Harun Aisha, Oh Esther S, Bigelow Robin T, Studenski Stephanie, Agrawal Yuri
*Department of Otolaryngology-Head and Neck Surgery †Department of Medicine ‡Department of Psychiatry and Behavioral Sciences §Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland ||Longitudinal Studies Section, Translational Gerontology Branch, National Institute of Aging, National Institutes of Health, Baltimore, Maryland.
Otol Neurotol. 2016 Sep;37(8):1137-42. doi: 10.1097/MAO.0000000000001157.
Recent studies suggest an association between vestibular and cognitive function. The goal of the study was to investigate whether vestibular function was impaired in individuals with mild cognitive impairment (MCI) and Alzheimer's disease (AD) compared with cognitively normal individuals.
Cross-sectional study.
Outpatient memory clinic and longitudinal observational study unit.
Older individuals ≥55 years with MCI or AD. Age, sex, and education-matched normal controls were drawn from the Baltimore Longitudinal Study of Aging (BLSA).
Saccular and utricular function was assessed with cervical and ocular vestibular-evoked myogenic potentials (c- and oVEMPs) respectively, and horizontal semicircular canal function was assessed with video head impulse testing.
Presence or absence of VEMP responses, VEMP amplitude, and vestibular ocular reflex (VOR) gain were measured.
Forty-seven individuals with cognitive impairment (MCI N = 15 and AD N = 32) underwent testing and were matched with 94 controls. In adjusted analyses, bilaterally absent cVEMPs were associated with an over three-fold odds of AD (OR 3.42, 95% CI 1.33-8.91, p = 0.011). One microvolt increases in both cVEMP and oVEMP amplitudes were associated with decreased odds of AD (OR 0.28, 95% CI 0.09-0.93, p = 0.038 and OR 0.92, 95% CI 0.85-0.99, p = 0.036, respectively). There was no significant difference in VOR gain between the groups.
These findings confirm and extend emerging evidence of an association between vestibular dysfunction and cognitive impairment. Further investigation is needed to determine the causal direction for the link between peripheral vestibular loss and cognitive impairment.
近期研究表明前庭功能与认知功能之间存在关联。本研究的目的是调查与认知正常个体相比，轻度认知障碍（MCI）和阿尔茨海默病（AD）患者的前庭功能是否受损。
横断面研究。
门诊记忆诊所和纵向观察研究单位。
年龄≥55岁的MCI或AD老年个体。年龄、性别和教育程度匹配的正常对照来自巴尔的摩老年纵向研究（BLSA）。
分别通过颈前庭诱发肌源性电位（cVEMP）和眼前庭诱发肌源性电位（oVEMP）评估球囊和椭圆囊功能，通过视频头脉冲测试评估水平半规管功能。
测量VEMP反应的有无、VEMP振幅和前庭眼反射（VOR）增益。
47名认知障碍患者（MCI患者15名，AD患者32名）接受了测试，并与94名对照进行匹配。在调整分析中，双侧cVEMP缺失与AD发生几率增加三倍以上相关（比值比[OR] 3.42，95%置信区间[CI] 1.33 - 8.91，p = 0.011）。cVEMP和oVEMP振幅每增加1微伏均与AD发生几率降低相关（分别为OR 0.28，95% CI 0.09 - 0.93，p = 0.038；OR 0.92，95% CI 0.85 - 0.99，p = 0.036）。两组之间的VOR增益无显著差异。
这些发现证实并扩展了前庭功能障碍与认知障碍之间存在关联的新证据。需要进一步研究以确定外周前庭功能丧失与认知障碍之间联系的因果方向。
