Background:Saccades are often observed on video head impulse tests(vHIT)in patients with Meniere's Disease(MD)and Vestibular Migraine(VM).However,their saccadic features are not fully described.Objective:This stud...Background:Saccades are often observed on video head impulse tests(vHIT)in patients with Meniere's Disease(MD)and Vestibular Migraine(VM).However,their saccadic features are not fully described.Objective:This study aims to identify the saccades characteristics of MD and VM.Methods:75 VM patients and 103 definite unilateral MD patients were enrolled in this study.First raw saccades were exported and analyzed.The VM patients were divided into left and right based on their ears,while the MD patients were separated into affected and unaffected subgroups based on their audiograms and symptoms.Results:The MD patients have more saccades on the affected side(85%vs.69%),and saccade velocity is more consistent than the contralateral side(shown by the coefficient of variation).The saccades occurrence rates on both sides are similar in VM(77%vs.76%),as are other saccadic parameters.The MD patients have more significant inter-aural differences than the VM patients,manifested in higher velocity(p-value 0.000),earlier arriving(p-value 0.010),and more time-domain gathered(p-value 0.003)on the affected side.Conclusions:Bilateral saccades are commonly observed in MD and VM.In contrast to MD,saccades on VM are subtle,scattered,and late-arrived.Furthermore,the MD patients showed inconsistent saccadic distribution with more velocity-uniform saccades on the affected side.展开更多
Objective:Saccades accompanied by normal gain in video head impulse tests(vHIT)are often observed in patients with vestibular migraine(VM).However,they are not considered as an independent indicator,reducing their uti...Objective:Saccades accompanied by normal gain in video head impulse tests(vHIT)are often observed in patients with vestibular migraine(VM).However,they are not considered as an independent indicator,reducing their utility in diagnosing VM.To better understand clinical features of VM,it is necessary to understand raw saccades data.Methods:Fourteen patients with confirmed VM,45 patients with probable VM(p-VM)and 14 agematched healthy volunteers were included in this study.Clinical findings related to spontaneous nystagmus(SN),positional nystagmus(PN),head-shaking nystagmus(HSN),caloric test and vHIT were recorded.Raw saccades data were exported and numbered by their sequences,and their features analyzed.Results:VM patients showed no SN,PN or HSN,and less than half of them showed unilateral weakness(UW)on caloric test.The first saccades from lateral semicircular canal stimulation were the most predominant for both left and right sides.Neither velocity nor time parameters were significantly different when compared between the two sides.Most VM patients(86%)exhibited small saccades,around 35%of the head peak velocity,with a latency of 200e400 ms.Characteristics of saccades were similar in patients with p-VM.Only four normal subjects showed saccades,all unilateral and seemingly random.Conclusions:Small saccades involving bilateral semicircular canals with a scattered distribution pattern are common in patients with VM and p-VM.展开更多
Objective To compare the performances among three different systems for video head impulse test(vHIT),and to identify an optimal target angle for precisely evaluating the function of vertical semicircular canals in vH...Objective To compare the performances among three different systems for video head impulse test(vHIT),and to identify an optimal target angle for precisely evaluating the function of vertical semicircular canals in vHIT.Methods A two-center prospective study was done.Participants were sit 1.2 m away from the wall in a noise-proved room that dedicated for vHIT experiments.During the comparison experiments,similar settings were ensured in both hospitals,with the same distance to wall and angle of staring.For each equipment,the procedures followed the developers’recommendations.The same examiner performed the comparison between two systems in one location.For the eye-position projects,targets were placed on the wall sequentially at the pre-marked lines for different angles.For the comparison projects,9 and 13 participants were recruited,respectively.Any participant with otologic or vestibular disorders was excluded.A total of 26 healthy participants were recruited in the eye-position experiments,16 of which were further involved in inter-examiner tests.Results Our evaluations of three different systems showed that a new vHIT system,VertiGoggles®ZT-VNG-I(VG)performed as good as the long-tested Otometrics®ICS impulse(Oto)and EyeSeeCam®(ESC).During the comparison,we validated 25-degree,instead of right ahead at 0 degree,is a better place to set the targets when torsion was applied at vertical semicircular canal planes.Conclusion The new VG system is good for clinical practices.Furthermore,we proposed a new protocol to set the targets 25 degrees from right ahead after tilting head 45 degrees to evaluate vertical canals during vHIT.展开更多
目的分析儿童常见周围性眩晕的视频头脉冲试验(video head impulse test,vHIT)结果并探讨vHIT的诊断价值。方法回顾性选取2020年1月至2022年3月就诊于苏州大学附属第二医院眩晕诊治中心的儿童常见周围性眩晕患儿78例,根据年龄将患儿分为...目的分析儿童常见周围性眩晕的视频头脉冲试验(video head impulse test,vHIT)结果并探讨vHIT的诊断价值。方法回顾性选取2020年1月至2022年3月就诊于苏州大学附属第二医院眩晕诊治中心的儿童常见周围性眩晕患儿78例,根据年龄将患儿分为≤10岁组26例和>10岁组52例,分析其vHIT检查结果。结果78例周围性眩晕患儿中儿童良性阵发性眩晕(benign paroxysmal vertigo of childhood,BPVC)28例,前庭性偏头痛(vestibular mi⁃graine,VM)20例,前庭神经炎(vestibular neuritis,VN)15例,突发性聋伴眩晕(sudden deafness with vertigo,SD)8例,梅尼埃病(Meniere's disease,MD)7例。vHIT检查结果异常47例,其中BPVC14例,VM12例,VN14例,SD3例,MD4例。儿童vHIT检查中出现伪迹的概率更高,最常见的伪迹类型为眨眼,高增益值及追踪震荡,≤10岁组vHIT检查出现伪迹多于>10岁组,差异有统计学意义(P<0.001)。结论儿童周围性眩晕最常见的病因主要为BPVC及VM,vHIT在儿童眩晕的诊断中具有很高的特异性,但出现伪迹的概率较高,检查过程中需注意甄别并防范。展开更多
目的回顾性分析前庭神经炎(vestibular neuritis,VN)患者急性期视频头脉冲试验(video head impulse test,vHIT)及双温试验结果,探讨其对于VN诊断的意义及二者相关性。方法回顾性选取2019年1月至2022年10月唐山市眩晕诊疗康复中心收治的V...目的回顾性分析前庭神经炎(vestibular neuritis,VN)患者急性期视频头脉冲试验(video head impulse test,vHIT)及双温试验结果,探讨其对于VN诊断的意义及二者相关性。方法回顾性选取2019年1月至2022年10月唐山市眩晕诊疗康复中心收治的VN急性期患者40例,依据半规管轻瘫(cannal paralysis,CP)值患者分为A组(CP>50%)15例,B组(25%≤CP≤50%)17例,C组(CP<25%)8例,比较分析其vHIT、双温试验结果。结果水平半规管、前半规管vHIT阳性均高于后半规管,差异有统计学意义(P<0.001)。双温试验结果阳性率80.00%。A组受损侧水平半规管vHIT增益值低于B组、C组,差异均有统计学意义(P<0.05);B组受损侧水平半规管vHIT增益值低于C组,差异有统计学意义(P<0.05)。结论VN患者水平半规管、前半规管高频受损概率高于后半规管。双温试验CP值越大,相应水平半规管vHIT的增益值越低。VN超早期水平半规管可能出现低频损伤反应延迟现象,需联合vHIT共同评估半规管功能。展开更多
目的探讨视频头脉冲试验(video head impulse test,vHIT)在梅尼埃病(Meniere’s disease,MD)患者中的应用以及vHIT是否与MD分期相关。方法回顾性选取2021年1月至2022年12月复旦大学附属眼耳鼻喉科医院耳鼻喉科收治的67例单侧MD患者为研...目的探讨视频头脉冲试验(video head impulse test,vHIT)在梅尼埃病(Meniere’s disease,MD)患者中的应用以及vHIT是否与MD分期相关。方法回顾性选取2021年1月至2022年12月复旦大学附属眼耳鼻喉科医院耳鼻喉科收治的67例单侧MD患者为研究对象,根据听力损失是否>40 dB将患者分为早期组15例和晚期组52例,观察两组增益值和扫视波。结果患侧半规管异常29例,其中前半规管异常1例、水平半规管异常29例、后半规管异常11例。健侧半规管异常13例,其中前半规管异常1例、水平半规管异常11例、后半规管异常4例;患侧半规管异常多于健侧,差异有统计学意义(P<0.001)。患侧水平半规管vHIT增益值低于健侧,增益值降低例数、显性扫视波例数多于健侧,差异均有统计学意义(P<0.05)。患侧前半规管、后半规管vHIT结果与健侧比较,差异无统计学意义(P>0.05)。早期组MRI造影检查阳性率与晚期组比较,差异无统计学意义(P>0.05)。早期组vHIT前半规管、后半规管异常与晚期组比较,差异无统计学意义(P>0.05)。晚期组水平半规管显性扫视波例数多于早期组,差异有统计学意义(P<0.05)。晚期组水平半规管vHIT增益值、增益值降低例数、隐性扫视波例数与早期组比较,差异均无统计学意义(P>0.05)。结论MD较易累及水平半规管,其次为后半规管,前半规管极少出现异常。vHIT水平半规管显性扫视波的出现还与MD分期相关。vHIT有可能成为预测MD分期的有效检测指标。展开更多
目的:通过开发一款新的量化评估软件,分析自发性眼震(SN)和摇头眼震(HSN)患者的扫视波参数,以揭示前庭功能障碍患者的扫视波特征及其在不同代偿状态下的变化。方法:回顾性分析2023年9月至2024年6月在中国人民解放军总医院第一医学中心...目的:通过开发一款新的量化评估软件,分析自发性眼震(SN)和摇头眼震(HSN)患者的扫视波参数,以揭示前庭功能障碍患者的扫视波特征及其在不同代偿状态下的变化。方法:回顾性分析2023年9月至2024年6月在中国人民解放军总医院第一医学中心眩晕诊疗中心就诊患者的临床数据,采用自主开发的Saccades All in One(v1.0)软件处理视频头脉冲测试(vHIT)的原始数据,对SN组、HSN组和无眼震(None)组患者的扫视波参数进行分析。结果:SN组和HSN组患侧在第一和第二扫视波的数量、幅度和增益均显著高于健侧,且随代偿进展,受累侧的扫视波数量和幅度逐渐下降,到达时间提前,而健侧变化不明显。统计分析进一步证实了3组间扫视波参数存在显著差异,尤其在扫视波的数量和幅度方面。结论:通过本研究开发的量化工具能有效评估并区分代偿与未代偿状态下的扫视波特征,有助于前庭功能障碍患者的诊断与治疗。展开更多
目的研究正常成年人视频头脉冲检查(video head impulse test,vHIT)各项指标的正常值参考范围。方法 2017年1月至2017年8月对符合纳入标准的120例正常成年人进行视频头脉冲检查,记录以下指标:左侧、右侧水平半规管60ms瞬时增益值,左侧...目的研究正常成年人视频头脉冲检查(video head impulse test,vHIT)各项指标的正常值参考范围。方法 2017年1月至2017年8月对符合纳入标准的120例正常成年人进行视频头脉冲检查,记录以下指标:左侧、右侧水平半规管60ms瞬时增益值,左侧、右侧水平半规管回归增益值,左右侧水平半规管回归增益的不对称比,右前-左后半规管、左前-右后半规管的回归增益及其不对称比,分析结果。结果正常成年人60ms瞬时增益值的均值:水平半规管为1.55±0.37;回归增益值的均值:水平半规管为1.44±0.39,垂直半规管为1.27±0.19;回归增益不对称比的均值:水平半规管为4.17%±3.54%,垂直半规管为3.54%±3.33%。结论本研究得出正常成年人vHIT 60ms瞬时增益值的正常范围:水平半规管为>0.94;回归增益值的正常范围:水平半规管为>0.80,垂直半规管为>0.96;回归增益不对称比的正常范围:水平半规管为<9.98,垂直半规管为<9.00。本研究结果可为其临床应用提供参考。展开更多
基金supported by grants from National Key Research and Development Program of China-part3(2020YFC2005203)Capital's Funds for Health Improvement and Research(No.2022-1-2023).
文摘Background:Saccades are often observed on video head impulse tests(vHIT)in patients with Meniere's Disease(MD)and Vestibular Migraine(VM).However,their saccadic features are not fully described.Objective:This study aims to identify the saccades characteristics of MD and VM.Methods:75 VM patients and 103 definite unilateral MD patients were enrolled in this study.First raw saccades were exported and analyzed.The VM patients were divided into left and right based on their ears,while the MD patients were separated into affected and unaffected subgroups based on their audiograms and symptoms.Results:The MD patients have more saccades on the affected side(85%vs.69%),and saccade velocity is more consistent than the contralateral side(shown by the coefficient of variation).The saccades occurrence rates on both sides are similar in VM(77%vs.76%),as are other saccadic parameters.The MD patients have more significant inter-aural differences than the VM patients,manifested in higher velocity(p-value 0.000),earlier arriving(p-value 0.010),and more time-domain gathered(p-value 0.003)on the affected side.Conclusions:Bilateral saccades are commonly observed in MD and VM.In contrast to MD,saccades on VM are subtle,scattered,and late-arrived.Furthermore,the MD patients showed inconsistent saccadic distribution with more velocity-uniform saccades on the affected side.
文摘Objective:Saccades accompanied by normal gain in video head impulse tests(vHIT)are often observed in patients with vestibular migraine(VM).However,they are not considered as an independent indicator,reducing their utility in diagnosing VM.To better understand clinical features of VM,it is necessary to understand raw saccades data.Methods:Fourteen patients with confirmed VM,45 patients with probable VM(p-VM)and 14 agematched healthy volunteers were included in this study.Clinical findings related to spontaneous nystagmus(SN),positional nystagmus(PN),head-shaking nystagmus(HSN),caloric test and vHIT were recorded.Raw saccades data were exported and numbered by their sequences,and their features analyzed.Results:VM patients showed no SN,PN or HSN,and less than half of them showed unilateral weakness(UW)on caloric test.The first saccades from lateral semicircular canal stimulation were the most predominant for both left and right sides.Neither velocity nor time parameters were significantly different when compared between the two sides.Most VM patients(86%)exhibited small saccades,around 35%of the head peak velocity,with a latency of 200e400 ms.Characteristics of saccades were similar in patients with p-VM.Only four normal subjects showed saccades,all unilateral and seemingly random.Conclusions:Small saccades involving bilateral semicircular canals with a scattered distribution pattern are common in patients with VM and p-VM.
基金supported by grants from the National Science Foundation for Outstanding Young People(No.81922018)the Transformation and Industrialization of Scientific and Technological Achievements in Shanghai(No.18441904000)+3 种基金the National Natural Science Foundation of China(No.81771011)the National Natural Science Foundation of China Young Investigator Program(No.81800907)the Development Fund for Shanghai Talents(No.2017046)the Excellent Personnel Training Plan for the Shanghai Health System(No.2017Q003).
文摘Objective To compare the performances among three different systems for video head impulse test(vHIT),and to identify an optimal target angle for precisely evaluating the function of vertical semicircular canals in vHIT.Methods A two-center prospective study was done.Participants were sit 1.2 m away from the wall in a noise-proved room that dedicated for vHIT experiments.During the comparison experiments,similar settings were ensured in both hospitals,with the same distance to wall and angle of staring.For each equipment,the procedures followed the developers’recommendations.The same examiner performed the comparison between two systems in one location.For the eye-position projects,targets were placed on the wall sequentially at the pre-marked lines for different angles.For the comparison projects,9 and 13 participants were recruited,respectively.Any participant with otologic or vestibular disorders was excluded.A total of 26 healthy participants were recruited in the eye-position experiments,16 of which were further involved in inter-examiner tests.Results Our evaluations of three different systems showed that a new vHIT system,VertiGoggles®ZT-VNG-I(VG)performed as good as the long-tested Otometrics®ICS impulse(Oto)and EyeSeeCam®(ESC).During the comparison,we validated 25-degree,instead of right ahead at 0 degree,is a better place to set the targets when torsion was applied at vertical semicircular canal planes.Conclusion The new VG system is good for clinical practices.Furthermore,we proposed a new protocol to set the targets 25 degrees from right ahead after tilting head 45 degrees to evaluate vertical canals during vHIT.
文摘目的分析儿童常见周围性眩晕的视频头脉冲试验(video head impulse test,vHIT)结果并探讨vHIT的诊断价值。方法回顾性选取2020年1月至2022年3月就诊于苏州大学附属第二医院眩晕诊治中心的儿童常见周围性眩晕患儿78例,根据年龄将患儿分为≤10岁组26例和>10岁组52例,分析其vHIT检查结果。结果78例周围性眩晕患儿中儿童良性阵发性眩晕(benign paroxysmal vertigo of childhood,BPVC)28例,前庭性偏头痛(vestibular mi⁃graine,VM)20例,前庭神经炎(vestibular neuritis,VN)15例,突发性聋伴眩晕(sudden deafness with vertigo,SD)8例,梅尼埃病(Meniere's disease,MD)7例。vHIT检查结果异常47例,其中BPVC14例,VM12例,VN14例,SD3例,MD4例。儿童vHIT检查中出现伪迹的概率更高,最常见的伪迹类型为眨眼,高增益值及追踪震荡,≤10岁组vHIT检查出现伪迹多于>10岁组,差异有统计学意义(P<0.001)。结论儿童周围性眩晕最常见的病因主要为BPVC及VM,vHIT在儿童眩晕的诊断中具有很高的特异性,但出现伪迹的概率较高,检查过程中需注意甄别并防范。
文摘目的:通过开发一款新的量化评估软件,分析自发性眼震(SN)和摇头眼震(HSN)患者的扫视波参数,以揭示前庭功能障碍患者的扫视波特征及其在不同代偿状态下的变化。方法:回顾性分析2023年9月至2024年6月在中国人民解放军总医院第一医学中心眩晕诊疗中心就诊患者的临床数据,采用自主开发的Saccades All in One(v1.0)软件处理视频头脉冲测试(vHIT)的原始数据,对SN组、HSN组和无眼震(None)组患者的扫视波参数进行分析。结果:SN组和HSN组患侧在第一和第二扫视波的数量、幅度和增益均显著高于健侧,且随代偿进展,受累侧的扫视波数量和幅度逐渐下降,到达时间提前,而健侧变化不明显。统计分析进一步证实了3组间扫视波参数存在显著差异,尤其在扫视波的数量和幅度方面。结论:通过本研究开发的量化工具能有效评估并区分代偿与未代偿状态下的扫视波特征,有助于前庭功能障碍患者的诊断与治疗。
