The effects of Multiple Sclerosis on the audio-vestibular system: A systematic review

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Objective: Systematically investigate effects of Multiple Sclerosis (MS) on the audio-vestibular system.
Methods: Systematic review of literature investigating audio-vestibular conditions in persons with MS (PwMS) aged > 18 years. PUBMED, SCOPUS, NICE, Web of Science were searched. Randomised control trials, cohort, case-control, observational, retrospective studies in English, published from 2000 to 21st November 2021, evaluated PwMS with at least one outcome (Pure Tone Audiometry, Auditory Brainstem Response, Otoacoustic Emissions, Cortical Auditory Evoked Potentials, Functional MRI assessing auditory function, Vestibular Evoked Myogenic Potentials, Videonystagmography, Electonystagmography, Posturography, Rotary Chair, Gaps-in-Noise, Word Discrimination Scores, Duration Pattern Sequence Test) were included. Study selection and assessments of bias were independently conducted by two reviewers using the Risk of Bias Assessment Tool for Nonrandomized Studies, Newcastle Ottawa Scale (NOS), and the NOS adapted for cross-sectional studies.
Results: 35 studies were included. Auditory function was evaluated in 714 PwMS and 501 controls, vestibular function was evaluated in 682 PwMS and 446 controls. Peripheral auditory function results were contradictory between studies; some found abnormalities in PwMS, and others found no differences. Tests of brainstem and central auditory functions were more consistently found to be abnormal in PwMS. Most vestibular tests were reported as abnormal in PwMS, abnormalities were either peripheral or central or both. However, quantitative analyses could not be performed due to discrepancies between studies in results reporting, test stimulus and recording parameters.
Conclusions: Although abnormal results on auditory and vestibular tests were noted in PwMS, specific effects of MS on the audio-vestibular system could not be determined due to the heterogeneity between studies that restricted the ability to conduct any quantitative analyses. Further research with consistent reporting, consistent stimulus and consistent recording parameters are needed in order to quantify the effects of MS on the auditory and vestibular systems.
Original languageEnglish
JournalBMJ Open
Publication statusAccepted/In press - 29 Jun 2022


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