Abnormal Vestibulo–Ocular Reflex Function Correlates with Balance and Gait Impairment in People with Multiple Sclerosis

Author:

Tramontano Marco12ORCID,Casagrande Conti Laura3,Orejel Bustos Amaranta Soledad34ORCID,Ferri Nicola1ORCID,Lelli Tommaso3ORCID,Nocentini Ugo35ORCID,Grasso Maria Grazia3,Turolla Andrea12ORCID,Pillastrini Paolo12ORCID,Manzari Leonardo6ORCID

Affiliation:

1. Department of Biomedical and Neuromotor Sciences, University of Bologna, 40138 Bologna, Italy

2. Unit of Occupational Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy

3. Santa Lucia Foundation, Scientific Institute for Research and Health Care, 00179 Rome, Italy

4. Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, 00135 Rome, Italy

5. Department of Clinical Sciences and Translational Medicine, University of Rome Tor Vergata, 00133 Rome, Italy

6. MSA ENT Academy Center, 03043 Cassino, Italy

Abstract

Background: Multiple Sclerosis (MS) is the most prevalent autoimmune neurological condition in the world, leading to a wide variety of symptoms, including balance disorders. Objective: To evaluate the angular vestibulo–ocular reflex (aVOR) of all six semicircular canals (SCCs) through Head Impulse (HIMP) and Suppression HIMP (SHIMP) paradigms and any correlations with clinical balance scales. Methods: All participants were assessed using the Expanded Disability Status Scale (EDSS), Berg Balance Scale (BBS), and Mini-BESTest (MBT). Vestibular function was measured by video Head Impulse Test (vHIT), obtaining aVOR gain for each SSC. Results: Twenty-seven PwMS (mean age 47.93 ± 8.51 years old, 18 females) were recruited. Most of the patients (81.48%) presented abnormal aVOR gains for at least one SSC. A moderate to strong correlation between aVOR gains of the left anterior SSC and, respectively, the MBT and the BBS was found. The subgroup analysis, based on the EDSS class, confirmed the correlation with the BBS in the patients with the most significant disability. Conclusions: People with MS may present impairments of the aVOR in one or more semicircular canals. The aVOR gain impairment of the vertical semicircular canals correlates with balance and gait disorders identified through clinical scales in PwMS.

Publisher

MDPI AG

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