Visual Dependency and Dizziness after Vestibular Neuritis
Visual Dependency and Dizziness after Vestibular Neuritis
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DOI：
10.1371/journal.pone.0105426
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发表时间：
2014-09-18
期刊：
影响因子：
3.7
通讯作者：
Bronstein, Adolfo M.
中科院分区：
文献类型：
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作者：
Cousins, Sian;Cutfield, Nicholas J.;Bronstein, Adolfo M.
急性前庭神经炎（VN）后的症状恢复是可变的，约50%的患者报告长期前庭症状;因此，识别与不良临床结局相关的因素至关重要。在这里，我们调查是否过度依赖视觉输入的空间定位（视觉依赖）与长期前庭症状急性VN。28例VN患者和25例正常对照者被包括在内。患者在急性疾病后至少6个月入组。恢复状态不是进入研究的标准，允许招募具有各种持续症状的患者。我们用基于笔记本电脑的棒盘测试测量视觉依赖，用头晕障碍量表（DHI）测量症状的严重程度。显示最差临床结局的第三位患者（平均DHI评分36-80）的视觉依赖性显著高于正常受试者（分别为6.35度和3.39度，p = 0.03）。无症状的患者和那些有轻微残留症状的患者与对照组没有差异。视觉依赖与急性VN后高水平的持续性前庭症状相关。过度依赖视觉信息的空间定位是恢复不良的前庭神经炎患者的特征之一。这一发现可能是临床上有用的，因为视觉依赖可以通过康复脱敏技术来改变。
Symptomatic recovery after acute vestibular neuritis (VN) is variable, with around 50% of patients reporting long term vestibular symptoms; hence, it is essential to identify factors related to poor clinical outcome. Here we investigated whether excessive reliance on visual input for spatial orientation (visual dependence) was associated with long term vestibular symptoms following acute VN. Twenty-eight patients with VN and 25 normal control subjects were included. Patients were enrolled at least 6 months after acute illness. Recovery status was not a criterion for study entry, allowing recruitment of patients with a full range of persistent symptoms. We measured visual dependence with a laptop-based Rod-and-Disk Test and severity of symptoms with the Dizziness Handicap Inventory (DHI). The third of patients showing the worst clinical outcomes (mean DHI score 36-80) had significantly greater visual dependence than normal subjects (6.35 degrees error vs. 3.39 degrees respectively, p = 0.03). Asymptomatic patients and those with minor residual symptoms did not differ from controls. Visual dependence was associated with high levels of persistent vestibular symptoms after acute VN. Over-reliance on visual information for spatial orientation is one characteristic of poorly recovered vestibular neuritis patients. The finding may be clinically useful given that visual dependence may be modified through rehabilitation desensitization techniques.