Romatizmal Hastalıkların Vestibüler Sistem Üzerindeki Etkisinin İncelenmesi

Abstract

Kent, A.E., Investigation of the Effects of Rheumatic Diseases on Vestibular System. Hacettepe University, Institute of Health Sciences, Audiology and Speech Pathology Program, PhD Dissertation, Ankara, 2019. In rheumatoid arthritis (RA) and ankylosing spondylitis (AS), vestibular evaluation is not included in the routine diagnosis and in the differential diagnosis of the disease. Rheumatic diseases are chronic diseases and thus may cause destruction of cells and neural structures. The aim of this study was to evaluate the effects of rheumatic diseases on vestibular system. The study included 78 volunteers aged 20-65 years. The study group consisted of 34 RA and 24 AS patients and the control group consisted of 20 healthy individuals. The vestibulocervical neural pathways of patients diagnosed with RA and AS were evaluated by air-stimulated cervical vestibular evoked myogenic potentials (cVEMP), which is an objective electrophysiological test. It was aimed to compare the results with each other and the control group for both groups. Furthermore, in the RA and AS patient groups, the balance scale was measured using the Berg Balance Scale (BBS), the vestibulospinal tests used to evaluate the vestibular system disorders and the Dizziness Handicap Inventory (DHI) questionnaire, which evaluated the negative effects of vestibular system disorders on the subjects. The prolongation of cVEMP P1 and N1 latencies from RA and AS patients was not statistically significant compared to the control group (p≥0,05). However, amplitude asymmetry ratios (AAR) were statistically higher than the control group (p<0,05). The mean value obtained from patients with AS was lower than 45 (BBS = 42.6 ± 3.6). According to the results of DHI, the mean scores of functional capacity were found to be significantly higher in patients with RA than in AS patients (p<0,05). The results suggest that objective and subjective vestibular tests may help us to understand the impact on the vestibular system in the diagnosis and evaluation of rheumatic diseases. Keywords: Arthritis, Rheumatism, Ankylosing, Vestibular, Rheumatoid