REM sleep without atonia and vestibular-evoked myogenic potentials: clinical brainstem dysfunction in early-stage Parkinson's disease and isolated REM sleep behavior disorder

Xie, Wei-ye; Shen, Yun; Chen, Ying; Zhuang, Sheng; Wang, Yali; Hong, Jing; Li, Han-xing; Yan, Jiahui; Li, Ying; Mao, Cheng‐Jie; Dai, Yong-Ping; Liu, Chunfeng

doi:10.1016/j.sleep.2021.12.004

Cited by 9 publications

(13 citation statements)

References 45 publications

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“…Most studies agreed that the amplitudes decreased and the asymmetry ratio of VEMPs increased in patients with PD compared with age-matched controls, suggesting reduced vestibular nuclei excitability within the brainstem [ 7 , 11 , 16 , 23 , 27 ]. However, there were also studies that observed no obvious differences in the amplitudes of the three VEMPs, which is partly in disagreement with previous findings [ 14 , 15 ]. In our study, a decreased peak-to-peak amplitude and an increased AAR of cVEMP were also found in patients with PD.…”

Section: Discussioncontrasting

confidence: 86%

“… Forest plot of absent VEMP responses in patients with PD: ( A ) the absence rate of cVEMP [ 6 , 7 , 11 , 15 , 22 , 25 , 26 , 27 ]; ( B ) the absence rate of oVEMP [ 7 , 11 , 15 , 26 ]; ( C ) the absence rate of mVEMP [ 11 , 15 ]. …”

Section: Figurementioning

confidence: 99%

“… ( A ) Meta-analysis of cVEMP P13 latency in patients with PD compared with healthy controls [ 6 , 7 , 8 , 11 , 13 , 14 , 15 , 16 , 17 , 22 , 23 , 24 , 25 , 26 , 27 ]; ( B ) meta-analysis of oVEMP P15 latency in patients with PD compared with healthy controls [ 7 , 8 , 11 , 13 , 14 , 15 , 23 , 26 ]; ( C ) meta-analysis of peak-to-peak amplitude of cVEMP in patients with PD compared with healthy controls [ 8 , 11 , 13 , 15 , 16 , 17 , 23 , 24 , 26 , 27 ]; ( D ) Forest plot of AAR of cVEMP in patients with PD compared with healthy controls [ 7 , 8 , 11 , 23 ]. …”

Section: Figurementioning

confidence: 99%

“…cVEMP responses are mainly influenced in lower brainstem (the pontine and upper medullary) lesions, whereas oVEMP responses are influenced in upper brainstem (midbrain) lesions [ 11 ]. Recently, VEMP responses were reported to be correlated with multiple motor and non-motor symptoms of PD [ 6 , 12 , 13 , 14 , 15 ]. Hence, combining VEMP findings with these symptoms may strengthen the detection of PD.…”

Section: Introductionmentioning

confidence: 99%

“…VEMP abnormalities have been widely reported in patients with PD, and they comprise absent, delayed, or low-amplitude VEMP responses [ 15 , 16 ]. Contrarily, there have also been studies indicating the opposite or no significant difference in VEMP findings in patients with PD compared with controls [ 7 , 17 ].…”

Section: Introductionmentioning

confidence: 99%

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Assessment of Vestibular-Evoked Myogenic Potentials in Parkinson’s Disease: A Systematic Review and Meta-Analysis

2022

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(1) Background: The brainstem plays an essential role in the early stage of Parkinson’s disease (PD), but it is not widely tested in clinical examinations of PD. Vestibular-evoked myogenic potentials (VEMPs) are recognized as fundamental tools in the assessment of brainstem function. The aim of our meta-analysis was to assess the abnormal findings of VEMPs in patients with PD. (2) Methods: Up to 14 February 2022, PubMed, Embase, and Web of Science were searched to evaluate VEMPs in patients with PD in comparison with respective controls. The study protocol was registered at PROSPERO (CRD42022311103). (3) Results: A total of 15 studies were finally included in our meta-analysis. The absence rates of VEMPs in patients with PD were significantly higher than those of control groups (cVEMP: OR = 6.77; oVEMP: OR = 13.9; mVEMP: OR = 7.52). A delayed P13 latency, a decreased peak-to-peak amplitude, and an increased AAR of cVEMP, and a delayed oVEMP P15 latency were also found in patients with PD. (4) Conclusions: Our meta-analysis indicates abnormal VEMP findings in patients with PD, revealing the dysfunction of the brainstem in PD. VEMP tests, especially cVEMP tests, could be a helpful method for the early detection of PD.

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