Absent vestibular evoked myogenic potentials and graviception cofactors in adults with diabetes

This study was designed to explore the clinical characteristics (including quadriceps strength) of 166 adults (28–80 years old) with diabetes who have either present or absent bilateral otolith reflex responses by Vestibular Evoked Myogenic Potentials (VEMPs), and its relation to graviception by the Subjective Visual Vertical (S.V.V.). After retinoscopy, electromyography, audiology, vestibular function and quadriceps strength evaluations, assessments were performed on ocular and cervical VEMPs, and estimation of S.V.V., during static condition and on-axis/ off-axis rotation (utricle/ semicircular canal stimulation). 43.9% participants had absent ocular VEMPs, which were not related to on-axis/ off-axis estimations, but to the quadriceps strength; 5.4% participants had absent cervical VEMPs. The S.V.V. during on-axis and off-axis rotation showed no linear relation to present/absent VEMPs, but to static S.V.V. standard deviation (precision), and to an interaction among gender, high blood pressure and dyslipidemia. In conclusion, in adults with diabetes, metabolic compromise and macrovascular factors might contribute to otolith dysfunction; while the presence/absence of ocular VEMPs can be dissociated from the presence/absence of cervical VEMPs and from graviception during utricle/semicircular canal stimulation.