No Evidence of a Contribution of the Vestibular System to Frequent Falls in Progressive Supranuclear Palsy

Goldschagg, Nicolina; Bremova-Ertl, Tatiana; Bardins, Stanislav; Dinca, Nora; Feil, Katharina; Krafczyk, Siegbert; Lorenzl, Stefan und Strupp, Michael (2019): No Evidence of a Contribution of the Vestibular System to Frequent Falls in Progressive Supranuclear Palsy. In: Journal of Clinical Neurology, Bd. 15, Nr. 3: S. 339-346

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 agematched 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 peak to -peak amplitude of the oVEMP (13.5+/-7.2 mu V and 12.5+/-5.6 mu V, respectively;p=0.8) or the corrected peaktopeak amplitude of the cVEMP (0.6+/-0.3 mu V and 0.5+/-0.2 p=0.3). The total rootmeansquare 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 degrees/sec and 442+/-66 degrees/sec, respectively;downward, 109+/-105 degrees/sec and 344+/-72 degrees/sec;and upward, 121+/-110 degrees/sec and 348+/-78 degrees/sec (all p<0.01). Conclusions We found no evidence of impairment of either high- or lowfrequency 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.

• Dokumententyp: Zeitschriftenartikel
• Fakultät: Medizin
• Themengebiete: 600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin und Gesundheit
• ISSN: 1738-6586
• Sprache: Englisch