Subscribe to RSS
![](/products/assets/desktop/img/oa-logo.png)
DOI: 10.1055/s-0040-1722174
Cervical Vestibular-Evoked Myogenic Potentials and Balance Testing in Children with Down Syndrome
![](https://www.thieme-connect.de/media/10.1055-s-00025477/202104/lookinside/thumbnails/10-1055-s-0040-1722174_200255-1.jpg)
Abstract
Introduction Vestibular otolith function plays a major role in balance control.
Objective To investigate the saccular and balance functions of children with Down syndrome (DS).
Methods In total, 15 children with DS aged between 9 and 11 years were included. An age- and gender-matched control group (CG) composed of 15 normal participants was also included. The subjects with DS had trisomy 21, without hearing or organic problems, and they had independence in stance. The saccular function among the children with DS and among the controls was tested using air-conduction cervical vestibular-evoked myogenic potentials (cVEMPs). In addition, the static and dynamic balance statuses were evaluated using the following assessments; the Pediatric Balance Scale (PBS), the modified Clinical Test of Sensory Interaction on Balance (mCTSIB), the Romberg test, and the Timed Up and Go (TUG) test.
Results In the present study, the results of the saccular function test showed that there was a significant difference between children with and without DS (p < 0.05). The DS subjects had significantly earlier N1 latancy and lower amplitude of the cVEMPs (< 70 μV) compared with the control subjects. The static-dynamic balance ability was statistically and significantly different in children with DS compared with the controls (p < 0.05).
Conclusion These results revealed that saccular function seems to be affected in DS subjects. The dysfunction in static and dynamic balance abilities of the children with DS may be attributed to vestibular dysfunction as well as low gross motor skills. This knowledge should be taken into account when assessing motor performance in those subjects. Additional larger studies testing other dimensions of the vestibular system in children with DS are needed.
Availability of Data and Material
The datasets used during the current study may be made available by the corresponding author upon reasonable request.
Publication History
Received: 27 August 2020
Accepted: 08 November 2020
Article published online:
19 February 2021
© 2021. Fundação Otorrinolaringologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)
Thieme Revinter Publicações Ltda.
Rua do Matoso 170, Rio de Janeiro, RJ, CEP 20270-135, Brazil
-
References
- 1 Presson AP, Partyka G, Jensen KM. et al. Current estimate of Down Syndrome population prevalence in the United States. J Pediatr 2013; 163 (04) 1163-1168
- 2 Roizen NJ, Magyar CI, Kuschner ES. et al. A community cross-sectional survey of medical problems in 440 children with Down syndrome in New York State. J Pediatr 2014; 164 (04) 871-875
- 3 Chen HL, Yeh CF, Howe TH. Postural control during standing reach in children with Down syndrome. Res Dev Disabil 2015; 38: 345-351
- 4 Franjoine MR, Gunther JS, Taylor MJ. Pediatric balance scale: a modified version of the berg balance scale for the school-age child with mild to moderate motor impairment. Pediatr Phys Ther 2003; 15 (02) 114-128
- 5 Black FO, Wall III C, Rockette Jr HE, Kitch R. Normal subject postural sway during the Romberg test. Am J Otolaryngol 1982; 3 (05) 309-318
- 6 Shumway-Cook A, Horak FB. Assessing the influence of sensory interaction of balance. Suggestion from the field. Phys Ther 1986; 66 (10) 1548-1550
- 7 Podsiadlo D, Richardson S. The timed “Up & Go”: a test of basic functional mobility for frail elderly persons. J Am Geriatr Soc 1991; 39 (02) 142-148
- 8 Horak FB, Shupert CL, Dietz V, Horstmann G. Vestibular and somatosensory contributions to responses to head and body displacements in stance. Exp Brain Res 1994; 100 (01) 93-106
- 9 Goldberg JM. The vestibular system: a sixth sense. Oxford; New York: Oxford University Press; 2012
- 10 Layman AJ, Li C, Carey JP. et al. Influence of age-related loss of otolith function on gait: Data from the baltimore longitudinal study on aging. Otol Neurotol 2015; 36 (02) 260-266
- 11 Wilson VJ, Boyle R, Fukushima K. et al. The vestibulocollic reflex. J Vestib Res 1995; 5 (03) 147-170
- 12 Rigoldi C, Galli M, Mainardi L, Crivellini M, Albertini G. Postural control in children, teenagers and adults with Down syndrome. Res Dev Disabil 2011; 32 (01) 170-175
- 13 Gomes MM, Barela JA. Postural control in down syndrome: the use of somatosensory and visual information to attenuate body sway. Mot Contr 2007; 11 (03) 224-234
- 14 Galli M, Rigoldi C, Mainardi L, Tenore N, Onorati P, Albertini G. Postural control in patients with Down syndrome. Disabil Rehabil 2008; 30 (17) 1274-1278
- 15 Vuillerme N, Marin L, Debu B. Assessment of static postural control in teenagers with Down syndrome. Adapt Phys Activ Q 2001; 18 (04) 417-433
- 16 Isaradisaikul S, Navacharoen N, Hanprasertpong C, Kangsanarak J. Cervical vestibular-evoked myogenic potentials: norms and protocols. Int J Otolaryngol 2012; 2012: 913515
- 17 Picciotti PM, Fiorita A, Di Nardo W, Calò L, Scarano E, Paludetti G. Vestibular evoked myogenic potentials in children. Int J Pediatr Otorhinolaryngol 2007; 71 (01) 29-33
- 18 Kelsch TA, Schaefer LA, Esquivel CR. Vestibular evoked myogenic potentials in young children: test parameters and normative data. Laryngoscope 2006; 116 (06) 895-900
- 19 Sheykholeslami K, Megerian CA, Arnold JE, Kaga K. Vestibular-evoked myogenic potentials in infancy and early childhood. Laryngoscope 2005; 115 (08) 1440-1444
- 20 Murofushi T. Clinical application of vestibular evoked myogenic potential (VEMP). Auris Nasus Larynx 2016; 43 (04) 367-376
- 21 Chang CL, Kubo M, Ulrich BD. Emergence of neuromuscular patterns during walking in toddlers with typical development and with Down syndrome. Hum Mov Sci 2009; 28 (02) 283-296
- 22 Gonzalez E, Piqeras M, Martin V. et al. [The vestibulocollic reflex: assessment and characteristics of vestibular-evoked myogenic potentials analysed by age groups]. Rev Neurol 2007; 44 (06) 339-442
- 23 Tribukait A, Brantberg K, Bergenius J. Function of semicircular canals, utricles and saccules in deaf children. Acta Otolaryngol 2004; 124 (01) 41-48
- 24 De Kegel A, Maes L, Baetens T, Dhooge I, Van Waelvelde H. The influence of a vestibular dysfunction on the motor development of hearing-impaired children. Laryngoscope 2012; 122 (12) 2837-2843