Clinical characteristics and analysis of vestibular-evoked myogenic potentials in patients with sudden sensorineural hearing loss in different ages

BACKGROUND Numerous studies have found that patients experiencing sudden sensorineural hearing loss(SSHL),with or without accompanying vertigo,often show impaired vestibular function.However,there is a dearth of studies analyzing vestibularevoked myogenic potentials(VEMPs)in SSHL patients across various age groups.AIM To investigate vestibular condition in SSHL patients across various age demographics.METHODS Clinical data of 84 SSHL patients were investigated retrospectively.Audiometry,cervical vestibular evoked myogenic potentials(c-VEMPs),and ocular vestibular evoked myogenic potentials(o-VEMPs)were conducted on these patients.Parameters assessed included the latencies of P1 and N1 waves,as well as the amplitudes of P1–N1 waves.Moreover,the study evaluated the influence of factors such as sex,affected side,configuration of hearing loss,and presence of accompanying vertigo.RESULTS Among the 84 SSHL patients,no significant differences were observed among the three groups in terms of gender,affected side,and the presence or absence of vertigo.Group II(aged 41–60 years)had the highest number of SSHL cases.The rates of absent o-VEMPs in the affected ears were 20.83%,31.58%,and 22.72%for the three age groups,respectively,with no statistically significant difference among them.The rates of absent c-VEMPs in the affected ears were 8.3%,34.21%,and 18.18%for the three age groups,respectively,with significant differences.In the unaffected ears,there were differences observed in the extraction rates of o-VEMPs in the unaffected ears among the age groups.In the three age groups,no significant differences were noted in the three age groups in the latencies of P1 and N1 waves or in the amplitude of N1–P1 waves for c-VEMPs and o-VEMPs,either on the affected side or on the unaffected side,across the three age groups.CONCLUSION The extraction rate of VEMPs is more valuable than parameters.Regardless of the presence of vertigo,vestibular organs are involved in SSHL.Notably,SSHL patients aged 41–60 appear more susceptible to damage to the inferior vestibular nerve and saccule.

Retro-labyrinthine Lesion Site Detected by Galvanic Vestibular Stimulation Elicited Vestibular-evoked Myogenic Potentials in Patients with Auditory Neuropathy

Objective Auditory neuropathy(AN)is a unique pattern of hearing loss with preservation of hair cell function.The condition is characterized by the presence of otoacoustic emissions(OAE)or cochlear microphonic(CM)responses with severe abnormalities of the auditory brainstem response(ABR).The vestibular branches of the VIII cranial nerve and the structures innervated by it can also be affected.However,the precise lesion sites in the vestibular system are not well characterized in patients with AN.Methods The air-conducted sound(ACS)vestibular-evoked myogenic potentials(VEMPs)and galvanic vestibular stimuli(GVS)-VEMPs were examined in 14 patients with AN.Results On examination of VEMPs(n=14,28 ears),the absent rates of ACS-cervical VEMP(cVEMP),ACS-ocular VEMP(oVEMP),GVS-cVEMP,GVS-oVEMP and caloric test were 92.9%(26/28),85.7%(24/28),67.9%(19/28),53.6%(15/28),and 61.5%(8/13),respectively.Impaired functions of the saccule,inferior vestibular nerve,utricle,superior vestibular nerve,and horizontal semicircular canal were found in 25.0%(7/28),67.9%(19/28),32.1%(9/28),53.6%(15/28)and 61.5%(8/13)patients,respectively.On comparing the elicited VEMPs parameters of AN patients with those of normal controls,both ACS-VEMPs and GVS-VEMPs showed abnormal results in AN patients(such as,lower presence rates,elevated thresholds,prolonged latencies,and decreased amplitudes).Conclusion The study suggested that patients with AN often have concomitant vestibular disorders.Retro-labyrinthine lesions were more frequently observed in this study.GVS-VEMPs combined with ACS-VEMPs may help identify the lesion sites and facilitate detection of areas of vestibular dysfunction in these patients.

A study on vestibular-evoked myogenic potentials via galvanic vestibular stimulation in normal people

Objectives: The aim of our study is to examine vestibular-evoked myogenic potentials(VEMPs) elicited by the galvanic vestibular stimulation in the sternocleidomastoid muscle(SCM) in healthy subjects for clinical applications of auditory neuropathy or vestibular neuropathy in the future.Methods: We enrolled sixteen healthy subjects to record the average responses of SCM to galvanic vestibular stimulation(GVS) [current 3 mA;duration 1 ms] by electromyography(EMG). SPSS 18.0 software was used to analyze the obtained data for mean and standard deviation.Results: In all healthy subjects mastoid-forehead galvanic vestibular stimulation produced a positive-negative biphasic EMG responses on SCM ipsilateral to the cathodal electrode. The latency of p13 was 11.7 ± 3.0 ms. The latency of n23 was 17.8 ± 3.4 ms. The amplitude of p13-n23 was147.0 ± 69.0 μV. The interaural asymmetry ratio(AR) of p13, n23 latency and the amplitude was respectively 0.12 ± 0.09, 0.08 ± 0.08 and0.16 ± 0.10.Discussions: Galvanic vestibular stimulation could elicit biphasic EMG responses from SCM via the vestibular nerve but not from the otolith organs. Galvanic stimulation together with air conducted sound(ACS) or bone conducted vibration(BCV) can elicit VEMPs and may enable the differentiation of retrolabyrinthine lesions from labyrinthine lesions in vestibular system.

Vestibular-evoked myogenic potentials recorded from miniature pigs and rats

Objective:To report vestibular evoked myogenic potentials from different recording sites(neck extensor or masseter muscles) in miniature pigs and rats.Methods:Potentials were recorded using 1000 Hz tone bursts from the neck extensor muscle or masseter muscle in normal adult Bama miniature pigs and rats anesthetized with 3%pentobarbital sodium and Sumianxin Ⅱ.Results:At 80 dB SPL,the first positive wave(P wave) of VEMPs was recognizable in 58%of rats with a latency of 6.45±0.23 ms and an amplitude of 1.45±0.49 μV when recorded from the neck extensor muscle,and in 50%of rats with a latency of 6.38±0.34 ms and an amplitude of 1.57±0.35 μV when recorded from the masseter muscle.In miniature pigs,at the same stimulus intensity,P wave was recognizable in 58%of the animals with a latency of 7.65±0.64 ms and an amplitude of 1.66±0.34 μV when recorded from the neck extensor muscle,and in 50%of the animals with a latency of 7.65±0.64 ms and an amplitude of 0.31±0.28 μV when recorded from the masseter muscle.Conclusion:VEMP can be induced from both neck extensor and masseter muscles in the miniature pig and rat.For a given species,the site of recording affects P wave induction rate and amplitude but not latency.Consistency and repeatability analysis suggests that the masseter muscle is a better recording site in miniature pigs while the cervical extensor is a better recording site in rats.For a given recording site,both latency and amplitude of the P wave are slightly greater in miniature pigs than in rats.

Vestibular-evoked myogenic potentials in miniature pigs

Objective:To report detection of vestibular-evoked myogenic potentials (VEMPs) in the miniature pig. Methods:Potentials evoked by 1000 Hz tone bursts were recorded from neck extensor muscles and the masseter muscles in normal adult Bama miniature pigs anesthetized with 3%pentobarbital sodium and Carbachol II. Results:The latency of the first positive wave P from neck extensor muscles was 7.65 ± 0.64 ms, with an amplitude of 1.66 ± 0.34 uv and a rate of successful induction of 75%at 80 dB SPL. The latency of potentials evoked from the masseter muscles was 7.60 ± 0.78 ms, with an amplitude of 1.31 ± 0.28 uv and a rate successful induction of 66%at 80 dB SPL. Conclusion:The latencies and thresholds of VEMPs recorded from the neck extensor muscle and the masseter muscle appear to be comparable in normal adult Bama miniature pigs, although the amplitude recorded from the neck extensor muscle seems to be higher than that from the masseter muscle. However, because of their usually relatively superficial and easily accessible location, as well as their large volume and strong contractions, masseter muscles may be better target muscles for recording myogenic potentials.

Masseter Vestibular evoked myogenic potentials: A new tool to assess the vestibulomasseteric reflex pathway

Purpose: This review article provides the readers with an in-depth insight in understanding and interpreting various research literatures on the masseter vestibular evoked myogenic potentials(mVEMP). The article also reviews the contemporary researches involving the clinical applications of the mVEMP. Conclusions: Masseter VEMP is an evolving yet clinically promising neuro-otology test tool that has recently gained more research interest and is considered an additional tool to diagnose various vestibular disorders. Masseter VEMP assesses the functional integrity of the acoustic-masseteric and vestibulo-masseteric reflex pathways. The mVEMP could be used as a complementary test to evaluate the same peripheral generator as the cervical VEMP but a different central pathway i.e., vestibulo-trigeminal pathway. Various research studies that have experimented on parameters such as the effect of different electrode montages(zygomatic vs mandibular configurations), stimulation rates, filter settings and stimuli used to evoke mVEMP have been discussed in this article that could assist in the optimization of a comprehensive clinical protocol. The latency and the amplitude of mVEMP waveforms serve as significant parameters in differentiating normals from those of the clinical populations. Along with the cVEMPs and oVEMPs, mVEMP might help diagnose brainstem lesions in REM Sleep behaviour disorders, Multiple Sclerosis and Parkinson's disease. However, further studies are required to probe in this area of research.

Vestibular evoked myogenic potentials in patients with diabetes mellitus

Although the exact mechanism and most involved region of the vestibular system have not yet been fully clarified, vestibular dysfunction has been demonstrated in patients with diabetes mellitus (DM). Vestibular evoked myogenic potential (VEMP) is a short latency electromyographic response to sound or vibration stimuli that may reflect otolith organ or related reflex functions. Since its first description in 1992, VEMP has become a significant part of the vestibular test battery as an objective measurement tool. In diabetic patients, VEMP responses have been studied in order to determine any otolith organ or related reflex dysfunctions. Here, we review the literature with regard to VEMP findings representing any peripheral vestibular end-organ dysfunction in patients with DM. Distinctive vestibular end-organ impairments seem to be demonstrated in patients with DM either with or without DNP via objective vestibular testing tools including VEMP recordings according to relevant studies. However, further studies with larger sample sizes are required to reveal the more definitive findings of VEMP recordings regarding the vestibular pathologies in patients with DM.

Evaluation of ocular and cervical vestibular evoked myogenic potentials in a conductive hearing loss model

Objective:To investigate the effects of conductive hearing loss (CHL) on vestibular evoked myogenic potentials (VEMPs) using a simulated CHL model, and to provide the basis for future studies. Methods:Twenty-one healthy subjects were recruited in this study. We measured ocular VEMPs (oVEMPs) and cervical VEMPs (cVEMPs) in these subjects by air-conduction sound (ACS) stimulation. CHL was simulated later by blocking the right external auditory canal with a soundproof earplug to evaluate its impacts on VEMPs. Subjects' responses before simulated CHL served as the control, and were compared to their responses following simulated CHL. Results: oVEMPs following simulated CHL showed decreased response rate, elevated thresholds, attenuated amplitudes and prolonged N1 latencies compared with those before simulated CHL, and the differences were statistically significant. Similarly, cVEMPs following simulated CHL also showed decreased response rate, elevated thresholds and attenuated amplitudes, with prolonged P1 latencies compared with those before simulated CHL, although only differences in response rate, threshold and amplitude were significant. Conclusions:Conductive hearing loss affects the response rate and other response parameters in oVEMPs and cVEMPs.

Vestibular evoked myogenic potential

Vestibular evoked myogenic potential （VEMP）, is an electromyographic response of vestibular origin evoked by sound, vibration or electrical stimulation. VEMP is widely used as a clinical test of the otolith organs. Now-adays, two kinds of VEMP, cervical VEMP （cVEMP） and ocular VEMP （oVEMP） are clinically used. cVEMP is a test of sacculo-collic refex while oVEMP is a test of utri-culo-ocular refex. Absence of responses, large interau-ral asymmetry of amplitudes, prolonged peak latencies, and abnormal thresholds of responses are regarded as abnormal responses. Clinical application to various diseases of the vestibular system was performed. Using VEMP, a new type of vestibular neuritis, inferior ves-tibular neuritis was established. A prominent feature of VEMP in Meniere’s disease is a shift of a preferred fre-quency in cVEMP. The whole aspects of VEMP fndings in patients with benign paroxysmal positional vertigo are not clarifed yet. Sensitivity of cVEMP to vestibular schwannoma was 80.0%, while specifcity was 52.7%. Concerning diagnosis of superior canal dehiscence syn-drome （SCDS）, oVEMP to air-conducted sound is the most helpful. Augmentation of oVEMP responses is a prominent feature in SCDS. I also presented “idiopathic otolithic vertigo”, which I proposed as a new clinical en-tity based on VEMP fndings. Some patients complained of lateral tilting sensation in the roll plane, or tilting or translational sensation in the pitch plane without rota-tory vertigo. Majority of patients with these symptoms had absent or decreased responses of oVEMP and/or cVEMP. I proposed that these patients could be diag-nosed as having “idiopathic otolithic vertigo”.

The effect of EMG magnitude on the masseter vestibular evoked myogenic potential(mVEMP)

Introduction:The masseter vestibular evoked myogenic potential(mVEMP)is a bilaterally generated,electromyographically(EMG)-mediated response innervated by the trigeminal nerve.The purpose of the present investigation was to 1)determine whether subjects could accurately achieve and maintain a range of EMG target levels,2)to examine the effects of varied EMG levels on the latencies and amplitudes of the mVEMP,and 3)to investigate the degree of side-to-side asymmetry and any effects of EMG activation.Methods:Subjects were nine neurologically and otologically normal young adults.A high-intensity tone burst was presented monaurally while subjects were seated upright and asked to match a range of EMG target levels by clenching their teeth.Recordings were made from the ipsilateral and contralateral masseter muscles referenced to the ear being monaurally stimulated.Results:We found that the tonic EMG target had no effect on mVEMP latency.Additionally,although mVEMP amplitudes“scaled”to the EMG target,there was a tendency for the subjects’EMG level to“undershoot”the EMG target levels greater than 50 mV.While some individuals did generate differences in EMG activation between sides,there were no significant differences on average EMG activation between sides.Further,while average corrected amplitude asymmetry was similar across EMG targets,some individuals demonstrated large,corrected amplitude asymmetry ratios.Conclusions:The results of this investigation suggest that,as with cVEMP recordings,the underlying EMG activation may vary between subjects and could impact mVEMP amplitudes,yet could be mitigated by amplitude correction techniques.Further it is important to be aware that even young normal subjects have difficulty maintaining large,tonic EMG activity during the mVEMP recording.

Vestibular function for children with insulin dependent diabetes using cervical vestibular evoked myogenic potentials testing

BACKGROUND Healthy vestibular system adjusts balance during static and dynamic conditions.This is important for normal development(standing up and walking).Vestipulopathies(central and peripheral)are common complications of diabetes in adult population.Related studies are scare in children with type 1 diabetes(T1D).AIM To assess saccular function of otolith organ in children with T1D and predictors for its dysfunction.METHODS Cervical vestibular evoked myogenic potential(cVEMP)was used for objective evaluation.RESULTS The study included 40 patients(boys=15;girls=25).Patients had mean age of 13.63±1.50 years,duration of diabetes of 5.62±2.80 years,frequent attacks of diabetic ketoacidosis(55%)and hypoglycemia(30%),hyperlipidemia(20%),hypertension(12.5%)and peripheral neuropathy(40%).Dizziness was found in 10%.Compared to healthy children(n=25),patients had prolonged cVEMP P1 and N1 latencies and reduced P1-N1 amplitude.Bilateral cVEMP abnormalities were found in 60%(vs 25%for unilateral abnormalities).Higher frequencies and severe vestibulopathies were found with chronic diabetes of>5 years,hemoglobin A1c values>7%,frequent diabetic ketoacidosis and hypoglycemic attacks and presence of dizziness.Regression analyses showed that predictors for prolonged P1 latencies and reduced P1-N1 amplitudes were only chronic diabetes(>5 years){odds ratio(OR)=2.80[95%confidence interval(CI):1.80–5.33],P=0.01;OR=3.42(95%CI:2.82–6.81)}and its severity(hemoglobin A1c>7%)[OR=3.05(95%CI:2.55–6.82),P=0.01;OR=4.20(95%CI:3.55–8.50),P=0.001].CONCLUSION Dysfunction or injury of the saccular macula and its pathways is prevalent in children with T1D.Optimum glycemic control is important to prevent diabetes related vestipulopathies.

不同年龄段健听人颈性前庭诱发肌源性电位参数的研究

目的探讨颈性前庭诱发肌源性电位在不同年龄段健听人群中的正常参考值范围。方法将60例健康志愿者分为儿童组和成人组,利用丹麦WDH集团的Eclipse客观听觉测试平台分别进行颈性前庭诱发肌源性电位测试,对数据进行统计学分析。结果两组中左侧和右侧间P1、Nl潜伏期、P1-N1波间期、振幅、不对称比均无显著差异;两组中男性和女性间P1、Nl潜伏期、P1-N1波间期、振幅、不对称比均无显著差异;儿童组中P1正常值范围为13.97±1.46 ms,N1正常值范围为21.82±1.85 ms,振幅正常范围为100.71±91.17μV,波间期正常范围为7.85±1.12 ms;成人组中P1正常值范围为16.11±2.23 ms,N1正常值范围为24.66±2.35 ms,振幅正常范围为61.26±27.74μV,波间期正常范围为8.58±1.48 ms;两组之间P1、Nl潜伏期、P1-N1波间期、振幅均有显著差异(P<0.05),不对称比无显著差异。结论颈性前庭诱发肌源性电位的波形及参数与侧别、性别无相关性,潜伏期、波间期随年龄增长而延长,振幅随年龄的增长而减小。

突发性聋耳石器损伤情况及眼性前庭诱发肌源性电位与主观视觉垂直线相关性分析

目的 观察突发性聋患者耳石器损伤情况及其对预后的影响,探讨眼性前庭诱发肌源性电位(ocular vestibular evoked myogenic potential,oVEMP)与主观视觉垂直线(subjective visual vertical,SVV)的相关性。方法 选取2021年10月至2022年3月广西医科大学第二附属医院耳鼻咽喉头颈外科收治的单侧突发性聋患者66例,根据是否伴发眩晕,分为不伴眩晕组38例和伴眩晕组28例;根据耳石功能是否正常,分为耳石功能正常组37例和耳石功能异常组29例。选取同期30例无耳科疾病健康志愿者为对照组。治疗前后分别行纯音听阈、oVEMP、颈性前庭诱发肌源性电位(cervical vestibular evoked myogenic potential,cVEMP)及SVV检查,分析结果及oVEMP与SVV相关性。结果 伴眩晕组oVEMP、cVEMP、SVV异常率均高于不伴眩晕组、对照组,差异均有统计学意义(P<0.05);不伴眩晕组耳石器功能异常率均高于对照组,差异均有统计学意义(P<0.05)。突发性聋患者oVEMP与SVV无相关性,差异无统计学意义(P>0.05)。治疗后,不伴眩晕组总有效率高于伴眩晕组,差异有统计学意义(P<0.05);耳石器功能正常组总有效率高于耳石器功能异常组,差异均有统计学意义(P<0.05)。结论 突发性聋患者存在一定程度的耳石器功能损伤,突发性聋伴眩晕患者预后较不伴眩晕者差,耳石器功能对突发性聋患者的预后有一定的评估价值,oVEMP与SVV作为相对独立的两项耳石器功能检查,二者可相互补充,不能相互替代。

直流电刺激诱发的前庭诱发肌源性电位儿童检测方法的建立

目的 建立健康儿童直流电刺激诱发(galvanic vestibular stimulation,GVS)的颈肌前庭诱发肌源性电位(cervical vestibular evoked myogenic potential,cVEMP)和眼肌前庭诱发肌源性电位(ocular vestibular evoked myogenic potential,oVEMP)的检测方法,并确定正常范围。方法 对健康儿童20例(3~14岁)和健康成人24例(18~30岁)分别进行GVS-cVEMP和GVS-oVEMP检测,儿童组直流电刺激强度不超过3 mA,成人组最大刺激强度5 mA,记录两组GVS-cVEMP和GVS-oVEMP的引出率和特点,并进行不同刺激强度下的疼痛评分。结果 GVS-cVEMP和GVS-oVEMP在儿童组和成人组的引出率均为100.0%。儿童组GVS-cVEMP的p1潜伏期、n1潜伏期和p1-n1波间期分别为10.46±1.84 ms、16.98±2.12 ms和6.52±1.42 ms,n1潜伏期和p1-n1波间期较成人组明显缩短(P<0.05)。儿童组GVS-oVEMP的n1潜伏期、p1潜伏期和p1-n1波间期分别为8.87±1.40 ms、12.25±1.80 ms和3.39±1.07 ms,与成人组无明显差异。儿童组GVS-cVEMP和GVS-oVEMP的阈值均明显低于成人组(P<0.01),但振幅和振幅不对称比无明显差异。本文健康儿童检测结果可作为其正常范围。随着电流刺激强度的增加,受试者的疼痛评分增高,其对应的GVS-cVEMP和GVS-oVEMP的引出率也增加。结论 采取3 mA刺激强度和适宜的记录方法,可在3岁以上儿童及青少年人群中进行GVS-cVEMP和GVS-oVEMP检测并引出波形,并得到了其正常范围,儿童GVS-cVEMP潜伏期略短于成人,进行评估时,建议选取同年龄段健康儿童进行比较。

0~14岁儿童前庭诱发肌源性电位研究进展

在儿童中,平衡及前庭功能受损发生率较高,影响患儿听力和平衡能力,不及早干预将会影响其身心发展和正常生活学习。由于较小患儿不能准确表达他们的症状,且注意力保持时间短,需要一种安全有效的前庭测试评估患儿前庭功能。前庭诱发肌源性电位(vestibular evoked Myogenic potentials,VEMP)是一种耳石器功能评估方法,主要反映球囊和前庭上神经通路以及椭圆囊和前庭下神经通路功能,操作简便,安全有效,适用于儿童前庭功能评估。本文主要综述0~14岁儿童VEMP的检测方法和临床应用。

帕金森病患者前庭诱发肌源性电位特点及其与姿势平衡障碍及非运动症状的相关性

目的:探讨帕金森病(PD)患者前庭诱发肌源性电位(VEMP)特点并分析其与姿势平衡障碍及非运动症状的相关性。方法:纳入2022年6月至2023年6月河北医科大学第一医院神经内科收治的65例原发PD患者及性别、年龄相匹配的60例健康体检者(HC),均进行VEMP检查,采用统一帕金森病评定量表(UPDRS)、Hoehn-Yahr分期量表(H-Y)评估患者的运动症状及疾病严重程度,采用蒙特利尔认知评价量表(MOCA)、简易智能状态检查量表(MMSE)、汉密尔顿抑郁量表24项(HAMD-24)、汉密尔顿焦虑量表14项(HAMA-14)、匹兹堡睡眠量表(PSQI)、快速眼动睡眠期行为障碍相关量表(RBD-SQ)、帕金森病睡眠障碍量表(PDSS)、自主神经功能量表(SCOPA-AUT)、简易疲劳量表(BFI)、国际不宁腿综合征量表(IRLS)、帕金森病疼痛量表(KPPS)、Wexner便秘评分(WCGS)评价患者的非运动症状,采用Berg平衡量表(BBS)、平衡信心量表(ABC)、Tinetti平衡与步态量表(Tinetti-POMA)评估患者的姿势平衡障碍。采用Spearman相关性分析探讨VEMP与其姿势平衡障碍及非运动症状的相关性。结果:PD患者VEMP异常率显著高于HC[72.31%(47/65)vs. 33.33%(20/60),χ^(2)=19.056,P<0.001],异常模式以反应缺失为主[58.46%(38/47)]。VEMP评分与PD患者病程、LEDD及各量表评分间的Spearman相关性分析显示,VEMP评分与BBS评分(r=-0.307,P=0.013)、Tinetti-POMA评分(r=-0.255,P=0.042)呈负相关关系,与HAMA-14评分(r=0.323,P=0.009)、RBD-SQ(r=0.476,P=0.001)评分呈正相关关系。结论:PD患者的VEMP异常率会显著升高,且异常模式以反应缺失为主,VEMP异常与PD患者的姿势平衡障碍、焦虑情绪严重程度及RBD严重程度具有显著相关性。VEMP作为一种无创、客观的神经电生理学指标,可为诊断PD的脑干功能受损情况提供依据,为前庭刺激及前庭康复等辅助治疗PD奠定理论基础。

前庭诱发肌源性电位在帕金森病诊断中的应用

前庭诱发肌源性电位(VEMPs)是一种临床评估前庭功能的常用电生理检测技术。帕金森病患者常伴前庭功能异常,以VEMPs参数异常最为常见。本文在介绍VEMPs技术的基础上,就帕金森病患者VEMPs参数异常特征、与临床表型的关联性、潜在的病理生理学基础进行综述,为进一步的临床研究及应用提供新的思路。

两种刺激声坐姿下颈部及眼部前庭诱发肌源性电位特征分析

目的研究不同刺激声在坐姿下诱发的前庭诱发肌源性电位(vestibular-evoked myogenic potentials,VEMPs)特征,提供各波潜伏期及振幅等参数的正常值参考范围。方法分别用500 Hz短纯音(tone-burst)及500 Hz线性调频脉冲音(CE-chirp)两种刺激声对21名(男11人,女10人)听力正常且无耳蜗及前庭系统疾病的青年人(年龄22~33岁,平均年龄23.95±3.29岁)进行VEMPs测试,测试起始强度为110 dB nHL,以5 dB为步阶测试至阈值,记录各强度参数,并进行分析。结果两种刺激声坐姿下诱发的cVEMP及oVEMP阈值分别为tone-burst cVEMP 85.00±6.10 dB nHL,CE-chirp cVEMP 84.63±4.99 dB nHL;tone-burst oVEMP 83.38±6.54 dB nHL,CE-chirp oVEMP 82.50±6.20 dB nHL。两种刺激声测得的各强度p1潜伏期、n1潜伏期有显著差异(P<0.05),p1-n1波间期、p1-n1振幅、双侧不对称性、双侧振幅比、双侧对称系数等均无显著差异(P>0.05)。结论坐姿下正常青年人两种刺激声给声强度100 dB nHL时VEMPs的引出率均为100%,500 Hz线性调频脉冲音可作为VEMPs测试的刺激声应用于临床,评估椭圆囊和球囊功能。

前庭诱发肌源性电位对前庭性偏头痛的应用研究

目的通过前庭诱发肌源性电位(VEMPs)评价前庭性偏头痛(VM)患者的椭圆囊、球囊、前庭上神经通路以及前庭下神经通路的功能状况,探讨其临床应用价值。方法参照VM的诊断标准,选取36例VM患者作为VM组,同时选取36例健康体检者作为对照组,采用前瞻性对照研究的方法,对两组个体分别进行颈肌前庭诱发电位(cVEMP)和眼肌前庭诱发电位(oVEMP)检查,对其相关指标进行比较分析。结果与对照组相比,VM组cVEMP的引出率和潜伏期无明显差异,但其波幅明显降低,耳间不对称比明显升高。结论VM患者的椭圆囊和前庭上神经通路出现不同程度的功能障碍,oVEMP可作为其确诊的重要检查手段。

梅尼埃病患者c VEMPs与内淋巴积水相关性研究进展

梅尼埃病(Meniere’s disease,MD)是常见的耳源性眩晕疾病,主要表现为发作性眩晕,波动性听力下降,耳鸣和耳胀满感。目前病因不明,其主要的病理学特点为内淋巴的产生与吸收失衡导致的内淋巴积水,内耳核磁钆造影使得内淋巴积水可视化,前庭积水导致前庭功能下降,颈前庭诱发肌源性电位各参数异常,已有国内外相关文献报道两者对于梅尼埃病的应用价值。本文旨总结二者在梅尼埃病中的应用价值,分析相关性,以进一步总结归纳梅尼埃病形态变化与功能变化之间的联系,更好地应用于临床,指导梅尼埃病的诊断和治疗。