Cervical vestibular evoked myogenic potentials and video head impulse test studies: alternative methods for detecting brainstem involvement in multiple sclerosis

Abstract

Background

Brainstem involvement (BSI) has been reported as a major predictive factor for future disability in Multiple Sclerosis (MS).

Aims/Objectives

To evaluate whether Cervical Vestibular Evoked Myogenic Potentials (cVEMPs) and Video Head Impulse Test (vHIT) can be used to detect demyelinating lesions in vestibular pathways in MS.

Material and Methods

Fifty three people with MS and 40 controls were evaluated with Dizziness Handicap Inventory (DHI), vHIT and cVEMP.

Results

The median value of DHI in MS group was significantly higher than controls (p<.001). According to vHIT results, while the results of horizontal canal vestibulo-ocular reflex gain in group with brain stem involvement (gBSI (+)) were significantly different from both controls and group without brain stem involvement (gBSI (−)) (p= .036 and .024, respectively), results of gBSI (−) were similar with controls (p= .858). When cVEMP results were examined, mean P1 wave latency in gBSI (+) was significantly longer than controls (p= .002), but difference between gBSI (−) and controls and gBSI (+) was not statistically significant (p= .104 and .279, respectively).

Conclusions and Significance

vHIT and cVEMP can be used in diagnosis and follow-up of people with MS without demyelinating brainstem lesions on MRI.

Chinese abstract

背景：据报道, 脑干受累 (BSI) 是多发性硬化症 (MS) 未来残疾的主要预测因素。

目的：评估颈前庭诱发肌源性电位 (cVEMPs) 和视频头部脉冲测试 (vHIT) 是否可用于检测 MS 前庭通路中的脱髓鞘病变。

材料和方法：用头晕障碍量表 (DHI)、vHIT 和 cVEMP 评估了 53 名 MS 患者和 40 名对照者。

结果：MS 组的 DHI 中值显著高于对照组 (p<.001)。根据vHIT结果, 虽然脑干受累组（gBSI（+））的水平管前庭眼反射增益结果与对照组和无脑干受累组（gBSI（-））有着显著差异（分别为p = . 036 和p = .024）, gBSI (-) 的结果与对照组相似 (p= .858)。当检查 cVEMP 结果时, gBSI (+) 的平均 P1 波潜伏期明显长于对照组 (p= .002), 但 gBSI (-) 与对照组和 gBSI (+) 之间的差异无统计学意义 (分别为p= .104和p= .279）。

结论与意义：vHIT和cVEMP可用于MRI不显示脑干脱髓鞘病变的MS患者的诊断和随访。

Keywords:

• Multiple Sclerosis
• brainstem
• cervical vestibular evoked myogenic potentials
• video head impulse test

Disclosure statement

The authors report there are no competing interests to declare