The Dizziness Handicap Inventory does not correlate with vestibular function tests: a prospective study
The Dizziness Handicap Inventory does not correlate with vestibular function tests: a prospective study
复制标题
DOI：
10.1007/s00415-018-8834-7
复制
发表时间：
2018-05-01
影响因子：
6
通讯作者：
Strupp, Michael
中科院分区：
文献类型：
--
作者：
Yip, Chun Wai;Strupp, Michael
头晕障碍量表（DHI）被认为可以量化与潜在前庭功能障碍的存在或严重程度相关的障碍。然而，慢性前庭疾病患者可能表现出不同程度的行为和生理适应，导致DHI的变化。我们的主要研究目的是评估DHI和可测量的前庭参数之间的相关性。其次，我们比较了不同前庭疾病（中枢性、外周性和功能性）和不同类型的解剖缺陷（半规管与耳石性）之间的DHI。我们还将DHI与姿势图相关联。我们前瞻性地评估了799例患者的精确前庭诊断使用视频头脉冲测试（vHIT），热量灌洗，和颈部/眼部前庭诱发肌源性电位（c/oVEMP）。对84例患者进行了姿势图检查。所有参与者都完成了DHI。DHI与（1）前庭眼反射参数：单侧无力r =-0.018，总热量r = 0.055，vHIT右侧r = 0.007，vHIT左侧r =-0.091，vHIT不对称r = 0.013，（2）耳石参数：cVEMP振幅右r =-0.034，振幅左r =-0.004，不对称r = 0.016; oVEMP振幅右r = 0.044，振幅左r =-0.007，不对称r =-0.008。中枢性前庭障碍患者的DHI高于外周性（z =-4.743，p = 0.001）或功能性障碍患者（z =-2.902，p = 0.004）。耳道或耳石功能缺陷患者的DHI与无缺陷患者无显著差异（z = 2.153，p = 0.541）。DHI与姿势图上的姿势摇摆无显著相关性。因此，DHI与前庭试验无关，既不能反映外周前庭功能障碍的存在和严重程度。
The Dizziness Handicap Inventory (DHI) is believed to quantitate the handicap related to the presence or severity of underlying vestibular dysfunction. However, patients with chronic vestibular diseases may manifest various degrees of behavioural and physiological adaptation resulting in variances of the DHI. Our primary study objective is to evaluate the correlation between the DHI and measurable vestibular parameters. Secondarily, we compared DHI among different vestibular disorders (central, peripheral and functional), and different types of anatomic deficits (semicircular canal vs otolithic). We also correlated the DHI and posturography. We prospectively evaluated 799 patients with precise vestibular diagnoses using video head impulse testing (vHIT), caloric irrigation, and cervical/ocular vestibular-evoked myogenic potentials (c/oVEMP). Posturography was done for 84 patients. All participants completed the DHI. No significant correlation was found between DHI and (1) vestibulo-ocular reflex parameters: unilateral weakness r = - 0.018, total calorics r = 0.055, vHIT right r = 0.007, vHIT left r = - 0.091, vHIT asymmetry r = 0.013; (2) otolith parameters: cVEMP amplitude right r = - 0.034, amplitude left r = - 0.004, asymmetry r = 0.016; oVEMP amplitude right r = 0.044, amplitude left r = - 0.007, asymmetry r = - 0.008. Patients with central vestibular disorders had higher DHI than those with peripheral (z = - 4.743, p = 0.001) or functional disorders (z = - 2.902, p = 0.004). DHI of patients with deficits of canal or otolith function did not differ significantly from those with no deficits (z = 2.153, p = 0.541). There was no significant correlation between DHI and postural sway on posturography. Therefore, the DHI does not correlate with vestibular tests, and neither reflects the presence nor severity of peripheral vestibular deficits.