Bu çalışmada biz Alzheimer ve vasküler demans hastalarında VEMP testinin erken ve ayırıcı tanıda kullanılıp kullanılamayacağını belirlemeyi amaçladık. Çalışmaya farklı evrelerde 66’sı Alzheimer demans, 34’ü vasküler demans olmak üzere toplam 100 hasta ve kontrol grubu olarak da 23 sağlıklı gönüllü aldık.
Her iki tipteki demans hastalarının ve kontrol grubunun VEMP yanıtları birbirleriyle kıyaslandı. Demans hastalarının ortalama P13 latansı istatistiksel olarak anlamlı şekilde kontrol grubundan daha uzun bulundu. Ortalama yanıt amplitüdü de istatistiksel olarak anlamlı şekilde kontrol grubundan daha düşük bulundu. Hastaların N23 latansı kontrol grubundan daha uzundu, ancak bu farklılık istatistiksel olarak anlamlı bulunmadı.
Demansın hasta yakınları ve bakıcılar üzerindeki yüksek ekonomik, sosyal ve psikolojik etkileri nedeniyle önleyici yöntemler ve erken tanı çok önemlidir.
Erken tanının önemli olması nedeniyle, literatürde yüksek maliyetli ve her merkezde bulunmayan çeşitli değerlendirme metotları önerilmiştir. Günümüzde kullanılan tanı yöntemleri sadece geri dönüşü olmayan hasar oluştuktan sonra nöronal dejenerasyonu saptayabilmektedir.
VEMP sakkulokolik refleksi kullanır ve uzun yıllardır vestibüler sistem hastalıklarını saptamak için nöro-otoloji alanında kullanılmıştır. Sakkulokolik refleksin nöral yolu beyinsapına geçtiği için, bu refleks beyinsapını tutan hastalıklar hakkında bilgi sağlayabilir. Alzheimer hastalığının önce beyinsapının alt yapılarında başladığı, daha sonra neokortekse yayıldığı düşünülürse sakkulokolik refleks yolağının etkilendiği anlaşılır. Vasküler demanslarda iskemiye bağlı nöronal iletide aksama meydana gelir ve bu da refleks yolağını etkiler.
VEMP testi ucuz, güvenilir, kullanımı kolay, hekimler ve hastalar tarafından tolere edilebilen, non invaziv bir testtir. VEMP testi demansın erken tanısı için yardımcı olabilir.
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