Comprehensive Clinical Assessment of Vestibular Function in Multiple Sclerosis

Area of Science:

• Neuroscience
• Ophthalmology
• Audiology

Background:

• Balance disorders and dizziness are common in multiple sclerosis (MS), indicating vestibular system dysfunction.
• Objective clinical vestibular tools are crucial for understanding vestibular function in MS.

Purpose of the Study:

• To evaluate vestibular-ocular reflex (VOR), dynamic visual acuity (DVA), subjective visual vertical (SVV), and vestibular-evoked myogenic potentials (VEMPs) in individuals with and without MS.
• To compare vestibular test performance between MS patients and controls.
• To correlate vestibular function with MS disability (EDSS).

Main Methods:

• A cross-sectional study involving 40 individuals with relapsing-remitting MS (EDSS ≤6.5) and 20 healthy controls.
• Administration of a comprehensive vestibular testing battery including VOR, DVA, SVV, and c/oVEMP.
• Statistical analysis comparing groups and correlating results with EDSS scores.

Main Results:

• Individuals with MS demonstrated reduced VOR cancellation ability and increased SVV response variance.
• The Expanded Disability Status Scale (EDSS) significantly correlated with VOR cancellation, SVV variance, and DVA.
• VOR cancellation and SVV variance were significant predictors of EDSS scores.

Conclusions:

• Vestibular functions reliant on central integration, unlike reflexive VEMPs, are impaired in MS and linked to disability.
• Clinical evaluations focusing on central vestibular integration may be more sensitive for detecting vestibular deficits in mild to moderate MS.
• Objective vestibular testing provides valuable insights into MS-related neurological deficits.