Department of Experimental Medicine and Pathology, La Sapienza University of Rome, Italy.
Clin Neurophysiol. 2010 Jul;121(7):1092-101. doi: 10.1016/j.clinph.2010.02.003. Epub 2010 Mar 3.
Two indicators of otolithic function were used to measure dynamic otolith function in the same patients both during an acute attack of Ménière's disease (MD) and in the quiescent period between attacks.
The early negative component (n10) of the ocular vestibular-evoked myogenic potential (the oVEMP) to brief 500 Hz bone conducted vibration (BCV) stimulation of the forehead, in the midline at the hairline (Fz) was recorded by surface EMG electrodes just beneath both eyes while the patient looked up. It has been proposed that the n10 component of the oVEMP to 500 Hz Fz BCV indicates utricular function. It has been proposed that the early positive component (p13) of the cervical vestibular-evoked myogenic potential (the cVEMP) recorded by surface electrodes on both tensed SCM neck muscles to 500 Hz Fz BCV indicates saccular function.
Sixteen healthy control subjects tested on two occasions showed no detectable change in the symmetry of oVEMPs or cVEMPs to 500 Hz Fz BCV. In response to 500 Hz Fz BCV 15 early MD patients tested at both attack and quiescent phases showed a dissociation: there was a significant increase in contralesional of n10 of the oVEMP during the attack compared to quiescence but a significant decrease in the ipsilesional p13 of the cVEMP during the attack compared to quiescence.
During an MD attack, dynamic utricular function in the affected ear as measured by the n10 of the oVEMP to 500 Hz Fz BCV is enhanced, whereas dynamic saccular function in the affected ear as measured by the p13 of the cVEMP to 500 Hz Fz BCV is not similarly affected.
The MD attack appears to affect different otolithic regions differentially.
使用两种耳石功能指标来测量梅尼埃病（MD）急性发作期和发作间期同一患者的动态耳石功能。
额中线发际处（Fz）用 500Hz 骨导振动（BCV）刺激，记录眼前庭诱发肌源性电位（oVEMP）的早期负成分（n10），采用表面肌电图电极在双眼下方记录。据推测，500Hz Fz BCV 的 oVEMP 的 n10 成分可反映椭圆囊功能。据推测，500Hz Fz BCV 记录的颈前庭诱发肌源性电位（cVEMP）的早期正成分（p13），双侧紧张胸锁乳突肌（SCM）表面电极记录，可反映球囊功能。
16 例健康对照者在两次测试中，500Hz Fz BCV 的 oVEMP 和 cVEMP 无对称性变化。15 例早期 MD 患者在发作期和缓解期分别接受 500Hz Fz BCV 测试，结果显示两者分离：与缓解期相比，发作期患侧 oVEMP 的 n10 显著增加，而患侧 cVEMP 的 p13 在发作期显著下降。
在 MD 发作期间，受影响耳的 500Hz Fz BCV 的 oVEMP 的 n10 测量的动态椭圆囊功能增强，而受影响耳的 500Hz Fz BCV 的 cVEMP 的 p13 测量的动态球囊功能未受类似影响。
MD 发作似乎对不同的耳石区产生不同的影响。
