Revision of a furosemide-loading vestibular-evoked myogenic potential protocol for detecting endolymphatic hydrops
Revision of a furosemide-loading vestibular-evoked myogenic potential protocol for detecting endolymphatic hydrops
复制标题
DOI：
10.1080/00016489.2017.1355565
复制
发表时间：
2017-01-01
影响因子：
1.4
通讯作者：
Doi, Katsumi
中科院分区：
文献类型：
--
作者：
Seo, Toru;Shiraishi, Ko;Doi, Katsumi
目的：通过提高速尿(速尿负载VEMP)后前庭诱发肌源性电位(VEMP)的波幅，提示内淋巴积水的存在。作者的目的是确定刺激频率和判断标准，以确定修订的FVEMP方案是否可以应用于临床。方法：研究包括25名单侧梅尼埃病(MD)患者和11名正常健康志愿者。用250、500、700、1000、1500和2000赫兹的短声测得两组患者服用速尿前后VEMP的归一化波幅。结果：除500 Hz外，正常对照组与MD组在各频率下的IR均无显著差异。受试者工作特征曲线分析显示，500 HZ时IR的临界值为14.2%，灵敏度为0.706，特异度为0.810。结论：在给药前未发现双相波的病例中，当IR>14.2%或给药后可检测到双相波时，采用500 Hz短纯音刺激和归一化幅度的改良FVEMP方案为阳性。
Objective: The presence of endolymphatic hydrops can be suggested by improving the amplitude of vestibular-evoked myogenic potential (VEMP) after furosemide administration (furosemide loading VEMP [FVEMP]). The authors aimed to determine a stimulation frequency and judgment criteria to ascertain whether a revised FVEMP protocol can be applied to clinical settings.Methods: The study included 25 individuals with unilateral Meniere's disease (MD) and 11 normal healthy volunteers. Normalized amplitude of VEMP, using a tone burst sound at 250, 500, 700, 1000, 1500 and 2000 Hz, was measured before and after furosemide administration in the two groups. Improvement ratio (IR) of amplitude was calculated at each frequency.Results: There were no significant differences in IR between the control group and the MD group at each frequency, except at 500 Hz. Receiver operating characteristic curve analysis revealed an IR cut-off value of 14.2% at 500 Hz, with a sensitivity of 0.706 and a specificity of 0.810.Conclusions: The revised FVEMP protocol using a 500 Hz tone burst stimulus and normalized amplitudes was defined as positive when IR exceeded 14.2% or when a biphasic wave could be detected after furosemide administration in cases without a detectable biphasic wave before administration.