Otero-Millan Jorge, Treviño Carolina, Winnick Ariel, Zee David S, Carey John P, Kheradmand Amir
a Department of Neurology , The Johns Hopkins Hospital , Baltimore , MD , USA.
b Department of Otolaryngology , University of Minnesota Medical Center , Minneapolis , MN , USA.
Acta Otolaryngol. 2017 Jun;137(6):593-597. doi: 10.1080/00016489.2016.1269364. Epub 2017 Jan 13.
vOCR can detect loss of otolith-ocular function without specifying the side of vestibular loss. Since vOCR is measured with a simple head tilt maneuver, it can be potentially used as a bedside clinical test in combination with video head impulse test.
Video-oculography (VOG) goggles are being integrated into the bedside assessment of patients with vestibular disorders. Lacking, however, is a method to evaluate otolith function. This study validated a VOG test for loss of otolith function.
VOG was used to measure ocular counter-roll (vOCR) in 12 healthy controls, 14 patients with unilateral vestibular loss (UVL), and six patients with bilateral vestibular loss (BVL) with a static lateral head tilt of 30°. The results were compared with vestibular evoked myogenic potentials (VEMP), a widely-used laboratory test of otolith function.
The average vOCR for healthy controls (4.6°) was significantly different from UVL (2.7°) and BVL (1.6°) patients (p < 0.0001). The vOCR and VEMP measurements were correlated across subjects, especially the click and tap oVEMPs (click oVEMP R = 0.45, tap oVEMP R = 0.51; p < 0.0003). The receiver operator characteristic (ROC) analysis showed that vOCR and VEMPs detected loss of otolith function equally well. The best threshold for vOCR to detect vestibular loss was at 3°. The vOCR values from the side of vestibular loss and the healthy side were not different in UVL patients (2.53° vs 2.8°; p = 0.59).
视频眼震电图（vOCR）可检测耳石 - 眼反射功能丧失，但无法明确前庭功能丧失的侧别。由于vOCR通过简单的头部倾斜动作进行测量，它有可能与视频头脉冲试验结合用作床边临床检查。
视频眼震图（VOG）护目镜正被纳入前庭疾病患者的床边评估。然而，目前缺乏评估耳石功能的方法。本研究验证了一种用于检测耳石功能丧失的VOG测试。
使用VOG测量12名健康对照者、14名单侧前庭功能丧失（UVL）患者和6名双侧前庭功能丧失（BVL）患者在静态头部向一侧倾斜30°时的眼反向转动（vOCR）。将结果与前庭诱发肌源性电位（VEMP）进行比较，VEMP是一种广泛应用的耳石功能实验室检测方法。
健康对照者的平均vOCR（4.6°）与UVL患者（2.7°）和BVL患者（1.6°）有显著差异（p < 0.0001）。vOCR和VEMP测量值在受试者之间具有相关性，尤其是短声和短纯音oVEMP（短声oVEMP R = 0.45，短纯音oVEMP R = 0.51；p < 0.0003）。受试者工作特征（ROC）分析表明，vOCR和VEMP在检测耳石功能丧失方面效果相当。vOCR检测前庭功能丧失的最佳阈值为3°。在UVL患者中，前庭功能丧失侧和健康侧的vOCR值无差异（2.53°对2.8°；p = 0.59）。
