de Natale, Edoardo Rosario (2014) I Riflessi del tronco encefalico nella malattia di Parkinson: uno studio clinico e neurofisiologico. Doctoral Thesis.
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Recent works have highlighted the rule of brainstem structures in the pathological spread of Parkinson’s Disease (PD). Vestibular Evoked Myogenic Potentials (VEMPs)
are a battery of reflexes providing information on a large portion of the brainstem.
Aim of the study is to test the VEMPs battery, namely Vestibulo-Ocular Reflex (VOR), Vestibulo-Masseter Reflex (VMR) and Vestibulo-Ocular Reflex (VOR) in a cohort of
PD patients and age-matched healthy controls and to correlate them with presence of symptoms ascribable to brainstem dysfunction.
19 PD patients and 15 healthy controls performed the VEMPs battery, and PD patients only underwent a series of clinical scales for evaluation of sleep disorders
and REM sleep behavior disorder (ESS, PDSS and RBD-SQ scale), postural instability (MiniBESTest) and depression (GDS).
VEMPs were significantly impaired in patients compared to controls with absence as the main alteration; more rostral VEMPs were most involved (p=0.056 for VCR,
0.005 for VMR and 0.022 for VOR, respectively). Both number of altered reflexes entity of compromission were significantly higher in patients than in controls
(p=0.017 and 0.001, respectively). A consistent correlation with VEMPs alterations was found only for high scores on RBD-SQ (p=0.014). VEMPs showed low sensibility and high specificity and positive predictive value.
VEMPs battery may arise as a new tool for detecting brainstem alterations in PD patients.
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