Auditory- and Vestibular-Evoked Potentials Correlate with Motor and Non-Motor Features of Parkinson’s Disease

Abstract

Degeneration of several brainstem nuclei has been long related to motor and non-motor symptoms (NMSs) of Parkinson’s disease (PD). Nevertheless, due to technical issues, there are only a few studies that correlate that association. Brainstem auditory-evoked potential (BAEP) and vestibular-evoked myogenic potential (VEMP) responses represent a valuable tool for brainstem assessment. Here, we investigated the abnormalities of BAEPs, ocular VEMPs (oVEMPs), and cervical VEMPs (cVEMPs) in patients with PD and its correlation to the motor and NMSs. Fifteen patients diagnosed as idiopathic PD were evaluated by Unified Parkinson’s Disease Rating Scale and its subscores, Hoehn and Yahr scale, Schwab and England scale, and Non-Motor Symptoms Scale. PD patients underwent pure-tone, speech audiometry, tympanometry, BAEP, oVEMPs, and cVEMPs, and compared to 15 age-matched control subjects. PD subjects showed abnormal BAEP wave morphology, prolonged absolute latencies of wave V and I–V interpeak latencies. Absent responses were the marked abnormality seen in oVEMP. Prolonged latencies with reduced amplitudes were seen in cVEMP responses. Rigidity and bradykinesia were correlated to the BAEP and cVEMP responses contralateral to the clinically more affected side. Contralateral and ipsilateral cVEMPs were significantly correlated to sleep (p = 0.03 and 0.001), perception (p = 0.03), memory/cognition (p = 0.025), and urinary scores (p = 0.03). The oVEMP responses showed significant correlations to cardiovascular (p = 0.01) and sexual dysfunctions (p = 0.013). PD is associated with BAEP and VEMP abnormalities that are correlated to the motor and some non-motor clinical characteristics. These abnormalities could be considered as potential electrophysiological biomarkers for brainstem dysfunction and its associated motor and non-motor features.

Stimulation of the subparafascicular thalamic nucleus modulates dopamine release in the inferior colliculus of rats

“…However, there is evidence demonstrating that these auditory deficits are not merely age‐related hearing loss, but are rather components of dysfunctional cognitive and sensory processing (Folmer, Vachhani, Theodoroff, Ellinger, & Riggins, ; Lai, Liao, Lin, Lin, & Sung, ; Yylmaz et al, ). As such, PD‐related auditory deficits also involve attentional, motivational and motoric components likely associated to parallel cortico‐thalamic‐striatal‐cerebellar loops modulated by dopamine (Clark, Adams, Dykstra, Moodie, & Jog, ; Gräber, Hertrich, Daum, Spieker, & Ackermann, ; Schröder, Nikolova, & Dengler, ; Shalash et al, ; Vitale et al, ). This was evidenced by improved performance of PD patients in perceiving somesthetic, visual, and auditory stimuli as separate entities after levodopa treatment (Artieda, Pastor, Lacruz, & Obeso, ).…”

Aplicações dos potenciais evocados miogênicos vestibulares: revisão sistemática de literatura

“…Regarding the design, eight (29%) studies were descriptive (5)(6)(16)(17)(18)28,(30)(31) ,19 (68%) were comparative cross-secti onal (7)(8)(9)(10)(12)(13)(14)(15)(19)(20)(21)29,(32)(33)(34)(35)(36)(37)(38) , and one (3%) was longitudinal cohort (39) .…”

“…With respect to the diseases, the most commonly investigated clinical applications in patients with vestibular disorders referred to Meniere's disease (5)(6)29) , superior semicircular canal dehiscence syndrome (8)(9)(10)32) , vestibular schwannoma (12)(13) , and central ischemic lesions (15)(16)(17)(18)(19)(20)(21)(36)(37) .…”

“…Concerning the type of applied stimulation, the number (%) of studies using the sound or the electric stimulation were: 19 (68%), auditory -rarefaction tone burst (6)(7)9,12,(14)(15)(16)(17)(18)21,(28)(29)(30)(31)33,(35)(36)(38)(39) ; three (11%), auditory -rarefaction tone burst and click (8,13,32) ; two (7%), auditory -click (10,37) ; two (7%), galvanic (20,34) ; one (3.5%), auditory -click and galvanic (5) ; one (3.5%), auditory -rarefaction tone burst and galvanic (19) . The electric current intensity of galvanic stimulation ranged from 1 to 5 mA (5,19,20,34) .…”

“…The VEMP has been utilized to study a variety of vestibular diseases. Among peripheral diseases, Meniere's disease (5,6) , vestibular neuritis (7) , superior semicircular canal dehiscence (8)(9)(10) , large vestibular aqueduct syndrome (11) , and vestibular schwannoma (12,13) are highlighted, whereas among central vestibular diseases, vestibular migraine (14) , Parkinson's disease (15) , central ischemic lesions (16)(17)(18) , and motor myelopathies (19)(20)(21)(22)(23)(24)(25) stand out.…”