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Author Notes:

Tel.: +1-410-955-7381; mschube1@jhmi.edu

Conceptualization, C.R.G. and M.C.S.; methodology, C.R.G., A.W. and V.B.Y.; software, A.W. and C.R.G.; validation, C.R.G. and M.C.S.; formal analysis, C.R.G. and V.B.Y.; investigation, C.R.G., V.B.Y., A.W. and B.J.L.; resources, L.E.D. and M.C.S.; data curation, B.J.L. and L.E.D.; writing—original draft preparation, C.R.G. and M.C.S.; writing—review and editing, C.R.G., A.W., V.B.Y., B.J.L., L.E.D. and M.C.S.; visualization, C.R.G. and M.C.S.; supervision, L.E.D. and M.C.S.; project administration, C.R.G.; funding acquisition, not applicable. All authors have read and agreed to the published version of the manuscript.

The authors acknowledge Annie Fangman, PT, DPT, and Lindsey Agnew, BS for their help in data collection.

The authors declare no conflict of interest.

Subjects:

Keywords:

  • compensatory saccade
  • multiple sclerosis
  • vestibulo–ocular reflex
  • video head impulse test

Greater Disability Is Associated with Worse Vestibular and Compensatory Oculomotor Functions in People Living with Multiple Sclerosis

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Journal Title:

Brain Sciences

Volume:

Volume 12, Number 11

Publisher:

Type of Work:

Article | Final Publisher PDF

Abstract:

Globally, there are nearly three million people living with multiple sclerosis (PLW-MS). Many PLW-MS experience vertigo and have signs of vestibular dysfunction, e.g., low vestibulo–ocular reflex (VOR) gains or the presence of compensatory saccades (CSs), on video head impulse testing (vHIT). We examined whether the vestibular function and compensatory oculomotor behaviors in PLW-MS differed based on the level of MS-related disability. The VOR gain, CS frequency and latency, and gaze position error (GPE) were calculated from the individual traces obtained during six-canal vHIT for 37 PLW-MS (mean age 53.4 ± 12.4 years-old, 28 females) with vertigo and/or an imbalance. The subjects were grouped by their Expanded Disability Status Scale (EDSS) scores: PLW-min-MS (EDSS = 1.0–2.5, n = 8), PLW-mild-MS (EDSS = 3.0–4.5, n = 23), and PLW-moderate-MS (EDSS = 5.0–6.0, n = 6). The between-group differences were assessed with Kruskal–Wallis tests. The VOR gains for most of the canals were higher for PLW-min-MS compared to PLW-mild- and mod-MS, respectively. CS occurred less often in PLW-min-MS versus PLW-mild- and mod-MS, respectively. No clear trend in CS latency was found. The GPE was often lower for PLW-min-MS compared to PLW-mild- and mod-MS, respectively. Thus, our data demonstrate that worse VOR and compensatory oculomotor functions are associated with a greater MS-related disability. PLW-MS may benefit from personalized vestibular physical therapy.

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© 2022 by the authors.

This is an Open Access work distributed under the terms of the Creative Commons Attribution 4.0 International License (https://creativecommons.org/licenses/by/4.0/).
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