前庭代偿与治疗机制研究进展

Research advances in the mechanism of vestibular compensation and treatment

与其他感觉系统不同,前庭系统通过“推-拉”的模式维持整个系统的张力平衡,局部功能异常增强或减弱都将导致整个系统的功能障碍。单侧外周前庭受损将引起显著的前庭症状,但其可在数日至数周内逐步自行缓解,该现象被称为“前庭代偿”。由于多数情况下的前庭外周损伤为不可逆性,因此广泛认为中枢机制是前庭代偿的主因。其中,静态症状在数周内消失,代偿较为完全,推测是前庭核团放电再平衡的结果;动态症状的代偿需要更长时间,通过感觉替代、行为替代等方式实现,且代偿不完全。本文简要综述了前庭代偿及治疗机制的研究进展以期为未来的研究工作和临床治疗策略提供参考。

Unlike other sensory systems,since the vestibular system maintains the tension balance of the entire system in a"push-pull"mode,local dysfunction in the system will cause the balance of the entire system to collapse.Unilateral peripheral vestibular dysfunction will cause severe vestibular symptoms,but it can recover spontaneously within a few days to several weeks.This phenomenon is called"vestibular compensation"(VC).Since the peripheral vestibular impact in most cases is irreversible,it is widely believed that the central mechanism plays a key role in the vestibular compensation process.Static symptom is fully compensated within a few weeks,which is in parallel with the restored balance in the resting discharge of the vestibular nucleus on both sides;the incomplete compensation of dynamic deficits takes longer and is achieved mainly through the mechanism of sensory substitution and behavioral substitution.Here we briefly reviewed the mechanism of vestibular compensation and treatment in order to provide an insight into further study and clinical treatment strategies.