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 appli...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.展开更多
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)respo...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.展开更多
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 health...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(o VEMPs) and cervical VEMPs(c VEMPs) 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: o VEMPs 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, c VEMPs 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 o VEMPs and c VEMPs.展开更多
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...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.展开更多
目的：了解刺激声强度差异对正常人气导短纯音诱发的眼肌前庭诱发肌源性电位（ocular vestibular-evoked myogenic potential, oVEMP）和颈肌前庭肌源性诱发电位（cervical vestibular-evoked myogenic potential, cVEMP）的影响。方法...目的：了解刺激声强度差异对正常人气导短纯音诱发的眼肌前庭诱发肌源性电位（ocular vestibular-evoked myogenic potential, oVEMP）和颈肌前庭肌源性诱发电位（cervical vestibular-evoked myogenic potential, cVEMP）的影响。方法选择国人正常人35例作为研究对象，男16例，女19例，年龄4~40岁（20.80±8.89），以500Hz tone brust为刺激音，按照100、95、90、85、80、75 dB nHL依次进行气导oVEMP和cVEMP检测，计算VEMP在不同刺激声强度的引出率、nI潜伏期、pI潜伏期、nI-pI波间期、振幅值和AR值，进行波形参数计算和声强度组间对比。结果全组正常人oVEMP和cVEMP的阈值分别为86.5±4.37 dB nHL、83.57±4.52 dB nHL。随着刺激声强度的减弱，无论oVEMP还是cVEMP，均表现出引出率下降、振幅减低等特点。在刺激声强度为100 dB nHL和95 dB nHL时，oVEMP和cVEMP的引出率均为100%，两者之间图形参数差异并不显著。结论随着刺激声强度的减弱，oVEMP和cVEMP出现引出率下降、振幅减低的趋势。对于40岁以下的国人人群，建议采用95 dB nHL作为VEMPs测试的最大起始刺激强度。展开更多
This study investigated the relationship among the severity of hearing impairment,vestibular function and balance function in patients with idiopathic sudden sensorineural hearing loss（ISSNHL）.A total of 35 ISSNHL p...This study investigated the relationship among the severity of hearing impairment,vestibular function and balance function in patients with idiopathic sudden sensorineural hearing loss（ISSNHL）.A total of 35 ISSNHL patients（including 21 patients with vertigo） were enrolled.All of the patients underwent audiometry,sensory organization test（SOT）,caloric test,cervical vestibular-evoked myogenic potential（cV EMP） test and ocular vestibular-evoked myogenic potential（o VEMP） test.Significant relationship was found between vertigo and hearing loss grade（P=0.009）,and between SOT VEST grade and hearing loss grade（P=0.001）.The abnormal rate of o VEMP test was the highest,followed by the abnormal rates of caloric and c VEMP tests,not only in patients with vertigo but also in those without vertigo.The vestibular end organs were more susceptible to damage in patients with vertigo（compared with patients without vertigo）.Significant relationship was found between presence of vertigo and SOT VEST grade（P=0.010）.We demonstrated that vestibular end organs may be impaired not only in patients with vertigo but also in patients without vertigo.The cochlear and vestibular impairment could be more serious in patients with vertigo than in those without vertigo.Vertigo does not necessarily bear a causal relationship with the impairment of the vestibular end organs.SOT VEST grade could be used to reflect the presence of vertigo state in the ISSNHL patients.Apart from audiometry,the function of peripheral vestibular end organs and balance function should be evaluated to comprehensively understand ISSNHL.Better assessment of the condition will help us in clinical diagnosis,treatment and prognosis evaluation of ISSNHL.展开更多
基金supported by Japan China Sasakawa Medical Fellowship 2016(YL)
文摘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.
基金supported by grants from the National Natural Science Foundation of China(No.81670945,No.81970891,No.81600809,No.81700915)the Shaanxi Major International Cooperative Project of China(No.2020KWZ-019)the Key R&D Projects in Shaanxi Province,China(No.2018SF-189).
文摘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.
基金supported by grants from the National Natural Science Foundation of China, China (No. 81670945, 81541040)Fundamental Research Funds for the Central Universities, China (No. 2012jdhz13)+1 种基金Shaanxi Major International Cooperative Project, China (No. 2013KW-28)Key Science and Technology Program of Xi'an, China (No. SF1315(1))
文摘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(o VEMPs) and cervical VEMPs(c VEMPs) 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: o VEMPs 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, c VEMPs 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 o VEMPs and c VEMPs.
文摘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.
文摘目的：了解刺激声强度差异对正常人气导短纯音诱发的眼肌前庭诱发肌源性电位（ocular vestibular-evoked myogenic potential, oVEMP）和颈肌前庭肌源性诱发电位（cervical vestibular-evoked myogenic potential, cVEMP）的影响。方法选择国人正常人35例作为研究对象，男16例，女19例，年龄4~40岁（20.80±8.89），以500Hz tone brust为刺激音，按照100、95、90、85、80、75 dB nHL依次进行气导oVEMP和cVEMP检测，计算VEMP在不同刺激声强度的引出率、nI潜伏期、pI潜伏期、nI-pI波间期、振幅值和AR值，进行波形参数计算和声强度组间对比。结果全组正常人oVEMP和cVEMP的阈值分别为86.5±4.37 dB nHL、83.57±4.52 dB nHL。随着刺激声强度的减弱，无论oVEMP还是cVEMP，均表现出引出率下降、振幅减低等特点。在刺激声强度为100 dB nHL和95 dB nHL时，oVEMP和cVEMP的引出率均为100%，两者之间图形参数差异并不显著。结论随着刺激声强度的减弱，oVEMP和cVEMP出现引出率下降、振幅减低的趋势。对于40岁以下的国人人群，建议采用95 dB nHL作为VEMPs测试的最大起始刺激强度。
基金supported by grants from the National Twelfth Five-Year Science and Technology Support Program of China(No.2012BAI12B02)the National Eleventh Five-Year Science and Technology Support Program of China(No.2007BAI18B13)
文摘This study investigated the relationship among the severity of hearing impairment,vestibular function and balance function in patients with idiopathic sudden sensorineural hearing loss（ISSNHL）.A total of 35 ISSNHL patients（including 21 patients with vertigo） were enrolled.All of the patients underwent audiometry,sensory organization test（SOT）,caloric test,cervical vestibular-evoked myogenic potential（cV EMP） test and ocular vestibular-evoked myogenic potential（o VEMP） test.Significant relationship was found between vertigo and hearing loss grade（P=0.009）,and between SOT VEST grade and hearing loss grade（P=0.001）.The abnormal rate of o VEMP test was the highest,followed by the abnormal rates of caloric and c VEMP tests,not only in patients with vertigo but also in those without vertigo.The vestibular end organs were more susceptible to damage in patients with vertigo（compared with patients without vertigo）.Significant relationship was found between presence of vertigo and SOT VEST grade（P=0.010）.We demonstrated that vestibular end organs may be impaired not only in patients with vertigo but also in patients without vertigo.The cochlear and vestibular impairment could be more serious in patients with vertigo than in those without vertigo.Vertigo does not necessarily bear a causal relationship with the impairment of the vestibular end organs.SOT VEST grade could be used to reflect the presence of vertigo state in the ISSNHL patients.Apart from audiometry,the function of peripheral vestibular end organs and balance function should be evaluated to comprehensively understand ISSNHL.Better assessment of the condition will help us in clinical diagnosis,treatment and prognosis evaluation of ISSNHL.
