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噪声性电前庭刺激可持续改善双侧前庭病患者的姿势。

Noisy Galvanic Vestibular Stimulation Sustainably Improves Posture in Bilateral Vestibulopathy.

作者信息

Fujimoto Chisato, Egami Naoya, Kawahara Takuya, Uemura Yukari, Yamamoto Yoshiharu, Yamasoba Tatsuya, Iwasaki Shinichi

机构信息

Department of Otolaryngology and Head and Neck Surgery, Graduate School of Medicine, University of Tokyo, Tokyo, Japan.

Biostatistics Division, Clinical Research Support Center, University of Tokyo Hospital, Tokyo, Japan.

出版信息

Front Neurol. 2018 Oct 22;9:900. doi: 10.3389/fneur.2018.00900. eCollection 2018.

Abstract

Patients with bilateral vestibulopathy (BV) suffer from persistent postural imbalance, leading to a marked decrease in quality of life and a higher risk of falls. However, so far, the effective treatments for BV are very limited. We examined whether long-term noisy galvanic vestibular stimulation (nGVS) keeps improving body balance after the cessation of the stimulus in BV patients. Thirteen BV patients received nGVS for 30 min with a lower intensity than the intensity at which they feel any cutaneous sensations, and their postural movement was monitored for 6 h after the stimuli. The same session was repeated at 14-day intervals. Stance tasks on two legs were performed with eyes closed. The velocity of the center of pressure (COP) movement, the area enclosed by the COP movement, and the root mean square of the displacement of the COP were measured. The power spectrum of the COP movement was assessed. Subjective improvement of body balance was graded as worsened (-2), slightly worsened (-1), unchanged (0), slightly improved (+1) and improved (+2) in comparison with that without nGVS. In each session, the velocity of the COP movement was significantly improved for 6 h after the stimulus had ceased ( < 0.01). Concomitantly, the mean frequency of the COP power spectrum was significantly reduced in the anterior-posterior axis ( < 0.05). Subjective symptoms of imbalance were improved during the post-stimulation effect ( < 0.05). nGVS leads to an improvement in body balance that lasts for several hours after the end of the stimulus in BV patients with a reduction in the high-frequency components of their postural movement. This trial was registered with the University Hospital Medical Information Network (UMIN) Clinical Trials Registry (UMINCTR: UMIN000028054).

摘要

双侧前庭病(BV)患者存在持续性姿势失衡,导致生活质量显著下降,跌倒风险增加。然而,迄今为止,BV的有效治疗方法非常有限。我们研究了长期噪声性前庭电刺激(nGVS)在刺激停止后是否能持续改善BV患者的身体平衡。13例BV患者接受强度低于其产生任何皮肤感觉的强度的nGVS刺激30分钟,并在刺激后监测其姿势运动6小时。每隔14天重复一次相同疗程。在闭眼状态下进行双腿站立任务。测量压力中心(COP)移动速度、COP移动所包围的面积以及COP位移的均方根。评估COP移动的功率谱。与未进行nGVS时相比,身体平衡的主观改善程度分为恶化(-2)、略有恶化(-1)、无变化(0)、略有改善(+1)和改善(+2)。在每次疗程中,刺激停止后6小时内COP移动速度均显著提高(<0.01)。与此同时,COP功率谱的平均频率在前后轴上显著降低(<0.05)。刺激后效应期间失衡的主观症状得到改善(<0.05)。nGVS可改善BV患者的身体平衡,且在刺激结束后持续数小时,同时其姿势运动的高频成分减少。本试验已在大学医院医学信息网络(UMIN)临床试验注册中心(UMINCTR:UMIN000028054)注册。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1017/6204397/ae37e9f5997d/fneur-09-00900-g0001.jpg

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