Brainstem auditory evoked potentials findings in ankylosing spondylitis

Abstract

Background. Ankylosing spondylitis (AS) is a chronic inflammatory potentially debilitating disease predominantly affecting the axial skeleton. A few intermittently published studies and research have proved the existence of some not yet explained neurophysiologic abnormalities in patients with AS. Objectives. The aim of this study was to investigate the brainstem auditory evoked potentials and its relationship with clinical findings, laboratory tests and pharmacological therapy used in patients with AS. Material and method. Thirty-nine patients with AS were included in the study. The control group was composed of 50 healthy subjects. BAEP were recorded for all subjects. Patients were assessed by clinical specific tests, inflammatory laboratory tests, Bath Ankylosing Spondylitis Functional Index (BASFI), Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and type of pharmacological therapy. Results. The results have shown differences between the control group and the patients with AS in most of the wave latencies. Correlations Schober test, Ott index, chest expansion measurement and BASDAI were significant for some waves. CRP seems to be more valuable than ESR as a possible marker for neurologic subclinical involvement. Axial AS is more likely to be associated with BAEP abnormalities. There were also differences between the group with TNF alpha blockers therapy comparative with the group with other therapies. Conclusions. This study highlights some abnormalities of BAEP in patients with AS. Diagnosis of multiple sclerosis or demyelination due to administration of TNF alpha blockers should be excluded in medical practice. Collaboration between neurologists and rheumatologists should be considered in monitoring AS patients.

Keywords

• ankylosing spondylitis
• auditory evoked potentials
• tnf-alpha blockers
• subclinical neurologic involvement