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用于评估双侧前庭病中视振荡的功能性摇头试验

The Functional Head Impulse Test to Assess Oscillopsia in Bilateral Vestibulopathy.

作者信息

van Dooren T S, Lucieer F M P, Duijn S, Janssen A M L, Guinand N, Pérez Fornos A, Van Rompaey V, Kingma H, Ramat S, van de Berg R

机构信息

Division of Balance Disorders, Department of Otorhinolaryngology and Head and Neck Surgery, Maastricht University Medical Centre, Maastricht, Netherlands.

Faculty of Health, Medicine and Life Sciences, University of Maastricht, Maastricht, Netherlands.

出版信息

Front Neurol. 2019 Apr 16;10:365. doi: 10.3389/fneur.2019.00365. eCollection 2019.

Abstract

Bilateral vestibulopathy (BV) is a chronic condition in which vestibular function is severely impaired or absent on both ears. Oscillopsia is one of the main symptoms of BV. Oscillopsia can be quantified objectively by functional vestibular tests, and subjectively by questionnaires. Recently, a new technique for testing functionally effective gaze stabilization was developed: the functional Head Impulse Test (fHIT). This study compared the fHIT with the Dynamic Visual Acuity assessed on a treadmill (DVA) and Oscillopsia Severity Questionnaire (OSQ) in the context of objectifying the experience of oscillopsia in patients with BV. Inclusion criteria comprised: (1) summated slow phase velocity of nystagmus of <20°/s during bithermal caloric tests, (2) torsion swing tests gain of <30% and/or phase <168°, and (3) complaints of oscillopsia and/or imbalance. During the fHIT (Beon Solutions srl, Italy) patients were seated in front of a computer screen. During a passive horizontal head impulse a Landolt C optotype was shortly displayed. Patients reported the seen optotype by pressing the corresponding button on a keyboard. The percentage correct answers was registered for leftwards and rightwards head impulses separately. During DVA patients were positioned on a treadmill in front of a computer screen that showed Sloan optotypes. Patients were tested in static condition and in dynamic conditions (while walking on the treadmill at 2, 4, and 6 km/h). The decline in LogMAR between static and dynamic conditions was registered for each speed. Every patient completed the Oscillopsia Severity Questionnaire (OSQ). In total 23 patients were included. This study showed a moderate correlation between OSQ outcomes and the fHIT [rightwards head rotations ( = -0.559; = 0.006) leftwards head rotations ( = -0.396; = 0.061)]. No correlation was found between OSQ outcomes and DVA, or between DVA and fHIT. All patients completed the fHIT, 52% of the patients completed the DVA on all speeds. The fHIT seems to be a feasible test to quantify oscillopsia in BV since, unlike DVA, it correlates with the experienced oscillopsia measured by the OSQ, and more BV patients are able to complete the fHIT than DVA.

摘要

双侧前庭病(BV)是一种慢性病,其前庭功能在双耳均严重受损或丧失。视振荡是BV的主要症状之一。视振荡可通过功能性前庭测试进行客观量化,也可通过问卷调查进行主观量化。最近,开发了一种用于测试功能性有效注视稳定的新技术:功能性头部脉冲试验(fHIT)。本研究在客观化BV患者视振荡体验的背景下,将fHIT与在跑步机上评估的动态视力(DVA)和视振荡严重程度问卷(OSQ)进行了比较。纳入标准包括:(1) 冷热试验期间眼球震颤的总慢相速度<20°/秒,(2) 扭转摆动试验增益<30%和/或相位<168°,以及(3) 视振荡和/或失衡的主诉。在fHIT(意大利Beon Solutions srl公司)测试期间,患者坐在电脑屏幕前。在被动水平头部脉冲期间,短暂显示一个兰多尔特C型视标。患者通过按下键盘上的相应按钮报告看到的视标。分别记录向左和向右头部脉冲的正确答案百分比。在DVA测试期间,患者站在跑步机上,面对显示斯隆视标的电脑屏幕。患者在静态和动态条件下(在跑步机上以2、4和6公里/小时的速度行走时)接受测试。记录每个速度下静态和动态条件之间的LogMAR下降情况。每位患者都完成了视振荡严重程度问卷(OSQ)。总共纳入了23名患者。本研究表明,OSQ结果与fHIT之间存在中度相关性[向右头部旋转(r = -0.559;p = 0.006),向左头部旋转(r = -0.396;p = 0.061)]。未发现OSQ结果与DVA之间或DVA与fHIT之间存在相关性。所有患者都完成了fHIT,52%的患者完成了所有速度下的DVA。fHIT似乎是一种用于量化BV患者视振荡的可行测试,因为与DVA不同,它与通过OSQ测量的视振荡体验相关,并且能够完成fHIT的BV患者比DVA更多。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e64a/6499172/a8b452f30c84/fneur-10-00365-g0001.jpg

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