Panichi R, Faralli M, Bruni R, Kiriakarely A, Occhigrossi C, Ferraresi A, Bronstein A M, Pettorossi V E
Dipartimento di Medicina Sperimentale, Sezione di Fisiologia Umana, Università di Perugia, Perugia, Italy.
Dipartimento di Specialità Medico-Chirurgiche e Sanità Pubblica, Sezione di Otorinolaringoiatria, Università di Perugia, Perugia, Italy; and.
J Neurophysiol. 2017 Nov 1;118(5):2819-2832. doi: 10.1152/jn.00674.2016. Epub 2017 Aug 16.
Self-motion perception was studied in patients with unilateral vestibular lesions (UVL) due to acute vestibular neuritis at 1 wk and 4, 8, and 12 mo after the acute episode. We assessed vestibularly mediated self-motion perception by measuring the error in reproducing the position of a remembered visual target at the end of four cycles of asymmetric whole-body rotation. The oscillatory stimulus consists of a slow (0.09 Hz) and a fast (0.38 Hz) half cycle. A large error was present in UVL patients when the slow half cycle was delivered toward the lesion side, but minimal toward the healthy side. This asymmetry diminished over time, but it remained abnormally large at 12 mo. In contrast, vestibulo-ocular reflex responses showed a large direction-dependent error only initially, then they normalized. Normalization also occurred for conventional reflex vestibular measures (caloric tests, subjective visual vertical, and head shaking nystagmus) and for perceptual function during symmetric rotation. Vestibular-related handicap, measured with the Dizziness Handicap Inventory (DHI) at 12 mo correlated with self-motion perception asymmetry but not with abnormalities in vestibulo-ocular function. We conclude that ) a persistent self-motion perceptual bias is revealed by asymmetric rotation in UVLs despite vestibulo-ocular function becoming symmetric over time, ) this dissociation is caused by differential perceptual-reflex adaptation to high- and low-frequency rotations when these are combined as with our asymmetric stimulus, ) the findings imply differential central compensation for vestibuloperceptual and vestibulo-ocular reflex functions, and ) self-motion perception disruption may mediate long-term vestibular-related handicap in UVL patients. A novel vestibular stimulus, combining asymmetric slow and fast sinusoidal half cycles, revealed persistent vestibuloperceptual dysfunction in unilateral vestibular lesion (UVL) patients. The compensation of motion perception after UVL was slower than that of vestibulo-ocular reflex. Perceptual but not vestibulo-ocular reflex deficits correlated with dizziness-related handicap.
在急性前庭神经炎导致单侧前庭病变（UVL）的患者中，于急性发作后1周以及4、8和12个月时研究了自我运动感知。我们通过测量在不对称全身旋转的四个周期结束时再现记忆视觉目标位置的误差，来评估前庭介导的自我运动感知。振荡刺激由一个慢（0.09Hz）半周期和一个快（0.38Hz）半周期组成。当慢半周期朝着病变侧传递时，UVL患者存在较大误差，但朝着健康侧传递时误差最小。这种不对称随时间逐渐减小，但在12个月时仍异常大。相比之下，前庭眼反射反应仅在最初显示出较大的方向依赖性误差，然后恢复正常。传统的反射性前庭测量（冷热试验、主观视觉垂直线和摇头性眼震）以及对称旋转期间的感知功能也出现了恢复正常的情况。在12个月时用头晕残障量表（DHI）测量的前庭相关残障与自我运动感知不对称相关，但与前庭眼功能异常无关。我们得出结论：）尽管前庭眼功能随时间变得对称，但UVL患者中不对称旋转仍揭示出持续的自我运动感知偏差；）这种分离是由于当高频和低频旋转如我们的不对称刺激那样组合时，感知 - 反射对其适应不同所致；）这些发现意味着前庭感知和前庭眼反射功能存在不同的中枢补偿；）自我运动感知障碍可能介导UVL患者长期的前庭相关残障。一种结合不对称慢和快正弦半周期的新型前庭刺激，揭示了单侧前庭病变（UVL）患者持续的前庭感知功能障碍。UVL后运动感知的补偿比前庭眼反射的补偿慢。感知而非前庭眼反射缺陷与头晕相关残障相关。
