Objective: The Aim of our study was to evaluate Nerve Conduction Velocity & Brainstem Auditory Evoked Response in patients with Parkinson’s disease.

Background: Parkinson’s disease is a progressive long-term,neurodegenerative disorder of central nervous system which mainly affects the motor system,caused by loss of dopaminergic neurons in the substantia nigra but also in other dopaminergic and nondopaminergic areas of the brain mainly in the brainstem1,2.

Parkinsonism is associated either with defective release of dopamine as impaired postsynaptic response to the neurotransmitter in the corpus stratum.The histopathoiogical presentation of the disease is depletion of pigment neurons in substantia nigra,presence of eosinophilic inclusions(Lewy bodies) in nigral cells,atopic changes in substantia nigra and depletion of neurons in lous coeruleus.(FIGURE:1)

Disability in Parkinson’s disease is mostly due to motor impairment3,4 but sensory symptoms are frequent complaints and many patients experience pain during the course of their illness5.The types of deficits inevitable with the progression of Parkinson’s disease suggest that the basal ganglia are critical for sensorimotor agility.6

Nerve Conduction Velocity Test does not evaluate large sensory endings and small fibres,but in a post-mortem study of Parkinson’s disease patients,researchers have reported a loss of unmyelinated nerve fibres in the sural nerve7

Methods: 30 subjects(Control & PD) were taken in the study.Age of Control Group was 61.2±11.6 & of Test Group 61.7±10.4.In our study the cases taken were patients visiting our medical college.In our study we aimed to find out the changes in the form of Brainstem and Peripheral Nerve study by BAER and NCV.In all the cases assessment of neurological examination was performed & clinically evaluated the deficit in Central Nervous System.Recordings of NCV & BAERs were performed with Neurostim software of Medicaid Company in the Neurophysiology Lab of Department of Physiology.The recordings were plotted for statically analysis using,appropriate statistical tests with the help of SPSS Software.(FIGURE:2&3)

Results: Results of NCV & BAER were interpreted.In our study there was reduction in Sural Nerve & Ulnar Nerve NCV and in BAER,Waves III,IV,V & Inter-Peak Latency III-V were significantly delayed bilaterally(FIGURE:4,5 & 6)

Conclusions: We concluded that myleinated and unmyleinated fibers show degeneration,along with basal ganglia.

References: 1.Etienne C. Hirsch, Peter Jenner, Serge Przedborski – Pathogenesis of Parkinson’s Disease – Movement Disorders, Vol. 28, No. 1, 2013 2.Pringsheim T., Jette N., Frolkis A. et al. (2014) The prevalence of Parkinson’ s disease: a systematic review and meta-analysis. Mov. Disorder. 29, 1583–1590 3. Gelb DJ, Oliver E, Gilman S. Diagnostic criteria for Parkinson disease. Arch Neurol (1999) 56:33?9. 4. Litvan I, Bhatia KP, Burn DJ, Goetz CG, Lang AE, McKeith I, et al. Movement Disorders Society Scientific Issues Committee. Movement Disorders Society Scientific Issues Committee report: SIC Task Force appraisal of clinical diagnostic criteria for Parkinsonian disorders. Mov Disord (2003) 18:467?86. 5. Schneider JS, Diamond SG, Markham CH. Parkinson’s disease: sensory and motor problems in arms and hands. Neurology (1987) 37:951?6. 6. Morris ME. Movement disorders in people with Parkinson disease: a model for physical therapy. Phys Ther. 2000;80:578–597 7 . Kanda T, Tsukagoshi H, Oda M, Miyamoto K, Tanabe H. Changes of unmyelinated nerve fibers in sural nerve in amyotrophic lateral sclerosis, Parkinson’s disease and multiple system atrophy. Acta Neuropathol (1996) 91:145?54

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MDS Abstracts - https://www.mdsabstracts.org/abstract/evaluation-of-brainstem-auditory-evoked-response-and-nerve-conduction-in-parkinsons-disease/