The Value of Subjective Visual Vertical in Diagnosis of Vestibular Migraine
The Value of Subjective Visual Vertical in Diagnosis of Vestibular Migraine
复制标题
主观垂直视觉对前庭性偏头痛的诊断价值
DOI：
10.1007/s11596-021-2418-y
复制
发表时间：
2021-08-01
影响因子：
2.4
通讯作者：
Zhang, Su-lin
中科院分区：
文献类型：
--
作者：
Li, Fei;Xu, Jin;Zhang, Su-lin
目的探讨主观视觉垂直度（SVV）对前庭性偏头痛（VM）的诊断价值。方法本研究纳入128例VM患者和64名年龄匹配的正常人。我们在两组发作之间的间隔期间检测到 SVV，即直坐、头部向左或向右倾斜 45°。然后我们检查了SVV结果与前庭诱发肌源性电位（VEMP）和耳管麻痹（CP）之间的相关性。结果发现VM患者和正常对照在直立位时SVV有显着性差异（P=0.006），而在向左或向右倾斜45°时两组之间没有发现显着性差异。直立位SVV结果与颈椎VEMP显着相关（P=0.042），而与CP、VEMP不显着相关。两组之间对穆勒效应（M效应）的符合性没有显着差异。 ROC分析显示，SVV在直立位的敏感性、特异性分别为67.200%和62.500%。直立位时SVV的诊断价值显着高于左右倾斜45°时的诊断价值（P=0.006）。结论 SVV异常可能源于VM患者小脑或高级皮层中枢持续功能障碍或与前庭代偿有关。 SVV对VM的诊断价值较低，SVV在VM中的价值值得进一步研究。
ObjectiveTo study the value of the subjective visual vertical (SVV) in the diagnosis of vestibular migraine (VM).MethodsThis study recruited 128 VM patients and 64 age-matched normal subjects. We detected the SVV during the interval between attacks in both groups, in sitting upright, and the head tilted at 45° to the left or right. We then examined the correlation between the SVV results with the vestibular evoked myogenic potential (VEMP) and canal paresis (CP).ResultsIt was found there was a significant difference in SVV at the upright position between VM patients and normal controls (P=0.006) and no significant difference was found at the tilts of 45° to the left or right between the two groups. The SVV results at the upright position were significantly correlated with cervical VEMP (P=0.042) whereas not significantly correlated with CP and VEMP. There existed no significant difference in the conformity to the Müller effect (M effect) between the two groups. ROC analysis exhibited that the sensitivity, specificity of SVVs at the upright were 67.200% and 62.500% respectively. The diagnostic value of SVV at the upright position was significantly higher than that at tilts of 45° to the left and right (P=0.006). Nonetheless the diagnostic accuracy was relatively low.ConclusionAbnormality in SVV possibly stems from the lasting functional disorder of cerebellar or high-level cortical centers in VM patients or is linked to the vestibular compensation. The SVV is of low diagnostic value for VM and the value of SVV in VM warrants further study.