Jacobson Gary P, Piker Erin G, Grantham Sarah L, English Lauren N
Department of Hearing and Speech Sciences, Divisions of Audiology and Vestibular Sciences, Vanderbilt University Medical Center, Nashville, TN, USA.
Department of Communication Sciences and Disorders, James Madison University, Harrisonburg, VA, USA.
J Otol. 2018 Mar;13(1):5-9. doi: 10.1016/j.joto.2017.10.005. Epub 2017 Nov 14.
The absence of vertigo during the caloric test, despite a robust response, has been suggested to represent a central vestibular system phenomenon. The purpose of this investigation was to determine the prevalence of absent caloric-induced vertigo perception in an unselected group of patients and to assess possible predicting variables.
Prospective investigation of 92 unselected patients who underwent caloric testing. Inclusion criteria were that each patient generate a maximum slow phase velocity (maxSPV) ≥ 15 deg/sec and a caloric asymmetry of ≤10%. Following the caloric, patients were asked, "Did you have any sensation of motion?"
Results showed 75% of patients reported motion with a mean age of 56.51 years compared to a mean age of 66.55 in the 25% of patients reporting an absence of motion. A logistic regression was performed and the overall model was statistically significant accounting for 29% of the variance in caloric perception. The significant predictor variables were patient age and maxSPV of the caloric response. The effect size for both variables was small with an odds ratio of .9 for maxSPV and 1.06 for age.
The current investigation showed that both age and maxSPV of the caloric response were significant predictors of vertigo perception during the caloric exam. However, the association between age and caloric perception is not conclusive. Although there is evidence to suggest that these findings represent age-related changes in the central processing of vestibular system stimulation, there are additional unmeasured factors that influence the perception of caloric-induced vertigo.
尽管冷热试验反应强烈，但冷热试验期间无眩晕感被认为是一种中枢前庭系统现象。本研究的目的是确定一组未经筛选的患者中冷热诱发眩晕感知缺失的患病率，并评估可能的预测变量。
对92例未经筛选的接受冷热试验的患者进行前瞻性研究。纳入标准为每位患者产生的最大慢相速度（maxSPV）≥15度/秒，冷热不对称性≤10%。冷热试验后，询问患者：“你有任何运动感觉吗？”
结果显示，75%的患者报告有运动感觉，平均年龄为56.51岁，而25%报告无运动感觉的患者平均年龄为66.55岁。进行了逻辑回归分析，总体模型具有统计学意义，解释了冷热感知差异的29%。显著的预测变量是患者年龄和冷热反应的maxSPV。两个变量的效应大小都较小，maxSPV的优势比为0.9，年龄的优势比为1.06。
目前的研究表明，年龄和冷热反应的maxSPV都是冷热试验期间眩晕感知的显著预测因素。然而，年龄与冷热感知之间的关联并不确定。虽然有证据表明这些发现代表了前庭系统刺激中枢处理过程中与年龄相关的变化，但还有其他未测量的因素影响冷热诱发眩晕的感知。
