ABSTRACT
Degeneration of several brainstem nuclei has been long related to motor and non-motor symptoms (NMSs) of Parkinson's disease (PD). Nevertheless, due to technical issues, there are only a few studies that correlate that association. Brainstem auditory-evoked potential (BAEP) and vestibular-evoked myogenic potential (VEMP) responses represent a valuable tool for brainstem assessment. Here, we investigated the abnormalities of BAEPs, ocular VEMPs (oVEMPs), and cervical VEMPs (cVEMPs) in patients with PD and its correlation to the motor and NMSs. Fifteen patients diagnosed as idiopathic PD were evaluated by Unified Parkinson's Disease Rating Scale and its subscores, Hoehn and Yahr scale, Schwab and England scale, and Non-Motor Symptoms Scale. PD patients underwent pure-tone, speech audiometry, tympanometry, BAEP, oVEMPs, and cVEMPs, and compared to 15 age-matched control subjects. PD subjects showed abnormal BAEP wave morphology, prolonged absolute latencies of wave V and I-V interpeak latencies. Absent responses were the marked abnormality seen in oVEMP. Prolonged latencies with reduced amplitudes were seen in cVEMP responses. Rigidity and bradykinesia were correlated to the BAEP and cVEMP responses contralateral to the clinically more affected side. Contralateral and ipsilateral cVEMPs were significantly correlated to sleep (p = 0.03 and 0.001), perception (p = 0.03), memory/cognition (p = 0.025), and urinary scores (p = 0.03). The oVEMP responses showed significant correlations to cardiovascular (p = 0.01) and sexual dysfunctions (p = 0.013). PD is associated with BAEP and VEMP abnormalities that are correlated to the motor and some non-motor clinical characteristics. These abnormalities could be considered as potential electrophysiological biomarkers for brainstem dysfunction and its associated motor and non-motor features.
ABSTRACT
OBJECTIVE: Disrupted auditory nerve activity in auditory neuropathy (AN) significantly impairs the sequential processing of auditory information, resulting in poor speech perception. This study investigated the ability of AN subjects to perceive temporally modified consonant-vowel (CV) pairs and shed light on their phonological awareness skills. DESIGN: Four Arabic CV pairs were selected: /ki/-/gi/, /to/-/do/, /si/-/sti/ and /so/-/zo/. The formant transitions in consonants and the pauses between CV pairs were prolonged. Rhyming, segmentation and blending skills were tested using words at a natural rate of speech and with prolongation of the speech stream. STUDY SAMPLE: Fourteen adult AN subjects were compared to a matched group of cochlear-impaired patients in their perception of acoustically processed speech. RESULTS: The AN group distinguished the CV pairs at a low speech rate, in particular with modification of the consonant duration. Phonological awareness skills deteriorated in adult AN subjects but improved with prolongation of the speech inter-syllabic time interval. CONCLUSIONS: A rehabilitation program for AN should consider temporal modification of speech, training for auditory temporal processing and the use of devices with innovative signal processing schemes. Verbal modifications as well as visual imaging appear to be promising compensatory strategies for remediating the affected phonological processing skills.
