Ocular torsion responses to electrical vestibular stimulation in vestibular schwannoma.
Ocular torsion responses to electrical vestibular stimulation in vestibular schwannoma.
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DOI：
10.1016/j.clinph.2018.08.023
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发表时间：
2018-11
期刊：
影响因子：
--
通讯作者：
Reynolds RF
中科院分区：
文献类型：
--
作者：
Mackenzie SW;Irving R;Monksfield P;Kumar R;Dezso A;Reynolds RF
电前庭刺激（EVS）诱发的眼球运动是可跟踪的红外摄像机。单侧前庭神经鞘瘤可减弱EVS引起的眼球扭转反应。EVS诱发的眼球扭转反应提供了一种方便的、非侵入性的前庭评估。我们确定了前庭电刺激（EVS）引起的眼球运动是否可用于检测单侧前庭神经鞘瘤（VS）患者的前庭功能障碍。在25名Koos 1-3级肿瘤患者中测量了对单耳正弦EVS电流（±2 mA，2 Hz）的眼球扭转反应。为了比较的目的，我们还测量了对EVS的姿势摇摆反应，并额外评估了前庭功能与横向头脉冲测试（HIT）。将患者反应与年龄匹配的健康对照受试者进行比较。与对照组相比，患者对病灶同侧EVS的眼部反应较小，并且显示出较大的不对称比（AR）（19.4%对3.3%，p < 0.05）。EVS诱发的摇摆反应在同侧耳中也较小，但表现出比眼动反应略大的变异性，沿着具有略低的辨别能力（患者与对照：AR = 16.6 vs 2.6%，p < 0.05）。HIT测试显示组间无显著差异。这些结果表明VS患者对EVS的眼球扭转反应明显不足。该测试的快速、方便和非侵入性非常适合临床使用。
Electrical vestibular stimulation (EVS)-evoked eye movements are trackable with an infrared camera. Unilateral vestibular schwannoma attenuated the ocular torsion response to EVS. EVS-evoked ocular torsion responses provide a convenient, non-invasive vestibular assessment. We determined if eye movements evoked by Electrical Vestibular Stimulation (EVS) can be used to detect vestibular dysfunction in patients with unilateral vestibular schwannoma (VS). Ocular torsion responses to monaural sinusoidal EVS currents (±2 mA, 2 Hz) were measured in 25 patients with tumours ranging in size from Koos grade 1–3. For comparative purposes we also measured postural sway response to EVS, and additionally assessed vestibular function with the lateral Head Impulse Test (HIT). Patient responses were compared to age-matched healthy control subjects. Patients exhibited smaller ocular responses to ipsilesional versus contralesional EVS, and showed a larger asymmetry ratio (AR) than control subjects (19.4 vs. 3.3%, p < 0.05). EVS-evoked sway responses were also smaller in ipsilesional ear, but exhibited slightly more variability than the eye movement response, along with marginally lower discriminatory power (patients vs. controls: AR = 16.6 vs 2.6%, p < 0.05). The HIT test exhibited no significant difference between groups. These results demonstrate significant deficits in the ocular torsion response to EVS in VS patients. The fast, convenient and non-invasive nature of the test are well suited to clinical use.
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