Usefulness of masseter vestibular evoked myogenic potentials in identifying brainstem dysfunction among individuals with multiple sclerosis

Abstract

Objective

The present study aimed to investigate the findings of cervical, ocular and masseter vestibular evoked myogenic potentials (cVEMP, oVEMP and mVEMP) among Multiple sclerosis (MS) and correlate with clinical and MRI findings.

Design

Standard group comparison research design

Study sample

Individuals with relapsing-remitting MS (n = 45) and age-sex-matched controls (n = 45) were the participants. All of them underwent case history, neurological examination, cVEMP, oVEMP and mVEMP testing. MRI was obtained only for MS participants.

Results

Abnormal result on at least one vestibular evoked myogenic potential (VEMP) sub-type was evidenced in 95.56% of participants whereas, unilateral or bilateral abnormal result on all three VEMP sub-types was observed in 60% of participants. The mVEMP abnormality was higher (82.22%) than cVEMP (75.56%) and oVEMP (75.56%) abnormalities but the differences were not significant (p > 0.05). There was no significant association of VEMP abnormalities with the presence of the brainstem symptoms, the brainstem signs, or the MRI lesions (p > 0.05). In the MS group, 38% had normal brainstem MRI; however, mVEMP, cVEMP and oVEMP abnormalities were evidenced in 82.4%, 64.7% and 52.94%, respectively.

Conclusions

Among the three VEMP sub-types, mVEMP appears to be of greater value in identifying silent brainstem dysfunction undetected by clinical and MRI findings in the MS population.

Keywords:

• Vestibular evoked myogenic potentials
• multiple sclerosis
• electrophysiology
• masseter muscle

Acknowledgements

We thank the patients and professionals involved in this study. This research is supported by the Department of Neurology, Tamil Nadu Government Multi Super Specialty Hospital, Chennai – A government organization.

Author contributions

S.S.V. designed and conceptualised study, acquired data, analysed the data; drafted the manuscript for intellectual content; R.M.B. designed and conceptualised the study, acquired data, and revised manuscript for intellectual content. at the centre in Chennai, N.K.S. Analysed and interpreted the data, revised manuscript for intellectual content; K.R. Designed and conceptualised the study, revised manuscript for intellectual content at the centre in Mysuru.

Disclosure statement

None of the authors have potential conflicts of interest to be disclosed.

Data availability statement

The data is presently with the authors; however, since it is a part of the Doctoral Thesis of one of the author’s, it will be submitted to the institute along with the thesis submission. It can be made available to the journal at any time, if required. The person whose doctoral thesis this work represents is the first author on this article submission.