Frontiers in neurology · 2026
Vestibular function in degenerative parkinsonism.
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Özçelik Pınar, Koçoğlu Koray, Eraslan Boz Hatice, Akkoyun Müge, Dönmez Çolakoğlu Beril, Çakmur Raif, Halmagyi Gabor Michael, Akdal Gulden
Аннотация
INTRODUCTION: The degenerative pathology in Parkinson's disease (PD), multisystem atrophy (MSA) and progressive supranuclear palsy (PSP) have different spatial distribution in the brainstem. Our aim was find out in what way this pathology affects brainstem vestibular reflex pathways in each of these diseases.
METHODS: We studied 30 patients: 15 with PD, 9 with PSP (Richardson syndrome) and 6 with MSA (cerebellar) and compared their results with results from 37 age-matched healthy controls (HC). Motor functions of the patient groups were evaluated with the Unified Parkinson's Disease Rating Scale (UPDRS) motor scale. We evaluated the vestibulo-ocular reflex (VOR) with the video Head Impulse Test (vHIT) and the vestibulo-collic reflex with the cervical Vestibular Evoked Mygenic Potential (cVEMP).
RESULTS: We found that PD group have reduced VOR gain in posterior and lateral SCCs and reduced cVEMP amplitude. MSA group have reduced VOR gain in posterior SCCs and reduced cVEMP amplitude while PSP group have normal VOR gain in all SCCs and normal cVEMP amplitude.
CONCLUSION: We show that brainstem vestibular reflex pathways impaired in PD and in MSA but not in PSP by obtaining reduced VOR gain and cVEMP amplitudes. We suggest these findings are due to the presence of synuclein pathology in the lower brainstem and in vestibular nucleus in these diseases.
METHODS: We studied 30 patients: 15 with PD, 9 with PSP (Richardson syndrome) and 6 with MSA (cerebellar) and compared their results with results from 37 age-matched healthy controls (HC). Motor functions of the patient groups were evaluated with the Unified Parkinson's Disease Rating Scale (UPDRS) motor scale. We evaluated the vestibulo-ocular reflex (VOR) with the video Head Impulse Test (vHIT) and the vestibulo-collic reflex with the cervical Vestibular Evoked Mygenic Potential (cVEMP).
RESULTS: We found that PD group have reduced VOR gain in posterior and lateral SCCs and reduced cVEMP amplitude. MSA group have reduced VOR gain in posterior SCCs and reduced cVEMP amplitude while PSP group have normal VOR gain in all SCCs and normal cVEMP amplitude.
CONCLUSION: We show that brainstem vestibular reflex pathways impaired in PD and in MSA but not in PSP by obtaining reduced VOR gain and cVEMP amplitudes. We suggest these findings are due to the presence of synuclein pathology in the lower brainstem and in vestibular nucleus in these diseases.