Session Time: 12:30pm-2:00pm
Location: Exhibit Hall located in Hall B, Level 2
Objective: To investigate the degree of brainstem impairment in a cohort of patients with iRBD through recording of a VEMPs battery able to indirectly assess the whole brainstem.
Background: Brainstem dysfunction in established Parkinson’s disease (PD) has been previously evidenced by a consistent VEMP impairment, with identification of alterations even in the early stages of disease (1). A misfunction of complex neurotransmitter connections within the brainstem has been accounted for the pathophysiology of the iRBD, which is thought to antedate synucleinopathies such as PD by many years (2).
Methods: Click-evoked cervical (cVEMP), masseter (mVEMP) and ocular (oVEMP) VEMPs were recorded in 12 polysomnography-proven iRBD patients (10M, 2F; 66.8±7.6 years old) and in 12 age and sex-matched healthy controls. In the two groups the p1 peak latency, n1 peak latency and peak-to-peak amplitude were measured for all VEMPs. The degree of severity of alterations was calculated through a VEMP score.
Results: Compared with controls, iRBD patients displayed a significantly higher rate of abnormal oVEMPs (50% versus 0%, p=0.02), mVEMPs (58.3% versus 8.3%, p=0.03) but not of cVEMPs (33.3% versus 0%, p=0.1). The most represented alterations seen in iRBD patients were absence of the response for oVEMP and mVEMP and amplitude reduction for cVEMPs. In those patients with preserved responses, the amplitude of mVEMPs and of oVEMPs was significantly reduced (p<0.0001) and peak latencies of mVEMPs were significantly delayed (p<0.0001). The VEMP score denoted a significantly higher severity of alterations for mVEMP (p=0.02) and oVEMP (p=0.016) but not for cVEMP (p=0.17).
Conclusions: In iRBD patients, VEMP assessment was able to reveal a brainstem dysfunction with an apparent caudo-rostral gradient effect of severity.
To cite this abstract in AMA style:E.R. de Natale, F. Ginatempo, I. Laccu, B. Mercante, A. Manca, M. Figorilli, M. Puligheddu, F. Deriu. Neurophysiological investigation of brainstem in idiopathic REM sleep behavior disorder (iRBD) through vestibular evoked myogenic potentials (VEMPs) [abstract]. Mov Disord. 2016; 31 (suppl 2). https://www.mdsabstracts.org/abstract/neurophysiological-investigation-of-brainstem-in-idiopathic-rem-sleep-behavior-disorder-irbd-through-vestibular-evoked-myogenic-potentials-vemps/. Accessed November 29, 2023.
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MDS Abstracts - https://www.mdsabstracts.org/abstract/neurophysiological-investigation-of-brainstem-in-idiopathic-rem-sleep-behavior-disorder-irbd-through-vestibular-evoked-myogenic-potentials-vemps/