Programa de Pós-Graduação em Infectologia e Medicina Tropical, Faculdade de Medicina da Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
PLoS One. 2018 Sep 27;13(9):e0204449. doi: 10.1371/journal.pone.0204449. eCollection 2018.
The vestibular evoked myogenic potential triggered by galvanic vestibular stimulation (galvanic-VEMP) has been used to assess the function of the vestibulospinal motor tract and is a candidate biomarker to predict and monitor the human T-cell lymphotropic virus type 1 (HTLV-1) associated myelopathy (HAM). This study determined the agreement and reliability of this exam.
Galvanic-VEMP was performed in 96 participants, of which 24 patients presented HAM, 27 HTLV-1-asymptomatic carriers, and 45 HTLV-1-negative asymptomatic controls. Galvanic vestibular stimulation was achieved by passing a binaural and bipolar current at a 2 milliamperes (mA) intensity for 400 milliseconds (ms) between the mastoid processes. Galvanic-VEMP electromyographic wave responses of short latency (SL) and medium latency (ML) were recorded from the gastrocnemius muscle. Intrarater (test-retest) and interrater (two independent examiners) agreement and reliability were assessed by standard error of measurement (SEM), coefficient of repeatability (CR), intraclass correlation coefficient (ICC), and Kappa coefficient.
In the total sample (n = 96), SL and ML medians were 56 ms (IQR 52-66) and 120 ms (IQR 107-130), respectively. The intrarater repeatability measures for SL and ML were, respectively: SEM of 6 and 8 ms; CR of 16 and 22 ms; ICC of 0.80 (p<0.001) and 0.91 (p<0.001); and a Kappa coefficient of 0.53 (p<0.001) and 0.82 (p<0.001). The interrater reproducibility measures for SL and ML were, respectively: SEM of 3 and 10 ms; CR of 8 and 27 ms; ICC of 0.95 (p<0.001) and 0.86 (p<0.001); and a Kappa coefficient of 0.77 (p<0.001) and 0.88 (p<0.001).
Galvanic-VEMP is a reliable and reproducible method to define the integrity of the vestibulospinal tract. Longitudinal studies will clarify its validity in the clinical context, aimed at achieving an early diagnosis and the monitoring of HAM.
电刺激前庭诱发肌源性电位（galvanic-VEMP）已被用于评估前庭脊髓运动通路的功能，是预测和监测人类 T 细胞嗜淋巴细胞病毒 1 型（HTLV-1）相关脊髓病（HAM）的候选生物标志物。本研究旨在确定该检查的一致性和可靠性。
对 96 名参与者进行了电刺激前庭诱发肌源性电位检查，其中 24 名患者患有 HAM，27 名 HTLV-1 无症状携带者和 45 名 HTLV-1 阴性无症状对照者。通过在乳突之间施加 2 毫安（mA）强度的双耳双极电流 400 毫秒（ms）来实现电刺激前庭。从腓肠肌记录短潜伏期（SL）和中潜伏期（ML）的电刺激前庭诱发肌源性电位肌电图波反应。通过测量标准误差（SEM）、可重复性系数（CR）、组内相关系数（ICC）和 Kappa 系数评估内部观察者（测试-再测试）和外部观察者（两位独立检查者）的一致性和可靠性。
在总样本（n=96）中，SL 和 ML 的中位数分别为 56ms（IQR 52-66）和 120ms（IQR 107-130）。SL 和 ML 的内部观察者重复性测量值分别为：SEM 分别为 6ms 和 8ms；CR 分别为 16ms 和 22ms；ICC 分别为 0.80（p<0.001）和 0.91（p<0.001）；Kappa 系数分别为 0.53（p<0.001）和 0.82（p<0.001）。SL 和 ML 的外部观察者可重复性测量值分别为：SEM 分别为 3ms 和 10ms；CR 分别为 8ms 和 27ms；ICC 分别为 0.95（p<0.001）和 0.86（p<0.001）；Kappa 系数分别为 0.77（p<0.001）和 0.88（p<0.001）。
电刺激前庭诱发肌源性电位是一种可靠且可重复的方法，可用于确定前庭脊髓束的完整性。纵向研究将阐明其在临床环境中的有效性，旨在实现 HAM 的早期诊断和监测。
Zotero 插件