Interaction of somatoform and vestibular disorders
Interaction of somatoform and vestibular disorders
复制标题
DOI：
10.1136/jnnp.2005.072934
复制
发表时间：
2006-05-01
影响因子：
11
通讯作者：
Dieterich, M
中科院分区：
文献类型：
--
作者：
Best, C;Eckhardt-Henn, A;Dieterich, M
背景资料：器质性前庭和躯体形式眩晕综合征的高度一致性似乎支持它们之间存在强烈联系的致病模型。据推测，持续性前庭功能障碍导致焦虑症的发展。目的：通过一项跨学科前瞻性研究，确定前庭功能障碍与躯体形式眩晕症之间的关系。方法：参与者被分为8个诊断组：健康志愿者（n = 26）和良性阵发性定位性眩晕患者（BPPV，n = 11）、前庭神经炎（n = 11）、梅尼埃病（n = 7）、前庭性偏头痛（n = 15）、焦虑（n = 23）、抑郁（n = 12）或躯体形式障碍（n = 22）。神经耳科诊断程序包括眼电图与旋转和冷热测试，正视检查与主观视觉垂直（SVV）和眼球扭转的测量，和神经系统检查。结果：BPPV患者（35.3%）和前庭神经炎患者（52.2%）的病理检查值与热量灌洗法比较有显著性差异（P < 0.001）。仅前庭神经炎患者出现SVV病理性倾斜和眼球扭转的耳石功能障碍（P < 0.001）。梅尼埃病、前庭性偏头痛和精神疾病患者的前庭测试参数正常，但心理测量值为病理值。病理神经和病理心理测量parameters.Conclusions：高焦虑分数是不是前庭功能障碍或功能障碍的结果之间没有相关性。梅尼埃病和前庭性偏头痛而非前庭功能障碍患者的精神共病率最高。因此，眩晕综合征的病程和预先存在的精神病理性人格的可能性应被认为是器质性和心理测量性眩晕综合征之间任何联系的致病因素。
Background: The high coincidence of organic vestibular and somatoform vertigo syndromes has appeared to support pathogenic models showing a strong linkage between them. It was hypothesised that a persisting vestibular dysfunction causes the development of anxiety disorders.Objective: To determine the relation between vestibular deficits and somatoform vertigo disorders in an interdisciplinary prospective study.Methods: Participants were divided into eight diagnostic groups: healthy volunteers (n = 26) and patients with benign paroxysmal positioning vertigo (BPPV, n = 11), vestibular neuritis (n = 11), Meniere's disease (n = 7), vestibular migraine (n = 15), anxiety (n = 23), depression (n = 12), or somatoform disorders (n = 22). Neuro-otological diagnostic procedures included electro-oculography with rotatory and caloric testing, orthoptic examination with measurements of subjective visual vertical (SVV) and ocular torsion, and a neurological examination. Psychosomatic diagnostic procedures comprised interviews and psychometric instruments.Results: Patients with BPPV (35.3%) and with vestibular neuritis (52.2%) had pathological test values on caloric irrigation (p < 0.001). Otolith dysfunction with pathological tilts of SVV and ocular torsion was found only in patients with vestibular neuritis (p < 0.001). Patients with Meniere's disease, vestibular migraine, and psychiatric disorders showed normal parameters for vestibular testing but pathological values for psychometric measures. There was no correlation between pathological neurological and pathological psychometric parameters.Conclusions: High anxiety scores are not a result of vestibular deficits or dysfunction. Patients with Meniere's disease and vestibular migraine but not vestibular deficits showed the highest psychiatric comorbidity. Thus the course of vertigo syndromes and the possibility of a pre-existing psychopathological personality should be considered pathogenic factors in any linkage between organic and psychometric vertigo syndromes.