I Riflessi del tronco encefalico nella malattia di Parkinson: uno studio clinico e neurofisiologico

Recent works have highlighted the rule of brainstem structures in the pathological spread of Parkinson’s Disease (PD). Vestibular Evoked Myogenic Potentials (VEMPs) are a battery of reflexes providing information on a large portion of the brainstem.Aim of the study is to test the VEMPs battery, namely Vestibulo-Ocular Reflex (VOR), Vestibulo-Masseter Reflex (VMR) and Vestibulo-Ocular Reflex (VOR) in a cohort of PD patients and age-matched healthy controls and to correlate them with presence of symptoms ascribable to brainstem dysfunction.19 PD patients and 15 healthy controls performed the VEMPs battery, and PD patients only underwent a series of clinical scales for evaluation of sleep disorders and REM sleep behavior disorder (ESS, PDSS and RBD-SQ scale), postural instability (MiniBESTest) and depression (GDS).VEMPs were significantly impaired in patients compared to controls with absence as the main alteration; more rostral VEMPs were most involved (p=0.056 for VCR, 0.005 for VMR and 0.022 for VOR, respectively). Both number of altered reflexes entity of compromission were significantly higher in patients than in controls (p=0.017 and 0.001, respectively). A consistent correlation with VEMPs alterations was found only for high scores on RBD-SQ (p=0.014). VEMPs showed low sensibility and high specificity and positive predictive value.VEMPs battery may arise as a new tool for detecting brainstem alterations in PD patients.