Mallinson Arthur I, Kuijpers Anouk C M, Van Zwieten Gusta, Kakal Juzer, Mullings Warren, Longridge Neil S
Neuro- Otology Unit, Vancouver General Hospital Fourth floor - Diamond Centre, 2775 Laurel Street, Vancouver, BC V5Z 1M9, Canada; Division of otolaryngology, Department of Surgery, Faculty of Medicine, University of British Columbia Fourth floor - Diamond Centre, 2775 Laurel Street, Vancouver, BC V5Z 1M9, Canada.
Division of otolaryngology, Department of Surgery, Faculty of Medicine, University of British Columbia Fourth floor - Diamond Centre, 2775 Laurel Street, Vancouver, BC V5Z 1M9, Canada.
Gait Posture. 2019 Jan;67:248-250. doi: 10.1016/j.gaitpost.2018.10.019. Epub 2018 Oct 16.
Computerized Dynamic Posturography (CDP)was developed by the American space program to assess imbalance in astronauts, and eventually evolved into a clinical diagnostic tool. However it is not a specific measure of vestibular function. Vestibular Evoked Myogenic Potential testing (VEMPs) is a new clinical tool which is sensitive and specific for measuring otolithic pathology, especially in the atypical vestibular patient.
As posturography measures ability to maintain balance, and VEMP testing measures the structures responsible for this, we wondered if CDP results would correlate with VEMP abnormalities in the clinical setting.
We analysed 180 patients sequentially referred to our unit for vestibular complaints. All patients had a full battery of vestibular assessments. We correlated VEMP results with CDP results to look for abnormality patterns and correlations. An occasional patient's only abnormality was on CDP RESULTS: There was a high rate of VEMP abnormalities seen, which correlates with the fact that our referral base consists of patients with chronic vestibular complaints. The rate of VEMP abnormalities was the same in patients with normal CDP and those with abnormal CDP.
Our results do not suggest that CDP is unnecessary, but we feel that they emphasize the idea that these tests are measuring two different aspects of balance control. In some patients, all assessments are abnormal, but in some patients only one assessment is abnormal, suggesting that these modalities measure different things and are all important in the diagnostic armamentarium. Hopefully in the near future, the use of virtual reality will reduce the cost of CDP to the point where it can be made widely accessible to patients and clinicians.
计算机化动态姿势描记法（CDP）由美国太空计划开发，用于评估宇航员的平衡失调情况，并最终演变成一种临床诊断工具。然而，它并非前庭功能的特异性检测方法。前庭诱发肌源性电位测试（VEMPs）是一种新的临床工具，对检测耳石病变敏感且特异，尤其适用于非典型前庭疾病患者。
由于姿势描记法测量维持平衡的能力，而VEMP测试测量负责此功能的结构，我们想知道在临床环境中CDP结果是否与VEMP异常相关。
我们分析了180例因前庭问题相继转诊至我们科室的患者。所有患者均接受了全面的前庭评估。我们将VEMP结果与CDP结果进行关联，以寻找异常模式和相关性。偶尔有患者仅在CDP上存在异常。结果：VEMP异常发生率很高，这与我们的转诊患者群体为慢性前庭疾病患者这一事实相关。CDP正常的患者和CDP异常的患者中VEMP异常发生率相同。
我们的结果并不表明CDP不必要，但我们认为这些结果强调了这些测试正在测量平衡控制的两个不同方面这一观点。在一些患者中，所有评估均异常，但在一些患者中只有一项评估异常，这表明这些方法测量的是不同的东西，并且在诊断工具中都很重要。希望在不久的将来，虚拟现实的应用能够降低CDP的成本，使其能够被患者和临床医生广泛使用。
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