Vestibulocervical reflexes in idiopathic Parkinson disease

• Published in: Neurophysiologie clinique Vol. 39; no. 4; pp. 235 - 240
• Main Authors: Pollak, L, Prohorov, T, Kushnir, M, Rabey, M
• Format: Journal Article
• Language: English
• Published: Paris Elsevier SAS 01.10.2009; Elsevier
• Subjects: Aged; Biological and medical sciences; Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases; Dementia - etiology; Depression - etiology; Evoked Potentials, Auditory - physiology; Female; Gait Disorders, Neurologic - etiology; Gait instability; Humans; Maladie de Parkinson; Male; Medical sciences; Middle Aged; Neurology; Parkinson disease; Parkinson Disease - complications; Parkinson Disease - physiopathology; Parkinson Disease - psychology; Postural instability; Posture; Potentiels évoqués vestibulaires myogéniques; Reference Values; Troubles de la marche; Troubles posturaux; Vestibular evoked myogenic potentials; Vestibular Function Tests; Vestibular evoked myogenic potentials; Postural instability; Troubles posturaux; Maladie de Parkinson; Troubles de la marche; Parkinson disease; Potentiels évoqués vestibulaires myogéniques; Gait instability; Reflex; Gait disorder; Nervous system diseases; Evoked potential; Central nervous system disease; Idiopathic; Electrophysiology; Degenerative disease; Cerebral disorder; Extrapyramidal syndrome
• ISSN: 0987-7053; 1769-7131
• DOI: 10.1016/j.neucli.2009.07.001

Summary Objectives The mechanism of gait instability in Parkinson disease (PD) is not completely understood. We examined the saccular part of the otolith function and its possible contribution to gait difficulties in idiopathic PD. Methods Fifty-four PD patients (mean age 66 years, 32 men) were included. These were characterized with respect to disease severity, duration, treatment, as well as the presence of disease complications, dementia and depression. Vestibular evoked myogenic potentials (VEMP) were recorded in patients and 53 healthy controls. Results VEMP responses were recorded in all controls. Unilaterally absent VEMP responses were found in 20 (37%) of PD patients and bilaterally absent responses in four (7.4%). All patients with preserved peaks had normal latencies as compared with controls. The number of PD patients with abnormal/absent VEMP was thus significantly higher than in controls ( p < 0.00). There were no correlations between VEMP abnormality and disease stage, falls or medication. A correlation was found between abnormal VEMP and depression/antidepressant treatment. Conclusion PD patients often have absent vestibulocollic reflexes. Further investigations are needed to elucidate the significance of this finding for postural stability and gait in this disorder.