…Similarly, sand rats with diet-induced hyperglycemia had reduced amplitudes and prolonged latencies of the linear vestibular evoked potential (VsEP), which is an objective correlate of otolith end organ dysfunction (26). Some (11, 12), but not all (13, 27), human studies also found delayed latencies of the cVEMP response among those with DM. However, our study was not designed to identify the histopatholgic correlates of cVEMP latency differences, as they are more likely to result from retrolabyrinthine neural pathology (28).…”

Section: Discussionmentioning

confidence: 96%

Vascular and Neuroepithelial Histopathology of the Saccule in Humans With Diabetes Mellitus

Koçdor

Kaya

Erdil

et al. 2016

Otology &Amp; Neurotology

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Hypothesis This study aimed to determine if there are quantitative differences in the neuroepithelium and microvasculature of the saccule between subjects with and without diabetes mellitus (DM). Background Histopathologic changes that may underlie the association between DM and vestibular dysfunction have not been characterized in humans. Methods Human temporal bones (HTBs) from 39 subjects with DM (n=16 type I DM (T1DM), n=23 type II DM (T2DM)) were compared to 40 group age-matched controls. Vessel wall thickness was measured from the saccular arteriole. Type I and type II vestibular hair cell (VHC) counts were performed on perpendicularly oriented saccular maculae using differential interference contrast microscopy (T1DM: 5 HTB/3 subjects; T2DM: 9HTB/8 subjects; controls: 25 HTB/20 subjects). Results The mean density of type I VHCs was 16 to 17% lower in the DM groups compared to controls (T1DM 52.21 [4.26], T2DM 53.3[5.34], control 63.14 [2.49] cells/mm2, p=0.02). There were no differences between T1DM, T2DM, and control groups in type II VHC density (T1DM 40.89 [5.17], T2DM 40.44 [6.93], control 42.80 [1.79] cells/mm2, p=0.92) or in mean vessel wall thickness (T1DM 2.23[0.62], T2DM 2.18 [0.53], control 2.00 [0.53] μm, p=0.26). Conclusion Neuroepithelial pathology, manifested as lower density of type I VHCs, was observed in the saccules of subjects with DM. Saccular microangiopathy, expressed as alterations in arteriole thickness, was not observed. These findings are consistent with histologic observations in animals with experimentally induced diabetes. DM may have a selective and deleterious effect on human vestibular sensory epithelia.

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“…10, 11 Degeneration of the maculae of the utricle and saccule can cause otoconia fragments to dislodge, which is the cause of one common peripheral vestibular condition, benign paroxysmal positional vertigo (BPPV). 12, 13 Recent studies have shown that BPPV is present in higher frequency in people with both type 1 and type 2 diabetes compared to healthy controls.…”

Section: Introductionmentioning

confidence: 99%

Otolith Dysfunction in Persons With Both Diabetes and Benign Paroxysmal Positional Vertigo

D’Silva

Staecker²,

Lin³

et al. 2017

Otology &Amp; Neurotology

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Objective-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.Study Design-Prospective, cross-sectional study. Setting-Tertiary HHS Public Access Author Manuscript Author ManuscriptAuthor Manuscript Author ManuscriptSubjects and Methods-Participants 40-65 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.Results-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 to 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).Conclusion-Although, BPPV and DM may independently affect utricle and saccule function, they do not appear to have a distinct cumulative effect.

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Electrophysiologic vestibular evaluation in type 2 diabetic and prediabetic patients: Air conduction ocular and cervical vestibular evoked myogenic potentials

Abstract: Subclinical vestibular neuropathy can be a newly defined diabetes-related complication.

Cited by 29 publications

References 28 publications

Postural sway in individuals with type 2 diabetes and concurrent benign paroxysmal positional vertigo

Postural sway in individuals with type 2 diabetes and concurrent benign paroxysmal positional vertigo

Vascular and Neuroepithelial Histopathology of the Saccule in Humans With Diabetes Mellitus

Otolith Dysfunction in Persons With Both Diabetes and Benign Paroxysmal Positional Vertigo

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