Vestibular Evoked Myogenic Potentials (VEMPs) in Parkinson’s Disease Patients with Monopolar Deep Brain Stimulation

Abstract

Whilst balance disturbances are common in people with advanced Parkinson’s disease, it has not previously been possible to record vestibular evoked myogenic potentials (VEMPs), and thus otolithic function, during monopolar deep brain stimulation (DBS) due to an overwhelming number of signal artifacts. A µVEMP device has been developed with parameters to allow VEMP recording during monopolar DBS. The aim of this proof-of-concept study was to ascertain whether, during DBS, VEMP responses could be accurately identified after signal filtering recordings from the µVEMP device. Both cervical and ocular VEMP responses to taps and clicks were recorded with the µVEMP device in five Parkinson’s disease patients with monopolar deep brain stimulation. Additionally, VEMP responses were recorded in one patient whose deep brain stimulation was switched ON and OFF to allow a direct comparison of the signals. Customised post-filtering analysis allowed successful VEMP response extraction from signal noise in all five patients with deep brain stimulation ON. VEMP responses with deep brain stimulation ON after filtering were similar to VEMP responses with deep brain stimulation OFF, validating the filtering analysis. We present the first study to record VEMP signals with monopolar deep brain stimulation using a µVEMP device coupled with customised post-filtering. This finding will allow patients to be assessed without requiring adjustment of their therapeutic deep brain stimulation.

Keywords

• vestibular
• Parkinson’s disease
• DBS
• VEMP
• signal filtering
• noise artifacts