No Evidence of a Contribution of the Vestibular System to Frequent Falls in Progressive Supranuclear Palsy
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Background and Purpose Conflicting results about vestibular function in progressive supranuclear palsy (PSP) prompted a systematic examination of the semicircular canal function, otolith function, and postural stability. Methods Sixteen patients with probable PSP [9 females, age=72±6 years (mean±SD), mean disease duration=3.6 years, and mean PSP Rating Scale score=31] and 17 age-matched controls were examined using the video head impulse test, caloric testing, ocular and cervical vestibular evoked myogenic potentials (o- and cVEMPs), video-oculography, and posturography. Results There was no evidence of impaired function of the angular vestibulo-ocular reflex (gain=1.0±0.1), and caloric testing also produced normal findings. In terms of otolith function, there was no significant difference between PSP patients and controls in the absolute peakto- peak amplitude of the oVEMP (13.5±7.2 μV and 12.5±5.6 μV, respectively; p=0.8) or the corrected peak-to-peak amplitude of the cVEMP (0.6±0.3 μV and 0.5±0.2 μV, p=0.3). The total root-mean-square body sway was significantly increased in patients with PSP compared to controls (eyes open/head straight/hard platform: 9.3±3.7 m/min and 6.9±2.1 m/min, respectively; p=0.032). As expected, the saccade velocities were significantly lower in PSP patients than in controls: horizontal, 234±92°/sec and 442±66°/sec, respectively; downward, 109±105°/sec and 344±72°/sec; and upward, 121±110°/sec and 348±78°/sec (all p<0.01). Conclusions We found no evidence of impairment of either high- or low-frequency semicircular function or otolith organ function in the examined PSP patients. It therefore appears that other causes such as degeneration of supratentorial pathways lead to postural imbalance and falls in patients with PSP.
Abstract
Background and Purpose Conflicting results about vestibular function in progressive supranuclear palsy (PSP) prompted a systematic examination of the semicircular canal function, otolith function, and postural stability. Methods Sixteen patients with probable PSP [9 females, age=72±6 years (mean±SD), mean disease duration=3.6 years, and mean PSP Rating Scale score=31] and 17 age-matched controls were examined using the video head impulse test, caloric testing, ocular and cervical vestibular evoked myogenic potentials (o- and cVEMPs), video-oculography, and posturography. Results There was no evidence of impaired function of the angular vestibulo-ocular reflex (gain=1.0±0.1), and caloric testing also produced normal findings. In terms of otolith function, there was no significant difference between PSP patients and controls in the absolute peakto- peak amplitude of the oVEMP (13.5±7.2 μV and 12.5±5.6 μV, respectively; p=0.8) or the corrected peak-to-peak amplitude of the cVEMP (0.6±0.3 μV and 0.5±0.2 μV, p=0.3). The total root-mean-square body sway was significantly increased in patients with PSP compared to controls (eyes open/head straight/hard platform: 9.3±3.7 m/min and 6.9±2.1 m/min, respectively; p=0.032). As expected, the saccade velocities were significantly lower in PSP patients than in controls: horizontal, 234±92°/sec and 442±66°/sec, respectively; downward, 109±105°/sec and 344±72°/sec; and upward, 121±110°/sec and 348±78°/sec (all p<0.01). Conclusions We found no evidence of impairment of either high- or low-frequency semicircular function or otolith organ function in the examined PSP patients. It therefore appears that other causes such as degeneration of supratentorial pathways lead to postural imbalance and falls in patients with PSP.
참고문헌 (26)
- Litvan I, "Clinical research criteria for the diagnosis of progressive supranuclear palsy (Steele-Richardson-Olszewski syndrome): report of the NINDSSPSP international workshop", Neurology, 47, pp.1~9 (1996)
- Schlick C, "Falls and fear of falling in vertigo and balance disorders : a controlled crosssectional study", J Vestib Res, 25, pp.241~251 (2016)
- Leigh RJ, "The Neurology of Eye Movements" (2006), Oxford University Press
- Curthoys IS, "Otolithic disease : clinical features and the role of vestibular evoked myogenic potentials", Semin Neurol, 33, pp.231~237 (2013)
- Manzari L, "Selective otolith dysfunctions objectively verified", J Vestib Res, 24, pp.365~373 (2014)
- Layman AJ, "Association between saccular function and gait speed : data from the Baltimore Longitudinal Study of Aging", Otol Neurotol, 36, pp.260~266 (2015)
- Serrador JM, "Loss of otolith function with age is associated with increased postural sway measures", Neurosci Lett, 465, pp.10~15 (2009)
- Maleki M, "Effect of aging on saccular function", Med J Islam Repub Iran, 28, pp.117~ (2014)
- Chen AL, "The disturbance of gaze in progressive supranuclear palsy : implications for pathogenesis", Front Neurol, 1, pp.147~ (2010)
- Liao K, "Why do patients with PSP fall? Evidence for abnormal otolith responses", Neurology, 70, pp.802~809 (2008)
- Bisdorff AR, "Torticollis due to disinhibition of the vestibulo-collic reflex in a patient with Steele-Richardson-Olszewski syndrome", Mov Disord, 12, pp.328~336 (1997)
- Murdin L, "Head deviation in progressive supranuclear palsy : enhanced vestibulo-collic reflex or loss of resetting head movements", J Neurol, 256, pp.1143~1145 (2009)
- Halmagyi GM, "The human horizontal vestibulo-ocular reflex in response to high-acceleration stimulation before and after unilateral vestibular neurectomy", Exp Brain Res, 81, pp.479~490 (1990)
- Rosengren SM, "Vestibular evoked myogenic potentials : past, present and future", Clin Neurophysiol, 121, pp.636~651 (2010)
- Schneider E, "EyeSeeCam : an eye movement-driven head camera for the examination of natural visual exploration", Ann N Y Acad Sci, 1164, pp.461~467 (2009)
- Bremova T, "Comparison of linear motion perception thresholds in vestibular migraine and Menière’s disease", Eur Arch Otorhinolaryngol, 273, pp.2931~2939 (2016)
- Krafczyk S, "Artificial neural network : a new diagnostic posturographic tool for disorders of stance", Clin Neurophysiol, 117, pp.1692~1698 (2006)
- Golbe LI, "A clinical rating scale for progressive supranuclear palsy", Brain, 130, pp.1552~1565 (2007)
- Dias N, "The German version of the Falls Efficacy Scale-International Version(FES-I)", Z Gerontol Geriatr, 39, pp.297~300 (2006)
- Volz-Sidiropoulou E, "The ‘dizziness handicap inventory’ : initial psychometric evaluation of the German version", Laryngorhinootologie, 89, pp.418~423 (2010)
- Williams DR, "Pathological tau burden and distribution distinguishes progressive supranuclear palsy-parkinsonism from Richardson’s syndrome", Brain, 130, pp.1566~1576 (2007)
- Zwergal A, "Parallel ascending vestibular pathways : anatomical localization and functional specialization", Ann N Y Acad Sci, 1164, pp.51~59 (2009)
- Kirsch V, "Structural and functional connectivity mapping of the vestibular circuitry from human brainstem to cortex", Brain Struct Funct, 221, pp.1291~1308 (2016)
- Zwergal A, "Postural imbalance and falls in PSP correlate with functional pathology of the thalamus", Neurology, 77, pp.101~109 (2011)
- Kammermeier S, "Qualitative postural control differences in Idiopathic Parkinson’s disease vs. Progressive Supranuclear Palsy with dynamic-on-static platform tilt", Clin Neurophysiol, 129, pp.1137~1147 (2018)
- Kim S, "Postural feedback scaling deficits in Parkinson’s disease", J Neurophysiol, 102, pp.2910~2920 (2009)