Dorn Linda Josephine, Lappat Annabelle, Neuhuber Winfried, Scherer Hans, Olze Heidi, Hölzl Matthias
Department of Otorhinolaryngology, Charité Universitätsmedizin, Berlin, Germany.
Department of Otorhinolaryngology, Sankt Gertrauden Hospital, Berlin, Germany.
Int Arch Otorhinolaryngol. 2017 Jan;21(1):46-57. doi: 10.1055/s-0036-1583759. Epub 2016 May 5.
Interdisciplinary research has contributed greatly to an improved understanding of the vestibular system. To date, however, very little research has focused on the vestibular system's somatosensory afferents. To ensure the diagnostic quality of vestibular somatosensory afferent data, especially the extra cranial afferents, stimulation of the vestibular balance system has to be precluded. Sophisticated movements require intra- and extra cranial vestibular receptors. The study's objective is to evaluate an investigation concept for cervico-vestibular afferents with respect to clinical feasibility. A dedicated chair was constructed, permitting three-dimensional trunk excursions, during which the volunteer's head remains fixed. Whether or not a cervicotonic provocation nystagmus (c-PN) can be induced with static trunk excursion is to be evaluated and if this can be influenced by cervical monophasic transcutaneous electrical nerve stimulation (c-TENS) with a randomized test group. 3D-video-oculography (VOG) was used to record any change in cervico-ocular examination parameters. The occurring nystagmuses were evaluated visually due to the small caliber of nystagmus amplitudes in healthy volunteers. The results demonstrate: no influence of placebo-controlled c-TENS on the spontaneous nystagmus; a significant increase of the vertical nystagmus on the 3D-trunk-excursion chair in static trunk flexion with cervical provocation in all young healthy volunteers (n = 49); and a significant difference between vertical and horizontal nystagmuses during static trunk excursion after placebo-controlled c-TENS, except for the horizontal nystagmus during trunk torsion. We hope this cervicotonic investigation concept on the 3D trunk-excursion chair will contribute to new diagnostic and therapeutic perspectives on cervical pathologies in vestibular head-to-trunk alignment.
跨学科研究为增进对前庭系统的理解做出了巨大贡献。然而，迄今为止，很少有研究关注前庭系统的躯体感觉传入神经。为确保前庭躯体感觉传入数据（尤其是颅外传入神经数据）的诊断质量，必须排除对前庭平衡系统的刺激。复杂的运动需要颅内和颅外前庭感受器。本研究的目的是评估一项关于颈前庭传入神经的研究概念在临床可行性方面的情况。制造了一把专用椅子，允许躯干进行三维移动，在此过程中志愿者的头部保持固定。要评估在静态躯干移动时是否能诱发颈张力性激发性眼球震颤（c-PN），以及这是否会受到随机试验组的颈部单相经皮电神经刺激（c-TENS）的影响。使用三维视频眼震图（VOG）记录颈眼检查参数的任何变化。由于健康志愿者的眼震幅度较小，对出现的眼震进行了视觉评估。结果表明：安慰剂对照的c-TENS对自发性眼震没有影响；在所有年轻健康志愿者（n = 49）中，在静态躯干屈曲并伴有颈部激发的情况下，在三维躯干移动椅上垂直眼震显著增加；在安慰剂对照的c-TENS后，静态躯干移动期间垂直眼震和水平眼震之间存在显著差异，但躯干扭转期间的水平眼震除外。我们希望这种在三维躯干移动椅上进行的颈张力性研究概念将为前庭头与躯干对齐方面的颈部疾病带来新的诊断和治疗前景。
