Cervico-Ocular reflex in normal subjects and patients with unilateral vestibular hypofunction
Cervico-Ocular reflex in normal subjects and patients with unilateral vestibular hypofunction
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DOI：
10.1097/00129492-200401000-00013
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发表时间：
2004-01-01
影响因子：
2.1
通讯作者：
Herdman, SJ
中科院分区：
文献类型：
--
作者：
Schubert, MC;Das, V;Herdman, SJ
目的：探讨颈眼反射对单侧前庭功能减退患者凝视稳定性的影响。研究设计：前瞻性研究。设置：第三转诊中心。患者：单侧前庭功能减退患者(n=3)前庭功能恢复前后及健康人(n=7)。干预：前庭功能恢复。主要观察指标：测量单侧前庭功能减退患者前庭功能恢复前后及健康人的颈眼反射。为了测量颈眼反射，我们用巩膜搜索线圈记录眼球运动，同时躯干在稳定的头部下方以0.3、1.0和1.5赫兹的频率移动。为了确定头部是否真正稳定，我们使用搜索线圈测量头部运动。结果：我们在七名健康受试者中的任何一人或两名单侧前庭功能减退的患者中都没有发现颈-眼反射的证据。在1例慢性单侧前庭功能减退的患者中，在前庭重建前仅在躯干向左旋转(相对头部向完好一侧旋转)时出现颈眼反射。在5周的安慰剂训练后，颈-眼反射没有变化。在包括前庭练习的额外5周后，躯干向左旋转的颈-眼反射增益增加了三倍。此外，现在有证据表明，躯干向右旋转的颈眼反射，可能补偿前庭缺陷。结论：颈眼反射似乎是一种高度不一致的机制。前庭训练后1例患者的颈眼反射改变提示，部分患者的颈眼反射可能具有适应性。
Objective: To determine whether the cervico-ocular reflex contributes to gaze stability in patients with unilateral vestibular hypofunction.Study Design: Prospective study.Setting: Tertiary referral center.Patients: Patients with unilateral vestibular hypofunction (n = 3) before and after vestibular rehabilitation and healthy subjects (n = 7).Interventions: Vestibular rehabilitation.Main Outcome Measures: We measured the cervico-ocular reflex in patients with unilateral vestibular hypofunction before and after vestibular rehabilitation and in healthy subjects. To measure the cervico-ocular reflex, we recorded eye movements with a scleral search coil while the trunk moved at 0.3, 1.0, and 1.5 Hz beneath a stabilized head. To determine whether the head was truly stabilized, we measured head movement using a search coil.Results: We found no evidence of cervico-ocular reflex in any of the seven healthy subjects or in two of the patients with unilateral vestibular hypofunction. In one patient with chronic unilateral vestibular hypofunction, the cervico-ocular reflex was present before vestibular rehabilitation only for leftward trunk rotation (relative head rotation toward the intact side). After 5 weeks of placebo exercises, there was no change in the cervico-ocular reflex. After an additional 5 weeks that included vestibular exercises, cervico-ocular reflex gain for leftward trunk rotation had increased threefold. In addition, there was now evidence of a cervico-ocular reflex for rightward trunk rotation, potentially compensating for the vestibular deficit.Conclusion: The cervico-ocular reflex appears to be a highly inconsistent mechanism. The change of the cervico-ocular reflex in one patient after vestibular exercises suggests that the cervico-ocular reflex may be adaptable in some patients.