Vestibular evoked myogenic potentials: early predictors of Alzheimer’s disease?
Background and Aim: Recent studies have reported connections between vestibular function and cognition and also reported more prevalence of vestibular impairment in patients with Alzheimer's disease. Because patients with amnestic mild cognitive impairment (aMCI) are more likely to develop Alzheimer's disease, this study was conducted to evaluate vestibular dysfunction of otolith organs in aMCI patients compared to normal subjects.
Methods: In our case-control study, 11 patients (22 ears) with aMCI with mean age of 56.73±8.83 years and 11 normal participants (22 ears) with mean age of 54.30±7.4 years were evaluated for ocular and cervical vestibular evoked myogenic potentials (o- and cVEMP). Occurrence of VEMP responses, amplitude, latency and threshold of these waves were recorded and compared between the two groups.
Results: Ocular VEMP was absent in 63.6% of aMCI patients and in 18.2% of the normal group. The difference was significant (p=0.002), while occurrence rate, amplitude, latencies and threshold of cVEMP were not significantly different between the two groups (p>0.05). McNemar's test showed that there was no significant relationship between occurrences of two potentials in aMCI group.
Conclusion: These findings show the presence of vestibular dysfunction, especially in the pathways of ocular vestibular evoked potential, in patients with amnestic mild cognitive impairment. Given that previous studies have shown that cVEMP was absent in Alzheimer's disease, absence of oVEMP can be used as an indicator for predicting future impairment in individuals with amnestic MCI.
2. Hitier M, Besnard S, Smith PF. Vestibular pathways involved in cognition. Front Integr Neurosci. 2014;8:59. doi: 10.3389/fnint.2014.00059
3. Black FO, Pesznecker S, Stallings V. Permanent gentamicin vestibulotoxicity. Otol Neurotol. 2004;25(4):559-69.
4. Gurvich C, Maller JJ, Lithgow B, Haghgooie S, Kulkarni J. Vestibular insights into cognition and psychiatry. Brain Res. 2013;1537:244-59. doi: 10.1016/j.brainres.2013.08.058
5. Previc FH, Krueger WW, Ross RA, Roman MA, Siegel G. The relationship between vestibular function and topographical memory in older adults. Front Integr Neurosci. 2014;8:46. doi: 10.3389/fnint.2014.00046
6. Smith PF. Vestibular-hippocampal interactions. Hippocampus. 1997;7(5):465-71. doi: 10.1002/(SICI)1098-1063(1997)7:5<465::AID-HIPO3>3.0.CO;2-G
7. Birdane L, Incesulu A, Gurbuz MK, Ozbabalik D. Sacculocolic reflex in patients with dementia: is it possible to use it for early diagnosis? Neurol Sci. 2012;33(1):17-21. doi: 10.1007/s10072-011-0595-3
8. Harun A, Oh ES, Bigelow RT, Studenski S, Agrawal Y. Vestibular impairment in dementia. Otol Neurotol. 2016;37(8):1137-42. doi: 10.1097/MAO.0000000000001157
9. Petersen RC. Mild cognitive impairment. Continuum (Minneap Minn). 2016;22(2 Dementia):404-18. doi: 10.1212/CON.0000000000000313
10. Pandya SY, Clem MA, Silva LM, Woon FL. Does mild cognitive impairment always lead to dementia? A review. J Neurol Sci. 2016;369:57-62. doi: 10.1016/j.jns.2016.07.055
11. Busse A, Hensel A, Gühne U, Angermeyer MC, Riedel-Heller SG. Mild cognitive impairment: long-term course of four clinical subtypes. Neurology. 2006;67(12):2176-85. doi: 10.1212/01.wnl.0000249117.23318.e1
12. Fang ML, Coatta K, Badger M, Wu S, Easton M, Nygård L, et al. Informing understandings of mild cognitive impairment for older adults: implications from a scoping review. J Appl Gerontol. 2017;36(7):808-39. doi: 10.1177/0733464815589987
13. Kondo D, Ota K, Kasanuki K, Fujishiro H, Chiba Y, Murayama N, et al. Characteristics of mild cognitive impairment tending to convert into Alzheimer's disease or dementia with Lewy bodies: A follow-up study in a memory clinic. J Neurol Sci. 2016;369:102-108. doi: 10.1016/j.jns.2016.08.011
14. Nakamagoe K, Fujimiya S, Koganezawa T, Kadono K, Shimizu K, Fujizuka N, et al. Vestibular function impairment in Alzheimer's disease. J Alzheimers Dis. 2015;47(1):185-96. doi: 10.3233/JAD-142646
15. Scheltens P, Blennow K, Breteler MM, de Strooper B4, Frisoni GB, Salloway S, et al. Alzheimer's disease. Lancet. 2016;388(10043):505-17. doi: 10.1016/S0140-6736(15)01124-1
16. Heide G, Luft B, Franke J, Schmidt P, Witte OW, Axer H. Brainstem representation of vestibular evoked myogenic potentials. Clin Neurophysiol. 2010;121(7):1102-8. doi: 10.1016/j.clinph.2010.02.007
17. Sanyelbhaa H, Sanyelbhaa A. Vestibular-evoked myogenic potentials and subjective visual vertical testing in patients with vitamin D deficiency/insufficiency. Eur Arch Otorhinolaryngol. 2015;272(11):3233-9. doi: 10.1007/s00405-014-3395-6
18. McCaslin DL, Jacobson GP. Vestibular-evoked myogenic potentials (VEMPs). In: Jacobson GP, Shepard NT, editors. Balance function assessment and management. 2nd ed. San Diego, CA: Plural Publishing; 2016. p. 533-79.
19. Bidelman GM, Lowther JE, Tak SH, Alain C. Mild cognitive impairment is characterized by deficient brainstem and cortical representations of speech. J Neurosci. 2017;37(13):3610-3620. doi: 10.1523/JNEUROSCI.3700-16.2017
20. Shin BM, Han SJ, Jung JH, Kim JE, Fregni F. Effect of mild cognitive impairment on balance. J Neurol Sci. 2011;305(1-2):121-5. doi: 10.1016/j.jns.2011.02.031
Copyright (c) 2018 Auditory and Vestibular Research
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.