Vestibular Performance During High-Acceleration Stimuli Correlates with Clinical Decline in SCA6

Vestibular Performance During High-Acceleration Stimuli Correlates with Clinical Decline in SCA6
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DOI:
10.1007/s12311-015-0650-3
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发表时间:
2015-06-01
期刊:
影响因子:
3.5
通讯作者:
Zee, David S.
Zee, David S.
中科院分区:
医学3区
文献类型:
--
作者:
Huh, Young Eun;Kim, Ji-Soo;Zee, David S.

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In spinocerebellar ataxia type 6 (SCA6), the vestibular dysfunction and its correlation with other clinical parameters require further exploration. We determined vestibular responses over a broad range of stimulus acceleration in 11 patients with SCA6 (six men, age range=33-72 years, mean age +/- SD=59 +/- 12 years) using bithermal caloric irrigations, rotary chair, and head impulse tests. Correlations were also pursued among disability scores, as measured using the International Cooperative Ataxia Rating Scale, disease duration, age at onset, cytosine-adenine-guanine (CAG) repeat length, and the gain of the vestibulo-ocular reflex (VOR). In response to relatively low-acceleration, low-frequency rotational and bithermal caloric stimuli, the VOR gains were normal or increased regardless of the severity of disease. On the other hand, with relatively high-acceleration, high-frequency head impulses, there was a relative increase in gain in the mildly affected patients and a decrease in gain in the more severely affected patients and gains were negatively correlated with the severity of disease (Spearman correlation, R=-0.927, p < 0.001). Selective decrease of the vestibular responses during high-acceleration, high-frequency stimuli may be ascribed to degeneration of either the flocculus or vestibular nuclei. The performance of the VOR during high-acceleration, high-frequency head impulses may be a quantitative indicator of clinical decline in SCA6.