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头夹肌:老年和神经退行性疾病患者 cVEMP 的敏感靶点。

Splenius capitis: sensitive target for the cVEMP in older and neurodegenerative patients.

机构信息

Discipline of Biomedical Science, Sydney Medical School, University of Sydney, Sydney, NSW, Australia.

The Faculty of Medicine and Health Sciences, Linkoping University, Linköping, Sweden.

出版信息

Eur Arch Otorhinolaryngol. 2019 Nov;276(11):2991-3003. doi: 10.1007/s00405-019-05582-7. Epub 2019 Jul 29.

Abstract

BACKGROUND

The vestibular evoked myogenic potential (VEMP) is a technique used to assess vestibular function. Cervical VEMPs (cVEMPs) are obtained conventionally from the sternocleidomastoid (SCM) muscle; however, the dorsal neck muscle splenius capitis (SPL) has also been shown to be a reliable target alongside the SCM in young subjects.

OBJECTIVE

This study aimed to compare cVEMPs from the SCM and SPL in two positions across young, older, and Parkinson's disease (PD) patients.

METHOD

Experiments were carried out using surface EMG electrodes placed over the SCM and SPL. cVEMPs were measured using a 30 s, 126 dB sound stimulus with 222 individual tone bursts, while subjects were in a supine and head-turned posture (also known as the head elevation method), and in a seated head-turned posture.

RESULTS

When comparing cVEMPs across positions, the incidence of supine and seated SCM-cVEMPs diminished significantly in older and PD patients in comparison with young subjects. However, no statistically significant differences in incidences were found in seated SPL-cVEMPs when comparing young, older and PD patients. SPL-cVEMPs were present significantly more often than seated SCM-cVEMPs in PD patients.

CONCLUSIONS

SPL-cVEMPs are not altered to the same extent that SCM-cVEMPs are by aging and disease and its addition to cVEMP testing may reduce false-positive tests for vestibulopathy.

摘要

背景

前庭诱发肌源性电位(VEMP)是一种用于评估前庭功能的技术。颈性 VEMP(cVEMP)通常从胸锁乳突肌(SCM)中获得;然而,在年轻受试者中,已证明头夹肌(SPL)也与 SCM 一样是可靠的靶肌。

目的

本研究旨在比较 SCM 和 SPL 的 cVEMP 在年轻、老年和帕金森病(PD)患者的两个位置。

方法

使用放置在 SCM 和 SPL 上的表面肌电图电极进行实验。cVEMPs 使用 30 秒、126dB 的声音刺激和 222 个单独的音爆进行测量,同时患者处于仰卧位和头部倾斜位(也称为头抬高法)以及坐位和头部倾斜位。

结果

当比较不同位置的 cVEMP 时,与年轻受试者相比,老年和 PD 患者仰卧位和坐位 SCM-cVEMP 的发生率显著降低。然而,在比较年轻、老年和 PD 患者时,坐位 SPL-cVEMP 的发生率没有统计学上的显著差异。PD 患者的 SPL-cVEMP 出现频率明显高于坐位 SCM-cVEMP。

结论

SPL-cVEMP 不像 SCM-cVEMP 那样受到老化和疾病的影响,因此在 cVEMP 测试中增加 SPL-cVEMP 可能会减少前庭病假阳性测试。

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