Institute of Clinical Neurosciences, Royal Prince Alfred Hospital, Central Clinical School, University of Sydney, Sydney, Australia.
Clin Neurophysiol. 2013 Oct;124(10):2036-45. doi: 10.1016/j.clinph.2012.12.041. Epub 2013 Jul 10.
To explore the galvanic-evoked vestibulospinal reflex in health and disease.
Vestibular-evoked whole-body movement was measured in 60 controls and eight patients with bilateral vestibular impairment, using 1mA × 2s Galvanic Vestibular Stimulation (GVS). The displacement (s) and velocity (v) of 7 markers placed on the head, neck, shoulders, mid-thorax and hips and ground reaction forces (F) were recorded.
Monaural GVS evoked anterolateral whole-body movement away from the cathode. For controls, peak response magnitudes were 22.3 ± 12.4mm, 25.9 ± 14.3 mms(-1) and 3.2 ± 1.3N for s, v and F. Left right asymmetry measured using the Jongkee's formula was 12.59 ± 8.64%, 11.94 ± 11.09% and 11.68 ± 8.99% for s, v and F. All three measures were symmetrical for left and right mastoid stimulation and showed good to excellent test retest reliability. Patients with bilateral vestibular failure had absent or attenuated responses. For this patient group, the ("R/B") ratios between the "response period" and baseline body-sway for s, v and F were 2.1 ± 0.8, 1.7 ± 1.1 and 1.3 ± 0.6, which were significantly lower than 5.4 ± 4.2, 4.1 ± 2.5 and 2.3 ± 0.8 for controls, with s and v providing better separation between controls and patients. There were no significant correlations between the amplitudes of galvanic body sway responses and vestibular-evoked myogenic potentials (VEMPs).
GVS enables non-invasive assessment of the vestibulospinal reflex.
This method offers a clinically applicable, test of vestibular contributions to standing balance.
探索健康和疾病状态下的电刺激前庭脊髓反射。
使用 1mA×2s 电流刺激（GVS），对 60 名对照者和 8 名双侧前庭功能障碍患者进行前庭诱发全身运动测量。记录放置在头部、颈部、肩部、中胸部和臀部的 7 个标记物的位移（s）和速度（v）以及地面反作用力（F）。
单耳 GVS 诱发阴极侧的前外侧全身运动。对于对照组，峰值反应幅度为 s 为 22.3±12.4mm、v 为 25.9±14.3 mms(-1)和 F 为 3.2±1.3N。使用 Jongkee 公式测量的左右不对称性为 s 为 12.59±8.64%、v 为 11.94±11.09%和 F 为 11.68±8.99%。左右乳突刺激的这三个测量值均对称，且具有良好到极好的测试重测可靠性。双侧前庭功能丧失的患者反应缺失或减弱。对于该患者组，s、v 和 F 的“反应期”与基线身体摆动的（“R/B”）比值分别为 2.1±0.8、1.7±1.1 和 1.3±0.6，显著低于对照组的 5.4±4.2、4.1±2.5 和 2.3±0.8，s 和 v 提供了更好的对照组和患者之间的区分。GVS 诱发的体摆动反应幅度与前庭诱发肌源性电位（VEMPs）之间无显著相关性。
GVS 可实现对前庭脊髓反射的非侵入性评估。
该方法提供了一种临床适用的、评估前庭对站立平衡贡献的测试。
