Cervical Vestibular-Evoked Myogenic Potentials (cVEMPs) in Parkinson's Disease Patients: Prospective, Case-Control study.

Abstract

<b>Introduction:</b> Postural stability depends on the integration of various neural circuits, including somatosensory, motor, visual, vestibular, and cognitive systems, which enable flexible posture and gait control. However, the understanding of vestibular otolith function and its brain connections remains limited.<b>Aim:</b> To elucidate the anomalies of cervical vestibular-evoked myogenic potentials (cVEMPs) and their clinical correlation with symptoms associated with brainstem involvement in individuals with Parkinson's disease (PD).<b>Methods:</b> This prospective, observational, case-control study consisted of 62 subjects: 31 idiopathic PD patients (cases) and 31 healthy volunteers (controls). Each participant underwent an otological examination, hearing evaluation, cVEMP test, and pull test. We also recorded the affected side, previous frequent falls, and illnesses duration.<b>Results:</b> The mean Revised Movement Disorder Society Unified Parkinson's Disease Rating Scale Section III score was 14.10 8.42, and the mean scale of Hoehn and Yahr was 1.77 0.62. A statistically significant difference (P < 0.001) was found between the two groups in cVEMP identification, with presence of response in almost two thirds of Parkinson's disease patients. In the case group, there was a considerable delay in the mean P13 and N23 latencies (P < 0.001) and a significant reduction in the mean P13-N23 amplitude (P = 0.001).<b>Conclusions:</b> cVEMP is a quick, easy, and noninvasive method to investigate brainstem dysfunction and the pathophysiological dynamics of the saccular section of the otolith and its central connection in patients with PD.