Usher's Syndrome Type II: A Comparative Study of Genetic Mutations and Vestibular System Evaluation

Otolaryngol Head Neck Surg. 2017 Nov;157(5):853-860. doi: 10.1177/0194599817715235. Epub 2017 Jun 27.

Abstract

Objective Usher's syndrome type II (USH2) is characterized by moderate to profound congenital hearing loss, later onset of retinitis pigmentosa, and normal vestibular function. Recently, a study investigating the vestibular function of USH2 patients demonstrated a pathologic response to vestibular tests. In this cross-sectional study we performed vestibular tests of a group patients with genetic diagnosis of USH2 syndrome to demonstrate if vestibular damage is present in USH2 patients. Study Design Cross-sectional study. Setting Tertiary referral center. Subjects and Methods Mutated genes of 7 patients with a clinical diagnosis of USH2 were evaluated. Vestibular function was investigated by audiometry, Fitzgerald-Hallpike caloric vestibular testing, cervical vestibular evoked myogenic potentials (C-VEMPs), ocular vestibular evoked myogenic potentials (O-VEMPs), and video head impulse test (v-HIT). Results Genetic tests confirmed the USH2 diagnosis in 5 of 7 patients examined, with 1 patient reporting a unique mutation on genetic tests. Four (80%) of the 5 patients with a genetic diagnosis of USH2 showed pathological O-VEMPs. Two patients (40%) reported bilateral absent or abnormal values of C-VEMPs. The superior semicircular canal presented a significant deficit in 2 (40%) patients. The same 2 cases showed a pathologic response of the v-HIT of the horizontal semicircular canal. Finally, the posterior semicircular canal presented a significant deficit in 4 (40.0%) patients. Conclusion A vestibular evaluation with vestibular evoked myogenic potentials and v-HIT seems to identify latent damage to the vestibular receptors of USH2 patients.

Keywords: USH2; Usher’s syndrome; VEMPs; v-HIT; vestibular disorders.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Cross-Sectional Studies
  • Extracellular Matrix Proteins / genetics*
  • Female
  • Humans
  • Italy
  • Male
  • Middle Aged
  • Mutation
  • Receptors, G-Protein-Coupled / genetics*
  • Usher Syndromes / genetics*
  • Usher Syndromes / physiopathology*
  • Vestibular Function Tests

Substances

  • ADGRV1 protein, human
  • Extracellular Matrix Proteins
  • Receptors, G-Protein-Coupled
  • USH2A protein, human