Toupet Michel, Van Nechel Christian, Hautefort Charlotte, Duquesne Ulla, Heuschen Sylvie, Bozorg Grayeli Alexis
*Centre d'Explorations Fonctionnelles Otoneurologiques †Institut de Recherche Oto-Neurologique (IRON) ‡Otolaryngology Department, Dijon University Hospital and Burgundy University §Clinique des Vertiges, Brussels, Belgium ||Otolaryngology Department, Hôpital Lariboisière, Paris ¶Centre National de Recherche Scientifique, Unité Mixte de Recherche-6306, Electronic, Image and Computer Research Laboratory, Dijon, France.
Otol Neurotol. 2017 Aug;38(7):1010-1016. doi: 10.1097/MAO.0000000000001462.
We aimed to study the participation of proprioceptive and visual inputs in subjective visual vertical (SVV) in bilateral vestibular hypofunction and in normal subjects.
Prospective case-control study.
Tertiary referral center.
SVV (six replicates) was measured on a tiltable rehabilitation seat in 26 adult patients with idiopathic bilateral vestibular hypofunction (IBVH) and 33 adult controls. Subjects were asked to place vertically a 45 degrees-tilted red line on a screen (three replicates to left and three to right alternatively) using a remote control in total darkness and in seven body positions: vertical, head, and body left- and right-tilts to 12 and 24 degrees, and then body left- and right-tilt to 24 degrees with the head upright.
In the vertical position, SVV did not differ between IBVH and controls. Patients with IBVH were more sensitive to body tilt than controls (SVV: -8.1 ± 4.66 degrees for IBVH versus -0.2 ± 3.23 for control at 24 degrees body and head left-tilt, p < 0.0001, unpaired t test). The visual attraction effect defined by a deviation of the SVV to the side of the initial line presentation appeared to be higher in the IBVH than in controls suggesting higher visual dependence in IBVH. Placing the head upright while the body was still tilted significantly reduced this difference. Similar results were observed for the right-tilts.
Not only otolithic function but also visual plus body and neck proprioceptive entries participate in SVV. The influence of vision and proprioception appears to be enhanced in case of IBVH.
我们旨在研究本体感觉和视觉输入在双侧前庭功能减退患者及正常受试者主观视觉垂直（SVV）中的作用。
前瞻性病例对照研究。
三级转诊中心。
在可倾斜的康复座椅上对26例特发性双侧前庭功能减退（IBVH）成年患者和33例成年对照者进行SVV测量（六次重复）。受试者被要求在完全黑暗的环境中，通过遥控器将屏幕上一条倾斜45度的红线垂直放置（左右交替各三次），共进行七种身体姿势的测试：垂直位、头部及身体向左和向右侧倾斜12度和24度，然后头部直立，身体向左和向右侧倾斜24度。
在垂直位时，IBVH患者与对照组的SVV无差异。IBVH患者比对照组对身体倾斜更敏感（在身体和头部向左倾斜24度时，IBVH组的SVV为-8.1±4.66度，对照组为-0.2±3.23度，p<0.0001，非配对t检验）。由SVV向初始线条呈现侧的偏差所定义的视觉吸引效应在IBVH患者中似乎比对照组更高，表明IBVH患者对视觉的依赖性更高。当身体仍倾斜时将头部扶正可显著减小这种差异。右侧倾斜时观察到类似结果。
不仅耳石功能，而且视觉以及身体和颈部本体感觉输入均参与SVV。在IBVH患者中，视觉和本体感觉的影响似乎增强。
Zotero 插件