Patient and normal three-dimensional eye-movement responses to maintained (DC) surface galvanic vestibular stimulation
Patient and normal three-dimensional eye-movement responses to maintained (DC) surface galvanic vestibular stimulation
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DOI：
10.1097/01.mao.0000169766.08421.ef
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发表时间：
2005-05-01
影响因子：
2.1
通讯作者：
Halmagyi, GM
中科院分区：
文献类型：
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作者：
MacDougall, HG;Brizuela, AE;Halmagyi, GM
假设：人类患者的前庭终末器官的疾病或功能障碍将减少或消除受影响的终末器官对DC表面电流前庭刺激（GVS）的总眼动反应的贡献。背景：假设DC GVS（在5mA的电流下）刺激所有前庭终末器官，这一假设得到生理学证据的有力支持，包括通过电流刺激激活初级前庭传入神经元。以前的研究也描述了前庭激活的眼反应。刺激单个半规管导致眼球平行于受刺激半规管的平面运动，刺激椭圆囊黄斑导致眼球扭转位置的变化。还假设对GVS的总三维眼动响应是所有前庭终末器官的眼动驱动的贡献之和。如果一个特定的前庭终末器官患病或功能障碍，那么它对GVS诱导的眼刺激反应的贡献将减少或不存在，并且因此受影响的患者与正常健康个体的反应相比，其GVS诱导的眼刺激反应将具有系统性差异。三维视频眼动记录进行了完全黑暗的正常健康受试者和患者的各种类型的前庭功能障碍，独立的前庭临床试验诊断。测量了长时间双侧和单侧表面GVS的眼动反应。独立诊断为双侧前庭功能障碍、单侧前庭功能障碍、CHARGE综合征的患者GVS期间水平、垂直和扭转眼球速度和眼球位置的模式（半规管发育不全），半规管闭塞，或前庭下神经炎的反应系统地不同于正常健康受试者的反应，其方式与研究概念方法的预期相对应。该研究报告的第一个数据之间的差异GVS的正常反应和患者的临床前庭条件，包括单侧前庭损失，运河阻滞，前庭神经炎。前庭功能障碍患者的GVS诱导的眼球运动模式与涉及其特定疾病状况的终末器官的眼功能贡献减少或缺失一致。
Hypothesis: That disease or dysfunction of vestibular end organs in human patients will reduce or eliminate the contribution of the affected end organs to the total eye-movement response to DC surface galvanic vestibular stimulation (GVS).Background: It was assumed that DC GVS (at current of 5 mA) stimulates all vestibular end organs, an assumption that is strongly supported by physiological evidence, including the activation of primary vestibular afferent neurons by galvanic stimulation. Previous studies also have described the oculomotor responses to vestibular activation. Stimulation of individual semicircular canals results in eye movements parallel to the plane of the stimulated canal, and stimulation of the utricular macula produces changes in ocular torsional position. It was also assumed that the total three-dimensional eye-movement response to GVS is the sum of the contributions of the oculomotor drive of all the vestibular end organs. If a particular vestibular end organ were to be diseased or dysfunctional, it was reasoned that its contribution to the GVS-induced oculomotor response would be reduced or absent and that patients thus affected would have a systematic difference in their GVS-induced oculomotor response compared with the response of normal healthy individuals.Methods: Three-dimensional video eye-movement recording was carried out in complete darkness on normal healthy subjects and patients with various types of vestibular dysfunction, as diagnosed by independent vestibular clinical tests. The eye-movement response to long-duration bilateral and unilateral surface GVS was measured.Results: The pattern of horizontal, vertical, and torsional eye velocity and eye position during GVS of patients independently diagnosed with bilateral vestibular dysfunction, unilateral vestibular dysfunction, CHARGE syndrome (semicircular canal hypoplasia), semicircular canal occlusion, or inferior vestibular neuritis differed systematically from the responses of normal healthy subjects in ways that corresponded to the expectations from the conceptual approach of the study.Conclusion: The study reports the first data on the differences between the normal response to GVS and those of patients with a number of clinical vestibular conditions including unilateral vestibular loss, canal block, and vestibular neuritis. The GVS-induced eye-movement patterns of patients with vestibular dysfunction are consistent with the reduction or absence of oculomotor contribution from the end organs implicated in their particular disease condition.