Tap-hammer前庭诱发肌源性电位激发系统的研发和初步应用

Tap-hammer elicited vestibular-evoked myogenic potentials system: its design and preliminary application

目的研发可用于前庭诱发肌源性电位(vestibular-evoked myogenic potentials,VEMP)检测的Tap-hammer激发系统,并报告Tap-hammer刺激在VEMP检测中的初步应用结果。方法研发携带惯性触发开关的Tap-hammer激发系统,并将其与肌电诱发电位记录仪耦合,使之能够用于骨导振动刺激诱发的VEMP检测。对20名(男7例、女13例,年龄20~37岁,共40耳)健康志愿者进行气导声刺激(air-conducted sound,ACS)诱发的VEMP(ACS-VEMP)和Tap-hammer诱发的VEMP(Tap-VEMP)检测,记录和分析Tap-VEMP的波形特点及其参数,并应用SPSS 22.0进行统计分析。结果20名健康志愿者ACS-VEMP和Tap-VEMP的引出率均为100%(40/40)。Tap-hammer诱发的眼肌前庭诱发肌源性电位(Tap-oVEMP)的n1潜伏期、p1潜伏期、n1-p1波间期、振幅以及耳间不对称比分别为(9.80±2.51)ms、(13.90±3.26)ms、(4.09±1.43)ms、(16.43±9.61)μV及(22.68±17.35)%;Tap-hammer诱发的颈肌前庭诱发肌源性电位(Tap-cVEMP)的p1潜伏期、n1潜伏期、p1-n1波间期、振幅及耳间不对称比分别为(13.26±2.07)ms、(21.84±2.89)ms、(8.58±2.10)ms、(457.65±274.94)μV及(20.42±13.46)%。与ACS-VEMP检测结果相比,Tap-VEMP的n1、p1潜伏期较短(P值均<0.05),而两种刺激方式的波间期、振幅和耳间不对称比,差异均无统计学意义(P值均>0.05)。结论Tap-hammer激发系统可以在健康青年人中诱发出VEMP反应,该系统可以作为骨导VEMP检测的备选刺激方式。

Objective The aim of this study was to design and perform"Tap-hammer"system that can be used to elicit vestibular evoked myogenic potentials(VEMP)in normal adults and to report the preliminary results of this system.Methods A triggered Tap-hammer was designed,made and connected with an electric recording system,to form as a system for Tap-VEMP recording.Twenty healthy adult volunteers(7 males and 13 females,aged 20 to 37 years,40 ears in total)were recruited for air-conducted sound VEMP(ACS-VEMP)and Tap-VEMP examinations.Waveforms and parameters of both VEMPs were recorded and analyzed.SPSS 22.0 software was used for statistical analysis.Results The response rates of ACS-,Tap-ocular VEMP(oVEMP)and ACS-,Tap-cervical VEMP(cVEMP)were both 100%(40/40).The mean±SD n1 latency,p1 latency,n1-p1 interval,amplitude,and asymmetry ratio(AR%)of Tap-oVEMP were(9.80±2.51)ms,(13.90±3.26)ms,(4.09±1.43)ms,(16.43±9.61)μV,(22.68±17.35)%respectively.The mean±SD p1 latency,n1 latency,p1-n1 interval,amplitude,and asymmetry ratio(AR%)of Tap-cVEMP were(13.26±2.07)ms,(21.84±2.89)ms,(8.58±2.10)ms,(457.65±274.94)μV,(20.42±13.46)%respectively.Both n1 latency and p1 latency of Tap-VEMPs were shorter than those in ACS-VEMPs(P<0.05).No statistical difference could be found between the two stimulation methods in the parameters of n1-p1 interval,amplitude,and asymmetry ratio(P>0.05).Conclusion The Tap-hammer system can elicit VEMP responses in healthy young people.This system can be used as an alternative stimulation method for bone conduction VEMP.