Peripheral Vestibular System Involvement in Multiple Sclerosis and Associations with the Disease Severity

Aydın Cantürk İ.a· Mutlu B.Ö.b· Yılmaz O.b· Bayazıt Y.A.c

Author affiliations

aDepartment of Neurology, Goztepe Prof. Dr. Suleyman Yalcin Hospital, Istanbul, Turkey
bDepartment of Audiology, Istanbul Medipol University, Istanbul, Turkey
cDepartment of ENT, Istanbul Medipol University, Istanbul, Turkey

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Article / Publication Details

First-Page Preview

Abstract of Research Article

Received: September 05, 2022
Accepted: January 31, 2023
Published online: March 10, 2023

Number of Print Pages: 6
Number of Figures: 1
Number of Tables: 3

ISSN: 0301-1569 (Print)
eISSN: 1423-0275 (Online)

For additional information: https://www.karger.com/ORL

Abstract

Introduction: Multiple sclerosis (MS) is an autoimmune disease that can affect balance, gait, and improve fall risk. The aim of this study was to investigate peripheral vestibular system involvement in MS and associations with the disease severity. Methods: Thirty-five adult patients with MS and 14 age- and gender-matched healthy controls were evaluated using video head impulse test (v-HIT), cervical vestibular evoked myogenic potential (c-VEMP), ocular vestibular evoked myogenic potentials (o-VEMPs), and sensory organization test (SOT) of computerized dynamic posturography (CDP). The results of both groups were compared, and association with EDSS scores was evaluated. Results: There was no significant difference between the groups regarding v-HIT and c-VEMP results (p > 0.05). There was no association of the v-HIT, c-VEMP, and o-VEMP results with EDSS scores (p > 0.05). There was no significant difference between the o-VEMP results of the groups (p > 0.05) except for N1-P1 amplitudes (p = 0.01). The amplitudes of N1-P1 were significantly lower in the patients compared to controls (p = 0.01). There was no significant difference between the SOT results of the groups (p > 0.05). However, significant differences were found within and between groups when the patients were categorized according to their EDSS scores with a cutoff point of 3 (p < 0.05). There were negative correlations between the EDSS scores and composite (r = −396, p = 0.02) and somatosensory (SOM) scores (r = −487, p = 0.04) of CDP in the MS group. Conclusion: Although central and peripheral balance-related systems are affected in MS, the impact of disease on the peripheral vestibular end organ is subtle. In particular, the v-HIT, which was mentioned previously as a detector of brainstem dysfunction could not be a reliable tool in the detection of brainstem pathologies in MS patients. The o-VEMP amplitudes may be affected in the early stages of the disease, possibly due to the crossed ventral tegmental tract, oculomotor nuclei, or interstitial nucleus of Cajal involvements. An EDSS score >3 seems a cutoff level indicating abnormalities in balance integration.

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References Cameron MH, Nilsagard Y. Balance, gait, and falls in multiple sclerosis. Handb Clin Neurol. 2018 Jan;159:237–50. Garcia-Munoz C, Casuso-Holgado MJ, Hernandez-Rodriguez JC, Pinero-Pinto E, Palomo-Carrion R, Cortes-Vega MD. Feasibility and safety of an immersive virtual reality-based vestibular rehabilitation programme in people with multiple sclerosis experiencing vestibular impairment: a protocol for a pilot randomised controlled trial. BMJ Open. 2021 Nov;11(11):e051478. Yılmaz O, Mutlu BÖ, Yaman H, Bayazıt D, Demirhan H, Bayazıt YA. Assessment of balance after recovery from Covid-19 disease. Auris Nasus Larynx. 2022 Apr;49(2):291–8. Elsherif M, Eldeeb M. Video head impulse test in bilateral vestibulopathy. Braz J Otorhinolaryngol. 2022 Mar;88(2):181–6. Dorbeau C, Bourget K, Renard L, Calais C, Bakhos D. Vestibular evoked myogenic potentials. Eur Ann Otorhinolaryngol Head Neck Dis. 2021 Dec;138(6):483–8. Gofrit SG, Ilan O, Mayler Y, Eliashar R, Bdolah-Abram T, de Jong MA, et al. The association between video-nystagmography and sensory organization test of computerized dynamic posturography in patients with vestibular symptoms. Eur Arch Otorhinolaryngol. 2019;276(12):3513–7. Eğilmez OK, Tunç A, Yılmaz MS, Şahiner BG, Koçoğlu M, Eryılmaz HA, et al. Cervical vestibular evoked myogenic potentials and video head impulse test studies: alternative methods for detecting brainstem involvement in multiple sclerosis. Acta Otolaryngol. 2022;142(2):168–74. Ertugrul G, Konuskan B, Solmaz I, Anlar B, Aksoy S. Vestibulo-ocular reflex involvement in childhood-onset multiple sclerosis. Mult Scler Relat Disord. 2020 Sep;44:102329. Pavlović I, Ruška B, Pavičić T, Krbot Skorić M, Crnošija L, Adamec I, et al. Video head impulse test can detect brainstem dysfunction in multiple sclerosis. Mult Scler Relat Disord. 2017 May;14:68–71. Crnošija L, Krbot Skorić M, Gabelić T, Adamec I, Habek M. Vestibular evoked myogenic potentials and MRI in early multiple sclerosis: validation of the VEMP score. J Neurol Sci. 2017 Jan;372:28–32. Gazioglu S, Boz C. Ocular and cervical vestibular evoked myogenic potentials in multiple sclerosis patients. Clin Neurophysiol. 2012 Sep;123(9):1872–9. Felipe L, Carvalho SAS, Cunha LCM, Santos MAR, Peixoto MAL, Gonçalves DU. [Vestibular evoked myogenic potential findings on multiple sclerosis]. Rev Neurol. 2009 Mar;48(6):284–6. Oh SY, Kim HJ, Kim JS. Vestibular-evoked myogenic potentials in central vestibular disorders. J Neurol. 2016 Feb;263(2):210–20. Nelson SR, di Fabio RP, Anderson JH. Vestibular and sensory interaction deficits assessed by dynamic platform posturography in patients with multiple sclerosis. Ann Otol Rhinol Laryngol. 1995;104(1):62–8. Grassi L, Rossi S, Studer V, Vasco G, Motta C, Patanè F, et al. Quantification of postural stability in minimally disabled multiple sclerosis patients by means of dynamic posturography: an observational study. J Neuroeng Rehabil. 2017 Jan;14(1):4–12. Fritz NE, Newsome SD, Eloyan A, Marasigan RER, Calabresi PA, Zackowski KM. Longitudinal relationships among posturography and gait measures in multiple sclerosis. Neurology. 2015 May;84(20):2048–56. Hebert JR, Manago MM. Reliability and validity of the computerized dynamic posturography sensory organization test in people with multiple sclerosis. Int J MS Care. 2017;19(3):151–7. Article / Publication Details

First-Page Preview

Abstract of Research Article

Received: September 05, 2022
Accepted: January 31, 2023
Published online: March 10, 2023

Number of Print Pages: 6
Number of Figures: 1
Number of Tables: 3

ISSN: 0301-1569 (Print)
eISSN: 1423-0275 (Online)

For additional information: https://www.karger.com/ORL

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