Cervical vestibular evoked myogenic potentials and video head impulse test studies: alternative methods for detecting...

Area of Science:

• Neuroscience
• Ophthalmology
• Audiology

Background:

• Brainstem involvement (BSI) is a key predictor of disability in Multiple Sclerosis (MS).
• Vestibular pathway lesions are common in MS and contribute to disability.
• Accurate detection of these lesions is crucial for patient management.

Purpose of the Study:

• To assess the utility of Cervical Vestibular Evoked Myogenic Potentials (cVEMPs) and Video Head Impulse Test (vHIT) in identifying demyelinating lesions in the vestibular pathways of MS patients.
• To correlate vestibular test results with the presence or absence of brainstem involvement on MRI.

Main Methods:

• Fifty-three MS patients and 40 controls underwent evaluation using the Dizziness Handicap Inventory (DHI), vHIT, and cVEMP.
• Participants were categorized into groups with (gBSI (+)) and without (gBSI (-)) brainstem involvement based on MRI findings.

Main Results:

• MS patients reported significantly higher DHI scores than controls.
• vHIT showed significantly different horizontal canal vestibulo-ocular reflex gain in gBSI (+) compared to controls and gBSI (-).
• cVEMP revealed significantly longer P1 wave latency in gBSI (+) compared to controls, but no significant differences were found between gBSI (-) and controls or gBSI (+).

Conclusions:

• vHIT and cVEMP are valuable tools for diagnosing and monitoring MS patients.
• These vestibular tests can detect lesions in MS patients, particularly those without evident demyelinating brainstem lesions on MRI.
• The findings support the use of vHIT and cVEMP in the comprehensive assessment of MS patients.