Ocular and Cervical Vestibular Evoked Myogenic Potentials in Patients With Multiple Sclerosis

Gabelić, Tereza; Krbot, Magdalena; Šefer, Ana Branka; Išgum, Velimir; Adamec, Ivan; Habek, Mario

doi:10.1097/wnp.0b013e31827eda0c

Cited by 27 publications

(33 citation statements)

References 18 publications

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“…These findings are in congruence with those reported by Xie et al (2012) for oVEMP latencies. Since the latency abnormalities of cVEMP and oVEMP have been reported to most often exist in neural pathologies rather than the labyrinthine pathologies (Xue and Yang 2008;Gabelic et al 2013), the findings of the present study indicate towards a lack of neural involvement at least in the vestibulo-spinal and vestibulo-ocular reflex pathways in individuals with motion sickness. The results also indicate insensitivity of latency parameters of cVEMP and oVEMP in discriminating the motion sickness susceptible individuals from non-susceptible individuals.…”

Section: Discussionmentioning

confidence: 69%

Assessment of otolith function using cervical and ocular vestibular evoked myogenic potentials in individuals with motion sickness

2014

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The involvement of otolith organs in motion sickness has long been debated; however, equivocal findings exist in literature. The present study thus aimed at evaluating the otolith functioning in individuals with motion sickness. Cervical and ocular vestibular evoked myogenic potentials were recorded from 30 individuals with motion sickness, 30 professional drivers and 30 healthy individuals. The results revealed no significant difference in latencies and amplitudes between the groups (p>0.05). Nonetheless, thresholds were significantly elevated and inter-aural asymmetry ratio significantly higher in motion sickness susceptible group (p < 0.001) for both the potentials. All the individuals in the motion sickness group had high asymmetry ratio at least on one of the two potentials. Thus, reduced response and/or asymmetric otolithic function seem the likely reasons behind motion sickness susceptibility.

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Section: Discussionmentioning

confidence: 69%

Assessment of otolith function using cervical and ocular vestibular evoked myogenic potentials in individuals with motion sickness

2014

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“…The mean latencies of oVEMPs and cVEMPs were significantly increased in MS patients, and also correlated with the expanded disability status scale (EDSS) [47]. Another study of 62 MS patients found a higher prevalence of abnormal oVEMPs than abnormal cVEMPs (45.2 vs. 17.7 %, p \ 0.01) [48].…”

Section: Cvempsmentioning

confidence: 94%

“…oVEMPs Regarding oVEMPs, prolonged latency was found in 30 % and absent response in 40 % of patients on at least one side in a study of 30 MS patients [47]. The mean latencies of oVEMPs and cVEMPs were significantly increased in MS patients, and also correlated with the expanded disability status scale (EDSS) [47].…”

Section: Cvempsmentioning

confidence: 97%

Vestibular-evoked myogenic potentials in central vestibular disorders

Kim

2015

J Neurol

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Vestibular-evoked myogenic potentials (VEMPs) are short latency manifestations of vestibuloocular and vestibulocollic reflexes that originate from the utricle and saccule. Although cervical and ocular VEMPs have mostly been applied to peripheral vestibular disorders, the characteristics and the diagnostic values of VEMPs have been expanded to assess the function of the central otolithic pathways. In the central nervous system, the cervical VEMPs (cVEMPs) are mediated by the vestibular nuclei and uncrossed medial vestibulospinal tract descending in the lower brainstem and spinal cord. In contrast, the ocular VEMPs (oVEMPs) reflect the function of the vestibular nuclei and the crossed vestibulo-ocular reflex (VOR) pathways, mostly contained in the medial longitudinal fasciculus (MLF). Therefore, lesions involving the vestibular nuclei can present abnormalities of both cVEMPs and oVEMPs. The medullary lesions involving the descending MLF or the spinal accessory nucleus impair cVEMPs. In contrast, the lesions involving the MLF, the crossed ventral tegmental tract, oculomotor nuclei and the interstitial nucleus of Cajal can impair oVEMPs. Patients with unilateral cerebellar infarctions may show abnormal VEMPs especially when they have the ocular tilt reaction. Delayed responses of VEMPs are characteristic of multiple sclerosis (MS). Reduced VEMP responses can be observed in patients with vestibular migraine. VEMPs are useful in evaluating central as well as peripheral otolithic function that are not readily defined by conventional vestibular function tests, and can aid in detecting and localizing central lesions, especially silent brainstem lesions such as tiny infarctions or MS plaques.

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“…We have recently observed that prolonged latencies of both oVEMP and cVEMP are present in up to 80% of patients with multiple sclerosis, indicating that prolonged VEMP latencies are associated with a demyelinating process. 26 One can extrapolate that prolonged latencies in patients with VN indicate a lesion of myelin at the 8 cranial nerve root entry zone or the nerve itself. 27 Inferior branch involvement demonstrated by cVEMP was not associated with oVEMP recovery or worsening.…”

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confidence: 99%

The Role of Cervical and Ocular Vestibular-Evoked Myogenic Potentials in the Follow-Up of Vestibular Neuritis

et al. 2013

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This study evaluates the recovery of vestibular nerve function after vestibular neuritis (VN) by vestibular-evoked myogenic potentials (VEMPs). Twenty-six patients with the diagnosis of VN were included. All patients underwent ocular VEMP (oVEMP) and cervical VEMP (cVEMP) recordings, at 6 days and 6 months from the onset of the symptoms. Of the 26 patients, 14 showed improvement on oVEMP at month 6 (group 1), and 12 showed no change or worsening on oVEMP at 6 months (group 2). At the same time, there was no change in the amplitudes of the cVEMP on either healthy or affected sides in both groups. Inability to perform the Fukuda test, and chronic white matter supratentorial lesions present on brain magnetic resonance imaging (MRI) were more frequent in patients with worse outcome on oVEMP (P = 0.044 and 0.045, respectively). Although involvement of the inferior branch of the vestibular nerve was not associated with oVEMP outcome, oVEMP latencies (N10 and P13) were associated with improvement or worsening in oVEMP amplitudes, showing that prolonged latencies correlate with 6-month improvement in oVEMP amplitudes (Pearson correlation -0.472, P = 0.041 and -0.580, P = 0.009, respectively). This study identified clinical, MRI and neurophysiological predictors of recovery in patients with superior VN, and offers additional insight into, and better understanding of, the role of VEMP in diagnosis and prognosis of patients with VN. Further studies are needed to validate this diagnostic procedure and to assess its clinical usefulness in VN management.

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Ocular and Cervical Vestibular Evoked Myogenic Potentials in Patients With Multiple Sclerosis

Abstract: Combination of cVEMP and oVEMP in MS patients allows better estimation of brainstem lesions.

Cited by 27 publications

References 18 publications

Assessment of otolith function using cervical and ocular vestibular evoked myogenic potentials in individuals with motion sickness

Assessment of otolith function using cervical and ocular vestibular evoked myogenic potentials in individuals with motion sickness

Vestibular-evoked myogenic potentials in central vestibular disorders

The Role of Cervical and Ocular Vestibular-Evoked Myogenic Potentials in the Follow-Up of Vestibular Neuritis

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