Vestibular-evoked myogenic potential: an easy neurophysiological tool for evaluating brain stem involvement in multiple sclerosis

Koura, Rabab Ahmed; Hussein, M. M.

doi:10.4103/ejo.ejo_73_17

Cited by 5 publications

(10 citation statements)

References 14 publications

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“…To determine the abnormal latencies of the cVEMP, We used the cut off values determined by ROC curve for left and right p13 latency of [>13.98 and >14.1] respectively, and for left and right N23 latency of [>24 and >24.8] respectively. This agreed with values in Zainun et al [17] . On the other side, there was no statistical significance between study and control group in asymmetry ratio and P13, N23 amplitudes.…”

Section: Disucssionsupporting

confidence: 93%

Vestibular Evoked Myogenic Potential in Multiple Sclerosis (MS)

Hamed

Beshr

Behairy

et al. 2020

International Journal of Medical Arts

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Background: Involvement of the brainstem in multiple sclerosis [MS] has significant implications on the disease course and can be presented with different symptoms. There are many tests able to detect brain-stem involvement in MS with various degrees of success. Aim of the work: To study the changes in vestibular evoked myogenic potential [VEMP], in patients with MS, and to detect its sensitivity for detection of the brain-stem lesions previously diagnosed with magnetic resonance imaging [MRI] in MS patients. Patients and Methods: Sixty participants had been enrolled and divided into two groups: 30 healthy subjects [Control group] and 30 MS patients [Study group]. Both groups had been subjected to otological examinations, pure tone audiometry, acoustic impedance, cervical vestibular evoked myogenic potential [cVEMP], ocular vestibular evoked myogenic potential [oVEMP] and MRI. Results: In MS group, oVEMP mean latencies of n1 and p1 and cVEMP mean p13 and n23 latencies were significantly prolonged. In addition, 14 MS patients [46.7%] had brainstem lesions as confirmed by MRI. Finally, oVEMP test had higher sensitivity than the cVEMP in prediction of brainstem lesions. Conclusion: oVEMP seems to be useful and more sensitive than cVEMP as an adjunct test in the evaluation of brain-stem dysfunction in MS patients.

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Section: Disucssionsupporting

confidence: 93%

Vestibular Evoked Myogenic Potential in Multiple Sclerosis (MS)

Hamed

Beshr

Behairy

et al. 2020

International Journal of Medical Arts

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“…Koura and Hussein [20] found that 60% of patients with MS were found to have absent VEMP (P13-N23) on both the right and left sides, which is a higher percentage than ours. Patients with preserved VEMP were found to have significantly delayed latency (P13-N23) in both right and left sides than controls.…”

Section: Comparison Of Cvemp and Ovemp In Ms And Controlscontrasting

confidence: 68%

Relation Between Cervical and Ocular Vestibular Evoked Myogenic Potentials and Brainstem Symptoms and Mri Lesions in Multiple Sclerosis Patients

Dabbous¹,

Shalaby²,

Abousetta³

et al. 2021

J Hear Sci

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Background: In multiple sclerosis (MS), even in the presence of clinical brainstem symptoms, the brainstem does not always show gross lesions on magnetic resonance imaging (MRI). However, MS may impair vestibular-evoked myogenic potential (VEMP) responses. Material and methods:This study included 70 participants, 40 who were MS patients and 30 healthy adult volunteers as controls. All participants were subjected to history taking, otological examination, basic audiological evaluation, bedside examination of the dizzy patient, cervical VEMP (cVEMP), and ocular VEMP (oVEMP).Results: Of the 40 MS patients, 37.5% had abnormal cVEMP and 67.5% had abnormal oVEMP. Some 23% of the 21 MS patients without brainstem lesions on MRI had abnormal cVEMP and oVEMP, including 69% of those who had vertigo. MS patients with brainstem lesions on MRI had significantly greater oVEMP latency than patients without similar MRI findings.Conclusions: MS patients showed dysfunction in the vestibulo-ocular and vestibulo-spinal reflexes. This dysfunction is reflected in impaired oVEMP and cVEMP respectively despite the absence of structural brainstem abnormalities. Thus, VEMP, especially oVEMP, can be used as an early indicator of brainstem involvement in MS before radiological signs appear on MRI.

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“…A total of 14 studies assessed VEMPs and included 724 participants (435 PwMS and 289 healthy controls), sample size varied from 30 to 88 and age range was between 18 and 71 years. Four studies evaluated both oVEMPs and cVEMPs35 58–60 and 10 studies evaluated cVEMPs 28–30 50 61–66. Thirteen of the 14 studies reported abnormalities in different VEMP components in PwMS as follows:…”

Section: Resultsmentioning

confidence: 99%

“… 29 Versino et al found abnormalities in 31.4% 28 and Koura and Hussein found abnormalities in 100% of PwMS who participated in their study. 66 The majority did not report type or duration of MS, or severity of impairment; therefore, it is difficult to speculate why some studies reported higher percentages of VEMP abnormalities in PwMS than others. The most common reported cVEMP abnormalities were prolonged p13 and n23 latencies 28–30 35 58 61–66 and the most common reported oVEMP abnormalities were prolonged p1 and n1 latencies.…”

Section: Discussionmentioning

confidence: 97%

“…For instance, Sartucci and Logi presented clicks at 140 dB sound pressure level at a rate of 3 per second, 61 Aidar and Suzuki presented clicks at 95 dB hearing level (HL) at a rate of 2 per second, 62 Kavasoğlu et al presented clicks at 100 dB nHL at a rate of 5 per second 65 and Koura and Hussein presented a 500 Hz tone burst at 95 dB HL. 66 Two studies conducted rotary chair testing. However, they tested and reported results from the same sample.…”

Section: Ms and Vestibular Functionmentioning

confidence: 99%

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Effects of multiple sclerosis on the audio-vestibular system: a systematic review

2022

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ObjectiveSystematically investigate the effects of multiple sclerosis (MS) on the audio-vestibular system.MethodsSystematic review of literature investigating audio-vestibular conditions in persons with MS (PwMS) aged ≥18 years. PubMed, Scopus, NICE and Web of Science were searched. Randomised controlled trials, and cohort, case–control, observational and retrospective studies in English, published from 2000 to 21 November 2021, evaluated PwMS with at least one outcome (pure tone audiometry, auditory brainstem response, otoacoustic emissions, cortical auditory evoked potentials, functional MRI assessing auditory function, vestibular evoked myogenic potentials, videonystagmography, electronystagmography, posturography, rotary chair, gaps in noise, word discrimination scores, duration pattern sequence test), were included. Study selection and assessments of bias were independently conducted by two reviewers using the Risk of Bias Assessment Tool for Non-randomized Studies, Newcastle-Ottawa Scale (NOS) and the NOS adapted for cross-sectional studies.Results35 studies were included. Auditory function was evaluated in 714 PwMS and 501 controls, vestibular function was evaluated in 682 PwMS and 446 controls. Peripheral auditory function results were contradictory between studies; some found abnormalities in PwMS, and others found no differences. Tests of brainstem and central auditory functions were more consistently found to be abnormal in PwMS. Most vestibular tests were reported as abnormal in PwMS, abnormalities were either peripheral or central or both. However, quantitative analyses could not be performed due to discrepancies between studies in results reporting, test stimulus and recording parameters.ConclusionsAlthough abnormal results on auditory and vestibular tests were noted in PwMS, specific effects of MS on the audio-vestibular system could not be determined due to the heterogeneity between studies that restricted the ability to conduct any quantitative analyses. Further research with consistent reporting, consistent stimulus and consistent recording parameters is needed in order to quantify the effects of MS on the auditory and vestibular systems.PROSPERO registration numberCRD42020180094.

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Vestibular-evoked myogenic potential: an easy neurophysiological tool for evaluating brain stem involvement in multiple sclerosis

Cited by 5 publications

References 14 publications

Vestibular Evoked Myogenic Potential in Multiple Sclerosis (MS)

Vestibular Evoked Myogenic Potential in Multiple Sclerosis (MS)

Relation Between Cervical and Ocular Vestibular Evoked Myogenic Potentials and Brainstem Symptoms and Mri Lesions in Multiple Sclerosis Patients

Effects of multiple sclerosis on the audio-vestibular system: a systematic review

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