Institute of Clinical Neurosciences, Royal Prince Alfred Hospital, Central Clinical School, University of Sydney, NSW, Australia.
Clin Neurophysiol. 2011 Jun;122(6):1256-63. doi: 10.1016/j.clinph.2010.11.009. Epub 2010 Dec 17.
To define the ocular and cervical vestibular evoked myogenic potential (oVEMP and cVEMP) profile in Ménière's Disease (MD), we studied air-conducted (AC) sound and bone-conducted vibration (BCV)-evoked responses in 77 patients and 35 controls.
oVEMPs were recorded from unrectified infra-orbital surface electromyography (EMG) during upward gaze. cVEMPs were recorded from rectified and unrectified sternocleidomastoid EMG during head elevation against gravity. Responses to AC clicks delivered via headphones and BC forehead taps delivered with a mini-shaker (bone-conduction vibrator) and a triggered tendon-hammer were recorded.
In clinically definite unilateral MD (n=60), the prevalence of unilateral VEMP abnormalities was 50.0%, 10.2% and 11.9% for click, minitap and tendon-hammer evoked oVEMPs, 40.0%, 22.8% and 10.7% for click, minitap and tendon-hammer evoked cVEMPs. The most commonly observed profile was abnormality to AC stimulation alone (33.3%), followed by abnormalities to both AC and BCV stimuli (26.7%). Isolated abnormalities to BCV stimuli were rare (5%) and limited to the minitap cVEMP. The prevalence of abnormalities for each of the AC VEMPs was significantly higher than for any one BCV VEMP. For click cVEMP, click oVEMP and minitap cVEMP, average Reflex Asymmetry Ratios (AR) were significantly higher in MD compared with controls. Test results for AC cVEMP, AC oVEMP, minitap cVEMP and caloric asymmetry were significantly correlated with hearing loss.
Predominance of abnormalities in oVEMP and cVEMP responses to AC sound is characteristic of MD and indicative of saccular involvement.
This pattern of VEMP abnormalities may enable separation of Ménière's disease from other peripheral vestibulopathies.
为了定义梅尼埃病（MD）的眼和颈前庭诱发肌源性电位（oVEMP 和 cVEMP）特征，我们研究了 77 例患者和 35 例对照者的空气传导（AC）声音和骨传导振动（BCV）诱发反应。
在向上凝视时，从未整流的眶下表面肌电图（EMG）记录 oVEMPs。当头颈抬高抵抗重力时，从整流和未整流的胸锁乳突肌 EMG 记录 cVEMPs。通过耳机记录 AC 点击刺激和使用微型振荡器（骨导振动器）和触发腱锤的额部敲击刺激的反应。
在临床确诊的单侧 MD 中（n=60），单侧 VEMP 异常的发生率为 50.0%、10.2%和 11.9%，分别为点击、微敲击和腱锤诱发的 oVEMPs，40.0%、22.8%和 10.7%，分别为点击、微敲击和腱锤诱发的 cVEMPs。最常见的异常表现是仅对 AC 刺激异常（33.3%），其次是 AC 和 BCV 刺激均异常（26.7%）。孤立的 BCV 刺激异常罕见（5%），仅限于微敲击 cVEMP。每种 AC VEMP 的异常发生率均显著高于任何一种 BCV VEMP。对于点击 cVEMP、点击 oVEMP 和微敲击 cVEMP，与对照组相比，平均反射不对称比（AR）显著升高。AC cVEMP、AC oVEMP、微敲击 cVEMP 和冷热刺激的不对称性测试结果与听力损失显著相关。
AC 声音的 oVEMP 和 cVEMP 反应异常的优势是 MD 的特征，表明球囊受累。
这种 VEMP 异常模式可能使梅尼埃病与其他周围前庭疾病区分开来。
