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用于诊断多发性硬化症的前庭诱发肌源性电位:它有益吗?

Vestibular evoked myogenic potential for diagnoses of multiple sclerosis: is it beneficial?

作者信息

Harirchian Mohammad Hossein, Karimi Narges, Nafisi Shahriar, Akrami Shahram, Ghanbarian Davod, Gharibzadeh Shahriar

机构信息

Neurology Department, Iranian Center of Neurological Research, Tehran University of Medical Sciences, Tehran, ²Neurology Department, Mazandaran University of Medical Sciences, Sari, Iran3Department of Physical Medicine and Rehabilitation, Tehran University of Medical Sciences, Tehran, 4Neurologist, Shafa Center of Neuroscience Research, Khatamolanbia Hospital, Tehran; Iran, 5Neuromuscular System Laboratory, Biomedical Engineering Department, Amirkabir University of Technology, Tehran, Iran.

出版信息

Med Glas (Zenica). 2013 Aug;10(2):321-6.

Abstract

AIM

To determine the sensitivity of the vestibular evoked myogenic potential (VEMP) in multiple sclerosis (MS) patients as well as its relation to clinical signs and symptoms, course of the disease and other evoked potentials.

METHODS

This case-control study was conducted on 40 subjects (20 MS patients and 20 healthy participants). Participants were selected from Imam Khomeini Hospital, Tehran, Iran. Two hundred stimuli (clicks of 0.1 ms of duration and 2 Hz frequency) were applied to each ear. These stimuli were repeated in two consecutive cycles. In order to evaluate the reproducibility the stimulation intensity of 95dBNHL was applied. During the test, individuals were requested to be seated on a chair and rotate their head to the opposite side of the stimulated ear to activate the ipsilateral sternocleidomastoid muscle (SCM).

RESULTS

A biphasic, initially positive, p13-n23 wave pattern was found in all patients. All of the parameters, including latencies and amplitudes fit the normal Kolmogorov-Smirnov (KS) distribution. Fourteen (70%) patients reported abnormal results, and VEMP abnormality was significantly related to disease duration also. In addition, there was a significant correlation between abnormality of VEMP and abnormality of visual evoked potential (VEP) as well as the abnormality of VEMP and brainstem auditory evoked potential (BAEP).

CONCLUSION

Vestibular evoked myogenic potential has a high sensitivity (70%) in MS patients, and VEMP could be recommended as a useful complementary neurophysiological method to evaluate the MS patients.

摘要

目的

确定多发性硬化症(MS)患者前庭诱发肌源性电位(VEMP)的敏感性及其与临床体征和症状、疾病进程及其他诱发电位的关系。

方法

本病例对照研究纳入40名受试者(20例MS患者和20名健康参与者)。参与者选自伊朗德黑兰伊玛目霍梅尼医院。向每只耳朵施加200次刺激(持续时间0.1毫秒、频率2赫兹的点击声)。这些刺激在两个连续周期中重复。为评估可重复性,采用95分贝听力级(dBNHL)的刺激强度。测试期间,要求个体坐在椅子上,将头部转向受刺激耳朵的对侧,以激活同侧胸锁乳突肌(SCM)。

结果

所有患者均发现双相、初始为正的p13 - n23波形。所有参数,包括潜伏期和波幅均符合正常的柯尔莫哥洛夫 - 斯米尔诺夫(KS)分布。14名(70%)患者报告结果异常,VEMP异常也与疾病持续时间显著相关。此外,VEMP异常与视觉诱发电位(VEP)异常以及VEMP异常与脑干听觉诱发电位(BAEP)异常之间存在显著相关性。

结论

前庭诱发肌源性电位在MS患者中具有较高敏感性(70%),VEMP可作为评估MS患者的一种有用的补充神经生理学方法。

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