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What might cervical vestibular–evoked myogenic potential abnormalities mean in essential tremor?

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Abstract

Aim/background

Essential tremor (ET) is one of the most common movement disorders. However, its pathogenesis is unclear. Human vestibular reflexes are essential not only for gait and posture but also for goal-directed voluntary movements. In this study, cervical vestibular–evoked myogenic potentials (cVEMPs), the electrophysiological equivalent of the vestibulo-collic reflex was studied in ET patients to understand the interaction between the tremor network and the vestibular neural pathways.

Methods

cVEMPs were recorded in 40 ET patients and 40 age and sex-matched healthy controls (HCs). The latencies of peaks p13 and n23 and peak-to-peak amplitude of p13-n23 were measured.

Results

There was no statistically significant difference between the p13 latencies of the HC and ET groups (p 0.79 and p 0.23 for the right and left sides respectively). n23 latency was shortened bilaterally in the ET group (p 0.009 and p 0.02 for the right and left sides respectively). p13-n23 amplitudes of the ET patients were bilaterally reduced when compared with the HC (p <0.001 and p 0.001 for the right and left sides respectively).

Conclusion

Information provided by vestibular afferents is crucial in the control of voluntary movements in humans. Despite this silent but significant effect, the role of the vestibular system in movement disorders is often overlooked. In this study, it was found that cVEMP responses reflecting the activity of the vestibulo-collic pathway were affected in ET which can be either caused by dysfunctional structures or pathways responsible from ET or an additional disorder of vestibular information processing in these patients.

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Authors and Affiliations

  1. Department of Neurology, Izmir Tepecik Education and Research Hospital, Izmir, Turkey

    Feray Gulec Uyaroglu & Roza Ucar

  2. Department of Neurology and Clinical Neurophysiology, Ege University Medical School, Bornova, 35100, Izmir, Turkey

    Ahmet Acarer & Nese Celebisoy

Authors
  1. Feray Gulec Uyaroglu
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  2. Roza Ucar
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  3. Ahmet Acarer
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  4. Nese Celebisoy
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Corresponding author

Correspondence to Nese Celebisoy.

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Ethics approval

This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Local Ethics Committee of Izmir Tepecik Education and Research Hospital (reference number 17-15/2016, approval date September 19th 2016). Informed consent was obtained from all participants included in the study. All authors gave their consent for publication. The data is available. All authors contributed to the publication of the study and manuscript.

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The authors declare no competing interests.

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Uyaroglu, F.G., Ucar, R., Acarer, A. et al. What might cervical vestibular–evoked myogenic potential abnormalities mean in essential tremor?. Neurol Sci 42, 5271–5276 (2021). https://doi.org/10.1007/s10072-021-05248-5

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