Citation

Liao K, Wagner J, Joshi A, Estrovich I, Walker MF, Strupp M, Leigh RJ. Neurology 2008; 70(10): 802-809.

Affiliation

Neurology Service and Daroff-Dell'Osso Laboratory, Veterans Affairs Medical Center and University Hospitals, Case Western Reserve University, Cleveland, OH, USA.

Copyright

(Copyright © 2008, Lippincott Williams and Wilkins)

DOI

10.1212/01.wnl.0000304134.33380.1e

PMID

18199830

Abstract

BACKGROUND: Patients with progressive supranuclear palsy (PSP) fall frequently, beginning early in the course of their disease. Abnormal vestibulospinal reflexes are suspected, but the angular vestibulo-ocular reflex, which is mediated by the labyrinthine semicircular canals, survives late into the course of the disease. OBJECTIVE: To test the hypothesis that otolithic-mediated reflexes are abnormal in PSP. METHODS: We tested otolith-ocular reflexes (the translational vestibulo-ocular reflex tVOR.) during combined rotation-translation in nine patients with PSP and nine age-matched control subjects; subjects viewed far and near targets. We also tested click-induced otolith-spinal reflexes (vestibular-evoked myogenic potentials VEMPs.) in 10 patients with PSP and 30 age-matched controls. RESULTS: All patients with PSP had small tVOR responses during near viewing that were, on average, only 12% of those of control subjects (p = 0.001). Patients with PSP also showed a reduction of the amplitude of VEMPs compared to control subjects (median range.: 54.3 16.8 to 214. vs 149 11.6 to 466., p = 0.001). CONCLUSIONS: Taken together, these results indicate that abnormal otolith-mediated reflexes may be at least partly responsible for frequent falls in progressive supranuclear palsy, and deserve further study.

Language: en